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<1>
Accession Number
2029077801
Title
Principle and design of clinical efficacy observation of extracorporeal
cardiac shock wave therapy for patients with myocardial
ischemia-reperfusion injury: A prospective randomized controlled trial
protocol.
Source
PLoS ONE. 18(12 December) (no pagination), 2023. Article Number: e0294060.
Date of Publication: December 2023.
Author
Li X.; Zhang C.; Liu C.; Ma Y.; Shi Y.; Ye Y.; Ma X.; Liu Y.; Luo X.; Lin
F.; Wang J.; Tao J.; Lun J.; Cai H.; Hu Z.
Institution
(Li, Zhang, Ma, Shi, Ye, Ma, Liu, Luo, Lin, Wang, Tao, Lun, Cai, Hu)
Department of Cardiology, The First Affiliated Hospital of Kunming Medical
University, Yunnan, Kunming, China
(Liu) Department of Vascular Surgery, The First Affiliated Hospital of
Kunming Medical University, Yunnan, Kunming, China
Publisher
Public Library of Science
Abstract
Background Acute ST-segment elevation myocardial infarction (STEMI)
remains a serious life threatening event with a poor prognosis due to
myocardial ischemia/reperfusion injury despite coronary revascularization.
Extracorporeal cardiac shock wave (ECSW) is a safe, effective and
non-invasive new method for the treatment of cardiovascular diseases. The
current results show that extracorporeal cardiac shock wave provides a new
treatment option for patients with severe and advanced coronary heart
disease. However, there are relatively few clinical studies on the
application of in vitro cardiac shock waves in patients with myocardial
ischemia-reperfusion injury. We hypothesized that extracorporeal cardiac
shock therapy would also be effective in reducing clinical endpoints in
patients with STEMI reperfusion. Objective This study is order to provide
a new therapeutic method for patients with myocardial ischemia-reperfusion
injury and reveal the possible mechanism of ECSW for ischemia-reperfusion
injury. Methods and materials CEECSWIIRI is a single-center, prospective
randomized controlled trial that plans to enroll 102 eligible patients
with acute ST-segment elevation myocardial infarction reperfusion.
Eligible patients with STEMI reperfusion will be randomly divided into
external cardiac shock therapy (ECSW) trial group and blank control group.
The blank control group will receive optimal drug therapy, and the
experimental group will receive optimal drug therapy combined with ECSW.
The shock wave treatment plan will be 3-month therapy, specifically 1 week
of treatment per month, 3 weeks of rest, 3 times of ECSW in each treatment
week, respectively on the first day, the third day and the fifth day of
the treatment week, lasting for 3 months and follow-up for 2 years. The
primary endpoint will be to assess the 2-year improvement in all-cause
death, re-hospitalization due to cardiovascular disease, major
unintentional cerebrovascular events, including cardiogenic death,
myocardial infarction, heart failure, arrhythmia, emergency coronary
revascularization, and stroke in patients with STEMI reperfusion.
Secondary endpoints will include improvements in angina pectoris, quality
of life, cardiac structure and function, coronary microcirculation, and
endothelial progenitor cell-derived miR-140-3p in relation to survival
outcomes.<br/>Copyright &#xa9; 2023 Li 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.

<2>
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Accession Number
2028942958
Title
Epidural analgesia versus oral morphine for postoperative pain management
following video-assisted thoracic surgery: A randomised, controlled,
double-blind trial.
Source
European Journal of Anaesthesiology. 41(1) (pp 61-69), 2024. Date of
Publication: 01 Jan 2024.
Author
Holm J.H.; Andersen C.; Toft P.
Institution
(Holm, Andersen, Toft) The Department of Anaesthesiology and Intensive
Care, Odense University Hospital, Odense, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe use of thoracic epidural analgesia for postoperative pain
management in video-assisted thoracic surgery (VATS) is controversial.
Still, the evidence on omitting it in favour of systemic opioids is
inconclusive, and studies are small and non-blinded.OBJECTIVEWe aimed to
compare pain after VATS using epidural analgesia or enteral opioids for
postoperative pain management.DESIGN/SETTING/PATIENTS/INTERVENTIONA
randomised, double-blind, controlled trial at a Danish tertiary hospital.
Adult patients scheduled for VATS were assigned to multimodal non-opioid
baseline analgesia supplemented with either thoracic epidural analgesia
(TE Group) or oral morphine (OM Group) for postoperative pain management.
We recorded pain five times a day, both at rest and during activity, using
the Numeric Rating Scale (NRS) and categorised it into "acceptable pain"or
"unacceptable pain". Unacceptable pain was defined as NRS (at rest) >=3 or
NRS (with activity) >=5 when supplementary analgesics were given.MAIN
OUTCOME MEASURESThe primary outcomes were the proportions of patients
experiencing "unacceptable pain"during the postoperative period and the
use of intravenous "rescue"opioids.RESULTSOf the 161 included patients,
146 received the allocated treatment and their data were analysed. At
rest, 34% of patients in the TE Group and 64% of patients in the OM Group
experienced unacceptable pain during the study period, a significant
between-group difference of 30% (P < 0.0005). During activity these
percentages were 32% of patients in the TE Group and 59% in the OM group,
a difference of 27% (P < 0.005). The median intravenous rescue morphine
consumption during the study period was 4.5 [interquartile range (IQR),
0-10.0] mg in the TE Group and 7.5 [0-19.0] mg in the OM Group (P <
0.005).CONCLUSIONEpidural analgesia provided better pain relief after VATS
than oral morphine. The between-group difference in rescue intravenous
morphine consumption was statistically significant but clinically
irrelevant.<br/>Copyright &#xa9; 2023 The Author(s).

<3>
Accession Number
2028901998
Title
Endovascular treatment of mycotic aneurysms: An update meta-analysis.
Source
Clinical Neurology and Neurosurgery. 236 (no pagination), 2024. Article
Number: 108068. Date of Publication: January 2024.
Author
Batista S.; Oliveira L.D.B.; Filho J.A.A.; Abreu L.V.; Andreao F.F.;
Palavani L.B.; Bertani R.; Alves Filho C.A.F.; de Oliveira Braga F.;
Machado E.A.T.; da Mata Pereira P.J.; Filho P.N.; Pereira V.M.
Institution
(Batista, Abreu, Andreao) Faculty of Medicine, Federal University of Rio
de Janeiro, Rio de Janeiro, Brazil
(Oliveira) Faculty of medicine, State University of Ponta Grossa, Faculty
of Medicine, Parana, Brazil
(Filho) Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio
de Janeiro, Brazil
(Palavani) Faculty of Medicine, Max Planck University Center, SP,
Indaiatuba, Brazil
(Bertani) Department of Neurosurgery, University of Sao Paulo
(da Mata Pereira, Filho) Department of Neurosurgery, Paulo Niemeyer State
Brain Institute, Rio de Janeiro, Brazil
(Filho, Alves Filho, de Oliveira Braga, Machado) Department of
Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de
Janeiro, Brazil
(Pereira) Division of Neuroradiology, Department of Medical Imaging and
Division of Neurosurgery, Department of Surgery, University Health
Network, Toronto Western Hospital, Toronto, ON, Canada
Publisher
Elsevier B.V.
Abstract
Introduction: Intracranial mycotic or infectious aneurysms result from the
infection of arterial walls, most caused by bacterial or fungal organisms.
These infections can weaken the arterial wall, leading to the formation of
an aneurysm, a localized dilation, or a bulge. The management can be
conservative mainly based on antibiotics or invasive methods such as
clipping or endovascular treatment. <br/>Purpose(s): We performed a
systematic review and meta-analysis of the current literature on
endovascular treatment of mycotic aneurysms, analyzing the safety and
efficacy associated with this procedure. <br/>Method(s): We systematically
searched on PUBMED, Cochrane Library, Embase, and Web of Science
databases. Our search strategy was carefully crafted to conduct a thorough
investigation of the topic, utilizing a comprehensive combination of
relevant keywords. This meta-analysis included all studies that reported
endovascular treatment of mycotic aneurysms. To minimize the risk of bias,
studies with fewer than four patients, studies where the main outcome was
not found, and studies with no clear differentiation between microsurgical
and endovascular treatment were excluded. <br/>Result(s): In a
comprehensive analysis of 134 patients, it was observed that all except
one patient received antibiotics as part of their treatment. Among the
patients, 56% (a total of 51 out of 90 patients) underwent cardiac
surgery. Additionally, three patients required a craniotomy following
endovascular treatment. 12 patients experienced morbidity related to the
procedures performed, indicating complications arising from the
interventions. Furthermore, four aneurysms experienced rebleeding while
treatment. A pooled analysis of the endovascular treatment of the mycotic
aneurysm revealed a good level of technical success, achieving a 100%
success rate in 12 out of 14 studies (97-100%; CI 95%; I² =
0%), as illustrated in Fig. 2. Similarly, the aneurysm occlusion rate
demonstrated a notable efficacy, with a success rate of 97% observed in 12
out of 14 studies (97-100%; CI 95%; I² = 0%), as depicted in
Fig. 3. <br/>Conclusion(s): The results strongly support the efficacy of
endovascular treatment in achieving technical success, complete aneurysm
occlusion, and favorable neurological outcomes. Additionally, the notably
low incidence of complications and procedure-related mortality reaffirms
the safety and benefits associated with this intervention.<br/>Copyright
&#xa9; 2023 Elsevier B.V.

<4>
Accession Number
2028873929
Title
An Accessible Pre-Rehabilitation Bundle for Patients Undergoing Elective
Heart Valve Surgery with Limited Resources: The TIME Randomized Clinical
Trial.
Source
Reviews in Cardiovascular Medicine. 24 (no pagination), 2023. Article
Number: 308. Date of Publication: 2023.
Author
Luo Z.; Zhang X.; Wang Y.; Huang W.; Chen M.; Yang M.; Yu P.
Institution
(Luo, Zhang, Huang, Yang, Yu) Department of Rehabilitation Medicine, West
China Hospital, Sichuan University, Sichuan, Chengdu 610041, China
(Wang, Chen) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Sichuan, Chengdu 610041, China
Publisher
IMR Press Limited
Abstract
Background: Despite gradually increasing evidence for pre-rehabilitation
for heart valve surgery, it remains underused, especially in developing
countries with limited resources. The study aimed to investigate the
feasibility and effects of an innovative three-day pre-rehabilitation
bundle for patients undergoing elective heart valve surgery.
<br/>Method(s): This was a single-center, assessor-blind, randomized
clinical trial. A total of 165 patients were randomly assigned to either
usual care (control group, n = 83) or usual care with an additional 3-day
pre-rehabilitation bundle (Three-day of Inspiratory muscle training,
aerobic Muscle training, and Education (TIME) group, n = 82). The main
outcome of the study was the incidence of postoperative pulmonary
complications (PPCs). Secondary outcomes included the feasibility of the
intervention, duration of the non-invasive ventilator, length of stay, and
PPCs-related medical costs on discharge. <br/>Result(s): Of 165 patients
53.94% were male, the mean age was 63.41 years, and PPCs were present in
26 of 82 patients in the TIME group and 44 of 83 in the control group
(odds ratio (OR), 0.60 95% CI, 0.41-0.87, p = 0.006). The feasibility of
the pre-rehabilitation bundle was good, and no adverse events were
observed. Treatment satisfaction and motivation scored on 10-point scales,
were 9.1 +/- 0.8 and 8.6 +/- 1.4, respectively. The TIME group also had
fewer additional PPCs-related medical costs compared to the control group
(6.96 vs. 9.57 thousand CNY (1.01 vs. 1.39 thousand USD), p < 0.001).
<br/>Conclusion(s): The three-day accessible pre-rehabilitation bundle
reduces the incidence of PPCs, length of stay, and PPCs-related medical
costs in patients undergoing elective valve surgery. It may provide an
accessible model for the expansion of pre-rehabilitation in countries and
regions with limited medical resources. Clinical Trial Registration: This
trial was based on the Consolidated Standards of Reporting Trials
(CONSORT) guidelines. This trial was registered in the Chinese Clinical
Trial Registry (identifier ChiCTR2000039671).<br/>Copyright &#xa9; 2023
IMR Press Limited. All rights reserved.

<5>
Accession Number
2028609363
Title
Clinical outcomes of rifampicin combination therapy in implant-associated
infections due to staphylococci and streptococci: A systematic review and
meta-analysis.
Source
International Journal of Antimicrobial Agents. 63(1) (no pagination),
2024. Article Number: 107015. Date of Publication: January 2024.
Author
Yusuf E.; Bramer W.; Anas A.A.
Institution
(Yusuf, Anas) Department of Medical Microbiology and Infectious Diseases,
Erasmus University Medical Center, Rotterdam, Netherlands
(Bramer) Medical Library, Erasmus University Medical Center, Rotterdam,
Netherlands
(Anas) Department of Internal Medicine, Section of Infectious Diseases,
Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier B.V.
Abstract
Objectives: Adjunctive rifampicin for implant-associated infections is
controversial. This study investigated the clinical outcomes of rifampicin
combination therapy compared with monotherapy in treating prosthetic joint
infection (PJI) or prosthetic valve endocarditis (PVE) due to
staphylococci and streptococci. <br/>Method(s): A systematic search was
performed from inception to 13 June 2022 in Embase, MEDLINE, Cochrane and
Web of Science to investigate the clinical outcomes of rifampicin
combination therapy compared with monotherapy in treating staphylococcal
and streptococcal PJI or PVE. Randomised controlled trials (RCTs) and
observational studies were included in the systematic review and
meta-analysis. <br/>Result(s): Fourteen studies were included. A moderate
quality of evidence was found in favour of rifampicin in patients with
staphylococcal PJI who underwent a debridement, antibiotics and implant
retention (DAIR) procedure [odds ratio = 2.49, 95% confidence interval
(CI) 1.93-3.23]. Including the two RCTs only, adding rifampicin to the
antibiotic regimen after DAIR was also in favour of rifampicin, but this
was not statistically significant (risk ratio = 1.27, 95% CI 0.79-2.04; n
= 126). Pooling data for patients with staphylococcal PJI who underwent a
two-stage procedure showed that adding rifampicin was not associated with
therapeutic success. Limited evidence was found for the use of rifampicin
for PVE caused by staphylococci. <br/>Conclusion(s): Adding rifampicin in
the treatment of staphylococcal PJI treated by DAIR clearly increased the
likelihood for therapeutic success. The clinical benefit of adjunctive
rifampicin in the treatment of other staphylococci and streptococci
implant-associated infections is still unclear.<br/>Copyright &#xa9; 2023
The Author(s)

<6>
Accession Number
2027902180
Title
Extracorporeal cardiopulmonary resuscitation-based approach to refractory
out-of-hospital cardiac arrest: A focus on organ donation, a secondary
analysis of a Prague OHCA randomized study.
Source
Resuscitation. 193 (no pagination), 2023. Article Number: 109993. Date of
Publication: December 2023.
Author
Smalcova J.; Havranek S.; Pokorna E.; Franek O.; Huptych M.; Kavalkova P.;
Pudil J.; Rob D.; Dusik M.; Belohlavek J.
Institution
(Smalcova, Havranek, Kavalkova, Pudil, Rob, Dusik, Belohlavek) 2nd
Department of Cardiovascular Medicine, General University Hospital in
Prague, First Faculty of Medicine, Charles University in Prague, Prague,
Czechia
(Pokorna) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Smalcova, Franek) Emergency Medical Service Prague, Prague, Czechia
(Huptych) Czech Institute of Informatics, Robotics and Cybernetics
(CIIRC), Czech Technical University in Prague, Prague, Czechia
Publisher
Elsevier Ireland Ltd
Abstract
Background: Refractory out-of-hospital cardiac arrest (OHCA) has a poor
outcome. In patients, who cannot be rescued despite using advanced
techniques like extracorporeal cardiopulmonary resuscitation (ECPR), organ
donation may be considered. This study aims to evaluate, in refractory
OHCA, how ECPR versus a standard-based approach allows organ donorship.
<br/>Method(s): The Prague OHCA trial randomized adults with a witnessed
refractory OHCA of presumed cardiac origin to either an ECPR-based or
standard approach. Patients who died of brain death or those who died of
primary circulatory reasons and were not candidates for cardiac
transplantation or durable ventricle assist device were evaluated as
potential organ donors by a transplant center. In this post-hoc analysis,
the effect on organ donation rates and one-year organ survival in
recipients was examined. <br/>Result(s): Out of 256 enrolled patients, 75
(29%) died prehospitally or within 1 hour after admission and 107 (42%)
during the hospital stay. From a total of 24 considered donors, 21 and 3
(p = 0.01) were recruited from the ECPR vs standard approach arm,
respectively. Fifteen brain-dead and none cardiac-dead subjects were
ultimately accepted, 13 from the ECPR and two from the standard strategy
group. A total of 36 organs were harvested. The organs were successfully
transplanted into 34 recipients. All transplanted organs were fully
functional, and none of the recipients died due to graft failure within
the one-year period post-transplant. <br/>Conclusion(s): The ECPR-based
approach in the refractory OHCA trial is associated with increased organ
donorship and an excellent outcome of transplanted organs. Trial
registration: ClinicalTrials.gov Identifier: NCT 01511666. Registered
January 19, 2012.<br/>Copyright &#xa9; 2023 The Authors

<7>
Accession Number
2027134371
Title
Functional intervention following cardiac surgery to prevent postoperative
delirium in older patients (FEEL WELL study).
Source
Journal of Intensive Care. 11(1) (no pagination), 2023. Article Number:
62. Date of Publication: December 2023.
Author
Dogan T.D.; Guttenthaler V.; Zimmermann A.; Kunsorg A.; Dinc M.O.; Knuelle
N.; Schewe J.-C.; Wittmann M.
Institution
(Dogan, Dinc) Department of Anaesthesia and Intensive Care Medicine,
Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
(Guttenthaler, Kunsorg, Schewe, Wittmann) Department of Anaesthesia and
Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
(Zimmermann, Knuelle) University Bonn, Bonn, Germany
(Schewe) Department of Anaesthesiology, Intensive Care Medicine and Pain
Therapy, University Medical Centre Rostock, Rostock, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium is a common complication in patients
after cardiac surgery, especially in older patients, and can manifest as a
disturbance of attention and consciousness. It can lead to increased
postoperative morbidity, prolonged need for care, and mortality. The
presented study investigates whether the occurrence of postoperative
delirium after cardiac surgery can be prevented by a multisensory
stimulation. It was conducted as a prospective, randomized, controlled,
non-pharmacological intervention study in the years 2021 and 2022 at the
University Hospital Bonn in Germany. A total of 186 patients over 65 years
with elective cardiac surgery were enrolled. Patients were randomized
either to the intervention or control group. In both groups, postoperative
delirium was assessed with the 3-min diagnostic interview for confusion
assessment method on the first 5 days after surgery and pain was assessed
using the Numeric Rating Scale. Multisensory stimulation was performed 20
min a day for the first three postoperative days in the intervention
group. <br/>Result(s): The incidence of postoperative delirium was 22.6%
in the intervention group and 49.5% in the control group (p < 0.001).
Duration of postoperative delirium was significantly shorter in the
intervention group (p < 0.001). Stay in the intensive care unit was
significantly longer in the control group (p = 0.006). In the regression
model non-intervention, high pain scores, advanced age, and prolonged
mechanical ventilation were associated with postoperative delirium (p =
0.007; p = 0.032; p = 0.006; p = 0.006, respectively). <br/>Conclusion(s):
Results of the study imply that a multisensory stimulation done on the
first 3 days after planned cardiac surgery can reduce the incidence and
duration of postoperative delirium in older patients. Influence of the
treatment on the incidence of delirium in other patient groups, the length
of stay in the intensive care unit, and patients' postoperative pain
should be confirmed in further clinical studies. Trial registration: DRKS,
DRKS00026909. Registered 28 October 2021, Retrospectively registered,
https://drks.de/search/de/trial/DRKS00026909 .<br/>Copyright &#xa9; 2023,
The Author(s).

<8>
Accession Number
2028114393
Title
Effect of colchicine on perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery in patients undergoing major thoracic
surgery (COP-AF): an international randomised trial.
Source
The Lancet. 402(10413) (pp 1627-1635), 2023. Date of Publication: 04 Nov
2023.
Author
Conen D.; Ke Wang M.; Popova E.; Chan M.T.V.; Landoni G.; Reimer C.; Reyes
J.C.T.; Grande A.M.; Tallada A.G.; Fleischmann E.; Kabon B.; Voltolini L.;
Cruz P.; Gutierrez-Soriano L.; Tandon V.; Martinez-Tellez E.;
Guerra-Londono J.J.; DuMerton D.; Wong R.H.L.; McGuire A.L.; Kidane B.;
Roux D.P.; Shargall Y.; Vincent J.; Xu L.; Li Z.; Jolly S.S.; Devereaux
P.J.; Wang M.K.; Wells J.R.; Healey J.S.; McIntyre W.F.; Sessler D.I.;
Srinathan S.K.; Amir M.; Bangdiwala S.I.; Bossard M.; Chan M.T.; Eikelboom
J.W.; Jolly S.; Montes F.R.; Schmartz D.; Wang C.Y.; Ofori S.N.; Blum S.;
Alvarez-Garcia J.; Lo Bianco G.; Traquair H.; Guerrero-Pinedo F.A.;
Oleynick C.; Meyre P.B.; Mendez-Zurita F.; Chiarella-Redfern H.; Marcucci
M.; Donati F.; Gonzalez-Osuna A.; Minervini F.; Moreno Weidmann Z.;
Guerra-Ramos J.M.; Dion G.; Ramos-Pachon A.; Borges F.K.; de Sa
Boasquevisque D.; Mosconi M.G.; Amarenco P.; Mitchell L.B.; Wyse G.; Cheng
D.; McAlister F.A.; Wells G.A.; Baskaran G.; Burns A.T.; Gennaccaro J.;
Howe R.; Mastrangelo L.; Pettit S.; Popovic M.; Shahbaz S.; Tosh M.;
Zucchetto S.J.; Heenan L.; Lee S.F.; Hoetzenecker K.; Schweiger T.;
Reiterer C.; Zotti O.; Bsuchner P.; Hochreiter B.; Taschner A.;
Adamowitsch N.; Horvath K.; Hantakova N.; Bidgoli J.; Huybrechts I.;
Cappeliez S.; Neary J.D.; Finley C.; Agzarian J.; Hanna W.; Abdulrahman
M.; Lawrence K.; Gregus K.; Quraishi F.; Wikkerink S.; Wallace C.; Prine
M.; Gregus E.; Hare J.; Lombardo K.; Fezia B.; Columbus T.; Rushton J.;
Reid K.; Parlow J.; Chung W.; Karizhenskaia M.; Malik A.; Tanzola R.;
Giles A.; McLean S.R.; McGuire A.; Lohser J.; Lim S.; Grey R.; Yee J.;
Grant K.; Lee A.L.; Choi J.J.; Dewar L.R.; Durkin C.; Schisler T.; Hecht
P.; Hughes B.; Liu R.; Tan L.; Gowing S.; Buduhan G.; Enns S.; Poole E.;
Graham K.; Dubik N.; Chin A.; Maziak D.E.; Seely A.J.; Gilbert S.;
Villeneuve P.J.; Sundaresan S.; Gingrich M.; Fazekas A.; Bucciero K.;
Malthaner R.A.; Lewis D.; Fortin D.; Qiabi M.; Nayak R.; Plourde M.M.;
Haider T.; Murphy R.; Sellers D.; Donahoe L.; Lefebvre M.; Lanthier L.; Ko
M.A.; Parente D.; Cheung V.; Schieman C.; Bessissow A.; Wong R.H.; Joynt
G.M.; Lam C.K.; Lau R.W.; Wan I.Y.; Underwood M.J.; Wu W.K.; Wong W.T.;
Choi G.Y.; Lee E.; Hui K.Y.; Fung B.; Chan C.S.; Ng F.K.; Thung K.H.;
Castaneda L.C.; Tellez L.J.; Ortiz-Ramirez L.M.; Baiardo-Redaelli M.;
Belletti A.; Dieci E.; Monaco F.; Muriana P.; Nakhnoukh C.; Novellis P.;
Turi S.; Viscardi S.; Veronesi G.; Bongiolatti S.; Salvicchi A.; Gatteschi
L.; Indino R.; Tombelli S.; Ravasin A.; Salimbene O.; Rosboch G.L.;
Balzani E.; Ceraolo E.; Neitzert L.; Brazzi L.; Londero F.; Grossi W.;
Massullo D.; Fiorelli S.; Margaritora S.; Hashim S.A.; Krishnasamy S.; See
W.S.; Nawaz M.A.; Bilal H.; Trujillo Reyes J.C.; Belda Sanchis J.; Planas
Canovas G.; Libreros Nino A.; Parera Ruiz A.; Cladellas Gutierrez E.;
Guarino M.; Urrutia Cuchi G.; Argilaga Nogues M.; Rovira Juan A.;
Medina-Aedo M.; Turro Castillejo M.A.; Gil Sanchez J.M.; Arauz-Sarmiento
I.; Herranz Perez G.; Chavarria Murillo S.; Garcia-Osuna A.;
Rodriguez-Arias A.; Berga Garrote N.; Martin Grande A.; Parise Roux D.;
Gajate Martin L.; De Pablo Pajares A.; Candela Toha A.M.; Moreno Mata N.;
Munoz Molina G.; Caballero Silva U.; Cabanero A.; Fra Fernandez S.;
Cavestany Garcia-Matres C.; Simon L.; Montenegro C.; Pozo S.;
Gonzalez-Tallada A.; Gonzalez Suarez S.; Ribas Ball M.; De Nadal Clanchet
M.; Perez Velez J.; Sanchez-Pedrosa G.; Duque P.; Gonzalez G.; Huerta L.;
Rodriguez L.; Garutti I.; Ruiz-Villa L.; Marti-Ejarque M.D.M.; Gili-Bueno
M.; Maddio Vieyra R.M.; Fibla J.J.; Duran N.; de Temple Pla M.;
Rodriguez-Fuster A.; Bermejo-Martinez S.; Carraminana A.; Opitz I.;
Etienne H.; Cata J.P.; Rajaram R.; Corrales G.; Vaporciyan A.; Mehran R.;
Sepesi B.; Walsh G.; Rice D.; Cukierman D.S.; Swisher S.; Marchant B.E.;
Harris L.C.; Cusson B.D.; Miller S.A.; Ayad S.; Araujo J.; Marquez-Roa L.;
Hofstra R.L.; Wudel L.J.; Minear S.C.; Teixeira C.; Pimentel M.; Popoff
A.M.; Marsack K.; Meehan S.; Chen T.H.; Essandoh M.; Poppers J.S.
Institution
(Conen, Ke Wang, McIntyre, Wells, Ofori, Vincent, Xu, Li, Eikelboom,
Jolly, Healey, Devereaux) Population Health Research Institute, Hamilton,
ON, Canada
(Conen, Ke Wang, McIntyre, Tandon, Ofori, Xu, Eikelboom, Jolly, Healey,
Devereaux) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Conen, McIntyre, Jolly, Devereaux) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain
(Popova) Centro Cochrane Iberoamericano, Barcelona, Spain
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, Shatin, Hong Kong
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) School of Medicine, Vita-Salute University San Raffaele, Milan,
Italy
(Cata, Guerra-Londono) Department of Anesthesiology and Perioperative
Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Reimer) Department of Anesthesiology, Queen's University, Kingston Health
Sciences Centre, Kingston, ON, Canada
(McLean) Vancouver Acute Department of Anesthesia and Perioperative
Medicine, Vancouver General Hospital, Vancouver, BC, Canada
(Srinathan, Kidane) Department of Surgery, University of Manitoba,
Winnipeg, MB, Canada
(Reyes, Martinez-Tellez) Department of Thoracic Surgery, Hospital de la
Santa Creu i Sant Pau, Barcelona, Spain
(Grande, Roux) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Vall d'Hebron Hospital
Universitari, Barcelona, Spain
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Voltolini) Thoracic Surgery Unit, University Hospital Careggi, Florence,
Italy
(Cruz) Service of Anesthesiology and Reanimation, General University
Hospital Gregorio Maranon, Madrid, Spain
(Maziak) Division of Thoracic Surgery, Department of Surgery, The Ottawa
Hospital, University of Ottawa, Ottawa, ON, Canada
(Gutierrez-Soriano) Anesthesiology Department, Anesthesiology Research
Group, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
(DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, The
Chinese University of Hong Kong, Hong Kong Special Administrative Region,
Hong Kong
(McGuire) Division of Thoracic Surgery, Vancouver General Hospital,
Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Background: Higher levels of inflammatory biomarkers are associated with
an increased risk of perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery (MINS). Colchicine is an
anti-inflammatory drug that might reduce the incidence of these
complications. <br/>Method(s): COP-AF was a randomised trial conducted at
45 sites in 11 countries. Patients aged 55 years or older and undergoing
major non-cardiac thoracic surgery were randomly assigned (1:1) to receive
oral colchicine 0.5 mg twice daily or matching placebo, starting within 4
h before surgery and continuing for 10 days. Randomisation was done with
use of a computerised, web-based system, and was stratified by centre.
Health-care providers, patients, data collectors, and adjudicators were
masked to treatment assignment. The coprimary outcomes were clinically
important perioperative atrial fibrillation and MINS during 14 days of
follow-up. The main safety outcomes were a composite of sepsis or
infection, and non-infectious diarrhoea. The intention-to-treat principle
was used for all analyses. This trial is registered with
ClinicalTrials.gov, NCT03310125. <br/>Finding(s): Between Feb 14, 2018,
and June 27, 2023, we enrolled 3209 patients (mean age 68 years [SD 7],
1656 [51.6%] male). Clinically important atrial fibrillation occurred in
103 (6.4%) of 1608 patients assigned to colchicine, and 120 (7.5%) of 1601
patients assigned to placebo (hazard ratio [HR] 0.85, 95% CI 0.65 to 1.10;
absolute risk reduction [ARR] 1.1%, 95% CI -0.7 to 2.8; p=0.22). MINS
occurred in 295 (18.3%) patients assigned to colchicine and 325 (20.3%)
patients assigned to placebo (HR 0.89, 0.76 to 1.05; ARR 2.0%, -0.8 to
4.7; p=0.16). The composite outcome of sepsis or infection occurred in 103
(6.4%) patients in the colchicine group and 83 (5.2%) patients in the
placebo group (HR 1.24, 0.93-1.66). Non-infectious diarrhoea was more
common in the colchicine group (134 [8.3%] events) than the placebo group
(38 [2.4%]; HR 3.64, 2.54-5.22). <br/>Interpretation(s): In patients
undergoing major non-cardiac thoracic surgery, administration of
colchicine did not significantly reduce the incidence of clinically
important atrial fibrillation or MINS but increased the risk of mostly
benign non-infectious diarrhoea. <br/>Funding(s): Canadian Institutes of
Health Research, Accelerating Clinical Trials Consortium, Innovation Fund
of the Alternative Funding Plan for the Academic Health Sciences Centres
of Ontario, Population Health Research Institute, Hamilton Health
Sciences, Division of Cardiology at McMaster University, Canada; Hanela
Foundation, Switzerland; and General Research Fund, Research Grants
Council, Hong Kong.<br/>Copyright &#xa9; 2023 Elsevier Ltd

<9>
Accession Number
2027197590
Title
Use of intraoperative haemoadsorption in patients undergoing heart
transplantation: a proof-of-concept randomized trial.
Source
ESC Heart Failure. (no pagination), 2023. Date of Publication: 2023.
Author
Nemeth E.; Soltesz A.; Kovacs E.; Szakal-Toth Z.; Tamaska E.; Katona H.;
Racz K.; Csikos G.; Berzsenyi V.; Fabry S.; Ulakcsai Z.; Tamas C.; Nagy
B.; Varga M.; Merkely B.
Institution
(Nemeth, Soltesz, Kovacs, Szakal-Toth, Tamaska, Katona, Racz, Csikos,
Berzsenyi, Fabry, Ulakcsai, Tamas, Merkely) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Nemeth, Soltesz, Kovacs, Tamaska, Katona, Racz, Csikos, Berzsenyi, Fabry,
Ulakcsai) Department of Anaesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Nagy) Department of Pathology and Experimental Cancer Research,
Semmelweis University, Budapest, Hungary
(Varga) Department of Laboratory Medicine, Semmelweis University,
Budapest, Hungary
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this trial was to compare the clinical effects of
intraoperative haemoadsorption versus standard care in patients undergoing
orthotopic heart transplantation (OHT). <br/>Methods and Results: In a
randomized, controlled trial, OHT recipients were randomized to receive
intraoperative haemoadsorption or standard care. Outcomes were
vasoactive-inotropic score (VIS), frequency of vasoplegic syndrome (VS) in
the first 24 h; post-operative change in procalcitonin (PCT) and
C-reactive protein (CRP) levels; intraoperative change in mycophenolic
acid (MPA) concentration; frequency of post-operative organ dysfunction,
major complications, adverse immunological events and length of
in-hospital stay and 1-year survival. Sixty patients were randomized
(haemoadsorption group N = 30, control group N = 25 plus 5 exclusions).
Patients in the haemoadsorption group had a lower median VIS and rate of
VS (VIS: 27.2 [14.6-47.7] vs. 41.9 [22.4-63.2], P = 0.046, and VS: 20.0%
vs. 48.0%, P = 0.028, respectively), a 6.4-fold decrease in the odds of
early VS (OR: 0.156, CI: 0.029-0.830, P = 0.029), lower PCT levels,
shorter median mechanical ventilation (MV: 25 [19-68.8] hours vs. 65
[23-287] hours, P = 0.025, respectively) and intensive care unit stay (ICU
stay: 8.5 [8.0-10.3] days vs. 12 [8.5-18.0] days, P = 0.022, respectively)
than patients in the control group. Patients in the haemoadsorption versus
control group experienced lower rates of acute kidney injury (AKI: 36.7%
vs. 76.0%, P = 0.004, respectively), renal replacement therapy (RRT: 0%
vs. 16.0%, P = 0.037, respectively) and lower median per cent change in
bilirubin level (PCB: 2.5 [-24.6 to 71.1] % vs. 72.1 [11.2-191.4] %, P =
0.009, respectively) during the post-operative period. MPA concentrations
measured at pre-defined time points were comparable in the haemoadsorption
compared to control groups (MPA pre-cardiopulmonary bypass: 2.4
[1.15-3.60] mug/mL vs. 1.6 [1.20-3.20] mug/mL, P = 0.780, and MPA 120 min
after cardiopulmonary bypass start: 1.1 [0.58-2.32] mug/mL vs. 0.9
[0.45-2.10] mug/mL, P = 0.786). The rates of cardiac allograft rejection,
30-day mortality and 1-year survival were similar between the groups.
<br/>Conclusion(s): Intraoperative haemoadsorption was associated with
better haemodynamic stability, mitigated PCT response, lower rates of
post-operative AKI and RRT, more stable hepatic bilirubin excretion, and
shorter durations of MV and ICU stay. Intraoperative haemoadsorption did
not show any relevant adsorption effect on MPA. There was no increase in
the frequency of early cardiac allograft rejection related to
intraoperative haemoadsorption use.<br/>Copyright &#xa9; 2023 The Authors.
ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<10>
Accession Number
2021886449
Title
Thoracic organ donation after circulatory determination of death.
Source
Transplantation Reports. 8(1) (no pagination), 2023. Article Number:
100125. Date of Publication: February 2023.
Author
Hatami S.; Conway J.; Freed D.H.; Urschel S.
Institution
(Hatami) Department of Medicine, University of Alberta, Edmonton, AB,
Canada
(Conway, Urschel) Department of Pediatrics, University of Alberta,
Edmonton, AB, Canada
(Freed) Department of Physiology, University of Alberta, Edmonton, AB,
Canada
(Freed) Biomedical Engineering, University of Alberta, Edmonton, AB,
Canada
(Freed) Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Hatami, Freed, Urschel) Alberta Transplant Institute, Edmonton, AB,
Canada
(Freed, Urschel) Canadian Transplant Research Program, Canada
Publisher
Elsevier Inc.
Abstract
The availability of thoracic organ transplantation as the treatment of
choice for end-stage cardiac or pulmonary diseases is limited by the
insufficient number of donor organs from brain dead donors, especially for
organs where live-donation is not an option. Patients, who have not
progressed to brain death, but have exhausted therapeutic options and life
sustaining therapies are withdrawn can become donors with circulatory
determination of death (DCD) when they meet criteria for the definition of
this state. This approach can fulfill the wish of a patient to become an
organ donor and also help to increase the number of donor organs. The DCD
process exposes organs to prolonged warm ischemia that increases the
possibility of primary graft dysfunction and failure. However, new
technologies help in protecting the organs from cold preservation-related
ischemia and facilitate resuscitation and monitoring of viability after
the occurrence of the DCD-related ischemic insult. Herein, we review the
opportunities and challenges in DCD thoracic organ transplantation,
emerging techniques in preservation and monitoring of these organs and the
potential effect of DCD thoracic organ transplantation on expanding the
donor pool.<br/>Copyright &#xa9; 2022

<11>
Accession Number
2029010176
Title
Impact of fetal pulmonary valvuloplasty in in-utero critical pulmonary
stenosis: A systematic review and meta-analysis.
Source
International Journal of Cardiology Congenital Heart Disease. 15 (no
pagination), 2024. Article Number: 100485. Date of Publication: March
2024.
Author
Mendel B.; Kohar K.; Yumnanisha D.A.; Djiu R.J.; Winarta J.; Prakoso R.;
Siagian S.N.
Institution
(Mendel, Prakoso, Siagian) Division of Pediatric Cardiology and Congenital
Heart Disease, Department of Cardiology and Vascular Medicine, National
Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta,
Indonesia
(Mendel) Department of Cardiology and Vascular Medicine, Sultan Sulaiman
Government Hospital, Serdang Bedagai, North Sumatera, Indonesia
(Kohar, Yumnanisha, Djiu, Winarta) Faculty of Medicine Universitas
Indonesia, Jakarta, Indonesia
Publisher
Elsevier B.V.
Abstract
Background: Untreated critical pulmonary stenosis may develop into
pulmonary atresia with intact ventricular septum, which is associated with
a high risk of morbidity and mortality both in fetuses and neonates. In
this meta-analysis, we sought to discover the potential of fetal pulmonary
valvuloplasty that might affect patients' survival compared to other
available procedures. <br/>Method(s): This systematic review and
meta-analysis were conducted based on the PRISMA guideline. The authors
thoroughly searched the recognized and potential interventions for PA-IVS,
including FPV, total ventricular repair, and palliative procedures. The
primary outcome was the mortality rate. We used R software (version 4.1.3)
to calculate the overall proportion using the random-effects model of
proportional meta-analysis. <br/>Result(s): The FPV procedure was
performed at a mean gestational age of 26.28 weeks (95%CI: 24.83-27.73)
and was successful in 87.6 % (95 % CI: 78.3-96.3 %) of patients. A total
of 52.9 % patients attained biventricular circulation postnatally (95 %
CI: 31.2-74.7 %). Successful FPV was associated with a slightly higher
overall mortality rate [periprocedural death 4.7 % (95%CI: 0-10.7 %) and
postnatal death 8 % (95%CI: 3-13 %)] compared to the three currently
available definitive therapies, namely the Fontan procedure [10 % (95%CI:
4-17 %)], 1.5V repair [11 % (95%CI: 5-17 %), and 2V repair [8 % (95%CI:
1-15 %)]. <br/>Conclusion(s): FPV can potentially increase the likelihood
of biventricular circulation in fetuses with critical pulmonary valve
stenosis.<br/>Copyright &#xa9; 2023 The Authors

<12>
Accession Number
2028846499
Title
Assessing the Efficacy of Omega-3 Fatty Acids + Statins vs. Statins Only
on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of
40,991 Patients.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102245. Date of Publication: February 2024.
Author
Irfan A.; Haider S.H.; Nasir A.; Larik M.O.; Naz T.
Institution
(Irfan, Haider, Nasir, Larik, Naz) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Clinical guidelines recommend statin use in patients with a
vast array of cardiovascular disturbances. However, there is insufficient
evidence regarding the concomitant use of omega-3 fatty acids in addition
to statins. This meta-analysis aims to uncover the complete effects of
this combination therapy on cardiovascular outcomes, lipid biomarkers,
inflammatory markers, and plaque markers. <br/>Method(s): A detailed
literature search was conducted using PubMed, Cochrane, and MEDLINE
databases, and all the relevant studies found up to September 2023 were
included. The primary outcomes assessed in this meta-analysis was 1)
Composite of fatal and non-fatal myocardial infarction, 2) Composite of
fatal and non-fatal stroke, 3) Coronary revascularization, 4) Death due to
cardiovascular causes, 5) MACE (Major Adverse Cardiovascular Events), 6)
Unstable angina, 7) Hospitalization due to unstable angina, 8) and lipid
volume index. Secondary outcomes included lipid markers, hsCRP, EPA
levels, and EPA/AA ratio. <br/>Result(s): 14 RCTs were included, featuring
a total of 40,991 patients. Patients receiving the omega-3 + statin
regimen were associated with a statistically significant decrease in the
incidence of MI, MACE, unstable angina, hospitalization due to unstable
angina, Total cholesterol levels, triglycerides, hsCRP, and lipid volume
index in comparison to their counterparts receiving placebo + statin (P <
0.05). In contrast, our analysis found no statistically significant
difference in the incidence of fatal and non-fatal stroke, coronary
revascularization, and cardiovascular mortality. <br/>Conclusion(s): Our
research reinforces that all patients, regardless of their cardiovascular
health, may benefit from adding omega-3 fatty acids to their statin
therapy.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<13>
Accession Number
2027157989
Title
Effects of prehabilitation resistance training in mild to moderate
clinically frail patients awaiting coronary artery bypass graft surgery.
Source
Journal of Investigative Medicine. 72(1) (pp 151-158), 2024. Date of
Publication: January 2024.
Author
Sahar W.; Waseem M.; Riaz M.; Nazeer N.; Ahmad M.; Haider Z.
Institution
(Sahar, Ahmad) Department of Physiotherapy, The University of Lahore,
Lahore, Pakistan
(Waseem) Faculty of Rehabilitation & Allied Health Sciences, Riphah
International University, Islamabad, Pakistan
(Riaz) Department of Allied Health Sciences, University of Sargodha,
Sargodha, Pakistan
(Nazeer) Post Graduate Resident Cardiology Department, Bahawal Victoria
Hospital Bahawalpur, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
(Haider) Department of Cardiac Surgery, Quaid-e-Azam Medical College,
Bahawalpur, Pakistan
Publisher
SAGE Publications Inc.
Abstract
Coronary artery disease is one of the main causes of mortality and
morbidity among chronic heart diseases worldwide. Patients reported
chronic chest pain as the primary symptom of coronary artery disease. Due
to its progressive nature, it affects the health status and functional
capacity of the patients. The current study was planned to compare the
effects of prehabilitation resistance training in mild to moderate
clinically frail patients awaiting coronary artery bypass graft (CABG). A
randomized controlled trial was conducted on 74 patients awaiting CABG at
the Faisalabad Institute of Cardiology, Faisalabad, Pakistan. A Modified
Healthy Heart Questionnaire was used for screening of the patients.
Interventions applied were resistance training by using cuff
weights/dumbbells at light intensity (40%-50%) of a maximum of one
repetition (10-15 repetitions for one to three times a day) per major
muscle groups of upper and lower limbs of the body on weekly basis. The
main outcome measures were the 6-minute walk test (6MWT), the New York
Heart Association (NYHA) for heart failure, the clinical frailty score,
and the essential frailty toolset. Significant differences between group A
(resistance training group) and group B (conventional physical therapy
group) patients were observed. The mean ranks for 6MWT in group A and
group B were 1.70 and 1.55, respectively. The mean ranks of NYHA in group
A and group B were 1.68 and 2.84, respectively. Clinical frailty scores in
group A and group B were 2.68 and 2.74, respectively, with the essential
frailty toolset in group A and group B were 1.14 and 1.11, respectively.
There were significant (p < 0.05) differences within and between groups
for prehabilitation resistance training after CABG. The study showed that
the resistance training group had improved the clinical frailty score,
strength, endurance, and functional capacity in patients who underwent
elective CABG.<br/>Copyright &#xa9; 2023 American Federation for Medical
Research.

