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<1>
Accession Number
2017488981
Title
Lung ultrasound is non-inferior to bronchoscopy for confirmation of
double-lumen endotracheal tube positioning: a randomized controlled
noninferiority study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 168. Date
of Publication: December 2022.
Author
Kanavitoon S.; Raksamani K.; Troy M.P.; Suphathamwit A.; Thongcharoen P.;
Suksompong S.; Oh S.S.
Institution
(Kanavitoon, Raksamani, Suphathamwit, Suksompong) Department of
Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University,
2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
(Troy, Oh) Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Medicine, David Geffen School of Medicine at UCLA, Los
Angeles, CA, United States
(Thongcharoen) Division of Cardiothoracic Surgery, Department of Surgery,
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand
Publisher
BioMed Central Ltd
Abstract
Background: Appropriate placement of left-sided double-lumen endotracheal
tubes (LDLTs) is paramount for optimal visualization of the operative
field during thoracic surgeries that require single lung ventilation.
Appropriate placement of LDLTs is therefore confirmed with fiberoptic
bronchoscopy (FOB) rather than clinical assessment alone. Recent studies
have demonstrated lung ultrasound (US) is superior to clinical assessment
alone for confirming placement of LDLT, but no large trials have compared
US to the gold standard of FOB. This noninferiority trial was devised to
compare lung US with FOB for LDLT positioning and achievement of lung
collapse for operative exposure. Method(s): This randomized,
controlled, double-blind, noninferiority trial was conducted at the
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand from October 2017 to July 2019. The study enrolled 200 ASA
classification 1-3 patients that were scheduled for elective thoracic
surgery requiring placement of LDLT. Study patients were randomized into
either the FOB group or the lung US group after initial blind placement of
LDLT. Five patients were excluded due to protocol deviation. In the FOB
group (n = 98), fiberoptic bronchoscopy was used to confirm lung collapse
due to proper positioning of the LDLT, and to adjust the tube if
necessary. In the US group (n = 97), lung ultrasonography of four
pre-specified zones (upper and lower posterior and mid-axillary) was used
to assess lung collapse and guide adjustment of the tube if necessary. The
primary outcome was presence of adequate lung collapse as determined by
visual grading by the attending surgeon on scale from 1 to 4. Secondary
outcomes included the time needed to adjust and confirm lung collapse, the
time from finishing LDLT positioning to the grading of lung collapse, and
intraoperative parameters such has hypotension or hypertension, hypoxia,
and hypercarbia. The patient, attending anesthesiologist, and attending
thoracic surgeon were all blinded to the intervention arm. Result(s):
The primary outcome of lung collapse by visual grading was similar between
the intervention and the control groups, with 89 patients (91.8%) in the
US group compared to 83 patients (84.1%) in the FOB group (p = 0.18)
experiencing adequate collapse. This met criteria for noninferiority per
protocol analysis. The median time needed to confirm and adjust LDLT
position in the US group was 3 min (IQR 2-5), which was significantly
shorter than the median time needed to perform the task in the FOB group
(6 min, IQR 4-10) (p = 0.002). Conclusion(s): In selected patients
undergoing thoracic surgery requiring LDLT, lung ultrasonography was
noninferior to fiberoptic bronchoscopy in achieving adequate lung collapse
and reaches the desired outcome in less time. Trial Registration: This
study was registered at clinicaltrials.gov, NCT03314519, Principal
investigator: Kasana Raksamani, Date of registration:
19/10/2017. Copyright © 2022, The Author(s).

<2>
Accession Number
2029835307
Title
Alcohol consumption, alcohol use disorder and organ transplantation.
Source
Minerva Gastroenterology. 69(4) (pp 553-565), 2023. Date of Publication:
December 2023.
Author
Testino G.; Pellicano R.; Caputo F.
Institution
(Testino) Unit of Addiction and Hepatology, Alcohological Regional Center,
ASL3 Liguria, IRCCS San Martino University Hospital, Genoa, Italy
(Testino) Centro Studi Mutual-self-help, Community Programs and Caregiver
Training, ASL3 Liguria, Genoa, Italy
(Pellicano) Unit of Gastroenterology, Molinette Hospital, Turin, Italy
(Caputo) Department of Translational Medicine, University of Ferrara,
Ferrara, Italy
(Caputo) Center for the Study and Treatment of Alcohol-Related Diseases,
Department of Translational Medicine, University of Ferrara, Ferrara,
Italy
(Caputo) Department of Internal Medicine, Santissima Annunziata Hospital,
University of Ferrara, Ferrara, Italy
Publisher
Edizioni Minerva Medica
Abstract
In the present experience we have evaluated the link alcohol
consumption/alcohol use disorder (AUD) and organ transplantation (OT) in
order to provide adequate suggestions. The data used for the preparation
of these recommendations are based on a detailed analysis of the
scientific literature published before August 31, 2022 (Web of Science,
Scopus, Google Scholar). Furthermore, in the process of developing this
work, we consulted the guidelines/position papers of the scientific
societies. With regard to the liver transplantation, there are position
papers/guidelines that clearly define indications and contraindications
for including the AUD patient in the transplant list. One of the major
difficulties in this area is psychosocial assessment which can be
influenced by stigma. To solve this problem, it is necessary to use
objective tools. However, this assessment should be carried out after
providing the patient and family adequate tools to be able to create or
recreate reliable socio-family support. This behavior should also be used
in the case of other OTs. For the latter, however, adequate guidelines
must be created which at the moment do not exist or if there are, as in
the case of heart transplantation, they are not sufficient. Even in the
absence of obvious alcohol addiction, it is recommended to use alcohol use
disorder identification test and to include the addiction specialist in
the multidisciplinary transplant team. Besides, providing family members
with the tools necessary to better support the patient is essential. They
are patients with alcohol use disorder/ possible presence of
psychopathological manifestations and alcohol-related pathology
(cirrhosis, cardiomyopathy, liver-kidney disfunction, etc.). A
cardiovascular and oncologic surveillance post-OT is recommended. For the
selection of patients to be included in the list for non-LT (heart, lung,
kidney, multivisceral, etc.) it is mandatory to include the diagnosis and
treatment of AUDs in the guidelines. What has already been indicated for
LT may be useful. Timing of alcoholic abstention in relation to clinical
severity, optimal psychosocial activity, anticraving therapy in relation
to the type of underlying disease and clinical severity. Close
collaboration between scientific societies is required to better manage
AUD patients who need OT. Copyright © 2022 EDIZIONI MINERVA
MEDICA.

