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<1>
Accession Number
2015363045
Title
A randomised controlled feasibility trial of a clinical protocol to manage
hypotension during major non-cardiac surgery.
Source
Anaesthesia. 77(7) (pp 795-807), 2022. Date of Publication: 01 July 2022.
Author
Wijeysundera D.N.; Duncan D.; Moreno Garijo J.; Jerath A.; Meineri M.;
Parotto M.; Wasowicz M.; McCluskey S.A.
Institution
(Wijeysundera) Department of Anesthesia, St. Michael's Hospital, Toronto,
ON, Canada
(Wijeysundera, Duncan, Moreno Garijo, Jerath, Meineri, Parotto, Wasowicz,
McCluskey) Department of Anesthesiology and Pain Medicine, University of
Toronto, ON, Canada
(Meineri) Department of Anaesthesia and Intensive Care, Heart Centre
Leipzig, Germany
Publisher
John Wiley and Sons Inc
Abstract
Intra-operative hypotension is a risk factor for postoperative morbidity
and mortality. Minimally invasive monitors that derive other haemodynamic
parameters, such as stroke volume, may better inform the management of
hypotension. As a prelude to a multicentre randomised controlled trial, we
conducted a single-centre feasibility trial of a protocol to treat
hypotension as informed by minimally invasive haemodynamic monitoring
during non-cardiac surgery. We recruited adults aged >=40 years with
cardiovascular risk factors who underwent non-cardiac surgery requiring
invasive arterial pressure monitoring. Participants were randomly
allocated to usual care, or a clinical protocol informed by an arterial
waveform contour analysis monitor. Participants, outcome assessors,
clinicians outside operating theatres and analysts were blinded to
treatment allocation. Feasibility was evaluated based on: consent rate;
recruitment rate; structured feedback from anaesthesia providers; and
between-group differences in blood pressure, processes-of-care and
outcomes. The consent rate among eligible patients was 33%, with 30
participants randomly allocated to the protocol and 30 to usual care.
Anaesthesia providers rated the protocol to be feasible and acceptable.
The protocol was associated with reduced fluid balance and hypotension
exposure in the peri-operative setting. Postoperative complications
included: acute myocardial injury in 18 (30%); acute kidney injury in 17
(28%); and surgical site infection in 7 (12%). The severity of
complications was rated as moderate or severe in 25 (42%) participants. In
summary, this single-centre study confirmed the feasibility of a
multicentre trial to assess the efficacy and safety of a physiologically
guided treatment protocol for intra-operative hypotension based on
minimally invasive haemodynamic monitors.<br/>Copyright &#xa9; 2022
Association of Anaesthetists.

<2>
Accession Number
2028278425
Title
Chronic total occlusion rotational atherectomy (CTO RA) versus non-CTO RA
in coronary artery disease: A meta-analysis of clinical outcomes and
complications.
Source
American Heart Journal Plus: Cardiology Research and Practice. 36 (no
pagination), 2023. Article Number: 100345. Date of Publication: December
2023.
Author
Devireddy R.R.; Qaqish O.; Pannikottu K.; Ramireddy S.; Kumar A.; Saad C.;
Kambhatla S.; Kondur A.; George N.; Hasan M.S.
Institution
(Devireddy, Kambhatla) Department of Internal Medicine, Garden City
Hospital, MI, United States
(Qaqish, Pannikottu, Ramireddy, Kumar, Kondur) Department of Cardiology,
Garden City Hospital, MI, United States
(Saad) Department of Nephrology, Garden City Hospital, MI, United States
(George) Garden City Hospital, Garden City, MI, United States
(Hasan) Department of Statewide Campus System- College of Osteopathic
Medicine, Michigan State University, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Chronic total occlusion rotational atherectomy (CTO RA) is an
emerging intervention in coronary artery disease (CAD), although data
comparing its outcomes and complications with non-CTO RA are scarce. We
sought to evaluate the outcomes of RA in CTO lesions compared to those in
non-CTO lesions by performing a meta-analysis. <br/>Method(s): We
conducted a systematic review and meta-analysis of studies comparing the
clinical outcomes and complications between CTO RA and non-CTO RA in
patients with CAD. We searched PUBMED, CINAHL, EMBASE and Cochrane Central
Register of Clinical Trials for any studies that compared the outcomes of
RA in CTO and non-CTO lesions. The outcomes analyzed included in-hospital
major adverse cardiovascular events (MACE), target vessel
revascularization (TVR), angiographic success, procedural success,
periprocedural complications, coronary perforation, and all-cause
mortality. <br/>Result(s): Four studies with a total of 1868 patients were
included, spanning from 2018 to 2022, from Germany, Taiwan, and Korea. The
median age of included patients was 71. The rate of the pooled results
indicated a moderate, non-significant increase in in-hospital MACE and TVR
for CTO RA compared to non-CTO RA. There was a small, non-significant
decrease in angiographic and procedural success in CTO RA compared to
non-CTO RA. CTO RA was associated with a non-significant increase in
periprocedural complications and a significant increase in coronary
perforation compared to non-CTO RA. All-cause mortality showed a
non-significant increase in the CTO RA group. <br/>Conclusion(s): This
meta-analysis provides evidence that while CTO RA may be associated with a
higher risk of coronary perforation, the risk of other outcomes including
MACE, TVR, and all-cause mortality is not significantly different compared
to non-CTO RA. More research is needed to further understand these
relationships and to optimize treatment strategies in patients with CAD
undergoing CTO RA.<br/>Copyright &#xa9; 2023

<3>
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.

<4>
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.

<5>
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.

<6>
Accession Number
2027874101
Title
Systematic review and meta-analysis of deep venous reflux correction in
chronic venous insufficiency.
Source
Journal of Vascular Surgery: Venous and Lymphatic Disorders. 11(6) (pp
1265-1275.e5), 2023. Date of Publication: November 2023.
Author
Maleti O.; Orso M.; Lugli M.; Perrin M.
Institution
(Maleti, Lugli) National reference Training Center in Phlebology, UEMS,
Vascular Surgery, Cardiovascular Department Hesperia Hospital, Modena,
Italy
(Orso) Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche
'Togo Rosati', Perugia, Italy
(Perrin) Jean Kunlin, Vascular Unit, Chassieu, France
Publisher
Elsevier Inc.
Abstract
Objective: The aim of this study was to investigate the technical
feasibility, operative techniques, safety, and efficacy outcomes of
procedures aimed at correcting deep venous reflux, in patients with
chronic venous insufficiency. <br/>Method(s): We performed systematic
literature searches in PubMed, Embase, and Web of Science from databases'
inception to February 2022. We included systematic reviews, randomized
controlled trials, and observational studies describing surgical
procedures to treat patients with deep reflux due to primary and secondary
incompetence, post-thrombotic syndrome (PTS). Proportion meta-analyses
were performed for all the efficacy and safety outcomes. <br/>Result(s):
We included 57 studies in the quantitative synthesis: three randomized
controlled trials including 252 patients and 54 case series including 4004
patients. Studies included a median of 38 patients, with a mean age of 51
years; 52% of them were males. Forty percent of studies included 2291
patients with primary incompetence, 29% of studies included 595 patients
with PTS, and 31% of studies included 1118 patients with both diseases. As
for primary incompetence, pooled estimates for all procedures showed an
89% (95% confidence interval [CI], 82%-94%) of ulcer healing, 10% (95% CI,
4%-18%) ulcer recurrence, 98% (95% CI, 93%-100%) valve patency, 84% (95%
CI, 78%-90%) valve competence, 0.05% (1/1904 patients) pulmonary embolism,
1% (95% CI, 0%-3%) wound infections, 5% (95% CI, 1%-9%) hematoma, 2% (95%
CI, 0%-6%) lymphocele, 2% (95% CI, 1%-4%) thrombosis, 85% (95% CI,
74%-94%) pain improvement, 89% (95% CI, 65%-100%) edema improvement, and
85% (95% CI, 73%-93%) lipodermatosclerosis improvement. Patients with PTS
showed less favorable outcomes: 82% (95% CI, 71%-91%) of ulcer healing,
18% (95% CI, 5%-36%) ulcer recurrence, 88% (95% CI, 78%-96%) valve
patency, 78% (95% CI, 66%-88%) valve competence, no pulmonary embolism, 6%
(95% CI, 0%-22%) wound infections, 6% (95% CI, 3%-10%) hematoma, 5% (95%
CI, 1%-12%) lymphocele, 7% (95% CI, 1%-16%) thrombosis, 79% (95% CI,
59%-94%) pain improvement, 75% (95% CI, 61%-88%) edema improvement, and
64% (95% CI, 9%-100%) lipodermatosclerosis improvement.
<br/>Conclusion(s): The number of studies included in each meta-analysis
are limited, and knowing how this element can affect the statistical
power, as well as the absence of comparative control groups, it is not
possible to draw definitive conclusions. Nevertheless, deep venous
reconstructive surgery for reflux may increase the probability of clinical
improvement in patients affected by chronic venous insufficiency. Outcomes
appear to be satisfactory even if possible adjunctive procedures may be
required over the course of the patient's lifetime. Consequently, a strict
follow-up protocol is required to maintain outcomes. Further studies are
required to evaluate deep venous reconstructive surgery for reflux
particularly as to how it compares with the more recently introduced
endovenous approaches.<br/>Copyright &#xa9; 2023

<7>
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

<8>
Accession Number
2026517451
Title
Untangling the relationship between bempedoic acid and gout: results from
a systematic literature review.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1234601. Date of Publication: 2023.
Author
Alunno A.; Carubbi F.; Campanozzi E.; Bellisario F.; Schoones J.W.;
Mariani F.M.; Di Ruscio E.; Altieri P.; Ferri C.
Institution
(Alunno, Carubbi, Campanozzi, Bellisario, Mariani, Di Ruscio, Altieri,
Ferri) Department of Clinical Medicine, Life, Health & Environmental
Sciences, Internal Medicine and Nephrology Division, ASL1
Avezzano-Sulmona-L'Aquila, San Salvatore Hospital, University of L'Aquila,
L'Aquila, Italy
(Schoones) Directorate of Research Policy, Leiden University Medical
Center, Leiden, Netherlands
Publisher
Frontiers Media SA
Abstract
Background: Bempedoic acid (BA) is a small-molecule first-in-class of
inhibitor of ATP citrate lyase that significantly lowers low-density
lipoproteins cholesterol (LDL-c) in statin-intolerant and inadequate
responders. Increased serum uric acid (SUA) levels and gout incidence have
been described in BA-treated patients. The aim of this systematic review
was to investigate the safety of BA regarding SUA levels and gout in
randomised controlled trials (RCTs). <br/>Method(s): A search on 7
databases was performed from inception to May 4, 2023. RCTs of BA
monotherapy or combination with other lipid-lowering treatment (LLT) in
patients with increased LDL-c were included. Dual data extraction was
performed with disagreements resolved through consensus. Due to the
methodological purpose of this review risk-of-bias assessment of studies
was not performed. <br/>Result(s): 6 Phase 3 RCTs (N = 17,975 patients of
which 9,635 received BA) 9 Phase 2 RCTs (N = 362 patients of which 170
received BA) and an open-label extension of a Phase 3 RCT were included.
Gout and/or hyperuricemia were not mentioned as exclusion criteria,
previous/current use of urate-lowering therapies (ULT) and/or colchicine
and/or dietary patterns were not reported. Phase 3 RCTs: 2 studies
specified the number of patients experiencing hyperuricemia over the study
period (BA: 4.9%-11%; placebo: 1.9%-5.6%) and the effect size was
significant only in 1 study (OR = 2.0, 95% CI 1.8-2.3). Four RCTs reported
a higher incidence of gout in the BA arm however, when we calculated the
effect size, it was small and often not significant. Two studies reported
0 cases of gout. The paucity of information about SUA levels at baseline
and/or at the end of follow-up do not allow us to quantify the effect
sizes for BA-induced SUA elevation. Data on gout from Phase 2 RCTs is
scant. <br/>Conclusion(s): Data from phase 2 and 3 RCTs do not allow for
confirming a clear association between BA and gout. It is conceivable that
a careful assessment of SUA levels/history of gout at baseline and the
concomitant use of urate-lowering agents may be instrumental to minimise
the risk of new-onset gout/gout flares in patients treated with
BA.<br/>Copyright 2023 Alunno, Carubbi, Campanozzi, Bellisario, Schoones,
Mariani, Di Ruscio, Altieri and Ferri.

<9>
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.

<10>
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.

<11>
Accession Number
2024836675
Title
Transient ischemic attack and minor stroke as "surgeons affairs": a
narrative review.
Source
Neurological Sciences. 44(12) (pp 4233-4245), 2023. Date of Publication:
December 2023.
Author
Caproni S.; Ottavi P.; Borghetti V.; Taddei G.; Conti C.; Riva A.; Di
Schino C.; Costantini F.; Colosimo C.
Institution
(Caproni, Di Schino, Costantini, Colosimo) Neurology and Stroke Unit,
Neuroscience Department, "S. Maria" University Hospital, via Tristano di
Joannuccio 1, Terni 05100, Italy
(Ottavi) Vascular Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Borghetti) Heart Surgery, Cardio-Thoraco-Vascular Department, "S. Maria"
University Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Taddei) Neurosurgery, Surgery Department, "S. Maria Goretti" Hospital,
Via Lucia Scaravelli, Latina 04100, Italy
(Conti) Neurosurgery, Neuroscience Department, "S. Maria" University
Hospital, via Tristano di Joannuccio 1, Terni 05100, Italy
(Riva) Neurology, Medicine Department, "Universita Politecnica delle
Marche", Via Conca 71, Ancona 60126, Italy
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Objective: The scope of this paper is to review the subtypes of transient
ischemic attack (TIA) and minor stroke (mS) in which a surgical treatment
is needed, discussing the importance and the timing of a multidisciplinary
approach, in order to achieve an optimized management and prevent major
strokes or other critical complications. <br/>Material(s) and Method(s):
The keywords "transient ischemic attack," "minor stroke," "surgical
treatment," "vascular surgery," "heart surgery," "neurosurgery," and
"multidisciplinary" were searched using MEDLINE, EMBASE, and Scopus.
Relevant search results were discussed by the authors for references
inclusion. <br/>Result(s): Notwithstanding that best medical therapy is
usually the first choice for the most part of cases, there are specific
but recurrent etiologies that must be properly recognized because of a
potential surgical approach, even in urgency. In fact, symptomatic carotid
stenosis, or particular cases of hemodynamic cerebrovascular events,
should be promptly referred to vascular surgeon, since increasing
evidences highlighted a benefit from an early artery revascularization. In
addition, beyond arrhythmic causes, cardioembolic events due to bacterial
endocarditis and atrial myxoma should be quickly diagnosed, possibly in
emergency department, because they are a presumptive urgency for heart
surgery. In addition to the above-mentioned conditions, in patients
suffering from vertebrobasilar TIA or mS, clinicians should keep in mind
the Bow Hunter disease, because surgical artery decompression can
represent the only suitable treatment in selected cases.
<br/>Conclusion(s): TIA and mS require a multidisciplinary in order to
discuss therapeutic options, comparing risks and benefits and determining
the best timing for an optimized management.<br/>Copyright &#xa9; 2023,
Fondazione Societa Italiana di Neurologia.

<12>
Accession Number
642695446
Title
Midterm Survival of Low-Risk Patients Treated With Transcatheter Versus
Surgical Aortic Valve Replacement: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 12(21) (pp e030012), 2023. Date
of Publication: 07 Nov 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Serna-Gallegos D.; Chu D.; Clavel
M.-A.; Pibarot P.; Sultan I.
Institution
(Sa, Serna-Gallegos, Chu) Department of Cardiothoracic Surgery University
of Pittsburgh PA USA
(Sa, Serna-Gallegos, Chu) UPMC Heart and Vascular Institute University of
Pittsburgh Medical Center Pittsburgh PA USA
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences KU Leuven
Leuven Belgium, Belgium
(Clavel, Pibarot, Sultan) Centre de Recherche de l'Institut Universitaire
de Cardiologie et de Pneumologie de Quebec Quebec City Quebec Canada,
Canada
(Clavel, Pibarot, Sultan) Department of Medicine, Faculty of Medicine
Universite Laval Quebec City Quebec Canada, Canada
Abstract
Background We performed a meta-analysis of reconstructed time-to-event
data from randomized controlled trials (RCTs) and propensity-score matched
(PSM) studies comparing transcatheter versus surgical aortic valve
replacement (TAVR versus SAVR) to evaluate midterm outcomes in patients
considered low risk for SAVR. Methods and Results Study-level
meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves
of RCTs and PSM studies published by December 31, 2022 was conducted.
Eight studies (3 RCTs, 5 PSM studies) met our eligibility criteria and
included 5444 patients; 2639 patients underwent TAVR, and 2805 patients
underwent SAVR. TAVR showed a higher risk of all-cause mortality at 8years
of follow-up (hazard ratio [HR] 1.22, [95% CI, 1.03-1.43], P=0.018). Up to
2years of follow-up, TAVR was not inferior to SAVR (HR, 1.08 [95% CI,
0.89-1.31], P=0.448); however, we observed a statistically significant
difference after 2years with higher mortality with TAVR (HR, 1.51 [95% CI,
1.14-2.00]; P=0.004). This difference was driven by PSM studies; our
sensitivity analysis showed a statistically significant difference between
TAVR and SAVR when we included only PSM studies (HR, 1.41 [95% CI,
1.16-1.72], P=0.001) but no statistically significant difference when we
included only RCTs (HR, 0.89 [95% CI, 0.69-1.16], P=0.398). Conclusions In
comparison with TAVR, SAVR appeared to be associated with improved
survival beyond 2years in low-risk patients. However, the survival benefit
of SAVR was observed only in PSM studies and not in RCTs. The addition of
data from ongoing RCTs as well as longer follow-up in previous RCTs will
help to confirm if there is a difference in mid- and long-term survival
between TAVR versus SAVR in the low-risk population.

<13>
Accession Number
641972978
Title
Robotic Lobectomy Is Cost-effective and Provides Comparable Health Utility
Scores to Video-assisted Lobectomy: Early Results of the RAVAL Trial.
Source
Annals of surgery. 278(6) (pp 841-849), 2023. Date of Publication: 01 Dec
2023.
Author
Patel Y.S.; Baste J.-M.; Shargall Y.; Waddell T.K.; Yasufuku K.; Machuca
T.N.; Xie F.; Thabane L.; Hanna W.C.
Institution
(Patel, Shargall, Hanna) Department of Surgery, Division of Thoracic
Surgery, McMaster University, Hamilton, ON, Canada
(Baste) Department of Surgery, Division of Thoracic Surgery, Rouen
Normandy University, France
(Waddell, Yasufuku) Department of Surgery, Division of Thoracic Surgery,
University of Toronto, Toronto, ON, Canada
(Machuca) Department of Surgery, Division of Thoracic and Cardiovascular
Surgery, University of Florida, Gainesville, FL, Puerto Rico
(Xie, Thabane) Department of Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
Abstract
OBJECTIVE: The aim of this study was to determine if robotic-assisted
lobectomy (RPL-4) is cost-effective and offers improved patient-reported
health utility for patients with early-stage non-small cell lung cancer
when compared with video-assisted thoracic surgery lobectomy
(VATS-lobectomy). BACKGROUND: Barriers against the adoption of RPL-4 in
publicly funded health care include the paucity of high-quality
prospective trials and the perceived high cost of robotic surgery.
<br/>METHOD(S): Patients were enrolled in a blinded, multicentered,
randomized controlled trial in Canada, the United States, and France, and
were randomized 1:1 to either RPL-4 or VATS-lobectomy. EuroQol 5 Dimension
5 Level (EQ-5D-5L) was administered at baseline and postoperative day 1;
weeks 3, 7, 12; and months 6 and 12. Direct and indirect costs were
tracked using standard methods. Seemingly Unrelated Regression was applied
to estimate the cost effect, adjusting for baseline health utility. The
incremental cost-effectiveness ratio was generated by 10,000 bootstrap
samples with multivariate imputation by chained equations. <br/>RESULT(S):
Of 406 patients screened, 186 were randomized, and 164 analyzed after the
final eligibility review (RPL-4: n=81; VATS-lobectomy: n=83). Twelve-month
follow-up was completed by 94.51% (155/164) of participants. The median
age was 68 (60-74). There were no significant differences in body mass
index, comorbidity, pulmonary function, smoking status, baseline health
utility, or tumor characteristics between arms. The mean 12-week health
utility score was 0.85 (0.10) for RPL-4 and 0.80 (0.19) for VATS-lobectomy
( P =0.02). Significantly more lymph nodes were sampled [10 (8-13) vs 8
(5-10); P =0.003] in the RPL-4 arm. The incremental cost/quality-adjusted
life year of RPL-4 was $14,925.62 (95% CI: $6843.69, $23,007.56) at 12
months. <br/>CONCLUSION(S): Early results of the RAVAL trial suggest that
RPL-4 is cost-effective and associated with comparable short-term
patient-reported health utility scores when compared with
VATS-lobectomy.<br/>Copyright &#xa9; 2023 Wolters Kluwer Health, Inc. All
rights reserved.

<14>
Accession Number
642709437
Title
Utilizing Continuous Glucose Monitoring Post Open Heart Surgery.
Source
Journal of the Endocrine Society. Conference: Endocrine Society's Annual
Meeting, ENDO 2023. Chicago, IL United States. 7(Supplement 1) (pp
A514-A515), 2023. Date of Publication: October - November 2023.
Author
Chen Y.-J.; Velazquez A.C.; Wahab M.M.A.; Aljassani K.; Rajak K.; Halder
A.; Atrash A.; Renu J.
Institution
(Chen, Velazquez, Wahab, Aljassani, Rajak, Halder, Atrash, Renu) UPMC
Central Pa., Harrisburg, PA, United States
Publisher
Endocrine Society
Abstract
Introduction: It is a standardized practice to monitor blood glucose (BG)
levels while on insulin infusion therapy in patients who undergo open
heart surgery regardless of their diabetes status. Hyperglycemia was often
noted in these patients due to catecholamine surge induced by
intraoperative stress. This study is to investigate whether using
Continuous Glucose Monitoring (CGM) is a safer option compared to
traditional finger stick (FS) glycemic monitoring in postoperative
patients. <br/>Method(s): This is a prospective randomized controlled
trial. Patients planned for open heart surgery including coronary artery
bypass surgery, valvular repair, or replacements at UPMC Harrisburg
hospital from May 2021 to August 2022 were voluntarily involved and
randomized by 2:1 ratio into CGM or FS glycemic monitoring methods during
the first 48-hour postoperative period on insulin infusion therapy and in
the intensive care unit (ICU). Patient demographics, comorbidities,
diabetes (DM) status, and glycemic data within the first 48 hours after
surgery were compared between the two groups. <br/>Result(s): A total of
42 patients were recruited, including 31 males (81.6%). Four patients were
excluded due to missing data, 22 were randomized to theCGMgroup, and 16 to
the FS group. There was no difference in demographics between the two
groups. The mean glucose level of the CGM group (123.09 mg/dL) was no
different from the FS group (116.31mg/dL) (p=0.09). The CGM group detected
significantly more events of level 2 hypoglycemia (BG <54 mg/dL, p=0.01)
and hyperglycemia (BG>=180 mg/dL, p=0.01) compared to the FS group. In the
CGM group, the mean time of normoglycemia (BG 70-179 mg/dL), hypoglycemia,
and hyperglycemia in all 22 patients was 91.1%, 2.58%, and 6.34%
respectively. Time in normoglycemia was longer in non-DM patients (95.8%)
than in DM patients (87.1%). <br/>Discussion(s): CGM signatures the
convenience of frequent BG checks, enabling the reduction of glucose
variability and improvement of glycemic control. In this study, although
no difference was noted in the mean BG between CGM and FS groups, CGM was
noted to be especially effective in hypoglycemia detection. Our findings
suggest that CGM brings in the potential benefit of improving patient
safety compared to traditional glucose monitoring. To conclude, CGM is
probably non-inferior as a glucose monitoring method compared to FS and it
might bring the additional benefit of improving patient safety by higher
sensitivity of detecting significant hyper/hypoglycemic events for
postoperative population on insulin drip in the ICU setting.

<15>
Accession Number
642700670
Title
IMPROVE AKI: Sustainability of Team-Based Coaching Interventions to
Improve AKI in a Cluster-Randomized Trial.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2023 Annual Meeting. Philadelphia, PA United States. 34 (pp 59), 2023.
Date of Publication: 2023.
Author
Matheny M.E.; Solomon R.J.; Davis S.E.; Cox K.C.; Stabler M.E.; Westerman
D.; Dorn C.A.; O'Malley J.; Brown J.R.
Institution
(Matheny, Davis, Westerman, Dorn) Vanderbilt University Medical Center,
Nashville, TN, United States
(Matheny) VA Tennessee Valley Healthcare System, Nashville, TN, United
States
(Solomon) University of Vermont Medical Center, Burlington, VT, United
States
(Cox, Stabler, O'Malley, Brown) Dartmouth College Geisel, School of
Medicine, Hanover, NH, United States
Publisher
Wolters Kluwer Health
Abstract
Background: Up to 14% who undergo cardiac catheterization procedures in
the U.S. each year may experience acute kidney injury (AKI). An absence of
standards for implementing known interventions hinders efforts to prevent
AKI. In a 2x2 factorial cluster-randomized trial, we found the combination
of team-based coaching and a datadriven surveillance dashboard reduced the
odds of AKI by 46%. We hypothesized these improvements would persist in
the period following the active intervention phase of the trial.
<br/>Method(s): A 2x2 factorial cluster-randomized trial was conducted
that randomized 20 Veteran Affairs hospitals to receive team-based
coaching in a Virtual Learning Collaborative (VLC) compared to Technical
Assistance with an AKI Prevention Toolkit (TA), both with and without
Automated Surveillance Reporting (VLC+ASR and TA+ASR). Patient outcomes
were collected over 18 months following the active intervention phase.
Multilevel logistic models for AKI were fit with site-level random effects
to account for the clustered design. <br/>Result(s): Across 20 randomized
sites, 440 of 4,160 patients experienced AKI during 18-months following
the active intervention phase, including 216 of 1,260 patients with
pre-existing chronic kidney disease (CKD). We observed a substantial
reduction in AKI within the VLC+ASR cluster compared to the TA cluster
(aOR=0.60; 0.42- 0.86) consistent with the effect previously reported for
the active intervention phase (aOR=0.54; 0.40-0.74). <br/>Conclusion(s):
Team-based coaching along with a data-driven surveillance dashboard can
sustainably reduce AKI by 40%, even after active participation in the
trial is complete. These combined interventions are an effective, scalable
framework to establish aggressive AKI prevention protocols.

<16>
Accession Number
642698394
Title
Low-Value Surgical Procedures in Low- and Middle-Income Countries: A
Systematic Scoping Review.
Source
JAMA network open. 6(11) (pp e2342215), 2023. Date of Publication: 01 Nov
2023.
Author
Albarqouni L.; Abukmail E.; MohammedAli M.; Elejla S.; Abuelazm M.;
Shaikhkhalil H.; Pathirana T.; Palagama S.; Effa E.; Ochodo E.;
Rugengamanzi E.; AlSabaa Y.; Ingabire A.; Riwa F.; Goraya B.; Bakhit M.;
Clark J.; Arab-Zozani M.; Alves da Silva S.; Pramesh C.S.; Vanderpuye V.;
Lang E.; Korenstein D.; Born K.; Tabiri S.; Ademuyiwa A.; Nabhan A.;
Moynihan R.
Institution
(Albarqouni, Abukmail, Ingabire, Riwa, Bakhit, Clark, Moynihan) Institute
for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine,
Bond University, Gold Coast, Australia
(MohammedAli) Medicine & Health Sciences Faculty, Department of Medicine,
An-Najah National University, Nablus, Palestine
(Elejla, Shaikhkhalil) Faculty of Medicine, Islamic University of Gaza,
Gaza Strip, Palestine
(Abuelazm) Faculty of Medicine, Tanta University, Egypt
(Pathirana, Palagama) School of Medicine and Dentistry, Griffith
University, Sunshine Coast, Australia
(Effa) Department of Internal Medicine, Faculty of Clinical Sciences,
College of Medical Sciences, University of Calabar, Calabar, Nigeria
(Ochodo) Centre for Global Health Research, Kenya Medical Research
Institute, Kenya
(Ochodo) Centre for Evidence-Based Health Care, Department of Global
Health, Faculty of Medicine and Health Sciences, Stellenbosch University,
Stellenbosch, South Africa
(Rugengamanzi) Department of Clinical Oncology, Muhimbili University of
Health and Allied Sciences, Dar es Salaam, Tanzania
(AlSabaa) Faculty of Medicine, Al-Azhar University of Gaza, Gaza Strip,
Palestine
(Goraya) Princess Margaret Cancer Centre, Toronto, ON, Canada
(Arab-Zozani) Social Determinants of Health Research Center, Birjand
University of Medical Sciences, Birjand, Iran, Islamic Republic of
(Alves da Silva) Department of Epidemiology, HCor Hospital, Sao Paulo,
Brazil
(Pramesh) Tata Memorial Centre, Homi Bhabha National Institute, Mumbai,
India
(Vanderpuye) National Centre for Radiotherapy, Oncology and Nuclear
Medicine, Korle Bu Teaching Hospital, Accra, Ghana
(Lang) Department of Emergency Medicine, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Korenstein) Department of Medicine, Icahn School of Medicine at Mount
Sinai, NY, United States
(Born) Institute of Health Policy, Management and Evaluation, Dalla Lana
School of Public Health, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Tabiri) Department of Surgery, University for Development Studies-School
of Medicine and Tamale Teaching Hospital, Tamale, Ghana
(Ademuyiwa) Paediatric Surgery Unit, Department of Surgery, Faculty of
Clinical Sciences, College of Medicine of the University of Lagos and
Lagos University Teaching Hospital, Lagos, Nigeria
(Nabhan) Department of Obstetrics and Gynecology, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
Abstract
Importance: Overuse of surgical procedures is increasing around the world
and harms both individuals and health care systems by using resources that
could otherwise be allocated to addressing the underuse of effective
health care interventions. In low- and middle-income countries (LMICs),
there is some limited country-specific evidence showing that overuse of
surgical procedures is increasing, at least for certain procedures.
<br/>Objective(s): To assess factors associated with, extent and
consequences of, and potential solutions for low-value surgical procedures
in LMICs. Evidence Review: We searched 4 electronic databases (PubMed,
Embase, PsycINFO, and Global Index Medicus) for studies published from
database inception until April 27, 2022, with no restrictions on date or
language. A combination of MeSH terms and free-text words about the
overuse of surgical procedures was used. Studies examining the problem of
overuse of surgical procedures in LMICs were included and categorized by
major focus: the extent of overuse, associated factors, consequences, and
solutions. <br/>Finding(s): Of 4276 unique records identified, 133 studies
across 63 countries were included, reporting on more than 9.1 million
surgical procedures (median per study, 894 [IQR, 97-4259]) and with more
than 11.4 million participants (median per study, 989 [IQR, 257-6857]).
Fourteen studies (10.5%) were multinational. Of the 119 studies (89.5%)
originating from single countries, 69 (58.0%) were from
upper-middle-income countries and 30 (25.2%) were from East Asia and the
Pacific. Of the 42 studies (31.6%) reporting extent of overuse of surgical
procedures, most (36 [85.7%]) reported on unnecessary cesarean delivery,
with estimated rates in LMICs ranging from 12% to 81%. Evidence on other
surgical procedures was limited and included abdominal and percutaneous
cardiovascular surgical procedures. Consequences of low-value surgical
procedures included harms and costs, such as an estimated US $3.29 billion
annual cost of unnecessary cesarean deliveries in China. Associated
factors included private financing, and solutions included social media
campaigns and multifaceted interventions such as audits, feedback, and
reminders. <br/>Conclusions and Relevance: This systematic review found
growing evidence of overuse of surgical procedures in LMICs, which may
generate significant harm and waste of limited resources; the majority of
studies reporting overuse were about unnecessary cesarean delivery.
Therefore, a better understanding of the problems in other surgical
procedures and a robust evaluation of solutions are needed.

