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<1>
Accession Number
2028140943
Title
Pharmacologic interventions for the therapy of postanesthetic shivering in
adults: a systematic review and network meta-analysis.
Source
Minerva Anestesiologica. 89(10) (pp 925-935), 2023. Date of Publication:
October 2023.
Author
Dinges H.-C.; Al-Dahna T.; Rucker G.; Wulf H.; Eberhart L.; Wiesmann T.;
Schubert A.-K.
Institution
(Dinges, Al-Dahna, Wulf, Eberhart, Wiesmann, Schubert) Department of
Anesthesia and Intensive Care, University Hospital Marburg, Marburg,
Germany
(Rucker) Faculty of Medicine and Medical Center, Institute of Medical
Biometry and Statistics, University of Freiburg, Freiburg, Germany
(Wiesmann) Department of Anesthesiology and Intensive Care Medicine,
Diakoneo Diak Klinikum Schwabisch-Hall, Schwabisch-Hall, Germany
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Shivering is a common side effect after general anesthesia.
Risk factors are hypothermia, young age and postoperative pain. Severe
complications of shivering are rare but can occur due to increased oxygen
consumption. Previous systematic reviews are outdated and have summarized
the evidence on the topic using only pairwise comparisons. The objective
of this manuscript was a quantitative synthesis of evidence on
pharmacological interventions to treat postanesthetic shivering. EVIDENCE
ACQUSITION: Systematic review and frequentist network meta-analysis using
the R package netmeta. Endpoints were the risk ratio (RR) of persistent
shivering at one, five and 10 minutes after treatment with saline/placebo
as the comparator. Data were retrieved from Medline, Embase, Central and
Web of Science up to January 2022. Eligibility criteria were: randomized,
controlled, and blinded trials comparing pharmacological interventions to
treat shivering after general anesthesia. Studies on shivering during or
after any type of regional anesthesia were excluded as well as sedated
patients after cardiac surgery. EVIDENCE SYNTHESIS: Thirty-two trials were
eligible for data synthesis, including 28 pharmacological interventions.
The largest network included 1431 patients. The network geometry was
two-centered with most comparisons linked to saline/placebo or pethidine.
The best interventions were after one minute: doxapram 2 mg/kg, tramadol 2
mg/kg and nefopam 10 mg, after 5 minutes: tramadol 2 mg/kg, nefopam 10 mg
and clonidine 150 microg and after 10 minutes: nefopam 10 mg,
methylphenidate 20 mg and tramadol 1 mg/kg, all reaching statistical
significance. Pethidine 25 mg and clonidine 75 microg also performed well
and with statistical significance in all networks. <br/>CONCLUSION(S):
Nefopam, tramadol, pethidine and clonidine are the most effective
treatments to stop postanesthetic shivering. The efficacy of doxapram is
uncertain since different doses showed contradictory effects and the
evidence for methylphenidate is based on a single comparison in only one
network. Furthermore, both lack data on side effects. Further studies are
needed to clarify the efficacy of dexmedetomidine to treat postanesthetic
shivering.<br/>Copyright &#xa9; 2023 EDIZIONI MINERVA MEDICA.

<2>
Accession Number
2028061083
Title
A scoping review: urinary markers of metabolic maturation in infants with
CHD and the relationship to growth.
Source
Cardiology in the Young. 33(10) (pp 1879-1888), 2023. Date of Publication:
03 Oct 2023.
Author
Marino L.V.; Paulson S.; Ashton J.J.; Weeks C.; Young A.; Pappachan
J.V.P.; Swann J.R.; Johnson M.J.; Beattie R.M.
Institution
(Marino) Paediatric Intensive Care Unit, Southampton Children's Hospital,
NIHR Southampton Biomedical Research Centre University Hospital
Southampton NHS Foundation Trust, Faculty of Health Science, University of
Southampton, Southampton, United Kingdom
(Paulson) Paediatric Intensive Care Unit, Southampton Children's Hospital,
NIHR, Southampton, United Kingdom
(Ashton, Beattie) Paediatric Gastroenterology, Southampton Children's
Hospital, NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust; Faculty of Human Genetics and Genomic
Medicine, University of Southampton, Southampton, United Kingdom
(Weeks) Paediatric Intensive Care Unit, Southampton Children's Hospital,
University Hospital Southampton NHS Foundation Trust, Southampton, United
Kingdom
(Young) Department of Neonatal Medicine, Southampton Children's Hospital,
University Hospital Southampton NHS Foundation Trust, NIHR Southampton
Biomedical Research Centre, United Kingdom
(Pappachan) Paediatric Intensive Care Unit, Southampton Children's
Hospital, NIHR Southampton Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust; Faculty of Medicine, University of
Southampton, Southampton, United Kingdom
(Swann) Biomolecular Medicine, School of Human Development and Health,
Faculty of Medicine, University of Southampton, Southampton, United
Kingdom
(Johnson) Neonatal Medicine, Southampton Children's Hospital, NIHR
Southampton Biomedical Research Centre, University Hospital Southampton
NHS Foundation Trust, University of Southampton, Southampton, United
Kingdom
Publisher
Cambridge University Press
Abstract
Background: Growth failure in infants born with CHD is a persistent
problem, even in those provided with adequate nutrition.
<br/>Objective(s): To summarise the published data describing the change
in urinary metabolites during metabolic maturation in infants with CHD and
identify pathways amenable to therapeutic intervention Design: Scoping
review. Eligibility criteria: Studies using qualitative or quantitative
methods to describe urinary metabolites pre- and post-cardiac surgery and
the relationship with growth in infants with CHD. Sources of evidence:
NICE Healthcare Databases website was used as a tool for multiple
searches. <br/>Result(s): 347 records were identified, of which 37 were
duplicates. Following the removal of duplicate records, 310 record
abstracts and titles were screened for inclusion. The full texts of eight
articles were reviewed for eligibility, of which only two related to
infants with CHD. The studies included in the scoping review described
urinary metabolites in 42 infants. A content analysis identified two
overarching themes of metabolic variation predictive of neurodevelopmental
abnormalities associated with anaerobic metabolism and metabolic signature
associated with the impact on gut microbiota, inflammation, energy, and
lipid digestion. <br/>Conclusion(s): The results of this scoping review
suggest that there are considerable gaps in our knowledge relating to
metabolic maturation of infants with CHD, especially with respect to
growth. Surgery is a key early life feature for CHD infants and has an
impact on the developing biochemical phenotype with implications for
metabolic pathways involved in immunomodulation, energy, gut microbial,
and lipid metabolism. These early life fingerprints may predict those
individuals at risk for neurodevelopmental abnormalities.<br/>Copyright
&#xa9; The Author(s), 2022. Published by Cambridge University Press.

<3>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2023 ARSMB-KVBMG. All rights
reserved.

<4>
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. <br/>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.
<br/>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.<br/>Copyright
&#xa9; 2023, The Author(s).

<5>
Accession Number
2027355779
Title
The Paradox of Choice in Transcatheter Edge-to-Edge Mitral Valve Repair
for Functional Mitral Regurgitation: What Meta-Analyses Can and Can Not
Tell Us.
Source
American Journal of Cardiology. 207 (pp 515-517), 2023. Date of
Publication: 15 Nov 2023.
Author
Barbieri A.; Mantovani F.
Institution
(Barbieri) Division of Cardiology, Department of Diagnostics, Clinical and
Public Health Medicine, Policlinico University Hospital of Modena, Modena,
Italy
(Mantovani) Cardiology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio
Emilia, Italy
Publisher
Elsevier Inc.

<6>
Accession Number
2027096182
Title
One-Lung Ventilation and Postoperative Pulmonary Complications After Major
Lung Resection Surgery. A Multicenter Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(12) (pp 2561-2571),
2023. Date of Publication: December 2023.
Author
Piccioni F.; Langiano N.; Bignami E.; Guarnieri M.; Proto P.; D'Andrea R.;
Mazzoli C.A.; Riccardi I.; Bacuzzi A.; Guzzetti L.; Rossi I.; Scolletta
S.; Comi D.; Benigni A.; Pierconti F.; Coccia C.; Biscari M.; Murzilli A.;
Umari M.; Peratoner C.; Serra E.; Baldinelli F.; Accardo R.; Diana F.;
Fasciolo A.; Amodio R.; Ball L.; Greco M.; Pelosi P.; Della Rocca G.
Institution
(Piccioni) Department of Anesthesia and Intensive Care, IRCCS Humanitas
Research Hospital, Rozzano, Milan, Italy
(Langiano, Riccardi) SOC Anesthesia and Intensive Care Medicine Clinic -
Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Guarnieri) Department of Medicine and Surgery, University of Milan
Bicocca, Milan, Italy
(Proto) Department of Critical and Supportive Therapy, Fondazione IRCCS
Istituto Nazionale Tumori, Milan, Italy
(D'Andrea) Department of Anesthesia, Intensive Care Medicine and
Emergency, IRRCS Policlinico di Sant' Orsola, Bologna Academic Hospital,
Bologna, Italy
(Mazzoli) Department of Anesthesia, Intensive Care Medicine and
Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna,
Italy
(Bacuzzi, Guzzetti) ASST Settelaghi Ospedale di Circolo e Fondazione
Macchi, Varese, Italy
(Rossi, Scolletta) Cardio-thoracic and vascular Department, UOC
Cardio-thoracic and vascular Anesthesia and ICM, Azienda
ospedaliero-universitaria Senese, Siena, Italy
(Comi, Benigni) Anesthesia and Intensive Care Unit, ASST Papa Giovanni
XXIII, Bergamo, Italy
(Pierconti, Coccia) IRCCS-IFO National Institute of Oncology - Regina
Elena, DPT of Oncologic Clinic and Research, UOC Anesthesia and ICM, Rome,
Italy
(Biscari, Murzilli) Arcispedale Santa Maria Nuova, IRCCS AUSL di Reggio
Emilia, Italy
(Umari, Peratoner) SOC Anesthesia and Intensive Care Medicine - Azienda
Sanitaria Universitaria Giuliana, Cattinara Hospital, Trieste, Italy
(Serra) Anesthesia and Intensive Care Medicine Institute - Azienda
Ospedaliera-Universita of Padua, Padua, Italy
(Baldinelli) Azienda Sanitaria dell'Alto Adige, Bozen, Italy
(Accardo) Division of Anesthesia, Department of Anesthesia, Endoscopy and
Cardiology, Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS,
Naples, Italy
(Diana) Anesthesia and Intensive Care Unit, Azienda Ospedaliera Brotzu -
Ospedale Oncologico Businco, Cagliari, Italy
(Fasciolo) IRRCS Policlinico San Martino Hospital, Genoa, Italy
(Amodio) Department of Anesthesia, Intensive Care and Pain Medicine, IRCCS
Centro di Riferimento Oncologico della Basilicata/OECI Clinical Cancer
Center - Rionero in Vulture, Potenza, Italy
(Ball, Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
(Greco) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(Greco) Department of Anaesthesiology and Intensive Care, IRCCS Humanitas
Research Hospital, Milan, Italy
(Della Rocca) Department of Medical Area, University of Udine, Udine,
Italy
Publisher
W.B. Saunders
Abstract
Objectives: The effect of one-lung ventilation (OLV) strategy based on low
tidal volume (TV), application of positive end-expiratory pressure (PEEP),
and alveolar recruitment maneuvers (ARM) to reduce postoperative acute
respiratory distress syndrome (ARDS) and pulmonary complications (PPCs)
compared with higher TV without PEEP and ARM strategy in adult patients
undergoing lobectomy or pneumonectomy has not been well established.
<br/>Design(s): Multicenter, randomized, single-blind, controlled trial.
<br/>Setting(s): Sixteen Italian hospitals. <br/>Participant(s): A total
of 880 patients undergoing elective major lung resection.
<br/>Intervention(s): Patients were randomized to receive lower tidal
volume (LTV group: 4 mL/kg predicted body weight, PEEP of 5
cmH<inf>2</inf>O, and ARMs) or higher tidal volume (HTL group: 6 mL/kg
predicted body weight, no PEEP, and no ARMs). After OLV, until extubation,
both groups were ventilated using a tidal volume of 8 mL/kg and a PEEP
value of 5 cmH<inf>2</inf>O. The primary outcome was the incidence of
in-hospital ARDS. Secondary outcomes were the in-hospital rate of PPCs,
major cardiovascular events, unplanned intensive care unit (ICU)
admission, in-hospital mortality, ICU length of stay, and in-hospital
length of stay. <br/>Measurements and Main Results: ARDS occurred in 3 of
438 patients (0.7%, 95% CI 0.1-2.0) and in 1 of 442 patients (0.2%, 95% CI
0-1.4) in the LTV and HTV group, respectively (Risk ratio: 3.03 95% CI
0.32-29, p = 0.372). Pulmonary complications occurred in 125 of 438
patients (28.5%, 95% CI 24.5-32.9) and in 136 of 442 patients (30.8%, 95%
CI 26.6-35.2) in the LTV and HTV group, respectively (risk ratio: 0.93,
95% CI 0.76-1.14, p = 0.507). The incidence of major complications,
in-hospital mortality, and unplanned ICU admission, ICU and in-hospital
length of stay were comparable in both groups. <br/>Conclusion(s): In
conclusion, among adult patients undergoing elective lung resection, an
OLV with lower tidal volume, PEEP 5 cmH<inf>2</inf>O, and ARMs and a
higher tidal volume strategy resulted in low ARDS incidence and comparable
postoperative complications, in-hospital length of stay, and
mortality.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<7>
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. <br/>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. <br/>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. <br/>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).
<br/>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.<br/>Copyright &#xa9;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.

<8>
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. <br/>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.
<br/>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. <br/>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.

<9>
Accession Number
638212981
Title
Impact of educational videos on maternal anxiety caused by children's
heart surgery.
Source
Nursing in critical care. 28(6) (pp 1106-1114), 2023. Date of Publication:
01 Nov 2023.
Author
Liu S.-J.; Yen W.-J.; Chang Y.-Z.; Ku M.-S.
Institution
(Liu, Chang) Institute of Medicine, Chung Shan Medical University,
Taichung, Taiwan (Republic of China)
(Liu, Yen) Department of Nursing, Chung Shan Medical University, Taichung,
Taiwan (Republic of China)
(Liu, Yen) Department of Nursing, Chung Shan Medical University Hospital,
Taichung, Taiwan (Republic of China)
(Chang) Drug Testing Center, Department of Clinical Laboratory, Chung Shan
Medical University Hospital, Taichung, Taiwan (Republic of China)
(Ku) School of Medicine, Chung Shan Medical University, Taichung, Taiwan
(Republic of China)
(Ku) Division of Allergy, Asthma and Rheumatology, Department of
Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
(Republic of China)
Abstract
BACKGROUND: Mothers of children undergoing surgery for congenital heart
disease experience significant stress. Therefore, finding a strategy to
decrease this is vital. AIMS: To examine whether adding educational
digital video discs to routine education can reduce maternal anxiety and
depression when their children undergo heart surgery and when surgical or
post-surgical complications occur. STUDY DESIGN: In a teaching hospital,
120 mothers whose children underwent elective heart surgery were randomly
and equally divided into two groups: mothers receiving routine education
plus a digital video disc before surgery and mothers receiving only
routine education. Mothers' anxiety and depression levels were compared
before education, after education (before surgery), and on discharge day.
The effect of watching the digital video disc on maternal anxiety and
depression on discharge day was evaluated for the participants whose
children had surgical or post-surgical complications. <br/>RESULT(S):
Compared with only routine education, mothers' anxiety after education and
on the discharge day decreased more if digital video disc was added.
Depression decreased more after education, but no difference was found on
the discharge day. Anxiety levels of mothers whose children had surgical
or post-surgical complications on the discharge day decreased more if they
watched the digital video disc, compared with those receiving only routine
education (Beck anxiety inventory score 3.4 +/- 1.9 and 6.1+/-2.4
respectively; p-value .001). <br/>CONCLUSION(S): Compared with only
routine education, adding digital video disc could decrease mothers'
anxiety, and until the day of discharge. Compared with only routine
education, adding digital video disc could decrease mothers' anxiety on
the discharge day if their child had surgical or post-surgical
complications. RELEVANCE TO CLINICAL PRACTICE: Adding educational digital
video disc to routine education could decrease mothers' anxiety until the
day of discharge. It could also decrease mothers' anxiety if their child
had surgical or post-surgical complications.<br/>Copyright &#xa9; 2022
British Association of Critical Care Nurses.

<10>
Accession Number
642457143
Title
11th Annual Scientific Sessions of the Cardiac Neurodevelopmental Outcome
Collaborative.
Source
Cardiology in the Young. Conference: 11th Annual Scientific Sessions of
the Cardiac Neurodevelopmental Outcome Collaborative. Montreal, QC Canada.
33(7) (no pagination), 2023. Date of Publication: July 2023.
Author
Anonymous
Publisher
Cambridge University Press
Abstract
The proceedings contain 57 papers. The topics discussed include: parenting
stress is associated with executive functioning in preschool-age children
with congenital heart disease; caregiver perspectives on family centered
follow-up after pediatric ECMO; the association between overprotective
parenting and the growth and development of children with congenital heart
disease: a systematic review; single ventricle patients: determining the
need for neuropsychological evaluation through in-clinic consultation and
screening; implementation of a dedicated cardiac neurodevelopmental
program; the provision and impact of rehabilitation provided by
physiotherapists in children with congenital heart disease following
cardiac surgery: a scoping review; fetal hemodynamics are associated with
survival and short-term neurodevelopmental outcomes in patients with
cyanotic congenital heart disease; and impact of a systematic
developmental follow-up program on the neurodevelopment of school-aged
children with complex congenital heart disease: preliminary results.

<11>
Accession Number
642457134
Title
The provision and impact of rehabilitation provided by Physiotherapists in
children with congenital heart disease following cardiac surgery: A
scoping review.
Source
Cardiology in the Young. Conference: 11th Annual Scientific Sessions of
the Cardiac Neurodevelopmental Outcome Collaborative. Montreal, QC Canada.
33(7) (pp S1240-S1241), 2023. Date of Publication: July 2023.
Author
Clarke S.; Milburn N.; Menzies J.; Drury N.
Institution
(Clarke, Milburn, Menzies, Drury) Birmingham Women's and Children's
Hospital NHS Foundation Trust, Birmingham, United Kingdom
Publisher
Cambridge University Press
Abstract
Introduction: Children with congenital heart disease (CHD) are at risk of
delayed motor development with increased risk for those requiring cardiac
surgical intervention. We conducted a scoping review to identify the
provision and impact of physiotherapydelivered rehabilitation in children
with CHD following cardiac surgery Methods: CINAHL, EMBASE, PUBMED, AHMED,
EMCARE, Cochrane Database of Systematic Reviews, NHS Evidence databases
were searched (2000-2022). Included studies were published in full, in
English and reported the use of physiotherapy in CHD (participants 0-18
years) post-surgical procedure Articles were screened by title and
abstract and through full-text review with results structured in
accordance with the PAGER framework and PRISMA- ScR checklist.
<br/>Result(s): 5747 papers were screened, with seven full-text
peerreviewed papers published 2014-2021 identified. Included papers were
predominantly from non-randomised cohort studies with sample size between
1-247. Study participants ranged from 0-16 years, with a variety of
cyanotic and acyanotic congenital heart defects and surgical procedures.
There was wide variation in duration, frequency, length and type of
physiotherapeutic interventions and lack of standardised assessment of
impact. Few adverse events were reported, however assessment of stability
prior and during interventions varied significantly. <br/>Discussion(s):
Assessing the impact and provision of physiotherapy in CHD post-surgical
intervention is challenging due to low sample sizes, lack of control
groups, heterogeneous demographics and variable intervention and formats
delivered. Further research is required to identify optimum format of
physiotherapy provision, establish potential impact of physiotherapy
delivered rehabilitation on motor function and development and establish
recommendations regarding measures of stability pre and during
intervention.

<12>
Accession Number
642457117
Title
The association between overprotective parenting and the growth and
development of children with congenital heart disease: a systematic
review.
Source
Cardiology in the Young. Conference: 11th Annual Scientific Sessions of
the Cardiac Neurodevelopmental Outcome Collaborative. Montreal, QC Canada.
33(7) (pp S1239), 2023. Date of Publication: July 2023.
Author
Avedissian T.; Noureddine S.; Hneiny L.; Atwi S.
Institution
(Avedissian, Hneiny, Atwi) American University of Beirut, Beirut, Lebanon
(Noureddine) University of South Dakota, Sioux Falls, SD, United States
Publisher
Cambridge University Press
Abstract
Introduction: Congenital Heart Disease (CHD) is the most common birth
defect of childhood. Over recent years, advances in the treatments
significantly improved the preoperative and perioperative outcomes of
children with CHD, with 90% surviving into adulthood. However, the disease
still marks these children with residual sequelae after surgical
interventions. One of the main health problems that persist even after
surgical intervention is the growth and developmental delay. Even with the
recent improvements in the management of CHD, neurodevelopmental outcomes
after cardiac surgery have improved only modestly over time. Parents are
primarily responsible for the care of the child with CHD after
hospitalization. However, the demands of such a chronic illness place
these parents under high levels of stress, which in turn impact the
parent-child relationship. Because of the child's long-term illness
process, some parents tend to perceive the child as highly vulnerable and
become overprotective, further limiting the developmental opportunities
and subsequently influencing their growth and development. Overprotective
parenting was found to affect healthy and chronically ill children's
psychological and behavioral outcomes negatively. However, studies on the
association between overprotective parenting practices and the growth and
development of children with CHD are seldom investigated. Therefore, this
study aimed to answer the following research question, whether there was
an association between overprotective parenting and the growth and
development of children with congenital heart disease. <br/>Method(s):
This study used a systematic review methodology and included CINAHL,
EMBASE, MEDLINE and PsycINFO databases. The GRADE guidelines were followed
to assess the risk of bias. <br/>Result(s): PRISMA reporting guidelines
were employed. Of the 11,583 abstracts screened, 56 full-text articles
were retrieved and four met the pre-determined criteria for the narrative
analysis. There was no reporting found on the association between parental
overprotectiveness and the growth of children with CHD. However, regarding
development, studies suggested that maternal overprotectiveness was
significantly higher in children with CHD than in healthy controls and
appeared to be associated with some of the domains of child development.
<br/>Discussion(s): Targeting parenting approaches remain important to
enhance the development of children with CHD, since overprotective
parenting appeared to be associated with some of the domains of
development. However, more research is needed given the limitations of the
studies reviewed.

<13>
Accession Number
642648968
Title
Outcomes of Ozaki Procedure/Aortic Valve Neocuspidization for Aortic Valve
Diseases: A Systematic Review.
Source
Anatolian journal of cardiology. 27(11) (pp 619-627), 2023. Date of
Publication: 01 Nov 2023.
Author
Badalyan S.S.; Markosyan S.V.; Ismailbaev A.M.; Asghar A.; Ur Rehman A.
Institution
(Badalyan) Department of Cardiology, I.M. Sechenov University Hospital
First Moscow State Medical University, Moscow, Russian Federation
(Markosyan) Department of Cardiology, Yerevan State Medical University
after Mkhitar Heratsi, Yerevan, Armenia
(Ismailbaev) Department of Cardiovascular Surgery, I.M. Sechenov
University Hospital First Moscow State Medical University, Moscow, Russian
Federation
(Asghar) Institute of Pharmaceutical Sciences, University of Veterinary
and Animal Sciences, Lahore, Pakistan
(Ur Rehman) Department of Food Science and Human Nutrition, University of
Veterinary and Animal Sciences, Lahore, Pakistan
Abstract
BACKGROUND: Perfect heart valve prostheses have optimized hemodynamics,
reduced surgical morbidity, long-lasting durability, and extended patient
survival with greater quality of life. Mechanical valves are recommended;
however, young children may need anticoagulant medication for life. In
this study, we looked at the success rate and viability of aortic valve
neocuspidization (AVNeo) surgery for a variety of aortic disorders.
<br/>METHOD(S): A methodical search strategy was used to fully evaluate
the AVNeo results. Boolean operators were used to combine important words
like 'Ozaki Procedure,' 'Aortic Valve Neocuspidization,' 'AVNeo,' and
associated terms. Reputable databases such as PubMed, MEDLINE, Embase, Web
of Science, and Scopus were the focus of our search. Study quality was
assessed using a critical evaluation created with the Critical Appraisal
Skills Programme tool. <br/>RESULT(S): The findings are summarized in the
'Results' section that contains descriptive and critical analysis,
ramifications, and explanations. According to research, AVNeo improved
valve function and had few side effects. Aortic valve neocuspidization has
a lower mean pressure gradient and a larger mean efficient orifice area
than Trifecta. Aortic valve neocuspidization surgery reduces aortic valve
regurgitation and pressure gradients. Postoperative echocardiograms
indicated a decrease in peak and a rise in mean pressure gradient.
<br/>CONCLUSION(S): The Ozaki method restores a healthy laminar flow
pattern while preventing bivalvular disease. Ozaki procedure should be
explored for valve repair in infants with truncal valve and congenital
aortic disease. Aortic valve tricuspidization with glutaraldehyde-treated
autologous pericardium results in considerable effective orifice area,
modest pressure gradients, and little regurgitation.

<14>
[Use Link to view the full text]
Accession Number
2028159420
Title
Enhanced CT-guided adrenal venous sampling versus traditional X-ray-guided
adrenal venous sampling in patients with primary aldosteronism.
Source
Medicine (United States). 102(42) (pp E35611), 2023. Date of Publication:
20 Oct 2023.
Author
Chen C.; Li F.; Han J.; Chen X.
Institution
(Chen) Department of Clinical Nutrition, The First Affiliated Hospital,
Fujian Medical University, Fuzhou, China
(Chen) Department of Clinical Nutrition, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Li) Department of Endocrinology, Xiangyang Central Hospital, Affiliated
Hospital of Hubei University of Arts and Science, Xiangyang, China
(Han) Department of Interventional Radiology, Xiangyang Central Hospital,
Affiliated Hospital of Hubei University of Arts and Science, Xiangyang,
China
(Chen) Department of Endocrinology, The First Affiliated Hospital, Fujian
Medical University, Fuzhou, China
(Chen) Department of Endocrinology, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Chen) Diabetes Research Institute of Fujian Province, The First
Affiliated Hospital, Fujian Medical University, Fuzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
To compare the accuracy, safety, operation time, and radiation dose of
enhanced computed tomography (CT)-guided adrenal vein sampling (AVS)
versus traditional X-ray-guided AVS in patients with primary
aldosteronism. A total of 97 patients with primary aldosteronism were
randomly assigned to either the enhanced CT-guided group (n = 48) or the
traditional X-ray-guided group (n = 49). Baseline characteristics were
compared between the 2 groups. The primary outcome was the accuracy of
AVS, assessed by aldosterone-to-cortisol ratio. Secondary outcomes
included safety measures (intraoperative and postoperative complication
rates, procedure termination rates, blood pressure, and heart rate
changes), operation time, and radiation dose. The CT-guided group
demonstrated significantly higher aldosterone-to-cortisol ratios,
indicating improved accuracy in AVS (P <.001). The CT-guided group also
showed significantly lower intraoperative blood pressure change and
intraoperative heart rate change compared to the X-ray-guided group (P
<.05). In addition, the CT-guided group had significantly shorter
operation times (P <.001) and lower radiation exposure (P <.001). The
enhanced CT-guided AVS demonstrated significantly better accuracy, safety,
and efficiency compared to traditional X-ray-guided AVS in patients with
primary aldosteronism. The enhanced CT-guided approach also resulted in
lower radiation exposure for patients, making it a favorable option in the
diagnosis and treatment of primary aldosteronism.<br/>Copyright &#xa9;
2023 Lippincott Williams and Wilkins. All rights reserved.

<15>
Accession Number
2026504667
Title
Combined Administration of Nitric Oxide and Hydrogen into Extracorporeal
Circuit of Cardiopulmonary Bypass as a Method of Organ Protection during
Cardiac Surgery.
Source
Sovremennye Tehnologii v Medicine. 15(5) (pp 15-22), 2023. Date of
Publication: 2023.
Author
Pichugin V.V.; Derugina A.V.; Domnin S.E.; Shirshin A.S.; Fedorov S.A.;
Buranov S.N.; Jourko S.A.; Ryazanov M.V.; Danilova D.A.; Brichkin Yu.D.
Institution
(Pichugin, Domnin, Fedorov, Jourko, Ryazanov, Brichkin) Specialized
Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, 209
Vaneeva St., Nizhny Novgorod 603136, Russian Federation
(Pichugin) Department of Anesthesiology, Intensive Care Medicine,
Transfusiology, Privolzhsky Research Medical University, 10/1 Minin and
Pozharsky Square, Nizhny Novgorod 603005, Russian Federation
(Derugina, Danilova) Department of Physiology Anatomy, National Research
Lobachevsky State University of Nizhny Novgorod, 23 Prospect Gagarina,
Nizhny Novgorod 603022, Russian Federation
(Shirshin, Buranov) Russian Federal Nuclear Center - All-Russian
Scientific Research Institute of Experimental Physics (RFNC-VNIIEF), 37
Prospect Mira, Sarov 607188, Russian Federation
(Ryazanov) Department of Hospital Surgery named after B.A. Korolev,
Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square,
Nizhny Novgorod 603005, Russian Federation
Publisher
Privolzhsky Research Medical University
Abstract
The aim is to study the effect of combined introduction of nitric oxide
and hydrogen into the extracorporeal circuit of cardiopulmonary bypass
(CPB) for antioxidant activity and organ damage during cardiac surgery.
Materials and Methods. The study included 91 patients who underwent heart
surgery under CPB. The patients were randomized into 3 groups: group 1
comprised 30 patients (control); group 2 consisted of 33 patients with an
isolated supply of nitric oxide (40 ppm) to the extracorporeal circuit;
group 3 included 28 patients with a combined supply of nitric oxide (40
ppm) and hydrogen (1.2 ppm) into the extracorporeal circuit. The intensity
of lipid peroxidation processes was studied by the content of diene
conjugates (DC), triene conjugates (TC), Schiff bases (SB) in blood
plasma; erythrocyte aggregation was also examined. The studies were
carried out at the following stages: stage 1 (initial) - after induction
of anesthesia; stage 2 - before CPB; stage 3 - 5 min after CPB initiation;
stage 4 - at the 30^th minute of CPB; stage 5 - at the
60^th minute of CPB; stage 6 - at the 90^th minute of
CPB; stage 7 - at CPB termination; stage 8 - at the end of the operation.
Results. The content of DC increased statistically significantly at the
90^th minute of CPB to 1.093+/-0.573 rel. units (M+/-SD) in
patients of group 1; to 0.322+/-0.047 rel. units in group 2; to
0.287+/-0.003 rel. units in group 3, while the DC content was
statistically significantly lower in patients of groups 2 and 3 compared
to group 1. A statistically significant increase in the content of TC
compared to the initial value was observed at the 90^th minute
of CPB in group 1 (up to 0.334+/-0.114 rel. units), while the content of
TC was statistically significantly lower in patients of groups 2 and 3. A
statistically significant growth in the content of SB occurred at the
90^th minute of CPB in patients of group 1 up to 33.324+/-15.640
rel. units. This indicator was statistically significantly lower in groups
2 and 3 relative to the patients of group 1. The dynamics of erythrocyte
aggregation in patients of group 1 showed statistically significant growth
of this indicator from the start of CPB to the end of the operation (from
44.8+/-1.4 to 73.1+/-2.2%). The statistically significant difference from
the indicator at the beginning of the operation started at the
30^th minute of CPB and lasted until the end of the operation.
In patients of group 2, it decreased statistically significantly during
CPB (from 56.5+/-2.3% before the CPB initiation to 47.4+/-1.2% at the CPB
termination); in patients of group 3, it was decreasing from the
60^th minute of CPB to the end of the operation and was
statistically significantly lower than in patients of both groups 1 and 2.
No postoperative complications were noted (acute heart failure, acute
respiratory failure, multiple organ failure) in patients of groups 2 and
3. A statistically significant decrease in both the duration of mechanical
ventilation and stay in the intensive care unit was registered in group 3
compared to group 2. Conclusion. The combined use of gaseous nitric oxide
and hydrogen during CPB allowed a statistically significant decrease in
the level of activation of lipid peroxidation and erythrocyte aggregation,
which ensured a higher level of organ protection during cardiac surgery,
faster activation of patients, and a shorter stay in the intensive care
unit.<br/>Copyright &#xa9; 2023, Privolzhsky Research Medical University.
All rights reserved.

<16>
Accession Number
2028120891
Title
Magnesium prophylaxis of new-onset atrial fibrillation: A systematic
review and meta-analysis.
Source
PLoS ONE. 18(10 October) (no pagination), 2023. Article Number: e0292974.
Date of Publication: October 2023.
Author
Curran J.; Ross-White A.; Sibley S.
Institution
(Curran, Sibley) Department of Critical Care Medicine, Queen's University,
Kingston, Canada
(Ross-White) Bracken Health Sciences Library, Queen's University,
Kingston, Canada
Publisher
Public Library of Science
Abstract
Purpose Atrial fibrillation (AF) is the most common cardiac arrhythmia in
intensive care units (ICU) and is associated with increased morbidity and
mortality. Magnesium prophylaxis has been shown to reduce incidence of AF
in cardiac surgery patients, however, evidence outside this population is
limited. The objective of this study is to summarize studies examining
magnesium versus placebo in the prevention of NOAF outside the setting of
cardiac surgery. Source We performed a comprehensive search of MEDLINE,
EMBASE, and Cochrane Library (CENTRAL) from inception until January
3^rd, 2023. We included all interventional research studies that
compared magnesium to placebo and excluded case reports and post cardiac
surgery patients. We conducted meta-analysis using the inverse variance
method with random effects modelling. Principal findings Of the 1493
studies imported for screening, 87 full texts were assessed for
eligibility and six citations, representing five randomized controlled
trials (n = 4713), were included in the review, with four studies (n =
4654) included in the pooled analysis. Administration of magnesium did not
significantly reduce the incidence of NOAF compared to placebo (OR 0.72,
[95% CI 0.48 to 1.09]). Conclusion Use of magnesium did not reduce the
incidence of NOAF, however these studies represent diverse groups and are
hindered by significant bias. Further studies are necessary to determine
if there is benefit to magnesium prophylaxis for NOAF in non-cardiac
surgery patients.<br/>Copyright &#xa9; 2023 Curran et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<17>
Accession Number
2028201416
Title
Valve-Sparing Aortic Root Replacement With Reimplantation vs Remodeling: A
Meta-analysis.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Sa M.P.; Jacquemyn X.; Awad A.K.; Brown J.A.; Chu D.; Serna-Gallegos D.;
Kari F.A.; Sultan I.
Institution
(Sa, Brown, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Chu, 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
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Kari) Section of Pediatric and Congenital Cardiac Surgery, European
Pediatric Heart Center, Ludwig Maximilian University (LMU) University
Hospital and German Heart Center, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: Long-term outcomes of valve-sparing aortic root replacement
(VSARR) with reimplantation vs remodeling in patients undergoing aortic
root surgery remains a controversial subject. <br/>Method(s): This study
was a pooled meta-analysis of Kaplan-Meier-derived data from comparative
studies published by December 31, 2022. <br/>Result(s): Fifteen studies
met our eligibility criteria, comprising 3044 patients (1991 in the
reimplantation group and 2018 in the remodeling group). Patients who
underwent VSARR with remodeling had a higher risk of all-cause death
(hazard ratio [HR], 1.54; 95% CI, 1.16-2.03; P = .002, log-rank test P <
.001). Landmark analysis (with 4 years as the landmark time point)
demonstrated that survival was lower in patients who underwent VSARR with
remodeling (HR, 2.15; 95% CI, 1.43-3.24; P < .001) in the first 4 years.
Beyond the 4-year time point, no difference in survival was observed (HR,
1.04; 95% CI, 0.72-1.50; P = .822). The risk for need of aortic valve
and/or root reintervention was higher in patients undergoing VSARR with
remodeling (HR, 1.49; 95% CI, 1.07-2.07; P = .019, log-rank test P <
.001). We did not find statistically significant coefficients for the
covariates of age, female sex, connective tissue disorders, bicuspid
aortic valve, aortic dissection, coronary bypass surgery, total arch
replacement, or annular stabilization, which means that these covariates
did not modulate the effects observed in our pooled analyses.
<br/>Conclusion(s): VSARR with reimplantation is associated with better
overall survival and lower risk of need for reintervention over time
compared with VSARR with remodeling. Regarding overall survival, we
observed a time-varying effect that favored the reimplantation technique
up to 4 years of follow-up, but not beyond this time point.<br/>Copyright
&#xa9; 2023 The Society of Thoracic Surgeons

<18>
Accession Number
2026418560
Title
Barriers to Accessing Congenital Heart Surgery in Low- and Middle-Income
Countries: A Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2023. Date of Publication: 2023.
Author
Cheng S.P.S.; Heo K.; Joos E.; Vervoort D.; Joharifard S.
Institution
(Cheng, Heo) Faculty of Medicine, University of British Columbia,
Vancouver, BC, Canada
(Joos) Division of General Surgery, Department of Surgery, Vancouver
General Hospital, University of British Columbia, Vancouver, BC, Canada
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Joharifard) Division of Pediatric Surgery, Department of Surgery, British
Columbia Children's Hospital, University of British Columbia, Vancouver,
BC, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Congenital heart disease (CHD) is the most common major
congenital anomaly. Ninety percent of children with CHD are born in low-
and middle-income countries (LMICs), where over 90% of patients lack
access to necessary treatments. Reports on barriers to accessing CHD care
are limited. Accordingly, it is difficult to design evidence-based
interventions to increase access to congenital cardiac surgical care in
LMICs. <br/>Objective(s): We performed a qualitative systematic review to
understand barriers to accessing congenital cardiac surgical care in
LMICs. <br/>Method(s): We conducted a search of Ovid MEDLINE and CINAHL
databases to identify relevant articles from January 2000 to May 2021. We
then used a thematic analysis to summarize qualitative data into a
framework of preoperative, perioperative, and postoperative barriers.
<br/>Result(s): Our search yielded 1,585 articles, of which 67 satisfied
the inclusion criteria. Notable preoperative barriers included delayed
diagnosis, insufficient caregiver education, financial constraints,
difficulty reaching treatment centers, sociocultural stigma of CHD,
sex-based discrimination of patients with CHD, and Indigeneity.
Perioperative barriers included lack of hospital resources and workforce,
need for prolonged hospitalization, and strained physician-patient
relationships. Many patients faced barriers postoperatively and into
adulthood due to a shortage of critical care resources, inadequate
caregiver counseling and patient education, lack of follow-up, and debt
from hospital bills and missed work. <br/>Conclusion(s): Reducing neonatal
and childhood mortality begins with recognizing barriers to accessing
health care. Our systematic review identifies and classifies challenges in
accessing CHD in LMICs and suggests solutions to major
barriers.<br/>Copyright &#xa9; The Author(s) 2023.

