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<1>
Accession Number
2028318817
Title
Efficacy and safety of the serratus anterior block compared to thoracic
epidural analgesia in surgery: Systematic review and meta-analysis.
Source
Tzu Chi Medical Journal. 35(4) (pp 329-337), 2023. Date of Publication:
October 2023.
Author
Lusianawati; Suhardi C.J.; Sumartono C.; Wungu C.D.K.
Institution
(Lusianawati, Suhardi, Sumartono) Department of Anesthesiology and
Reanimation, Faculty of Medicine, Airlangga University/ Dr. Soetomo
Hospital, Surabaya, Indonesia
(Wungu) Department of Physiology and Medical Biochemistry, Faculty of
Medicine, Airlangga University, Surabaya, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objectives: The objective of this study was to compare the efficacy and
safety of serratus anterior plane block (SAPB) and thoracic epidural
analgesia (TEA) in thoracic region surgery. Material(s) and
Method(s): We implemented a systematic search of PubMed, ScienceDirect,
SCOPUS, and Web of Science and through gray literature for all randomized
controlled trials that compared SAPB, a novel thoracic wall nerve block,
and TEA in surgery. The evaluated outcomes included the Visual Analog
Scale (VAS), hypotension, and postoperative nausea and vomiting (PONV).
Review Manager, version 5.4.1, was implemented for the analysis of
statistics. Result(s): The pooled analysis included six trials that
fulfilled the inclusion criteria. In total 384, surgery had received
regional blocks (162 - SAPB and 163 - TEA). VAS did not differ
significantly between SAPB and TEA, with a mean difference of 0.71, P =
0.08. PONV incidence did not differ significantly between SAPB and TEA
(odds ratio = 0.25, P = 0.07). Hypotension incidence was lower in SAPB
compared to TEA (odds ratio = 0.10, P = 0.0001). Conclusion(s): SAPB
yielded comparable VAS with TEA in pain management of thoracic region
surgery. The incidence of hypotension was lower in SAPB than in TEA. No
difference in PONV incidence was observed. SAPB can be a viable
alternative to TEA in thoracic region surgery. Copyright © 2023
Tzu Chi Medical Journal Published by Wolters Kluwer - Medknow.

<2>
Accession Number
2026121530
Title
Preoperative Sildenafil in Pediatric Patients Undergoing Congenital Heart
Surgeries: A Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 27(4) (pp 252-259),
2023. Date of Publication: December 2023.
Author
Fikri Y.A.; Mulia E.P.B.; Nugroho F.W.
Institution
(Fikri) Dr. R. Soetrasno Regional General Hospital, Rembang, Indonesia
(Mulia, Nugroho) Department of Cardiology and Vascular Medicine, Dr. R.
Soetrasno Regional General Hospital, Rembang, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background. Pulmonary hypertension (PH) is a common complication of
congenital heart disease (CHD). With early surgical intervention, outcomes
have improved over the last two decades. Persistent PH, however, may still
occur following surgery. Sildenafil has been shown to be beneficial for
postoperative pulmonary hypertensive crises. The role of preoperative
sildenafil in controlling postoperative PH is poorly elucidated. This
study aimed to evaluate the effect of preoperative sildenafil on pediatric
patients undergoing congenital heart surgeries. Methods. A comprehensive
literature search was conducted in scientific databases. We included
randomized controlled trials which assessed the effect of preoperative
sildenafil in pediatric patients with CHD undergoing repair surgeries.
Primary outcomes were pre- and postoperative differences in mean pulmonary
arterial pressure (mPAP) and mean pulmonary artery/aortic pressure ratio
(PA/Ao ratio). Results. Four studies (n = 233) were retained for the final
analysis. Dose of sildenafil ranged from.3 to.5 mg/kg every 4-6 hours via
oral/nasogastric route, with timing of administration varied from 1 to 2
weeks before surgery. Compared to controls, preoperative sildenafil was
associated with greater reduction in postoperative mPAP (MD -5.02; 95% CI
[-8.91, -1.13]) and mean PA/Ao ratio (MD -.11; 95% CI [-.17, -.06]).
Shorter CPB time, ICU length of stay, and duration of mechanical
ventilation were also observed in the sildenafil group. Conclusion.
Preoperative sildenafil is beneficial in reducing PAP, thereby reducing
the risk of postoperative PH crisis. Further studies are warranted to
identify the optimal dosage and timing of administration of sildenafil in
CHD patients prior to surgery. Copyright © The Author(s) 2023.

<3>
Accession Number
2025947523
Title
Diagnostic performance of resting full-cycle ratio in identifying coronary
lesions causing myocardial ischaemia: a meta-analysis.
Source
Acta Cardiologica. 78(10) (pp 1103-1109), 2023. Date of Publication: 2023.
Author
Luo Y.; Mao M.; Wu F.; Ma K.; Chang J.; Xiang R.
Institution
(Luo, Mao, Wu, Ma, Chang, Xiang) Department of Cardiology, The First
Affiliated Hospital of Chongqing Medical University, Chongqing, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: The resting full-cycle ratio (RFR), a new non-congestive
resting index, is commonly used for physiological evaluations of coronary
arteries. Aim(s): This study aims to evaluate the accuracy of RFR in
detecting coronary artery stenosis with hemodynamic significance using
fractional flow reserve (FFR) as the reference standard. Method(s):
Using 'RFR, resting full-cycle ratio' as the search term, we searched
PubMed, Embase, Cochrane Library, and Web of Science databases, screening
the literature according to the inclusion and exclusion criteria. By
applying FFR <= 0.80 and RFR <= 0.89 as the diagnostic criteria for
ischaemia, we analysed the synthetic sensitivity, specificity, and
corresponding 95% confidence intervals, then synthesised the summary
receiver operating characteristic curve (SROC). Result(s): Three
studies were included in this meta-analysis, comprising 1,084 patients
with 1,312 lesions. When we used FFR <= 0.80 as the reference standard,
the synthesised sensitivity, specificity, positive predictive value (PPV),
negative predictive value (NPV), positive likelihood ratio (LR+), and
negative likelihood ratio (LR-) of RFR in the diagnosis of coronary
ischaemia were 73%, 81%, 67%, 85%, 3.95, and 0.33, respectively. Besides,
the area under the curve (AUC) was 0.8276. Conclusion(s): Using FFR
as the reference standard, RFR has good diagnostic accuracy in detecting
coronary ischaemic lesions and may be an effective alternative to FFR in
the future, to some extent. Copyright © 2023 Belgian Society of
Cardiology.

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

<5>
Accession Number
2026813312
Title
The effects of bariatric surgery on cardiac function: a systematic review
and meta-analysis.
Source
International Journal of Obesity. (no pagination), 2023. Date of
Publication: 2023.
Author
Sargsyan N.; Chen J.Y.; Aggarwal R.; Fadel M.G.; Fehervari M.; Ashrafian
H.
Institution
(Sargsyan, Chen, Aggarwal, Fadel, Fehervari, Ashrafian) Department of
General Surgery, Imperial College Healthcare NHS Foundation Trust, London,
United Kingdom
(Fadel, Fehervari, Ashrafian) Department of Surgery and Cancer, Imperial
College London, London, United Kingdom
Publisher
Springer Nature
Abstract
Introduction: Obesity is associated with alterations in cardiac structure
and haemodynamics leading to cardiovascular mortality and morbidity.
Culminating evidence suggests improvement of cardiac structure and
function following bariatric surgery. Objective(s): To evaluate the
effect of bariatric surgery on cardiac structure and function in patients
before and after bariatric surgery. Method(s): Systematic review and
meta-analysis of studies reporting pre- and postoperative cardiac
structure and function parameters on cardiac imaging in patients
undergoing bariatric surgery. Result(s): Eighty studies of 3332
patients were included. Bariatric surgery is associated with a
statistically significant improvement in cardiac geometry and function
including a decrease of 12.2% (95% CI 0.096-0.149; p < 0.001) in left
ventricular (LV) mass index, an increase of 0.155 (95% CI 0.106-0.205; p <
0.001) in E/A ratio, a decrease of 2.012 mm (95% CI 1.356-2.699; p <
0.001) in left atrial diameter, a decrease of 1.16 mm (95% CI 0.62-1.69; p
< 0.001) in LV diastolic dimension, and an increase of 1.636% (95% CI
0.706-2.566; p < 0.001) in LV ejection fraction after surgery.
 Conclusion(s): Bariatric surgery led to reverse remodelling and
improvement in cardiac geometry and function driven by metabolic and
haemodynamic factors. Copyright © 2023, The Author(s).

<6>
Accession Number
642841484
Title
Thoracic day surgery versus thoracic inpatient surgery for treatment of
patients with lung cancer: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 341), 2023. Date of
Publication: 25 Nov 2023.
Author
Shen C.; Che G.
Institution
(Shen, Che) Department of Thoracic Surgery, West-China Hospital, Sichuan
University, Chengdu 610041, China
Abstract
BACKGROUND: The successful implementation of the Enhanced recovery after
surgery (ERAS) concept in thoracic surgery has made it possible to
complete the surgery in the day surgery unit. However, it is still unclear
whether day surgery for lung cancer patients can achieve the same or even
better results. METHOD(S): A systematic literature search was
completed in common databases for studies published before May 2022 and
the data analyzed using the Review Manager 5.3 software. RESULT(S):
We ultimately included 7 retrospective articles that met our criteria for
the study. The results of age, smoking status, comorbidity and pulmonary
function tests in day surgery group were better than in inpatient surgery
group. Minimally invasive surgical method with segmentectomy was more used
in day surgery group than in normal surgery group. The 30-day mortality
was also lower in Day surgery group and it displayed that early discharged
patients had fewer overall complications than the inpatient surgery group.
 CONCLUSION(S): We demonstrate that younger patients, patients
receiving segmental resections by VATS, and those with better pulmonary
function tests or without comorbidity can be discharged early with low
rates of complications and 30-day mortality, especial with ERAS
program. Copyright © 2023. The Author(s).

<7>
Accession Number
642836763
Title
Common Complications and Cardiopulmonary Resuscitation in Patients with
Left Ventricular Assist Devices: A Narrative Review.
Source
Medicina (Kaunas, Lithuania). 59(11) (no pagination), 2023. Date of
Publication: 10 Nov 2023.
Author
Zaloznik Djordjevic J.; Ozkan T.; Goncz E.; Ksela J.; Mockel M.; Strnad M.
Institution
(Zaloznik Djordjevic, Strnad) Department of Emergency Medicine, University
Medical Centre Maribor, Maribor 2000, Slovenia
(Ozkan, Goncz, Mockel) Department of Emergency and Acute Medicine,
Charite-Universitatsmedizin Berlin, Berlin 10117, Germany
(Ksela) Department of Cardiovascular Surgery, University Medical Centre
Ljubljana, Ljubljana 1000, Slovenia
Abstract
Heart failure remains a major global burden regarding patients' morbidity
and mortality and health system organization, logistics, and costs.
Despite continual advances in pharmacological and resynchronization device
therapy, it is currently well accepted that heart transplantation and
mechanical circulatory support represent a cornerstone in the management
of advanced forms of this disease, with the latter becoming an
increasingly accepted treatment modality due to the ongoing shortage of
available donor hearts in an ever-increasing pool of patients. Mechanical
circulatory support strategies have seen tremendous advances in recent
years, especially in terms of pump technology improvements, indication for
use, surgical techniques for device implantation, exchange and
explantation, and postoperative patient management, but not in the field
of treatment of critically ill patients and those undergoing cardiac
arrest. This contemporary review aims to summarize the collected knowledge
of this topic with an emphasis on complications in patients with left
ventricular assist devices, their treatment, and establishing a clear-cut
algorithm and the latest recommendations regarding out-of-hospital or
emergency department management of cardiac arrest in this patient
population.

<8>
Accession Number
2028619955
Title
Outcomes of Patients With Left Ventricular Assist Devices Requiring
Intermittent Hemodialysis: Single-Center Cohort, Systematic Review, and
Individual-Participant Data Meta-Analysis.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102090. Date of Publication: January 2024.
Author
daSilva-deAbreu A.; Faaborg-Andersen C.; Joury A.; Tutor A.; Desai S.;
Eiswirth C.; Krim S.R.; Wever-Pinzon J.; Lavie C.J.; Ventura H.O.
Institution
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Faaborg-Andersen) Department of Internal Medicine, Massachusetts General
Hospital/Harvard Medical School, Boston, MA, United States
(Joury) Division of Cardiology, McGill University Health Centre, McGill
University, Montreal, QC, Canada
(Joury) King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi
Arabia
(Tutor, Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) John Ochsner
Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA,
United States
(Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) The University of
Queensland Ochsner Clinical School, Faculty of Medicine, The University of
Queensland, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Patients with left ventricular assist devices (LVADs) who require
intermittent hemodialysis (iHD) are considered to have a poor prognosis
despite a paucity of supportive evidence, mostly from small single-center
cohorts and extrapolations from studies of patients who received
continuous renal replacement therapy but no iHD. We conducted a systematic
review and individual-participant-data meta-analysis of the literature
including our single-center cohort to examine the outcomes of patients
initiated on iHD following LVAD implantation. Sixty-four patients from 5
cohorts met selection criteria (age 57.5 [46-64.5] years, 87% HeartMate
II, mostly bridge to transplantation). Follow-up after iHD initiation was
87.5 (38.5-269.5) days, although it was considerably longer in our center
than in other cohorts (601.5 [93-1559] days vs 65 [26-180] days, P =
0.0007). The estimated median survival was 308 (76-912.5) days and varied
significantly among cohorts, ranging from 60 (57-65) to 838 (103-1872)
days (P = 0.0096). Twelve (18.8%) patients achieved either heart
transplantation (HT) or remission during follow-up. Patients who received
HT had an 8-fold longer estimated median survival (1972 [799-1972] days vs
244 [64-838] days, P = 0.0112). Being from a more recent cohort was
associated with better 1-year survival. Renal recovery occurred in eight
patients (13.1%) at 30 days and its cumulative incidence increased to 73%
(27/37 patients with available data) at 1 year. Most patients initiated on
iHD after LVAD experienced renal recovery within the first year after
implantation. Improved survival was observed for patients who received HT
and in those from more recent cohorts. Some patients were able to survive
on LVAD and iHD support for several years. Copyright © 2023
Elsevier Inc.

<9>
Accession Number
2028537329
Title
Red Blood Cell Transfusion: 2023 AABB International Guidelines.
Source
JAMA. 330(19) (pp 1892-1902), 2023. Date of Publication: 21 Nov 2023.
Author
Carson J.L.; Stanworth S.J.; Guyatt G.; Valentine S.; Dennis J.; Bakhtary
S.; Cohn C.S.; Dubon A.; Grossman B.J.; Gupta G.K.; Hess A.S.; Jacobson
J.L.; Kaplan L.J.; Lin Y.; Metcalf R.A.; Murphy C.H.; Pavenski K.;
Prochaska M.T.; Raval J.S.; Salazar E.; Saifee N.H.; Tobian A.A.R.;
So-Osman C.; Waters J.; Wood E.M.; Zantek N.D.; Pagano M.B.
Institution
(Carson) Department of Medicine, Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
(Stanworth) Department of Haematology, Oxford University Hospitals NHS
Trust, Oxford, United Kingdom
(Stanworth) NHSBT, Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
(Stanworth) Department of Transfusion Medicine, NHS Blood and Transplant,
Oxford, United Kingdom
(Guyatt) Departments of Clinical Epidemiology and Biostatistics and
Medicine, McMaster University, Hamilton, ON, Canada
(Valentine) Department of Pediatrics, University of Massachusetts, Chan
Medical School, Worcester, United States
(Dennis) Cochrane Injuries Group, London School of Hygiene and Tropical
Medicine, London, United Kingdom
(Bakhtary) Department of Laboratory Medicine, University of California,
San Francisco, United States
(Cohn, Zantek) Department of Laboratory Medicine and Pathology, University
of Minnesota, Minneapolis, United States
(Dubon) Patient Partner, United States
(Grossman) Department of Pathology and Immunology, Washington University,
School of Medicine in St Louis, St Louis, MO, United States
(Gupta) Department of Pathology and Laboratory Medicine, Memorial Sloan
Kettering Cancer Center, New York, NY, United States
(Hess) Departments of Anesthesiology and Pathology, Laboratory Medicine,
University of Wisconsin-Madison, Madison, United States
(Jacobson) Department of Pathology, New York University, Grossman School
of Medicine, New York, United States
(Jacobson) NYC, Health + Hospitals/Bellevue, New York, NY, United States
(Kaplan) Department of Surgery, Division of Trauma, Surgical Critical Care
and Surgical Emergencies, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, United States
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Department of Laboratory Medicine and Pathobiology,
University of Toronto, Toronto, ON, Canada
(Metcalf) Department of Pathology, University of Utah, Salt Lake City,
United States
(Murphy) Pathology Associates of Albuquerque, Albuquerque, NM, United
States
(Pavenski) Department of Laboratory Medicine and Pathobiology, University
of Toronto, St Michael's Hospital, Unity Health Toronto, Toronto, ON,
Canada
(Prochaska) Department of Medicine, University of Chicago, Chicago, IL,
United States
(Raval) Department of Pathology, University of New Mexico, Albuquerque,
United States
(Salazar) Department of Pathology and Laboratory Medicine, UT Health San
Antonio, San Antonio, TX, United States
(Saifee) Department of Laboratory Medicine and Pathology, Seattle
Children's Hospital, Seattle, WA, United States
(Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MA,
United States
(So-Osman) Department of Unit Transfusion Medicine (UTG), Sanquin Blood
Bank, Amsterdam, Netherlands
(So-Osman) Department Hematology, Erasmus Medical Center, Rotterdam,
Netherlands
(Waters) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh, Pittsburgh, PA, United States
(Wood) Department of Haematology, Monash Health, Monash University, School
of Public Health and Preventive Medicine, Melbourne, VIC, Australia
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, United States
Publisher
American Medical Association
Abstract
Importance: Red blood cell transfusion is a common medical intervention
with benefits and harms. Objective(s): To provide recommendations for
use of red blood cell transfusion in adults and children. Evidence Review:
Standards for trustworthy guidelines were followed, including using
Grading of Recommendations Assessment, Development and Evaluation methods,
managing conflicts of interest, and making values and preferences
explicit. Evidence from systematic reviews of randomized controlled trials
was reviewed. Finding(s): For adults, 45 randomized controlled trials
with 20599 participants compared restrictive hemoglobin-based transfusion
thresholds, typically 7 to 8 g/dL, with liberal transfusion thresholds of
9 to 10 g/dL. For pediatric patients, 7 randomized controlled trials with
2730 participants compared a variety of restrictive and liberal
transfusion thresholds. For most patient populations, results provided
moderate quality evidence that restrictive transfusion thresholds did not
adversely affect patient-important outcomes. Recommendation 1: for
hospitalized adult patients who are hemodynamically stable, the
international panel recommends a restrictive transfusion strategy
considering transfusion when the hemoglobin concentration is less than 7
g/dL (strong recommendation, moderate certainty evidence). In accordance
with the restrictive strategy threshold used in most trials, clinicians
may choose a threshold of 7.5 g/dL for patients undergoing cardiac surgery
and 8 g/dL for those undergoing orthopedic surgery or those with
preexisting cardiovascular disease. Recommendation 2: for hospitalized
adult patients with hematologic and oncologic disorders, the panel
suggests a restrictive transfusion strategy considering transfusion when
the hemoglobin concentration is less than 7 g/dL (conditional
recommendations, low certainty evidence). Recommendation 3: for critically
ill children and those at risk of critical illness who are hemodynamically
stable and without a hemoglobinopathy, cyanotic cardiac condition, or
severe hypoxemia, the international panel recommends a restrictive
transfusion strategy considering transfusion when the hemoglobin
concentration is less than 7 g/dL (strong recommendation, moderate
certainty evidence). Recommendation 4: for hemodynamically stable children
with congenital heart disease, the international panel suggests a
transfusion threshold that is based on the cardiac abnormality and stage
of surgical repair: 7 g/dL (biventricular repair), 9 g/dL
(single-ventricle palliation), or 7 to 9 g/dL (uncorrected congenital
heart disease) (conditional recommendation, low certainty evidence).
 Conclusions and Relevance: It is good practice to consider overall
clinical context and alternative therapies to transfusion when making
transfusion decisions about an individual patient.. Copyright ©
2023 American Medical Association. All rights reserved.

<10>
Accession Number
2026815230
Title
Comparison of amiodarone and esmolol for prevention of reperfusion
ventricular fibrillation in individuals undergoing heart valve or aortic
surgery: a study protocol for a randomized controlled clinical trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 758. Date of
Publication: December 2023.
Author
Zhu D.; Li Y.; Tian A.-Y.; Wang H.-N.
Institution
(Zhu, Li, Tian, Wang) Department of Anesthesiology, The First Hospital of
China Medical University, 155 Nanjing North Street, Heping District,
Liaoning Province, Shenyang City, China
Publisher
BioMed Central Ltd
Abstract
Background: Amiodarone and esmolol can help to prevent and treat
post-cardiac surgery reperfusion ventricular fibrillation. However, the
relative efficacies of these two drugs remain unknown. The aim of the
current trial is to compare the performances of amiodarone and esmolol for
preventing reperfusion ventricular fibrillation following open heart
surgery. Methods/design: This is a single-center, prospective,
double-blind, controlled clinical trial. A total of 260 patients
undergoing heart valve or aortic surgery will be assigned randomly to
treatment with prophylactic esmolol (intervention group) or amiodarone
(control group). The main outcome is the incidence of reperfusion
ventricular fibrillation following aortic opening during extracorporeal
circulation. The secondary outcomes are the rate of automatic cardiac
resuscitation, energy and frequency of electrical defibrillation, number
of electrical defibrillations, and pacemaker use in the two groups of
patients. Information on the patients' general condition and the durations
of anesthesia, extracorporeal circulation, aortic occlusion, and operation
time will be recorded. We will also compare the heart rate, mean arterial
pressure, and central venous pressure between the two groups of patients
at induction of anesthesia (T1), start of surgery (T2), start of
extracorporeal circulation (T3), aortic block (T4), aortic opening (T5),
after opening for 10 (T6), 20 (T7), and 30 min (T8), at cessation of
extracorporeal circulation (T9), and at the end of surgery (T10) and
compare blood gas analysis results at T1, T5, T9, and T10.
 Discussion(s): This study will determine if prophylactic esmolol is
more effective than amiodarone for reducing the incidence of reperfusion
ventricular fibrillation in patients undergoing heart valve or aortic
surgery. Trial registration: China Clinical Trials Registry
ChiCTR1900026429. Registered on 2019.10.9. Copyright © 2023, The
Author(s).

<11>
Accession Number
2026797086
Title
Physical Image Quality Metrics for the Characterization of X-ray Systems
Used in Fluoroscopy-Guided Pediatric Cardiac Interventional Procedures: A
Systematic Review.
Source
Children. 10(11) (no pagination), 2023. Article Number: 1784. Date of
Publication: November 2023.
Author
Nocetti D.; Villalobos K.; Wunderle K.
Institution
(Nocetti, Villalobos) Departamento de Tecnologia Medica, Facultad de
Ciencias de la Salud, Universidad de Tarapaca, Arica 1010069, Chile
(Wunderle) Department of Radiology, Cleveland Clinic, Cleveland, OH 44195,
United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Pediatric interventional cardiology procedures are essential in diagnosing
and treating congenital heart disease in children; however, they raise
concerns about potential radiation exposure. Managing radiation doses and
assessing image quality in angiographs becomes imperative for safe and
effective interventions. This systematic review aims to comprehensively
analyze the current understanding of physical image quality metrics
relevant for characterizing X-ray systems used in fluoroscopy-guided
pediatric cardiac interventional procedures, considering the main factors
reported in the literature that influence this outcome. A search in Scopus
and Web of Science, using relevant keywords and inclusion/exclusion
criteria, yielded 14 relevant articles published between 2000 and 2022.
The physical image quality metrics reported were noise, signal-to-noise
ratio, contrast, contrast-to-noise ratio, and high-contrast spatial
resolution. Various factors influencing image quality were investigated,
such as polymethyl methacrylate thickness (often used to simulate water
equivalent tissue thickness), operation mode, anti-scatter grid presence,
and tube voltage. Objective evaluations using these metrics ensured
impartial assessments for main factors affecting image quality, improving
the characterization of fluoroscopic X-ray systems, and aiding informed
decision making to safeguard pediatric patients during
procedures. Copyright © 2023 by the authors.

<12>
Accession Number
2028575493
Title
A Randomized Comparison of Two Doses of Tranexamic Acid in High-Risk
Open-Heart Surgery.
Source
Nepalese Heart Journal. 20(5) (pp 1-6), 2023. Date of Publication: 2023.
Author
Shrestha B.K.; Khadka R.; Bhusal S.; Baidya R.; Bhandari S.; Suraj K.C.
Institution
(Shrestha, Baidya, Bhandari) Department of Anesthesiology, Shahid Gangalal
National Heart Center, Bansbari, Kathmandu, Nepal
(Khadka) Department of Anesthesiology, National Trauma Center, Kathmandu,
Nepal
(Bhusal) Department of Anesthesiology, National Academy of Medical
Sciences, Kathmandu, Nepal
(Suraj) B P Koirala Institute of Health Sciences, Dharan, Nepal
Publisher
Cardiac Society of Nepal
Abstract
Background and aims: Tranexamic acid is commonly used in cardiac surgery
to minimize perioperative bleeding. There are wide variations in dose of
this drug. This study aims to find out the minimal effective dose of
tranexamic acid. Method(s): Patients were randomized into low dose
group receiving 10 mg/kg and high dose group receiving 30 mg/kg bolus of
tranexamic acid each followed by an infusion of 1mg/kg/hr until the end of
surgery. Primary objective was to compare blood loss during the first
postoperative day. Secondary objectives were to compare total blood
products transfused during 24 hours post-operative period, to compare the
incidence of re-explorations and to compare the adverse drug reactions
between the groups. Result(s): There were sixty patients in each
group. There was a significant difference in blood loss (435.17+/- 299.91
ml vs 528.64 +/-254.04 ml) between the low dose group and High dose group
(p=0.010). Transfusion of packed red blood cell, re-exploration and
adverse drug reactions were higher in high dose group however these were
not statistically significant. Conclusion(s): Higher dose of
tranexamic acid is not effective in reducing blood loss in open heart
surgery in first postoperative day. Copyright © 2023 Cardiac
Society of Nepal. All rights reserved.

<13>
Accession Number
2028654362
Title
Intravenous acetaminophen for postoperative pain in the neonatal intensive
care unit: A protocol for a pilot randomized controlled trial (IVA POP).
Source
PLoS ONE. 18(11 November) (no pagination), 2023. Article Number: e0294519.
Date of Publication: November 2023.
Author
Archer V.A.; Samiee-Zafarghandy S.; Farrokyhar F.; Briatico D.; Braga
L.H.; Walton J.M.
Institution
(Archer) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Samiee-Zafarghandy) Division of Neonatology, Department of Pediatrics,
McMaster University, Hamilton, ON, Canada
(Farrokyhar, Briatico) Department of Surgery, McMaster University,
Hamilton, ON, Canada
(Braga) Division of Urology, McMaster University, Hamilton, ON, Canada
(Walton) Division of Pediatric General Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
Publisher
Public Library of Science
Abstract
Background In neonates, uncontrolled pain and opioid exposure are both
correlated with short- and longterm adverse events. Therefore, managing
pain using opioid-sparing approaches is critical in neonatal populations.
Multimodal pain control offers the opportunity to manage pain while
reducing short- and long-term opioid-related adverse events. Intravenous
(IV) acetaminophen may represent an appropriate adjunct to opioid-based
postoperative pain control regimes. However, no trials assess this drug in
patients less than 36 weeks post-conceptual age or weighing less than 1500
g. Objective The proposed study aims to determine the feasibility of
conducting a randomized control trial to compare IV acetaminophen and
fentanyl to a saline placebo and fentanyl for patients admitted to the
neonatal intensive care unit (NICU) undergoing major abdominal or thoracic
surgery. Methods and design This protocol is for a single-centre, external
pilot randomized controlled trial (RCT). Infants in the NICU who have
undergone major thoracic or abdominal surgery will be enrolled. Sixty
participants will undergo 1:1 randomization to receive intravenous
acetaminophen and fentanyl or saline placebo and fentanyl. After surgery,
IV acetaminophen or placebo will be given routinely for eight days (192
hours). Appropriate dosing will be determined based on the participant's
gestational age. Patients will be followed for eight days after surgery
and will undergo a chart review at 90 days. Primarily feasibility outcomes
include recruitment rate, follow-up rate, compliance, and blinding index.
Secondary clinical outcomes will be collected as well. Conclusion This
external pilot RCT will assess the feasibility of performing a multicenter
RCT comparing IV acetaminophen and fentanyl to a saline placebo and
fentanyl in NICU patients following major abdominal and thoracic surgery.
The results will inform the design of a multicenter RCT, which will have
the appropriate power to determine the efficacy of this treatment.
 Copyright © 2023 Archer 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.

<14>
Accession Number
2028627476
Title
Effect of coronary artery bypass grafting on quality of life: a
meta-analysis of randomized trials.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(3) (no
pagination), 2022. Article Number: qcab075. Date of Publication: May 2022.
Author
Creber R.M.; Dimagli A.; Spadaccio C.; Myers A.; Moscarelli M.; Demetres
M.; Little M.; Fremes S.; Gaudino M.
Institution
(Creber, Myers) Division of Health Informatics, Department of Healthcare
Policy and Research, Weill Cornell Medicine, New York, NY, United States
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Spadaccio) Institute of Cardiovascular and Medical Sciences, University
of Glasgow, United Kingdom
(Spadaccio) Lancashire Cardiac Center, Blackpool Victoria Teaching
Hospital, Blackpool, United Kingdom
(Moscarelli) Department of Cardiac Surgery, Imperial College London,
London, United Kingdom
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Little) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, United Kingdom
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
Oxford University Press
Abstract
Aims We conducted a systematic review and meta-analysis to evaluate
temporal trends in quality of life (QoL) after coronary artery bypass
grafting (CABG) surgery in randomized clinical trials, and a quantitative
comparison from before surgery to up to 5 years after surgery.Methods and
results We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and
PsycINFO from 2010 to 2020 to identify studies that included the
measurement of QoL in patients undergoing CABG. The primary outcome was
the Seattle Angina Questionnaire (SAQ), and secondary outcomes were the
36-item Short Form Health Survey (SF-36) and EuroQol Questionnaire
(EQ-5D). We pooled the means and the weighted mean differences over the
follow-up period. In the meta-analysis, 2586 studies were screened and 18
full-text studies were included. There was a significant trend towards
higher QoL scores from before surgery to 1 year post-operatively for the
SAQ angina frequency (AF), SAQ QoL, SF-36 physical component (PC), and
EQ-5D, whereas the SF-36 mental component (MC) did not improve
significantly. The weighted mean differences from before surgery to 1 year
after was 24 [95% confidence interval (CI): 21.6-26.4] for the SAQ AF, 31
(95% CI: 27.5-34.6) for the SAQ QoL, 9.8 (95% CI: 7.1-12.8) for the SF-36
PC, 7.1 (95% CI: 4.2-10.0) for the SF-36 MC, and 0.1 (95% CI: 0.06-0.14)
for the EQ-5D. There was no evidence of publication bias or small-study
effect.Conclusion CABG had both short- and long-term improvements in
disease-specific QoL and generic QoL, with the largest improvement in
angina frequency. Copyright © The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<15>
Accession Number
2028591318
Title
Early percutaneous mitral commissurotomy or conventional management for
asymptomatic mitral stenosis: a randomised clinical trial.
Source
Heart. 107(24) (pp 1980-1986), 2021. Date of Publication: December 2021.
Author
Kang D.-H.; Lee S.-A.; Lee S.; Kim D.-H.; Park D.-W.; Yun S.-C.; Hong
G.-R.; Song J.-M.; Hong M.-K.; Park S.W.; Park S.-J.
Institution
(Kang, Lee, Lee, Kim, Park, Song, Park) Division of Cardiology, Asan
Medical Center, Seoul, South Korea
(Park, Park) Division of Cardiology, Samsung Medical Center, Seoul, South
Korea
(Yun) Department of Biostatistics, University of Ulsan College of
Medicine, Seoul, South Korea
(Hong, Hong) Division of Cardiology, Severance Cardiovascular Hospital,
Yonsei University Health System, Seoul, South Korea
Publisher
BMJ Publishing Group
Abstract
Objective The decision to perform percutaneous mitral commissurotomy (PMC)
on asymptomatic patients requires careful weighing of the potential
benefits against the risks of PMC, and we conducted a multicentre,
randomised trial to compare long-term outcomes of early PMC and
conventional treatment in asymptomatic, severe mitral stenosis (MS).
Methods We randomly assigned asymptomatic patients with severe MS (defined
as mitral valve area between 1.0 and 1.5 cm2) to early PMC (84
patients) or to conventional treatment (83 patients). The primary endpoint
was a composite of major cardiovascular events, including PMC-related
complications, cardiovascular mortality, cerebral infarction and systemic
thromboembolic events. The secondary endpoints were death from any cause
and mitral valve (MV) replacemen during follow-up. Results In the early
PMC group, there were no PMC-related complications. During the median
follow-up of 6.4 years, the composite primary endpoint occurred in seven
patients in the early PMC group (8.3%) and in nine patients in the
conventional treatment group (10.8%) (HR 0.77; 95% CI 0.29 to 2.07;
p=0.61). Death from any cause occurred in four patients in the early PMC
group (4.8%) and three patients in the conventional treatment group (3.6%)
(HR 1.30; 95% CI 0.29 to 5.77). Ten patients (11.9%) in the early PMC
group and 17 patients (20.5%) in the conventional treatment group
underwent MV replacement (HR 0.59; 95% CI 0.27 to 1.29). Conclusions
Compared with conventional treatment, early PMC did not significantly
reduce the incidence of cardiovascular events among asymptomatic patients
wit severe MS during the median follow-up of 6 years. Copyright ©
Author(s) (or their employer(s)) 2021.