<17>
[Use Link to view the full text]
Accession Number
642696524
Title
Effects of music therapy on pain relief during fundus screening in
infants: Randomized controlled clinical trial.
Source
Medicine. 102(44) (pp e35878), 2023. Date of Publication: 03 Nov 2023.
Author
Chen R.; Duan S.; Wang Y.; He F.; Ren L.; Peng W.
Institution
(Chen, Duan, Wang, He, Ren, Peng) Department of Nursing, West China Second
University Hospital, Sichuan University, Key Laboratory of Birth Defects
and Related Diseases of Women and Children (Sichuan University), Ministry
of Education, Chengdu, Sichuan, China
(Chen, Peng) West China School of Nursing, Sichuan University, Chengdu,
Sichuan, China
Abstract
BACKGROUND: To determine the efficacy of music therapy on pain relief
during fundus screening in infants. <br/>METHOD(S): The sample consisted
of infants aged 0 to 3 months who required fundus screening. Infants were
randomized to fast music, slow music, and control groups. All groups
underwent fundus screening under topical anesthesia. Music therapy was
provided to the music groups prior to, during, and after the operation.
The patient's heart rate (HR), transcutaneous oxygen saturation, and
crying decibel were measured. The Face, Legs, Activity, Cry, Consolability
scale was used for pain measurement. <br/>RESULT(S): A total of 300
subjects' data were collected. The quantitative analysis revealed that in
both music groups, peripheral capillary oxygen saturation and satisfaction
levels increased while pain scores decreased (P < .05). The slow music
group's HR was shown to have significantly decreased (P < .05).
<br/>CONCLUSION(S): Music therapy can effectively reduce pain and crying,
and increase blood oxygen saturation during fundus examination of infants.
Music with a rhythm of 60 to 80 beats per minute can decrease HR. Music
therapy must be remembered to increase infants' comfort during fundus
examination.<br/>Copyright &#xa9; 2023 the Author(s). Published by Wolters
Kluwer Health, Inc.

<18>
Accession Number
2026584981
Title
Perioperative myocardial injury is associated with increased postoperative
non-cardiac complications in patients undergoing vascular surgery: a post
hoc analysis of a randomised clinical pilot trial.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 58.
Date of Publication: December 2023.
Author
Valadkhani A.; Gupta A.; Bell M.
Institution
(Valadkhani, Gupta, Bell) Perioperative Medicine and Intensive Care (PMI),
Karolinska University Hospital, Stockholm, Sweden
(Valadkhani, Gupta, Bell) Department of Pharmacology and Physiology,
Karolinska Institutet, Stockholm, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Elevated cardiac biomarkers, such as high-sensitivity cardiac
Troponin T and N-terminal pro-B-type natriuretic peptide improve the
prediction of major adverse cardiac events. However, very few trials have
investigated the association between perioperative cardiac injury and
non-cardiac complications. The primary aim of this study was to determine
the association between peri-operative myocardial injury and non-cardiac
complications in patients undergoing vascular surgery. Additionally, the
association between elevated pre-operative high-sensitivity cardiac
Troponin T or N-terminal pro-B-type natriuretic peptide and non-cardiac
complications was explored. <br/>Method(s): This study is a post hoc
analysis of a multicentre randomised controlled trial. Patients were
recruited from three centres in Sweden between 2016 and 2019. Cardiac
troponin level was measured pre-operatively and at 4, 24, and 48 h after
the start of surgery in patients undergoing vascular surgery. N-terminal
pro-B-type natriuretic peptide was measured pre-operatively. The primary
outcome was a composite of major postoperative non-cardiac complications
assessed at 30 days. <br/>Result(s): A total of 184 patients undergoing
peripheral or aortic vascular surgery were included in this study. The
primary endpoint occurred in 67 (36%) patients. Perioperative myocardial
injury was significantly associated with non-cardiac complications, with
an adjusted odds ratio (OR) of 2.71 (95% confidence interval 1.33-5.55, P
= 0.01). Sensitivity and specificity were 0.40 and 0.81, respectively. No
association was found between pre-operative hs-cTnT or NT-proBNP and
non-cardiac complications. <br/>Conclusion(s): In this pilot study, we
found that new peri-operative myocardial injury is associated with an
increased risk of non-cardiac complications within 30 days after index
surgery in patients undergoing vascular surgery. Pre-operative
high-sensitivity cardiac Troponin T or N-terminal pro-B-type natriuretic
peptide did not appear to predict non-cardiac complications. Larger
studies are needed to confirm our findings. Trial registration: EudraCT
database: 2016-001584-36<br/>Copyright &#xa9; 2023, The Author(s).

<19>
Accession Number
2026579080
Title
Incidence and Factors Related to Prolonged Postoperative Cognitive Decline
(POCD) in Elderly Patients Following Surgery and Anaesthesia: A Systematic
Review.
Source
Journal of Multidisciplinary Healthcare. 16 (pp 3405-3413), 2023. Date of
Publication: 2023.
Author
Arefayne N.R.; Berhe Y.W.; van Zundert A.A.
Institution
(Arefayne, Berhe) Department of Anaesthesia, College of Medicine and
Health Sciences, University of Gondar, Gondar, Ethiopia
(van Zundert) The University of Queensland & Royal Brisbane and Women's
Hospital, Department of Anaesthesia and Perioperative Medicine, Brisbane,
QLD, Australia
Publisher
Dove Medical Press Ltd
Abstract
Aim: The aim of this systematic review is to explore the current
literature to provide evidence regarding the incidence and risk factors of
prolonged POCD in elderly patients following cardiac and non-cardiac
surgical interventions. <br/>Method(s): The PubMed and Google Scholar
databases were searched using appropriate keywords and search engines for
adequate evidence from studies meeting the inclusion criteria so as to
reveal the end-point, which was the presence of prolonged POCD in elderly
patients following surgery and anaesthesia. The incidence of POCD at
different time intervals and the variables predicting the occurrence of
POCD were analysed. <br/>Result(s): The results of 23 articles covering
5077 patients (3694 non cardiac and 1383 cardiac surgeries) were carefully
analysed. POCD occurs from the first postoperative day and lasts for
potentially long periods. The incidence of POCD in this review ranged from
2.2% to 35.7%. More specifically, it ranged from 2.2% to 31.5% in
non-cardiac surgeries and 11.8% to 35.7% in patients who had undergone
cardiac surgeries. Some of the independent risk factors (predictors) for
the development of POCD were advanced age, high concentration of
neuroinflammatory mediators detectable in plasma, low SpO<inf>2</inf>,
longer anaesthetic and surgical duration, and depth of anaesthesia.
<br/>Conclusion(s): This review can only provide limited evidence of
prolonged POCD (more than a year) and further research that involves
better study designs, larger samples, involving longer follow-up, and at
different sites (multicentre) is highly advised. This in turn may help
researchers and clinicians to discover the actual causes and risk factors
and develop appropriate preventive and treatment protocols to tackle POCD
in the ageing surgical population.<br/>Copyright &#xa9; 2023 Arefayne et
al.

<20>
Accession Number
2026558238
Title
COMPARISON OF AMIODARONE VERSUS MAGNESIUM SULPHATE IN PREVENTION OF POST
OPERATIVE ARRHYTHMIAS IN OPEN HEART SURGERY: A RANDOMIZED CONTROLLED TRIAL
AT LADY READING HOSPITAL PESHAWAR.
Source
Journal of Postgraduate Medical Institute. 37(4) (pp 238-243), 2023. Date
of Publication: 06 Nov 2023.
Author
Ali A.; Moin Ud Din M.H.; Hassanain S.S.; Izaz M.; Ahmad M.A.
Institution
(Ali, Moin Ud Din, Hassanain, Izaz, Ahmad) Department of Anesthesia, Lady
Reading Hospital Peshawar, Pakistan
Publisher
Postgraduate Medical Institute
Abstract
Objective: To compare the frequency of postoperative arrhythmias with
amiodarone versus magnesium sulphate in patients undergoing open heart
surgery Methodology: This randomized Controlled trial was done at
Department of Anethesia Lady Reading Hospital, Peshawar. Eighty patients
of age 40-70 years, either gender undergoing open heart surgery under
general anesthesia were enrolled via Non-probability, consecutive sampling
technique. Then they were divided in two groups by using lottery method.
In group A, patients were given loading dose of amiodarone 5mg/Kg and in
group B, patients were given 2g of MgSO4 in 100ml of isotonic 0.9%
solution intravenously. After surgery, patients were followed-up there for
3 days. Patients were monitored through ECG monitor for postoperative
arrhythmias. <br/>Result(s): The mean age of patients was 49.93+/-7.38
years in amiodarone group while 51.45+/-7.31yeas in MgSO4 group. There
were 26 (65%) males and 14 (35%) females in group A while 15 males (37.5%)
and 25 females (62.5%) in group B. Postoperative arrhythmias were observed
in 10 (25%) cases with amiodarone while in 16 (40%) cases with MgSO4,
although the difference was insignificant (p>0.05). <br/>Conclusion(s):
The frequency of postoperative arrhythmias is reduced with using
amiodarone than MgSO4.<br/>Copyright &#xa9; 2023, Postgraduate Medical
Institute. All rights reserved.

<21>
Accession Number
2028272522
Title
erector spinae plane block versus paravertebral block for postoperative
pain management in thoracic surgery: a systematic review and
meta-analysis.
Source
Minerva Anestesiologica. 89(11) (pp 1042-1050), 2023. Date of Publication:
November 2023.
Author
Capuano P.; Hileman B.A.; Martucci G.; Raffa G.M.; Toscano A.; Burgio G.;
Arcadipane A.; Kowalewski M.
Institution
(Capuano, Martucci, Burgio, Arcadipane) Department of Anesthesia and
Intensive Care, Irccs-isMett (Istituto Mediterraneo per i Trapianti e
Terapie ad Alta Specializzazione), Palermo, Italy
(Hileman) University of Pittsburgh, School of Medicine, Pittsburgh, Pa,
United States
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Irccs-isMett, Palermo, Italy
(Toscano) Department of Anesthesia, Critical Care and Emergency, Citta
Della Salute e Della Scienza, University of Turin, Turin, Italy
(Kowalewski) Department of Cardiac Surgery and Transplantology, Central
Clinical Hospital of the Ministry of Interior, Center of Postgraduate
Medical Education, Warsaw, Poland
(Kowalewski) Department of Cardiothoracic Surgery, Heart and Vascular
Center, Maastricht University Medical Center, Maastricht, Netherlands
(Kowalewski) Cardiovascular Research Institute Maastricht (CariM),
Maastricht, Netherlands
(Kowalewski) Thoracic Research Center, Collegium Medicum, Innovative
Medical Forum, Nicolaus Copernicus University, Bydgoszcz, Poland
Publisher
Edizioni Minerva Medica
Abstract
introDUction: the 2018 guidelines for enhanced recovery in thoracic
surgery recommend paravertebral block (PvB) for postoperative pain
management. However, recent studies demonstrate that erector spinae plane
block (esPB) achieves similar postoperative pain control with reduced
block-related complications. eviDence acQUisition: We conducted a
meta-analysis of randomized controlled trials to evaluate the analgesic
efficacy and safety of ESPB versus PvB for pain management after thoracic
surgery. PubMed, embase, and scopus were searched through December 2022
(ProsPero registration - crD42023395593). Primary outcomes were
postoperative pain scores, resting at 6, 12, 24, and 48 hours, and at
movement at 24 and 48 hours. secondary outcomes included opioid
consumption at 24 and 48 hours, and incidence of postoperative nausea and
vomiting or block-related complications in the first 48 hours. eviDence
sYntHesis: ten randomized control trials enrolling a total of 624 total
patients were included. there were no significant differences in pain
scores, resting or at movement, at any time points except reduced resting
pain scores at 12 hours with PVB (mean difference [MD]) 0.60, 95%
confidence interval [CI] 0.32 to 0.88). Opioid consumption demonstrated no
significant differences at 24 hours; PVB reduced opioid consumption at 48
hours (MD 0.40, 95% CI -0.09 to 0.89). There were no significant
differences in postoperative nausea or vomiting. ESPB exhibited a
nonsignificant trend toward reduced cumulative block-related complications
(risk difference [RD] 0.05, 95% CI -0.10 to 0.00). <br/>CONCLUSION(S):
Compared with PVB, ESPB is safe and demonstrates no clinically significant
differences in pain management after thoracic surgery.<br/>Copyright
&#xa9; 2023 eDiZioni Minerva MeDica.

<22>
Accession Number
2028272435
Title
Plasmalyte and Ringer Lactate as Priming Solutions in Pediatric
Cardiopulmonary Bypass: A Comparative Study.
Source
Cardiometry. (28) (pp 34-42), 2023. Date of Publication: August 2023.
Author
Abdellatif A.E.; Alassal M.A.; Raihan-Ul-Haq; Abdelsabour M.M.
Institution
(Abdellatif, Alassal) Cardiothoracic Surgery Department, Faculty of
Medicine, Benha University, Benha 13511, Egypt
(Raihan-Ul-Haq) AIIMS, New Delhi, India
(Raihan-Ul-Haq) PAAMCC, Arar, Saudi Arabia
(Abdelsabour) Cardiothoracic Surgery Department, Faculty of Medicine,
Menoufia University, Menoufia, Egypt
Publisher
Novyi Russkii Universitet
Abstract
Background: Pediatric heart surgery, particularly for cyanotic congenital
heart conditions, commonly requires the utilization of cardiopulmonary
bypass (CPB) to assist with surgical interventions. The choice of priming
solution for the CPB circuit can influence postoperative outcomes. This
study aimed to assess the impact of two different priming solutions,
Plasmalyte and Ringer's Lactate, on postoperative outcomes, blood
biochemistry, pulmonary and renal function, bleeding, and hemostasis in
children undergoing open cardiac surgery with CPB. <br/>Method(s): This
randomized prospective study was conducted on 80 pediatric patients aged 1
to 10 years, undergoing elective cardiac surgery with CPB. Patients were
randomly assigned to receive either Plasmalyte (Group A) or Ringer's
Lactate (Group B) as their CPB circuit priming solution. Standardized
protocols for anesthesia, CPB circuit components, and surgical techniques
were maintained. Postoperative parameters including blood chemistry,
perfusion indicators, and physiological measurements were recorded and
analyzed. <br/>Result(s): After CPB initiation, lactate levels were
significantly higher in Group B (Ringer's Lactate) compared to Group A
(Plasmalyte) (P-value <0.001). Calcium levels also showed a significant
difference between the two groups (P-value <0.001). Postoperative lactate
levels remained higher in Group B (P-value <0.001), while bicarbonate,
calcium, urine output, urea, and creatinine levels at 6th hour
postoperatively were statistically significant (p<0.05).
<br/>Conclusion(s): Priming the CPB circuit with Plasmalyte may be
associated with favorable outcomes in terms of lactate and calcium levels
compared to Ringer Lactate in pediatric patients undergoing cardiac
surgery.<br/>Copyright &#xa9; 2023 Novyi Russkii Universitet. All rights
reserved.

<23>
Accession Number
2028341509
Title
Transcatheter edge-to-edge repair in mitral regurgitation: A comparison of
device systems and recommendations for tailored device selection. A
systematic review and meta-analysis.
Source
Progress in Cardiovascular Diseases. (no pagination), 2023. Date of
Publication: 2023.
Author
Alqeeq B.F.; Al-Tawil M.; Hamam M.; Aboabdo M.; Elrayes M.I.; Leick J.;
Zeinah M.; Haneya A.; Harky A.
Institution
(Alqeeq, Hamam, Aboabdo) Faculty of Medicine, Islamic University of Gaza,
Gaza, Palestine
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Elrayes) Department of Pediatric Surgery, Great Ormond Street Hospital
for Children, London, United Kingdom
(Leick) Department of Cardiology, Heart Center Trier, Trier, Germany
(Zeinah) School of Medicine, Ain Shams University, Cairo, Egypt
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Haneya) Department of Cardiac and Thoracic Surgery, Heart Center Trier,
Trier, Germany
Publisher
W.B. Saunders
Abstract
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) is a
minimally invasive method for the treatment of mitral regurgitation (MR)
in patients with prohibitive surgical risks. The traditionally used
device, MitraClip, showed both safety and effectiveness in M-TEER. PASCAL
is a newer device that has emerged as another feasible option to be used
in this procedure. <br/>Method(s): We searched for observational studies
that compared PASCAL to MitraClip devices in M-TEER. The electronic
databases searched for relevant studies were PubMed/MEDLINE, Scopus, and
Embase. The primary outcomes were technical success and the grade of MR at
follow-up. Secondary outcomes included all-cause mortality, bleeding,
device success and reintervention. <br/>Result(s): Technical success
(PASCAL: 96.5% vs MitraClip: 97.6%, p = 0.24) and MR <= 2 at 30-day
follow-up (PASCAL: 89.4vs MitraClip 89.9%, p = 0.51) were comparable
between both groups. Both devices showed similar outcomes including
all-cause mortality (RR: 0.68 [0.34, 1.38]; P = 0.28), major bleeding (RR:
1.87 [0.68, 5.10]; P = 0.22) and reintervention (RR: 1.02 [0.33, 3.16]; P
= 0.97). Device success was more frequent with PASCAL device (PASCAL: 86%
vs MitraClip 68.5%; P = 0.44), however, the results did not reach
statistical significance. <br/>Conclusion(s): Clinical outcomes of PASCAL
were comparable to those of MitraClip with no significant difference in
safety and effectiveness. The choice between MitraClip and PASCAL devices
should be guided by various factors, including mitral valve anatomy,
etiology of regurgitation, and device-specific
characteristics.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<24>
Accession Number
2028262120
Title
Efficacy of the intertransverse process block: single or multiple
injection? A randomized, non-inferiority, blinded, cross-over trial in
healthy volunteers.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2023. Article
Number: 104972. Date of Publication: 2023.
Author
Nielsen M.V.; Tanggaard K.; Bojesen S.; Birkebaek A.D.L.F.; Therkelsen
A.S.; Sorensen H.; Klementsen C.; Hansen C.; Vazin M.; Poulsen T.D.;
Borglum J.
Institution
(Nielsen, Tanggaard, Birkebaek, Therkelsen, Sorensen, Klementsen, Hansen,
Vazin, Poulsen, Borglum) Department of Anesthesiology and Intensive Care
Medicine, Zealand University Hospital, Roskilde, Denmark
(Bojesen) Department of Plastic and Breast Surgery, Zealand University
Hospital, Roskilde, Denmark
(Borglum) Department of Clinical Medicine, University of Copenhagen,
Faculty of Health and Medical Sciences, Copenhagen, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction: The intertransverse process block is increasingly used to
ameliorate postoperative pain following a plethora of surgical procedures
involving the thoracic wall. Nevertheless, the optimal approach and
cutaneous extent of the sensory block are currently unknown. We aimed to
further describe the intertransverse process block, single injection
versus multiple injection, and we hypothesized that the single-injection
intertransverse process block is a non-inferior technique. <br/>Method(s):
Twelve healthy male volunteers were cross-over randomized to receive
either single-injection intertransverse process block with 21 mL
ropivacaine 7.5 mg/mL, including two sham injections, at the thoracic
level T4/T5 or multiple-injection intertransverse process block with three
injections of 7 mL ropivacaine 7.5 mg/mL at the thoracic levels T2/T3,
T4/T5 and T6/T7 at the first visit. At the second visit, the other
technique was applied on the contralateral hemithorax. A non-inferiority
margin of 1.5 anesthetized thoracic dermatomes was chosen. <br/>Result(s):
The mean difference (95% CI) in the number of anesthetized thoracic
dermatomes was 0.82 (-0.41 to 2.05) pnon-inf<0.01 indicating
non-inferiority favoring the single-injection technique. Both techniques
anesthetized the ipsilateral thoracic wall and demonstrated contralateral
cutaneous involvement to a variable extent. The multiple-injection
intertransverse process block anesthetized a significantly larger
cutaneous area on the posterior hemithorax and decreased mean arterial
pressure at 30 and 60 min postblock application. Thoracic thermography
showed no intermodality temperature differences yet compared with baseline
temperatures both techniques showed significant differences.
<br/>Conclusion(s): Single-injection intertransverse process block is
non-inferior to multiple injection in terms of anesthetized thoracic
dermatomes. Both techniques generally anesthetize the hemithoracic wall to
a variable extent. EU clinical trials register: 2022-501312-34-01.
<br/>Copyright &#xa9; American Society of Regional Anesthesia & Pain
Medicine 2023. No commercial re-use. See rights and permissions. Published
by BMJ.

<25>
Accession Number
2027953743
Title
Delirium in older patients given propofol or sevoflurane anaesthesia for
major cancer surgery: a multicentre randomised trial. Comment on Br J
Anaesth 2023; 131: 253-65.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
O'Reilly D.; Naughton R.; Lavelle A.
Institution
(O'Reilly, Naughton, Lavelle) Department of Anaesthesiology, St. James's
Hospital, Dublin, Ireland
Publisher
Elsevier Ltd

<26>
Accession Number
642707198
Title
Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for
Thoracic Ligamentous Ossification: A Systematic Review and Meta-Analysis.
Source
Spine. (no pagination), 2023. Date of Publication: 06 Nov 2023.
Author
Ye J.; Guo W.; Hu Y.; Fan X.
Institution
(Ye, Guo, Hu, Fan) Department of Orthopedics, Hospital of Chengdu
University of Traditional Chinese Medicine, Chengdu, China
(Ye, Guo, Hu) Chengdu University of Traditional Chinese Medicine, Chengdu,
China
Abstract
STUDY DESIGN: Systematic review and meta-analysis. <br/>OBJECTIVE(S): This
study systematically reviewed and evaluated the safety and efficacy of
spinal endoscopic techniques as a treatment for thoracic ligamentum flavum
ossification (TOLF). SUMMARY OF BACKGROUND DATA: The use of spinal
endoscopic techniques for the treatment of TOLF has increased in recent
years. The present study is the first comprehensive systematic review and
meta-analysis focused on the use of spinal endoscopic techniques for TOLF.
<br/>METHOD(S): The Cochrane Central, PubMed, Web of Science, and Embase
databases were systematically searched for studies focused on patients
undergoing spinal endoscopic techniques to treat symptomatic TOLF.
<br/>RESULT(S): This meta-analysis included 23 studies. We included 323
patients (177 males, 146 females) with a mean age of 58.40+/-10.06 years,
with 304 total recorded lesion locations of which 245 were located in the
lower thoracic spine. Complications affected 35/323 patients, and the mean
operative duration for 305 patients was 108.15+/-47.34 minutes. For 187
patients, the mean operative bleeding was 25.13+/-12.54 mL, while for 87
patients the mean duration of hospitalization was 4.59+/-1.93 days. At
last follow-up,functional assessment was performed for 260 patients, of
whom 200 were in excellent condition, visual analog scale (VAS) scores
were assessed for 160 patients, with a mean improvement of 4.40
(3.95,4.86) Japanese Orthopedic Association (JOA) scores were recorded for
115 patients, with a mean improvement of 2.99 (2.77,3.22) , and modified
Japanese Orthopedic Association (mJOA) scores were recorded for 208
patients, with a mean improvement of 3.41 (3.17,3.64) .
<br/>CONCLUSION(S): These results support several advantages of spinal
endoscopic techniques for the treatment of symptomatic TOLF. These include
low complication rates, rapid postoperative recovery, and good functional
recovery when used for single-segment, non-nodular ossification and no
combined dural ossification.<br/>Copyright &#xa9; 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<27>
Accession Number
2027203694
Title
Recurrent Cardiac Sarcoidosis and Giant Cell Myocarditis After Heart
Transplant: A Case Report and Systematic Literature Review.
Source
American Journal of Cardiology. 207 (pp 271-279), 2023. Date of
Publication: 15 Nov 2023.
Author
Stein A.P.; Stewart B.D.; Patel D.C.; Al-Ani M.; Vilaro J.; Aranda J.M.;
Ahmed M.M.; Parker A.M.
Institution
(Stein) Department of Medicine
(Stewart) Department of Pathology
(Patel) Division of Pulmonary, Critical Care and Sleep Medicine
(Al-Ani, Vilaro, Aranda, Ahmed, Parker) Division of Cardiology, Department
of Medicine, University of Florida Gainesville, Florida, United States
Publisher
Elsevier Inc.
Abstract
Recurrence of cardiac sarcoidosis (CS) and giant cell myocarditis (GCM)
after heart transplant is rare, with rates of 5% in CS and 8% in GCM. We
aim to identify all reported cases of recurrence in the literature and to
assess clinical course, treatments, and outcomes to improve understanding
of the conditions. A systematic review, utilizing Preferred Reporting
Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, was
conducted by searching MEDLINE/PubMed and Embase of all available
literature describing post-transplant recurrent granulomatous myocarditis,
CS, or GCM. Data on demographics, transplant, recurrence, management, and
outcomes data were collected from each publication. Comparison between the
2 groups were made using standard statistical approaches. Post-transplant
GM recurrence was identified in 39 patients in 33 total publications.
Reported cases included 24 GCM, 12 CS, and 3 suspected cases. Case reports
were the most frequent form of publication. Mean age of patients
experiencing recurrence was 42 years for GCM and 48 years for CS and
favored males (62%). Time to recurrence ranged from 2 weeks to 9 years
post-transplant, occurring earlier in GCM (mean 1.8 vs 3.0 years).
Endomyocardial biopsies (89%) were the most utilized diagnostic method
over cardiac magnetic resonance and positron emission tomography.
Recurrence treatment regimens involved only steroids in 40% of CS, whereas
other immunomodulatory regimens were utilized in 70% of GCM. In
conclusion, GCM and CS recurrence after cardiac transplantation holds
associated risks including concurrent acute cellular rejection, a higher
therapeutic demand for GCM recurrence compared with CS, and mortality. New
noninvasive screening techniques may help modify post-transplant
monitoring regimens to increase both early detection and treatment of
recurrence.<br/>Copyright &#xa9; 2023

<28>
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

<29>
Accession Number
2026542200
Title
Protocol: dexmedetomidine on myocardial injury after noncardiac surgery-a
multicenter, double-blind, controlled trial.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 57.
Date of Publication: December 2023.
Author
Zhang J.; Peng K.; Meng X.; Shan X.; Huo W.; Liu H.; Lei Y.; Ji F.
Institution
(Liu, Peng, Meng, Shan, Huo, Lei, Ji) Department of Anesthesiology, The
First Affiliated Hospital of Soochow University, Suzhou, China
(Liu, Peng, Meng, Ji) Institute of Anesthesiology, Soochow University,
Suzhou, China
(Zhang) Department of Pain Medicine, Shenzhen People's Hospital (The
Second Clinical Medical College, Jinan University; The First Affiliated
Hospital, Southern University of Science and Technology), Shenzhen, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
BioMed Central Ltd
Abstract
Aims: Myocardial injury after noncardiac surgery (MINS) is common in
elderly patients and considered as an independent predictor of 30-day
mortality after noncardiac surgery. Dexmedetomidine possesses
cardiac-protective profile. Previous clinical studies have found that
perioperative application of dexmedetomidine is associated with decreased
1-year mortality in patients undergoing cardiac surgery. The current study
protocol aims to investigate the effects of dexmedetomidine on the
incidence of MINS, complications, and 30-day mortality in elderly patients
subjected to noncardiac surgery. <br/>Method(s): A multicenter,
randomized, controlled, double-blind, prospective trial is designed to
explore cardiac protection of dexmedetomidine in the elderly patients
undergoing noncardiac surgery. A total of 960 patients aged over 65 years
will be recruited and randomly assigned to dexmedetomidine group (group
Dex) and normal saline placebo group (group NS) in a ratio of 1:1.
Patients in group Dex will receive a bolus dose of 0.5 mug/kg
dexmedetomidine within 10 min before surgical incision, followed by a
consistent infusion at the rate of 0.3-0.5 mug/kg/h throughout the
operation. Group NS patients will receive the same volume of normal
saline. The primary outcome is the incidence of MINS via detecting the
hs-TnT level within 3 days after the operation. The secondary outcome
includes myocardial ischemic symptoms, the incidence of major adverse
cardiovascular events (MACE) in hospital, length of ICU and postoperative
hospital stay, the incidence of inhospital complications, and 30-day
all-cause mortality. <br/>Discussion(s): The results of the current study
will illustrate the effect of dexmedetomidine on myocardial injury for
elderly patients undergoing major noncardiac surgery. Trial registration:
The trial was registered with Chinese Clinical Trial Registry (CHICTR) on
Aug 24, 2021 (ChiCTR2100049946,
http://www.chictr.org.cn/showproj.aspx?proj=131804).<br/>Copyright &#xa9;
2023, The Author(s).