<14>
Accession Number
2025574752
Title
Transcatheter closure of atrial septal defect in the elderly: a systematic
review and meta-analysis.
Source
Heart. 109(23) (pp 1741-1750), 2023. Date of Publication: 01 Dec 2023.
Author
Baroutidou A.; Arvanitaki A.; Farmakis I.T.; Patsiou V.; Giannopoulos A.;
Efthimiadis G.; Ziakas A.; Giannakoulas G.
Institution
(Baroutidou, Arvanitaki, Farmakis, Patsiou, Efthimiadis, Ziakas,
Giannakoulas) First Department of Cardiology, Ahepa University Hospital,
Aristotle University of Thessaloniki, Central Macedonia, Thessaloniki,
Greece
(Arvanitaki) Centre for Adult Congenital Heart Disease, Royal Brompton
Hospital, Guy's and St Thoma's Foundation Trust, London, United Kingdom
(Farmakis) Center for Thrombosis and Hemostasis, University Medical Center
of the Johannes Gutenberg University, Mainz, Germany
(Giannopoulos) Pediatric Department, Ahepa University Hospital, Aristotle
University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
Publisher
BMJ Publishing Group
Abstract
Objective Despite the establishment of transcatheter closure as the
treatment of choice in adults with secundum atrial septal defects (ASDs),
the effectiveness of this approach in the elderly is disputed. This
systematic review and meta-analysis aims to explore the impact of
transcatheter ASD closure in patients >=60 years old. Methods We
systematically searched four major electronic databases (PubMed, CENTRAL
(Cochrane Central Register of Controlled Trials), Scopus and Web of
Science), ClinicalTrials.gov, article references and grey literature.
Primary outcomes were the right ventricular end-diastolic diameter (RVEDD)
and the New York Heart Association functional class change, whereas
secondary outcomes included systolic pulmonary arterial pressure (sPAP),
left ventricular end-diastolic diameter (LVEDD), brain natriuretic peptide
(BNP), tricuspid valve regurgitation (TR) change, as well as the rate of
atrial arrhythmias and all-cause mortality. Results In total, 18
single-arm cohorts comprising 1184 patients were included. RVEDD was
reduced after ASD closure (standardised mean difference (SMD) -0.9, 95% CI
-1.2 to -0.7). Elderly patients had 9.5 times higher odds of being
asymptomatic after ASD closure (95% CI 5.06 to 17.79). Furthermore, ASD
closure improved sPAP (mean difference (MD) -10.8, 95% CI -14.6 to -7),
LVEDD (SMD 0.8, 95% CI 0.7 to 1.0), TR severity (OR 0.39, 95% CI 0.25 to
0.60) and BNP (MD -68.3, 95% CI -114.4 to -22.1). There was a neutral
effect of ASD closure on atrial arrhythmias. Conclusions Transcatheter ASD
closure is beneficial for the elderly population since it improves
functional capacity, biventricular dimensions, pulmonary pressures, TR
severity and BNP. However, the incidence of atrial arrhythmias did not
change significantly after the intervention. PROSPERO registration number
CRD42022378574.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<15>
Accession Number
2017877258
Title
Rivaroxaban After Transcatheter Aortic Valve Replacement: A Critical
Appraisal of the GALILEO Trial.
Source
Cardiovascular Drugs and Therapy. 37(6) (pp 1239-1241), 2023. Date of
Publication: December 2023.
Author
Sulzgruber P.; Hammer A.; Niessner A.
Institution
(Sulzgruber, Hammer, Niessner) Division of Cardiology, Department of
Internal Medicine II, Medical University of Vienna, Waehringer Guertel
18-20, Vienna 1090, Austria
Publisher
Springer
Abstract
Purpose: The anti-thrombotic approach in individuals undergoing
transcatheter aortic valve replacement (TAVR) mirrors a controversial
field in clinical practice. Methods/Results: The aim of this article was
to critically appraise the randomized controlled GALILEO trial, where two
different antithrombotic regimes (10 mg rivaroxaban + 3 months aspirin vs.
aspirin + 3 months clopidogrel) were compared in patients who underwent
TAVR as well as available evidence in literature in this field.
<br/>Conclusion(s): The GALILEO trial was prematurely terminated as a
consequence of increased risk of both death or thromboembolic
complications and a higher risk of bleeding in the anticoagulation arm,
compared to the antiplatelet-based strategy. Various concerns have been
raised that the negative results of the GALILEO trial need to be regarded
with caution. A routine use of oral anticoagulation (OAC) for the
prevention of atherothrombotic events and valve thrombosis after TAVR in
individuals who do not have an indication for oral anticoagulation, can
currently not be recommended when considering the evidence base of
available literature. However, the negative results of the GALILEO trial
need to be interpreted with caution - especially in terms of dose of
rivaroxaban - and should not discourage from performing further trials
investigating safety and efficacy of this therapeutic approach.
Additionally, further dose-finding trials for rivaroxaban should be
considered.<br/>Copyright &#xa9; 2022, The Author(s).

<16>
Accession Number
642162022
Title
Lipoprotein(a) and calcific aortic valve disease: current evidence and
future directions.
Source
Current opinion in clinical nutrition and metabolic care. 27(1) (pp
77-86), 2024. Date of Publication: 01 Jan 2024.
Author
Lan N.S.R.; Khan Z.; Watts G.F.
Institution
(Lan, Watts) Departments of Cardiology and Internal Medicine, Royal Perth
Hospital
(Lan, Watts) School of Medicine, University of Western Australia, Perth,
WA, Australia
(Khan) Department of Cardiology, Barts Heart Centre, London, United
Kingdom
(Khan) University of South Wales, Cardiff, United Kingdom
Abstract
PURPOSE OF REVIEW: Calcific aortic valve disease (CAVD), the most common
cause of aortic stenosis (AS), is characterized by slowly progressive
fibrocalcific remodelling of the valve cusps. Once symptomatic, severe AS
is associated with poor survival unless surgical or transcatheter valve
replacement is performed. Unfortunately, no pharmacological interventions
have been demonstrated to alter the natural history of CAVD.
Lipoprotein(a) [Lp(a)], a low-density lipoprotein-like particle, has been
implicated in the pathophysiology of CAVD. RECENT FINDINGS: The mechanisms
by which Lp(a) results in CAVD are not well understood. However, the
oxidized phospholipids carried by Lp(a) are considered a crucial mediator
of the disease process. An increasing number of studies demonstrate a
causal association between plasma Lp(a) levels and frequency of AS and
need for aortic valve replacement, which is independent of inflammation,
as measured by plasma C-reactive protein levels. However, not all studies
show an association between Lp(a) and increased progression of
calcification in individuals with established CAVD. SUMMARY:
Epidemiologic, genetic, and Mendelian randomization studies have
collectively suggested that Lp(a) is a causal risk factor for CAVD.
Whether Lp(a)-lowering can prevent initiation or slow progression of CAVD
remains to be demonstrated.<br/>Copyright &#xa9; 2023 Wolters Kluwer
Health, Inc. All rights reserved.

<17>
Accession Number
641922962
Title
Roles and competencies of nurses and physicians in shared decision-making
in cardiac surgery: A scoping review.
Source
Journal of advanced nursing. 80(1) (pp 60-72), 2024. Date of Publication:
01 Jan 2024.
Author
van Dieen M.S.H.; Paans W.; Mariani M.A.; Dieperink W.; Blokzijl F.
Institution
(van Dieen, Paans, Dieperink, Blokzijl) Research Group Nursing
Diagnostics, Hanze University of Applied Sciences, Groningen, Netherlands
(van Dieen, Paans, Dieperink) Department of Critical Care, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Mariani, Blokzijl) Department of Cardiothoracic Surgery, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
Abstract
AIM: Identification and synthesis of research data related to the roles
and competencies of physicians and nurses that are prerequisites for
careful shared decision-making with patients potentially undergoing
cardiac surgery. DESIGN: A scoping review was conducted in accordance with
the Joanna Briggs Institute's methodology for scoping reviews and the
PRISMA Extension for Scoping Reviews. <br/>METHOD(S): PubMed, EMBASE and
CINAHL were searched from inception dates up to March 2022, to identify
primary studies published in a peer-reviewed journal. Study selection,
assessment of the methodological quality and data extracting of the
included studies were done by at least two independent researchers. To
describe the findings of the studies, an emergent synthesis approach was
used to visualize a descriptive representation of professional roles and
competencies in shared decision-making, in an overview. <br/>RESULT(S):
The systematic search revealed 10,055 potential papers, 8873 articles were
screened on title and abstract and 76 full texts were retrieved. Eight
articles were included for final evaluation. For nurses and physicians, 26
different skills were identified in the literature to practice shared
decision-making in cardiac surgery. The skills that emerged were divided
into five professional roles: moderator; health educator; data collector;
psychological supporter and translator. <br/>CONCLUSION(S): This review
specifies the professional roles and required competencies related to
shared decision-making in cardiac surgery. Further research is needed to
compare our findings with other clinical areas and from there to arrive at
a professional division of roles between the different clinical
disciplines involved. IMPACT: The visualization of generic shared
decision-making competencies and roles should establish the professional
division of positions between various clinical physician and nurse
disciplines in order to create a treatment plan based on evidence, values,
preferences and the patient's personal situation. PATIENT OR PUBLIC
CONTRIBUTION: No patient or public contribution.<br/>Copyright &#xa9; 2023
The Authors. Journal of Advanced Nursing published by John Wiley & Sons
Ltd.

<18>
[Use Link to view the full text]
Accession Number
2029072037
Title
Days at Home after Transcatheter Versus Surgical Aortic Valve Replacement
in Low-Risk Patients.
Source
Circulation: Cardiovascular Quality and Outcomes. 16(12) (pp E010034),
2023. Date of Publication: 01 Dec 2023.
Author
Chung M.; Almarzooq Z.I.; Xu J.; Song Y.; Baron S.J.; Kazi D.S.; Yeh R.W.
Institution
(Chung) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, United States
(Almarzooq, Xu, Song, Baron, Kazi, Yeh) Division of Cardiovascular
Medicine, Department of Medicine, Smith Center for Outcomes Research in
Cardiology, United States
(Xu, Song, Baron, Kazi, Yeh) Division of Cardiovascular Medicine,
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA,
United States
(Almarzooq) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Baron) Department of Cardiology, Lahey Hospital and Medical Center,
Burlington, MA, United States
(Baron) Baim Institute for Clinical Research, Boston, MA, United States
(Chung) Richard A. and Susan F. Smith Center for Outcomes Research in
Cardiology, Beth Israel Deaconess Medical Center, 375 Longwood Ave, 4th
Floor, Boston, MA 02215, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Days at home (DAH) represents an important patient-oriented
outcome that quantifies time spent at home after a medical event; however,
this outcome has not been fully evaluated for low-surgical-risk patients
undergoing transcatheter aortic valve replacement (TAVR). We sought to
compare 1- and 2-year DAH (DAH<inf>365</inf> and DAH<inf>730</inf>) among
low-risk patients participating in a randomized trial of TAVR with a
self-expanding bioprosthesis versus surgical aortic valve replacement
(SAVR). <br/>METHOD(S): Using Medicare-linked data from the Evolut Low
Risk trial, we identified 619 patients: 606 (322 TAVR/284 SAVR) and 593
(312 TAVR/281 SAVR) were analyzed at 1 and 2 years, respectively. DAH was
calculated as days alive and spent outside a hospital, inpatient
rehabilitation, skilled nursing facility, long-term acute care hospital,
emergency department, or observation stay. Mean DAH was compared using the
t test. <br/>RESULT(S): The mean (SD) age and female sex were 74.7 (5.1)
and 74.3 (4.9) years and 34.6% (115/332) and 30.3% (87/287) in TAVR and
SAVR, respectively. Postprocedural discharge to rehabilitation occurred in
<=3.0% (<=10/332) in TAVR and 4.5% (13/287) in SAVR. The mean
DAH<inf>365</inf> was comparable in TAVR versus SAVR (352.2+/-45.4 versus
347.8+/-39.0; difference in days, 4.5 [95% CI, 2.3-11.2]; P=0.20).
DAH<inf>730</inf> was also comparable in TAVR versus SAVR (701.6+/-106.0
versus 699.6+/-94.5; difference in days, 2.0 [-14.1 to 18.2]; P=0.81).
Secondary outcomes DAH<inf>30</inf> and DAH<inf>90</inf> were higher in
TAVR (DAH<inf>30</inf>, 26.0+/-3.6 versus 20.7+/-6.4; difference in days,
5.3 [4.5-6.2]; P<0.001; DAH<inf>90</inf>, 85.1+/-8.3 versus 78.7+/-13.6;
difference in days, 6.4 [4.6-8.2]; P<0.001). <br/>CONCLUSION(S): In the
Evolut Low Risk trial linked to Medicare, low-risk patients undergoing
TAVR spend a similar number of days at home at 1 and 2 years compared with
SAVR. Days spent at home at 30 and 90 days were higher in TAVR. In
contrast to higher-risk patients studied in prior work, there is no clear
advantage of TAVR versus SAVR for DAH in the first 2 years after AVR in
low-surgical-risk patients.<br/>Copyright &#xa9; 2023 Lippincott Williams
and Wilkins. All rights reserved.

<19>
Accession Number
2029102205
Title
Ultrasound-guided serratus anterior plane block to prevent neurocognitive
impairment in elderly patients after thoracoscopic lobectomy: Protocol for
a single-centre, double-blind, randomised controlled trial.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e069652. Date of
Publication: 11 Dec 2023.
Author
Wang D.-Y.; Feng D.; Liu M.-Y.; Wu W.; Xu H.; Shi H.
Institution
(Wang, Feng, Liu, Wu, Xu, Shi) Department of Anesthesiology, Shanghai
Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative neurocognitive dysfunction (PND), including
postoperative delirium (POD), is a common complication in elderly patients
after major surgeries, often leading to poor postoperative recovery.
Although the pathological mechanism underlying PND is still unclear,
postoperative pain is strongly associated with the development of PND. The
ultrasound-guided serratus anterior plane block (SAPB) has been reported
to relieve postoperative pain in thoracic surgery. Therefore, this
prospective trial hypothesises that SAPB may reduce the incidence of PND
in the elderly undergoing thoracoscopic lobectomy. Methods and analysis
This study is designed as a single-centre, double-blind, randomised
controlled clinical trial. A total of 256 elderly patients scheduled to
undergo thoracoscopic lobectomy at Shanghai Pulmonary Hospital will be
randomly assigned to general anaesthesia group or SAPB group. The primary
outcome is the incidence of PND 7 days postoperatively or before discharge
from hospital. The secondary outcomes include the occurrence of POD, the
postoperative pain scores, Quality of Recovery at 1-2 days postoperatively
and incidence of PND at 3 months postoperatively. The levels of fasting
blood glucose in peripheral blood will be examined before and 1-2 days
postoperatively. Ethics and dissemination The trial has been approved by
the Clinical Research Ethics Committee of Shanghai Pulmonary Hospital
(identifier: K20-290). All participants will be required to provide
written informed consent before any protocol-specific procedures. Findings
will be disseminated in a peer-reviewed journal and in national and/or
international meetings to guide future practice. Trial registration number
ChiCTR2100052633. <br/>Copyright &#xa9; 2023 BMJ Publishing Group. All
rights reserved.

<20>
Accession Number
2027008144
Title
Drug-coated balloons versus drug-eluting stents in patients with acute
myocardial infarction undergoing percutaneous coronary intervention: an
updated meta-analysis with trial sequential analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
605. Date of Publication: December 2023.
Author
Abdelaziz A.; Hafez A.; Atta K.; Elsayed H.; Abdelaziz M.; Elaraby A.;
Kadhim H.; Mechi A.; Ezzat M.; Fadel A.; Nasr A.; Bakr A.; Ghaith H.S.
Institution
(Abdelaziz, Hafez, Atta, Elsayed, Abdelaziz, Elaraby, Ezzat, Fadel, Bakr,
Ghaith) Medical Research Group of Egypt (MRGE), Cairo, Egypt
(Abdelaziz, Abdelaziz, Elaraby, Bakr, Ghaith) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Hafez, Atta) Institute of Medicine, National Research Mordovia State
University, Saransk, Russian Federation
(Elsayed) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Kadhim) Al Muthanna University College of Medicine, Samawah, Iraq
(Mechi) Medicine College, Internal Medicine Department, University of
Kufa, Najaf, Iraq
(Ezzat) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Fadel) Faculty of Medicine, Sohag University, Sohag, Egypt
(Nasr) Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Drug-coated balloons (DCBs) are an established strategy for
coronary artery disease. However, the new generation drug-eluting stent
(DES) is recommended for patients with Acute myocardial infarction (AMI)
for coronary artery revascularization. Our aim is to provide a
comprehensive appraisal of the efficacy of DCBs in patients with AMI
undergoing PCI. <br/>Method(s): We searched the WOS, PubMed, Scopus, and
Cochrane CENTRAL till March 2023, for studies that compared DCBs versus
DES in patients with AMI undergoing PCI. We used a random-effects model to
compare major adverse cardiac events (MACE), cardiac death, all-cause
death, myocardial infarction, target lesion revascularization (TLR), stent
thrombosis, Late lumen Loss (LLL), and minimum lumen diameter (MLD)
between the two groups. <br/>Result(s): Thirteen studies comprising 2644
patients were included. The pooled OR showed non-inferiority of DCB over
DES in terms of MACE (OR = 0.89, 95% CI [0.57 to 1.40], p = 0.63). When we
defined MACE as a composite of cardiac death, MI, and TLR; the pooled OR
favored DCB over DES (OR = 0.50, 95% CI [0.28 to 0.9], p = 0.02).
Moreover, DCB was not inferior to DES in terms of all-cause mortality (OR
= 0.88, 95% CI: 0.43 to 1.8, p = 0.73), cardiac mortality, (OR = 0.59, 95%
CI: 0.22 to 1.56, p = 0.29), MI (OR = 0.88, 95% CI: 0.34 to 2.29, p =
0.79), stent thrombosis (OR = 1.21, 95% CI: 0.35 to 4.23, p = 0.76), TLR
(OR = 0.9, 95% CI: 0.43 to 1.93, p = 0.8), LLL (MD = -0.6, 95% CI: -0.3 to
0.19, p = 0.64), or MLD (MD = -0.4, 95% CI: -0.33 to 0.25, p = 0.76).
<br/>Conclusion(s): Our meta-analysis indicated that DCB intervention was
not inferior to DES in the PCI setting in patients with AMI, and can be
recommended as a feasible strategy in AMI. PROSPERO registration:
CRD42023412757.<br/>Copyright &#xa9; 2023, The Author(s).

<21>
Accession Number
2020663009
Title
Meta-Analysis on the Anesthetic Effects of Remifentanil plus
Dexmedetomidine versus Remifentanil Alone in Cardiac Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1077980. Date of Publication: 2022.
Author
Zeng X.-L.; Liao J.-H.; Zhong H.-S.; Yin X.-H.; Wang R.; Liang J.-P.;
Zhang Z.-S.
Institution
(Zeng, Yin, Wang) Department of Cardiology, Shenzhen University General
Hospital, Shenzhen, China
(Liao) Guangzhou Yujia Biotechnology Co., Ltd., Guangzhou, China
(Zhong) Cardiac Surgery Center, The First Affiliated Hospital of Gannan
Medical University, Jiangxi, China
(Liang) Department of Radiology, Shenzhen bao'An District Songgang
People's Hospital, Shenzhen, China
(Zhang) Department of Cardiology, Pingshan District People's Hospital of
Shenzhen, Pingshan General Hospital, Southern Medical University,
Guangdong, Shenzhen, China
Publisher
Hindawi Limited
Abstract
In this study, we performed a meta-analysis to investigate the anesthesia
effects of remifentanil plus dexmedetomidine versus remifentanil alone in
cardiac surgery. Literature search was performed on PubMed, Web of
Science, Embase, China Knowledge Infrastructure, Wanfang Data, and other
databases for relevant literature published in English or Chinese before
October 2021. A total of 17 studies, consisting of 1350 patients, were
included in this study. Of these, 10 studies showed that remifentanil plus
dexmedetomidine had a good anesthesia effect in cardiac surgery (OR=3.61,
95% CI: 1.73, 7.52, P<0.001), and 8 studies showed that the Ramsay score
test of anesthesia (SMD=0.88; 95% CI: -0.77, 2.53; P<0.001) in the
experimental group was better than that in the control group. In addition,
changes in the hemodynamic heart rate (SMD=-0.74; 95% CI: -1.41, -0.07;
P<0.001) and mean arterial pressure (SMD=-0.18; 95% CI: -0.72, 0.36;
P<0.001) of the two groups of anesthesia were counted in 17 studies, which
also showed that the anesthesia effect of remifentanil plus
dexmedetomidine was good. Thus, remifentanil plus dexmedetomidine may be a
more promising option for cardiac surgery anesthesia than remifentanil
alone.<br/>Copyright &#xa9; 2022 Xiao-Lin Zeng et al.

<22>
Accession Number
2020659407
Title
Meta-Resolve of Risk Factors for Nosocomial Infection in Patients
Undergoing Thoracic Surgery.
Source
Contrast Media and Molecular Imaging. 2022 (no pagination), 2022. Article
Number: 2836014. Date of Publication: 2022.
Author
Chen J.; Zhang W.; Yang D.
Institution
(Chen, Zhang, Yang) Department of Cardiothoracic Surgery, Chongqing
Emergency Medical Center, Chongqing University Central Hospital,
Chongqing, China
Publisher
Hindawi Limited
Abstract
As we all know, various complications may occur after surgery, and
postoperative bleeding and infection are the most common in clinical
practice. Postoperative infection mainly manifests as abdominal abscess,
peritonitis, and fungal infection. Thoracic surgery is a very common
clinical operation. It can directly deal with the relevant lesions, so a
better curative effect can usually be obtained. However, patients
undergoing thoracic surgery are generally more severely ill, with low
immune resistance, long duration, and complicated surgical treatment
process. Therefore, the probability of nosocomial infection is high, and
there are many risk factors for infection. After the occurrence of HAI, it
not only increases the suffering and economic burden of patients and the
workload of medical staff but also prolongs the hospitalization time of
patients, reduces the turnover rate of hospital beds, causes unnecessary
economic losses, and affects the social and economic benefits of
hospitals. Based on this, this paper proposes to analyze the risk factors
of nosocomial infection in patients undergoing thoracic surgery, so as to
provide a reference for the prevention or control of nosocomial infection.
This paper analyzes the actual situation of nosocomial infection in a city
hospital and then uses meta-analysis to determine the factors of
nosocomial infection from the perspective of relevant research literature.
Meta-analysis results show that patients older than 60 years have twice
the risk of postoperative infection compared with patients younger than 60
years.<br/>Copyright &#xa9; 2022 Junjian Chen et al.

<23>
Accession Number
2029022188
Title
Individualized red-cell transfusion strategy for non-cardiac surgery in
adults: a randomized controlled trial.
Source
Chinese Medical Journal. 136(23) (pp 2857-2866), 2023. Date of
Publication: 05 Dec 2023.
Author
Liao R.; Liu J.; Zhang W.; Zheng H.; Zhu Z.; Sun H.; Yu Z.; Jia H.; Sun
Y.; Qin L.; Yu W.; Luo Z.; Chen Y.; Zhang K.; Ma L.; Yang H.; Wu H.; Liu
L.; Yuan F.; Xu H.; Zhang J.; Zhang L.; Liu D.; Huang H.
Institution
(Liao, Liu, Luo, Xu) Department of Anesthesiology, Research Unit for
Perioperative Stress Assessment and Clinical Decision, Chinese Academy of
Medical Sciences (2018RU012), West China Hospital of Sichuan University,
Sichuan, Chengdu 610041, China
(Zhang, Zhang) Department of Anesthesiology, The First Affiliated Hospital
of Zhengzhou University, Henan, Zhengzhou 450052, China
(Zheng, Zhang) Department of Anesthesiology, The First Affiliated Hospital
of Xinjiang Medical University, Xinjiang, Urumqi 830054, China
(Zhu, Liu) Department of Anesthesiology, The Affiliated Hospital of Zunyi
Medical College, Guizhou, Zunyi 563003, China
(Sun) Department of Anesthesiology, Beijing Friendship Hospital of Capital
Medical University, Beijing 100069, China
(Yu) Department of Bioinformatics and Biostatistics, School of Life
Science and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240,
China
(Jia) Department of Anesthesiology, The Fourth Hospital of Hebei Medical
University, Hebei, Shijiangzhuang 050019, China
(Sun) Department of Anesthesiology, Xijing Hospital, The Fourth Military
Medical University, Shaanxi, Xi'an 710032, China
(Qin) Department of Transfusion, West China Hospital of Sichuan
University, Sichuan, Chengdu 610041, China
(Yu) Department of Anesthesiology, Tianjin First Center Hospital, Tianjin
300192, China
(Chen) Department of Anesthesiology, Fujian Provincial Hospital, Fujian,
Fuzhou 350001, China
(Zhang) Department of Anesthesiology, Sichuan Cancer Hospital & Institute,
Sichuan, Chengdu 610041, China
(Ma) Department of Anesthesiology, Peking Union Medical College Hospital,
Beijing 100032, China
(Yang) Department of Anesthesiology, Tongji Hospital of Tongji Medical
College, Huazhong University of Science and Technology, Hubei, Wuhan
430030, China
(Wu) Department of Hepato-Bilio-Pancreatic Surgery, West China Hospital of
Sichuan University, Sichuan, Chengdu 610041, China
(Liu) Department of Orthopedic Surgery, West China Hospital of Sichuan
University, Sichuan, Chengdu 610041, China
(Yuan) Department of Anesthesiology, General Hospital Affiliated to
Tianjin Medical University, Tianjin 300052, China
(Huang) Department of Anesthesiology and Translational Neuroscience
Center, West China Second University Hospital of Sichuan University,
Sichuan, Chengdu 610041, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Red-cell transfusion is critical for surgery during the
peri-operative period; however, the transfusion threshold remains
controversial mainly owing to the diversity among patients. The patient's
medical status should be evaluated before making a transfusion decision.
Herein, we developed an individualized transfusion strategy using the
West-China-Liu's Score based on the physiology of oxygen
delivery/consumption balance and designed an open-label, multicenter,
randomized clinical trial to verify whether it reduced red cell
requirement as compared with that associated with restrictive and liberal
strategies safely and effectively, providing valid evidence for
peri-operative transfusion. <br/>Method(s): Patients aged >14 years
undergoing elective non-cardiac surgery with estimated blood loss > 1000
mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly
assigned to an individualized strategy, a restrictive strategy following
China's guideline or a liberal strategy with a transfusion threshold of
hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the
proportion of patients who received red blood cells (superiority test) and
a composite of in-hospital complications and all-cause mortality by day 30
(non-inferiority test). <br/>Result(s): We enrolled 1182 patients: 379,
419, and 384 received individualized, restrictive, and liberal strategies,
respectively. Approximately 30.6% (116/379) of patients in the
individualized strategy received a red-cell transfusion, less than 62.5%
(262/ 419) in the restrictive strategy (absolute risk difference, 31.92%;
97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI:
2.70-5.30%; P<0.001), and 89.8% (345/384) in the liberal strategy
(absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio,
20.06; 97.5% CI: 12.74-31.57; P<0.001). No statistically significant
differences were found in the composite of in-hospital complications and
mortality by day 30 among the three strategies. <br/>Conclusion(s): The
individualized red-cell transfusion strategy using the West-China-Liu's
Score reduced red-cell transfusion withou increasing in-hospital
complications and mortality by day 30 when compared with restrictive and
liberal strategies in elective non cardiac surgeries.<br/>Copyright &#xa9;
2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc.

<24>
Accession Number
2028970983
Title
Preinterventional frailty assessment in patients scheduled for cardiac
surgery or transcatheter aortic valve implantation: a consensus statement
of the European Association for Cardio-Thoracic Surgery (EACTS) and the
European Association of Preventive Cardiology (EAPC) of the European
Society of Cardiology (ESC).
Source
European Journal of Cardio-thoracic Surgery. 64(4) (no pagination), 2023.
Article Number: ezad181. Date of Publication: 01 Oct 2023.
Author
Sundermann S.H.; Back C.; Bischoff-Ferrari H.A.; Dehbi H.-M.; Szekely A.;
Voller H.; Niebauer J.
Institution
(Sundermann) Deutsches Herzzentrum der Charite, Department of
Cardiothoracic and Vascular Surgery, Berlin, Germany
(Sundermann) Charite- Universitatsmedizin Berlin, Freie Universitat
Berlin, Humboldt Universitat zu Berlin, Berlin, Germany
(Sundermann) DZHK (German Center of Cardiovascular Research), Partner Site
Berlin, Berlin, Germany
(Back) Department of Cardiothoracic Surgery, RT, Rigshospitalet,
Copenhagen University Hospital, Copenhagen, Denmark
(Bischoff-Ferrari) Center on Ageing and Mobility, University Hospital,
University of Zurich, Zurich, Switzerland
(Dehbi) University College London, Comprehensive Clinical Trials Unit,
London, United Kingdom
(Szekely) Semmelweis University, Department of Anesthesiology and
Intensive Therapy, Budapest, Hungary
(Voller) Faculty of Health Sciences Brandenburg, University of Potsdam,
Department of Rehabilitation Medicine, Potsdam, Germany
(Voller) Klinik am See, Rehabilitation Centre for Internal Medicine,
Rudersdorf, Germany
(Niebauer) Paracelsus Medical University Salzburg, Institute of Sports
Medicine, Prevention and Rehabilitation, Salzburg, Austria
(Niebauer) Ludwig Boltzmann Institute for Digital Health and Prevention,
Salzburg, Austria
(Niebauer) REHA-Zentrum Salzburg, University Hospital Salzburg, Austria
Publisher
European Association for Cardio-Thoracic Surgery

<25>
Accession Number
2028896768
Title
Twelve-month follow-up effects of cognitive training after heart valve
surgery on cognitive functions and health-related quality of life: A
randomised clinical trial.
Source
Open Heart. 10(2) (no pagination), 2023. Article Number: e002411. Date of
Publication: 27 Nov 2023.
Author
Butz M.; Gerriets T.; Sammer G.; El-Shazly J.; Tschernatsch M.; Braun T.;
Meyer R.; Schramm P.; Doeppner T.R.; Boning A.; Mengden T.; Choi Y.-H.;
Schonburg M.; Juenemann M.
Institution
(Butz, Gerriets, Sammer, Tschernatsch, Braun, Meyer, Schramm, Schonburg,
Juenemann) Heart and Brain Research Group, Kerckhoff Clinic, Bad Nauheim,
Germany
(Butz, Gerriets, Tschernatsch, Braun, Schramm, Doeppner, Juenemann)
Department of Neurology, University Hospitals Giessen, Marburg Campus
Giessen, Giessen, Germany
(Sammer) Department of Psychology, University of Giessen, Giessen, Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Clinic, Bad Nauheim,
Germany
(Boning) Department of Cardiovascular Surgery, University Hospitals
Giessen, Marburg Campus Giessen, Giessen, Germany
(Mengden) Department of Rehabilitation, Kerckhoff Clinic, Bad Nauheim,
Germany
(Choi, Schonburg) Department of Cardiac Surgery, Kerckhoff Clinic, Bad
Nauheim, Germany
Publisher
BMJ Publishing Group
Abstract
Objectives Postoperative cognitive decline (POCD) or decreased
health-related quality of life (HQL) have been reported after cardiac
surgery. A previous investigation showed beneficial effects of
postoperative cognitive training on POCD and HQL 3 months after heart
surgery. Here, we present the 12-month follow-up results. Methods This
bicentric, 1:1 randomised and treatment-as-usual controlled trial included
elderly patients scheduled for elective heart valve surgery. The training
consisted of paper-and-pencil-based exercises practising multiple
cognitive functions for 36 min/day 6 days/week over a period of 3 weeks.
Neuropsychological tests and questionnaires assessing HQL (36-Item Short
Form Health Survey (SF-36)) and cognitive failures in daily living
(Cognitive Failures Questionnaire) were performed presurgery and 12 months
after training. Results Twelve months post training, the training group
(n=30) showed improvements in HQL compared with the control group (n=28),
especially in role limitations due to physical health (U=-2.447, p=0.015,
* 2 =0.109), role limitations due to emotional problems (U=-2.245,
p=0.025, * 2 =0.092), pain (U=-1.979, p=0.049, * 2 =0.068), average of all
SF-36 factors (U=-3.237, p<0.001, * 2 =0.181), health change from the past
year to the present time (U=-2.091, p=0.037, * 2 =0.075), physical
component summary (U=-2.803, p=0.005, * 2 =0.138), and mental component
summary (U=-2.350, p=0.018, * 2 =0.095). Furthermore, the training group
(n=19) showed an improvement compared with the control group (n=27) in
visual recognition memory (U=-2.137, p=0.034, * 2 =0.099). POCD frequency
was 22% (n=6) in the control group and 11% (n=2) in the training group
(chi2(1) =1.06, p=0.440; OR=2.43, 95% CI 0.43 to 13.61). Conclusion In
conclusion, postoperative cognitive training shows enhancing effects on
HQL in cardiac surgery patients after 12 months.<br/>Copyright &#xa9; 2023
BMJ Publishing Group Limited.

<26>
Accession Number
2027355764
Title
Cognitive Deficits in Executive and Language Functions Predict
Postoperative Delirium.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(12) (pp 2552-2560),
2023. Date of Publication: December 2023.
Author
Olotu C.; Lebherz L.; Ascone L.; Scherwath A.; Kuhn S.; Harter M.;
Kiefmann R.
Institution
(Olotu, Kiefmann) Department of Anaesthesiology, University Medical Center
Hamburg, Hamburg, Germany
(Lebherz, Scherwath, Harter) Institute of Medical Psychology, University
Medical Center Hamburg, Hamburg, Germany
(Ascone, Kuhn) Department of Psychiatry and Psychotherapy, University
Medical Center Hamburg, Hamburg, Germany
(Scherwath) Department of Stem Cell Transplantation, University Medical
Center Hamburg, Hamburg, Germany
(Kiefmann) Anesthesia Department, Rotkreuzklinikum Munich, Munich, Germany
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative delirium (POD) remains the most common
complication in older adults, with cognitive impairment being the main
risk factor. Patients with mild cognitive impairment, in particular, have
much to lose from delirium; despite this, their cognitive impairment might
be clinically overlooked. Understanding which cognitive domains are
particularly predictive in this regard may improve the sensitivity of
preoperative testing and allow for a more targeted application of
resource-intensive measures to prevent delirium in the perioperative
period. The authors conducted this study with the aim of identifying the
most indicative cognitive domains. <br/>Design(s): A secondary analysis of
a randomized controlled trial. <br/>Setting(s): At a single center, the
University Medical Centre Hamburg in Hamburg, Germany.
<br/>Participant(s): Patients >=60 years without major neurocognitive
disorders (dementia, Mini-Mental State Examination score <=23) scheduled
for cardiovascular surgery. <br/>Measurements and Main Results:
Preoperative neuropsychologic testing and delirium screening were
performed twice daily until postoperative day 5. A multiple logistic
regression model was applied to determine the predictive ability of test
performances for the development of delirium. <br/>Result(s): A total of
541 patients were included in the analysis; the delirium rate was 15.6%.
After controlling for confounders, only low performance within the Trail
Making Test B/A (odds ratio [OR] = 1.32; 95% CI: 1.05-1.66) and letter
fluency (OR = 0.66; 95% CI: 0.45-0.96) predicted a particularly high risk
for delirium development. The discriminative ability of the final multiple
logistic regression model to predict POD had an area under the curve of
0.786. <br/>Conclusion(s): Impairment in the cognitive domains of
executive function and language skills associated with memory, inhibition,
and access speed seem to be particularly associated with the development
of delirium after surgery in adults >=65 years of age without apparent
preoperative neurocognitive impairment.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<27>
Accession Number
2024918427
Title
Patient and Management Variables Associated With Survival After
Postcardiotomy Extracorporeal Membrane Oxygenation in Adults: The PELS-1
Multicenter Cohort Study.
Source
Journal of the American Heart Association. 12(14) (no pagination), 2023.
Article Number: e029609. Date of Publication: 18 Jul 2023.
Author
Mariani S.; Heuts S.; Van Bussel B.C.T.; Di Mauro M.; Wiedemann D.; Saeed
D.; Pozzi M.; Loforte A.; Boeken U.; Samalavicius R.; Bounader K.; Hou X.;
Bunge J.J.H.; Buscher H.; Salazar L.; Meyns B.; Herr D.; Sacha Matteucci
M.L.; Sponga S.; Maclaren G.; Russo C.; Formica F.; Sakiyalak P.; Fiore
A.; Camboni D.; Raffa G.M.; Diaz R.; Wang I.-W.; Jung J.-S.; Belohlavek
J.; Pellegrino V.; Bianchi G.; Pettinari M.; Barbone A.; Garcia J.P.;
Shekar K.; Whitman G.J.R.; Lorusso R.
Institution
(Mariani, Heuts, Di Mauro, Lorusso) Cardio-Thoracic Surgery Department,
Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
(Van Bussel) Department of Intensive Care Medicine and Cardiovascular
Research Institute Maastricht, Maastricht, Netherlands
(Wiedemann) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Saeed) Department of Cardiac Surgery, Leipzig Heart Center, Leipzig,
Germany
(Pozzi) Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital,
Lyon, France
(Loforte) Division of Cardiac Surgery, Istituto di Ricovero e Cura a
Carattere Scientifico Azienda Ospedaliero-Universitaria di Bologna,
Bologna, Italy
(Loforte) Department of Surgical Sciences, University of Turin, Turin,
Italy
(Boeken) Department of Cardiac Surgery, Medical Faculty, Heinrich Heine
University, Duesseldorf, Germany
(Samalavicius) II Department of Anesthesiology, Centre of Anesthesia,
Intensive Care and Pain Management, Vilnius University Hospital
Santariskiu Klinikos, Vilnius, Lithuania
(Bounader) Division of Cardiothoracic and Vascular Surgery, Pontchaillou
University Hospital, Rennes, France
(Hou) Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung
and Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Bunge) Department of Intensive Care Adults, Erasmus Medical Center,
Rotterdam, Netherlands
(Buscher) Department of Intensive Care Medicine, Center of Applied Medical
Research, St Vincent's Hospital, Darlinghurs, NSW, Australia
(Buscher) University of New South Wales, Sydney, Australia
(Salazar) Department of Cardiology, Fundacion Cardiovascular de Colombia,
Bucaramanga, Colombia
(Meyns) Department of Cardiac Surgery, University Hospitals Leuven and
Department of Cardiovascular Sciences, University of Leuven, Leuven,
Belgium
(Herr) Departments of Medicine and Surgery, University of Maryland,
Baltimore, MD, United States
(Sacha Matteucci) Struttura Organizzativa Dipartimentale di
Cardiochirurgia, Ospedali Riuniti 'Umberto I-Lancisi- Salesi' Universita
Politecnica delle Marche, Ancona, Italy
(Sponga) Division of Cardiac Surgery, Cardiothoracic Department,
University Hospital of Udine, Udine, Italy
(Maclaren) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Singapore, Singapore
(Russo) Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department,
Niguarda Hospital, Milan, Italy
(Formica) Department of Medicine and Surgery, Cardiac Surgery Clinic, San
Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
(Formica) Department of Medicine and Surgery, University of Parma, Cardiac
Surgery Unit, University Hospital of Parma, Parma, Italy
(Sakiyalak) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Fiore) Department of Cardio-Thoracic Surgery, University Hospital
Henri-Mondor, Creteil, Paris, France
(Camboni) Department of Cardiothoracic Surgery, University Medical Center
Regensburg, Regensburg, Germany
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituti di Ricovero e Cura a
Carattere Scientifico - Istituto Mediterraneo per i Trapianti e Terapie ad
Alta Specializzazione, Palermo, Italy
(Diaz) Extracorporeal Membrane Oxygenation Unit, Departamento de
Anestesia, Clinica Las Condes, Las Condes, Santiago, Chile
(Wang) Division of Cardiac Surgery, Memorial Healthcare System, Hollywood,
FL, United States
(Jung) Department of Thoracic and Cardiovascular Surgery, Korea University
Anam Hospital, Seoul, South Korea
(Belohlavek) Department of Internal Medicine, Cardiovascular Medicine
General Teaching Hospital, Faculty of Medicine, Charles University in
Prague, Prague, Czechia
(Pellegrino) Intensive Care Unit, The Alfred Hospital, Melbourne, VIC,
Australia
(Bianchi) Ospedale del Cuore Fondazione Toscana "G. Monasterio", Massa,
Italy
(Pettinari) Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Barbone) Cardiac Surgery Unit, Istituto di Ricovero e Cura a Carattere
Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy
(Garcia) Indiana University Health Advanced Heart and Lung Care, Indiana
University Methodist Hospital, Indianapolis, IN, United States
(Shekar, Whitman) Adult Intensive Care Services, The Prince Charles
Hospital, Brisbane, Australia
(Shekar, Whitman) Cardiac Intensive Care Unit, Johns Hopkins Hospital,
Baltimore, MD, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been
increasingly used for postcardiotomy cardiogenic shock, but without a
concomitant reduction in observed in-hospital mortality. Long-term
outcomes are unknown. This study describes patients' characteristics,
in-hospital outcome, and 10-year survival after postcardiotomy ECMO.
Variables associated with in-hospital and postdischarge mortality are
investigated and reported. METHODS AND RESULTS: The retrospective
international multicenter observational PELS-1 (Postcardiotomy
Extracorporeal Life Support) study includes data on adults requiring ECMO
for postcardiotomy cardiogenic shock between 2000 and 2020 from 34
centers. Variables associated with mortality were estimated
preoperatively, intraoperatively, during ECMO, and after the occurrence of
any complications, and then analyzed at different time points during a
patient's clinical course, through mixed Cox proportional hazards models
containing fixed and random effects. Follow-up was established by
institutional chart review or contacting patients. This analysis included
2058 patients (59% were men; median [interquartile range] age, 65.0
[55.0-72.0] years). In-hospital mortality was 60.5%. Independent variables
associated with in-hospital mortality were age (hazard ratio [HR], 1.02
[95% CI, 1.01-1.02]) and preoperative cardiac arrest (HR, 1.41 [95% CI,
1.15-1.73]). In the subgroup of hospital survivors, the overall 1-, 2-,
5-, and 10-year survival rates were 89.5% (95% CI, 87.0%-92.0%), 85.4%
(95% CI, 82.5%-88.3%), 76.4% (95% CI, 72.5%-80.5%), and 65.9% (95% CI,
60.3%-72.0%), respectively. Variables associated with postdischarge
mortality included older age, atrial fibrillation, emergency surgery, type
of surgery, postoperative acute kidney injury, and postoperative septic
shock. <br/>CONCLUSION(S): In adults, in-hospital mortality after
postcardiotomy ECMO remains high; however, two-thirds of those who are
discharged from hospital survive up to 10 years. Patient selection,
intraoperative decisions, and ECMO management remain key variables
associated with survival in this cohort. REGISTRATION: URL:
Https://www.clini caltr ials.gov; Unique identifier:
NCT03857217.<br/>Copyright &#xa9; 2023 The Authors.