<3>
Accession Number
2029699263
Title
Pain and sleep after open-heart surgery-inhalation peppermint essence:
Double-blind randomized clinical trial.
Source
BMJ Supportive and Palliative Care. 13(e3) (pp E1318-E1325), 2023. Date of
Publication: 03 Aug 2023.
Author
Pour-Abbasi M.-S.; Yadollahi S.; Maghami M.; Azizi-Fini I.; Afazel M.-R.
Institution
(Maghami, Yadollahi, Azizi-Fini, Afazel) Trauma Nursing Research Center,
Kashan University of Medical Sciences, Kashan, Iran, Islamic Republic of
(Pour-Abbasi) Cardiac Surgery Department, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Maghami) Biostatics and Epidemiology Department, Isfahan University of
Medical Sciences, Isfahan, Iran, Islamic Republic of
Publisher
BMJ Publishing Group
Abstract
Objective The aim of this study was to determine the effect of inhaling
peppermint essence on pain relief and sleep quality after open-heart
surgery. Methods In a double-blind randomised clinical trial carried out
in Iran in 2020, 64 cardiac patients were selected by convenience sampling
and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups.
The aromatherapy and control groups received inhaled aromatherapy using
peppermint essence and distilled water, respectively. Data gathering tools
were the Numeric Pain Rating Scale and St Mary's Hospital Sleep
Questionnaire. Data were analysed using an independent t-test, chi 2 test,
Mann-Whitney U test and generalised estimating equation analysis. Results
The mean severity of pain in the aromatherapy and placebo groups was
3.22+/-0.88 and 4.56+/-0.90, respectively, which was a statistically
significant difference (p=0.0001). The mean sleep scores after the
intervention on day 1 were 20.10+/-4.90 and 25.76+/-6.36 in the
aromatherapy and placebo groups, respectively, and 18.63+/-5.56 and
22.62+/-5.69, respectively, on day 2. The difference between the two
groups was statistically significantly different after the intervention in
terms of sleep quality (p<0.05). Conclusion Aromatherapy attenuated pain
and improved sleep quality after open-heart surgery. Peppermint essence
aromatherapy is therefore recommended after surgery. Copyright ©
Author(s) (or their employer(s)) 2023. No commercial re-use. See rights
and permissions. Published by BMJ.

<4>
Accession Number
2028974251
Title
Long-Term Clinical and Echocardiographic Outcomes Following the Ross
Procedure: A Post Hoc Analysis of a Randomized Clinical Trial.
Source
JAMA Cardiology. 9(1) (pp 6-14), 2024. Date of Publication: 10 Jan 2024.
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(s):
To evaluate the long-term clinical and echocardiographic outcomes
following the Ross procedure for the treatment of adults with AVD.
 Design, Setting, and Participant(s): 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. Result(s): 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. Trial
Registration: isrctn.org Identifier: ISRCTN03530985. Copyright ©
2024 American Medical Association. All rights reserved.

<5>
Accession Number
2027991674
Title
Safety, feasibility, tolerability, and clinical effects of repeated
psilocybin dosing combined with non-directive support in the treatment of
obsessive-compulsive disorder: protocol for a randomized,
waitlist-controlled trial with blinded ratings.
Source
Frontiers in Psychiatry. 14 (no pagination), 2023. Article Number:
1278823. Date of Publication: 2023.
Author
Ching T.H.W.; Amoroso L.; Bohner C.; D'Amico E.; Eilbott J.; Entezar T.;
Fitzpatrick M.; Fram G.; Grazioplene R.; Hokanson J.; Kichuk S.A.; Martins
B.; Patel P.; Schaer H.; Shnayder S.; Witherow C.; Pittenger C.; Kelmendi
B.
Institution
(Ching, Amoroso, Bohner, D'Amico, Eilbott, Entezar, Fitzpatrick, Fram,
Grazioplene, Hokanson, Kichuk, Martins, Patel, Schaer, Shnayder, Witherow,
Pittenger, Kelmendi) Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, United States
(Pittenger) Department of Psychology, Yale University, New Haven, CT,
United States
(Pittenger) Center for Brain and Mind Health, Yale University School of
Medicine, New Haven, CT, United States
(Pittenger) Child Study Center, Yale University School of Medicine, New
Haven, CT, United States
Publisher
Frontiers Media SA
Abstract
Background: To date, few randomized controlled trials of psilocybin with
non-directive support exist for obsessive-compulsive disorder (OCD).
Results and participant feedback from an interim analysis of an ongoing
single-dose trial (NCT03356483) converged on the possibility of
administering a higher fixed dose and/or more doses of psilocybin in
future trials for presumably greater benefits. Objective(s): This
trial aims to evaluate the safety, feasibility, tolerability, and clinical
effects of two doses of psilocybin paired with non-directive support in
the treatment of OCD. This trial also seeks to examine whether two doses
of psilocybin lead to greater OCD symptom reduction than a single dose,
and to elucidate psychological mechanisms underlying the effects of
psilocybin on OCD. Design(s): A randomized (1:1), waitlist-controlled
design with blinded ratings will be used to examine the effects of two
doses of oral psilocybin paired with non-directive support vs. waitlist
control on OCD symptoms. An adaptive dose selection strategy will be
implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods
and analysis: This single-site trial will enroll 30 adult participants
with treatment-refractory OCD. Aside from safety, feasibility, and
tolerability metrics, primary outcomes include OCD symptoms assessed on
the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A
blinded independent rater will assess primary outcomes at baseline and the
primary endpoint at the end of the second dosing week. Participants will
be followed up to 12 months post-second dosing. Participants randomized to
waitlist will be rescreened after 7 weeks post-randomization, and begin
their delayed treatment phase thereafter if still eligible. Ethics:
Written informed consent will be obtained from participants. The
institutional review board has approved this trial (protocol v. 1.7; HIC
#2000032623). Discussion(s): This study seeks to advance our ability
to treat refractory OCD, and catalyze future research seeking to optimize
the process of psilocybin treatment for OCD through understanding relevant
psychological mechanisms. Clinical trial registration: ClinicalTrials.gov,
identifier NCT05370911. Copyright © 2024 Ching, Amoroso, Bohner,
D'Amico, Eilbott, Entezar, Fitzpatrick, Fram, Grazioplene, Hokanson,
Kichuk, Martins, Patel, Schaer, Shnayder, Witherow, Pittenger and
Kelmendi.