<19>
Accession Number
642648717
Title
Risk factors for sternal wound infection after open-heart operations: A
systematic review and meta-analysis.
Source
International wound journal. (no pagination), 2023. Date of Publication:
01 Nov 2023.
Author
Chen D.; Zhang J.; Wang Y.; Jiang W.; Xu Y.; Xiong C.; Feng Z.; Han Y.;
Chen Y.
Institution
(Chen, Wang, Jiang, Xu, Xiong, Han, Chen) Department of Plastic and
Reconstructive Surgery, First Medical Centre of Chinese PLA General
Hospital, Beijing, China
(Zhang) Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army
Medical University, Chongqing, China
(Feng) Department of Cardiovascular Surgery, First Medical Centre of
Chinese PLA General Hospital, Beijing, China
Abstract
We aimed to quantitatively and systematically elucidate the rationality of
the examined variables as independent risk factors for sternal wound
infection. We searched databases to screen studies, ascertained the
variables to be analysed, extracted the data and applied meta-analysis to
each qualified variable. Odds ratios and mean differences were considered
to be the effect sizes for binary and continuous variables, respectively.
A random-effects model was used for these procedures. The source of
heterogeneity was evaluated using a meta-regression. Publication bias was
tested by funnel plot and Egger's test, the significant results of which
were then calculated using trim and fill analysis. We used a sensitivity
analysis and bubble chart to describe their robustness. After screening
all variables in the eligible literature, we excluded 55 because only one
or no research found them significant after multivariate analysis, leaving
33 variables for synthesis. Two binary variables (age over 65years, NYHA
class >2) and a continuous variable (preoperative stay) were not
significant after the meta-analysis. The most robust independent risk
factors in our study were diabetes mellitus, obesity, use of bilateral
internal thoracic arteries, chronic obstructive pulmonary disease,
prolonged surgery time, prolonged ventilation and critical preoperative
state, followed by congestive heart failure, atrial fibrillation, renal
insufficiency, stroke, peripheral vascular disease and use of an
intra-aortic balloon pump. Relatively low-risk factors were
emergent/urgent surgery, smoking, myocardial infarction, combined surgery
and coronary artery bypass grafting. Sternal wound infection after
open-heart surgery is a multifactorial disease. The detected risk factors
significantly affected the wound healing process, but some were different
in strength. Anything that affects wound healing and antibacterial
ability, such as lack of oxygen, local haemodynamic disorders,
malnutrition condition and compromised immune system will increase the
risk, and this reminds us of comprehensive treatment during the
perioperative period.<br/>Copyright &#xa9; 2023 The Authors. International
Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons
Ltd.

<20>
Accession Number
642648319
Title
Methylxanthine Derivatives in the Treatment of Sinus Node Dysfunction: A
Systematic Review.
Source
Cardiology in review. (no pagination), 2023. Date of Publication: 01 Nov
2023.
Author
Roth H.R.; Reinert J.P.
Institution
(Roth) From the Department of Pharmacy Practice, The University of Toledo
College of Pharmacy and Pharmaceutical Sciences, Toledo, OH
Abstract
While the chronotropic effects of theophylline and aminophylline are
well-known, their clinical application in the treatment of sinus node
dysfunction has not been established in a review. The purpose of this
systematic review is to evaluate the efficacy and safety of
methylxanthines in the treatment of bradyarrhythmias associated with sinus
node dysfunction. A systematic review was conducted in accordance with
PRISMA guidelines on Embase, PubMed, MEDLINE, Cochrane Central, Web of
Science, SciELO, Korean Citation Index, Global Index Medicus, and CINAHL
through June 2023. A total of 607 studies were identified through the
literature search. After applying the inclusion and exclusion criteria, 14
studies were included in this review. The causes of bradyarrhythmias
involving the sinoatrial node included acute cervical spinal cord injury,
coronavirus disease of 2019, carotid sinus syncope, chronotropic
incompetence, heart transplant, and chronic sinus node dysfunction.
Theophylline and aminophylline were shown to be effective for increasing
heart rate and reducing the reoccurrence of bradyarrhythmias. The data on
symptom resolution was conflicting. While many case studies reported a
resolution of symptoms, a randomized controlled trial reported no
significant difference in symptom scores between the control,
theophylline, and pacemaker groups in the treatment of sick sinus
syndrome. The incidence of adverse effects was low across all study
designs. The data suggests methylxanthines may be useful as an alternative
or bridge to nonpharmacologic pacing; however, dosing has yet to be
established for various indications. Overall, methylxanthines proved safe
and effective as a pharmacologic therapy for bradyarrhythmic
manifestations of sinus node dysfunction.<br/>Copyright &#xa9; 2023
Wolters Kluwer Health, Inc. All rights reserved.

<21>
Accession Number
642460512
Title
Coronary Calcification In Patients Presenting With Acute Coronary
Syndromes: Insights From The Matrix Trial.
Source
European heart journal. Acute cardiovascular care. (no pagination), 2023.
Date of Publication: 09 Oct 2023.
Author
Sanz Sanchez J.; Garcia-Garcia H.M.; Branca M.; Frigoli E.; Leonardi S.;
Gagnor A.; Calabro P.; Garducci S.; Rubartelli P.; Briguori C.; Ando G.;
Repetto A.; Limbruno U.; Garbo R.; Sganzerla P.; Russo F.; Lupi A.;
Cortese B.; Ausiello A.; Ierna S.; Esposito G.; Santarelli A.; Sardella
G.; Varbella F.; Tresoldi S.; de Cesare N.; Rigattieri S.; Zingarelli A.;
Tosi P.; van 't Hof A.; Boccuzzi G.; Omerovic E.; Sabate M.; Heg D.;
Vranckx P.; Valgimigli M.
Institution
(Sanz Sanchez) Hospital Universitari i Politecnic La Fe, Valencia, Spain
(Sanz Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV) -
Madrid, Spain
(Garcia-Garcia) Interventional Cardiology, MedStar Washington Hospital
Center, WA, United States
(Branca, Frigoli, Heg) CTU Bern, University of Bern, Bern, Switzerland
(Leonardi, Repetto) Coronary Care Unit, Department of Molecular Medicine,
University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia,
Italy
(Gagnor) Department of Invasive Cardiology, Maria Vittoria Hospital,
Turin, Italy
(Calabro) Division of Cardiology, "Sant'Anna e San Sebastiano" Hospital,
Caserta, Italy
(Calabro) Department of Translational Medicine, University of Campania
"Luigi Vanvitelli", Caserta, Italy
(Garducci) A.O. Ospedale Civile di Vimercate, Vimercate, Italy
(Rubartelli) Department of Cardiology, ASL3 Ospedale Villa Scassi, Genoa,
Italy
(Briguori) Clinica Mediterranea, Naples, Italy
(Ando) Azienda Ospedaliera Universitaria Policlinico "Gaetano Martino",
University of Messina, Messina, Italy
(Limbruno) UO Cardiologia, ASL 9 Grosseto, Italy
(Garbo, Boccuzzi) GVM Care & Research, Turin, Italy
(Sganzerla) AO Ospedale Treviglio-Caravaggio, Treviglio, Italy
(Russo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Lupi) Division of Cardiology, ASL VCO, Verbania, Italy
(Cortese) Ospedale FatebeneFratelli, Milano, Italy
(Ausiello) Casa di Cura Villa Verde, Taranto, Italy
(Ierna) Ospedale Sirai, Carbonia, Italy
(Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, Federico II University of Naples, Naples, Italy
(Santarelli) Cardiovascular Department, Infermi Hospital, Rimini, Italy
(Sardella) "Sapienza" University of Rome, Policlinico Umberto I, Rome,
Italy
(Varbella) Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3,
Turin, Italy
(Tresoldi) Azienda Ospedaliera Ospedale di Desio, Desio, Italy
(de Cesare) Policlinico San Marco, Italy
(Rigattieri) Interventional Cardiology Unit, Sandro Pertini Hospital Rome
(Zingarelli) IRCCS Azienda Ospedaliera Universitaria San Martino
(Tosi) Mater Salutis Hospital, Legnago, Italy
(van 't Hof) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Omerovic) ahlgrenska University Hospital, Goteborg, Sweden
(Sabate) Hospital Clinic, University of Barcelona, Thorax Institute,
Department of Cardiology, Barcelona, Philippines
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale, Lugano, Switzerland
Abstract
OBJECTIVE: The role of coronary calcification on clinical outcomes among
different revascularization strategies in patients presenting with acute
coronary syndromes (ACS) has been rarely investigated. The aim of this
investigation is to evaluate the role of coronary calcification, detected
by coronary angiography, in the whole spectrum of patients presenting with
acute ACS. <br/>METHOD(S): The present study was a post hoc analysis of
the MATRIX program. The primary endpoint was major adverse cardiovascular
events (MACE), defined as the composite of all-cause mortality, myocardial
infarction (MI), or stroke up to 365 days. <br/>RESULT(S): Among the 8,404
patients randomized in the MATRIX trial, data about coronary calcification
was available in 7446 (88.6%) and therefore were included in this post-hoc
analysis. Overall, 875 patients (11.7%) presented with severe coronary
calcification, while 6,571 patients (88.3%) did not present severe
coronary calcification on coronary angiography. Fewer patients with severe
coronary calcification underwent percutaneous coronary intervention
whereas coronary artery bypass grafting or medical therapy-only was more
frequent compared with patients without severe calcification. At 1-year
follow-up, MACE occurred in 237 (27.1%) patients with severe calcified
coronary lesions and 985 (15%) patients without severe coronary calcified
lesions [HR 1.91; 95% CI 1.66-2.20, p<0.001]. All-cause mortality was 8.6%
in patients presenting with and 3.7% in those without severe coronary
calcification (HR 2.38, 1.84-3.09; p<0.001). Patients with severe coronary
calcification incurred higher rate of MI (20.1% vs 11.5%, HR 1.81; 95% CI
1.53-2.1, p<0.001) and similar rate of stroke (0.8% vs 0.6%, HR 1.35; 95%
CI 0.61-3.02, p=0.46). <br/>CONCLUSION(S): Patients with ACS and severe
coronary calcification, as compared to those without, are associated with
worse clinical outcomes irrespective of the management
strategy.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<22>
Accession Number
2028093643
Title
Learning how to recover from stress: Results from an internet-based
randomized controlled pilot trial.
Source
Internet Interventions. 34 (no pagination), 2023. Article Number: 100681.
Date of Publication: December 2023.
Author
Asplund R.P.; Carvallo F.; Christensson H.; Videsater E.; Haggman A.;
Ljotsson B.; Carlbring P.; Andersson G.
Institution
(Asplund, Carvallo, Christensson, Videsater, Haggman, Andersson) Linkoping
University, Linkoping, Sweden
(Ljotsson) Karolinska Institute, Sweden
(Carlbring) Stockholm University, Sweden
Publisher
Elsevier B.V.
Abstract
Introduction: This randomized, controlled pilot trial evaluated the
efficacy of a brief internet-based recovery training intervention
targeting a clinical sample of distressed employees. <br/>Method(s): A
sample of 69 employees with elevated symptoms of stress were assigned
randomly to a five-week guided recovery training intervention (iRTP, n =
35) or a wait-list control (WLC, n = 34). The study was conducted in
Sweden and participants enrolled via an open recruitment strategy.
Self-report data were collected pre- and post-intervention, then six and
12 months after the intervention. The primary outcome measure was the
Recovery Experience Questionnaire (REQ. The secondary outcome measures
gauged other relevant mental and work-related health outcomes.
Participants in the wait-list control group received access to iRTP after
the six-month follow-up. <br/>Result(s): Compared with the controls,
participants in the intervention group showed a significant and large
overall improvement on the primary outcome REQ (d = 0.93), and small to
moderate effects on the secondary outcomes including, perceived stress (d
= 0.48), anxiety (d = 0.49), quality of life (d = 0.47), and work ability
(d = 0.47) during post-assessment. No significant differences were found
at any time point regarding burnout, exhaustion, depression, physical
exercise, work experience, or sickness absences. <br/>Conclusion(s): This
pilot trial is one of the first to examine a brief recovery training
program's efficacy, suggesting that employees across a wide range of
professions could learn how to recover from elevated stress symptoms. This
type of accessible and brief recovery intervention could potentially
prevent and reduce the negative effects of stress, as well as improve
recovery and quality of life. However, more research is needed with larger
samples before further conclusions can be drawn. Trial Registration: The
study was registered at Clinical Trials (clinicaltrials.gov) number
NCT05220592.<br/>Copyright &#xa9; 2023

<23>
[Use Link to view the full text]
Accession Number
2028057655
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, Medical University of Innsbruck,
Austria
(Pamminger, Troger, Kremser, Mayr) University Clinic of Radiology, Medical
University of Innsbruck, Austria
(Ulmer) Institute of Medical Statistics and Informatics, Medical
University of Innsbruck, Austria
(Lasnig, Danninger, Binder) Department of Cardiology and Intensive Care,
University Teaching Hospital Klinikum Wels-Grieskrichen, Wels, Austria
Publisher
Lippincott Williams and Wilkins
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.
<br/>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%. <br/>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). <br/>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.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<24>
[Use Link to view the full text]
Accession Number
2028057654
Title
Bivalirudin Versus Heparin During PCI in NSTEMI: Individual Patient Data
Meta-Analysis of Large Randomized Trials.
Source
Circulation. 148(16) (pp 1207-1219), 2023. Date of Publication: 17 Oct
2023.
Author
Bikdeli B.; Erlinge D.; Valgimigli M.; Kastrati A.; Han Y.; Steg P.G.;
Stables R.H.; Mehran R.; James S.K.; Frigoli E.; Goldstein P.; Li Y.;
Shahzad A.; Schupke S.; Mehdipoor G.; Chen S.; Redfors B.; Crowley A.;
Zhou Z.; Stone G.W.
Institution
(Bikdeli) Cardiovascular Medicine Division, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Bikdeli) Thrombosis Research Group, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Mehdipoor) Division of Nuclear Medicine, Department of Radiology,
Montefiore Medical Center, Bronx, NY, United States
(Bikdeli) Yale-New Haven Hospital, Yale Center for Outcomes Research and
Evaluation, New Haven, CT, United States
(Erlinge) Lund University, Sweden
(Valgimigli, Frigoli) Bern University Hospital, University of Bern,
Switzerland
(Kastrati, Schupke) Deutsches Herzzentrum Munchen, Technische Universitat,
Munich, Germany
(Kastrati, Schupke) German Center for Cardiovascular Research, Partner
Site Munich Heart Alliance, Germany
(Han, Li) General Hospital of Northern Theater Command, Shenyang, China
(Steg) Universite Paris-Cite, French Alliance for Cardiovascular Trials,
L'Institut national de la sante et de la recherche medicale U-1148,
Assistance Publique - Hopitaux de Paris, Hopital Bichat, Paris, France
(Steg) Imperial College, Royal Brompton Hospital, London, United Kingdom
(Stables, Shahzad) Liverpool Heart and Chest Hospital, United Kingdom
(Stables, Shahzad) University of Liverpool, United Kingdom
(Mehran, Stone) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Mehran, Zhou) Cardiovascular Research Foundation, New York, NY, United
States
(James) Uppsala University, Sweden
(Goldstein) Lille University Hospital, France
(Chen) Weill-Cornell Cornell Medical Center, New York-Presbyterian
Hospital, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Crowley) Genesis Research, Hoboken, NJ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The benefit:risk profile of bivalirudin versus heparin
anticoagulation in patients with non-ST-segment-elevation myocardial
infarction undergoing percutaneous coronary intervention (PCI) is
uncertain. Study-level meta-analyses lack granularity to provide
conclusive answers. We sought to compare the outcomes of bivalirudin and
heparin in patients with non-ST-segment-elevation myocardial infarction
undergoing PCI. <br/>METHOD(S): We performed an individual patient data
meta-analysis of patients with non-ST-segment-elevation myocardial
infarction in all 5 trials that randomized >=1000 patients with any
myocardial infarction undergoing PCI to bivalirudin versus heparin (MATRIX
[Minimizing Adverse Hemorrhagic Events by Transradial Access Site and
Systemic Implementation of Angiox], VALIDATE-SWEDEHEART [Bivalirudin
Versus Heparin in ST-Segment and Non-ST-Segment Elevation Myocardial
Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web
System for Enhancement and Development of Evidence-Based Care in Heart
Disease Evaluated According to Recommended Therapies Registry Trial],
ISAR-REACT 4 [Intracoronary Stenting and Antithrombotic Regimen: Rapid
Early Action for Coronary Treatment 4], ACUITY [Acute Catheterization and
Urgent Intervention Triage Strategy], and BRIGHT [Bivalirudin in Acute
Myocardial Infarction vs Heparin and GPI Plus Heparin Trial]). The primary
effectiveness and safety end points were 30-day all-cause mortality and
serious bleeding. <br/>RESULT(S): A total of 12 155 patients were
randomized: 6040 to bivalirudin (52.3% with a post-PCI bivalirudin
infusion), and 6115 to heparin (53.2% with planned glycoprotein IIb/IIIa
inhibitor use). Thirty-day mortality was not significantly different
between bivalirudin and heparin (1.2% versus 1.1%; adjusted odds ratio,
1.24 [95% CI, 0.86-1.79]; P=0.25). Cardiac mortality, reinfarction, and
stent thrombosis rates were also not significantly different. Bivalirudin
reduced serious bleeding (both access site-related and non - access
site-related) compared with heparin (3.3% versus 5.5%; adjusted odds
ratio, 0.59; 95% CI, 0.48-0.72; P<0.0001). Outcomes were consistent
regardless of use of a post-PCI bivalirudin infusion or routine
lycoprotein IIb/IIIa inhibitor use with heparin and during 1-year
follow-up. <br/>CONCLUSION(S): In patients with non-ST-segment-elevation
myocardial infarction undergoing PCI, procedural anticoagulation with
bivalirudin and heparin did not result in significantly different rates of
mortality or ischemic events, including stent thrombosis and reinfarction.
Bivalirudin reduced serious bleeding compared with heparin arising both
from the access site and nonaccess sites.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<25>
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).
<br/>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. <br/>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. <br/>Conclusion(s): Inhalational induction
with sevoflurane is a better alternative for IV induction with propofol
due to its quicker and better hemodynamic stability.<br/>Copyright &#xa9;
2023 Society for Healthcare and Research Development. All rights reserved.

<26>
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). <br/>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. <br/>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
4^thhourly (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). <br/>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.<br/>Copyright &#xa9; 2023 Society for
Healthcare and Research Development. All rights reserved.

<27>
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. <br/>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.<br/>Copyright &#xa9; 2023 The Authors.
Published on behalf of the American Heart Association, Inc., by Wiley.

<28>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9;
2023, BioMed Central Ltd., part of Springer Nature.

<29>
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.<br/>Copyright &#xa9; 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<30>
Accession Number
642459529
Title
Long term major adverse cardiovascular events following myocardial injury
after non-cardiac surgery (MINS): A systematic review and meta-analysis.
Source
British Journal of Surgery. Conference: Annual Congress of the Association
of Surgeons of Great Britain and Ireland. Harrogate United Kingdom.
110(Supplement 6) (pp vi76-vi77), 2023. Date of Publication: September
2023.
Author
Quintela E.; Strickland S.; Wilson M.; Lee M.
Institution
(Quintela, Wilson, Lee) University of Sheffield, United Kingdom
(Quintela, Strickland, Lee) Sheffield Teaching Hospitals, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Myocardial injury after non-cardiac surgery (MINS) is diagnosed
following asymptomatic troponin elevation in the perioperative period.
MINS is associated with high mortality rates and significant rates of
major adverse cardiac events (MACE) within the first 30 days following
surgery. However, less is known regarding its impact on mortality and
morbidity beyond this time. This systematic review and meta-analysis aims
to establish the rates of long term morbidity and mortality associated
with MINS. <br/>Method(s): This review was registered with PROSPERO
(CRD42021283995). Medline, EMBASE and Cochrane CENTRAL were searched, and
abstracts screened by two reviewers. Observational studies and control
arms of trials reporting mortality and cardiovascular outcomes beyond 30
days in adult patients diagnosed with MINS following non-cardiac surgery
were included. Risk of bias was assessed using the Quality in Prognostic
Studies tool (QUIPS). A random effects model was used for meta-analysis of
outcome subgroups. <br/>Result(s): Searches identified 40 studies.
Meta-analysis of 37 cohort studies found a rate of MACE associated MINS of
21% and mortality following MINS was 25% at one year follow-up. A
non-linear increase in mortality rates was observed up to 1 year post
surgery. MACE rates were also lower in elective surgery compared to a
subgroup which included emergency cases. Analysis demonstrated a wide
variety of accepted MINS and MACE diagnostic criteria within the included
studies. <br/>Conclusion(s): A diagnosis of MINS is associated with high
rates of poor cardiovascular outcomes up to one year. Work is needed to
standardise diagnostic criteria and reporting of MINS related outcomes.

<31>
Accession Number
642458903
Title
The incidence of surgical site infections in China: a comprehensive
literature review.
Source
Antimicrobial Resistance and Infection Control. Conference: 7th
International Conference on Prevention and Infection Control, ICPIC 2023.
Geneva Switzerland. 12(Supplement 1) (no pagination), 2023. Date of
Publication: 2023.
Author
Peng Y.; Lin J.; Qiao F.; Guo L.; Tao S.; Li S.; Huang W.
Institution
(Peng, Lin, Qiao, Guo, Tao, Li, Huang) Infection Control, West China
Hospital, Sichuan University, Chengdu, China
Publisher
BioMed Central Ltd.
Abstract
Introduction: The incidence of SSIs in the mainland of China is still
largely unclear. To address the recent incidence of SSIs in the mainland
of China, we composed a review based on literature review.
<br/>Objective(s): Our primary aim was to present the incidence of
postoperative SSIs as a whole (regardless of the surgical site) and that
stratified by major sites in the last decade in the mainland of China. Our
secondary aims were: (1) to present the spectrum of microorganisms
associated with SSIs, and (2) to evaluate the impact of SSIs on patient
outcomes and financial burden in the China mainland. <br/>Method(s): We
searched six databases for studies of SSIs in the mainland China published
between January 2010 and February 2023. All studies or surveillance data
related to SSIs published in English or Chinese were eligible, while
review articles, case reports, case-control studies, editorials/ letters,
and cross-sectional surveys were excluded. <br/>Result(s): A total of 231
eligible studies were included for analysis. We identified a median SSI
incidence of 2.91% and calculated a pooled SSI incidence of 3.18%. We
found that various criteria were used for determining SSIs. Among the 15
surgical sites or procedures screened, the highest SSI incidence (median,
14.89%; pooled, 12.54%) was seen after colorectal surgeries.
Enterobacterales were the most common type of microorganisms recovered
from samples associated with SSIs after various surgeries involving the
abdomen, while staphylococci were the dominant type associated with SSIs
after cardiac and neurological procedures. SSIs prolonged hospital length
of stay and led to increased mortality rates and also imposed elevated
direct economic burden for affected patients. <br/>Conclusion(s): The
findings highlight the necessity of establishing a nationwide network for
surveillance on SSIs with unified criteria with the aid of informatic
techniques, underscore the importance of implementing tailored tackling
measures well informed by local data and observation, and identify the
impact of SSIs as a critical area for further studies. We hope that this
review could serve as a stepping stone to inspire more studies of SSIs in
China.

<32>
Accession Number
2028151123
Title
Comparison of tirzepatide and dulaglutide on major adverse cardiovascular
events in participants with type 2 diabetes and atherosclerotic
cardiovascular disease: SURPASS-CVOT design and baseline characteristics.
Source
American Heart Journal. 267 (pp 1-11), 2024. Date of Publication: January
2024.
Author
Nicholls S.J.; Bhatt D.L.; Buse J.B.; Prato S.D.; Kahn S.E.; Lincoff A.M.;
McGuire D.K.; Nauck M.A.; Nissen S.E.; Sattar N.; Zinman B.; Zoungas S.;
Basile J.; Bartee A.; Miller D.; Nishiyama H.; Pavo I.; Weerakkody G.;
Wiese R.J.; D'Alessio D.
Institution
(Nicholls, Zoungas) Victorian Heart Institute, Monash University,
Melbourne, VIC, Australia
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Buse) University of North Carolina, Chapel Hill, NC, United States
(Prato) Department of Clinical and Experimental Medicine, Section of
Metabolic Diseases and Diabetes, University of Pisa, Pisa, Sant'Anna
School of Advanced Studies, Pisa, Italy
(Kahn) Division of Metabolism, Endocrinology and Nutrition, Department of
Medicine, VA Puget Sound Health Care System and University of Washington,
Seattle, WA, United States
(Lincoff, Nissen) Cleveland Clinic Coordinating Center for Clinical
Research (C5Research) and Department of Cardiovascular Medicine,
Cleveland, OH, United States
(McGuire) University of Texas Southwestern Medical Center and Parkland
Health and Hospital System, Dallas, TX, United States
(Nauck) Diabetes, Endocrinology and Metabolism Section, Department of
Medicine I, St. Josef-Hospital, Katholisches Klinikum Bochum gGmbH, Ruhr
University of Bochum, Bochum, Germany
(Sattar) School of Cardiovascular and Metabolic Health, University of
Glasgow, United Kingdom
(Zinman) University of Toronto, Lunenfeld-Tanenbaum Research Institute and
Mount Sinai Hospital, Toronto, ON, Canada
(Zoungas) School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Basile) Medical University of South Carolina, Ralph H. Johnson VA Medical
Center, Charleston, SC, United States
(Bartee, Miller, Nishiyama, Pavo, Weerakkody, Wiese) Eli Lilly and
Company, Indianapolis, IN, United States
(D'Alessio) Duke University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Tirzepatide, a once-weekly GIP/GLP-1 receptor agonist, reduces
blood glucose and body weight in people with type 2 diabetes. The
cardiovascular (CV) safety and efficacy of tirzepatide have not been
definitively assessed in a cardiovascular outcomes trial. <br/>Method(s):
Tirzepatide is being studied in a randomized, double-blind,
active-controlled CV outcomes trial. People with type 2 diabetes aged >=40
years, with established atherosclerotic CV disease, HbA1c >=7% to <=10.5%,
and body mass index >=25 kg/m² were randomized 1:1 to once
weekly subcutaneous injection of either tirzepatide up to 15 mg or
dulaglutide 1.5 mg. The primary outcome is time to first occurrence of any
major adverse cardiovascular event (MACE), defined as CV death, myocardial
infarction, or stroke. The trial is event-driven and planned to continue
until >=1,615 participants experience an adjudication-confirmed component
of MACE. The primary analysis is noninferiority for time to first MACE of
tirzepatide vs dulaglutide by demonstrating an upper confidence limit
<1.05, which will also confirm superiority vs a putative placebo, and also
to determine whether tirzepatide produces a greater CV benefit than
dulaglutide (superiority analysis). <br/>Result(s): Over 2 years, 13,299
people at 640 sites in 30 countries across all world regions were
randomized. The mean age of randomized participants at baseline was 64.1
years, diabetes duration 14.7 years, HbA1c 8.4%, and BMI 32.6
kg/m². Overall, 65.0% had coronary disease, of whom 47.3%
reported prior myocardial infarction and 57.4% had prior coronary
revascularization. 19.1% of participants had a prior stroke and 25.3% had
peripheral artery disease. The trial is fully recruited and ongoing.
<br/>Conclusion(s): SURPASS-CVOT will provide definitive evidence as to
the CV safety and efficacy of tirzepatide as compared with dulaglutide, a
GLP-1 receptor agonist with established CV benefit.<br/>Copyright &#xa9;
2023 The Authors

<33>
Accession Number
2028121148
Title
Efficacy and safety of patients with chronic kidney disease undergoing
left atrial appendage closure for atrial fibrillation.
Source
PLoS ONE. 18(10 October) (no pagination), 2023. Article Number: e0287928.
Date of Publication: October 2023.
Author
Liu C.; Han S.; Cui K.; Wang F.
Institution
(Liu) School of Nursing, Chengdu University of Traditional Chinese
Medicine, Chengdu, China
(Han, Cui) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
(Wang) Guang'an Hospital of Traditional Chinese Medicine, Beijing, China
Publisher
Public Library of Science
Abstract
Background The relative safety and efficacy of left atrial appendage
closure (LAAC) for atrial fibrillation (AF) in patients with chronic
kidney disease (CKD) have not been well defined. To evaluate the results
in this cohort, we conducted a systematic review and meta-analysis of
observational studies. Methods We searched the PubMed, EMBASE, Web of
Science, and Cochrane Library databases from inception to January 2023 for
all relevant studies. Our inclusion criteria were met by twelve
observational studies that included 61324 patients altogether. Results
Compared with no CKD group, in-hospital mortality (OR: 2.84, 95% CI:
2.12-3.81, p<0.01, I² = 0%), acute kidney injury (AKI) (OR:
4.39,95% CI:4.00-4.83, P<0.01, I² = 3%), major bleeding events
(OR: 1.44, 95% CI: 1.29-1.60, p<0.01 I² = 0%), and pericardial
effusion/ tamponade (OR 1.30; 95% CI 1.13-1.51, p < 0.01; I² =
0%) were more common in the CKD group, especially in patients with
end-stage renal disease (ESRD). No significant difference was observed in
the occurrence of stroke (OR: 1.24, 95% CI: 0.86-1.78, P = 0.25,
I² = 0%), LAAC success rates (OR: 1.02, 95% CI: 0.33-3.16, p =
0.97, I² = 58%) and vascular access complications (OR: 1.13,
95% CI: 0.91-1.39, p = 0.28, I² = 0%) between the two groups.
During the follow-up, there was no difference in the risk of stroke
between the two groups. Conclusions CKD patients who receive LAAC have a
greater risk of in-hospital mortality, AKI, pericardial
effusion/tamponade, and major bleeding events than those without CKD,
especially in patients with ESRD. No significant difference in the risk of
stroke was found in the long-term follow-up after LAAC between the two
groups, demonstrating a similar efficacy of LAAC to prevent stroke in CKD
patients.<br/>Copyright: &#xa9; 2023 Liu et al.

<34>
Accession Number
2028111458
Title
Systemic right ventricle complications in levo-transposition of the great
arteries: A case report and review of literature.
Source
World Journal of Cardiology. 15(10) (pp 542-552), 2023. Date of
Publication: 26 Oct 2023.
Author
Almajed M.R.; Almajed A.; Khan N.; Obri M.S.; Ananthasubramaniam K.
Institution
(Almajed, Khan, Obri) Department of Internal Medicine, Henry Ford
Hospital, Detroit, MI 48202, United States
(Almajed) College of Medicine and Medical Sciences, Arabian Gulf
University, Manama 00000, Bahrain
(Ananthasubramaniam) Heart and Vascular Institute, Henry Ford West
Bloomfield Hospital, West Bloomfield, MI 48322, United States
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Congenitally corrected levo-transposition of the great arteries
(L-TGA) is a congenital heart disease in which the ventricles and great
arteries are transposed from their typical anatomy. In L-TGA, the double
discordance, atrioventricular and ventriculoarterial, create an acyanotic
milieu which allows patients to survive their early decades, however,
progressive systemic right ventricle (sRV) dysfunction creates
complications later in life. sRV dysfunction and remodeling predisposes
patients to intracardiac thrombus (ICT) formation. CASE SUMMARY A
40-year-old male with L-TGA presented with symptoms of acute decompensated
heart failure. In childhood, he had surgical repair of a ventricular
septal defect. In adulthood, he developed sRV dysfunction, systemic
tricuspid valve (sTV) regurgitation, and left-bundle branch block for
which he underwent cardiac resynchronization therapy. Transthoracic
echocardiogram showed a sRV ejection fraction of 40%, severe sTV
regurgitation, and a newly identified sRV ICT. ICT was confirmed by
ultrasound-enhancing agents and transesophageal echocardiography. Our
patient was optimized with guideline-directed medical therapy and
diuresis. Anticoagulation was achieved with a vitamin K antagonist (VKA)
and he was later referred for evaluation by advanced heart failure and
heart transplant services. CONCLUSION Anticoagulation with VKA is the
mainstay of treatment in the absence of conclusive data supporting direct
oral anticoagulant use in ICT in patients with congenital heart disease.
This case illustrates the natural history of L-TGA and highlights the
importance of surveillance and monitoring with dedicated cardiac imaging
to identify complications.<br/>Copyright &#xa9;The Author(s) 2023.
Published by Baishideng Publishing Group Inc. All rights reserved.