<28>
Accession Number
2023311175
Title
Exploring the link between poor oral hygiene and mesh infection after
hernia repair: a systematic review and proposed best practices.
Source
Hernia. 27(6) (pp 1387-1395), 2023. Date of Publication: December 2023.
Author
East B.; Podda M.; Beznoskova-Seydlova M.; de Beaux A.C.
Institution
(East) 3rd Department of Surgery of 1st Faculty of Medicine at Charles
University, Motol University Hospital, Prague, Czechia
(Podda) Department of Surgical Science, Emergency Surgery Unit, University
of Cagliari, Cagliari, Italy
(Beznoskova-Seydlova) Private dentist, Prague, Czechia
(de Beaux) Spire Murrayfield Hospital, Edinburgh and The University of
Edinburgh, Edinburgh, United Kingdom
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background: There is a reasonable body of evidence around oral/dental
health and implant infection in orthopaedic and cardiovascular surgery.
Another large area of surgical practice associated with a permanent
implant is mesh hernia repair. This study aimed to review the evidence
around oral/dental health and mesh infection. <br/>Method(s): The research
protocol was registered in PROSPERO (CRD42022334530). A systematic review
of the literature was undertaken according to the PRISMA 2020 statement.
The initial search identified 582 publications. A further four papers were
identified from references. After a review by title and abstract, 40
papers were read in full text. Fourteen publications were included in the
final review, and a total of 47,486 patients were included.
<br/>Result(s): There is no published evidence investigating the state of
oral hygiene/health and the risk of mesh infection or other infections in
hernia surgery. Improvement in oral hygiene/health can reduce surgical
site infection and implant infection in colorectal, gastric, liver,
orthopaedic and cardiovascular surgery. Poor oral hygiene/health is
associated with a large increase in oral bacteria and bacteraemia in
everyday activities such as when chewing or brushing teeth. Antibiotic
prophylaxis does not appear to be necessary before invasive dental care in
patients with an implant. <br/>Conclusion(s): Good oral hygiene and oral
health is a strong public health message. The effect of poor oral hygiene
on mesh infection and other complications of mesh hernia repair is
unknown. While research is clearly needed in this area, extrapolating from
evidence in other areas of surgery where implants are used, good oral
hygiene/health should be encouraged amongst hernia patients both prior to
and after their surgery.<br/>Copyright &#xa9; 2023, The Author(s).

<29>
Accession Number
642918383
Title
Limited versus full sternotomy for aortic valve replacement.
Source
Cochrane Database of Systematic Reviews. 2023(12) (no pagination), 2023.
Article Number: CD011793. Date of Publication: 06 Dec 2023.
Author
Kirmani B.H.; Jones S.G.; Muir A.; Malaisrie S.C.; Chung D.A.; Williams
R.J.N.N.; Akowuah E.
Institution
(Kirmani, Muir, Williams) Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Kirmani) University of Liverpool, Liverpool, United Kingdom
(Kirmani) Liverpool Centre for Cardiovascular Science, Liverpool, United
Kingdom
(Jones) Department of Cardiac Surgery, University Hospital Coventry and
Warwickshire, Coventry, United Kingdom
(Malaisrie) Division of Cardiac Surgery, Northwestern University, Chicago,
IL, United States
(Chung) High Lane Medical Centre, Stockport, United Kingdom
(Akowuah) Academic Cardiovascular Unit, South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
(Akowuah) Translational and Clinical Research Institute, Newcastle
University, Newcastle, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Aortic valve disease is a common condition easily treatable
with cardiac surgery. This is conventionally performed by opening the
sternum ('median sternotomy') and replacing the valve under
cardiopulmonary bypass. Median sternotomy is well tolerated, but as less
invasive options become available, the efficacy of limited incisions has
been called into question. In particular, the effects of reducing the
visibility and surgical access have raised safety concerns with regard to
the placement of cannulae, venting of the heart, epicardial wire
placement, and de-airing of the heart at the end of the procedure. These
difficulties may increase operating times, affecting outcome. The benefits
of smaller incisions are thought to include decreased pain; improved
respiratory mechanics; reductions in wound infections, bleeding, and need
for transfusion; shorter intensive care stay; better cosmesis; and a
quicker return to normal activity. This is an update of a Cochrane review
first published in 2017, with seven new studies. <br/>Objective(s): To
assess the effects of minimally invasive aortic valve replacement via a
limited sternotomy versus conventional aortic valve replacement via median
sternotomy in people with aortic valve disease requiring surgical
replacement. <br/>Search Method(s): We performed searches of CENTRAL,
MEDLINE and Embase from inception to August 2021, with no language
limitations. We also searched two clinical trials registries and
manufacturers' websites. We reviewed references of primary studies to
identify any further studies of relevance. <br/>Selection Criteria: We
included randomised controlled trials comparing aortic valve replacement
via a median sternotomy versus aortic valve replacement via a limited
sternotomy. We excluded trials that performed other minimally invasive
incisions such as mini-thoracotomies, port access, transapical,
transfemoral or robotic procedures. Although some well-conducted
prospective and retrospective case-control and cohort studies exist, these
were not included in this review. <br/>Data Collection and Analysis: Two
review authors independently assessed trial papers to extract data, assess
quality, and identify risk of bias. A third review author provided
arbitration where required. We determined the certainty of evidence using
the GRADE methodology and summarised results of patient-relevant outcomes
in a summary of findings table. <br/>Main Result(s): The review included
14 trials with 1395 participants. Most studies had at least two domains at
high risk of bias. We analysed 14 outcomes investigating the effects of
minimally invasive limited upper hemi-sternotomy on aortic valve
replacement as compared to surgery performed via full median sternotomy.
Upper hemi-sternotomy may have little to no effect on mortality versus
full median sternotomy (risk ratio (RR) 0.93, 95% confidence interval (CI)
0.45 to 1.94; 10 studies, 985 participants; low-certainty evidence). Upper
hemi-sternotomy for aortic valve replacement may increase cardiopulmonary
bypass time slightly, although the evidence is very uncertain (mean
difference (MD) 10.63 minutes, 95% CI 3.39 to 17.88; 10 studies, 1043
participants; very low-certainty evidence) and may increase aortic
cross-clamp time slightly (MD 6.07 minutes, 95% CI 0.79 to 11.35; 12
studies, 1235 participants; very low-certainty evidence), although the
evidence is very uncertain. Most studies had at least two domains at high
risk of bias. Postoperative blood loss was probably lower in the upper
hemi-sternotomy group (MD -153 mL, 95% CI -246 to -60; 8 studies, 767
participants; moderate-certainty evidence). Low-certainty evidence
suggested that there may be no change in pain scores by upper
hemi-sternotomy (standardised mean difference (SMD) -0.19, 95% CI -0.43 to
0.04; 5 studies, 649 participants). Upper hemi-sternotomy may result in
little to no difference in quality of life (MD 0.03 higher, 95% CI 0 to
0.06 higher; 4 studies, 624 participants; low-certainty evidence). Two
studies reporting index admission costs concluded that limited sternotomy
may be more costly at index admission in the UK National Health Service
(MD 1190 GBP more, 95% CI 420 GBP to 1970 GBP, 2 studies, 492
participants; low-certainty evidence). Authors' conclusions: The evidence
was of very low to moderate certainty. Sample sizes were small and
underpowered to demonstrate differences in some outcomes. Clinical
heterogeneity was also noted. Considering these limitations, there may be
little to no effect on mortality. Differences in extracorporeal support
times are uncertain, comparing upper hemi-sternotomy to full sternotomy
for aortic valve replacement. Before widespread adoption of the minimally
invasive approach can be recommended, there is a need for a well-designed
and adequately powered prospective randomised controlled trial. Such a
study would benefit from also performing a robust cost analysis. Growing
patient preference for minimally invasive techniques merits thorough
quality of life analyses to be included as end points, as well as
quantitative measures of physiological reserve.<br/>Copyright &#xa9; 2023
The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<30>
Accession Number
2029010229
Title
Cardiovascular outcomes post bariatric surgery in patients with metabolic
dysfunction-associated steatotic liver disease - A systematic review and
meta-analysis.
Source
Clinics and Research in Hepatology and Gastroenterology. 48(1) (no
pagination), 2024. Article Number: 102261. Date of Publication: January
2024.
Author
Kumar J.; Mohsin S.; Hasan M.; Bilal A.R.; Ali K.M.; Umer A.; Hadi D.Z.M.;
Nandlal S.; Kumar S.
Institution
(Kumar, Kumar) School of Medicine, Wayne State University, Detroit, MI,
United States
(Mohsin, Hasan, Bilal, Umer, Nandlal) Ziauddin Medical College, 4/B,
Saharah-e-Ghalib, Block 6, Clifton, Sindh, Karachi 75600, Pakistan
(Ali, Hadi) Jinnah Sindh Medical University, Karachi, Pakistan
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease
(MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is
linked with an increased risk of adverse cardiovascular events. Studies
have suggested an association between the reduction of incident
cardiovascular events in patients with MASLD after bariatric surgery. This
systematic review and meta-analysis were performed to assess the influence
of bariatric surgery on cardiovascular outcomes in patients with diagnosed
MASLD by identifying all available cohort studies and pooling their data.
<br/>Method(s): PubMed and Google Scholar databases were searched till
July 2023 for published studies that assessed the effect of bariatric
surgery on cardiovascular outcomes in MASLD patients. Using a random
effects model, hazard ratios (HRs) with 95 % confidence intervals (CIs)
were pooled. <br/>Result(s): The systematic review identified three cohort
studies. The analysis of 240,516 MASLD patients found a significantly
reduced incidence of cardiovascular events. (HR 0.51; 95 % CI 0.48 to
0.54, P value <0.00001). <br/>Conclusion(s): Bariatric surgery in MASLD
patients significantly reduced the incidence of cardiovascular events,
suggesting that bariatric surgery is an effective therapeutic tool among
MASLD patients compared to non-surgical interventions.<br/>Copyright
&#xa9; 2023 Elsevier Masson SAS

<31>
Accession Number
2028997680
Title
Pharmacological and non-pharmacological interventions to prevent delirium
after cardiac surgery: a protocol for a systematic review and
meta-analysis.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e076919. Date of
Publication: 10 Dec 2023.
Author
Cottuli De Cothi E.; Perry R.; Kota R.; Walker-Smith T.; Barnes J.D.;
Pufulete M.; Gibbison B.
Institution
(Cottuli De Cothi, Perry, Kota, Pufulete, Gibbison) University of Bristol,
Bristol, United Kingdom
(Walker-Smith) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
(Barnes) North Bristol Nhs Trust, Bristol, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a syndrome characterised by a disturbance in
attention, awareness and cognition as a result of another physical
condition. It occurs in up to 50% of patients after cardiac surgery and is
associated with increased mortality, prolonged intensive care and hospital
stay and long-term cognitive dysfunction. Identifying effective preventive
interventions is important. We will therefore conduct a systematic review
to identify all randomised controlled studies that have tested a
pharmacological or non-pharmacological intervention to prevent delirium.
Methods and analysis We will search electronic databases (CDSR (Reviews),
CENTRAL (Trials), MEDLINE Ovid, Embase Ovid, PsycINFO Ovid) as well as
trial registers (clinicaltrials.gov and ISCRTN) for randomised controlled
trials of both pharmacological and non-pharmacological interventions
designed to prevent delirium after cardiac surgery in adults. Screening of
search results and data extraction from included articles will be
performed by two independent reviewers using Rayyan. The primary outcome
will be the incidence of delirium. Secondary outcomes include: duration of
postoperative delirium, all-cause mortality, length of postoperative
hospital and intensive care stay, postoperative neurological complications
other than delirium, health-related quality of life and
intervention-specific adverse events. Studies will be assessed for risk of
bias using the Cochrane RoB2 tool. A narrative synthesis of all included
studies will be presented and meta-analysis (if appropriate network
meta-analysis) will be undertaken where there are sufficient studies
(three or more) for pooling results. Results will be reported according to
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
statement. Ethics and dissemination No ethical approval is required. This
review will be disseminated via peer-reviewed manuscript and conferences.
PROSPERO registration number CRD42022369068. <br/>Copyright &#xa9; 2023
BMJ. All rights reserved.

<32>
Accession Number
2028997674
Title
Effect of percutaneous cerebral oximetry-guided anaesthetic management on
postoperative delirium in older adults undergoing off-pump coronary artery
bypass grafting: study protocol for a single-centre prospective randomised
controlled trial in a tertiary academic hospital in China.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e076419. Date of
Publication: 09 Dec 2023.
Author
Tian L.; Wang H.; Jia Y.; Jin L.; Zhou C.; Zhou H.; Yuan S.
Institution
(Tian, Wang, Jia, Jin, Zhou, Yuan) Department of Anesthesiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Zhou) Department of Intensive Care Unit, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium is a prominent and clinically
important complication in older adults after coronary artery bypass
grafting (CABG) surgery, resulting in prolonged hospital stay, long-term
cognitive impairment and increased morbidity and mortality. Many studies
have shown that cerebral desaturation is associated with increased risk of
postoperative delirium during on-pump cardiac surgery. However, few
studies have focused on the effect of optimising regional cerebral oxygen
saturation (rSO 2) on postoperative delirium during off-pump CABG. The
purpose of this study is to investigate whether intraoperative anaesthetic
management based on percutaneous cerebral oximetry monitoring decreases
the incidence of postoperative delirium in older adults undergoing
off-pump CABG. Methods This single-centre randomised controlled trial will
randomly assign 200 patients to the intervention group or the control
group at a ratio of 1:1. The patients in the intervention group will be
observed by percutaneous cerebral oximetry monitoring that the
desaturation (a drop of more than 20% from baseline value or rSO 2 less
than 55% for >60 consecutive seconds at either probe) during the procedure
triggered the intervention strategies, while the cerebral oximetry data of
the control group will be hidden from the clinical team and patients will
be anaesthetised by the usual anaesthetic management. The primary outcome
will be the incidence of postoperative delirium during the first 7 days
after off-pump CABG. Delirium will be comprehensively evaluated by the
combination of the Richmond Agitation Sedation Scale and the Confusion
Assessment Method for the intensive care unit. The secondary outcomes will
include the incidence of postoperative acute kidney injury and myocardial
infarction during the hospital stay, as well as the intensive care unit
and hospital length of stay. Ethics and dissemination This study was
approved by the Ethics Committee of the Chinese Academy of Medical
Sciences, Fuwai Hospital (No 2022-1824). Written informed consent will be
obtained from each patient or their legal representatives before
enrolment. The results of this trial will be published in an international
peer-reviewed scientific journal. Trial registration number
ChiCTR2300068537. <br/>Copyright &#xa9; The Author(s) 2023.

<33>
Accession Number
2028023573
Title
Mollicutes-related infections in thoracic surgery including lung and heart
transplantation: A systematic review.
Source
Journal of Heart and Lung Transplantation. 43(1) (pp 169-180), 2024. Date
of Publication: January 2024.
Author
Farfour E.; Vasse M.; Vallee A.
Institution
(Farfour, Vasse) Service de Biologie Clinique, Hopital Foch, Suresnes,
France
(Vasse) Universite Paris-Saclay, INSERM Hemostase Inflammation Thrombose
HITH U1176, Le Kremlin-Bicetre, France
(Vallee) Departement d'Epidemiologie et de Sante Publique, Hopital Foch,
Suresnes, France
Publisher
Elsevier Inc.
Abstract
Background: Urogenital Mollicutes, that is, Mycoplasma hominis and
Ureaplasma spp., can colonize the urogenital tract. While urogenital
colonization is frequent, infections are rare but should not be missed.
Furthermore, extragenital infections are even rarer. Over the past years,
they have been increasingly documented as a cause of hyperammonemia
syndrome (HS) and post-surgical infections. We review the literature on
studies focused on post-surgical infections and HS involving urogenital
Mollicutes after thoracic surgery including lung (LTR) and heart (HTR)
transplantation. <br/>Method(s): A systematic review was performed by
searching PubMed/Medline case reports, case series, cohort studies, and
clinical trials. Cases of infections and HS by urogenital Mollicutes after
HTR and LTR transplantations were reported. <br/>Result(s): Overall,
urogenital Mollicutes were associated with 15 HS, 31 infections in HTR and
LTR, and 18 post-thoracic surgical infections in another context.
Post-surgical infections were reported in all contexts. They were mainly
due to M hominis, the only species that could cultivate on standard
enriched agar forming pinpoint colonies after 3-5 days of incubation.
Microbiologists should be prompted to pinpoint colonies even if the
examination of Gram-staining is negative. The patients' management
required surgical treatment and antimicrobials, almost always
tetracyclines and/or fluoroquinolones. Conversely, HS occurred almost
exclusively in bilateral LTR and is more likely due to Ureaplasma spp. As
Ureaplasma spp. do not cultivate on standard media, the microbiological
diagnosis was performed using molecular methods. <br/>Conclusion(s):
Infections involving urogenital Mollicute should be considered in LTR with
HS. The overall rate of mortality is high and might be due in part to
delay in etiologic diagnosis. Post-surgical infections were reported in
all contexts. The route of contamination with Mollicutes remains unknown
in HTR and non-transplant surgery, but evidence of transmission from
donors has been documented for LTR.<br/>Copyright &#xa9; 2023

<34>
Accession Number
2027129972
Title
Bivalirudin anticoagulation for cardiopulmonary bypass during cardiac
surgery.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Meshulami N.; Murthy R.; Meyer M.; Meyer A.D.; Kaushik S.
Institution
(Meshulami, Murthy, Meyer, Kaushik) Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Murthy) Division of Pediatric Cardiac Surgery, Department of
Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Meyer) Division of Critical Care, Department of Pediatrics, Long School
of Medicine, University of Texas Health Science Center, San Antonio, TX,
United States
(Kaushik) Pediatric Critical Care, Department of Pediatrics, Kravis
Children's Hospital at Mount Sinai, Icahn School of Medicine, New York,
NY, United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Heparin is the primary anticoagulant for cardiopulmonary
bypass (CPB) support during cardiac surgery. While widely used, ~2% of
cardiac surgery patients develop heparin-induced thrombocytopenia (HIT)
and 4-26% develop heparin resistance. Bivalirudin is an alternative
anticoagulant mainly used for percutaneous coronary interventions. Given
the challenges associated with heparin anticoagulation, we conducted a
review to explore the use of bivalirudin for CPB surgery. <br/>Method(s):
PubMed and Embase scoping review included 2 randomized controlled trials,
a retrospective comparison study, 3 pilot studies, and 30 case reports. To
provide a contemporary series, we searched for articles published from
2010 to 2023. Our review included studies from both adult and pediatric
populations. <br/>Result(s): While data is limited, bivalirudin seems to
supply similar effectiveness and safety as heparin for CPB
anticoagulation. Across the three comparative studies, the heparin cohorts
had a 0-9% mortality rate and 0-27% rate of major bleeding/reoperation
compared to a 0-3% mortality and 0-6% major bleeding/reoperation rate for
the bivalirudin cohorts. Bivalirudin was successfully used as an
anticoagulant in a wide range of CPB surgeries (e.g., heart transplants,
ventricular assisted device placements, and valve repairs). Successful
patient outcomes were reported with bivalirudin infusion of ~2 mg/kg/hour,
activated clotting time monitoring (target >400 s or 2.5x baseline), use
of cardiotomy suctions, minimization of stagnant blood, and post-bypass
modified ultrafiltration. <br/>Conclusion(s): Bivalirudin is a safe and
effective anticoagulant for CPB, especially for patients with HIT or
heparin resistance. Further comparative research is called for to optimize
bivalirudin utilization for CPB during cardiac surgery.<br/>Copyright
&#xa9; The Author(s) 2023.

<35>
Accession Number
2027049376
Title
Evaluation of the efficacy and safety of amustaline/glutathione
pathogen-reduced RBCs in complex cardiac surgery: the Red Cell Pathogen
Inactivation (ReCePI) study-protocol for a phase 3, randomized, controlled
trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 799. Date of
Publication: December 2023.
Author
Snyder E.L.; Sekela M.E.; Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.;
Beaver T.M.; Pelletier J.P.R.; Gorham J.D.; McNeil J.S.; Sniecinski R.M.;
Pearl R.G.; Nuttall G.A.; Sarode R.; Reece T.B.; Kaplan A.; Davenport
R.D.; Ipe T.S.; Benharash P.; Lopez-Plaza I.; Gammon R.R.; Sadler P.;
Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.; Varrone J.; Benjamin
R.J.
Institution
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Sekela) Gill Heart Institute University of Kentucky, Lexington, KY,
United States
(Welsby) Duke University Medical Center, Durham, NC, United States
(Toyoda) Temple University Hospital, Philadelphia, PA, United States
(Alsammak) Temple University Health System, Philadelphia, PA, United
States
(Sodha) Rhode Island Hospital, Providence, RI, United States
(Beaver, Pelletier) University of Florida, Gainesville, FL, United States
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Sniecinski) Emory University, Atlanta, GA, United States
(Reece) University of Colorado Hospital, Denver, CO, United States
(Pearl) Stanford University, Stanford, CA, United States
(Davenport) University of Michigan, Ann Arbor, MI, United States
(Gorham, McNeil) University of Virginia Health System, Charlottesville,
VA, United States
(Sarode) University of Texas, Southwestern, Dallas, TX, United States
(Ipe) Our Blood Institute, Oklahoma City, OK, United States
(Ipe) University of Arkansas for Medical Sciences, Little Rock, AR, United
States
(Nuttall) Mayo Clinic, Rochester, MN, United States
(Benharash) UCLA, Los Angeles, CA, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, MI, United States
(Gammon) Scientific, Medical and Technical and Research Department,
OneBlood, Orlando, FL, United States
(Sadler) Central California Blood Center, Fresno, CA, United States
(Pitman, Liu, Bentow, Corash, Mufti, Varrone, Benjamin) Cerus Corporation,
1220 Concord Ave, Concord, CA 94520, United States
(Kaplan) Vitalant, Pittsburgh, PA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Red blood cell (RBC) transfusion is a critical supportive
therapy in cardiovascular surgery (CVS). Donor selection and testing have
reduced the risk of transfusion-transmitted infections; however, risks
remain from bacteria, emerging viruses, pathogens for which testing is not
performed and from residual donor leukocytes. Amustaline
(S-303)/glutathione (GSH) treatment pathogen reduction technology is
designed to inactivate a broad spectrum of infectious agents and
leukocytes in RBC concentrates. The ReCePI study is a Phase 3 clinical
trial designed to evaluate the efficacy and safety of pathogen-reduced
RBCs transfused for acute anemia in CVS compared to conventional RBCs, and
to assess the clinical significance of treatment-emergent RBC antibodies.
<br/>Method(s): ReCePI is a prospective, multicenter, randomized,
double-blinded, active-controlled, parallel-design, non-inferiority study.
Eligible subjects will be randomized up to 7 days before surgery to
receive either leukoreduced Test (pathogen reduced) or Control
(conventional) RBCs from surgery up to day 7 post-surgery. The primary
efficacy endpoint is the proportion of patients transfused with at least
one study transfusion with an acute kidney injury (AKI) diagnosis defined
as any increased serum creatinine (sCr) level >= 0.3 mg/dL (or 26.5
micromol/L) from pre-surgery baseline within 48 +/- 4 h of the end of
surgery. The primary safety endpoints are the proportion of patients with
any treatment-emergent adverse events (TEAEs) related to study RBC
transfusion through 28 days, and the proportion of patients with
treatment-emergent antibodies with confirmed specificity to
pathogen-reduced RBCs through 75 days after the last study transfusion.
With >= 292 evaluable, transfused patients (> 146 per arm), the study has
80% power to demonstrate non-inferiority, defined as a Test group AKI
incidence increase of no more than 50% of the Control group rate, assuming
a Control incidence of 30%. <br/>Discussion(s): RBCs are transfused to
prevent tissue hypoxia caused by surgery-induced bleeding and anemia. AKI
is a sensitive indicator of renal hypoxia and a novel endpoint for
assessing RBC efficacy. The ReCePI study is intended to demonstrate the
non-inferiority of pathogen-reduced RBCs to conventional RBCs in the
support of renal tissue oxygenation due to acute anemia and to
characterize the incidence of treatment-related antibodies to
RBCs.<br/>Copyright &#xa9; 2023, The Author(s).

<36>
Accession Number
2027007921
Title
Donor Heart Preservation: Current Knowledge and the New Era of Machine
Perfusion.
Source
International Journal of Molecular Sciences. 24(23) (no pagination), 2023.
Article Number: 16693. Date of Publication: December 2023.
Author
Kounatidis D.; Brozou V.; Anagnostopoulos D.; Pantos C.; Lourbopoulos A.;
Mourouzis I.
Institution
(Kounatidis, Brozou, Anagnostopoulos, Pantos, Lourbopoulos, Mourouzis)
Department of Pharmacology, National and Kapodistrian University of
Athens, Athens 11527, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Heart transplantation remains the conventional treatment in end-stage
heart failure, with static cold storage (SCS) being the standard technique
used for donor preservation. Nevertheless, prolonged cold ischemic storage
is associated with the increased risk of early graft dysfunction
attributed to residual ischemia, reperfusion, and rewarming damage. In
addition, the demand for the use of marginal grafts requires the
development of new methods for organ preservation and repair. In this
review, we focus on current knowledge and novel methods of donor
preservation in heart transplantation. Hypothermic or normothermic machine
perfusion may be a promising novel method of donor preservation based on
the administration of cardioprotective agents. Machine perfusion seems to
be comparable to cold cardioplegia regarding donor preservation and allows
potential repair treatments to be employed and the assessment of graft
function before implantation. It is also a promising platform for using
marginal organs and increasing donor pool. New pharmacological cardiac
repair treatments, as well as cardioprotective interventions have emerged
and could allow for the optimization of this modality, making it more
practical and cost-effective for the real world of transplantation.
Recently, the use of triiodothyronine during normothermic perfusion has
shown a favorable profile on cardiac function and microvascular
dysfunction, likely by suppressing pro-apoptotic signaling and increasing
the expression of cardioprotective molecules.<br/>Copyright &#xa9; 2023 by
the authors.

<37>
Accession Number
2019632272
Title
Preliminary Report from a Randomized Controlled Trial Comparing Two Bovine
Pericardial Valves.
Source
Thoracic and Cardiovascular Surgeon. 71(8) (pp 648-655), 2022. Date of
Publication: 28 Jan 2022.
Author
Sohn S.H.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University, Bundang Hospital, Seongnam, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background A randomized controlled trial was designed to compare 1-year
hemodynamic profiles and clinical outcomes after bioprosthetic aortic
valve replacement (AVR) using a recently introduced (study group) and
world-widely used (control group) bovine pericardial bioprostheses. This
study evaluated early postoperative outcomes as a preliminary analysis.
Methods The primary end point of the trial was the mean pressure gradient
across the aortic valve (AVMPG) at 1 year after surgery. Patients were
screened to enroll 70 patients in each group based on a noninferiority
design. Early postoperative hemodynamic and clinical outcomes were
compared between the two groups. Results There were no differences in
baseline characteristics, including sex and body surface area (1.64 +/-
0.18 vs. 1.65 +/- 0.15 m ²) between the two groups. The AVMPG
on early postoperative echocardiography was 15.2 +/- 4.6 mm Hg and 16.5
+/- 6.2 mm Hg in the study and control groups, respectively (p = 0.177).
Although AVMPG of the 19 mm prostheses was lower in the study group than
in the control group (17.0 +/- 6.3 mm Hg vs. 22.8 +/- 6.6 mm Hg, p =
0.039), there were no significant differences in the effective orifice
area in all patients (1.57 +/- 0.41 cm ²vs. 1.53 +/- 0.34 cm
², p = 0.568), and each valve size. The effective orifice area
index was also similar between the two groups in overall (p = 0.352), and
in each valve size. There were no significant differences in clinical
outcomes including operative mortality and postoperative complications
between the two groups. Conclusion Early postoperative hemodynamic and
clinical results after AVR using a recently introduced bovine pericardial
valve were comparable with those using the control valve
(NCT03796442).<br/>Copyright &#xa9; 2022 Georg Thieme Verlag. All rights
reserved.

<38>
Accession Number
642976686
Title
Mitral Valve Repair vs. Mitral Valve Replacement in Rheumatic Heart
Disease Patients: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ul Hassan O.; Yasmin F.; Moeed A.; Rahman S.U.U.; Jawed S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background Mitral valve repair (MVP) is recommended over mitral valve
replacement (MVR) for mitral valve disease. However, its benefits in
rheumatic heart disease (RHD) patients are unclear. We conducted this
meta-analysis to compare perioperative and long-term clinical and safety
outcomes of MVP vs. MVR. <br/>Method(s): MEDLINE, Google Scholar, and
Scopus were searched from inception till June 2023 comparing clinical
outcomes with MVP vs. MVR in RHD patients. Primary outcomes were early
mortality and long-term survival. Secondary outcomes were freedom from
reoperation, freedom from valve related adverse events, postoperative
infective endocarditis (IE), thromboembolic events (TEE), and hemorrhagic
events. The outcome measures were summary random effects risk ratio (RR)
and hazard ratios (HR) with 95% confidence intervals. <br/>Result(s): A
total of 19 studies with 10,724 RHD patients (3,495 MVP vs. 7,229 MVR;
mean age: 38.3 years for MVP vs. 43.5 years for MVR) were included. MVP
was associated with significantly lower early mortality (RR 0.62 [0.45,
0.85]; p=0.003), and long-term mortality (HR 0.53 [0.37, 0.76]; p=0.0006).
Upon meta-regression analysis, only increasing age was associated with
early mortality (Coeff: 0.0194, p=0.037). However, MVP was associated with
significantly lower freedom from reoperation at both 5- (RR 0.88 [0.83,
0.93]; p<0.0001) and 10-year (RR 0.90 [0.83, 0.98]; p=0.01) follow-ups.
Freedom from valve related adverse events was higher in the MVP group at
10-year follow-up (RR 1.15 [1.06, 1.24]; p=0.0006) with no significant
difference at 5-year follow-up (RR 1.03 [0.94, 1.14]; p=0.50). No
significant difference was seen for IE (RR 1.03, p=0.91) and hemorrhagic
events (RR 0.70, p=0.05). TEE were significantly lower in the MVP group
(RR 0.59 [0.44, 0.78]; p=0.0003). <br/>Conclusion(s): In RHD, MVP reduced
early- and long-term mortality and achieved greater freedom from valve
related adverse events. However, there was a higher risk of reoperation in
MVP. (Figure Presented).

<39>
Accession Number
642976387
Title
Mineralocorticoid Antagonist Use for Transthyretin Amyloid Cardiomyopathy
and Associated Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Stern L.K.; Kim S.K.; Singer-Englar T.; Kobashigawa J.A.; Kittleson M.M.;
Patel J.K.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Diuretics have been the mainstay of symptomatic treatment for
patients with amyloid cardiomyopathy however, there remains no established
guideline directed medical therapy for this population. The anti-fibrotic
properties of mineralocorticoid antagonists (MRA) are intriguing for
potential use in transthyretin amyloid cardiomyopathy (ATTR CM); while
they have shown promise for treatment of patients with heart failure with
preserved ejection fraction, their use has never been studied specifically
in the ATTR CM population. The purpose of our study is to evaluate the
real-world use of MRA and associated outcomes in patients with ATTR CM at
a large cardiac amyloid treatment center. <br/>Method(s): Between 2009 and
2023, 168 patients with ATTR CM at our center were assessed for history of
MRA use. Biomarkers, including baseline levels of troponin and natriuretic
peptides, as well as kidney function were assessed. We also assessed the
outcomes of 5-year survival, need for heart transplant, hospitalization,
and mechanical circulatory support (MCS) use. <br/>Result(s): Of the 168
patients, 49 (29%) had a history of MRA use and 119 (71%) had no prior
use. Between the two groups, there was no significant difference in age,
frequency of ATTR CM subtype, kidney disease, or biomarker level at the
time of diagnosis. While 5-year survival and need for MCS were similar
between the two groups, there was a higher rate of transplant and
hospitalization in the MRA use group. <br/>Conclusion(s): In a cohort of
patients with ATTR CM, MRA use is uncommon and was not associated with
improved outcomes. It was associated with higher rates of hospitalizations
and heart transplantation; however, this may represent confounding by
indication. Future investigations with larger registry cohorts and
randomized control trials are warranted for further evaluation of
biological and clinical effect of MRA use. .

<40>
Accession Number
642976267
Title
Outcomes From Left Atrial Appendage Occlusion Utilizing the Watchman FLX
versus Watchman 2.5: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Aldaas O.M.; Barat M.; Aldaas A.M.; Han F.; Hoffmayer K.S.; Krummen D.E.;
Ho G.; Raissi F.; Birgersdotter-Green U.; Reeves R.; Feld G.K.; Hsu J.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Left atrial appendage occlusion with the Watchman device has
been shown to be noninferior to oral anticoagulation in preventing strokes
in patients with atrial fibrillation. The Watchman FLX device was designed
to overcome many of the limitations of the Watchman 2.5. Hypothesis: The
Watchman FLX will have better short- and long-term safety and efficacy
relative to the Watchman 2.5. <br/>Method(s): We performed an extensive
literature search and systematic review of studies that compared the
short- and/or long-term safety and efficacy of the Watchman FLX versus
Watchman 2.5. Risk ratio 95% confidence intervals (CI) were measured using
the Mantel-Haenszel method for dichotomous variables, where a RR<1.0
favors the FLX group. <br/>Result(s): Seven studies with a total of 2315
patients were included, of which 24.0% (n=555) had the FLX and 76.0%
(n=1760) had the 2.5 implanted. There were no statistically significant
differences in procedural complications or device-related thrombosis, but
significantly less peri-device leak at follow-up, as shown in Figure 1.
There were no statistically significant differences in pericardial
effusion/tamponade (MD 0.54; 95% CI 0.09-3.25) or device embolization (MD
0.44; 95% CI 0.05-4.14). No statistically significant differences were
seen in major bleeding (MD 1.06; 95% CI 0.55-2.05), transient ischemic
attack, stroke or systemic embolism (MD 0.31; 95% CI 0.08-1.20) or
all-cause mortality (MD 1.65; 95% CI 0.76-3.57) at follow-up.
<br/>Conclusion(s): Based on the results of this meta-analysis, the
Watchman FLX appears to be as safe as the Watchman 2.5, but with lower
rates of peri-device leak.

<41>
Accession Number
642976243
Title
Robotic-Assisted versus Conventional Mitral Valve Repair: An Updated
Meta-Analysis of Operative and Post- Operative Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Elfaituri M.K.; Khaled A.; Ben Ghatnsh A.; Khaled T.; Faraj H.A.A.;
Msherghi A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Cardiac surgery has seen notable advancements, especially in
mitral valve repair, with the emergence of robotic-assisted mitral valve
repair (RAMVR). Amid ongoing debates about RAMVR's efficacy and safety
versus conventional mitral valve repair (CMVR), this updated meta-analysis
offers a comprehensive comparison based on recently published data.
<br/>Aim(s): The study aims to provide a comparison of RAMVR and CMVR,
focusing on key operative and postoperative outcomes. <br/>Method(s): A
systematic search was conducted utilizing databases such as PubMed,
EMBASE, and the Cochrane Library, until January 2023. The inclusion
criteria included studies that compared RAMVR with CMVR. The meta-analysis
incorporated a random-effects model to calculate pooled mean differences
(MD) and relative risks (RR). All statistical analyses were carried out
using R software (version 4.0.3), by metafor and meta packages.
<br/>Result(s): Ten studies with a total of 54,235 patients (5,092 in the
RAMVR group and 49,143 in the CMVR group) were included. The meta-analysis
showed that RAMVR was associated with a significantly shorter hospital
stay (MD -1.79 days; 95% CI -2.77 to -0.83, P=<0.01, I2=100%) and ICU
length of stay (MD -16.76 days; 95% CI -29.34 to -4.19, P=<0.01, I2=98%).
However, RAMVR was associated with significantly longer cardiopulmonary
bypass time (MD 42.90 minutes; 95% CI 29.58 to 56.22, P<0.01, I2=98%) and
cross-clamp time (MD 29.67 minutes; 95% CI 19.84 to 39.51, P<0.01,
I2=98%). In terms of relative risks, RAMVR had a lower rate of overall
mortality (RR 0.55; 95% CI 0.42 to 0.74, P<0.01, I2=0%) and rate of
infection (RR 0.62; 95% CI 0.52 to 0.74, P<0.01, I2=0%). However, there
was no statistically significant difference in the rate of blood
transfusion, stroke rate, atrial fibrillation, and transient ischemic
attack. <br/>Conclusion(s): This study suggests that RAMVR may offer
benefits such as shorter hospital and ICU stays and lower overall
mortality and infection rates, but it also involves longer cardiopulmonary
bypass and cross-clamp times. Given the high heterogeneity across the
included studies, this underlines the importance of further highquality
randomized controlled trials to optimize RAMVR techniques for improving
patient outcomes in mitral valve repair.

<42>
Accession Number
642976069
Title
Takotsubo Syndrome and Surgery: A Systematic Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Li P.; Dobbin T.; Cai P.; Shi A.; Liu Q.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Takotsubo syndrome (TTS) is a rare cardiovascular condition
characterized by reversible ventricular dysfunction. An increasing number
of studies have shown surgery as a trigger for TTS. <br/>Method(s): We
performed a systematic review of all case reports and case series
reporting an association between surgery and TTS by searching PubMed,
EMBASE, and Cochrane Library databases in June 2022. A total of 172 cases
(Surgery-TTS) were selected and compared with previously reported 1,750
TTS patients of any type (All-TTS). <br/>Result(s): In TTS patients
triggered by surgery, the most common symptom was dyspnea (48.6%),
followed by chest pain (31.8%) and dizziness (4.7%). The most common type
of TTS was apical, accounting for 80.4% of cases, followed by the basal
(8.2%), biventricular (5.1%), and midventricular (3.8%) types. Among these
cases, 46.5% were associated with intraabdominal procedures, 25% with
cardiothoracic surgery, followed by 12.3% with ENT/Ophthalmology and 8.7%
with neurosurgery. Compared with the All-TTS cohort, the Surgery-TTS
cohort was younger (55.9 vs 66.4, P < 0.001) and had a lower incidence of
chest pain (75.9% vs. 31.8%; P < 0.001) and QT prolongation (18.0% vs.
47.7%, P < 0.001) but a significantly increased in-hospital mortality
(10.4% vs 4.1%, P = 0.001). Furthermore, basal-type TTS was significantly
more common in the Surgery-TTS cohort than in the All-TTS cohort (8.2% vs.
2.2%, P < 0.001). <br/>Conclusion(s): Surgical triggers are associated
with increased mortality and atypical presentation in TTS patients when
compared with patients who have TTS of all types. A high degree of
clinical suspicion is required to concurrently diagnose TTS in surgical
patients.

<43>
Accession Number
642976011
Title
Revascularization Shows Beneficial Cardiovascular Outcomes in Severe
Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Fatima S.; Hurera A.; Rivera M.T.; Sezer A.; Hickey G.W.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Revascularization approach is historically prioritized over
optimal medical therapy (OMT) for patients with severe stable ischemic
cardiomyopathy (ICM) with ejection fraction < 35%. However, with
advancement in OMT, recent studies have shown similar cardiovascular
outcomes between the two strategies. Herein, we present a systematic
review and meta-analysis examining the cardiovascular outcomes of
revascularization strategies compared to OMT. Research Question: Is
revascularization associated with improved cardiovascular outcomes in
patients with severe stable ICM compared to OMT alone? Methods: PubMed,
Embase, Cochrane, CT.gov, ICTRP were searched using the search terms
coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI) versus OMT and ICM or heart failure (HF) from inception
till May 2023. Included studies compared all-cause mortality,
cardiovascular mortality, HF-related deaths, acute myocardial infarction
(AMI), stroke and HF hospitalization. Data were pooled into risk ratios
(RR) using fixed-effects model. <br/>Result(s): 3 studies (n= 2050,
Revascularization = 1026 and OMT= 1024) met our inclusion criteria. The
follow-up period ranged from 3.4-9.8 years. Revascularization strategies
primarily through CABG had protective effects for all-cause mortality (RR
0.91, 95% CI 0.84-0.98, p= 0.01, I2 0%, N= 3 studies), cardiovascular
death (RR 0.83, 95% CI 0.74-0.93, p=0.00, I2 0%, N= 2 studies) and HF
hospitalizations (RR 0.80, 95% CI 0.69-0.93, p= 0.00, I2 19.20%, N= 2
studies). No significant differences were observed in risks of HF related
deaths, AMI and stroke between the two strategies. <br/>Conclusion(s):
Revascularization primarily through CABG reduces all-cause and
cardiovascular mortality as well as HF hospitalizations in severe stable
ICM. Further studies are warranted to determine which patients can derive
the greatest advantages from revascularization.