<6>
Accession Number
2026625617
Title
The effects of perioperative dexmedetomidine infusion on hemodynamic
stability during laparoscopic adrenalectomy for pheochromocytoma: a
randomized study.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1276535.
Date of Publication: 2023.
Author
Kim Y.; Yoo Y.C.; Kim N.Y.; Shin H.J.; Kweon K.H.; Moon J.; Kang S.-W.
Institution
(Kim, Yoo, Kim, Kweon, Moon) Department of Anesthesiology and Pain
Medicine, Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, Seoul, South Korea
(Shin) Department of Research Affairs, Biostatistics Collaboration Unit,
Yonsei University College of Medicine, Seoul, South Korea
(Kang) Department of Surgery, Yonsei University College of Medicine,
Seoul, South Korea
Publisher
Frontiers Media SA
Abstract
Introduction: Pheochromocytoma is a rare catecholamine-producing
neuroendocrine tumor originating from the adrenal medulla chromaffin
cells. Hemodynamic instability can occur during the induction of
anesthesia and surgical manipulation of the tumor. This study investigated
the effects of intraoperative dexmedetomidine administration on
hemodynamic stability in patients undergoing laparoscopic adrenalectomy
for pheochromocytoma. Method(s): Forty patients who underwent
laparoscopic adrenalectomy for pheochromocytoma were randomly assigned to
the dexmedetomidine (n = 20) or control (n = 20) group. The primary
outcome of this study was intraoperative hemodynamic stability, and the
secondary endpoint was the plasma catecholamine concentrations,
specifically of epinephrine and norepinephrine. Result(s): The
intraoperative maximum blood pressures were significantly lower in the
dexmedetomidine group (control vs. dexmedetomidine group: 182 +/- 31 vs.
161 +/- 20, 102 +/- 17 vs. 90 +/- 10, and 128 +/- 22 vs. 116 +/- 12 [mean
+/- SD] mmHg and p = 0.020, 0.015, and 0.040 for systolic, diastolic, and
mean blood pressure, respectively). The maximum heart rate during surgery
was 108 +/- 15 bpm in the control group and 95 +/- 12 bpm in the
dexmedetomidine group (p = 0.010). Other parameters of hemodynamic
instability were comparable between both groups. Plasma catecholamine
concentrations did not differ between the groups. Conclusion(s):
Dexmedetomidine infusion following the induction of anesthesia at a rate
of 0.5 mug/kg/h significantly attenuated the maximum intraoperative SBP,
DBP, MBP, and HR, contributing to improved hemodynamic
stability. Copyright © 2023 Kim, Yoo, Kim, Shin, Kweon, Moon and
Kang.

<7>
Accession Number
2028023949
Title
Bicuspid Aortic Valve Disease: Classifications, Treatments, and Emerging
Transcatheter Paradigms.
Source
Structural Heart. 8(1) (no pagination), 2024. Article Number: 100227. Date
of Publication: January 2024.
Author
Kalra A.; Das R.; Alkhalil M.; Dykun I.; Candreva A.; Jarral O.; Rehman
S.M.; Majmundar M.; Patel K.N.; Rodes-Cabau J.; Reardon M.J.; Puri R.
Institution
(Kalra) Department of Cardiology, Franciscan Health, Lafayette, IN, United
States
(Das, Alkhalil) Department of Cardiothoracic Services, Freeman Hospital,
Newcastle-upon-Tyne, United Kingdom
(Dykun, Puri) Department of Cardiovascular Medicine, Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Candreva) Department of Cardiology, University Heart Centre, University
Hospital Zurich, Zurich, Switzerland
(Jarral) Department of Cardiothoracic Surgery, St. Thomas Hospital,
London, United Kingdom
(Rehman) Department of Cardiothoracic Surgery, OLV Hospital, Aalst,
Belgium
(Majmundar) Department of Cardiology, University of Kansas Medical Center,
Kansas City, KS, United States
(Patel) Department of Cardiology, West Virginia University Hospital,
Morgantown, WV, United States
(Rodes-Cabau) Department of Interventional Cardiology, Quebec Heart & Lung
Institute, Quebec City, Canada
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist
Hospital, Houston, TX, United States
Publisher
Cardiovascular Research Foundation
Abstract
Bicuspid aortic valve (BAV) is a common congenital valvular malformation,
which may lead to early aortic valve disease and bicuspid-associated
aortopathy. A novel BAV classification system was recently proposed to
coincide with transcatheter aortic valve replacement being increasingly
considered in younger patients with symptomatic BAV, with good clinical
results, yet without randomized trial evidence. Procedural technique,
along with clinical outcomes, have considerably improved in BAV patients
compared with tricuspid aortic stenosis patients undergoing transcatheter
aortic valve replacement. The present review summarizes the novel BAV
classification systems and examines contemporary surgical and
transcatheter approaches. Copyright © 2023 The Author(s)

<8>
Accession Number
2027969467
Title
Efficacy of ultrasound-guided erector spinae plane block on analgesia and
quality of recovery after minimally invasive direct coronary artery bypass
surgery: protocol for a randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 65. Date of
Publication: December 2024.
Author
Xin L.; Wang L.; Feng Y.
Institution
(Xin, Wang, Feng) Department of Anesthesiology, Peking University People's
Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive direct coronary artery bypass (MIDCAB)
surgery offers an effective option for coronary artery disease (CAD)
patients with the avoidance of median sternotomy and fast postoperative
recovery. However, MIDCAB is still associated with significant
postoperative pain which may lead to delayed recovery. The erector spinae
plane block (ESPB) is a superficial fascial plane block. There have not
been randomized controlled trials evaluating the effects of ESPB on
analgesia and patient recovery following MIDCAB surgery. We therefore
designed a double-blind prospective randomized placebo-controlled trial,
aiming to prove the hypothesis that ESPB reduces postoperative pain scores
in patients undergoing MIDCAB surgery. Method(s): The study protocol
has been reviewed and approved by the Ethical Review Committee of Peking
University People's Hospital. Sixty adult patients of either sex scheduled
for MIDCAB surgery under general anesthesia (GA) will be included.
Patients will be randomly allocated to receive either a preoperative
single-shot ESPB with 30 mL of ropivacaine 0.5% (ESPB group) or normal
saline 0.9% (control group). The primary outcomes are the difference
between the two groups in numeric rating scale (NRS) scores at rest at
different time points (6, 12, 18, 24, 48 h) after surgery. The secondary
outcomes include NRS scores on deep inspiration within 48 h, postoperative
hydromorphone consumption, and quality of patient recovery at 24 h and 48
h, using the Quality of Recovery-15 (QoR-15) scale. The other outcomes
include intraoperative fentanyl requirements, the need for additional
postoperative rescue analgesics, time to tracheal extubation and chest
tube removal after surgery, incidence of postoperative nausea and vomiting
(PONV) and postoperative cognitive dysfunction (POCD), intensive care unit
(ICU) length of stay (LOS), hospital discharge time, and 30-day mortality.
Adverse events will be also evaluated. Discussion(s): This is a novel
randomized controlled study evaluating a preoperative ultrasound-guided
single-shot unilateral ESPB on analgesia and quality of patient recovery
in MIDCAB surgery. The results of this study will characterize the degree
of acute postoperative pain and clinical outcomes following MIDCAB. Our
study may help optimizing analgesia regimen selection and improving
patient comfort in this specific population. Trial registration: The study
was prospectively registered with the Chinese Clinical Trial Registry
(trial identifier: ChiCTR2100052810). Date of registration: November 5,
2021. Copyright © 2024, The Author(s).