<16>
Accession Number
642834740
Title
The impact of cardiopulmonary rehabilitation in phase II cardiac
rehabilitation program on the health-related quality of life of patients
undergoing coronary artery bypass graft surgery.
Source
Current problems in cardiology. (pp 102221), 2023. Date of Publication:
22 Nov 2023.
Author
Akar M.; Miri K.; Mazloum S.R.; Hajiabadi F.; Hamedi Z.; Vakilian F.;
Dehghan H.
Institution
(Akar) Department of Medical - Surgical Nursing, School of Nursing and
Midwifery (MSC Student), Nursing and Midwifery Care Research Center,
Mashhad University Medical of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Miri) Department of Nursing, School of Nursing and Midwifery, Torbat
Heydariyeh University of Medical Sciences, Iran, Islamic Republic of
(Mazloum) Department of Medical - Surgical Nursing, School of Nursing and
Midwifery, Mashhad University Medical of Medical Sciences, Nursing and
Midwifery Care Research Center, Mashhad, Iran, Islamic Republic of
(Hajiabadi) Department of Medical - Surgical Nursing, School of Nursing
and Midwifery, Mashhad University Medical of Medical Sciences, Nursing and
Midwifery Care Research Center, Mashhad, Iran, Islamic Republic of
(Hamedi) Department of Cardiac Rehabilitation, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Vakilian, Dehghan) Department of Cardiology, Preventive Atherosclerotic
Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Abstract
BACKGROUND: Coronary artery bypass surgery is the leading cause of change
in the quality of life and pulmonary function of patients. One strategy to
enhance lung muscle strength and improve overall quality of life is
pulmonary rehabilitation. This study aimed to investigate the impact of
incorporating a pulmonary rehabilitation program into phase II cardiac
rehabilitation program on the quality of life of patients undergoing
coronary artery bypass graft surgery. METHOD(S): This randomized
clinical trial study included 53 patients who underwent coronary artery
bypass graft surgery at Imam Reza Hospital in Mashhad between September
2019 and March 2020. The research participants were selected based on
specific inclusion criteria and divided into two groups. The control group
followed the routine rehabilitation program, whereas the intervention
group underwent a pulmonary rehabilitation program for 20-30 minutes after
each session of the cardiac rehabilitation program. Data collection tools
included a demographic information questionnaire and the Ferrans and
Powers' quality of life index. The data were analyzed using the
independent t-test, Mann-Whitney test, paired t-test, Spearman
correlation, Wilcoxon test, and SPSS25. RESULT(S): The mean quality
of life score in the intervention group(20.7+/-1.8) was significantly
higher than that of the control group (18.8+/-2.3)(P<0.05). Furthermore,
the intervention group exhibited significantly higher mean scores in the
physical, psychological-spiritual, and family dimensions than the control
group(P<0.05). CONCLUSION(S): The study results demonstrate the
positive impact of incorporating a pulmonary rehabilitation program into
cardiac rehabilitation on the health-related quality of life of patients
undergoing coronary artery bypass graft surgery. TRIAL REGISTRATION:
IRCT20190707044132N1. Copyright © 2023. Published by Elsevier
Inc.

<17>
Accession Number
2028411745
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in patients at low to intermediate surgical risk: rationale
and design of the randomised DEDICATE Trial.
Source
EuroIntervention. 19(8) (pp 652-658), 2023. Date of Publication: October
2023.
Author
Seiffert M.; Vonthein R.; Baumgartner H.; Borger M.A.; Choi Y.-H.; Falk
V.; Frey N.; Hagendorff A.; Hagl C.; Hamm C.; Konig I.R.; Landmesser U.;
Massberg S.; Reichenspurner H.; Thiele H.; Twerenbold R.; Vens M.; Walther
T.; Ziegler A.; Cremer J.; Blankenberg S.
Institution
(Seiffert) Department of Cardiology, University Heart and Vascular Center
Hamburg, Martinistrase 52, Hamburg 20246, Germany
(Seiffert, Twerenbold, Ziegler, Blankenberg) Department of Cardiology,
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Seiffert, Twerenbold, Ziegler, Blankenberg) Centre for Population Health
Innovation (POINT), University Heart and Vascular Center Hamburg,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Seiffert, Konig, Reichenspurner, Twerenbold, Cremer, Blankenberg) DZHK
(German Centre for Cardiovascular Research) partner site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Vonthein, Konig, Vens) Institute of Medical Biometry and Statistics,
University of Lubeck, Lubeck, Germany
(Baumgartner) Department of Cardiology III - Adult Congenital and Valvular
Heart Disease, University Hospital Muenster, Muenster, Germany
(Borger) Department of Cardiac Surgery, Heart Center Leipzig, University
of Leipzig, Leipzig, Germany
(Choi) Department of Cardiac Surgery, Kerckhoff-Klinik, Bad Nauheim,
Germany
(Choi, Hamm, Walther) DZHK (German Centre for Cardiovascular Research)
partner site Rhine-Main, Rhine-Main, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany
(Falk, Landmesser) DZHK (German Centre for Cardiovascular Research)
partner site Berlin, Berlin, Germany
(Falk) Department of Health Sciences & Technology, ETH Zurich,
Translational Cardiovascular Technology, Zurich, Switzerland
(Frey) Department of Cardiology, Angiology, and Pneumology, Heidelberg
University Hospital, Heidelberg, Germany
(Frey) DZHK (German Centre for Cardiovascular Research) partner site
Heidelberg/Mannheim, Heidelberg, Germany
(Hagendorff) Department of Cardiology, University of Leipzig, Leipzig,
Germany
(Hagl, Massberg) Department of Cardiac Surgery, University Hospital
Munich, Ludwig-Maximilians-University Munich, Munich, Germany
(Hagl) DZHK (German Centre for Cardiovascular Research) partner site
Munich Heart Alliance, Munich, Germany
(Hamm) Campus Kerckhoff and Medical Clinic I, University of Giessen,
Giessen, Germany
(Landmesser) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany and
Charite Universitatsmedizin Berlin, Berlin, Germany
(Massberg) Department of Cardiology, University Hospital Munich,
Ludwig-Maximilians-University Munich, Munich, Germany
(Reichenspurner) Department of Cardiovascular Surgery, University Heart,
Vascular Center Hamburg, Hamburg, Germany
(Thiele) Department of Cardiology, Heart Center Leipzig, University of
Leipzig, Leipzig, Germany
(Thiele) Leipzig Heart Science, Leipzig, Germany
(Walther) Department of Thoracic and Cardiovascular Surgery, University
Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main,
Germany
(Ziegler) Cardio-CARE, Medizincampus Davos, Davos, Switzerland
(Ziegler) School of Mathematics, Statistics and Computer Science,
University of KwaZulu-Natal, Pietermaritzburg, South Africa
(Cremer) Department of Cardiovascular Surgery, University Hospital of
Schleswig-Holstein, Kiel, Germany
Publisher
Europa Group
Abstract
Transcatheter aortic valve implantation (TAVI) has become the preferred
treatment option for patients with severe aortic stenosis at increased
risk for surgical aortic valve replacement (SAVR) and for older patients
irrespective of risk. However, in younger, low-risk patients for whom both
therapeutic options, TAVI and SAVR, are applicable, the optimal treatment
strategy remains controversial, as data on long-term outcomes remain
limited. The DEDICATE-DZHK6 Trial is an investigator-initiated,
industry-independent, prospective, multicentre, randomised controlled
trial investigating the efficacy and safety of TAVI compared to SAVR in
low- to intermediate-risk patients aged 65 years or older. To evaluate
both treatment strategies, approximately 1,404 patients determined
eligible for both TAVI and SAVR by the interdisciplinary Heart Team were
randomised to TAVI or SAVR. Broad inclusion and strict exclusion criteria
targeted an all-comers patient population. Procedures were performed
according to local best practice with contemporary routine medical
devices. The primary endpoints are a composite of mortality or stroke at 1
year and 5 years in order to incorporate midterm efficacy results and
complement early safety data. Primary outcomes will be tested sequentially
for non-inferiority and superiority. The DEDICATE-DZHK6 Trial has been
designed to mirror clinical reality for the treatment of severe aortic
stenosis and provide unique information on overall outcomes after TAVI and
SAVR that can be directly applied to clinical routines. Its results will
help further define optimal treatment strategies for low- to
intermediate-risk patients in whom both TAVI and SAVR are currently
advisable. Copyright © 2023 Authors. All rights reserved.

<18>
Accession Number
2028411741
Title
Clinical outcomes following different stenting techniques for coronary
bifurcation lesions: a systematic review and network meta-analysis of
randomised controlled trials.
Source
EuroIntervention. 19(8) (pp 664-675), 2023. Date of Publication: October
2023.
Author
Bujak K.; Verardi F.M.; Arevalos V.; Gabani R.; Spione F.; Rajwa P.;
Milasinovic D.; Stankovic G.; Gasior M.; Sabate M.; Brugaletta S.
Institution
(Bujak, Verardi, Arevalos, Gabani, Spione, Sabate, Brugaletta) Hospital
Clinic, Cardiovascular Clinic Institute, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona,
Barcelona, Spain
(Bujak, Gasior) 3rd Department of Cardiology, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Verardi) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Cona, Italy
(Spione) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Rajwa) Department of Urology, Medical University of Vienna, Vienna,
Austria
(Milasinovic, Stankovic) Department of Cardiology, University Clinical
Center of Serbia, Belgrade, Serbia
(Milasinovic, Stankovic) Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Publisher
Europa Group
Abstract
Background: Controversy still exists regarding the optimal treatment of
coronary bifurcation lesions. Aim(s): We aimed to analyse the
evidence from randomised controlled trials (RCTs) to compare outcomes
following different bifurcation stenting techniques. Method(s): We
systematically searched for RCTs comparing different techniques published
up to July 2022. We then conducted a pairwise meta-analysis to compare
outcomes between provisional stenting (PS) versus upfront 2-stent
techniques. Moreover, we performed a network meta-analysis (NMA) to
compare all strategies with each other. The primary endpoint was major
adverse cardiac events (MACE). Result(s): Twenty-four RCTs (6,890
patients) analysed PS, T-stenting, double-kissing (DK)-crush, crush, or
culotte stenting. The pairwise meta-analysis did not reveal a significant
difference between the PS and 2-stent techniques. However, the
prespecified sensitivity analysis, which included RCTs exclusively
enrolling patients with true bifurcation lesions, showed a lower rate of
MACE following 2-stent techniques, and meta-regression indicated that a
longer side branch lesion was associated with a greater benefit from the
2-stent strategy, which was the most apparent in RCTs with a mean lesion
length >11 mm. NMA revealed that DK-crush was associated with the lowest
MACE rate (odds ratio 0.47, 95% confidence interval: 0.36-0.62; p<0.01; PS
as a reference). Conclusion(s): Overall, 2-stent techniques were not
significantly better than PS in terms of clinical outcomes. However, the
results of the sensitivity analysis suggested that there might be a
benefit of a 2-stent approach in selected patients with true bifurcation
lesions, especially in the case of long side branch lesions. An NMA
revealed that DK-crush was associated with the lowest event rates when
compared with other techniques. Copyright © 2023 University of
Punjab (new Campus). All rights reserved.

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

<20>
[Use Link to view the full text]
Accession Number
2028397973
Title
Extracorporeal Life Support in Infarct-Related Cardiogenic Shock.
Source
New England Journal of Medicine. 389(14) (pp 1286-1297), 2023. Date of
Publication: 2023.
Author
Thiele H.; Zeymer U.; Akin I.; Behnes M.; Rassaf T.; Mahabadi A.A.;
Lehmann R.; Eitel I.; Graf T.; Seidler T.; Schuster A.; Skurk C.;
Duerschmied D.; Clemmensen P.; Hennersdorf M.; Fichtlscherer S.; Voigt I.;
Seyfarth M.; John S.; Ewen S.; Linke A.; Tigges E.; Nordbeck P.; Bruch L.;
Jung C.; Franz J.; Lauten P.; Goslar T.; Feistritzer H.-J.; Poss J.;
Kirchhof E.; Ouarrak T.; Schneider S.; Desch S.; Freund A.
Institution
(Thiele, Feistritzer, Poss, Desch, Freund) Heart Center Leipzig,
University of Leipzig, Germany
(Kirchhof) Helios Health Institute, Leipzig, Germany
(Zeymer, Ouarrak, Schneider) Institut fur Herzinfarktforschung, Germany
(Zeymer) Klinikum Ludwigshafen, Ludwigshafen, Germany
(Akin, Behnes, Duerschmied) University Medical Center Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
(Rassaf, Mahabadi) West German Heart and Vascular Center, University
Hospital Essen, Germany
(Voigt) Contilia Elisabeth-Krankenhaus, Essen, Germany
(Lehmann) Essen, Asklepios Clinic Langen, Langen, Germany
(Eitel, Graf) University Heart Center Lubeck, German Center for
Cardiovascular Research, Partner Site Hamburg-Kiel-Lubeck, Lubeck, Germany
(Seidler, Schuster) Heart Center Gottingen, University Medicine Gottingen,
Gottingen, Germany
(Skurk) Deutsches Herzzentrum der Charite, Department of Cardiology,
Angiology and Intensive Care Medicine, Germany
(Bruch) Unfallkrankenhaus Berlin, Berlin, Germany
(Clemmensen) University Heart and Vascular Center Hamburg, Germany
(Tigges) Asklepios Clinic St. Georg, Hamburg, Germany
(Hennersdorf) SLK Kliniken Heilbronn, Heilbronn, Germany
(Fichtlscherer) University Heart and Vascular Center Frankfurt, Frankfurt,
Germany
(Seyfarth) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(John) Paracelsus Private University, Clinic Nuremberg South, Nuremberg,
Germany
(Ewen) Saarland University Medical Center, Saarland University Faculty of
Medicine, Homburg, Germany
(Linke) Technische Universitat Dresden, Heart Center, Dresden, Germany
(Nordbeck) University Clinic Wurzburg, Wurzburg, Germany
(Jung) University Clinic Dusseldorf, Dusseldorf, Germany
(Franz) Clinic Winnenden, Winnenden, Germany
(Lauten) Zentralklinik Bad Berka, Bad Berka, Germany
(Goslar) University Medical Center Ljubljana, Ljubljana, Slovenia
Publisher
Massachussetts Medical Society
Abstract
Background Extracorporeal life support (ECLS) is increasingly used in the
treatment of infarct-related cardiogenic shock despite a lack of evidence
regarding its effect on mortality. Methods In this multicenter trial,
patients with acute myocardial infarction complicated by cardiogenic shock
for whom early revascularization was planned were randomly assigned to
receive early ECLS plus usual medical treatment (ECLS group) or usual
medical treatment alone (control group). The primary outcome was death
from any cause at 30 days. Safety outcomes included bleeding, stroke, and
peripheral vascular complications warranting interventional or surgical
therapy. Results A total of 420 patients underwent randomization, and 417
patients were included in final analyses. At 30 days, death from any cause
had occurred in 100 of 209 patients (47.8%) in the ECLS group and in 102
of 208 patients (49.0%) in the control group (relative risk, 0.98; 95%
confidence interval [CI], 0.80 to 1.19; P=0.81). The median duration of
mechanical ventilation was 7 days (interquartile range, 4 to 12) in the
ECLS group and 5 days (interquartile range, 3 to 9) in the control group
(median difference, 1 day; 95% CI, 0 to 2). The safety outcome consisting
of moderate or severe bleeding occurred in 23.4% of the patients in the
ECLS group and in 9.6% of those in the control group (relative risk, 2.44;
95% CI, 1.50 to 3.95); peripheral vascular complications warranting
intervention occurred in 11.0% and 3.8%, respectively (relative risk,
2.86; 95% CI, 1.31 to 6.25). Conclusions In patients with acute myocardial
infarction complicated by cardiogenic shock with planned early
revascularization, the risk of death from any cause at the 30-day
follow-up was not lower among the patients who received ECLS therapy than
among those who received medical therapy alone. (Funded by the Else Kroner
Fresenius Foundation and others; ECLS-SHOCK ClinicalTrials.gov number,
NCT03637205.). Copyright © 2023 Massachusetts Medical Society.

<21>
Accession Number
2028041609
Title
Comparison of Figure-of-Eight Suture and Perclose ProGlide Suture-Mediated
Closure in Large Bore Venous Access Hemostasis: A Randomized Controlled
Trial.
Source
American Journal of Cardiology. 209 (pp 181-183), 2023. Date of
Publication: 15 Dec 2023.
Author
Lodhi H.; Shaukat S.; Mathews A.; Maini B.; Khalili H.
Institution
(Lodhi, Shaukat, Mathews, Maini, Khalili) Florida Atlantic University,
Boca Raton, FL, United States
(Khalili) Memorial Health Cardiovascular Institute, Hollywood, Florida,
United States
Publisher
Elsevier Inc.
Abstract
Suture-mediated closure device and Figure-of-Eight suture are commonly
used to achieve hemostasis after use of large bore venous access. Although
both methods of closure are commonly used in clinical practice, a
head-to-head comparison in a controlled setting has not been performed.
Patients presenting to a single center for elective left atrial appendage
occlusion or transcatheter edge-to-edge mitral valve repair were
randomized to large bore venous closure using the Perclose ProGlide
suture-based closure or a Figure-of-Eight suture closure. The patients
were followed for 1 month after the procedure. Primary outcome, a
composite of access site large ecchymosis, hematoma, infection, pain, need
for unscheduled venous ultrasound and need for transfusion, was compared
between the 2 arms. A total of 40 patients were randomized in a 1:1
fashion to the 2 venous closure strategies. Baseline characteristics were
similar between the 2 groups. Perclose ProGlide arm required use of more
devices for hemostasis (1.5 +/- 0.5 vs 1 +/- 0 respectively, p <0.0001),
and there was a significant difference in the cost of closure device
($367.00 +/- 122.00 vs $1.00 +/- 0 respectively, p <0.001). At 1 month
post-procedure, the primary outcome occurred in 4 patients (20%) in the
Perclose arm and 7 (35%) patients in the Figure-of-Eight arm, a difference
that was not statistically significant (p = 0.48). Time to hemostasis
between Figure-of-Eight and Perclose arms did not reach statistical
significance (2.5 +/- 2.1 vs 3.7 +/- 2.3, p = 0.09). In conclusion, both
Perclose ProGlide suture-based device and Figure-of-Eight closure are
equally feasible and safe for patients who underwent large bore venous
access. Figure-of-Eight-based closure is more cost
effective. Copyright © 2023

<22>
Accession Number
2026646473
Title
The efficacy of phase I cardiac rehabilitation training based on augmented
reality on the self-efficacy of patients undergoing coronary artery bypass
graft surgery: A randomized clinical trial.
Source
BMC Sports Science, Medicine and Rehabilitation. 15(1) (no pagination),
2023. Article Number: 156. Date of Publication: December 2023.
Author
Ghlichi Moghaddam N.; Namazinia M.; Hajiabadi F.; Mazlum S.R.
Institution
(Ghlichi Moghaddam) Department of Medical - Surgical Nursing, School of
Nursing and Midwifery (MSC Student), Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Namazinia) Department of Nursing, School of Nursing and Midwifery, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Hajiabadi, Mazlum) Department of Medical - Surgical Nursing, School of
Nursing and Midwifery, Mashhad University Medical of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Ghlichi Moghaddam, Hajiabadi, Mazlum) Nursing and Midwifery Care Research
Center, Mashhad University Medical of Medical Sciences, Mashhad, Iran,
Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Open-heart surgery is considered one of the primary treatments
for severe coronary artery stenosis, but it comes with its own set of
complications. However, these complications can be reduced through the
implementation of proper cardiac rehabilitation during phase I. This study
aimed to examine the impact of phase I cardiac rehabilitation training,
using augmented reality, on the self-efficacy of cardiac management in
patients undergoing coronary artery bypass grafting. Methodology: This
randomized clinical trial study involved 60 patients who were admitted to
the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The
software used in this study consisted of various videos and educational
images demonstrating physical exercises for cardiac rehabilitation. The
software was developed to train the patients in the intervention group on
the rehabilitation program, starting from their admission to the Intensive
Care Unit until their discharge from the hospital. The collected data were
analyzed using statistical tests such as independent t-test, Mann-Whitney
test, paired t-test, chi-square test, as well as descriptive indicators.
Cohen's d was also used to evaluate the magnitude of the effect size.
 Result(s): The findings of this study revealed that the total mean
score for cardiovascular management self-efficacy significantly increased
during the transfer to the Intensive Care Unit and at the time of
discharge. Notably, the increase observed in the intervention group was
significantly greater than that of the control group (P < 0.001).
 Conclusion(s): The results of this study indicated that implementing
early rehabilitation programs, using innovative educational technology
like augmented reality, enhanced the self-efficacy of patients undergoing
coronary artery bypass grafting. These findings suggest that such programs
can be effectively employed as educational tools throughout different
stages of cardiac rehabilitation. Trial Registration: This study was
registered in the Iranian Registry of Clinical Trials (no.
IRCT20200203046361N1) on 16/02/2020. Copyright © 2023, The
Author(s).

<23>
Accession Number
2026445764
Title
Coronary arterial repair in patients with stable angina pectoris or acute
coronary syndrome after ultrathin biodegradable polymer sirolimus-eluting
stent implantation at 1-year follow-up by coronary angioscopy.
Source
Catheterization and Cardiovascular Interventions. 102(6) (pp 1012-1019),
2023. Date of Publication: 15 Nov 2023.
Author
Ichikawa M.; Matsuoka Y.; Hasebe T.
Institution
(Ichikawa, Matsuoka) Department of Cardiology, Higashi-Osaka City Medical
Center, Osaka, Japan
(Hasebe) Department of Radiology, Tokai University School of Medicine,
Kanagawa, Japan
(Hasebe) Department of Radiology, Tokai University Hachioji Hospital,
Tokyo, Japan
(Hasebe) Vascular and Interventional Center, Tokai University Hachioji
Hospital, Tokyo, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: Imaging modality-based evidence is limited that compares the
extent of coronary arterial repair after percutaneous coronary
intervention between patients with stable angina pectoris (SAP) and those
with acute coronary syndrome (ACS). Method(s): Between December 2018
and November 2021, a single-center, nonrandomized, observational study was
conducted in 92 patients with SAP (n = 42) or ACS (n = 50), who were
implanted with Orsiro sirolimus-eluting stent (O-SES) providing a hybrid
(active and passive) coating and underwent 1-year follow-up by coronary
angioscopy (CAS) after implantation. CAS assessed neointimal coverage
(NIC), maximum yellow plaque (YP), and mural thrombus (MT).
 Result(s): Baseline clinical characteristics were comparable between
the SAP and ACS groups. The follow-up periods were comparable between the
two groups (390.1 +/- 69.9 vs. 390.6 +/- 65.7 days, p = 0.99). The
incidences of MT at 1 year after implantation were comparable between the
two groups (11.4% vs. 11.1%, p = 0.92). The proportions of "Grade 1" in
dominant NIC grades were highest in both groups, and the proportions of
maximum YP grades and MT were comparable between the two groups.
 Conclusion(s): O-SES-induced coronary arterial repair at the site of
stent implantation, irrespective of the types of coronary artery
disease. Copyright © 2023 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<24>
Accession Number
2026111308
Title
A systematic review of full economic evaluations of robotic-assisted
surgery in thoracic and abdominopelvic procedures.
Source
Journal of Robotic Surgery. 17(6) (pp 2671-2685), 2023. Date of
Publication: December 2023.
Author
Sadri H.; Fung-Kee-Fung M.; Shayegan B.; Garneau P.Y.; Pezeshki P.
Institution
(Sadri) Department of Health Economic and Outcomes Research, Medtronic
ULC, 99 Hereford St., Brampton, ON L6Y 0R3, Canada
(Fung-Kee-Fung) Champlain Regional Cancer Program Depts OB/GYN, Surgery,
The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
(Shayegan) Division of Urology, Department of Surgery, McMaster
University, 50 Charlton Ave., Hamilton, ON L8N 4A6, Canada
(Garneau) Surgical Department, Hopital du Sacre-Coeur de Montreal, 5400
Boul Gouin O, Montreal, QC H4J 1C5, Canada
(Pezeshki) Department of Clinical Research, Medtronic ULC, 99 Hereford
St., Brampton, ON L6Y 0R3, Canada
Publisher
Springer Nature
Abstract
This study aims to conduct a systematic review of full economic analyses
of robotic-assisted surgery (RAS) in adults' thoracic and abdominopelvic
indications. Authors used Medline, EMBASE, and PubMed to conduct a
systematic review following the preferred reporting items for systematic
reviews and meta-analyses (PRISMA) 2020 guidelines. Fully published
economic articles in English were included. Methodology and reporting
quality were assessed using standardized tools. Majority of studies
(28/33) were on oncology procedures. Radical prostatectomy was the most
reported procedure (16/33). Twenty-eight studies used quality-adjusted
life years, and five used complication rates as outcomes. Nine used
primary and 24 studies used secondary data. All studies used modeling. In
81% of studies (27/33), RAS was cost-effective or potentially
cost-effective compared to comparator procedures, including radical
prostatectomy, nephrectomy, and cystectomy. Societal perspective,
longer-term time-horizon, and larger volumes favored RAS. Cost-drivers
were length of stay and equipment cost. From societal and payer
perspectives, robotic-assisted surgery is a cost-effective strategy for
thoracic and abdominopelvic procedures. Clinical trial registration This
study is a systematic review with no intervention, not a clinical
trial. Copyright © 2023, The Author(s).

<25>
Accession Number
2026811840
Title
Comparison of post-operative pain and quality of life between total
thoracoscopic surgery and conventional full-sternotomy for aortic valve
replacement.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
580. Date of Publication: December 2023.
Author
Lin Z.; Chen X.; Xu Z.; Chen L.; Dai X.
Institution
(Lin, Chen, Xu, Chen, Dai) Department of Cardiovascular Surgery, Union
Hospital, Fujian Medical University, Xinquan Road 29#, Fuzhou 350001,
China
(Lin, Chen, Xu, Chen, Dai) Key Laboratory of Cardio-Thoracic Surgery,
Fujian Medical University, Fujian Province University, Fuzhou 350001,
China
Publisher
BioMed Central Ltd
Abstract
Background: To compare the post-operative pain and quality of life of
patients who underwent total thoracoscopic surgery (TTS) or conventional
full-sternotomy (CFS) for aortic valve replacement (AVR). Method(s):
We reviewed the records of 223 consecutive AVR patients with either TTS or
CFS from January 2018 to December 2022. We used a visual analogue scale
(VAS) and the Short Form-36 Health Survey (SF-36) to measure the
post-operative pain and quality of life, respectively. We also compared
the operative data and clinical outcomes between the two groups.
 Result(s): The TTS group had lower adjusted mean VAS scores than the
CFS group at all time points after surgery (at 1 to 3 days and at 3 and 6
months, p <.001 for all comparisons), indicating less pain. The TTS group
also had higher mean SF-36 scores than the CFS group up to 6 months after
surgery (p <.001 for all comparisons), indicating better quality of life.
The operative time was similar between the two groups (p =.224), but the
TTS group had longer cardiopulmonary bypass time and aortic cross-clamp
time than the CFS group (p <.001). The TTS group had more pulmonary
complications than the CFS group (p =.023). However, there were no
significant differences in other major complications or mortality between
the two groups. Conclusion(s): TTS is a safe and effective
alternative to CFS for AVR. TTS resulted in less pain and better quality
of life, especially in the early recovery period. However, further
prospective randomized controlled studies are needed to confirm our
findings. Copyright © 2023, The Author(s).

<26>
Accession Number
2026762589
Title
Reoperation rate and risk factors of reoperation for ossification of the
posterior longitudinal ligament (OPLL): a systematic review and
meta-analysis.
Source
Neurosurgical Review. 46(1) (no pagination), 2023. Article Number: 313.
Date of Publication: December 2023.
Author
Tayal A.; Pahwa B.; Garg K.
Institution
(Tayal, Pahwa) University College of Medical Sciences and G.T.B. Hospital,
Delhi, India
(Garg) Department of Neurosurgery, All India Institute of Medical
Sciences, Delhi, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Revision surgery for OPLL is undesirable for both patients and physicians.
However, the risk factors for reoperation are not clear. Thus, we sought
to review the existing literature and determine the factors associated
with higher reoperation rates in patients with OPLL. A search was
performed using Pubmed, Embase, Web of Sciences, and Ovid to include
studies regarding the risk factors of reoperation for OPLL. RoBANS (Risk
of Bias Assessment tool for Nonrandomized Studies) was used for risk of
bias analysis. Heterogeneity of studies and publication bias was assessed,
and sensitivity analysis was performed. Statistical analysis was performed
with a p-value < 0.05 using SPSS software (version 23). Twenty studies
with 129 reoperated and 2,793 non-reoperated patients were included. The
pooled reoperation rate was 5% (95% CI: 4% to 7). The most common cause of
reoperation was residual OPLL or OPLL progression (n = 51, 39.53%). An
increased risk of additional surgery was found with pre-operative cervical
or thoracic angle (Standardized mean difference = -0.44; 95% CI: -0.69 to
-0.19; p = 0.0061), post-operative CSF leak (Odds ratio, OR = 4.97; 95%
CI: 2.48 to 9.96; p = 0.0005), and graft and/or hardware failure (OR =
192.09; 95% CI: 6.68 to 5521.69; p = 0.0101). Apart from the factors
identified in our study, the association of other variables with the risk
of second surgery could not be ruled out, owing to the complexity of the
relationship and significant bias in the current literature. Copyright
© 2023, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<27>
Accession Number
2026800367
Title
The effect of using virtual reality technology on anxiety and vital signs
before surgery in patients undergoing open heart surgery.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 62.
Date of Publication: December 2023.
Author
Amiri A.; Jalali R.; Salari N.
Institution
(Amiri, Jalali, Salari) Kermanshah University of Medical Sciences,
Kermanshah, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Introduction: Preoperative anxiety is one of the most common psychological
problems in open-heart surgery patients. Not controlling this problem can
negatively the operation outcome and the patient's physical condition.
Among various training methods and tools introduced to deal with this
issue, the ideal method still remains unknown. Therefore, the present
study was to determine the effect of using virtual reality technology on
preoperative anxiety in patients undergoing open heart surgery.
 Material(s) and Method(s): The participants of this
interventional-educational study included 60 patients who were candidates
for open heart surgery. The samples were randomly divided into two groups
virtual reality(n = 30)and ordinary video (n = 30). For the virtual
reality group, a virtual reality film and for the ordinary video group, an
ordinary video of the physical space and operating room staff were
displayed the day before the operation. Patients' anxiety in both groups
was assessed using the Spielberger State-Trait Anxiety Inventory (STAI)
before and after the intervention. Data analysis was performed using the
SPSS software version 25. Result(s): The mean anxiety score before
the intervention was 55.8 and 58.33 in the virtual reality group and the
ordinary video group, respectively. After the intervention, it reached
38.60 in the virtual reality group and 45.13 in the control group. There
was no statistically significant difference between the anxiety scores of
the subjects in the virtual reality and ordinary video groups before the
intervention (p > 0.05). However, the difference between the anxiety
scores of the subjects in the virtual reality and ordinary video groups
after the intervention was significant (p < 0.05). Conclusion(s):
Although virtual reality and ordinary video interventions effectively
reduce anxiety in heart surgery patients, virtual reality seems to lower
anxiety in heart surgery patients by diverting attention from external
stimuli and immersing the person in the virtual world more than ordinary
video. Copyright © 2023, The Author(s).

<28>
Accession Number
2026797900
Title
The VEST External Support for Saphenous Vein Grafts in Coronary Surgery: A
Review of Randomized Clinical Trials.
Source
Journal of Cardiovascular Development and Disease. 10(11) (no pagination),
2023. Article Number: 453. Date of Publication: November 2023.
Author
Soletti G.J.; Dell'Aquila M.; Harik L.; Cancelli G.; Alzghari T.;
Perezgrovas-Olaria R.; Dimagli A.; An K.R.; Leith J.; Rossi C.S.; Barile
C.F.; Demetres M.; Lau C.; Girardi L.N.; Gaudino M.
Institution
(Soletti, Dell'Aquila, Harik, Cancelli, Alzghari, Perezgrovas-Olaria,
Dimagli, An, Leith, Rossi, Barile, Lau, Girardi, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, 525 East 68th Street, New
York, NY 10021, United States
(Demetres) Samuel J. Wood Library, C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY 10021, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Saphenous vein grafts (SVGs) are the most frequently used conduits in
coronary artery bypass grafting (CABG), but their higher rate of occlusion
compared to arterial conduits remains a concern. Previous studies have
shown that SVG failure is mainly driven by intimal hyperplasia, an
adaptative response to higher pressures of the arterial circulation. The
VESTTM device (Vascular Graft Solutions, Tel Aviv, Israel), an
external support designed to mitigate intimal hyperplasia in SVGs, has
been tested in few clinical trials (RCTs). Herein, we descriptively
evaluated the randomized evidence on the VEST device. Copyright ©
2023 by the authors.