<44>
Accession Number
642975783
Title
Lessons From Launching a Digital Health Trial for Hybrid Cardiac
Rehabilitation.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Kim C.H.; Nimbalkar M.; Isakadze N.; Gao Y.; MacFarlane Z.; Ding J.;
Broderick A.; Bush A.; Gallagher J.; Wiley B.; Lobien J.; Reddy T.; Aguado
C.; Benjamin P.; Neigh B.; Stewart K.J.; Mathews L.M.; Spaulding E.;
Martin S.S.; Marvel F.A.
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Despite the well-established benefits of cardiac
rehabilitation (CR) for secondary prevention of cardiovascular disease,
participation remains low due to limited supply and access barriers. We
built a hybrid CR program that combines in-person and home-based CR (with
smartphone app (Corrie Health), smartwatch, Bluetooth blood pressure
monitor, and health coaching delivered over 12 weeks). We assessed this
novel CR program in a pilot study at Johns Hopkins Hospital and applied
the lessons learned to launch a randomized controlled trial (mTECH REHAB;
NCT05238103) of hybrid versus traditional CR. <br/>METHOD(S): We examined
pilot data from Nov 2022 to Feb 2023 for electronic health record (EHR)
screening, bedside enrollment, technology onboarding, access to CR, and
weekly health coaching. We identified barriers in the enrollment process
which we then used to guide trial design and team organization.
<br/>RESULT(S): EHR screening yielded 1,270 candidates, among which 209
(16.5%) were eligible following chart review. Our team approached 106
(50.7%) at bedside and 20 (9.6%) were enrolled into the pilot study. Ten
(50.0%) were lost to follow up, with reasons of: loss of interest (3),
post-procedural complication (3), frailty requiring acute CR (1), no
insurance coverage (1), follow up in external CR (1), and technology
challenges (1). These findings informed trial design as follows: 1)
pre-specified filters for cardiovascular procedures/surgeries were added
to EHR screening; 2) remote enrollment pathway was added; 3) a 2-week
run-in period was added to verify insurance and continued interest
following hospital discharge; and 4) standardized workflows and
specialized teams were developed for patient recruitment, technology
onboarding, and health coaching. The mTECH REHAB trial was launched in Apr
2023. In the first 9 weeks, 851 patients were screened, 157 (18.4%) were
eligible, 148 (94.2%) were able to be reached at bedside or via telephone,
41 (27.7%; 16 bedside, 25 remote) were enrolled, and 5 (12.2%) were lost
to early follow up because of: loss of interest (3), post-procedural
complication (1), and patient relocation (1). <br/>CONCLUSION(S): A pilot
study can inform and improve the enrollment process in a multi-component
digital health trial.

<45>
Accession Number
642975597
Title
Prothrombin Complex Concentrate is Superior to Fresh Frozen Plasma for the
Management of Bleeding in Patients Undergoing Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Viana P.; Relvas J.H.; Persson M.Z.; Dias Delfino Cabral T.; De Oliveira
J.S.; Persson J.E.Z.; Bonow P.A.; Freire C.V.S.; Velasquez C.; Amaral S.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Prothrombin Complex Concentrate (PCC) and Fresh Frozen
Plasma (FFP) are commonly used for management of bleeding in cardiac
surgery patients. However, the relative efficacy and safety of these two
strategies remain uncertain. Hypothesis: We conducted a meta-analysis to
compare outcomes of PCC vs. FFP in patients who undergo cardiac surgery
complicated by bleeding. <br/>Method(s): PubMed, Embase, and Cochrane were
searched for studies comparing PCC vs. FFP in patients who have cardiac
surgery complicated by bleeding. Review Manager 5.4 was used for
statistical analysis. Binary and continuous outcomes were compared with
pooled odds-ratio and mean differences, respectively. The metaanalysis
protocol was registered prospectively in PROSPERO. <br/>Result(s): We
included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC.
The mean follow-up period ranged from 28-90 days. The PCC group had
significantly lower chest tube drainage at 24 hours (MD -148.50 mL; 95% CI
-253.02 to -43.99 mL; p = 0.005; I²= 42%; Figure 1A). Also,
there were fewer units of RBC transfusion within the first 24 hours (MD
-1.02 units; 95% CI -1.81 to -0.24 units; p = 0.01; I²= 56%;
Figure 1B) and fewer patients requiring RBC transfusion within the first
24 hours (OR 0.38; 95% CI 0.28-0.52; p < 0.001; I²= 3%) in the
PCC group. There was no significant difference between groups in all-cause
mortality, thromboembolic events, stroke, or length of hospital stay. A
subgroup analysis restricted to RCTs showed a significant reduction in the
number of patients requiring RBC transfusion within 24 hours with PCC
relative to FFP (OR 0.51; 95% CI 0.27-0.95; p = 0.04; I²= 0%).
<br/>Conclusion(s): These findings suggest that PCC is an effective
strategy compared with FFP in reducing chest tube drainage and the need
for RBC transfusion within the first 24 hours in patients who undergo
cardiac surgery complicated by bleeding, without a significant difference
in mortality or thromboembolic events between groups. (Figure Presented).

<46>
Accession Number
642975576
Title
Does Mineralocorticoid Receptor Blockade Affect the Occurrence of
Perioperative Atrial Fibrillation in Cardiac Surgery Patients? - A
Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Rajak K.; Halder A.; Ghimire M.; Gautam S.S.; Khanal R.; Jaiswal V.;
Atrash A.; Goswami R.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mineralocorticoid receptor antagonists (MRAs) have emerged as
potential therapy to prevent atrial fibrillation (AF). However,
inconsistent results of MRAs effect on perioperative AF have been reported
in the literature in patients undergoing cardiac surgery. To our
knowledge, this is the first metanalysis to assess the effect of MRAs on
occurrence of perioperative AF in patients undergoing cardiac surgery.
<br/>Method(s): We searched different electronic databases from inception
to April 30th, 2023, for randomized controlled trials (RCTs) and
observational studies that evaluated the use of MRAs in patients with
heart failure and left ventricular ejection fraction (LVEF) 30-50% who
were referred for Coronary Artery Bypass Grafting (CABG) and/or valve
surgery without any AF history. Primary outcome was occurrence of
perioperative AF. Three independent reviewers selected and appraised the
data. A random-effects metaanalysis was performed to estimate pooled odds
ratios (OR) and 95% confidence intervals (CI). <br/>Result(s): We included
4 studies, 1 RCT and 3 observational cohorts, with a cumulative number of
1,128 patients with mean age 65.15 years. 412(36.5%) received an MRA
(spironolactone or eplerenone). The follow up duration was 5 days to 1
month. During follow-up, 118 (28.64%) patients treated with MRAs,
developed AF, compared to 224 (31.28%) patients, without MRA treatment.
However, metanalysis showed that there is no significant reduction in
occurrence of perioperative AF in MRA treated patients (OR: 0.88 CI:
0.58-1.33 p=0.55), I2 53%; Figure] <br/>Conclusion(s): Experimental data
have shown that MRA blockade prevents perioperative AF in animal models
but our metanalysis demonstrated that MRAs were not protective for
perioperative AF in patients undergoing cardiac surgery. Larger trials in
humans are warranted to evaluate its efficacy, particularly in patients
undergoing cardiac surgery.

<47>
Accession Number
642975555
Title
Patient Reported Outcomes Measures Are Infrequently Used in Clinical
Studies of Heart Transplant Recipients.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Austin M.A.; Reza N.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction / Background: The goals of heart transplantation (HT) are to
improve symptoms, restore quality of life, and extend survival. Clinical
trials in HT recipients have largely focused on objective outcomes such as
measures of cardiac function and survival; however, a paucity of data
exists regarding the use of patient reported outcome measures (PROMs) as
outcomes in these studies. <br/>Aim(s): We aimed to characterize the use
of PROMs in registered clinical trials of HT recipients. <br/>Method(s):
All clinical studies of adult HT recipients were queried from
ClinicalTrials.gov, and studies were stratified by inclusion of PROMs.
Studies reporting PROMs were identified via specific search terms using
the "outcomes measures" field. Summary statistics compared characteristics
of studies that did versus did not report PROMs. Results/Data: Between
November 1999 and August 2022, 227 studies of HT recipients were
registered on ClinicalTrials.gov. At least one PROM was reported in 11%
(n=24/227) of registered studies. Studies reporting PROMs were more likely
to be conducted outside of the United States (91.7% vs 54.2%, p<0.001) and
report a greater number of total primary/secondary outcomes (PROMs: median
7 [IQR: 4, 9] vs. No PROMs: median 3 [IQR: 2, 6]; p<0.001). The majority
of studies reporting PROMs (58.3%) were initiated after 2020. Twenty-one
distinct PROM tools/domains were reported as outcome measures, with the
Short Form Health Survey 36 being most frequently used (n=10/24). Thirteen
of the 21 PROMs included questions assessing mental health, whereas only
three PROM tools were cardiac-specific (Figure). <br/>Conclusion(s): Only
about one in ten registered clinical trials of HT recipients include
PROMs, and mental health was the most commonly assessed domain when a PROM
was included. Development and validation of PROM tools is needed to assess
the multifaceted nature of health-related quality of life in HT
recipients. (Figure Presented).

<48>
Accession Number
642975512
Title
Role of Elevated High-Sensitivity Cardiac Troponin T in Determining the
Clinical and Angiographic Outcomes in Patients With Chronic Total
Occlusion Undergoing Percutaneous Intervention: A Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Damarlapally N.; Sawhney A.; Verma J.; Klair H.S.S.; Kolli D.; Sibia B.S.;
Chalasani V.; Reddy R.; Teja Kolli J.; Desai R.; Sachdeva R.; Kumar G.;
Paul T.K.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Percutaneous Coronary Intervention of Chronic Total Occlusion
(CTO-PCI) leads to higher periprocedural myocardial injury (PMI); however,
the prognostic value of high-sensitive-Cardiac Troponin T (Hs-cTnT) in
CTO-PCI outcomes is not well studied. This review evaluated the
association of Hs-cTnT with major adverse cardiovascular events (MACE)
following CTO-PCI. <br/>Method(s): We conducted a thorough literature
search in PubMed, Scopus, Embase, and Google Scholar, using relevant
keywords, to identify studies up to 2022. The primary outcome of interest
was MACE, which included all-cause mortality, PMI, target vessel
revascularization (TVR), and target vessel reocclusion (TVRO). Pooled odds
ratios (OR) and 95% confidence intervals (CI) were estimated using binary
random-effects models. Heterogeneity was assessed using I statistics.
<br/>Result(s): Our analysis included four studies investigating 1499
post-CTO-PCI patients (mean age 66.77+/-10.09 years, 81.5% male). Patients
with multivessel disease, retrograde approach, and previous PCI or
coronary artery bypass graft procedures were more likely to present with
elevated Hs-cTnT levels due to the complexity of the procedure. No
difference in baseline comorbidities was noted in patients with and
without elevated Hs-cTnT, including diabetes and hypertension. There was
no significant association between Hs-cTnT levels and MACE (OR:1.56
p=0.25), TVR (OR:2.03, p=0.22), PMI (OR:3.45, p=0.07), and mortality
(OR:2.35, p=0.14) (Figure 1). However, a significant association was found
between HscTnT levels and TVRO [OR:8.78 (95% C.I. 3.64-21.17) p<0.01, I2
0%]. <br/>Conclusion(s): Patients with elevated Hs-cTnT levels have a
nine-fold higher risk of TVRO than those with normal levels in CTO-PCI.
Periprocedural Hs-cTnT measurement can be utilized for risk stratification
of TVRO after CTO-PCI with no association with MACE. Overall smaller
sample size warrants more randomized studies to substantiate the results.

<49>
Accession Number
642975415
Title
Inflammation and Cholesterol as Predictors of Cardiovascular Events and
Risk Reduction With Bempedoic Acid Among Statin Intolerant Patients: An
Analysis of the CLEAR Outcomes Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ridker P.M.; Lei L.; Louie M.J.; Haddad T.M.; Nicholls S.J.; Lincoff A.M.;
Libby P.; Nissen S.E.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Among contemporary statin-treated patients, residual
inflammatory risk assessed by high-sensitivity C-reactive protein (hsCRP)
is a stronger predictor of future cardiovascular (CV) events and all-cause
mortality than residual cholesterol risk assessed by low density
lipoprotein cholesterol (LDLC). Whether these relationships are present
among statin-intolerant patients is unknown but has implications for the
choice of preventive therapies including bempedoic acid, an agent that
reduces both LDLC and hsCRP. <br/>Method(s): In the multi-national
CLEAR-Outcomes trial, 13,970 statin-intolerant patients were randomly
allocated 1:1 to 180 mg oral bempedoic acid daily or matching placebo and
followed for incident myocardial infarction (MI), stroke, coronary
revascularization, CV death, and all-cause mortality. Quartiles of
increasing baseline hsCRP and LDLC were assessed as predictors of future
adverse CV events after adjustment for traditional risk factors and
treatment (bempedoic acid vs. placebo). <br/>Result(s): Baseline hsCRP was
significantly associated with incident composite endpoint of MI, stroke,
coronary revascularization, and CV death (highest vs lowest hsCRP
quartile, HR=1.43, 95% CI 1.24- 1.65), CV mortality (HR=2.00, 95% CI
1.53-2.61), and all-cause mortality (HR=2.21, 95% CI 1.79- 2.73). By
contrast, the relationship of baseline LDLC quartile (highest vs. lowest)
to future CV events was smaller for the composite endpoint (HR=1.19, 95%
CI 1.04-1.37) and neutral for CV mortality (HR 0.90, 95% CI 0.70-1.17) and
all-cause mortality (HR 0.95, 95% CI 0.78-1.16) such that risks were high
for those with elevated hsCRP irrespective of LDLC level. Compared to
placebo, bempedoic acid reduced median hsCRP by 21.6% and mean LDLC levels
by 21.1% at 6 months and demonstrated similar efficacy in reducing major
adverse CV events across all levels of hsCRP and LDLC.
<br/>Interpretation(s): Among contemporary statin-intolerant patients,
inflammation assessed by hsCRP was a stronger predictor of risk for future
CV events and death than was hyperlipidemia assessed by LDLC. Compared to
placebo, bempedoic acid had similar efficacy for reducing CV risk across
hsCRP and LDLC strata.

<50>
Accession Number
642975368
Title
Efficacy and Safety of Bempedoic Acid for Prevention of Cardiovascular
Events and Diabetes Mellitus: A Systematic Review and Meta-Analysis of
Randomized Control Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Yasmin F.; Najeeb H.; Moeed A.; Ali E.; Ur U Rahman S.; Khan M.S.; Shah
N.; Michos E.D.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Bempedoic acid (BA) is considered an alternative therapy for
hyperlipidemia (HLD) in statin-intolerant patients. Given the positive
results from the CLEAR-OUTCOMES trial, we performed a meta-analysis
pooling recently conducted randomized control trials (RCTs) to provide a
comprehensive clinical evaluation of the safety and efficacy of BA.
Hypothesis: Bempedoic acid therapy in HLD patients with statin intolerance
may be associated with a significant reduction in LDL-C levels, and CV
events. <br/>Method(s): All RCTs reporting CV outcomes and/or % change in
LDL-C from baseline till completion of follow-up duration in HLD patients
with statin-intolerance were included in MEDLINE, Google Scholar, and
Scopus databases (Inception to April 2023). The outcome measures were
summary random effects risk ratio (RR) and mean differences (MD) with 95%
confidence intervals. <br/>Result(s): Twelve RCTs were included with 18
510 patients (10,033 BA vs. 8,477 placebo). BA therapy resulted in greater
significant % reduction in LDL-C levels post-treatment (mean difference
from baseline: 21.73% [-26.94, -16.51], p<0.00001) with no significant
impact of the male sex, age, and follow-up duration on LDL-C upon
meta-regression analysis. The risk of MACE (RR, 0.86 [0.79, 0.93], p <
0.0004), coronary artery revascularization (RR, 0.81 [0.72, 0.91], p =
0.0005), and myocardial infarction (RR, 0.71 [0.51, 0.99], p= 0.04) were
significantly reduced with BA (Figure 1). However, no significant
reduction in cardiac death (RR, 1.05 [0.89, 1.24], p = 0.56) was observed.
A total of 1,019 new-onset DM events (521/6027 with BA; 498/4946 with
placebo) were reported, and demonstrated a non-significant lower risk of
new-onset or worsening DM (RR 0.83; 95% CI [0.62, 1.13]; P = 0.24) with BA
vs. placebo. <br/>Conclusion(s): BA was observed to be safe, efficacious,
associated with improved cardiovascular outcomes, and with no effect on
new-onset or worsening DM among HLD patients with statin intolerance.
(Figure Presented).

<51>
Accession Number
642975199
Title
Long-Term Outcomes of Prosthesis-Patient Mismatch After Surgical Aortic
Valve Replacement: Meta- Analysis of Kaplan-Meier-Derived Individual
Patient Data.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sa M.P.; Jacquemyn X.; Van Den Eynde J.; Chu D.; Serna-Gallegos D.; Ebels
T.; Clavel M.-A.; Pibarot P.; Sultan I.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction - It remains controversial whether prosthesis-patient
mismatch (PPM) impacts long-term outcomes after surgical aortic valve
replacement (SAVR). Hypothesis - PPM is associated with poor outcomes
after SAVR. Methods - Study-level meta-analysis of reconstructed
time-to-event data from Kaplan-Meier curves of studies published by March
2023. Results - Sixty-five studies met our eligibility criteria and
included 122,989 patients (any PPM: 68,332 patients, 55.6%). At 25 years
of follow-up, the survival rates were 11.8% and 20.6% in patients with and
without any PPM, respectively (HR 1.16; 95%CI 1.13-1.18, p<0.001). At 20
years of follow-up, the survival rates were 19.5%, 12.1 and 8.8% in
patients with no, moderate and severe, respectively (moderate vs no PPM:
HR 1.09; 95%CI 1.06-1.11; p<0.001; severe vs no PPM: HR 1.29; 95%CI 1.24-
1.35; p<0.001). RMST was 0.8 years shorter in patients with moderate PPM,
and 2.1 years shorter in patients with severe PPM in comparison with
patients without PPM (10.2 years and 8.9 years vs. 11.0 years
respectively, p<0.001). PPM was associated with higher risk of cardiac
death, HF-related hospitalizations and aortic valves reinterventions over
time (p<0.001). Statistically significant associations between PPM and
worse survival were observed regardless of type of valves (bioprosthetic
vs mechanical valves), contemporary PPM definitions unadjusted and
adjusted to body mass index and PPM quantification method (in vitro, in
vivo, Doppler echocardiography). Our metaregression analysis revealed that
populations with more women tend to have higher HRs for all-cause death
associated with PPM. Conclusions - The results of the present study
suggest that any degree of PPM is associated with poorer long-term
outcomes following SAVR and provide support for implementation of
preventive strategies to avoid PPM after SAVR. (Figure Presented).

<52>
Accession Number
642974973
Title
Outcomes of Leadless Pacemaker Implantation Following Transvenous Lead
Removal of Infected Cardiac Implantable Electronic Device: A Systematic
Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Tan M.C.; Tan J.L.; Tay S.T.; Sorajja D.; Scott L.; Cha Y.-M.; Russo A.M.;
Hussein A.; Lee J.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The outcomes of leadless pacemaker (LP) implantation after
transvenous lead removal (TLR) of infected cardiac implantable electronic
devices (CIED) are not well-established. <br/>Objective(s): This study
sought to describe the outcomes of LP implantation following TLR of
infected CIED. <br/>Method(s): We conducted a literature search using
PubMed and Embase for a combination of term including leadless pacemaker
implantation, transvenous lead extraction, transvenous lead removal,
transvenous lead explant, infected cardiac implantable electronic device.
The inclusion criterion was LP implantation after TLR of infected CIED.
The exclusion criterion was TLR for non-infectious reason. Study
end-points were procedural complications and LP infection. <br/>Result(s):
Of 132 publications reviewed, 13 studies with a total of 253 patients (74
+/- 14 years of age, 69% males) were included. Amongst, 56.8% had systemic
CIED infection and 43.2% had isolated pocket infection. Staphylococcus
Aureus was the most common causative organism in 33% of the reported
patients. Of 253 patients included, 105 patients (41.5%) underwent
concomitant LP implantation during TLR procedure, and 36 patients (14.2%)
had transvenous pacing as a bridge from TLR to LP implantation. During the
LP implantation, 1 patient (0.4%) had an intra-procedural complication
requiring sternotomy. Post-LP implantation, 2 patients (0.8%) developed
groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula,
and 1 patient (0.4%) developed pericardial effusion requiring
pericardiocentesis. During a mean follow-up of 11.3 +/-10.6 months, 3
patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed
acute on chronic heart failure exacerbation, and only 1 patient (0.4%)
developed LP-related infection requiring LP retrieval. <br/>Conclusion(s):
This study suggests that LP implant is feasible and safe post-removal of
infected CIED with cumulative adverse events at 4% and a reinfection rate
of 0.4%.

<53>
Accession Number
642974967
Title
Mid-Term Survival of Low-Risk Patients Treated With Transcatheter versus
Surgical Aortic Valve Replacement: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sa M.P.; Jacquemyn X.; Van Den Eynde J.; Serna-Gallegos D.; Chu D.; Clavel
M.-A.; Pibarot P.; Sultan I.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We performed a meta-analysis of reconstructed time-to-event
data from randomized controlled trials (RCTs) and propensity-score matched
(PSM) studies comparing transcatheter versus surgical aortic valve
replacement (TAVR versus SAVR) to evaluate mid-term outcomes in patients
considered low risk for SAVR. <br/>Methods and Results: Study-level
meta-analysis of Kaplan-Meier-derived time-to-event of RCTs and PSM
studies published by December 31, 2022. Eight studies (3 RCTs; 5 PSM
studies) met our eligibility criteria and included 5,444 patients (2,639
patients underwent TAVR and 2,805 patients underwent SAVR). TAVR showed a
higher risk of all-cause mortality at 8 years of follow-up [hazard ratio
(HR) 1.22, 95% confidence interval (CI) 1.03-1.43, P=0.018]. Up to 2 years
of follow-up, TAVR was not inferior to SAVR (HR 1.08, 95%CI 0.89-1.31,
P=0.448); however, we observed a statistically significant difference
after 2 years with higher mortality with TAVR (HR 1.51; 95% CI 1.14-2.00;
P=0.004). This difference was driven by PSM studies; our sensitivity
analysis showed a statistically significant difference between TAVR and
SAVR when we included only PSM studies (HR 1.41, 95%CI 1.16-1.72,
P=0.001), but no statistically significant difference when we included
only RCTs (HR 0.89, 95%CI 0.69-1.16, P=0.398). At 8 years of follow-up
after the primary intervention, the treatment difference in restricted
mean survival time (RMST) is statistically significant, resulting in a
benefit of 187.2 days (95% CI, 85.1-289.2, P<0.001) in the SAVR arm.
<br/>Conclusion(s): In comparison with TAVR, SAVR appeared to be
associated with improved survival beyond 2 years in low-risk patients.
However, the survival benefit of SAVR was only observed in PSM studies and
not in RCTs. The addition of data from ongoing RCTs as well as longer
follow-up in previous RCTs will help to confirm if there is a difference
in mid- and long-term survival between TAVR vs. SAVR in low-risk
population. (Figure Presented).

<54>
Accession Number
642974927
Title
Safety and Efficacy of Left Atrial Appendage Occlusion in Patients With
Chronic Kidney Disease: A MetaAnalysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Chia T.H.; Iglesias J.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Left atrial appendage occlusion (LAAO) has been recognized
as an alternative to preventing thromboembolic stroke in selected patients
with non-valvular atrial fibrillation (AF). However, limited evidence
exists regarding the safety of LAAO in patients with chronic kidney
disease (CKD). This meta-analysis aims to evaluate the safety and efficacy
of LAAO in CKD patients. <br/>Method(s): We conducted a comprehensive
search across various electronic databases, including PubMed, Embase, and
the Cochrane Library, to identify relevant studies comparing the outcomes
of CKD and non-CKD patients undergoing LAAO. The outcomes of interest
included procedural success, inhospital mortality, major bleeding, stroke,
transient ischemic attack (TIA), and pericardial effusion/tamponade. The
outcomes were pooled using the Hartung-Knapp-Sidik-Jonkman random-effects
model, and the results were expressed as odds ratios (OR) with their
corresponding 95% confidence intervals (CI). <br/>Result(s): Seven studies
involving 38,184 patients (5,742 CKD, 32,442 non-CKD) were included in the
final analysis. The rate of procedural success (98.4% vs. 97.2%, OR 1.64,
95% CI: 0.78-3.45, p=0.19) was similar between both groups. Regarding
procedural complications, there were no significant differences in terms
of the risk of in-hospital mortality (OR 1.87, 95% CI: 0.60-5.82, p=0.28),
stroke (OR 2.19, 95% CI: 0.76-6.29, p=0.15), TIA (OR 1.64, 95% CI:
0.78-3.45, p=0.19), major bleeding (OR 1.85, 95% CI: 0.78-4.42, p=0.16),
or pericardial effusion/tamponade (OR 1.23, 95% CI: 0.76-2.00, p=0.39)
between the two patient groups. <br/>Conclusion(s): Our study demonstrates
comparable safety and efficacy of LAAO in patients with CKD compared to
those without CKD. Further large prospective studies are warranted to
confirm these findings.

<55>
Accession Number
642974910
Title
Changes in Triglyceride Levels During Omega-3 Fatty Acid Supplementation,
and Incident Cardiovascular Events: Secondary Analysis From the OMEMI
Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Myhre P.L.; Kalstad A.; Tveit S.H.; Laake K.; Nilsen D.; Tveit A.; Solheim
S.; Seljeflot I.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Elevated triglyceride levels are associated with increased
cardiovascular risk. Omega-3 polyunsaturated fatty acids (n-3PUFA) are
known to reduce triglyceride levels, but whether changes in triglycerides
mediate any cardiovascular effects of n-3PUFA, remains unclear.
<br/>Method(s): In the randomized controlled OMEMI trial, 1014 elderly
(70-82 years) patients with a recent acute myocardial infarction (AMI)
were treated with 1.8 g/day of eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) or placebo (corn oil) for two years, and
followed for the primary outcome of MACE (AMI, coronary revascularization,
stroke, heart failure hospitalization or all-cause death). Relative
changes in triglycerides from baseline to 3 months (n=920, 91%), were
associated with incident MACE (N=175) using landmark Cox regression
models. <br/>Result(s): The median (Q1-Q3) baseline triglyceride
concentration was 97 (74-135) mg/dL, and higher levels were associated
with higher BMI, diabetes and heart failure, in multivariable models.
After 3 months of treatment, triglycerides decreased by median -10% and 0%
in the n-3PUFA and placebo groups, respectively, followed by relatively
stable levels at 12 and 24 months (Figure). Greater triglyceride
reductions at 3-months were associated with a lower risk of MACE in the
n-3PUFA group (HR 1.98 [95%CI 1.23-3.17] per doubling, p=0.004; Figure),
and this persisted after adjusting for baseline triglycerides, age, sex,
BMI and comorbidities (HR 2.34 [1.37-3.98], p=0.002). Changes in
triglycerides did not associate with MACE in the placebo group (HR 1.13
[0.63-2.02], p=0.68). <br/>Conclusion(s): Treatment with 1.8 g/day of
EPA/DHA modestly reduced triglyceride levels and greater ontreatment
triglyceride-reductions were associated with a lower risk of MACE.
Although the overall OMEMItrial was neutral, these findings suggest that
n-3PUFA-related triglyceride changes may play a role with respect to
cardiovascular outcomes. .

<56>
Accession Number
642974811
Title
Associations Among Self-Reported and Physiologic Sleep Measurements and
Fatigue in Adults Following Major Cardiac Events.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Forster A.; Alwine J.; Wierenga K.L.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Insufficient sleep contributes to fatigue and cardiometabolic
disorders. Current sleep measures vary in accuracy, with weak correlations
between self-report and physiologic measures. Developing reliably
associated self-report and physiologic sleep measures can optimize data
collection methods. <br/>Purpose(s): Investigate correlations between
self-reported and physiologic sleep measures in cardiac rehabilitation
patients and determine associations with fatigue. <br/>Method(s):
Participants (N = 25, 58% male, 89% non-Hispanic white, mean age = 61
years) recruited from cardiac rehabilitation centers participated in a
three-arm RCT. Inclusion criteria were experiencing a myocardial
infarction or revascularization procedure, enrollment in cardiac
rehabilitation, and experiencing depression or anxiety. Participants
without complete sleep measures were excluded. Data was collected at
baseline, 3-, and 6-months. Sleep was measured over 8 days with an
investigator-developed self-report diary and an ActiGraph GT9X Link
accelerometer. ActiGraphs collected data with a 30Hz sampling rate and
were scored using the autodetected sleep periods to determine total sleep
time. Mean daily minutes of sleep were calculated from self-report and
ActiGraph data. Participants also completed a demographics survey and
Fatigue Severity Scale. Statistical methods included Pearson correlation
coefficients with 95% confidence intervals (CI) estimated with Fisher's
r-to-z transformation. <br/>Result(s): Results showed self-reported and
ActiGraph measured sleep were highly correlated (r = 0.889, [95% CI 0.812,
0.935], p < 0.001). Fatigue was not correlated with self-reported (r =
0.074, [95% CI -0.206, 0.342] p = 0.607) or ActiGraph measured sleep (r =
0.150, [95% CI -0.131, 0.408] p = 0.295). Even though the finding was
non-significant, the correlation between fatigue and ActiGraph measured
sleep was larger than self-reported sleep. <br/>Conclusion(s): Accurate
sleep measures are essential to inform future research and interventions.
Unlike past work, this investigator-developed, self-report measure was
strongly correlated with the physiologic measure. Researchers should
consider reliability when selecting sleep measures.

<57>
Accession Number
642974744
Title
The Effect of Sacubitril/Valsartan Therapy on Hospitalization and
Mortality in Patients Non-Respondent to Cardiac Resynchronization Therapy.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Szabo K.M.; Toth A.Z.; Racz V.; Nagy A.C.; Barta J.; Borbely A.; Csanadi
Z.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Non-responders to Cardiac Resynchronization Therapy (CRT-NR)
have poor prognosis. Sacubitril/valsartan (SV) treatment improved the
outcomes of heart failure patients with reduced left ventricular (LV)
ejection fraction (HFrEF) in randomized trials; however, limited data are
available on the specific cohort of CRT-NRs. Aim of the study: We have
compared heart failure hospitalization (HFH) and mortality rates in three
patient cohorts: CRT-NR patients on S/V versus on ACEi/ARB and general
HFrEF patients on S/V. <br/>Method(s): 275 HF patients, including 70
CRT-NRs receiving S/V at least for 6 months (Group I); 70 CRT-NRs on
ACEi/ARB treatment (Group II); and 135 HFrEF patients without CRT
indication on S/V therapy at least for 6 months (Group III) were included.
CRT-NR was defined as a less than 10% improvement in left ventricular
ejection fraction (LVEF) 6 months after device implantation. Rates of HFH
and the composite of all-cause mortality/heart transplantation/LVAD
therapy were compared with a mean follow-up of 21.5 months. A subgroup
analysis was also performed in patients on S/V (Groups I and III) who
demonstrated a more versus less than 10% increase in LVEF after 6 months
of S/V treatment (S/V super-responders versus S/V moderate responders,
respectively). <br/>Result(s): HFH rates were similar in Groups I and III
(28.5% vs. 28.1%, respectively; p>0.05), while significantly higher
(54.2%) in Group II (p=0.02). No significant difference in the composite
mortality endpoint was demonstrated between the three groups (22.8% vs.
24.2% vs. 22.2%, p=0.08). On S/V treatment, 13 out of the 70 (18.5%)
CRT-NR patients (Group I) and 24 out of the 135 (17.8%) HFrEF patients
(Group III) were found to be SV super-responders. Comparing these 37
patients with the 168 S/V moderate responders, neither the HFH (24.3% vs
30.9%, p=0.07), nor the composite mortality rates (24.3% vs 23.2%, p=0.53)
demonstrated significant differences. <br/>Conclusion(s): S/V treatment in
CRT-NRs improved hospitalization rates similarly to what was observed in a
general HFrEF population. No benefit in mortality rates was demonstrated
in this cohort. The extent of change in LVEF on S/V was not predictive of
a better response on HFH or mortality.

<58>
Accession Number
642974724
Title
Long-Term Risk of Stroke After Coronary Artery Bypass Surgery With Carotid
Revascularization: A Randomized Controlled Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Knipp S.C.; Holst H.T.T.; Bilbilis K.; Kamler M.; Weimar C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: In patients with carotid artery stenosis, combined coronary
and carotid surgery has been widely used despite lack of evidence from
randomized trials. Moreover, there are no data on long-term outcome
following carotid revascularization versus best medical treatment.
Hypothesis: May simultaneous coronary artery bypass grafting (CABG) and
carotid endarterectomy (CEA) prevent the long-term risk of stroke?
Methods: In the Coronary Artery Bypass graft surgery in patients with
Asymptomatic Carotid Stenosis (CABACS) trial, patients with coronary
disease and high-grade carotid stenosis (NASCET >=70%) were randomized to
receive combined simultaneous CABG+CEA or CABG alone. Primary endpoint was
the composite rate of non-fatal stroke or death within 30 days after
surgery, with both treatments assumed to be equally safe and efficacious.
Secondary endpoints included any stroke, stroke or vascular death and
death of any cause, and follow-up was five years. While our previous
report focused on primary outcome, here we evaluate the long-term results
of the trial. <br/>Result(s): The trial was terminated prematurely after
recruitment of 129 patients in 17 centers in Germany and the Czech
Republic. The rate of stroke or death at 30 days was not significantly
different following combined CABG+CEA and CABG alone (18.5% (95%
confidence interval [95% CI]: 0.099-0.300) versus 9.7% (95% CI:
0.036-0.199), p=0.203). By 5 years, stroke or death rate was 40.6% (95%
CI: 0.285-0.536) following CABG+CEA and 35.0% (95% CI: 0.231-0.484)
following CABG alone (p=0.581). Strokes of any kind tended to occur more
frequently after CABG+CEA (5 years: 29.4% vs. 18.8%, p=0.245), while death
rate was similar in both treatment arms (25.4% vs 23.3% (p=0.837).
Subgroup analysis revealed no significant effect of center on outcomes.
<br/>Conclusion(s): Long-term risk of stroke or death was higher after
combined CABG+CEA, mainly due to increased perioperative event rates.
Because of minor power, further trials are warranted to confirm our
results.

<59>
Accession Number
642974707
Title
Lipoprotein (a) as a Predictor of Recurrent Myocardial Infarction/Coronary
Revascularization in Patients With Acute Coronary Syndrome Who Underwent
PCI: A Meta- Analysis of Observational Studies.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Singh S.; Singh D.; Srikanth S.; Subramanian L.; Bhanushali A.K.; Suchday
P.; Guddeti A.V.; Naseem H.; Shenoy A.; Puli S.; Desai R.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Lipoprotein (a) [Lp(a)] has been recognized as an
independent predictor of atherosclerotic cardiovascular disease (ASCVD).
However, there is limited data on the association between Lp(a) levels and
risk of recurrent myocardial infarction (MI)/coronary revascularization in
patients with acute coronary syndrome (ACS) who underwent percutaneous
coronary intervention (PCI). <br/>Method(s): PubMed/Medline, EMBASE, and
Scopus were searched for studies evaluating the association of Lp(a) with
recurrent ischemic events from the year 2000-2023. Patients with coronary
artery disease or ACS with baseline Lp(a) who underwent PCI or coronary
stenting and had outcomes as recurrent MI/ coronary revascularization were
included. Random effects models and I statistics were used for pooled
hazard ratios (HR), odds ratio (OR), and heterogeneity assessment. A
leaveone- out sensitivity analysis was also performed. <br/>Result(s): The
initial search resulted in 651 articles, of which nine studies with 27964
patients (mean age 58-66 years, 74.79% male) were included. Of the nine
studies, six were retrospective and three prospective. Mean+/-SD/Median
(IQ) follow-up duration was four years [range 2-7 years]. There was an
increased risk of recurrent MI/coronary revascularization associated with
Lp(a) >=30 mg/dL (OR, 1.44, 95% CI: 1.09-1.89, I²= 79.24%,
p=0.009) (Fig 1a) and Lp(a) >=10-30 mg/dL (OR, 1.19, 95% CI: 1.009- 1.416,
I²= 0%, p=0.039) (Fig 1b), but failed to reach significance
with Lp(a) as a continuous variable (OR, 1.004, 95% CI: 0.998-1.009,
I²= 85.02%, p=0.221) (Fig 1c). Leave-one-out sensitivity
analysis showed an equivalent result for various Lp(a) cutoffs (Fig 1a,
1b, and 1c). <br/>Conclusion(s): Our meta-analysis suggests an association
of raised Lp(a) with increased risk of recurrent MI/coronary
revascularization in ACS patients who underwent PCI. (Figure Presented).

<60>
Accession Number
642974555
Title
Analysis of the Composite of Death and Stroke at Follow-Up Among Risk
Profiles in Trials Comparing Transcatheter and Surgical Aortic Valve
Implantation. A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Barili F.; Anselmi A.; Brophy J.; Boden W.E.; De Caterina R.S.; Dayan V.;
Roda J.R.; Sousa-Uva M.; Almeida R.M.; Tomasi J.; Verhoye J.-P.; Musumeci
F.; Mandrola J.M.; Kaul S.; Parolari A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: To compare the effectiveness of transcatheter vs surgical
aortic valve implantation on mid-term composite of death for any cause or
stroke within high, intermediate and low-risk profiles. <br/>Method(s): We
performed a systematic review of the literature between 2007 and 2023
including randomized controlled trials comparing a composite of all-cause
mortality or stroke of transcatheter vs surgical aortic valve replacement.
Hazard ratios (HRs) and restricted mean survival time (RMST) differences
within high, intermediate and low-risk profiles were estimated by
reconstructing time-toevent data from Kaplan-Meier curves. <br/>Result(s):
Seven trials were included (8418 participants). The incidence of composite
endpoint increases concordantly with higher risk profiles for both
treatments. A time variant effect unites all the risk profiles with
transcathteter superior to surgery early and a trend toward HR reversal
after 24 months, also supported by an cumulative additional time-to-event
of 0.57 months at 3 years driven by high risk (95%CI 0.19 - 0.9) that is
reabsorbed at 60 months, The benefit of transcatheter approach increased
over time till 5 years in high risk, while intermediate and low risk
showed a similar quadratic association (a parameter -0.0004, 95%CI -0.0008
- 0, p-value 0.05; b parameter 0.029, 95%CI 0.012 - 0.046, p-value 0.001),
with a smaller increase of the transcatheter that is reabsorbed after a
nadir at 36 months. <br/>Conclusion(s): There is a different trend of
benefit of transcatheter approach within risks. TAVI maintains a benefit
over surgery at 5-years in high risk, while its advantage is smaller and
runs out at 5 years in the low-mid risk groups. (Figure Presented).

<61>
Accession Number
642974497
Title
Performance of a Polygenic Risk Score for Coronary Artery Disease Across
the Spectrum of ASCVD: An Analysis of 60k Patients From 6 TIMI Randomized
Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Zimerman A.; Kamanu F.; Melloni G.; Roselli C.; Antman E.M.; Bhatt D.;
Bonaca M.P.; Cannon C.P.; Giugliano R.; O'Donoghue M.; Scirica B.; Wiviott
S.D.; Braunwald E.; Ellinor P.T.; Sabatine M.S.; Ruff C.; Marston N.A.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Coronary artery disease (CAD) polygenic risk scores (PRS) may
improve risk stratification, but whether performance differs by ASCVD
status remains unclear. <br/>Purpose(s): To compare the predictive ability
of a CAD PRS for coronary events in pts with ASCVD and prior event, ASCVD
without event, and without overt ASCVD. <br/>Method(s): We studied
genotyped pts from 6 multinational TIMI RCTs. Using a 2.3 million SNP CAD
PRS, we first assigned pts to low (Q1), intermediate (Q2-4), or high (Q5)
genetic risk, after which pts were grouped by ASCVD status at baseline.
The primary endpoint was any coronary event, a composite of death from
coronary disease, myocardial infarction, or coronary revascularization.
Cox proportional hazards models were used to estimate risk of events,
adjusted for ancestry (principal components 1-5), age, sex, SBP, eGFR,
diabetes, smoking, and trial. <br/>Result(s): We included 59,905 pts (mean
age 66 yrs; 71% male; 79% with prior ASCVD; 49% with diabetes), of whom
10.6% had coronary events during follow-up. Compared with low genetic risk
pts, event rates were greater in intermediate (HR 1.59 [95% CI 1.47-1.71];
p<0.001) and high (HR 2.08 [1.91-2.27]; p<0.001) genetic risk pts. There
was a significant interaction between the CAD PRS and clinical ASCVD
(P<inf>interaction</inf><0.001), such that genetic risk discriminated
relative risk of future coronary events more strongly in pts without overt
ASCVD (Fig 1A). In this subgroup, high genetic risk pts had a nearly
5-fold higher hazard of events than low genetic risk pts (8.5% vs 1.6% at
3 yrs; HR 4.63 [3.46-6.21]; p<0.001). Pts without clinical ASCVD and high
genetic risk had event rates comparable to pts with established ASCVD and
low genetic risk (Fig 1B). <br/>Conclusion(s): The gradient of relative
risk prediction of coronary events from a CAD PRS depends on the presence
of known ASCVD and is strongest in patients without clinical disease.
Genetic risk stratification may be more useful in pts without overt ASCVD
to help focus preventive measures. (Figure Presented).

<62>
Accession Number
642974455
Title
Outcomes of High-Intensity Interval Training Are Superior to Moderate
Exercise Training Among Post-Heart Transplant Patients.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sulague R.M.; Coronel M.-K.; Alfonso P.G.; Cartojano T.D.; Cruz N.;
Mortalla E.D.; Lavie C.J.
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Heart failure patients who underwent heart transplantation
(Htx) need to undergo cardiac rehabilitation (CR) to regain and improve
their physical ability and functional capacity. To date, there is no
established exercise regimen that optimizes this recovery. This study aims
to compare the outcomes of HighIntensity Interval Training (HIIT) versus
Moderate Exercise Training (MT) among Htx patients. Hypothesis: The
outcomes of HIIT are superior to MT among Htx patients. <br/>Method(s): A
systematic review was conducted in multiple databases including PubMed,
Embase, and Google Scholar from inception to 2022 following the PRISMA
guidelines to look for randomized controlled trials that directly compare
clinical outcomes of HIIT versus MT. Joanna Briggs Institute (JBI)
critical assessment tool was used to assess the risk of bias. A
meta-analysis was performed using a random effect model to calculate mean
differences with 95% confidence intervals (CI). This study is registered
on Prospero (CRD42023403954). <br/>Result(s): This study included four
clinical trials (n=177 patients). The average age was 51 years +/- 10.57,
with a majority male (73%). On average, patients were overweight (BMI =
25.78 +/- 4.08) with comorbidities including hypertension (81%) and
diabetes (12%). Compared to baseline levels, the peak oxygen consumption
(VO2 peak), maximal muscle strength extensors, maximal muscle endurance,
body mass index, and FEV1 were statistically significantly increased after
the intervention of either HIIT or MT. Of these, HIIT had higher percent
changes in VO2 peak at 0.205 (95% CI: 0.007 to 0.417, p=0.0578), maximal
muscle strength extensors at 0.100 (95% CI: 0.059 to 0.141, p<0.001), and
maximal muscle endurance at 0.263 (95% CI: 0.185 to 0.341, p<0.001)
compared to MT. <br/>CONCLUSION(S): Both exercise CR regimens
significantly improved the physical ability and functional performance of
Htx patients. However, HIIT was superior to MT in terms of VO2 peak,
maximal muscle strength extensors, and maximal muscle endurance, which may
be associated with higher survival.