<9>
Accession Number
2026392508
Title
Postoperative outcomes of pediatric patients with perioperative COVID-19
infection: a systematic review and meta-analysis of observational studies.
Source
Journal of Anesthesia. 38(1) (pp 125-135), 2024. Date of Publication:
February 2024.
Author
Gong T.; Huang Q.; Zhang Q.; Cui Y.
Institution
(Gong, Huang, Zhang, Cui) Department of Anesthesiology, Chengdu Women's
and Children's Central Hospital, School of Medicine, University of
Electronic Science and Technology of China, No. 1617, Riyue Avenue,
Qingyang District, Chengdu 611731, China
Publisher
Springer
Abstract
Objective: To quantify the risk of adverse postoperative outcomes in
pediatric patients with COVID-19 infection. Method(s): We searched
PubMed, Embase, Cochrane Library from December 2019 to 21 April 2023.
Observational cohort studies that reported postoperative early mortality
and pulmonary complications of pediatric patients with confirmed
COVID-19-positive compared with COVID-19-negative were eligible for
inclusion. We excluded pediatric patients underwent organ transplantation
or cardiac surgery. Reviews, case reports, letters, and editorials were
also excluded. We used the Newcastle-Ottawa Scale to assess the
methodological quality and risk of bias for each included study. The
primary outcome was postoperative early mortality, defined as mortality
within 30 days after surgery or during hospitalization. The random-effects
model was performed to assess the pooled estimates, which were expressed
as risk ratio (RR) or mean difference (MD) with 95% confidence intervals
(CI). Result(s): 9 studies involving 23,031 pediatric patients were
included, and all studies were rated as high quality. Compared with
pediatric patients without COVID-19, pediatric patients with COVID-19
showed a significantly increased risk of postoperative pulmonary
complications (PPCs) (RR = 4.24; 95% CI 2.08-8.64). No clear evidence was
found for differences in postoperative early mortality (RR = 0.84; 95% CI
0.34-2.06), postoperative intensive care unit (ICU) admission (RR = 0.80;
95% CI 0.39-1.68), and length of hospital stay (MD = 0.35, 95% CI
-1.81-2.51) between pediatric patients with and without COVID-19.
 Conclusion(s): Perioperative COVID-19 infection was strongly
associated with increased risk of PPCs, but it did not increase the risk
of postoperative early mortality, the rate of postoperative ICU admission,
and the length of hospital stay in pediatric patients. Our preplanned
sensitivity analyses confirmed the robustness of our study
findings. Copyright © 2023, The Author(s) under exclusive licence
to Japanese Society of Anesthesiologists.

<10>
Accession Number
2024272696
Title
Bioprosthetic versus mechanical valves for mitral valve replacement in
patients < 70 years: an updated pairwise meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 72(2) (pp 95-103), 2024. Date
of Publication: February 2024.
Author
Ahmed A.; Awad A.K.; Varghese K.S.; Sehgal V.S.; Hisham K.; George J.;
Pandey R.; Vega E.; Polizzi M.; Mathew D.M.
Institution
(Ahmed, Varghese, Sehgal, Pandey, Vega, Polizzi, Mathew) CUNY School of
Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United States
(Awad, Hisham) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
Publisher
Springer
Abstract
Background: The ideal conduit for mitral valve replacement (MVR) remains
elusive, particularly among younger patients due to increased life
expectancy. We perform a pairwise meta-analysis comparing the use of
bioprosthetic valves (BPV) and mechanical mitral valves (MMV) in patients
< 70 years old undergoing MVR. Method(s): We comprehensively searched
medical databases to identify studies comparing the use of BPV and MMV in
patients < 70 years old undergoing MVR. Pairwise meta-analysis was
performed using the Mantel-Haenszel method in R version 4.0.2. Outcomes
were pooled using the random effect model as risk ratios (RR) with their
95% confidence intervals (95% CI). Result(s): 16,879 patients from 15
studies were pooled. Compared to MMV, BPV was associated with
significantly higher rates of 30-day mortality (RR 1.53, p = 0.0006) but
no difference in 30-day stroke (RR 0.70, p = 0.43). At a weighted mean
follow-up duration of 14.1 years, BPV was associated with higher rates of
long-term mortality (RR 1.28, p = 0.0054). No difference was seen between
the two groups for risk of long-term stroke (RR 0.92, p = 0.67),
reoperation(RR 1.72, p = 0.12), or major-bleeding (RR 0.57, p = 0.10) at a
weighted mean follow-up duration of 11.7, 11.3, and 11.9 years,
respectively. Conclusion(s): The use of MMV in patients < 70
undergoing MVR is associated with lower rates of 30-day/long-term
mortality compared to BPV. No significant differences were observed for
risk of 30-day/long-term stroke, long-term reoperation, and long-term
major bleeding. These findings support the use of MMV in younger patients,
although prospective, randomized trials are still needed. Copyright
© 2023, The Author(s), under exclusive licence to The Japanese
Association for Thoracic Surgery.

<11>
Accession Number
2029877060
Title
Low-Flow, Low-Gradient Severe Aortic Stenosis in patients with preserved
or reduced ejection fraction: a systematic literature review.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102392. Date of Publication: March 2024.
Author
Aguilar-Molina O.; Barbosa-Balaguera S.; Campo-Rivera N.; Cabrales-Salcedo
Y.; Camacho-Garcia R.; Herrera-Escandon A.
Institution
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Herrera-Escandon)
Cardiology Unit, Universidad del Valle, Cali, Colombia
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Cabrales-Salcedo,
Herrera-Escandon) Hospital Universitario del Valle, Cali, Colombia
(Camacho-Garcia) Universidad de Cartagena, Cartagena, Colombia
Publisher
Elsevier Inc.
Abstract
OBJECTIVES: A systematic review of the literature was conducted to analyze
the current evidence on low-flow, low-gradient severe aortic stenosis.
This analysis aimed to differentiate between subgroups of patients with
reduced and preserved left ventricular ejection fraction (LVEF).
 Method(s): After conducting a systematic literature review, 35
observational studies were included. Out of these, 28 were prospective and
7 retrospective. The studies that included a mortality risk stratification
of low-flow, low-gradient aortic stenosis (LF- LG AS) with both preserved
and reduced LVEF were reviewed. Result(s): The importance of
considering multiple clinical and echocardiographic variables in
diagnostic evaluation and therapeutic decision-making was highlighted.
 Conclusion(s): LF- LG AS, in any of its subgroups, is a common and
challenging valve lesion. A careful assessment of severity and, in
specific scenarios, a thorough reclassification is important. More
high-quality studies are required to more precisely define the
classification and prognosis of this entity. Copyright © 2024
Elsevier Inc.