<29>
Accession Number
2026782636
Title
Pulmonary Lobectomy for Early-Stage Lung Cancer with Uniportal versus
Three-Portal Video-Assisted Thoracic Surgery: Results from a Single-Centre
Randomized Clinical Trial.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7167. Date of Publication: November 2023.
Author
Tosi D.; Mazzucco A.; Musso V.; Bonitta G.; Rosso L.; Mendogni P.; Righi
I.; Carrinola R.; Damarco F.; Palleschi A.
Institution
(Tosi, Mazzucco, Musso, Bonitta, Rosso, Mendogni, Righi, Carrinola,
Damarco, Palleschi) Thoracic Surgery and Lung Transplantation Unit,
Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan 20122,
Italy
(Musso, Bonitta, Rosso, Palleschi) Department of Patho-Physiology and
Transplantation, University of Milan, Milan 20122, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Video-assisted thoracic surgery (VATS) is a consolidated approach;
however, there is no consensus on the number of ports leading to less
postoperative pain. We compared early postoperative pain after uniportal
and three-portal VATS lobectomy for early-stage NSCLC. In this randomized
clinical trial, patients undergoing VATS lobectomy were randomly assigned
to receive uniportal (U-VATS Group) or three-portal (T-VATS Group) VATS.
The inclusion criteria were age <= 80 years and ASA < 4. The exclusion
criteria were clinical T3, previous thoracic surgery, induction therapy,
chest radiotherapy, connective tissue or vascular diseases, major organ
failure, and analgesics or corticosteroids use. The postoperative
analgesia protocol was based on NRS. Pain was measured as analgesic
consumption; the secondary endpoints were intra- and postoperative
complications, conversion rate, surgical time, dissected lymph nodes,
hospital stay, and respiratory function. Out of 302 eligible patients, 120
were included; demographics were distributed homogeneously. The mean
cumulative morphine consumption (CMC) in the U-VATS Group after 7 days was
lower than in the T-VATS Group (77.4 mg vs. 90.1 mg, p = 0.003).
Intraoperative variables and postoperative complications were comparable.
The 30-day intercostal neuralgia rate was lower in the U-VATS Group,
without reaching statistical significance. Patients undergoing U-VATS
showed a lower analgesic consumption compared with the T-VATS Group;
analgesic consumption was moderate in both groups. Copyright ©
2023 by the authors.

<30>
Accession Number
2026782597
Title
Saphenous Vein Graft Failure: Current Challenges and a Review of the
Contemporary Percutaneous Options for Management.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7118. Date of Publication: November 2023.
Author
Back L.; Ladwiniec A.
Institution
(Back, Ladwiniec) Glenfield Hospital, Leicester LE39QP, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The use of saphenous vein grafts (SVGs) in the surgical management of
obstructive coronary artery disease remains high despite a growing
understanding of their limitations in longevity. In contemporary practice,
approximately 95% of patients receive one SVG in addition to a left
internal mammary artery (LIMA) graft. The precise patency rates for SVGs
vary widely in the literature, with estimates of up to 61% failure rate at
greater than 10 years of follow-up. SVGs are known to progressively
degenerate over time and, even if they remain patent, demonstrate marked
accelerated atherosclerosis. Multiple studies have demonstrated a marked
acceleration of atherosclerosis in bypassed native coronary arteries
compared to non-bypassed arteries, which predisposes to a high number of
native chronic total occlusions (CTOs) and subsequent procedural
challenges when managing graft failure. Patients with failing SVGs
frequently require revascularisation to previously grafted territories,
with estimates of 13% of CABG patients requiring an additional
revascularisation procedure within 10 years. Redo CABG confers a
significantly higher risk of in-hospital mortality and, as such,
percutaneous coronary intervention (PCI) has become the favoured strategy
for revascularisation in SVG failure. Percutaneous treatment of a
degenerative SVG provides unique challenges secondary to a tendency for
frequent superimposed thrombi on critical graft stenoses, friable lesions
with marked potential for distal embolization and subsequent no-reflow
phenomena, and high rates of peri-procedural myocardial infarction (MI).
Furthermore, the rates of restenosis within SVG stents are
disproportionately higher than native vessel PCI despite the advances in
drug-eluting stent (DES) technology. The alternative to SVG PCI in failed
grafts is PCI to the native vessel, 'replacing' the grafts and restoring
patency within the previously grafted coronary artery, with or without
occluding the donor graft. This strategy has additional challenges to de
novo coronary artery PCI, however, due to the high burden of complex
atherosclerotic lesion morphology, extensive coronary calcification, and
the high incidence of CTO. Large patient cohort studies have reported
worse short- and long-term outcomes with SVG PCI compared to native vessel
PCI. The PROCTOR trial is a large and randomised control trial aimed at
assessing the superiority of native vessel PCI versus vein graft PCI in
patients with prior CABG awaiting results. This review article will
explore the complexities of SVG failure and assess the contemporary
evidence in guiding optimum percutaneous interventional
strategy. Copyright © 2023 by the authors.

<31>
Accession Number
2026782574
Title
Optimal Management of Patients with Phlegmonous Esophagitis: A Systematic
Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7147. Date of Publication: November 2023.
Author
Jin D.H.; Woo W.; Lee J.; Moon D.H.; Lee S.
Institution
(Jin, Woo, Lee, Moon, Lee) Department of Thoracic and Cardiovascular
Surgery, Gangnam Severance Hospital, Yonsei University College of
Medicine, Seoul 03722, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Goals: To assess the characteristics and prognosis-influencing factors of
phlegmonous esophagitis, a rare condition marked by suppurative
inflammation of the esophageal submucosa and muscular layers.
 Background(s): Effective management strategies for phlegmonous
esophagitis are lacking. This study aims to systematically review cases to
better understand the disease's features and prognostic determinants.
 Method(s): A systematic search was performed using PubMed/MEDLINE and
Google Scholar from inception to 20 April 2023. Phlegmonous esophagitis
case reports and studies with patient information were included; clinical
manifestations, laboratory results, imaging findings, other diagnostic
findings, and outcomes were analyzed. A pooled analysis was performed to
investigate mortality-related risk factors. Result(s): A total of 35
cases of phlegmonous esophagitis were selected from 31 case reports and 2
case series (median age, 57.0 years; male, 54.3%). The patients presented
various clinical symptoms, with neck-to-epigastric pain and dysphagia
being the most common. Comorbid diabetes mellitus was a major predisposing
factor; one-third of the patients had no previous medical history.
Computed tomography (CT) and endoscopic examinations were predominantly
used for phlegmonous esophagitis diagnosis. Radiological findings showed
that the upper and middle esophagus were most frequently involved.
Treatments included administration of broad-spectrum antibiotics and
drainage via endoscopy or surgery. There were three cases of mortality,
and non-survivors tended to have shorter hospital stays, indicating rapid
disease progression. In logistic regression, thoracic surgery was a
significant mortality-related risk factor (odds ratio, 19.30; 95%
confidence interval, 1.33-282.00, p = 0.03). Conclusion(s):
Advancements in CT and endoscopy have led to less-invasive diagnostic and
treatment methods for phlegmonous esophagitis. Endoscopic localized
abscess treatment is associated with positive outcomes. Copyright
© 2023 by the authors.

<32>
Accession Number
2026762821
Title
Impact of periprocedural myocardial injury after transcatheter aortic
valve implantation on long-term mortality: a meta-analysis of Kaplan-Meier
derived individual patient data.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1228305. Date of Publication: 2023.
Author
de Sa Marchi M.F.; Calomeni P.; Gauza M.D.M.; Kanhouche G.; Ravani L.V.;
Rodrigues C.V.F.; Tarasoutchi F.; de Brito F.S.; Rodes-Cabau J.; Van
Mieghem N.M.; Abizaid A.; Ribeiro H.B.
Institution
(de Sa Marchi, Calomeni, Kanhouche, Ravani, Rodrigues, de Brito, Abizaid,
Ribeiro) Departamento de Cardiologia Intervencionista e Hemodinamica,
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(de Sa Marchi, Van Mieghem) Department of Interventional Cardiology,
Erasmus Medical Center, Rotterdam, Netherlands
(Gauza) Universidade Regional de Joinville, Joinville, Brazil
(Tarasoutchi) Unidade Clinica de Valvopatias, Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Rodes-Cabau) Department of Cardiovascular Medicine, Quebec Heart and Lung
Institute, Laval University, Quebec City, QC, Canada
(Rodes-Cabau) Department of Cardiovascular Medicine, Institut Clinic
Cardiovascular, Hospital Clinic de Barcelona, Barcelona, Spain
Publisher
Frontiers Media SA
Abstract
Background: Periprocedural myocardial injury (PPMI) frequently occurs
after transcatheter aortic valve implantation (TAVI), although its impact
on long-term mortality is uncertain. Method(s): We performed a pooled
analysis of Kaplan-Meier-derived individual patient data to compare
survival in patients with and without PPMI after TAVI. Flexible parametric
models with B-splines and landmark analyses were used to determine PPMI
prognostic value. Subgroup analyses for VARC-2, troponin, and creatine
kinase-MB (CK-MB)-defined PPMI were also performed. Result(s):
Eighteen observational studies comprising 10,094 subjects were included.
PPMI was associated with lower overall survival (OS) after two years (HR =
1.46, 95% CI 1.30-1.65, p < 0.01). This was also observed when restricting
the analysis to overall VARC-2-defined PPMI (HR = 1.23, 95% CI 1.07-1.40,
p < 0.01). For VARC-2 PPMI criteria and VARC-2 troponin-only, higher
mortality was restricted to the first 2 months after TAVI (HR = 1.64, 95%
CI 1.31-2.07, p < 0.01; and HR = 1.32, 95% CI 1.05-1.67, p = 0.02,
respectively), while for VARC-2 defined CK-MB-only the increase in
mortality was confined to the first 30 days (HR = 7.44, 95% CI 4.76-11.66,
p < 0.01). Conclusion(s): PPMI following TAVI was associated with
lower overall survival compared with patients without PPMI. PPMI
prognostic impact is restricted to the initial months after the procedure.
The analyses were consistent for VARC-2 criteria and for both biomarkers,
yet CK-MB was a stronger prognostic marker of mortality than
troponin. Copyright 2023 de Sa Marchi, Calomeni, Gauza, Kanhouche,
Ravani, Rodrigues, Tarasoutchi, de Brito, Rodes-Cabau, Van Mieghem,
Abizaid and Ribeiro.

<33>
Accession Number
2028591478
Title
Ischaemic stroke in anticoagulated patients with atrial fibrillation.
Source
Journal of Neurology, Neurosurgery and Psychiatry. 92(11) (pp 1164-1172),
2021. Date of Publication: November 2021.
Author
Stretz C.; Wu T.Y.; Wilson D.; Seiffge D.J.; Smith E.E.; Gurol M.E.; Yaghi
S.
Institution
(Stretz, Yaghi) Department of Neurology, Brown University, Providence, RI,
United States
(Wu) Department of Neurology, Christchurch Hospital, Christchurch, New
Zealand
(Wilson) Stroke Research Centre, UCL Institute of Neurology, London,
United Kingdom
(Seiffge) Department of Neurology and Stroke Center, Inselspital,
University Hospital Bern, Bern, Switzerland
(Smith) Department of Clinical Neurosciences, University of Calgary,
Calgary, AB, Canada
(Gurol) Department of Neurology, Massachusetts General Hospital, Boston,
MA, United States
Publisher
BMJ Publishing Group
Abstract
Anticoagulation substantially reduces the risk of stroke in patients with
atrial fibrillation (AF). However, recent studies have shown that up to
22%-36% of patients on anticoagulation will suffer an ischaemic stroke
(IS). In this narrative review, we provide an overview of risk factors,
mechanisms, management of acute IS and strategies for secondary prevention
for patients with AF with stroke despite oral anticoagulation. For this
paper, we reviewed available literature from important studies (randomised
clinical trials, meta-analyses, reviews and case series) on patients with
IS despite anticoagulation. We focused on recent studies that examined
safety and efficacy of acute stroke treatments and evaluation and
management strategies for secondary prevention. The literature review
suggests that patients with AF with IS despite anticoagulation are a
heterogeneous group with several possible mechanisms, which may include
reduced or non-adherence to anticoagulation, competing non-cardioembolic
stroke aetiologies or cardioembolic mechanisms separate from AF. The
identification of one or more possible mechanisms of stroke despite
anticoagulation may allow for a more targeted and individualised approach
for secondary prevention. There are limited data to guide management in
such patients, and strategies to prevent recurrent strokes include strict
risk factor control and therapies targeting the most likely stroke
mechanism. In cases where AF is suspected to be the culprit, clinical
trials are needed to test the safety and efficacy of left atrial appendage
occlusion plus anticoagulation versus continued anticoagulation alone.
 Copyright © 2021 Author(s) (or their employer(s)).

<34>
Accession Number
2028411747
Title
Dual-therapy CD34 antibody-covered sirolimus-eluting COMBO stents versus
sirolimus-eluting Orsiro stents in patients treated with percutaneous
coronary intervention: the three-year outcomes of the SORT OUT X
randomised clinical trial.
Source
EuroIntervention. 19(8) (pp 676-683), 2023. Date of Publication: October
2023.
Author
Jakobsen L.; Christiansen E.H.; Freeman P.; Kahlert J.; Veien K.; Maeng
M.; Raungaard B.; Ellert J.; Villadsen A.B.; Kristensen S.D.; Christensen
M.K.; Terkelsen C.J.; Aaroe J.; Thim T.; Lassen J.F.; Hougaard M.;
Eftekhari A.; Jensen R.V.; Stottrup N.B.; Rasmussen J.G.; Junker A.;
Jensen S.E.; Hansen H.S.; Jensen L.O.
Institution
(Jakobsen, Christiansen, Maeng, Kristensen, Terkelsen, Thim, Eftekhari,
Jensen, Stottrup) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Freeman, Raungaard, Villadsen, Rasmussen, Jensen) Department of
Cardiology, Aalborg University Hospital, Aalborg, Denmark
(Kahlert) Department of Clinical Epidemiology, Aarhus University Hospital,
Aarhus, Denmark
(Veien, Ellert, Christensen, Aaroe, Lassen, Hougaard, Junker, Hansen,
Jensen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
Publisher
Europa Group
Abstract
Background: Target lesion failure (TLF) remains an issue with contemporary
drug-eluting stents. The dual-therapy sirolimus-eluting and CD34
antibody-coated COMBO stent (DTS) was designed to improve early healing.
 Aim(s): We aimed to compare the 3-year outcomes of the DTS and the
sirolimus-eluting Orsiro stent (SES) in all-comer patients treated with
percutaneous coronary intervention. Method(s): The SORT OUT X trial
is a prospective multicentre randomised clinical trial with a
registry-based follow-up comparing DTS and SES. The primary endpoint, TLF,
is a composite of cardiac death, myocardial infarction or target lesion
revascularisation (TLR). Result(s): A total of 3,146 patients were
randomised to treatment with the DTS (1,578 patients) or the SES (1,568
patients). At 3 years, an intention-to-treat analysis showed that 155
patients (9.8%) who were assigned the DTS and 118 patients (7.5%) who were
assigned the SES met the primary endpoint (incidence rate ratio for
TLF=1.33, 95% confidence interval: 1.04-1.70; p=0.02). This difference was
caused by a significantly higher TLF rate in the DTS group compared to the
SES group within the first year, which was mainly explained by a higher
incidence of TLR in the DTS group compared to the SES group. Of note, the
TLF rates were almost identical from 1 year to 3 years in both stent
groups. Conclusion(s): At 3 years, the SES was superior to the DTS,
mainly because the DTS was associated with an increased risk of TLF within
the first year but not from 1 to 3 years. ClinicalTrials.gov:
NCT03216733. Copyright © 2023 Authors. All rights reserved.

<35>
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. 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. 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).
 Conclusion(s): Pre-ICNB reduces intra-operative opioid consumption,
speeding PACU recovery, and manages perioperative pain as well as
post-ICNB. Copyright © 2023 EManuscript Technologies. All rights
reserved.

<36>
Accession Number
2028241250
Title
Status of Quality and Compliance to Inpatient Quality Indicators and
Patient Safety Indicators in a Selected Private Corporate Hospital at
Dhaka City Bangladesh.
Source
Bangladesh Medical Research Council Bulletin. 49(2) (pp 98-112), 2023.
Date of Publication: 2023.
Author
Giasuddin A.S.M.; Shahjahan M.; Seoty N.R.; Hossain S.
Institution
(Giasuddin, Shahjahan, Seoty) Department of Public Health, School of
Health Sciences, State University of Bangladesh (SUB), Dhanmondi, Dhaka,
Bangladesh
(Hossain) Department of Quality Assurance, Labaid Hospitals (LSH), Dhaka,
Bangladesh
Publisher
Bangladesh Medical Research Council
Abstract
Bacground: The stutus of quality and compliance to inpatient quality
indicators (IQIs) and patient safety indicators (PSIs) in corporate
hospitals at dhaka city Bangladesh are not known as they are not
adequately studied. Objective(s): The present descriptive
cross-sectional study was therefore undertaken to know the status of
quality and compliance to selected IQIs and PSIs in a selected private
(corporate) hospital at Dhaka City Bangladesh. The period of study and
hospital data collection period were May to August 2019 and January to
March 2019 respectively. Method(s): Selected IQIs and PSIs developed
by Agency for Healthcare Research and Quality (AHRQ), USA and hospital
facilities utilization parameters were investigated. Data were collected
using questionnaires and checklists for the period of January to March
2019 from the purposively selected private (corporate) hospital.
Sociodemographic information of randomly selected junior doctors and
nurses were taken. Randomly selected senior clinicians, nurses and
executives were interviewed regarding knowledge about selective IQIs,
PSIs, JCIS, ISO relevant to quality healthcare. Data were analysed by SPSS
programme version 20. Result(s): The hospital has all relevant
admistrative and clinical departments, bed patterns and has efficient
admission and discharge processes for inpatients. Bed utilization was
87.5% of total 159 available beds. Patients visited OPD: 2434 per day,
admitted: 28 per day and discharged with successful outcome: 27 per day.
Average length of stay (ALS), hospital acquired infection (HAI) and
hospital deaths were 3.6 days, 1.76% (18/ 1000 cases), and 124 (01 per
day) respectively during data collection period. Tests done in Laboratory
Medicine were 267637 with Clinical Biochemistry tests highest (51.21%) and
investigations in Radiology-Imaging departments were 74997 with X-rays
being highest (40.22%). Of the five selected IQIs, total CABG cases done
were 191 with 04 hospital deaths i.e. 2.1% (21 per 1000 cases) and total
AMI cases done were 140 with 12 hospital deaths i.e. 8.5% (85 per 1000
cases). No casualties were reported for caesarean deliveries or
primary/normal deliveries. None of the five selected PSIs were traced over
the data collection period. Conclusion(s): These findings suggested
that the selected hospital's services were demanding and it was concerned
about quality healthcare services. However, comparative studies with other
private corporate hospotals at Dhaka City including larger number of
respodents are warrented. Copyright © 2023 Bangladesh Medical
Research Council. All rights reserved.

<37>
Accession Number
2028100294
Title
The Role of Natriuretic Peptides in Predicting Adverse Outcomes After
Cardiac Surgery: An Updated Systematic Review.
Source
American Journal of Cardiology. 210 (pp 16-36), 2024. Date of Publication:
01 Jan 2024.
Author
Rao R.A.; Varghese S.S.; Ansari F.; Rao A.; Meng E.; El-Diasty M.
Institution
(Rao, Varghese, Ansari, Rao, Meng) Queen's University School of Medicine,
Kingston, ON, Canada
(El-Diasty) Harrington Heart and Vascular Institute, Cardiac Surgery
Department, University Hospitals, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
The increasing global burden of cardiovascular disease, particularly, in
the aging population, has led to an increase in high-risk cardiac surgical
procedures. The current preoperative risk stratification scores, such as
the European System for Cardiac Operative Risk Evaluation and the Society
for Thoracic Surgeons score, have limitations in their predictive accuracy
and tend to underestimate the mortality risk in higher-risk populations.
This systematic review aimed to evaluate the utility of natriuretic
peptides, brain natriuretic peptide (BNP) and its precursor prohormone
(N-terminal prohormone BNP), as predictive biomarkers for adverse outcomes
after cardiac surgery. A comprehensive search strategy was performed, and
63 studies involving 40,667 patients who underwent major cardiac
operations were included for data extraction. Preoperative levels of BNP
and N-terminal prohormone BNP seemed to be associated with an increased
risk of short- and long-term mortality, postoperative heart failure,
kidney injury, and length of intensive care unit stay. However, their
predictive value for postoperative arrhythmias and myocardial infarction
was less established. Our findings suggest that natriuretic peptides may
play an important role in risk prediction in patients who underwent
cardiac surgery. The addition of these biomarkers to the existing clinical
risk stratification strategies may enhance their predictive accuracy.
However, this needs to be endorsed by data derived from wide-scale
clinical trials. Copyright © 2023 Elsevier Inc.

<38>
Accession Number
2025364755
Title
Three Ablation Techniques for Atrial Fibrillation during Concomitant
Cardiac Surgery: A Systematic Review and Network Meta-Analysis.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5716. Date of Publication: September 2023.
Author
Hanafy D.A.; Erdianto W.P.; Husen T.F.; Nathania I.; Vidya A.P.; Angelica
R.; Suwatri W.T.; Lintangella P.; Prasetyo P.; Sugisman
Institution
(Hanafy, Suwatri, Lintangella, Prasetyo, Sugisman) Division of
Cardiothoracic and Vascular Surgery, Department of Surgery, Faculty of
Medicine, University of Indonesia, Jl. Salemba Raya No. 6, Kenari, Jakarta
10430, Indonesia
(Hanafy, Erdianto, Suwatri, Sugisman) Division of Adult Cardiac Surgery,
Department of Surgery, National Cardiovascular Center, Harapan Kita,
Jakarta 11420, Indonesia
(Husen, Nathania, Vidya, Angelica) Faculty of Medicine, University of
Indonesia, Pondok Cina, Beji, Depok 16424, Indonesia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Atrial fibrillation (AF) ablation is a frequent procedure used in
concomitant cardiac surgery. However, uncertainty still exists concerning
the optimal extent of lesion sets. Hence, the objective of this study was
to assess the results of various ablation techniques, aiming to offer a
reference for clinical decision making. This review is listed in the
prospective register of systematic reviews (PROSPERO) under ID
CRD42023412785. A comprehensive search was conducted across eight
databases (Scopus, Google Scholar, EBSCOHost, PubMed, Medline, Wiley,
ProQuest, and Embase) up to 18 April 2023. Studies were critically
appraised using the Cochrane Risk of Bias 2.0 for randomized control
trials (RCTs) and the Newcastle Ottawa Scale adapted by the Agency for
Healthcare Research and Quality (AHRQ) for cohort studies. Forest plots of
pooled effect estimates and surface under the cumulative ranking (SUCRA)
were used for the analysis. Our analysis included 39 studies and a total
of 7207 patients. Both bi-atrial ablation (BAA) and left atrial ablation
(LAA) showed similar efficacy in restoring sinus rhythm (SR; BAA (77.9%) >
LAA (76.2%) > pulmonary vein isolation (PVI; 66.5%); LAA: OR = 1.08 (CI
0.94-1.23); PVI: OR = 1.36 (CI 1.08-1.70)). However, BAA had higher
pacemaker implantation (LAA: OR = 0.51 (CI 0.37-0.71); PVI: OR = 0.52 (CI
0.31-0.86)) and reoperation rates (LAA: OR = 0.71 (CI 0.28-1.45); PVI: OR
= 0.31 (CI 0.1-0.64)). PVI had the lowest efficacy in restoring SR and a
similar complication rate to LAA, but had the shortest procedure time
(Cross-clamp (Xc): PVI (93.38) > LAA (37.36) > BAA (13.89));
Cardiopulmonary bypass (CPB): PVI (93.93) > LAA (56.04) > BAA (0.03)). We
suggest that LAA is the best surgical technique for AF ablation due to its
comparable effectiveness in restoring SR, its lower rate of pacemaker
requirement, and its lower reoperation rate compared to BAA. Furthermore,
LAA ranks as the second-fastest procedure after PVI, with a similar CPB
time. Copyright © 2023 by the authors.

<39>
Accession Number
2026760173
Title
Enhanced recovery after thoracic surgery in low- and middle-income
countries: Feasibility and outcomes.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2023. Date of
Publication: 2023.
Author
Hentati A.; Ayed A.B.; Jdidi J.; Chaari Z.; Halima G.B.; Frikha I.
Institution
(Hentati, Ayed, Jdidi, Chaari, Halima, Frikha) University of Sfax, Faculty
of Medicine of Sfax, Sfax, Tunisia
(Hentati, Chaari, Halima, Frikha) Department of Cardiovascular and
Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
(Ayed) Surgery Department, Gabes University Hospital, Gabes, Tunisia
(Jdidi) Community Medicine Department, Hedi Chaker University Hospital,
Sfax, Tunisia
Publisher
SAGE Publications Inc.
Abstract
Background: Enhanced Recovery After Surgery (ERAS) applies multimodal,
perioperative, and evidence-based practices to decrease postoperative
morbi-mortality, the length of hospital stay, and hospitalization costs.
Implementing enhanced recovery after thoracic surgery (ERATS) in low- and
middle-income countries (LMIC) is problematic. This randomized controlled
trial evaluated the feasibility and effectiveness of an ERATS protocol
adapted to LMIC conditions in Tunisia. Material(s) and Method(s): We
conducted this randomized controlled trial between December 2015 and
August 2017 in the Thoracic and Cardiovascular Surgery Department at Habib
Bourguiba University Hospital of Sfax, Tunisia. Result(s): One
hundred patients undergoing thoracic surgery were randomly allocated to
the ERATS group or Control group. During the postoperative phase, 13
patients (13%) were excluded secondary. These complication rates were
lower in the ERATS group: lack of reexpansion (14.63% vs 16.10%: p =
0.72), pleural effusion (0% vs 10.86%, p = 0.05), and prolonged air leak
(17.07% vs 30.43%, p = 0.14). The pain level decreased significantly in
the ERATS group from postoperative H3 (p = 0.006). This difference was
significant at H6 (p = 0.001), H24 (p = 0.05), H48 (p = 0.01), discharge
(p = 0.002), and after 15 days (p = 0.01), with a decreased analgesic
consumption. The length of hospital stay was shorter in the ERAS group
(median six days vs seven days, p = 0.17). Conclusion(s): This study
provides an adapted ERATS protocol, applicable regardless of the surgical
approach or the type of resection and suitable for LMIC hospital's
conditions. This protocol can improve the postoperative outcomes of
thoracic surgery. Copyright © The Author(s) 2023.

<40>
Accession Number
2026748805
Title
Computed tomography derived anatomical predictors of vascular access
complications following transfemoral transcatheter aortic valve
implantation: A systematic review.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Androshchuk V.; Chehab O.; Prendergast B.; Rajani R.; Patterson T.;
Redwood S.
Institution
(Androshchuk, Chehab, Patterson, Redwood) School of Cardiovascular
Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College
London, London, United Kingdom
(Androshchuk, Chehab, Prendergast, Rajani, Patterson, Redwood) Department
of Cardiology, St Thomas' Hospital, King's College London, London, United
Kingdom
(Rajani) School of Biomedical Engineering and Imaging Sciences, Faculty of
Life Sciences & Medicine, King's College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Vascular complications after percutaneous transfemoral
transcatheter aortic valve implantation (TAVI) are associated with adverse
clinical outcomes and remain a significant challenge. Aim(s): The
purpose of this review is to synthesize the existing evidence regarding
the iliofemoral artery features predictive of vascular complications after
TAVI on pre-procedural contrast-enhanced multidetector computed tomography
(MDCT). Method(s): A systematic search was performed in Embase and
Medline (Pubmed) databases. Studies of patients undergoing transfemoral
TAVI with MDCT were included. Studies with only valve-in-valve TAVI,
planned surgical intervention and those using fluoroscopic assessment were
excluded. Data on study cohort, procedural characteristics and significant
predictors of vascular complications were extracted. Result(s): We
identified 23 original studies involving 8697 patients who underwent TAVI
between 2006 and 2020. Of all patients, 8514 (97.9%) underwent
percutaneous transfemoral-TAVI, of which 8068 (94.8%) had
contrast-enhanced MDCT. The incidence of major vascular complications was
6.7 +/- 4.1% and minor vascular complications 26.1 +/- 7.8%. Significant
independent predictors of major and minor complications related to vessel
dimensions were common femoral artery depth (>54 mm),
sheath-to-iliofemoral artery diameter ratio (>0.91-1.19),
sheath-to-femoral artery diameter ratio (>1.03-1.45) and sheath-to-femoral
artery area ratio (>1.35). Substantial iliofemoral vessel tortuosity
predicted 2-5-fold higher vascular risk. Significant iliofemoral
calcification predicted 2-5-fold higher risk. The iliac morphology score
was the only hybrid scoring system with predictive value.
 Conclusion(s): Independent iliofemoral predictors of access-site
complications in TAVI were related to vessel size, depth, calcification
and tortuosity. These should be considered when planning transfemoral TAVI
and in the design of future risk prediction models. Copyright ©
2023 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<41>
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. 71(1) (no pagination), 2024. Article Number:
e30759. Date of Publication: January 2024.
Author
Regling K.; Sehgal S.; Hollon W.; Rayner P.; Stricker L.; Sarnaik A.;
Sassalos P.; Al-Ahmadi M.; Rajpurkar M.; Chitlur M.B.
Institution
(Regling, Rajpurkar, Chitlur) Division of Hematology Oncology, Department
of Pediatrics, Children's Hospital of Michigan, Central Michigan
University College of Medicine, Detroit, MI, United States
(Sehgal) Division of Cardiology, Department of Pediatrics, Children's
Hospital of Michigan, Central Michigan University College of Medicine,
Detroit, MI, United States
(Hollon, Rayner) Detroit Medical Center, Children's Hospital of Michigan,
Detroit, MI, United States
(Stricker) Department of Anesthesia, Children's Hospital of Michigan,
Wayne State University School of Medicine, Detroit, MI, United States
(Sarnaik) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Children's Hospital of Michigan, Central Michigan University
College of Medicine, Detroit, MI, United States
(Sassalos, Al-Ahmadi) Department of Pediatric Cardiovascular Surgery,
Children's Hospital of Michigan, Detroit, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Hemophilia A is a disorder resulting in a deficiency of clotting factor
VIII that can lead to life-threatening bleeding. Evidence-based guidelines
for surgical interventions like cardiac surgery are limited.
Anticoagulation is necessary for cardiac bypass, thus risk of bleeding in
a patient with hemophilia is increased and requires careful attention to
maintain hemostasis. We report the first infant with severe hemophilia A
and dilated cardiomyopathy who underwent successful cardiac
transplantation, and review the literature on previous cardiac transplant
cases in congenital hemophilia. To ensure safe and effective management, a
multidisciplinary approach was used to develop the surgical protocol for
transplant. Copyright © 2023 Wiley Periodicals LLC.

<42>
[Use Link to view the full text]
Accession Number
642595418
Title
Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years.
Source
The New England journal of medicine. 389(21) (pp 1949-1960), 2023. Date of
Publication: 23 Nov 2023.
Author
Mack M.J.; Leon M.B.; Thourani V.H.; Pibarot P.; Hahn R.T.; Genereux P.;
Kodali S.K.; Kapadia S.R.; Cohen D.J.; Pocock S.J.; Lu M.; White R.;
Szerlip M.; Ternacle J.; Malaisrie S.C.; Herrmann H.C.; Szeto W.Y.; Russo
M.J.; Babaliaros V.; Smith C.R.; Blanke P.; Webb J.G.; Makkar R.
Institution
(Mack, Leon, Thourani, Pibarot, Hahn, Genereux, Kodali, Kapadia, Cohen,
Pocock, Lu, White, Szerlip, Ternacle, Malaisrie, Herrmann, Szeto, Russo,
Babaliaros, Smith, Blanke, Webb, Makkar) From Baylor Scott and White
Health, Plano, TX (M.J.M., M.S.); Columbia University (M.B.L., R.T.H.,
S.H.K., C.R.S.) and the Cardiovascular Research Foundation (M.B.L.,
R.T.H., S.H.K., D.J.C., C.R.S.), New York, and St. Francis Hospital and
Heart Center, Roslyn (D.J.C.) - all in New York; Marcus Heart Valve
Center, Piedmont Heart Institute (V.H.T.), and Emory University (V.B.) -
both in Atlanta; Laval University, Quebec, QC (P.P.), and St. Paul's
Hospital, University of British Columbia, Vancouver (P.B., J.G.W.) - both
in Canada; Morristown Medical Center, Morristown (P.G.), and Robert Wood
Johnson University Hospital, New Brunswick (M.J.R.) - both in New Jersey;
Cleveland Clinic, Cleveland (S.R.K.); London School of Hygiene and
Tropical Medicine, London (S.J.P.); Edwards Lifesciences, Irvine (M.L.,
R.W.), and Cedars-Sinai Medical Center, Los Angeles (R.M.) - both in
California; Heart Valve Unit, Haut-Leveque Cardiological Hospital,
Bordeaux University, Pessac, France (J.T.); Northwestern University,
Chicago (S.C.M.); and the University of Pennsylvania, Philadelphia
(H.C.H., W.Y.S.)
Abstract
BACKGROUND: A previous analysis in this trial showed that among patients
with severe, symptomatic aortic stenosis who were at low surgical risk,
the rate of the composite end point of death, stroke, or rehospitalization
at 1 year was significantly lower with transcatheter aortic-valve
replacement (TAVR) than with surgical aortic-valve replacement.
Longer-term outcomes are unknown. METHOD(S): We randomly assigned
patients with severe, symptomatic aortic stenosis and low surgical risk to
undergo either TAVR or surgery. The first primary end point was a
composite of death, stroke, or rehospitalization related to the valve, the
procedure, or heart failure. The second primary end point was a
hierarchical composite that included death, disabling stroke, nondisabling
stroke, and the number of rehospitalization days, analyzed with the use of
a win ratio analysis. Clinical, echocardiographic, and health-status
outcomes were assessed through 5 years. RESULT(S): A total of 1000
patients underwent randomization: 503 patients were assigned to undergo
TAVR, and 497 to undergo surgery. A component of the first primary end
point occurred in 111 of 496 patients in the TAVR group and in 117 of 454
patients in the surgery group (Kaplan-Meier estimates, 22.8% in the TAVR
group and 27.2% in the surgery group; difference, -4.3 percentage points;
95% confidence interval [CI], -9.9 to 1.3; P=0.07). The win ratio for the
second primary end point was 1.17 (95% CI, 0.90 to 1.51; P=0.25). The
Kaplan-Meier estimates for the components of the first primary end point
were as follows: death, 10.0% in the TAVR group and 8.2% in the surgery
group; stroke, 5.8% and 6.4%, respectively; and rehospitalization, 13.7%
and 17.4%. The hemodynamic performance of the valve, assessed according to
the mean (+/-SD) valve gradient, was 12.8+/-6.5 mm Hg in the TAVR group
and 11.7+/-5.6 mm Hg in the surgery group. Bioprosthetic-valve failure
occurred in 3.3% of the patients in the TAVR group and in 3.8% of those in
the surgery group. CONCLUSION(S): Among low-risk patients with
severe, symptomatic aortic stenosis who underwent TAVR or surgery, there
was no significant between-group difference in the two primary composite
outcomes. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov
number, NCT02675114.). Copyright © 2023 Massachusetts Medical
Society.