<30>
Accession Number
2026211905
Title
A Systematic Review of Short-Term Outcomes of Leadless Pacemaker
Implantation After Transvenous Lead Removal of Infected Cardiac
Implantable Electronic Device.
Source
American Journal of Cardiology. 203 (pp 444-450), 2023. Date of
Publication: 15 Sep 2023.
Author
Tan M.C.; Tan J.L.; Tay S.T.; Sorajja D.; Scott L.; Cha Y.-M.; Russo A.M.;
Hussein A.; Lee J.Z.
Institution
(Tan, Sorajja, Scott) Division of Cardiovascular Medicine, Mayo Clinic,
Phoenix, Arizona, United States
(Tan) Department of Internal Medicine, New York Medical College at Saint
Michael's Medical Center, Newark, New Jersey, United States
(Tan) Division of Cardiovascular Medicine, Hospital of the University of
Pennsylvania, Philadelphia, Pennsylvania, United States
(Tay) Department of Medicine, School of Medicine, Chang Gung University,
Taoyuan City, Taiwan (Republic of China)
(Cha) Division of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Russo) Division of Cardiovascular Medicine, Cooper University Health
Care/Cooper Medical School of Rowan University, Camden, New Jersey, United
States
(Hussein, Lee) Division of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
The outcomes of leadless pacemaker (LP) implantation after transvenous
lead removal (TLR) of infected cardiac implantable electronic devices
(CIEDs) are not well-established. This study sought to describe the
outcomes of LP implantation after TLR of infected CIED. We conducted a
literature search using PubMed and Embase for a combination of terms
including LP implantation, transvenous lead extraction, TLR, transvenous
lead explant, infected CIED, infected pacemaker, and infected implantable
cardioverter defibrillator. The inclusion criterion was LP implantation
after TLR of infected CIED. The exclusion criterion was TLR for
noninfectious reasons. Study end points included procedural complications
and LP infection during follow-up. Of 132 publications reviewed, 13
studies with a total of 253 patients (74 +/- 14 years of age, 174 [69%]
males) were included. The most common indication of the initial device
implantations was a high-degree atrioventricular block (n = 100 of 253,
39.5%). Of the 253 patients included, 105 patients (41.5%) underwent
concomitant LP implantation during the TLR procedure, and 36 patients
(14.2%) had temporary transvenous pacing as a bridge from TLR to LP
implantation. Of the 148 patients with data on the type of CIED infection,
56.8% had systemic CIED infection and 43.2% had isolated pocket infection.
Staphylococcus aureus was the most common causative organism in 33% of the
reported patients. The LP was implanted an average of 5.4 +/- 10.7 days
after TLR of infected CIED. During the LP implantation, 1 patient (0.4%)
had unsuccessful implantation because of an intraprocedural complication
requiring sternotomy. After LP implantation, 2 patients (0.8%) developed
groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula,
and 1 patient (0.4%) developed pericardial effusion requiring
pericardiocentesis. During a mean follow-up of 11.3 +/- 10.6 months, 3
patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed
acute on chronic heart failure exacerbation, and only 1 patient (0.4%)
developed LP-related infection requiring LP retrieval. This study suggests
that LP implant is feasible and safe after removal of infected CIED with
cumulative adverse events at 4% and a reinfection rate of 0.4%. Large
prospective studies are needed to better evaluate the best timing of LP
implantation after TLR of an infected CIED.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<31>
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)

<32>
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

<33>
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

<34>
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)

<35>
Accession Number
2028108119
Title
Risk Scores for Prediction of Postoperative Atrial Fibrillation After
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 209 (pp 232-240), 2023. Date of
Publication: 15 Dec 2023.
Author
Pandey A.; Okaj I.; Ichhpuniani S.; Tao B.; Kaur H.; Spence J.D.; Young
J.; Healey J.S.; Devereaux P.J.; Um K.J.; Benz A.P.; Conen D.; Whitlock
R.P.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Pandey, Okaj, Ichhpuniani, Kaur) Michael G. DeGroote School of Medicine,
McMaster University, Hamilton, ON, Canada
(Tao) Faculty of Medicine, University of British Columbia, Vancouver, BC,
Canada
(Spence, Healey, Devereaux, Benz, Conen, Whitlock, Belley-Cote, McIntyre)
Population Health Research Institute, Hamilton, ON, Canada
(Young) Health Sciences Library, McMaster University, Hamilton, ON, Canada
(Healey, Devereaux, Um, Conen, Belley-Cote, McIntyre) Division of
Cardiology, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery and is associated with poor clinical outcomes. The
objective of this systematic review and meta-analysis was to assess the
performance of risk scores to predict POAF in cardiac surgery patients. We
searched MEDLINE, Embase, and Cochrane CENTRAL for studies that
developed/evaluated a POAF risk prediction model. Pairs of reviewers
independently screened studies and extracted data. We pooled area under
the receiver operating curves (AUCs), sensitivity and specificity, and
adjusted odds ratios from multivariable regression analyses using the
generic inverse variance method and random effects models. Forty-three
studies (n = 63,847) were included in the quantitative synthesis. Most
scores were originally developed for other purposes but evaluated for
predicting POAF. Pooled AUC revealed moderate POAF discrimination for the
EuroSCORE II (AUC 0.59, 95% confidence interval [CI] 0.54 to 0.65),
Society of Thoracic Surgeons (AUC 0.60, 95% CI 0.56 to 0.63), EuroSCORE
(AUC 0.63, 95% CI 0.58 to 0.68), CHADS<inf>2</inf> (AUC 0.66, 95% CI 0.57
to 0.75), POAF Score (AUC 0.66, 95% CI 0.63 to 0.68), HATCH (AUC 0.67, 95%
CI 0.57 to 0.75), CHA<inf>2</inf>DS<inf>2</inf>-VASc (AUC 0.68, 95% CI
0.60 to 0.75) and SYNTAX scores (AUC 0.74, 95% CI 0.71 to 0.78). Pooled
analyses at specific cutoffs of the CHA<inf>2</inf>DS<inf>2</inf>-VASc,
CHADS<inf>2</inf>, HATCH, and POAF scores demonstrated moderate-to-high
sensitivity (range 46% to 87%) and low-to-moderate specificity (range 31%
to 70%) for POAF prediction. In conclusion, existing clinical risk scores
offer at best moderate prediction for POAF after cardiac surgery. Better
models are needed to guide POAF risk stratification in cardiac surgery
patients.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<36>
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.

<37>
Accession Number
2026470209
Title
Preoperative anemia and anemia treatment in cardiac surgery: a systematic
review and meta-analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Lau M.P.X.L.; Low C.J.W.; Ling R.R.; Liu N.S.H.; Tan C.S.; Ti L.K.;
Kofidis T.; MacLaren G.; Ramanathan K.
Institution
(Lau, Low, Ling, Liu, Tan, Ti, Kofidis, MacLaren, Ramanathan) Yong Loo Lin
School of Medicine, National University of Singapore, National University
Health System, Singapore, Singapore
(Tan) Saw Swee Hock School of Public Health, National University of
Singapore, National University Health System, Singapore, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singapore, Singapore
(Kofidis) Department of Cardiac, Thoracic, and Vascular Surgery, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(MacLaren, Ramanathan) Cardiothoracic Intensive Care Unit, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Level 9, 1E Kent Ridge Road,
Singapore 119228, Singapore
Publisher
Springer
Abstract
Purpose: We aimed to conduct a systematic review and meta-analysis to
assess the effects of anemia and anemia severity on patient outcomes in
cardiac surgery and determine whether preoperative treatments confer
postoperative benefit. Source: We searched four international databases
for observational and randomized studies published until 1 October 2022.
Study quality was assessed via Newcastle-Ottawa scores and the Cochrane
Risk-of-Bias 2 tool and certainty of evidence was rated with the Grading
of Recommendations, Assessment, Development and Evaluations approach. We
conducted random-effects meta-analyses for our primary outcome of
mortality, for secondary outcomes including length of stay (LOS) in the
hospital and intensive care unit, and for postsurgical complications. As
part of a secondary analysis, we analyzed short-term preoperative anemia
treatments and conducted trial sequential analysis of randomized trials to
assess the efficacy of these treatment programs. Principal findings: We
included 35 studies (159,025 patients) in our primary meta-analysis.
Preoperative anemia was associated with increased mortality (odds ratio
[OR], 2.5; 95% confidence interval [CI], 2.2 to 2.9; P < 0.001, high
certainty). Study-level meta-regression revealed lower hemoglobin levels
and studies with lower proportions of male patients to be associated with
increased risk of mortality. Preoperative anemia was also associated with
an increase in LOS and postsurgical complications. Our secondary analysis
(seven studies, 1,012 patients) revealed short-term preoperative anemia
treatments did not significantly reduce mortality (OR, 1.1; 95% CI, 0.65
to 1.9; P = 0.69). Trial sequential analysis suggested that there was
insufficient evidence to conclude if treatment programs yield any benefit
or harm. <br/>Conclusion(s): Preoperative anemia is associated with
mortality and morbidity after cardiac surgery. More research is warranted
to test the efficacy of current anemia treatment programs. Study
registration: PROSPERO (CRD42022319431); first submitted 17 April
2023.<br/>Copyright &#xa9; 2023, Canadian Anesthesiologists' Society.

<38>
Accession Number
2026449270
Title
Impact of intracardiac echocardiography versus transesophageal
echocardiography guidance on left atrial appendage occlusion procedures: A
meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2023. Date
of Publication: 2023.
Author
Diaz J.C.; Bastidas O.; Duque M.; Marin J.E.; Aristizabal J.; Nino C.D.;
Hoyos C.; Matos C.D.; Gabr M.; Steiger N.A.; Kapur S.; Sauer W.H.; Romero
J.E.
Institution
(Diaz) Cardiac Arrhythmia and Electrophysiology Service, Universidad CES
Medical School, Division of Cardiology, Clinica Las Vegas, Medellin,
Colombia
(Bastidas, Nino) Cardiac Arrhythmia and Electrophysiology Service,
Hospital Pablo Tobon Uribe, Medellin, Colombia
(Duque, Aristizabal) Cardiac Electrophysiology Service, Hospital San
Vicente Fundacion, Rionegro, Colombia
(Marin) Department of Medicine, Cardiac Arrhythmia and Electrophysiology
Service, Division of Cardiology, Clinica Las Americas, Medellin, colombia,
Medellin, Colombia
(Hoyos, Matos, Gabr, Steiger, Kapur, Sauer, Romero) Cardiac Arrhythmia
Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Intracardiac echocardiography (ICE) is increasingly used
during left atrial appendage occlusion (LAAO) as an alternative to
transesophageal echocardiography (TEE). The objective of this study is to
evaluate the impact of ICE versus TEE guidance during LAAO on procedural
characteristics and acute outcomes, as well the presence of peri-device
leaks and residual septal defects during follow-up. <br/>Method(s): All
studies comparing ICE-guided versus TEE-guided LAAO were identified. The
primary outcomes were procedural efficacy and occurrence of
procedure-related complications. Secondary outcomes included lab
efficiency (defined as a reduction in in-room time), procedural time,
fluoroscopy time, and presence of peri-device leaks and residual
interatrial septal defects (IASD) during follow-up. <br/>Result(s): Twelve
studies (n = 5637) were included. There were no differences in procedural
success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p =.27; I²
= 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p =.25;
I² = 0%) between the ICE-guided and TEE-guided groups. ICE
guidance reduced in in-room time (mean-weighted 28.6-min reduction in
in-room time) without differences in procedural time or fluoroscopy time.
There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27,
p = 0.64); however, an increased prevalence of residual IASD was observed
with ICE-guided versus TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI
1.05-4.75, p = 0.04). <br/>Conclusion(s): ICE guidance is associated with
similar procedural efficacy and safety, but could result in improved lab
efficiency (as established by a significant reduction in in-room time). No
differences in the rate of periprocedural leaks were found. A higher
prevalence of residual interatrial septal defects was observed with ICE
guidance.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<39>
Accession Number
2026445986
Title
Cardiovascular anomalies in patients with Tessier syndrome: a systematic
review.
Source
European Journal of Pediatrics. (no pagination), 2023. Date of
Publication: 2023.
Author
Nazari S.; Vaezi A.; Mossavarali S.; Ghanavati K.; Shafiee A.
Institution
(Nazari) Pediatric Congenital Hematologic Disorders Research Center,
Research Institute for Children Health, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Vaezi, Mossavarali) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ghanavati) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Cardiac Primary Prevention Research Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Department of Cardiovascular Research, Tehran Heart Center,
North Kargar Ave., Tehran 1411713138, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Tessier clefts are skeletal and soft tissue abnormalities of a neonate's
facial structures. They could be classified as syndromic and non-syndromic
clefts, which can be attributed to disruptions in fetal development and
genetic mutations, respectively. Reported cases of these clefts typically
document the presence of additional abnormalities associated with these
clefts. In this systematic review, we analyzed reports of Tessier clefts
accompanied by cardiovascular anomalies, as one of the commonly
encountered anomalies. We systematically searched PubMed (MEDLINE),
Scopus, Web of Science, Science Direct, and Google Scholar. We selected
and included case reports, case series, and case reviews on patients with
Tessier cleft and cardiovascular anomalies. The critical appraisal of the
included studies was performed by two independent investigators using the
Consensus-based Clinical Case Reporting Guideline Development (CARE)
checklist. Overall, 20 reports (18 case reports and 2 case series) were
eligible for inclusion in this review. Tessier clefts 3 and 30 were the
most commonly observed. In addition, the most prevalent cardiovascular
anomalies consisted of the ventricular septal defect (VSD), double-outlet
right ventricle, and atrial septal defect (ASD). Most of the patients
received cosmetic and cardiovascular surgeries. However, some were not
proper candidates for cardiovascular surgery because of their unstable
condition and therefore did not survive. <br/>Conclusion(s): Regardless of
the focus placed on the cleft and subsequent plastic surgery procedures in
these cases, it is important to prioritize other abnormalities that may be
associated with mortality. A complete cardiovascular system and associated
disorders assessment should be performed before facial cosmetic surgeries.
What is Known: * Tessier clefts are congenital defects in the soft tissues
and bones of the face and like many other congenital defects, they are
accompanied by defects in other parts of the body. * In the current
literature, the emphasis is on clefts and the cosmetic issues rather than
the coinciding defects, particularly cardiovascular anomalies. What is
New: * Review the cardiovascular anomalies that are commonly encountered
in patients with Tessier clefts.<br/>Copyright &#xa9; 2023, The Author(s),
under exclusive licence to Springer-Verlag GmbH Germany, part of Springer
Nature.

<40>
Accession Number
2025401623
Title
Effect of valve leaflet surface patterning on valve hydrodynamic
performance.
Source
International Journal of Artificial Organs. 46(10-11) (pp 569-573), 2023.
Date of Publication: October-November 2023.
Author
Wang A.; Wang Y.; Liu W.; Liu L.; Zhou J.
Institution
(Wang, Wang, Zhou) State Key Laboratory of Cardiovascular Disease, FuWai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Liu) Beijing Star Medical Devices Co., Ltd, Beijing, China
(Liu) Center for Medical Devices Testing, National Institutes for Food and
Drug Control, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Objective: We aimed to elucidate the effects of the micro-structure of the
pyrolytic carbon for artificial heart valves on its hydrodynamic
performance. <br/>Method(s): Bileaflet mechanical valves of GKS 23 and 29
A were randomly selected. According to ISO5840, mean transvalvular
pressure (MPG), regurgitation fraction (RF), and effective orifice area
(EOA) of valve were assessed. Then, parallel-groove pattern was
constructed by laser etching on leaflet surface, and the valves were
subjected again to the same test. <br/>Result(s): Compared with before
patterning at 2, 3.5, 5, and 7 L/min, the MPG of the valves in two
specifications were higher, the EOA was larger in 23 A, but smaller in 29
A, and the RF was contrary to EOA. At 5 L/min, the RF in both
specifications was lower after etching at 45 bpm. At 70 bpm however, the
RF in 23 A decreased, in 29 A increased. <br/>Conclusion(s): The
parallel-groove pattern on leaflet surface affected the hemodynamic
performance of the valve prostheses.<br/>Copyright &#xa9; The Author(s)
2023.

<41>
Accession Number
642137615
Title
Effect of colchicine on perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery in patients undergoing major thoracic
surgery (COP-AF): an international randomised trial.
Source
Lancet (London, England). 402(10413) (pp 1627-1635), 2023. Date of
Publication: 04 Nov 2023.
Author
Conen D.; Ke Wang M.; Popova E.; Chan M.T.V.; Landoni G.; Cata J.P.;
Reimer C.; McLean S.R.; Srinathan S.K.; Reyes J.C.T.; Grande A.M.; Tallada
A.G.; Sessler D.I.; Fleischmann E.; Kabon B.; Voltolini L.; Cruz P.;
Maziak D.E.; Gutierrez-Soriano L.; McIntyre W.F.; Tandon V.;
Martinez-Tellez E.; Guerra-Londono J.J.; DuMerton D.; Wong R.H.L.; McGuire
A.L.; Kidane B.; Roux D.P.; Shargall Y.; Wells J.R.; Ofori S.N.; Vincent
J.; Xu L.; Li Z.; Eikelboom J.W.; Jolly S.S.; Healey J.S.; Devereaux P.J.
Institution
(Conen, McIntyre, Jolly, Devereaux) Population Health Research Institute,
Hamilton, ON, Canada; Department of Medicine, McMaster University,
Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Ke Wang, Ofori, Xu, Eikelboom, Healey) Population Health Research
Institute, Hamilton, ON, Canada; Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain;
Centro Cochrane Iberoamericano, Barcelona, Spain
(Chan) Chinese University of Hong Kong, Hong Kong Special Administrative
Region, Shatin, China
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute
University San Raffaele, Milan, Italy
(Cata, Guerra-Londono) Department of Anesthesiology and Perioperative
Medicine, University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Reimer) Department of Anesthesiology, Queen's University, Kingston Health
Sciences Centre, Kingston, ON, Canada
(McLean) Vancouver Acute Department of Anesthesia and Perioperative
Medicine, Vancouver General Hospital, Vancouver, BC, Canada
(Srinathan, Kidane) Department of Surgery, University of Manitoba,
Winnipeg, MB, Canada
(Reyes, Martinez-Tellez) Department of Thoracic Surgery, Hospital de la
Santa Creu i Sant Pau, Barcelona, Spain
(Grande, Roux) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Vall d'Hebron Hospital
Universitari, Barcelona, Spain
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Voltolini) Thoracic Surgery Unit, University Hospital Careggi, Florence,
Italy
(Cruz) Service of Anesthesiology and Reanimation, General University
Hospital Gregorio Maranon, Madrid, Spain
(Maziak) Division of Thoracic Surgery, Department of Surgery, Ottawa
Hospital, University of Ottawa, Ottawa, ON, Canada
(Gutierrez-Soriano) Anesthesiology Department, Anesthesiology Research
Group, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
(Tandon) Department of Medicine, McMaster University, Hamilton, ON, Canada
(DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Chinese
University of Hong Kong, Hong Kong Special Administrative Region, China
(McGuire) Division of Thoracic Surgery, Vancouver General Hospital,
Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
(Wells, Vincent, Li) Population Health Research Institute, Hamilton, ON,
Canada
Abstract
BACKGROUND: Higher levels of inflammatory biomarkers are associated with
an increased risk of perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery (MINS). Colchicine is an
anti-inflammatory drug that might reduce the incidence of these
complications. <br/>METHOD(S): COP-AF was a randomised trial conducted at
45 sites in 11 countries. Patients aged 55 years or older and undergoing
major non-cardiac thoracic surgery were randomly assigned (1:1) to receive
oral colchicine 0.5 mg twice daily or matching placebo, starting within 4
h before surgery and continuing for 10 days. Randomisation was done with
use of a computerised, web-based system, and was stratified by centre.
Health-care providers, patients, data collectors, and adjudicators were
masked to treatment assignment. The coprimary outcomes were clinically
important perioperative atrial fibrillation and MINS during 14 days of
follow-up. The main safety outcomes were a composite of sepsis or
infection, and non-infectious diarrhoea. The intention-to-treat principle
was used for all analyses. This trial is registered with
ClinicalTrials.gov, NCT03310125. FINDINGS: Between Feb 14, 2018, and June
27, 2023, we enrolled 3209 patients (mean age 68 years [SD 7], 1656
[51.6%] male). Clinically important atrial fibrillation occurred in 103
(6.4%) of 1608 patients assigned to colchicine, and 120 (7.5%) of 1601
patients assigned to placebo (hazard ratio [HR] 0.85, 95% CI 0.65 to 1.10;
absolute risk reduction [ARR] 1.1%, 95% CI -0.7 to 2.8; p=0.22). MINS
occurred in 295 (18.3%) patients assigned to colchicine and 325 (20.3%)
patients assigned to placebo (HR 0.89, 0.76 to 1.05; ARR 2.0%, -0.8 to
4.7; p=0.16). The composite outcome of sepsis or infection occurred in 103
(6.4%) patients in the colchicine group and 83 (5.2%) patients in the
placebo group (HR 1.24, 0.93-1.66). Non-infectious diarrhoea was more
common in the colchicine group (134 [8.3%] events) than the placebo group
(38 [2.4%]; HR 3.64, 2.54-5.22). INTERPRETATION: In patients undergoing
major non-cardiac thoracic surgery, administration of colchicine did not
significantly reduce the incidence of clinically important atrial
fibrillation or MINS but increased the risk of mostly benign
non-infectious diarrhoea. FUNDING: Canadian Institutes of Health Research,
Accelerating Clinical Trials Consortium, Innovation Fund of the
Alternative Funding Plan for the Academic Health Sciences Centres of
Ontario, Population Health Research Institute, Hamilton Health Sciences,
Division of Cardiology at McMaster University, Canada; Hanela Foundation,
Switzerland; and General Research Fund, Research Grants Council, Hong
Kong.<br/>Copyright &#xa9; 2023 Elsevier Ltd. All rights reserved.

<42>
Accession Number
2028284393
Title
Pre-emptive intercostal nerve block effect on video-assisted thoracic
lobectomy Patients recovery.
Source
Journal of Cardiovascular Disease Research. 14(10) (pp 1666-1670), 2023.
Date of Publication: 2023.
Author
Kuppuswamy P.; Chaganti Y.S.R.; Hari P.; Mothilal
Institution
(Kuppuswamy, Chaganti, Hari) Department of Cardiothoracic and Vascular
Surgery, Guntur Medical College, Andhra Pradesh, Guntur, India
(Mothilal) Department of Cardiothoracic and Vascular Surgery, Guntur
Medical College, Andhra Pradesh, Guntur, India
Publisher
EManuscript Technologies
Abstract
Background and Objectives: It is questionable if pre-emptive intercostal
nerve block (pre-ICNB) or post-ICNB has the same analgesic effects. For
patients undergoing video-assisted thoracic surgery (VATS), the purpose of
study is to assess the effectiveness of pre-emptive ICNB on perioperative
outcomes. <br/>Method(s): This study had an open-label, randomised design.
The eligible patients scheduled for lobectomy for lung cancer were
assigned to either the pre-ICNB group or the post-ICNB group. The present
study involved the observation of postoperative pain assessment, patient
rehabilitation, and opioid utilisation. <br/>Result(s): The patient count
was 86. Compared to the post-ICNB group, the pre-ICNB group had less
concurrent hypertension (P = 0.023), less morphine MME use (P = 0.016),
and faster extubation (P = 0.019). The pre-ICNB group had identical
Bruggrmann Comfort Scale (BCS) scores in the postoperative 6 h, 12 h, 24
h, and 48 h (p> 0.05) and dynamic pain Numeric Rating Scale (NRS) scores
in the PACU. The pre-ICNB and post-ICNB groups had identical Mini-mental
state examination (MMSE) and Ramsay test outcomes, except for the
postoperative 6-hour results (P = 0.048 and P = 0.019, respectively).
After 1 month, pain assessment was similar to the ICBN group (p> 0.05).
<br/>Conclusion(s): Pre-ICNB reduces intra-operative opioid consumption,
speeding PACU recovery, and manages perioperative pain as well as
post-ICNB.<br/>Copyright &#xa9; 2023 EManuscript Technologies. All rights
reserved.

<43>
Accession Number
2026567233
Title
Outcomes of left-sided heart valve surgery after heart transplantation: a
systematic review.
Source
Heart Failure Reviews. (no pagination), 2023. Date of Publication: 2023.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Modine T.; Labrousse L.; Pernot M.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Modine, Labrousse, Pernot)
Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Av. Magellan,
Pessac 33604, France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Louvain, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Springer
Abstract
As the survival after heart transplantation (HTx) is steadily improving,
an increasing number of patients with late cardiac pathologies such as
valvular disease is expected to rise. Nevertheless, no guidelines for
indication of redo cardiac surgery after HTx exists. The aim of the
present systematic review is to describe the results reported in the
literature of surgical management of severe aortic and/or mitral valve
disease. A systematic review was conducted including studies reporting on
adult patients with severe mitral or aortic valve pathology needing
surgery after their previous HTx. Exclusion criteria consisted in surgery
with no left heart valve surgery, concomitant valve surgery during heart
transplant, transcatheter interventions, and heterotopic HTx. A total of
35 papers met our inclusion criteria out of 2755 potentially eligible
studies with 44 mitral valve surgery patients and 20 aortic valve surgery
patients. In the entire population, the mean time from HTx to
reintervention was 6.19 +/- 5.22 years. After a mean follow-up of 2.78 +/-
3.54 years and 1.53 +/- 2.26 years from reintervention, 65.6% mitral and
86.7% aortic patients were reported as alive, respectively. As guidelines
on cardiac surgery after HTx are currently lacking, left-sided valvular
cardiac reinterventions can be considered a possible therapeutic approach
in carefully selected patients. These interventions may not only improve
the patient's functional status and survival, but may ultimately reduce
the need for re-transplantation due to the chronic shortage of donor
hearts. However, the support of more robust data is
warranted.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<44>
Accession Number
642692064
Title
Minimally Invasive Surgical Versus Transcatheter Aortic Valve Replacement:
A Retrospective Observational Single-Center Study in Japan.
Source
Innovations (Philadelphia, Pa.). (pp 15569845231205587), 2023. Date of
Publication: 07 Nov 2023.
Author
Yamamoto H.; Nakayama T.; Ishii N.; Nakamura Y.
Institution
(Yamamoto) Department of Cardiovascular Medicine, Narita-Tomisato
Tokushukai Hospital, Japan
(Nakayama, Nakamura) Department of Cardiovascular Surgery, Chiba-Nishi
General Hospital, Matsudo, Japan
(Ishii) Department of Gastroenterology, Tokyo Shinagawa Hospital, Japan
Abstract
OBJECTIVE: This study aimed to compare the outcomes of minimally invasive
aortic valve replacement (MICS-AVR) versus transfemoral transcatheter
aortic valve replacement (TF-TAVR) in Asian patients. <br/>METHOD(S): We
conducted a retrospective, observational, single-center study in Japan,
including cases of MICS-AVR (n = 202) and TF-TAVR (n = 248) between 2014
and 2021. In a total of 450 cases, propensity score matching was performed
at a ratio of 1:1, resulting in 96 pairs. Furthermore, we performed
competing-risk regression and mediation analyses to determine the
treatment effect on outcomes of interests, considering death as a
competing risk, and to evaluate the mediation effect of paravalvular leak
(PVL) severity. <br/>RESULT(S): There were similar incidences of all-cause
death, cardiac death, stroke and cerebral hemorrhage, and aortic valve
reintervention between the 2 groups. However, the TF-TAVR cohort had a
longer hospital length of stay and higher rates of significant PVL
compared with the MICS-AVR cohort. Multivariable-adjusted Cox regression
analyses revealed that heart failure hospitalization (hazard ratio [HR] =
0.129, 95% confidence interval [CI]: 0.038 to 0.445, p = 0.001) and
permanent pacemaker implantation (HR = 0.050, 95% CI: 0.006 to 0.409, p =
0.005) favored MICS-AVR. Competing-risk regression analyses confirmed
similar findings. All outcomes were unrelated to PVL severity.
<br/>CONCLUSION(S): To our knowledge, this is the first comparative study
of clinical outcomes in Asian patients undergoing MICS-AVR versus TF-TAVR,
revealing that MICS-AVR could be a feasible and efficient alternative to
TF-TAVR. Future larger-scale randomized controlled trials are needed to
validate the present results.

<45>
Accession Number
642690122
Title
Inflammation and Cholesterol as Predictors of Cardiovascular Events Among
13970 Contemporary High-Risk Patients With Statin Intolerance.
Source
Circulation. (no pagination), 2023. Date of Publication: 06 Nov 2023.
Author
Ridker P.M.; Lei L.; Louie M.J.; Haddad T.; Nicholls S.J.; Lincoff A.M.;
Libby P.; Nissen S.E.
Institution
(Ridker, Libby) Center for Cardiovascular Disease Prevention, Division of
Preventive Medicine and the Division of Cardiovascular Medicine, Brigham
and Women's Hospital, Boston, MA, United States
(Lei, Louie) Esperion Therapeutics, Ann Arbor, MI, United States
(Haddad) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Lincoff, Nissen) Cleveland Clinic Heart and Vascular Institute,
Cleveland, OH, United States
Abstract
Background: Among patients treated with statin therapy to
guideline-recommended cholesterol levels, residual inflammatory risk
assessed by high-sensitivity C-reactive protein (hsCRP) is at least as
strong a predictor of future cardiovascular events as is residual risk
assessed by low-density lipoprotein cholesterol (LDLC). Whether these
relationships are present among statin-intolerant patients with higher
LDLC levels is uncertain but has implications for the choice of preventive
therapies, including bempedoic acid, an agent that reduces both LDLC and
hsCRP. <br/>Method(s): The multinational CLEAR-Outcomes trial (Cholesterol
Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen Outcomes Trial)
randomly allocated 13970 statin-intolerant patients to 180 mg of oral
bempedoic acid daily or matching placebo and followed them for a
4-component composite of incident myocardial infarction, stroke, coronary
revascularization, or cardiovascular death, and for all-cause mortality.
Quartiles of increasing baseline hsCRP and LDLC were assessed as
predictors of future adverse events after adjustment for traditional risk
factors and randomized treatment assignment. <br/>Result(s): Compared with
placebo, bempedoic acid reduced median hsCRP by 21.6% and mean LDLC levels
by 21.1% at 6 months. Baseline hsCRP was significantly associated with the
primary composite end point of major cardiovascular events (highest versus
lowest hsCRP quartile; hazard ratio [HR], 1.43 [95% CI, 1.24-1.65]),
cardiovascular mortality (HR, 2.00 [95% CI, 1.53-2.61]), and all-cause
mortality (HR, 2.21 [95% CI, 1.79-2.73]). By contrast, the relationship of
baseline LDLC quartile (highest versus lowest) to future events was
smaller in magnitude for the primary composite cardiovascular end point
(HR, 1.19 [95% CI, 1.04-1.37]) and neutral for cardiovascular mortality
(HR, 0.90 [95% CI, 0.70-1.17]) and all-cause mortality (HR, 0.95 [95% CI,
0.78-1.16]). Risks were high for those with elevated hsCRP irrespective of
LDLC level. Bempedoic acid demonstrated similar efficacy in reducing
cardiovascular events across all levels of hsCRP and LDLC.
<br/>Conclusion(s): Among contemporary statin-intolerant patients,
inflammation assessed by hsCRP predicted risk for future cardiovascular
events and death more strongly than hyperlipidemia assessed by LDLC.
Compared with placebo, bempedoic acid had similar efficacy for reducing
cardiovascular risk across hsCRP and LDLC strata.