<12>
Accession Number
2028037481
Title
Risk predictions of surgical wound complications based on a machine
learning algorithm: A systematic review.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14665. Date of Publication: January 2024.
Author
Zhang H.; Zhao J.; Farzan R.; Alizadeh Otaghvar H.
Institution
(Zhang) The Second Clinical Medical School, Lanzhou University, Lanzhou,
China
(Zhao) Department of Clinical Medicine, Health Science Center, Lanzhou
University, Lanzhou, China
(Farzan) Department of Plastic & Reconstructive Surgery, School of
Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Alizadeh Otaghvar) of Plastic Surgery, Trauma and Injury Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Surgical wounds may arise due to harm inflicted upon soft tissue during
surgical intervention, and many complications and injuries may accompany
them. These complications can lead to prolonged hospitalization and poorer
clinical outcomes. Also, Machine learning (ML) is a Section of artificial
intelligence (AI) that has emerged in medical care and is increasingly
used for diagnosis, complications, prognosis and recurrence prediction.
This study aims to investigate surgical wound risk predictions and
management using a ML algorithm by R programming language analysis. The
systematic review, following PRISMA guidelines, spanned electronic
databases using search terms like 'machine learning', 'surgical' and
'wound'. Inclusion criteria covered experimental studies from 1990 to the
present on ML's application in surgical wound evaluation. Exclusion
criteria included studies lacking full text, focusing on ML in all
surgeries, neglecting wound assessment and duplications. Two authors
rigorously assessed titles, abstracts and full texts, excluding reviews
and guidelines. Ultimately, relevant articles were then analysed. The
present study identified nine articles employing ML for surgical wound
management. The analysis encompassed various surgical procedures,
including Cardiothoracic, Caesarean total abdominal colectomy, Burn
plastic surgery, facial plastic surgery, laparotomy, minimal invasive
surgery, hernia repair and unspecified surgeries. ML was skillful in
evaluating surgical site infections (SSI) in seven studies, while two
extended its use to burn-grade diagnosis and wound classification. Support
Vector Machine (SVM) and Convolutional Neural Network (CNN) were the most
utilized algorithms. ANN achieved a 96% accuracy in facial plastic surgery
wound management. CNN demonstrated commendable accuracies in various
surgeries, and SVM exhibited high accuracy in multiple surgeries and burn
plastic surgery. In sum, these findings underscore ML's potential for
significant improvements in postoperative management and the development
of enhanced care techniques, particularly in surgical wound
management. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<13>
Accession Number
2028015561
Title
Desmopressin to reduce periprocedural bleeding and transfusion: a
systematic review and meta-analysis.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 5.
Date of Publication: December 2024.
Author
Wang C.; Lebedeva V.; Yang J.; Anih J.; Park L.J.; Paczkowski F.; Roshanov
P.S.
Institution
(Wang, Roshanov) Department of Medicine, Western University, London, ON,
Canada
(Lebedeva) London Health Sciences Centre, London, ON, Canada
(Yang, Paczkowski, Roshanov) Schulich School of Medicine & Dentistry,
Western University, London, ON, Canada
(Anih) McMaster University, Hamilton, ON, Canada
(Park) Department of Surgery, Division of General Surgery, McMaster
University, Hamilton, ON, Canada
(Roshanov) Department of Epidemiology and Biostatistics, Western
University, London, ON, Canada
(Park, Roshanov) Population Health Research Institute, Hamilton, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
We systematically reviewed the literature to investigate the effects of
peri-procedural desmopressin in patients without known inherited bleeding
disorders undergoing surgery or other invasive procedures. We included 63
randomized trials (4163 participants) published up to February 1, 2023.
Seven trials were published after a 2017 Cochrane systematic review on
this topic. There were 38 trials in cardiac surgery, 22 in noncardiac
surgery, and 3 in non-surgical procedures. Meta-analyses demonstrated that
desmopressin likely does not reduce the risk of receiving a red blood cell
transfusion (25 trials, risk ratio [RR] 0.95, 95% confidence interval [CI]
0.86 to 1.05) and may not reduce the risk of reoperation due to bleeding
(22 trials, RR 0.75, 95% CI 0.47 to 1.19) when compared to placebo or
usual care. However, we demonstrated significant reductions in number of
units of red blood cells transfused (25 trials, mean difference -0.55
units, 95% CI - 0.94 to - 0.15), total volume of blood loss (33 trials,
standardized mean difference - 0.40 standard deviations; 95% CI - 0.56 to
- 0.23), and the risk of bleeding events (2 trials, RR 0.45, 95% CI 0.24
to 0.84). The certainty of evidence of these findings was generally low.
Desmopressin increased the risk of clinically significant hypotension that
required intervention (19 trials, RR 2.15, 95% CI 1.36 to 3.41). Limited
evidence suggests that tranexamic acid is more effective than desmopressin
in reducing transfusion risk (3 trials, RR 2.38 favoring tranexamic acid,
95% CI 1.06 to 5.39) and total volume of blood loss (3 trials, mean
difference 391.7 mL favoring tranexamic acid, 95% CI - 93.3 to 876.7 mL).
No trials directly informed the safety and hemostatic efficacy of
desmopressin in advanced kidney disease. In conclusion, desmopressin
likely reduces periprocedural blood loss and the number of units of blood
transfused in small trials with methodologic limitations. However, the
risk of hypotension needs to be mitigated. Large trials should evaluate
desmopressin alongside tranexamic acid and enroll patients with advanced
kidney disease. Copyright © 2024, The Author(s).