<43>
Accession Number
642086545
Title
Periprocedural continuation versus interruption of oral anticoagulant
drugs during transcatheter aortic valve implantation: rationale and design
of the POPular PAUSE TAVI trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
19(9) (pp 766-771), 2023. Date of Publication: 17 Nov 2023.
Author
van Ginkel D.J.; Bor W.L.; Dubois C.L.F.; Aarts H.M.; Rooijakkers M.J.P.;
van Bergeijk K.H.; Rosseel L.; Veenstra L.; De Backer O.; Van Mieghem
N.M.; van der Kley F.; Wilgenhof A.; Leonora R.; Halim J.; Schotborgh
C.E.; Barbato E.; Van Der Heyden J.A.S.; Frambach P.; Ferdinande B.;
Mylotte D.; Fabris E.; Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer
J.; Nijenhuis V.J.; Peper J.; Vriesendorp P.A.; de Laat B.; Ninivaggi M.;
Stragier H.; Voskuil M.; IJsselmuiden A.J.J.; Hermanides R.S.; Agostoni
P.; van 't Hof A.W.J.; Wykrzykowska J.J.; van Royen N.; Delewi R.; Ten
Berg J.M.
Institution
(van Ginkel, Bor, Rensing, Timmers, Swaans, Brouwer, Nijenhuis, Peper, Ten
Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Dubois) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Aarts, Wilgenhof, Delewi) Department of Cardiology, Amsterdam,
Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Rooijakkers, van Royen) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(Rosseel) Department of Cardiology, Algemeen Stedelijk Hospital Aalst,
Aalst, Belgium
(Veenstra, Vriesendorp, van 't Hof) Department of Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(De Backer) Heart Center, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(van der Kley, Hermanides, Agostoni) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Wilgenhof) Department of Cardiology, Hospital Network Antwerp (ZNA)
Middelheim, Antwerp, Belgium
(Leonora) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Halim, IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Barbato) Cardiovascular Center Aalst, Onze Lieve Vrouwe Hospital, Aalst,
Netherlands
(Van Der Heyden) Department of Cardiology, Sint-Jan Hospital, Brugge,
Belgium
(Frambach) Department of Cardiology, Institut National de Chirurgie
Cardiaque et de Cardiologie Interventionnelle, Luxembourg
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(de Laat, Ninivaggi) Department of Functional Coagulation, Synapse
Research Institute, Maastricht, Netherlands
(Stragier) Department of Anesthesiology, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium
(Stragier, van 't Hof, Ten Berg) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
Abstract
About one-third of patients undergoing transcatheter aortic valve
implantation (TAVI) use oral anticoagulants (OAC), mainly due to atrial
fibrillation. General guidelines advise interrupting OAC in patients with
a high risk of bleeding undergoing interventions. However, preliminary
observational data suggest that the continuation of OAC during TAVI is
safe and may reduce the risk of periprocedural thromboembolic events. The
Periprocedural Continuation Versus Interruption of Oral Anticoagulant
Drugs During Transcatheter Aortic Valve Implantation (POPular PAUSE TAVI)
is a multicentre, randomised clinical trial with open-label treatment and
blinded endpoint assessment. Patients are randomised 1:1 to periprocedural
continuation versus interruption of OAC and are stratified for vitamin K
antagonist or direct oral anticoagulant use. The primary endpoint is a
composite of cardiovascular mortality, all stroke, myocardial infarction,
major vascular complications and type 2-4 bleeding within 30 days after
TAVI, according to the Valve Academic Research Consortium-3 criteria.
Secondary endpoints include separate individual and composite outcomes,
quality of life and cost-effectiveness. Since continuation of OAC is
associated with the ancillary benefit that it simplifies periprocedural
management, the primary outcome is first analysed for non-inferiority; if
non-inferiority is proven, superiority will be tested. Recruitment started
in November 2020, and the trial will continue until a total of 858
patients have been included and followed for 90 days. In summary, POPular
PAUSE TAVI is the first randomised clinical trial to assess the safety and
efficacy of periprocedural continuation versus interruption of OAC in
patients undergoing TAVI.

<44>
Accession Number
642830022
Title
Impact of the COVID-19 pandemic on delayed care of cardiovascular diseases
in Europe: a systematic review.
Source
Lancet (London, England). 402(Supplement 1) (pp S61), 2023. Date of
Publication: 01 Nov 2023.
Author
Khan Y.; Verhaeghe N.; Devleesschauwer B.; Cavillot L.; Gadeyne S.;
Pauwels N.S.; Van den Borre L.; De Smedt D.
Institution
(Khan) Department of Public Health and Primary Care, Ghent University,
Ghent, Belgium; Department of Epidemiology and Public Health, Sciensano,
Brussels, Belgium; Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
(Verhaeghe) Department of Public Health and Primary Care, Ghent
University, Ghent, Belgium; Department of Rehabilitation Sciences, Ghent
University, Ghent, Belgium; Research Institute for Work and Society, KU
Leuven, Leuven, Belgium
(Devleesschauwer) Department of Epidemiology and Public Health, Sciensano,
Brussels, Belgium; Department of Translational Physiology, Infectiology
and Public Health, Ghent University, Merelbeke, Belgium
(Cavillot) Department of Epidemiology and Public Health, Sciensano,
Brussels, Belgium; Research Institute of Health and Society, University of
Louvain, Brussels, Belgium
(Gadeyne) Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
(Pauwels) Faculty of Medicine, Ghent University, Ghent, Belgium
(Van den Borre) Department of Epidemiology and Public Health, Sciensano,
Brussels, Belgium; Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
(De Smedt) Department of Public Health and Primary Care, Ghent University,
Ghent, Belgium
Abstract
BACKGROUND: Cardiovascular diseases remain the foremost global cause of
death. The COVID-19 pandemic has strained health-care systems, leading to
delays in essential medical services, including treatment for
cardiovascular diseases. We aimed to examine the impact of the pandemic on
delayed cardiovascular care in Europe. METHOD(S): In this systematic
review, we searched PubMed, Embase, and Web of Science for peer-reviewed
and published quantitative studies in English from Nov 1, 2019, to Sept
18, 2022, that addressed pandemic-induced delays in cardiovascular disease
care for adult patients in Europe. Data appraisal, extraction, and quality
assessment were done by two reviewers using the 14-item QualSyst tool
checklist. We extracted summary patient-level data from the studies,
including around 3.5 million patients. Evaluated outcomes included changes
pre-March 2020 and during the COVID-19 pandemic in hospital admissions,
mortality rates, medical help-seeking delays post-symptom onset, treatment
initiation delays, and treatment procedure counts. The protocol is
registered on PROSPERO (CRD42022354443). FINDINGS: Of the 132 included
studies (20% from the UK), all were observational retrospective, with 87%
focusing on the first wave of the pandemic. Results were categorised into
five disease groups: ischaemic heart diseases, cerebrovascular diseases,
cardiac arrests, heart failures, and others. Hospital admissions showed
significant decreases around the ranges of 12-66% for ischaemic heart
diseases, 9-40% for cerebrovascular diseases, 9-66% for heart failures,
27-88% for urgent and elective cardiac procedures, and an increase between
11-56% for cardiac arrests. Mortality rates were significantly higher
during the pandemic, ranging between 1-25% (vs 16-22% before the pandemic)
for ischaemic heart diseases and 8-70% (vs 8-26% before the pandemic) for
cerebrovascular diseases. Only one study ranked low in quality.
INTERPRETATION: The pandemic led to reduced acute CVD hospital admissions
and increased mortality rates. Delays in seeking medical help were
observed, while urgent and elective cardiac procedures decreased.
Policymakers and health-care systems should work together on implementing
adequate resource allocation strategies and clear guidelines on how to
handle care during health crises, reducing diagnosis and treatment
initiation delays, and promoting a healthy lifestyle. Future studies
should evaluate the long-term impact of pandemics on delayed CVD care, and
the health-economic impact of COVID-19. FUNDING: Belgian Science Policy
Office. Copyright © 2023 Elsevier Ltd. All rights reserved.

<45>
Accession Number
642829576
Title
Early offering transcatheter aortic valve replacement to patients with
moderate aortic stenosis: quantifying costs and benefits - a Markov
model-based simulation study.
Source
BMJ open. 13(11) (pp e073254), 2023. Date of Publication: 22 Nov 2023.
Author
Nguyen D.; Marwick T.; Moodie M.; Gao L.
Institution
(Nguyen, Moodie, Gao) Deakin Health Economics, Institute for Health
Transformation, School of Health and Social Development, Deakin University
Faculty of Health, Geelong, VIC, Australia
(Marwick) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
Abstract
OBJECTIVE: Aortic stenosis (AS) is one of the most common acquired cardiac
valvular diseases. The success of transcatheter aortic valve implantation
(TAVI) for severe AS has led to increasing interest in its use to earlier
disease-moderate AS (MAS). DESIGN: Model-based study using a Markov
microsimulation technique to evaluate the long-term costs and benefits
associated with 'early' TAVI. Key data inputs were sourced from the
international literature and costs were obtained from Australian sources.
SETTING: Australian health care system perspective. PARTICIPANTS: 10 000
hypothetical MAS patients with or without left ventricular diastolic
dysfunction or impaired left ventricular ejection fraction. INTERVENTION:
Comparing early TAVI to medical management over a life time horizon for
MAS patients aged >65 years. We evaluated the cost-effectiveness of
offering early TAVI in five scenarios (10%, 25%, 50%, 75% and 90% take-up
rates). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome
measure is quality-adjusted life years (QALY) gained and the incremental
cost-utility ratio (ICUR). Secondary outcomes are life-years gained and
the number of heart failure case avoided. RESULT(S): Offering early
TAVI for MAS patients resulted in both higher healthcare costs and greater
benefits (an increase of 3.02 QALYs or 3.99 life-years) per person
treated. The ICUR was around $A10867 and $A11926 per QALY gained for all
five scenarios, with the total cost of early TAVI to the healthcare system
being anticipated to be up to $A3.66billion. Sensitivity analyses
indicated a 100% probability of being cost-effective with a willingness to
pay threshold of $A50 000/QALY. The benefits remained, even with
assumptions of high levels of repeat valve replacement after TAVI.
 CONCLUSION(S): While ongoing randomised controlled trials will define
the benefit of TAVI to MAS patients, these results suggest that this
intervention is likely to be cost-effective. Copyright ©
Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<46>
Accession Number
2028563686
Title
Prognosis of Elevated Mitral Valve Pressure Gradient After Transcatheter
Edge-to-Edge Repair: Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102095. Date of Publication: February 2024.
Author
Du Y.; Han H.; Zhang T.; Shen H.; Han W.; Jia S.; Yu Y.; Guo Y.; Wang Z.;
Liu Y.; Shi D.; Zhou Y.
Institution
(Du, Han, Zhang, Shen, Han, Jia, Yu, Guo, Wang, Liu, Shi, Zhou) Department
of Cardiology, Beijing Anzhen Hospital, Capital Medical University,
Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key
Laboratory of Precision Medicine of Coronary Atherosclerotic Disease,
Clinical Center for Coronary Heart Disease, Capital Medical University,
Beijing, China
Publisher
Elsevier Inc.
Abstract
Elevation in mitral valve pressure gradient (MVPG) after mitral valve
transcatheter edge-to-edge repair (M-TEER) is common, however, evidence on
its prognosis is scarce and debatable. Thus, this study aims to
investigate the impact of increased MVPG after M-TEER on outcomes. Studies
reporting the associations between the elevated MVPG after M-TEER and
outcomes were identified in a systematic search of published literatures.
Associations were pooled by meta-analysis using a random-effects model.
The primary outcome was the composite of all-cause mortality and heart
failure (HF) hospitalization. Seven observational studies with 2,730
patients (mean age, 77.7 +/- 9.3 years; male, 64.4%; functional mitral
regurgitation [MR], 65.2%) were eligible for the present analysis. M-TEER
was performed entirely using the MitraClip system (Abbott), followed by
29.7% of patients having increased MVPG. Elevated postprocedural MVPG was
not associated with a higher risk of the primary outcome, compared to low
MVPG [hazard ratio (HR) = 1.22; 95% confidence interval (CI) 0.95-1.58; p
= 0.12; I2 = 53.5%). However, the prognosis of elevated MVPG
was observed in degenerative MR patients (HR = 1.37; 95% CI 1.03-1.84; p =
0.03; I2 = 0%), whereas not in functional MR patients. Patients
with low MVPG + high residual MR had a higher risk of the primary outcome
than those with high MVPG + low residual MR after M-TEER (HR = 1.50; 95%
CI 1.10-2.03; p = 0.01; I2 = 13%). In conclusion, elevated MVPG
seems to predict adverse outcomes mainly in patients with degenerative MR.
Future studies are needed to prove these findings. Copyright ©
2023 Elsevier Inc.

<47>
Accession Number
2028562787
Title
Epigenetic MicroRNAs as Prognostic Markers of Postoperative Atrial
Fibrillation: A Systematic Review.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102106. Date of Publication: January 2024.
Author
Lee J.; Lee H.; Sherbini A.E.; Baghaie L.; Leroy F.; Abdel-Qadir H.;
Szewczuk M.R.; El-Diasty M.
Institution
(Lee, Lee, Sherbini) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Baghaie, Leroy, Szewczuk) Department of Biomedical & Molecular Sciences,
Queen's University, Kingston, ON, Canada
(Leroy) Faculte de Medecine, Maieutique et Sciences de la Sante,
Universite de Strasbourg, Strasbourg, France
(Abdel-Qadir) Women's College Hospital, Peter Munk Cardiac Center,
Toronto, ON, Canada
(El-Diasty) Department of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery, increasing the risk for adverse outcomes such as
perioperative and long-term mortality, stroke, myocardial infarction, and
other thromboembolic events. Epigenetic biomarkers show promise as
prognostic tools for POAF. Epigenetic changes, such as DNA methylation,
histone modification, and microRNAs (miRNA), can result in altered gene
expression and the development of various pathological conditions. This
systematic review aims to present the current literature on the
association between various epigenetic markers and the development of POAF
following cardiac surgery. Here, an electronic literature search was
performed using MEDLINE, EMBASE, Cochrane Central Register of Controlled
Trials, ClinicalTrials.gov, and Google Scholar to identify studies that
reported the role of epigenetic markers in the development of POAF. Five
of the 6 studies focused on miRNAs and their association with POAF. In
POAF patients, the expression of miR-1 and miR-483-5p were upregulated in
the right atrial appendage (RAA), while the levels of miR-133A, miR-208a,
miR-23a, miR-26a, miR-29a, miR-29b, and miR-29c were decreased in the RAA
and venous blood. One study examined cytosines followed by guanines (CpGs)
as DNA methylation markers. Across all studies, 488 human subjects who had
undergone cardiac surgery were investigated, and 195 subjects (39.9%)
developed new-onset POAF. The current literature suggests that miRNAs may
play a role in predicting the development of atrial fibrillation after
cardiac surgery. However, more robust clinical data are required to
justify their role in routine clinical practice. Copyright © 2023
Elsevier Inc.

<48>
Accession Number
2028560797
Title
Skeletonized versus Pedicled harvesting of internal mammary artery: A
systematic review and Meta-analysis.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102160. Date of Publication: January 2024.
Author
Shafiq A.; Maniya M.T.; Duhan S.; Jamil A.; Hirji S.A.
Institution
(Shafiq, Jamil) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Maniya) Department of Medicine, Ziauddin Medical University, Karachi,
Pakistan
(Duhan) Department of Medicine, Sinai Hospital of Baltimore, MD, United
States
(Hirji) Division of Thoracic and Cardiac Surgery, Department of Surgery,
Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, United
States
Publisher
Elsevier Inc.
Abstract
There are two recognized internal mammary artery (IMA) harvesting
techniques during coronary artery bypass grafting (CABG): pedicled and
skeletonized. This systematic review and meta-analysis sought to compare
the clinical outcomes of the two harvesting techniques. A comprehensive
electronic literature search of PubMed, Scopus, and Embase was conducted
from inception till June 2023. Thirty-one studies with a total of 13005
patients met our inclusion criteria. The results from the included studies
were presented as weighted mean difference (WMD) with its relevant
standard deviation (SD) for continuous variables, while Odds Ratio (OR)
was used for dichotomous variables. A 95% confidence interval (CI) was
used, and the results were pooled using a random effects model. The
skeletonized IMA demonstrated a significantly reduced risk of sternal
wound infection (SWI) compared to the pedicled IMA (OR = 0.45 [95% CI,
0.32-0.66]; p = 0.0001). The conduit length used was significantly longer
in the skeletonized IMA (WMD -2.48, 95% CI, [-3.75, -1.20], P = 0.0001)
and a significantly higher postoperative flow rate was observed while
using skeletonization compared to the pedicled harvesting (WMD -13.11, 95%
CI, [-22.52, -3.70], P = 0.006). However, no significant difference was
seen in mortality between the two techniques (OR = 1.19 [95% CI,
1.00-1.41]; p = 0.05). Pedicled harvesting demonstrated significantly
reduced incidents of MI (OR = 1.38 [95% CI, 1.13-1.69]; p = 0.002), while
significant results in graft patency were observed favoring pedicled
harvesting over skeletonization (OR = 0.63 [95% CI, 0.40-0.98]; p =
0.04). Copyright © 2023

<49>
Accession Number
2028586531
Title
Getting out of the box: the future of the UK donation after circulatory
determination of death heart programme.
Source
eClinicalMedicine. 66 (no pagination), 2023. Article Number: 102320. Date
of Publication: December 2023.
Author
Louca J.O.; Manara A.; Messer S.; Ochsner M.; McGiffin D.; Austin I.; Bell
E.; Leboff S.; Large S.
Institution
(Louca, Ochsner, Austin) University of Cambridge School of Clinical
Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, United
Kingdom
(Manara) The Intensive Care Unit, Southmead Hospital, North Bristol NHS
Trust, Bristol BS 10 5NB, United Kingdom
(Messer) Golden Jubilee Hospital, Agamermnon Street, Glasgow G81 4DY,
United Kingdom
(McGiffin) The Alfred and Monash University, Australia 55 Commercial Rd,
Melbourne, VIC 3004, Australia
(Bell, Leboff, Large) Royal Papworth Hospital Biomedical Campus, Cambridge
CB2 0AY, United Kingdom
Publisher
Elsevier Ltd
Abstract
Heart failure imposes a significant burden on all health care systems and
has a 5-year mortality of 50%. Heart transplantation and ventricular
assist device (VAD) implantation are the definitive therapies for end
stage heart disease, although transplantation appears to offer superior
long-term survival and quality of life over VAD implantation.
Transplantation is limited by a shortage in donor hearts, resulting in
considerable waiting list mortality. Donation after circulatory
determination of death (DCD) offers a significant uplift in the number of
donors for heart transplantation. The outcomes both from the UK and
internationally have been exciting, with outcomes at least as good as
conventional donation after brain death (DBD) transplantation. Currently,
DCD hearts are reperfused using ex-situ machine perfusion (ESMP). Whilst
ESMP has enabled the development of DCD transplantation, it comes at
significant cost, with the per run cost of approximately GBP 90,000.
In-situ perfusion of the heart, otherwise known as thoraco-abdominal
normothermic regional perfusion (taNRP) is cheaper, but there are ethical
concerns regarding the potential to restore cerebral perfusion in the
donor. We must determine whether there is any cerebral circulation during
in-situ perfusion of the heart to ensure that it does not invalidate the
diagnosis of death and potentially violate the dead donor rule. Besides
this, there is a need for a randomised controlled trial to definitively
determine whether taNRP offers any clinical advantages over ex-situ
machine perfusion. This viewpoint article explores these issues in more
detail. Copyright © 2023 The Authors

<50>
Accession Number
2028569120
Title
Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting
for Chronic Total Occlusion of Coronary Arteries: A Systematic Review and
Meta-Analysis.
Source
Journal of Interventional Cardiology. 2023 (no pagination), 2023. Article
Number: 9928347. Date of Publication: 2023.
Author
Wang C.; Liu S.; Kamronbek R.; Ni S.; Cheng Y.; Yan H.; Zhang M.
Institution
(Wang, Liu, Kamronbek, Ni, Zhang) Center for Coronary Heart Disease,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Cheng) Key Laboratory on Assisted Circulation, Ministry of Health,
Department of Cardiology, First Affiliated Hospital, Sun Yat-Sen
University, Guangzhou, China
(Yan) Department of Cardiology, Hangjinqi People's Hospital, Hangjinqi
Mongolia, China
Publisher
Hindawi Limited
Abstract
Introduction. Chronic total occlusion (CTO) of coronary arteries
constitutes a substantial clinical challenge and has historically been
managed through medical management and coronary artery bypass grafting
(CABG). However, with the advancement in interventional technology, the
success rate of percutaneous treatment has been significantly improved,
and percutaneous coronary intervention (PCI) has emerged as a primary mode
of treatment for CTOs, demonstrating remarkable clinical efficacy. The
objective of this systematic review and meta-analysis is to evaluate and
contrast the outcomes of PCI and CABG in patients with CTO. Methods and
Results. A systematic search was conducted in the databases of PubMed,
Embase, and Web of Science. The primary endpoints evaluated in this
meta-analysis were the occurrence of major adverse cardiac events (MACE)
and all-cause mortality. Secondary endpoints included myocardial
infarction (MI), cardiac death, and the need for repeat revascularization.
Nine studies, encompassing a total of 8,674 patients, were found to meet
the criteria for inclusion and had a mean follow-up duration of 4.3 years.
The results of the meta-analysis revealed that compared to CABG, PCI was
associated with a lower incidence of all-cause mortality (RR: 0.78, 95%
CI: 0.66-0.92; P = 0.003) and cardiac death (RR: 0.55; 95% CI: 0.31-0.96;
P < 0.05), but an increased risk of myocardial infarction (MI) (RR: 1.96;
95%CI: 1.07-3.62; P < 0.05) and repeat revascularization (RR: 7.13; 95%
CI: 5.69-8.94; P < 0.00001). There was no statistically significant
difference in MACE (RR: 1.11; 95% CI: 0.69-1.81; P = 0.66) between the PCI
and CABG groups. Conclusion. In the present meta-analysis comparing PCI
and CABG in patients with chronic total occlusion of the coronary
arteries, the results indicated that PCI was superior to CABG in reducing
all-cause mortality and cardiac death but inferior in decreasing
myocardial infarction and repeat revascularization. There was no
statistically significant difference in MACE between the two groups.
 Copyright © 2023 Chenyang Wang et al.

<51>
Accession Number
2026759261
Title
Computed Tomography Scanning for Sternal Wound Infections: A Systematic
Review.
Source
Ulster Medical Journal. 92(3) (pp 139-147), 2023. Date of Publication: Sep
2023.
Author
Shirke M.M.; Dominic C.; Debnath P.; Sunny J.; Haq M.; Nawaz H.; Harky A.
Institution
(Shirke) School of Medicine, Queen's University Belfast, School of
Medicine, Belfast, United Kingdom
(Dominic, Nawaz) Barts and the London School of Medicine, QMUL, United
Kingdom
(Debnath) School of Medicine, University of Nottingham, Nottingham, United
Kingdom
(Sunny) Department of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Haq) Faculty of Medicine, St. George's University of London, London,
United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Ulster Medical Society
Abstract
Background Sternal wound infection (SWI) has always been a significant
risk in patients who undergo sternotomies as part of their cardiac
surgical procedures. Computed tomography (CT) imaging is often used to
diagnose and assess sternal wound infections. Its purpose includes
identifying and locating infection and any sternal dehiscence. Methods A
systematic literature review across PubMed, Embase, and Ovid was performed
according to PRISMA guidelines to identify relevant articles that
discussed the utility of CT scanning for SWI, common features identified,
patient outcomes and sensitivity/specificity (Figure 1). Results 25 papers
were included. 100% (n=25) of the papers were published in peer-reviewed
journals. CT scans in SWIs can be seen as a beneficial aid in diagnosing
as well as determining the components of infection. Commonalities were
identified such as fluid collection in the mediastinum, free gas, pleural
effusions, and sternal dehiscence which point towards the presence of
sternal wound infection. Conclusion CT scanning is a novel and emerging
methodology for imaging in SWI and post-sternotomy complications, hence
increased research is required to expand the literature on this area as
well as the creation of guidelines and cut-offs or signs for radiology
professionals to identify and determine the extent of
infection. Copyright © 2023, Ulster Medical Society. All rights
reserved.

<52>
[Use Link to view the full text]
Accession Number
2028541883
Title
Feasibility of selective coronary angiography and percutaneous coronary
intervention following self-expanding transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Coronary Artery Disease. 33(8) (pp 678-681), 2022. Date of Publication: 01
Dec 2022.
Author
Gin J.H.; Castles A.; Koshy A.N.; Yudi M.B.
Institution
(Gin, Castles, Koshy, Yudi) Department of Cardiology, Austin Health,
Melbourne, VIC, Australia
(Castles, Koshy, Yudi) Department of Medicine, The University of
Melbourne, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins

<53>
Accession Number
642829917
Title
Postoperative Pain Management in Coronary Artery Bypass Grafting: An
Integrative Review.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2023. Date of
Publication: 21 Nov 2023.
Author
Bertolini B.; Dos Santos Felix M.M.; de Andrade EV.; Raponi M.B.G.;
Calegari I.B.; Barichello E.; da Silva Pires P.; Barbosa M.H.
Institution
(Bertolini, Dos Santos Felix, de Andrade, Calegari, Barichello) Stricto
sensu Graduate Program Health Care. Federal University of Triangulo
Mineiro, MG, Uberaba, Brazil
(Raponi) Medical school. Nursing School. Federal University of Uberlandia,
MG, Uberlandia, Brazil
(da Silva Pires) Multidisciplinary Institute in Health-Campus Anisio
Teixeira. Federal University of Bahia, BA, Brazil
(Barbosa) Stricto sensu Graduate Program Health Care. Federal University
of Triangulo Mineiro, MG, Uberaba, Brazil
Abstract
PURPOSE: To identify pharmacological and nonpharmacological interventions
adopted for pain relief in the postoperative period of coronary artery
bypass graft surgery. DESIGN: Integrative review. METHOD(S): Studies
published in English, Spanish, and Portuguese from January 2010 to
December 2019 in Cumulative Index to Nursing and Allied Health Literature
(CINAHL), Latin American and Caribbean Literature on Health Science,
PubMed, and Web of Science. Two hundred studies were identified and eleven
were included. Methodological analysis was performed using the Medical
Education Research Study Quality Instrument. FINDINGS: The studies found
were organized into three thematic categories: pharmacological
interventions (methadone, morphine, lidocaine gel, remifentanil,
sufentanil, and nefopam), nonpharmacological interventions (low-level
laser therapy, light-emitting diode, Class IV laser, and transcutaneous
nerve stimulation) and anesthetic techniques (dexmedetomidine,
ultrasound-guided pectoral nerve block, high thoracic epidural analgesia,
and perioperative parasternal block with levobupivacaine).
 CONCLUSION(S): A greater tendency to use drug strategies for
postoperative pain relief was identified. The drugs used demonstrated
efficacy and safety in the treatment of pain, with the exception of
nefopam, which showed little benefit in this population.
Nonpharmacological interventions, used as adjuvants to drug treatment,
were shown to be safe, effective, and well tolerated by the
patients. Copyright © 2023 The American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<54>
Accession Number
642826392
Title
An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting:
STOPDAPT-3 Randomized Trial.
Source
Circulation. (no pagination), 2023. Date of Publication: 23 Nov 2023.
Author
Natsuaki M.; Watanabe H.; Morimoto T.; Yamamoto K.; Obayashi Y.; Nishikawa
R.; Ando K.; Domei T.; Suwa S.; Ogita M.; Isawa T.; Takenaka H.; Yamamoto
T.; Ishikawa T.; Hisauchi I.; Wakabayashi K.; Onishi Y.; Hibi K.; Kawai
K.; Yoshida R.; Suzuki H.; Nakazawa G.; Kusuyama T.; Morishima I.; Ono K.;
Kimura T.
Institution
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Japan
(M.N.), Japan
(Watanabe, Takenaka, Yamamoto, Kimura) Division of Cardiology, Hirakata
Kohsai Hospital, Japan (H.W., H.T., Hirakata, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Japan (T.M.), Japan
(Yamamoto, Ando, Domei) Department of Cardiology, Kokura Memorial
Hospital, Japan (K.Y., K.A
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Graduate
School of Medicine, Kyoto University, Japan (Y. Obayashi, R.N
(Suwa, Ogita) Department of Cardiology, Juntendo University Shizuoka
Hospital, Izunokuni, Japan (S.S., Japan
(Isawa) Department of Cardiology, Sendai Kousei Hospital, Japan (T.
Isawa), Japan
(Ishikawa, Hisauchi) Department of Cardiology, Dokkyo Medical University
Saitama Medical Center, Japan (T. Ishikawa, Koshigaya, Japan
(Wakabayashi) Department of Cardiology, Showa University Koto Toyosu
Hospital, Japan (K.W.), Tokyo, Japan
(Onishi) Department of Cardiology, Hiratsuka Kyosai Hospital, Japan (Y.
Onishi), Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Japan (K.H.), Japan
(Kawai) Division of Cardiology, Chikamori Hospital, Japan (K.K.), Kochi,
Japan
(Yoshida) Division of Cardiology, Japanese Red Cross Aichi Medical Center
Nagoya Daini Hospital, Japan (R.Y.), Nagoya, Japan
(Suzuki) Division of Cardiology, Showa University Fujigaoka Hospital,
Japan (H.S.), Yokohama, Japan
(Nakazawa) Department of Cardiology, Kindai University Faculty of
Medicine, Osakasayama, Japan (G.N.), Japan
(Kusuyama) Division of Cardiology, Tsukazaki Hospital, Japan (T.
Kusuvama), Himeji, Japan
(Morishima) Department of Cardiology, Ogaki Municipal Hospital, Japan
(I.M.), Japan
Abstract
BACKGROUND: Bleeding rates on dual antiplatelet therapy (DAPT) within 1
month after percutaneous coronary intervention (PCI) remain high in
clinical practice, particularly in patients with acute coronary syndrome
or high bleeding risk. Aspirin-free strategy might result in lower
bleeding early after PCI without increasing cardiovascular events, but its
efficacy and safety have not yet been proven in randomized trials.
 METHOD(S): We randomly assigned 6002 patients with acute coronary
syndrome or high bleeding risk just before PCI either to prasugrel (3.75
mg/day) monotherapy or to DAPT with aspirin (81-100 mg/day) and prasugrel
(3.75 mg/day) after loading of 20 mg of prasugrel in both groups. The
coprimary end points were major bleeding (Bleeding Academic Research
Consortium 3 or 5) for superiority and cardiovascular events (a composite
of cardiovascular death, myocardial infarction, definite stent thrombosis,
or stroke) for noninferiority with a relative 50% margin. RESULT(S):
The full analysis set population consisted of 5966 patients (no-aspirin
group, 2984 patients; DAPT group, 2982 patients; age, 71.6+/-11.7 years;
men, 76.6%; acute coronary syndrome, 75.0%). Within 7 days before
randomization, aspirin alone, aspirin with P2Y12 inhibitor, oral
anticoagulants, and intravenous heparin infusion were given in 21.3%,
6.4%, 8.9%, and 24.5%, respectively. Adherence to the protocol-specified
antiplatelet therapy was 88% in both groups at 1 month. At 1 month, the
no-aspirin group was not superior to the DAPT group for the coprimary
bleeding end point (4.47% and 4.71%; hazard ratio, 0.95 [95% CI,
0.75-1.20]; Psuperiority=0.66). The no-aspirin group was noninferior to
the DAPT group for the coprimary cardiovascular end point (4.12% and
3.69%; hazard ratio, 1.12 [95% CI, 0.87-1.45]; Pnoninferiority=0.01).
There was no difference in net adverse clinical outcomes and each
component of coprimary cardiovascular end point. There was an excess of
any unplanned coronary revascularization (1.05% and 0.57%; hazard ratio,
1.83 [95%CI, 1.01-3.30]) and subacute definite or probable stent
thrombosis (0.58% and 0.17%; hazard ratio, 3.40 [95% CI, 1.26-9.23]) in
the no-aspirin group compared with the DAPT group. CONCLUSION(S): The
aspirin-free strategy using low-dose prasugrel compared with the DAPT
strategy failed to attest superiority for major bleeding within 1 month
after PCI but was noninferior for cardiovascular events within 1 month
after PCI. However, the aspirin-free strategy was associated with a signal
suggesting an excess of coronary events. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT04609111.