<63>
Accession Number
642974363
Title
Utility of Intracardiac Echocardiography for Prosthetic Valve Infective
Endocarditis and Cardiovascular Device-Related Infection: A Contemporary
Systematic Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sanchez-Nadales A.; Cedeno J.; Sonnino A.; Sarkar A.; Asher C.R.; Xu B.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Infective endocarditis (IE), particularly prosthetic valve
endocarditis (PVE) and cardiac devicerelated endocarditis (CDIE), presents
significant diagnostic challenges. The efficacy of intra-cardiac
echocardiography (ICE) for diagnosing IE and assessing intra-cardiac
infections when transesophageal echocardiography (TEE) is contraindicated,
is not extensively studied. <br/>Method(s): We searched six databases,
including PubMed, Embase, Scopus, Ovid, Science Direct, and Web of
Science, for articles published between September 2002 and November 2022,
related to the utility of ICE in IE. Eligibility screening followed the
search. <br/>Result(s): From the 12 identified studies discussing ICE for
IE diagnosis, ten cases of IE were highlighted in nine reports, and three
cohort studies included 236 patients without individual patient details.
ICE was not used in any native valve IE case. Predominantly male patients
(90%) had a median age of 42 years, developing endocarditis 2.5 years post
initial cardiac procedure. The most common microorganisms identified were
Staphylococcus species. ICE proved beneficial in various scenarios,
particularly PVE and CDIE, especially when echocardiography studies were
inconclusive or contraindicated. As an alternative to TEE, ICE offers
clear visualization of right heart structure, guiding interventions such
as pacemaker lead extractions. It excels in detecting device lead
abnormalities and small vegetations in CDIE cases, supporting risk
stratification and preparation for infected device extraction. Notably,
all PVE cases involved bioprosthetic valves, affecting various heart
structures and valves. <br/>Conclusion(s): This systematic review
highlights ICE as an adjunct imaging modality in IE, especially in PVE and
CDIE when TEE is contraindicated. Preliminary data suggest its valuable
role during intracardiac lead extractions.

<64>
Accession Number
642974159
Title
Use of Computed Tomography Coronary Angiography in Pre-Operative Risk
Assessment in Non-Cardiac Surgeries.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Shah R.P.; Yadav R.; Duhan S.; Patel N.N.; Raheela F.; AlJaroudi W.; Paul
T.K.; Alraies M.C.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Computed Tomography Coronary Angiography (CTCA) has emerged
as a promising tool for detecting and evaluating coronary artery diseases
(CAD). However, the role of CTCA for risk assessment tool for patients
undergoing noncardiac surgeries is unknown. <br/>Method(s): We searched
databases like PubMed and Google Scholar to compile the literature
including reviews, meta-analyses, scientific articles, and guidelines,
describing the use of CTCA in the diagnosis and evaluation of cardiac risk
assessment in noncardiac surgeries. <br/>Result(s): Based on our
literature review we found that CTCA is a promising adjunctive tool for
preoperative assessment in noncardiac surgeries to evaluate cardiac risk
with high sensitivity and negative predictive value. VISION-CTA sub study
showed that CTCA combined with Myocardial Perfusion Imaging (MPI) predicts
major adverse cardiac events within 30 days of surgery with higher
accuracy than either test alone. McCarthy KJ et al found an increase in
the proportion of CTCAs performed from before 2018, 2018 to post 2018,
(3%, 6.3%, and 26.3% respectively; p <0.001) and obstructive CAD diagnosis
using CTCA (0%, 30%, and 51.4% respectively; p = 0.04). Hence supporting a
shift to non-invasive CTCA for pre-operative assessment of liver
transplant candidates. According to Ahn J et al, CTCA shows 100%
sensitivity and 99.3% negative predictive value in predicting major
adverse cardiac events and can be used to stratify intermediate risk
noncardiac surgery patients. <br/>Conclusion(s): CTCA is a valuable risk
assessment tool in patients undergoing noncardiac surgery because of its
high sensitivity and negative predictive value. There is a need for
further research and guidelines for using CTCA as a risk assessment tool
in noncardiac surgeries.

<65>
Accession Number
642974055
Title
Evaluating the Predictive Accuracy of Viscoelastic Blood Coagulation
Measurements for Postoperative Bleeding in Cardiac Surgery: A Diagnostic
Accuracy Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Elfaituri M.K.; Khaled A.; Faraj H.A.A.; Ben Ghatnsh A.; Msherghi A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Postoperative bleeding in cardiac surgery significantly
impacts patient morbidity and mortality. Viscoelastic blood coagulation
measurements, such as point-of-care (POC) viscoelastic hemostatic assays
(VHAs), are proposed tools for predicting this complication and enabling
proactive management. However, thoroughly evaluating existing evidence is
essential to confirm their effectiveness. Hypothesis: This study aims to
evaluate the diagnostic accuracy of viscoelastic blood coagulation
measurements in predicting postoperative bleeding following cardiac
surgery. <br/>Method(s): A systematic search of studies published up to
May 2022 was conducted, employing databases such as PubMed, EMBASE, and
the Cochrane Library. Included studies implemented viscoelastic blood
coagulation measurements in cardiac surgery settings, providing data on
diagnostic accuracy for predicting postoperative bleeding. Major
postoperative blood loss, as defined within each study setting, was used
as the reference standard. Statistical analysis was performed using R
software (version 4.0.3) with mada package. This analysis enabled various
diagnostic accuracy metrics pooling, all presented with a 95% Confidence
Interval (CI). <br/>Result(s): This analysis incorporated 10 studies
comprising 2048 patients, 374 of them experienced confirmed postoperative
bleeding after cardiac surgery. The pooled sensitivity and specificity of
viscoelastic blood coagulation measurements for predicting postoperative
bleeding were found to be 65% (95% CI: 42.9-82%, I2=89.4%) and 85% (95%
CI: 69.7-93.3%, I2=95.1%) respectively. The falsepositive rate was
identified as 15% (95% CI: 6.7-30.3%). The diagnostic odds ratio was 10.50
(95% CI: 2.93-37.57). The positive and negative Likelihood Ratios were
4.34 (95% CI: 1.89-9.95) and 0.42 (95% CI: 0.23-0.75), respectively.
<br/>Conclusion(s): Despite moderate sensitivity, viscoelastic blood
coagulation measurements exhibit high specificity in predicting
postoperative bleeding in cardiac surgery, potentially enhancing patient
management through early intervention. However, due to the observed
heterogeneity, further largescale studies are required to confirm these
results and assess their impact on patient outcomes.

<66>
Accession Number
642974014
Title
Acute Type A Aortic Dissection Surgical Repair in Octogenarians, Meta
Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Hasan M.T.; Rezq H.S.; Aboeldahab H.; Elkhashab M.K.; Hamouda S.M.;
Elkersh H.; Awad A.K.; Nabeel A.; Gardezi S.K.; Awan R.U.
Publisher
Lippincott Williams and Wilkins
Abstract
Aortic dissection is a serious medical condition that can lead to
life-threatening complications. Type A aortic dissection (TAAD) is a
subtype that occurs in the ascending aorta and is associated with
increased morbidity and mortality rates. Surgical intervention is the
standard of care for TAAD, but the optimal surgical approach for
octogenarians remains a topic of debate. This meta-analysis aimed to
investigate the long-term surgical outcomes of TAAD in octogenarians.
Electronic databases were searched from inception to September 20, 2022,
to include any randomized clinical trials (RCT) and observational studies
that compare TAAD in octogenarians versus TAAD in septuagenarians. The
Mantel-Haenszel method was used to pool study estimates and calculate odds
ratios (OR) with 95% confidence intervals (CI). Twenty-seven observational
studies comprising 18,057 participants were included in the metaanalysis.
Surgical repair for TAAD in octogenarians had a lower risk of
re-exploration (RR = 0.08), stroke (RR = 0.09), renal failure (RR = 0.09),
respiratory failure (RR = 0.18), neurological complications (RR = 0.09),
and bleeding (RR = 0.08), compared to septuagenarians. On the other hand,
antegrade cerebral perfusion (RR = 0.39) and tracheostomy (RR = 0.11) were
less likely to be used in octogenarians than in septuagenarians. In terms
of surgical parameters, octogenarians had a significantly shorter
cardiopulmonary bypass surgery time and systemic cardiac arrest time than
septuagenarians (MD = -13.84 and -2.46), respectively. Even though
postoperative mortality rose dramatically with age, surgical care was
associated with a significantly reduced inpatient mortality rate when
compared to medical management. Octogenarians undergoing surgical repair
for type A aortic dissection have a statistically significant difference
in cardiopulmonary bypass surgery time, systemic cardiac arrest time, and
5-year survival rate when compared to septuagenarians. (Figure Presented).

<67>
Accession Number
642973917
Title
Annual Vascular and Bleeding Outcomes in East Asian Poststenting Patients
With Acute Coronary Syndrome: The BRIC-ACS II Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Li D.; Chen Y.; Yu Y.; Tuo X.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: To determine the incidence of bleeding and thrombotic vascular
events in the 'realworld'acute coronary syndromes (ACS) Chinese patients
over 1-year following stent implantation. <br/>Background(s): The balance
between vascular and bleeding outcomes during dual antiplatelet therapy
(DAPT) is a matter of considerable controversy, especially in Asian
populations. In contrast to Europeans, Chinese patients experience more
bleeding but less thrombotic events over aggressive DAPT with ticagrelor
than after conventional clopidogrel. <br/>Methods and Results: From
November 2017 till April 2020 we enrolled post-stenting ACS patients
(n=5,515) from 30 tertiary hospitals with the strict 1-year follow-up
(n=5.150). Only few 153(3.0%) patients developed MACE (a composite of
all-cause death, myocardial infarction, ischemic stroke, or urgent
coronary revascularization). The cumulative incidence of annual bleeding
(BARC >=2) was 5.8% (298/5150) among patients who completed 1year
follow-up.The BARC >=2 bleeding was almost twice higher 298 (5.8%) and was
not associated with worsened MACE [CI:0.37 -1.67; P =0.52). Patients
treated with ticagrelor (n=1620, 6.0%) had a significantly increased risk
of bleeding than those treated with clopidogrel (n=2331; 4.1%) (HR=1.486;
95% CI:1.12-1.97; P=0.006), but similar risk of vascular MACE (2.7% vs
2.8%; HR= 0.94; 95% CI:0.64-1.38; P = 0.747).The factors independently
associated with the comprehensive risk of BARC >=2 bleeding and MACE ,
including female gender, renal insufficiency, peptic ulcer, atrial
fibrillation, continuous use of ticagrelor and non-continuous DAPT. The
discrimination of the nomogram model was further tested by the ROC curve
(AUC value:0.610 (95% CI, 0.577-0.642 )). <br/>Conclusion(s): The annual
incidence of BARC>=2 bleeding in ACS patients treated with PCI in China
was almost twice higher (5.8%) than MACE (3.0%). DAPT with ticagrelor
increased the bleeding rates with no trend towards MACE reduction. The
trial was registered at the clinnicaltrials.org as NCT03402711.This study
was sponsored by Sanofi.

<68>
Accession Number
642973810
Title
Sex-Specific Differences in Outcomes Following Alcohol Septal Ablation or
Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy: A Systematic
Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Saravanabavanandan R.; Jaimalani A.; Khan M.A.N.; Riaz S.; Mangas G.;
Ahsan S.M.; Posani S.; Patel T.; Fawad M.; Al-Tawil M.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Clinical evidence and emerging studies suggest that the
clinical heterogeneity observed in hypertrophic obstructive cardiomyopathy
(HOCM) could be due to sex-based differences. However, definite evidence
to guide sex-specific treatment is not yet available. We aim to explore
the sexrelated differences in treatment outcomes following alcohol septal
ablation (ASA) and septal myectomy (SM). <br/>Method(s): We searched
PUBMED/MEDLINE, EMBASE, and SCOPUS to identify studies that report
sex-stratified comparison of outcomes in adults undergoing ASA or SM. The
primary outcomes were the short-term/ 30-day mortality, post-operative
permanent pacemaker (PPM) requirement, and the length of in-hospital stay.
<br/>Result(s): Fifteen studies totaling 31,907 patients (47% men and 53%
women) met our eligibility criteria. Among patients undergoing ASA
(n=13357) or SM (n=18550), females were found to be significantly older at
the time of intervention (ASA - mean difference (MD): 7.55 years; 95% CI
[4.83, 10.28]; p < 0.00001; SM - MD: 4.41; 95% CI [2.79, 6.03]; p <
0.00001).In both the ASA and SM treatment arms, females had a
significantly higher risk of short-term all-cause mortality (ASA - RR:
0.48, 95% CI [0.32, 0.71]; p = 0.0003; SM - RR: 0.63; 95% CI [0.44, 0.90];
p = 0.01), greater PPM implantation rate (ASA - p = 0.002; SM - p = 0.05),
and longer in-hospital stay (ASA - MD: 1.00 days; p < 0.00001; SM - MD:
0.69; p < 0.00001). Among those undergoing ASA, females had a
significantly higher rate of atrioventricular (AV) block (p < 0.00001).
However, the 30-day re-admission rate following SM was similar in both
sexes. <br/>Conclusion(s): This is the first meta-analysis to compare sex
differences in HOCM treatment outcomes. Female patients were older, had
higher short-term mortality, and required more PPM implants compared to
males, regardless of whether they received ASA or SM. This emphasizes the
critical need for a sex-specific treatment approach in managing HOCM. .

<69>
Accession Number
642973740
Title
Safety and Efficacy of Botulinum Toxin Type A for Prevention of
Postoperative Atrial Fibrillation in Cardiac Surgery Patients: Pulmonary
Function Test Results From the Phase 2 NOVA Study.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Lang J.E.; Leaback R.; Ailawadi G.; Iribarne A.; Gleason K.J.; Sullivan
A.O.; Huang N.-Y.; Ferguson W.G.; Miller J.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
complication after cardiac surgery. Autonomic neuromodulation, including
injection of botulinum toxin into epicardial fat pads, may suppress and/or
attenuate atrial fibrillation. The respiratory safety of a potential
preventative treatment for AF is critical. <br/>Aim(s): To assess efficacy
and pulmonary safety of botulinum toxin type A (BoNT/A; AGN-151607) 125U
and 250U vs placebo for prevention of POAF after coronary artery bypass
graft and/or valve surgery. <br/>Method(s): NeurOtoxin for the PreVention
of post-operative Atrial fibrillation (NOVA; NCT03779841) was a phase 2,
international, multicenter, randomized, placebo-controlled trial. The
primary endpoint was proportion of patients with continuous AF >=30
seconds within the first 30 days. Respiratory function was assessed via
pulmonary function tests (PFTs) performed at baseline and day 30 after
treatment. Adverse events (AEs), serious adverse events (SAEs), and time
to extubation were recorded. <br/>Result(s): A total of 323 patients were
randomized: BoNT/A 125U (n=106), 250U (n=109), placebo (n=108). The
primary endpoint occurred in 46.1% of the placebo group, 36.5% of the 125U
group (relative risk [RR] vs placebo, 0.80 [95% CI: 0.58, 1.10]; P=0.16),
and 47.2% of the 250U group (RR vs placebo, 1.04 [95% CI: 0.79, 1.37];
P=0.78). Baseline, day 30, and change from baseline PFT results were
similar for active treatment vs placebo (Table). Median time to extubation
was 9.7, 9.6, and 9.6 h in the placebo, 125U, and 250U groups,
respectively. Respiratory AEs were reported in 42.9%, 38.1%, and 50.5% of
patients, and respiratory SAEs in 11.4%, 6.7%, and 5.5% of patients in the
placebo, 125U, and 250U groups, respectively. <br/>Conclusion(s): In this
analysis of respiratory function, there appeared to be no detrimental
effect of AGN151607 compared with placebo, as evidenced by similar
outcomes in PFT parameters and respiratory AE/SAE incidences among
treatment arms.

<70>
Accession Number
642973720
Title
A Randomised Open-Label Controlled Trial of a Remote Cardiac
Rehabilitation System With Wearable Medical Devices - An Interim Report of
the TELE-REHA Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Nakayama A.; Ishii N.; Hori K.; Yoshida A.; Isobe M.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Outpatient cardiac rehabilitation (CR) prevents recurrence
after cardiac surgery or cardiac catheterisation, but participation rate
of outpatient CR is low. Although attempts at remote CR have been
investigated with advances in equipment, they have not yet reached the
stage of social implementation, and it is not clear whether remote CR can
be an alternative to outpatient CR. <br/>Objective(s): The aim of this
study was to confirm the safety and efficacy of remote CR management using
wearable devices feasible in Japan, and to implement the device early in
society. <br/>Primary Outcome: All-cause death, cardiovascular events,
EFs, e/e', BNPs, CRPs, PeakVO2, VEVCO2 slop, muscle mass; secondary
outcome: EQ5D. Subjects: Patients discharged home after hospitalization
for cardiovascular diseases. Study design: A single-centre, randomised,
open-label, parallel-group study was conducted to evaluate the efficacy
and safety of wearable device (Apple Watch)-based Remote-CR versus
Outpatient-CR. In Remote-CR group, ECG and SpO2 are measured by Apple
Watch before and after exercise. Biweekly health information, weight,
blood pressure, heart rate, electrocardiogram (ECG) and EQ5D are
automatically transmitted by the app. Tele-nursing was provided by trained
nurses on a bi-weekly basis, based on the health information provided by
the app. For both groups, the intervention period was 90 days, and blood
sampling, ECG, cardiopulmonary exercise testing (CPX), and body
composition testing were performed at the end of the study.
<br/>Result(s): A total of 110 cardiovascular patients were randomly
divided into Remote-CR group and Outpatient-CR group. The background of
the two groups was similar. Though the PeakVO2 and EQ5D scores after the
CR program were not significantly improved in Outpatient-CR group, those
were significantly improved in Remote-CR group (P=0.02). The dropout rate
from CR program was lower in Remote-CR group than Outpatient-CR group. No
significant incident occurred in both group. <br/>Conclusion(s): Remote-CR
is expected to be as effective as Outpatient-CR and safe for patients
after cardiac treatment, and can provide a relapse prevention programme
for those who are difficult to attend.

<71>
Accession Number
642973304
Title
Lipoprotein(a) and Oxidized Phospholipids on Lipoproteins and
Cardiovascular Outcomes in Patients With Chronic Coronary Syndrome Treated
With Colchicine.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Mohammadnia N.; Van Broekhoven A.; Bax W.A.; Eikelboom J.W.; Mosterd A.;
Yang X.; Tijssen J.G.; Thompson P.L.; De Kleijn D.; El Messaoudi S.;
Tsimikas S.; Yeang C.; Cornel J.H.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Lipoproteins carrying pro-inflammatory oxidized
phospholipids (OxPL), exemplified by lipoprotein(a) [Lp(a)], contribute to
residual risk for major adverse cardiovascular events (MACE) in patients
with chronic coronary syndrome (CCS) despite optimal medical treatment.
Hypothesis: Anti-inflammatory colchicine therapy modifies MACE in patients
with elevated Lp(a), OxPL on apo(a) [OxPL-apo(a)], and OxPL on apoB
containing lipoproteins (OxPL-apoB). Aims To study the relationship of
Lp(a), OxPL-apo(a) and OxPL-apoB with MACE in 1777 LoDoCo2 trial
participants with CCS randomized to colchicine or placebo. <br/>Method(s):
End of study but not baseline samples were available. Because Lp(a),
OxPL-apo(a) and OxPL-apoB levels are strongly genetically determined, we
assumed that end of study values would reflect baseline values. The
primary endpoint was a composite of MI, ischemic CVA or ischemia driven
coronary revascularization. Cox regression was used to compare the
incidence of the primary endpoint by Lp(a) dichotomized at 125 nmol/L and
OxPL-apo(a) and OxPL-apoB in tertiles. <br/>Result(s): At study end,
median (IQR) on-colchicine Lp(a), OxPL-apo(a), and OxPL-apoB levels in
nmol/L were 22.4 (7.2-102.7), 7.8 (2.0-34.5) and 3.1 (1.3-6.3), similar to
on-placebo levels of 23.9 (9.9-95.7), 8.8 (2.7-34.0), and 3.1 (1.4-5.9),
respectively (p = 0.20, 0.98 and 0.18). MACE reduction with colchicine was
independent of Lp(a) and OxPL-apo(a) (P<inf>interaction</inf>= 0.92 and
0.66 respectively). However, the largest MACE reduction was present in the
highest vs lowest OxPL-apoB tertile (Figure, P<inf>interaction</inf> <
0.05). <br/>Conclusion(s): The benefit of colchicine in reducing MACE was
highest in subjects with elevated OxPL-apoB, suggesting colchicine may be
most effective in subjects with heightened oxidation-driven inflammation.
These findings may be hypothesis-generating and require validation in
larger trials with baseline biomarker assessment including CRP and IL-6.
(Figure Presented).

<72>
Accession Number
642973188
Title
Identifying the Genetic Determinants of Early Heart Failure in Patients
With Congenital Heart Disease.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Bair C.A.; Kurzlechner L.; George I.; Monaco G.; Berkman A.; Kreinbrook
J.; Moya-Mendez M.E.; Gonzalez C.D.; Gurumoorthi M.; Bidzimou M.; Pace L.;
Allen A.; Beckerman Z.; Andersen N.D.; Turek J.W.; Leong M.E.; Hoffman T.;
Li J.S.; Landstrom A.P.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Heart failure (HF) is the most common cause of death in
patients with congenital heart disease (CHD). Evidence suggests genetics
play a role in HF predisposition. In particular, variants in
cardiomyopathy-associated genes may be associated with HF and early
mortality in CHD populations. Goal: Our goal is to leverage a large,
well-curated, population-based cohort of individuals with CHD in North
Carolina (NC) to determine the genetic underpinnings of HF in CHD.
Hypothesis: We hypothesize that rare variants in cardiomyopathy-associated
genes will be overrepresented in CHD patients with HF compared to patients
without HF. <br/>Method(s): Patients were enrolled with inclusion criteria
of 1) presence of CHD, 2) 2+ cardiac evaluations. Whole blood was
collected for exome sequencing (ES). The presence of HF was defined as
death, cardiac transplantation or listed for cardiac transplantation, VAD
placement, ECMO cannulation, EF <= 40% on 2 images, or diagnosis of HF by
a cardiologist and taking at least 1 HF medication. ES data was filtered
for variants in cardiomyopathy-associated genes. <br/>Result(s): We have
established NC-DEFINE: Determining the Genetic Basis of Heart Failure in
Patients with CHD in NC, a prospectively enrolled cohort of patients with
CHD for which ES data are available. We enrolled 138 CHD patients (mean
age at enrollment [std dev]: 7.44+/-11.89 years; 40.6% female, 1.4% Asian,
23.9% Black, 6.5% Hispanic). About half (52.9%) have single ventricle
physiology and 26% have HF. In a pilot ES cohort of 48 patients, there was
an average of 524.2 variants/patient in cardiomyopathy genes of interest.
After filtering out common and tolerated variants, 8 loss-of-function and
28 missense variants were identified and interpreted using ACMG criteria.
Likely pathogenic or pathogenic (LPP) variants were found in 26.9% (7/26)
of HF patients and 9.1% (2/22) of non-HF patients (p=0.15). The RR for
having a cardiomyopathy-associated LPP variant and developing HF in the
setting of CHD was 1.60 (95% CI 1.0-2.57). <br/>Conclusion(s): We have
established NC-DEFINE, a novel prospectively enrolled CHD cohort, to
define the genetic architecture of HF in CHD. In a pilot ES cohort, we
found enrichment of rare, LPP variants in cardiomyopathy-associated genes
in patients with HF. .

<73>
Accession Number
642973124
Title
Oral Anticoagulation for New Onset PostOperative Atrial Fibrillation After
Combined Coronary Artery Bypass Grafting and Valve Surgery is Not
Associated With Improved Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Tejpal A.; Lee J.G.; Fang J.; Jeong I.; Ouzounian M.; Atzema C.; Austin
P.; Ha A.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Post-operative atrial fibrillation (POAF) after cardiac
surgery is common and is associated with increased risk of stroke and
death. The incidence of POAF is highest among patients who undergo
combined CABG and valve surgery, at 40-60%. The risks and benefits of oral
anticoagulation (OAC) in this high-risk population are not well
established. Research Question: Among patients with POAF after combined
CABG and valve surgery, what is the association between OAC use and
clinical outcomes? Methods: From a population-based registry in Ontario,
Canada, we identified consecutive patients >65 years of age who developed
POAF after combined CABG and left-sided, non-mechanical valve surgery from
Oct/08-Mar/18. The exposure of interest was OAC prescription within 90
days after hospital discharge. Outcomes included death, cardiovascular
death, stroke, MI, thromboembolism, and bleeding. Follow-up began at 90
days after discharge and continued for 24 months. Outcomes were analyzed
using inverse probability of treatment weighting using the propensity
score. Statistical measures of association were reported as hazard ratios
with 95% confidence intervals. <br/>Result(s): Among 4,836 patients who
had combined CABG/valve surgery, 1,939 (40.1%) developed POAF and these
patients had a higher rate of death (HR 1.31, 95% CI 1.01-1.68 P=0.04).
OAC was prescribed in 1,153 (59.5%) patients (86% warfarin and 14% DOAC).
The use of OAC was not associated with a lower rate of death,
stroke/MI/thromboembolism, or cardiovascular death but was associated with
an increased rate of bleeding (HR 1.62, 95% CI 1.00-2.61, P=0.048).
<br/>Conclusion(s): Among patients with POAF after combined CABG/valve
surgery, use of warfarin or DOAC did not improve ischemic cardiovascular
outcomes or survival and was associated with higher rates of bleeding.
Randomized control trials are needed to define the risk and benefit of OAC
use in this high-risk population. Until then, routine use of OAC is not
recommended.

<74>
Accession Number
642973101
Title
Impact of the Type of Tricuspid Annuloplasty Ring Concomitant With Mitral
Annuloplasty on Atrial Arrhythmia Behaviour and Pacemaker Implantation
Rate, Fact or Fancy.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Hassan M.; Keller D.; Makhmetov B.; Omerbasic Z.; Radakovic D.; Madrahimov
N.; Leyh R.; Bening C.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Tricuspid valve repair has been advocated in patients
undergoing mitral valve surgery who have not only preoperative severe TR
but also for tricuspid annular dilatation (TAD) of >40 mm. We sought to
analyze the impact of the type of tricuspid annuloplasty ring on the
atrial arrhythmia behavior and the incidence of permanent pacemaker
implantations in patients undergoing mitral valve annuloplasty.
<br/>Method(s): We performed a retrospective review of 408 patients
underwent combined tricuspid and mitral valve annuloplasty in our
institution between the years 2007 and 2014.Patients were 68,8 +/- 10,7
years old, 67% male, 33% female. A total of 325 patients met the inclusion
criteria; 201 received threedimensional (3D) rigid ring (group 1) and 124
received ring annuloplasty with flexible bands (group2). The distribution
of the preoperative and perioperative variables was similar.
<br/>Result(s): There was no statistical difference in the incidence of
high-grade heart conduction disorders lasting more than 3 days
postoperatively (13.4% in group 1 and 12.9% in group 2; P = 0.89).
Likewise, there was no difference in the incidence of postoperative atrial
fibrillation between the two groups (41.2% in group 1 and 37.1% in group
2; P = 0.45). On the other hand, there was statistical difference in the
incidence of permanent pacemaker implantation between the two groups
(12.9% in group 1 and 25.8% in group 2; P = 0.003). Likewise, there was
difference in the incidence of sick sinus syndrome between the two groups
(0.01% in group 1 and 16.1% in group 2; P < 0.00001). <br/>Conclusion(s):
The need for permanent pacemaker implantation and the incidence of sick
sinus syndrom may be increased after the use of flexible tricuspid
annuloplasty ring in the setting of mitral valve surgery.Moreover, the
present study found no association between the use of Flexible tricuspid
annuloplasty ring and a higher incidence of postoperative atrial
fibrillation or high-grade heart conduction disorders.Further large-scale
randomized controlled studies are needed to elucidate the Impact of the
type of tricuspid annuloplasty ring.

<75>
Accession Number
642972772
Title
The Efficacy and Safety of Botulinum Toxin Type A to Prevent Postoperative
Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A
Meta-Analysis of Randomized Controlled Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Abdelazeem B.; Kambalapalli S.; Saleh O.; AlBarakat M.M.; Gowaily I.;
Mahmoud A.; Ali S.; Abuelazm M.T.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative atrial fibrillation (POAF) is prevalent in about
30 to 60 percent of patients undergoing cardiac surgery leading to worse
outcomes. However, effective POAF therapies are lacking. Botulinum toxin
type A (BTX) epicardial injection can prevent POAF by impairing
cholinergic signaling. <br/>Method(s): We conducted a systematic review
and meta-analysis synthesizing randomized controlled trials (RCTs), which
were retrieved by systematically searching: PubMed, EMBASE, Web of
Science, SCOPUS, and Cochrane through November 23 , 2022. RevMan version
5.4 software was used to pool dichotomous outcomes using risk ratio (RR)
and continuous outcomes using mean difference (MD) presented with the
corresponding confidence interval (CI). <br/>Result(s): Three RCTs with a
total of 509 patients (308 in the BTX group and 205 in the placebo group)
were included in our analysis. Two RCTs included patients undergoing
open-chest cardiac surgery, including coronary artery bypass graft (CABG)
and/ or valve surgery, while one RCT included patients undergoing CABG
only. There was no difference between BTX and placebo regarding POAF
incidence (RR: 0.81 with 95% CI [0.65, 1.00], P= 0.05), postoperative
hospital length of stay in days (MD: -0.03 with 95% CI [-0.54, 0.49], P=
0.91), all-cause mortality, (RR: 1.64 with 95% CI [0.22, 12.17], P= 0.63),
any adverse event (RR: 1.03 with 95% CI [0.94, 1.12], P= 0.51), and any
serious adverse event (RR: 0.89 with 95% CI [0.68, 1.15], P= 0.36).
<br/>Conclusion(s): There was no difference between epicardial fat
injection of BTX versus placebo for preventing POAF; however, BTX showed a
similar safety profile compared to placebo and our analysis can be
underpowered to detect a significant effect. Hence, further large-scale
RCTs are warranted to investigate BTX for POAF, especially in high-risk
cohorts.

<76>
Accession Number
642972265
Title
Carvedilol Outperforms Metoprolol in Preventing Postoperative Atrial
Fibrillation: A Systematic Review and MetaAnalysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Abouzid M.R.; Eldahtoury S.; Naccour S.; Anwar J.; Elshafei S.; Vyas A.;
Nwaukwa C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is a common
complication following cardiac surgery. Current guidelines suggest
beta-blockers for the prevention of POAF. Carvedilol is a nonselective
betablocker with anti-inflammatory, antioxidant, and various cationic
channel-blocking effects. This metaanalysis aims to compare the efficacy
of carvedilol versus metoprolol in the prevention of POAF. <br/>Method(s):
We considered randomized controlled studies (RCTs) and retrospective
studies that demonstrated the efficacy of carvedilol versus metoprolol in
the prevention of POAF. Pooled data were analyzed using either the
fixed-effect or random-effect model in Review Manager 5.3. The incidence
of POAF was the primary endpoint, while mortality rate and bradycardia
were secondary outcomes. <br/>Result(s): A total of five RCTs and two
retrospective studies (1000 patients) were included in this metaanalysis.
The overall effect did not favor either of the two groups in terms of
mortality rate [Risk ratio 0.45, 95 % CI (0.1-1.97), P=0.29] as well as
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]. <br/>Conclusion(s): In patients undergoing cardiac surgery,
carvedilol has been shown to successfully minimize the occurrence of POAF.
It appeared to be more effective than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, largescale, well-designed
randomized controlled trials are required.

<77>
Accession Number
642971725
Title
Long-Term Efficacy of Evolocumab in Patients With and Without Multivessel
Coronary Artery Disease.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
McClintick D.J.; O'Donoghue M.L.; De Ferrari G.M.; Ferreira J.M.; Ran X.;
Im K.A.; Lopez J.A.; Elliott-Davey M.; Wang B.; Monsalvo M.L.; Atar D.;
Keech A.; Giugliano R.P.; Sabatine M.S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In FOURIER, the magnitude of reduction in risk of major
adverse cardiovascular events (MACE) was larger in patients with
multivessel disease (MVD) than in those without. However, the median
follow-up was only 2.2 yrs. The open-label extension (FOURIER-OLE) allows
for a better assessment of the long-term benefit of intensive
lipid-lowering in these two subgroups. <br/>Method(s): Patients with CAD
at time of enrollment in the parent FOURIER trial were categorized based
on the presence or absence of MVD (>=40% stenosis in >=2 large vessels).
Primary endpoint (PEP; CV death, MI, stroke, hospitalization for UA, or
coronary revascularization) and key secondary endpoint (SEP; CV death, MI,
or stroke) were assessed through FOURIER and FOURIER-OLE, during which all
patients received evolocumab. <br/>Result(s): At enrollment in FOURIER,
23,674 patients had CAD, of whom 25% had MVD (N=6007). In the placebo arm,
those with MVD had a higher risk of the PEP (HR 1.45 [95%CI 1.32-1.60],
P<0.0001) & SEP (HR 1.37 [1.22-1.56], P<0.0001) than those without MVD.
The magnitude of the overall relative risk reduction in those initially
randomized to evolocumab tended to be greater in patients with MVD than in
those without (RRR 23% vs. 12% for PEP; 30% vs. 15% for SEP;
P<inf>int</inf> 0.07 & 0.04, respectively). The magnitude of benefit
tended to grow over the first several years (Fig). This was especially
true for CV death, in which for patients with MVD, initial randomization
to evolocumab reduced the risk of CV death in the later years (HR 0.70
[0.51-0.97]; Fig bottom). <br/>Conclusion(s): Evolocumab reduced the rate
of MACE in patients with and without MVD, with earlier and larger benefit
seen in patients with MVD. The magnitude of benefit grew over time,
supporting early initiation of intensive LDL-C lowering both in patients
with and without MVD.

<78>
Accession Number
2029058958
Title
Functionally unicuspid aortic valve in an adult: Case report and
literature review.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102223. Date of Publication: February 2024.
Author
Abraham A.; Charles K.; Pozo D.; Bishev D.; Pondicherry-Harish R.
Institution
(Abraham, Charles, Pozo, Bishev, Pondicherry-Harish) Graduate Medical
Education / HCA Florida North Florida Hospital, Internal Medicine
Residency Program, University of Central Florida College of Medicine, 6500
W Newberry Rd, Gainesville, FL 32605, United States
(Pondicherry-Harish) The Cardiac and Vascular Institute, 1151 NW 64th
Terrace, Gainesville, FL 32605, United States
Publisher
Elsevier Inc.
Abstract
Aortic stenosis is one of the most prevalent cardiac valvular diseases
throughout the world and has a significant impact on quality of life.
While there are several etiologies, we will be discussing the case of a
male in his mid-thirties of southeast Asian descent with a bicuspid aortic
valve which was found to be functionally unicuspid and complicated by
aortic dilation. Following a comprehensive review of literature, it
appears this subset of aortic stenosis is not commonly encountered. In
addition to presenting this fascinating case, we will review the
epidemiology, classification and management of aortic stenosis.
Furthermore, we will examine the latest evidence-based literature on
bicuspid aortic valve and unicuspid aortic valve and discuss interventions
and diagnostic tools that may improve clinical prognosis.<br/>Copyright
&#xa9; 2023

<79>
Accession Number
2028978986
Title
Retraction: Meta-Analysis on the Anesthetic Effects of Remifentanil plus
Dexmedetomidine versus Remifentanil Alone in Cardiac Surgery
(Computational and Mathematical Methods in Medicine (2022) 2022 (1077980)
DOI: 10.1155/2022/1077980).
Source
Computational and Mathematical Methods in Medicine. 2023 (no pagination),
2023. Article Number: 9852927. Date of Publication: 2023.
Author
Anonymous
Publisher
Hindawi Limited
Abstract
This article has been retracted by Hindawi, as publisher, following an
investigation undertaken by the publisher [1]. This investigation has
uncovered evidence of systematic manipulation of the publication and
peer-review process. We cannot, therefore, vouch for the reliability or
integrity of this article. Please note that this notice is intended solely
to alert readers that the peer-review process of this article has been
compromised. Wiley and Hindawi regret that the usual quality checks did
not identify these issues before publication and have since put additional
measures in place to safeguard research integrity. We wish to credit our
Research Integrity and Research Publishing teams and anonymous and named
external researchers and research integrity experts for contributing to
this investigation. The corresponding author, as the representative of all
authors, has been given the opportunity to register their agreement or
disagreement to this retraction. We have kept a record of any response
received.<br/>Copyright &#xa9; 2023 Computational and Mathematical Methods
in Medicine.

<80>
Accession Number
643006177
Title
Randomized Clinical Trial of Hybrid vs. Surgical vs. Percutaneous
Multivessel Coronary Revascularization: 5-year Follow-up of HREVS Trial.
Source
Kardiologiia. 63(11) (pp 57-63), 2023. Date of Publication: 05 Dec 2023.
Author
Ganyukov V.I.; Kochergin N.A.; Shilov A.A.; Tarasov R.S.; Kozyrin K.A.;
Prokudina E.S.; Barbarash O.L.; Barbarash L.S.
Institution
(Ganyukov, Kochergin, Shilov, Tarasov, Kozyrin, Prokudina, Barbarash,
Barbarash) "Scientific Research Institute of Complex Problems of
Cardiovascular Diseases", Kemerovo, Russian Federation
Abstract
Aim To evaluate 5-year results of the HREVS (Hybrid REvascularization
Versus Standarts) study.Material and methods The study included 155
consecutive patients with multivessel coronary artery disease who were
randomized into 3 groups: coronary artery bypass grafting (CABG) (n=50),
hybrid coronary revascularization (HCR) (n=52) and percutaneous coronary
intervention (PCI) (n=53) according to the consensus of the cardiology
team on the technical and clinical feasibility of each of the three
coronary revascularization strategies. The primary endpoint of the study
was residual ischemia 12 months after revascularization according to data
of single-photon emission computed tomography (SPECT). Secondary endpoints
were major adverse cardiac and cerebrovascular events (MACCE) over 5 years
of follow-up, which included all-cause death, myocardial infarction,
stroke, and clinically determined repeat myocardial
revascularization.Results Baseline characteristics of patients did not
differ between study groups. Median residual ischemia determined by SPECT
data after 12 months was not statistically significantly different in the
CABG, HCR and PCI groups: 6.7 [4.6; 8.8]%, 6.4 [4.3; 8.5]% and 7.9 [5.9;
9.8]%, respectively (p=0.45). Mean follow-up period was 76.5 months (at
least 60 months). There were no statistically significant differences in
all-cause mortality between the CABG, HCR and PCI groups, 10.6, 12.8 and
8.2 %, respectively (p=0.23). Statistically significant differences
between the groups of CABG, HCR and PCI in the incidence of myocardial
infarction (12.8; 8.5 and 16.3 %; p=0.12), stroke (4.2; 6.4 and 10.2 % ;
p=0.13), repeat revascularization for clinical indications (23.4; 23.4 and
34.7 %; p=0.11) were not observed either. However, the cumulative 5-year
MACCE value was similar in the HCR group and the CABG group but
significantly lower than in the PCI group (51.1, 51.1 and 69.4 %,
respectively; p = 0.03).Conclusion HCR that combines advantages of PCI and
CABG is a promising strategy for coronary revascularization in multivessel
coronary artery disease. HCR demonstrates satisfactory long-term results
comparable to those of CABG but superior to PCI. To confirm the safety and
efficacy of HCR, a large multicenter study is required that would have a
sufficient power to evaluate clinical endpoints.

<81>
Accession Number
2028994548
Title
The prognostic impact of diastolic dysfunction after transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102228. Date of Publication: February 2024.
Author
Stalikas N.; Anastasiou V.; Botis I.; Daios S.; Karagiannidis E.; Zegkos
T.; Karamitsos T.; Vassilikos V.; Ziakas A.; Kamperidis V.; Giannakoulas
G.; Giannopoulos G.
Institution
(Stalikas, Anastasiou, Botis, Daios, Zegkos, Karamitsos, Ziakas,
Kamperidis, Giannakoulas) AHEPA Hospital, Medical School, Aristotle
University, St. Kiriakidi 1, Thessaloniki GR54636, Greece
(Karagiannidis, Vassilikos, Giannopoulos) Ippokratio General Hospital,
Medical School, Aristotle University, Thessaloniki, Greece
Publisher
Elsevier Inc.
Abstract
Background: Diastolic dysfunction (DD) is a long-established marker of
disease progression in patients with aortic valve stenosis (AS),
indicating valvular myocardial damage. Recently, substantial observational
data have emerged demonstrating that worse pre-operative DD assessed using
echocardiography is associated with adverse long-term clinical outcomes
after transcatheter aortic valve replacement (TAVR). <br/>Aim(s): To
systematically appraise and quantitatively synthesize current evidence on
the prognostic impact of echocardiographic severe DD derived by
echocardiography before TAVR. <br/>Method(s): A systemic literature review
was undertaken in electronic databases to identify studies reporting the
predictive value of severe DD in AS subjects undergoing TAVR. A
random-effects meta-analysis was conducted to quantify the adjusted and
unadjusted hazard ratios (HRs) for all-cause mortality and major adverse
cardiovascular events (MACEs) for the presence of severe DD.
<br/>Result(s): Ten studies were deemed eligible for inclusion. Of those,
9 provided appropriate quantitative data for the meta-analysis,
encompassing a total of 4,619 patients. The presence of severe DD was
associated with increased risk for all-cause mortality (pooled unadjusted
HR=2.56 [1.46-4.48]; p<0.01; I²=76 %) and MACEs (pooled
unadjusted HR=1.82 [1.29-2.58]; p<0.01; I²=86 %). When adjusted
for clinically-relevant parameters, the presence of severe DD retained
independent association with all-cause mortality (pooled adjusted HR=2.35
[1.26-4.37]; p<0.01; I²=79 %) and MACEs (pooled adjusted HR=
2.52 [1.72-3.65]; p<0.01; I²=0 %). In subgroup analysis there
was no difference on post-TAVR risk between the use of different diastolic
function grading scores. <br/>Conclusion(s): Presence of severe DD
assessed by echocardiography pre-TAVR is a major determinant of long-term
adverse outcomes after the procedure.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<82>
Accession Number
2026999682
Title
Direct Oral Anticoagulants use in Patients with Stable Coronary Artery
Disease, Acute Coronary Syndrome or Undergoing Percutaneous Coronary
Intervention.
Source
Current Pharmaceutical Design. 29(35) (pp 2787-2794), 2023. Date of
Publication: 2023.
Author
Sagris M.; Theofilis P.; Papanikolaou A.; Antonopoulos A.S.; Tsioufis C.;
Tousoulis D.
Institution
(Sagris, Theofilis, Papanikolaou, Antonopoulos, Tsioufis, Tousoulis) 1st
Cardiology Department, "Hippokration" General Hospital, University of
Athens Medical School, Athens, Greece
Publisher
Bentham Science Publishers
Abstract
The investigation for the optimal anticoagulation strategy for patients
with stable coronary artery disease, acute coronary syndromes, and
undergoing percutaneous coronary intervention constitutes a great
challenge for physicians and is a field of extensive research. Although
aspirin is commonly recommended as a protective measure for all patients
with coronary artery disease and dual antiplatelet therapy for those
undergoing procedures, such as percutaneous coronary intervention or
coronary artery bypass graft surgery, the risk of recurrent cardiovascular
events remains significant. In this context, the shortcomings associated
with the use of vitamin K antagonists have led to the assessment of direct
oral anticoagulants as promising alternatives. This review will explore
and provide a comprehensive analysis of the existing data regarding the
use of direct oral anticoagulants in patients with stable coronary artery
disease or acute coronary syndrome, as well as their effectiveness in
those undergoing percutaneous coronary intervention or coronary artery
bypass graft surgery.<br/>Copyright &#xa9; 2023 Bentham Science
Publishers.