<14>
Accession Number
2028037523
Title
Efficacy and safety of transcranial direct current stimulation over the
left dorsolateral prefrontal cortex in children and adolescents with
attention-deficit/hyperactivity disorder: a randomized, triple-blinded,
sham-controlled, crossover trial.
Source
Frontiers in Psychiatry. 14 (no pagination), 2023. Article Number:
1217407. Date of Publication: 2023.
Author
Guimaraes R.S.Q.; Bandeira I.D.; Barretto B.L.; Wanke T.; Alves C.O.C.;
Barretto T.L.; Carvalho C.F.D.; Dorea-Bandeira I.; Tolentino A.;
Lins-Silva D.H.; Lucena P.H.; Lucena R.
Institution
(Guimaraes, Bandeira) Programa de Pos-Graduacao em Medicina e Saude,
Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador,
Brazil
(Bandeira) Department of Psychiatry and Behavioral Sciences, Stanford
University, Stanford, CA, United States
(Barretto, Barretto, Dorea-Bandeira, Tolentino, Lins-Silva) Faculdade de
Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
(Wanke, Alves) Instituto de Psicologia, Universidade Federal da Bahia,
Salvador, Brazil
(Carvalho) Departamento de Psicologia, Universidade Federal de Santa
Catarina, Florianopolis, Brazil
(Lucena) Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil
(Lucena) Departamento de Neurociencias e Saude Mental, Faculdade de
Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
Publisher
Frontiers Media SA
Abstract
Introduction: Although pharmacological treatment for
Attention-Deficit/Hyperactivity Disorder (ADHD) has demonstrated efficacy,
several individuals persist in experiencing social and academic
impairment. Additionally, the occurrence of significant side effects may
render the use of psychotropic medications untenable. However,
Transcranial Direct Current Stimulation (tDCS), a non-invasive brain
stimulation technique, shows promising results in treating ADHD.
 Objective(s): To investigate the efficacy and safety of tDCS on the
performance of children and adolescents with ADHD in neuropsychological
tests involving visual attention, visual and verbal working memory, and
inhibitory control. Methodology: This study was a triple-blind,
randomized, sham-controlled, crossover clinical trial. The intervention
consisted of a daily session of tDCS (2 mA) or sham targeting the left
dorsolateral prefrontal cortex (L-DLPFC), for 30 min, on five consecutive
days. The primary outcome was change in the Visual Attention Test, Fourth
Edition (TAVIS-4) before and after each intervention. Subjects were also
evaluated pre and post-tDCS using the Digit Span subtest of the Wechsler
Intelligence Scale for Children, Fifth Edition (WISC-V), the Developmental
Neuropsychological Assessment, Second Edition (NEPSY-II) Inhibiting
Response (IR) subtest, and the Corsi Block-Tapping Task. Result(s):
Fifteen individuals were included, and no statistically significant
difference was observed when comparing the results of the TAVIS-4, the IR
of NEPSY-II, and the intragroup Digit Span subtest of WISC-V undertaken
before and after the procedure. Adverse events were mainly self-limiting
and transient. The participants did not perceive any benefit from tDCS
when measured on the Patient Global Impression of Improvement (PGI-I)
Scale. Conclusion(s): This study did not meet its primary endpoint
and found no performance enhancement in any investigated
neuropsychological outcomes relating to the intervention
group. Copyright © 2024 Guimaraes, Bandeira, Barretto, Wanke,
Alves, Baretto, Carvalho, Dorea-Bandeira, Tolentino, Lins-Silva, Lucena
and Lucena.

<15>
Accession Number
2028011438
Title
Post-TAVR conduction abnormalities leading to permanent pacemaker
implantation: Risk factors, prevention, and management.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Ghazal R.; Garabedian H.; Sawaya F.; Refaat M.M.
Institution
(Ghazal, Garabedian) Faculty of Medicine, American University of Beirut,
Beirut, Lebanon
(Sawaya) Structural Heart and Valve Division, American University of
Beirut Medical Center, Beirut, Lebanon
(Sawaya, Refaat) Internal Medicine Department, American University of
Beirut Medical Center, Beirut, Lebanon
(Refaat) Cardiac Electrophysiology Division, American University of Beirut
Medical Center, Beirut, Lebanon
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) often leads to conduction
abnormalities, necessitating pacemaker implantation. This review of 38
meta-analyses identified preexisting right bundle branch block (RBBB),
LAHB, and new-onset left bundle branch block as key risk factors, with a
higher PPM risk in male and older patients. Procedural factors like
transfemoral access and self-expandable valves also increase this risk.
Prevention focuses on tailoring TAVR to individual electrophysiological
and anatomical profiles. However, there's a lack of consensus in managing
these conduction disturbances post-TAVR, highlighting the need for further
research and standardized treatment strategies. Copyright © 2024
Wiley Periodicals LLC.

<16>
Accession Number
643291032
Title
Comparison of lactated ringer's solution and Plasma-Lyte a as a base
solution for del nido cardioplegia: a prospective randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 20 Jan 2024.
Author
Kantathut N.; Krathong P.; Khajarern S.; Leelayana P.; Cherntanomwong P.
Institution
(Kantathut, Krathong, Khajarern, Leelayana, Cherntanomwong) Division of
Thoracic and Cardiovascular Surgery, Department of Surgery, Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
Abstract
OBJECTIVES: The use of del Nido cardioplegia has been increasing in
popularity for adult cardiac surgery. However, the base solution,
Plasma-Lyte A, is not always available in many countries. This prospective
randomized controlled trial evaluated myocardial preservation and clinical
outcomes when using lactated Ringer's solution compared to Plasma-Lyte A
as a base solution for del Nido cardioplegia. METHOD(S): Adult
patients undergoing first-time elective cardiac surgery for acquired heart
disease, including isolated coronary artery bypass grafting, isolated
valve surgery, combined valve surgery, or concomitant coronary artery
bypass grafting and valve surgery were randomized to receive either
lactated Ringer's solution (n=100) or Plasma-Lyte A (n=100).
 RESULT(S): There were no significant differences between the two
groups in terms of age, co-morbidities, Society of Thoracic Surgeons risk
score, and type of procedures. The primary outcome, postoperative
troponin-T at 24hours, was similar in both groups (0.482 vs 0.524ng/mL;
P=0.464). Other cardiac markers were also similar at all time points. The
lactated Ringer's solution group had a lower pH (7.228 vs 7.246; P=0.005)
and higher calcium levels (0.908 vs 0.358mmol/L; P<0.001) in the delivered
cardioplegia, but there were no significant differences in clinical
outcomes, such as ventricular fibrillation, left ventricular ejection
fraction, inotrope/vasopressor requirement, intra-aortic balloon pump
support, intensive care unit stay, hospital stay, atrial fibrillation, red
cell transfusion, and complications. CONCLUSION(S): The results
suggest that lactated Ringer's solution can be used as an alternative to
Plasma-Lyte A as the base solution for del Nido cardioplegia, with similar
myocardial preservation and clinical outcomes. Copyright © The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<17>
Accession Number
643286356
Title
Role of Cerebral Embolic Protection Devices in Patients Undergoing
Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Journal of the American Heart Association. (pp e030587), 2024. Date of
Publication: 19 Jan 2024.
Author
Kaur A.; Dhaliwal A.S.; Sohal S.; Gwon Y.; Gupta S.; Bhatia K.; Dominguez
A.C.; Basman C.; Tamis-Holland J.
Institution
(Kaur, Gupta) Department of Medicine Icahn School of Medicine at Mount
Sinai Morningside/West- New York New York NY
(Dhaliwal) Population Health Science and Policy Icahn School of Medicine
at Mount Sinai- New York New York NY
(Sohal) Division of Cardiovascular Medicine Newark Beth Israel Medical
Center- Newark Newark NJ, Israel
(Gwon) Department of Biostatistics University of Nebraska Medical Center
Omaha NE
(Bhatia, Dominguez) Division of Cardiology Icahn School of Medicine at
Mount Sinai Morningside- New York New York NY
(Basman) Division of Cardiology Lenox Hill Hospital- New York New York NY
(Tamis-Holland) Department of Cardiovascular Medicine Cleveland Clinic
Main Campus Cleveland OH
Abstract
BACKGROUND: Cerebral embolic protection devices (CEPD) capture embolic
material in an attempt to reduce ischemic brain injury during
transcatheter aortic valve replacement. Prior reports have indicated mixed
results regarding the benefits of these devices. With new data emerging,
we performed an updated meta-analysis examining the effect of CEPD during
transcatheter aortic valve replacement on various clinical, neurological,
and safety parameters. METHODS AND RESULTS: A comprehensive review of
electronic databases was performed comparing CEPD and no-CEPD in
transcatheter aortic valve replacement. Primary clinical outcome was
all-cause stroke. Secondary clinical outcomes were disabling stroke and
all-cause mortality. Neurological outcomes included worsening of the
National Institutes of Health Stroke Scale score, Montreal Cognitive
Assessment score from baseline at discharge, presence of new ischemic
lesions, and total lesion volume on neuroimaging. Safety outcomes included
major or minor vascular complications and stage 2 or 3 acute kidney
injury. Seven randomized controlled trials with 4016 patients met the
inclusion criteria. There was no statistically significant difference in
the primary clinical outcome of all-cause stroke; secondary clinical
outcomes of disabling stroke, all-cause mortality, neurological outcomes
of National Institutes of Health Stroke Scale score worsening, Montreal
Cognitive Assessment worsening, presence of new ischemic lesions, or total
lesion volume on diffusion-weighted magnetic resonance imaging between
CEPD versus control groups. There was no statistically significant
difference in major or minor vascular complications or stage 2 or 3 acute
kidney injury between the groups. CONCLUSION(S): The use of CEPD in
transcatheter aortic valve replacement was not associated with a
statistically significant reduction in the risk of clinical, neurological,
and safety outcomes.