<55>
Accession Number
642825676
Title
Clinical Utility of Computed Tomography-Derived Myocardial Extracellular
Volume Fraction: A Systematic Review and Meta-Analysis.
Source
JACC. Cardiovascular imaging. (no pagination), 2023. Date of Publication:
08 Nov 2023.
Author
Kato S.; Misumi Y.; Horita N.; Yamamoto K.; Utsunomiya D.
Institution
(Kato) Department of Diagnostic Radiology, Yokohama City University
Graduate School of Medicine, Yokohama, Japan
(Misumi, Utsunomiya) Department of Diagnostic Radiology, Yokohama City
University Graduate School of Medicine, Yokohama, Japan
(Horita) Chemotherapy Center, Yokohama City University Graduate School of
Medicine, Yokohama, Japan
(Yamamoto) Department of Biostatistics, Yokohama City University School of
Medicine, Yokohama, Japan
Abstract
BACKGROUND: Computed tomography (CT)-derived extracellular volume fraction
(ECV) is a noninvasive method to quantify myocardial fibrosis. Although
studies suggest CT is a suitable measure of ECV, clinical use remains
limited. OBJECTIVE(S): A meta-analysis was performed to determine the
clinical value of CT-derived ECV in cardiovascular diseases.
 METHOD(S): Electronic database searches of PubMed, Web of Science
Core Collection, Cochrane advanced search, and EMBASE were performed. The
most pivotal analysis entailed the comparison of ECV ascertained through
CT-ECV among the control, aortic stenosis, and cardiac amyloidosis
cohorts. The diagnostic test accuracy for detecting cardiac amyloidosis
was assessed using summary receiver-operating characteristics curve.
 RESULT(S): Pooled CT-derived ECV values were 28.5% (95% CI:
27.3%-29.7%) in the control, 31.9 (95% CI: 30.2%-33.8%) in the aortic
stenosis, and 48.9% (95% CI: 44.5%-53.3%) in the cardiac amyloidosis
group. ECV was significantly elevated in aortic stenosis (P = 0.002; vs
controls) but further elevated in cardiac amyloidosis (P < 0.001; vs
aortic stenosis). CT-derived ECV had a high diagnostic accuracy for
cardiac amyloidosis, with sensitivity of 92.8% (95% CI: 86.7%-96.2%),
specificity of 84.8% (95% CI: 68.6%-93.4%), and area under the summary
receiver-operating characteristic curve of 0.94 (95% CI: 0.88-1.00).
 CONCLUSION(S): This study is the first comprehensive systematic
review and meta-analysis of CT-derived ECV evaluation in cardiac disease.
The high diagnostic accuracy of CT-ECV suggests the usefulness of CT-ECV
in the diagnosis of cardiac amyloidosis in preoperative CT planning for
transcatheter aortic valve replacement. Copyright © 2023 American
College of Cardiology Foundation. Published by Elsevier Inc. All rights
reserved.

<56>
Accession Number
642825212
Title
Dilemmas of Adopting Goal-Directed Perfusion in Extracorporeal
Circulation: A Narrative Review.
Source
Innovations (Philadelphia, Pa.). (pp 15569845231211904), 2023. Date of
Publication: 24 Nov 2023.
Author
Lukaszewski M.
Institution
(Lukaszewski) Department for Anaesthesiology and Intensive Care Therapy,
Sokolowski Specialized Hospital Walbrzych, Poland
Abstract
OBJECTIVE: Extracorporeal circulation (ECC) is generally based on
standards established in the last decade. In recent years, a concept of
perfusion management during ECC, goal-directed perfusion (GDP), has
emerged to create optimal conditions for oxygen delivery and extraction,
initiated by Rannuci et al. The aim of the present work was to determine
whether the ECC procedure can truly be optimized with the current state of
knowledge and understanding of human physiology. METHOD(S): Discussed
articles from 2017 to 2022 were selected from the MEDLINE (PubMed)
database using the keywords "cardiopulmonary bypass" AND "cardiac surgery"
AND "oxygen delivery" with the conditions of "clinical trial" OR
"randomized controlled trial." RESULTS: The concept of GDP is an attempt
to reproduce the physiological conditions of tissue respiration during
ECC. Published articles, also due to their retrospective nature, are based
on standards and recommendations that do not fully fit the field of
physiological circulation. There are still insufficient tools to assess
the relationship between volemia, perfusion pressure, and pump
performance. Limitations include indications for vasoactive drugs.
Methodology has rarely taken into account the period of starting and
stopping the heart-lung machine, the most pronounced periods of
circulatory destabilization with reduced oxygen delivery.
 CONCLUSION(S): Problems associated with ECC such as acute kidney
injury, liver failure, vasoplegic syndrome, and others must await its
resolution. The use of advanced monitoring technology and data engineering
may allow the development of baseline hemodynamic models, which may make
the ECC procedure more physiologic and thus improve the safety of the
procedure.

<57>
Accession Number
2028557351
Title
Very Long-term Outcome of Bilateral Internal Thoracic Artery in Diabetic
Patients: A Systematic Review and Reconstructed Time-To-Event
Meta-analysis.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102135. Date of Publication: January 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Grassa G.; Pattuzzi C.; Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy
(Gallingani, Grassa, Pattuzzi, Nicolini) Cardiac Surgery Unit, University
Hospital of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Publisher
Elsevier Inc.
Abstract
The benefits of single (SITA) and bilateral internal thoracic arteries
(BITA) in diabetics undergoing coronary bypass grafting (CABG) are
conflicting. We undertook a study-level meta-analysis to compare early and
long-term outcomes of both CABG configurations. PubMed, CENTRAL, and
EMBASE were searched for studies comparing BITA versus SITA for isolated
CABG surgery in diabetics. Randomized trials or observational studies were
considered eligible for the analysis. Kaplan-Meier curves of long-term
survival were reconstructed and compared with Cox linear regression;
incidence rate ratios (IRR) with 95% confidence intervals (CI) for
long-term survival were calculated. Landmark analysis and time-varying
hazard ratio (HR) were analyzed. Odds ratios (OR) were extracted for early
mortality, postoperative stroke, deep sternal wound infection (DSWI), and
myocardial infarction (MI). A random effects meta-analysis was performed.
Sensitivity analyses included leave-one-out-analyses and meta-regression.
Thirteen studies (7332 patients) were included. Overall, at 20-year
follow-up, BITA was associated with higher survival (HR = 0.77; 95% CI,
0.71-0.84; P < 0.0001). Time-varying HR and landmark analysis reported
BITA was associated with a higher rate of 10-year survival (HR = 0.75, 95%
CI 0.68-0.82, P < 0.0001), while from 10 to 20-year follow-up no
difference was revealed (HR = 0.99, 95% CI 0.82-1.19, P = 0.93). There was
no increase in early mortality, postoperative MI, stroke, or DSWI between
the groups. At meta-regression, the higher the age, the higher the
long-term overall survival in patients with BITA. In diabetics, the BITA
approach is associated with improved 10-year survival with no increase in
early mortality, MI, stroke, or DSWI. In the 10-20-year timeframe, BITA
and SITA showed comparable survival. Copyright © 2023 Elsevier
Inc.

<58>
Accession Number
2028551364
Title
Expanding the Criteria for Heart Transplantation Donors: A Review of DCD,
Increased Ischemic Times, HCV, HIV, and Extended Criteria Donors.
Source
Heart Surgery Forum. 26(5) (pp E639-E655), 2023. Date of Publication:
2023.
Author
Jenkins R.T.; Shah M.M.; Larson E.L.; Zhou A.L.; Ruck J.M.; Kilic A.
Institution
(Jenkins, Shah, Larson, Zhou, Ruck, Kilic) Division of Cardiothoracic
Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, MD
21218, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
With the demand for heart transplantation continuing to outpace the
available donor organs, previously underutilized donors are now being
reconsidered. We sought to describe the emerging techniques and outcomes
of expanded criteria heart transplantation. A comprehensive review of the
recent literature concerning expanded donor selection in heart
transplantation was performed using the PubMed MEDLINE database. To
characterize trends in transplant practice, the United Network for Organ
Sharing (UNOS/OPTN) registry was queried for all adult isolated heart
transplants since 2010, and data regarding transplant parameters was
collected. Donation after cardiac death (DCD), DCD with normothermic
regional perfusion, increased ischemic time, hepatitis C positive donor
organs, HIV-positive donor organs, and extended criteria donors were
identified as promising avenues currently being explored to expand the
number of donor organs. The utilization of various expanded criteria for
heart transplantation was summarized since 2010 and showed an increasing
use of these donor organs, contributing to the overall increasing
frequency of heart transplantation. Utilization of expanded criteria for
donor selection in heart transplantation has the potential to increase the
supply of donor organs with comparable outcomes in selected recipients.
 Copyright © 2023 Forum Multimedia Publishing.

<59>
Accession Number
2028549045
Title
Outcomes of coronary revascularization vs. optimal medical therapy alone
for ischemic left ventricular dysfunction: A meta-analysis of randomized
controlled trials.
Source
Kardiologia Polska. 81(9) (pp 909-912), 2023. Date of Publication: 2023.
Author
Bujak K.; Hudzik B.; Pyka L.; Skrzypek M.; Brugaletta S.; Sabate M.;
Tajstra M.; Legutko J.; Wojakowski W.; Gasior M.
Institution
(Bujak, Hudzik, Pyka, Tajstra, Gasior) 3rd Department of Cardiology,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia,
Katowice, Poland
(Bujak, Brugaletta, Sabate) Hospital Clinic, Cardiovascular Clinic
Institute, Institut d'Investigacions Biomediques August Pi i Sunyer
(IDIBAPS), University of Barcelona, Barcelona, Spain
(Skrzypek) Department of Biostatistics, Faculty of Health Sciences in
Bytom, Medical University of Silesia, Katowice, Poland
(Legutko) Clinical Department of Interventional Cardiology, John Paul II
Hospital, Krakow, Poland
(Legutko) Department of Interventional Cardiology, Institute of
Cardiology, Jagiellonian University Medical College, Krakow, Poland
(Wojakowski) Department of Cardiology and Structural Heart Diseases,
Medical University of Silesia, Katowice, Poland
Publisher
Via Medica

<60>
Accession Number
2026634288
Title
Analysis of the Research Hotspot of Exosomes in Cardiovascular Disease: A
Bibliometric-based Literature Review.
Source
Current Vascular Pharmacology. 21(5) (pp 316-345), 2023. Date of
Publication: 2023.
Author
Cui J.; Li Y.; Zhu M.; Liu Y.
Institution
(Cui, Li, Zhu, Liu, Liu) National Clinical Research Centre for Chinese
Medicine Cardiology, Xiyuan Hospital of China Academy of Chinese Medical
Sciences, Beijing, China
(Liu) Second Department of Geriatrics, Xiyuan Hospital of China Academy of
Chinese Medical Sciences, Beijing, China
Publisher
Bentham Science Publishers
Abstract
Objective: To investigate the current status and development trend of
research on exosomes in cardiovascular disease (CVD) using bibliometric
analysis and to elucidate trending research topics. Method(s):
Research articles on exosomes in CVD published up to April 2022 were
retrieved from the Web of Science database. Data were organized using
Microsoft Office Excel 2019. CiteSpace 6.1 and VOSviewer 1.6.18 were used
for bibliometric analysis and result visualization. Result(s):
Overall, 256 original research publications containing 190 fundamental
research publications and 66 clinical research publications were included.
"Extracellular vesicle" was the most frequent research keyword, followed
by "microrna," "apoptosis," and "angiogenesis." Most publications were
from China (187, 73.05%), followed by the United States (57, 22.27%), the
United Kingdom (7, 2.73%), and Japan (7, 2.73%). A systematic review of
the publications revealed that myocardial infarction and stroke were the
most popular topics and that exosomes and their contents, such as
microRNAs (miRNAs), play positive roles in neuroprotection, inhibition of
autophagy and apoptosis, promotion of angiogenesis, and protection of
cardiomyocytes. Conclusion(s): Research on exosomes in CVD has
attracted considerable attention, with China having the most published
studies. Fundamental research has focused on CVD pathogenesis; exosomes
regulate the progression of CVD through biological processes, such as the
inflammatory response, autophagy, and apoptosis. Clinical research has
focused on biomarkers for CVD; studies on using miRNAs in exosomes as
disease markers for diagnosis could become a future trend. Copyright
© 2023 Bentham Science Publishers.

<61>
Accession Number
2026407884
Title
Percutaneous coronary intervention in patients undergoing transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
Netherlands Heart Journal. 31(12) (pp 489-499), 2023. Date of Publication:
December 2023.
Author
Aarts H.M.; van Hemert N.D.; Meijs T.A.; van Nieuwkerk A.C.; Berg J.M.;
Wykrzykowska J.J.; van Royen N.; Schotborgh C.E.; Tonino P.A.L.;
IJsselmuiden A.; Vossenberg T.N.; van Houwelingen G.K.; Slagboom T.;
Voskuil M.; Delewi R.
Institution
(Aarts, van Hemert, Meijs, Voskuil) Department of Cardiology, University
Medical Centre Utrecht, Utrecht, Netherlands
(Aarts, Meijs, van Nieuwkerk, Delewi) Department of Cardiology, Amsterdam
University Medical Centre, Amsterdam, Netherlands
(Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Berg) Department of Cardiology, Maastricht University Medical Centre,
Maastricht, Netherlands
(Wykrzykowska) Department of Cardiology, Groningen University Medical
Centre, University of Groningen, Groningen, Netherlands
(van Royen) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Vossenberg) Department of Cardiology, Medical Centre Leeuwarden,
Leeuwarden, Netherlands
(van Houwelingen) Department of Cardiology, Thorax Centre Twente, Medical
Spectrum Twente, Enschede, Netherlands
(Slagboom) Department of Cardiology, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Objective: The importance of revascularisation of significant coronary
artery disease (CAD) in patients undergoing transcatheter aortic valve
implantation (TAVI) is unclear. Despite the lack of randomised controlled
trials comparing different revascularisation strategies, guidelines
currently recommend percutaneous coronary intervention (PCI) in patients
with significant proximal CAD undergoing TAVI. Method(s): In this
systematic review and meta-analysis, a systematic search was conducted to
identify studies comparing TAVI with and without PCI in patients with
significant CAD on pre-TAVI coronary angiography. Endpoints were all-cause
mortality, cardiac death, stroke, myocardial infarction and major
bleeding. Result(s): In total, 14 studies were included, involving
3838 patients, of whom 1806 (47%) underwent PCI before TAVI. All-cause
mortality did not differ significantly between TAVI with and without
preceding PCI at 30 days, 1 year and >1 year. There were no significant
differences in risk of cardiac death, stroke or myocardial infarction
between the groups. However, TAVI performed with PCI resulted in a higher
risk of major bleeding within 30 days after TAVI (odds ratio: 0.66; 95%
confidence interval: 0.46-0.94). Conclusion(s): This systematic
review and meta-analysis showed no significant differences in clinical
outcomes between patients with concomitant significant CAD who were
treated with TAVI with and without preceding PCI at both short- and
long-term follow-up. However, there was a higher risk of major bleeding at
30 days in patients undergoing TAVI with preceding PCI. In the context of
serious risk of bias in the included studies, results of randomised
controlled trials are warranted. Copyright © 2023, The Author(s).

<62>
Accession Number
2028496326
Title
The impact of the COVID-19 pandemic on delayed care of cardiovascular
diseases in Europe: a systematic review.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(7) (pp
647-661), 2023. Date of Publication: 01 Nov 2023.
Author
Khan Y.; Verhaeghe N.; Devleesschauwer B.; Cavillot L.; Gadeyne S.;
Pauwels N.; Van den Borre L.; De Smedt D.
Institution
(Khan, Verhaeghe, De Smedt) Department of Public Health and Primary Care,
Ghent University, Ghent 9000, Belgium
(Khan, Devleesschauwer, Cavillot, Van den Borre) Department of
Epidemiology and Public Health, Sciensano, Brussels 1050, Belgium
(Khan, Gadeyne, Van den Borre) Department of Sociology, Interface
Demography, Vrije Universiteit Brussel, Brussels 1050, Belgium
(Verhaeghe) Research Institute for Work and Society, KU Leuven, Leuven
3000, Belgium
(Verhaeghe) Department of Rehabilitation Sciences, Ghent University, Ghent
9000, Belgium
(Devleesschauwer) Department of Translational Physiology, Infectiology and
Public Health, Ghent University, Merelbeke 9000, Belgium
(Cavillot) Research Institute of Health and Society, University of
Louvain, Brussels 1200, Belgium
(Pauwels) Faculty of Medicine, Ghent University, Ghent 9000, Belgium
Publisher
Oxford University Press
Abstract
Aims Cardiovascular diseases (CVD) are the leading cause of death
worldwide. The coronavirus disease 2019 (COVID-19) pandemic has disrupted
healthcare systems, causing delays in essential medical services, and
potentially impacting CVD treatment. This study aims to estimate the
impact of the pandemic on delayed CVD care in Europe by providing a
systematic overview of the available evidence. Methods and results PubMed,
Embase, and Web of Science were searched until mid-September 2022 for
studies focused on the impact of delayed CVD care due to the pandemic in
Europe among adult patients. Outcomes were changes in hospital admissions,
mortality rates, delays in seeking medical help after symptom onset,
delays in treatment initiation, and change in the number of treatment
procedures. We included 132 studies, of which all were observational
retrospective. Results were presented in five disease groups: ischaemic
heart diseases (IHD), cerebrovascular accidents (CVA), cardiac arrests
(CA), heart failures (HF), and others, including broader CVD groups. There
were significant decreases in hospital admissions for IHD, CVA, HF and
urgent and elective cardiac procedures, and significant increases for CA.
Mortality rates were higher for IHD and CVA. Conclusion The pandemic led
to reduced acute CVD hospital admissions and increased mortality rates.
Delays in seeking medical help were observed, while urgent and elective
cardiac procedures decreased. Adequate resource allocation, clear
guidelines on how to handle care during health crises, reduced delays, and
healthy lifestyle promotion should be implemented. The long-term impact of
pandemics on delayed CVD care, and the health-economic impact of COVID-19
should be further Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<63>
Accession Number
2028496309
Title
Platelet activation and endothelial dysfunction biomarkers in acute
coronary syndrome: the impact of PCSK9 inhibition.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 9(7) (pp
636-646), 2023. Date of Publication: 01 Nov 2023.
Author
Ziogos E.; Chelko S.P.; Harb T.; Engel M.; Vavuranakis M.A.; Landim-Vieira
M.; Walsh E.M.; Williams M.S.; Lai S.; Halushka M.K.; Gerstenblith G.;
Leucker T.M.
Institution
(Ziogos, Chelko, Harb, Vavuranakis, Williams, Gerstenblith, Leucker)
Division of Cardiology, Department of Medicine, Johns Hopkins University,
School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, United
States
(Chelko, Engel, Landim-Vieira) Department of Biomedical Sciences, College
of Medicine, Florida State University, Tallahassee, FL, United States
(Walsh, Halushka) Department of Pathology, Johns Hopkins University,
School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, United
States
(Walsh) Department of Genetic Medicine, Johns Hopkins University, School
of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, United States
(Lai) Department of Epidemiology and Public Health, Institute of Human
Virology, University of Maryland, School of Medicine, 660 W. Redwood
Street, Baltimore, MD 21201, United States
Publisher
Oxford University Press
Abstract
Aims Platelet activation and endothelial dysfunction contribute to adverse
outcomes in patients with acute coronary syndromes (ACS). The goals of
this study were to assess the impact of proprotein convertase
subtilisin/kexin type 9 (PCSK9) inhibition on markers of platelet
activation and endothelial dysfunction in ACS patients and the interaction
among PCSK9, platelets, and endothelial cells (ECs) on left internal
mammary artery (LIMA) vascular endothelium using specimens obtained during
coronary artery bypass surgery (CABG). Acute coronary syndromes patients
enrolled in the Evolocumab in ACS trials were randomized to placebo or a
single dose of 420 mg evolocumab within 24 h of hospitalization. Serum
samples for analysis of platelet factor 4 (PF4) and P-selectin, markers of
platelet activation, and von Willebrand factor (vWF), a marker of
endothelial dysfunction, were obtained at baseline and 30 days.
Additionally, LIMA segments obtained during CABG from patients who were
and were not receiving evolocumab were immunostained with PCSK9; CD61, a
platelet-specific marker; and CD31, an endothelial cell-specific marker.
Forty-six participants were randomized to placebo or to evolocumab.
Controlling for baseline levels, PF4 and vWF were significantly lower in
the evolocumab, than in the placebo, group at 30 days. Immunostaining of
LIMA specimens from twelve participants undergoing CABG revealed
colocalization of PCSK9, CD61, and CD31 at the vascular endothelium.
Administration of evolocumab was associated with decreased overlap of
PCSK9, CD61, and CD31. Proprotein Convertase Subtilisin/Kexin 9 inhibition
decreases markers of platelet activation and endothelial dysfunction in
ACS patients. PCSK9 is associated with platelets and vascular ECs in LIMA
segments and PCSK9 inhibition decreases that interaction. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<64>
Accession Number
2028496185
Title
Type A aortic dissection: optimal annual case volume for surgery.
Source
European Heart Journal. 44(41) (pp 4357-4372), 2023. Date of Publication:
01 Nov 2023.
Author
Kawczynski M.J.; van Kuijk S.M.J.; Olsthoorn J.R.; Maessen J.G.; Kats S.;
Bidar E.; Heuts S.
Institution
(Kawczynski, Olsthoorn, Maessen, Kats, Bidar, Heuts) Department of
Cardiothoracic Surgery, Maastricht University Medical Center (MUMC+), P.
Debyelaan 25, Limburg, Maastricht 6629HX, Netherlands
(Kawczynski, Maessen, Bidar, Heuts) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University, Universiteitssingel 50,
Maastricht, PO Box 616, Maastricht 6200 MD, Netherlands
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Center (MUMC+), Maastricht,
Netherlands
(Olsthoorn) Department of Cardiothoracic Surgery, Catharina Hospital
Eindhoven, Eindhoven, Netherlands
Publisher
Oxford University Press
Abstract
Background and Aims The current study proposes a novel volume-outcome
(V-O) meta-analytical approach to determine the optimal annual hospital
case volume threshold for cardiovascular interventions in need of
centralization. This novel method is applied to surgery for acute type A
aortic dissection (ATAAD) as an illustrative example. Methods A systematic
search was applied to three electronic databases (1 January 2012 to 29
March 2023). The primary outcome was early mortality in relation to annual
hospital case volume. Data were presented by volume quartiles (Qs).
Restricted cubic splines were used to demonstrate the V-O relation, and
the elbow method was applied to determine the optimal case volume. For
clinical interpretation, numbers needed to treat (NNTs) were calculated.
Results One hundred and forty studies were included, comprising 38 276
patients. A significant non-linear V-O effect was observed (P < .001),
with a notable between-quartile difference in early mortality rate [10.3%
(Q4) vs. 16.2% (Q1)]. The optimal annual case volume was determined at 38
cases/year [95% confidence interval (CI) 37-40 cases/year, NNT to save a
life in a centre with the optimal volume vs. 10 cases/year = 21]. More
pronounced between-quartile survival differences were observed for
long-term survival [10-year survival (Q4) 69% vs. (Q1) 51%, P < .01,
adjusted hazard ratio 0.83, 95% CI 0.75-0.91 per quartile, NNT to save a
life in a high-volume (Q4) vs. low-volume centre (Q1) = 6]. Conclusions
Using this novel approach, the optimal hospital case volume threshold was
statistically determined. Centralization of ATAAD care to high-volume
centres may lead to improved outcomes. This method can be applied to
various other cardiovascular procedures requiring
centralization. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<65>
Accession Number
2028318341
Title
Effects of a forced-air warming system and warmed intravenous fluids on
hemodynamic parameters, shivering, and time to awakening in elderly
patients undergoing open cardiac surgery.
Source
Annals of Cardiac Anaesthesia. 26(4) (pp 386-392), 2023. Date of
Publication: October 2023.
Author
Akbarpour Roshan M.; Jafarpoor H.; Shamsalinia A.; Fotokian Z.; Hamidi S.
Institution
(Akbarpour Roshan, Shamsalinia, Fotokian) Nursing Care Research Center,
Health Research Institute, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Jafarpoor) Department of Anesthesiology and Operating Room, School of
Allied Medical Sciences and Social Determinants of Health Research Center,
Health Research Institute, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Hamidi) Department of Anesthesiology, School of Medicine, Babol
University of Medical Sciences, Babol, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: As one of the most common postoperative complications,
hypothermia is the main cause of numerous problems during treatment,
especially in elderly patients with decreased cardiac reserves.
 Objective(s): The aim of the present study was to compare the effects
of forced-air warming system (FAWS), warmed intravenous fluids (WIVFs) and
routine method on hemodynamic parameters, arterial blood gases (ABGs),
shivering, and time to awakening in elderly patients undergoing open
cardiac surgery (OCS). Method(s): This clinical randomized controlled
trial was conducted on 94 elderly patients who underwent OCS at Ayatollah
Rouhani Hospital, Babol, Iran. They were divided into three groups, namely
FAWS (n=31), WIVFs (n=31) and routine rewarming method (RRWM, with a
blanket) (n=32). The data were then recorded in a checklist. Descriptive
and inferential statistics were performed using SPSS 26 at a significance
level of less than 0.05. Result(s): The findings demonstrated that
the degree of hypothermia had a significant decreasing trend in the groups
receiving FAWS and WIVFs (P=0.002). Additionally, increased respiratory
rate (P=0.013), higher bicarbonate (HCO3-) levels on arrival up to 4 hours
after surgery (P=0.045), reduced lactate level (P=0.005), normal base
excess (BE) and accelerated time to awakening (P=0.004) were observed in
patients receiving FAWS. There was no significant difference in the study
groups regarding shivering. Conclusion(s): The results revealed that
FAWS could mitigate the degree of hypothermia, increase body temperature
and decrease the postoperative serum lactate levels. Moreover, BE as one
of the most important parameters for ABGs, could remain at a normal level.
Besides, the use of FAWS could lead to early awakening, and thus
facilitate weaning and extubation of these patients. Copyright ©
2023 Wolters Kluwer Medknow Publications. All rights reserved.

<66>
Accession Number
2028241060
Title
The Effect of Liver Cirrhosis on Patients Undergoing Cardiac Surgery.
Source
Global Heart. 18(1) (no pagination), 2023. Article Number: 54. Date of
Publication: 05 Oct 2023.
Author
Liu F.; Li Z.-W.; Liu X.-R.; Liu X.-Y.; Yang J.
Institution
(Liu, Li, Liu, Liu) Department of Gastrointestinal Surgery, The First
Affiliated Hospital, Chongqing Medical University, Chongqing, China
(Yang) Department of Anesthesiology, The First Affiliated Hospital,
Chongqing Medical University, Chongqing, China
Publisher
Ubiquity Press
Abstract
The aim of this study was to investigate the impact of liver cirrhosis
(LC) on postoperative complications and long-term outcomes in patients who
underwent cardiac surgery. Three databases, including PubMed, Embase, and
the Cochrane Library, were searched on July 24, 2022. A total of 1,535,129
patients were enrolled in the seven included studies for analysis.
According to our analysis, LC was a risk factor for postoperative overall
complications (OR = 1.48, 95% CI = 1.21 to 1.81, I2 = 90.35%, P
= 0.00 < 0.1). For various complications, more patients developed
pulmonary (OR = 1.86, 95% CI = 1.21 to 2.87, I2 = 90.79%, P =
0.00 < 0.1), gastrointestinal (OR = 2.03, 95% CI = 1.32 to 3.11,
I2 = 0.00%, P = 0.00 < 0.05), renal (OR = 2.20, 95% CI = 1.41
to 3.45, I2 = 91.60%, P = 0.00 < 0.1), neurological (OR = 1.14,
95% CI = 1.03 to 1.26, I2 = 7.35%, P = 0.01 < 0.05), and
infectious (OR = 2.02, 95% CI = 1.17 to 3.50, I2 = 92.37%, P =
0.01 < 0.1) complications after surgery in the LC group. As for
cardiovascular (OR = 1.07, 95% CI = 0.85 to 1.35, I2 = 75.23%,
P = 0.58 > 0.1) complications, there was no statistical significance
between the 2 groups. As for long-term outcomes, we found that in-hospital
death (OR = 2.53, 95% CI = 1.86 to 3.20, I2 = 44.58%, P = 0.00
< 0.05) and death (OR = 3.31, 95% CI = 1.54 to 5.07, I2 =
93.81%, P = 0.00 < 0.1) in the LC group were higher than the non-LC group.
LC was a risk factor for cardiac surgery. Patients with LC who would
undergo cardiac surgery should be fully assessed for the risks of cardiac
surgery. Similarly, the surgeon should assess the patient's liver function
before surgery. BACKGROUND Liver cirrhosis (LC) is a common disease that
kills about 1.03 million people each year [1-2]. Patients with LC often
suffered from nutritional damage, immune system dysfunction, coagulation
disorders, acute kidney injury, etc. [3-5]. These issues cause surgeons to
be hesitant to operate on patients with LC. Surgery on patients with LC
remains a challenge for surgeons and anaesthetists. This challenge depends
on the type of liver disease and its severity, the surgical procedure, and
the type of anaesthesia [6-7]. As for cardiothoracic surgery, especially
cardiac surgery requiring cardiopulmonary bypass, LC remains a tricky
problem [8-10]. Liver disease remains a major risk factor in the
perioperative period of cardiac surgery [11]. Cardiac disease could be a
fatal condition. Surgery was an excellent treatment. As for LC patients,
the surgeon should assess the patient's liver function before surgery. The
underlying physiological conditions caused by LC make these patients
vulnerable to coagulation dysfunction and major organ dysfunction after
direct cardiac surgery with extracorporeal circulation [12]. Figuring out
the impact and mechanism of LC on cardiac surgery could help surgeons find
preventive measures. However, according to our review of previous studies,
the effects of LC on the postoperative outcomes of cardiac surgery
continued to be controversial. Some studies suggest a poor effect of LC on
postoperative outcomes in cardiac surgery [13-17]. Other studies
demonstrated that there was no association between LC and postoperative
cardiac surgery outcomes [18-19]. Therefore, this pooling-up analysis
aimed to investigate the impact of LC on postoperative complications and
long-term outcomes in patients who underwent cardiac surgery. METHODS Our
meta-analysis was produced in accordance with the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [20].
Three databases were searched, including PubMed, Embase, and the Cochrane
Library, on July 24, 2022. The key words of the search strategy were LC
and cardiac surgery. The search strategy for LC was as follows: "liver
cirrhosis" OR "cirrhosis" OR "cirrhotic", and as for cardiac surgery, we
searched "cardiac surgery" OR "cardiac operation" OR "heart surgery" OR
"heart operation" OR "thoracic surgery" OR "cardiac surgical procedures"
OR "cardiopulmonary bypass" OR "CPB" OR "congenital heart disease". Then,
the two search strategies were combined by "AND". The search was limited
to titles and abstracts, and the language was limited to English. The
inclusion criteria for eligible studies were as follows: 1) all patients
were diagnosed with cardiac disease and underwent cardiac surgery; 2) both
the LC group and the non-LC group were reported; 3) at least 1 of the
following complications (cardiovascular, pulmonary, gastrointestinal,
renal, neurological, infectious) was reported; and 4) as for long-term
outcomes, in-hospital death or death should be reported. The exclusion
criteria were as follows: 1) case reports, case series, comments, letters
to the editor, conference abstracts, and nonoriginal articles; 2) data was
repeated or overlapped; and 3) incomplete information. Two authors
searched the databases and identified eligible studies separately. First,
duplicate studies were excluded. Then, the two authors scanned the titles
and abstracts to find eligible studies. Finally, the full text would be
read to identify studies that could be included. Any disagreements were
settled by a third author. Patients were divided into the LC group and the
non-LC group according to whether they were diagnosed with LC. The cardiac
surgery types included coronary artery bypass graft, surgery with
cardiopulmonary bypass, cardiac surgery, and aortic valve replacement. The
complication was defined as a cardiovascular, pulmonary, gastrointestinal,
renal, neurological, or infectious disease that occurred after surgery.
Overall complication was the sum of all complications reported in the
included studies that were not directly reported. In-hospital death was
defined as a patient's cause of death when they died in the hospital after
surgery. Death was defined as a patient's cause of death after they left
the hospital. The information included characteristics of the studies,
baseline information on patients, medical history, postoperative
complications, and long-term outcomes. The characteristics of the studies
were as follows: the first author, published year, published country,
study date, sample size of the LC group and the non-LC group, and
Newcastle-Ottawa Scale (NOS) score. The baseline information for patients
included age, gender, and race. For medical history, hypertension,
diabetes, chronic obstructive pulmonary disease (COPD), heart failure,
prior myocardial infarction (MI), and malignancy were collected. For
complications, cardiovascular, pulmonary, gastrointestinal, renal,
neurological, and infectious diseases were collected. As for long-term
outcomes, in-hospital death and death were collected. In-hospital death
was defined as a death that occurred during hospitalization, regardless of
cause. Death was defined as a death that occurred after discharge from the
hospital due to cardiac failure or liver cirrhosis. If the cause of death
during this period was unknown, it was also considered related. The NOS
was used to assess the quality of the included studies [21]. High-quality
studies would be scored at nine points. Median quality had scores ranging
from 7 to 8 points. Low-quality studies were indicated by a score of less
than 7 points. The mean difference (MD) and 95% confidence interval (CI)
were calculated for age. The odds ratio (OR) and 95% CI were calculated
for gender, medical history, complications, and long-term outcomes.
I2 values were used to assess the statistical heterogeneity of
the included studies [22-23]. When I2 > 50%, which was
considered to be high heterogeneity, the random effects model was used,
and P < 0.1 was considered statistically significant. Otherwise, the fixed
effects model would be used, and p < 0.05 meant statistically significant.
We performed data analysis with Stata V16.0 software. RESULTS A total of
1,158 studies were searched from the three databases (353 studies in
PubMed, 778 studies in Embase, and 27 studies in the Cochrane Library).
359 duplicate studies were eliminated. After the remaining 799 studies
were viewed for titles and abstracts, 21 studies were left for full-text
screening. Then, there were 13 studies left for qualitative synthesis.
Finally, seven eligible studies were included in this analysis [13-19].
(Figure 1) Copyright © 2023 The Author(s).