<35>
Accession Number
2027742209
Title
Impact of surgical technique on outcome measures in chest masculinization:
A systemic review and meta-analysis.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 87 (pp 109-116),
2023. Date of Publication: December 2023.
Author
Zhu J.; Wang E.; Liu S.; Koos J.; Shroyer L.; Krajewski A.
Institution
(Zhu, Wang, Liu) Renaissance School of Medicine at Stony Brook University,
Stony Brook, NY, United States
(Koos) Stony Brook University, Stony Brook, NY, United States
(Shroyer, Krajewski) Department of Surgery, Stony Brook Renaissance School
of Medicine, Stony Brook, NY, United States
Publisher
Churchill Livingstone
Abstract
Background: Among plastic surgeons, there are several conventional
techniques for performing chest surgery. Research on surgical approaches
has focused cis-gender patients with medical conditions, such as breast
cancer or gynecomastia, but has never studied transgender populations. The
aim of this study is to perform the first systematic review of
gender-affirming surgery (GAS) in transgender populations and determine
postoperative outcomes differences in relation to surgical technique.
<br/>Method(s): Two reviewers independently searched Medline, Embase,
CINAHL, Web of Science, and Cochrane databases for studies published prior
to 2021. Studies selected for inclusion were retrospective or prospective
studies of adult transgender men undergoing GAS that utilized appropriate
operative techniques and reported complications and/or patient-reported
outcomes. <br/>Result(s): A total of 26 randomized controlled trials,
including 40 distinct populations and 3055 patients, were identified.
Surgical techniques compared double incision free nipple graft (DIFNG)
(2053 patients [67.20%]), pedicled nipple techniques (PNT) (297 [9.72%]),
and periareolar techniques (PAT) (705 [23.08%]). Pairwise analysis found
the lowest complication rates associated with procedures utilizing DIFNG,
followed by PNT, then PAT. Patients with PAT had significantly higher
satisfaction scores than DIFNG. <br/>Conclusion(s): This is the first
systematic review to evaluate outcomes of chest surgery techniques among
the transgender population. Results indicate significantly more
complications for PAT compared to DIFNG or PNT. Analysis of
patient-reported outcomes was limited due to heterogeneity in
reporting.<br/>Copyright &#xa9; 2023

<36>
[Use Link to view the full text]
Accession Number
2027599365
Title
Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel
Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial.
Source
Circulation. 148(12) (pp 950-958), 2023. Date of Publication: 19 Sep 2023.
Author
Zimmermann F.M.; Ding V.Y.; Pijls N.H.J.; Piroth Z.; Van Straten A.H.M.;
Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.; Kharbanda R.;
Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar N.; Jagic N.;
Dambrink J.-H.E.; Kala P.; Angeras O.; Maccarthy P.; Wendler O.; Casselman
F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom T.;
Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Otsuki H.; Kobayashi Y.;
Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.; De Bruyne B.;
Fearon W.F.
Institution
(Zimmermann, Pijls, Van Straten, Tonino) Catharina Hospital, Eindhoven,
Netherlands
(Ding, Desai) Quantitative Sciences Unit, Stanford University, CA, United
States
(Hlatky) Departments of Health Policy and Medicine, Stanford University,
CA, United States
(Woo) Department of Cardiothoracic Surgery, Stanford University, CA,
United States
(Otsuki, Yeung, Fearon) Division of Cardiovascular Medicine, Stanford
Cardiovascular Institute, Stanford University, CA, United States
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Lithuania
(Davidavicius, Kalinauskas) Vilnius University Hospital Santaros Klinikos,
Lithuania, Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Canada
(Kharbanda) Oxford University Hospital NHS Trust, United Kingdom
(Ostlund-Papadogeorgos) Danderyd University Hospital and Karolinska
Institutet, Solna, Sweden
(Aminian) Centre Hospitalier Universitaire de Charleroi, Belgium
(Oldroyd, Al-Attar) Golden Jubilee National Hospital, Glasgow, United
Kingdom
(Jagic) Clinical Hospital Centre Zemun, University of Belgrade, Serbia
(Dambrink) Isala Hospital, Zwolle, Netherlands
(Kala) Medical Faculty of Masaryk University, University Hospital Brno,
Czechia
(Angeras) Sahlgrenska University Hospital, Sweden
(Maccarthy, Wendler) Kings College Hospital, London, United Kingdom
(Casselman, De Bruyne) Cardiovascular Center Aalst, Belgium
(Witt) Sodersjukhuset Hospital, Stockholm, Sweden
(Witt) Karolinska Institutet, Solna, Sweden
(Mavromatis) Atlanta VA Healthcare System, Decatur, GA, United States
(Mavromatis) Emory University School of Medicine, Atlanta, GA, United
States
(Miner) Southlake Regional Health Centre, Newmarket, Canada
(Sarma) Wythenshawe Hospital, Manchester, United Kingdom
(Engstrom) Rigshospitalet, Copenhagen, Denmark
(Christiansen) Aarhus University Hospital, Denmark
(Reardon) Houston Methodist Hospital, TX, United States
(Kobayashi) New York Presbyterian Brooklyn Methodist and Weill Cornell
Medical College, United States
(Mahaffey) Stanford Center for Clinical Research, Department of Medicine,
Stanford University School of Medicine, CA, United States
(De Bruyne) Lausanne University Centre Hospital, Switzerland
(Fearon) VA Palo Alto Health Care System, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Previous studies comparing percutaneous coronary intervention
(PCI) with coronary artery bypass grafting (CABG) in patients with
multivessel coronary disease not involving the left main have shown
significantly lower rates of death, myocardial infarction (MI), or stroke
after CABG. These studies did not routinely use current-generation
drug-eluting stents or fractional flow reserve (FFR) to guide PCI.
<br/>METHOD(S): FAME 3 (Fractional Flow Reserve versus Angiography for
Multivessel Evaluation) is an investigator-initiated, multicenter,
international, randomized trial involving patients with 3-vessel coronary
artery disease (not involving the left main coronary artery) in 48 centers
worldwide. Patients were randomly assigned to receive FFR-guided PCI using
zotarolimus drug-eluting stents or CABG. The prespecified key secondary
end point of the trial reported here is the 3-year incidence of the
composite of death, MI, or stroke. <br/>RESULT(S): A total of 1500
patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved
in >96% of patients in both groups. There was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI,
0.98-1.83]; P=0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95%
CI, 0.6-1.7]; P=0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI,
0.4-1.7]; P=0.56) were not different. MI occurred more frequently after
PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P=0.02).
<br/>CONCLUSION(S): At 3-year follow-up, there was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
with current-generation drug-eluting stents compared with CABG. There was
a higher incidence of MI after PCI compared with CABG, with no difference
in death or stroke. These results provide contemporary data to allow
improved shared decision-making between physicians and patients with
3-vessel coronary artery disease. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT02100722.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<37>
Accession Number
2026413290
Title
Valve Abnormalities, Risk Factors for Heart Valve Disease and Valve
Replacement Surgery in Spondyloarthritis. A Systematic Review of the
Literature.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 719523. Date of Publication: 2021.
Author
Park H.-S.; Laiz A.; Sanchez-Vega J.; Diaz del Campo P.; Martin-Martinez
M.A.; Guerra-Rodriguez M.; Corominas H.
Institution
(Park, Corominas) Rheumatology Department, Hospital Dos de Maig,
Barcelona, Spain
(Laiz, Corominas) Rheumatology and Autoimmune Diseases Department,
Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
(Laiz, Corominas) Department of Medicine, Universitat Autonoma de
Barcelona (UAB), Barcelona, Spain
(Sanchez-Vega) Cardiology Department, Hospital Universitari Bellvitge,
Hospitalet de Llobregat, Spain
(Sanchez-Vega) Department of Medicine, Universitat de Barcelona (UB),
Barcelona, Spain
(Diaz del Campo, Martin-Martinez, Guerra-Rodriguez) Research Unit, Spanish
Society of Rheumatology, Madrid, Spain
Publisher
Frontiers Media SA
Abstract
Objective: Evaluate the evidence on the abnormalities of the aortic root
and heart valves, risk and prognostic factors for heart valve disease and
valve replacement surgery in spondyloarthritis. <br/>Method(s): A
systematic literature review was performed using Medline, EMBASE and
Cochrane databases until July 2021. Prevalence, incidence, risk and
prognostic factors for heart valve disease; dimension, morphology, and
pathological abnormalities of the valves were analyzed. Patient
characteristics (younger age, history of cardiac disease or longer disease
duration) and period of realization were considered for the analysis. The
SIGN Approach was used for rating the quality of the evidence of the
studies. <br/>Result(s): In total, 37 out of 555 studies were included.
Overall, the level of evidence was low. The incidence of aortic
insufficiency was 2.5-3.9. Hazard Ratio for aortic insufficiency was
1.8-2.0. Relative risk for aortic valve replacement surgery in ankylosing
spondylitis patients was 1.22-1.46. Odds ratio for aortic insufficiency
was 1.07 for age and 1.05 for disease duration. Mitral valve abnormalities
described were mitral valve prolapse, calcification, and thickening.
Aortic valve abnormalities described were calcification, thickening and an
echocardiographic "subaortic bump." Abnormalities of the aorta described
were thickening of the wall and aortic root dilatation. The most common
microscopic findings were scarring of the adventitia, lymphocytic
infiltration, and intimal proliferation. <br/>Conclusion(s): A higher
prevalence and risk of aortic valve disease is observed in patients with
ankylosing spondylitis. Studies were heterogeneous and analysis was not
adjusted by potential confounders. Most studies did not define accurate
outcomes and may have detected small effects as being statistically
significant.<br/>Copyright &#xa9; 2021 Park, Laiz, Sanchez-Vega, Diaz del
Campo, Martin-Martinez, Guerra-Rodriguez and Corominas.

<38>
Accession Number
2026406344
Title
Heart Transplantation in Mustard Patients Bridged With Continuous Flow
Systemic Ventricular Assist Device - A Case Report and Review of
Literature.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 651496. Date of Publication: 2021.
Author
Bou Chaaya R.G.; Simon J.W.; Turrentine M.; Herrmann J.L.; Kay W.A.;
Guglin M.; Saleem K.; Rao R.A.
Institution
(Bou Chaaya) Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Simon, Kay, Guglin, Rao) Krannert Institute of Cardiology, Indiana
University School of Medicine, Indianapolis, IN, United States
(Turrentine) Division of Pediatric Cardiothoracic Surgery, Riley Hospital
for Children, Indianapolis, IN, United States
(Herrmann, Saleem) Division of Cardiothoracic Surgery, Indiana University
School of Medicine, Indianapolis, IN, United States
Publisher
Frontiers Media SA
Abstract
Thirty four-year-old male with history of D-transposition of the great
arteries (D-TGA) who underwent Mustard operation at 14 months of age
presented in cardiogenic shock secondary to severe systemic right
ventricular failure. Catheterization revealed significantly increased
pulmonary pressures. Due to the patient's inotrope dependence and
prohibitive pulmonary hypertension, he underwent implantation of a Heart
Ware HVAD for systemic RV support. Within 4 months of continuous flow
ventricular assist device (VAD) implantation complete normalization of
pulmonary vascular resistance (PVR) was achieved. He ultimately underwent
orthotopic heart transplantation with favorable outcomes. This is the
second report of complete normalization of PVR following VAD implantation
into a systemic RV in <4 months. We conducted a thorough literature review
to identify Mustard patients that received systemic RV VAD as a bridge to
a successful heart transplantation. In this article, we summarize the
outcomes and focus on pulmonary hypertension reversibility following VAD
implant.<br/>Copyright &#xa9; 2021 Bou Chaaya, Simon, Turrentine,
Herrmann, Kay, Guglin, Saleem and Rao.

<39>
Accession Number
2026406337
Title
Increased Phospholipid Transfer Protein Activity Is Associated With
Markers of Enhanced Lipopolysaccharide Clearance in Human During
Cardiopulmonary Bypass.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 756269. Date of Publication: 2021.
Author
Nguyen M.; Gautier T.; Reocreux G.; Pallot G.; Maquart G.; Bahr P.-A.;
Tavernier A.; Grober J.; Masson D.; Bouhemad B.; Guinot P.-G.
Institution
(Nguyen, Reocreux, Bahr, Bouhemad, Guinot) Department of Anesthesiology
and Intensive Care, Dijon University Hospital, Dijon, France
(Nguyen, Gautier, Grober, Masson, Bouhemad, Guinot) University of Burgundy
and Franche-Comte, LNC UMR1231, Dijon, France
(Nguyen, Gautier, Pallot, Maquart, Bahr, Tavernier, Grober, Masson,
Bouhemad, Guinot) INSERM, LNC UMR1231, Dijon, France
(Nguyen, Gautier, Grober, Masson, Bouhemad, Guinot) FCS Bourgogne-Franche
Comte, LipSTIC LabEx, Dijon, France
(Grober) AgroSup, LNC UMR1231, Dijon, France
Publisher
Frontiers Media SA
Abstract
Introduction: Lipopolysaccharide (LPS) is a component of gram-negative
bacteria, known for its ability to trigger inflammation. The main pathway
of LPS clearance is the reverse lipopolysaccharide transport (RLT), with
phospholipid transfer protein (PLTP) and lipoproteins playing central
roles in this process in experimental animal models. To date, the
relevance of this pathway has never been studied in humans. Cardiac
surgery with cardiopulmonary bypass is known to favor LPS digestive
translocation. Our objective was to determine whether pre-operative PLTP
activity and triglyceride or cholesterol-rich lipoprotein concentrations
were associated to LPS concentrations in patients undergoing cardiac
surgery with cardiopulmonary bypass. <br/>Method(s): A post-hoc analysis
was conducted on plasma samples obtained from patients recruited in a
randomized controlled trial.Total cholesterol, high density lipoprotein
cholesterol (HDLc), low density lipoprotein cholesterol (LDLc),
triglyceride and PLTP activity were measured before surgery. LPS
concentration was measured by mass spectrometry before surgery, at the end
of cardiopulmonary bypass and 24 h after admission to the intensive care
unit. <br/>Result(s): High PLTP activity was associated with lower LPS
concentration but not with inflammation nor post-operative complications.
HDLc, LDLc and total cholesterol were not associated with LPS
concentration but were lower in patients developing post-operative adverse
events. HDLc was negatively associated with inflammation biomarkers (CRP,
PCT). Triglyceride concentrations were positively correlated with LPS
concentration, PCT and were higher in patients with post-operative
complications. <br/>Conclusion(s): Our study supports the role of PLTP in
LPS elimination and the relevance of RLT in human. PLTP activity, and not
cholesterol rich lipoproteins pool size seemed to be the limiting factor
for RLT. PLTP activity was not directly related to post-operative
inflammation and adverse events, suggesting that LPS clearance is not the
main driver of inflammation in our patients. However, HDLc was associated
with lower inflammation and was associated with favorable outcomes,
suggesting that HDL beneficial anti-inflammatory effects could be, at
least in part independent of LPS clearance.<br/>Copyright &#xa9; 2021
Nguyen, Gautier, Reocreux, Pallot, Maquart, Bahr, Tavernier, Grober,
Masson, Bouhemad and Guinot.

<40>
Accession Number
2028207340
Title
Antithrombotic Treatment After Transcatheter Valve Interventions: Current
Status and Future Directions.
Source
Clinical Therapeutics. (no pagination), 2023. Date of Publication: 2023.
Author
Maznyczka A.; Pilgrim T.
Institution
(Maznyczka, Pilgrim) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: The optimal antithrombotic strategy after transcatheter valve
interventions is a subject of ongoing debate. Although there is evidence
from randomized trials in patients undergoing transcatheter aortic valve
replacement (TAVR), current evidence on optimal antithrombotic management
after transcatheter mitral or tricuspid valve interventions is sparse.
This article appraises the current evidence on this topic. <br/>Method(s):
This narrative review presents key research findings and guideline
recommendations, as well as highlights areas for future research.
<br/>Finding(s): After TAVR, randomized trial evidence suggests that
single antiplatelet therapy is reasonable for patients without
pre-existing indications for oral anticoagulation (OAC). If there is a
concurrent indication for OAC, the addition of antiplatelet therapy
increases bleeding risk. Whether direct oral anticoagulants achieve better
outcomes than vitamin K antagonists is uncertain in this setting. Although
OAC has been shown to reduce subclinical leaflet thrombosis (which may
progress to structural valve degeneration), bleeding events are
unacceptably high. There is a lack of randomized trial data comparing
antithrombotic strategies after transcatheter mitral or tricuspid valve
replacement or after mitral or tricuspid transcatheter edge-to-edge
repair. Single antiplatelet therapy after mitral or tricuspid
transcatheter edge-to-edge repair may be appropriate, whereas at least 3
months of OAC is suggested after transcatheter mitral valve replacement or
transcatheter tricuspid valve replacement. Implications: Randomized
studies are warranted to address the knowledge gaps in antithrombotic
therapy after transcatheter valve interventions and to optimize
outcomes.<br/>Copyright &#xa9; 2023 The Author(s)

<41>
Accession Number
2026424044
Title
Landiolol for the prevention of postoperative atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Cafaro T.; Allwood M.; McIntyre W.F.; Park L.J.; Daza J.; Ofori S.N.; Ke
Wang M.; Borges F.K.; Conen D.; Marcucci M.; Healey J.S.; Whitlock R.P.;
Lamy A.; Belley-Cote E.P.; Spence J.D.; McGillion M.; Devereaux P.J.
Institution
(Cafaro, McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey,
Whitlock, Lamy, Belley-Cote, Spence, McGillion, Devereaux) Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
(Cafaro) Division of Internal Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Department of Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Lady Davis Institute, Jewish General Hospital, Montreal, QC,
Canada
(Allwood) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey, Whitlock,
Lamy, Belley-Cote, Spence, McGillion, Devereaux) Health Research Methods,
Evidence, and Impact (HEI), Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Park) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Daza) Division of General Surgery, Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Cafaro) David Braley Research Institute, C1-109, 237 Barton Street East,
Hamilton, ON L8L 2X2, Canada
Publisher
Springer
Abstract
Purpose: Postoperative atrial fibrillation (POAF) is a common complication
following cardiac surgery. Although the evidence suggests that beta
blockers prevent POAF, they often cause hypotension. Landiolol, an
ultra-short-acting beta<inf>1</inf> blocker, may prevent POAF, without
adverse hemodynamic consequences. Source: We searched MEDLINE, CENTRAL,
Embase, and trial registries between January 1970 and March 2022. We
included randomized controlled trials (RCTs) that evaluated the effect of
landiolol for the prevention of POAF after cardiac surgery. Two reviewers
independently assessed eligibility, extracted data, and assessed risk of
bias using the Risk of Bias 2.0 tool. We pooled data using random-effects
models. We used the Grading of Recommendations, Assessment, Development
and Evaluations framework to assess certainty of evidence. Principal
findings: Nine RCTs including 868 participants met the eligibility
criteria. Patients randomized to landiolol (56/460) had less POAF compared
with controls (133/408) with a relative risk (RR) of 0.40 (95% confidence
interval [CI], 0.30 to 0.54; I² = 0%;) and an absolute risk of
12.2% vs 32.6% (absolute risk difference, 20.4%; 95% CI, 15.0 to 25.0).
Landiolol resulted in a shorter hospital length-of-stay (LOS) (268
patients; mean difference, -2.32 days; 95% CI, -4.02 to -0.57;
I² = 0%). We found no significant difference in bradycardia
(RR, 1.11; 95% CI, 0.48 to 2.56; I² = 0%). No hypotension was
reported with landiolol. We judged the certainty of evidence as moderate
for POAF (because of indirectness as outcomes were not clearly defined)
and low for LOS (because of imprecision and concern of reporting bias).
<br/>Conclusion(s): In patients undergoing cardiac surgery, landiolol
likely reduces POAF and may reduce LOS. A definitive large RCT is needed
to confirm these findings. Study registration: PROSPERO (CRD42021262703);
registered 25 July 2021.<br/>Copyright &#xa9; 2023, The Author(s).

<42>
Accession Number
2025493076
Title
The safety and efficacy of balloon-expandable versus self-expanding
trans-catheter aortic valve replacement in high-risk patients with severe
symptomatic aortic stenosis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1130354. Date of Publication: 2023.
Author
Senguttuvan N.B.; Bhatt H.; Balakrishnan V.K.; Krishnamoorthy P.; Goel S.;
Reddy P.M.K.; Subramanian V.; Claessen B.E.; Kumar A.; Majmundar M.; Ro
R.; Lerakis S.; Jayaraj R.; Kalra A.; Flather M.; Dangas G.; Tang G.H.L.
Institution
(Senguttuvan, Balakrishnan, Reddy, Subramanian) Department of Cardiology,
Sri Ramachandra Institute of Higher Education and Research, Chennai, India
(Senguttuvan, Bhatt, Claessen, Ro, Lerakis, Dangas) Department of
Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Bhatt, Krishnamoorthy, Goel) Department of Cardiology, Hackensack
Meridian Health, New Jersey, NJ, United States
(Claessen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Kumar, Kalra) Department of Internal Medicine, Cleveland Clinic Akron
General, Akron, OH, United States
(Majmundar) Department of Internal Medicine, New York Medical College,
Metropolitan Hospital, New York, NY, United States
(Jayaraj) Jindal Institute of Behavioral Sciences (JIBS), Jindal Global
Institution of Eminence Deemed to Be University, Sonipat, India
(Kalra) Department of Cardiovascular Medicine, Franciscan Health, Indiana,
IN, United States
(Flather) Cardiology, Norwich Medical School, University of East Anglia,
Norwich, United Kingdom
(Tang) Department of Cardiovascular Surgery, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Kalra) Kalra Hospitals, New Delhi, India
Publisher
Frontiers Media SA
Abstract
Aim: Transfemoral Trans-catheter Aortic Valve Replacement (TF-TAVR) is a
safe and effective therapy compared with surgical aortic valve replacement
(SAVR) in patients across all risk profiles using balloon-expandable
valves (BEV) and self-expanding valves (SEV). Our aim was to compare
safety and efficacy of BEV vs. SEV in high-risk patients undergoing
TF-TAVR. <br/>Methods and Results: We searched PubMed, EMBASE,
Clinicaltrials.gov, Scopus, and Web of sciences for studies on patients
with severe aortic stenosis undergoing TAVR. Primary outcome was 30-day
all-cause mortality. Secondary outcomes defined by Valve Academic Research
Consortium 2 (VARC-2) criteria were also examined. Six studies with 2,935
patients (1,439 to BEV and 1,496 to SEV) were included. BEV was associated
with lower risk of all-cause mortality (2.2% vs. 4.5%; RR: 0.51; 95% CI:
0.31-0.82; p < 0.006) and cardiovascular mortality [(2.5% vs. 4.3%; RR:
0.54; 95% CI: 0.32-0.90; p = 0.01) at 30 days compared with SEV.
Implantation of more than one valve per procedure (0.78% vs. 5.11%; RR:
0.15; 95% CI: 0.07-0.31; p < 0.00001), and moderate/severe AR/PVL (2.5%
vs. 9.01%; RR: 0.3; 95% CI: 0.17-0.48); p < 0.00001) were also lower in
the BEV arm. <br/>Conclusion(s): BEV TAVR is associated with reduced
all-cause mortality (High level of GRADE evidence), cardiovascular
mortality (very low level) at 30 days compared with SEV TAVR in high
surgical risk patients. Data are necessary to determine if the difference
in outcomes persists in longer-term and if the same effects are seen in
lower-risk patients. Systematic Review Registration: identifier,
CRD42020181190.<br/>Copyright 2023 Senguttuvan, Bhatt, Balakrishnan,
Krishnamoorthy, Goel, Reddy, Subramanian, Claessen, Kumar, Majmundar, Ro,
Lerakis, Jayaraj, Kalra, Flather, Dangas and Tang.

<43>
Accession Number
635010164
Title
Impact of Serum Uric Acid Lowering and Contemporary Uric Acid-Lowering
Therapies on Cardiovascular Outcomes: A Systematic Review and
Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 641062. Date of Publication: 23 Mar 2021.
Author
Ying H.; Yuan H.; Tang X.; Guo W.; Jiang R.; Jiang C.
Institution
(Ying, Tang, Guo, Jiang, Jiang) Key Laboratory of Cardiovascular
Intervention and Regenerative Medicine of Zhejiang Province, Department of
Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of
Medicine, Hangzhou, China
(Yuan) Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Objective: This study aimed to evaluate the potential association between
uric acid (UA) lowering and cardiovascular risk reduction among
UA-lowering therapies in adults. <br/>Method(s): A systematic search for
randomized controlled trials (RCTs) was conducted according to the
protocol pre-registered in PROSPERO (No. CRD42020199259). We search for
RCTs in PubMed, Embase, Web of Science, the Cochrane Library, and
ClinicalTrials.gov up to July 1, 2020. A meta-analysis was performed using
a fixed- or random-effects model. <br/>Result(s): In total, 30 studies
involving 18,585 hyperuricaemic patients were included. Xanthine oxidase
inhibitor (XOI) therapy produced a 6.0% reduction in relative risk (RR)
for major adverse cardiovascular events (MACEs). The use of febuxostat was
associated with a higher risk of cardiovascular events (CVEs) (RR: 1.09,
95% CI 0.998-1.19, I² = 0.0%), but the difference was not
statistically significant. Allopurinol treatment was associated with a
lower CVE risk (RR: 0.61, 95% CI 0.46-0.80, I² = 21.0%). Among
the UA-lowering therapies, the drug treatments were associated with
all-cause mortality (RR: 1.20, 95% CI 1.02-1.41, I² = 0.0%).
The subgroup with a UA endpoint <7 mg/dl was not associated with a higher
CVE risk (RR: 0.57, 95% CI 0.35-0.92, I² = 0.0%), and in the
subgroup with a UA endpoint <5 mg/dl group, a lower risk of CVEs was not
observed (RR: 0.99, 95% CI 0.69-1.44, I² = 0.0%).
<br/>Conclusion(s): UA reduction caused by XOIs reduced the incidence of
MACEs. UA-lowering medicines were associated with changes in all-cause
mortality but not cardiovascular outcomes. The lower UA endpoint was not
associated with reduced cardiovascular risk.<br/>&#xa9; Copyright &#xa9;
2021 Ying, Yuan, Tang, Guo, Jiang and Jiang.

<44>
Accession Number
2028115896
Title
Real-world clinical outcomes of oral anticoagulants among Japanese
patients with atrial fibrillation and concomitant coronary artery disease.
Source
IJC Heart and Vasculature. 49 (no pagination), 2023. Article Number:
101285. Date of Publication: December 2023.
Author
Chen Y.; Gong X.; Bao H.
Institution
(Chen, Gong) Boehringer Ingelheim, Shanghai, China
(Bao) Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, United
States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Stroke prevention is complicated in patients with atrial
fibrillation (AF) and coronary artery disease (CAD). We compared the risk
of major bleeding among Japanese patients with AF and CAD commencing
warfarin, dabigatran, or rivaroxaban. <br/>Method(s): This study included
adults with AF and CAD who were newly prescribed the non-vitamin K
antagonist oral anticoagulants (NOACs) dabigatran or rivaroxaban, or
warfarin, and registered between 18 April 2011 through 31 December 2020 in
the Medical Data Vision hospital-based clinical database. The primary
outcome was major bleeding, and the secondary outcome was a composite of
stroke, systemic embolism, myocardial infarction, all-cause inpatient
mortality, major bleeding, major gastrointestinal bleeding, and
intracerebral hemorrhage. Cox proportional hazard models with stabilized
inverse probability treatment weighting were used to estimate hazard
ratios (HRs) with 95 % CIs via a two-step approach; first between warfarin
and each NOAC, then between NOACs if sample size conditions were met.
<br/>Result(s): Dabigatran, rivaroxaban, and warfarin groups included
6712, 20,329, and 12,316 patients, respectively. Major bleeding risk was
lower in NOACs versus warfarin (dabigatran: HR 0.50, 95 % CI: 0.40-0.62;
rivaroxaban: HR 0.78, 95 % CI: 0.69-0.90); this risk was lower with
dabigatran compared with rivaroxaban (HR 0.64, 95 % CI: 0.51-0.79). Net
clinical benefit was superior to warfarin in both NOACs (dabigatran: HR
0.78, 95 % CI: 0.71-0.85; rivaroxaban: HR 0.83, 95 % CI: 0.78-0.88).
<br/>Conclusion(s): Among real-world Japanese patients with AF and CAD,
NOACs were associated with better clinical outcomes than warfarin.
Treatment with dabigatran had a lower risk of major bleeding than
rivaroxaban. Clinical trial registration: NCT05051904
(ClinicalTrials.gov)<br/>Copyright &#xa9; 2023

<45>
[Use Link to view the full text]
Accession Number
2028057653
Title
Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided
Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial.
Source
Circulation. 148(16) (pp 1195-1206), 2023. Date of Publication: 17 Oct
2023.
Author
Kang D.-Y.; Ahn J.-M.; Yun S.-C.; Hur S.-H.; Cho Y.-K.; Lee C.H.; Hong
S.J.; Lim S.; Kim S.-W.; Won H.; Oh J.-H.; Choe J.C.; Hong Y.J.; Yoon
Y.-H.; Kim H.; Choi Y.; Lee J.; Yoon Y.W.; Kim S.-J.; Bae J.-H.; Park
D.-W.; Park S.-J.
Institution
(Kang, Ahn, Kim, Choi, Lee, Park, Park) Division of Cardiology, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Yun) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Hur, Cho, Lee) Division of Cardiology, Keimyung University Dongsan
Hospital, Daegu, South Korea
(Hong, Lim) Department of Cardiology, Cardiovascular Center, Korea
University Anam Hospital, Seoul, South Korea
(Kim) Division of Cardiology, Chung-Ang University Gwangmyeong Hospital,
Chung-Ang University College of Medicine, South Korea
(Won) Division of Cardiology, Chung-Ang University Hospital, Chung-Ang
University College of Medicine, Seoul, South Korea
(Oh, Choe) Division of Cardiology, Department of Internal Medicine,
Medical Research Institute, Pusan National University Hospital, South
Korea
(Hong) Department of Cardiology, Chonnam National University Hospital,
Chonnam National University Medical School, Gwangju, South Korea
(Yoon) Division of Cardiology, Chungnam National University Sejong
Hospital, South Korea
(Yoon) Division of Cardiology, Heart Center, Gangnam Severance Hospital,
Yonsei University College of Medicine, Seoul, South Korea
(Kim) Department of Cardiology, College of Medicine, Kyung Hee University,
Seoul, South Korea
(Bae) Department of Cardiology, Konyang University Hospital, Daejeon,
South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Intravascular imaging-guided percutaneous coronary
intervention (PCI) with intravascular ultrasound (IVUS) or optical
coherence tomography (OCT) showed superior clinical outcomes compared with
angiography-guided PCI. However, the comparative effectiveness of
OCT-guided and IVUS-guided PCI regarding clinical outcomes is unknown.
<br/>METHOD(S): In this prospective, multicenter, open-label, pragmatic
trial, we randomly assigned 2008 patients with significant coronary artery
lesions undergoing PCI in a 1:1 ratio to undergo either an OCT-guided or
IVUS-guided PCI. The primary end point was a composite of death from
cardiac causes, target vessel-related myocardial infarction, or
ischemia-driven target-vessel revascularization at 1 year, which was
powered for noninferiority of the OCT group compared with the IVUS group.
Safety outcomes were also assessed. <br/>RESULT(S): At 1 year, primary end
point events occurred in 25 of 1005 patients (Kaplan-Meier estimate, 2.5%)
in the OCT group and in 31 of 1003 patients (Kaplan-Meier estimate, 3.1%)
in the IVUS group (absolute difference, -0.6 percentage points; upper
boundary of one-sided 97.5% CI, 0.97 percentage points; P<0.001 for
noninferiority). The incidence of contrast-induced nephropathy was similar
(14 patients [1.4%] in the OCT group versus 15 patients [1.5%] in the IVUS
group; P=0.85). The incidence of major procedural complications was lower
in the OCT group than in the IVUS group (22 [2.2%] versus 37 [3.7%];
P=0.047), although imaging procedure-related complications were not
observed. <br/>CONCLUSION(S): In patients with significant coronary artery
lesions, OCT-guided PCI was noninferior to IVUS-guided PCI with respect to
the incidence of a composite of death from cardiac causes, target
vessel-related myocardial infarction, or ischemia-driven target-vessel
revascularization at 1 year. The selected study population and
lower-than-expected event rates should be considered in interpreting the
trial. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique number:
NCT03394079.<br/>Copyright &#xa9; 2023 Lippincott Williams and Wilkins.
All rights reserved.

<46>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023 The
Authors

<47>
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.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<48>
[Use Link to view the full text]
Accession Number
2026311348
Title
Rhomboid intercostal block or thoracic paravertebral block for
postoperative recovery quality after video-assisted thoracic surgery: A
prospective, non-inferiority, randomised controlled trial.
Source
European Journal of Anaesthesiology. 40(9) (pp 652-659), 2023. Date of
Publication: 01 Sep 2023.
Author
Wang X.; Jia X.; Li Z.; Zhou Q.
Institution
(Wang, Jia, Li, Zhou) Department of Anaesthesiology and Pain Medicine,
Affiliated Hospital of Jiaxing University, Zhejiang Province, Jiaxing,
China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe analgesic characteristics of rhomboid intercostal block
(RIB) remain unclear. Before it can be fully recommended, we compared the
recovery quality and analgesic effects of RIB and thoracic paravertebral
block (TPVB) for video-assisted thoracoscopic surgery (VATS).OBJECTIVEThe
current study aimed to investigate whether there is a difference in
postoperative recovery quality between TPVB and RIB.DESIGNA prospective,
non-inferiority, randomised controlled trial.SETTINGAffiliated Hospital of
Jiaxing University in China from March 2021 to August 2022.PATIENTSEighty
patients aged 18 to 80 years, with ASA physical status I to III, and
scheduled for elective VATS were enrolled in the
trial.INTERVENTIONUltrasound-guided TPVB or RIB was performed with 20 ml
0.375% ropivacaine.MAIN OUTCOME MEASURESThe primary outcome of the study
was the mean difference of quality of recovery-40 scores 24 h
postoperatively. The non-inferiority margin was defined as 6.3. Numeric
rating scores (NRS) for pain at 0.5, 1, 3, 6, 12, 24 and 48 h
postoperatively in all patients were also recorded.RESULTSA total of 75
participants completed the study. The mean difference of quality of
recovery-40 scores 24 h postoperatively was -1.6 (95% CI, -4.5 to 1.3),
demonstrating the non-inferiority of RIB to TPVB. There was no significant
difference between the two groups in the area under the curve for pain NRS
over time, at rest and on movement, at 6, 12, 24 and 48 h postoperatively
(all P > 0.05), except for the area under the curve pain NRS over time on
movement at 48 h postoperatively (P = 0.046). There were no statistical
differences between the two groups in the postoperative sufentanil use at
0 to 24 h or 24 to 48 h (all P > 0.05).CONCLUSIONOur study suggests that
RIB was non-inferior to TPVB for the quality of recovery, with almost the
same postoperative analgesic effect as TPVB after VATS.CLINICAL TRIAL
REGISTRATIONchictr.org.cn: ChiCTR2100043841.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<49>
Accession Number
2023162403
Title
Right ventricular failure: Current strategies and future development.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 998382. Date of Publication: 2023.
Author
Monteagudo-Vela M.; Tindale A.; Monguio-Santin E.; Reyes-Copa G.; Panoulas
V.
Institution
(Monteagudo-Vela, Monguio-Santin, Reyes-Copa) Cardiothoracic Surgery
Department, Hospital Universitario de la Princesa, Madrid, Spain
(Monteagudo-Vela) Department of Cardiothoracic Transplantation and
Mechanical Circulatory Support, Royal Brompton and Harefield Hospitals,
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
(Tindale, Panoulas) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
(Tindale, Panoulas) Cardiovascular Sciences, National Heart and Lung
Institute, Imperial College London, London, United Kingdom
Publisher
Frontiers Media SA
Abstract
Right heart failure can be defined as a clinical syndrome consisting of
signs and symptoms of heart failure resulting from right ventricular
dysfunction. Function is normally altered due to three mechanisms: (1)
pressure overload (2) volume overload, or (3) a decrease in contractility
due to ischaemia, cardiomyopathy or arrythmias. Diagnosis is based upon a
combination of clinical assessment plus echocardiographic, laboratory and
haemodynamic parameters, and clinical risk assessment. Treatment includes
medical management, mechanical assist devices and transplantation if
recovery is not observed. Distinct attention to special circumstances such
as left ventricular assist device implantation should be sought. The
future is moving towards new therapies, both pharmacological and device
centered. Immediate diagnosis and management of RV failure, including
mechanical circulatory support where needed, alongside a protocolized
approach to weaning is important in successfully managing right
ventricular failure.<br/>Copyright 2023 Monteagudo-Vela, Tindale,
Monguio-Santin, Reyes-Copa and Panoulas.

<50>
Accession Number
2025296883
Title
Bempedoic Acid can Reduce Cardiovascular Events in Combination with
Statins or As Monotherapy: A Systematic Review and Meta-analysis.
Source
American Journal of Cardiovascular Drugs. 23(6) (pp 695-708), 2023. Date
of Publication: November 2023.
Author
Zhang J.; Guan X.; Zhang B.; Wang J.; Jin X.; Zhao Y.; Li B.
Institution
(Zhang, Guan, Zhang) School of Clinical Medicine, Affiliated Hospital of
Weifang Medical University, Weifang Medical University, Weifang 261053,
China
(Wang) Department of Cardiology, Binzhou Medical University Hospital, No.
661 Huanghe 2nd Road, Shandong Province, Binzhou City 256603, China
(Jin) Department of Geriatrics, Zibo Central Hospital, No. 10, South
Shanghai Road, Zibo, China
(Zhao, Li) Department of Cardiology, Zibo Central Hospital Affiliated to
Binzhou Medical College, NO.10, South Shanghai Road, Zibo, China
Publisher
Adis
Abstract
Aim: Bempedoic acid has shown noteworthy progress in the prevention and
management of atherosclerotic cardiovascular disease (ASCVD) in recent
years. However, there has been a lack of high-quality evidence regarding
the risk reduction of clinical events with bempedoic acid. Therefore, the
aim of this article is to conduct a comprehensive evaluation of the impact
of bempedoic acid on the incidence of cardiovascular events.
<br/>Method(s): A systematic review and meta-analysis of randomized
controlled trials pertaining to bempedoic acid was carried out. We
conducted a systematic search across the Pubmed, Embase, and Cochrane
Central Register of Controlled Trials databases to identify relevant
studies published from inception to 23 April 2023. A total of four trials
comparing the clinical benefit achieved with bempedoic acid versus placebo
were included. <br/>Result(s): Our analysis comprised four trials that
encompassed a total of 17,323 patients. In comparison to the placebo,
bempedoic acid showed a significant reduction in the risk of major adverse
cardiovascular events (MACE) [relative risk (RR), 0.86, 95% confidence
interval (CI) 0.87-0.94]. Additionally, bempedoic acid substantially
lowered the occurrence of fatal or nonfatal myocardial infarction (RR
0.76, 95% CI 0.66-0.89), hospitalization for unstable angina (RR 0.70, 95%
CI 0.55-0.89), and coronary revascularization (RR 0.82, 95% CI 0.73-0.92).
There was also a similar reduction in MACE in patients on the maximally
tolerated statin therapy. <br/>Conclusion(s): Bempedoic acid may reduce
the risk of cardiovascular events regardless of whether the patient is
taking stains or not. Registration: PROSPERO registration number
CRD42023422932.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<51>
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.
<br/>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). <br/>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. <br/>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. <br/>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.