<18>
Accession Number
643288983
Title
The provision and impact of rehabilitation provided by physiotherapists in
children and young people with congenital heart disease following cardiac
surgery: a scoping review.
Source
Physiotherapy. 122 (pp 47-56), 2023. Date of Publication: 29 Sep 2023.
Author
Clarke S.L.; Milburn N.C.; Menzies J.C.; Drury N.E.
Institution
(Clarke) Department of Physiotherapy, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Milburn) Department of Physiotherapy, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Menzies) Paediatric Intensive Care, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Drury) Department of Paediatric Cardiac Surgery, Birmingham Children's
Hospital, Steel House Lane, Birmingham B4 6NH, UK; Institute of
Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham
B15 2TT, UK
Abstract
INTRODUCTION: Children with congenital heart disease (CHD) are at risk of
delayed motor development with increased risk for those requiring cardiac
surgical intervention. We conducted a scoping review to identify the
provision and impact of physiotherapy-delivered rehabilitation in children
and young people with CHD following cardiac surgery. METHOD(S):
CINAHL, EMBASE, PUBMED, AHMED, EMCARE, Cochrane Database of Systematic
Reviews, NHS Evidence databases were searched (2000-2022). Included
studies were published in full, in English and reported the use of
physiotherapy in CHD (participants 0-18years) post-surgical procedure.
Articles were screened by title and abstract and through full-text review
with results structured in accordance with the PAGER framework and PRISMA-
ScR checklist. RESULT(S): Seven full text peer reviewed papers
published 2014-2021 were identified from 5747 papers screened. Included
papers were predominantly non-randomised cohort studies with a sample size
of between one and 247. Study participants ranged from eight days to 16
years, with a variety of congenital heart defects and surgical procedures.
The provision of physiotherapy varied with a range of rehabilitation
formats and physiotherapeutic interventions utilised. Physiotherapy
provision appeared to have a positive impact on functional/ developmental
outcomes and muscle strength. DISCUSSION: Assessing the impact and
provision of physiotherapy in CHD post-surgical intervention is
challenging based on the published literature, due to small sample sizes,
lack of control groups, heterogeneous demographics and variable
intervention and formats delivered. Further research is required to
identify the optimum format of physiotherapy provision and establish the
potential impact of physiotherapy delivered rehabilitation on motor
function and development. CONTRIBUTION OF THE PAPER. Copyright ©
2023 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All
rights reserved.

<19>
Accession Number
2029566821
Title
When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC
State-of-the-Art Review.
Source
Journal of the American College of Cardiology. 83(3) (pp 444-465), 2024.
Date of Publication: 23 Jan 2024.
Author
Bejjani A.; Khairani C.D.; Assi A.; Piazza G.; Sadeghipour P.; Talasaz
A.H.; Fanikos J.; Connors J.M.; Siegal D.M.; Barnes G.D.; Martin K.A.;
Angiolillo D.J.; Kleindorfer D.; Monreal M.; Jimenez D.; Middeldorp S.;
Elkind M.S.V.; Ruff C.T.; Goldhaber S.Z.; Krumholz H.M.; Mehran R.;
Cushman M.; Eikelboom J.W.; Lip G.Y.H.; Weitz J.I.; Lopes R.D.; Bikdeli B.
Institution
(Bejjani, Khairani, Piazza, Goldhaber, Bikdeli) Thrombosis Research Group,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Bejjani, Khairani, Piazza, Ruff, Goldhaber, Bikdeli) Cardiovascular
Medicine Division, Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Bejjani) Department of Medicine, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Assi, Piazza) Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sadeghipour) Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour) Clinical Trial Center, Rajaie Cardiovascular, Medical, and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Talasaz) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Talasaz) Virginia Commonwealth University, Richmond, VA, United States
(Fanikos) Department of Pharmacy, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Connors) Hematology Division, Department of Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Siegal) Division of Hematology, Department of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Barnes) Frankel Cardiovascular Center, Department of Internal Medicine,
University of Michigan, Ann Arbor, MI, United States
(Martin) Division of Hematology/Oncology, Department of Medicine,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Kleindorfer) University of Cincinnati, Cincinnati, OH, United States
(Monreal) Catedra de Enfermedad Tromboembolica, Universidad Catolica San
Antonio de Murcia, Spain
(Jimenez) Respiratory Department, Hospital Ramon y Cajal and Medicine
Department, Universidad de Alcala (Instituto de Ramon y Cajal de
Investigacion Sanitaria), Centro de Investigacion Biomedica en Red de
Enfermedades Respiratorias (CIBERES), Madrid, Spain
(Middeldorp, Bikdeli) Department of Internal Medicine, Radboud University
Medical Center, Nijmegen, Netherlands
(Elkind) Department of Neurology, Vagelos College of Physicians and
Surgeons, New York, NY, United States
(Elkind) Department of Epidemiology, Mailman School of Public Health,
Columbia University, New York, NY, United States
(Krumholz) Yale New Haven Hospital/Yale Center for Outcomes Research and
Evaluation, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
(Krumholz) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Cushman) Department of Medicine, Larner College of Medicine at the
University of Vermont, Burlington, VT, United States
(Cushman) Department of Pathology and Laboratory Medicine, Larner College
of Medicine at the University of Vermont, Burlington, VT, United States
(Eikelboom) Population Health Research Institute, Hamilton Health
Sciences, McMaster University, Hamilton, ON, Canada
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Clinical Health Services Research, Department of
Clinical Medicine, Aalborg University, Aalborg, Denmark
(Weitz) McMaster University, Hamilton, ON, Canada
(Weitz) Thrombosis and Atherosclerosis Research Institute, Hamilton, ON,
Canada
(Lopes) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC, United States
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Bikdeli) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
For most patients, direct oral anticoagulants (DOACs) are preferred over
vitamin K antagonists for stroke prevention in atrial fibrillation and for
venous thromboembolism treatment. However, randomized controlled trials
suggest that DOACs may not be as efficacious or as safe as the current
standard of care in conditions such as mechanical heart valves, thrombotic
antiphospholipid syndrome, and atrial fibrillation associated with
rheumatic heart disease. DOACs do not provide a net benefit in conditions
such as embolic stroke of undetermined source. Their efficacy is uncertain
for conditions such as left ventricular thrombus, catheter-associated deep
vein thrombosis, cerebral venous sinus thrombosis, and for patients with
atrial fibrillation or venous thrombosis who have end-stage renal disease.
This paper provides an evidence-based review of randomized controlled
trials on DOACs, detailing when they have demonstrated efficacy and
safety, when DOACs should not be the standard of care, where their safety
and efficacy are uncertain, and areas requiring further
research. Copyright © 2024 American College of Cardiology
Foundation