<46>
Accession Number
642688793
Title
Prevalence and clinical characteristics of oral lesions in heart
transplant patients induced by Sirolimus and Everolimus: a systematic
review and meta-analysis on a global scale.
Source
Oral surgery, oral medicine, oral pathology and oral radiology. (no
pagination), 2023. Date of Publication: 02 Oct 2023.
Author
Moura A.E.O.; Besseler M.O.; Perez-de-Oliveira M.E.; Normando A.G.C.;
Neves I.L.I.; Neves R.S.; Vargas P.A.; Azeka E.; Santos-Silva A.R.;
Montano T.C.P.
Institution
(Moura, Besseler, Perez-de-Oliveira, Normando, Vargas, Santos-Silva) Oral
Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba
Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo,
Brazil
(Neves, Neves) Dental Unit, Instituto do Coracao (InCor), Hospital das
Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao Paulo,
Brazil
(Azeka) Pediatric Cardiology Unit, Instituto do Coracao (InCor), Hospital
das Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao
Paulo, Brazil
(Montano) Oral Diagnosis Department, Semiology and Oral Pathology Areas,
Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba,
Sao Paulo, Brazil; Dental Unit, Instituto do Coracao (InCor), Hospital das
Clinicas, Medical School, University of Sao Paulo (HCFMUSP), Sao Paulo,
Brazil
Abstract
OBJECTIVE: Sirolimus (SRL) and Everolimus (EVL) are increasingly included
in immunosuppressive protocols after heart transplantation. They present
some side effects, including the appearance of painful lesions in the oral
cavity. Therefore, this systematic review aimed to verify the global
prevalence and clinical characteristics of oral lesions induced by SRL and
EVL in heart transplant patients. STUDY DESIGN: A systematic review was
performed using 5 main electronic databases (Medline/PubMed, SCOPUS,
EMBASE, Web of Science, and LILACS), in addition to the gray literature.
Studies were independently assessed by 2 reviewers based on established
eligibility criteria. The risk of bias was assessed using the Joanna
Briggs Institute appraisal tools, and the certainty of evidence was
evaluated through GRADE assessment. <br/>RESULT(S): Seventeen studies (860
patients) were included in the qualitative analysis. Of these, 11 studies
were pooled in a meta-analysis of prevalence. The worldwide prevalence of
oral lesions induced by SRL and EVL in heart transplant patients was
10.0%, and most lesions were described as ulcers >1.0 cm, related to
significant pain. <br/>CONCLUSION(S): Oral lesions induced by SRL and/or
EVL, although not very prevalent, have a relevant impact on patient's
lives and the continuity of treatment.<br/>Copyright &#xa9; 2023 Elsevier
Inc. All rights reserved.

<47>
Accession Number
642688050
Title
Application of three-dimensional printing in cardiovascular diseases: a
bibliometric analysis.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 03 Nov 2023.
Author
Zhang X.; Yi K.; Xu J.-G.; Wang W.-X.; Liu C.-F.; He X.-L.; Wang F.-N.;
Zhou G.-L.; You T.
Institution
(Zhang, Wang, He, Wang) First School of Clinical Medicine of Gansu
University of Chinese Medicine, Lanzhou, China
(Zhang, Yi, Wang, Liu, He, Wang, Zhou, You) Gansu International Scientific
and Technological Cooperation Base of Diagnosis and Treatment of
Congenital Heart Disease, Lanzhou, China
(Yi, Zhou, You) Department of Cardiovascular Surgery, Gansu Provincial
Hospital, Lanzhou, China
(Xu, Liu) Evidence-Based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, Lanzhou, China
Abstract
AIM: This paper aimed to explore the application of Three-dimensional (3D)
printing in cardiovascular diseases, to reach an insight in this field and
prospect the future trend. <br/>METHOD(S): The articles were selected from
the Web of Science Core Collection database. Excel 2019, VOSviewer 1.6.16,
and CiteSpace 6.1.R6 were used to analyze the information. <br/>RESULT(S):
A total of 467 papers of 3D printing in cardiovascular diseases were
identified, and the first included literature appeared in 2000. A total of
692 institutions from 52 countries participated in the relevant research,
while the United States of America contributed to 160 articles and were in
a leading position. The most productive institution was Curtin University
, and Zhonghua Sun who has posted the most articles (n=8) was also from
there. The Frontiers in Cardiovascular Medicine published most papers
(n=25). The Journal of Thoracic and Cardiovascular Surgery coveted the
most citations (n=520). Related topics of frontiers will still focus on
congenital heart disease, valvular heart disease, and left atrial
appendage closure. <br/>CONCLUSION(S): We summarized the publication
information of the application of 3D printing in cardiovascular diseases
related literature from 2000 to 2023, including country and institution of
origin, authors, and publication journal. This study can reflect the
current hotspots and novel directions for the application of 3D printing
in cardiovascular diseases.<br/>Copyright &#xa9; 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<48>
Accession Number
642683131
Title
Epicardial Ventricular Tachycardia Ablation: Patient Selection, Access,
and Ablation Techniques and Strategies to Manage Complications.
Source
JACC. Clinical electrophysiology. (no pagination), 2023. Date of
Publication: 13 Oct 2023.
Author
Raad M.; Supple G.E.
Institution
(Raad, Supple) Electrophysiology Section, Division of Cardiovascular
Medicine, Perelman School of Medicine at the University of Pennsylvania,
Philadelphia, PA, United States
Abstract
Epicardial ventricular tachycardia ablation is an important treatment
modality for refractory ventricular tachycardia. This comprehensive review
guides clinicians through optimized strategies for improved procedural
outcomes and patient safety during epicardial ventricular tachycardia
ablation. Patient selection criteria, including cardiomyopathy type,
electrocardiogram findings, and prior ablation history, are discussed.
Detailed techniques for safe pericardial access are provided. Potential
complications and strategies for prevention and management are explored.
The review also addresses challenges and pitfalls of epicardial mapping
and ablation.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<49>
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)

<50>
Accession Number
2028060112
Title
A Parent-child yoga intervention for reducing attention deficits in
children with congenital heart disease: The Yoga for Little Hearts
Feasibility Study Protocol.
Source
BMJ Open. 13(10) (no pagination), 2023. Article Number: e079407. Date of
Publication: 17 Oct 2023.
Author
Simard M.-N.; Lepage C.; Gaudet I.; Paquette N.; Doussau A.; Poirier N.C.;
Beauchamp M.H.; Cote S.M.; Pinchefsky E.; Brossard-Racine M.; Masse B.;
Gallagher A.
Institution
(Simard, Lepage, Gaudet, Paquette, Beauchamp, Cote, Gallagher) Centre de
Recherche, CHU Sainte-Justine, Montreal, QC, Canada
(Simard) School of Rehabilitation, Universite de Montreal, Montreal, QC,
Canada
(Lepage, Paquette, Beauchamp, Gallagher) Department of Psychology,
Universite de Montreal, Montreal, QC, Canada
(Gaudet) Department of Health Sciences, Universite du Quebec A Chicoutimi,
Chicoutimi, QC, Canada
(Doussau, Poirier, Pinchefsky) Clinique d'Investigation Neurocardiaque,
CHU Sainte-Justine, Montreal, QC, Canada
(Poirier) Department of Surgery, Division of Cardiac Surgery, Universite
de Montreal, Montreal, QC, Canada
(Cote, Masse) Department of Social and Preventive Medicine, Universite de
Montreal, Montreal, QC, Canada
(Pinchefsky) Department of Pediatrics, Universite de Montreal, Montreal,
QC, Canada
(Brossard-Racine) School of Physical and Occupational Therapy, Centre
Universitaire de Sante McGill, Montreal, QC, Canada
(Brossard-Racine) Institut de Recherche, Centre Universitaire de Sante
McGill, Montreal, QC, Canada
(Masse) Institut de Recherche Clinique et Appliquee, CHU Sainte-Justine,
Montreal, QC, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Preschoolers and school-aged children with congenital heart
disease (CHD) are at higher risk of attention deficit hyperactivity
disorder (ADHD) compared with the general population. To this day, no
randomised controlled trial (RCT) aiming to improve attention has been
conducted in young children with CHD. There is emerging evidence
indicating that parent-child yoga interventions improve attention and
reduce ADHD symptoms in both typically developing and clinical
populations. Methods and analysis This is a single-blind, two-centre,
two-arm trial during which 24 children with CHD and their parents will be
randomly assigned to (1) a parent-child yoga intervention in addition to
standard clinical care or (2) standard clinical care alone. All
participants will undergo standardised assessments: (1) at baseline, (2)
immediately post-treatment and (3) 6 months post-treatment. Descriptive
statistics will be used to estimate the feasibility and neurodevelopmental
outcomes. This feasibility study will evaluate: (1) recruitment capacity;
(2) retention, drop-out and withdrawal rates during the yoga programme and
at the 6-month follow-up; (3) adherence to the intervention; (4)
acceptability of the randomisation process by families; (5) heterogeneity
in the delivery of the intervention between instructors and use of
home-based exercises between participants; (6) proportion of missing data
in the neurodevelopmental assessments and (7) SD of primary outcomes of
the full RCT in order to determine the future appropriate sample size.
Ethics and dissemination Ethical approval has been obtained by the
Research Ethics Board of the Sainte-Justine University Hospital. The
findings will be disseminated in peer-reviewed journals and conferences
and presented to the Canadian paediatric grand round meetings. Trial
registration number NCT05997680.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<51>
Accession Number
2026377784
Title
Double-Outlet Left Ventricle: Case Series and Systematic Review of the
Literature.
Source
Diagnostics. 13(20) (no pagination), 2023. Article Number: 3175. Date of
Publication: October 2023.
Author
Lioncino M.; Calcagni G.; Badolato F.; Antonelli G.; Leonardi B.; de Zorzi
A.; Secinaro A.; Brancaccio G.; Albanese S.; Carotti A.; Drago F.; Rinelli
G.
Institution
(Lioncino, Calcagni, Badolato, Antonelli, Leonardi, de Zorzi, Drago,
Rinelli) Pediatric Cardiology and Cardiac Arrhythmias and Syncope Unit,
Bambino Gesu Children's Hospital, IRCSS, Rome 00146, Italy
(Secinaro) Advanced Cardiothoracic Imaging Unit, Bambino Gesu Children's
Hospital, IRCSS, Rome 00165, Italy
(Brancaccio, Albanese, Carotti) Cardiac Surgery Unit, Department of
Pediatric Cardiology and Cardiac Surgery, Bambino Gesu Children's
Hospital, IRCCS, Rome 00165, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Double-outlet left ventricle (DOLV) is an abnormal ventriculo-arterial
connection characterized by the origin of both great arteries from the
morphological left ventricle. The aim of our paper is to describe the
morphological and imaging features of DOLV and to assess the prevalence of
the associated malformations and their surgical outcomes. METHODS From
2011 to 2022, we retrospectively reviewed the electronic case records of
patients diagnosed with DOLV at the Bambino Gesu Children's Hospital. A
systematic search was developed in MEDLINE, Web of Science, and EMBASE
databases to identify reports assessing the morphology and outcomes of
DOLV between 1975 and 2023. <br/>RESULT(S): Over a median follow-up of 9.9
years (IQR 7.8-11.7 y), four cases of DOLV were identified at our
institution. Two patients were diagnosed with (S,D,D) DOLV subaortic VSD
and pulmonary stenosis (PS): one patient had (S,D,D) DOLV with doubly
committed VSD and hypoplastic right ventricle, and another patient had
(S,D,L) DOLV with subaortic VSD and PS (malposition type). Pulmonary
stenosis was the most commonly associated lesion (75%). LITERATURE REVIEW:
After systematic evaluation, a total of 12 reports fulfilled the
eligibility criteria and were included in our analysis. PS or right
ventricular outflow tract obstruction was the most commonly associated
lesion (69%, 95% CI 62-76%). The most common locations of VSD were
subaortic (pooled prevalence: 75%, 95% CI 68-81), subpulmonary (15%, 95%
CI 10-21), and doubly committed (7%, 95% CI 4-12). The position of the
great arteries showed that d-transposition of the aorta was present in 128
cases (59% 95% CI 42-74), and l-transposition was present in 77 cases
(35%, 95% CI 29-43).<br/>Copyright &#xa9; 2023 by the authors.

<52>
Accession Number
2026287299
Title
Bilateral versus single internal mammary artery in diabetic patients:
systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 31(9) (pp 781-794), 2023. Date
of Publication: November 2023.
Author
Parissis H.; Ahmed S.; Al Nasir J.; Khan J.; Ferwana M.
Institution
(Parissis, Khan) Royal Victoria Hospital, Belfast, United Kingdom
(Ahmed, Al Nasir) Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
(Ferwana) King Abdullah International Medical Research Center, King Saud
bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Publisher
SAGE Publications Inc.
Abstract
Objectives: Data on bilateral internal mammary artery (BIMA) versus single
internal mammary artery (SIMA) on diabetics were analyzed; This is the
only meta-analysis, the last 7 years. <br/>Method(s): Medline through
PubMed/EMBASE/CINHAL and the Cochrane Central Register of Controlled
Trials; 179 articles were studied; 19 studies deemed suitable and were
included in the analysis. <br/>Result(s): The mortality was 2.41% for BIMA
versus 1.71% for SIMA (odds ratio [OR] = 0.95; 95% confidence interval
[CI]: 0.74-1.22). Postoperative reopening for bleeding was higher at 3.75%
for BIMA versus 2.91% for SIMA (OR = 1.49; 95% CI: 1.15-1.93). The
incidence of MI was 0.87% for BIMA versus 0.83% for SIMA (OR = 0.73; 95%
CI: 0.37-1.44). Deep sternal wound infection was 3.02% for BIMA and 1.95%
for SIMA (OR = 1.57; 95% CI: 1.26-1.95). When skeletonized, the incidence
of DSWI was 2.5% for BIMA versus 2.41% for SIMA. There was a significant
difference at 5-year survival favoring the BIMA, 85.15% BIMA versus 80.77%
SIMA (OR = 1.79; 95% CI: 1.60-2.01). The 10-year overall survival was
74.04% BIMA versus 61.57% SIMA (OR = 1.79; 95% CI: 1.61-1.98). The 15-year
survival was 47.08% for BIMA versus 37.06% for SIMA (OR = 1.69; 95% CI:
1.52-1.88). <br/>Conclusion(s): Postoperative bleeding was higher in BIMA
group. Bilateral internal mammary artery in diabetic patients should be
carried out in a skeletonize fashion, to reduce DSWI. There is a survival
benefit of using BIMA in diabetics within 5 years of surgery; it remains
significant up to 15 years.<br/>Copyright &#xa9; The Author(s) 2023.

<53>
Accession Number
2025857279
Title
Aortic Root Reinforcement Combined with Vascular Grafts Eversion and
Built-in Procedure (XJ-Procedure) for Acute Type A Aortic Dissection
Surgery.
Source
Advances in Therapy. 40(12) (pp 5354-5365), 2023. Date of Publication:
December 2023.
Author
Li J.; Zhao C.; Li B.; Yan P.; Zhang Y.; Li Y.; Wang Q.; He X.; Zheng X.;
Yan Y.
Institution
(Li, Zhao, Yan, Zhang, Li, He, Zheng, Yan) Department of Cardiovascular
Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No.
277 Yanta West Road, Shaanxi, Xi'an 710061, China
(Li) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Xi'an Jiaotong University, Xi'an, China
(Wang) Department of Operation and Anesthesia, The First Affiliated
Hospital of Xi'an Jiaotong University, Xi'an, China
Publisher
Adis
Abstract
Introduction: Current root reinforcement methods for acute type A aortic
dissection (ATAAD) risk the tearing of endothelial tissue by sutures. This
study proposed a novel technique for aortic root reinforcement and
evaluated its effectiveness. <br/>Method(s): Patients who diagnosed with
ATAAD and had mild to moderate aortic root involvement, combined with
aortic arch involvement undergoing Sun's procedure in the First Affiliated
Hospital of Xi'an Jiaotong University from January 2020 to December 2021,
were retrospectively enrolled. They were divided into two groups according
to their surgical procedures of aortic root: continuous aortic root suture
group (CARS group) and aortic root reinforcement combined with vascular
grafts eversion and built-in procedure (XJ-procedure) group. The 30-day
mortality rates and incidence of operation-related complications were
evaluated. <br/>Result(s): The study cohort comprised 183 patients,
including 114 in the XJ-procedure group. The 30-day mortality rates were
7.2% in the CARS group and 6.9% in the XJ-procedure group (P = 1.000). The
incidence of residual aortic root dissection in the XJ-procedure group was
lower than that in the CARS group before discharge (1.8% vs. 10.1%, P =
0.028), at 3-month (0% vs. 8.7%, P = 0.002) and 6-month (0% vs. 7.2%, P =
0.007) follow-up. In the CARS group, the incidence of anastomotic
pseudoaneurysm was 2.9%, 2.9%, and 2.9% compared with none in the
XJ-procedure group before discharge, at 3 and 6 months. The XJ-procedure
group also showed less chest tube drainage in the first 24-h after the
surgery, with lower incidence of hemodialysis and sepsis during
hospitalization. No differences were observed in the incidence of bleeding
necessitating reoperation and severe aortic regurgitation between the two
groups. <br/>Conclusion(s): The XJ-procedure did not increase 30-day
mortality and effectively reduced the incidence of residual aortic root
dissection during the 6-month follow-up. Subsequent studies with larger
samples and prolonged follow-up are needed to evaluate it. Trial
Registration: NCT05751200. [MediaObject not available: see
fulltext.].<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer Healthcare Ltd., part of Springer Nature.

<54>
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.

<55>
Accession Number
2024235558
Title
Influenza vaccination and cardiovascular events in patients with ischaemic
heart disease and heart failure: A meta-analysis.
Source
European Journal of Heart Failure. 25(9) (pp 1685-1692), 2023. Date of
Publication: September 2023.
Author
Modin D.; Lassen M.C.H.; Claggett B.; Johansen N.D.; Keshtkar-Jahromi M.;
Skaarup K.G.; Nealon J.; Udell J.A.; Vardeny O.; Solomon S.D.; Gislason
G.; Biering-Sorensen T.
Institution
(Modin, Lassen, Johansen, Skaarup, Gislason, Biering-Sorensen) Department
of Cardiology, Copenhagen University Hospital - Herlev & Gentofte,
Copenhagen, Denmark
(Claggett, Solomon) Cardiovascular Medicine Division, Department of
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Keshtkar-Jahromi) Division of Infectious Diseases, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Nealon) School of Public Health, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Hong Kong
(Udell) Cardiovascular Division, Department of Medicine, Women's College
Hospital, Toronto, ON, Canada
(Vardeny) Department of Medicine, University of Minnesota, Minneapolis,
MN, United States
(Gislason) Institute of Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
(Biering-Sorensen) Department of Biomedical Sciences, Faculty of Health
and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Randomized controlled trials (RCTs) enrolling patients at high
cardiovascular risk have found that influenza vaccination may reduce the
incidence of cardiovascular events. We performed an updated meta-analysis
assessing the effect of influenza vaccination on the incidence of
cardiovascular events in patients with ischaemic heart disease or heart
failure. <br/>Methods and Results: We searched PubMed, EMBASE and other
sources to identify RCTs examining the effect of influenza vaccination on
the incidence of cardiovascular events assessed as efficacy outcomes in
patients with ischaemic heart disease or heart failure. Eligible studies
followed patients for at least one influenza season, defined as a minimum
duration of 6 months. The primary endpoint was a composite of
cardiovascular death, acute coronary syndrome, stent thrombosis or
coronary revascularization, stroke or heart failure hospitalization. The
secondary endpoints were cardiovascular death and all-cause death. Two
investigators independently identified and extracted data from studies.
Results were compared using hazard ratios (HRs) in both random effects and
fixed effects models. We included five peer-reviewed and one non
peer-reviewed RCTs for a total of 9340 patients. Five trials included
patients with ischaemic heart disease (n = 4211) and one trial included
patients with heart failure (n = 5129). Influenza vaccination was
associated with a reduced incidence of the primary composite endpoint
(random effects HR [rHR] 0.74, 95% confidence interval [CI] 0.63-0.88, p <
0.001, I² = 52%), cardiovascular death (rHR 0.63, 95% CI
0.42-0.95, p = 0.028, I² = 58%) and all-cause death (rHR 0.72,
95% CI 0.54-0.95, p = 0.0227, I² = 52%). Results were similar
when non peer-reviewed data were excluded. <br/>Conclusion(s): In this
meta-analysis of available RCTs in patients at high cardiovascular risk,
influenza vaccination was associated with a reduced incidence of
cardiovascular events, cardiovascular death and all-cause death as
compared to placebo or no treatment.<br/>Copyright &#xa9; 2023 European
Society of Cardiology.

<56>
Accession Number
642550537
Title
Effects of interventions targeting the systemic inflammatory response to
cardiac surgery on clinical outcomes in adults.
Source
Cochrane Database of Systematic Reviews. 2023(10) (no pagination), 2023.
Article Number: CD013584. Date of Publication: 24 Oct 2023.
Author
Abbasciano R.G.; Tomassini S.; Roman M.A.; Rizzello A.; Pathak S.; Ramzi
J.; Lucarelli C.; Layton G.; Butt A.; Lai F.; Kumar T.; Wozniak M.J.;
Murphy G.J.
Institution
(Abbasciano, Roman, Rizzello, Pathak, Butt, Lai, Wozniak, Murphy)
Department of Cardiovascular Sciences, University of Leicester, Leicester,
United Kingdom
(Tomassini) University of Warwick, Warwick, United Kingdom
(Ramzi) Leicester Medical School, University of Leicester, Leicester,
United Kingdom
(Lucarelli) Department of Cardiac Surgery, University of Verona, Verona,
Italy
(Layton) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Kumar) Leicester Clinical Trials Unit, University of Leicester,
Leicester, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Organ injury is a common and severe complication of cardiac
surgery that contributes to the majority of deaths. There are no effective
treatment or prevention strategies. It has been suggested that innate
immune system activation may have a causal role in organ injury. A wide
range of organ protection interventions targeting the innate immune
response have been evaluated in randomised controlled trials (RCTs) in
adult cardiac surgery patients, with inconsistent results in terms of
effectiveness. <br/>Objective(s): The aim of the review was to summarise
the results of RCTs of organ protection interventions targeting the innate
immune response in adult cardiac surgery. The review considered whether
the interventions had a treatment effect on inflammation, important
clinical outcomes, or both. <br/>Search Method(s): CENTRAL, MEDLINE,
Embase, conference proceedings and two trial registers were searched on
October 2022 together with reference checking to identify additional
studies. <br/>Selection Criteria: RCTs comparing organ protection
interventions targeting the innate immune response versus placebo or no
treatment in adult patients undergoing cardiac surgery where the treatment
effect on innate immune activation and on clinical outcomes of interest
were reported. <br/>Data Collection and Analysis: Searches, study
selection, quality assessment, and data extractions were performed
independently by pairs of authors. The primary inflammation outcomes were
peak IL-6 and IL-8 concentrations in blood post-surgery. The primary
clinical outcome was in-hospital or 30-day mortality. Treatment effects
were expressed as risk ratios (RR) and standardised mean difference (SMD)
with 95% confidence intervals (CI). Meta-analyses were performed using
random effects models, and heterogeneity was assessed using I².
<br/>Main Result(s): A total of 40,255 participants from 328 RCTs were
included in the synthesis. The effects of treatments on IL-6 (SMD -0.77,
95% CI -0.97 to -0.58, I² = 92%) and IL-8 (SMD -0.92, 95% CI
-1.20 to -0.65, I² = 91%) were unclear due to heterogeneity.
Heterogeneity for inflammation outcomes persisted across multiple
sensitivity and moderator analyses. The pooled treatment effect for
in-hospital or 30-day mortality was RR 0.78, 95% CI 0.68 to 0.91,
I² = 0%, suggesting a significant clinical benefit. There was
little or no treatment effect on mortality when analyses were restricted
to studies at low risk of bias. Post hoc analyses failed to demonstrate
consistent treatment effects on inflammation and clinical outcomes. Levels
of certainty for pooled treatment effects on the primary outcomes were
very low. Authors' conclusions: A systematic review of RCTs of organ
protection interventions targeting innate immune system activation did not
resolve uncertainty as to the effectiveness of these treatments, or the
role of innate immunity in organ injury following cardiac
surgery.<br/>Copyright &#xa9; 2023 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<57>
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.

<58>
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.

<59>
Accession Number
2027355764
Title
Cognitive Deficits in Executive and Language Functions Predict
Postoperative Delirium.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Olotu C.; Lebherz L.; Ascone L.; Scherwath A.; Kuhn S.; Harter M.;
Kiefmann R.
Institution
(Olotu, Kiefmann) Department of Anaesthesiology, University Medical Center
Hamburg, Hamburg, Germany
(Lebherz, Scherwath, Harter) Institute of Medical Psychology, University
Medical Center Hamburg, Hamburg, Germany
(Ascone, Kuhn) Department of Psychiatry and Psychotherapy, University
Medical Center Hamburg, Hamburg, Germany
(Scherwath) Department of Stem Cell Transplantation, University Medical
Center Hamburg, Hamburg, Germany
(Kiefmann) Anesthesia Department, Rotkreuzklinikum Munich, Munich, Germany
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative delirium (POD) remains the most common
complication in older adults, with cognitive impairment being the main
risk factor. Patients with mild cognitive impairment, in particular, have
much to lose from delirium; despite this, their cognitive impairment might
be clinically overlooked. Understanding which cognitive domains are
particularly predictive in this regard may improve the sensitivity of
preoperative testing and allow for a more targeted application of
resource-intensive measures to prevent delirium in the perioperative
period. The authors conducted this study with the aim of identifying the
most indicative cognitive domains. <br/>Design(s): A secondary analysis of
a randomized controlled trial. <br/>Setting(s): At a single center, the
University Medical Centre Hamburg in Hamburg, Germany.
<br/>Participant(s): Patients >=60 years without major neurocognitive
disorders (dementia, Mini-Mental State Examination score <=23) scheduled
for cardiovascular surgery. <br/>Measurements and Main Results:
Preoperative neuropsychologic testing and delirium screening were
performed twice daily until postoperative day 5. A multiple logistic
regression model was applied to determine the predictive ability of test
performances for the development of delirium. <br/>Result(s): A total of
541 patients were included in the analysis; the delirium rate was 15.6%.
After controlling for confounders, only low performance within the Trail
Making Test B/A (odds ratio [OR] = 1.32; 95% CI: 1.05-1.66) and letter
fluency (OR = 0.66; 95% CI: 0.45-0.96) predicted a particularly high risk
for delirium development. The discriminative ability of the final multiple
logistic regression model to predict POD had an area under the curve of
0.786. <br/>Conclusion(s): Impairment in the cognitive domains of
executive function and language skills associated with memory, inhibition,
and access speed seem to be particularly associated with the development
of delirium after surgery in adults >=65 years of age without apparent
preoperative neurocognitive impairment.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<60>
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).

<61>
Accession Number
2026268503
Title
Pulmonary atresia and ventricular septal defect: How accurate is the fetal
echocardiography, and do the major aortopulmonary collateral arteries
matter?.
Source
Echocardiography. 40(11) (pp 1259-1268), 2023. Date of Publication:
November 2023.
Author
Uygur L.; Demirci O.; Yucel I.K.
Institution
(Uygur, Demirci) Department of Perinatology, Zeynep Kamil Gynecologic and
Pediatric Training Research Hospital, Health Sciences University,
Istanbul, Turkey
(Yucel) Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and
Cardiovascular Surgery Training and Research Hospital, Health Sciences
University, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Objective: To assess the accuracy of prenatal echocardiography in defining
pulmonary vasculature in pulmonary atresia with VSD (PAVSD). The second
aim is to compare the perinatal and postnatal outcomes of different
pulmonary blood supply types. Study design: The cases prenatally diagnosed
with PAVSD between 2017 and 2022 in a single tertiary fetal medicine
center were identified on the electronic database. Fetal echocardiography
reports and images were reviewed retrospectively. Postnatal outcomes were
acquired from the hospital records of relevant pediatric cardiology and
cardiovascular surgery clinics. Fetal echocardiography results were
compared with postnatal results. Perinatal and postnatal outcomes were
compared between the different pulmonary vascular supply types.
<br/>Result(s): Among the 24 PAVSD cases, six were diagnosed with major
aortopulmonary collateral arteries (MAPCA) dependent, eleven were
diagnosed with ductus arteriosus (DA) dependent pulmonary supply, and
seven were diagnosed with double pulmonary supply (MAPCA + DA) on prenatal
echocardiography. Seventeen cases were live-born and have undergone
postnatal investigations. Fetal echocardiography was 88.2% accurate about
the type of pulmonary supply. The accuracy of fetal echocardiography
regarding pulmonary vascular anatomy was 82.3%. Postoperative survival was
69.2%. Mortality before surgery and postoperative survival did not differ
between pulmonary supply groups. Survival was impaired by the extracardiac
anomalies. The need for early interventions was significantly higher in
the DA group. <br/>Conclusion(s): Pulmonary vascularization in PAVSD can
be defined precisely on fetal echocardiography. The source of pulmonary
blood supply does not impact postnatal short-term outcomes significantly
but it impacts the management. The associated anomalies highly contribute
to postnatal mortality.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<62>
Accession Number
642680185
Title
Comparison of hemodynamic consequences of hand ventilation versus machine
ventilation for transportation of post-operative pediatric cardiac
patients.
Source
Annals of cardiac anaesthesia. 26(2) (pp 166-170), 2023. Date of
Publication: 01 Apr 2023.
Author
Chauhan A.; P Rajesh V.S.; Pujara J.; Singh G.; Patel P.; Patel K.; Pandya
H.
Institution
(Chauhan, P Rajesh, Pujara, Singh, Patel, Patel) Department of Cardiac
Anesthesia, U.N. Mehta Institute of Cardiology and Research Center,
Ahmedabad, Gujarat, India
(Pandya) Department of Research, U.N. Mehta Institute of Cardiology and
Research Center, Ahmedabad, Gujarat, India
Abstract
Learning Objective: Hemodynamic monitoring during in-hospital transport of
intubated patients is vital; however, no prospective randomized trials
have evaluated the hemodynamic consequences of hand versus machine
ventilation during transport among pediatric patients' post-cardiac
surgery. The authors hypothesized that manual ventilation after pediatric
cardiac surgery would alter hemodynamic and arterial blood gas (ABG)
parameters during transport compared to mechanical ventilation.
<br/>Design(s): A prospective randomized trial. <br/>Setting(s): Tertiary
cardiac care hospital. <br/>Participant(s): Pediatric cardiac surgery
patients. <br/>Material(s) and Method(s): One hundred intubated pediatric
patients were randomized to hand or machine ventilation immediately
post-cardiac surgery during transport from the operating room to the
pediatric post-operative intensive care unit (PICU). Hemodynamic
variables, including end-tidal CO2 (ETCO2), oxygen saturation, heart rate,
systolic blood pressure (SBP), diastolic blood pressure (DBP), peak airway
pressure (Ppeak), and mean airway pressure (Pmean), were measured at
origin, during transport, and at the destination. ABG was measured before
and upon arrival in the PICU, and adverse events were recorded. The
Chi-square test and independent t-test were used for comparison of
categorical and continuous parameters, respectively. Results and
Discussion: The mean transport time was comparable between hand-ventilated
(5.77 +/- 1.46 min) and machine-ventilated (5.96 +/- 1.19 min) groups (P =
0.47). ETCO2 consistently dropped during transport and after shifting in
the hand-ventilated group, with significantly higher ETCO2 excursion than
in machine-ventilated patients (P < 0.05). SBP and DBP significantly
decreased during transport (at 5 and 6 min intervals) and after shifting
in hand-ventilated patients than in the other group (P < 0.05).
Additionally, after shifting, a significant increase in Ppeak (P < 0.001),
Pmean (P < 0.001), and pH (P < 0.001), and a decrease in pCO2 (P = 0.0072)
was observed in hand-ventilated patients than machine-ventilated patients.
No adverse event was noted during either mode of ventilation.
<br/>Conclusion(s): Hand ventilation leads to more significant variation
in ABG and hemodynamic parameters than machine ventilation in pediatric
patients during transport post-cardiac surgery. Therefore, using a
mechanical ventilator is the preferred method for transporting
post-operative pediatric cardiac patients.