<52>
Accession Number
2028162353
Title
Prospective Study of Risk Factors for Postoperative Atrial Fibrillation
After Cardiac Surgery.
Source
Journal of Surgical Research. 294 (pp 262-268), 2024. Date of Publication:
February 2024.
Author
Bowdish M.E.; Bagiella E.; Giustino G.; Atluri P.; Alexander J.H.;
Thourani V.H.; Gammie J.S.; DeRose J.J.; Taddei-Peters W.C.; Jeffries
N.O.; O'Gara P.T.; Moskowitz A.J.; Gillinov M.; Gelijns A.C.; Ailawadi G.
Institution
(Bowdish) Department of Cardiac Surgery, Cedars-Sinai Medical Center,
Smidt Heart Institute, Los Angeles, CA, United States
(Bagiella, Giustino, Moskowitz, Gelijns) Department of Population Health
Science and Policy, Icahn School of Medicine at Mount Sinai Health, New
York, NY, United States
(Atluri) Department of Surgery, University of Pennsylvania, Philadelphia,
PA, United States
(Alexander) Department of Medicine, Duke University Medical Center,
Durham, NC, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart Institute, Atlanta, GA, United States
(Gammie) Division of Cardiac Surgery, Johns Hopkins Heart and Vascular
Institute, Baltimore, MD, United States
(DeRose) Department of Cardiothoracic and Vascular Surgery,
Montefiore-Einstein Medical Center, New York, NY, United States
(Taddei-Peters) Division of Cardiovascular Sciences, National Heart, Lung,
and Blood Institute, NIH, Bethesda, MD, United States
(Jeffries) National Heart, Lung, and Blood Institute, National Institutes
of Health, Bethesda, MD, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Gillinov) Department of Thoracic & Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Ailawadi) Cardiac Surgery, University of Michigan Health System, Ann
Arbor, MI, United States
Publisher
Academic Press Inc.
Abstract
Introduction: To examine risk factors for new-onset postoperative atrial
fibrillation (POAF) after cardiac surgery. <br/>Method(s): Patients
enrolled in the Cardiothoracic Surgical Trials Network multicenter,
randomized trial of rate control versus rhythm control for POAF were
included. Predictors of POAF were determined using multivariable logistic
regression. <br/>Result(s): Among the 2104 patients who were enrolled
preoperatively, 695 developed POAF (33.0%). Rates of POAF were 28.1% after
isolated coronary artery bypass grafting (CABG), 33.7% after isolated
valve repair or replacement, and 47.3% after CABG plus valve repair or
replacement. Baseline characteristics associated with an increased risk of
POAF identified on multivariable analysis included older age (odds ratio
[OR] 1.57; 95% confidence interval [CI] 1.42-1.73, per 10 y), White race
or non-Hispanic ethnicity (OR 1.52; CI: 1.11-2.07), history of heart
failure (OR 1.55; CI: 1.16-2.08), and history of hypothyroidism (OR 1.42;
CI 1.04-1.94). The type of cardiac procedure was associated with an
increased risk of POAF with both isolated valve repair or replacement (OR
1.33, CI 1.08-1.64) and combined CABG plus valve repair or replacement (OR
1.64, CI 1.24-2.17) having increased risk of POAF compared to isolated
CABG. No preoperative cardiac medication was associated with POAF.
<br/>Conclusion(s): In this prospective cohort of patients, older age, a
history of hypothyroidism, a history of heart failure, and valve repair or
replacement, with or without CABG, and White non-Hispanic race were
associated with an increased risk of POAF.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<53>
Accession Number
2028132628
Title
Letter to the editor regarding "Efficacy of erector spinae plane block for
minimally invasive mitral valve surgery: Results of a double-blind,
prospective randomized placebo-controlled trial".
Source
Journal of Clinical Anesthesia. 92 (no pagination), 2024. Article Number:
111313. Date of Publication: February 2024.
Author
Xue F.-S.; Cheng Y.; Yuan Y.-J.
Institution
(Xue, Cheng, Yuan) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing, China
Publisher
Elsevier Inc.

<54>
Accession Number
2028089065
Title
Treatment Satisfaction and Convenience for Patients With Atrial
Fibrillation on Edoxaban or Vitamin K Antagonists After Transcatheter
Aortic Valve Replacement: A Post Hoc Analysis from the ENVISAGE-TAVI AF
Trial.
Source
American Journal of Cardiology. 209 (pp 212-219), 2023. Date of
Publication: 15 Dec 2023.
Author
Hengstenberg C.; Van Mieghem N.M.; Wang R.; Shi L.; Guo S.; Chen C.; Jin
J.; Ye X.; Dangas G.; Unverdorben M.
Institution
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Vienna General Hospital, Medical University, Vienna, Austria
(Van Mieghem) Department of Cardiology, Erasmus University Medical Centre,
Thoraxcenter, Rotterdam, Netherlands
(Wang, Chen, Jin, Ye, Unverdorben) Daiichi Sankyo, Inc., Basking Ridge,
United States
(Ye, Shi, Guo) Evidera PPD, LLC, Bethesda, Maryland, United States
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital, New York, New York, United States
(Dangas) School of Medicine, National and Kapodistrian University of
Athens, Athens, Greece
Publisher
Elsevier Inc.
Abstract
ENVISAGE-TAVI AF (Edoxaban versus Standard of Care and Their Effects on
Clinical Outcomes in Patients Having Undergone Transcatheter Aortic Valve
Implantation-Atrial Fibrillation; NCT02943785) was a prospective,
randomized, open-label trial comparing non-vitamin K oral anticoagulant
(NOAC) edoxaban with vitamin K antagonists (VKAs) in patients with atrial
fibrillation after successful transcatheter aortic valve replacement
(TAVR). The effect of edoxaban- or VKA-based therapy on patient-reported
outcomes remains unknown, as most studies focus on efficacy and safety.
Pre-TAVR patient-reported expectations and post-TAVR Treatment
Satisfaction and Convenience with edoxaban or VKA treatment (at months 3
and 12) were analyzed using the Perception of Anticoagulation Treatment
Questionnaire (PACT-Q). This analysis included randomized and dosed
patients with an evaluable PACT-Q1 assessment at baseline and >=1
postbaseline assessment (PACT-Q2). Subanalyses included patients
stratified by pre-TAVR anticoagulant (NOAC, VKA, no NOAC/VKA). Edoxaban-
(n = 585) and VKA-treated (n = 522) patients had similar baseline
characteristics and treatment expectations. Pre-TAVR anticoagulant use did
not affect treatment expectations. After TAVR, edoxaban-treated patients
had significantly higher Treatment Satisfaction and Convenience scores
compared with VKA-treated patients at all time points (p <0.001 for all).
Among edoxaban-treated patients, those who received VKAs pre-TAVR were
significantly more satisfied with treatment than those who received NOACs
(p <0.001) or no NOACs/VKAs (p = 0.003); however, there was no significant
difference in the perception of convenience (p = 0.927 and p = 0.092,
respectively). Conversely, among VKA-treated patients, the type of
anticoagulant used pre-TAVR did not affect Treatment Satisfaction or
Convenience scores post-TAVR. In conclusion, patients with atrial
fibrillation who received edoxaban post-TAVR reported significantly higher
Treatment Satisfaction and Convenience scores compared with those who
received VKAs, resulting in a clinically meaningful difference between
treatment groups.<br/>Copyright &#xa9; 2023 The Authors

<55>
Accession Number
2028129001
Title
The role of CD38 in ischemia reperfusion injury in cardiopulmonary bypass
and thoracic transplantation: a narrative review.
Source
Journal of Thoracic Disease. 15(10) (pp 5736-5749), 2023. Date of
Publication: October 2023.
Author
Gouchoe D.A.; Vijayakumar A.; Aly A.H.; Cui E.Y.; Essandoh M.; Gumina
R.J.; Black S.M.; Whitson B.A.
Institution
(Gouchoe, Cui, Black, Whitson) COPPER Laboratory, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Gouchoe) 88th Surgical Operations Squadron, Wright-Patterson Medical
Center, Wright Patterson AFB, OH, United States
(Gouchoe, Vijayakumar, Aly, Whitson) Division of Cardiac Surgery,
Department of Surgery, The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Essandoh) Department of Anesthesiology, The Ohio State University Wexner
Medical Center, Columbus, OH, United States
(Gumina) Division of Cardiovascular Medicine, Department of Internal
Medicine, The Ohio State University Wexner Medical Center, Columbus, OH,
United States
(Gumina, Whitson) Davis Heart and Lung Institute, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Black) Division of Transplantation, Department of Surgery, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Ischemia reperfusion injury (IRI) is often the
underlying cause of endothelium breakdown and damage in cardiac or
transplantation operations, which can lead to disastrous post-operative
consequences. Recent studies of cluster of differentiation 38 (CD38) have
identified its critical role in IRI. Our objective is to provide a
comprehensive overview of CD38-mediated axis, pathways, and potential CD38
translational therapies for reducing inflammation associated with
cardiopulmonary bypass (CPB) or thoracic transplantation and IRI.
<br/>Method(s): We conducted a review of the literature by performing a
search of the PubMed database on 2 April 2023. To find relevant
publications on CD38, we utilized the MeSH terms: "CD38" AND "Ischemia" OR
"CD38" AND "Transplant" OR "CD38" AND "Heart" from 1990-2023. Additional
papers were included if they were felt to be relevant but were not
captured in the MeSH terms. We found 160 papers that met this criterion,
and following screening, exclusion and consensus a total of 36 papers were
included. Key Content and Findings: CD38 is most notably a nicotine
adenine dinucleotide (NAD)⁺ glycohydrolase (NADase), and a
generator of Ca²⁺ signaling secondary messengers. Ultimately,
the release of these secondary messengers leads to the activation of
important mediators of cellular death. In the heart and during thoracic
transplantation, this pathway is intimately involved in a wide variety of
injuries; namely the endothelium. In the heart, activation generally
results in vasoconstriction, poor myocardial perfusion, and ultimately
poor cardiac function. CD38 activation also prevents the accumulation of
atherosclerotic disease. During transplantation, intracellular activation
leads to infiltration of recipient innate immune cells, tissue edema, and
ultimately primary graft dysfunction (PGD). Specifically, in heart
transplantation, extracellular activation could be protective and improve
allograft survival. <br/>Conclusion(s): The knowledge gap in understanding
the molecular basis of IRI has prevented further development of novel
therapies and treatments. The possible interaction of CD38 with CD39 in
the endothelium, and the modulation of the CD38 axis may be a pathway to
improve cardiovascular outcomes, heart and lung donor organ quality, and
overall longevity.<br/>Copyright &#xa9; Journal of Thoracic Disease. All
rights reserved.

<56>
Accession Number
2028151191
Title
1-Year Comparison of PASCAL vs MitraClip for Mitral Valve Transcatheter
Edge-to-Edge Repair: A Quasi-Randomized Study.
Source
JACC: Cardiovascular Interventions. 16(21) (pp 2687-2689), 2023. Date of
Publication: 13 Nov 2023.
Author
Haschemi J.; Haurand J.M.; Oehler D.; Wolff G.; Spieker M.; Polzin A.;
Kelm M.; Horn P.
Publisher
Elsevier Inc.

<57>
Accession Number
2026482919
Title
Impact of Coronary CT Angiography-derived Fractional Flow Reserve on
Downstream Management and Clinical Outcomes in Individuals with and
without Diabetes.
Source
Radiology: Cardiothoracic Imaging. 5(5) (no pagination), 2023. Article
Number: e220276. Date of Publication: October 2023.
Author
Gulsin G.S.; Tzimas G.; Holmes K.-R.; Takagi H.; Sellers S.L.; Blanke P.;
Koweek L.M.H.; Norgaard B.L.; Jensen J.; Rabbat M.G.; Pontone G.;
Fairbairn T.A.; Chinnaiyan K.M.; Douglas P.S.; Huey W.; Matsuo H.; Sand
N.P.R.; Nieman K.; Bax J.J.; Amano T.; Kawasaki T.; Akasaka T.; Rogers C.;
Berman D.S.; Patel M.R.; De Bruyne B.; Mullen S.; Leipsic J.A.
Institution
(Gulsin, Tzimas, Holmes, Takagi, Sellers, Blanke, Leipsic) Department of
Medicine and Radiology, University of British Columbia, 1081 Burrard St,
Vancouver, BC V6T 1Z3, Canada
(Gulsin) Department of Cardiovascular Sciences, University of Leicester
and the NIHR Biomedical Research Centre, Glenfield Hospital, Leicester,
United Kingdom
(Tzimas) Department of Heart Vessels, Cardiology Service, Lausanne
University Hospital and University of Lausanne, Lausanne, Switzerland
(Sellers, Leipsic) Centre for Heart Lung Innovation, University of British
Columbia and St Paul's Hospital, Vancouver, BC, Canada
(Koweek, Patel) Division of Cardiology, Department of Medicine, Duke
University Medical Center, Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Norgaard, Jensen) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Rabbat) Department of Cardiology, Loyola University of Chicago, Chicago,
IL, United States
(Rabbat) Department of Cardiology, Edward Hines Jr VA Hospital, Hines, IL,
United States
(Pontone) Department of Cardiology, Centro Cardiologico Monzino, Milan,
Italy
(Fairbairn) Department of Cardiology, University of Liverpool, Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
(Chinnaiyan) Department of Cardiology, Beaumont Health, Royal Oak, MI,
United States
(Douglas) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
(Matsuo) Department of Cardiology, Gifu Heart Center, Gifu, Japan
(Sand) Cardiac Research Unit, Institute of Regional Health Research,
University Hospital of SouthWest DK, University of Southern Denmark,
Odense, Denmark
(Nieman) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Amano) Department of Cardiology, Aichi Medical University, Aichi, Japan
(Akasaka) Cardiovascular Center, Shin Koga Hospital, Fukuoka, Japan
(Akasaka) Department of Cardiovascular Medicine, Wakayama Medical
University, Wakayama, Japan
(Huey, Rogers, Mullen) HeartFlow Inc, Redwood City, CA, United States
(Berman) Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai
Heart Institute, Los Angeles, CA, United States
(De Bruyne) Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
Publisher
Radiological Society of North America Inc.
Abstract
Purpose: To compare the clinical use of coronary CT angiography
(CCTA)-derived fractional flow reserve (FFR) in individuals with and
without diabetes mellitus (DM). <br/>Material(s) and Method(s): This
secondary analysis included participants (enrolled July 2015 to October
2017) from the prospective, multicenter, international The Assessing
Diagnostic Value of Noninvasive CT-FFR in Coronary Care (ADVANCE) registry
(ClinicalTrials. gov identifier, NCT 02499679) who were evaluated for
suspected coronary artery disease (CAD), with one or more coronary
stenosis >=30% on CCTA images, using CT-FFR. CCTA and CT-FFR findings,
treatment strategies at 90 days, and clinical outcomes at 1-year follow-up
were compared in participants with and without DM. <br/>Result(s): The
study included 4290 participants (mean age, 66 years +/- 10 [SD]; 66% male
participants; 22% participants with DM). Participants with DM had more
obstructive CAD (one or more coronary stenosis >=50%; 78.8% vs 70.6%, P <
.001), multivessel CAD (three-vessel obstructive CAD; 18.9% vs 11.2%, P <
.001), and proportionally more vessels with CT-FFR <= 0.8 (74.3% vs 64.6%,
P < .001). Treatment reclassification by CT-FFR occurred in two-thirds of
participants which was consistent regardless of the presence of DM. There
was a similar graded increase in coronary revascularization with declining
CT-FFR in both groups. At 1 year, presence of DM was associated with
higher rates of major adverse cardiovascular events (hazard ratio, 2.2;
95% CI: 1.2, 4.1; P = .01). However, no between group differences were
observed when stratified by stenosis severity (<50% or >=50%) or CT-FFR
positivity. <br/>Conclusion(s): Both anatomic CCTA findings and CT-FFR
demonstrated a more complex pattern of CAD in participants with versus
without DM. Rates of treatment reclassification were similar regardless of
the presence of DM, and DM was not an adverse prognostic indicator when
adjusted for diameter stenosis and CT-FFR.<br/>Copyright &#xa9; RSNA,
2023.

<58>
[Use Link to view the full text]
Accession Number
2027599314
Title
Dyslipidemia and aortic valve disease.
Source
Current Opinion in Lipidology. 32(6) (pp 349-354), 2021. Date of
Publication: 01 Dec 2021.
Author
Mata P.; Alonso R.; Perez De Isla L.; Badimon L.
Institution
(Mata, Alonso, Perez De Isla, Badimon) Fundacion Hipercolesterolemia
Familiar, Madrid, Spain
(Alonso) Center for Advanced Metabolic Medicine and Nutrition, Santiago,
Chile
(Perez De Isla) Cardiology Department, Hospital Clinico San Carlos,
IDISSC, Facultad de Medicina, Universidad Complutense, Madrid, Spain
(Badimon) Cardiovascular Program-ICCC, Institut de Recerca Del Hospital
Santa Creu i Sant Pau, IIB Sant Pau, Ciber CV, Barcelona, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewDegenerative aortic stenosis (AS) is one of the most
prevalent heart valve diseases in the adult population. The understanding
of AS pathophysiology and involved risk factors have recently undergone a
great advance, with low-density lipoprotein cholesterol (LDL-C),
lipoprotein (a) [Lp(a)] and other clinical conditions taking on a relevant
role. Although little is known about the prevention of AS, we can
progressively find more evidence of the possible use of drugs to control
risk factors as tools that may delay the progression to severe AS and
aortic valve replacement.Recent findingsSeveral factors have shown to be
solid predictors of the development of AS. Mendelian randomization and
observational studies on risk factors specifically lipid factors, such as
hypercholesterolemia, Lp(a), proprotein convertase subtilisin/kexin type 9
and hypertension have provided meaningful new information. The SAFEHEART
study has significantly contributed to define the role of LDL-C and Lp(a)
in AS.SummaryIn this review we discuss the interrelationship of
dyslipidemia, especially hypercholesterolemia and Lp(a) in the development
and prognosis of valvular AS. New imaging tools may contribute to its
early detection. Future studies with proprotein convertase
subtilisin/kexin type 9 inhibitors and specific therapies to lower Lp(a)
might contribute to delay AS development.<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<59>
Accession Number
2026402184
Title
Efficacy and Safety of Colchicine in Post-acute Myocardial Infarction
Patients: A Systematic Review and Meta-Analysis of Randomized Controlled
Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 676771. Date of Publication: 2021.
Author
Diaz-Arocutipa C.; Benites-Meza J.K.; Chambergo-Michilot D.; Barboza J.J.;
Pasupuleti V.; Bueno H.; Sambola A.; Hernandez A.V.
Institution
(Diaz-Arocutipa, Barboza, Hernandez) Vicerrectorado de Investigacion,
Universidad San Ignacio de Loyola, Lima, Peru
(Diaz-Arocutipa) Programa de Atencion Domiciliaria - EsSalud, Lima, Peru
(Benites-Meza, Chambergo-Michilot, Barboza) Tau Relaped Group, Trujillo,
Peru
(Benites-Meza) Facultad de Medicina, Universidad Nacional de Trujillo,
Trujillo, Peru
(Chambergo-Michilot) Facultad de Ciencias de la Salud, Universidad
Cientifica del Sur, Lima, Peru
(Pasupuleti) MedErgy HealthGroup, Inc, Yardley, PA, United States
(Bueno) Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
(Bueno) Cardiology Department, Hospital Universitario 12 de Octubre,
Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12),
Madrid, Spain
(Bueno) Facultad de Medicina, Universidad Complutense de Madrid, Madrid,
Spain
(Bueno, Sambola) Centro de Investigacion Biomedica en Red Enfermedades
Cardiovasculares, Madrid, Spain
(Sambola) Department of Cardiology, University Hospital Vall d'hebron,
Universitat Autonoma, Barcelona, Spain
(Hernandez) Health Outcomes, Policy, and Evidence Synthesis Group,
University of Connecticut School of Pharmacy, Storrs, CT, United States
Publisher
Frontiers Media SA
Abstract
Background: Inflammation plays a key role in atherosclerotic plaque
destabilization and adverse cardiac remodeling. Recent evidence has shown
a promising role of colchicine in patients with coronary artery disease.
We evaluated the efficacy and safety of colchicine in post-acute
myocardial infarction (MI) patients. <br/>Method(s): We searched five
electronic databases from inception to January 18, 2021, for randomized
controlled trials (RCTs) evaluating colchicine in post-acute MI patients.
Primary outcomes were cardiovascular mortality and recurrent MI. Secondary
outcomes were all-cause mortality, stroke, urgent coronary
revascularization, levels of follow-up high-sensitivity C-reactive protein
(hs-CRP), and drug-related adverse events. All meta-analyses used
inverse-variance random-effects models. <br/>Result(s): Six RCTs involving
6,005 patients were included. Colchicine did not significantly reduce
cardiovascular mortality [risk ratio (RR), 0.91; 95% confidence interval
(95% CI), 0.52-1.61; p = 0.64], recurrent MI (RR, 0.87; 95% CI, 0.62-1.22;
p = 0.28), all-cause mortality (RR, 1.06; 95% CI, 0.61-1.85; p = 0.78),
stroke (RR, 0.28; 95% CI, 0.07-1.09; p = 0.05), urgent coronary
revascularization (RR, 0.46; 95% CI, 0.02-8.89; p = 0.19), or decreased
levels of follow-up hs-CRP (mean difference, -1.95 mg/L; 95% CI, -12.88 to
8.98; p = 0.61) compared to the control group. There was no increase in
any adverse events (RR, 0.97; 95% CI, 0.89-1.07; p = 0.34) or
gastrointestinal adverse events (RR, 2.49; 95% CI, 0.48-12.99; p = 0.20).
Subgroup analyses by colchicine dose (0.5 vs. 1 mg/day), time of follow-up
(<1 vs. >=1 year), and treatment duration (<=30 vs. >30 days) showed no
changes in the overall findings. <br/>Conclusion(s): In post-acute MI
patients, colchicine does not reduce cardiovascular or all-cause
mortality, recurrent MI, or other cardiovascular outcomes. Also,
colchicine did not increase drug-related adverse events.<br/>Copyright
&#xa9; 2021 Diaz-Arocutipa, Benites-Meza, Chambergo-Michilot, Barboza,
Pasupuleti, Bueno, Sambola and Hernandez.

<60>
Accession Number
2026402057
Title
Association Between Previous or Active Cancer and Clinical Outcomes in
TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 763557. Date of Publication: 2021.
Author
Diaz-Arocutipa C.; Torres-Valencia J.; Zavaleta-Camacho G.; Vicent L.
Institution
(Diaz-Arocutipa) Vicerrectorado de Investigacion, Universidad San Ignacio
de Loyola, Lima, Peru
(Diaz-Arocutipa) Programa de Atencion Domiciliaria - EsSalud, Lima, Peru
(Torres-Valencia, Zavaleta-Camacho) Departamento de Cardiologia, Hospital
Nacional Edgardo Rebagliati Martins, Lima, Peru
(Torres-Valencia, Zavaleta-Camacho) Facultad de Medicina Alberto Hurtado,
Universidad Peruana Cayetano Heredia, Lima, Peru
(Vicent) Cardiology Department, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Vicent) Instituto de Investigacion Sanitaria Hospital 12 de Octubre
(imas12), Madrid, Spain
Publisher
Frontiers Media SA
Abstract
Background: It has been proposed that transcatheter aortic valve
replacement (TAVR) may be an option for patients with cancer and severe
aortic stenosis. We assessed the association between previous or active
cancer and clinical outcomes in TAVR patients. <br/>Method(s): We searched
four electronic databases from inception to March 05, 2021. The primary
outcome was all-cause mortality. Secondary outcomes were cardiovascular
mortality, myocardial infarction, stroke, acute kidney injury, pacemaker
implantation, major bleeding, and vascular complications. All
meta-analyses were performed using a random-effects model. Relative risks
(RRs) and adjusted hazard ratios (aHRs) with their 95% confidence interval
(95% CI) were pooled. <br/>Result(s): Thirteen cohort studies involving
255,840 patients were included. The time period for mortality ranged from
inpatient to 10 years. Patients with active cancer had a higher risk of
all-cause mortality using both crude (RR, 1.46; 95% CI, 1.13-1.88) and
adjusted (aHR, 1.79; 95% CI, 1.43-2.25) estimates compared to non-cancer
group. In contrast, the risk of cardiovascular mortality (RR, 1.26; 95%
CI, 0.58-2.73), myocardial infarction (RR, 0.94; 95% CI, 0.34-2.57),
stroke (RR, 0.90; 95% CI, 0.75-1.09), pacemaker implantation (RR, 0.87;
95% CI, 0.50-1.53), acute kidney injury (RR, 0.88; 95% CI, 0.74-1.04),
major bleeding (RR, 1.15; 95% CI, 0.80-1.66), and vascular complications
(RR, 0.96; 95% CI, 0.79-1.18) was similar between patients with or without
cancer. <br/>Conclusion(s): Our review shows that TAVR patients with
active cancer had an increased risk of all-cause mortality. No significant
association with secondary outcomes was found.<br/>Copyright &#xa9; 2021
Diaz-Arocutipa, Torres-Valencia, Zavaleta-Camacho and Vicent.

<61>
Accession Number
2026401975
Title
Dual Antiplatelet Therapy vs. Single Antiplatelet Therapy After
Transcatheter Aortic Valve Replacement: An Updated Systematic Review and
Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 679703. Date of Publication: 2021.
Author
Zhang Y.; Shen L.; Yang W.; He B.
Institution
(Zhang, Shen, Yang, He) Department of Cardiology, Shanghai Chest Hospital,
Shanghai Jiao Tong University, Shanghai, China
(Zhang, Shen, Yang, He) Shanghai Jiao Tong University School of Medicine,
Shanghai, China
Publisher
Frontiers Media SA
Abstract
Background: Although mainstream guidelines recommend dual antiplatelet
therapy (DAPT) with aspirin and clopidogrel in patients following
transcatheter aortic valve replacement (TAVR), it is not evidence-based.
We aim to investigate the safety and efficacy of DAPT vs. single
antiplatelet therapy (SAPT) after TAVR, and review updated evidence.
<br/>Method(s): We systematically searched PubMed, Embase, and Cochrane
for studies comparing DAPT to SAPT after TAVR from inception to November
30, 2020. The primary outcome was major adverse cardiac and
cerebrovascular events, including all-cause mortality, cardiovascular
death, myocardial infarction (MI), stroke, and major or life-threatening
bleeding (LTB). Subgroup analysis was performed according to study type
(randomized control trials vs. observational studies) using a
fixed-effects model. The quality of evidence was assessed by two scoring
systems and GRADE (Grading of Recommendations Assessment, Development, and
Evaluation). <br/>Result(s): Twelve studies of 20,766 patients were
included in our meta-analysis. Compared with SAPT, DAPT was associated
with an increased risk for combined life threatening and major bleeding
[OR 1.73 (1.19-2.51), p = 0.004] after TAVR. Such a difference was largely
driven by major bleeding [OR 2.29 (1.68-3.11), p < 0.001]. There were no
significant differences on major adverse cardiovascular events (MACE) [OR
1.19 (0.99-1.44), p = 0.07], cardiovascular mortality [OR 1.46
(0.93-2.30), p = 0.10], and stroke [OR 0.97 (0.80-1.16), p = 0.71].
<br/>Conclusion(s): Compared with SAPT, post-TAVR DAPT was associated with
increased risks of major or life-threatening bleeding without additional
benefits of reducing thrombotic events. Future guidelines for post-TAVR
antiplatelet strategy are expected to be updated as new high-quality
evidence emerges. Systematic Review Registration: PROSPERO, Identifier:
CRD42021230075.<br/>Copyright &#xa9; 2021 Zhang, Shen, Yang and He.

<62>
Accession Number
2026401953
Title
Mitral Valve Surgery in Patients With Rheumatic Heart Disease: Repair vs.
Replacement.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 685746. Date of Publication: 2021.
Author
Fu G.; Zhou Z.; Huang S.; Chen G.; Liang M.; Huang L.; Wu Z.
Institution
(Fu, Zhou, Huang, Chen, Liang, Huang, Wu) Department of Cardiac Surgery,
First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
(Fu, Zhou, Huang, Chen, Liang, Huang, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-sen University, Guangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: High morbidity and mortality caused by rheumatic heart disease
(RHD) are global burdens, especially in low-income and developing
countries. Whether mitral valve repair (MVP) benefits RHD patients remains
controversial. Thus, we performed a meta-analysis to compare the
perioperative and long-term outcomes of MVP and mitral valve replacement
(MVR) in RHD patients. <br/>Methods and Results: A systematic literature
search was conducted in major databases, including Embase, PubMed, and the
Cochrane Library, until 17 December 2020. Studies comparing MVP and MVR in
RHD patients were retained. Outcomes included early mortality, long-term
survival, freedom from reoperation, postoperative infective endocarditis,
thromboembolic events, hemorrhagic events, and freedom from valve-related
adverse events. Eleven studies that met the inclusion criteria were
included. Of a total of 5,654 patients, 1,951 underwent MVP, and 3,703
underwent MVR. Patients who undergo MVP can benefit from a higher
long-term survival rate (HR 0.72; 95% CI, 0.55-0.95; P = 0.020;
I² = 44%), a lower risk of early mortality (RR 0.62; 95% CI,
0.38-1.01; P = 0.060; I² = 42%), and the composite outcomes of
valve-related adverse events (HR 0.60; 95% CI, 0.38-0.94; P = 0.030;
I² = 25%). However, a higher risk of reoperation was observed
in the MVP group (HR 2.60; 95% CI, 1.89-3.57; P<0.001; I² =
4%). Patients who underwent concomitant aortic valve replacement (AVR) in
the two groups had comparable long-term survival rates, although the trend
still favored MVP. <br/>Conclusion(s): For RHD patients, MVP can reduce
early mortality, and improve long-term survival and freedom from
valve-related adverse events. However, MVP was associated with a higher
risk of reoperation. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=228307.<br
/>Copyright &#xa9; 2021 Fu, Zhou, Huang, Chen, Liang, Huang and Wu.

<63>
Accession Number
2026401944
Title
Transcarotid Access Versus Transfemoral Access for Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 687168. Date of Publication: 2021.
Author
Lu H.; Monney P.; Hullin R.; Fournier S.; Roguelov C.; Eeckhout E.;
Rubimbura V.; Faroux L.; Barrier A.; Muller O.; Kirsch M.
Institution
(Lu, Monney, Hullin, Fournier, Roguelov, Eeckhout, Rubimbura, Muller)
Service of Cardiology, Lausanne University Hospital, University of
Lausanne, Lausanne, Switzerland
(Faroux) Cardiology Department, Reims University Hospital, Reims, France
(Barrier) Service of Internal Medicine, Lausanne University Hospital,
University of Lausanne, Lausanne, Switzerland
(Kirsch) Service of Cardiovascular Surgery, Lausanne University Hospital,
University of Lausanne, Lausanne, Switzerland
Publisher
Frontiers Media SA
Abstract
Background: The transfemoral (TF) route is the gold-standard access for
transcatheter aortic valve replacement (TAVR). In 10-15% of patients,
alternative accesses are needed, such as the transcarotid (TC) access. We
performed a meta-analysis to compare 30-day mortality and complications
between TC-TAVR and TF-TAVR. <br/>Method(s): We searched PubMed/MEDLINE
and EMBASE from inception to January 2021 to identify articles comparing
TC-TAVR and TF-TAVR. Patients' baseline characteristics, procedural
outcomes, and clinical 30-day outcomes were extracted. <br/>Result(s): We
identified 9 studies, among which 2 used propensity-score matching,
including 1,374 TC patients and 3,706 TF patients. TC-TAVR was associated
with significantly higher EuroSCORE II and Logistic EuroSCORE values
(respectively 8.0 +/- 6.7 vs. 6.3 +/- 5.4, p = 0.002 and 20.8 +/- 14.2%
vs. 20.0 +/- 13.4%, p = 0.04), a higher prevalence of peripheral artery
disease (52.6 vs. 32.8%, p = 0.001), previous cardiac surgery (26.3 vs.
22.4%, p = 0.008) and coronary artery disease (64.6 vs. 60.5%, p = 0.020).
The pooled results found TC-TAVR to be associated with a significantly
higher 30-day mortality risk (RR, 1.41, 95% CI, 1.02-1.96, p = 0.040), and
a lower rate of 30-day major vascular complications (RR, 0.48, 95% CI,
0.25-0.92, p = 0.030). No significant difference was found regarding
permanent pacemaker implantation, major bleeding and acute kidney injury.
A subgroup analysis of the two propensity-score matched studies found a
statistically increased risk of 30-day neurovascular complications (RR,
1.61, 95% CI, 1.02-2.55, p = 0.040). <br/>Conclusion(s): Compared with
TF-TAVR, TC-TAVR was associated with an increased risk of 30-day
mortality, likely related to a higher surgical risk and comorbidity
burden, and with an increased risk of 30-day neurovascular complications.
Careful preprocedural patient selection and close periprocedural
neurological monitoring are paramount.<br/>Copyright &#xa9; 2021 Lu,
Monney, Hullin, Fournier, Roguelov, Eeckhout, Rubimbura, Faroux, Barrier,
Muller and Kirsch.

<64>
Accession Number
2026401941
Title
Association Between the Circulating Level of 25-Hydroxyvitamin D and
Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic
Review.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 734504. Date of Publication: 2021.
Author
Zhang Y.; Li J.; Qiu Y.; Gong X.; He Y.; Yue P.; Zheng X.; Liu L.; Liao
H.; Zhou K.; Hua Y.; Li Y.
Institution
(Zhang, Li, Qiu, Gong, He, Yue, Zheng, Liu, Liao, Zhou, Hua, Li) Key
Laboratory of Birth Defects and Related Diseases of Women and Children of
MOE, Department of Pediatrics, West China Second University Hospital,
Sichuan University, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Vitamin D (VitD) is an important pleiotropic hormone for organ
systems. Studies have focused on the level of VitD, especially that of
25-hydroxyvitamin D (25-(OH)-VitD), in patients after cardiac surgery and
the relationship between VitD deficiency and adverse outcomes, but the
results have been inconsistent. We carried out a meta-analysis to evaluate
differences in the 25-(OH)-VitD level before and after cardiac surgery,
and evaluated the predictive value of 25-(OH)-VitD level in the clinical
outcomes of patients undergoing cardiac surgery. <br/>Method(s): Studies
related to VitD level and cardiac surgery were searched from PubMed,
EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials
databases from inception to October 2020. We applied the Newcastle-Ottawa
Scale to assess the risk of a bias in individual studies. We examined the
heterogeneity and publication bias and performed subgroup analyses and
sensitivity analyses. <br/>Result(s): Fifteen studies were included in our
analysis. The 25-(OH)-VitD level was significantly lower immediately after
surgery [stand mean difference (SMD), 0.69; 95%CI (0.1, 1.28), P = 0.023]
and 24-h after surgery [0.84; (0.47, 1.21), 0.000] compared with that
before surgery. A higher prevalence of 25-(OH)-VitD deficiency was
recorded 24 h after surgery [RR, 0.59; 95%CI (0.47, 0.73), P = 0.00].
Pooled results demonstrated a significant relationship between the
preoperative 25-(OH)-VitD level and vasoactive-inotropic score (VIS) [SMD,
-3.71; 95%CI (-6.32, -1.10); P = 0.005], and patients with 25-(OH)-VitD
deficiency revealed a comparatively poor prognosis and severe condition
after cardiac surgery [-0.80; (-1.41, -0.19), 0.01]. However, 25-(OH)-VitD
deficiency was not associated with the duration of stay in the intensive
care unit. <br/>Conclusion(s): Cardiac surgery would leads to deficiency
of 25-(OH)-VitD. And the preoperative and postoperative levels of
25-(OH)-VitD are associated with adverse events, which is eligible to work
as an indicator to demonstrate clinical outcomes.<br/>Copyright &#xa9;
2021 Zhang, Li, Qiu, Gong, He, Yue, Zheng, Liu, Liao, Zhou, Hua and Li.