<67>
Accession Number
2026651434
Title
Safe and Effective Blood Preservation Through Acute Normovolemic
Hemodilution and Low-Dose Tranexamic Acid in Open Partial Hepatectomy.
Source
Journal of Pain Research. 16 (pp 3905-3916), 2023. Date of Publication:
2023.
Author
Yang J.; Zhang J.; Luo J.; Ouyang J.; Qu Q.; Wang Q.; Si Y.
Institution
(Yang, Zhang, Ouyang, Qu, Wang, Si) Department of Anesthesiology, Second
Affiliated Hospital of Kunming Medical University, Kunming 650101, China
(Luo) Department of Anesthesiology, People's Hospital of Yanting, Sichuan
621600, China
Publisher
Dove Medical Press Ltd
Abstract
Objective: In this study, we evaluated the efficacy of tranexamic acid
(TXA) and acute normovolemic hemodilution (ANH) with 6% hydroxyethyl
starch (130/0.4) in minimizing blood loss during open partial liver
resection. Coagulation function was assessed using thromboelastography
(TEG) and hemostasis tests, while renal function changes were tracked
through serum creatinine values post-surgery. Method(s): Thirty
patients undergoing open partial liver resection were allocated to two
groups: Group T received TXA + ANH, and Group A received ANH alone. Blood
was drawn from the radial artery under general anesthesia. Both groups
received peripheral vein injections of 6% hydroxyethyl starch 130/0.4.
Group T additionally received intravenous TXA. Primary outcomes included
blood loss and allogeneic blood transfusions. TEG assessed coagulation
status and renal function was monitored. Result(s): Group T
demonstrated superior outcomes compared to Group A. Group T had
significantly lower intraoperative blood loss (700 mL vs 1200 mL) and a
lower bleeding rate per kilogram of body weight (13.3 mL/kg vs 20.4
mL/kg). Coagulation parameters favored Group T, with higher TEG maximum
amplitude (55.91 mm vs 45.88 mm) and lower activated partial
thromboplastin time (38.04 seconds vs 41.49 seconds). Neither group
experienced acute renal injury or kidney function deficiency during
hospitalization. Conclusion(s): TXA and ANH in a small dose during
liver resection stabilize clotting, reduce blood loss by 6% compared to
hydroxyethyl starch 130/0.4, and do not affect renal
function. Copyright © 2023 Yang et al.

<68>
Accession Number
2026648982
Title
Heart graft preservation technics and limits: an update and perspectives.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1248606. Date of Publication: 2023.
Author
Ughetto A.; Roubille F.; Molina A.; Battistella P.; Gaudard P.; Demaria
R.; Guihaire J.; Lacampagne A.; Delmas C.
Institution
(Ughetto, Roubille, Molina, Gaudard, Lacampagne, Delmas) Phymedexp INSERM,
CNRS, University of Montpellier, CHRU Montpellier, Montpellier, France
(Ughetto, Gaudard) Department of Anesthesiology and Critical Care
Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, University of
Montpellier, Montpellier, France
(Roubille) Cardiology Department, CHU de Montpellier, University of
Montpellier, Montpellier, France
(Molina, Battistella, Demaria) Cardio-thoracic and Vascular Surgery
Department, CHU de Montpellier, University of Montpellier, Montpellier,
France
(Guihaire) Cardiac and Vascular Surgery, Marie Lanelongue Hospital, Paris
Saclay University, Le Plessis Robinson, France
(Delmas) Intensive Cardiac Care Unit, Cardiology Department, Rangueil
University Hospital, Toulouse, France
(Delmas) REICATRA, Institut Saint Jacques, CHU de Toulouse, Toulouse,
France
Publisher
Frontiers Media SA
Abstract
Heart transplantation, the gold standard treatment for end-stage heart
failure, is limited by heart graft shortage, justifying expansion of the
donor pool. Currently, static cold storage (SCS) of hearts from donations
after brainstem death remains the standard practice, but it is usually
limited to 240 min. Prolonged cold ischemia and ischemia-reperfusion
injury (IRI) have been recognized as major causes of post-transplant graft
failure. Continuous ex situ perfusion is a new approach for donor organ
management to expand the donor pool and/or increase the utilization rate.
Continuous ex situ machine perfusion (MP) can satisfy the metabolic needs
of the myocardium, minimizing irreversible ischemic cell damage and cell
death. Several hypothermic or normothermic MP methods have been developed
and studied, particularly in the preclinical setting, but whether MP is
superior to SCS remains controversial. Other approaches seem to be
interesting for extending the pool of heart graft donors, such as blocking
the paths of apoptosis and necrosis, extracellular vesicle therapy, or
donor heart-specific gene therapy. In this systematic review, we summarize
the mechanisms involved in IRI during heart transplantation and existing
targeting therapies. We also critically evaluate all available data on
continuous ex situ perfusion devices for adult donor hearts, highlighting
its therapeutic potential and current limitations and
shortcomings. Copyright 2023 Ughetto, Roubille, Molina, Battistella,
Gaudard, Demaria, Guihaire, Lacampagne and Delmas.

<69>
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. 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. 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. Conclusion(s): SGB can reduce
the hemodynamic responses to surgery and anesthesia, intraoperative
tachyarrhythmias, and ICU and hospital stays. Copyright © 2023
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<70>
Accession Number
2025560436
Title
Safety and immunogenicity of the live-attenuated varicella vaccine in
pediatric solid organ transplant recipients: A systematic review and
meta-analysis.
Source
American Journal of Transplantation. 23(11) (pp 1757-1770), 2023. Date of
Publication: November 2023.
Author
Piche-Renaud P.-P.; Yue Lee E.; Ji C.; Qing Huang J.Y.; Uleryk E.; Teoh
C.W.; Morris S.K.; Top K.A.; Upton J.E.M.; Vyas M.V.; Allen U.D.
Institution
(Piche-Renaud, Morris, Allen) Division of Infectious Diseases, the
Hospital for Sick Children, Toronto, ON, Canada
(Piche-Renaud, Yue Lee, Qing Huang, Vyas) Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Yue Lee) Division of Clinical Immunology and Allergy, St. Michael's
Hospital, Toronto, ON, Canada
(Yue Lee) Eliot Phillipson Clinician Scientist Training Program,
University of Toronto, Toronto, ON, Canada
(Ji) Department of Family and Community Medicine, University of Toronto,
Toronto, ON, Canada
(Ji) Toronto Western Family Health Team, University Health Network,
Toronto, ON, Canada
(Qing Huang) Division of Geriatric Medicine, Department of Medicine,
University of Toronto, Toronto, ON, Canada
(Uleryk) E.M. Uleryk Consulting, Mississauga, ON, Canada
(Teoh, Morris, Allen) Department of Pediatrics, Temerty Faculty of
Medicine, University of Toronto, Toronto, ON, Canada
(Teoh) Division of Nephrology, the Hospital for Sick Children, Toronto,
ON, Canada
(Morris) Centre for Global Child Health, the Hospital for Sick Children,
Toronto, ON, Canada
(Morris) Clinical Public Health, Dalla Lana School of Public Health,
University of Toronto, Toronto, ON, Canada
(Top) Departments of Pediatrics and Community Health & Epidemiology,
Dalhousie University, Halifax, NS, Canada
(Upton) Division of Immunology and Allergy, Department of Paediatrics, the
Hospital for Sick Children, Toronto, ON, Canada
(Vyas) Division of Neurology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier B.V.
Abstract
This study aimed to synthesize the available evidence on the
immunogenicity, safety, and effectiveness of live-attenuated varicella
vaccine in solid organ transplant recipients. Medline and EMBASE were
searched using predefined search terms to identify relevant studies. The
included articles reported varicella vaccine administration in the
posttransplant period in children and adults. A pooled proportion of
transplant recipients who seroconverted and who developed vaccine-strain
varicella and varicella disease was generated. Eighteen articles (14
observational studies and 4 case reports) were included, reporting on 711
transplant recipients who received the varicella vaccine. The pooled
proportion was 88.2% (95% confidence interval 78.0%-96.0%, 13 studies) for
vaccinees who seroconverted, 0% (0%-1.2%, 13 studies) for vaccine-strain
varicella, and 0.8% (0%-4.9%, 9 studies) for varicella disease. Most
studies followed clinical guidelines for administering live-attenuated
vaccines, with criteria that could include being at least 1 year
posttransplant, 2 months postrejection episode, and on low-dose
immunosuppressive medications. Varicella vaccination in transplant
recipients was overall safe in the included studies, with few cases of
vaccine-strain-induced varicella or vaccine failure, and although it was
immunogenic, the proportion of recipients who seroconverted was lower than
that seen in the general population. Our data support varicella
vaccination in select pediatric solid organ transplant
recipients. Copyright © 2023 American Society of Transplantation
& American Society of Transplant Surgeons

<71>
Accession Number
2024575896
Title
Prognostic value of myocardial perfusion imaging by cadmium zinc telluride
single-photon emission computed tomography in patients with suspected or
known coronary artery disease: a systematic review and meta-analysis.
Source
European Journal of Nuclear Medicine and Molecular Imaging. 50(12) (pp
3647-3658), 2023. Date of Publication: October 2023.
Author
Assante R.; Zampella E.; Cantoni V.; Green R.; D'Antonio A.; Mannarino T.;
Gaudieri V.; Nappi C.; Buongiorno P.; Panico M.; Petretta M.; Cuocolo A.;
Acampa W.
Institution
(Assante, Zampella, Cantoni, Green, D'Antonio, Mannarino, Gaudieri, Nappi,
Buongiorno, Cuocolo, Acampa) Department of Advanced Biomedical Sciences,
University of Naples Federico II, Naples, Italy
(Panico) Institute of Biostructure and Bioimaging, National Council of
Research, Naples, Italy
(Petretta) IRCCS SDN, Naples, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Aim of this study was to define the prognostic value of stress
myocardial perfusion imaging by cadmium zinc telluride (CZT) single-photon
emission computed tomography (SPECT) for prediction of adverse
cardiovascular events in patients with known or suspected coronary artery
disease (CAD). Methods and Results: Studies published until November
2022 were identified by database search. We included studies using stress
myocardial perfusion imaging by CZT-SPECT to evaluate subjects with known
or suspected CAD and providing primary data of adverse cardiovascular
events. Total of 12 studies were finally included recruiting 36,415
patients. Pooled hazard ratio (HR) for the occurrence of adverse events
was 2.17 (95% confidence interval, CI, 1.78-2.65) and heterogeneity was
66.1% (P = 0.001). Five studies reported data on adjusted HR for the
occurrence of adverse events. Pooled HR was 1.69 (95% CI, 1.44-1.98) and
heterogeneity was 44.9% (P = 0.123). Seven studies reported data on
unadjusted HR for the occurrence of adverse events. Pooled HR was 2.72
(95% CI, 2.00-3.70). Nine studies reported data useful to calculate
separately the incidence rate of adverse events in patients with abnormal
and normal myocardial perfusion. Pooled incidence rate ratio was 2.38 (95%
CI, 1.39-4.06) and heterogeneity was 84.6% (P < 0.001). The funnel plot
showed no evidence of asymmetry (P = 0.517). At meta-regression analysis,
we found an association between HR for adverse events and presence of
angina symptoms and family history of CAD. Conclusion(s): Stress
myocardial perfusion imaging by CZT-SPECT is a valuable noninvasive
prognostic indicator for adverse cardiovascular events in patients with
known or suspected CAD. Copyright © 2023, The Author(s).

<72>
Accession Number
2023448459
Title
Capnodynamic monitoring of lung volume and pulmonary blood flow during
alveolar recruitment: a prospective observational study in postoperative
cardiac patients.
Source
Journal of Clinical Monitoring and Computing. 37(6) (pp 1463-1472), 2023.
Date of Publication: December 2023.
Author
Keleher E.; Iftikhar H.; Schulz L.F.; McCanny P.; Austin D.; Stewart A.;
O'Regan W.; Hallback M.; Wallin M.; Aneman A.
Institution
(Keleher, Iftikhar) Faculty of Medicine, University of New South Wales,
Sydney, NSW, Australia
(Schulz, McCanny, Austin, Stewart, O'Regan, Aneman) Intensive Care Unit,
Liverpool Hospital, South Western Sydney Local Health District, Sydney,
NSW, Australia
(Hallback) Maquet Critical Care AB, Solna, Sweden
(Wallin) Department of Physiology and Pharmacology, Karolinska Institute,
Stockholm, Sweden
(Aneman) Southwestern Clinical School, University of New South Wales,
Sydney, NSW, Australia
(Aneman) Ingham Institute for Applied Medical Research, Sydney, NSW,
Australia
(Aneman) Intensive Care Unit, Liverpool Hospital, Locked Bag 7103,
Liverpool BC, NSW 1871, Australia
Publisher
Springer Science and Business Media B.V.
Abstract
Alveolar recruitment manoeuvres may mitigate ventilation and perfusion
mismatch after cardiac surgery. Monitoring the efficacy of recruitment
manoeuvres should provide concurrent information on pulmonary and cardiac
changes. This study in postoperative cardiac patients applied capnodynamic
monitoring of changes in end-expiratory lung volume and effective
pulmonary blood flow. Alveolar recruitment was performed by incremental
increases in positive end-expiratory pressure (PEEP) to a maximum of 15
cmH<inf>2</inf>O from a baseline of 5 cmH<inf>2</inf>O over 30 min. The
change in systemic oxygen delivery index after the recruitment manoeuvre
was used to identify responders (> 10% increase) with all other changes
(<= 10%) denoting non-responders. Mixed factor ANOVA using Bonferroni
correction for multiple comparisons was used to denote significant changes
(p < 0.05) reported as mean differences and 95% CI. Changes in
end-expiratory lung volume and effective pulmonary blood flow were
correlated using Pearson's regression. Twenty-seven (42%) of 64 patients
were responders increasing oxygen delivery index by 172 (95% CI 61-2984)
mL min-1 m-2 (p < 0.001). End-expiratory lung volume
increased by 549 (95% CI 220-1116) mL (p = 0.042) in responders associated
with an increase in effective pulmonary blood flow of 1140 (95% CI
435-2146) mL min-1 (p = 0.012) compared to non-responders. A
positive correlation (r = 0.79, 95% CI 0.5-0.90, p < 0.001) between
increased end-expiratory lung volume and effective pulmonary blood flow
was only observed in responders. Changes in oxygen delivery index after
lung recruitment were correlated to changes in end-expiratory lung volume
(r = 0.39, 95% CI 0.16-0.59, p = 0.002) and effective pulmonary blood flow
(r = 0.60, 95% CI 0.41-0.74, p < 0.001). Capnodynamic monitoring of
end-expiratory lung volume and effective pulmonary blood flow early in
postoperative cardiac patients identified a characteristic parallel
increase in both lung volume and perfusion after the recruitment manoeuvre
in patients with a significant increase in oxygen delivery. Trial
registration This study was registered on ClinicalTrials.gov (NCT05082168,
18th of October 2021). Copyright © 2023, The Author(s), under
exclusive licence to Springer Nature B.V.

<73>
Accession Number
2028540428
Title
Dexmedetomidine improves pulmonary outcomes in thoracic surgery under
one-lung ventilation: A meta-analysis.
Source
Journal of Clinical Anesthesia. 93 (no pagination), 2024. Article Number:
111345. Date of Publication: May 2024.
Author
Zorrilla-Vaca A.; Grant M.C.; Law M.; Messinger C.J.; Pelosi P.; Varelmann
D.
Institution
(Zorrilla-Vaca, Messinger, Varelmann) Department of Anesthesiology, Pain
and Perioperative Medicine, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Zorrilla-Vaca) Department of Anesthesiology, Universidad del Valle, Cali,
Colombia
(Grant) Department of Anesthesiology and Critical Care Medicine, The Johns
Hopkins Hospital, Baltimore, MD, United States
(Law) Medical Research Council Biostatistics Unit, University of
Cambridge, Cambridge, United Kingdom
(Pelosi) Anesthesiology and Critical Care, San Martino Policlinico
Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
(Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
University of Genoa, Genoa, Italy
Publisher
Elsevier Inc.
Abstract
Introduction: Dexmedetomidine improves intrapulmonary shunt in thoracic
surgery and minimizes inflammatory response during one-lung ventilation
(OLV). However, it is unclear whether such benefits translate into less
postoperative pulmonary complications (PPCs). Our objective was to
determine the impact of dexmedetomidine on the incidence of PPCs after
thoracic surgery. Method(s): Major databases were used to identify
randomized trials that compared dexmedetomidine versus placebo during
thoracic surgery in terms of PPCs. Our primary outcome was atelectasis
within 7 days after surgery. Other specific PPCs included hypoxemia,
pneumonia, and acute respiratory distress syndrome (ARDS). Secondary
outcome included intraoperative respiratory mechanics (respiratory
compliance [Cdyn]) and postoperative lung function (forced expiratory
volume [FEV1]). Random effects models were used to estimate odds ratios
(OR). Result(s): Twelve randomized trials, including 365 patients in
the dexmedetomidine group and 359 in the placebo group, were analyzed in
this meta-analysis. Patients in the dexmedetomidine group were less likely
to develop postoperative atelectasis (2.3% vs 6.8%, OR 0.42, 95%CI
0.18-0.95, P = 0.04; low certainty) and hypoxemia (3.4% vs 11.7%, OR 0.26,
95%CI 0.10-0.68, P = 0.01; moderate certainty) compared to the placebo
group. The incidence of postoperative pneumonia (3.2% vs 5.8%, OR 0.57,
95%CI 0.25-1.26, P = 0.17; moderate certainty) or ARDS (0.9% vs 3.5%, OR
0.39, 95%CI 0.07-2.08, P = 0.27; moderate certainty) was comparable
between groups. Both intraoperative Cdyn and postoperative FEV1 were
higher among patients that received dexmedetomidine with a mean difference
of 4.42 mL/cmH<inf>2</inf>O (95%CI 3.13-5.72) and 0.27 L (95%CI
0.12-0.41), respectively. Conclusion(s): Dexmedetomidine
administration during thoracic surgery may potentially reduce the risk of
postoperative atelectasis and hypoxemia. However, current evidence is
insufficient to demonstrate an effect on pneumonia or ARDS. Copyright
© 2023 Elsevier Inc.

<74>
Accession Number
2026731126
Title
Effect of 5% albumin on endothelial glycocalyx degradation during off-pump
coronary artery bypass.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Nan Z.; Soh S.; Shim J.-K.; Kim H.B.; Yang Y.S.; Kwak Y.L.; Song J.W.
Institution
(Nan, Soh, Shim, Yang, Kwak) Department of Anesthesiology and Pain
Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Nan, Soh, Shim, Kwak) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Song) Department of Anesthesiology and Pain Medicine, Anesthesia and Pain
Research Institute, Yonsei Cardiovascular Hospital, Yonsei University
College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
Publisher
Springer
Abstract
Purpose: The integrity of the endothelial glycocalyx (EG), a critical
player in vascular homeostasis, reportedly influences the outcomes of
critically ill patients. We investigated the effect of 5% albumin, which
preserved EG integrity in preclinical studies, vs balanced crystalloid
solution on EG degradation in patients undergoing off-pump coronary
surgery. Method(s): Patients were randomized to receive either 5%
albumin (N = 51) or balanced crystalloid solution (Plasma-Lyte [Baxter
Incorporated, Seoul, Republic of Korea]; N = 53) for intravenous volume
replacement during surgery (double-blinded). The primary outcome was
plasma syndecan-1 concentration, a marker of EG degradation, measured
after anesthetic induction (baseline), completion of grafting, and sternal
closure. Secondary outcomes were atrial natriuretic peptide (ANP), tumour
necrosis factor (TNF)-alpha, soluble thrombomodulin, and perioperative
fluid balance. Result(s): The mean (standard deviation) fluid
requirements were 833 (270) mL and 1,323 (492) mL in the albumin and
Plasma-Lyte group, respectively (mean difference, -489 mL; 95% confidence
interval [CI], -643 to -335; P < 0.001). Plasma syndecan-1 concentration
increased after completion of grafting (median difference, 116
ng.mL-1; 95% CI, 67 to 184; P < 0.001) and sternal closure
(median difference, 57 ng.mL-1; 95% CI, 36 to 80; P < 0.001)
compared with those at baseline, without any intergroup differences.
Atrial natriuretic peptide, TNF-alpha, and soluble thrombomodulin
concentrations were similar between the two groups. The amount of chest
tube drainage was greater in the albumin group than that in the
Plasma-Lyte group (median difference, 190 mL; 95% CI, 18 to 276; P =
0.03). Conclusion(s): Off-pump coronary surgery was associated with
significant EG degradation. Yet, intraoperative fluid therapy with 5%
albumin could not ameliorate EG degradation when compared with balanced
crystalloid solution. Trial registration: ClinicalTrials.gov
(NCT03699462); first posted 9 October 2018. Copyright © 2023,
Canadian Anesthesiologists' Society.

<75>
Accession Number
2026731118
Title
Ultrasound-guided erector spinae plane block for postoperative analgesia
in patients undergoing minimally invasive direct coronary artery bypass
surgery: a double-blinded randomized controlled trial.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Xin L.; Wang L.; Feng Y.
Institution
(Xin, Wang) Department of Anesthesiology, Peking University People's
Hospital, Beijing, China
(Feng) Department of Anesthesiology, Peking University People's Hospital,
No. 11 Xizhimen South Street, Xicheng District, Beijing, China
Publisher
Springer
Abstract
Purpose: Minimally invasive direct coronary artery bypass (MIDCAB) surgery
is associated with significant postoperative pain. We aimed to investigate
the efficacy of ultrasound-guided erector spinae plane block (ESPB) for
analgesia after MIDCAB. Method(s): We conducted randomized controlled
trial in 60 patients undergoing MIDCAB who received either a single-shot
ESPB with 30 mL of ropivacaine 0.5% (ESPB group, n = 30) or normal saline
0.9% (control group, n = 30). The primary outcome was numerical rating
scale (NRS) pain scores at rest within 48 hr postoperatively. The
secondary outcomes included postoperative NRS pain scores on deep
inspiration within 48 hr, hydromorphone consumption, and quality of
recovery-15 (QoR-15) score at 24 and 48 hr. Result(s): Compared with
the control group, the ESPB group had lower NRS pain scores at rest at 6
hr (estimated mean difference, -2.1; 99% confidence interval [CI], -2.7 to
-1.5; P < 0.001), 12 hr (-1.9; 99% CI, -2.6 to -1.2; P < 0.001), and 18 hr
(-1.2; 99% CI, -1.8 to -0.6; P < 0.001) after surgery. The ESPB group also
showed lower pain scores on deep inspiration at 6 hr (-2.9; 99% CI, -3.6
to -2.1; P < 0.001), 12 hr (-2.3; 99% CI, -3.1 to -1.5; P < 0.001), and 18
hr (-1.0; 99% CI, -1.8 to -0.2; P = 0.01) postoperatively. Patients in the
ESPB group had lower total intraoperative fentanyl use, lower 24-hr
hydromorphone consumption, a shorter time to extubation, and a shorter
time to intensive care unit (ICU) discharge. Conclusion(s): Erector
spinae plane block provided early effective postoperative analgesia and
reduced opioid consumption, time to extubation, and ICU discharge in
patients undergoing MIDCAB. Trial registration: www.chictr.org.cn
(ChiCTR2100052810); registered 5 November 2021. Copyright © 2023,
The Author(s).

<76>
Accession Number
2026729530
Title
Impact of diabetic versus non-diabetic patients undergoing coronary artery
bypass graft surgery on postoperative wound complications: A
meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
He L.; Liu M.; He Y.; Guo A.
Institution
(He) Operating Room, Xiang'an Hospital, Xiamen University, Xiamen, China
(Liu) Department of Endocrinology Hospital of Xiamen University, School of
Medicine, Xiamen University, Xiamen, China
(He) Department of Rheumatology and Immunology, Run Run Shaw Hospital of
the School of Medicine of Zhejiang University, Hangzhou, China
(Guo) Department of Cardiac Surgery, Xiangan Hospital Affiliated to Xiamen
University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
The effect of diabetes mellitus (DM) on the incidence of postoperative
wound complications in patients with coronary artery bypass grafting
(CABG) is still unclear. Thus, we performed a meta-analysis of CABG in DM
patients to evaluate existing data from both prospective and historical
cohorts. The objective of this trial was to assess the relevance and
extent of the effect of diabetes on the outcome of previous CABG
procedures. Data sources like Embase and Pubmed were found throughout the
research, and the language was limited to English through manual search.
The searches were performed up to August 2023. The data were extracted
from the study of the inclusion/exclusion criteria, the features of the
population, the statistical approach and the clinical results. A
qualitative evaluation of the qualifying studies has been carried out. Out
of the 1874 studies identified, 21 cohort studies were chosen for
analysis. Meta-analyses were performed in 258 454 patients (71 351
diabetic and 187 103 non-diabetic). Twenty-one studies on deep sternal
wound infections in CABG patients showed a lower rate of deep sternal
wound infections in non-diabetes group compared with those with diabetes
(OR, 2.13; 95% CI: 1.97, 2.31, p < 0.00001). And 16 studies of superficial
wound infections in patients undergoing CABG were found to be associated
with a lower rate of superficial injury (OR, 1.93; 95% CI: 1.53, 2.43, p <
0.00001) compared with those with diabetes; In five trials, perfusion time
during CABG (MD, 2.31; 95% CI: -0.16, 4.79, p = 0.07) was observed, and
there were no significant differences between diabetes and non-diabetes.
Currently, there is a higher risk for CABG in diabetes than in
non-diabetes patients with sternal infections and superficial injuries.
Future randomized trials will concentrate on the treatment of such
perioperatively related complications, which will lower the risk of
postoperative wound infection in diabetes. Copyright © 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<77>
Accession Number
2026727717
Title
Effect of different surgical approaches on the survival and safety of
Siewert type II esophagogastric junction adenocarcinoma: a systematic
review and meta-analysis.
Source
BMC Cancer. 23(1) (no pagination), 2023. Article Number: 1130. Date of
Publication: December 2023.
Author
Zheng H.; Yin X.; Pan T.; Tao X.; Xu X.; Li Z.
Institution
(Zheng, Pan, Tao, Xu) Department of Thoracic Surgery, Third Affiliated
Hospital of Naval Medical University, Shanghai 201805, China
(Yin) Department of Blood Transfusion, Third Affiliated Hospital of Naval
Medical University, Shanghai 201805, China
(Li) Department of Digestive Surgery, Shanghai Songjiang District Central
Hospital, No. 746 Zhongshan Middle Road, Songjiang District Shanghai,
Shanghai 201600, China
Publisher
BioMed Central Ltd
Abstract
Background: Whether a transthoracic (TT) procedure by a thoracic surgeon
or a transabdominal (TA) by a gastrointestinal surgeon is best for Siewert
type II esophagogastric junction adenocarcinoma (EGJA) remains unknown.
Survival and perioperative outcomes were compared between the two groups
in this meta-analysis to clarify this argument. Method(s): We
searched 7 databases for eligible studies comparing TT and TA procedures
for Siewert type II EGJA. The final analyzed endpoints included
intraoperative and hospitalization outcomes, recurrence, complication, and
survival. Result(s): Seventeen studies involving 10,756 patients met
the inclusion criteria. The TA group had higher rates of overall survival
(OS) (HR: 1.31 [1.20 ~ 1.44], p < 0.00001) and disease-free survival (DFS)
(HR: 1.49 [1.24 ~ 1.79], p < 0.0001). The survival advantage of OSR and
DFSR increased with time. Subgroup analysis of OS and DFS suggested that
TA remained the preferred approach among all subgroups. More
total/positive lymph nodes were retrieved, and fewer lymph node
recurrences were found in the TA group. The analysis of perioperative
outcomes revealed that the TA procedure was longer, had more
intraoperative blood loss, and prolonged hospital stay. Similar R0
resection rates, as well as total recurrence, local recurrence, liver
recurrence, peritoneal recurrence, lung recurrence, anastomosis recurrence
and multiple recurrence rates, were found between the two groups. The
safety analysis showed that the TT procedure led to more total
complications, anastomotic leakages, cases of pneumonia, and cases of
pleural effusion. Conclusion(s): The TA procedure appeared to be a
suitable choice for patients with Siewert type II EGJA because of its
association with longer survival, fewer recurrences, and better
safety. Copyright © 2023, The Author(s).