<63>
Accession Number
2028171281
Title
Transcatheter Vacuum-Assisted Mass Extraction Versus Surgical Debridement
for Vegetations in Tricuspid Valve Infective Endocarditis: A Meta-Analysis
of Observational Studies.
Source
American Journal of Cardiology. 210 (pp 69-75), 2024. Date of Publication:
01 Jan 2024.
Author
Kim A.G.; Salazar A.M.; Panama G.; Saeed M.; Sabanci R.; Al-Asad K.S.;
Yavari M.; Prasad R.M.; Rayamajhi S.; Abela G.S.
Institution
(Kim, Salazar, Panama, Saeed, Sabanci, Al-Asad, Yavari, Rayamajhi)
Divisions of Internal Medicine
(Prasad, Abela) Cardiology, Michigan State University, East Lansing, MI,
United States
Publisher
Elsevier Inc.
Abstract
Tricuspid valve infective endocarditis (TVIE), often associated with
vegetation in people who inject drugs, has introduced a less invasive
option for vegetation removal: transcatheter vacuum-assisted mass
extraction (TVME). This technique is emerging as an alternative to
standard surgical debridement (SD) and valve repair. However, the
comparative effectiveness of TVME versus SD in treating TVIE has yet to be
investigated. A comprehensive systematic literature search was performed
on PubMed, Embase, and Cochrane to identify all relevant studies comparing
TVME with SD in patients with TVIE. The search covered studies from
inception up to August 15, 2023. For data analysis, Review Manager
(RevMan) 5.4 software was employed, using a random-effects model to
calculate risk ratios (RRs), mean differences, and 95% confidence
intervals (CIs). Five studies included a total of 431 patients (244 in the
TVME arm and 187 in the SD arm). In-hospital mortality (p = 0.72),
procedural mortality (p = 0.77), 30-day mortality (p = 0.25), and 1-year
mortality (p = 0.44) insignificantly favored SD over TVME. Overall
mortality across the 5 studies insignificantly favored TVME over SD (RR =
0.66, 95% CI 0.31 to 1.39, p = 0.27, I² = 57%). When addressing
heterogeneity by excluding 1 study, no statistical significance in the
difference between the 2 arms regarding overall mortality was observed (RR
0.99, 95% CI 0.60 to 1.63, p = 0.97, I² = 0%). This
meta-analysis of the 5 observational studies found no significant
difference in overall mortality between TVME and SD for the treatment of
TVIE. However, prospective randomized controlled trials are necessary to
further understand and compare the outcomes of these 2
approaches.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<64>
Accession Number
2026516903
Title
Effects of stellate ganglion block on the perioperative hemodynamics for
coronary artery bypass grafting surgery.
Source
Egyptian Journal of Anaesthesia. 39(1) (pp 856-861), 2023. Date of
Publication: 2023.
Author
Shorbagy M.S.; Hosny M.R.; Abdelmoneim W.
Institution
(Shorbagy, Hosny, Abdelmoneim) Faculty of Medicine, Ain-Shams University
Cairo, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Stellate ganglion block (SGB) is a successful technique that
can potentially maintain hemodynamics and terminate fatal arrhythmia. We
aimed to study the efficacy of SGB on hemodynamic changes after on pump
coronary artery bypass grafting (CABG) surgery. <br/>Method(s): Forty
patients who underwent CABG surgery at the Cardiac Surgical Academy Ain
Shams University Hospital were randomly allocated to receive SGB or
placebo between June 2020 and February 2021. After fulfilling the
inclusion criteria, patients were classified as American Society of
Anesthesiologists III and IV. Patients were randomly assigned to one of
two groups utilizing a computer-generated block number in a sealed
envelope. Group S (20 patients) received SGB, and Group C (20 patients)
included matched controls who received a placebo solution in the SGB.
Primary outcome was perioperative changes in heart rate and systolic and
diastolic blood pressures. Secondary outcomes included the incidence of
atrial and ventricular fibrillation, and myocardial ischemia in addition
to the times from ICU admission to extubation, ICU stay, and hospital
stay. <br/>Result(s): A statistically substantial increase in systolic and
diastolic blood pressure as well as increased incidence of AF and VF was
found in the control group compared to the SGB group with p values <0.001,
<0.001, 0.037, and 0.028, respectively. <br/>Conclusion(s): SGB can reduce
the hemodynamic responses to surgery and anesthesia, intraoperative
tachyarrhythmias, and ICU and hospital stays.<br/>Copyright &#xa9; 2023
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<65>
Accession Number
2028271009
Title
Outcomes of Ozaki Procedure/Aortic Valve Neocuspidization for Aortic Valve
Diseases: A Systematic Review.
Source
Anatolian Journal of Cardiology. 27(11) (pp 619-627), 2023. Date of
Publication: November 2023.
Author
Badalyan S.S.; Markosyan S.V.; Ismailbaev A.M.; Asghar A.; Rehman A.U.
Institution
(Badalyan) Department of Cardiology, I.M. Sechenov University Hospital
First Moscow State Medical University, Moscow, Russian Federation
(Markosyan) Department of Cardiology, Yerevan State Medical University
after Mkhitar Heratsi, Yerevan, Armenia
(Ismailbaev) Department of Cardiovascular Surgery, I.M. Sechenov
University Hospital First Moscow State Medical University, Moscow, Russian
Federation
(Asghar) Institute of Pharmaceutical Sciences, University of Veterinary
and Animal Sciences, Lahore, Pakistan
(Rehman) Department of Food Science and Human Nutrition, University of
Veterinary and Animal Sciences, Lahore, Pakistan
Publisher
Turkish Society of Cardiology
Abstract
Background: Perfect heart valve prostheses have optimized hemodynamics,
reduced surgical morbidity, long-lasting durability, and extended patient
survival with greater quality of life. Mechanical valves are recommended;
however, young children may need anticoagulant medication for life. In
this study, we looked at the success rate and viability of aortic valve
neocuspidization (AVNeo) surgery for a variety of aortic disorders.
<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.<br/>Copyright@Author(s) - Available online at
anatoljcardiol.com.

<66>
Accession Number
2028210482
Title
Perioperative Blood Transfusion in Pediatrics.
Source
Anestezi Dergisi. 31 (pp 15-19), 2023. Date of Publication: 2023.
Author
Karisik M.
Institution
(Karisik) University of Montenegro Faculty of Medicine, Department of
Anesthesiology and Intensive Care, Institute for Children Disease,
Clinical Center of Montenegro, Montenegro
Publisher
Anestezi Dergisi
Abstract
Objective: Perioperataive blood transfusion management in pediatric
patients must be individualized for each child's clinical condition and
type of surgery. Potential risks and benefites of transfusion should
always be considered but the primary goal is always the same, to maintain
hemodynamic stability, support oxygen delivery, maintain adequate organ
perfusion, avoid over-transfusion and reduce harm and side effects
associated with transfusion. <br/>Method(s): A literature review using
Pubmed, Medline and Cohrane databases was completed on articles using key
terms: "perioperative blood transfusion in pediatric surgery", "blood
management in pediatrics", "perioperative massive hemorhage in pediatric
patients, "periopeartive bleeding". <br/>Result(s): The variation in blood
management perioperatively might come from: the operation type
(significant perioprative hemorrage is expected in trauma, cardiac
surgery, neurosurgery, liver transplant, major abdominal operations), age
of the child (neonates who received a preoperative blood transfusion had a
higer rate of preoperative comorbidity and worse postoperative outcomes
compared to those who did not receive a blood transfusion), transfusion
triggers and lack of common guidance. <br/>Conclusion(s): Making a
multidisciplinary blood management for pediatric patients is substantual
to create effective and safe system in case of expected or unexpected
massive hemorrhage as well as institutional protocols of indications,
prevention, management of transfusion, and the use of perioprative
hemostatic agents.<br/>Copyright &#xa9; 2023 Anestezi Dergisi. All rights
reserved.

<67>
Accession Number
642682832
Title
Splenic artery infectious aneurysms in infective endocarditis - An
observational study and comprehensive literature review.
Source
Annals of vascular surgery. (no pagination), 2023. Date of Publication:
31 Oct 2023.
Author
Boukobza M.; Raffoul R.; Rebibo L.; Khalil A.; Laissy J.-P.
Institution
(Boukobza) Department of Radiology, Bichat-Claude Bernard University
Hospital, Assistance Publique-Hopitaux de Paris ,46 rue Henri Huchard,
Paris 75018, France
(Raffoul) Department of Cardiac Surgery, Bichat-Claude Bernard University
Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
(Rebibo) Department of Digestive, Esogastric and Bariatric Surgery,
Bichat-Claude Bernard University Hospital, Assistance Publique-Hopitaux de
Paris, Paris, France
(Khalil) Department of Radiology, Bichat-Claude Bernard University
Hospital, Paris, France, Assistance Publique-Hopitaux de Paris, Paris,
France; Paris University, France
(Laissy) Department of Radiology, Bichat-Claude Bernard University
Hospital, Paris, France, Assistance Publique-Hopitaux de Paris, Paris,
France ; INSERM U1148, Paris, France; Paris University, France
Abstract
PURPOSE: To determine the prevalence, the clinical and radiological
features, associated factors, treatment and outcome of splenic artery
aneurysms (SAAs) in infective endocarditis (IE). <br/>METHOD(S): We
retrospectively reviewed 474 consecutive patients admitted to our
institution with definite IE (2005-2020) RESULTS: Six patients had SAAs
(1.3%; 3 women; mean age: 50). In all cases the diagnosis was obtained by
abdominal CT-angiography (CTA). SAAs-IE were solitary, saccular with a
mean diameter of 30mm (range: 10-90mm). SAAs-IE were intrasplenic (n=4) or
hilar (n=2). Streptococcus spp were the predominant organisms (n=4). In
all cases a left-sided native valve was involved (aortic, n=3; mitral,
n=2, mitral-aortic, n=1). SAAs were silent in half-patients, and were
revealed by abdominal pain (n=2) and by the resurgence of fever after
cardiac surgery (n=1). All patients underwent emergent valve replacement.
One patient died within 24h from multiorgan failure. For the others,
uneventful coil embolization was performed in 4 patients after valve
replacement (3 diagnosed early, one at 8 weeks). In the remaining
patients, SAA-IE diagnosed at abdominal-CTA at day 16, with complete
resolution under appropriate antibiotherapy alone. <br/>CONCLUSION(S):
SAAs-IE are a rare occurrence that may be clinically silent. SAAs-IE can
be intrasplenic or hilar in location. Endovascular treatment in this
context was safe. According to current guidelines, radiologic screening by
abdominal-CTA allowed the detection of silent SAAs which could be managed
by endovascular treatment to prevent rupture. The delayed formation of
these SAAs could justify a CTA control at the end of
antibiotherapy.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<68>
Accession Number
642682715
Title
Hypothermic oxygenated perfusion (HOPE) safely and effectively extends
acceptable donor heart preservation times - results of the Australian and
New Zealand trial.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2023. Date of Publication: 31 Oct 2023.
Author
McGiffin D.C.; Kure C.E.; Macdonald P.S.; Jansz P.C.; Emmanuel S.; Marasco
S.F.; Doi A.; Merry C.; Larbalestier R.; Shah A.; Geldenhuys A.; Sibal
A.K.; Wasywich C.A.; Mathew J.; Paul E.; Cheshire C.; Leet A.; Hare J.L.;
Graham S.; Fraser J.F.; Kaye D.M.
Institution
(McGiffin) Department of Cardiothoracic Surgery and Transplantation, The
Alfred, Melbourne, Australia; Department of Surgery, Central Clinical
School, Monash University, Melbourne; Critical Care Research Group, Adult
Intensive Care Unit, The Prince Charles Hospital, Brisbane; University of
Queensland, Brisbane
(Kure, Marasco) Department of Cardiothoracic Surgery and Transplantation,
The Alfred, Melbourne, Australia; Department of Surgery, Central Clinical
School, Monash University, Melbourne
(Macdonald) Department of Cardiology, St Vincent's Hospital, Sydney,
Australia
(Jansz, Emmanuel) Department of Cardiothoracic Surgery, St Vincent's
Hospital, Sydney, Australia
(Doi, Merry) Department of Cardiothoracic Surgery and Transplantation, The
Alfred, Melbourne, Australia
(Larbalestier, Geldenhuys) Department of Cardiothoracic Surgery, Fiona
Stanley Hospital, Perth, Australia
(Shah) Department of Cardiology, Fiona Stanley Hospital, Perth, Australia
(Sibal) Department of Cardiothoracic Surgery, Auckland City Hospital,
Auckland, New Zealand
(Wasywich) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Mathew) Department of Cardiology, Royal Children's Hospital, Melbourne,
Australia
(Paul) School of Public Health and Preventive Medicine, Monash University,
Melbourne, Australia
(Cheshire, Leet, Hare, Graham) Department of Cardiology, The Alfred,
Melbourne, Australia
(Fraser) Department of Surgery, Central Clinical School, Monash
University, Melbourne; Critical Care Research Group, Adult Intensive Care
Unit, The Prince Charles Hospital, Brisbane; University of Queensland,
Brisbane; St Andrews War Memorial Hospital, Brisbane
(Kaye) Department of Surgery, Central Clinical School, Monash University,
Melbourne; Monash-Alfred-Baker Centre for Cardiovascular Research, Monash
University, Melbourne
Abstract
BACKGROUND: Cold static storage (CSS) preservation of donor hearts for
periods longer than 4 hours increases the risk of primary graft
dysfunction (PGD). The aim of the study was to determine if hypothermic
oxygenated perfusion (HOPE) could safely prolong the preservation time of
donor hearts. <br/>METHOD(S): We conducted a non-randomised, single arm,
multi-center investigation of the effect of HOPE using the XVIVO Heart
Preservation System on donor hearts with a projected preservation time of
6-8 hours on 30-day recipient survival and allograft function
post-transplant. Each center completed 1 or 2 short preservation time
followed by long preservation time cases. PGD was classified as occurring
in the first 24 hours after transplantation or secondary (SGD) occurring
at any time with a clearly defined cause. Trial survival was compared with
a comparator group based on data from the International Society of Heart
and Lung Transplantation Registry. <br/>RESULT(S): We performed heart
transplants using 7 short and 29 long preservation time donor hearts
placed on the HOPE system. The mean preservation time for the long
preservation time cases was 414 minutes, the longest being 8 hours and 47
minutes. There was 100% survival at 30 days. One long preservation time
recipient developed PGD, and 1 developed SGD. One short preservation time
patient developed SGD. 30-day survival was superior to the ISHLT
comparator group despite substantially longer preservation times in the
trial patients. <br/>CONCLUSION(S): HOPE provides effective preservation
out to preservation times of nearly 9 hours allowing retrieval from remote
geographic locations.<br/>Copyright &#xa9; 2023. Published by Elsevier
Inc.

<69>
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.

<70>
[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.

<71>
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

<72>
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.

<73>
Accession Number
2026448904
Title
Direct wire pacing during measurement of fractional flow reserve: A
randomized proof-of-concept noninferiority crossover trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1137309. Date of Publication: 2023.
Author
Faurie B.; Acheampong A.; Abdellaoui M.; Dessus I.; Monsegu J.;
Wintzer-Wehekind J.
Institution
(Faurie, Acheampong, Abdellaoui, Dessus, Monsegu, Wintzer-Wehekind)
Institut Cardiovasculaire de Grenoble, Grenoble, France
(Acheampong) Universite Libre de Bruxelles, Bruxelles, Belgium
(Dessus) Universite Grenoble-Alpes, CHU Grenoble-Alpes, Grenoble, France
Publisher
Frontiers Media SA
Abstract
Background: Adenosine administration for fractional flow reserve (FFR)
measurement may induce heart pauses. <br/>Aim(s): To assess the accuracy
and tolerability of direct wire pacing (DWP) during measurement of FFR.
<br/>Method(s): Adults with at least one intermediate coronary artery
stenosis (40%-80%) were consecutively enrolled between June 2021 and
February 2022 in this randomized, noninferiority, crossover trial
(NCT04970082) carried out in France. DWP was applied (DWP) or not
(standard method) through the pressure guidewire used for FFR measurement
during adenosine-induced maximal hyperaemia. Subjects were randomly
assigned to the allocation sequence (DWP first or standard first). A
2-minute washout period was observed between the two FFR measurements
performed for each stenosis. The primary endpoint was the reproducibility
of FFR measurements between methods. <br/>Result(s): A total of 150 focal
lesions, presented by 94 subjects, were randomized (ratio: 1:1). The FFR
values obtained with each method were nearly identical (R = 0.98, p =
0.005). The mean FFR difference of 0.00054 (95% confidence interval: 0.004
to 0.003) showed the noninferiority of FFR measurement with DWP vs. that
with the standard method. Higher levels of chest discomfort were reported
with DWP than with the standard method (0.61 +/- 0.84 vs. 1.05 +/- 0.89, p
< 0.001), and a correlation was observed between the electrical sensations
reported with DWP and chest discomfort (p < 0.001). Pauses (n = 20/148
lesions) were observed with the standard method, but did not correlate
with chest discomfort (p = 0.21). No pauses were observed with DWP.
<br/>Conclusion(s): DWP during FFR measurement resulted in accurate and
reproducible FFR values, and eliminated the pauses induced by
adenosine.<br/>Copyright 2023 Faurie, Acheampong, Abdellaoui, Dessus,
Monsegu and Wintzer-Wehekind.

<74>
Accession Number
2026395134
Title
A comparative study between surgical cut down and percutaneous closure
devices in management of large bore arterial access.
Source
CVIR Endovascular. 6(1) (no pagination), 2023. Article Number: 53. Date of
Publication: December 2023.
Author
Mousa M.A.; Zahwy S.S.E.; Tamara A.F.; Samir W.; Tantawy M.A.
Institution
(Mousa, Zahwy, Tamara) Department of Cardiology, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
(Samir, Tantawy) Deaprtment of Cardiology, Faculty of Medicine, Misr
University for Science and Technology, 6th of October, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Compared to conventional open surgery, minimally invasive
catheter-based procedures have less post procedural complications.
Transcatheter aortic valve implantation (TAVI) and endovascular aneurysm
repair (EVAR) require large bore arterial access. Optimal site management
of large bore arterial access is pivotal to reduce the hospital-acquired
complications associated with large bore arterial access. We wanted to
compare surgical cutdown versus percutaneous closure devices in site
management of large bore arterial access. <br/>Method(s): Participants
planned for TAVI or EVAR with large bore arterial access more than 10
French were included, while participants with history of bypass surgery,
malignancies, thrombophilia, or sepsis were excluded. A consecutive sample
of 100 participants (mean age 74.66 +/- 2.65 years, 61% males) was
selected, underwent TAVI or EVAR with surgical cutdown (group 1) versus
TAVI or EVAR with ProglideTM percutaneous closure device (group 2).
<br/>Result(s): The incidence rate of hematoma was significantly lower in
group 2 versus group 1 (p = 0.014), the mean procedure time (minutes) and
the median hospital stay (days) were significantly higher in group 1
versus group 2 (t(98) = - 2.631, p = 0.01, and U = 2.403, p = 0.018,
respectively), and the c-reactive protein pre-procedure and the c-reactive
protein post-procedure were significantly lower in group 2 versus group 1
(U = -2.969, p = 0.003, and U = -2.674, p = 0.007, respectively).
<br/>Conclusion(s): Our study showed a lower incidence rate of large bore
arterial access complications as hematoma, a shorter procedure time, and a
shorter hospital stay with percutaneous closure devices compared to
surgical cutdown.<br/>Copyright &#xa9; 2023, The Author(s).

<75>
Accession Number
2025061571
Title
Baseline characteristics of patients enrolled in the EMPACT-MI trial.
Source
European Journal of Heart Failure. 25(9) (pp 1708-1715), 2023. Date of
Publication: September 2023.
Author
Harrington J.; Udell J.A.; Jones W.S.; Anker S.D.; Bhatt D.L.; Petrie
M.C.; Andersen K.R.; Sumin M.; Zwiener I.; Hernandez A.F.; Butler J.
Institution
(Harrington, Jones, Hernandez) Division of Cardiology, Duke University
Department of Medicine, Durham, NC, United States
(Harrington, Jones, Hernandez) Duke University Medical Center, Duke
Clinical Research Institute, Durham, NC, United States
(Udell) Women's College Hospital and Peter Munk Cardiac Centre, Toronto
General Hospital, all at University of Toronto, Toronto, ON, Canada
(Anker) Department of Cardiology (CVK) of German Heart Center Charite;
Institute of Health Center for Regenerative Therapies (BCRT), German
Centre for Cardiovascular Research (DZHK) partner site Berlin, Charite
Universitatsmedizin, Berlin, Germany
(Anker) Institute of Heart Disease, Wroclaw Medical University, Wroclaw,
Poland
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Petrie) Institute of Cardiovascular and Medical Sciences, British Heart
Foundation Glasgow Cardiovascular Research Centre, University of Glasgow,
Glasgow, United Kingdom
(Andersen) Boehringer Ingelheim Norway KS, Asker, Norway
(Sumin) Boehringer Ingelheim International GmbH, Ingelheim, Germany
(Zwiener) Boehringer Ingelheim Pharma GmbH & Co KG, Ingelheim, Germany
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Butler) Department of Medicine, University of Mississippi, Jackson, MS,
United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Empagliflozin has been shown to reduce the risk of adverse
cardiovascular outcomes in patients with type 2 diabetes and in those with
heart failure. The impact of empagliflozin in post-acute myocardial
infarction (AMI) patients is unknown. <br/>Methods and Results: The Study
to Test the Effect of Empagliflozin on Hospitalization for Heart Failure
and Mortality in Patients with Acute Myocardial Infarction (EMPACT-MI)
trial screened 6610 participants with AMI and randomized 6522 to
empagliflozin or placebo in addition to standard of care. The median
(interquartile) age was 64 (56-71) years and 75.1% of patients were male.
Major comorbidities included hypertension (69.1%), type 2 diabetes
(31.7%), prior myocardial infarction (13.0%), and atrial fibrillation
(10.9%). The majority (74.3%) of patients presented with an ST-elevation
myocardial infarction. Overall, 56.9% of patients had acute signs or
symptoms of congestion requiring treatment and 78.3% had left ventricular
systolic dysfunction with ejection fraction <45%. Clinical
characteristics, including baseline demographics, rates of
revascularization, and cardiovascular medications at discharge were
largely comparable to recent trials of the post-AMI population.
<br/>Conclusion(s): The EMPACT-MI trial will establish the benefit and
risks of empagliflozin treatment in patients with AMI.<br/>Copyright
&#xa9; 2023 The Authors. European Journal of Heart Failure published by
John Wiley & Sons Ltd on behalf of European Society of Cardiology.

<76>
Accession Number
2027744894
Title
TCT-55 Comparison of Figure-of-8 Suture and Perclose ProGlide
Suture-Mediated Closure in Large Bore Venous Access Hemostasis: A
Randomized Controlled Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B22), 2023. Date of Publication: 24 Oct 2023.
Author
Lodhi H.; Shaukat S.; Mathews A.; Maini B.; Khalili H.
Institution
(Lodhi) Case Western Reserve University, Bowling Green, KY, United States
(Shaukat) Florida Atlantic University, Lake Worth, FL, United States
(Mathews) Deborah Heart and Lung/Thomas Jefferson University, Lutz, FL,
United States
(Maini) East End Medical I, Miramar, FL, United States
(Khalili) Florida Atlantic University, Davie, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: Suture-mediated closure device and figure-of-8 suture are
commonly used to achieve hemostasis after use of large bore venous access.
Although both methods of closure are commonly used in clinical practice, a
head-to-head comparison in a controlled setting has not been performed.
<br/>Method(s): Patients presenting to a single center for elective left
atrial appendage occlusion or transcatheter edge-to-edge mitral valve
repair were randomized to large bore venous closure using the Perclose
ProGlide suture-based closure or a figure-of-8 suture closure. The
patients were followed for 1 month after procedure. Primary outcome, a
composite of access site large ecchymosis, hematoma, infection, pain, need
for unscheduled venous ultrasound, and need for transfusion, was compared
between the 2 arms. <br/>Result(s): A total of 40 patients were randomized
in a 1:1 fashion to the 2 venous closure strategies. Baseline
characteristics were similar between the 2 groups. Perclose ProGlide arm
required use of more devices for hemostasis (1.5 +/- 0.5 vs 1 +/- 0; P <
0.0001), and there was a significant difference in the cost of closure
device ($367.00 +/- 122.00 vs $1.00 +/- 0; P < 0.001). At 1 month after
procedure, the primary outcome occurred in 4 patients (20%) in the
Perclose arm and in 7 patients (35%) in the figure-of-8 arm, a difference
that was not statistically significant (P = 0.48) (Table 1). Time to
hemostasis between figure-of-8 and Perclose arms did not reach statistical
significance (2.5 +/- 2.1 vs 3.7 +/- 2.3, P = 0.09). [Formula presented]
<br/>Conclusion(s): In patients undergoing large-bore venous access, both
Perclose ProGlide suture-based closure and figure-of-8 closure appear
equally feasible and safe, wherease figure-of-8-based closure is more
cost-effective. Categories: VASCULAR ACCESS: Valvular Access:
Structural<br/>Copyright &#xa9; 2023

<77>
Accession Number
2027744882
Title
TCT-133 Reinterventions After CoreValve/Evolut Transcatheter or Surgical
Aortic Valve Replacement for Treatment of Severe Aortic Stenosis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B52), 2023. Date of Publication: 24 Oct 2023.
Author
Grubb K.; Lisko J.; O'Hair D.; Merhi W.; Forrest J.; Mahoney P.; van
Mieghem N.; Windecker S.; Yakubov S.; Chetcuti S.; Deeb G.M.; Kleiman N.;
Althouse A.; Reardon M.
Institution
(Grubb) Emory University, Atlanta, GA, United States
(Lisko) Emory University School of Medicine, Atlanta, GA, United States
(O'Hair) Boulder Heart, Boulder Community Health, Boulder, CO, United
States
(Merhi) Spectrum Health, Grand Rapids, MI, United States
(Forrest) Yale School of Medicine, New Haven, CT, United States
(Mahoney) UPMC Pinnacle Health, Harrisburg, PA, United States
(van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
(Windecker) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Yakubov) Ohiohealth Riverside Methodist Hospital, Columbus, OH, United
States
(Chetcuti) University of Michigan Health Center, Ann Arbor, MI, United
States
(Deeb) University of Michigan, Ann Arbor, MI, United States
(Kleiman, Reardon) Houston Methodist Debakey Heart and Vascular Center,
Houston, TX, United States
(Althouse) Medtronic, Mounds View, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: Valve durability after transcatheter or surgical aortic valve
replacement (TAVR or SAVR) is important for the lifetime management of
patients with aortic stenosis. We compared the 5-year frequency of
reintervention with self-expanding supra-annular CoreValve/Evolut TAVR or
SAVR. <br/>Method(s): Pooled data from CoreValve/Evolut R/PRO (Medtronic)
randomized trials and continued access studies encompassed 5,925 TAVR
(4,478 CoreValve, 1,447 Evolut) and 1,832 SAVR patients. Reinterventions
were categorized by indication, timing (early [<1 year] or delayed [1-5
years]), and treatment. Cumulative incidence of reintervention with
competing risk of death was compared between TAVR (CoreValve + Evolut) vs
SAVR, Evolut vs CoreValve, and Evolut vs SAVR through 5 years and
landmarked at 1 year. <br/>Result(s): There were 99 reinterventions across
studies: 80 TAVR (69 CoreValve, 11 Evolut) and 19 SAVR. The cumulative
incidence of reintervention through 5 years was higher with TAVR vs SAVR
(2.2% vs 1.5%; P = 0.021) and observed early after procedure (HR: 3.4; 95%
CI: 1.5-7.9) but not from 1-5 years (HR: 1.0; 95% CI: 0.5-2.2). The most
common reasons for reintervention were paravalvular regurgitation (59%,
47/80) after TAVR and endocarditis (42%, 8/19) after SAVR. Most TAVR
reinterventions were managed percutaneously (75%), and reoperative surgery
was most often required after SAVR (63%). Evolut had significantly lower
incidence of reintervention than CoreValve (0.9% vs 1.6%; P = 0.046) at 5
years, with differences observed early (HR: 0.4; 95% CI: 0.2-0.9) but not
from 1-5 years (HR: 0.8; 95% CI: 0.3-2.2). Through 5 years, the incidence
of reintervention with Evolut vs SAVR was similar (0.9% vs 1.5%; P =
0.43). Delayed events trended higher in the SAVR group, although not
statistically significantly. <br/>Conclusion(s): For patients enrolled in
the CoreValve/Evolut R/PRO trials or continued access studies, a low
incidence of reintervention was observed through 5 years. Reintervention
occurred most often at <1 year for TAVR and at >1 year for SAVR. The
majority of early reinterventions were with first-generation CoreValve and
managed percutaneously. Evolut R/PRO valves required fewer reinterventions
than CoreValve, with rates similar to surgery. Categories: STRUCTURAL:
Valvular Disease: Aortic<br/>Copyright &#xa9; 2023