<65>
Accession Number
2026401891
Title
Incidence, Risk Factors and Outcomes of Postoperative Headache After
Stanford Type a Acute Aortic Dissection Surgery.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 781137. Date of Publication: 2021.
Author
Wang D.; Le S.; Luo J.; Chen X.; Li R.; Wu J.; Song Y.; Xie F.; Li X.;
Wang H.; Huang X.; Ye P.; Du X.; Zhang A.
Institution
(Wang, Le, Luo, Chen, Li, Song, Wang, Huang, Du) Department of
Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Wuhan, China
(Wu) Key Laboratory for Molecular Diagnosis of Hubei Province, The Central
Hospital of Wuhan, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan, China
(Xie) Department of Cardiovascular Surgery, First Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Li) Department of Nursing, Huaihe Hospital of Henan University, Kaifeng,
China
(Ye, Zhang) Department of Cardiology, The Central Hospital of Wuhan,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative headache (POH) is common in clinical practice,
however, no studies about POH after Stanford type A acute aortic
dissection surgery (AADS) exist. This study aims to describe the
incidence, risk factors and outcomes of POH after AADS, and to construct
two prediction models. <br/>Method(s): Adults who underwent AADS from 2016
to 2020 in four tertiary hospitals were enrolled. Training and validation
sets were randomly assigned according to a 7:3 ratio. Risk factors were
identified by univariate and multivariate logistic regression analysis.
Nomograms were constructed and validated on the basis of independent
predictors. <br/>Result(s): POH developed in 380 of the 1,476 included
patients (25.7%). Poorer outcomes were observed in patients with POH.
Eight independent predictors for POH after AADS were identified when both
preoperative and intraoperative variables were analyzed, including younger
age, female sex, smoking history, chronic headache history,
cerebrovascular disease, use of deep hypothermic circulatory arrest, more
blood transfusion, and longer cardiopulmonary bypass time. White blood
cell and platelet count were also identified as significant predictors
when intraoperative variables were excluded from the multivariate
analysis. A full nomogram and a preoperative nomogram were constructed
based on these independent predictors, both demonstrating good
discrimination, calibration, clinical usefulness, and were well validated.
Risk stratification was performed and three risk intervals were defined
based on the full nomogram and clinical practice. <br/>Conclusion(s): POH
was common after AADS, portending poorer outcomes. Two nomograms
predicting POH were developed and validated, which may have clinical
utility in risk evaluation, early prevention, and doctor-patient
communication.<br/>Copyright &#xa9; 2021 Wang, Le, Luo, Chen, Li, Wu,
Song, Xie, Li, Wang, Huang, Ye, Du and Zhang.

<66>
Accession Number
2026401819
Title
Transcatheter Aortic Valve Implantation in Sievers Type 0 vs. Type 1
Bicuspid Aortic Valve Morphology: Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 771789. Date of Publication: 2021.
Author
Du Y.; Wang Z.; Liu W.; Guo Y.; Han W.; Shen H.; Jia S.; Yu Y.; Han K.;
Shi D.; Zhao Y.; Zhou Y.
Institution
(Du, Wang, Liu, Guo, Han, Shen, Jia, Yu, Han, Shi, Zhao, Zhou) Beijing Key
Laboratory of Precision Medicine of Coronary Atherosclerotic Disease,
Department of Cardiology, Clinical Center for Coronary Heart Disease,
Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has achieved
satisfactory outcomes in the selected patients with bicuspid aortic valve
(BAV), predominately type 1 BAV (~90%). However, there are few reports
about the safety and efficacy of TAVI in type 0 BAV. Therefore, in the
current study, we aimed to compare procedural and 30-day outcomes after
TAVI between type 0 and type 1 BAV. <br/>Method(s): Studies comparing the
outcomes of TAVI in Sievers type 0 vs. type 1 BAV were retrieved from
PubMed, EMBASE, Cochrane Library, and Web of Science from inception to May
2021. The data were extracted regarding the study characteristics and
outcomes. The odds ratios (ORs) with 95% CIs were pooled for procedural
and 30-day outcomes. <br/>Result(s): Six observational studies were
included with determined type 0 BAV in 226 patients and type 1 BAV in 902
patients. The patients with type 0 BAV were slightly younger, had larger
supra-annular structure, and more frequently implanted self-expanding
prosthesis compared with type 1 BAV. In the pooled analyses, the patients
with type 0 BAV had a similar incidence of procedural death (OR = 2.6, 95%
CI 0.7-10.3), device success (OR = 0.6; 95% CI 0.3-1.3), and >= mild (OR =
0.8; 95% CI 0.4-1.6) or moderate (OR = 0.9, 95% CI 0.4-1.8) paravalvular
leak, whereas significantly higher mean aortic gradient (mean difference =
1.4 mmHg, 95% CI 0.03-2.7) and increased coronary compromise risk (OR =
7.2; 95% CI 1.5-34.9), compared with type 1 BAV. Meanwhile, the incidence
of death (OR = 1.2; 95% CI 0.5-3.1), stroke (OR = 0.5; 95% CI 0.1-2.4),
and new pacemaker (OR = 0.6; 95% CI 0.2-2.2) at 30 days were not
significantly different between the BAV morphologies (p > 0.05). The
treatment effect heterogeneity across the studies for the above outcomes
were low. <br/>Conclusion(s): The patients with type 0 BAV appear to have
similar short-term outcomes after TAVI compared with type 1 BAV. Whereas,
TAVI for type 0 BAV aortic stenosis might lead to an elevated coronary
obstruction risk and suboptimal aortic valvular
hemodynamics.<br/>Copyright &#xa9; 2021 Du, Wang, Liu, Guo, Han, Shen,
Jia, Yu, Han, Shi, Zhao and Zhou.

<67>
Accession Number
2026401802
Title
Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring
Selection.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 799994. Date of Publication: 2021.
Author
Jedrzejczyk J.H.; Carlson Hanse L.; Javadian S.; Skov S.N.; Hasenkam J.M.;
Thornild M.J.
Institution
(Jedrzejczyk, Carlson Hanse, Javadian, Skov, Hasenkam, Thornild)
Department of Cardiothoracic and Vascular Surgery, Aarhus University
Hospital, Aarhus, Denmark
(Jedrzejczyk, Carlson Hanse, Javadian, Skov, Hasenkam, Thornild)
Department of Clinical Medicine, Aarhus University Hospital, Aarhus,
Denmark
(Hasenkam) Department of Surgery, University of the Witwatersrand,
Johannesburg, South Africa
Publisher
Frontiers Media SA
Abstract
Objectives: To provide an overview that describes the characteristics of a
mitral annuloplasty device when treating patients with a specific type of
mitral regurgitation according to Carpentier's classification of mitral
regurgitation. <br/>Method(s): Starting with the key search term "mitral
valve annuloplasty," a literature search was performed utilising PubMed,
Google Scholar, and Web of Science to identify relevant studies. A
systematic approach was used to assess all publications. <br/>Result(s):
Mitral annuloplasty rings are traditionally categorised by their
mechanical compliance in rigid-, semi-rigid-, and flexible rings. There is
a direct correlation between remodelling capabilities and rigidity. Thus,
a rigid annuloplasty ring will have the highest remodelling capability,
while a flexible ring will have the lowest. Rigid- and semi-rigid rings
can furthermore be divided into flat and saddled-shaped rings.
Saddle-shaped rings are generally preferred over flat rings since they
decrease annular and leaflet stress accumulation and provide superior
leaflet coaptation. Finally, mitral annuloplasty rings can either be
complete or partial. <br/>Conclusion(s): A downsized rigid- or semi-rigid
ring is advantageous when higher remodelling capabilities are required to
correct dilation of the mitral annulus, as seen in type I, type IIIa, and
type IIIb mitral regurgitation. In type II mitral regurgitation, a
normosized flexible ring might be sufficient and allow for a more
physiological repair since there is no annular dilatation, which
diminishes the need for remodelling capabilities. However, mitral
annuloplasty ring selection should always be based on the specific
morphology in each patient.<br/>Copyright &#xa9; 2022 Jedrzejczyk, Carlson
Hanse, Javadian, Skov, Hasenkam and Thornild.

<68>
Accession Number
2026401697
Title
Effect of High-Frequency Oscillatory Ventilation Combined With Pulmonary
Surfactant in the Treatment of Acute Respiratory Distress Syndrome After
Cardiac Surgery: A Prospective Randomised Controlled Trial.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 675213. Date of Publication: 2021.
Author
Zheng Y.-R.; Lei Y.-Q.; Liu J.-F.; Wu H.-L.; Xu N.; Huang S.-T.; Cao H.;
Chen Q.
Institution
(Zheng, Lei, Liu, Wu, Xu, Huang, Cao, Chen) Department of Cardiac Surgery,
Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China
(Zheng, Lei, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Children's Hospital,
Fuzhou, China
(Zheng, Lei, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Maternity and Child
Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou,
China
(Zheng, Lei, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Key Laboratory of Women
and Children's Critical Diseases Research, Fujian Maternity and Child
Health Hospital, Fuzhou, China
Publisher
Frontiers Media SA
Abstract
Background: This study aimed to evaluate the effects of pulmonary
surfactant (PS) combined with high-frequency oscillatory ventilation
(HFOV) or conventional mechanical ventilation (CMV) in infants with acute
respiratory distress syndrome (ARDS) after congenital cardiac surgery.
<br/>Method(s): A total of 61 infants with ARDS were eligible and were
randomised to the CMV + PS group (n = 30) or the HFOV + PS group (n = 31)
between January 2020 and December 2020. The primary outcomes were the
changes in arterial blood gas parameters. The duration of mechanical
ventilation, length of hospitalisation and the incidence of complications
were considered secondary outcomes. <br/>Result(s): A total of 61 infants
completed the study. In the HFOV + PS group, the blood gas analysis
results were significantly improved (P < 0.05), while the duration of
mechanical ventilation and length of hospitalisation were shorter than the
CMV + PS group (P < 0.05). However, the incidence of complications was not
different between the two groups (P > 0.05). <br/>Conclusion(s): Compared
with the CMV + PS group, the HFOV + PS group showed significantly improved
ABG variables and had a shortened length of hospitalisation and mechanical
ventilation in infants with ARDS after cardiac surgery. Clinical Trial
Registration: Chinese Clinical Trial Registry; Number:
ChiCTR2000039457.<br/>Copyright &#xa9; 2021 Zheng, Lei, Liu, Wu, Xu,
Huang, Cao and Chen.

<69>
Accession Number
2026401688
Title
Anticoagulation Therapy After Biologic Aortic Valve Replacement.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 698784. Date of Publication: 2021.
Author
Myllykangas M.E.; Kiviniemi T.O.; Gunn J.M.; Salomaa V.V.; Pietila A.;
Niiranen T.J.; Aittokallio J.
Institution
(Myllykangas, Aittokallio) Department of Anesthesiology, Intensive Care,
Emergency Care, and Pain Medicine, University of Turku, Turku, Finland
(Myllykangas, Aittokallio) Division of Perioperative Services, Intensive
Care Medicine, and Pain Management, Turku University Hospital, Turku,
Finland
(Kiviniemi, Gunn) Heart Centre, Turku University Hospital, Turku, Finland
(Kiviniemi, Niiranen) Department of Internal Medicine, University of
Turku, Turku, Finland
(Gunn) Division of Surgery, University of Turku, Turku, Finland
(Salomaa, Pietila, Niiranen) Department of Public Health and Welfare,
Finnish Institute for Health and Welfare, Helsinki, Finland
(Niiranen) Division of Medicine, Turku University Hospital, Turku, Finland
Publisher
Frontiers Media SA
Abstract
Objectives: Thromboembolism prophylaxis after biologic aortic valve
replacement (BAVR) is recommended for 3 months postoperatively. We
examined the continuation of oral anticoagulation (OAC) treatment and its
effect on the long-term prognosis after BAVR. <br/>Method(s): We used
nation-wide register data from 4,079 individuals who underwent BAVR. We
examined the association between warfarin and the non-vitamin K antagonist
oral anticoagulant use with death, stroke and major bleeding in 2010 -
2016. <br/>Result(s): The risk of stroke was higher (HR 2.39, 95% CI 1.62
- 3.53, p < 0.001) and the risk of death was lower (HR 0.79, 95% CI 0.65 -
0.96, p = 0.016) in OAC-users compared to individuals without OAC. We
observed no significant associations between OAC use and bleeding risk.
<br/>Conclusion(s): OAC use after BAVR was associated with increased risk
of stroke and decreased risk of death. These observational findings
warrant validation in randomized controlled trials before any clinical
conclusions can be drawn.<br/>Copyright &#xa9; 2021 Myllykangas,
Kiviniemi, Gunn, Salomaa, Pietila, Niiranen and Aittokallio.

<70>
Accession Number
2026401687
Title
Benefits and Pitfalls of the Perceval Sutureless Bioprosthesis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 789392. Date of Publication: 2021.
Author
Dokollari A.; Ramlawi B.; Torregrossa G.; Sa M.P.; Sicouri S.; Prifti E.;
Gelsomino S.; Bonacchi M.
Institution
(Dokollari) St. Michael's Hospital, Toronto, ON, Canada
(Ramlawi, Torregrossa, Sa, Sicouri) Department of Cardiac Surgery,
Lankenau Heart Institute, Wynnewood, PA, United States
(Ramlawi, Torregrossa, Sa, Sicouri) Department of Cardiac Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Prifti) Mother Teresa Hospital, University of Tirana, Tirana, Albania
(Gelsomino) Department of Cardiac Surgery, Maastricht University Medical
Center, Maastricht, Netherlands
(Gelsomino) Department of Cardiothoracic Surgery, Cardiovascular Research
Institute Maastricht-CARIM, Maastricht, Netherlands
(Bonacchi) Cardiac Surgery Unit, Department of Experimental and Clinical
Medicine, University of Florence, Florence, Italy
Publisher
Frontiers Media SA
Abstract
Objective: To highlight the main target points covered by clinical studies
on the Perceval sutureless valve for surgical aortic valve replacement
(SAVR) and raise a point of discussion for further expansion of its use
when compared with stented bioprostheses (SB) and transcatheter aortic
valve replacement (TAVR). <br/>Method(s): We reviewed clinical trials and
retrospective studies published up to date and compared the outcomes in
terms of mortality, myocardial infarction (MI) stroke, paravalvular leak
(PVL), permanent pacemaker implantation (PPI), bleeding and long-term
outcomes. <br/>Result(s): Clinical studies showed that 30-day mortality
ranged from 0-4% for Perceval and 2.9-7% for TAVR. The incidence of PVL
(Perceval 1.9-19.4 vs. TAVR 9-53.5%), PPI (Perceval 2-11.2 vs. TAVR
4.9-25.5%), stroke (Perceval 0 vs. TAVR 0-2.8%), MI (Perceval 0 vs. TAVR
0-3.5%), were all higher in the TAVR group. Compared to other SB,
mortality ranged from 0-6.4% for Perceval and 0-5.9% for SB. The incidence
of PVR (Perceval 1-19.4 vs. SB 0-1%), PPI (Perceval 2-10.7 vs. SB
1.8-8.5%), stroke (Perceval 0-3.7 vs. SB 1.8-7.3%) and MI (Perceval 0-7.8
vs. SB 0-4.3%) were comparable among the groups. In patients with a
bicuspid aortic valve, mortality rate was (0-4%) and PVL incidence was
(0-2.3%). However, there was a high incidence of PPI (0-20%), and stroke
(0-8%). Long-term survival ranged between 96.7-98.6%. <br/>Conclusion(s):
The Perceval bioprosthesis has proved to be a reliable prosthesis for
surgical aortic valve replacement due to its implantation speed, the
reduced cardiopulmonary bypass time, the reduced aortic cross-clamp time
and the shorter intensive care unit and hospital length of
stay.<br/>Copyright &#xa9; 2022 Dokollari, Ramlawi, Torregrossa, Sa,
Sicouri, Prifti, Gelsomino and Bonacchi.

<71>
Accession Number
2026413741
Title
Effects of Clopidogrel, Prasugrel and Ticagrelor on Microvascular Function
and Platelet Reactivity in Patients With Acute Coronary Syndrome
Undergoing Coronary Artery Stenting. A Randomized, Blinded, Parallel Group
Trial.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 780605. Date of Publication: 2021.
Author
Schnorbus B.; Jurk K.; Lackner K.J.; Welk C.; Munzel T.; Gori T.
Institution
(Schnorbus, Welk, Munzel, Gori) Zentrum fur Kardiologie, Kardiologie I,
Universitatsmedizin Mainz, Johannes Gutenberg-University Mainz, Mainz,
Germany
(Schnorbus, Jurk) Center for Thrombosis and Hemostasis,
Universitatsmedizin Mainz, Johannes Gutenberg- University Mainz, Mainz,
Germany
(Lackner) Institute of Clinical Chemistry and Laboratory Medicine,
Universitatsmedizin Mainz, Johannes Gutenberg- University Mainz, Mainz,
Germany
(Gori) Deutsches Zentrum fur Herz Kreislauf-Forschung (DZHK), Standort
Rhein-Main, Partnereinrichtung Mainz, Mainz, Germany
Publisher
Frontiers Media SA
Abstract
Aims: In this pre-specified analysis of the "endothelium, stent and
antiplatelet therapy" study, we investigate the impact of antiplatelet
therapies on microvascular function in patients undergoing stenting for an
acute coronary syndrome. <br/>Methods and Results: Fifty-six patients
[age: 63(55-67) years, males, 10 diabetics, 27 non-ST-elevation myocardial
infarction] were randomized to receive clopidogrel, ticagrelor or
prasugrel in form of oral loading 2 h before stenting followed by oral
therapy. Investigators were blinded to the allocation. Laser-Doppler
microvascular function and ADP-induced platelet aggregation capacity were
measured at baseline, 2 h after oral antiplatelet loading, and 1 day, 1
week and 1 month after stenting during chronic therapy with the same
antiplatelet agent. Platelet aggregation decreased in all groups 2 h after
oral loading, with a significantly larger effect in the prasugrel group (P
= 0.009). Similarly, prasugrel and ticagrelor loading was followed by an
increase in microvascular reactive hyperemia (P = 0.007 and P = 0.042
compared to clopidogrel). This effect disappeared one day after coronary
intervention, with a significant decrease in the prasugrel group (P =
0.026). Similarly, analysis of microvascular conductance showed a larger
increase in the prasugrel group 2 h after loading (P = 0.022 among
groups), and a decrease in all groups after stenting. <br/>Conclusion(s):
Oral loading with prasugrel (and less consistently ticagrelor) is
associated with improved microvascular function and stronger platelet
inhibition in acute coronary syndrome patients. The microvascular effect
was however lost 1 day after stenting and during subsequent follow-up.
Further studies are necessary to clarify the the long-term effects and
potential benefits of P2Y12 inhibitors on microvascular damage.
ClINICALTRIALS.gov Ndegree: NCT01700322 EUDRACT-Ndegree:
2011-005305-73.<br/>Copyright &#xa9; 2021 Schnorbus, Jurk, Lackner, Welk,
Munzel and Gori.

<72>
Accession Number
2026413669
Title
Influence of Dexmedetomidine on Post-operative Atrial Fibrillation After
Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 721264. Date of Publication: 2021.
Author
Peng S.; Wang J.; Yu H.; Cao G.; Liu P.
Institution
(Peng, Wang, Liu) Department of Anesthesiology, Seventh People's Hospital,
Shanghai University of Traditional Chinese Medicine, Shanghai, China
(Yu, Cao) Department of Cardiovascular Surgery, Shanxi Fenyang Hospital,
Fenyang, China
Publisher
Frontiers Media SA
Abstract
Background: Previous clinical studies and meta-analysis evaluating the
influence of dexmedetomidine on postoperative atrial fibrillation showed
inconsistent results. We performed an updated meta-analysis to evaluate
the influence of dexmedetomidine on incidence of postoperative atrial
fibrillation after cardiac surgery. <br/>Method(s): Randomized controlled
trials that evaluated the potential influence of dexmedetomidine on the
incidence of atrial fibrillation after cardiac surgery were obtained by
search of PubMed, Embase, and Cochrane's Library databases from inception
to April 12, 2021. A random-effects model incorporating the potential
publication bias was used to pool the results. Influences of patient or
study characteristics on the efficacy of dexmedetomidine on atrial
fibrillation after cardiac surgery were evaluated by meta-regression and
subgroup analyses. <br/>Result(s): Fifteen studies with 2,733 patients
were included. Pooled results showed that dexmedetomidine significantly
reduced the incidence of atrial fibrillation compared to control (OR:
0.72, 95% CI: 0.55-0.94, p = 0.02) with mild heterogeneity (I²
= 26%). Subgroup analysis showed that dexmedetomidine significantly
reduced the incidence of atrial fibrillation in studies from Asian
countries (OR: 0.41, 95% CI: 0.26-0.66, p < 0.001), but not in those from
non-Asian countries (OR: 0.89, 95% CI: 0.71-1.10, p = 0.27; p for subgroup
difference = 0.004). Meta-regression analysis showed that the mean age and
proportion of male patients may modify the influence of dexmedetomidine on
POAF (coefficient = 0.028 and 0.021, respectively, both p < 0.05).
Subgroup analysis further showed that Dex was associated with reduced risk
of atrial fibrillation after cardiac surgery in studies with younger
patients (mean age <= 61 years, OR = 0.44, 95% CI: 0.28-0.69, p = 0.004)
and smaller proportion of males (<=74%, OR = 0.55, 95% CI: 0.36-0.83, p =
0.005), but not in studies with older patients or larger proportion of
males (p for subgroup difference = 0.02 and 0.04). <br/>Conclusion(s):
Current evidence supports that perioperative administration of
dexmedetomidine may reduce the risk of incidental atrial fibrillation
after cardiac surgery, particularly in Asians.<br/>Copyright &#xa9; 2021
Peng, Wang, Yu, Cao and Liu.

<73>
Accession Number
2026413568
Title
Reassessing Revascularization Strategies in Coronary Artery Disease and
Type 2 Diabetes Mellitus.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 738620. Date of Publication: 2021.
Author
Liang B.; He X.; Gu N.
Institution
(Liang, He) Nanjing University of Chinese Medicine, Nanjing, China
(Gu) Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University
of Chinese Medicine, Nanjing, China
Publisher
Frontiers Media SA
Abstract
Percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) is still controversial in patients with coronary artery
disease (CAD) and type 2 diabetes mellitus (T2DM). Here, we aimed to
evaluate the long-term follow-up events of PCI and CABG in these
populations. Relevant randomized controlled trials were retrieved from
PubMed, Embase, and the Cochrane databases. The pooled results were
represented as risk ratios (RRs) with 95% confidence intervals (CIs) with
STATA software. A total of six trials with 1,766 patients who received
CABG and 2,262 patients who received PCI were included in our study.
Patients in the CABG group were significantly associated with a lower
all-cause mortality compared with those in the PCI group (RR = 0.74, 95%
CI = 0.56-0.98, P = 0.037). Cardiac mortality, recurrent myocardial
infarction, and repeat revascularization were also significantly lower in
the CABG group (RR = 0.79, 95% CI = 0.40-1.53, P = 0.479; RR = 0.70, 95%
CI = 0.32-1.56, P = 0.387; and RR = 0.36, 95% CI = 0.28-0.46, P < 0.0001;
respectively). However, compared with the PCI group, the cerebral vascular
accident was higher in the CABG group (RR = 2.18, 95% CI = 1.43-3.33, P <
0.0001). There was no publication bias in our study. CABG
revascularization was associated with significantly lower long-term
adverse clinical outcomes, except cerebral vascular accident, compared
with PCI in patients with CAD and T2DM. Systematic Review Registration:
PROSPERO, identifier: CRD42020216014.<br/>Copyright &#xa9; 2021 Liang, He
and Gu.

<74>
Accession Number
2026413511
Title
A Novel Multiple Risk Score Model for Prediction of Long-Term Ischemic
Risk in Patients With Coronary Artery Disease Undergoing Percutaneous
Coronary Intervention: Insights From the I-LOVE-IT 2 Trial.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 756379. Date of Publication: 2021.
Author
Qiu M.; Li Y.; Na K.; Qi Z.; Ma S.; Zhou H.; Xu X.; Li J.; Xu K.; Wang X.;
Han Y.
Institution
(Qiu) Second Affiliated Hospital of Dalian Medical University, Dalian,
China
(Qiu, Li, Na, Qi, Ma, Zhou, Xu, Li, Xu, Wang, Han) The Department of
Cardiology, General Hospital of Northern Theater Command, Shenyang, China
(Na) Postgraduate College, Shenyang Pharmaceutical University, Shenyang,
China
(Qi, Li) Second Affiliated Hospital of Harbin Medical University, Harbin,
China
(Ma) The Second Hospital of Jilin University, Changchun, China
(Zhou) Postgraduate College, Liaoning University of Traditional Chinese
Medicine, Shenyang, China
Publisher
Frontiers Media SA
Abstract
Backgrounds: A plug-and-play standardized algorithm to identify the
ischemic risk in patients with coronary artery disease (CAD) undergoing
percutaneous coronary intervention (PCI) could play a valuable step to
help a wide spectrum of clinic workers. This study intended to investigate
the ability to use the accumulation of multiple clinical routine risk
scores to predict long-term ischemic events in patients with CAD
undergoing PCI. <br/>Method(s): This was a secondary analysis of the
I-LOVE-IT 2 (Evaluate Safety and Effectiveness of the Tivoli drug-eluting
stent (DES) and the Firebird DES for Treatment of Coronary
Revascularization) trial, which was a prospective, multicenter, and
randomized study. The Global Registry for Acute Coronary Events (GRACE),
baseline Synergy Between Percutaneous Coronary Intervention with Taxus and
Cardiac Surgery (SYNTAX), residual SYNTAX, and age, creatinine, and
ejection fraction (ACEF) score were calculated in all patients. Risk
stratification was based on the number of these four scores that met the
established thresholds for the ischemic risk. The primary end point was
ischemic events at 48 months, defined as the composite of cardiac death,
nonfatal myocardial infarction, stroke, or definite/probable stent
thrombosis (ST). <br/>Result(s): The 48-month ischemic events had a
significant trend for higher event rates (from 6.61 to 16.93%) with an
incremental number of risk scores presenting the higher ischemic risk from
0 to >=3 (p trend < 0.001). In addition, the categories were associated
with increased risk for all components of ischemic events, including
cardiac death (from 1.36 to 3.15%), myocardial infarction (MI) (from 3.31
to 9.84%), stroke (3.31 to 6.10%), definite/probable ST (from 0.58 to
1.97%), and all-cause mortality (from 2.14 to 6.30%) (all p trend < 0.05).
The net reclassification index after combined with four risk scores was
12.5% (5.3-20.0%), 9.4% (2.0-16.8%), 12.1% (4.5-19.7%), and 10.7%
(3.3-18.1%), which offered statistically significant improvement in the
performance, compared with SYNTAX, residual SYNTAX, ACEF, and GRACE score,
respectively. <br/>Conclusion(s): The novel multiple risk score model was
significantly associated with the risk of long-term ischemic events in
these patients with an increment of scores. A meaningful improvement to
predict adverse outcomes when multiple risk scores were applied to risk
stratification.<br/>Copyright &#xa9; 2022 Qiu, Li, Na, Qi, Ma, Zhou, Xu,
Li, Xu, Wang and Han.

<75>
Accession Number
2026413370
Title
Personal Protective Equipment and Donning and Doffing Techniques in the
Cardiac Catheterization Laboratory During the COVID-19 Pandemic: Insights
From an Internet Search for Protocols.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 652298. Date of Publication: 2021.
Author
Haloot J.; Sheikh O.; Dollar F.; Javeri H.; Fichardt H.J.; Fernandes G.;
Garcia M.; Prasad A.
Institution
(Haloot, Sheikh, Dollar, Fichardt, Fernandes, Garcia, Prasad) Division of
Cardiology, Department of Medicine, The University of Texas Health Science
Center at San Antonio, San Antonio, TX, United States
(Javeri) Division of Infectious Disease, Department of Medicine, The
University of Texas Health Science Center at San Antonio, San Antonio, TX,
United States
Publisher
Frontiers Media SA
Abstract
Background: Due to the ongoing coronavirus disease 2019 (COVID-19)
pandemic, a need for precise donning and doffing protocols for personal
protective equipment (PPE) among healthcare infrastructures is paramount.
Procedures involving the cardiac catheterization laboratory (CCL) are
routinely non-aerosolizing but have the potential for rapid patient
deterioration, creating the need for aerosolizing generating procedures.
Multiple societal and governmental guidelines on the use of PPE during
medical procedures are available on Internet websites; however, there is
limited literature available in peer-reviewed formats in this context.
This study aims to provide an overview of current PPE donning and doffing
protocols specific to the catheterization laboratory. <br/>Method(s): A
series of internet searches regarding donning and doffing of PPE in the
CCL including published articles and internet protocols were compiled and
compared using Pubmed.gov, Google.com, www.twitter.com, and
www.youtube.com. <br/>Result(s): Most institutions used N95 masks, shoe
covers, at least one head covering, face shield or goggles, two pairs of
gloves, and inner and outer gowns. Doffing variation was greater than
donning. Doffing has the potential to contaminate the healthcare worker
(HCW), and therefore, this step of PPE management requires further study.
Common steps in temporal priority included cleaning of gloved hands,
removal of outer (or only) gown, removal of outer gloves, repeat gloved
hand cleaning, removal of facial PPE last, and a final non-gloved hand
cleaning. <br/>Conclusion(s): This analysis provides a summary of commonly
used practices that may be considered when designing CCL-specific PPE
protocols. Analysis of consistent steps from the literature led the
authors to formulate a suggested protocol for CCL HCWs when performing
procedures on patients with confirmed or suspected/unknown
COVID-19.<br/>Copyright &#xa9; 2021 Haloot, Sheikh, Dollar, Javeri,
Fichardt, Fernandes, Garcia and Prasad.

<76>
Accession Number
2026413339
Title
One-Stop Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery
Bypass Grafting in Patients With Multivessel Coronary Artery Disease.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 755797. Date of Publication: 2021.
Author
Li D.; Guo Y.; Gao Y.; An X.; Liu Y.; Gu S.; Zhang X.; Zhong J.; Gao J.;
Su P.
Institution
(Li, Guo, Gao, An, Liu, Gu, Zhang, Gao, Su) Department of Cardiac Surgery,
Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang
Hospital, Capital Medical University, Beijing, China
(Zhong) Heart Center and Beijing Key Laboratory of Hypertension, Beijing
Chaoyang Hospital, Capital Medical University, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: Data on one-stop hybrid coronary revascularization (HCR) are
limited. This study aimed to compare the early and midterm outcomes of
one-stop HCR with off-pump coronary artery bypass grafting (OPCAB) in
patients with multivessel coronary artery disease. <br/>Method(s): From
April 2018 to May 2021, 752 patients with multivessel coronary artery
disease who underwent isolated one-stop HCR or OPCAB were retrospectively
included in this analysis. After exclusion and propensity score matching,
151 patients who underwent HCR were matched with 151 patients who
underwent OPCAB. The primary endpoints were midterm major adverse
cardiovascular and cerebrovascular events (MACCE) after the procedure. The
secondary endpoints were in-hospital complications and outcomes.
<br/>Result(s): The preprocedural characteristics were well balanced
between the two groups after matching. The HCR group was associated with a
lower rate of perioperative transfusion (23.8 vs. 53.0%, p < 0.001) and
new-onset atrial fibrillation (AF) (5.3 vs. 15.2%, p = 0.004), shorter
time of mechanical ventilation (h) [15 (16, 17) vs. 17 (16, 20), p <
0.001], and shorter length of stay (LOS) in the hospital (days) [19 (16,
24) vs. 22 (18, 27), p = 0.001]. Cumulated MACCE rates were similar
between the two groups (15.9 vs. 14.0%, p = 0.59) during a median
follow-up of 20 months. <br/>Conclusion(s): One-stop HCR is safe and
efficacious with less invasiveness and faster postoperative recovery in
selected patients with multivessel coronary artery disease. Randomized
controlled trials with larger sample sizes and long-term follow-up are
warranted to confirm these findings.<br/>Copyright &#xa9; 2021 Li, Guo,
Gao, An, Liu, Gu, Zhang, Zhong, Gao and Su.

<77>
Accession Number
2026408589
Title
Methylprednisolone Plasma Concentrations During Cardiac Surgery With
Cardiopulmonary Bypass in Pediatric Patients.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 640543. Date of Publication: 2021.
Author
van Saet A.; Zeilmaker-Roest G.A.; Veen K.M.; de Wildt S.N.; Sorgel F.;
Stolker R.J.; Bogers A.J.J.C.; Tibboel D.
Institution
(van Saet, Stolker) Department of Anesthesiology, Erasmus Medical Center,
Rotterdam, Netherlands
(Zeilmaker-Roest, Tibboel) Department of Intensive Care and Pediatric
Surgery, Erasmus Medical Center, Rotterdam, Netherlands
(Zeilmaker-Roest, Veen, Bogers) Department of Cardiothoracic Surgery,
Erasmus Medical Center, Rotterdam, Netherlands
(de Wildt) Department of Pharmacology and Toxicology, Radboud Institute
for Health Sciences, Nijmegen, Netherlands
(Sorgel) Faculty of Medicine, Institute of Pharmacology, University
Duisburg-Essen, Essen, Germany
(Sorgel) Department of Clinical Pharmacology, Institute for Biomedical and
Pharmaceutical Research, Nurnberg-Heroldsberg, Germany
Publisher
Frontiers Media SA
Abstract
Introduction: To our knowledge, methylprednisolone pharmacokinetics and
plasma concentrations have not been comprehensively investigated in
children with congenital heart disease undergoing cardiac surgery with
cardiopulmonary bypass. It is unknown whether there is a significant
influence of cardiopulmonary bypass on the plasma concentrations of
methylprednisolone and whether this may be an explanation for the limited
reported efficacy of steroid administration in cardiac surgery with
cardiopulmonary bypass. <br/>Method(s): The study was registered in the
Dutch Trial Register (NTR3579; https://www.trialregister.nl/trial/3428).
Methylprednisolone 30 mg/kg was administered as an intravenous bolus after
induction of anesthesia. Methylprednisolone concentration was measured
with liquid chromatography tandem mass spectrometry and analyzed using
linear mixed-effects modeling. <br/>Result(s): Thirty-nine patients were
included in the study, of which three were excluded. There was an acute
decrease in observed methylprednisolone plasma concentration on initiation
of cardiopulmonary bypass (median = 26.8%, range = 13.9-48.14%, p <
0.001). We found a lower intercept (p = 0.02), as well as a less steep
slope of the model predicted methylprednisolone concentration vs. time
curve for neonates (p = 0.048). A lower intercept (p = 0.01) and a less
steep slope (p = 0.0024) if the volume of cell saver blood processed was
larger than 91 ml/kg were also found. <br/>Discussion(s): We report
similar methylprednisolone plasma concentrations as earlier studies
performed in children undergoing cardiopulmonary bypass, and we confirmed
the large interindividual variability in achieved methylprednisolone
plasma concentrations with weight-based methylprednisolone administration.
A larger volume of distribution and a lower clearance of
methylprednisolone for neonates were suggested. The half-life of
methylprednisolone in our study was calculated to be longer than 6 h for
neonates, 4.7 h for infants, 3.6 h for preschool children and 4.7 h for
school children. The possible influence of treatment of pulmonary
hypertension with sildenafil and temperature needs to be investigated
further.<br/>Copyright &#xa9; 2021 van Saet, Zeilmaker-Roest, Veen, de
Wildt, Sorgel, Stolker, Bogers and Tibboel.

<78>
Accession Number
2026408568
Title
The Effect of Intraoperative Cerebral Oximetry Monitoring on Postoperative
Cognitive Dysfunction and ICU Stay in Adult Patients Undergoing Cardiac
Surgery: An Updated Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 814313. Date of Publication: 2021.
Author
Tian L.-J.; Yuan S.; Zhou C.-H.; Yan F.-X.
Institution
(Tian, Yuan, Zhou, Yan) Department of Anesthesiology, State Key Laboratory
of Cardiovascular Disease, National Center for Cardiovascular Diseases,
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Beijing, China
Publisher
Frontiers Media SA
Abstract
Aim: Determining whether intraoperative cerebral oximetry
monitoring-guided intervention reduces the risk of postoperative cognitive
dysfunction remains controversial. The objective of this study was to
conduct an up-to-date meta-analysis to comprehensively assess the effects
of regional cerebral oxygen saturation (rSO<inf>2</inf>) monitoring-guided
intervention on cognitive outcomes after cardiac surgery. <br/>Method(s):
PubMed, EMBASE, Ovid, and Cochrane Library databases were systematically
searched using the related keywords for cardiac surgical
randomized-controlled trials (RCTs) published from their inception to July
31, 2021. The primary outcome was postoperative delirium (POD). The
secondary outcomes were postoperative cognitive decline (POCD) and other
major postoperative outcomes. The odds ratio (OR) or weighted mean
differences (WMDs) with 95% confidence interval (CI) were used to pool the
data. The random-effect model was used for the potential clinical
inconsistency. We performed meta-regression and subgroup analyses to
assess the possible influence of rSO<inf>2</inf> monitoring-guided
intervention on clinical outcomes. <br/>Result(s): In total, 12 RCTs with
1,868 cardiac surgical patients were included. Compared with controls, the
incidences of POD (n = 6 trials; OR, 0.28; 95% CI, 0.09-0.84; p = 0.02;
I² = 81%) and POCD (n = 5 trials; OR, 0.38; 95% CI, 0.16-0.93;
p = 0.03; I² = 78%) were significantly lower in the
intervention group. Cerebral oximetry desaturation also showed a positive
association with the incidence of POD (n = 5 trials; OR, 2.02; 95% CI,
1.25-3.24; p = 0.004; I² = 81%). The duration of intensive care
unit (ICU) stay was markedly shorter in the intervention group than in the
control group (n = 10 trials; WMD, -0.22 days; 95% CI, -0.44 to -0.00; p =
0.05; I² = 74%). Univariate meta-regression analyses showed
that the major sources of heterogeneity were age (p = 0.03), body mass
index (BMI, p = 0.05), and the proportion of congenital heart disease
(CHD, p = 0.02) for POD, age (p = 0.04) for POCD, diabetes mellitus (DM, p
= 0.07), cerebrovascular accident (CVA, p = 0.02), and chronic obstructive
pulmonary disease (COPD, p = 0.09) for ICU stay. Subsequent subgroup
analyses also confirmed these results. <br/>Conclusion(s): Available
evidence from the present study suggests that an intraoperative cerebral
oximetry desaturation is associated with an increased POD risk, and the
rSO<inf>2</inf> monitoring-guided intervention is correlated with a lower
risk of POD and POCD, and a shorter ICU stay in adults undergoing cardiac
surgery. These clinical benefits may be limited in patients with older
age, diabetes status, high BMI, non-CHD, non-COPD, or a previous
cardiovascular accident. Systematic Review Registration: [PROSPREO],
identifier: [CRD42021252654].<br/>Copyright &#xa9; 2022 Tian, Yuan, Zhou
and Yan.