<78>
Accession Number
2025669681
Title
USING NON-INVASIVE CLINICAL PARAMETERS TO PREDICT MORTALITY AND MORBIDITY
AFTER CARDIAC INTERVENTIONS: A SYSTEMATIC REVIEW.
Source
Gastroenterology. Conference: DDW. Chicago United States. 164(6
Supplement) (pp S-406), 2023. Date of Publication: May 2023.
Author
Mathew C.T.; Patel A.; Cholankeril G.T.; Flores A.G.; Hernaez R.
Publisher
W.B. Saunders
Abstract
Introduction: Cardiovascular disease is a common cause of mortality and
morbidity for the aging population, even those with advanced liver
disease. These patients undergo cardiac interventions to improve cardiac
outcomes. Patients with cirrhosis are known to have an increased risk of
post-procedural complications including bleeding, renal and respiratory
failure, and further decompensation, including death. Having non-invasive
tools to riskstratify and predict complications is critical in managing
patients with cirrhosis. Aim(s): To systematically review the use of
clinical scores to assess the risk of mortality and reported complications
in patients with cirrhosis undergoing cardiovascular procedures.
 Method(s): We created a search with key terms cirrhosis and different
cardiovascular interventions in PubMed and EMBASE from database inception
to 8/1/2022. Two reviewers independently assessed the studies. We included
studies reporting any form of the clinical score (e.g., Model for End
Stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT)), any form of
cardiovascular intervention, and mortality outcomes (or morbidity when
reported). We independently abstracted data from eligible studies. Given
clinical heterogeneity, we provided a qualitative summary of each study.
 Result(s): Of 8142 studies screened, 8 met our inclusion criteria.
Procedures included tricuspid valve surgery, catheterization-related
procedures, aortic valve replacement (AVR), pericardiectomy, and
left-ventricular assist device (LVAD) placement. MELD was used to predict
mortality in most studies (n = 4), followed by CPT (n = 2). Other
non-invasive predictors included INR (n = 1), serum albumin level (n = 2),
and serum creatinine (n = 1). One study showed a significant increase in
mortality for patients with MELD > 15 who underwent tricuspid valve
surgery. In patients who underwent TAVR, albumin, creatinine, and MELD
were all significantly associated with increased mortality, although they
were not stratified by specific values. CPT also was significantly
associated with increased mortality for patients undergoing cardiac
catheterization or pericardiectomy. In LVAD placement, increasing MELD
scores led to increased unadjusted odds for perioperative mortality. Other
studies including cardiac surgeries and specific risk scores were largely
not evaluated due to non-stratification of procedure type. There were only
two papers that addressed blood transfusion requirements without any study
addressing the risk of decompensation (variceal bleeding and
acute-on-chronic liver failure). Discussion(s): Our systematic review
showed that clinical parameters could predict mortality risk in patients
with cirrhosis undergoing cardiac interventions. Future studies should
include information about the risk of cirrhosis complications such as the
development of acute-on-chronic liver failure. Copyright © 2023
AGA Institute

<79>
Accession Number
2025635007
Title
FAST TRACK PATHWAY TO ACCELERATED CHOLECYSTECTOMY VERSUS STANDARD OF CARE
FOR ACUTE CHOLECYSTITIS (FAST) PILOT TRIAL.
Source
Gastroenterology. Conference: DDW. Chicago United States. 164(6
Supplement) (pp S-1496), 2023. Date of Publication: May 2023.
Author
Park L.J.; Borges F.; Nenshi R.; Serrano P.E.; Engels P.; Vogt K.; Sante
E.D.; Vincent J.; Tsiplova K.; Devereaux P.J.
Publisher
W.B. Saunders
Abstract
Background The timing to surgery for acute cholecystitis (AC) remains
variable, ranging anywhere from early (<7 days) to delayed surgery (>7
days). Accelerated surgery for AC may result in better outcomes by
reducing patient exposure to inflammatory, hypercoagulable, and stress
states. We undertook a pilot trial to determine the feasibility of
providing accelerated care (i.e., surgery within 6 hours of diagnosis)
compared to standard care among patients with calculus AC. Methods Adult
patients with AC requiring surgery were randomized to receive accelerated
surgery or standard care. The primary feasibility outcome included
recruitment of 1 patient per site per month, >= 95% follow-up at 90 days,
and determining timelines of accelerated surgery. The secondary outcome
was a composite of major perioperative complications (all-cause mortality,
reinterventions and reoperations, various intra- and post-operative
complications, cardiovascular events, venous thromboembolism, bleeding)
within 90 days of randomization. Other outcomes included individual
components of the composite, length of hospital stay, readmissions,
surgery duration, and feasibility of drawing preoperative point-of-care
N-terminal-pro hormone BNP (NT-proBNP) in >= 90% of patients. Analysis
included descriptive statistics and cox proportional hazards models to
calculate hazard ratios (HR) and 95% confidence interval (CI) for outcomes
with time to event data. Results Sixty patients were randomly assigned to
accelerated surgery (N=31) and standard care (N=29) across 4 Canadian
hospitals. There was >= 1 patient recruited per site per month. All
patients completed 90 day follow up. The median time and interquartile
range (IQR) from diagnosis to surgery in the accelerated arm was 5.8
[4.4-11.1] hours versus 20.3 [6.8-26.8] hours in the standard care arm. A
major perioperative complication occurred in 9/31 (29.0%) patients in the
accelerated and 4/29 (13.8%) patients in the standard care arm (HR 2.42,
95% CI 0.74-7.91). The main contribution was from 5/31 (16.1%) versus 1/29
(3.4%) post-operative endoscopic retrograde cholangiopancreatography
performed in the accelerated versus standard care arm, respectively (HR
5.11, 95% CI 0.60-43.9). Of note, 4/31 and 3/29 patients in the
accelerated and standard care groups underwent intraoperative
cholangiogram. Between both groups, there were no differences in surgery
duration (mean (standard deviation): 86.8 (30.0) vs. 86.4(32.3) minutes),
length of hospital stay (median [IQR]: 2.0 [1.0-3.0] vs. 2.0 [2.0-3.0]
days), readmissions (2/31 vs. 4/29), or cardiovascular events (2/31 vs.
1/29). Preoperative NT-proBNP was drawn in 57/60 (95.0%) patients.
Conclusion These results demonstrate the feasibility of a trial comparing
accelerated and standard care among patients requiring surgery for AC and
supports a definitive trial. Copyright © 2023 AGA Institute

<80>
Accession Number
2026760737
Title
Rationale and design of a randomized clinical trial evaluating the
efficacy of mechanical neuroprotection in reducing the risk of silent
brain infarcts associated with percutaneous left atrial appendage closure:
study protocol for a LAAC-SBI trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 749. Date of
Publication: December 2023.
Author
Streb W.; Lasek-Bal A.; Mitrega K.; Kowalczyk J.; Podolecki T.; Kowalska
W.; Olma A.; Sobczyk A.; Kalarus Z.
Institution
(Streb, Kowalczyk, Podolecki, Kowalska, Sobczyk, Kalarus) Department of
Cardiology, Congenital Heart Diseases and Electrotherapy, Faculty of
Medical Sciences in Zabrze, Medical University of Silesia, Katowice,
Poland
(Streb, Mitrega, Kowalczyk, Podolecki, Kowalska, Olma, Sobczyk, Kalarus)
Silesian Centre for Heart Diseases in Zabrze, Curie-Sklodowskiej 9, Zabrze
41-800, Poland
(Lasek-Bal) Department of Neurology, Faculty of Health Sciences in
Katowice, Medical University of Silesia, Katowice, Poland
Publisher
BioMed Central Ltd
Abstract
Background: Left atrial appendage closure (LAAC) procedures prevent
cardioembolic stroke in patients with atrial fibrillation who have
contraindications to oral anticoagulant medications. However, these
procedures carry certain risks of peri-procedural complications. One such
complication is silent brain infarcts (SBI), which can lead to cognitive
impairment and mood disturbances. The implementation of mechanical
neuroprotection systems during LAAC procedures may reduce the risk of SBI
and associated cognitive and mood disorders. Method(s): The LAAC-SBI
trial is a prospective, multicenter, randomized, and double-blind
interventional study. The study aims to enroll a total of 240 patients,
with 120 patients allocated to each group. The study group will evaluate
the use of the Sentinel CPS during LAAC, while the control group will
undergo LAAC procedures without the Sentinel CPS. The primary endpoint of
the study is the number of new SBIs or stroke foci detected by
diffusion-weighted magnetic resonance imaging (DW MRI). Secondary
endpoints include deterioration of cognitive function, development of
dementia syndrome, and occurrence of depressive disorders. These endpoints
will be assessed using questionnaire tools such as the Montreal Cognitive
Assessment (MoCA), Trail Making Test (TMT), Controlled Oral Word
Association Test (COWAT), and Hospital Anxiety and Depression Scale
(HADS). The observational period for patients in the study is 2 years.
 Discussion(s): If the study demonstrates a favorable outcome with
reduced incidence of SBI and improved cognitive and mood outcomes in
patients receiving cerebral protection devices during LAAC, it will have
significant implications for clinical management standards. This would
support the use of neuroprotection devices not only for LAAC but also in
procedures such as atrial fibrillation ablation or transcatheter mitral
valve interventions, where the risk of embolic events and subsequent brain
injury may also be present. Trial registration: ClinicalTrials.gov
NCT05369195. Registration on 11.05.2022. Copyright © 2023, The
Author(s).

<81>
Accession Number
642815940
Title
Which Should You Choose for Post Operative Atrial Fibrillation, Carvedilol
or Metoprolol? A Systemic Review and Meta-analysis.
Source
Current problems in cardiology. (pp 102220), 2023. Date of Publication:
19 Nov 2023.
Author
Abouzid M.R.; Vyas A.; Eldahtoury S.; Anwar J.; Naccour S.; Elshafei S.;
Memon A.; Subramaniam V.; Bennett W.; Morin D.P.; Lavie C.J.; Nwaukwa C.
Institution
(Abouzid, Eldahtoury, Anwar, Naccour, Elshafei, Memon, Nwaukwa) Department
of Internal Medicine, Baptist Hospitals of Southeast Texas
(Vyas, Subramaniam, Bennett, Morin, Lavie) Department of Cardiology,
Ochsner Medical Center, New Orleans, LA, United States
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common
arrhythmic complication following cardiac surgery. Current guidelines
suggest beta-blockers for the prevention of POAF. In comparing metoprolol
succinate with carvedilol, later has sparked interest in its usage as an
important medication for POAF prevention. METHOD(S): We considered
randomized controlled studies (RCTs) and retrospective studies that
evaluated the efficacy of carvedilol versus metoprolol for the prevention
of POAF. After literature search, data extraction, and quality evaluation,
pooled data were analyzed using either the fixed-effect or random-effect
model using Review Manager 5.3. The Cochrane risk of bias tool was used to
assess the bias of included studies. The incidence of POAF was the primary
endpoint, while mortality rate and bradycardia were secondary outcomes.
 RESULT(S): In meta-analysis 5 RCTs and 2 retrospective studies with a
total of 1000 patients were included. The overall effect did not favor the
carvedilol over metoprolol groups in terms of mortality rate [risk ratio
0.45, 95 % CI (0.1-1.97), P=0.29] or incidence of bradycardia [risk ratio
0.63, 95 % CI (0.32-1.23), P=0.17]. However, the incidence of POAF was
lower in patients who received carvedilol compared to metoprolol [risk
ratio 0.54, 95 % CI (0.42-0.71), P < 0.00001]. CONCLUSION(S): In
patients undergoing cardiac surgery, carvedilol may minimize the
occurrence of POAF more effectively than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, a large-scale, well-designed
randomized controlled trials are required. Copyright © 2023.
Published by Elsevier Inc.

<82>
Accession Number
642814894
Title
Anaesthesia-related cognitive dysfunction following cardiothoracic surgery
in late middle-age and younger adults: A scoping review.
Source
Nursing in critical care. (no pagination), 2023. Date of Publication: 20
Nov 2023.
Author
Varpaei H.A.; Robbins L.B.; Ling J.; Lehto R.H.; Bender C.M.
Institution
(Varpaei, Robbins, Ling, Lehto) College of Nursing, Michigan State
University, East Lansing, MI, United States
(Bender) Nursing and Clinical and Translational Science Institute,
University of Pittsburgh, Pittsburgh, PA, United States
Abstract
AIM: This review aimed to evaluate factors associated with
anaesthesia-related postoperative cognitive dysfunction (POCD) among
adults younger than 65years who underwent cardiothoracic surgeries. STUDY
DESIGN: A systematic keyword search, following the scoping review
framework, was performed in the PubMed and CINAHL databases. Original
English-language studies that included adults younger than 65years and
addressed cognitive function after surgery along with anaesthesia
management were included. Retrospective studies, animal research and in
vitro and in vivo studies were excluded. RESULT(S): Twenty-three
articles were included (65.2% interventional studies). All studies lacked
theoretical or conceptual frameworks. Ketamine's neuroprotective potential
is questionable, and intravenous lidocaine may be considered a possible
early agent for preventing POCD, but long-term effectiveness is uncertain.
Compared to inhalational anaesthesia, total intravenous anaesthesia (TIVA)
may be related to a decreased incidence of POCD. Variation in POCD
assessment impacted the lack of homogeneity in obtained data. Moreover,
the shorter-term timing of POCD evaluation such as in early days after
surgery could be greatly influenced by medication and delirium.
 CONCLUSION(S): Although strategies such as TIVA, the use of
neuroprotective anaesthetics and comprehensive preoperative assessments
are suggested to prevent POCD, this multifactorial phenomenon cannot be
explicitly attributed solely to anaesthetics or anaesthesia-related
techniques. Use of standardized, reliable and valid tools for POCD
assessment is encouraged for cross-study comparison. RELEVANCE TO CLINICAL
PRACTICE: Nurses and certified nurse anaesthetists must be aware of risk
factors for postoperative delirium and POCD so they can assess patients
before and after surgery. Patients and caregivers need to be educated
about cognitive changes after surgery and advised to report them to their
health care provider if they occur. Copyright © 2023 The Authors.
Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of
British Association of Critical Care Nurses.

<83>
Accession Number
642812234
Title
Using noninvasive clinical parameters to predict mortality and morbidity
after cardiac interventions in patients with cirrhosis: A systematic
review.
Source
Saudi journal of gastroenterology : official journal of the Saudi
Gastroenterology Association. (no pagination), 2023. Date of Publication:
18 Nov 2023.
Author
Mathew C.; Patel A.; Cholankeril G.; Flores A.; Hernaez R.
Institution
(Mathew, Patel, Cholankeril, Flores, Hernaez) Department of Internal
Medicine, Baylor College of Medicine, Houston, TX, United States
(Cholankeril) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine, Baylor St. Luke's Medical Center,
Houston, TX, United States
(Flores, Hernaez) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine and Michael E DeBakey Veterans
Affairs Medical Center, Houston, TX, United States
Abstract
BACKGROUND: Cardiovascular disease commonly affects advanced liver disease
patients. They undergo cardiac interventions to improve cardiac outcomes.
Cirrhosis increases complication risk, including bleeding, renal and
respiratory failure, and further decompensation, including death, posing a
clinical dilemma to proceduralists. Predicting outcomes is crucial in
managing patients with cirrhosis. Our aim was to systematically review
clinical parameters to assess the mortality and complication risk in
patients with cirrhosis undergoing cardiac interventions. METHOD(S):
We searched cirrhosis and cardiovascular intervention terminology in
PubMed and Excerpta Medica Database (EMBASE) from inception to January 8,
2023. We included studies reporting clinical scores (e.g. Model for
End-stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT), cardiovascular
interventions, mortality, and morbidity outcomes). We independently
abstracted data from eligible studies and performed qualitative summaries.
 RESULT(S): Eight studies met the inclusion criteria. Procedures
included tricuspid valve surgery, catheterization-related procedures,
aortic valve replacement (AVR), pericardiectomy, and left ventricular
assist device (LVAD) placement. MELD primarily predicted mortality (n =
4), followed by CPT (n = 2). Mortality is significantly increased for MELD
> 15 after tricuspid valve surgery. Albumin, creatinine, and MELD were
significantly associated with increased mortality after transcatheter AVR
(TAVR), although specific values lacked stratification. CPT was
significantly associated with increased mortality after cardiac
catheterization or pericardiectomy. In LVAD placement, increasing MELD
increased the unadjusted odds for perioperative mortality.
 CONCLUSION(S): Our systematic review showed that clinical parameters
predict mortality and morbidity risk in patients with cirrhosis undergoing
cardiac procedures. Copyright © 2023 Copyright: © 2023 Saudi
Journal of Gastroenterology.

<84>
Accession Number
2028297428
Title
The Ability of Near-Infrared Spectroscopy to Identify Vulnerable Patients
and Plaques: A Systematic Review and Meta-Analysis.
Source
Heart Failure Clinics. 20(1) (pp 101-112), 2024. Date of Publication:
January 2024.
Author
Bass R.D.; Phillips J.; Sanchez J.S.; Shah P.; Sum S.; Waksman R.;
Garcia-Garcia H.M.
Institution
(Bass) School of Medicine, Georgetown University, 3800 Reservoir Road,
NorthWest, Washington, DC 20007, United States
(Phillips) University of Iowa Hospitals and Clinics, 200 Hawkins Drive,
Iowa City, IA 52242, United States
(Sanchez) Hospital Universitari I Politecnic La Fe, Avinguda de Fernando
Abril Martorell, no 106, Valencia 46026, Spain
(Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Avenue,
Monforte de Lemos, 3-5. Pabellon 11. Planta 0., Madrid 28029, Spain
(Shah, Sum) InfraRedx, A Nipro Company, 28 Crosby Drive, Suite 100,
Bedford, MA 01730, United States
(Waksman, Garcia-Garcia) Interventional Cardiology, MedStar Washington
Hospital Center, 110 Irving Street, Suite 4B-1, Washington, DC 20010,
United States
Publisher
Elsevier Inc.

<85>
Accession Number
2028254970
Title
App-based assessment of memory functions in patients after transfemoral
aortic valve replacement.
Source
Journal of Geriatric Cardiology. 20(9) (pp 664-672), 2023. Date of
Publication: September 2023.
Author
Nubel J.; Hauptmann M.; Schon J.; Fritz G.; Butter C.; Haase-Fielitz A.
Institution
(Nubel, Butter, Haase-Fielitz) Department of Cardiology, University
Hospital Heart Centre Brandenburg, Brandenburg Medical School (MHB)
Theodor Fontane, Bernau, Germany
(Hauptmann) Institute of Biostatistics and Registry Research, Brandenburg
Medical School Theodor Fontane, Neuruppin, Germany
(Hauptmann, Butter, Haase-Fielitz) Faculty of Health Sciences (FGW), Joint
Faculty of the University of Potsdam, Brandenburg Medical School Theodor
Fontane, The Brandenburg Technical University Cottbus-Senftenberg,
Cottbus, Germany
(Schon) Anesthesia and Intensive Care, University Hospital Ruppin
Brandenburg (Ukrb), Brandenburg Medical School (MHB) Theodor Fontane,
Neuruppin, Germany
(Fritz) Department of Anesthesiology, Intensive Care and Pain Therapy,
University Hospital Heart Centre Brandenburg, Brandenburg Medical School
(MHB) Theodor Fontane, Bernau, Germany
(Haase-Fielitz) Institute of Social Medicine and Health System Research,
Otto von Guericke University Magdeburg, Germany
Publisher
Science Press
Abstract
BACKGROUND Transfemoral aortic valve replacement (TAVR) is the standard
treatment for elderly patients with aortic valve stenosis. Although safe
and well-established, there is a risk of intraprocedural hemodynamic
instability and silent cerebral embolism, which can lead to a decline in
neurocognitive function and dementia. In clinical practice, comprehensive
cognitive testing is difficult to perform. AI-assisted digital
applications may help to optimize diagnosis and monitoring. METHODS
Neurocognitive function was assessed by validated psychometric tests using
"DELTAelta -App", which uses artificial intelligence and computational
linguistic methods for extraction and analysis. Memory function was
assessed using the 'Consortium to Establish a Registry for Alzheimer's
Disease' (CERAD) word list and digit span task (DST) before TAVR and
before hospital discharge. The study is registered in the German Register
of Clinical Trials (https://drks.de/search/de/trial/DRKS00020813). RESULTS
From October 2020 until March 2022, 141 patients were enrolled at
University Hospital Heart Centre Brandenburg. Mean age was 81 +/- 6 years,
42.6% were women. Time between the pre- and post-interventional test was
on average 6 +/- 3 days. Memory function before TAVR was found to be below
average in relation to age and educational level. The pre-post TAVR
comparison showed significant improvements in the wordlist repeat, P <
0.001 and wordlist recall test of CERAD, P < 0.001. There were no changes
in the digital span test. CONCLUSIONS Despite impaired preoperative memory
function before TAVR, no global negative effect on memory function after
TVAR was detected. The improvements shown in the word list test should be
interpreted as usual learning effects in this task. Copyright ©
2023 JGC All rights reserved.

<86>
Accession Number
2028060102
Title
Comparisons of procedural characteristics and clinical outcomes between
SMARTTOUCH SURROUNDFLOW catheter and other catheters for atrial
fibrillation radiofrequency catheter ablation: A systematic literature
review.
Source
BMJ Open. 13(10) (no pagination), 2023. Article Number: e075579. Date of
Publication: 17 Oct 2023.
Author
Li J.; Zhou G.; Li X.; Huang S.; Lin H.; Lin S.; Tan L.; Chen W.; Huang
X.; Wang Y.
Institution
(Li, Zhou, Li, Huang, Lin, Lin, Huang, Wang) Department of Cardioloqy,
Southern Medical University Nanfang Hospital, Guangdong, Guangzhou, China
(Tan) Changsha Normin Health Technology Ltd, Changsha, China
(Chen) Normin Health Consulting Ltd, Mississauga, ON, Canada
(Chen) THETA Collaborative, University of Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Background SMARTTOUCH SURROUNDFLOW (STSF) catheter is the new generation
of SMARTTOUCH (ST) catheter with an upgraded irrigation system for
radiofrequency catheter ablation (RFCA) in patients with atrial
fibrillation (AF). Methods This systematic literature review searched the
major English and Chinese bibliographic databases from 2016 to 2022 for
any original clinical studies assessing the STSF catheter for RFCA in AF
patients. Meta-analysis with a random effects model was used for evidence
synthesis. Results Pooled outcomes from 19 included studies indicated that
STSF catheter was associated with a significantly shorter procedure time
(weighted mean difference (WMD): -17.4 min, p<0.001), shorter ablation
time (WMD: -6.6 min, p<0.001) and lower catheter irrigation fluid volume
(WMD: -492.7 mL, p<0.001) than ST catheter. Pooled outcomes from four
included studies with paroxysmal AF patients reported that using the STSF
catheter for RFCA was associated with a significantly shorter ablation
time (WMD: -5.7 min, p<0.001) and a lower risk of 1-year postablation
arrhythmia recurrence (rate ratio: 0.504, p<0.001) than the SURROUNDFLOW
(SF) catheter. Significant reductions in procedure time and ablation time
associated with the STSF catheter were also reported in the other four
studies using non-ST/SF catheters as the control. Overall complications of
STSF catheter and control catheters were comparable. Conclusions Using the
STSF catheter was superior to using the ST catheter to conduct RFCA for AF
by significantly reducing procedure time, ablation time, fluoroscopy time
and irrigation fluid volume. The superiority of the STSF catheter over the
SF catheter and other non-ST/SF catheters for RFCA needs further
confirmation. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<87>
Accession Number
2025313534
Title
Concomitant Coronary Artery Disease in Identical Twins: Case Report and
Systematic Literature Review.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5742. Date of Publication: September 2023.
Author
Kamzolas O.; Papazoglou A.S.; Gemousakakis E.; Moysidis D.V.; Kyriakoulis
K.G.; Brilakis E.S.; Milkas A.
Institution
(Kamzolas, Gemousakakis) 401 General Military Hospital of Athens, Athens
11525, Greece
(Papazoglou, Kyriakoulis, Milkas) Athens Naval Hospital, Athens 11521,
Greece
(Moysidis) 424 General Military Hospital of Thessaloniki, Thessaloniki
56429, Greece
(Brilakis) Center for Coronary Artery Disease, Minneapolis Heart Institute
and Minneapolis Heart Institute Foundation, Abbott Northwestern,
Minneapolis, MN 55407, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Coronary artery disease (CAD) is multifactorial and strongly affected by
genetic, epigenetic and environmental factors. Several studies have
reported development of concomitant CAD in identical twins. We report a
case in which a pair of Caucasian male monozygotic twins presented almost
concomitantly with acute coronary syndrome (ACS) and had concordant
coronary anatomy and identical site of occlusion. We performed a
systematic literature review of PubMed, Web Of Science and Scopus
databases from inception until 28 February 2023 of case reports/case
series reporting the concomitant development of CAD in monozygotic twins.
We found 25 eligible case reports with a total of 31 monozygotic twin
pairs (including the case from our center) suffering from CAD and
presenting (most of them simultaneously) with ACS (mean age of
presentation: 45 +/- 12 years, males: 81%). Coronary angiograms
demonstrated lesion and anatomy concordance in 77% and 79% of the twin
pairs, respectively. Screening for disease-related genetic mutations was
performed in six twin pairs leading to the identification of five
CAD-related genetic polymorphisms. This is the first systematic literature
review of studies reporting identical twin pairs suffering from CAD. In
summary, there is high concordance of coronary anatomy and clinical
presentation between monozygotic twins. Future monozygotic twin
studies-unbiased by age effects-can provide insights into CAD heritability
being able to disentangle the traditional dyad of genetic and
environmental factors and investigate the within-pair epigenetic
drift. Copyright © 2023 by the authors.

<88>
Accession Number
2025313156
Title
Sarcopenia Adversely Affects Outcomes following Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(17) (no pagination), 2023. Article
Number: 5573. Date of Publication: September 2023.
Author
Ansaripour A.; Arjomandi Rad A.; Koulouroudias M.; Angouras D.; Athanasiou
T.; Kourliouros A.
Institution
(Ansaripour, Kourliouros) Department of Cardiothoracic Surgery, John
Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust,
Oxford OX3 9DU, United Kingdom
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford
OX1 3AZ, United Kingdom
(Koulouroudias) Department of Cardiac Surgery, Nottingham University
Hospitals NHS Trust, Nottingham NG5 1PB, United Kingdom
(Angouras) Department of Cardiac Surgery, Attikon University Hospital,
National and Kapodistrian University of Athens, Athens 10679, Greece
(Athanasiou) Department of Surgery and Cancer, Imperial College London,
London SW7 2BX, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Sarcopenia is a degenerative condition characterised by the
loss of skeletal muscle mass and strength. Its impact on cardiac surgery
outcomes remains poorly investigated. This meta-analysis aims to provide a
comprehensive synthesis of the available evidence to determine the effect
of sarcopenia on cardiac surgery outcomes. Method(s): A systematic
review and meta-analysis followed PRISMA guidelines from inception to
April 2023 in EMBASE, MEDLINE, Cochrane database, and Google Scholar.
Twelve studies involving 2717 patients undergoing cardiac surgery were
included. Primary outcomes were early and late mortality; secondary
outcomes included surgical time, infection rates, and functional outcomes.
Statistical analyses were performed using appropriate methods.
 Result(s): Sarcopenic patients (906 patients) had a significantly
higher risk of early mortality (OR: 2.40, 95% CI: 1.44 to 3.99, p =
0.0007) and late mortality (OR: 2.65, 95% CI: 1.57 to 4.48, p = 0.0003)
compared to non-sarcopenic patients (1811 patients). There were no
significant differences in overall surgical time or infection rates.
However, sarcopenic patients had longer ICU stays, higher rates of renal
dialysis, care home discharge, and longer intubation times.
 Conclusion(s): Sarcopenia significantly increases the risk of early
and late mortality following cardiac surgery, and sarcopenic patients also
experience poorer functional outcomes. Copyright © 2023 by the
authors.

<89>
Accession Number
2025811220
Title
Acute Glycemic Variability and Early Outcomes after Cardiac Surgery: A
Meta-Analysis.
Source
Hormone and Metabolic Research. 55(11) (pp 771-780), 2023. Date of
Publication: 20 Apr 2023.
Author
Chang S.; Xu M.; Wang Y.; Zhang Y.
Institution
(Chang, Zhang) Surgery ICU Cardiac Surgery, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, Beijing, China
(Xu, Wang) Surgery ICU, Cardiac Surgery, Fuwai Yunnan Cardiovascular
Hospital, Kunming, China
Publisher
Georg Thieme Verlag
Abstract
The influence of acute glycemic variability (GV) on early outcomes of
patients after cardiac surgery remains not fully determined. We performed
a systematic review and meta-analysis to evaluate the association between
acute GV and in-hospital outcomes of patients after cardiac surgery.
Relevant observational studies were obtained by search of electronic
databases including Medline, Embase, Cochrane Library, and Web of Science.
A randomized-effects model was selected to pool the data by incorporating
the influence of potential heterogeneity. Nine cohort studies involving 16
411 patients after cardiac surgery were included in this meta-analysis.
Pooled results showed that a high acute GV was associated with an
increased risk of major adverse events (MAE) during hospitalization for
patients after cardiac surgery [odds ratio [OR]: 1.29, 95% CI: 1.15 to
1.45, p<0.001, I22=38%]. Sensitivity analysis limited to studies of
on-pump surgery and GV evaluated by coefficient of variation of blood
glucose showed similar results. Subgroup analysis suggested that a high
acute GV was related to an increased incidence of MAE in patients after
coronary artery bypass graft, but not for those after isolated valvular
surgery (p=0.04), and the association was weakened after adjustment of
glycosylated hemoglobin (p=0.01). Moreover, a high acute GV was also
related to an increased risk of in-hospital mortality (OR: 1.55, 95% CI:
1.15 to 2.09, p=0.004; I22=0%). A high acute GV may be associated with
poor in-hospital outcomes in patients after cardiac surgery. Copyright
© 2023 Georg Thieme Verlag. All rights reserved.

<90>
Accession Number
2024855348
Title
Hybrid delivery of behavioral health screening and prevention intervention
for pediatric heart transplant recipients and families: A randomized pilot
study.
Source
Pediatric Transplantation. 27(8) (no pagination), 2023. Article Number:
e14577. Date of Publication: December 2023.
Author
Wijesekera K.; Kiff C.; Aralis H.; Sinclair M.; Bursch B.; Alejos J.C.;
Lester P.
Institution
(Wijesekera, Kiff, Aralis, Sinclair, Bursch, Lester) Department of
Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at
UCLA, Los Angeles, CA, United States
(Bursch, Alejos) Department of Pediatrics, David Geffen School of Medicine
at UCLA, Los Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: A significant number of pediatric heart transplant recipients
and their families experience post-traumatic stress symptoms following
transplantation, which can impact recipient behavioral and medical health
outcomes. Preventive behavioral health interventions may improve outcomes,
especially if interventions can be delivered at a distance to decrease
barriers to mental health care. This pilot study examined the
acceptability and accessibility of an evidence-informed resilience
training program delivered using a video telehealth platform. A secondary
aim was to assess the preliminary efficacy of the intervention on
recipient behavioral health outcomes, perceived barriers to recipient
medication adherence, parent behavioral health outcomes, and family
functioning. Method(s): Seventeen heart transplant recipients (8-18
years old) and their families were recruited and randomly assigned to a
treatment as usual (n = 8) or an intervention group (n = 9). Baseline
assessment data collected included demographic information and validated
behavioral health measures. Follow-up assessments included the validated
measures and acceptability and satisfaction ratings. Result(s): The
study demonstrated that the program has high acceptability by recipients
and parents, and a positive impact on recipients and parents, including
significant reductions in youth behavioral difficulties as well as parent
depression and post-traumatic stress symptoms. Conclusion(s): Results
of this study are promising and call for further evaluation of hybrid
delivery models for behavioral health screening and prevention
interventions for pediatric heart transplant recipients and their
families. Copyright © 2023 The Authors. Pediatric Transplantation
published by Wiley Periodicals LLC.

<91>
Accession Number
642785137
Title
Tight perioperative blood pressure management to reduce complications: a
randomised feasibility trial.
Source
BMJ open. 13(11) (pp e071328), 2023. Date of Publication: 17 Nov 2023.
Author
Li K.; Hu Z.; Li W.; Shah K.; Sessler D.
Institution
(Li, Hu, Li) Department of Anesthesiology, China-Japan Union Hospital of
Jilin University, Changchun, Jilin, China
(Shah) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Shah, Sessler) Outcomes Research, Cleveland Clinic, Cleveland, OH, United
States
Abstract
OBJECTIVE: Evaluate the feasibility of a trial of perioperative
hypotension and serious complications. DESIGN: A patient and
assessor-blinded randomised feasibility trial. SETTING: We included
patients in a tertiary university hospital. PARTICIPANTS: We enrolled 80
adults scheduled for major non-cardiac surgery. INTERVENTIONS: In patients
randomised to tight blood pressure control, intraoperative mean arterial
pressure (MAP) was targeted to >=85mm Hg maintained with norepinephrine
infusion, and restarting chronic antihypertensive medications was delayed
until the third postoperative day. In the reference group, intraoperative
blood pressure was managed per routine and antihypertensive medications
were restarted immediately after surgery. PRIMARY AND SECONDARY OUTCOME
MEASURES: Our first co-primary outcome was the fraction of time when
intraoperative MAP was >85mm Hg, intraoperative area (time integral) of
MAP >85mm Hg and MAP <65mm Hg. The second co-primary outcome was time
until antihypertensive medications were restarted after surgery. Secondary
outcomes were time-weighted average intraoperative MAP, cumulative minimum
MAP for 10min, average postoperative systolic blood pressure (SBP) and
mean of the lowest three postoperative SBPs. RESULT(S): Forty
patients in each group were analysed. The median for intraoperative area
of MAP >85mm Hg was 1303 (772-2419)mm Hg*min in routine blood pressure
(BP) cases and 2425 (1926-3545)mm Hg*min in tight BP control. The area for
intraoperative MAP <65mm Hg was 7 (0-40)mm Hg*min with routine BP
management, and 0 (0-0)mm Hg*min with tight BP control. The fraction of
time with MAP >85mm Hg was 0.52 (0.25) and 0.87 (0.15). Antihypertensive
medications were restarted 2 (1-3)days later in tight BP control cases.
However, postoperative SBPs were similar. CONCLUSION(S): Tight BP
management markedly increased intraoperative MAP and reduced the amount of
hypotension. In contrast, delaying chronic antihypertensive medications
had little effect on postoperative SBP. The full trial appears feasible
and remains necessary but should not include postoperative
antihypertensive management. TRIAL REGISTRATION:
NCT04789733. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<92>
Accession Number
642385898
Title
Association of general anesthesia exposure with risk of postoperative
delirium in patients receiving transcatheter aortic valve replacement: a
meta-analysis and systematic review.
Source
Scientific reports. 13(1) (pp 16241), 2023. Date of Publication: 27 Sep
2023.
Author
Ko C.-C.; Hung K.-C.; Chang Y.-P.; Liu C.-C.; Cheng W.-J.; Wu J.-Y.; Li
Y.-Y.; Lin T.-C.; Sun C.-K.
Institution
(Ko) Department of Medical Imaging, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
(Ko) Department of Health and Nutrition, Chia Nan University of Pharmacy
and Science, Tainan City, Taiwan (Republic of China)
(Hung, Cheng) Department of Anesthesiology, Chi Mei Medical Center, Tainan
City, Taiwan (Republic of China)
(Hung) School of Medicine, College of Medicine, National Sun Yat-Sen
University, Kaohsiung City, Taiwan (Republic of China)
(Chang) Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital,
Kaohsiung Medical University, Kaohsiung City, Taiwan (Republic of China)
(Chang) Department of Neurology, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung City, Taiwan (Republic of China)
(Liu) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung City, Taiwan (Republic of China)
(Wu) Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
(Republic of China)
(Li) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
(Lin) Department of Anesthesiology, Tri-Service General Hospital, National
Defense Medical Center, Taipei City, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou
University, No. 305, Dachang 1St Road ,Kaohsiung City, Taiwan (Republic of
China)
(Sun) School of Medicine for International Students, College of Medicine,
I-Shou University, Kaohsiung City, Taiwan (Republic of China)
Abstract
The aim of this meta-analysis was to assess the association of general
anesthesia (GA) exposure with the risk of POD in this patient population.
Databases including Medline, EMBASE, Cochrane library, and Google Scholar
were searched from inception to December 2022. Analysis of 17 studies
published between 2015 and 2021 involving 10,678 individuals revealed an
association of GA exposure with an elevated risk of POD [odd ratio
(OR)=1.846, 95% CI 1.329 to 2.563, p=0.0003, I2=68.4%, 10,678 patients].
Subgroup analysis of the diagnostic methods also demonstrated a positive
correlation between GA exposure and POD risk when validated methods were
used for POD diagnosis (OR=2.199, 95% CI 1.46 to 3.31, p=0.0002).
Meta-regression analyses showed no significant impact of age, male
proportion, and sample size on the correlation between GA and the risk of
POD. The reported overall incidence of POD from the included studies
regardless of the type of anesthesia was between 0.8 and 27%. Our
meta-analysis showed a pooled incidence of 10.3% (95% CI 7% to 15%). This
meta-analysis suggested an association of general anesthesia with an
elevated risk of postoperative delirium, implying the necessity of
implementing appropriate prophylactic strategies against this complication
when general anesthesia was used in this clinical setting. Copyright
© 2023. The Author(s).