<83>
[Use Link to view the full text]
Accession Number
2029038297
Title
Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer
Care Ontario) Guideline.
Source
Journal of Clinical Oncology. 41(35) (pp 5448-5472), 2023. Date of
Publication: 10 Dec 2023.
Author
Khurshid H.; Ismaila N.; Bian J.; Dabney R.; Das M.; Ellis P.; Feldman J.;
Hann C.; Kulkarni S.; Laskin J.; Manochakian R.; Mishra D.R.; Preeshagul
I.; Reddy P.; Saxena A.; Weinberg F.; Kalemkerian G.P.
Institution
(Khurshid) Brown University, Providence, RI, United States
(Ismaila) American Society of Clinical Oncology (ASCO), Alexandria, VA,
United States
(Bian) Maine Health, South Portland, ME, United States
(Dabney) Texas Oncology, Grapevine, TX, United States
(Das) Stanford University, Stanford, CA, United States
(Ellis) Juravinski Cancer Center, Hamilton Health Sciences, Hamilton, ON,
Canada
(Feldman) EGFR Resisters Patient Advocacy Group, Deerfield, IL, United
States
(Hann) Johns Hopkins University, Baltimore, MD, United States
(Kulkarni) Western University, Windsor Regional Cancer Program, Windsor,
ON, Canada
(Laskin) University of British Columbia, Vancouver, BC, Canada
(Manochakian) Mayo Clinic, Jacksonville, FL, United States
(Mishra) Janata Clinic, Aloknagar, Kathmandu, Nepal
(Preeshagul) Memorial Sloan Kettering Cancer Center, Montvale, NJ, United
States
(Reddy) Cancer Center of Kansas, Wichita, KS, United States
(Saxena) Weill Cornell Medicine, New York, NY, United States
(Weinberg) University of Illinois, Chicago, IL, United States
(Kalemkerian) University of Michigan, Ann Arbor, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE To provide evidence-based recommendations to practicing clinicians
on the management of patients with small-cell lung cancer. METHODS An
Expert Panel of medical oncology, thoracic surgery, radiation oncology,
pulmonary, community oncology, research methodology, and advocacy experts
were convened to conduct a literature search, which included systematic
reviews, meta-analyses, and randomized controlled trials published from
1990 through 2022. Outcomes of interest included response rates, overall
survival, disease-free survival or recurrence-free survival, and quality
of life. Expert Panel members used available evidence and informal
consensus to develop evidence-based guideline recommendations. RESULTS The
literature search identified 95 relevant studies to inform the evidence
base for this guideline. RECOMMENDATIONS Evidence-based recommendations
were developed to address systemic therapy options, timing of therapy,
treatment in patients who are older or with poor performance status, role
of biomarkers, and use of myeloid-supporting agents in patients with
small-cell lung cancer. Additional information is available at
www.asco.org/thoracic-cancerguidelines.<br/>Copyright &#xa9; 2023 by
American Society of Clinical Oncology.

<84>
Accession Number
643006100
Title
Residual leaks following percutaneous left atrial appendage occlusion and
outcomes: a meta-analysis.
Source
European heart journal. (no pagination), 2023. Date of Publication: 13
Dec 2023.
Author
Samaras A.; Papazoglou A.S.; Balomenakis C.; Bekiaridou A.; Moysidis D.V.;
Patsiou V.; Orfanidis A.; Giannakoulas G.; Kassimis G.; Fragakis N.; Saw
J.; Landmesser U.; Alkhouli M.A.; Tzikas A.
Institution
(Samaras, Moysidis, Kassimis, Fragakis, Tzikas) Second Department of
Cardiology, Faculty of Health Sciences, School of Medicine, General
Hospital 'Hippokration', Aristotle University of Thessaloniki,
Konstantinoupoleos 49, Thessaloniki 54642, Greece
(Papazoglou, Balomenakis, Bekiaridou, Moysidis, Patsiou, Orfanidis)
Faculty of Health Sciences, School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece
(Bekiaridou) Institute of Bioelectronic Medicine, Feinstein Institutes for
Medical Research, Manhasset, NY, United States
(Patsiou, Giannakoulas) First Department of Cardiology, Faculty of Health
Sciences, School of Medicine, AHEPA University Hospital, Aristotle
University of Thessaloniki, Thessaloniki, Greece
(Saw) Division of Cardiology, Vancouver General Hospital, University of
British Columbia, Vancouver, Canada
(Landmesser) Department of Cardiology, Charite Universitatsmedizin,
Berlin, Germany
(Alkhouli) Department of Cardiovascular Disease, Mayo Clinic, Rochester,
MN, United States
(Tzikas) European Interbalkan Medical Center, Department of Cardiology,
Asklipiou 10, Pylaia, Thessaloniki 57001, Greece
Abstract
BACKGROUND AND AIMS: Residual leaks are not infrequent after left atrial
appendage occlusion. However, there is still uncertainty regarding their
prognostic implications. The aim of this study is to evaluate the impact
of residual leaks after left atrial appendage occlusion. <br/>METHOD(S): A
literature search was conducted until 19 February 2023. Residual leaks
comprised peri-device leaks (PDLs) on transoesophageal echocardiography
(TEE) or computed tomography (CT), as well as left atrial appendage
patency on CT. Random-effects meta-analyses were performed to assess the
clinical impact of residual leaks. <br/>RESULT(S): Overall 48 eligible
studies (44 non-randomized/observational and 4 randomized studies)
including 61 666 patients with atrial fibrillation who underwent left
atrial appendage occlusion were analysed. Peri-device leak by TEE was
present in 26.1% of patients. Computed tomography-based left atrial
appendage patency and PDL were present in 54.9% and 57.3% of patients,
respectively. Transoesophageal echocardiography-based PDL (i.e. any
reported PDL regardless of its size) was significantly associated with a
higher risk of thromboembolism [pooled odds ratio (pOR) 2.04, 95%
confidence interval (CI): 1.52-2.74], all-cause mortality (pOR 1.16, 95%
CI: 1.08-1.24), and major bleeding (pOR 1.12, 95% CI: 1.03-1.22), compared
with no reported PDL. A positive graded association between PDL size and
risk of thromboembolism was noted across TEE cut-offs. For any PDL of >0,
>1, >3, and >5 mm, the pORs for thromboembolism were 1.82 (95% CI:
1.35-2.47), 2.13 (95% CI: 1.04-4.35), 4.14 (95% CI: 2.07-8.27), and 4.44
(95% CI: 2.09-9.43), respectively, compared with either no PDL or PDL
smaller than each cut-off. Neither left atrial appendage patency, nor PDL
by CT was associated with thromboembolism (pOR 1.45 and 1.04, 95% CI:
0.84-2.50 and 0.52-2.07, respectively). <br/>CONCLUSION(S): Peri-device
leak detected by TEE was associated with adverse events, primarily
thromboembolism. Residual leaks detected by CT were more frequent but
lacked prognostic significance.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<85>
Accession Number
643004907
Title
Systematic review of carbon footprint of surgical procedures.
Source
Journal of visceral surgery. (no pagination), 2023. Date of Publication:
11 Dec 2023.
Author
de'Angelis N.; Conso C.; Bianchi G.; Rodriguez A.G.B.; Marchegiani F.;
Carra M.C.; Lafont C.; Canoui-Poitrine F.; Slim K.; Pessaux P.
Institution
(de'Angelis, Bianchi, Rodriguez, Marchegiani) DIGEST department, unit of
colorectal and digestive surgery, faculty of medicine, Beaujon university
hospital, university of Paris Cite, AP-HP, Paris, France
(Conso) Service de chirurgie orthopedique, Institut Mutualiste Montsouris,
boulevard Jourdan, Paris 75014, France
(Carra) Service of odontology, department of periodontology, Rothschild
hospital, universite de Paris, AP-HP, Paris 75006, France
(Lafont, Canoui-Poitrine) Service de sante publique, hopital Henri-Mondor,
94010 Creteil cedex, France; IMRB, Inserm U955, equipe Clinical
Epidemiology And Ageing (CEpiA), universite Paris Est Creteil (UPEC),
France
(Slim) Department of digestive surgery, Francophone Group for Enhanced
Recovery After Surgery (GRACE), university hospital, CHU Clermont-Ferrand,
place Lucie-Aubrac, France
(Pessaux) Digestive surgery department, HPB unit, Nouvel Hopital Civil,
university of Strasbourg, place de l'Hopital, Strasbourg 67091, France
Abstract
The ecological sustainability of the operating room (OR) is a matter of
recent interest. The present systematic review aimed to review the current
literature assessing the carbon footprint of surgical procedures in
different surgical fields. Following to the PRISMA statement checklist,
three databases (MEDLINE, EMBASE, Cochrane Library) were searched by
independent reviewers, who screened records on title and abstract first,
and then on the full text. Risk of bias was evaluated using the MINORS
system. Over the 878 articles initially identified, 36 original studies
were included. They considered ophthalmologic surgical procedures (30.5%),
general/digestive surgery (19.4%), gynecologic procedures (13.9%),
orthopedic procedures (8.3%), neurosurgery (5.5%), otolaryngology/head and
neck surgery (5.5%), plastic/dermatological surgery (5.5%), and cardiac
surgery (2.8%). Despite a great methodological heterogeneity, data showed
that a single surgical procedure emits 4-814 kgCO2e, with anesthetic gases
and energy consumption representing the largest sources of greenhouse gas
emission. Minimally invasive surgical techniques may require more
resources than conventional open surgery, particularly for packaging and
plastics, energy use, and waste production. Each OR has the potential to
produce from 0.2 to 4kg of waste per case with substantial differences
depending on the type of intervention, hospital setting, and geographic
area. Overall, the selected studies were found to be of moderate quality.
Based on a qualitative synthesis of the available literature, the OR can
be targeted by programs and protocols implemented to reduce the carbon
footprint and improve the waste stream of the OR.<br/>Copyright &#xa9;
2023 Elsevier Masson SAS. All rights reserved.

<86>
Accession Number
642989290
Title
Health-related quality of life following TAVI or cardiac surgery in
patients at intermediate and low risk: a systematic review and
meta-analysis.
Source
Clinical medicine (London, England). 23(6) (pp 594-605), 2023. Date of
Publication: 01 Nov 2023.
Author
Gonnah A.R.; Abdelwahab M.; Taylor R.; Labib A.; Masoud O.; Debski M.;
Abdelaziz H.K.; Roberts D.H.
Institution
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Abdelwahab) Boston University, Boston, MA, United States
(Taylor) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Labib) Southport and Ormskirk NHS Foundation Trust, Southport, United
Kingdom
(Masoud) University College London Hospitals NHS Foundation Trust, London,
United Kingdom
(Debski) University of East Anglia, UK and research fellow, Norfolk and
Norwich University Hospital, Norwich, United Kingdom
(Abdelaziz) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) Lancashire Cardiac Centre, honorary senior lecturer, University
of Liverpool, Blackpool, United Kingdom
Abstract
Recent randomised trials have shown that clinical outcomes with
transcatheter aortic valve implantation (TAVI) are non-inferior to
surgical aortic valve replacement (SAVR) in patients with symptomatic
aortic stenosis at intermediate to low risk. Health-related quality of
life (HrQoL) outcomes in these patient groups remain uncertain. A
systematic search of the literature was conducted that included nine
trials and 11,295 patients. Kansas City Cardiomyopathy Questionnaire
(KCCQ), a heart-failure-specific measure and EuroQol-5D (EQ-5D) (a generic
health status tool) changes were the primary outcomes. New York Heart
Association (NYHA) classification was the secondary outcome. Improvement
in KCCQ scores was greater with TAVI (mean difference (MD)=13.56, 95%
confidence interval (CI) 11.67-15.46, p<0.001) at 1 month, as was the
improvement in EQ-5D (MD=0.07, 95% CI 0.05-0.08, p<0.001). There was no
difference in KCCQ (MD=1.05, 95% CI -0.11 to 2.21, p=0.08) or EQ-5D
(MD=-0.01, 95% CI -0.03 to 0.01), p=0.37) at 12 months. NYHA functional
class 3/4 was lower in patients undergoing TAVI at 1 month (MD=0.51, 95%
CI 0.34-0.78, p=0.002), but there was no difference at 12 months (MD=1.10;
95% CI 0.87-1.38, p=0.43). Overall, TAVI offers early benefit in HRQoL
outcomes compared with SAVR, but they are equivalent at 12
months.<br/>Copyright &#xa9; Royal College of Physicians 2023. All rights
reserved.

<87>
Accession Number
643003803
Title
Innovative designs for trials informing the care of cardiac surgical
patients: part I.
Source
Current opinion in anaesthesiology. (no pagination), 2023. Date of
Publication: 01 Dec 2023.
Author
Anusic N.; Sessler D.I.
Institution
(Anusic) Department of Outcomes Research, Cleveland Clinic, Cleveland, OH,
United States
Abstract
PURPOSE OF REVIEW: Randomized clinical trials, now commonplace and
regarded as top-tier evidence, are actually a recent development. The
first randomized trial took place in 1948, just six decades ago. As
anticipated from a relatively young field, rapid progress continues in
response to an ever-increasing number of medical questions that demand
answers. We examine evolving methodologies in cardiac anesthesia clinical
trials, focusing on the transition towards larger sample sizes, increasing
use of pragmatic trial designs, and the innovative adoption of real-time
automated enrollment and randomization. We highlight how these changes
enhance the reliability and feasibility of clinical trials. RECENT
FINDINGS: Recent understanding in clinical trial methodology acknowledges
the importance of large sample sizes, which increase the reliability of
findings. As illustrated by P value fragility, small trials can mislead
despite statistical significance. Pragmatic trials have gained prominence,
offering real-world insights into the effectiveness of various treatments.
Additionally, the use of real-time automated enrollment and randomization,
particularly in situations where obtaining prior consent is impractical is
an important methodological advance. SUMMARY: The landscape of cardiac
anesthesia clinical trials is rapidly evolving, with a clear trend towards
large sample sizes and innovative approaches to enrollment. Recent
developments enhance the quality and applicability of research findings,
thus providing robust guidance to clinicians.<br/>Copyright &#xa9; 2023
Wolters Kluwer Health, Inc. All rights reserved.

<88>
Accession Number
643003748
Title
Get your 7-point golden medal for pain management in video-assisted
thoracoscopic surgery.
Source
Current opinion in anaesthesiology. (no pagination), 2023. Date of
Publication: 10 Nov 2023.
Author
Hoogma D.F.; Brullot L.; Coppens S.
Institution
(Hoogma, Brullot, Coppens) Department of Anesthesiology, University
Hospitals of Leuven
(Hoogma, Coppens) Department of Cardiovascular Sciences, Biomedical
Sciences Group, University of Leuven, Leuven, Belgium
Abstract
PURPOSE OF REVIEW: Thoracic surgery is evolving, necessitating an
adaptation for perioperative anesthesia and analgesia. This review
highlights the recent advancements in perioperative (multimodal) analgesia
for minimally invasive thoracic surgery. RECENT FINDINGS: Continuous
advancements in surgical techniques have led to a reduction in surgical
trauma. However, managing perioperative pain remains a major challenge,
impeding postoperative recovery. The traditional neuraxial technique is
now deemed outdated for minimally invasive thoracic surgery. Instead,
newer regional techniques have emerged, and traditional approaches have
undergone (re-)evaluation by experts and professional societies to
establish guidelines and practices. Assessing the quality of recovery,
evenafter discharge, has become a crucial factor in evaluating the
effectiveness of these strategies, aiding clinicians in making informed
decisions to improve perioperative care. SUMMARY: In the realm of
minimally invasive thoracic surgery, perioperative analgesia is typically
administered through systemic and regional techniques. Nevertheless,
collaboration between anesthesiologists and surgeons, utilizing surgically
placed nerve blocks and an active chest drain management, has the
potential to significantly improve overall patient care.<br/>Copyright
&#xa9; 2023 Wolters Kluwer Health, Inc. All rights reserved.

<89>
Accession Number
643003516
Title
Innovative designs for trials informing the care of cardiac surgical
patients: Part II.
Source
Current opinion in anaesthesiology. (no pagination), 2023. Date of
Publication: 08 Dec 2023.
Author
Anusic N.; Sessler D.I.
Institution
(Anusic) Department of Outcomes Research, Cleveland Clinic, Cleveland, OH,
United States
Abstract
PURPOSE OF REVIEW: This review examines advances in clinical trial
methodologies relevant to cardiac anesthesia. It focuses on innovative
approaches, including factorial randomization, composite outcomes, and
cluster randomized trials, which enhance the efficiency, practical
relevance, and generalizability of trial outcomes. RECENT FINDINGS:
Factorial randomization is becoming popular because the approach allows
investigators to simultaneously evaluate two or more interventions.
Furthermore, factorial designs can evaluate interactions among treatments,
which is highly relevant information that cannot be obtained from separate
trials. Composite outcomes are also increasingly utilized, combining
multiple individual outcomes into a single measure, which increases
statistical power and can better represent relevant physiology. Designing
valid composites requires careful consideration of component outcome
severity and incidence. Cluster randomized trials, including stepped wedge
and multiple crossover designs, are addressing the challenges of
group-level effects and shared environments. SUMMARY: The evolution of
clinical trial designs is marked by a shift towards methodologies that
enhance efficiency and provide more nuanced insights into treatment
effects. These include factorial designs for simultaneous intervention
assessment, composite outcomes for comprehensive physiological
representation, and cluster trials for group-level effect analysis. Such
advancements are shaping the future of clinical research, making it more
relevant, efficient, and broadly applicable.<br/>Copyright &#xa9; 2023
Wolters Kluwer Health, Inc. All rights reserved.

<90>
Accession Number
642999414
Title
Coronary Artery Aneurysms, Arteriovenous Malformations, and Spontaneous
Dissections - A Review of the Evidence.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 09 Dec 2023.
Author
Dimagli A.; Malas J.; Chen S.; Sandner S.; Scwhann T.; Tatoulis J.; Puskas
J.; Bowdish M.E.; Gaudino M.
Institution
(Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY
(Malas, Bowdish) Department of Cardiac Surgery, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Chen) Division of Cardiac Surgery, University of California Davis Health,
Sacramento, CA, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Scwhann) Department of Surgery, University of Massachusetts-Baystate,
Springfield, MA, United States
(Tatoulis) Royal Melbourne Hospital, University of Melbourne, Melbourne,
Australia
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY. Electronic address: mfg9004@med.cornell.edu
Abstract
BACKGROUND: Coronary artery aneurysms (CAAs), arteriovenous malformations
(CAVMs), and spontaneous dissections (SCAD) are rare clinical entities and
much is unknown about their natural history, prognosis and management.
<br/>METHOD(S): A systematic search of MEDLINE, Embase and Cochrane
Library databases was performed in March 2023 to identify published papers
related to CAAs, CAVMs and SCAD. <br/>RESULT(S): CAAs are found in 0.3-12%
of patients undergoing angiography and are often associated with coronary
atherosclerosis. They are usually asymptomatic but can be complicated by
thrombosis in up to 4.8% of patients and rarely by rupture (0.2%). CAAs
can be managed medically, percutaneously using stents or coil
embolization, and surgically. The most common surgical procedure is
ligation of the aneurysm followed by coronary artery bypass grafting
(CABG). The incidence of CAVMs is 0.1-0.2% in patients undergoing
angiography and they are most likely associated with congenital abnormal
development of the coronary vessels. The diagnosis of CAVMs is usually
incidental. Surgical or percutaneous intervention is indicated for
patients with large CAVMs, which carry a potential risk of myocardial
infarction. SCADs represent 1-4% of all acute coronary syndromes and
typically affect young women. SCADs are strongly correlated with pregnancy
suggesting the role of sex hormones in their pathogenesis. Conservative
management of SCAD is preferred for stable patients without signs of
ischemia as spontaneous resolution is frequently reported. Unstable
patients should undergo revascularization either percutaneously or with
CABG. <br/>CONCLUSION(S): Further evidence regarding the management of
these rare diseases is needed and can ideally be derived from multi-center
collaborations.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<91>
Accession Number
642999330
Title
Antithrombotic therapy in patients after transcatheter aortic valve
implantation: a network meta-analysis.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2023. Date of Publication: 11 Dec 2023.
Author
Turgeon R.D.; Ellis U.M.; Barry A.R.
Institution
(Turgeon, Barry) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC, Canada
(Turgeon) St. Paul's Hospital, Vancouver, BC, Canada
(Ellis) Woodward Library, University of British Columbia, Vancouver, BC,
Canada
(Barry) Jim Pattison Outpatient Care and Surgery Centre, Lower Mainland
Pharmacy Services, Surrey, BC, Canada
Abstract
AIMS: The optimal antithrombotic therapy to balance the risk of thrombosis
and bleeding in patients who undergo transcatheter aortic valve
implantation (TAVI) is unknown. This systematic review/network
meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the
efficacy and safety of different oral anticoagulant and antiplatelet
regimens in patients post-TAVI. METHODS AND RESULTS: MEDLINE, Embase,
CENTRAL, and ClinicalTrials.gov were searched from inception to April
2023. Co-primary outcomes were all-cause death and major bleeding. We
conducted Bayesian network meta-analyses to compare all interventions
simultaneously. For each outcome, we generated odds ratios (ORs) with 95%
credible intervals using a random-effects model with informative priors,
and ranked interventions based on mean surface under the cumulative
ranking curve. We included 11 RCTs (n = 6415), including one unpublished
RCT. Three trials enrolled patients with an indication for an oral
anticoagulant (OAC). Overall risk of bias was low or with some concerns.
Median age was 81 years. Median follow-up was 6 months. The Combination of
OAC plus single antiplatelet therapy (SAPT) increased the risk of
all-cause death compared with dual antiplatelet therapy (DAPT) (OR 1.78,
95% credible interval 1.15-2.77). No other comparisons for all-cause death
were significantly different. For major bleeding, SAPT reduced the risk
compared with DAPT, direct-acting OAC, and OAC + SAPT (OR 0.20-0.40), and
DAPT reduced the risk compared with OAC + SAPT. SAPT and DAPT ranked best
for all-cause death, while SAPT ranked best for major bleeding.
<br/>CONCLUSION(S): In post-TAVI patients, SAPT may provide the optimal
balance of reducing thrombotic events while minimizing the risk of
bleeding.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<92>
Accession Number
642998872
Title
Perioperative Outcomes of Bi-Pigtail Catheters Drainage Strategy Versus
Conventional Chest Tube after Uni-Portal Video-Assisted Thoracic Lung
Surgery.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 11 Dec 2023.
Author
Song L.; Chen X.; Zhu L.; Qian G.; Xu Y.; Song Z.; Li J.; Chen T.; Huang
J.; Luo Q.; Cheng X.; Yang Y.
Institution
(Song, Chen, Song, Li, Chen, Huang, Luo, Cheng, Yang) Department of
Oncological Surgery, Shanghai Chest Hospital Affiliated to Shanghai
Jiaotong University School of Medicine, 241 West Huaihai Road ,Xuhui
District, Shanghai 200030, China
(Zhu) Department of Radiology, Shanghai Chest Hospital, Shanghai Chest
Hospital Affiliated to Shanghai Jiaotong University School of Medicine,
241 West Huaihai Road ,Xuhui District, Shanghai 200030, China
(Qian) Department of Thoracic Surgery, Zhangjiagang Third People's
Hospital, 8 Middle Renmin Road, Suzhou, China
(Xu) Department of Thoracic Surgery, Zhejiang Hospital Affiliated to
Zhejiang University School of Medicine, West Lake District, 12 Lingyin
Road, Hangzhou 310013, China
Abstract
BACKGROUND: Chest tube drainage is a main cause of postoperative pain in
lung surgery. Here, we introduced a novel drainage strategy with
bi-pigtail catheters and conducted a randomized controlled trial to
compare with conventional chest tube drainage after uniportal VATS lung
surgery. <br/>METHOD(S): A single-center, prospective, open-labelled,
randomized controlled trial (ChiCTR2000035337) was conducted with a
preplanned sample size of 396. The primary outcome was the numerical pain
rating scale (NPRS) on the first postoperative day. Secondary outcomes
included other indicators of postoperative pain, drainage volume, duration
of drainage, postoperative hospital stay, incidence of postoperative
complications, chest tube reinsertion, and medical costs. <br/>RESULT(S):
A total number of 396 patients were randomized between August 2020 and
January 2021, 387 of which were included in the final analysis. The
baseline and clinical characteristics of the patients were well balanced
between two groups. The NPRS on the first postoperative day was
significantly lower in the Pigtail Catheter (PC) group than in the Chest
Tube (CT) group (2.40+/-1.27 vs 3.02+/-1.39, p<0.001), as well as the
second/third-day NPRS, the incidence of sudden severe pain (9/192, 4.7% vs
34/195, 17.4%, p<0.001), and pain requiring intervention (19/192, 9.9% vs
46/195, 23.6%, p<0.001). In addition, the medical cost in the PC group was
lower (US$7809+/-1646 vs $8205+/-1815, p=0.025). Univariable and
multivariable analyses revealed that the drainage strategy was the only
factor influencing the incidence of pain requiring intervention.
<br/>CONCLUSION(S): The drainage strategy with bi-pigtail catheters in
patients undergoing uniportal VATS lung surgery alleviates postoperative
pain with adequate safety and efficacy.<br/>Copyright &#xa9; The Author(s)
2023. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<93>
Accession Number
642993633
Title
Long-term Outcomes of Valve-in-Valve Transcatheter Aortic Valve
Implantation Versus Redo Surgical Aortic Valve Replacement: Meta-Analysis
of Kaplan-Meier-derived Data.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 07 Dec 2023.
Author
Sa M.P.; Jacquemyn X.; Serna-Gallegos D.; Makani A.; Kliner D.; Toma C.;
West D.; Ahmad D.; Yousef S.; Brown J.A.; Yoon P.; Kaczorowski D.; Bonatti
J.; Chu D.; Sultan I.
Institution
(Sa) Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, Pennsylvania; UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address:
michel_pompeu@yahoo.com.br
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Serna-Gallegos, West, Ahmad, Yousef, Brown, Yoon, Kaczorowski, Bonatti,
Chu, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, Pennsylvania; UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
(Makani, Kliner, Toma) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of
Interventional Cardiology, University of Pittsburgh, Pittsburgh,
Pennsylvania
Abstract
Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) in
patients with failed bioprostheses arose as an alternative to redo
surgical aortic valve replacement (SAVR). To evaluate all-cause mortality
in ViV-TAVI versus redo SAVR, we performed study-level meta-analysis of
reconstructed time-to-event data from Kaplan-Meier curves of
non-randomized studies published by August 2023. Sixteen studies met our
eligibility criteria with a total of 4,373 patients (2,204 patients
underwent ViV-TAVI and 2,169 patients underwent redo SAVR). Pooling all
the studies, ViV-TAVI showed a lower risk of all-cause mortality in the
first 6 months [hazard ratio (HR) 0.58, 95% confidence interval (CI)
0.46-0.73, P<0.001], with an HR reversal after this timepoint favoring
redo SAVR (HR 1.92; 95%CI 1.58-2.33; P<0.001). Pooling only the matched
populations (which represented 64.6% of the overall population), ViV-TAVI
showed a lower risk of all-cause mortality in the first 6 months days (HR
0.56, 95%CI 0.43-0.73, P<0.001], with a reversal after 6 months days
favoring redo SAVR (HR 1.55; 95% CI 1.25-1.93; P<0.001). The
meta-regression analyses revealed a modulating effect of the following
covariates: age, coronary artery disease (CAD), history of coronary artery
bypass graft (CABG) surgery and implanted valves <25mm. In conclusion,
ViV-TAVI is associated with better survival immediately after the
procedure in comparison with redo SAVR, however, this primary advantage
reverses over time and redo SAVR seems to offer better survival at a later
stage. Since these results are pooled data from observational studies,
they should be interpreted with caution and randomized controlled trials
are warranted.<br/>Copyright &#xa9; 2023 Elsevier Ltd. All rights
reserved.

<94>
Accession Number
642988732
Title
Extract from the 2022 ESC Guidelines on cardiovascular assessment and
management of patients undergoing non-cardiac surgery - Patient Blood
Management.
Source
Blood transfusion = Trasfusione del sangue. (no pagination), 2023. Date
of Publication: 06 Dec 2023.
Author
Halvorsen S.; Mehilli J.; Choorapoikayil S.; Zacharowski K.
Institution
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval,
University of Oslo, Oslo, Norway
(Mehilli) Department of Cardiology, Pneumology and Intensive Medicine,
Hospital Landshut-Achdorf, Landshut, Germany
(Mehilli) Munich University Clinic, Ludwig-Maximilians University, Munich,
Germany
(Mehilli) German Centre for Cardiovascular Research (DZHK), partner site
Munich Heart Alliance, Munich, Germany
(Choorapoikayil, Zacharowski) University Hospital Frankfurt, Department of
Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe
University FrankfurtFrankfurt, Germany
Abstract
The 2022 Guidelines on cardiovascular assessment and management of
patients undergoing non-cardiac surgery of the European Society of
Cardiology are an update on the previous guidelines reported in 2014. The
revised guidelines provide standardized perioperative cardiovascular
management of surgical patients and emphasis on risk assessment of the
patient combined with the inherent risk of the surgical procedure. One of
the novelties in these guidelines is the Patient Blood Management
programme, which is based on a three pillar concept: preoperative
hemoglobin optimization, minimize iatrogenic blood loss and bleeding, and
harness tolerance to anemia in an effort to improve patient outcome. In
this review, we highlight the three pillars of Patient Blood Management
and recommendations made by the 2022 ESC Guidelines on cardiovascular
assessment and management of patients undergoing non-cardiac surgery.

<95>
Accession Number
642987936
Title
Individualised, perioperative open-lung ventilation strategy during
one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled
clinical trial.
Source
The Lancet. Respiratory medicine. (no pagination), 2023. Date of
Publication: 05 Dec 2023.
Author
Ferrando C.; Carraminana A.; Pineiro P.; Mirabella L.; Spadaro S.; Librero
J.; Ramasco F.; Scaramuzzo G.; Cervantes O.; Garutti I.; Parera A.;
Argilaga M.; Herranz G.; Unzueta C.; Vives M.; Regi K.; Costa-Reverte M.;
Sonsoles Leal M.; Nieves-Alonso J.; Garcia E.; Rodriguez-Perez A.; Farina
R.; Cabrera S.; Guerra E.; Gallego-Ligorit L.; Herrero-Izquierdo A.;
Valles-Torres J.; Ramos S.; Lopez-Herrera D.; De La Matta M.; Gokhan S.;
Kucur E.; Mugarra A.; Soro M.; Garcia L.; Sastre J.A.; Aguirre P.; Salazar
C.J.; Ramos M.C.; Morocho D.R.; Trespalacios R.; Ezequiel-Fernandez F.;
Lamanna A.; Pia Cantatore L.; Laforgia D.; Bellas S.; Lopez C.;
Navarro-Ripoll R.; Martinez S.; Vallverdu J.; Jacas A.; Yepes-Temino M.J.;
Belda F.J.; Tusman G.; Suarez-Sipmann F.; Villar J.
Institution
(Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain;
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III,
Madrid, Spain. Electronic address: cafeoranestesia@gmail.com
(Carraminana, Navarro-Ripoll, Vallverdu, Jacas) Department of
Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona,
Spain
(Pineiro, Garutti, Ramos, Martinez) Department of Anesthesiology and
Critical Care, Hospital Universitario Gregorio Maranon, Madrid, Spain
(Mirabella, Lamanna, Pia Cantatore, Laforgia) Department of Medical and
Surgical Sciences, Universita Degli Studi di Foggia, Foggia, Italy
(Spadaro, Scaramuzzo) Department of Anesthesiology and Critical Care,
Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
(Librero) UPNA, REDISSEC Red de Investigacion en Servicios de Salud,
Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
(Ramasco, Nieves-Alonso, Garcia) Department of Anesthesiology and Critical
Care, Hospital Universitario de La Princesa, Madrid, Spain
(Cervantes) Department of Anesthesiology and Critical Care, Hospital
Universitario Germans Trias i Pujol, Barcelona, Spain
(Parera, Argilaga, Herranz, Unzueta) Department of Anesthesiology and
Critical Care, Hospital Universitario Santa Creu i Sant Pau, Barcelona,
Spain
(Vives, Regi) Department of Anesthesiology and Critical Care, Hospital
Universitario Josep Trueta, Girona, Spain
(Costa-Reverte) Department of Anesthesiology and Critical Care, Hospital
Universitario de Bellvitge, Barcelona, Spain
(Sonsoles Leal) Hospital Rivera Povisa, Vigo, Spain
(Rodriguez-Perez, Farina, Cabrera, Guerra) Department of Anesthesiology
and Critical Care, Hospital Universitario de Gran Canaria Dr Negrin, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Department of
Anesthesiology and Critical Care, Hospital Universitario Miguel Servet,
Zaragoza, Spain; Instituto de Investigacion Sanitaria Aragon IIS Aragon,
Zaragoza, Spain
(Lopez-Herrera, De La Matta) Department of Anesthesiology and Critical
Care, Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Gokhan) Department of Anesthesiology and Critical Care, Bakirkoy Dr Sadi
Konuk Training and Research Hospital, Istanbul, Turkey; Outcomes Research
Consortium, Cleveland, OH, USA
(Kucur) Department of Anesthesiology and Critical Care, Bakirkoy Dr Sadi
Konuk Training and Research Hospital, Istanbul, Turkey
(Mugarra, Soro, Garcia, Belda) Department of Anesthesiology and Critical
Care, Hospital Universitario Clinico de Valencia, Valencia, Spain
(Sastre) Department of Anesthesiology and Critical Care, Hospital
Universitario de Salamanca, Salamanca, Spain
(Aguirre) Department of Anesthesiology and Critical Care, Hospital Alvaro
Cunqueiro, Vigo, Spain
(Salazar, Ramos) Department of Anesthesiology and Critical Care, Hospital
Universitario Ntra Sra de Candelaria, Santa Cruz de Tenerife, Spain
(Morocho) Department of Anesthesiology, Hospital Eugenio Espejo, Quito,
Ecuador
(Trespalacios, Ezequiel-Fernandez) Department of Anesthesiology and
Critical Care, Hospital Universitario Central de Asturias, Oviedo, Spain
(Bellas) Department of Anesthesiology and Critical Care, Hospital
Universitario Fundacion Jimenez Diaz, Madrid, Spain
(Lopez) Department of Anesthesiology and Critical Care, Hospital
Universitario Marques de Valdecilla, Santander, Spain
(Yepes-Temino) Department of Anesthesiology and Critical Care, Clinica
Universidad de Navarra, Pamplona, Spain
(Tusman) Department of Anesthesiology, Hospital Privado de Comunidad, Mar
de Plata, Buenos Aires, Argentina
(Suarez-Sipmann) CIBER de Enfermedades Respiratorias CIBERES, Instituto de
Salud Carlos III, Madrid, Spain; Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
(Villar) CIBER de Enfermedades Respiratorias, Madrid, Spain; Hospital
Universitario Dr Negrin, Las Palmas de Gran Canaria, Spain; Li Ka Shing
Knowledge Institute for Medical Science, St Michael's Hospital, Toronto,
ON, Canada
Abstract
BACKGROUND: It is uncertain whether individualisation of the perioperative
open-lung approach (OLA) to ventilation reduces postoperative pulmonary
complications in patients undergoing lung resection. We compared a
perioperative individualised OLA (iOLA) ventilation strategy with standard
lung-protective ventilation in patients undergoing thoracic surgery with
one-lung ventilation. <br/>METHOD(S): This multicentre, randomised
controlled trial enrolled patients scheduled for open or video-assisted
thoracic surgery using one-lung ventilation in 25 participating hospitals
in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age
>=18 years) were randomly assigned to receive iOLA or standard
lung-protective ventilation. Eligible patients (stratified by centre) were
randomly assigned online by local principal investigators, with an
allocation ratio of 1:1. Treatment with iOLA included an alveolar
recruitment manoeuvre to 40 cm H2O of end-inspiratory pressure followed by
individualised positive end-expiratory pressure (PEEP) titrated to best
respiratory system compliance, and individualised postoperative
respiratory support with high-flow oxygen therapy. Participants allocated
to standard lung-protective ventilation received combined intraoperative 4
cm H2O of PEEP and postoperative conventional oxygen therapy. The primary
outcome was a composite of severe postoperative pulmonary complications
within the first 7 postoperative days, including atelectasis requiring
bronchoscopy, severe respiratory failure, contralateral pneumothorax,
early extubation failure (rescue with continuous positive airway pressure,
non-invasive ventilation, invasive mechanical ventilation, or
reintubation), acute respiratory distress syndrome, pulmonary infection,
bronchopleural fistula, and pleural empyema. Due to trial setting, data
obtained in the operating and postoperative rooms for routine monitoring
were not blinded. At 24 h, data were acquired by an investigator blinded
to group allocation. All analyses were performed on an intention-to-treat
basis. This trial is registered with ClinicalTrials.gov, NCT03182062, and
is complete. FINDINGS: Between Sept 11, 2018, and June 14, 2022, we
enrolled 1380 patients, of whom 1308 eligible patients (670 [434 male, 233
female, and three with missing data] assigned to iOLA and 638 [395 male,
237 female, and six with missing data] to standard lung-protective
ventilation) were included in the final analysis. The proportion of
patients with the composite outcome of severe postoperative pulmonary
complications within the first 7 postoperative days was lower in the iOLA
group compared with the standard lung-protective ventilation group (40
[6%] vs 97 [15%], relative risk 0.39 [95% CI 0.28 to 0.56]), with an
absolute risk difference of -9.23 (95% CI -12.55 to -5.92). Recruitment
manoeuvre-related adverse events were reported in five patients.
INTERPRETATION: Among patients subjected to lung resection under one-lung
ventilation, iOLA was associated with a reduced risk of severe
postoperative pulmonary complications when compared with conventional
lung-protective ventilation. FUNDING: Instituto de Salud Carlos III and
the European Regional Development Funds.<br/>Copyright &#xa9; 2023
Elsevier Ltd. All rights reserved.

<96>
[Use Link to view the full text]
Accession Number
2028833971
Title
Intravenous Levothyroxine for Unstable Brain-Dead Heart Donors.
Source
New England Journal of Medicine. 389(22) (pp 2029-2038), 2023. Date of
Publication: 30 Nov 2023.
Author
Dhar R.; Marklin G.F.; Klinkenberg W.D.; Wang J.; Goss C.W.; Lele A.V.;
Kensinger C.D.; Lange P.A.; Lebovitz D.J.
Institution
(Dhar) The Department of Neurology, Section of Neurocritical Care, St.
Louis, United States
(Wang, Goss) The Center for Biostatistics and Data Science, St. Louis,
United States
(Marklin, Klinkenberg) Washington University School of Medicine, St.
Louis, United States
(Marklin, Klinkenberg) Mid-America Transplant, St. Louis, United States
(Lele) The Department of Anesthesiology and Pain Medicine, University of
Washington, Harborview Medical Center, Seattle, WA, United States
(Lele) LifeCenter Northwest, Bellevue, WA, United States
(Kensinger) LifeLink of Georgia, Norcross, GA, United States
(Kensinger) Piedmont Transplant Institute, Atlanta, GA, United States
(Lange) Donor Alliance, Denver, United States
(Lebovitz) Akron Children's Hospital, Akron, OH, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Hemodynamic instability and myocardial dysfunction are major
factors preventing the transplantation of hearts from organ donors after
brain death. Intravenous levothyroxine is widely used in donor care, on
the basis of observational data suggesting that more organs may be
transplanted from donors who receive hormonal supplementation. METHODS In
this trial involving 15 organ-procurement organizations in the United
States, we randomly assigned hemodynamically unstable potential heart
donors within 24 hours after declaration of death according to neurologic
criteria to open-label infusion of intravenous levothyroxine (30 microg
per hour for a minimum of 12 hours) or saline placebo. The primary outcome
was transplantation of the donor heart; graft survival at 30 days after
transplantation was a prespecified recipient safety outcome. Secondary
outcomes included weaning from vasopressor therapy, donor ejection
fraction, and number of organs transplanted per donor. RESULTS Of the 852
brain-dead donors who underwent randomization, 838 were included in the
primary analysis: 419 in the levothyroxine group and 419 in the saline
group. Hearts were transplanted from 230 donors (54.9%) in the
levothyroxine group and 223 (53.2%) in the saline group (adjusted risk
ratio, 1.01; 95% confidence interval [CI], 0.97 to 1.07; P = 0.57). Graft
survival at 30 days occurred in 224 hearts (97.4%) transplanted from
donors assigned to receive levothyroxine and 213 hearts (95.5%)
transplanted from donors assigned to receive saline (difference, 1.9
percentage points; 95% CI, -2.3 to 6.0; P<0.001 for noninferiority at a
margin of 6 percentage points). There were no substantial between-group
differences in weaning from vasopressor therapy, ejection fraction on
echocardiography, or organs transplanted per donor, but more cases of
severe hypertension and tachycardia occurred in the levothyroxine group
than in the saline group. CONCLUSIONS In hemodynamically unstable
brain-dead potential heart donors, intravenous levothyroxine infusion did
not result in significantly more hearts being transplanted than saline
infusion. (Funded by Mid-America Transplant and others; ClinicalTrials
.gov number, NCT04415658.).<br/>Copyright &#xa9; 2023 Massachusetts
Medical Society.