<79>
Accession Number
2026408525
Title
Development and Validation of Nomogram Models for Postoperative Pneumonia
in Adult Patients Undergoing Elective Cardiac Surgery.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 750828. Date of Publication: 2021.
Author
Wang D.; Chen X.; Wu J.; Le S.; Xie F.; Li X.; Wang H.; Huang X.; Zhang
A.; Du X.
Institution
(Wang, Chen, Le, Wang, Huang, Du) Department of Cardiovascular Surgery,
Union Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Wu) Key Laboratory for Molecular Diagnosis of Hubei Province, The Central
Hospital of Wuhan, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan, China
(Xie) Department of Cardiovascular Surgery, First Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Li) Department of Nursing, Huaihe Hospital of Henan University, Kaifeng,
China
(Zhang) Department of Cardiology, The Central Hospital of Wuhan, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative pneumonia (POP) is a frequent complication
following cardiac surgery, related to increased morbidity, mortality and
healthcare costs. The objectives of this study were to investigate the
risk factors associated with POP in adults undergoing elective cardiac
surgery and to develop and validate nomogram models. <br/>Method(s): We
conducted a multicenter retrospective study in four cardiac centers in
China. Adults operated with elective open-heart surgery from 2016 to 2020
were included. Patients were randomly allocated to training and validation
sets by 7:3 ratio. Demographics, comorbidities, laboratory data, surgical
factors, and postoperative outcomes were collected and analyzed. Risk
factors for POP were identified by univariate and multivariate analysis.
Nomograms were constructed based on the multivariate logistic regression
models and were evaluated with calibration, discrimination and decision
curve analysis. <br/>Result(s): A total of 13,380 patients meeting the
criteria were included and POP developed in 882 patients (6.6%). The
mortality was 2.0%, but it increased significantly in patients with POP
(25.1 vs. 0.4%, P < 0.001). Using preoperative and intraoperative
variables, we constructed a full nomogram model based on ten independent
risk factors and a preoperative nomogram model based on eight preoperative
factors. Both nomograms demonstrated good calibration, discrimination, and
were well validated. The decision curves indicated significant clinical
usefulness. Finally, four risk intervals were defined for better clinical
application. <br/>Conclusion(s): We developed and validated two nomogram
models for POP following elective cardiac surgery using preoperative and
intraoperative factors, which may be helpful for individualized risk
evaluation and prevention decisions.<br/>Copyright &#xa9; 2021 Wang, Chen,
Wu, Le, Xie, Li, Wang, Huang, Zhang and Du.

<80>
Accession Number
2026406361
Title
Design of a Randomized Placebo-Controlled Trial to Evaluate the
Anti-inflammatory and Senolytic Effects of Quercetin in Patients
Undergoing Coronary Artery Bypass Graft Surgery.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 741542. Date of Publication: 2021.
Author
Dagher O.; Mury P.; Noly P.-E.; Fortier A.; Lettre G.; Thorin E.; Carrier
M.
Institution
(Dagher, Noly, Thorin, Carrier) Department of Surgery, Faculty of
Medicine, Universite de Montreal, Montreal, QC, Canada
(Dagher, Mury, Noly, Lettre, Thorin, Carrier) Research Centre, Montreal
Heart Institute, Universite de Montreal, Montreal, QC, Canada
(Dagher) Department of Cardiac Sciences, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Fortier) Montreal Health Innovations Coordinating Center, Universite de
Montreal, Montreal, QC, Canada
(Lettre) Department of Medicine, Faculty of Medicine, Universite de
Montreal, Montreal, QC, Canada
Publisher
Frontiers Media SA
Abstract
Background: Following an acute coronary syndrome, patients display an
elevated inflammatory profile, promoted in part by cellular senescence.
For patients requiring a coronary artery bypass (CABG) surgery, exposure
to the surgical intervention and cardiopulmonary bypass further exacerbate
their residual inflammation. Experimental evidence identified quercetin, a
natural senolytic drug, as a cardioprotective agent against inflammatory
injuries. The Q-CABG study aims to explore the efficacy of quercetin to
reduce inflammation, myocardial injury and senescence in patients
undergoing CABG following an acute coronary syndrome. <br/>Method(s):
Q-CABG is a phase II, prospectively registered, randomized, double-blind
and placebo-controlled clinical trial. Recruited patients awaiting CABG
surgery at the Montreal Heart Institute (n = 100) will be randomly
assigned in a 1:1 ratio to receive either quercetin supplementation (500
mg twice daily) or placebo, starting 2 days before surgery and until the
seventh postoperative day. The primary endpoint examines the effects of
quercetin on blood inflammatory cytokines and markers of myocardial injury
and senescence in this patient population. Blood samples will be taken at
four time points: baseline, postoperative day 1, postoperative day 4 and
at hospital discharge, or after a maximum of seven postoperative days. The
secondary endpoint is the assessment of endothelial (dys) function by
looking at ex vivo vascular reactivity and mRNA expression of endothelial
cells from the wall of discarded segments of internal mammary artery.
<br/>Discussion(s): The preventive intake of quercetin supplementation may
help limit the vigorous inflammatory response triggered by CABG and
subsequent postoperative complications in patients suffering from an acute
coronary syndrome. In an exploratory way, quercetin supplementation could
also improve endothelial function by eliminating senescent vascular
endothelial cells. The results of this trial should provide valuable
information regarding a novel approach to improve biological, and
potentially clinical, outcomes post CABG. Clinical Trial Registration:
ClinicalTrials.gov, Identifier NCT04907253.<br/>Copyright &#xa9; 2021
Dagher, Mury, Noly, Fortier, Lettre, Thorin and Carrier.

<81>
Accession Number
2026406302
Title
Comparative Quantitative Aortographic Assessment of Regurgitation in
Patients Treated With VitaFlow Transcatheter Heart Valve vs. Other
Self-Expanding Systems.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 747174. Date of Publication: 2021.
Author
Wang R.; Kawashima H.; Gao C.; Mou F.; Li P.; Zhang J.; Yang J.; Luo J.;
Mylotte D.; Wijns W.; Onuma Y.; Soliman O.; Tao L.; Serruys P.W.
Institution
(Wang, Gao, Mou, Tao) Department of Cardiology, Xijing Hospital, Xi'an,
China
(Wang, Kawashima, Gao, Mylotte, Wijns, Onuma, Soliman, Serruys) Department
of Cardiology, CORRIB Research Center for Advanced Imaging and Core
Laboratory, National University of Ireland, NUIG, Galway, Ireland
(Wang, Gao) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Kawashima) Heart Center, Department of Clinical and Experimental
Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University
of Amsterdam, Amsterdam, Netherlands
(Li) Department of Cardiology, Yulin First People's Hospital, The Sixth
Affiliated Hospital of Guangxi Medical University, Yulin, China
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Yang) Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, China
(Luo) Department of Cardiology, Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, Guangzhou, China
(Wijns) The Lambe Institute for Translational Medicine and Curam, National
University of Ireland Galway (NUIG), Galway, Ireland
(Serruys) Department of Cardiology, Imperial College London, London,
United Kingdom
Publisher
Frontiers Media SA
Abstract
Objectives: To compare the quantitative angiographic aortic regurgitation
(AR) of six self-expanding valves after transcatheter aortic valve
replacement (TAVR). <br/>Background(s): Quantitative videodensitometric
aortography (LVOT-AR) is an accurate and reproducible tool for assessment
of AR following TAVR. <br/>Method(s): This is a retrospective central
core-lab analysis of 1,257 consecutive cine aortograms performed
post-TAVR. The study included 107 final aortograms of consecutive patients
who underwent TAVR with first-generation VitaFlow in four Chinese centers
and 1,150 aortograms with five other transcatheter aortic valves (Evolut
Pro, Evolut R, CoreValve, Venus A-Valve, and Acurate Neo). LVOT-AR
analyses of these five valves were retrieved from a previously published
pooled database. <br/>Result(s): Among 172 aortograms of patients treated
with VitaFlow, 107 final aortograms (62.2%) were analyzable by LVOT-AR. In
this first in man eight cases necessitated a procedural valve in valve due
to inappropriate TAVR positioning and severe aortic paravalvular
regurgitation. In the VitaFlow group, the mean LVOT-AR of the intermediate
aortograms was 7.3 +/- 7.8% and the incidence of LVOT-AR >17% was 8.6%.
The mean LVOT-AR of the final aortogram was 6.1 +/- 6.4% in the VitaFlow
group, followed by Evolut Pro (7.3 +/- 6.5%), Evolut R (7.9 +/- 7.4%),
Venus A-valve (8.9 +/- 10.0%), Acurate Neo (9.6 +/- 9.2%), and lastly
CoreValve (13.7 +/- 10.7%) (analysis of variance p < 0.001). Post hoc
2-by-2 testing showed that CoreValve had significantly higher LVOT-AR
compared with each of the other five THVs. No statistical difference in
LVOT-AR was observed between VitaFlow, Evolut Pro, Evolut R, Acurate Neo,
and Venus A-valves. The VitaFlow system had the lowest proportion of
patients with LVOT-AR >17% (4.7%) (AR after the final aortograms),
followed by Evolut Pro (5.3%), Evolut R (8.8%), Acurate Neo (11.3%), Venus
A-valve (14.2%), and CoreValve (30.1%) (chi-square p < 0.001).
<br/>Conclusion(s): Compared to other commercially available
self-expanding valves, VitaFlow seems to have a low degree of AR and a low
proportion of patients with >=moderate/severe AR as assessed by
quantitative videodensitometric angiography. Once the learning phase is
completed, comparisons of AR between different transcatheter heart valves
should be attempted in a prospective randomized trial.<br/>Copyright
&#xa9; 2022 Wang, Kawashima, Gao, Mou, Li, Zhang, Yang, Luo, Mylotte,
Wijns, Onuma, Soliman, Tao and Serruys.

<82>
Accession Number
2026405889
Title
Attenuating the Variability of Lipids Is Beneficial for the Hypertension
Management to Reduce the Cardiovascular Morbidity and Mortality in Older
Adults.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 692773. Date of Publication: 2021.
Author
Dong Y.; Liu X.; Zhao Y.; Chai Q.; Zhang H.; Gao Y.; Liu Z.
Institution
(Dong) Department of Community, Lanshan District People Hospital, Linyi,
China
(Liu, Zhao, Chai, Zhang, Liu) Basic Medical College, Shandong First
Medical University, Jinan, China
(Zhao, Chai, Zhang, Liu) Cardio-Cerebrovascular Control and Research
Center, Institute of Clinical Medicine, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Jinan, China
(Gao) Department of Cardiology, Hekou District People Hospital, Dongying,
China
Publisher
Frontiers Media SA
Abstract
Objective: To investigate the beneficial of attenuating the variability of
lipids to the hypertension management in older adults. <br/>Method(s):
Between April 2008 and November 2010, 1,244 hypertensive patients aged
>=60 years were recruited and randomized into placebo and rosuvastatin
groups. Outcomes and inter-visit plasma lipids variability were assessed.
<br/>Result(s): Over an average follow-up of 83.5 months, the coefficients
of variation (CVs) in total cholesterol (TCHO), triglycerides,
high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein
cholesterol (LDL-c) were significantly lower in the rosuvastatin group
than the placebo group (p < 0.05). The risks of composite cardiovascular
event, myocardial infarction, coronary revascularization, heart failure,
total stroke, ischemic stroke, cardiovascular death, and all-cause death
were significantly lower in the rosuvastatin group than the placebo group
(all p < 0.05). The differences in the risks were significantly diminished
after the CVs for TCHO, triglycerides, HDL-c, and LDL-c were separately
included as confounders. One-SD of CVs for TCHO, triglycerides, HDL-c, and
LDL-c increment were significantly associated with the risks of composite
cardiovascular event, myocardial infarction, heart failure, total stroke,
ischemic stroke, cardiovascular death, and all-cause death, respectively
(all p < 0.05). <br/>Conclusion(s): Rosuvastatin significantly attenuated
the intra-visit variability in lipids and decreased the risk of
cardiovascular mortality and morbidity. Controlling the variability of
lipids is as important as antihypertensive treatment to reduce the
cardiovascular morbidity and mortality in the management of older
hypertensive patients. Clinical Trial Registration: ChiCTR.org.cn,
ChiCTR-IOR-17013557.<br/>Copyright &#xa9; 2021 Dong, Liu, Zhao, Chai,
Zhang, Gao and Liu.

<83>
Accession Number
2028202776
Title
Safety and Efficacy of Albumin for Pump Priming in Cardiac Surgery: A
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Yin J.; Sun M.; Zeng Y.; Cai M.; Liu H.; Jin Y.
Institution
(Yin, Zeng, Cai, Liu, Jin) Department of Pain Medicine, Jinling Hospital,
Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
(Sun) Department of Anesthesiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Sun) Institute of Anesthesia and Critical Care Medicine, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Sun) Key Laboratory of Anesthesiology and Resuscitation (Huazhong
University of Science and Technology), Ministry of Education, Wuhan, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the efficacy and safety of albumin as pump priming
fluid in cardiac surgery. <br/>Design(s): Meta-analysis of randomized
controlled trials. <br/>Setting(s): Each study was conducted in a surgical
center or intensive care unit. <br/>Participant(s): Adult and pediatric
patients undergoing cardiac surgery with cardiopulmonary bypass who
received circuit priming fluids. <br/>Intervention(s): Extracorporeal
circuit priming with either albumin or crystalloid. Measurements and
Results: Fourteen eligible randomized controlled trials with 741 patients
were included in the present meta-analysis. Albumin prime had lower
bleeding (CI -202.20 to -142.88 mL, p < 0.00001) and showed a greater
advantage in preserving platelet counts (CI 14.85-21.48 x 10³
mm^-3, p < 0.00001), maintaining colloid osmotic pressure and
sustaining negative fluid balance. No significant differences were found
in the remaining study outcomes. <br/>Conclusion(s): Albumin was shown to
be safe and efficacious in extracorporeal circulation perfusion. However,
its clinical advantages were not clearly highlighted, as there were no
significant differences in the number of deaths, length of hospital stay,
or intensive care unit duration. The results should be interpreted
cautiously, as most included studies were small in scale, and the total
number of participants was limited.<br/>Copyright &#xa9; 2023

<84>
Accession Number
2028135682
Title
Coronary Artery Bypass Surgery to Treat Anomalous Origin of Coronary
Arteries in Adults: A Systematic Review.
Source
Heart Lung and Circulation. (no pagination), 2023. Date of Publication:
2023.
Author
Alzghari T.; Sandner S.; Di Franco A.; Harik L.; Perezgorvas-Olaria R.;
Soletti G.; Dimagli A.; Cancelli G.; Demetres M.; Lau C.; Girardi L.N.;
Gaudino M.
Institution
(Alzghari, Di Franco, Harik, Perezgorvas-Olaria, Soletti, Dimagli,
Cancelli, Lau, Girardi, Gaudino) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
Publisher
Elsevier Ltd
Abstract
Objective: To review the available literature on the use of coronary
artery bypass grafting (CABG) as a treatment option for anomalous origin
of coronary artery in adults. <br/>Method(s): A systematic literature
search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase,
and the Cochrane Library databases) to identify studies reporting the use
of CABG in adult patients with anomalous origin of coronary artery.
<br/>Result(s): A total of 31 studies and 62 patients were included, 32
patients (52%) were women, and the mean age was 45.1+/-16.1 years. The
most common coronary anomaly was the right coronary artery arising from
the left coronary sinus in 26 patients (42%), followed by an anomalous
left coronary artery from the pulmonary artery in 23 patients (37%). A
total of 65 conduits were used in 61 patients, and 1 case report did not
report conduit type. Reported grafts included saphenous vein (23 of 65
[35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal
thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]);
right gastroepiploic artery and basilic vein were used once (1.5%) each.
Ligation of the native coronary artery was performed in 42 (67.7%)
patients. Patient follow-up was available in 19 studies with a mean of
31.2 months. Only 1 operative mortality was reported. <br/>Conclusion(s):
Based on the limited available data, CABG can be performed with good early
results. Use of arterial conduits and ligation of the native coronary
artery may improve long-term graft patency.<br/>Copyright &#xa9; 2023
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<85>
Accession Number
2028135648
Title
Commissural alignment during TAVR reduces the risk of overlap to coronary
ostia.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131572. Date of Publication: 2023.
Author
Carabetta N.; Siller-Matula J.M.; Boccuto F.; Panuccio G.; Indolfi C.;
Torella D.; De Rosa S.
Institution
(Carabetta, Boccuto, Panuccio, Indolfi, De Rosa) Department of Medical and
Surgical Sciences, Magna Graecia University, Catanzaro, Italy
(Siller-Matula) Department of Cardiology, Medical University of Vienna,
Vienna, Austria
(Indolfi) Mediterranea Cardiocentro, Naples, Italy
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) showed safety
and efficacy in patients with severe aortic stenosis. Commissural
alignment (CA) during TAVR has the potential to reduce the impact of the
prostheses on accessibility of coronary arteries, as misalignment of the
neocommissures could cause partial overlap with coronary ostia. Therefore,
the aim of this study was to investigate the impact of CA on coronary
overlap rates. <br/>Method(s): We examined the techniques of CA and their
impact on coronary access. Eligible studies were searched for on Pubmed,
SCOPUS and DOAJ and selected using PRISMA guidelines. The primary endpoint
was the incidence of a severe coronary overlap or failed coronary
re-access. Results of the analysis are expressed as Risk Ratio (RR) with
95% CI. <br/>Result(s): Four studies were included in this analysis. In
these, 681 patients underwent TAVR with CA and 210 underwent TAVR without
CA. We examined Evolut valves and Acurate Neo valves. The primary endpoint
occurred in 138 patients undergoing TAVR with CA and in 154 patients
without CA (RR = 0.279; 95% CI 0.201-0.386; p < 0.001). Neither
prosthesis-related, nor patient-related factors had a significant
interaction with the measured effect. <br/>Conclusion(s): Commissural
alignment was associated with significantly lower rates of
commissure-to-coronary ostia overlap and failure of coronary access.
Consequently, a modified insertion technique could reduce coronary overlap
and coronary occlusion, particularly in supra-annular valves. Therefore,
controlled orientation of prostheses by CA during TAVR could favour
coronary access, especially in younger patients that could require
coronary re-access after TAVR.<br/>Copyright &#xa9; 2023

<86>
Accession Number
2028135612
Title
Gender disparities in patients with acute aortic dissection: A scoping
review.
Source
Seminars in Vascular Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Filiberto A.C.; Ramadan O.I.; Wang G.J.; Cooper M.A.
Institution
(Filiberto, Cooper) Department of Surgery, Division of Vascular Surgery,
University of Florida, Gainesville, FL 32610, United States
(Ramadan, Wang) Department of Surgery, University of Pennsylvania Perelman
School of Medicine, Philadelphia, PA, United States
(Ramadan, Wang) Leonard Davis Institute of Health Economics, University of
Pennsylvania, Philadelphia, PA, United States
Publisher
W.B. Saunders
Abstract
Disparities in outcomes for patients with cardiovascular disease and those
undergoing cardiac or vascular operations are well-established. These
disparities often span several dimensions and persist despite advancements
in medical and surgical care; gender is among the most pervasive.
Specifically, female gender has been implicated as a predictor of poor
outcomes in both patients with acute type A aortic dissections (ATAADs)
and type B aortic dissections (TBADs). For instance, one study, using the
International Registry of Acute Aortic Dissection database, found that
women with acute aortic dissection-including ATAAD and TBAD that were
either medically or surgically managed-had 40% higher odds of in-hospital
mortality than men. Notably, both types of acute aortic dissections affect
men more commonly than women and can be life-threatening without prompt,
appropriate treatment. The underlying mechanisms for these disparities are
unclear but are thought to be multifactorial. The association of gender
with patterns of disease and outcomes in patients with ATAAD or TBAD
remains unclear, with conflicting reports from different studies. Thus, we
sought to review the literature regarding gender disparities in patients
with ATAAD and TBAD.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<87>
Accession Number
2027727285
Title
Left Atrium Volume Reduction Procedure Concomitant With Cox-Maze Ablation
in Patients Undergoing Mitral Valve Surgery: A Meta-Analysis of Clinical
and Rhythm Outcomes.
Source
Heart Lung and Circulation. (no pagination), 2023. Date of Publication:
2023.
Author
Baudo M.; Rosati F.; Di Bacco L.; D'Alonzo M.; Benussi S.; Muneretto C.
Institution
(Baudo, Rosati, Di Bacco, D'Alonzo, Benussi, Muneretto) Division of
Cardiac Surgery, Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
Publisher
Elsevier Ltd
Abstract
Background: The management of an enlarged left atrium (LA) in mitral valve
(MV) disease with atrial fibrillation (AF) is still being debated. It has
been postulated that a reduction in LA size may improve patient outcomes.
This meta-analysis aimed to assess rhythm and clinical outcomes of
combined surgical AF treatment with or without LA volume reduction (LAVR)
in patients undergoing MV surgery. <br/>Method(s): A systematic review was
performed and all available literature to May 2022 was included. The
primary endpoint was analysis of early and late mortality and rhythm
outcomes. Secondary outcomes included early and late cerebrovascular
accident (CVA) and permanent pacemaker implantation. <br/>Result(s): The
search strategy yielded 2,808 potentially relevant articles, and 19 papers
were eventually included. The pooled estimated rate of 30-day mortality
was 3.76% (95% CI 2.52-5.56). The incidence rate of late mortality and
late cardiac-related mortality was 1.75%/year (95% CI 0.63-4.84) and
1.04%/year (95% CI 0.31-3.53), respectively. At subgroup analysis when
comparing the surgical procedure with and without AF ablation, the
ablation subgroup showed a significantly lower rate of postoperative CVA
(p<0.0001) and higher restoration to sinus rhythm at discharge (p=0.0124),
with only a trend of lower AF recurrence at 1 year (p=0.0608). At
univariable meta-regression, reintervention was significantly associated
with higher late mortality (p=0.0033). <br/>Conclusion(s): In enlarged LA
undergoing MV surgery, LAVR combined with AF ablation showed a trend of
improved rhythm outcomes when compared with AF ablation without LAVR. Each
LAVR technique has its advantages and disadvantages, which must be managed
accordingly.<br/>Copyright &#xa9; 2023 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<88>
Accession Number
2025945156
Title
A model for predicting postoperative persistent acute kidney injury (AKI)
in AKI after cardiac surgery patients with normal baseline renal function.
Source
Clinical Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Chen Y.; Mo Z.; Chu H.; Hu P.; Fan W.; Wu Y.; Song L.; Zhang L.; Li Z.;
Liu S.; Ye Z.; Liang X.
Institution
(Chen, Mo, Wu, Song, Zhang, Li, Liu, Ye, Liang) Department of Nephrology,
Guangdong Provincial People's Hospital (Guangdong Academy of Medical
Sciences), Southern Medical University, Guangzhou, China
(Chu, Hu, Fan) Division of Nephrology, The Affiliated Yixing Hospital of
Jiangsu University, Jiangsu, Yixing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Persistent acute kidney injury (AKI) after cardiac surgery is
not uncommon and linked to poor outcomes. Hypothesis: The purpose was to
develop a model for predicting postoperative persistent AKI in patients
with normal baseline renal function who experienced AKI after cardiac
surgery. <br/>Method(s): Data from 5368 patients with normal renal
function at baseline who experienced AKI after cardiopulmonary bypass
cardiac surgery in our hospital were retrospectively evaluated. Among
them, 3768 patients were randomly assigned to develop the model, while the
remaining patients were used to validate the model. The new model was
developed using logistic regression with variables selected using least
absolute shrinkage and selection operator regression. <br/>Result(s): The
incidence of persistent AKI was 50.6% in the development group. Nine
variables were selected for the model, including age, hypertension,
diabetes, coronary heart disease, cardiopulmonary bypass time, AKI stage
at initial diagnosis after cardiac surgery, postoperative serum magnesium
level of <0.8 mmol/L, postoperative duration of mechanical ventilation,
and postoperative intra-aortic balloon pump use. The model's performance
was good in the validation group. The area under the receiver operating
characteristic curve was 0.761 (95% confidence interval: 0.737-0.784).
Observations and predictions from the model agreed well in the calibration
plot. The model was also clinically useful based on decision curve
analysis. <br/>Conclusion(s): It is feasible by using the model to
identify persistent AKI after cardiac surgery in patients with normal
baseline renal function who experienced postoperative AKI, which may aid
in patient stratification and individualized precision treatment
strategy.<br/>Copyright &#xa9; 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<89>
Accession Number
2028149510
Title
Oral Anticoagulation Versus Antiplatelet Treatment After Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 210 (pp 58-64), 2024. Date of Publication:
01 Jan 2024.
Author
Tomsic A.; Zhao C.; Schoones J.W.; Klautz R.J.M.; Palmen M.
Institution
(Tomsic, Zhao, Klautz, Palmen) Department of Cardiothoracic Surgery,
Leiden University Medical Centre, Leiden, Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Centre, Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Oral anticoagulation with vitamin K antagonists is currently advised for a
period of 3 months after surgical mitral valve repair, regardless of the
rhythm status. The evidence supporting this recommendation is weak and
recent studies have challenged the safety and efficacy of this
recommendation. A systematic review of literature was conducted by
searching PubMed, Embase, Web of Science, Emcare, and Cochrane Library
databases for original publications comparing the efficacy and safety of
oral anticoagulation with vitamin K antagonists to antiplatelet treatment
early after mitral valve surgery in patients with no atrial fibrillation.
Study end points included thromboembolic complications, bleeding
complications and survival. A total of 5 studies, including 5,093
patients, met the inclusion criteria; 2,824 patients were included in the
oral anticoagulation and 2,269 in the antiplatelet treatment group. Pooled
analyses demonstrated no beneficial effect of oral anticoagulation on the
incidence of thromboembolic complications (risk ratio 1.14, 95% confidence
interval 0.76 to 1.70, p = 0.53, I² = 8%). Moreover, oral
anticoagulation did not result in a significantly increased risk of
bleeding complications (risk ratio 0.89, 95% confidence interval 0.32 to
2.44, p = 0.81, I² = 87%). When combining the efficacy and
safety end points, no difference was observed between groups (risk ratio
1.01, 95% confidence interval 0.51 to 1.97, p = 0.99 I² = 85%).
Likewise, mortality did not differ between groups (risk ratio 0.89, 95%
confidence interval 0.15 to 5.23, p = 0.90 I² = 71%). Our
results confirmed the safety but failed to confirm the efficacy of oral
anticoagulation in patients who underwent mitral valve surgery. A
randomized controlled trial would provide the evidence needed to support
treatment recommendations.<br/>Copyright &#xa9; 2023 The Author(s)

<90>
Accession Number
2028148135
Title
Risk factors for stroke post coronary artery bypass graft surgery: A
review of literature.
Source
Medicina Clinica Practica. 7(1) (no pagination), 2024. Article Number:
100405. Date of Publication: 01 Jan 2024.
Author
Jannati M.
Institution
(Jannati) Cardiovascular Surgery Ward, Namazee Hospital, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Elsevier Espana S.L.U
Abstract
Objective: Stroke is acknowledged as a devastating complication post
coronary artery bypass grafting surgery (CABG), that may reduce the
quality of life and increase mortality. The incidence of post-CABG stroke
results in more hospital mortality, longer times of hospital stays, and
raises the costs of hospital and rehabilitative support. Having knowledge
about risk factors of stroke after CABG could help to define the best
approach to reduce post-CABG strokes. <br/>Material(s) and Method(s): In
this study, we reviewed the risk factors associated with stroke after CABG
and the strategies for reducing the risk of stroke. <br/>Result(s):
According to the evaluation of this study, the incidence rate of stroke
after CABG was between 1.2% and 4.2%. The most prevalent risk factors for
stroke after CABG are advanced age, previous stroke, atrial fibrillation,
carotid artery disease, and diabetes mellitus. <br/>Conclusion(s):
Moreover, off-pump coronary artery bypass graft and epiaortic
ultrasonography have a positive effect on reducing the incidence of stroke
post-CABG.<br/>Copyright &#xa9; 2023

<91>
Accession Number
2028128991
Title
Effect of local warming for arterial catheterization in adult cardiac
surgery: a randomized controlled trial.
Source
Journal of Thoracic Disease. 15(10) (pp 5330-5339), 2023. Date of
Publication: October 2023.
Author
Park S.; Hye-Jin K.; Heo W.; Sang-Wook S.; Ji-Uk Y.; Gyeong-Jo B.; Lee J.;
Jung J.; Kim H.Y.
Institution
(Park, Hye-Jin, Heo, Sang-Wook, Ji-Uk, Gyeong-Jo, Lee, Jung, Kim)
Department of Anesthesia and Pain Medicine, Pusan National University
Yangsan Hospital, Yangsan, South Korea
(Park, Hye-Jin, Sang-Wook, Ji-Uk, Gyeong-Jo, Kim) Department of Anesthesia
and Pain Medicine, School of Medicine, Pusan National University, Yangsan,
South Korea
(Kim) Department of Anesthesia and Pain Medicine, School of Medicine,
Pusan National University, 20 Geumo-ro, Beomeo-ri, Mulgeumeup, Yangsan
50612, South Korea
Publisher
AME Publishing Company
Abstract
Background: The increase in internal diameter (ID) and cross-sectional
area (CSA) may facilitate better arterial catheterization. Since an
increase in body temperature can cause peripheral vasodilation, we aimed
to determine if local warming of the radial artery (RA) catheterization
site could improve the success rate of catheterization. <br/>Method(s):
This randomized, controlled study enrolled 160 patients aged >18 years who
were scheduled for heart surgery. They were randomized into non-warming
palpation (NP), non-warming ultrasonography-guided (NU), warming palpation
(WP), and warming ultrasonography-guided (WU) groups. After induction, the
baseline RA ultrasonography images were collected. In the warming groups
(WP, WU), local warming was applied on the catheterization site. Before
catheterization, the RA ultrasonography images were collected. The primary
outcome was the first-attempt success rate. The secondary outcomes
included the ID and CSA of the RA and overall complications.
<br/>Result(s): Totally 152 adults were included in the analysis. The
first-attempt success rates in each of the four groups were not
significantly different (P=0.985). The rates in the non-warming (NP + NU)
and warming (WP + WU) groups were also not different (P=0.827). Unlike
non-warming group, the warming group had increased ID (3.34+/-0.78 vs.
3.02+/-0.73 mm; P<0.001) and CSA (6.9+/-2.8 vs. 5.8+/-2.4 mm²;
P<0.001) compared with baseline. <br/>Conclusion(s): Local warming for
peripheral artery catheterization does not increase the first-attempt
success rate in adults undergoing cardiac surgery; however, it can
increase the ID and CSA of the RA and prevent vasospasm.<br/>Copyright
&#xa9; 2023 AME Publishing Company. All rights reserved.

<92>
[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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023 American Heart Association, Inc.

<93>
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.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<94>
Accession Number
2027263610
Title
Treat-to-Target LDL Strategy of Statin Dosing Is Noninferior to
High-Intensity Dosing.
Source
American Family Physician. 108(3) (pp 312A-312B), 2023. Date of
Publication: 01 Sep 2023.
Author
Slawson D.C.
Institution
(Slawson) Family Medicine, Atrium Health Charlotte, NC, United States
Publisher
American Academy of Family Physicians

<95>
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). <br/>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.
<br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2024, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<96>
[Use Link to view the full text]
Accession Number
2026311351
Title
Effect of permissive hypercarbia on lung oxygenation during one-lung
ventilation and postoperative pulmonary complications in patients
undergoing thoracic surgery: A prospective randomised controlled trial.
Source
European Journal of Anaesthesiology. 40(9) (pp 691-698), 2023. Date of
Publication: 01 Sep 2023.
Author
Joe Y.-E.; Lee C.Y.; Kim N.; Lee K.; Kang S.J.; Oh Y.J.
Institution
(Joe, Lee, Kim, Lee, Kang) Department of Anaesthesiology and Pain
Medicine, Anaesthesia and Pain Research Institute, South Korea
(Oh) Department of Thoracic and Cardiovascular Surgery, Yonsei University,
College of Medicine, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe effect of hypercarbia on lung oxygenation during thoracic
surgery remains unclear.OBJECTIVETo investigate the effect of hypercarbia
on lung oxygenation during one-lung ventilation in patients undergoing
thoracic surgery and evaluate the incidence of postoperative pulmonary
complications.DESIGNProspective randomised controlled trial.SETTINGA
tertiary university hospital in the Republic of Korea from November 2019
to December 2020.PATIENTSTwo hundred and ninety-seven patients with
American Society of Anaesthesiologists physical status II to III,
scheduled to undergo elective lung resection surgery.INTERVENTIONPatients
were randomly assigned to Group 40, 50, or 60. An autoflow ventilation
mode with a lung protective ventilation strategy was applied to all
patients. Respiratory rate was adjusted to maintain a partial pressure of
arterial carbon dioxide of 40 +/- 5 mmHg in Group 40, 50 +/- 5 mmHg in
Group 50 and 60 +/- 5 mmHg in Group 60 during one-lung ventilation and at
the end of surgery.MAIN OUTCOME MEASURESThe primary outcome was the
arterial oxygen partial pressure/fractional inspired oxygen ratio after 60
min of one-lung ventilation.RESULTSData from 262 patients were analysed.
The partial pressure/fractional inspired oxygen ratio was significantly
higher in Group 50 and Group 60 than in Group 40 (269.4 vs. 262.9 vs.
214.4; P < 0.001) but was not significantly different between Group 50 and
Group 60. The incidence of postoperative pulmonary complications was
comparable among the three groups.CONCLUSIONPermissive hypercarbia
improved lung oxygenation during one-lung ventilation without increasing
the risk of postoperative pulmonary complications or the length of
hospital stay.TRIAL REGISTRATIONNCT 04175379.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<97>
Accession Number
2026084840
Title
Remimazolam vs Etomidate: Haemodynamic Effects in Hypertensive Elderly
Patients Undergoing Non-Cardiac Surgery.
Source
Drug Design, Development and Therapy. 17 (pp 2943-2953), 2023. Date of
Publication: 2023.
Author
Chen J.; Zou X.; Hu B.; Yang Y.; Wang F.; Zhou Q.; Shen M.
Institution
(Chen) School of Anesthesiology, Guizhou Medical University, Guizhou
Province, Guiyang City, China
(Zou, Hu, Yang, Wang, Zhou, Shen) Department of Anesthesiology, Affiliated
Hospital of Guizhou Medical University, Guizhou Province, Guiyang City,
China
Publisher
Dove Medical Press Ltd
Abstract
Background: Remimazolam tosilate (RT) is a novel ultrashort-acting
gamma-aminobutyric acid subtype A (GABA<inf>A</inf>) agonist, with several
advantages including rapid induction and recovery, stable haemodynamics,
and mild respiratory inhibition. However, studies have not been conducted
to explore the haemodynamic effects of RT in elderly hypertensive subjects
undergoing non-cardiac surgery. Therefore, we sought to compare the
effects of anaesthesia induction using different doses of RT and etomidate
on the haemodynamics of this group of patients. <br/>Method(s): Patients
were recruited into this single-center, prospective, randomized,
double-blind trial from October 2022 to June 2023. A total of 150
hypertensive elderly undergoing non-cardiac surgery were randomly assigned
into 0.2 mg/kg RT group (Group RL), 0.3 mg/kg RT group (Group RH) and 0.3
mg/kg etomidate group (Group E). The primary outcome of the study was
haemodynamic changes (mean arterial pressure fluctuation value-MAP and
heart rate fluctuation value-HR) observed during anaesthesia induction.
Secondary outcomes included incidence of adverse cardiovascular events and
adverse drug reactions (injection pain and myoclonus), cumulative doses of
vasoactive drugs and vital signs at different time points. <br/>Result(s):
Patients in Group E and Group RL had significantly lower haemodynamic
fluctuations (MAP), lower incidence of hypotension and cumulative dose of
ephedrine than subjects in Group RH. Patients in groups RL and RH had
significantly lower incidence of injection pain and myoclonus compared
with patients in group E. The results showed no statistically significant
differences in HR, hypertension, bradycardia, tachycardia, and time to
loss of eye-opening reflex and start of intubation, and vital signs at
different time points among the three groups. <br/>Conclusion(s): Use of
low-dose RT (0.2 mg/kg) for induction of non-cardiac surgical anaesthesia
in elderly hypertensive patients is more effective in maintaining
haemodynamic stability and has fewer adverse effects compared with
etomidate.<br/>Copyright &#xa9; 2023 Chen et al. This work is published
and licensed by Dove Me.