<93>
Accession Number
642786017
Title
Does Calibration of Electromyo- graphy Guided by State Entropy Improve
Measurement Precision? - A randomized prospective observational
proof-of-concept study.
Source
Anasthesiologie und Intensivmedizin. Conference: 25. Hauptstadtkongress
der DGAI fur Anasthesiologie und Intensivtherapie, HAI 2023. Berlin
Germany. 64(Supplement 13) (pp S389-S390), 2023. Date of Publication:
October 2023.
Author
Scheffenbichler F.; Ulm B.; Borgstedt L.; Gaa N.; Friedrich V.; Kretsch
N.; Jungwirth B.; Blobner M.
Institution
(Scheffenbichler, Gaa, Friedrich, Jungwirth) Universitat Ulm, Germany
(Ulm, Borgstedt, Kretsch, Blobner) Technische Universitat Munchen, Germany
Publisher
Aktiv Druck and Verlag GmbH
Abstract
Background Neuromuscular monitoring is rarely calibrated due to its
difficulty and time-consuming nature coinciding with the patients' loss of
consciousness during anesthesia induction [1]. This is a randomized,
prospective, observational proof-of-concept study designed to evaluate
different time points during anesthesia induction for electromyography
(EMG) calibration in terms of precise neuromuscular monitoring
measurements. Methods IRB-approved randomized, prospective, observational
proof-of-concept study in 36 adult patients scheduled for elective,
non-cardiac surgery requiring general anesthesia and moderate
neuromuscular blockade (ethics committee Ulm University #229/21). EMG of
the adductor pollicis with a supramaximal trainof- four stimulation
pattern was used. Randomization groups were (1) before induction of
anesthesia: 3 minutes after 2 mug kg-1 fentanyl (2) during
induction of anesthesia: directly after loss of consciousness with
propofol infusion of 3 - 6 mg kg-1min-1, (3) uncalibrated:
start of EMG measurements without calibration at state entropy (SE) < 50.
Control electromyography on the contralateral arm was started at SE <= 50.
The primary endpoints repeatability coefficient and limits of agreement
during neuromuscular recovery (train-of-four ratios > 0.8) were analyzed
using Bland Altman analysis [2]. Results Thirty-six patients were
included, one of whom had to be excluded from the analysis due to
technical failure (Figure 1). Patient characteristics are shown in Table
1. Multiple attempts to calibrate EMG were performed in seven of 35
patients for the control EMG after induction of anesthesia and in 2 of 23
patients for the interventional calibrations. The repeatability
coefficient calculated of Train-of-four- Ratio (TOF-R) > 0.8 was 0.03 [95
% Confidence Interval (CI) 0.033 to 0.035] when calibration was performed
before induction, 0.12 [95 % CI 0.116 to 0.122] when calibration was
performed during induction, and 0.24 [95 % CI 0.232 to 0.243] without
calibration. The EMG on the control arm had a repeatability coefficient of
0.05 [95 % CI 0.045 to 0.046]. The limits of agreement between the control
EMG and the intervention arm were smallest when EMG was calibrated before
induction of anesthesia (Table 2). Conclusion The repeatability
coefficient was best when calibration was performed before induction of
anesthesia, possibly because patients were easier to guide than during
induction where excitation might occur. The precision of EMG readings was
unacceptable when calibration was performed directly after loss of
consciousness or without calibration. A repeatability coefficient of e.g.,
0.2 means that a TOF-R of 0.9 can be 0.2 larger or smaller when measured
again under unchanged conditions with 95 % certainty.

<94>
Accession Number
642789822
Title
Quality of Life After Percutaneous Coronary Intervention Versus Coronary
Artery Bypass Grafting.
Source
Journal of the American Heart Association. (pp e030069), 2023. Date of
Publication: 20 Nov 2023.
Author
Dimagli A.; Spadaccio C.; Myers A.; Demetres M.; Rademaker-Havinga T.;
Stone G.W.; Spertus J.A.; Redfors B.; Fremes S.; Gaudino M.; Masterson
Creber R.
Institution
(Dimagli) Bristol Heart Institute, University of Bristol Bristol United
Kingdom, United Kingdom
(Dimagli, Demetres, Gaudino) Department of Cardiothoracic Surgery Weill
Cornell Medical College New York NY
(Spadaccio) Mayo Clinic Department of Cardiovascular Surgery Rochester MN
(Myers) Columbia University Irving Medical Center New York NY
(Rademaker-Havinga) Cardialysis Rotterdam The Netherlands
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai New York NY
(Spertus) Saint Luke's Mid America Heart Institute, University of Missouri
Kansas City MO, United States
(Redfors) Sahlgrenska University Hospital Gothenburg Sweden, Sweden
(Fremes) Sunnybrook Health Sciences Center University of Toronto Toronto
Canada, Canada
(Masterson Creber) Columbia University School of Nursing Columbia
University Irving Medical Center New York NY
Abstract
BACKGROUND: Differences in quality of life (QoL) after coronary artery
bypass grafting (CABG) compared with percutaneous coronary intervention
(PCI) are not well characterized. We aimed to compare the short- and
long-term effects of CABG versus PCI on QoL. METHODS AND RESULTS: We
performed a systematic review and meta-analysis of randomized controlled
trials comparing CABG versus PCI using the Seattle Angina Questionnaire
(SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and
Short-Form Questionnaire. We calculated mean changes within each group
from baseline to 1, 6, 12, and 36 to 60months (latest follow-up) and the
weighted mean differences between groups using inverse-variance methods. A
total of 10760 patients were enrolled in 5 trials. From baseline to
12months and 36 to 60months, the mean change in SAQ-Angina Frequency was
>22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean
difference in SAQ-Angina Frequency was similar between procedures at
1month and at 36 to 60months but favored CABG at 12 months (1.97 [95% CI,
0.68-3.26]). SAQ-QoL favored PCI at 1month (-2.92 [95% CI, -4.66 to
-1.18]) and CABG at 6 (2.50 [95% CI, 1.02-3.97]), 12 (3.30 [95% CI,
1.78-4.82]), and 36 to 60months (3.17 [95% CI, 0.54 5.80). SAQ-Physical
Limitations (-12.61 [95% CI, -16.16 to -9.06]) and EuroQoL-5D (-0.07 [95%
CI, -0.08 to -0.07) favored PCI at 1month. Short-Form
Questionnaire-Physical Component favored CABG at 12months (1.18 [95% CI,
0.46-1.90]). CONCLUSION(S): Both PCI and CABG improved long-term
disease-specific and generic QoL.

<95>
Accession Number
642784201
Title
Novel Uses of Indocyanine Green in Thoracic Surgery: A Review and Case
Series.
Source
Surgical technology international. 43 (no pagination), 2023. Date of
Publication: 16 Nov 2023.
Author
Olivera J.A.; Faith I.; Onugha O.
Institution
(Olivera, Faith) Albert Einstein College of Medicine, Bronx, NY, United
States
(Onugha) Charles Drew University, Los Angeles, CA, United States
Abstract
Indocyanine green (ICG) is a water-soluble molecule that emits
fluorescence in the near-infrared light spectrum. Due to its fluorescence
properties, safety profile, and cost-effectiveness, ICG is used in
minimally invasive surgery, enabling real-time visualization of structures
during the operation. Until recently, its use was mainly limited to
robotic surgery, which required specific technological setups to visualize
the fluorescence. With recent technological advancements, however, similar
capabilities can now be integrated into smaller laparoscopic instruments,
broadening the accessibility and usefulness of ICG. In this article, we
present various innovative applications of ICG in thoracic surgery,
drawing from recent developments in the field and our own experiences.
Specifically, we focus on the novel role of ICG in the evaluation of
gastric conduit perfusion, lung nodule localization, and thoracic duct
ligation.

<96>
Accession Number
2026644577
Title
EFFECTS OF TAI CHI EXERCISES ON PHYSICAL ACTIVITY AND PULMONARY FUNCTION
IN PATIENTS WITH CORONARY ARTERY BYPASS GRAFTING.
Source
Journal of Medical Sciences (Peshawar). 31(4) (pp 261-265), 2023. Date of
Publication: 14 Nov 2023.
Author
Razzaq M.; Obaid S.; Tariq I.; Iqbal M.A.; Kiani S.K.; Ramzan T.
Institution
(Razzaq, Obaid, Tariq, Kiani) Riphah College of Rehabilitation & Allied
Health Sciences, Riphah International University, Islamabad, Pakistan
(Iqbal) Armed Forces Institute of Cardiology, National Institute of Heart
Diseases, Rawalpindi, Pakistan
(Ramzan) Shifa Tameer E Millat University, Islamabad, Pakistan
Publisher
Khyber Medical College
Abstract
Objective: To determine the effects of Tai Chi exercises on physical
activity, pulmonary function, and rate of perceived exertion in
post-coronary artery bypass grafting patients. Material(s) and
Method(s): A Randomized control trial was conducted in the Armed Forces
Institute of Cardiology/National Institute of Heart Diseases Rawalpindi
Pakistan from January 2018-July 2018. 50 post-coronary artery bypass
grafting patients were calculated by the open epi tool and randomly
allocated into two groups in equal halves through non-probability
purposive sampling with the toss the coin method. 40-60 years males and
females with >40% ejection fraction were included while vitally unstable
patients were excluded. The experimental group was given Tai Chi exercises
while the control group was given a bicycle. Levels of physical activity
and pulmonary functions were assessed at baseline, 4thand 6th week of
training. Result(s): Out of the total sample size only 39 were
analyzed 11 were dropped off due to not following proper follow-up, and
there was no statistical difference in heart rate P=0.095. Oxygen
saturation shows a significant difference with P<0.001, Physical activity
was low at baseline but after exercise training, the Tai Chi group showed
great improvement P< 0.01. Pulmonary functions showed statistically
insignificant results P=0.865. The rate of perceived exertion was high in
2nd week and gradually decreased with the mean of 3.20 and 3.37 while the
time of exercise was improved with P<0.01. Conclusion(s): Tai Chi
exercises have better improvement in pulmonary function, rate of perceived
exertion, time of exercise, and physical activity in post-coronary artery
bypass grafting patients. Copyright © 2023, Khyber Medical
College. All rights reserved.

<97>
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. 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. 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%. 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. Copyright © 2023, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<98>
Accession Number
2026647071
Title
Comparing acute normovolumic hemodilution with autologous platelet-rich
plasma for blood preservation during aortic surgery : study protocol for a
randomized controlled clinical trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 741. Date of
Publication: December 2023.
Author
Zhu D.; Li Y.; Tian A.-Y.; Wang H.-N.
Institution
(Zhu, Li, Tian, Wang) Department of Anesthesiology, The First Hospital of
China Medical University, 155 Nanjing North Street, Heping District,
Liaoning Province, Shenyang, China
Publisher
BioMed Central Ltd
Abstract
Background: Both acute normovolumic hemodilution (ANH) and autologous
platelet-rich plasma (aPRP) have been demonstrated blood-protective
effects in cardiac aortic surgery; however, the efficacies of the two
methods have not been compared. This study aims to compare the effects of
aPRP and ANH prior to aortic surgery on postoperative bleed and other
outcomes. Methods and analysis: This is a prospective, single-center,
double-blind controlled clinical trial including 160 patients randomized
1:1 to receive aPRP (test group) or autologous whole blood (ANH, control
group). The primary objective is to compare the drainage volumes in the
two groups at 24, 48, and 72 h postoperatively. Secondary outcomes include
input of allogeneic blood and blood products and durations of aortic
block, extracorporeal circulation, deep hypothermic arrest of circulation,
tracheal extubation, hospital stay, requirement for secondary surgical
hemostasis, and application of intra-aortic balloon pump or extracorporeal
membrane oxygenation in the two groups. In addition, heart rate, systolic
blood pressure, diastolic blood pressure, central venous pressure, and
thromboelastography recorded before blood reservation (T1), after blood
reservation (T2), before blood transfusion (T3), and after the blood is
returned (T4) to the transfusion will be compared between the two groups
of patients. Discussion(s): This study will demonstrate if the use of
aPRP could reduce the risk of bleeding after aortic surgery compared with
ANH. The results are expected to have practical clinical applications in
terms of more effective blood protection and shorter hospital stay. Trial
registration: This study was registered with the Chinese Clinical Trial
Registry (http://www.chictr.org.cn/) with the ID ChiCTR
1900023351.Registered on May 23, 2019. Trial status: Recruiting start
date: July 1, 2019; expected recruiting end date: July 1, 2024 Version
number and date: Version 2 of 05-04-2019 Copyright © 2023, The
Author(s).

<99>
Accession Number
642782826
Title
BACPR Annual Conference Abstracts.
Source
Heart. Conference: British Association for Cardiovascular Prevention and
Rehabilitation Annual Conference, BACPR 2023. Cardiff United Kingdom.
109(5) (no pagination), 2023. Date of Publication: October 2023.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 26 papers. The topics discussed include:
feasibility and acceptability of digitally adapted cardiac rehabilitation
for people with heart failure; feasibility of muscular fitness testing in
cardiac rehabilitation with portable movement sensor technology; a
systematic review of the use of diuretics in cardiorenal syndrome; protein
intake, grip strength, and quality of life in older adults: an evaluation
of an over 60's community exercise program; preoperative optimization of
patients awaiting lung resection in cardiothoracic surgery: unlock the
potential of cardiac rehabilitation and diversify; mobile health
biometrics to prescribe immediate remote physical activity for enhancing
uptake to cardiac rehabilitation (MOTIVATE-CR+): protocol for a randomized
controlled feasibility trial; developing scalable training for the
delivery of REACH-HF, home-based cardiac rehabilitation for heart failure;
and effects of cardiac rehabilitation on quality of life: role of
exercise, cultural and social factors; a qualitative study.

<100>
Accession Number
642782814
Title
VERY EARLY RESISTANCE TRAINING POST VALVE REPLACEMENT SURGERY IS SAFE AND
EFFECTIVE: IS IT THE TIME TO RECHECK THE CURRENT GUIDELINES?.
Source
Heart. Conference: British Association for Cardiovascular Prevention and
Rehabilitation Annual Conference, BACPR 2023. Cardiff United Kingdom.
109(5) (pp A9-A10), 2023. Date of Publication: October 2023.
Author
Atef H.; Helmy Z.; Ahmed M.; El-Ansary D.; Pengelly J.; Jones S.; Buckley
J.
Institution
(Atef, Jones, Buckley) School of Allied Health Professionals, Keele
University, United Kingdom
(Atef, Helmy, Ahmed) Faculty of Physical Therapy, Cairo University, Egypt
(El-Ansary) School of Physiotherapy, RMIT University, Australia
(Pengelly) School of Physiotherapy, Federation University, Australia
Publisher
BMJ Publishing Group
Abstract
Background Resistance training (RT) for improving muscular strength is a
fundamental part of the exercise component in Cardiac Rehabilitation (CR)
protocols for post-open-heart surgeries. Although very early postoperative
RT is safe and feasible, many delays start until after four weeks. It is
evidenced that such delays can significantly affect the efficacy of CR
outcomes. Aim For patients receiving valve replacement surgery, this study
aimed to investigate the effect of very early resistance training (2 days
postoperatively) on functional capacity, either when combined with aerobic
training or compared to aerobic training alone. Additional clinical
measures included the effects on the Electrocardiograph (ECG) P-R interval
and resting heart rate (RHR). Methods 40 male valve replacement surgery
patients (20-30 years) were randomly allocated into two equal groups:
Group A received aerobic and very early resistance training (6 exercises
targeting upper limbs, lower limbs, neck and back done till volitional
fatigue with 9-12 repetitions/exercise) three sessions per week for one
month and Group B received aerobic training only for the same frequency
and time. The primary outcome was functional capacity, assessed using a
six-minute walk test (6MWT). Secondary outcomes were P-R interval and RHR,
both assessed using a resting ECG. Results Functional capacity
(118.50+/-6.75m vs 41.75+/-6.75m for groups A and B respectively) and P-R
intervals (30.05 +/-3.21ms vs 11.65+/-3.21ms for groups A and B
respectively) showed significant improvements in both groups (p=0.001 and
0.02, respectively) with greater changes in group A. However, there were
no between-groups improvements in RHR (p= 0.75). Conclusion Very early
resistance training combined with aerobic is generally safe and effective
for patients after valve replacement surgery, however, potential gender
variations and a larger sample-sized study should be conducted in future
research. Also, different research designs with RT as a standalone
intervention might still be needed.

<101>
Accession Number
2028398787
Title
Efficacy and Safety of Tranexamic Acid for Reduction in Blood Transfusions
in Patients Undergoing Major Non-Cardiac Surgeries: A Systematic Review
and Meta-Analysis of Randomized Controlled Trials.
Source
Blood. Conference: 64th ASH Annual Meeting. New Orleans United States.
140(Supplement 1) (pp 5709-5710), 2022. Date of Publication: 15 Nov 2022.
Author
Fatima M.; Ahmed A.; Zaheer Z.; Zain A.; Azhar M.; Chaudhary M.A.H.; Murad
M.W.; Khan M.H.A.; Akbar U.A.; Rehman M.E.U.; Anwer F.
Institution
(Fatima, Ahmed, Zaheer, Azhar, Chaudhary, Khan) Department of Medicine,
King Edward Medical University, Lahore, Pakistan, Pakistan
(Zain) Services Institute of Medical Sciences, Lahore, Pakistan, Pakistan
(Murad) Department of Medicine, Shanxi Medical University China, Yuci
district, China, China
(Akbar) Department of Internal Medicine, Northwell Health, New York, NY
(Rehman) Rawalpindi Medical University, Rawalpindi, Pakistan, Pakistan
(Anwer) Department of Hematology and Medical Oncology, Taussig Cancer
Institute, Cleveland Clinic, Cleveland, OH
Publisher
Elsevier B.V.
Abstract
Abstract: Background and Objective: Tranexamic Acid (TXA) is an
anti-fibrinolytic agent that is effective in decreasing perioperative
bleeding thus subsequently reducing the risk of blood transfusions in
cardiac surgeries, however, there is limited data available on patients
undergoing major non-cardiac surgeries. The primary objective of this
meta-analysis is to elucidate the efficacy and safety of TXA in reducing
the risk of blood transfusions in major non-cardiac surgeries where TXA is
not standard of care. Method(s): A comprehensive literature search
was carried on PubMed (Medline), EMBASE, CENTRAL (Cochrane Library) and
Google Scholar from inception till May 2022. The inclusion criteria were
randomized controlled trials (RCTs) in adults (>=18 years) undergoing
major non-cardiac surgeries for which TXA was not standard of care. The
treatment group included patients receiving perioperative IV(Intravenous)
TXA. The control group included placebo, usual-care or active comparator
(Aprotinin, EACA(epsilon-aminocaproic acid), rFVIIa(activated recombinant
factor), Topical TXA, Oral TXA, batroxobin). Primary outcomes were
proportion of patients that received blood transfusion and volume of PRBCs
(Packed Red Blood Cells) transfused at the longest follow-up. Review
Manager Software (RevMan, version 5.3) was employed for statistical
analyses and forest plots were created to visually analyze the results.
The Mantel-Haenszel random effect model was applied. Higgins I2 test was
used to evaluate heterogeneity across the studies. The bias assessment was
carried out via Cochrane risk of Bias tool (Rob-2) and GRADE methodology
was utilized to assess the certainty of evidence. Result(s): A total
of 82 RCTs, n=16,638 patients were included (TXA n= 8303 vs Non-TXA
n=8335, TXA n=7986 vs Placebo n=7949, TXA n= 317 vs Comparator n=386). The
mean age of included patients was 48.2 years and included surgery types
were orthopedics, urology, plastic surgery, neurosurgery, general surgery,
obstetrics, gynaecology, hepatobiliary and spine surgery. The pooled
analysis of proportion of patients that received TXA showed a decreased
need of transfusion (RR(Risk Ratio): 0.63, 95% CI;0.54,0.74, I2=75 %, P=
<0.00001, low certainty) as compared to placebo or standard care or active
comparator, however, the results were limited by significant heterogeneity
(variable threshold for transfusion, ). The subgroup analysis according to
baseline transfusion rate of 10-19% and >=20%, trial size(<=50,
51-99,>=100) and risk of bias didn't report any significant difference in
overall risk ratio or resolved statistical heterogeneity. TXA also reduces
the volume of PRBCs transfused (mean difference)MD: -0.46, 95% CI;
-0.85,0.07, I2=98%, P,0.00001, low certainty) and the length of stay in
hospital (MD:-0.49, 95% CI;-0.91,-0.18,I2=82%, P= 0.002) as compared to
control in patients undergoing major non-cardiac surgeries, however, TXA
use was not found to be significantly associated with risk of deep vein
thrombosis (RR: 1.05, 95% CI;0.78,1.40,I2=0 %, P= 0.76), pulmonary
embolism (RR: 1.18, 95% CI;0.76,1.82,I2=0 %, P= 0.46), stroke (RR: 1.55,
95% CI;0.91,2.65,I2=0 %, P= 0.11), seizure(RR: 1.66, 95% CI;0.64,4.28,I2=0
%, P= 0.30), myocardial infarction (RR: 1.25, 95% CI;0.89,1.74,I2=0%, P=
0.19), all-cause mortality (RR: 1.02, 95% CI;0.77,1.36,I2=0 %, P= 0.88)
and need for re-operation due to hemorrhage (RR: 0.80, 95%
CI;0.58,1.11,I2=0 %, P= 0.18).Subgroup analysis based on trial size,
baseline risk of transfusion and risk of bias didn't resolve statistical
heterogeneity for the volume of PRBCs transfused. Conclusion(s):
Perioperative TXA administration reduces the risk of PRBC transfusion
needs for patients undergoing major non-cardiac surgeries for which TXA is
not standard of care as compared to placebo, standard care or other active
comparators. However, the results are limited by significant heterogeneity
and low quality of evidence. TXA group was also found to be associated
with decreased length of stay in hospital. However, there was no
significant increased risk of any major thrombotic event. There is need of
further high quality prospective RCTs to provide conclusive evidence.
[Formula presented] Disclosures: Anwer: Allogene Therapeutics: Research
Funding; Janssen: Consultancy; BMS: Consultancy, Research Funding,
Speakers Bureau. Copyright © 2022 The American Society of
Hematology

<102>
Accession Number
642773246
Title
Erratum: Non-pharmacological interventions to promote the sleep of
patients after cardiac surgery: a systematic review.
Source
Revista latino-americana de enfermagem. 31 (pp e4098), 2023. Date of
Publication: 13 Nov 2023.
Author
Anonymous
Abstract
[This corrects the article doi: 10.1590/1518-8345.1917.2926].

<103>
Accession Number
2026648722
Title
Propofol EC<inf>50</inf> for inducing loss of consciousness in patients
under combined epidural-general anesthesia or general anesthesia alone: a
randomized double-blind study.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1194077.
Date of Publication: 2023.
Author
Wang J.; Shen Y.; Guo W.; Zhang W.; Cui X.; Cai S.; Chen X.
Institution
(Wang, Shen, Chen) Department of Anesthesia, Women's Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Wang, Shen, Guo, Zhang, Cui, Cai) Department of Anesthesiology, Zhejiang
Cancer Hospital, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Combined epidural-general anesthesia (GA + EA) has been
recommended as a preferred technique for both thoracic and abdominal
surgery. The epidural anesthesia on the general anesthetic (GA)
requirements has not been well investigated. Therefore, we conducted the
present study to explore the predicted effect-site concentration of
propofol (Ce<inf>prop</inf>) required for achieving the loss of
consciousness (LOC) in 50% of patients (EC<inf>50</inf>) with or without
epidural anesthesia. Method(s): Sixty patients scheduled for
gastrectomy were randomized into the GA + EA group or GA alone group to
receive general anesthesia alone. Ropivacaine 0.375% was used for epidural
anesthesia to achieve a sensory level of T4 or above prior to the
induction of general anesthesia. The EC<inf>50</inf> of predicted
Ce<inf>prop</inf> for LOC was determined by the up-down sequential method.
The consumption of anesthetics, emergence time from anesthesia, and
postoperative outcomes were also recorded and compared. Result(s):
The EC<inf>50</inf> of predicted Ce<inf>prop</inf> for LOC was lower in
the GA + EA group than in the GA alone group [2.97 (95% CI: 2.63-3.31) vs.
3.36 (95% CI: 3.19-3.53) mug mL-1, (p = 0.036)]. The
consumption of anesthetics was lower in the GA + EA group than in the GA
alone group (propofol: 0.11 +/- 0.02 vs. 0.13 +/- 0.02 mg kg-1
min-1, p = 0.014; remifentanil: 0.08 +/- 0.03 vs. 0.14 +/- 0.04
mug kg-1 min-1, p < 0.001). The emergence time was
shorter in the GA + EA group than in the GA alone group (16.0 vs. 20.5
min, p = 0.013). Conclusion(s): Concomitant epidural anesthesia
reduced by 15% the EC<inf>50</inf> of predicted Ce<inf>prop</inf> for LOC,
decreased the consumptions of propofol and remifentanil during maintenance
of anesthesia, and fastened recovery from anesthesia. Clinical trial
registration: ClinicalTrials.gov, identifier: NCT05124704. Copyright
© 2023 Wang, Shen, Guo, Zhang, Cui, Cai and Chen.

<104>
Accession Number
2028506322
Title
A Global Systematic Review of Open Heart Valvular Surgery in
Resource-Limited Settings.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Rekhtman D.; Bermudez F.; Vervoort D.; Kaze L.; Patton-Bolman C.; Swain J.
Institution
(Rekhtman) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, Pennsylvania, United States
(Bermudez) Georgetown University School of Medicine, Washington, DC,
United States
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Kaze) Graduate School of Social and Political Science, University of
Edinburgh, Edinburgh, United Kingdom
(Kaze, Patton-Bolman, Swain) Team Heart, Inc, Kigali, Rwanda
(Swain) Division of Cardiovascular Surgery, Hospital of the University of
Pennsylvania, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: Many obstacles challenge the establishment and expansion of
cardiac surgery in low- and middle-income countries, despite the unmet
cardiac surgical needs. One challenge has been providing adequate
follow-up care to monitor anticoagulation, manage morbidity, and prevent
mortality. This systematic review describes outcomes after valvular
cardiac surgery and focuses on strategies for prolonged follow-up care in
resource-constrained settings. Method(s): Studies published between
2012 and 2022 were collected from Embase and the Cochrane Library. Article
inclusion criteria were adolescent and adult patients, open heart valvular
surgery, and analysis of at least 1 postoperative outcome at least 30 days
postoperatively. Studies that focused on pediatric patients, pregnant
patients, transcatheter procedures, in-hospital outcomes, and nonvalvular
surgical procedures were excluded. Descriptive statistics were assessed,
and articles were summarized after abstract screening, full-text review,
and data extraction. Result(s): Sixty-seven relevant publications
were identified after screening. The most commonly studied regions were
Asia (46%), Africa (36%), and Latin America (9%). Rheumatic heart disease
was the most commonly studied valvular disease (70%). Reported outcomes
included mortality, surgical reintervention, and thrombotic events.
Follow-up duration ranged from 30 days to 144 months; 11 studies reported
a follow-up length of 12 months. Conclusion(s): Addressing the unmet
cardiac care needs requires a multifaceted approach that leverages
telemedicine technology, enhances medical infrastructure, and aligns
advocacy efforts. Learning from the cost-effective establishment of
cardiac surgery in low- and middle-income countries, we can apply past
innovations to foster sustainable cardiac surgical capacity. Copyright
© 2023 The Society of Thoracic Surgeons

<105>
Accession Number
2028390179
Title
Neurodevelopment outcomes in the first 5 years of the life of children
with transposition of the great arteries surgically corrected in the
neonatal period: systematic review and meta-analysis.
Source
Cardiology in the Young. (no pagination), 2023. Date of Publication:
2023.
Author
Soares C.; Vieira R.J.; Costa S.; Moita R.; Andrade M.; Guimaraes H.
Institution
(Soares, Costa, Guimaraes) Faculty of Medicine of Porto University, Porto,
Portugal
(Vieira) Department of Community Medicine, Information and Health Decision
Sciences (MEDCIDS), Faculty of Medicine, Porto University, Porto, Portugal
(Vieira) Centre for Health Technology and Services Research, Health
Research Network (CINTESIS@RISE), Faculty of Medicine, Porto University,
Porto, Portugal
(Costa, Moita) Neonatology Department, Centro Hospitalar Universitario Sao
Joao, Porto, Portugal
(Andrade) Pediatrics Department, Centro Hospitalar Universitario Sao Joao,
Porto, Portugal
Publisher
Cambridge University Press
Abstract
Congenital Heart Defects are the most common abnormalities at birth,
resulting in many short- and long-term consequences. Objective(s): In
patients with transposition of the great arteries, surgical correction may
achieve definitive treatment, so a thorough knowledge of the long-term
outcomes, particularly neurodevelopment outcomes, is essential. Therefore,
we conducted a systematic review and meta-analysis to study the
neurodevelopment outcomes in the first 5 years of the life of children
submitted to corrective surgery for transposition of the great arteries in
the neonatal period. Method(s): A total of 17 studies from 18 reports
were included, assessing 809 individuals with surgically corrected
transposition of the great arteries. The neurodevelopmental outcomes were
assessed with the Bayley Scales of Infant and Toddler Development (BSID)
and the Wechsler Intelligence Scale for Children (WISC). Result(s):
Mean Mental Development Index (MDI) and Psychomotor Development Index
(PDI) were within the average values from 1 to 3 years of age, although
the proportion of children scoring more than 1 standard deviation below
the mean in PDI, MDI, motor, and language composite scores was
significantly higher than in the general population. From 4 to 5 years,
mean full-scale global intelligence quotient (IQ), verbal IQ, and
performance IQ scores did not differ significantly from the general
population. Conclusion(s): This study revealed neurodevelopment
scores within the normal range at 5 years of age in children submitted to
corrective surgery for transposition of the great arteries in the neonatal
period. However, these early outcomes may not adequately predict long-term
outcomes. Further studies are needed to identify specific risk factors and
early markers of later impairment to guide the establishment of early
interventions. Copyright © The Author(s), 2023. Published by
Cambridge University Press.

<106>
Accession Number
642777840
Title
Bartonella quintana endocarditis: A systematic review of individual cases.
Source
Clinical infectious diseases : an official publication of the Infectious
Diseases Society of America. (no pagination), 2023. Date of Publication:
17 Nov 2023.
Author
Boodman C.; Gupta N.; Nelson C.A.; van Griensven J.
Institution
(Boodman) University of Manitoba, Winnipeg, MB, Canada
(Boodman, Gupta, van Griensven) Institute of Tropical Medicine, Antwerp,
Belgium
(Gupta) Department of Infectious Disease, Kasturba Medical College,
Manipal Academy of Higher Education, Manipal, India
(Nelson) Centers for Disease Control and Prevention, Fort Collins, CO,
United States
Abstract
INTRODUCTION: Bartonella quintana is a louse-borne bacterium that remains
a neglected cause of endocarditis in low-resource settings. Our
understanding of risk factors, clinical manifestations and treatment of B.
quintana endocarditis are biased by older studies from high-income
countries. METHOD(S): We searched Pubmed Central, Medline, Scopus,
Embase, EBSCO (CABI) Global Health, Web of Science and international trial
registers for articles published before March 2023 with terms related to
Bartonella quintana endocarditis. We included articles containing
case-level information on B. quintana endocarditis and extracted data
related to patient demographics, clinical features, diagnostic testing,
treatment and outcome. RESULT(S): A total of 975 records were
identified, of which 569 duplicates were removed prior to screening. 84
articles were eligible for inclusion, describing a total of 167 cases.
Infections were acquired in 40 different countries. 62 cases (37.1%) were
acquired in low and middle-income countries (LMICs). Disproportionately
more female and pediatric patients were from LMICs. More patients
presented with heart failure (n=70/167 [41.9%]) than fever (n=65/167
[38.9%]). Mean time from symptom onset to presentation was 5.1 months.
25.7% of cases (n=43/167) were associated with embolization, most commonly
to the spleen and brain. 65.5% of antimicrobial regimens included
doxycycline. The vast majority of cases underwent valve replacement
surgery (n=154/167, [98.0%]). Overall case fatality rate was 9.6%
(n=16/167). CONCLUSION(S): B. quintana endocarditis has a global
distribution, and long delays between symptom onset and presentation
frequently occur. Improved clinician education and diagnostic capacity are
needed to screen at-risk populations and identify infection before
endocarditis develops. Copyright © The Author(s) 2023. Published
by Oxford University Press on behalf of Infectious Diseases Society of
America. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

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