<78>
Accession Number
2027743979
Title
TCT-97 Temporal Improvement in Outcomes of Isolated Tricuspid Repair:
Evidence From Meta-Analysis and Meta-Regression.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B38), 2023. Date of Publication: 24 Oct 2023.
Author
Welle G.; Al-Abcha A.; Saleh Y.; Abbasi M.; El-Am E.; Ismayl M.; Alkhouli
M.
Institution
(Welle, Al-Abcha, Abbasi, El-Am, Ismayl, Alkhouli) Mayo Clinic, Rochester,
Minnesota, United States
(Saleh) Houston Methodist, Houston, Texas, United States
Publisher
Elsevier Inc.
Abstract
Background: Isolated tricuspid regurgitation (TR) affects around 1.6
million individuals in the USA. Despite that, isolated tricuspid surgery
is rarely performed and constitutes less than 5% of all valvular
surgeries. <br/>Method(s): We conducted a comprehensive literature review
using PubMed, Embase, and Cochrane databases through September 2022. We
included studies reporting outcomes of adult patients undergoing isolated
tricuspid valve (TV) repair. We excluded studies that exclusively reported
outcomes in patients with TV endocarditis or congenital TV disease. The
primary endpoint was postoperative mortality. Secondary outcomes included
procedural complications (permanent pacemaker [PPM] implantation, acute
kidney injury (AKI), and stroke), and long-term mortality at follow-up.
<br/>Result(s): A total of 15 studies with 4,262 patients who underwent
isolated TV repair were included with a mean weighted follow-up of 7.2
years. Mean age was 55.4 years, 20.5% had previous cardiac surgery, and
36.9% had NYHA functional class III/IV symptoms at the time of operation.
Postoperative mortality rate was 6.0% (Figure 1A), and long-term mortality
rate was 35.0% (Figure 1B). Postoperative complications included PPM
implantation rate of 6.0%, AKI 15.0%, and stroke 1.0%. Meta-regression
demonstrated that isolated TV repair in more recent years was associated
with significantly lower long-term mortality (P = 0.001) (Figure 1C). In
addition, repeated surgical exploration was associated with higher
long-term mortality (P = 0.01) (Figure 1D). [Formula presented]
<br/>Conclusion(s): Our analysis documents a temporal improvement in the
outcomes of isolated TV repair Categories: STRUCTURAL: Valvular Disease:
Tricuspid<br/>Copyright &#xa9; 2023

<79>
Accession Number
2027743041
Title
TCT-28 Outcomes of Transcatheter Edge-to-Edge Repair for Atrial Functional
Mitral Regurgitation: A Meta-Analysis of Observational Studies.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B12), 2023. Date of Publication: 24 Oct 2023.
Author
Hamada S.; Ueyama H.; Aikawa T.; Kampaktsis P.; Misumida N.; Takagi H.;
Kuno T.; Latib A.
Institution
(Hamada) Imperial College London, London, United Kingdom
(Ueyama) Emory University Hospital, Atlanta, GA, United States
(Aikawa) Juntendo University Urayasu Hospital, Urayasu, Japan
(Kampaktsis) Columbia University Irving Medical Center, New York, New
York, United States
(Misumida) University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Shizuoka, Japan, Japan
(Kuno, Latib) Montefiore Medical Center, Bronx, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair (TEER) may have potential
benefits in the treatment of atrial functional mitral regurgitation
(AFMR), but robust evidence is currently lacking. We conducted a
systematic review and meta-analysis to investigate clinical outcomes of
TEER for AFMR, including comparisons to ventricular functional MR (VFMR).
<br/>Method(s): Medline and Embase were searched through January 2023 to
identify studies eligible for analysis. Primary outcome was postprocedural
MR severity. Postprocedural NYHA functional class classification and
all-cause mortality were also evaluated. Outcomes were stratified into
short-term (postprocedure to 6 months) and long-term (6 months to 2
years). <br/>Result(s): A total of 8 observational studies met the
inclusion criteria, enrolling 539 AFMR and 3486 VFMR patients.
Postprocedural MR grade <=2 in the AFMR group was observed in 93.7%
(454/491 patients; 95% CI: 91.1%-96.2%; I² = 24.3%) and 97.1%
(89/93 patients; 95% CI: 92.9%-100%; I² = 26.4%) in short- and
long-term follow-up, respectively. There was no difference in the rates of
postprocedural MR grade <=2 between AFMR and VFMR either in short-term
(RR: 1.00; 95% CI: 0.95-1.06; P = 0.90; I² = 53%) or long-term
(RR 1.08; 95% CI: 0.89-1.32; P = 0.44; I² = 22%) follow-up.
Similarly, no difference was observed between AFMR and VFMR in the rates
of postprocedural NYHA functional class <=2 or all-cause mortality.
<br/>Conclusion(s): TEER provides similar clinical outcomes for AFMR and
VFMR. A high rate of MR grade <=2 was observed in patients at both short-
and long-term follow-up. Further prospective studies with TEER vs medical
therapy and/or rhythm control for AFMR are warranted. Categories:
STRUCTURAL: Valvular Disease: Mitral<br/>Copyright &#xa9; 2023

<80>
Accession Number
2027743023
Title
TCT-202 Frailty-Based Prediction of Major Bleeding Risk in Patients
Undergoing TAVR: A POPular TAVI Subanalysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B78), 2023. Date of Publication: 24 Oct 2023.
Author
Jan van Ginkel D.; Overduin D.; Peper J.; Brouwer J.; Nijenhuis V.;
Rensing B.; Swaans M.; Timmers L.; Berg J.T.
Institution
(Jan van Ginkel, Peper, Timmers) St. Antonius Hospital, Nieuwegein,
Netherlands
(Overduin) St. Antonius Hospital, Nieuwegein, Netherlands
(Brouwer, Nijenhuis) St. Antonius Hospital, Nieuwegein, Netherlands
(Rensing) Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein,
Netherlands
(Swaans) St. Antonius Hospital, Hedel, Netherlands
(Berg) St. Antonius Hospital, Bilthoven, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Major bleeding remains a frequent complication after
transcatheter aortic valve replacement (TAVR), which is associated with
increased morbidity and mortality and leads to an increased strain on
health care resources. Identifying patients at high risk may guide
appropriate measures to prevent bleeding. Previous studies have identified
frailty as a potential predictor, but due to lack of consensus on how
frailty is best assessed, frailty was not included in the ARC-HBR
criteria, while further studies on this topic were encouraged.
<br/>Method(s): POPular TAVI was a randomized clinical trial, which
evaluated the addition of clopidogrel to aspirin (cohort A) or oral
anticoagulation (cohort B) in patients undergoing TAVR. Along with
demographics and medical history, data were collected on various measures
of frailty and functional status, including mobility, living situation,
functional independence, tendency to bruise, nasal bleeding, and the
Edmonton frail scale. These measures were analyzed as potential
predictors, along with the randomized strategy. Major bleeding was defined
according to the VARC-2 criteria, as major, life-threatening, or disabling
bleeding within 30 days after TAVR. Model building was performed using
multivariable backward logistic regression, based on Akaike's information
criterion. For internal validation, bootstrapping was applied to quantify
the optimism of the model. <br/>Result(s): A total of 978 patients were
included, of whom 78 (8.0%) experienced a major bleeding within 30 days
after TAVR. The best-fit model included the following predictors: female
sex, body mass index, dual antiplatelet/antithrombotic therapy usage,
tendency to bruise, nasal bleeding, and 4 components (1, 3, 9, and 11) of
the Edmonton frail scale. Discrimination of the model yielded an area
under the curve of 0.75 (95% CI: 0.69-0.82). Internal validation resulted
in an optimism-corrected area under the curve of 0.73. The model showed
good calibration with the observed outcomes. <br/>Conclusion(s): A
frailty-based clinical prediction model showed reasonably good accuracy in
predicting major bleeding in patients undergoing TAVR. External validation
of the model is needed to confirm its generalizability and utility.
Categories: STRUCTURAL: Valvular Disease: Aortic<br/>Copyright &#xa9; 2023

<81>
Accession Number
2027742655
Title
TCT-142 Impact of Chronic Total Occlusions on Outcomes in the FAME 3
Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics
(TCT)-Abstracts. Moscone Center, San Francisco United States. 82(17
Supplement) (pp B55), 2023. Date of Publication: 24 Oct 2023.
Author
Otsuki H.; Takahashi K.; Zimmermann F.; Mavromatis K.; Aminian A.;
Dambrink J.-H.; Kala P.; MacCarthy P.; Witt N.; de Bruyne B.; Pijls N.;
Fearon W.
Institution
(Otsuki) Stanford University, Stanford, CA, United States
(Takahashi) Stanford University, Stanford, CA, United States
(Zimmermann) Catharina Hospital Eindoven, Eindhoven, Netherlands
(Mavromatis) Atlanta VA Medical Center, Decatur, GA, United States
(Aminian) Centre Hospitalier Universitaire de Charleroi, Waterloo, Belgium
(Dambrink) Isala Heart Centre, Zwolle, Netherlands
(Kala) University Hospital Brno and Medical Faculty of Masaryk University,
Brno, Czechia
(MacCarthy) King's College Hospital, London, United Kingdom
(Witt) Sodersjukhuset, Stockholm, Sweden
(de Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(Pijls) Catharina Hospital, Eindhoven, Netherlands
(Fearon) Stanford Healthcare, Stanford, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: The clinical impact of a chronic total occlusion (CTO) in
patients being considered for fractional flow reserve (FFR)-guided
percutaneous coronary intervention (PCI) with current generation
drug-eluting stents or coronary artery bypass grafting (CABG) is unclear.
<br/>Method(s): The FAME 3 trial is a multicenter, international,
randomized study comparing FFR-guided PCI with CABG in patients with
3-vessel coronary disease. PCI did not meet the criterion for
noninferiority with respect to the primary endpoint of MACCE, a composite
of death, myocardial infarction (MI), stroke, or repeated
revascularization at 1 year. At 3 years, there was no difference in the
composite of death, MI, or stroke. In this substudy, we report the 3-year
outcomes of patients based on the presence or absence of a CTO.
<br/>Result(s): Of 1,500 patients randomized to PCI or CABG, 329 (21.9%)
had a CTO. The incidence of MACCE at 3 years was not significantly
different between those with or without a CTO (13.3% vs 16.6%; P = 0.12).
Each component of MACCE was similar, except for MI (3.4% vs 6.6%; P =
0.04). The relative benefit of CABG over PCI was also similar regardless
of CTO (Figure 1). Among the patients with a CTO, revascularization of a
CTO occurred more frequently after CABG compared with PCI (72% vs 47%; P <
0.001). In those with a CTO, revascularization was not associated with
improved 3-year MACCE in the PCI arm (13.8% vs 18.4%; P = 0.47) or in the
CABG arm (9.8% vs 10.7%; P = 0.89). [Formula presented]
<br/>Conclusion(s): The presence or absence of a CTO and its
revascularization did not significantly impact outcomes at 3 years in the
FAME 3 trial. Categories: CORONARY: Complex and Higher Risk Procedures for
Indicated Patients (CHIP)<br/>Copyright &#xa9; 2023

<82>
Accession Number
642672037
Title
Efficacy And Safety Of Degludec U100 Versus Glargine U300 For The Hospital
Management Of Patients With Type 2 Diabetes: A Prospective, Openlabel,
Non-inferiority Randomized Controlled Trial.
Source
Journal of the Endocrine Society. Conference: Endocrine Society's Annual
Meeting, ENDO 2022. Atlanta, GA United States. 6(Supplement 1) (pp
A284-A285), 2022. Date of Publication: November - December 2022.
Author
Kuchay M.S.; Mathew A.; Mishra M.; Parvathi S.; Kaur P.; Wasir J.S.; Gill
H.K.; Jain R.; Gagneja S.; Kohli C.; Kumari P.; Singh M.K.; Mishra S.K.
Institution
(Kuchay, Mathew, Mishra, Parvathi, Kaur, Wasir, Gill, Jain, Gagneja,
Kohli, Kumari, Singh, Mishra) Division of Endocrinology and
Diabetes,Medanta Institute of Education and Research, Medanta - The
Medicity Hospital, Gurgaon, Gurugram, Haryana, India
Publisher
Endocrine Society
Abstract
Aims: No head-to-head comparisons of two ultra-long acting insulins,
degludec-100 and glargine-300, have been reported in the inpatient
setting. We compared the efficacy and safety of these two insulins for the
hospital management of patients with type 2 diabetes (T2D).
<br/>Method(s): This target-to-treat, randomized controlled trial enrolled
patients with T2D admitted for coronary artery bypass graft surgery
(CABG). On the day of transition (day 2 of surgery) from intravenous
insulin infusion to multiple subcutaneous insulin injections, patients
were randomly assigned (1: 1) to receive a basal-bolus regimen using
either degludec-100 or glargine-300 as basal and glulisine as bolus before
meals. Insulin was adjusted daily to maintain a fasting blood glucose (BG)
<140 mg/dL and pre-meal BG <180, while avoiding hypoglycemia <70 mg/dL.
The primary endpoint was non-inferiority in mean differences between
groups in their daily BG concentrations measured during the duration of
the hospital stay and a week post-discharge, up to 12 days (point-of-care
measurements, pre-breakfast, pre-lunch, pre-dinner and nighttime [0300
hours]: non-inferiority was deemed a difference <18 mg/dL). The major
safety outcome was the occurrence of hypoglycemia. Secondary outcome
measures included mean differences between groups in their daily BG
concentrations, time in range (TIR, %), time below range (TBR, %), and
time above range(TAR, %), as assessed by continuous glucose monitoring
system (CGMS, n = 142). <br/>Result(s): Between October 12, 2021, and
February 10, 2022, 324 consecutive patients with T2D undergoing CABG were
screened, 239 patients were randomly assigned to treatment; 122 to
degludec-100 group and 117 to glargine-300 group. The mean daily BG
concentration in the degludec-100 group (157 mg/dL [SD 25]) was not
inferior to that in the glargine-300 group (162 mg/dL [SD 24]), with a
mean BG difference of -5 mg/dL (95% CI, -11 to 2, p = 0.18). There were no
differences between degludec-100 group and glargine-300 group in mean
percentage of readings within target BG of 70-180 mg/dL (74% +/- 29% vs.
73% +/- 30%, p = 0.19), daily basal insulin dose (19 +/- 8 vs. 21 +/- 9
units/day, p = 0.13), length of stay in hospital (median [IQR]: 9 [8-11]
vs. 9 [8-11] days, p = 0.51), or hospital complications (21.3% vs. 21.4%,
p = 0.99). There were no differences in the proportion of patients with BG
<70 mg/ dL (15.6% vs. 23.1%, p = 0.14) or <54 mg/dL (1.6% vs. 4.3%, p =
0.226) between degludec-100 and glargine-300 groups. There was no
difference between groups in mean daily BG concentrations (141 +/- 26 vs.
142 +/- 28 mg/dL, p = 0.88), TIR (72. 0% vs. 72.9%, p = 0.71), TBR (5.9%
vs. 5.2%, p = 0.50) and TAR (22. 0% vs. 21.8%, 0.93) as assessed by CGMS.
<br/>Conclusion(s): Treatment with degludec-100 as a basal insulin is as
effective and safe as glargine-300 for the hospital management of patients
with T2D admitted to cardiac surgery service in the non-intensive care
unit setting.

<83>
[Use Link to view the full text]
Accession Number
2028184216
Title
Peripherally inserted central catheter related pericardial
effusion/cardiac tamponade in neonates: Analysis of two cases and
literature review.
Source
Medicine (United States). 102(43) (pp E35779), 2023. Date of Publication:
27 Oct 2023.
Author
Liu Y.; Li M.; Shi W.; Tang B.
Institution
(Liu, Tang) School of Medicine, University of Electronic Science and
Technology, Chengdu, China
(Liu, Li, Shi, Tang) Department of Pediatrics, Sichuan Academy of Medical
Sciences, Sichuan Provincial People's Hospital, Sichuan Province, Chengdu,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale: Peripherally inserted central catheter (PICC)-related
pericardial effusion/cardiac tamponade is a rare but fatal complication
which cause a high mortality if not timely diagnosed and treated. However,
the atypical manifestations and the rapid deterioration present challenges
for neonatologists, and there has been limited investigation reported
globally to date. Furthermore, a systematic review and comprehensive
summary of clinical management are lacking. The significance of this
article lies in emphasizing the importance of maintaining vigilance in
high-risk neonates and implementing effective management strategies for
PICC-related pericardial effusion/cardiac tamponade, thereby contributing
to saving more lives. Patient concerns: In the current report, we discuss
2 cases of neonatal pericardial effusion/cardiac tamponade following PICC
catheterization. Diagnosis: The first case was diagnosed based on forensic
autopsy and the second case was diagnosed by bedside echocardiography.
Interventions and outcomes: The first case was treated conservatively and
the second case underwent pericardiocentesis, unfortunately both were
died. Lessons: Once sudden hemodynamic or respiratory abnormalities are
detected in neonates with PICC placement, particularly in the preterm
infants, prompt diagnosis by cardiac ultrasound is required to verify
pericardial effusion/cardiac tamponade and immediate pericardiocentesis or
pericardiotomy is necessary to improve survival.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<84>
[Use Link to view the full text]
Accession Number
2028184203
Title
Effect of manual hyperinflation with versus without positive
end-expiratory pressure on dynamic compliance in pediatric patients
following congenital heart surgery: A randomized controlled trial.
Source
Medicine (United States). 102(43) (pp E35715), 2023. Date of Publication:
27 Oct 2023.
Author
Guimaraes J.C.; Da Silva T.H.; Aragon D.C.; Johnston C.; Gastaldi A.C.;
Carlotti A.P.C.P.
Institution
(Guimaraes, Da Silva, Aragon, Carlotti) Department of Pediatrics, Division
of Pediatric Critical Care, Ribeirao Preto Medical School, University of
Sao Paulo, Ribeirao Preto, Brazil
(Johnston) Department of Pediatrics, Division of Pediatric Critical Care,
Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
(Gastaldi) Department of Health Sciences, Ribeirao Preto Medical School,
University of Sao Paulo, Ribeirao Preto, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We aimed to compare the effect of manual hyperinflation with
versus without positive end-expiratory pressure (PEEP) on dynamic
compliance of the respiratory system in pediatric patients undergoing
congenital heart surgery; to assess the safety of the technique in this
population. <br/>Method(s): This was a randomized controlled trial
conducted at the pediatric intensive care unit (PICU) of a tertiary-care
hospital. Patients admitted to the PICU following cardiac surgery and
receiving postoperative mechanical ventilation were randomized to the
experimental or control group. Patients in the experimental group (n = 14)
underwent manual hyperinflation with a PEEP valve set at 5 cm H2O, once
daily, during the first 48 hours after surgery. Patients allocated to the
control group (n = 16) underwent manual hyperinflation without PEEP, at
the same time points. Lung mechanics was assessed before (T0) and 5
minutes (T5) after manual hyperinflation. The primary endpoint was dynamic
compliance. Secondary outcomes included oxygen saturation index, duration
of mechanical ventilation, length of stay, 28-day mortality and safety.
<br/>Result(s): Demographic and clinical characteristics were comparable
in both groups. There was no significant difference in dynamic compliance
between times in each group (Day 1: (mean) 0.78 vs 0.81 and 0.70 vs 0.77;
Day 2: 0.85 vs 0.78 and 0.67 vs 0.68 mL/kg/cm H2O, in experimental and
control groups, respectively; P > .05). Mean deltas of dynamic compliance
were not significantly different between groups. The proportion of
patients extubated <72 hours after surgery was similar in experimental and
control groups (43% vs 50%, respectively; P = .73). Oxygen saturation
index, length of stay, and 28-day mortality were not significantly
different between groups. None of the patients had hemodynamic
instability. <br/>Conclusion(s): Manual hyperinflation was safe and well
tolerated in pediatric patients following surgery for congenital heart
disease. No significant change in dynamic compliance of the respiratory
system or in oxygenation was observed with the use of manual
hyperinflation with or without PEEP in this population.<br/>Copyright
&#xa9; 2023 Lippincott Williams and Wilkins. All rights reserved.

<85>
Accession Number
2026174352
Title
Neurological Complications following Paediatric Congenital Cardiac
Surgery: A Systematic Review.
Source
International Journal of Pharmaceutical and Clinical Research. 15(9) (pp
1359-1365), 2023. Date of Publication: 2023.
Author
Patil K.O.; Kumar V.
Institution
(Patil) Neonatal & Pediatric Laparoscopic Surgeon, Department of General
Surgery, MIMER Medical College, Dabhade, Maharashtra, Talegaon, India
(Kumar) Department of Surgery, S.M.M.H. Government Medical College, Uttar
Pradesh, Saharanpur, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: Neurological complications following paediatric congenital
cardiac surgery constitute a significant concern that can have lasting
effects on a child's development and quality of life. This systematic
review is being conducted with the objectives of providing a comprehensive
overview of postoperative neurological complications in paediatric
congenital cardiac surgery, and to identify risk factors associated with
the development of these complications. <br/>Method(s): The literature
search encompassed an extensive database including PubMed, EMBASE, and Web
of Science. Studies published after the year 2010 were included. The
quality of included studies was assessed using appropriate tools tailored
to the study design. The synthesis of data encompassed a narrative summary
of study characteristics, outcomes, and findings. <br/>Result(s): Sample
sizes in the selected studies ranged widely from 75 to over 3,800
participants. The mean age at surgery varied from 3 months to 5.5 years.
Mortality rates differed significantly, ranging from 0.004% to 33.33%.
Various neurological complications were reported, including seizures,
stroke, altered consciousness, and neurological deficits, with incidence
rates ranging from 1.75% to 37%. <br/>Conclusion(s): The study provides a
comprehensive overview of the current state of knowledge regarding
neurological complications following paediatric congenital cardiac
surgery. Moreover, they emphasize the importance of standardized data
collection and reporting practices to advance our understanding of this
critical aspect of paediatric cardiac care.<br/>Copyright &#xa9; 2023, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<86>
Accession Number
2026523543
Title
The effect of resistance training on PCSK9 levels in patients undergoing
cardiac rehabilitation after coronary artery bypass grafting: a randomized
study.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
549. Date of Publication: December 2023.
Author
Dwiputra B.; Santoso A.; Purwowiyoto B.S.; Radi B.; Ambari A.M.
Institution
(Dwiputra, Santoso, Purwowiyoto, Radi, Ambari) Department of Cardiology
and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ Harapan
Kita National Cardiovascular Center, Jl Letjen S Parman Kav 87, Palmerah,
Jakarta Barat 11420, Indonesia
Publisher
BioMed Central Ltd
Abstract
Background: Resistance training is commonly recommended as part of
secondary prevention for post-coronary artery bypass graft (CABG) patients
in conjunction with aerobic exercise. Despite its potential benefits,
there is currently a lack of studies investigating the impact of
resistance training on proprotein convertase subtilisin kexin 9 (PCSK9).
<br/>Aim(s): To evaluate the effect of intensive resistance training on
proprotein convertase subtilisin kexin 9 (PCSK9) levels among post-CABG
patients undergoing cardiac rehabilitation (CR). <br/>Method(s): In this
prospective, open-label, randomized trial, 87 post-coronary artery bypass
graft (CABG) patients were randomly assigned into two groups: moderate to
high intensity resistance training and aerobic training (n = 44) or
aerobic training alone (n = 43) for a total of 12 sessions. Changes in
PCSK9 levels was determined as a primary endpoint, while secondary
endpoints included changes in the six-minute walk test (6-MWT) results,
aerobic capacity, WHO-5 well-being index, fasting blood glucose, and lipid
profile. Both groups underwent intention-to-treat analysis.
<br/>Result(s): Following completion of cardiac rehabilitation program,
the intervention group demonstrated a significant decrease in mean PCSK9
levels when compared to the control group (beta = -55 ng/ml, 95% CI -6.7
to -103.3, p = 0.026), as well as significant improvements in the 6-MWT
result (beta = 28.2 m, 95% CI 2.4-53.9, p = 0.033), aerobic capacity (beta
= 0.9 Mets, 95% CI 0.1-1.7, p = 0.021), and WHO-5 well-being index (beta =
8.1, 95% CI 2.0-14.4, p = 0.011) in patients who received resistance and
aerobic training. No statistically significant changes were observed in
fasting blood glucose, cholesterol, LDL-C, HDL-C, and triglyceride levels.
<br/>Conclusion(s): Resistance training in CR significantly reduced PCSK-9
levels and increases patient's functional capacity and quality of life.
(NCT02674659 04/02/2016).<br/>Copyright &#xa9; 2023, The Author(s).

<87>
Accession Number
2026490144
Title
Interpretable machine learning models for early prediction of acute kidney
injury after cardiac surgery.
Source
BMC Nephrology. 24(1) (no pagination), 2023. Article Number: 326. Date of
Publication: December 2023.
Author
Jiang J.; Liu X.; Cheng Z.; Liu Q.; Xing W.
Institution
(Jiang, Liu, Xing) Department of Big Data Center for Cardiovascular
Disease, Heart Center of Henan Provincial People's Hospital, Fuwai Central
China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou
University, Zhengzhou, China
(Cheng, Liu) Department of Cardiovascular Surgery, Heart Center of Henan
Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital,
Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China
Publisher
BioMed Central Ltd
Abstract
Objective: Postoperative acute kidney injury (PO-AKI) is a common
complication after cardiac surgery. We aimed to evaluate whether machine
learning algorithms could significantly improve the risk prediction of
PO-AKI. <br/>Method(s): The retrospective cohort study included 2310 adult
patients undergoing cardiac surgery in a tertiary teaching hospital,
China. Postoperative AKI and severe AKI were identified by the modified
KDIGO definition. The sample was randomly divided into a derivation set
and a validation set based on a ratio of 4:1. Exploiting conventional
logistic regression (LR) and five ML algorithms including decision tree,
random forest, gradient boosting classifier (GBC), Gaussian Naive Bayes
and multilayer perceptron, we developed and validated the prediction
models of PO-AKI. We implemented the interpretation of models using
SHapley Additive exPlanation (SHAP) analysis. <br/>Result(s):
Postoperative AKI and severe AKI occurred in 1020 (44.2%) and 286 (12.4%)
patients, respectively. Compared with the five ML models, LR model for
PO-AKI exhibited the largest AUC (0.812, 95%CI: 0.756, 0.860, all P <
0.05), sensitivity (0.774, 95%CI: 0.719, 0.813), accuracy (0.753, 95%CI:
0.719, 0.781) and Youden index (0.513, 95%CI: 0.451, 0.573). Regarding
severe AKI, GBC algorithm showed a significantly higher AUC than the other
four ML models (all P < 0.05). Although no significant difference (P =
0.173) was observed in AUCs between GBC (0.86, 95%CI: 0.808, 0.902) and
conventional logistic regression (0.803, 95%CI: 0.746, 0.852), GBC
achieved greater sensitivity, accuracy and Youden index than conventional
LR. Notably, SHAP analyses showed that preoperative serum creatinine,
hyperlipidemia, lipid-lowering agents and assisted ventilation time were
consistently among the top five important predictors for both
postoperative AKI and severe AKI. <br/>Conclusion(s): Logistic regression
and GBC algorithm demonstrated moderate to good discrimination and
superior performance in predicting PO-AKI and severe AKI, respectively.
Interpretation of the models identified the key contributors to the
predictions, which could potentially inform clinical
interventions.<br/>Copyright &#xa9; 2023, The Author(s).

<88>
Accession Number
2028251914
Title
Trimethoprim-sulfamethoxazole significantly reduces the risk of
nocardiosis in solid organ transplant recipients: systematic review and
individual patient data meta-analysis.
Source
Clinical Microbiology and Infection. (no pagination), 2023. Date of
Publication: 2023.
Author
Passerini M.; Nayfeh T.; Yetmar Z.A.; Coussement J.; Goodlet K.J.; Lebeaux
D.; Gori A.; Mahmood M.; Temesgen Z.; Murad M.H.
Institution
(Passerini, Gori) Department of Pathophysiology and Transplantation,
University of Milano, Milan, Italy
(Passerini, Gori) Department of Infectious Disease, ASST FBF SACCO
Fatebenefratelli, Lombardia, Milan, Italy
(Nayfeh, Yetmar, Mahmood, Temesgen, Murad) Division of Public Health,
Infectious Diseases and Occupational Medicine, Department of Medicine,
Mayo Clinic, Rochester, MN, United States
(Yetmar) Department of Infectious Diseases, Respiratory Institute,
Cleveland Clinic Foundation, Cleveland, OH, United States
(Coussement) Sir Peter MacCallum Department of Oncology, The University of
Melbourne, Melbourne, VIC, Australia
(Coussement) Service de Maladies Infectieuses et Tropicales, Centre
Hospitalier Universitaire de Guadeloupe, Guadeloupe, Les Abymes, France
(Goodlet) Department of Pharmacy Practice, Midwestern University,
Glendale, AZ, United States
(Goodlet) Norton Thoracic Institute, Dignity Health - St. Joseph's
Hospital and Medical Center, Phoenix, AZ, United States
(Lebeaux) Institut Pasteur, Universite Paris Cite, CNRS, Genetics of
Biofilms Laboratory, UMR, Paris 6047, France
(Lebeaux) Departement de Maladies Infectieuses et Tropicales, Hopital
Saint-Louis, AP-HP, Lariboisiere, Paris, France
(Gori) Centre for Multidisciplinary Research in Health Science (MACH),
University of Milan, Milan, Italy
Publisher
Elsevier B.V.
Abstract
Background: Whether trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis
prevents nocardiosis in solid organ transplant (SOT) recipients is
controversial. <br/>Objective(s): To assess the effect of TMP-SMX in the
prevention of nocardiosis after SOT, its dose-response relationship, its
effect on preventing disseminated nocardiosis, and the risk of TMP-SMX
resistance in case of breakthrough infection. <br/>Method(s): A systematic
review and individual patient data meta-analysis. Data sources: MEDLINE,
Embase, Cochrane Central Register of Controlled Trials, Cochrane Database
of Systematic Reviews, Web of Science Core Collection, and Scopus up to 19
September 2023. Study eligibility criteria: (a) Risk of nocardiosis
between SOT recipients with and without TMP-SMX prophylaxis, or (b)
sufficient details to determine the rate of TMP-SMX resistance in
breakthrough nocardiosis. <br/>Participant(s): SOT recipients.
<br/>Intervention(s): TMP-SMX prophylaxis versus no prophylaxis.
Assessment of risk of bias: Risk Of Bias In Non-randomized Studies-of
Exposure (ROBINS-E) for comparative studies; dedicated tool for
non-comparative studies. Methods of data synthesis: For our primary
outcome (i.e. to determine the effect of TMP-SMX on the risk of
nocardiosis), a one-step mixed-effects regression model was used to
estimate the association between the outcome and the exposure. Univariate
and multivariable unconditional regression models were used to adjust for
the potential confounding effects. Certainty of evidence was assessed
using Grading of Recommendations Assessment, Development and Evaluation
(GRADE) approach. <br/>Result(s): Individual data from three case-control
studies were obtained (260 SOT recipients with nocardiosis and 519
uninfected controls). TMP-SMX prophylaxis was independently associated
with a significantly decreased risk of nocardiosis (adjusted OR = 0.3, 95%
CI 0.18-0.52, moderate certainty of evidence). Variables independently
associated with an increased risk of nocardiosis were older age, current
use of corticosteroids, high calcineurin inhibitor concentration, recent
acute rejection, lower lymphocyte count, and heart transplant.
Breakthrough infections (66/260, 25%) were generally susceptible to
TMP-SMX (pooled proportion 98%, 95% CI 92-100). <br/>Conclusion(s): In SOT
recipients, TMP-SMX prophylaxis likely reduces the risk of nocardiosis.
Resistance appears uncommon in case of breakthrough
infection.<br/>Copyright &#xa9; 2023 The Author(s)

<89>
Accession Number
2026487266
Title
Balancing anticoagulation and hemostasis in an infant with severe
hemophilia A during cardiac transplantation: Review of the literature and
development of a surgical protocol.
Source
Pediatric Blood and Cancer. (no pagination), 2023. Date of Publication:
2023.
Author
Regling K.; Sehgal S.; Hollon W.; Rayner P.; Stricker L.; Sarnaik A.;
Sassalos P.; Al-Ahmadi M.; Rajpurkar M.; Chitlur M.B.
Institution
(Regling, Rajpurkar, Chitlur) Division of Hematology Oncology, Department
of Pediatrics, Children's Hospital of Michigan, Central Michigan
University College of Medicine, Detroit, MI, United States
(Sehgal) Division of Cardiology, Department of Pediatrics, Children's
Hospital of Michigan, Central Michigan University College of Medicine,
Detroit, MI, United States
(Hollon, Rayner) Detroit Medical Center, Children's Hospital of Michigan,
Detroit, MI, United States
(Stricker) Department of Anesthesia, Children's Hospital of Michigan,
Wayne State University School of Medicine, Detroit, MI, United States
(Sarnaik) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Children's Hospital of Michigan, Central Michigan University
College of Medicine, Detroit, MI, United States
(Sassalos, Al-Ahmadi) Department of Pediatric Cardiovascular Surgery,
Children's Hospital of Michigan, Detroit, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Hemophilia A is a disorder resulting in a deficiency of clotting factor
VIII that can lead to life-threatening bleeding. Evidence-based guidelines
for surgical interventions like cardiac surgery are limited.
Anticoagulation is necessary for cardiac bypass, thus risk of bleeding in
a patient with hemophilia is increased and requires careful attention to
maintain hemostasis. We report the first infant with severe hemophilia A
and dilated cardiomyopathy who underwent successful cardiac
transplantation, and review the literature on previous cardiac transplant
cases in congenital hemophilia. To ensure safe and effective management, a
multidisciplinary approach was used to develop the surgical protocol for
transplant.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<90>
Accession Number
642463827
Title
Results beyond 5-years of surgery or percutaneous approach in severe
coronary disease. Reconstructed time-to-event meta-analysis of randomized
trials.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2023.
Date of Publication: 08 Oct 2023.
Author
Formica F.; Vaquero D.H.; Tuttolomondo D.; Gallingani A.; Singh G.;
Pattuzzi C.; Niccoli G.; Lorusso R.; Nicolini F.
Institution
(Formica) Department of Medicine and Surgery, University of Parma, Parma,
Italy
(Vaquero) Cardiac Surgery Department, Hospital Universitario Central de
Asturias, Oviedo, Spain
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Gallingani) Cardiac Surgery Unit, University Hospital of Parma, Parma,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Pattuzzi, Niccoli, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy; Cardiac Surgery Unit, University
Hospital of Parma, Parma, Italy
(Lorusso) Cardio-Thoracic Department, Maastricht University Medical
Centre, Heart and Vascular Centre, Maastricht, The Netherlands;
Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The
Netherlands
Abstract
INTRODUCTION AND OBJECTIVES: There is controversy about the optimal
revascularization strategy in severe coronary artery disease (CAD),
including left main disease and/or multivessel disease. Several
meta-analyses have analyzed the results at 5-year follow-up but there are
no results after the fifth year. We conducted a systematic review and
meta-analysis of randomized clinical trials, comparing results after the
fifth year, between coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) using drug-eluting stents in
patients with severe CAD. <br/>METHOD(S): We analyzed all clinical trials
between January 2010 and January 2023. The primary endpoint was all-cause
mortality. The databases of the original articles were reconstructed from
Kaplan-Meier curves, simulating an individual-level meta-analysis.
Comparisons were made at certain cutoff points (5 and 10 years). The
10-year restricted median survival time difference between CABG and PCI
was calculated. The random effects model and the DerSimonian-Laird method
were applied. <br/>RESULT(S): The meta-analysis included 5180 patients.
During the 10-year follow-up, PCI showed a higher overall incidence of
all-cause mortality (HR, 1.19; 95%, 1.04-1.32; P = .008)]. PCI showed an
increased risk of all-cause mortality within 5 years (HR, 1.2; 95%CI,
1.06-1.53; P =.008), while no differences in the 5-10-year period were
revealed (HR, 1.03; 95%CI, 0.84-1.26; P=.76). Life expectancy of CABG
patients was slightly higher than that of PCI patients (2.4months more).
<br/>CONCLUSION(S): In patients with severe CAD, including left main
disease and/or multivessel disease, there was higher a incidence of
all-cause mortality after PCI compared with CABG at 10 years of follow-up.
Specifically, PCI has higher mortality during the first 5 years and
comparable risk beyond 5 years.<br/>Copyright &#xa9; 2023 Sociedad
Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights
reserved.