<98>
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. <br/>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).
<br/>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). <br/>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.<br/>Copyright &#xa9; The Author(s) 2023.

<99>
Accession Number
2025198372
Title
The analgesic efficacy of erector spinae plane block versus paravertebral
block in thoracic surgeries: a meta-analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1208325.
Date of Publication: 2023.
Author
Fenta E.; Kibret S.; Hunie M.; Tamire T.; Mekete G.; Tiruneh A.; Fentie
Y.; Dessalegn K.; Teshome D.
Institution
(Fenta, Kibret, Hunie, Tamire, Mekete, Tiruneh, Fentie, Dessalegn,
Teshome) Department of Anesthesia, College of Health Sciences, Debre Tabor
University, Debre Tabor, Ethiopia
Publisher
Frontiers Media SA
Abstract
Background: Acute postoperative pain after thoracic surgery might lead to
chronic postsurgical pain (PSP), which lowers quality of life. The
literature suggests thoracic paravertebral block (PVB) as a pain
management approach. The ESPB (erector spinae plane block) is regarded to
be an effective PVB alternative. The analgesic efficacy of the two
analgesic therapies is controversial. The purpose of this study is to
compare the analgesic efficacy of ESPB and PVB in preventing acute PSP.
<br/>Method(s): We searched relevant articles in PubMed, Cochrane Library,
Embase, Web of Science, and Google Scholar databases. The primary outcome
was postoperative pain score, with secondary outcomes including analgesic
consumption, the frequency of rescue analgesia, and postoperative nausea
and vomiting. <br/>Result(s): This meta-analysis included ten RCTs with a
total of 670 patients. PVB significantly lowered the pain scores at
movement at 12 h following surgery as compared to the ESPB. The PVB group
used much less opioids within 24 h after surgery compared to the ESPB
group. However, there were no significant differences between the groups
in terms of postoperative rescue analgesia or in the incidence of
postoperative nausea and vomiting (p > 0.05). <br/>Conclusion(s): PVB
produced superior analgesia than ESPB in patients who underwent thoracic
surgeries. In addition, PVB demonstrated greater opioid sparing effect by
consuming much less opioids. Systematic review registration: This trial is
registered on PROSPERO, number CRD42023412159.<br/>Copyright &#xa9; 2023
Fenta, Kibret, Hunie, Tamire, Mekete, Tiruneh, Fentie, Dessalegn and
Teshome.

<100>
Accession Number
2027200631
Title
Impact of Neoadjuvant Immune Checkpoint Inhibitors on Surgery and
Perioperative Complications in Patients With Non-small-cell Lung Cancer: A
Systematic Review.
Source
Clinical Lung Cancer. 24(7) (pp 581-590.e5), 2023. Date of Publication:
November 2023.
Author
Takada K.; Takamori S.; Brunetti L.; Crucitti P.; Cortellini A.
Institution
(Takada) Department of Surgery, Saiseikai Fukuoka General Hospital,
Fukuoka, Japan
(Takamori) Department of Surgery and Science, Graduate School of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Brunetti, Cortellini) Medical Oncology Department, Fondazione Policlinico
Universitario Campus Bio-Medico, Rome, Italy
(Crucitti) Thoracic Surgery Department, Fondazione Policlinico
Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome,
Italy, Via Alvaro del Portillo 200, Rome 00128, Italy
(Cortellini) Department of Surgery and Cancer, Hammersmith Hospital
Campus, Imperial College London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Several clinical trials are currently underway to evaluate immune
checkpoint inhibitors (ICIs) as neoadjuvant treatment for patients with
early-stage non-small-cell lung cancer (NSCLC), and their use in clinical
practice is expected to increase in the future. Therefore, a proper
assessment of surgical outcomes and perioperative complications after
neoadjuvant ICIs is essential to establish recommendations and guidelines.
We performed a systematic literature review in accordance with the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
guidelines (PRISMA), searching the PubMed and Scopus databases from the
January 1, 2017, to the July 27, 2023, to identify potentially relevant
published trials of neoadjuvant ICIs in patients with reseactable NSCLC
with available information on surgical outcomes and perioperative
complications. A total of 18 studies were included in the review. The
rates of surgery cancellation ranged from 0% to 45.8%. Importantly,
adverse events (AEs) were the least reported underlying cause, while
disease progression caused from 0% to 75% of cancellations. Surgery delays
ranged from 0% to 31.3% with AEs as the most frequently reported
underlying cause. However, 6 out of 13 trials (46.2%) reported no surgery
delays. Conversion rates from minimally invasive to open chest surgery
were available for 7 trials and ranged from 0% to 53.8%. Thirty-day
mortality rates ranged from 0% to 5.4%, with 11 out of 16 trials reporting
0%. A few reports described perioperative complications in detail.
Considering the limited evidence available, we can preliminarily confirm
that preoperative ICIs are safe and well tolerated even from the surgical
perspective. Additional details on intraoperative findings from
prospective controlled trials are needed to establish and disseminate
guidelines and recommendations for thoracic surgeons.<br/>Copyright &#xa9;
2023 The Authors

<101>
Accession Number
2024828372
Title
Utilization and outcomes of V-AV ECMO: A systematic review and
meta-analysis.
Source
Artificial Organs. 47(10) (pp 1559-1566), 2023. Date of Publication:
October 2023.
Author
Saxena A.; Curran J.; Ahmad D.; Nasher N.; Miyamoto T.; Brailovsky E.;
Shah M.K.; Rajapreyar I.N.; Rame J.E.; Loforte A.; Entwistle J.W.; Massey
H.T.; Tchantchaleishvili V.
Institution
(Saxena, Curran, Ahmad, Nasher, Miyamoto, Entwistle, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Brailovsky, Shah, Rajapreyar, Rame) Division of Cardiology, Thomas
Jefferson University, Philadelphia, PA, United States
(Loforte) Dipartimento Cardio-Toraco-Vascolare, UOC di Cardiochirurgia,
Policlinico di S. Orsola, Universita di Bologna, Bologna, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Veno-arterial-venous extracorporeal membrane oxygenation (V-AV
ECMO) is a less commonly used configuration of ECMO. We sought to
understand the indications, utilization patterns, and outcomes of V-AV
ECMO by quantitatively pooling the existing evidence from the literature.
<br/>Method(s): Electronic search was performed to identify all relevant
studies reporting V-AV ECMO usage. Five studies comprising 77 patients
were selected and cohort-level data were extracted for further analysis.
<br/>Result(s): Mean patient age was 61 (95% CI: 55.2, 66.5) years and 30%
(23/77) were female. The majority of cases [91% (70/77)] were transitioned
to V-AV ECMO from another pre-existing ECMO configuration: V-A ECMO in 55%
(42/77) vs. V-V ECMO in 36% (28/77), p = 0.04. Only 9% (7/77) of cases
were directly placed on V-AV ECMO. The mean duration of hospital stay was
42.3 (95% CI: 10.5, 74.2) days, while ICU mortality was 46% (29, 64).
Transition to durable left ventricular assist device was performed in 3%
(2/64) of patients, while 3% (2/64) underwent heart transplantation. V-AV
ECMO was successfully weaned to explantation in 33% (21/64) of patients.
<br/>Conclusion(s): V-AV ECMO is a viable option for optimizing
cardiopulmonary support in selected patients. Survival to weaning or
bridging therapy appears comparable to more common ECMO
configurations.<br/>Copyright &#xa9; 2023 International Center for
Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

<102>
Accession Number
2026378524
Title
A Systematic Review of Individualized Heart Surgery with a Personalized
Prosthesis.
Source
Journal of Personalized Medicine. 13(10) (no pagination), 2023. Article
Number: 1483. Date of Publication: October 2023.
Author
Sazzad F.; Ramanathan K.; Moideen I.S.; Gohary A.E.; Stevens J.C.; Kofidis
T.
Institution
(Sazzad, Ramanathan, Moideen, Gohary, Stevens, Kofidis) Department of
Surgery, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore 117599, Singapore
(Ramanathan, Kofidis) Department of Cardiac, Thoracic and Vascular
Surgery, National University Heart Centre, Singapore 119228, Singapore
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Personalized surgery is not just a new trend but rather a patient-specific
approach to therapy that makes it possible to adopt a targeted approach
for a specific patient and closely mirrors the approach of personalized
medicine. However, the application of tailored surgery in the context of
cardiovascular replacement surgery has not been systematically reviewed.
The ability to customize a device is highly dependent on the collection of
radiological image data for precise prosthesis modeling. These facts are
essential to "tailor-made" device design for precise prosthesis
implantation. According to this study, computed tomography (CT) was the
most prominent imaging modality; however, transesophageal echocardiography
and echocardiography were also found to be helpful. Additionally, a
dynamic finite element simulation was also found to be an attractive
alternative to the finite element analysis for an in-silico experiment.
Nonetheless, there is a paucity of relevant publications and only sporadic
evidence. More clinical studies have been warranted, notwithstanding that
the derived data and results from this insight into the use of therapeutic
interventions may be evidence of multiple directives in clinical practices
and beyond. This study may help the integration of personalized devices
for better comprehension of predicted clinical outcomes, thus leading
towards enhanced performance gains.<br/>Copyright &#xa9; 2023 by the
authors.

<103>
Accession Number
2028041857
Title
The effect of intravenous milrinone in adult critically ill patients: A
meta-analysis of randomized clinical trials.
Source
Journal of Critical Care. 79 (no pagination), 2024. Article Number:
154431. Date of Publication: February 2024.
Author
Xu J.; Zhang Y.; Jiang J.; Yang Y.; Guo F.
Institution
(Xu, Yang, Guo) Jiangsu Provincial Key Laboratory of Critical Care
Medicine, Department of Critical Care Medicine, Zhongda Hospital, School
of Medicine, Southeast University, Nanjing 210009, China
(Zhang) Department of Critical Care Medicine, Zhongda Hospital, School of
Medicine, Southeast University, Nanjing 210009, China
(Jiang) Department of Critical Care Medicine, Zhongda Hospital, School of
Medicine, Nanjing Central Hospital, Nanjing 210009, China
Publisher
W.B. Saunders
Abstract
Background: Milrinone is widely used for enhancing myocardial
contractility, however, there is inadequate data to suggest whether it is
preferable to other inotropic agents in critically ill patients. To
observe the effect of milrinone on prognosis in adult critically ill
patients, we conducted this meta-analysis. <br/>Method(s): A search of the
following databases was conducted: Medline, Elsevier, Cochrane Central
Register of Controlled Trials and Web of Science databases, and eligible
randomized controlled trials including adult critically ill patients were
screened. Two reviewers collected data separately, information was
retrieved including study design, center number, sample size, gender, age,
intervention and outcome. Data were analyzed using methods recommended by
the Cochrane Collaboration Review Manager 4.2 software. Random errors were
evaluated by trial sequential analysis (TSA). <br/>Result(s): Twenty
studies including 2036 critically ill patients which compared milrinone
with control group were enrolled. When compared to control group, there
was no significant difference of all-cause mortality, while the incidence
of ventricular arrhythmia decreased significantly in patients with cardiac
surgery who using milrinone, but not in patients with cardiac dysfunction
and shock. There was no significant reduction in the incidence of
myocardial infarction and no improvement of hemodynamic parameters in the
milrinone group. TSA indicated lack of firm evidence for a beneficial
effect. <br/>Conclusion(s): The meta-analysis showed when compared with
control group, although no significant reduction in mortality and the
incidence of myocardial infarction was found in the milrinone group, the
incidence of ventricular arrhythmia decreased significantly in patients
with cardiac surgery. More randomized controlled trials are needed to
determine the reliable and conclusive evidence for milrinone's
effects.<br/>Copyright &#xa9; 2023

<104>
Accession Number
2026353011
Title
Left Atrial Appendage Occlusion versus Novel Oral Anticoagulation for
Stroke Prevention in Atrial Fibrillation-One-Year Survival.
Source
Journal of Clinical Medicine. 12(20) (no pagination), 2023. Article
Number: 6693. Date of Publication: October 2023.
Author
Tiosano S.; Banai A.; Mulla W.; Goldenberg I.; Bayshtok G.; Amit U.;
Shlomo N.; Nof E.; Rosso R.; Glikson M.; Guetta V.; Barbash I.; Beinart R.
Institution
(Tiosano, Mulla, Goldenberg, Bayshtok, Amit, Shlomo, Nof, Guetta, Barbash,
Beinart) Leviev Heart Center, Sheba Medical Center, Ramat Gan 52621,
Israel
(Tiosano, Banai, Goldenberg, Bayshtok, Amit, Shlomo, Nof, Rosso, Guetta,
Barbash, Beinart) Faculty of Medicine, Tel Aviv University, Ramat Aviv,
Tel Aviv 6997801, Israel
(Banai, Rosso) Department of Cardiology, Tel Aviv Sourasky Medical Center,
Tel Aviv 64239, Israel
(Mulla) Surgeon General Headquarters, Israel Defense Forces, Ramat Gan
5262000, Israel
(Bayshtok) Arrow Program, Sheba Medical Center, Ramat Gan 5266202, Israel
(Glikson) Jesselson Integrated Heart Center, Shaare Zedek Medical Center,
Jerusalem 9103102, Israel
(Glikson) Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem
9574425, Israel
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Aim To compare the 1-year survival rate of patients with atrial
fibrillation (AF) following left atrial appendage occluder (LAAO)
implantation vs. treatment with novel oral anticoagulants (NOACs).
<br/>Method(s): We have conducted an indirect, retrospective comparison
between LAAO and NOAC registries. The LAAO registry is a national
prospective cohort of 419 AF patients who underwent percutaneous LAAO
between January 2008 and October 2015. The NOACs registry is a multicenter
prospective cohort of 3138 AF patients treated with NOACs between November
2015 and August 2018. Baseline patient characteristics were
retrospectively collected from coded diagnoses of hospitalization and
outpatient clinic notes. Follow-up data was sorted from coded diagnoses
and the national civil registry. Subjects were matched according to
propensity score. Baseline characteristics were compared using Chi-Square
and student's t-test. Survival analysis was performed using Kaplan-Meier
survival curves, log-rank test, and multivariable Cox regression,
adjusting for possible confounding variables. <br/>Result(s): This study
included 114 subjects who underwent LAAO implantation and 342 subjects
treated with NOACs. The mean age of participants was 77.9 +/- 7.44 and
77.1 +/- 11.2 years in the LAAO and NOAC groups, respectively (p = 0.4).
The LAAO group had 70 (61%) men compared to 202 (59%) men in the NOAC
group (p = 0.74). No significant differences were found in baseline
comorbidities, renal function, or CHA<inf>2</inf>DS<inf>2</inf>-VASc
score. One-year mortality was observed in 5 (4%) patients and 32 (9%)
patients of the LAAO and NOAC groups, respectively. After adjusting for
confounders, LAAO was significantly associated with a lower risk for
1-year mortality (HR 0.38, 95%CI 0.14-0.99). In patients with impaired
renal function, this difference was even more prominent (HR 0.21 for
creatinine clearance (CrCl) < 60 mL/min). <br/>Conclusion(s): In a pooled
analysis of two registries, we found a significantly lower risk for 1-year
mortality in patients with AF who were implanted with LAAO than those
treated with NOACs. This finding was more prominent in patients with
impaired renal function. Future prospective direct studies should further
investigate the efficacy and adverse effects of both treatment
strategies.<br/>Copyright &#xa9; 2023 by the authors.

<105>
Accession Number
2027217381
Title
To evaluate the effectiveness of intraperitoneal instillation of 0.5%
ropivacaine for improving perioperative haemodynamics.
Source
Journal of Cardiovascular Disease Research. 12(7) (pp 2725-2730), 2021.
Date of Publication: 2021.
Author
Gupta P.
Institution
(Gupta) Dept. Anaesthesia, GRMC, MP, Gwalior, India
Publisher
EManuscript Technologies
Abstract
Background & Aim Pain following laparoscopy is due to irritation of
diaphragm and stretching of peritoneum associated with carbon dioxide
insufflation. The aim of the study is to evaluate the effectiveness of
intraperitoneal instillation of 0.5% ropivacaine for improving
perioperative haemodynamics in paediatric age group. Method After
receiving ethical committee approval in NSCB Medical College Jabalpur and
written and informed consent of parents,.60 ASA I and ASA II patients of
both sex of age group 6-14 years were randomly allocated to two groups. In
group R, 0.5% Ropivacaine was instilled intraperitoneally under the
surface of diaphragm after the creation of pneumoperitoneum. In group C
Normal Saline was instilled instead of ropivacaine. Both the groups were
subjected to pre-incisional periportal infiltration with
1%lignocaine.Heart rate(HR) and Mean Arterial Pressure(MAP) were recorded
at 5 minutes interval for a duration of 60 minutes.. Results Heart Rate
(HR)noted every five minutes for the duration of surgery were lower in
Group R(study group) in comparison to Group C(control group). The results
were comparable and the difference was found to be significant(p<0.0001)
in the two groups intraoperatively for the duration of surgery. Also heart
rate after extubation was significantly lower (p<0.0001) in the study
group(Mean 81.77+/-2.75) than the control group(Mean 99.27+/-1.36).Mean
blood pressure was recorded every 5 minutes in both the groups for the
duration of surgery. Blood pressure readings were significantly lower in
Group R (p<0.001)[Mean 81.27] than in Group C[Mean 85.70]. Conclusion
Intraperitoneal instillation of ropivacaine is a safe and effective
modality of providing analgesia that improves intraoperative
haemodynamics.<br/>Copyright &#xa9; 2021 EManuscript Technologies. All
rights reserved.

<106>
Accession Number
2028110783
Title
Comparison of Volatile Anesthetics Versus Propofol on Postoperative
Cognitive Function After Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Han J.; Ryu J.-H.; Jeon Y.-T.; Koo C.-H.
Institution
(Han) Department of Anesthesiology and Pain Medicine, Chung-Ang University
College of Medicine, Seoul, South Korea
(Ryu, Jeon, Koo) Department of Anesthesiology and Pain Medicine, Seoul
National University Bundang Hospital, Seongnam, South Korea
(Ryu, Jeon, Koo) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: To compare the effects of volatile anesthetics and propofol on
neurocognitive function after cardiac surgery. <br/>Design(s): A
systematic review and meta-analysis of randomized controlled trials.
<br/>Setting(s): A literature search of PubMed, EMBASE, CENTRAL, CINAHL,
Scopus, and Web of Science databases was conducted. <br/>Participant(s): A
total of 10 randomized controlled trials comparing volatile anesthetics
and propofol in cardiac surgery were included in the study.
<br/>Intervention(s): The standardized mean difference and risk ratio were
calculated to estimate pooled effect sizes. <br/>Measurements and Main
Results: The primary outcome was the postoperative neurocognitive function
score, and the secondary outcome was the incidence of delirium after
cardiac surgery. The analysis did not show significant differences in
postoperative neurocognitive function scores (standardized mean difference
-0.06, 95% CI -0.81-0.69; p = 0.879). The incidences of delirium (risk
ratio 1.10, 95% CI 0.81-1.50) between the volatile anesthetics and
propofol groups were not significant (p = 0.533). <br/>Conclusion(s):
Unlike noncardiac surgery, there are no differences between volatile
anesthetics and propofol regarding postoperative neurocognitive
dysfunction after cardiac surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<107>
Accession Number
2028110772
Title
Developments in Postoperative Analgesia in Open and Minimally Invasive
Thoracic Surgery Over the Past Decade.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Schwarzova K.; Whitman G.; Cha S.
Institution
(Schwarzova) Ascension Saint Agnes Hospital, Baltimore, Maryland, United
States
(Whitman, Cha) Johns Hopkins Hospital, Baltimore, Maryland, United States
Publisher
W.B. Saunders
Abstract
Whether through minimally invasive or conventional open techniques,
thoracic surgery is often reported to be one of the most painful surgical
procedures due to the incision of intercostal and respiratory muscles, rib
injury or resection, and placement of surgical drains. Some of the more
severe complications related to poor analgesia include prolonged intensive
care unit stay, mechanical ventilation, pneumonia, and the development of
chronic postoperative pain syndromes. Over the past few decades, much
progress has been made in recognizing the importance of multimodal
analgesic techniques. These may include a variety of regional anesthetic
techniques such as epidural anesthesia, fascial plane blocks, and
intrapleural catheters, as well as the utilization of opioid and
opioid-sparing oral regimens. This article provides an up-to-date review
of pain management following thoracic surgery, emphasizing multimodal
techniques and enhanced recovery pathways. In our review, we included
articles published between 2010 and 2022. PubMed and Google Scholar were
researched using the keywords thoracic, cardiac, pain control, thoracic
epidural analgesia, fascial plane blocks, multimodal analgesia, and
Enhanced Recovery after Surgery in thoracic surgery. Over 100 articles
were then reviewed. We excluded articles not in English and articles that
were not pertinent to cardiac or thoracic surgery. Eventually, 53 articles
were included in the review, composed of clinical trials, case series, and
retrospective cohort studies. A variety of pain control methods employed
in thoracic and cardiac surgery range from opioids and opioid-sparing
medications, such as acetaminophen and gabapentin, to regional techniques,
such as fascial plane blocks to epidural anesthesia. Multimodal anesthesia
combining regional and opioid-sparing analgesics and their combination in
enhanced recovery protocols were shown to provide adequate pain control,
decrease opioid consumption and lead to shorter lengths of stay.
Postoperative pain control remains one of the biggest challenges in the
care of thoracic surgery patients. Analgesic plans must be individualized
for each patient. Multimodal analgesia remains the gold standard; however,
more studies are still warranted. Finding the optimal combination of
opioid and non-opioid pain medication and local anesthetic delivered via
suitable regional technique will improve the outcomes and lead to
successful patient recovery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<108>
Accession Number
2026407884
Title
Percutaneous coronary intervention in patients undergoing transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
Netherlands Heart Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Aarts H.M.; van Hemert N.D.; Meijs T.A.; van Nieuwkerk A.C.; Berg J.M.;
Wykrzykowska J.J.; van Royen N.; Schotborgh C.E.; Tonino P.A.L.;
IJsselmuiden A.; Vossenberg T.N.; van Houwelingen G.K.; Slagboom T.;
Voskuil M.; Delewi R.
Institution
(Aarts, van Hemert, Meijs, Voskuil) Department of Cardiology, University
Medical Centre Utrecht, Utrecht, Netherlands
(Aarts, Meijs, van Nieuwkerk, Delewi) Department of Cardiology, Amsterdam
University Medical Centre, Amsterdam, Netherlands
(Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Berg) Department of Cardiology, Maastricht University Medical Centre,
Maastricht, Netherlands
(Wykrzykowska) Department of Cardiology, Groningen University Medical
Centre, University of Groningen, Groningen, Netherlands
(van Royen) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Vossenberg) Department of Cardiology, Medical Centre Leeuwarden,
Leeuwarden, Netherlands
(van Houwelingen) Department of Cardiology, Thorax Centre Twente, Medical
Spectrum Twente, Enschede, Netherlands
(Slagboom) Department of Cardiology, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Objective: The importance of revascularisation of significant coronary
artery disease (CAD) in patients undergoing transcatheter aortic valve
implantation (TAVI) is unclear. Despite the lack of randomised controlled
trials comparing different revascularisation strategies, guidelines
currently recommend percutaneous coronary intervention (PCI) in patients
with significant proximal CAD undergoing TAVI. <br/>Method(s): In this
systematic review and meta-analysis, a systematic search was conducted to
identify studies comparing TAVI with and without PCI in patients with
significant CAD on pre-TAVI coronary angiography. Endpoints were all-cause
mortality, cardiac death, stroke, myocardial infarction and major
bleeding. <br/>Result(s): In total, 14 studies were included, involving
3838 patients, of whom 1806 (47%) underwent PCI before TAVI. All-cause
mortality did not differ significantly between TAVI with and without
preceding PCI at 30 days, 1 year and >1 year. There were no significant
differences in risk of cardiac death, stroke or myocardial infarction
between the groups. However, TAVI performed with PCI resulted in a higher
risk of major bleeding within 30 days after TAVI (odds ratio: 0.66; 95%
confidence interval: 0.46-0.94). <br/>Conclusion(s): This systematic
review and meta-analysis showed no significant differences in clinical
outcomes between patients with concomitant significant CAD who were
treated with TAVI with and without preceding PCI at both short- and
long-term follow-up. However, there was a higher risk of major bleeding at
30 days in patients undergoing TAVI with preceding PCI. In the context of
serious risk of bias in the included studies, results of randomised
controlled trials are warranted.<br/>Copyright &#xa9; 2023, The Author(s).

<109>
Accession Number
2025820180
Title
Individualized heparin monitoring and management reduces protamine
requirements in cardiac surgery on minimal invasive extracorporeal
circulation; A prospective randomized study.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Gkiouliava A.; Argiriadou H.; Antonitsis P.; Goulas A.; Papapostolou E.;
Sarridou D.; Karapanagiotidis G.T.; Anastasiadis K.
Institution
(Gkiouliava, Argiriadou, Papapostolou, Sarridou) Department of
Anesthesiology and Intensive Care, AHEPA University Hospital, Aristotle
University of Thessaloniki School of Medicine, Thessaloniki, Greece
(Antonitsis, Karapanagiotidis, Anastasiadis) Cardiothoracic Department,
AHEPA University Hospital, Aristotle University of Thessaloniki School of
Medicine, Thessaloniki, Greece
(Goulas) First Laboratory of Pharmacology, Aristotle University of
Thessaloniki School of Medicine, Thessaloniki, Greece
Publisher
SAGE Publications Ltd
Abstract
Introduction: Individualized heparin and protamine management is
increasingly used as a strategy to reduce coagulation activation and
bleeding complications. While it is associated with increased heparin
requirements during Cardiopulmonary Bypass (CPB), the impact on protamine
administration remains controversial. We aim to investigate the effect of
heparin level-guided monitoring on protamine dosing during cardiac surgery
where low-anticoagulation protocols are implemented. <br/>Method(s): This
is a prospective, randomized, controlled trial. A total of 132 patients
undergoing elective full-spectrum cardiac surgery with Minimal Invasive
Extracorporeal Circulation (MiECC) were recruited. All patients were
managed by the same anaesthetic, surgical and perfusion team. Patients
were randomly allocated in two groups; the individualized
heparin-protamine titration (IHPT) group and the conventional
heparinization and reversal group by using ACT (cACT) with a 0.75:1,
protamine: heparin ratio. Titration was accomplished with the Hepcon HMS
Plus (Medtronic, Minneapolis, MN) system. The primary outcome of the study
was the total protamine dose used. Secondary outcomes comprised of the
total heparin dose, the percentage of patients achieving target ACT, 24-h
transfusion requirements, postoperative bleeding, duration of mechanical
ventilation, major morbidity and length of hospital stay. Patients in each
group were divided in two subgroups according to the target ACT; those
operated for coronary artery bypass grafting (CABG) using a target ACT
>300 s and the rest (non-CABG) patients operated with a target ACT >400 s,
respectively. <br/>Result(s): Protamine requirements were significantly
reduced when IHPT was implemented; CABG (118 +/- 24 mg vs 163 +/- 61 mg; p
< 0.001) and non-CABG cases (151 +/- 46 mg vs 197 +/- 45 mg; p < 0.001).
Moreover, heparin requirements were significantly higher in the non-CABG
subgroup managed with IHPT (34,539 +/- 7658 IU vs 29,893 +/- 9037 IU; p =
0.02). In overall, no significant differences were detected with respect
to postoperative bleeding, transfusion of RBC or other blood products.
<br/>Conclusion(s): Individualized heparin monitoring and management
reduces protamine requirements in cardiac surgery with MiECC implementing
reduced anticoagulation strategy. Trial registration: clinicaltrials.gov;
NCT04215588.<br/>Copyright &#xa9; The Author(s) 2023.

<110>
Accession Number
642630832
Title
Balloon-vs. Self-Expanding Transcatheter Valve for Failed Small Surgical
Aortic Bioprostheses:1-Year Results of the LYTEN Trial.
Source
JACC. Cardiovascular interventions. (no pagination), 2023. Date of
Publication: 18 Oct 2023.
Author
Nuche J.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.; Regueiro
A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly S.;
Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Giuliani C.;
Pelletier-Beaumont E.; Pibarot P.; Rodes-Cabau J.
Institution
(Nuche, Mohammadi, Giuliani, Pelletier-Beaumont, Pibarot, Rodes-Cabau)
Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Abbas) Beaumont Hospital, Royal Oak, MI, United States
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott and White The Heart Hospital Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Associates, Syracuse, NY, United States
(Conradi) University Heart and Vascular Center, Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M Ross
Hospital, Columbus, OH, United States
Abstract
BACKGROUND: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) field have been obtained
from retrospective studies. <br/>OBJECTIVE(S): To compare the 1-year
hemodynamic performance and clinical outcomes between balloon-expandable
valves (BEV) SAPIEN 3/ULTRA (Edwards Lifesciences) and self-expanding
valves (SEV) Evolut R/PRO/PRO+ (Medtronic) in ViV-TAVR. <br/>METHOD(S):
Patients with a failed small (<= 23 mm) surgical valve undergoing ViV-TAVR
were randomized to receive a SEV or a BEV. Patients had a clinical and
valve hemodynamic (Doppler-echocardiography) evaluation at 1-year
follow-up. Study outcomes were defined according to VARC-2/VARC-3
criteria. <br/>RESULT(S): A total of 98 patients underwent ViV-TAVR
(46-BEV, 52-SEV). Patients receiving a SEV had a lower peak and mean
trans-aortic gradients (peak: 42+/-15 mmHg-BEV vs. 27+/-14 mmHg-SEV,
p<0.001; mean: 22+/-8 mmHg-BEV vs. 14+/-7 mmHg-SEV, p < 0.001), and a
higher rate on intended valve hemodynamic performance (BEV:30%, SEV:76%, p
< 0.001). There were no cases of greater than mild aortic regurgitation.
There were no differences in functional status (NYHA class > II, BEV:
7.3%, SEV:4.1%, p=0.505) or quality of life (KCCQ, BEV:77.9+/-21.2,
SEV:81.8+/-14.8, p=0.334). No differences in all-cause mortality
(BEV:6.5%, SEV:3.9%, p=0.495), heart failure hospitalization (BEV:6.5%,
SEV:1.9%, p=0.214), stroke (BEV:0%, SEV:1.9%; p=0.369), myocardial
infarction (BEV:0%, SEV:1.9%, p=0.347), or pacemaker implantation
(BEV:2.2%, SEV:1.9%, p=0.898) were found. <br/>CONCLUSION(S): In patients
who underwent ViV-TAVR for small failed aortic bioprostheses, a better
hemodynamic profile was found after one year in patients receiving a SEV.
Differences were not found between SEV and BEV in regard to functional
status, quality of life, or clinical outcomes.<br/>Copyright &#xa9; 2023.
Published by Elsevier Inc.

<111>
Accession Number
2018496226
Title
Role of Aromatherapy as a Natural Complementary and Alternative Therapy in
Cardiovascular Disease: A Comprehensive Systematic Review.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 4543078. Date of Publication: 2022.
Author
Almohammed H.I.; A Alanazi N.; Maghrabi E.F.; A Alotaibi M.
Institution
(Almohammed) Department Of Basic Science, Faculty Of Medicine, Almaarefa
University, Riyadh 11597, Saudi Arabia
(A Alanazi, Maghrabi) Faculty Of Medicine, University Science Malaysia
(USM), Kelantan, Kubang Kerian 16150, Malaysia
(A Alotaibi) College Of Medicine, Imam Mohammad Ibn Saud Islamic
University, Riyadh, Saudi Arabia
Publisher
Hindawi Limited
Abstract
Background. The purpose of this study was a comprehensive review of
studies on the effect of aromatherapy with plant essential oils on the
improvement of some conditions, for example, anxiety, stress, sleep
quality, fatigue, and pain in people with cardiovascular disease.
Materials and Methods. We carried out this systematic review based on the
instructions of Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA). Ethical agreement was not necessary as main data
have not been collected. During March 2022, we searched the main English
databases, for example, Google Scholar, Web of Sciences, EMBASE, EBSCO,
ScienceDirect, Scopus, and PubMed/MEDLINE, with limitation to human
clinical trials. For this study, no time limit was applied for the
publication of articles. Results. Out of 1380 papers, 52 papers up to
March 2022 were eligible for review in this systematic review. Based on
the obtained results, the most widely used medicinal plants for
aromatherapy in patients with cardiovascular diseases were Lavandula
angustifolia (lavender, 55.7%), Rosa damascena (Damask rose, 11.5%), and
Mentha piperita (peppermint, 5.8%), respectively. Most studies have been
performed on the effect of aromatherapy on coronary angiography (21
papers, 40.4%), followed by artery bypass graft surgery (14 studies,
26.9%), and cardiac patients (5 studies, 9.6%). Most studies on the effect
of aromatherapy in cardiovascular diseases were performed on anxiety (31
papers, 59.6%), sleep quality (8 studies, 15.4%), and hemodynamic
parameters (6 studies, 11.5%), respectively. Conclusion. This study
systematically reviewed the effects of aromatherapy in patients with
cardiovascular diseases. The review of studies showed that lavender,
Damask rose, and peppermint are the most frequents plants used for
aromatherapy, whereas they significantly improved some illnesses and
conditions, especially anxiety and sleep quality. Therefore, it can be
concluded that cardiologist can used aromatherapy as a natural
complementary and alternative therapy particularly with lavender, Damask
rose, and peppermint to improve quality of life and some conditions such
as anxiety and sleep quality.<br/>Copyright &#xa9; 2022 Hamdan I
AlMohammed et al.

<112>
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. <br/>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. <br/>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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2023 Research Institute
for Gastroenterology and Liver Diseases. All rights reserved.

<113>
Accession Number
2027941020
Title
Comparing diagnostic accuracy of biomarkers for acute kidney injury after
major surgery: A PRISMA systematic review and network meta-analysis.
Source
Medicine (United States). 102(40) (pp E35284), 2023. Date of Publication:
06 Oct 2023.
Author
Lan H.; Liu X.; Yang D.; Zhang D.; Wang L.; Hu L.
Institution
(Lan, Liu, Yang) Department of Clinical Laboratory, Zigong Third People's
Hospital, Zigong City, China
(Zhang) Big Data Research Center, University of Electronic Science and
Technology, Chengdu, China
(Wang, Hu) Department of Neurology, Zigong Third People's Hospital, Zigong
City, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The timely identification of patients at risk of acute kidney
injury (AKI), along with early prevention, real-time monitoring, and
prompt intervention, plays a crucial role in enhancing patient prognosis
after major surgery. <br/>Method(s): We conducted a comprehensive search
across multiple databases, including Web of Science, EMBASE, MEDLINE,
China National Knowledge Infrastructure, and Cochrane Library. Each
study's risk of bias was independently evaluated as low, moderate, or
high, utilizing criteria adapted from Quality Assessment of Diagnostic
Accuracy Studies 2. The analysis was performed using STATA V.17.0 and R
software V.3.4.1. Diagnostic tests were ranked based on the dominance
index. We performed meta-analyses to calculate odds ratios (ORs) and 95%
confidence intervals (CIs) individually. We then carried out a network
meta-analysis to compare the performances of these biomarkers.
<br/>Result(s): Fifteen studies were included in this analysis. The
meta-analysis findings revealed that among all the biomarkers assessed,
serum cystatin C (s-CysC) (hierarchical summary receiver operating
characteristic curve [HSROC] 82%, 95% CI 0.78-0.85) exhibited the highest
HSROC value. The network meta-analysis demonstrated that urinary kidney
injury molecule-1 (u-KIM-1) and s-CysC displayed relatively higher
sensitivity and specificity, respectively. In subgroup analyses, u-KIM-1
in the urine output (OU) group (OR 303.75, 95% CI 3.39-1844.88), s-CysC in
the non-OU group (OR 10.31, 95% CI 3.09-26.2), interleukin-18 in the
noncardiac surgery group (OR 46.20, 95% CI 0.48-307.68), s-CysC in the
cardiac group (OR 12.42, 95% CI 2.9-35.86), u-KIM-1 in the retrospective
group (OR 243.00, 95% CI 1.73-1582.11), and s-CysC in the prospective
group (OR 8.35, 95% CI 2.34-21.15) had the best diagnostic accuracy.
However, it is important to note that existing publication bias may reduce
the reliability of the above-mentioned results. <br/>Conclusion(s): The
biomarker of s-CysC has the highest HSROC value to predicting acute kidney
injury after major surgery in meta-analysis and relatively higher
specificity in network meta-analyses. u-KIM-1 exhibited relatively higher
sensitivity, with best diagnostic accuracy in the OU and retrospective
group in the subgroup analysis.<br/>Copyright &#xa9; 2023 Lippincott
Williams and Wilkins. All rights reserved.