<97>
Accession Number
2028793628
Title
Neurocognition in adults with congenital heart disease post-cardiac
surgery: A systematic review.
Source
Heart and Lung. 64 (pp 62-73), 2024. Date of Publication: 01 Mar 2024.
Author
Cabrera-Mino C.; DeVon H.A.; Aboulhosn J.; Brecht M.-L.; Choi K.R.; Pike
N.A.
Institution
(Cabrera-Mino) University of California Los Angeles, United States
(DeVon) Professor and Associate Dean for Research, University of
California Los Angeles, United States
(Aboulhosn, Pike) Professor University of California Los Angeles, United
States
(Brecht) Adjunct Professor University of California Los Angeles, United
States
(Choi) Assistant Professor University of California Los Angeles, United
States
Publisher
Elsevier Inc.
Abstract
Background: Congenital heart disease (CHD) is the most common birth defect
worldwide. Neurocognitive deficits and psychiatric disorders, which can
impact daily life, have been reported in over 50% of adolescents and young
adults with moderate to complex CHD. <br/>Objective(s): Conduct a
systematic review of sex, clinical, psychological and social determinants
of health (SDoH) factors affecting neurocognition in adults with CHD
post-cardiac surgery. <br/>Method(s): PubMed, Cumulated Index to Nursing
and Allied Health Literature, and Embase were searched for relevant
studies over the past 5 years. Thirteen articles met inclusion criteria
of: 1) CHD post-cardiac surgery, 2) age >= 18 years, and 3) used a
validated measure of neurocognition. <br/>Result(s): A total of 507
articles were identified. After screening, 30 articles underwent full text
review yielding 13 eligible articles. Twelve articles reported deficits in
multiple domains including executive function, intellectual functioning,
visuospatial ability, and verbal fluency in more complex CHD. Only three
studies examined cognition based on sex, with female and lower parental
SES associated with worse cognitive outcomes. Most studies were from
Europe, predominantly sampled Caucasian participants, had heterogeneous
samples of CHD complexity, and lacked standardized cognitive measures
which limited generalizability of findings. <br/>Conclusion(s): Adults
with CHD present with a wide variety of cognitive deficits, with some
associations with sex, clinical history, and SDoH factors. It remains
unclear to what degree these factors affect cognition in adults with
moderate to complex CHD. Future longitudinal studies should focus on
age-related effects on cognition and potential health care disparities in
diverse CHD samples.<br/>Copyright &#xa9; 2023

<98>
Accession Number
2028790577
Title
1-Year Outcomes Following Transfemoral Transseptal Transcatheter Mitral
Valve Replacement: The HighLife TSMVR Feasibility Study.
Source
JACC: Cardiovascular Interventions. 16(23) (pp 2854-2865), 2023. Date of
Publication: 11 Dec 2023.
Author
Schneider L.-M.; Worthley S.; Nickenig G.; Huczek Z.; Wojakowski W.;
Tchetche D.; Dubois C.; Nasr M.; Verhees L.; Rothman M.; Piazza N.;
Buithieu J.; Yeow W.-L.; Kessler M.; Rottbauer W.
Institution
(Schneider, Kesler, Rottbauer) Department of Cardiology, University Heart
Center Ulm, Ulm, Germany
(Worthley) Macquarie University Hospital, Sydney, Australia
(Nickenig) University Hospital Bonn, Bonn, Germany
(Huczek) Medical University of Warsaw, Warsaw, Poland
(Wojakowski) Medical University of Silesia, Katowice, Poland
(Tchetche) Clinique Pasteur, Toulouse, France
(Dubois) University Hospital Leuven, Leuven, Belgium
(Nasr, Verhees, Rothman) HighLife Medical, Paris, France
(Piazza, Buithieu) McGill University Health Center, Montreal, QC, Canada
(Yeow) Genesis Care Mount Hospital, Perth, Australia
Publisher
Elsevier Inc.
Abstract
Background: A significant number of patients with severe mitral
regurgitation (MR) are not suitable for either surgical or transcatheter
edge-to-edge repair because of high surgical risk or inappropriate mitral
valve anatomy. <br/>Objective(s): The aim of this study was to evaluate
the HighLife Trans-Septal Mitral Valve Replacement (TSMVR) system in
patients with symptomatic MR and high surgical risk. <br/>Method(s): This
prospective, multicenter, nonrandomized feasibility study evaluated the
safety and performance of the HighLife TSMVR system in patients with
moderate to severe or severe symptomatic MR during 1-year follow-up.
Echocardiographic data were assessed at an independent core laboratory.
<br/>Result(s): A total of 30 patients (mean age 75.6 years, 27% women,
median Society of Thoracic Surgeons score 5.5%) with severe MR (90% with
secondary MR, median left ventricular ejection fraction 43%) were treated
at 13 sites. In 27 of the 30 patients, the HighLife TSMVR system was
implanted successfully (technical success rate 90%). Device success at 30
days was 83%. After 1 year, 5 patients (17%) had died. None of the
patients who underwent implantation required mitral valve reintervention.
All patients who underwent implantation had no or trace (78%) or mild
(22%) MR, the mean gradient of the HighLife valve was 5.1 mm Hg, and there
were no signs of left ventricular outflow tract obstruction (mean gradient
2.0 mm Hg). <br/>Conclusion(s): The 1-year results from the HighLife TSMVR
feasibility study demonstrate a high technical success rate, excellent
valve function, no left ventricular outflow tract obstruction, and no need
for mitral valve reintervention. Additional patient outcomes and longer
follow-up are needed to confirm these findings. (Expanded Study of the
HighLife 28mm Trans-Septal Trans-Catheter Mitral Valve in Patients With
Moderate-Severe or Severe Mitral Regurgitation and at High Surgical Risk;
NCT04029363)<br/>Copyright &#xa9; 2023

<99>
Accession Number
2028762843
Title
Comparison of video assisted thoracoscopic surgery and thoracotomy for
treatment of pleural infection stage II and III: a literature review.
Source
Journal of Thoracic Disease. 15(11) (pp 6323-6332), 2023. Date of
Publication: 2023.
Author
Steen K.; Sorensen J.; Christensen M.; Petersen R.H.; Naidu B.; Bendixen
M.; Rahman N.M.; Laursen C.B.; Christensen T.D.
Institution
(Steen, Sorensen, Bendixen, Christensen) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
(Christensen, Petersen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Petersen) Institute for Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
(Naidu) Department of Thoracic Surgery, Queen Elizabeth Hospital
Birmingham, Birmingham, United Kingdom
(Naidu) Institute of Inflammation and Ageing, University of Birmingham,
Birmingham, United Kingdom
(Rahman) NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, United Kingdom
(Laursen) Department of Respiratory Medicine, Odense University Hospital,
Odense, Denmark
(Laursen) Odense Respiratory Research Unit (ODIN), Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Christensen) Department of Clinical Medicine, Aarhus University Hospital,
Aarhus, Denmark
Publisher
AME Publishing Company
Abstract
Background and Objective: Pleural infection is associated with significant
mortality and morbidity worldwide, with a steadily increasing incidence.
We sought to investigate whether video-assisted thoracic surgery (VATS) or
thoracotomy provides the best outcomes in the treatment of stage II and
III pleural infection as indications remain controversial. <br/>Method(s):
Systematic review of relevant articles from the PubMed database. Key
Content and Findings: Nine non-randomized retrospective studies published
between 1996 and 2020 with a total of 2,121 patients were included.
Results varied between studies, but overall shorter operative and recovery
times and greater patient satisfaction were demonstrated using VATS
compared with thoracotomy. <br/>Conclusion(s): Although VATS and
thoracotomy are viable treatment options for stage II and III pleural
infection, VATS has potential advantages in terms of decreased operation
time, fewer days with tube drainage, shorter postoperative hospital stay,
reduced postoperative pain, increased patient satisfaction with the
procedure, and wound appearance. VATS has limitations in the treatment of
patients with stage III pleural infection, where delayed surgical referral
has been shown to increase the risk of intraoperative conversion to
thoracotomy. The data to date implies that debridement by VATS should be
proposed as soon as possible in stage II pleural infection and considered
in cases of stage III pleural infection.<br/>Copyright &#xa9; Journal of
Thoracic Disease. All rights reserved.

<100>
Accession Number
2027813148
Title
Intravenous iron administration before cardiac surgery reduces red blood
cell transfusion in patients without anaemia.
Source
British Journal of Anaesthesia. 131(6) (pp 981-988), 2023. Date of
Publication: December 2023.
Author
Friedman T.; Dann E.J.; Bitton-Worms K.; Makhoul M.; Glam R.; Weis A.; Tam
D.Y.; Bolotin G.
Institution
(Friedman, Bitton-Worms, Makhoul, Glam, Weis, Bolotin) Department of
Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel
(Dann) Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa,
Israel
(Dann) Department of Hematology and Bone Marrow Transplantation, Rambam
Health Care Campus, Haifa, Israel
(Friedman, Dann, Bolotin) Ruth and Bruce Rappaport Faculty of Medicine,
Technion, Haifa, Israel
(Tam) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Ltd
Abstract
Background: Reducing the need for blood transfusion among patients
undergoing cardiac surgery FLA reduce postoperative complications and
mortality. Our study aimed to assess the effects of administering
preoperative i.v. ferric carboxymaltose on postoperative red cell
transfusion requirements in patients without anaemia undergoing on-pump
cardiac surgery. <br/>Method(s): This double-blind, randomised,
placebo-controlled trial was conducted between October 2016 and November
2019, with a follow-up period of up to 6 weeks after surgery. Patients
without anaemia who underwent on-pump cardiac surgery were included as
participants and administered i.v. iron in the form of ferric
carboxymaltose or placebo once, 24-72 h before surgery. The primary
outcome was the number of red cell units transfused during the first four
postoperative days, and the secondary outcome measures were blood
haemoglobin concentrations at 4 days and 6 weeks after surgery.
<br/>Result(s): The 200 patients included were randomly assigned to the
ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative
Day 4, a significantly lower mean number of red cell units were transfused
in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6
(4.4), respectively; P=0.007. The mean haemoglobin concentrations on
postoperative Day 4 were 9.7 (1) g dl^-1 and 9.3 (1) g
dl^-1, respectively (P=0.03). Corresponding values at 6 weeks
after surgery were 12.6 (1.4) g dl^-1 and 11.8 (1.5) g
dl^-1, respectively (P=0.012). <br/>Conclusion(s): In patients
without anaemia undergoing on-pump cardiac surgery, treatment with a
single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery
significantly reduced the need for red cell transfusions and increased the
postoperative haemoglobin concentration. Clinical trial registration:
NCT02939794.<br/>Copyright &#xa9; 2023 British Journal of Anaesthesia

<101>
Accession Number
2026953559
Title
Comparisons of Electrolyte Balance Efficacy of Two Gelatin-Balanced
Crystalloid for Surgery Patients Under General Anesthesia: A Multi-Center,
Prospective, Randomized, Single-Blind, Controlled Study.
Source
International Journal of General Medicine. 16 (pp 5855-5868), 2023. Date
of Publication: 2023.
Author
Duan G.; Deng H.; Fu H.; Wang L.; Yang H.
Institution
(Duan) Department of Anesthesiology, The Second Affiliated Hospital of
Chongqing Medical University, Chongqing City 400000, China
(Deng) Department of Anesthesiology, Huizhou Third People's Hospital,
Guangzhou Medical University, Guangzhou 516002, China
(Fu) Department of Anesthesiology, Chongqing Emergency Medical Center,
Chongqing University Central Hospital, School of Medicine, Chongqing
University, Chongqing 400014, China
(Wang) Department of Anesthesiology, The Second Affiliated Hospital of
Guangzhou Medical University, Guangzhou 051026, China
(Yang) Department of Anesthesiology, The First Affiliated Hospital of
Guangzhou Medical University, Guangzhou 510120, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to compare the electrolyte balance efficacies of
two Gelatin-Balanced Crystalloid in clinical applications. <br/>Method(s):
A multi-center, prospective, randomized, single-blind, parallel controlled
study was conducted among non-cardiac surgery patients, with clinical
registration number ChiCTR2200062999. They were randomized into
Succinylated Gelatin, Multiple Electrolytes and Sodium Acetate Injection
(SG-MESAI) group (experimental group) and Succinylated Gelatin Injection
(SGI) infusion group (control group). The same anesthetic induction
technique, anesthetic method, and calculation method for the volume of
colloid infusion were used in the two groups. Between-group differences in
the changes in base excess (BE), Chloride ion (Cl^-),
bicarbonate radical (HCO<inf>3</inf>) and other parameters were recorded
at 15 min, 30 min after the infusion relative to the baseline. Hemodynamic
indicators were determined at 30 min after colloid infusion. Safety
follow-up was conducted by administering the following tests within 48
h+/-12 h after surgery. <br/>Result(s): A total of 225 subjects (full
analysis set) were finally enrolled, with 110 subjects in the experimental
group and 115 subjects in the control group. The baseline data were
comparable between the two groups. At 15 min after infusion, the mean
changes in BE, Cl^- and HCO<inf>3</inf> concentration in the
experimental group were smaller than those of the control group (P<0.001).
At 30 min after surgery, the mean changes in BE, Cl^-,
HCO<inf>3</inf>concentration and pH value were smaller in the experimental
group than in the control group (P<0.05). The incidences of adverse events
and adverse reactions in the experimental group was less than the control
group, but the difference was not statistically significant (P>=0.05).
Besides, no serious adverse events or adverse reactions were reported in
any subjects. <br/>Conclusion(s): Succinylated Gelatin, Multiple
Electrolytes and Sodium Acetate Injection maintained the balance of BE,
Cl^-, HCO<inf>3</inf> and pH value in a better way than
Succinylated Gelatin Injection in non-cardiac surgery patients under
general anesthesia.<br/>Copyright &#xa9; 2023 Duan et al.

<102>
Accession Number
2026931798
Title
The Role of Prone Position Combined With Nasal CPAP in Preventing
Extubation Failure in Infants After Cardiac Surgery.
Source
Respiratory Care. 68(2) (pp 241-246), 2023. Date of Publication: 01 Feb
2023.
Author
Wu H.-L.; Chen Y.-K.; Lin S.-H.; Chen Q.; Zheng Y.-R.
Institution
(Wu, Chen, Lin, Chen, Zheng) Department of Cardiac Surgery, Fujian
Children's Hospital, (Fujian Branch of Shanghai Children's Medical
Center), College of Clinical Medicine for Obstetrics and Gynecology and
Pediatrics, Fujian Medical University, Fuzhou, China
Publisher
American Association for Respiratory Care
Abstract
BACKGROUND: Previous studies suggest that prone position could improve
oxygenation and prevent lung injury. Whether prone position can improve
post-extubation clinical outcomes in infants undergoing cardiac surgery is
unknown. The aim of our study was to investigate the effects of prone
position in preventing extubation failure in noninvasively ventilated
infants after cardiac surgery. <br/>METHOD(S): Ninety-six infants who were
weaned to nasal CPAP after congenital cardiac surgery were randomly
divided into 2 groups: the prone position group (n 5 48) and the supine
position group (n 5 48). Primary outcomes measured were extubation failure
rate within 48 h of extubation and arterial blood gas values within 6 h of
a mandatory prone positioning session. Secondary outcomes included nasal
trauma, pressure ulcers, pneumothorax, gastroesophageal reflux, abdominal
distention, in-hospital mortality, postoperative nasal CPAP duration, and
hospital length of stay. <br/>RESULT(S): Compared with the supine position
group, the prone position group had fewer extubation failure infants (2.0%
vs 14.5%, P 5.02). Arterial blood gas values after 6 h after a mandatory
prone positioning session showed that the P<inf>aO2</inf> and
P<inf>aO2</inf>/F<inf>IO2</inf> in the prone position group were
significantly higher than those in the supine position group
(P<inf>aO2</inf> 93.3 6 8.5 vs 82.5 6 9.1, P <.05;
P<inf>aO2</inf>/F<inf>IO2</inf> 255.8 6 23.6 vs 235.8 6 20.7, P <.05).
Moreover, nasal CPAP duration and total hospital length of stay in the
prone position group were significantly shorter than those in the supine
position group (P <.05). <br/>CONCLUSION(S): In infants supported with
nasal CPAP following cardiac surgery, prone positioning improved
postextubation oxygenation, helped reduced extubation failure, and reduced
the duration of nasal CPAP ventilation and total hospital length of
stay.<br/>Copyright &#xa9; 2023, American Association for Respiratory
Care. All rights reserved.

<103>
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.
<br/>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.<br/>Copyright &#xa9; 2023, The
Author(s).

<104>
Accession Number
2026810842
Title
Quality of Life After Percutaneous Coronary Intervention Versus Coronary
Artery Bypass Grafting.
Source
Journal of the American Heart Association. 12(22) (no pagination), 2023.
Article Number: e030069. Date of Publication: 21 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.; Creber R.M.
Institution
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Dimagli, Demetres, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medical College, New York, United States
(Spadaccio) Mayo Clinic Department of Cardiovascular Surgery, Rochester,
MN, United States
(Myers) Columbia University Irving Medical Center, New York, NY, United
States
(Rademaker-Havinga) Cardialysis, Rotterdam, Netherlands
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, MO, United States
(Redfors) Sahlgrenska University Hospital, Gothenburg, Sweden
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
(Creber) Columbia University School of Nursing, Columbia University Irving
Medical Center, New York, NY, United States
Publisher
American Heart Association Inc.
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 60 months (latest follow-up) and the
weighted mean differences between groups using inverse-variance methods. A
total of 10 760 patients were enrolled in 5 trials. From baseline to 12
months and 36 to 60 months, 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 1
month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI,
0.68-3.26]). SAQ-QoL favored PCI at 1 month (-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 60 months (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 1 month. Short-Form
Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI,
0.46-1.90]). <br/>CONCLUSION(S): Both PCI and CABG improved long-term
disease-specific and generic QoL.<br/>Copyright &#xa9; 2023 The Authors.

<105>
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.<br/>Copyright
&#xa9; 2023, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<106>
Accession Number
2028974251
Title
Long-Term Clinical and Echocardiographic Outcomes Following the Ross
Procedure.
Source
JAMA Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Notenboom M.L.; Melina G.; Veen K.M.; De Robertis F.; Coppola G.; De Siena
P.; Navarra E.M.; Gaer J.; Ibrahim M.E.K.; El-Hamamsy I.; Takkenberg
J.J.M.; Yacoub M.H.
Institution
(Notenboom, Veen, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Center, Rotterdam, Netherlands
(Melina, Navarra) Department of Cardiac Surgery, Sant'Andrea Hospital,
Sapienza University of Rome, Rome, Italy
(De Robertis, Coppola, De Siena, Gaer) Department of Cardiothoracic
Surgery and Transplantation, Royal Brompton & Harefield Hospitals, Guy's
and St Thomas' NHS Foundation Trust, London, United Kingdom
(Ibrahim) Division of Cardiovascular Surgery, University of Pennsylvania,
Philadelphia, United States
(El-Hamamsy) Department of Cardiovascular Surgery, The Mount Sinai
Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Yacoub) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Yacoub) Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub
Foundation, Aswan, Egypt
Publisher
American Medical Association
Abstract
IMPORTANCE The Ross procedure as treatment for adults with aortic valve
disease (AVD) has been the subject of renewed interest. OBJECTIVE To
evaluate the long-term clinical and echocardiographic outcomes following
the Ross procedure for the treatment of adults with AVD. DESIGN, SETTING,
AND PARTICIPANTS This post hoc analysis of a randomized clinical trial
included adult patients (age <69 years) who underwent a Ross procedure for
the treatment of AVD, including those with active endocarditis, rheumatic
AVD, decreased ejection fraction, and previous cardiac surgery. The trial,
conducted from September 1, 1994, to May 31, 2001, compared homograft root
replacement with the Ross procedure at a single center. Data after 2010
were collected retrospectively in November and December 2022. EXPOSURE
Ross procedure. MAIN OUTCOMES AND MEASURES The primary end point was
long-term survival among patients who underwent the Ross procedure
compared with that in the age-, country of origin- and sex-matched general
population. Secondary end points were freedom from any reintervention,
autograft reintervention, or homograft reintervention and time-related
valve function, autograft diameter, and functional status. RESULTS This
study included 108 adults (92 [85%] male) with a median age of 38 years
(range, 19-66 years). Median duration of clinical follow-up was 24.1 years
(IQR, 22.6-26.1 years; 2488 patient-years), with 98% follow-up
completeness. Of these patients, 9 (8%) had active endocarditis and 45
(42%) underwent reoperations. The main hemodynamic lesion was stenosis in
30 (28%) and regurgitation in 49 (45%). There was 1 perioperative death
(0.9%). Twenty-five year survival was 83.0% (95% CI, 75.5%-91.2%),
representing a relative survival of 99.1% (95% CI, 91.8%-100%) compared
with the general population (83.7%). At 25 years, freedom from any
reintervention was 71.1% (95% CI, 61.6%-82.0%); from autograft
reintervention, 80.3% (95% CI, 71.9%-89.6%); and from homograft
reintervention, 86.3% (95% CI, 79.0%-94.3%). Thirty-day mortality after
the first Ross-related reintervention was 0% and after all Ross-related
reinterventions was 3.8% (n = 1); 10-year survival after reoperation was
96.2% (95% CI, 89.0%-100%). CONCLUSIONS AND RELEVANCE This study found
that the Ross procedure provided excellent survival into the third decade
postoperatively that was comparable to that in the general population.
Long-term freedom from reintervention demonstrated that the Ross procedure
may be a durable substitute into late adulthood, showing a delayed but
progressive functional decline.<br/>Copyright &#xa9; 2024 American Medical
Association. All rights reserved.

<107>
Accession Number
369637300
Title
Recovery after balloon aortic valvuloplasty in patients with aortic
stenosis and impaired left ventricular function: Predictors and prognostic
implications.
Source
Journal of Invasive Cardiology. 25(5) (pp 235-241), 2013. Date of
Publication: May 2013.
Author
Kefer J.; Gapira J.-M.; Pierard S.; De Meester C.; Gurne O.; Chenu P.;
Renkin J.
Institution
(Kefer, Gapira, Pierard, De Meester, Gurne, Chenu, Renkin) Cliniques
Universitaires Saint-Luc, Universite Catholique de Louvain, Division of
Cardiology, Avenue Hippocrate 10, 1200 Brussels, Belgium
Publisher
Cliggott Publishing Co.
Abstract
AIMS: The aim of this study was to evaluate predictors of recovery after
balloon aortic valvuloplasty (BAV) among patients with aortic stenosis and
depressed left ventricular ejection fraction (LVEF). Predictors for
recovery after BAV are not clearly defined. B-type natriuretic peptide
(BNP) predicts outcome after surgical and transcatheter aortic valve
replacement. Methods AND Results: Among 151 consecutive patients treated
in our institution by BAV, a total of 59 with poor LVEF underwent an
echocardiography at 1 month. In these 59 patients, LVEF significantly
improved in 22 patients (group 1) from 27 +/- 5% to 45 +/- 6% (P<.0001)
and remained unchanged in 37 patients (group 2) from 29 +/- 8% to 30 +/-
11% (P<=NS). BNP plasma levels at 24 hours only decreased in group 1 from
2170 +/- 967 pg/mL to 1208 +/- 662 pg/mL (P<=.001). By multivariate
analysis, BNP reduction >300 pg/mL was the strongest independent predictor
of LVEF improvement at 30 days (hazard ratio, 5.459; 95% confidence
interval, 1.580-18.860; P<=.007). Kaplan-Meier analysis showed that 1-year
survival after BAV was significantly higher in patients of group 1 than in
group 2 (95 +/- 4% vs 51 +/- 8%, respectively; P<=.02).
<br/>Conclusion(s): BAV in patients with poor left ventricular function
resulted in LVEF improvement at 30 days in 37% of cases, which was
detected by a reduction of BNP levels already seen at 24 hours. Survival
at 1 year was significantly higher in patients with such an improved LVEF
after BAV.

<108>
[Use Link to view the full text]
Accession Number
2028942976
Title
Sex-Related Differences in Postoperative Outcomes After Transcatheter
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. 32(1) (pp 30-44), 2024. Date of Publication: 01 Jan
2024.
Author
Bozso S.J.; El-Andari R.; J.h. Kang J.; Eckstein J.; Nagendran J.
Institution
(Bozso, J.h. Kang, Nagendran) The Division of Cardiac Surgery, Department
of Surgery, University of Alberta, Edmonton, AB, Canada
(El-Andari) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Eckstein) Division of Cardiology, Royal University Hospital, Saskatoon,
SK, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Aortic stenosis is the most common valvular disease of the heart and is
increasing in prevalence. Previous literature has found inferior outcomes
for females undergoing surgical aortic valve replacement, while recent
investigations have found equivalent or superior outcomes for females
undergoing transcatheter aortic valve replacement (TAVR). PubMed and
Medline were systematically searched for articles published from January
1, 2010, to April 30, 2021, for retrospective and prospective studies
comparing outcomes between males and females undergoing TAVR. One thousand
one hundred eighty titles and abstracts were screened, and 28 were
included in this review. Risk of bias was assessed using questions derived
from the ROBINS-I tool and previous literature. The data were compiled and
analyzed using the RevMan 5.4 software. The results of this review confirm
the previously published literature and have found rates of acute kidney
injury (P = 0.05) and postoperative pacemaker insertion (P < 0.00001)
favoring females and in-hospital mortality (P = 0.04), stroke (P <
0.00001), bleeding complications (P < 0.00001), and vascular complications
(P < 0.00001) favoring males. The previously published literature has
demonstrated consistently inferior outcomes for females undergoing heart
valve surgery when compared to males. However, contemporary literature
investigating sex differences after TAVR has found comparable outcomes for
females. While the postoperative outcomes after surgical aortic valve
replacement and TAVR are well established, the causal factors are still
unidentified. Future studies utilizing matching based on preoperative
characteristics and follow-up including collection of postoperative
ventricular remodeling and prosthetic valve performance data will aid in
elucidating the causal factors impacting outcomes for males and females
after TAVR.<br/>Copyright &#xa9; 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<109>
[Use Link to view the full text]
Accession Number
2028942975
Title
Robotic Assisted Versus Manual Percutaneous Coronary Intervention:
Systematic Review and Meta-Analysis.
Source
Cardiology in Review. 32(1) (pp 24-29), 2024. Date of Publication: 01 Jan
2024.
Author
Gupta R.; Malik A.H.; Chan J.S.K.; Lawrence H.; Mehta A.; Venkata V.S.;
Aedma S.K.; Ranchal P.; Dhaduk K.; Aronow W.S.; Vyas A.V.; Mehta S.S.;
Combs W.G.; Frishman W.H.; Patel N.C.
Institution
(Gupta, Vyas, Combs, Patel) The Department of Cardiology, Lehigh Valley
Heart Institute, Lehigh Valley Health Network, Allentown, PA, United
States
(Malik, Aronow, Frishman) Department of Cardiology, Westchester Medical
Center, New York Medical College, Valhalla, NY, United States
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Shatin, New Territories, Hong Kong, Hong Kong
(Lawrence) Department of Internal Medicine, Westchester Medical Center,
New York Medical College, Valhalla, NY, United States
(Mehta, Aedma) Department of Internal Medicine, Carle Foundation Hospital,
Urbana, IL, United States
(Venkata) Department of Medicine, Cheshire Medical Center,
Dartmouth-Hitchcock Keene, Keene, NH, United States
(Ranchal) Department of Medicine, Boston University, Boston, MA, United
States
(Dhaduk) Department of Medicine, Geisinger Wyoming Valley Medical Center,
Wilkes-Barre, PA, United States
(Mehta) Department of Cardiology, Heart and Vascular Institute, Carle
Foundation Hospital, Urbana, IL, United States
(Frishman) Department of Internal Medicine, Westchester Medical Center,
New York Medical College, Valhalla, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Robotics in percutaneous coronary intervention (R-PCI) has
been one such area of advancement where potential benefits may include
reduced operator radiation exposure, improved outcomes, and reduced rate
of adverse events. Limited data exist about the benefits of R-PCI versus
conventional manual PCI (M-PCI). We appraised the latest evidence in the
form of a meta-analysis of observational and retrospective studies.
<br/>Method(s): A comprehensive literature search was performed in PubMed,
Embase, and Cochrane to identify relevant clinical studies. Summary
effects were calculated using a DerSimonian and Laird random-effects model
as the pooled odds ratio or mean differences (MDs) with 95% confidence
intervals (CIs). All studies adhering to the inclusion criteria of direct
comparisons between R-PCI and M-PCI were evaluated. <br/>Result(s): Seven
studies with a total of 2230 patients were identified. There was
significant decrease in the chest-level operator radiation exposure (MD =
-442.32; 95% CI = -675.88 to -208.76), fluoroscopy time (MD = -1.46; 95%
CI = -2.92 to 0.00), and amount of contrast used (MD = -18.28; 95% CI =
-24.16 to -12.41) in the robotic group compared to the manual group. PCI
time and the procedural success rate was not statistically different
between the 2 groups. Clinical outcomes of major adverse cardiac events,
all-cause mortality, and myocardial infarction were not different between
the 2 groups. <br/>Conclusion(s): Robotic PCI is associated with reduced
operator radiation exposure, fluoroscopy time, and amount of contrast
used. While there is a significant reduction in the procedural
characteristics with robotic PCI, the clinical outcomes are not different
compared to M-PCI. R-PCI is safe and effective with potential benefits to
both the operator and the patient simultaneously.<br/>Copyright &#xa9;
2022 Wolters Kluwer Health, Inc. All rights reserved.

<110>
Accession Number
2028909037
Title
COVID-19 and Cardiovascular Diseases: From Cellular Mechanisms to Clinical
Manifestations.
Source
Aging and Disease. 14(6) (pp 2071-2088), 2023. Date of Publication: 01 Dec
2023.
Author
Shu H.; Wen Z.; Li N.; Zhang Z.; Ceesay B.M.; Peng Y.; Zhou N.; Wang D.W.
Institution
(Shu, Wen, Li, Zhang, Ceesay, Zhou, Wang) Division of Cardiology,
Department of Internal Medicine, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan 430000, China
(Shu, Wen, Li, Zhang, Ceesay, Zhou, Wang) Hubei Key Laboratory of Genetics
and Molecular Mechanism of Cardiologic Disorders, Huazhong University of
Science and Technology, Wuhan 430000, China
(Peng) Department of Orthopedics, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan 430000, China
Publisher
International Society on Aging and Disease
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2), quickly spread worldwide and led to
over 581 million confirmed cases and over 6 million deaths as 1 August
2022. The binding of the viral surface spike protein to the human
angiotensin-converting enzyme 2 (ACE2) receptor is the primary mechanism
of SARS-CoV-2 infection. Not only highly expressed in the lung, ACE2 is
also widely distributed in the heart, mainly in cardiomyocytes and
pericytes. The strong association between COVID-19 and cardiovascular
disease (CVD) has been demonstrated by increased clinical evidence.
Preexisting CVD risk factors, including obesity, hypertension, and
diabetes etc., increase susceptibility to COVID-19. In turn, COVID-19
exacerbates the progression of CVD, including myocardial damage,
arrhythmia, acute myocarditis, heart failure, and thromboembolism.
Moreover, cardiovascular risks post recovery and the
vaccination-associated cardiovascular problems have become increasingly
evident. To demonstrate the association between COVID-19 and CVD, this
review detailly illustrated the impact of COVID-19 on different cells
(cardiomyocytes, pericytes, endothelial cells, and fibroblasts) in
myocardial tissue and provides an overview of the clinical manifestations
of cardiovascular involvements in the pandemic. Finally, the issues
related to myocardial injury post recovery, as well as vaccination-induced
CVD, has also been emphasized.<br/>Copyright &#xa9; 2023 Shu H. et al.

<111>
Accession Number
2028892675
Title
Rescue analgesia with serratus anterior plane block improved pain relief
after thoracic surgery.
Source
Minerva Anestesiologica. 89 (pp 1082-1091), 2023. Date of Publication:
2023.
Author
Wu X.; Chen H.; Wang M.; Wang P.; Zhang Y.; Wu Y.
Institution
(Wu, Chen, Wang, Wang, Zhang, Wu) Department of Anesthesiology and
Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical
University, Anhui, Hefei, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Video-assisted thoracic surgery (VATSvats) is frequently
associated with substantial postoperative pain, which may lead to
hypopnea. Rescue analgesia using opioids has adverse effects. We aimed to
evaluate the effects of rescue analgesia with serratus anterior plane
block (SA PB) on moderate-to-severe pain and oxygenation in patients
undergoing VATSvats. MET HODS: Eighty patients undergoing VATS and
reporting a numeric rating scale (NRS, ranging from 0-10) score of cough
pain >=4 on the first postoperative day were randomized to receive either
sufentanil or SAPB for rescue analgesia. The primary outcome was the
degree of relief in cough pain 30 min after rescue analgesia. Arterial
oxygen pressure (PaO2), opioid consumption after rescue analgesia and the
incidence of chronic pain were also assessed. <br/>RESULT(S): The NRS
scores were significantly reduced after rescue analgesia in both groups
(Ppaired <0.001). Notably, the degree of relief in cough pain was
significantly higher in the SAPB group than that in the sufentanil group
(medians [interquartiles]: -3 [-4, -2] vs. -2 [-3, -1], P<0.001).
Moreover, patients receiving SAPB exhibited significantly higher PaO2 than
those before receiving rescue analgesia (Ppaired=0.007). However, there
were no significant differences in the PaO2 before and after receiving
rescue analgesia in the sufentanil group. No significant differences in
opioid consumption or the incidence of chronic pain were observed between
groups. <br/>CONCLUSION(S): Rescue analgesia with SAPB on the first
postoperative day had a greater effect on pain relief and oxygenation
after VATSvats. However, its long-term effect on chronic pain requires
further research.<br/>Copyright &#xa9; 2023 Edizioni Minerva Medica. All
rights reserved.

<112>
Accession Number
2028795404
Title
A Meta-Analysis of Atrial Septal Defect Closure in Patients With Severe
Pulmonary Hypertension: Is There a Room for Poking Holes Amid Debate?.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102121. Date of Publication: January 2024.
Author
Cool C.J.; Kamarullah W.; Pranata R.; Putra I.C.S.; Khalid A.F.; Akbar
M.R.; Setiabudiawan B.; Rahayuningsih S.E.
Institution
(Cool, Pranata, Putra, Khalid, Akbar) Department of Cardiology and
Vascular Medicine, Faculty of Medicine, University of Padjadjaran,
Bandung, Indonesia
(Kamarullah) Melinda Cardio Vascular Center, Bandung, Indonesia
(Setiabudiawan, Rahayuningsih) Department of Child Health, Faculty of
Medicine, University of Padjadjaran, Bandung, Indonesia
Publisher
Elsevier Inc.
Abstract
Severe pulmonary arterial hypertension (PAH) associated with atrial septal
defect (ASD) poses a challenge to a closure of ASD, particularly severe
PAH that persists even after pharmacological therapeutic strategy. Our
study was aimed to evaluate this matter. A systematic literature search
from several databases was conducted up until August 1st, 2023. A
meta-analysis was undertaken on studies that reported hemodynamic
measurements in ASD patients with severe PAH before and after closure. The
primary objectives were the extent of improvement in all hemodynamic
parameters following closure, and the secondary outcomes were major
adverse cardiac events (MACEs) during follow-up. Our study comprised 10
studies with a total of 207 participants. Patients were divided into
treat-and-repair and straight-to-repair groups based on the therapeutic
strategy. Meta-analysis of all studies demonstrated significant
improvement in mean pulmonary arterial pressure (mPAP), pulmonary vascular
resistance (PVR), pulmonary vascular resistance index (PVRI), 6-minutes
walking distance (6MWD), and lower prevalence of World Health Organization
functional classes (WHO fc), particularly in the treat-and-repair strategy
subgroup. Additionally, merely 4 of the 156 individuals died from cardiac
causes, and only 1 required rehospitalization, indicating a low likelihood
of MACEs arising. Our new findings support the notion that effective shunt
closure can improve various hemodynamic parameters in carefully chosen
patients with noncorrectable ASD-PAH. Further large and prospective
observational studies are still warranted to validate these
findings.<br/>Copyright &#xa9; 2023 The Authors

<113>
Accession Number
2028775430
Title
Early 6 months usage of single anTiplAtelet OR anTicoAgulant followed by
single antiplatelet after transcatheter aortic valve replacement: protocol
for a multicentre, open-label, randomised controlled clinical trial.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e076781. Date of
Publication: 21 Nov 2023.
Author
Hu X.; Xu H.; Wang C.; Wang Y.; Zhou D.; Zhu Q.; Xu K.; Yang J.; Zhang H.;
Jiang N.; Zhang J.; Fang Z.; Fu G.; Guo Y.; Li Y.; Wang M.; Feng D.; Niu
G.; Zhang E.; Chen Y.; Ye Y.; Wu Y.
Institution
(Hu, Xu, Wang, Wang, Feng, Niu, Zhang, Chen, Ye, Wu) Department of
Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Wang) Medical Research & Biometrics Center, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Wang) Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen
University, Fujian, Xiamen, China
(Zhou) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Zhu) Department of Cardiology, The Second Affiliated Hospital Zhejiang
University, School of Medicine, Zhejiang, Hangzhou, China
(Xu) Department of Cardiology, General Hospital of Northern Theater
Command, Liaoning, Shenyang, China
(Yang) Department of Cardiovascular Surgery, Xijing Hospital, Air Force
Medical University, Shaanxi, Xi'an, China
(Zhang) Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Jiang) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin Medical University, Tianjin, China
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Jiangsu, Nanjing, China
(Fang) Department of Cardiovascular Medicine, The Second Xiangya Hospital,
Central South University, Hunan, Changsha, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang, Hangzhou, China
(Guo) Department of Cardiovascular Surgery, West China Hospital of Sichuan
University, Sichuan, Chengdu, China
(Li) Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen
University, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction The strategy for initiating antithrombotic therapy to prevent
bioprosthetic valve thrombosis (BPVT) after transcatheter aortic valve
replacement (TAVR) remains uncertain. There is still lacking evidence on
the efficacy and safety of early 6 months usage of single-antiplatelet
therapy (SAPT) or oral anticoagulant (OAC) after TAVR in patients without
anticoagulant indications. Methods and analysis This is a multicentre,
randomised controlled, open-label trial, and 650 patients undergoing TAVR
from 13 top TAVR centres in China will be recruited. Each eligible
participant will be randomly assigned to two groups (1:1 ratio) as (1)
SAPT (aspirin 75-100 mg for 6 months) group or (2) OAC group (warfarin,
therapeutic international normalised ratio at 1.8-2.5 for 6 months), both
followed by sequential aspirin 75-100 mg for 6 months. Participants in
both groups will be invited for three follow-up visits of 1, 6 and 12
months after discharge. We will use both the net clinical benefit endpoint
(composite of all-cause mortality, myocardial infarction, stroke/transient
ischaemic attacks, peripheral artery thrombosis, intracardiac thrombosis
and major bleeding and disabling or life-threatening bleeding) and the
BPVT endpoint evaluated by four-dimensional CT as our primary endpoints. P
value of <0.05 of two-sided test will be considered statistically
significant. Ethics and dissemination The present study was approved by
the Institutional Review Boards at Fuwai Hospital, National Center for
Cardiovascular Diseases of China (Approval No. 2023-1947). All patients
will be informed of the details of the study and will sign an informed
consent prior to inclusion in the study. Results of this study will be
published in a peer-reviewed journal. Trial registration number
NCT05375474.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<114>
[Use Link to view the full text]
Accession Number
2028764800
Title
Comparison of direct intra-arterial pressure and ClearSight finger cuff
arterial pressure measurements in elderly patients undergoing
transcatheter aortic valve replacement.
Source
Blood Pressure Monitoring. 28(6) (pp 309-315), 2023. Date of Publication:
01 Dec 2023.
Author
Yahagi M.; Sasaki M.
Institution
(Yahagi, Sasaki) Department of Anaesthesiology, Hitachi General Hospital,
317-0077 2-1-1 Jounanchou, , Ibaraki, Hitachi, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This study aimed to assess the agreement between direct
intra-arterial pressure and ClearSight finger cuff arterial pressure
measurements in elderly patients undergoing transcatheter aortic valve
replacement (TAVR). <br/>Method(s): A prospective observational study was
conducted at Hitachi General Hospital, Japan, involving 30 patients aged
65years and older who underwent TAVR under general anesthesia.
Intra-arterial pressure and finger cuff arterial pressure measurements
were recorded for 30min after valve deployment. Bland-Altman analysis,
four-quadrant plot analysis, and error grid analysis were used to assess
the concordance between the two methods. Multiple regression analysis was
performed to explore potential confounding factors affecting the
agreement. <br/>Result(s): The bias and precision of ClearSight
measurements were -4.88+/-15.46 (mmHg) for SBP, 4.73+/-8.95 (mmHg) for
mean, and 9.53+/-9.01 (mmHg) for DBP. The Bland-Altman analysis
demonstrated acceptable agreement between intra-arterial pressure and
finger cuff arterial pressure measurements. The four-quadrant plot
analysis showed good trend-tracking ability, and the error grid analysis
revealed that most of the observed values fell into the no-risk category.
The mean BP match ratio and SBP match ratio were influenced by several
factors such as age, BSA, ejection fraction, valve size, and gender.
<br/>Conclusion(s): The ClearSight finger cuff arterial pressure
measurement showed good agreement with direct intra-arterial pressure in
elderly patients undergoing TAVR. However, factors such as age, BSA,
ejection fraction, valve size, and gender may influence the agreement
between the two methods.<br/>Copyright &#xa9; 2023 Lippincott Williams and
Wilkins. All rights reserved.

<115>
[Use Link to view the full text]
Accession Number
2028764689
Title
Are congenital heart defects connected to more severe
attention-deficit/hyperactivity disorder?: A systematic review and
meta-analysis.
Source
Medicine (United States). 102(47) (pp E36193), 2023. Date of Publication:
24 Nov 2023.
Author
Hasan M.T.; Shaban Abdelgalil M.; Elbadawy M.A.; Mahmoud Elrosasy A.;
Elkhadragy A.; El Garhy M.; Awad A.K.
Institution
(Hasan) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shaban Abdelgalil, Elbadawy, El Garhy, Awad) Faculty of Medicine, Ain
Shams University, Cairo 11835, Egypt
(Mahmoud Elrosasy) Helwan University Hospital, Cairo, Egypt
(Elkhadragy) Alexandria University, Faculty of Medicine, Cairo, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Congenital heart defects (CHDs) are the most common cause of
birth defect-related infant morbidity and mortality, affecting 1% of
40,000 births per year in the United States. On the other side, the
etiology of attention-deficit/hyperactivity disorder (ADHD) is
multifactorial. Multiple studies have found that cardiac surgery patients
have higher morbidity of having this disorder. Many studies have
investigated the prevalence of ADHD in different subtypes of CHD, but few
have focused on the severity of ADHD symptoms. Thus, we conducted this
systematic review and meta-analysis to investigate the severity of ADHD
symptoms in CHD patients. <br/>Method(s): We searched PubMed, Embase,
Scopus, and Web of Science were searched from inception to March 6, 2023
without any restrictions. We included observational studies published in
English language that evaluated burden of symptom of ADHD in CHD patients.
Moreover, the standardized mean difference (SMD) for continuous outcomes
with 95% confidence interval (CI) was pooled. P-values <.05 are considered
as significant, and we performed all statistical analyses using RevMan
software Version 5.4.1. <br/>Result(s): Eight studies were included in our
review with a total number of 120,158 patients. CHD was associated with a
statistically significant increase in both ADHD index T score and ADHD
Hyperactivity-Impulsivity Subscale (informant) with (SMD=0.65, 95% CI
[0.40, 0.90], P<.00001, I²=81%) and (SMD=0.16, 95% CI [0.04,
0.28], P=.008, I²=0%). Regarding ADHD Inattention Subscale
(informant), the pooled data showed that a significant increase of this
score in the CHD group (SMD=0.25, 95% CI [0.13, 0.37], P<.001,
I²=0%), and ADHD Combined Score (informant) showed a
significant increase of this score in the CHD group (SMD=0.23, 95% CI
[0.11, 0.35], P=.0002, I²=0%). <br/>Conclusion(s): Our study
revealed a strong association between CHD and not only ADHD, but also the
severity of ADHD, making early diagnosis of ADHD in children with CHD a
mandatory step in the clinical evaluation practice to improve these
children on both clinical and psychological aspects.<br/>Copyright &#xa9;
2023 Lippincott Williams and Wilkins. All rights reserved.