<91>
Accession Number
642461579
Title
Influence of Baseline Diastolic Blood Pressure on the Effects of Intensive
Blood Pressure Lowering: Results From the STEP Randomized Trial.
Source
Hypertension (Dallas, Tex. : 1979). (no pagination), 2023. Date of
Publication: 10 Oct 2023.
Author
Yang R.; Huang R.; Zhang L.; Li D.; Luo J.; Cai J.
Institution
(Yang, Cai) Hypertension Center, Fuwai Hospital, State Key Laboratory of
Cardiovascular Disease, National Center for Cardiovascular Diseases,
Peking Union Medical College & Chinese Academy of Medical Sciences, China
(R.Y., Beijing, China
(Huang) Department of Cardiology, First Affiliated Hospital of Guangxi
Medical University, China (R.H.), Nanning, China
(Zhang) Department of Cardiology, Shanxi Cardiovascular Hospital, China
(L.Z.), Taiyuan, China
(Li) Department of Cardiology, Wuxiang People's Hospital, China (D.L.),
Changzhi, China
(Luo) Department of Cardiology, Huizhou Municipal Central Hospital, China
(J.L.), China
Abstract
BACKGROUND: The STEP (Strategy of Blood Pressure Intervention in the
Elderly Hypertensive Patients) trial demonstrated that intensive systolic
blood pressure (SBP) lowering has cardiovascular benefits. However, the
influence of baseline diastolic blood pressure (DBP) on the effects of
intensive blood pressure lowering on cardiovascular outcomes has not been
fully elucidated. <br/>METHOD(S): We performed a post hoc analysis of the
STEP trial. Participants were randomly allocated to intensive (110 to <130
mmHg) or standard (130 to <150 mmHg) treatment groups. The effects of
intensive SBP lowering on the primary composite outcome (stroke, acute
coronary syndrome, acute decompensated heart failure, coronary
revascularization, atrial fibrillation, and cardiovascular death), major
adverse cardiac event (a composite of the individual components of the
primary outcome except for stroke), and all-cause mortality were analyzed
according to baseline DBP as both a categorical and a continuous variable.
<br/>RESULT(S): The 8259 participants had a mean age of 66.2+/-4.8 years,
and 46.5% were men. Participants with lower DBP were slightly older and
had greater histories of cardiovascular disease, diabetes, and
hyperlipidemia. Within each baseline DBP quartile, the mean achieved DBP
was lower in the intensive versus standard group. The effects of intensive
SBP lowering were not modified by baseline DBP as a continuous variable or
as a categorical variable (quartiles, or <70, 70 to <80, and >=80 mmHg;
all P value for interaction >0.05). <br/>CONCLUSION(S): The beneficial
effects of intensive SBP lowering on cardiovascular outcomes were
unaffected by baseline DBP. Lower DBP should not be an obstacle to
intensive SBP control. REGISTRATION: URL: https://www. CLINICALTRIALS:
gov; Unique identifier: NCT03015311.

<92>
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.

<93>
[Use Link to view the full text]
Accession Number
2028057289
Title
Effect of Glutamine Administration After Cardiac Surgery on Kidney Damage
in Patients at High Risk for Acute Kidney Injury: A Randomized Controlled
Trial.
Source
Anesthesia and Analgesia. 137(5) (pp 1029-1038), 2023. Date of
Publication: 01 Nov 2023.
Author
Weiss R.; Meersch M.; Gerke M.; Wempe C.; Schafers M.; Kellum J.A.;
Zarbock A.
Institution
(Weiss, Meersch, Gerke, Wempe, Zarbock) Department of Anesthesiology,
Intensive Care and Pain Medicine, University Hospital Munster, Munster,
Germany
(Schafers) Department of Nuclear Medicine, University Hospital Munster,
Munster, Germany
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication after
cardiac surgery and is associated with increased morbidity and mortality.
However, no specific treatment options are available, emphasizing the need
for preventive measures. The aim of this study was to clarify the effect
of glutamine on [TIMP2]*[IGFBP7] levels at the end of the intervention
period. <br/>METHOD(S): In a randomized clinical, double-blind pilot
study, 64 eligible cardiac surgery patients at high risk for AKI
identified by high urinary [TIMP2]*[IGFBP7] were randomized, and body
weight-adapted intravenous glutamine or saline-control was administered
continuously for 12 hours postoperatively. The primary outcome was urinary
[TIMP2]*[IGFBP7] at the end of the 12-hour study period. Secondary
outcomes included kidney injury molecule-1 (KIM-1) and neutrophil
gelatinase-associated lipocalin (NGAL) at 12 hours, overall AKI rates at
72 hours, free days through day 28 of mechanical ventilation and
vasoactive medication, renal recovery at day 90, requirement of renal
replacement therapy and mortality each at days 30, 60, and 90, length of
intensive care unit (ICU) and hospital stay, and major adverse kidney
events consisting of mortality, dialysis dependency, and persistent renal
dysfunction (serum creatinine >=2x compared to baseline value) at day 90
(major adverse kidney event; MAKE<inf>90</inf>). <br/>RESULT(S):
Sixty-four patients (mean age, 68.38 [standard deviation {SD} +/- 10.48]
years; 10 of 64 women) were enrolled and randomized. Patients received
coronary artery bypass graft surgery (32/64), valve surgery (18/64),
coronary artery bypass graft and valve surgery (6/64), or other procedures
(8/64). Mean on-pump time was 68.38 (standard deviation +/- 10.48)
minutes. After glutamine administration, urinary [TIMP-2]*[IGFBP7] was
significantly lower in the glutamine compared to the control group
(primary end point, intervention: median, 0.18 [Q1, Q3; 0.09, 0.29],
controls: median, 0.44 [Q1, Q3; 0.14, 0.79]; P =.01). In addition, [KIM-1]
and [NGAL] were also significantly lower in the glutamine group. The
overall AKI rate within 72 hours was not different among groups:
(intervention 11/31 [35.5%] versus control 8/32 [25.0%]; P =.419; relative
risk [RR], 0.86% [95% confidence interval {CI}, 0.62-1.20]). There were no
differences regarding secondary end points. <br/>CONCLUSION(S): Glutamine
significantly decreased markers of kidney damage in cardiac surgery
patients at high risk for AKI. Future trials have to be performed to
investigate whether the administration of glutamine might be able to
reduce the occurrence of AKI after cardiac surgery.<br/>Copyright &#xa9;
2023 International Anesthesia Research Society.

<94>
Accession Number
2028039059
Title
Mavacamten in Patients with Hypertrophic Cardiomyopathy Referred for
Septal Reduction: Week 56 Results from the VALOR-HCM Randomized Clinical
Trial.
Source
JAMA Cardiology. 8(10) (pp 968-977), 2023. Date of Publication: 11 Oct
2023.
Author
Desai M.Y.; Owens A.; Wolski K.; Geske J.B.; Saberi S.; Wang A.; Sherrid
M.; Cremer P.C.; Lakdawala N.K.; Tower-Rader A.; Fermin D.; Naidu S.S.;
Smedira N.G.; Schaff H.; McErlean E.; Sewell C.; Mudarris L.; Gong Z.;
Lampl K.; Sehnert A.J.; Nissen S.E.
Institution
(Desai, Smedira) The Hypertrophic Cardiomyopathy Center, Heart Vascular
and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Desai, Wolski, Cremer, McErlean, Sewell, Nissen) Department of
Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland
Clinic, Cleveland, OH, United States
(Desai, Wolski, Cremer, McErlean, Sewell, Nissen) Coordinating Center for
Clinical Research Heart Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Owens) Division of Cardiology, University of Pennsylvania, Philadelphia,
United States
(Geske) Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN,
United States
(Saberi) Department of Internal Medicine, University of Michigan, Ann
Arbor, United States
(Wang) Department of Cardiology, Duke University, Durham, NC, United
States
(Sherrid) Department of Cardiology, New York University, New York, United
States
(Lakdawala) Division of Cardiology, Brigham and Women's Hospital, Boston,
MA, United States
(Tower-Rader) Division of Cardiology, Massachusetts General Hospital,
Boston, United States
(Fermin) Department of Cardiology, Corewell Health, Grand Rapids, MI,
United States
(Naidu) Department of Cardiology, Westchester Medical Center, Valhalla,
NY, United States
(Smedira) Department of Cardiothoracic Surgery, Heart Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
United States
(Mudarris, Gong, Lampl, Sehnert) Bristol Myers Squibb, Princeton, NJ,
United States
Publisher
American Medical Association
Abstract
Importance: There is an unmet need for novel medical therapies before
recommending invasive therapies for patients with severely symptomatic
obstructive hypertrophic cardiomyopathy (HCM). Mavacamten has been shown
to improve left ventricular outflow tract (LVOT) gradient and symptoms and
may thus reduce the short-term need for septal reduction therapy (SRT).
<br/>Objective(s): To examine the cumulative longer-term effect of
mavacamten on the need for SRT through week 56. <br/>Design, Setting, and
Participant(s): This was a double-blind, placebo-controlled, multicenter,
randomized clinical trial with placebo crossover at 16 weeks, conducted
from July 2020 to November 2022. Participants were recruited from 19 US
HCM centers. Included in the trial were patients with obstructive HCM (New
York Heart Association class III/IV) referred for SRT. Study data were
analyzed April to August 2023. <br/>Intervention(s): Patients initially
assigned to mavacamten at baseline continued the drug for 56 weeks, and
patients taking placebo crossed over to mavacamten from week 16 to week 56
(40-week exposure). Dose titrations were performed using echocardiographic
LVOT gradient and LV ejection fraction (LVEF) measurements. Main Outcome
and Measure: Proportion of patients undergoing SRT, remaining guideline
eligible or unevaluable SRT status at week 56. <br/>Result(s): Of 112
patients with highly symptomatic obstructive HCM, 108 (mean [SD] age, 60.3
[12.5] years; 54 male [50.0%]) qualified for the week 56 evaluation. At
week 56, 5 of 56 patients (8.9%) in the original mavacamten group (3
underwent SRT, 1 was SRT eligible, and 1 was not SRT evaluable) and 10 of
52 patients (19.2%) in the placebo crossover group (3 underwent SRT, 4
were SRT eligible, and 3 were not SRT evaluable) met the composite end
point. A total of 96 of 108 patients (89%) continued mavacamten long term.
Between the mavacamten and placebo-to-mavacamten groups, respectively,
after 56 weeks, there was a sustained reduction in resting (mean
difference, -34.0 mm Hg; 95% CI, -43.5 to -24.5 mm Hg and -33.2 mm Hg; 95%
CI, -41.9 to -24.5 mm Hg) and Valsalva (mean difference, -45.6 mm Hg; 95%
CI, -56.5 to -34.6 mm Hg and -54.6 mm Hg; 95% CI, -66.0 to -43.3 mm Hg)
LVOT gradients. Similarly, there was an improvement in NYHA class of 1 or
higher in 51 of 55 patients (93%) in the original mavacamten group and in
37 of 51 patients (73%) in the placebo crossover group. Overall, 12 of 108
patients (11.1%; 95% CI, 5.87%-18.60%), which represents 7 of 56 patients
(12.5%) in the original mavacamten group and 5 of 52 patients (9.6%) in
the placebo crossover group, had an LVEF less than 50% (2 with LVEF <=30%,
one of whom died), and 9 of 12 patients (75%) continued treatment.
<br/>Conclusions and Relevance: Results of this randomized clinical trial
showed that in patients with symptomatic obstructive HCM, mavacamten
reduced the need for SRT at week 56, with sustained improvements in LVOT
gradients and symptoms. Although this represents a useful therapeutic
option, given the potential risk of LV systolic dysfunction, there is a
continued need for close monitoring. Trial Registration:
ClinicalTrials.gov Identifier: NCT04349072.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<95>
[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.

<96>
[Use Link to view the full text]
Accession Number
2027059965
Title
Pitavastatin to Prevent Cardiovascular Disease in HIV Infection.
Source
New England Journal of Medicine. 389(8) (pp 687-699), 2023. Date of
Publication: 2023.
Author
Grinspoon S.K.; Fitch K.V.; Zanni M.V.; Fichtenbaum C.J.; Umbleja T.;
Aberg J.A.; Overton E.T.; Malvestutto C.D.; Bloomfield G.S.; Currier J.S.;
Martinez E.; Roa J.C.; Diggs M.R.; Fulda E.S.; Paradis K.; Wiviott S.D.;
Foldyna B.; Looby S.E.; Desvigne-Nickens P.; Alston-Smith B.; Leon-Cruz
J.; McCallum S.; Hoffmann U.; Lu M.T.; Ribaudo H.J.; Douglas P.S.
Institution
(Grinspoon, Fitch, Zanni, Diggs, Fulda, Looby, McCallum) The Metabolism
Unit, United States
(Paradis, Foldyna, Lu) The Cardiovascular Imaging Research Center,
Department of Radiology, United States
(Looby) The Yvonne L. Munn Center for Nursing Research, United States
(Umbleja, Leon-Cruz, Ribaudo) Massachusetts General Hospital, Harvard
Medical School, The Center for Biostatistics in AIDS Research, Harvard
T.H. Chan School of Public Health, United States
(Wiviott) The Thrombolysis in Myocardial Infarction Study Group,
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical
School, United States
(Fichtenbaum) The Division of Infectious Diseases, University of
Cincinnati College of Medicine, Cincinnati, United States
(Malvestutto) The Division of Infectious Diseases, Ohio State University
Medical Center, Columbus, United States
(Aberg) The Division of Infectious Diseases, Icahn School of Medicine at
Mount Sinai, New York, United States
(Overton) The Division of Infectious Diseases, University of Alabama at
Birmingham, Birmingham, United States
(Bloomfield) The Department of Medicine, Duke Global Health Institute,
Duke Clinical Research Institute, Duke University, United States
(Douglas) Duke University Research Institute, Duke University School of
Medicine, Durham, NC, United States
(Currier) The Division of Infectious Diseases, David Geffen School of
Medicine, University of California, Los Angeles, Los Angeles, United
States
(Martinez) The Infectious Diseases Service, Hospital Clinic, University of
Barcelona, Barcelona, CIBER de Enfermedades Infecciosas, Instituto de
Salud Carlos III, Madrid, Spain
(Roa) DLH, Silver Spring, United States
(Desvigne-Nickens) The Division of Cardiovascular Sciences, National
Heart, Lung, and Blood Institute, United States
(Alston-Smith) The Division of AIDS, National Institute of Allergy and
Infectious Diseases, United States
(Hoffmann) National Institutes of Health, Bethesda, MD, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND The risk of cardiovascular disease is increased among persons
with human immunodeficiency virus (HIV) infection, so data regarding
primary prevention strategies in this population are needed. METHODS In
this phase 3 trial, we randomly assigned 7769 participants with HIV
infection with a low-to-moderate risk of cardiovascular disease who were
receiving antiretroviral therapy to receive daily pitavastatin calcium (at
a dose of 4 mg) or placebo. The primary outcome was the occurrence of a
major adverse cardiovascular event, which was defined as a composite of
cardiovascular death, myocardial infarction, hospitalization for unstable
angina, stroke, transient ischemic attack, peripheral arterial ischemia,
revascularization, or death from an undetermined cause. RESULTS The median
age of the participants was 50 years (interquartile range, 45 to 55); the
median CD4 count was 621 cells per cubic millimeter (interquartile range,
448 to 827), and the HIV RNA value was below quantification in 5250 of
5997 participants (87.5%) with available data. The trial was stopped early
for efficacy after a median follow-up of 5.1 years (interquartile range,
4.3 to 5.9). The incidence of a major adverse cardiovascular event was
4.81 per 1000 person-years in the pitavastatin group and 7.32 per 1000
person-years in the placebo group (hazard ratio, 0.65; 95% confidence
interval [CI], 0.48 to 0.90; P=0.002). Muscle-related symptoms occurred in
91 participants (2.3%) in the pitavastatin group and in 53 (1.4%) in the
placebo group; diabetes mellitus occurred in 206 participants (5.3%) and
in 155 (4.0%), respectively. CONCLUSIONS Participants with HIV infection
who received pitavastatin had a lower risk of a major adverse
cardiovascular event than those who received placebo over a median
follow-up of 5.1 years. (Funded by the National Institutes of Health and
others; REPRIEVE ClinicalTrials.gov number, NCT02344290.).<br/>Copyright
&#xa9; 2023 Massachusetts Medical Society.

<97>
Accession Number
2026316864
Title
An Unusual Case of a Double Tricuspid and Mitral Valves Infective
Endocarditis Complicated by Multiple Septic Embolisms Secondary to an
Atrial Septal Defect: A Case Report and Review of Literature.
Source
Infectious Disease Reports. 15(5) (pp 494-503), 2023. Date of Publication:
October 2023.
Author
Monari C.; Molinari D.; Cornelli A.; Alessio L.; Coppolino F.; Barbareschi
C.; De Pascalis S.; Torella M.; Cimmino G.; De Feo M.; Coppola N.;
Formisano T.
Institution
(Monari, Cornelli, Alessio, De Pascalis, Coppola) Infectious Diseases
Unit, Department of Mental Health and Public Medicine, Section of
Infectious Diseases, University of Campania Luigi Vanvitelli, Via L.
Armanni 5, Naples 80131, Italy
(Molinari, Barbareschi, Cimmino, Formisano) Cardiology Unit, Azienda
Ospedaliera Universitaria Luigi Vanvitelli, Piazza Miraglia 2, Naples
80138, Italy
(Coppolino) Department of Women, Child and General and Specialized
Surgery, Section of Anaesthesiology, University of Campania Luigi
Vanvitelli, Piazza Miraglia 2, Naples 80138, Italy
(Torella, De Feo) Department of Translational Medical Sciences, Section of
Cardiac Surgery and Heart Transplant, University of Campania Luigi
Vanvitelli, via L. Bianchi c/o Ospedale Monaldi, Naples 80131, Italy
(Cimmino) Department of Translational Medical Sciences, Section of
Cardiology, University of Campania Luigi Vanvitelli, via L. Bianchi c/o
Ospedale Monaldi, Naples 80131, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Multivalvular endocarditis (MVE) is an uncommon infection that mostly
involves mitral and aortic valves, and it is related to a higher risk of
congestive heart failure and a higher mortality. We described a case of a
bilateral MVE and performed a review of the literature on similar clinical
cases. We reported an unusual case of a 68-year-old male patient with a
tricuspid and mitral infective endocarditis due to a methicillin-resistant
Staphylococcus aureus complicated by multiple right- and left-sided septic
embolization (lungs, brain, spleen, L2-L3 vertebral bones) due to an
unknown atrial septal defect identified and repaired during cardiac
surgery. Despite the severity of the clinical case, the patient
experienced a good clinical outcome also thanks to a multidisciplinary
approach. We identified 21 case reports describing bilateral MVE. A
multidisciplinary approach is essential in the management of valve
diseases to improve the prognosis of patients, especially in bilateral
MVE.<br/>Copyright &#xa9; 2023 by the authors.

<98>
Accession Number
2024992256
Title
Influenza vaccination: Simple, safe, and effective for patients with
ischaemic heart disease and heart failure.
Source
European Journal of Heart Failure. 25(9) (pp 1693-1695), 2023. Date of
Publication: September 2023.
Author
Brennan A.C.; Campbell R.T.; Lee M.M.Y.
Institution
(Brennan, Campbell, Lee) BHF Glasgow Cardiovascular Research Centre,
School of Cardiovascular & Metabolic Health, University of Glasgow,
Glasgow, United Kingdom
Publisher
John Wiley and Sons Ltd

<99>
Accession Number
2018745007
Title
Effects of norepinephrine infusion during cardiopulmonary bypass on
perioperative changes in lactic acid level (Norcal).
Source
Perfusion (United Kingdom). 38(8) (pp 1584-1599), 2023. Date of
Publication: November 2023.
Author
Khalil M.A.; El Tahan M.R.; Khidr A.M.; Fallatah S.; Abohamar A.D.; Amer
M.M.; Makhdom F.; El Ghoneimy Y.; Al Bassam B.; Alghamdi T.; Abdulfattah
D.
Institution
(Khalil) Anesthesiology Department, College of Medicine, King Fahd
Hospital of the Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi
Arabia
(Khalil) Anesthesiology Department, College of Medicine, Cairo University,
Cairo, Egypt
(El Tahan, Khidr, Fallatah, Abohamar, Amer) Anesthesiology Department,
College of Medicine, King Fahd Hospital of the Imam Abdulrahman Bin Faisal
University, Al Khobar, Saudi Arabia
(Abohamar) Anesthesiology Department, College of Medicine, Tanta
University, Tanta, Lecturer, Egypt
(Makhdom, El Ghoneimy) Department of Surgery Cardiac Surgical Unit, King
Fahd Hospital of the Imam Abdulrahman Bin Faisal University, Al Khobar,
Saudi Arabia
(Al Bassam, Alghamdi) Demonstrator, Anesthesiology Department, College of
Medicine, King Fahd Hospital of the Imam Abdulrahman Bin Faisal
University, Al Khobar, Saudi Arabia
(Abdulfattah) Clinical Nursing Supervisor Operating Room, Day Surgery,
CSSD, Hemodialysis, and PDU, King Fahd Hospital of the Imam Abdulrahman
Bin Faisal University, Al Khobar, Saudi Arabia
Publisher
SAGE Publications Ltd
Abstract
Introduction: Hyperlactatemia, a problem reported in up to 30% of cardiac
surgery patients, results from excessive production of or decreased
clearance of lactate. It is typically a symptom of tissue hypoperfusion
and may be associated with the prevalence of postoperative acute
mesenteric ischemia and renal failure, or prolonged intensive care unit
(ICU) and hospital stay, and increased 30-day mortality. Methods and
measurements: Eighty cardiac surgery patients using cardiopulmonary bypass
(CPB) were randomly assigned into either a placebo (n = 39) or
norepinephrine 0.05-0.2 microg/kg/min (n = 41) as well as norepinephrine
boluses during CPB to maintain mean arterial blood pressure (MAP) at 65 to
80 mm Hg. Patient assignments were done after receiving ethical approval
to proceed. The primary result was the perioperative changes in lactic
acid level. Secondary findings were also recorded, including hemodynamic
variables, the incidence of vasoplegia, intraoperative hypotension,
myocardial ischemia, the need for vasopressor support, postoperative
complications, and mortality. <br/>Result(s): The peak levels and
perioperative changes in blood lactate during the first 24 postoperative
hours, the number of patients who experienced early hyperlactatemia on
admission to the ICU (Placebo: 46.2%, Norepinephrine: 51.2%, p =.650),
vasoplegia, hemodynamic changes, incidences of intraoperative hypotension,
myocardial ischemia, postoperative complications, and mortality rates were
similar in the two groups. Patients in the norepinephrine group received
lower intraoperative rescue norepinephrine boluses to maintain the target
MAP (p =.039) and had higher MAP values during the CPB and intraoperative
blood loss [mean difference [95% confidence interval]; 177 [20.9-334.3]
ml, p =.027]. <br/>Conclusion(s): norepinephrine and placebo infusions
during the CPB with the maintenance of MAP from 65 to 80 mmHg had
comparative effects on the changes in blood lactate and incidence of
vasoplegia after cardiac surgery. Norepinephrine infusion maintained
higher MAP values during the CPB.<br/>Copyright &#xa9; The Author(s) 2022.

<100>
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

<101>
Accession Number
2027698912
Title
Associations of Inflammatory Biomarkers With the Risk of Morbidity and
Mortality After Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. 39(11) (pp 1686-1694), 2023. Date of
Publication: November 2023.
Author
Heo R.H.; Wang M.K.; Meyre P.B.; Birchenough L.; Park L.; Vuong K.;
Devereaux P.J.; Blum S.; Lindahl B.; Stone G.; Conen D.
Institution
(Heo) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Heo, Wang, Devereaux, Blum, Conen) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Wang, Devereaux, Conen) Department of Health Research Methods, Evidence,
and Impact, McMaster University, Hamilton, ON, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Basel, Switzerland
(Birchenough, Park) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Vuong) Faculty of Health Sciences, Western University, London, ON, Canada
(Lindahl) Department of Medical Sciences, Uppsala University and Uppsala
Clinical Research Center, Uppsala, Sweden
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Stone) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although inflammatory biomarkers have been associated with
cardiovascular events in nonsurgical settings, these associations have not
been systematically addressed in patients undergoing cardiac surgery. This
review aimed to evaluate the relationships of inflammatory markers with
mortality and adverse cardiovascular events in patients undergoing cardiac
surgery. <br/>Method(s): Medline, Embase, and Central databases were
systematically searched for studies reporting pre- or postoperative levels
of inflammatory biomarkers in patients undergoing cardiac surgery.
Outcomes of interest were postoperative mortality, nonfatal myocardial
infarction, stroke, congestive heart failure, and major adverse
cardiovascular events (MACE). Studies reporting multivariable adjusted
risk estimates were included. Risk estimates were pooled with the use of
random-effects models and reported as summary odds ratios (ORs).
<br/>Result(s): Among 14,465 citations identified, 29 studies including
29,401 participants met the eligibility criteria. The average follow-up
time after surgery was 31 months. Preoperative C-reactive protein (CRP)
levels were associated with an increased risk of all-cause mortality (OR
1.88, 95% CI 1.60-2.20; I² = 19%; 11 studies) and MACE (OR
1.73, 95% CI 1.34-2.24; I² = 0%; 3 studies). CRP levels
measured on postoperative day 6 (OR 7.4, 95% CI 2.90-18.88, 1 study) and
day 10 (OR 11.8, 95% CI 3.50-39.78, 1 study) were associated with a higher
risk of all-cause mortality. Less, but overall similar, information was
available for other inflammatory biomarkers. <br/>Conclusion(s): In this
large meta-analysis, inflammatory biomarkers measured before or after
cardiac surgery were associated with mortality and adverse cardiovascular
outcomes in patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2023
Canadian Cardiovascular Society

<102>
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.