<114>
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. <br/>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. <br/>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. <br/>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). <br/>Conclusion(s): CT-guided LML is safer and more
successful than HWL for patients with PNs before VATS
resection.<br/>Copyright &#xa9; 2023 Termedia Publishing House Ltd.. All
rights reserved.

<115>
Accession Number
2026828225
Title
Clinical characteristics and somatic burden of patients with
mucopolysaccharidosis II with or without neurological involvement: An
analysis from the Hunter Outcome Survey.
Source
Molecular Genetics and Metabolism Reports. 37 (no pagination), 2023.
Article Number: 101005. Date of Publication: December 2023.
Author
Lau H.; Harmatz P.; Botha J.; Audi J.; Link B.
Institution
(Lau) Yale School of Medicine, New Haven, CT, United States
(Harmatz) UCSF Benioff Children's Hospital Oakland, Oakland, CA, United
States
(Botha, Audi) Takeda Pharmaceuticals International AG, Zurich, Switzerland
(Link) Division of Metabolism, Connective Tissue Unit, University
Children's Hospital Zurich, Zurich, Switzerland
Publisher
Elsevier Inc.
Abstract
Approximately two-thirds of patients with mucopolysaccharidosis II (MPS
II; Hunter syndrome) have neuronopathic disease, with central nervous
system involvement; one-third have non-neuronopathic disease. This
analysis of data from the Hunter Outcome Survey (HOS) compared the
clinical manifestations and surgical and nonsurgical procedure history in
patients with neuronopathic or non-neuronopathic MPS II. Prospective
patients were identified in July 2018 in HOS for inclusion in this
analysis as those with stable cognitive impairment status as assessed at
10 years of age and at a minimum of one follow-up visit at 11 to <20 years
of age. Patients were stratified according to cognitive impairment status
at 10 years into neuronopathic and non-neuronopathic groups, and clinical
manifestations and surgical and nonsurgical procedure history were
compared between the two groups. In total, 193 patients had cognitive
impairment status assessments available (at 10 years and 11 to <20 years
of age), 151 of whom had stable cognitive impairment status and were
included; 100/151 (66.2%) were in the neuronopathic group and 51/151
(33.8%) in the non-neuronopathic group. The proportion of patients
demonstrating manifestations by system organ class and the number of
surgical and nonsurgical procedures per patient were broadly comparable in
the neuronopathic and non-neuronopathic groups both before and after
patients' 10th birthdays. The most common manifestations before patients'
10th birthdays, including facial features, joint stiffness and limited
function, and hepatomegaly were reported in >80% of patients in both
groups. For the neuronopathic and non-neuronopathic groups, the median
[10th percentile, 90th percentile] number of different types of surgical
and nonsurgical procedures per patient (3 [1, 6] and 3 [1, 7],
respectively) and of all procedures per patient (4 [1, 10] and 5 [2, 11],
respectively) before patients' 10th birthdays were similar, although the
type of procedure may have differed. Thus, in the first two decades of
life, patients with non-neuronopathic disease were found to have similar
somatic manifestations to those of the neuronopathic group and undergo
procedures for complications as often as those with neuronopathic
disease.<br/>Copyright &#xa9; 2023 The Authors

<116>
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.<br/>Copyright &#xa9; 2023 by the authors.

<117>
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. <br/>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.
<br/>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.
<br/>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.<br/>Copyright &#xa9; 2023, BioMed Central Ltd.,
part of Springer Nature.

<118>
Accession Number
2025457132
Title
Implications for implementation and adoption of telehealth in developing
countries: a systematic review of China's practices and experiences.
Source
npj Digital Medicine. 6(1) (no pagination), 2023. Article Number: 174.
Date of Publication: December 2023.
Author
Ye J.; He L.; Beestrum M.
Institution
(Ye) Weill Cornell Medicine, New York, NY, United States
(Ye) Feinberg School of Medicine, Northwestern University, Chicago, IL,
United States
(He) Zilber College of Public Health, University of Wisconsin-Milwaukee,
Milwaukee, WI, United States
(Beestrum) Galter Health Sciences Library and Learning Center,
Northwestern University, Chicago, IL, United States
Publisher
Nature Research
Abstract
The rapid advancement of telehealth technologies has the potential to
revolutionize healthcare delivery, especially in developing countries and
resource-limited settings. Telehealth played a vital role during the
COVID-19 pandemic, supporting numerous healthcare services. We conducted a
systematic review to gain insights into the characteristics, barriers, and
successful experiences in implementing telehealth during the COVID-19
pandemic in China, a representative of the developing countries. We also
provide insights for other developing countries that face similar
challenges to developing and using telehealth during or after the
pandemic. This systematic review was conducted through searching five
prominent databases including PubMed/MEDLINE, Embase, Scopus, Cochrane
Library, and Web of Science. We included studies clearly defining any use
of telehealth services in all aspects of health care during the COVID-19
pandemic in China. We mapped the barriers, successful experiences, and
recommendations based on the Consolidated Framework for Implementation
Research (CFIR). A total of 32 studies met the inclusion criteria.
Successfully implementing and adopting telehealth in China during the
pandemic necessitates strategic planning across aspects at society level
(increasing public awareness and devising appropriate insurance policies),
organizational level (training health care professionals, improving
workflows, and decentralizing tasks), and technological level (strategic
technological infrastructure development and designing inclusive
telehealth systems). WeChat, a widely used social networking platform, was
the most common platform used for telehealth services. China's practices
in addressing the barriers may provide implications and evidence for other
developing countries or low-and middle- income countries (LMICs) to
implement and adopt telehealth systems.<br/>Copyright &#xa9; 2023,
Springer Nature Limited.

<119>
Accession Number
2028100294
Title
The Role of Natriuretic Peptides in Predicting Adverse Outcomes After
Cardiac Surgery: An Updated Systematic Review.
Source
American Journal of Cardiology. 210 (pp 16-36), 2024. Date of Publication:
01 Jan 2024.
Author
Rao R.A.; Varghese S.S.; Ansari F.; Rao A.; Meng E.; El-Diasty M.
Institution
(Rao, Varghese, Ansari, Rao, Meng) Queen's University School of Medicine,
Kingston, ON, Canada
(El-Diasty) Harrington Heart and Vascular Institute, Cardiac Surgery
Department, University Hospitals, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
The increasing global burden of cardiovascular disease, particularly, in
the aging population, has led to an increase in high-risk cardiac surgical
procedures. The current preoperative risk stratification scores, such as
the European System for Cardiac Operative Risk Evaluation and the Society
for Thoracic Surgeons score, have limitations in their predictive accuracy
and tend to underestimate the mortality risk in higher-risk populations.
This systematic review aimed to evaluate the utility of natriuretic
peptides, brain natriuretic peptide (BNP) and its precursor prohormone
(N-terminal prohormone BNP), as predictive biomarkers for adverse outcomes
after cardiac surgery. A comprehensive search strategy was performed, and
63 studies involving 40,667 patients who underwent major cardiac
operations were included for data extraction. Preoperative levels of BNP
and N-terminal prohormone BNP seemed to be associated with an increased
risk of short- and long-term mortality, postoperative heart failure,
kidney injury, and length of intensive care unit stay. However, their
predictive value for postoperative arrhythmias and myocardial infarction
was less established. Our findings suggest that natriuretic peptides may
play an important role in risk prediction in patients who underwent
cardiac surgery. The addition of these biomarkers to the existing clinical
risk stratification strategies may enhance their predictive accuracy.
However, this needs to be endorsed by data derived from wide-scale
clinical trials.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<120>
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. <br/>Design(s): Post hoc analysis of
a double-blinded randomized clinical trial. <br/>Setting(s): Single-center
study in the Helsinki University Hospital. <br/>Participant(s): A total of
1,386 adult on-pump cardiac surgical patients. <br/>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. <br/>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).
<br/>Conclusion(s): Both endogenous and exogenous albumin appear to be
cardioprotective regarding CK-MBm release in on-pump cardiac
surgery.<br/>Copyright &#xa9; 2023 The Authors

<121>
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.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature.

<122>
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. <br/>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). <br/>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.
<br/>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.<br/>Copyright &#xa9; 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<123>
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. <br/>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.
<br/>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. <br/>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).<br/>Copyright
&#xa9; 2023, The Author(s), under exclusive licence to Springer Nature
Limited.

<124>
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). <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<125>
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. <br/>Aim(s): This study aimed to analyze long-term
outcomes following TAVR using meta-analysis. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<126>
Accession Number
2023966288
Title
Safety and performance parameters of the Myval transcatheter aortic valve
bioprosthesis: The SAPPHIRE prospective registry.
Source
Cardiovascular Revascularization Medicine. 55 (pp 22-27), 2023. Date of
Publication: October 2023.
Author
Testa L.; Criscione E.; Popolo Rubbio A.; Squillace M.; Ielasi A.; Tespili
M.; Brambilla N.; Bedogni F.
Institution
(Testa, Criscione, Popolo Rubbio, Squillace, Tespili, Brambilla, Bedogni)
Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan,
Italy
(Ielasi) Cardiology Division, IRCCS Ospedale Galeazzi Sant'Ambrogio,
Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: TAVR is an established treatment for patients with severe
symptomatic aortic stenosis. Different THV platforms are nowadays
available, each of them with its inherent limitations and others are under
development aiming at overcoming such limitations. We thus sought to
investigate the performance and 1-year clinical outcome of a new
generation, balloon expandable, THV: the MyvalTM (Meril Life Sciences Pvt.
Ltd., Vapi, Gujarat, India). <br/>Method(s): This registry included the
first 100 consecutive patients (mean age 80.7 +/- 7.7; STS 4.3 +/- 3.3 %),
who underwent transcatheter aortic valve implantation for severe stenosis
of the native aortic valve from May 2020 to December 2020, in two Italian
Centers. Clinical and procedural outcomes were defined according to VARC-3
criteria. <br/>Result(s): Transfemoral Myval THV was successfully
implanted in all patients, with no intra-hospital mortality (technical
success 100 %): vascular access complications were all "minor" (16 %), and
managed by compression/balloon inflation; no cases of annular rupture or
coronary obstruction occurred; 5 % of patients required an in-hospital
pacemaker implantation (PM). Device success was 99 %. Overall and
cardiovascular mortality were 6 % (CI 5 %-7 %) and 4 % (CI 2 %-5 %) at 1-
year, while 12 % (CI 9 %-14 %) and 7 % (6-9 %) at 2 years. A total of 9 %
of the patients required a PM within 12 months, and no further PM
implantation occurred afterwards. No cerebrovascular events, renal failure
and myocardial infarction occurred between discharge and 2-year follow-up.
No events of structural valve deterioration but a sustained improvement of
echocardiographic parameters were observed. <br/>Conclusion(s): The Myval
THV has a promising safety/efficacy profile at 2 year follow up. This
performance should be further evaluated in the context of randomized
trials to better elucidate its potential.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<127>
[Use Link to view the full text]
Accession Number
2028113567
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 (United States). 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
Publisher
Lippincott Williams and Wilkins
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. <br/>Design(s): This was a prospective randomized controlled
clinical study. <br/>Setting(s): The study was single-centered and
conducted in a university hospital. <br/>Participant(s): There were 135
endoscopic thoracic sympathetic blockade patients in this study.
<br/>Intervention(s): 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. <br/>Measurements and Main Results: Both
groups were age and gender matched. Among all recorded variables, only
anesthesia time was found to be close to statistical significance (P =
.059, favoring single lumen). All other parameters were found to be
similar between groups. (P < .05). <br/>Conclusion(s): We reported that
DLT and single lumen tracheal intubation were equally effective for lung
deflation during surgery, and SLT with HFPPV ventilation mode during
endoscopic thoracic sympathetic blockade surgery provided the surgeon with
an adequate and clean workspace with shorter onset of anesthesia. We may
suggest the HFPPV technique for uncomplicated surgery groups or where
sufficient conditions for DLT cannot be provided in the operating room.
<br/>Copyright &#xa9; 2023 the Author(s). Published by Wolters Kluwer
Health, Inc.

<128>
Accession Number
2026458532
Title
Melatonin and Melatonin Agonists for Prevention of Delirium in the Cardiac
Surgical ICU: A Meta-analysis.
Source
Indian Journal of Critical Care Medicine. 27(11) (pp 837-844), 2023. Date
of Publication: November 2023.
Author
Niyogi S.G.; Naskar C.; Singh A.; Kumar B.; Grover S.
Institution
(Niyogi, Singh, Kumar) Department of Anaesthesia and Intensive Care,
Postgraduate Institute of Medical Education and Research, Chandigarh,
India
(Naskar, Grover) Department of Psychiatry, Postgraduate Institute of
Medical Education and Research, Chandigarh, India
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Aim and Background: Delirium is highly prevalent in the immediate
postoperative period following cardiac surgery and adversely impacts
outcomes. Melatonin has been increasingly used in pharmacological
prevention of delirium. We aimed to synthesize the available evidence
concerning the role of melatonin and melatonin agonists in preventing
delirium in patients after cardiac surgery. <br/>Material(s) and
Method(s): PubMed, Google Scholar, and Web of Science databases were
searched for relevant randomized and non-randomized trials in adults
undergoing cardiac surgery investigating melatonin agonists to prevent
delirium. Studies incorporating transplants, preoperative organ support,
prophylactic antipsychotics, or children were excluded. Risk-of-bias was
assessed using Cochrane ROB 2.0 and ROBINS-I tools. A systematic review
and meta-analysis were conducted, calculating pooled odds ratio (OR) for
the incidence of postoperative delirium using a random effects model with
the Mantel-Haenszel method with restricted maximum-likelihood estimator.
Trial sequential analysis was also carried out for the primary outcome.
<br/>Result(s): Six randomized trials and one non-randomized trial
involving 1,179 patients were included. Incidence of delirium was 16.7 and
29.6% in the intervention and comparator groups respectively, indicating a
pooled OR of 0.44 [95% confidence interval (CI) 0.27 - 0.71, p = 0.04]
favoring melatonin. Two studies had a high risk of bias, and I²
statistics indicated significant heterogeneity. However, publication bias
was insignificant, and trial sequential analysis indicated the
significance of the attained effect size. <br/>Conclusion(s): Based on
available studies, perioperative melatonin use significantly decreases
postoperative incidence of delirium after adult cardiac surgery. However,
the available quality of evidence is low, and larger trials with
standardization of nonpharmacological delirium prevention interventions,
in high-risk cohorts, and exploring various dosages and regimens should be
carried out.<br/>Copyright &#xa9; The Author(s). 2023.

<129>
Accession Number
2026408754
Title
Surgical Management for a Rare Pedunculated Left Ventricular Apical
Lipoma: A Case Report and Review of Literature.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 723975. Date of Publication: 2021.
Author
Song L.; Iroegbu C.D.; Yang J.; Fan C.
Institution
(Song, Iroegbu, Yang, Fan) Department of Cardiovascular Surgery, The
Second Xiangya Hospital, Central South University, Changsha, China
Publisher
Frontiers Media SA
Abstract
Cardiac lipomas, though extremely rare, are encapsulated tumors composed
primarily of mature fat cells. Despite their benign character, cardiac
lipomas can cause life-threatening complications by rapid growth. Cardiac
lipomas, which are frequently located in the left ventricle (LV) or right
atrium, can originate either from the subendocardium, subpericardium, or
the myocardium. They are usually asymptomatic and carry a good prognosis
during long-term follow-up; however, published reports show that untreated
cardiac lipomas may be fatal when they cause arrhythmic or obstructive
symptoms. In addition, several surgical options have been reported to
obtain an appropriate operative view following poor visualization,
primarily when tumors are located in the LV. Herein, we present a case of
a pedunculated LV apical lipoma in a symptomatic patient successfully
managed by surgical resection. We also discuss diagnostic modalities in
surgical planning and the choice of surgical approach.<br/>Copyright
&#xa9; 2021 Song, Iroegbu, Yang and Fan.

<130>
Accession Number
2026401991
Title
Revascularization vs. Conservative Medical Treatment in Patients With
Chronic Kidney Disease and Coronary Artery Disease: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 818958. Date of Publication: 2021.
Author
Liao G.-Z.; Li Y.-M.; Bai L.; Ye Y.-Y.; Peng Y.
Institution
(Liao, Li, Bai, Ye, Peng) Department of Cardiology, West China Hospital,
Sichuan University, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: As a strong risk factor for coronary artery disease (CAD),
chronic kidney disease (CKD) indicates higher mortality in patients with
CAD. However, the optimal treatment for the patients with two coexisting
diseases is still not well defined. <br/>Method(s): To conduct a
meta-analysis, PubMed, Embase, and the Cochrane database were searched for
studies comparing medical treatment (MT) and revascularization
[percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG)] in adults with CAD and CKD. Long-term all-cause mortality
was evaluated, and subgroup analyses were performed. <br/>Result(s): A
total of 13 trials met our selection criteria. Long-term (with at least a
1-year follow-up) mortality was significantly lower in the
revascularization arm [relative risk (RR) = 0.66; 95% CI = 0.60-0.72] by
either PCI (RR = 0.61; 95% CI = 0.55-0.68) or CABG (RR = 0.62; 95% CI =
0.46-0.84). The results were consistent in dialysis patients (RR = 0.68;
95% CI = 0.59-0.79), patients with stable CAD (RR = 0.75; 95% CI =
0.61-0.92), patients with acute coronary syndrome (RR = 0.62; 95% CI =
0.58-0.66), and geriatric patients (RR = 0.57; 95% CI = 0.54-0.61).
<br/>Conclusion(s): In patients with CKD and CAD, revascularization is
more effective in reducing mortality than MT alone. This observed benefit
is consistent in patients with stable CAD and elderly patients. However,
future randomized controlled trials (RCTs) are required to confirm these
findings.<br/>Copyright &#xa9; 2022 Liao, Li, Bai, Ye and Peng.

<131>
Accession Number
2028083153
Title
Systematic Review of the Use of the 6-Minute Walk Test in Measuring and
Improving Prognosis in Patients With Ischemic Heart Disease.
Source
CJC Open. (no pagination), 2023. Date of Publication: 2023.
Author
Coulshed A.; Coulshed D.; Pathan F.
Institution
(Coulshed) Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Coulshed, Pathan) Department of Cardiology, Nepean Hospital, University
of Sydney, Penrith, NSW, Australia
Publisher
Elsevier Inc.
Abstract
Introduction: The 6-minute walk test (6MWT) has been used for over 30
years to assess exercise capacity in patients with respiratory disease,
and more recently, in those with heart failure. However, despite being a
simple and reproducible test of real-world exercise capacity, its use in
patients with ischemic heart disease (IHD) is less well accepted. We
sought to review systematically the evidence surrounding the 6MWT in IHD.
<br/>Method(s): We searched the Medline, PubMed, Embase, and Scopus
databases for the following key terms: "six minute walk test/6 minute walk
test/6MWT" and "angina/coronary artery disease/coronary
disease/IHD/ischemic heart disease." We followed Preferred Reporting Items
for Systematic Reviews and Meta-analysis (PRISMA) guidelines to select
publications for full-text review and analyzed the collated data.
<br/>Result(s): A total of 1228 unique papers were found, of which 71 were
chosen for full-text review and 37 for detailed analysis. Most (23)
concerned the effect on 6MWT distance (6MWTd) of cardiac rehabilitation,
with measurements commenced after an intervention (acute myocardial
infarction, n = 4; open heart surgery (OHS), n = 5; percutaneous coronary
intervention (PCI), n = 3; or other, n = 11). The effect on 6MWTd of OHS
was investigated in 6 studies and of PCI in one study. The 6MWT is a
useful measurement of physical capacity; data are limited on its ability
to assess benefit following PCI. <br/>Conclusion(s): The 6MWT has been
studied inconsistently in IHD. The majority of data are on patients before
and after CR. Data are limited concerning the effect on 6MWTd of OHS or
PCI. The available data support the 6MWT as a measure of change in
performance status following coronary intervention. More work is required
to confirm this hypothesis.<br/>Copyright &#xa9; 2023 The Authors

<132>
Accession Number
642616671
Title
Health Status after Transcatheter Tricuspid-Valve Repair in Patients with
Severe Tricuspid Regurgitation: Results from the TRILUMINATE Pivotal
Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2023.
Date of Publication: 16 Oct 2023.
Author
Arnold S.V.; Goates S.; Sorajja P.; Adams D.H.; Stephan von Bardeleben R.;
Kapadia S.R.; Cohen D.J.
Institution
(Arnold) Saint Luke's Mid America Heart Institute and University of
Missouri-Kansas City, Kansas City, MO;
(Goates) AbbottCAUnited States
(Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Adams) Mount Sinai Health System, New York, NY
(Stephan von Bardeleben) University Medical Center of Mainz, Mainz,
Germany
(Kapadia) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Cohen) St. Francis Hospital, Roslyn, NY and Cardiovascular Research
Foundation, New York, NY
Abstract
BACKGROUND: In the TRILUMINATE Pivotal trial, tricuspid transcatheter
edge-to-edge repair (T-TEER) reduced TR and improved health status
compared with medical therapy alone with no benefit on heart failure
hospitalizations or survival. <br/>OBJECTIVE(S): To better understand the
health status benefits of T-TEER within the TRILUMINATE Pivotal trial.
<br/>METHOD(S): TRILUMINATE randomized patients with severe TR to T-TEER
(n=175) or medical therapy (n=175). Health status was assessed at baseline
and at 1, 6, and 12 months with the KCCQ (range 0-100; higher=better),
which was compared between treatment groups using mixed effects linear
regression. Alive and well was defined as KCCQ-OS >=60 and no decline from
baseline of >10 points at 1 year. <br/>RESULT(S): Compared with medical
therapy, T-TEER significantly improved health status at 1 month (mean
between-group difference in KCCQ-OS 9.4 points, 95% CI 5.3-13.4), with a
small additional improvement at 1 year (mean between-group difference 10.4
points, 95% CI 6.3-14.6). T-TEER patients were more likely to be alive and
well at 1 year (T-TEER vs. medical therapy: 74.8% vs. 45.9%, p<0.001),
with a number needed-to-treat of 3.5. Interaction analyses demonstrated
that the benefit of T-TEER diminished as baseline KCCQ-OS increased
(pint<0.001). Exploratory analyses suggested that much of the health
status benefit of T-TEER could be explained by TR reduction and that
improvement in health status after T-TEER was strongly correlated with
reduced 1-year mortality and heart failure hospitalization.
<br/>CONCLUSION(S): T-TEER with the TriClip system resulted in substantial
and sustained health status improvement in patients with severe TR
compared with medical therapy alone.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<133>
Accession Number
642614008
Title
A Global Systematic Review of Open-Heart Valvular Surgery in
Resource-Limited Settings.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 26 Oct 2023.
Author
Rekhtman D.; Bermudez F.; Vervoort D.; Kaze L.; Patton-Bolman C.; Swain J.
Institution
(Rekhtman) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, United States
(Bermudez) Georgetown University School of Medicine, Washington, D.C
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Kaze) Graduate School of Social and Political Science, University of
Edinburgh, Edinburgh, UK; Team Heart, Inc., Kigali, Rwanda
(Patton-Bolman) KigaliRwanda
(Swain) Team Heart, Inc., Kigali, Rwanda; Division of Cardiovascular
Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
Abstract
BACKGROUND: Many obstacles challenge the establishment and expansion of
cardiac surgery in low- and middle-income countries, despite the unmet
cardiac surgical needs. One challenge has been providing adequate
follow-up care to monitor anticoagulation, manage morbidity, and prevent
mortality. Here, we provide a systematic review of outcomes after valvular
cardiac surgery, focusing on strategies for prolonged follow-up care in
resource-constrained settings. <br/>METHOD(S): Studies published between
2012 and 2022 were collected from Embase and the Cochrane Library. Article
inclusion criteria were adolescent and adult patients, open-heart valvular
surgery, and analysis of at least one postoperative outcome at least 30
days postoperatively. Studies focused on pediatric patients, pregnant
patients, transcatheter procedures, in-hospital outcomes, and non-valvular
surgeries were excluded. Descriptive statistics were assessed and articles
were summarized after abstract screening, full-text review, and data
extraction. <br/>RESULT(S): Sixty-seven relevant publications were
identified after screening. The most commonly studied regions were Asia
(46%), Africa (36%), and Latin America (9%). Rheumatic heart disease was
the most commonly studied valvular disease (70%). Reported outcomes
included mortality, surgical reintervention, and thrombotic events.
Follow-up duration ranged from 30 days to 144 months; eleven studies
reported a follow-up length of 12 months. <br/>CONCLUSION(S): Addressing
the unmet cardiac care needs requires a multifaceted approach that
leverages telemedicine technology, enhances medical infrastructure, and
aligns advocacy efforts. Learning from the cost-effective establishment of
cardiac surgery in low- and middle-income countries, we can apply past
innovations to foster sustainable cardiac surgical capacity.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<134>
Accession Number
642613326
Title
A Randomized Trial Comparing One-year Hemodynamics of Two Bovine
Pericardial Valves.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2023. Date of
Publication: 26 Oct 2023.
Author
Sohn S.H.; Kang Y.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kang, Kim, Hwang) Thoracic and Cardiovascular Surgery, Seoul
National University Hospital, Seoul, South Korea
(Choi) Thoracic and Cardiovascular Surgery, Seoul National University
Hospital, Jongno-gu, South Korea
(Lee, Kim, Lim) Thoracic and Cardiovascular Surgery, Seoul National
University Bundang Hospital, Seongnam, South Korea
Abstract
BACKGROUND: This randomized controlled trial was designed to compare
1-year hemodynamic performances and clinical outcomes after aortic valve
replacement (AVR) using a recently introduced (the AVALUS group) and
worldwide used (the CEPME group) bovine pericardial bioprostheses.
<br/>METHOD(S): Patients were screened to enroll 70 patients in each group
based on a noninferiority design. The primary endpoint of the trial was
the mean pressure gradient across the aortic valve (AVMPG) at 1 year after
surgery. One-year echocardiographic data were obtained from 92.1% (129 of
140 patients) of the study patients. <br/>RESULT(S): There were no
differences in baseline characteristics, including sex and body surface
area (1.64+/-0.18 vs 1.65+/-0.15 m2) between the groups. The AVMPG on
1-year echocardiography was 14.0+/-4.3 mmHg and 13.9+/-5.1 mmHg in the
AVALUS and CEPME groups, respectively (P for noninferiority =.0004). In
the subgroup analyses for the respective size of the prostheses, AVMPG of
the 19mm prostheses was significantly lower in the AVALUS than CEPME group
(14.0+/-4.3 mmHg vs 20.0+/-4.7 mmHg, P =.012), whereas those of the other
sizes were not significantly different between the two groups. There were
no significant differences in the effective orifice area (1.49+/-0.40 cm2
vs 1.53+/-0.38 cm2, P =.500) or effective orifice area index (0.91+/-0.22
cm2/m2 vs 0.93+/-0.23 cm2/m2, P =.570) in all patients, or in the subgroup
analysis for the 19mm prosthesis. There were no differences in 1-year
clinical outcomes between the 2 groups. <br/>CONCLUSION(S): The 1-year
hemodynamic and clinical outcomes of the AVALUS group were noninferior to
those of the CEPME group. (NCT03796442).<br/>Copyright Thieme. All rights
reserved.

<135>
Accession Number
642610434
Title
Long-term surgical outcomes of congenital supravalvular aortic stenosis: a
systematic review, meta-analysis and microsimulation study.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 27 Oct 2023.
Author
Meccanici F.; Notenboom M.L.; Meijssen J.; Smit V.; van de Woestijne P.C.;
van den Bosch A.E.; Helbing W.A.; Bogers A.J.J.C.; Takkenberg J.J.M.;
Roos-Hesselink J.W.
Institution
(Meccanici, Meijssen, Smit, van den Bosch, Roos-Hesselink) Department of
Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands
(Notenboom, van de Woestijne, Bogers, Takkenberg) Department of
Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam,
Netherlands
(Helbing) Department of Paediatrics, Division of Paediatric Cardiology,
Erasmus University Medical Centre, Rotterdam, Netherlands
Abstract
OBJECTIVES: Congenital supravalvular aortic stenosis is a rare form of
congenital outflow tract obstruction and long-term outcomes are scarcely
reported. This study aims to provide an overview of outcomes after
surgical repair for congenital supravalvular aortic stenosis.
<br/>METHOD(S): A systematic review of published literature was conducted,
including observational studies reporting long-term clinical outcome (>2
years) after supravalvular aortic stenosis repair in children or adults
considering >20 patients. Early risks, late event rates and time-to-event
data were pooled and entered into a microsimulation model to estimate
30-year outcomes. Life-expectancy was compared to the age-, sex- and
origin-matched general population. <br/>RESULT(S): Twenty-three
publications were included, encompassing a total of 1,472 patients (13,125
patient-years; pooled mean follow-up: 9.0 (6.2) years; median follow-up:
6.3 years). Pooled mean age at surgical repair was 4.7 (5.8) years and the
most commonly used surgical technique was the single patch repair (43.6%).
Pooled early mortality was 4.2% (95% CI:3.2-5.5%) and late mortality was
0.61% (95% CI:0.45-0.83) per patient-year. Based on microsimulation, over
a 30 year time horizon, it was estimated that an average patient with
supravalvular aortic stenosis repair (mean age: 4.7y) had an observed
life-expectancy that was 90.7% (95% Credible Interval:90.0-91.6%) of
expected life-expectancy in the matched-general-population. The
microsimulation-based 30-year risk of myocardial infarction was 6.0% (95%
CrI:5.1-6.5) and reintervention 31.3% (95% CrI:29.6-33.4%), of which 27.2%
(95% CrI:25.8-29.1) due to repair dysfunction. <br/>CONCLUSION(S): After
surgical repair for supravalvular aortic stenosis, 30-year survival is
lower than the matched-general-population survival and the lifetime risk
of reintervention is considerable. Therefore, lifelong monitoring of the
cardiovascular system and in particular residual stenosis and coronary
obstruction is recommended.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<136>
Accession Number
642609981
Title
Transcatheter or Surgical Aortic Valve Replacement in Patients with Severe
Aortic Stenosis and Small Aortic Annulus: A Randomized Clinical Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 26 Oct 2023.
Author
Rodes-Cabau J.; Ribeiro H.; Mohammadi S.; Serra V.; Al-Atassi T.; Iniguez
A.; Vilalta V.; Nombela-Franco L.; Saez de Ibarra J.I.; Auffret V.;
Forcillo J.; Conradi L.; Urena M.; Moris C.; Munoz-Garcia A.; Paradis
J.-M.; Dumont E.; Kalavrouziotis D.; Pomerantzeff P.M.; Rosa V.E.E.; Lopes
M.P.; Sureda C.; Jimenez Diaz V.A.; Giuliani C.; Avvedimento M.;
Pelletier-Beaumont E.; Pibarot P.
Institution
(Rodes-Cabau, Mohammadi, Paradis, Dumont, Kalavrouziotis, Giuliani,
Avvedimento, Pelletier-Beaumont, Pibarot) Quebec Heart & Lung Institute,
Laval University, Quebec City, Canada
(Ribeiro, Pomerantzeff, Rosa, Lopes) INCOR, Sao Paulo, Brazil
(Serra, Sureda) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Al-Atassi) Ottawa Heart Institute, Ottawa, Canada
(Iniguez, Jimenez Diaz) Hospital Alvaro Cunqueiro, Vigo, Spain
(Vilalta) Hospital Germans Tries i Pujol, Badalona, Spain
(Nombela-Franco) Hospital Clinico San Carlos, Madrid, Spain
(Saez de Ibarra) Hospital Son Espases, Mallorca, Spain
(Auffret) Centre Hospitalier Universitaire de Rennes, Rennes, France
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, Canada
(Conradi) University Heart Center, Hamburg, Germany
(Urena) Bichat Hospital, Paris, France
(Moris) Hospital Central de Asturias, Oviedo, Spain
(Munoz-Garcia) Hospital Virgen de la Victoria, Malaga, Spain
Abstract
Background: The optimal treatment in patients with severe aortic stenosis
(AS) and small aortic annulus (SAA) remains to be determined. The
objectives of this study were to compare the hemodynamic and clinical
outcomes between transcatheter aortic valve replacement (TAVR) and
surgical aortic valve replacement (SAVR) in patients with a SAA.
<br/>Method(s): Prospective multicenter international randomized trial
performed in 15 university hospitals. Participants were 151 patients with
severe AS and SAA (mean diameter <23 mm) were randomized (1:1) to TAVR
(n=77) vs SAVR (n=74), The primary outcome was impaired valve hemodynamics
(i.e. severe prosthesis patient mismatch [PPM ] or moderate-severe aortic
regurgitation [AR]) at 60 days as evaluated by Doppler-echocardiography
and analyzed in a central echocardiography core laboratory. Clinical
events were secondary outcomes. <br/>Result(s): The mean age of the
participants was 75+/-5 years, with 140 (93%) women, a median STS of 2.50
(1.67-3.28)%, and a median annulus diameter of 21.1 (IQR: 20.4-22.0) mm.
There were no differences between groups in the rate of severe PPM or
moderate-severe AR (severe PPM (TAVR: 4 [5.6 %], SAVR: 7 [10.3%], p=0.30),
and moderate-severe AR (none in both groups). There were no differences
between groups regarding mortality (TAVR: 1 [1.3%], SAVR: 1 [1.4%],
p=1.00) and stroke (TAVR:0, SAVR: 2 [2.7%], p=0.24) at 30 days. After a
median follow-up of 2 (1-4) years, there were no differences between
groups regarding mortality (TAVR: 7 [9.1%], SAVR: 6 [8.1%], p=0.89),
stroke (TAVR: 3 [3.9%], SAVR: 3 [4.1%], p=0.95), and cardiac
hospitalization (TAVR: 15 [19.5%], SAVR: 15 [ 20.3%], p=0.80).
<br/>Conclusion(s): In patients with severe AS and SAA (women in the vast
majority), there was no evidence of superiority of contemporary TAVR vs.
SAVR regarding valve hemodynamic results. After a median follow-up of 2
years, there were no differences in clinical outcomes between groups.
These findings suggest that the 2 therapies represent a valid alternative
for treating patients with SA and SAA, and treatment selection should
likely be individualized according to baseline characteristics, additional
anatomical risk factors, and patient preference. However, the results of
this study should be interpreted with caution due to the limited sample
size leading to an underpowered study, and need to be confirmed in future
larger studies.

<137>
Accession Number
642444321
Title
EXPRESS: Effects of Prehabilitation Resistance Training in Mild to
Moderate Clinically Frail Patients Awaiting Coronary Artery Bypass Graft
Surgery.
Source
Journal of investigative medicine : the official publication of the
American Federation for Clinical Research. (pp 10815589231207795), 2023.
Date of Publication: 07 Oct 2023.
Author
Sahar W.; Waseem M.; Riaz M.; Nazeer N.; Ahmad M.; Haider Z.
Institution
(Sahar, Ahmad) Department of Physiotherapy, University of Lahore, Pakistan
(Waseem) Faculty of Rehabilitation & Allied Health Sciences, Riphah
International University, Islamabad, Pakistan
(Riaz) Department of Allied Health Sciences, University of Sargodha,
Sargodha, Pakistan
(Nazeer) Post Graduate Resident Cardiology Department Bahawal Victoria
Hospital Bahawalpur
(Haider) Consultant Cardiothoracic Surgeon, Department of Cardiac Surgery,
Quaid-e- Azam Medical College, Bahawalpur, Pakistan
Abstract
Coronary artery disease is one of the main cause of mortality and
morbidity among chronic heart diseases worldwide. Current study was
planned to compare the effects of pre-habilitation resistance training in
mild to moderate clinically frail patients awaiting coronary artery bypass
graft (CABG). A Randomized controlled trial was conducted on 74 patients
awaiting CABG at Faisalabad Institute of Cardiology, Pakistan. Modified
Healthy heart questionnaire was used for screening of the patients.
Interventions applied were resistance training by using cuff weights/
dumbbells at light intensity (40-50%) of a maximum one repetition (10-15
repetitions for one to three times a day) per major muscle groups of upper
and lower limbs of the body on weekly basis. Main outcome measures were
6-minute walk test (6MWT), New York heart association (NYHA) for heart
failure, clinical frailty score and essential frailty toolset. Significant
differences between group A and group B patients were observed. The mean
ranks for 6MWT in group A and group B were 1.70 and 1.55, respectively.
The mean ranks of NYHA in group A and group B were 1.68 and 2.84,
respectively. While clinical frailty score in group A and group B were
2.68 and 2.74, respectively with essential frailty toolset in group A and
group B were 1.14 and 1.11, respectively. There were significant (p<0.05)
differences within and between groups for prehabilitation resistance
training after CABG. The study showed that resistance training group had
improved the clinical frailty score, strength, endurance and functional
capacity in patients who underwent elective CABG.