<116>
Accession Number
2028759492
Title
Preloaded combination nicotine replacement therapy for smoking cessation
in Kazakhstan: A randomized controlled trial study protocol.
Source
PLoS ONE. 18(11 November) (no pagination), 2023. Article Number: e0292490.
Date of Publication: November 2023.
Author
Purushothama C.; Crape B.L.; Stolyarov V.; Jaxybayeva A.; La Fleur P.;
Olickal J.J.
Institution
(Purushothama) School of Sciences & Humanities, Nazarbayev University,
Nur-Sultan city, Kazakhstan
(Crape, Stolyarov) Nazarbayev University School of Medicine, Nur-Sultan
city, Kazakhstan
(Jaxybayeva) Astana Medical University, Astana, Kazakhstan
(La Fleur) Department of Medicine, Nazarbayev University School of
Medicine, Astana, Kazakhstan
(Olickal) Department of Public Health, Amrita Institute of Medical
Sciences, Kerala, Kochi, India
Publisher
Public Library of Science
Abstract
Background Tobacco use is a major cause of premature death and disease in
Kazakhstan, with over 22,500 deaths per year. Although efforts have been
made to control tobacco use, smokingrelated deaths have continued to
increase. One strategy to help smokers quit is to use nicotine replacement
therapy (NRT), with combination NRT resulting in higher long-term quit
rates than a single form of NRT. A study aims to determine the
effectiveness of preloaded combination NRT on smoking cessation, the
change in health-related quality of life due to smoking cessation, and
explore treatment adherence perceptions. Methods and analysis The study
will be conducted as a randomized, single-blind superiority trial, with
100 participants in each arm. The trial will be carried out at the
National Research Cardiac Surgery Center, Astana, Kazakhstan, and will
recruit current smokers aged 18 years and above with a motivation to quit.
Participants will be randomly allocated to either the intervention group
or the control group. The former will receive preloaded combination NRT,
while the latter will receive fast-acting NRT alone. The primary outcome
measure will be sustained abstinence from smoking after six months.
Secondary outcome measures will include health-related quality of life and
adherence to the treatment. Discussion The study may gather further
evidence that a combination NRT is more efficient than a fastacting NRT
alone. The findings of this study may help to improve tobacco cessation
strategies in Kazakhstan and other countries with high smoking prevalence
rates. Copyright:<br/>Copyright &#xa9; 2023 Purushothama 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.

<117>
Accession Number
2028728999
Title
Effect of using hypotension prediction index versus conventional
goal-directed haemodynamic management to reduce intraoperative hypotension
in non-cardiac surgery: A randomised controlled trial.
Source
Journal of Clinical Anesthesia. 93 (no pagination), 2024. Article Number:
111348. Date of Publication: May 2024.
Author
Yoshikawa Y.; Maeda M.; Kunigo T.; Sato T.; Takahashi K.; Ohno S.;
Hirahata T.; Yamakage M.
Institution
(Yoshikawa, Maeda, Kunigo, Sato, Takahashi, Ohno, Hirahata, Yamakage)
Department of Anaesthesiology, Sapporo Medical University School of
Medicine, South1 West16 291, Chuoku, Sapporo 060-8543, Japan
Publisher
Elsevier Inc.
Abstract
Study objective: It remains unclear whether it is the hypotension
prediction index itself or goal-directed haemodynamic therapy that
mitigates intraoperative hypotension. <br/>Design(s): A single centre
randomised controlled trial. <br/>Setting(s): Sapporo Medical University
Hospital. <br/>Patient(s): A total of 64 adults patients undergoing major
non-cardiac surgery under general anaesthesia. <br/>Intervention(s):
Patients were randomly assigned to either group receiving conventional
goal-directed therapy (FloTrac group) or combination of the hypotension
prediction index and conventional goal-directed therapy (HPI group). To
investigate the independent utility of the index, the peak rates of
arterial pressure and dynamic arterial elastance were not included in the
treatment algorithm for the HPI group. Measurements: The primary outcome
was the time-weighted average of the areas under the threshold. Secondary
outcomes were area under the threshold, the number of hypotension events,
total duration of hypotension events, mean mean arterial pressure during
the hypotension period, number of hypotension events with mean arterial
pressure < 50 mmHg, amounts of fluids, blood products, blood loss, and
urine output, frequency and amount of vasoactive agents, concentration of
haemoglobin during the monitoring period, and 30-day mortality. <br/>Main
Result(s): The time-weighted average of the area below the threshold was
lower in the HPI group than in the control group; 0.19 mmHg (interquartile
range, 0.06-0.80 mmHg) vs. 0.66 mmHg (0.28-1.67 mmHg), with a median
difference of -0.41 mmHg (95% confidence interval, -0.69 to -0.10 mmHg), p
= 0.005. Norepinephrine was administered to 12 (40%) and 5 (17%) patients
in the HPI and FloTrac groups, respectively (p = 0.045). No significant
differences were observed in the volumes of fluid and blood products
between the study groups. <br/>Conclusion(s): The current randomised
controlled trial results suggest that using the hypotension prediction
index independently lowered the cumulative amount of intraoperative
hypotension during major non-cardiac surgery.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<118>
Accession Number
2028562814
Title
Complete revascularization in elderly patients with myocardial
infarction-a safe, effective, and necessary strategy?.
Source
Cell Reports Medicine. 4(11) (no pagination), 2023. Article Number:
101284. Date of Publication: 21 Nov 2023.
Author
Gue Y.X.; Lip G.Y.H.
Institution
(Gue, Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
Publisher
Cell Press
Abstract
The FIRE trial compared culprit-only revascularization to
physiology-guided complete revascularization strategy in elderly patients
presenting with myocardial infarction. The study has shown that it is a
safe approach and may confer additional prognostic benefit in patients
with NSTEMI.<br/>Copyright &#xa9; 2023 The Author(s)

<119>
Accession Number
2027822896
Title
Health-Related Quality of Life After Percutaneous Coronary Intervention
for Stable Ischemic Heart Disease: A Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. 39(11) (pp 1539-1548), 2023. Date of
Publication: November 2023.
Author
Hirao Y.; Seki T.; Watanabe N.; Matoba S.
Institution
(Hirao, Seki, Matoba) Department of Cardiovascular Medicine, Graduate
School of Medical Science, Kyoto Prefectural University of Medicine,
Kyoto, Japan
(Watanabe) Department of Psychiatry, Soseikai General Hospital, Kyoto,
Japan
Publisher
Elsevier Inc.
Abstract
Background: There has been no meta-analysis of whether percutaneous
coronary intervention (PCI) with optimal medical therapy (OMT) improves
health-related quality of life (HRQL) compared with OMT alone in patients
with stable ischemic heart disease (SIHD). <br/>Method(s): We searched
MEDLINE, Cochrane Central Registry of Controlled Trials, Embase,
ClinicalTrials.gov, and International Clinical Trials Registry Platform in
November 2022. We included randomized controlled trials (RCTs) that
compared PCI with OMT vs OMT alone with HRQL in patients with SIHD. The
primary outcome was the aggregated physical HRQL, including physical
functioning using the Short Form (SF)-36 or RAND-36, physical limitation
using the Seattle Angina Questionnaire (SAQ) or SAQ-7, McMaster Health
Index Questionnaire, and Duke Activity Status Index within 6 months. Data
were analyzed using a random effects model when substantial heterogeneity
was identified or a fixed effect model otherwise. <br/>Result(s): Among 14
systematically reviewed RCTs, 12 RCTs with 12,238 patients were
meta-analyzed. Only 1 trial had a low risk of bias in all domains. PCI
with OMT improved aggregated physical HRQL (standardized mean difference,
0.16; 95% confidence interval [CI], 0.1-0.23; P < 0.0001) at 6 months.
Also, PCI with OMT improved physical functioning on the SF-36/RAND-36
(mean difference 3.65; 95% CI, 1.88-5.41) and physical limitation on the
SAQ/SAQ-7 (mean difference, 3.09; 95% CI, 0.93-5.24) compared with OMT
alone at 6 months. However, all of the aggregated physical HRQL domains
were classified into small effects, and no HRQL domain exceeded the
prespecified minimal clinically important difference. <br/>Conclusion(s):
These findings showed that PCI with OMT improved HRQL compared with OMT
alone in patients with SIHD, but the benefit was not large.<br/>Copyright
&#xa9; 2023 Canadian Cardiovascular Society

<120>
Accession Number
2027230657
Title
The Independent Association of Non-alcoholic Fatty Liver Disease With
Incident Cardiovascular Disease: A GRADE Evaluation of the Evidence
Through a Systematic Review and Meta-analysis.
Source
Journal of Clinical and Experimental Hepatology. 14(1) (no pagination),
2024. Article Number: 101277. Date of Publication: 01 Jan 2024.
Author
Prasad M.; Gupta S.; Sarin S.K.
Institution
(Prasad, Gupta, Sarin) Institute of Liver and Biliary Sciences, New Delhi,
India
Publisher
Elsevier B.V.
Abstract
Background: We conducted a systematic review and meta-analysis to study
the association between non-alcoholic fatty liver disease (NAFLD) and
incident cardiovascular disease (CVD). <br/>Method(s): We searched
Medline, Embase, Cochrane database and TRIP database. Random-effects model
meta-analyses were used to obtain pooled effect sizes and 95% confidence
intervals. The certainty in evidence was rated using the GRADE tool.
<br/>Result(s): Altogether 36 studies including a total of 7,068,007
participants were included in the systematic review and meta-analysis.
Pooled data from 19 cohort studies demonstrated a significant increase in
the risk of non-fatal CVD events in patients with NAFLD (HR 1.57, 95% CI
1.33-1.85, I² = 95%). Pooled data from eight studies showed a
significant increase in fatal CVD (HR 1.40, 95% CI 1.24-1.57,
I² =27%), and eight cohort studies suggested a significant
increase in combined non-fatal and fatal CVD (HR 1.41, 95% CI 1.13-1.76,
I² =80%). Meta-analysis of studies reporting adjusted estimates
in NAFLD patients with fibrosis revealed a significant increase in CVD
events with acceptable level of heterogeneity (HR 1.64, 95% CI 1.25-2.16,
I² = 31%). The anticipated absolute increase in the risk of
combined fatal and non-fatal CVD was estimated to be 29 more per thousand
with NAFLD; that of fatal CVD events 16 more per thousand and that of
non-fatal CVD events 19 more per thousand with NAFLD. The GRADE rating
ranged from very low to low for overall and subgroup analyses.
<br/>Conclusion(s): The present systematic review suggests that NAFLD
increases the risk of incident CVD. Cohort studies with the ability to
analyze subgroup effects based on severity, along with randomized
controlled trials that provide experimental evidence demonstrating a
decrease in cardiovascular disease events through the treatment of
non-alcoholic fatty liver disease, are necessary to validate and reinforce
these findings.<br/>Copyright &#xa9; 2023 Indian National Association for
Study of the Liver

<121>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023, The Author(s).

<122>
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. <br/>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<br/>Copyright &#xa9; 2023, The
Author(s).

<123>
Accession Number
2028460005
Title
A systematic review and meta-analysis of internal thoracic artery
harvesting techniques: Skeletonized vs pedicled.
Source
International Journal of Cardiology. 395 (no pagination), 2024. Article
Number: 131577. Date of Publication: 15 Jan 2024.
Author
Dimagli A.; Gemelli M.; Kumar N.; Mitra M.; Sinha S.; Fudulu D.; Harik L.;
Cancelli G.; Soletti G.; Olaria R.P.; Bonaros N.; Gaudino M.; Angelini
G.D.
Institution
(Dimagli, Harik, Cancelli, Soletti, Olaria, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Dimagli, Gemelli, Kumar, Mitra, Sinha, Fudulu, Angelini) Bristol Heart
Institute, University of Bristol, Bristol, United Kingdom
(Gemelli) Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular,
and Public Health Sciences, University of Padua, Padova, Italy
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Anichstr. 35, Innsbruck 6020, Austria
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: The aim of this meta-analysis was to compare clinical and
angiographic outcomes of skeletonized versus pedicled internal thoracic
artery for coronary artery bypass grafting. <br/>Method(s): A
comprehensive search on Ovid MEDLINE, Ovid EMBASE and Scopus was performed
from inception to December 2022. The primary outcome was follow-up
mortality and graft failure. Secondary outcomes were repeat
revascularization, cardiovascular death and operative mortality,
myocardial infarction, stroke, and sternal wound complications (SWCs).
Pooled estimate for follow-up outcomes was summarized as incidence rate
ratio (IRR) and 95% confidence interval (CI) while short-term outcomes
were pooled as odds ratio (OR) and 95% CI. For all outcomes, inverse
variance weighting was used for pooling. <br/>Result(s): Twenty-eight
studies, including 7 randomized trials and 21 observational studies, for a
total of 5664 patients in the skeletonized group and 7434 in the pedicled
group, were included in the analysis. At a mean weighted follow-up of 4.8
years, there was no difference in mortality between the two groups (IRR
1.14; 95% CI 0.59-2.20). However, the skeletonized group had a higher
incidence of graft failure compared to the pedicled group (IRR 1.87, 95%
CI 1.33-2.63) but a lower risk of SWCs (OR 0.42; 95% CI 0.30-0.60). There
was no difference in short-term outcomes. <br/>Conclusion(s): Compared to
the pedicled harvesting technique, skeletonization of the internal
thoracic artery is associated with higher rate of graft failure and lower
risk of SWCs without mortality difference.<br/>Copyright &#xa9; 2023

<124>
Accession Number
2028135648
Title
Commissural alignment during TAVR reduces the risk of overlap to coronary
ostia.
Source
International Journal of Cardiology. 395 (no pagination), 2024. Article
Number: 131572. Date of Publication: 15 Jan 2024.
Author
Carabetta N.; Siller-Matula J.M.; Boccuto F.; Panuccio G.; Indolfi C.;
Torella D.; De Rosa S.
Institution
(Carabetta, Boccuto, Panuccio, Indolfi, De Rosa) Department of Medical and
Surgical Sciences, Magna Graecia University, Catanzaro, Italy
(Siller-Matula) Department of Cardiology, Medical University of Vienna,
Vienna, Austria
(Indolfi) Mediterranea Cardiocentro, Naples, Italy
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) showed safety
and efficacy in patients with severe aortic stenosis. Commissural
alignment (CA) during TAVR has the potential to reduce the impact of the
prostheses on accessibility of coronary arteries, as misalignment of the
neocommissures could cause partial overlap with coronary ostia. Therefore,
the aim of this study was to investigate the impact of CA on coronary
overlap rates. <br/>Method(s): We examined the techniques of CA and their
impact on coronary access. Eligible studies were searched for on Pubmed,
SCOPUS and DOAJ and selected using PRISMA guidelines. The primary endpoint
was the incidence of a severe coronary overlap or failed coronary
re-access. Results of the analysis are expressed as Risk Ratio (RR) with
95% CI. <br/>Result(s): Four studies were included in this analysis. In
these, 681 patients underwent TAVR with CA and 210 underwent TAVR without
CA. We examined Evolut valves and Acurate Neo valves. The primary endpoint
occurred in 138 patients undergoing TAVR with CA and in 154 patients
without CA (RR = 0.279; 95% CI 0.201-0.386; p < 0.001). Neither
prosthesis-related, nor patient-related factors had a significant
interaction with the measured effect. <br/>Conclusion(s): Commissural
alignment was associated with significantly lower rates of
commissure-to-coronary ostia overlap and failure of coronary access.
Consequently, a modified insertion technique could reduce coronary overlap
and coronary occlusion, particularly in supra-annular valves. Therefore,
controlled orientation of prostheses by CA during TAVR could favour
coronary access, especially in younger patients that could require
coronary re-access after TAVR.<br/>Copyright &#xa9; 2023

<125>
Accession Number
2027810337
Title
Outcomes of untreated subclinical antibody-mediated rejection after heart
transplantation.
Source
Progress in Cardiovascular Diseases. 81 (pp 48-53), 2023. Date of
Publication: 01 Nov 2023.
Author
Boulet J.; Kelleher J.; Wanderley M.R.B.; Nohria A.; Andersson C.; Kim M.;
Mehra M.R.
Institution
(Boulet) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Kelleher, Wanderley, Nohria, Andersson, Kim, Mehra) Center for Advanced
Heart Disease, Brigham and Women's Hospital and Harvard Medical School,
Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Subclinical antibody-mediated rejection (AMR) is represented by
histopathological and/or immunopathological manifestations in the absence
of significant cardiac allograft dysfunction. Treatment remains uncertain
as there is a lack of data on asymptomatic heart transplant (HT)
recipients (HTR) with a positive cardiac biopsy. We sought to determine
the impact of untreated subclinical biopsy-proven AMR, regardless of
circulating donor-specific antigen (DSA) expression, when diagnosed on
surveillance biopsies in the first year after HT. This retrospective case
control study evaluated 260 HTR between May 2004 and February 2021. These
comprised 231 controls and 29 patients with untreated subclinical AMR. The
mortality event rate was higher in controls (2.63 events per 100
person-years) compared to the scAMR Group (1.71 events per 100
person-years), a difference that did not reach statistical significance
(hazard ratio 0.66, CI: 0.18-2.36). The combined event rate of cardiac
allograft vasculopathy (CAV), graft dysfunction, or mortality was higher
in the subclinical AMR group (5.60 events per 100 person-years) than in
controls (3.89 events per 100 person-years) but did not reach statistical
significance (hazard ratio 1.63, CI: 0.07-40.09). Our results suggest that
subclinical AMR diagnosed in the first year after HT on surveillance
biopsy is not associated with decreased survival. This may sway the
management of subclinical AMR towards a more conservative approach in
transplant-capable institutions that currently prioritize treatment,
though prospective, randomized studies of such a management strategy are
required.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<126>
Accession Number
2027727285
Title
Left Atrium Volume Reduction Procedure Concomitant With Cox-Maze Ablation
in Patients Undergoing Mitral Valve Surgery: A Meta-Analysis of Clinical
and Rhythm Outcomes.
Source
Heart Lung and Circulation. 32(11) (pp 1386-1393), 2023. Date of
Publication: November 2023.
Author
Baudo M.; Rosati F.; Di Bacco L.; D'Alonzo M.; Benussi S.; Muneretto C.
Institution
(Baudo, Rosati, Di Bacco, D'Alonzo, Benussi, Muneretto) Division of
Cardiac Surgery, Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
Publisher
Elsevier Ltd
Abstract
Background: The management of an enlarged left atrium (LA) in mitral valve
(MV) disease with atrial fibrillation (AF) is still being debated. It has
been postulated that a reduction in LA size may improve patient outcomes.
This meta-analysis aimed to assess rhythm and clinical outcomes of
combined surgical AF treatment with or without LA volume reduction (LAVR)
in patients undergoing MV surgery. <br/>Method(s): A systematic review was
performed and all available literature to May 2022 was included. The
primary endpoint was analysis of early and late mortality and rhythm
outcomes. Secondary outcomes included early and late cerebrovascular
accident (CVA) and permanent pacemaker implantation. <br/>Result(s): The
search strategy yielded 2,808 potentially relevant articles, and 19 papers
were eventually included. The pooled estimated rate of 30-day mortality
was 3.76% (95% CI 2.52-5.56). The incidence rate of late mortality and
late cardiac-related mortality was 1.75%/year (95% CI 0.63-4.84) and
1.04%/year (95% CI 0.31-3.53), respectively. At subgroup analysis when
comparing the surgical procedure with and without AF ablation, the
ablation subgroup showed a significantly lower rate of postoperative CVA
(p<0.0001) and higher restoration to sinus rhythm at discharge (p=0.0124),
with only a trend of lower AF recurrence at 1 year (p=0.0608). At
univariable meta-regression, reintervention was significantly associated
with higher late mortality (p=0.0033). <br/>Conclusion(s): In enlarged LA
undergoing MV surgery, LAVR combined with AF ablation showed a trend of
improved rhythm outcomes when compared with AF ablation without LAVR. Each
LAVR technique has its advantages and disadvantages, which must be managed
accordingly.<br/>Copyright &#xa9; 2023 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<127>
Accession Number
2026316967
Title
Long-term outcomes after transcatheter aortic valve replacement:
Meta-analysis of Kaplan-Meier-derived data.
Source
Catheterization and Cardiovascular Interventions. 102(7) (pp 1291-1300),
2023. Date of Publication: 01 Dec 2023.
Author
Shimamura J.; Takemoto S.; Fukuhara S.; Miyamoto Y.; Yokoyama Y.; Takagi
H.; Kampaktsis P.N.; Kolte D.; Grubb K.J.; Kuno T.; Latib A.
Institution
(Shimamura, Grubb) Department of Surgery, Division of Cardiothoracic
Surgery, Emory University School of Medicine, Atlanta, GA, United States
(Takemoto) Department of Cardiovascular Surgery, Kyushu University
Hospital, Fukuoka, Japan
(Fukuhara, Yokoyama) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Kolte) Division of Cardiology, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical center, Albert
Einstein Medical College, New York City, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical center, Albert Einstein
Medical College, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is as an
alternative treatment to surgical AVR, but the long-term outcomes of TAVR
remain unclear. <br/>Aim(s): This study aimed to analyze long-term
outcomes following TAVR using meta-analysis. <br/>Method(s): A literature
search was performed with MEDLINE, EMBASE, Cochrane Library, Web of
Science, and Google Scholar through November 2022; studies reporting
clinical outcomes of TAVR with follow-up periods of >=8 years were
included. The outcomes of interest were overall survival and/or freedom
from structural valve deterioration (SVD). Surgical risk was assessed with
the Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM)
score. A subgroup analysis was conducted for intermediate-/high-surgical
risk patients only. <br/>Result(s): Eleven studies including 5458 patients
were identified and analyzed. The mean age was 82.0 +/- 6.5 years, and
mean STS PROM score ranged from 2.9 to 10.6%. Survival rate at 5 and 10
years was 47.7% +/- 1.4% and 12.1 +/- 2.0%. Five studies including 1509
patients were analyzed for SVD. Freedom from SVD at 5 and 8 years was 95.5
+/- 0.7% and 85.1 +/- 3.1%. Similar results for survival and SVD were
noted in the subgroup analysis of intermediate-/high-risk patients.
<br/>Conclusion(s): Following TAVR, approximately 88% of patients died
within 10 years, whereas 85% were free from SVD at 8 years. These date
suggest that baseline patient demographic have the greatest impact on
survival, and SVD does not seem to have a prognostic impact in this
population. Further investigations on longer-term outcomes of younger and
lower-risk patients are warranted.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<128>
Accession Number
2026236255
Title
Proportional troponin changes and risk for outcomes with intervention
strategies in non-ST-elevation acute coronary syndrome across kidney
function.
Source
Catheterization and Cardiovascular Interventions. 102(7) (pp 1162-1176),
2023. Date of Publication: 01 Dec 2023.
Author
Mathew R.O.; Rangaswami J.; Abramov D.; Mahalwar G.; Vellanki S.; Abuazzam
F.; Fraser G.E.; Butler F.M.; Lo K.B.; Herzog C.A.; Shroff G.R.; Sidhu
M.S.; Bangalore S.
Institution
(Mathew) Division of Nephrology, Department of Medicine, Loma Linda VA
Healthcare System, Loma Linda, CA, United States
(Mathew, Abuazzam) Division of Nephrology, Department of Medicine, Loma
Linda University School of Medicine, Loma Linda, CA, United States
(Rangaswami) Division of Nephrology, Department of Medicine, Washington DC
VA Medical Center, Washington, DC, United States
(Rangaswami, Vellanki) Department of Medicine, George Washington
University School of Medicine, Washington, DC, United States
(Abramov, Fraser) Division of Cardiology, Department of Medicine, Loma
Linda University School of Medicine, Loma Linda, CA, United States
(Mahalwar) Department of Medicine, Cleveland Clinic Foundation, Cleveland,
OH, United States
(Fraser, Butler) Center for Nutrition, Healthy Lifestyle, and Disease
Prevention, School of Public Health, Loma Linda University, Loma Linda,
CA, United States
(Fraser, Butler) Adventist Health Study, Loma Linda University, Loma
Linda, CA, United States
(Fraser, Butler) Department of Preventive Medicine, School of Medicine,
Loma Linda University, Loma Linda, CA, United States
(Lo) Department of Medicine, Einstein Medical Center, Philadelphia, PA,
United States
(Lo) Department of Medicine, Sydney Kimmel College of Thomas Jefferson
University, Philadelphia, PA, United States
(Herzog, Shroff) Cardiology Division, Department of Internal Medicine,
Hennepin Healthcare, University of Minnesota, Minneapolis, MN, United
States
(Sidhu) Division of Cardiology, Department of Medicine, Albany Medical
College, Albany, NY, United States
(Bangalore) Division of Cardiology, New York University Grossman School of
Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Aims: This analysis evaluates whether proportional serial cardiac troponin
(cTn) change predicts benefit from an early versus delayed invasive, or
conservative treatment strategies across kidney function in
non-ST-elevation acute coronary syndrome (NSTE-ACS). <br/>Method(s):
Patients diagnosed with NSTE-ACS in the Veterans Health Administration
between 1999 and 2022 were categorized into terciles (<20%, 20 to <=80%,
>80%) of proportional change in serial cTn. Primary outcome included
mortality or rehospitalization for myocardial infarction at 6 and 12
months, in survivors of index admission. Adjusted hazard ratio (HR) with
95% confidence Intervals (95% confidence interval [CI]) were calculated
for the primary outcome for an early invasive (<=24 h of the index
admission), delayed invasive (>24 h of index admission to 90-days
postdischarge), or a conservative management. <br/>Result(s): Chronic
kidney disease (CKD) was more prevalent (45.3%) in the lowest versus 42.2%
and 43% in middle and highest terciles, respectively (p < 0.001). Primary
outcome is more likely for conservative versus early invasive strategy at
6 (HR: 1.44, 95% CI: 1.37-1.50) and 12 months (HR: 1.44, 95% CI:
1.39-1.50). A >80% proportional change demonstrated HR (95% CI): 0.90
(0.83-0.97) and 0.93 (0.88-1.00; p = 0.041) for primary outcome at 6 and
12 months, respectively, when an early versus delayed invasive strategy
was used, across CKD stages. <br/>Conclusion(s): Overall, the invasive
strategy was safe and associated with improved outcomes across kidney
function in NSTE-ACS. Additionally, >80% proportional change in serial
troponin in NSTE-ACS is associated with benefit from an early versus a
delayed invasive strategy regardless of kidney function. These findings
deserve confirmation in randomized controlled trials.<br/>Copyright &#xa9;
2023 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<129>
Accession Number
2025278311
Title
Early left atrial venting versus conventional treatment for left
ventricular decompression during venoarterial extracorporeal membrane
oxygenation support: The EVOLVE-ECMO randomized clinical trial.
Source
European Journal of Heart Failure. 25(11) (pp 2037-2046), 2023. Date of
Publication: November 2023.
Author
Park H.; Yang J.H.; Ahn J.-M.; Kang D.-Y.; Lee P.H.; Kim T.O.; Choi K.H.;
Kang P.J.; Jung S.-H.; Yun S.-C.; Park D.-W.; Lee S.-W.; Park S.-J.; Kim
M.-S.
Institution
(Park, Ahn, Kang, Lee, Kim, Park, Lee, Park, Kim) Division of Cardiology,
Department of Internal Medicine, Asan Medical Center Heart Institute,
University of Ulsan College of Medicine, Seoul, South Korea
(Park) Division of Cardiology, Department of Medicine, Gangneung Asan
Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
(Yang, Choi) Division of Cardiology, Department of Internal Medicine,
Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Kang, Jung) Department of Thoracic and Cardiovascular Surgery, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Yun) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Few studies have reported data on the optimal timing of left
ventricular (LV) unloading during venoarterial extracorporeal membrane
oxygenation (VA-ECMO) for cardiac arrest or shock. This study evaluated
the feasibility of an early LV unloading strategy compared with a
conventional strategy in VA-ECMO. <br/>Methods and Results: Between
December 2018 and August 2022, 60 patients at two institutions were
randomized in a 1:1 ratio to receive early (n = 30) or conventional (n =
30) LV unloading strategies. The early LV unloading strategy was defined
as LV unloading performed at the time of VA-ECMO insertion. LV unloading
was performed using a percutaneous transseptal left atrial cannulation via
the femoral vein incorporated into the ECMO venous circuit. The early and
conventional LV unloading groups included 29 (96.7%) and 23 (76.7%)
patients, respectively (median time from VA-ECMO insertion to LV
unloading: 48.4 h, interquartile range 47.8-96.5 h). The groups showed no
significant differences in the rate of VA-ECMO weaning as the primary
endpoint (70.0% vs. 76.7%; relative risk 0.91; 95% confidence interval
0.67-1.24; p = 0.386) and survival to discharge (53.3% vs. 50.0%, p =
0.796). However, the pulmonary congestion score index at 48 h after LV
unloading was significantly improved only in the early LV unloading group
(2.0 +/- 0.7 vs. 1.7 +/- 0.6 at baseline vs. at 48 h; p = 0.008).
<br/>Conclusion(s): Compared with the conventional approach, early LV
unloading did not improve the VA-ECMO weaning rate, despite the rapid
improvement in pulmonary congestion. Therefore, the results of this study
do not support the application of this strategy after VA-ECMO
insertion.<br/>Copyright &#xa9; 2023 European Society of Cardiology.

<130>
Accession Number
2017717896
Title
Bilateral internal thoracic artery versus single internal thoracic artery
plus radial artery: A double meta-analytic approach.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(1) (pp 183-195.e3),
2024. Date of Publication: January 2024.
Author
Urso S.; Sadaba R.; Gonzalez Martin J.M.; Nogales E.; Tena M.A.; Portela
F.
Institution
(Urso, Tena, Portela) Cardiac Surgery Department, Hospital Universitario
Dr. Negrin, Las Palmas de Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Hospital Universitario de Navarra,
Pamplona, Spain
(Gonzalez Martin) Research Unit, Hospital Universitario Dr. Negrin, Las
Palmas de Gran Canaria, Spain
(Nogales) Cardiology Department, Hospital Universitario Insular, Las
Palmas de Gran Canaria, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: We explored the current evidence on the best second conduit in
coronary surgery carrying out a double meta-analysis of propensity score
matched or adjusted studies comparing bilateral internal thoracic artery
(BITA) versus single internal thoracic artery plus radial artery.
<br/>Method(s): PubMed, Embase, and Google Scholar were searched for
propensity score matched or adjusted studies comparing BITA versus single
internal thoracic artery plus radial artery. The end point was long-term
mortality. Two statistical approaches were used: the generic inverse
variance method and the pooled meta-analysis of Kaplan-Meier-derived
individual patient data. <br/>Result(s): Twelve matched populations
comparing 6450 patients with BITA versus 9428 patients with single
internal thoracic artery plus radial artery were included in our
meta-analysis. The generic inverse variance method showed a statistically
significant survival benefit of the BITA group (hazard ratio, 0.84; 95%
CI, 0.74-0.95; P =.04). The Kaplan-Meier estimates of survival at 1, 5,
10, and 15 years of the BITA group were 97.0%, 91.3%, 80.0%, and 68.0%,
respectively. The Kaplan-Meier estimates of survival at 1, 5, 10, and 15
years of the single internal thoracic artery plus radial artery group were
97.3%, 91.5%, 79.9%, and 63.9%, respectively. The Kaplan-Meier-derived
individual patient data meta-analysis applied to very long follow-up time
data, showed that BITA provided a survival benefit after 10 years from
surgery (hazard ratio, 0.77; 95% CI, 0.63-0.94; P =.01). No differences in
terms of survival between the 2 groups were detected when the analysis was
focused on the first 10 years of follow-up (hazard ratio, 0.99; 95% CI,
0.91-1.09; P =.93). <br/>Conclusion(s): The present meta-analysis suggests
that double internal thoracic artery may provide, compared with single
internal thoracic artery plus radial artery, a statistically significant
survival advantage after 10 years of follow-up, but not before. Video
Abstract:[Formula presented]<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<131>
Accession Number
637409878
Title
Transcatheter Aortic Valve Replacement in Nonagenarians: A Systematic
Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E226-E236), 2022. Date of
Publication: 01 Mar 2022.
Author
Demir O.M.; Curio J.; Pagnesi M.; Rahman H.; Mitomo S.; Colombo A.; Chau
M.; Prendergast B.; Latib A.
Institution
(Demir) Department of Cardiology, St Thomas' Hospital, London SE1 7EH,
United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Nonagenarians represent only a small proportion of patients
included in large transcatheter aortic valve replacement (TAVR) trials,
but will become a relevant future population in need of treatment due to
demographic change. Thus, this study sought to evaluate outcomes of TAVR
for the treatment of severe aortic stenosis (AS) in nonagenarian patients.
<br/>METHOD(S): We screened Medline/Pubmed for studies that stated
specific outcomes for nonagenarians undergoing TAVR. A weighted
meta-analysis was conducted, calculating pooled estimate rates using a
binary random-effects model for dichotomous variables, and comparing
non-dichotomous outcomes with a continuous random-effects model.
<br/>RESULT(S): Data from 23 studies including 16,094 nonagenarians were
merged; 53.4% were women. Despite reasonable rates of comorbidities,
Society of Thoracic Surgeons mortality risk score was 10.2 +/- 5.4. Pooled
estimate rate of procedural success was 94.1% (95% confidence interval
[CI], 91.7-96.6), with major vascular complications occurring in 6.3% (95%
CI, 2.7-9.8) and at least moderate postprocedural paravalvular leak in
7.5% (95% CI, 4.4-10.6). The rate of periprocedural stroke or transient
ischemic attack was 2.6% (95% CI, 2.0-3.2). At 30 days, the pooled
estimate of mortality was 6.1% (95% CI, 4.7-7.4) and a permanent pacemaker
was implanted in 12.6% (95% CI, 7.6-17.6). After 1 year, the mortality
rate was 20.5% (95% CI, 15.9-25.1). <br/>CONCLUSION(S): TAVR in
nonagenarians is an effective and safe procedure, with encouraging
outcomes given the general life expectancy of these patients. Currently,
only selected nonagenarians are undergoing TAVR, but their number will
grow as life expectancy continues to increase in the developed world.
Specific research to identify ideal candidates and techniques in this
cohort is needed.

<132>
Accession Number
637409695
Title
Clinically Significant Incidental Findings on CT Imaging During TAVI
Work-up: A Systematic Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E218-E225), 2022. Date of
Publication: 01 Mar 2022.
Author
Ko K.; Zwetsloot P.-P.; Voskuil M.; Stella P.; Leiner T.; Kraaijeveld A.
Institution
(Kraaijeveld) Department of Cardiology, University Medical Centre Utrecht,
Heidelberglaan 100, CX Utrecht 3584, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The transcatheter aortic valve implantation (TAVI) population
is mostly elderly and frail. Clinically significant incidental findings
(SIFs) are commonly encountered in the work-up of TAVI patients. This is a
systematic review of current literature on the occurrence of SIFs on
computed tomography (CT) imaging preceding TAVI and their association with
mortality, delayed planning, and procedure cancellation. <br/>METHOD(S): A
systematic search on Medline, Embase, and Cochrane resulted in 19
retrospective studies (published from 2010-2020) reporting SIFs in the
work-up for TAVI. A total of 6358 individuals from 19 studies were
analyzed, with mean age of 80 years and sex equally divided. A
random-effects meta-analysis was performed, with weighting based on study
size. <br/>RESULT(S): Pooled prevalence of patients with SIF was 22.2%
(95% confidence interval [CI], 17.8-26.6) and most findings (48.3%) were
found in the lungs. Pooled prevalence of new malignancies was 3.4% (95%
CI, 2.5-4.4). Higher mortality in patients with SIF was only found in
studies with a follow-up period >4 years (hazard ratio, 1.5-1.7). TAVI was
more frequently cancelled in patients with SIF vs those with no SIF
(ranges, 10.1%-47.1% vs 5.2%-37.0%, respectively). SIF did not delay time
to TAVI (ranges, 6-91 days in SIF patients vs 4-81 days in non-SIF
patients). <br/>CONCLUSION(S): SIFs are common in patients screened for
TAVI. SIF is associated with a higher risk of TAVI cancellation and with
increased mortality risk over the long term, which should be taken into
consideration in decision making. These findings may help inform patients
and aid patient selection.

<133>
Accession Number
2028974110
Title
Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for
Minimally Invasive Thoracic Surgery A Randomized Clinical Trial.
Source
JAMA Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Chenesseau J.; Fourdrain A.; Pastene B.; Charvet A.; Rivory A.; Baumstarck
K.; Bouabdallah I.; Trousse D.; Boulate D.; Brioude G.; Gust L.; Vasse M.;
Braggio C.; Mora P.; Labarriere A.; Zieleskiewicz L.; Leone M.; Thomas
P.A.; D'Journo X.-B.
Institution
(Chenesseau, Fourdrain, Bouabdallah, Trousse, Boulate, Brioude, Gust,
Vasse, Braggio, Thomas, D'Journo) Department of Thoracic Surgery, Diseases
of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille
University, Assistance Publique-Hopitaux de Marseille, Marseille, France
(Pastene, Charvet, Rivory, Mora, Labarriere, Zieleskiewicz, Leone)
Department of Anesthesiology and Intensive Care Medicine, North Hospital,
Aix Marseille University, Assistance Publique-Hopitaux de Marseille,
Marseille, France
(Baumstarck) Departement of Biostatistics, Aix Marseille University,
Assistance Publique-Hopitaux de Marseille, Marseille, France
Publisher
American Medical Association
Abstract
IMPORTANCE In minimally invasive thoracic surgery, paravertebral block
(PVB) using ultrasound (US)-guided technique is an efficient postoperative
analgesia. However, it is an operator-dependent process depending on
experience and local resources. Because pain-control failure is highly
detrimental, surgeons may consider other locoregional analgesic options.
OBJECTIVE To demonstrate the noninferiority of PVB performed by surgeons
under video-assisted thoracoscopic surgery (VATS), hereafter referred to
as PVB-VATS, as the experimental group compared with PVB performed by
anesthesiologists using US-guided technique (PVB-US) as the control group.
DESIGN, SETTING, AND PARTICIPANTS In this single-center, noninferiority,
patient-blinded, randomized clinical trial conducted from September 8,
2020, to December 8, 2021, patients older than 18 years who were
undergoing a scheduled minimally invasive thoracic surgery with lung
resection including video-assisted or robotic approaches were included.
Exclusion criteria included scheduled open surgery, any antalgic World
Health Organization level greater than 2 before surgery, or a medical
history of homolateral thoracic surgery. Patients were randomly assigned
(1:1) to an intervention group after general anesthesia. They received
single-injection PVB before the first incision was made in the control
group (PVB-US) or after 1 incision was made under thoracoscopic vision in
the experimental group (PVB-VATS). INTERVENTIONS PVB-VATS or PVB-US. MAIN
OUTCOMES AND MEASURES The primary end point was mean 48-hour post-PVB
opioid consumption considering a noninferiority range of less than 7.5 mg
of opioid consumption between groups. Secondary outcomes included time of
anesthesia, surgery, and operating room occupancy; 48-hour pain visual
analog scale score at rest and while coughing; and 30-day postoperative
complications. RESULTS A total of 196 patients were randomly assigned to
intervention groups: 98 in the PVB-VATS group (mean [SD] age, 64.6 [9.5]
years; 53 female [54.1%]) and 98 in the PVB-US group (mean [SD] age, 65.8
[11.5] years; 62 male [63.3%]). The mean (SD) of 48-hour opioid
consumption in the PVB-VATS group (33.9 [19.8] mg; 95% CI, 30.0-37.9 mg)
was noninferior to that measured in the PVB-US group (28.5 [18.2] mg; 95%
CI, 24.8-32.2 mg; difference: -5.4 mg; 95% CI, - to -0.93; noninferiority
Welsh test, P <= .001). Pain score at rest and while coughing after
surgery, overall time, and postoperative complications did not differ
between groups. CONCLUSIONS AND RELEVANCE PVB placed by a surgeon during
thoracoscopy was noninferior to PVB placed by an anesthesiologist using
ultrasonography before incision in terms of opioid consumption during the
first 48 hours.<br/>Copyright &#xa9; 2023 American Medical Association.
All rights reserved.

<134>
Accession Number
2028952945
Title
Results beyond 5-years of surgery or percutaneous approach in severe
coronary disease. Reconstructed time-to-event meta-analysis of randomized
trials.
Source
Revista Espanola de Cardiologia. (no pagination), 2023. Date of
Publication: 2023.
Author
Formica F.; Hernandez-Vaquero D.; Tuttolomondo D.; Gallingani A.; Singh
G.; Pattuzzi C.; Niccoli G.; Lorusso R.; Nicolini F.
Institution
(Formica, Pattuzzi, Niccoli, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Tuttolomondo, Niccoli) Cardiology Unit, University Hospital of Parma,
Parma, Italy
(Gallingani, Pattuzzi, Nicolini) Cardiac Surgery Unit, University Hospital
of Parma, Parma, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Lorusso) Cardio-Thoracic Department, Maastricht University Medical
Centre, Heart and Vascular Centre, Maastricht, Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: There is controversy about the optimal
revascularization strategy in severe coronary artery disease (CAD),
including left main disease and/or multivessel disease. Several
meta-analyses have analyzed the results at 5-year follow-up but there are
no results after the fifth year. We conducted a systematic review and
meta-analysis of randomized clinical trials, comparing results after the
fifth year, between coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) using drug-eluting stents in
patients with severe CAD. <br/>Method(s): We analyzed all clinical trials
between January 2010 and January 2023. The primary endpoint was all-cause
mortality. The databases of the original articles were reconstructed from
Kaplan-Meier curves, simulating an individual-level meta-analysis.
Comparisons were made at certain cutoff points (5 and 10 years). The
10-year restricted median survival time difference between CABG and PCI
was calculated. The random effects model and the DerSimonian-Laird method
were applied. <br/>Result(s): The meta-analysis included 5180 patients.
During the 10-year follow-up, PCI showed a higher overall incidence of
all-cause mortality (HR, 1.19; 95%CI, 1.04-1.32; P = .008)]. PCI showed an
increased risk of all-cause mortality within 5 years (HR, 1.2; 95%CI,
1.06-1.53; P = .008), while no differences in the 5-10-year period were
revealed (HR, 1.03; 95%CI, 0.84-1.26; P = .76). Life expectancy of CABG
patients was slightly higher than that of PCI patients (2.4 months more).
<br/>Conclusion(s): In patients with severe CAD, including left main
disease and/or multivessel disease, there was higher a incidence of
all-cause mortality after PCI compared with CABG at 10 years of follow-up.
Specifically, PCI has higher mortality during the first 5 years and
comparable risk beyond 5 years.<br/>Copyright &#xa9; 2023 Sociedad
Espanola de Cardiologia