<103>
Accession Number
642662027
Title
Common Genetic Variants Associated with SERPINA6 Expression in Liver
Influence Cortisol-Responsive Transcriptional Networks in Human Adipose
Tissue.
Source
Journal of the Endocrine Society. Conference: Annual Meeting of the
Endocrine Society, ENDO 2020. San Francisco, CA United States.
4(Supplement 1) (pp A159-A160), 2020. Date of Publication: April - May
2020.
Author
Bankier S.A.; Crawford A.A.; Wang L.; Sukhavasi K.; Ermel R.; Andrew R.;
Ruusalepp A.; Timpson N.J.; Smith G.D.; Bjorkegren J.L.M.; Walker B.R.;
Michoel T.
Institution
(Bankier, Wang, Andrew, Walker) University of Edinburgh, Edinburgh, United
Kingdom
(Crawford, Timpson, Smith) University of Bristol, Bristol, United Kingdom
(Sukhavasi, Ermel, Ruusalepp) Tartu University Hospital, Tartu, Estonia
(Bjorkegren) Karolinska Institutet, Stockholm, Sweden
(Michoel) University of Bergen, Bergen, Norway
Publisher
Endocrine Society
Abstract
A genome wide meta-analysis by the CORtisol NETwork (CORNET) consortium(1)
has identified genetic variants spanning the SERPINA6/SERPINA1 locus on
chromosome 14, associated with morning plasma cortisol and predictive of
cardiovascular disease (Crawford et al, Unpublished). SERPINA6 encodes
Corticosteroid Binding Globulin (CBG), responsible for binding most
cortisol in blood and putatively mediating delivery of cortisol to target
tissues. We hypothesised that genetic variants in SERPINA6 influence CBG
expression in liver and cortisol delivery to extra-hepatic tissues,
influencing cortisol-regulated gene expression. The Stockholm Tartu
Atherosclerosis Reverse Networks Engineering Task study (STARNET)(2)
provides RNA sequencing data in 9 vascular and metabolic tissues from 600
genotyped individuals (mean age 65.8, 70.3% male) undergoing coronary
artery bypass grafting. We used STARNET to identify SNPs associated with
plasma cortisol at genome wide significance in CORNET as cis-eQTLs for
SERPINA6 in liver and as trans-eQTLs for the expression of genes across
STARNET tissues. Causal inference methodologies(3) were then employed for
the network reconstruction of these trans-genes and their downstream
targets. We identified 21 SNPs that both were associated with cortisol at
genome wide significance in CORNET (p <= 5x10^-8) and were
cis-eQTLs for SERPINA6 expression in liver (q <= 0.05). Moreover, these
SNPs were trans-eQTLs for sets of genes in liver, subcutaneous and
visceral abdominal adipose tissue, with over-representation of known
glucocorticoidregulated genes in adipose. The highest confidence gene
network identified was specific to subcutaneous adipose, with the
interferon regulatory trans-gene, IRF2, controlling a putative
glucocorticoid-regulated network. Targets in this network include LDB2 and
LIPA, both associated with coronary artery disease. We conclude that
variants in the SERPINA6/SERPINA1 locus mediate their effect on plasma
cortisol through variation in SERPINA6 expression in liver, and in turn
affect gene expression in extra-hepatic tissues through modulating
cortisol delivery. This supports a dynamic role for CBG in modulating
cortisol delivery to tissues. The cortisol-responsive gene networks
identified here represent candidate pathways to mediate cardiovascular
risk attributable to elevated cortisol.

<104>
Accession Number
2027752594
Title
A comparison of neurological event and mortality rates between
transcatheter aortic valve implantation and surgical aortic valve
replacement.
Source
Postepy w Kardiologii Interwencyjnej. 19(3) (pp 202-208), 2023. Date of
Publication: 2023.
Author
Yuan S.-M.; Yuan A.-H.
Institution
(Yuan) The First Hospital of Putian, Teaching Hospital, Fujian Medical
University, Putian, China
(Yuan) Department of Anesthesiology, The First Clinical College, China
Medical University, Shenyang, China
(Yuan) Department of Anesthesiology, The First Clinical College, China
Medical University, No. 92, North Second Road, Taiyuan Street, Heping
District, Liaoning Province, Shenyang, China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is the
treatment of choice for patients with symptomatic severe aortic stenosis.
<br/>Aim(s): To evaluate the neurological event and mortality rates of
TAVI in comparison with those of surgical aortic valve replacement (SAVR).
<br/>Material(s) and Method(s): A systematic literature search identified
pertinent full-text journal articles published from 2000 to 2022 that were
taken as the study materials. <br/>Result(s): Patients were at the age of
79.3 +/-2.8 years and 79.9 +/-2.9 years at the time of intervention/open
surgery in the TAVI and SAVR groups, respectively. Patients' age and
preoperative comorbidity rates were similar in both groups. A
self-expanding valve prosthesis and a percutaneous transfemoral route were
the most commonly used in patients receiving TAVI. The duration of the
procedure and the hospital stay were much shorter, and the number of
transfused blood units was much lower in the TAVI group than in the SAVR
group. No significant intergroup difference was found in the prevalence of
postoperative stroke, 1-month all-cause mortality, and 1-month and 1-year
cardiovascular mortality rates. However, 1-year all-cause mortality was
much lower in the TAVI than the SAVR group. The subgroups of risk
stratification showed better outcomes for non-high-risk patients compared
with high-risk patients. <br/>Conclusion(s): Irrespective of other
postoperative complications of TAVI, this study emphasizes the
postoperative major neurological events and mortality. TAVI appears to be
superior to SAVR with regard to 1-year all-cause mortality. TAVI is thus
recommended for elderly patients with symptomatic severe aortic stenosis
at very high surgical risk contraindicated for SAVR.<br/>Copyright &#xa9;
2023 Termedia Publishing House Ltd.. All rights reserved.

<105>
Accession Number
2026406355
Title
Melatonin and Cardioprotection in Humans: A Systematic Review and
Meta-Analysis of Randomized Controlled Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 635083. Date of Publication: 2021.
Author
Dominguez-Rodriguez A.; Abreu-Gonzalez P.; Baez-Ferrer N.; Reiter R.J.;
Avanzas P.; Hernandez-Vaquero D.
Institution
(Dominguez-Rodriguez, Baez-Ferrer) Hospital Universitario de Canarias,
Servicio de Cardiologia, Tenerife, Spain
(Dominguez-Rodriguez) Departamento de Enfermeria, Facultad de Ciencias de
la Salud, Universidad de La Laguna Tenerife, San Cristobal de La Laguna,
Spain
(Abreu-Gonzalez) Departamento de Fisiologia, Facultad de Medicina,
Universidad de La Laguna, Tenerife, San Cristobal de La Laguna, Spain
(Reiter) Department of Cell Systems and Anatomy UT Health San Antonio,
Long School of Medicine, San Antonio, TX, United States
(Avanzas, Hernandez-Vaquero) Area del Corazon, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Avanzas, Hernandez-Vaquero) Instituto de Investigacion Sanitaria del
Principado de Asturias, Oviedo, Spain
Publisher
Frontiers Media SA
Abstract
Myocardial ischemia/reperfusion (IR) injury represents a critical problem
associated with interventional approaches for coronary reperfusion.
Pharmacological cardioprotective interventions are advocated to ameliorate
IR injury. Melatonin is an anti-inflammatory and antioxidant agent with a
wide range of therapeutic properties that may contribute to its
cardioprotective effects. No systematic review or meta-analysis has
compared melatonin vs. placebo as a cardioprotective agent in humans. The
present study, based on a systematic review and meta-analysis, was carried
out to assess melatonin's efficacy as a cardioprotective treatment. We
performed a systematic review of the available literature. Randomized
controlled trials (RCTs) were identified and information was extracted
using predefined data extraction forms. The primary outcomes were (a) left
ventricular ejection fraction (LVEF) and (b) blood troponin levels in
patients who underwent myocardial revascularization and were randomized to
melatonin or placebo. The inverse-variance random-effects method was used
to pool the estimates. Heterogeneity and publication bias were assessed.
Weighted mean differences or standardized mean differences were
calculated. A total of 283 records were screened and seven RCTs met all
the inclusion criteria. After the pooled analysis, the results on LVEF
were consistent across all studies, and a significant heterogeneity was
found in the results on troponin levels. The melatonin-treated patients
had on average higher LVEF than the placebo-treated individuals with a
weighted mean difference = 3.1% (95% CI 0.6-5.5, p = 0.01). Five works
compared the levels of troponin after melatonin or placebo treatment. The
melatonin-treated patients had lower levels of troponin with a
standardized mean difference = -1.76 (95% CI -2.85 to -0.67, p = 0.002).
The findings of this meta-analysis revealed that melatonin administration
in humans as a cardioprotective agent attenuated heart dysfunction with a
favorable effect on the LVEF.<br/>Copyright &#xa9; 2021
Dominguez-Rodriguez, Abreu-Gonzalez, Baez-Ferrer, Reiter, Avanzas and
Hernandez-Vaquero.

<106>
Accession Number
2026406304
Title
N-Acetylcysteine for Cardiac Protection During Coronary Artery
Reperfusion: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 752939. Date of Publication: 2021.
Author
Khan S.A.; Campbell A.M.; Lu Y.; An L.; Alpert J.S.; Chen Q.M.
Institution
(Khan, Campbell, Chen) Department of Pharmacy Practice and Science,
College of Pharmacy, University of Arizona, Tucson, AZ, United States
(Lu) Graduate Interdisciplinary Program in Statistics and Data Science,
University of Arizona, Tucson, AZ, United States
(An) Department of Biosystems Engineering, College of Agriculture and Life
Sciences, University of Arizona, Tucson, AZ, United States
(An) Department of Epidemiology and Biostatistics, Mel & Enid Zuckerman
College of Public Health, University of Arizona, Tucson, AZ, United States
(Alpert) Department of Medicine and the Sarver Heart Center, University of
Arizona College of Medicine, Tucson, AZ, United States
Publisher
Frontiers Media SA
Abstract
Coronary artery reperfusion is essential for the management of symptoms in
the patients with myocardial ischemia. However, the benefit of reperfusion
often comes at an expense of paradoxical injury, which contributes to the
adverse events, and sometimes heart failure. Reperfusion is known to
increase the production of reactive oxygen species (ROS). We address
whether N-acetylcysteine (NAC) reduces the ROS and alleviates reperfusion
injury by improving the clinical outcomes. A literature search for the
randomized controlled trials (RCTs) was carried out in the five biomedical
databases for testing the effects of NAC in patients undergoing coronary
artery reperfusion by percutaneous coronary intervention, thrombolysis, or
coronary artery bypass graft. Of 787 publications reviewed, 28 RCTs were
identified, with a summary of 2,174 patients. A meta-analysis using the
random effects model indicated that NAC administration during or prior to
the reperfusion procedures resulted in a trend toward a reduction in the
level of serum cardiac troponin (cTn) [95% CI, standardized mean
difference (SMD) -0.80 (-1.75; 0.15), p = 0.088, n = 262 for control, 277
for NAC group], and in the incidence of postoperative atrial fibrillation
[95% CI, relative risk (RR) 0.57 (0.30; 1.06), p = 0.071, n = 484 for
control, 490 for NAC group]. The left ventricular ejection fraction or the
measures of length of stay in intensive care unit (ICU) or in hospital
displayed a positive trend that was not statistically significant. Among
the nine trials that measured ROS, seven showed a correlation between the
reduction of lipid peroxidation and improved clinical outcomes. These
lines of evidence support the potential benefit of NAC as an adjuvant
therapy for cardiac protection against reperfusion injury.<br/>Copyright
&#xa9; 2021 Khan, Campbell, Lu, An, Alpert and Chen.

<107>
Accession Number
2026405937
Title
Design Variation, Implantation, and Outcome of Transcatheter Mitral Valve
Prosthesis: A Comprehensive Review.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 782278. Date of Publication: 2021.
Author
Sazzad F.; Hon J.K.F.; Ramanathan K.; Nah J.H.; Ong Z.X.; Ti L.K.; Foo R.;
Tay E.; Kofidis T.
Institution
(Sazzad, Ramanathan, Nah, Ong, Ti, Foo, Kofidis) Yong Loo Lin School of
Medicine, National University of Singapore, Singapore, Singapore
(Sazzad, Hon, Ramanathan, Kofidis) Department of Cardiac, Thoracic and
Vascular Surgery, National University Hospital, Singapore, Singapore
(Sazzad, Foo, Kofidis) Cardiovascular Disease Translational Research
Programme, Centre for Translational Medicine, National University of
Singapore, Singapore, Singapore
(Hon, Ramanathan, Ti, Foo, Tay, Kofidis) National University Heart Centre,
National University Health System, Singapore, Singapore
(Tay) Asian Heart & Vascular Centre (AHVC), Mount Elizabeth Medical
Centre, Singapore, Singapore
Publisher
Frontiers Media SA
Abstract
The transcatheter mitral valve prosthesis is ideally suited for patients
with inoperable mitral etiology. The transcatheter mitral valve
implantation (TMVI) procedure has closely followed the evolution of
transcatheter aortic procedures. There are considerable design variations
amongst the limited TMVI prostheses currently available, and the
implantation profiles of the devices are notably different. This
comprehensive review will provide an overview of the current clinically
tried TMVI devices with a focused outcome analysis. In addition, we have
discussed the various design characteristics of TMVI and its associated
failure mode, implantation technology, delivery methods, first-in-man
trials, and pivotal trial summary for the synthesis of recent evidence.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255241,
identifier: CRD42021255241.<br/>Copyright &#xa9; 2022 Sazzad, Hon,
Ramanathan, Nah, Ong, Ti, Foo, Tay and Kofidis.

<108>
Accession Number
2026405926
Title
Comparison of the Direct Oral Anticoagulants and Warfarin in Patients With
Atrial Fibrillation and Valvular Heart Disease: Updated Systematic Review
and Meta-Analysis of Randomized Controlled Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 712585. Date of Publication: 2021.
Author
Bitar Y.D.S.L.; Duraes A.R.; Roever L.; Gomes Neto M.; Lins-Kusterer L.;
Bocchi E.A.
Institution
(Bitar, Duraes, Gomes Neto, Lins-Kusterer) Post-graduate Program in
Medicine and Health (PPgMS), Federal University of Bahia (UFBA), Salvador,
Brazil
(Bitar, Duraes, Gomes Neto, Lins-Kusterer) Federal University of Bahia,
UFBA, Salvador, Brazil
(Roever) Federal University of Uberlandia, Uberlandia, Brazil
(Bocchi) University of Sao Paulo Medical School, HCFMUSP, Sao Paulo,
Brazil
(Bocchi) Heart Institute, InCor, Sao Paulo, Brazil
Publisher
Frontiers Media SA
Abstract
Background: Direct oral anticoagulants (DOACS) are approved for use in
non-valvular atrial fibrillation (AF). This systematic review and
meta-analysis aimed to evaluate the efficacy and safety of DOACs vs.
warfarin and update the evidence for treatment of AF and valvular heart
disease (VHD). <br/>Method(s): We identified randomized clinical trials
(RCTs) and post-hoc analyses comparing the use of DOACS and Warfarin in AF
and VHD, including biological and mechanical heart valves (MHV), updating
from 2010 to 2020. Through systematic review and meta-analysis, by using
the "Rev Man" program 5.3, the primary effectiveness endpoints were stroke
and systemic embolism (SE). The primary safety outcome was major bleeding,
while the secondary outcome included intracranial hemorrhage. We performed
prespecified subgroup analyses. Data were analyzed by risk ratio (RR) and
95% confidence interval (CI) and the I-square (I²) statistic as
a quantitative measure of inconsistency. Risk of bias and methodological
quality assessment of included trials was evaluated with the modified
Cochrane risk-of-bias tool. <br/>Result(s): We screened 326 articles and
included 8 RCTs (n = 14.902). DOACs significantly reduced the risk of
stroke/SE (RR 0.80, 95% CI: 0.68-0.94; P = 0.008; moderate quality
evidence; I² = 2%) and intracranial hemorrhage (RR 0.40, 95%
CI: 0.24-0.66; P = 0.0004; I² = 49%) with a similar risk of
major bleeding (RR 0.83, 95% CI: 0.56-1.24; P = 0.36; I² = 88%)
compared to Warfarin. <br/>Conclusion(s): In this update, DOACs remained
with similar efficacy and safety compared to warfarin in
thromboprophylaxis for AF and VHD.<br/>Copyright &#xa9; 2021 Bitar,
Duraes, Roever, Gomes Neto, Lins-Kusterer and Bocchi.

<109>
Accession Number
2028222544
Title
Perioperative Implementation of Low-Dose Pregabalin in an Enhanced
Recovery After Cardiac Surgery Protocol: A Pre-Post Observational Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Patel A.; Shah A.; Apigo A.; Lin H.-M.; Ouyang Y.; Huang K.; Friedman S.;
Yimen M.; Puskas J.D.; Bhatt H.V.
Institution
(Patel, Apigo, Bhatt) Department of Anesthesiology, Perioperative and Pain
Medicine, Mount Sinai Morningside Medical Center, New York, NY, United
States
(Shah, Huang) Department of Pharmacy, Mount Sinai Morningside Medical
Center, New York, NY, United States
(Shah, Friedman, Yimen, Puskas) Department of Cardiothoracic Surgery and
Critical Care, Mount Sinai Morningside Medical Center, New York, NY,
United States
(Lin) Department of Anesthesiology, Yale School of Medicine, New Haven,
CT, United States
(Ouyang) Department of Population Health Science and Policy, Mount Sinai
Hospital, New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objectives: Determine the effect of low-dose pregabalin in the
perioperative enhanced recovery after cardiac surgery protocol.
<br/>Design(s): Pre-post observational study. <br/>Setting(s): Tertiary
care hospital. <br/>Participant(s): Patients undergoing off-pump coronary
artery bypass graft procedures. <br/>Intervention(s): Pregabalin 75 mg BID
for 48 hours postoperatively versus no pregabalin in a perioperative
setting. <br/>Measurements and Main Results: Perioperative opioid use,
pain scores, length of stay, time to extubation, and mortality were all
measured. Descriptive data were presented as mean (SD), median (IQR), or N
(%). Ordinal and continuous data used the t-test or Kruskal-Wallis test.
Categorical data were compared between groups using the chi-square test or
Fisher's exact test, as appropriate. Low-dose pregabalin administration
(75 mg twice daily for 48 hours after surgery) was associated with a
clinically significant reduction in opioid consumption on postoperative
day 0 by 30.6%, with a median requirement of 318 (233, 397) morphine
milligram equivalents (MME) in the pregabalin group compared with 458
(375, 526) MME in the control group (p < 0.001). There was no significant
difference in pain scores between the groups with the exception at 0-to-12
hours, during which the pregabalin group had greater pain scores (median
3.32 [1.65, 4.36] v 2.0 [0, 3.25], p = 0.013) (Table 3). Moreover, there
was no significant difference in pain scores on postoperative day 1 (p =
0.492), day 2 (p = 0.442), day 3 (p = 0.237), and day 4 (p = 0.649). The
difference in average Richmond Agitation Sedation Score scores was also
not statistically significant between groups at 12 hours (p = 0.954) and
at 24 hours (p = 0.301). The pregabalin group had no increased incidence
of adverse events or any significant differences in intensive care unit
length of stay, time to extubation, or mortality. <br/>Conclusion(s): In
this evaluation of perioperative pregabalin administration for patients
requiring cardiac surgery, pregabalin reduced postoperative opioid use,
with significant reductions on postoperative day 0, and without any
significant increase in adverse reactions. However, no differences in
intensive care unit length of stay, time to extubation, or mortality were
noted. The implementation of low-dose perioperative pregabalin within an
Enhanced Recovery After Cardiac Surgery protocol may be effective at
reducing postoperative opioid use in the immediate postoperative period,
and may be safe with regard to adverse events. Ideal dosing strategies
have not been determined; thus, further randomized control trials with an
emphasis on limiting confounding factors need to be
conducted.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<110>
Accession Number
2028162240
Title
A Randomized Trial Comparing One-year Hemodynamics of Two Bovine
Pericardial Valves.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 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, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul National University,
College of Medicine, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Bundang Hospital, Seoul National University, College
of Medicine, Seongnam, South Korea
Publisher
Georg Thieme Verlag
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 &#xa9; 2023 Georg Thieme Verlag. All rights
reserved.

<111>
Accession Number
2026401087
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:
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, The 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, The First Medical Centre of
Chinese PLA General Hospital, Beijing, China
Publisher
John Wiley and Sons Inc
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 65 years, 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.

<112>
Accession Number
642665709
Title
First-in-human study of the CAPTIS embolic protection system during
transcatheter aortic valve replacement.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 02 Nov 2023.
Author
Danenberg H.D.; Vaknin-Assa H.; Makkar R.; Virmani R.; Manevich L.; Codner
P.; Patel V.; Finn A.V.; Landes U.; Rubinshtein R.; Bar A.; Barnea R.;
Mezape Y.; Teichman E.; Eli S.; Weisz G.; Kornowski R.
Institution
(Danenberg, Manevich, Landes, Rubinshtein, Bar) Wolfson Medical Center,
Holon, Israel
(Danenberg, Vaknin-Assa, Manevich, Codner, Landes, Rubinshtein, Bar,
Barnea, Kornowski) Faculty of Medicine, Tel Aviv University, Ramat Aviv,
Tel Aviv, Israel
(Vaknin-Assa, Codner, Barnea, Kornowski) Beilinson Hospital, Rabin Medical
Center, Israel
(Makkar, Patel) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
(Virmani, Finn) CVPath Institute, Gaithersburg, MD, United States
(Mezape, Teichman, Eli, Weisz) CaesareaIsrael
(Weisz) NewYork-Presbyterian Hospital, Columbia University Medical Center,
New York, NY, USA
Abstract
BACKGROUND: Stroke and other clinically significant embolic complications
are well documented in the early period following transcatheter aortic
valve replacement (TAVR). The CAPTIS device is an embolic protection
system, designed to provide neurovascular and systemic protection by
deflecting debris away from the brain's circulation, capturing the debris
and thus avoiding systemic embolisation. AIMS: We aimed to study the
safety and feasibility study of the CAPTIS complete cerebral and full-body
embolic protection system during TAVR. <br/>METHOD(S): A first-in-human
study investigated the safety, feasibility and debris capturing ability of
CAPTIS during TAVR. Patients were followed for 30 days. The primary
endpoints were device safety and cerebrovascular events at 72 hours.
<br/>RESULT(S): Twenty patients underwent TAVR using balloon-expandable or
self-expanding valve systems. CAPTIS was successfully delivered,
positioned, deployed, and retrieved in all cases, and TAVR was
successfully completed without device-related complications. No
cerebrovascular events were observed. High numbers of debris particles
were captured in all patients. <br/>CONCLUSION(S): The use of the CAPTIS
full-body embolic protection system during TAVR was safe, and it captured
a substantial number of debris particles. No patient suffered from a
cerebrovascular event. A randomised clinical trial is warranted to prove
its efficacy.

<113>
Accession Number
642665183
Title
Metabolic syndrome and surgical complications: A systematic review and
meta-analysis of 13 million individuals.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 02 Nov 2023.
Author
Norris P.; Gow J.; Arthur T.; Conway A.; Fleming F.J.; Ralph N.
Institution
(Norris) School of Nursing and Midwifery, University of Southern
Queensland, Australia
(Gow) Professor, School of Commerce, University of Southern Queensland,
Toowoomba, Australia & Senior Research Associate, School of Accounting,
Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
(Arthur) Consultant General and Colorectal Surgeon, Toowoomba Hospital,
Department of Surgery and Adjunct Professor, Centre for Health Research,
University of Southern Queensland
(Conway) Senior Research Fellow, Peter Munk Cardiac Centre, Lawrence S.
Bloomberg Faculty of Nursing, University of Toronto, University Health
Network, Toronto, Canada
(Fleming) Associate Professor of Surgery and Oncology, University of
Rochester Medical Center, United States
(Ralph) School of Health, University of Sunshine Coast, Moreton Bay,
Australia
Abstract
BACKGROUND: Metabolic syndrome is characterised by the presence of at
least three of the five following components: insulin resistance, obesity,
chronic hypertension, elevated serum triglycerides and decreased
high-density lipoprotein cholesterol concentrations. It is estimated to
affect 1 in 3 people around the globe and reported to affect 46% of
surgical patients. For people with metabolic syndrome who undergo surgery,
an emerging body of literature points to significantly poorer
postoperative outcomes compared with non-affected populations. The aim of
this study is to review the current evidence on risks of surgical
complications in patients with metabolic syndrome compared to those
without metabolic syndrome. <br/>METHOD(S): Systematic review and
meta-analysis using PRISMA and AMSTAR reporting guidelines.
<br/>RESULT(S): The meta-analysis included 63 studies involving 1,919,347
patients with metabolic syndrome and 11,248,114 patients without metabolic
syndrome. Compared to individuals without the condition, individuals with
metabolic syndrome were at an increased risk of mortality (OR 1.75 95% CIs
[1.36-2.24]; P <0.01); all surgical site infection types as well as
dehiscence (OR 1.64 95% CIs [1.52 -1.77]; P <0.01); cardiovascular
complications (OR 1.56 95% CIs [1.41 -1.73]; P <0.01) including myocardial
infarction, stroke, cardiac arrest, cardiac arrythmias and deep vein
thrombosis; increased length of hospital stay (MD 0.65 95% CIs [0.39-0.9];
P <0.01); and hospital readmission (OR 1.55 95% CIs [1.41-1.71]; P <0.01).
<br/>CONCLUSION(S): Metabolic syndrome is associated with a significantly
increased risk of surgical complications including mortality, surgical
site infection, cardiovascular complications, increased length of stay and
hospital readmission. Despite these risks and the high prevalence of
metabolic syndrome in surgical populations there is a lack of evidence on
interventions for reducing surgical complications in patients with
metabolic syndrome. The authors suggest prioritising interventions across
the surgical continuum that include (1) preoperative screening for
metabolic syndrome; (2) surgical prehabilitation; (3) intraoperative
monitoring and management; and (4) postoperative rehabilitation and
follow-up.<br/>Copyright &#xa9; 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<114>
Accession Number
642664214
Title
RACE AND ETHNICITY IN CARDIAC SURGERY: A MISSED OPPORTUNITY?.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 30 Oct 2023.
Author
Elfaki L.A.; Nwakoby A.; Keshishi M.; Vervoort D.; Yanagawa B.; Fremes
S.E.
Institution
(Elfaki, Nwakoby, Keshishi) Temerty Faculty of Medicine, University of
Toronto
(Vervoort) Division of Cardiac Surgery, St. Michael's Hospital, University
of Toronto, Toronto, Ontario, Canada; Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, Ontario,
Canada; Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Ontario, Canada
(Yanagawa) Temerty Faculty of Medicine, University of Toronto; Division of
Cardiac Surgery, St. Michael's Hospital, University of Toronto, Toronto,
Ontario, Canada
(Fremes) Institute of Health Policy, Management and Evaluation, University
of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery,
Sunnybrook Health Sciences Centre, University of Toronto, Toronto,
Ontario, Canada
Abstract
BACKGROUND: Patients' race and/or ethnicity are increasingly being
associated with differential surgical access and outcomes in cardiac
surgery. However, poor diversity in study populations and conflicting
research methodology and findings have made it difficult to derive
evidence-based conclusions that can inform surgical care. Using a
fictional patient example, this review identifies areas of concern in
research engagement, methodology, and analyses as well as potential steps
to improve race and ethnicity considerations in cardiac surgical research.
<br/>METHOD(S): A narrative literature review was performed using the
PubMed/MEDLINE and Google Scholar databases with a combination of cardiac
surgery, race, ethnicity, and disparities keywords. <br/>RESULT(S): Less
than half of the published cardiac surgery randomized control trials
(RCTs) report research participants' race and/or ethnicity. Racial and/or
ethnic minorities make up less than 20% of most study populations and are
significantly underrepresented relative to their proportions of the
general population. Further, research participants' race and/or ethnicity
are variably categorized based on ancestry, geographical regions, cultural
similarities, or minority status. There is growing consideration of
analyzing interrelated and confounding variables, such as socioeconomic
status, geographical location, or hospital quality, to better elucidate
racial and/or ethnic disparities; however, intersectionality
considerations remain limited in cardiac surgery research.
<br/>CONCLUSION(S): Racial and/or ethnic disparities are increasingly
being reported in research engagement, cardiac pathologies, and surgical
outcomes. To promote equitable surgical care, tangible efforts are needed
to recruit racially and/or ethnically minoritized patients to research
studies, be transparent and consistent in their groupings, and elucidate
the impact of their intersectional social identities.<br/>Copyright &#xa9;
2023. Published by Elsevier Inc.

<115>
Accession Number
642663662
Title
Between a rock and a hard place: resumption of oral anticoagulant therapy
after intracranial haemorrhage.
Source
Journal of thrombosis and haemostasis : JTH. (no pagination), 2023. Date
of Publication: 30 Oct 2023.
Author
Grainger B.T.; McFadyen J.D.; Tran H.
Institution
(Grainger) Department of Clinical Haematology, Alfred Hospital, Melbourne,
Australia
(McFadyen) Department of Clinical Haematology, The Alfred Hospital,
Melbourne, Australia; Australian Centre for Blood Diseases, Central
Clinical School, Monash University, Melbourne, Australia; Atherothrombosis
and Vascular Biology Laboratory, Baker Heart and Diabetes Institute,
Melbourne, Australia; Baker Department of Cardiometabolic Health,
University of Melbourne, Melbourne, Australia
(Tran) Department of Clinical Haematology, The Alfred Hospital, Melbourne,
Australia; Australian Centre for Blood Diseases, Central Clinical School,
Monash University, Melbourne, Australia
Abstract
Intracranial haemorrhage (ICH) is the most feared and lethal complication
of oral anticoagulant (OAC) therapy. Resumption of OAC following ICH has
long posed a challenge for clinicians, complicated by the expanding range
of anticoagulant agents available in modern clinical practice, including
the direct oral anticoagulants (DOACs) and more recently, the factor XI
and XII inhibitors. A review of the current literature finds support for
resuming OAC in the majority of patients post-ICH based on pooled
retrospective data showing that resumption is associated a lower risk of
mortality and thromboembolism without a significantly increased risk of
recurrent haemorrhage. The optimal time to resume OAC is less clear,
however the available evidence suggests the composite risk of both
recurrent haemorrhage and thromboembolism is likely minimised somewhere
between 4-6 weeks after ICH in most patients. Specific considerations to
guide the optimal resumption time in the individual patient include ICH
location, mechanism and anticoagulant class. Patients with mechanical
heart valves and intracerebral malignancy represent high risk groups who
require more nuanced decision-making. Here we appraise the literature with
the aim of providing a practical guide for clinicians while also
discussing priorities for future investigation.<br/>Copyright &#xa9; 2023
International Society on Thrombosis and Haemostasis. Published by Elsevier
Inc. All rights reserved.

<116>
Accession Number
642663420
Title
Efficacy of erector spinae plane block for minimally invasive mitral valve
surgery: Results of a double-blind, prospective randomized
placebo-controlled trial: Response to Xue et al.
Source
Journal of clinical anesthesia. 92 (pp 111311), 2023. Date of Publication:
30 Oct 2023.
Author
Hoogma D.F.; Coppens S.; Rex S.
Institution
(Hoogma, Coppens, Rex) Department of Anesthesiology, University Hospitals
of Leuven, Leuven, Belgium; Department of Cardiovascular Sciences,
Biomedical Sciences Group, University of Leuven, Leuven, Belgium