<20>
Accession Number
2027919150
Title
Effects of albumin and crystalloid priming strategies on red blood cell
transfusions in on-pump cardiac surgery: a network meta-analysis.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 26. Date
of Publication: December 2024.
Author
Wang T.; Wang J.; Zhang M.; Zhang H.; Zhang Q.; Liu G.; Dong W.; Wang Y.;
Ji B.
Institution
(Wang, Wang, Zhang, Zhang, Liu, Ji) Department of Cardiopulmonary Bypass,
Fuwai Hospital, National Center for Cardiovascular Disease, State Key
Laboratory of Cardiovascular Medicine, Chinese Academy of Medical Sciences
& Peking Union Medical College, No. 167 Beilishi Road, Xicheng District,
Beijing 10010, China
(Zhang) Department of Anesthesiology, Beijing Tongren Hospital, Capital
Medical University, Beijing, China
(Dong, Wang) Surgical Intensive Care Unit, Beijing Shijitan Hospital,
Capital Medical University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: In on-pump cardiac surgery, the albumin priming strategy could
maintain colloid osmotic pressure better than crystalloid solutions and
reduce excessive perioperative fluid balance. However, a high-quality
meta-analysis is required to compare the safety of these approaches in
perioperative red blood cell (RBC) transfusions. Owing to limited direct
evidence, we conducted a network meta-analysis (NMA) to increase the pool
of studies and provide indirect evidence. Method(s): The pre-defined
primary outcomes were intraoperative and the first 24 h postoperative RBC
transfusion volume in units. The pre-defined secondary outcome was
postoperative blood loss (the first 24 h). We reviewed all randomized
controlled trials comparing albumin, crystalloid, and artificial colloid
priming strategies. Studies that only displayed pre-defined outcomes could
be included. A pairwise meta-analysis was performed on studies that
directly compared the pre-defined outcomes between albumin and
crystalloids. Additionally, a random-effects network meta-analysis (NMA)
model was employed to generate indirect evidence for the pre-defined
outcomes between albumin and crystalloids. Result(s): The literature
search identified 830 studies,10 of which were included in the final
analysis. Direct meta-analysis indicated that crystalloid priming
significantly decreased total perioperative RBC transfusions (MD: -0.68U;
95%CI: -1.26, -0.09U; P = 0.02) and intraoperative RBC transfusions (MD:
-0.20U; 95%CI: -0.39, -0.01U; P = 0.03) compared to albumin. Postoperative
RBC transfusions showed a decreasing trend in the crystalloid group;
however, the difference was not statistically significant. (MD: -0.16U;
95%CI: -0.45, 0.14U; P = 0.30). After including indirect evidence, the NMA
results continued to demonstrate a higher RBC receiving with the albumin
priming strategy compared to crystalloids, although the differences did
not reach statistical significance. For postoperative blood loss, direct
evidence showed no significant differences between albumin and crystalloid
priming strategies. However, NMA evidence displayed that albumin exist
higher probability of reducing postoperative blood loss than crystalloid.
 Conclusion(s): Both direct and NMA evidence indicated that the
albumin priming strategy resulted in more perioperative RBC transfusions
than crystalloids. Considering the additional blood management burden, the
application of an albumin-priming strategy in on-pump cardiac surgery
still needs more consideration. Copyright © 2024, The Author(s).

<21>
Accession Number
2029718541
Title
Evaluating registry-based trial economics: Results from the STRESS
clinical trial.
Source
Contemporary Clinical Trials Communications. 38 (no pagination), 2024.
Article Number: 101257. Date of Publication: April 2024.
Author
Eisenstein E.L.; Hill K.D.; Wood N.; Kirchner J.L.; Anstrom K.J.; Granger
C.B.; Rao S.V.; Baldwin H.S.; Jacobs J.P.; Jacobs M.L.; Kannankeril P.J.;
Graham E.M.; O'Brien S.M.; Li J.S.
Institution
(Eisenstein, Hill, Wood, Kirchner, O'Brien, Li) Duke Clinical Research
Institute, Durham, NC, United States
(Hill, Li) Duke Pediatric and Congenital Heart Center, Durham, NC, United
States
(Anstrom) Collaborative Studies Coordinating Center, Chapel Hill, NC,
United States
(Anstrom) Department of Biostatistics, University of North Carolina,
Chapel Hill, NC, United States
(Granger) Department of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Rao) NYU Langone Health, New York, NY, United States
(Baldwin, Kannankeril) Department of Pediatrics, Vanderbilt University
Medical Center, Nashville, TN, United States
(Jacobs) University of Florida Congenital Heart Center, Gainesville, FL,
United States
(Jacobs) Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Graham) Medical University of South Carolina, Charleston, SC, United
States
Publisher
Elsevier Inc.
Abstract
Background: Registry-based trials have the potential to reduce randomized
clinical trial (RCT) costs. However, observed cost differences also may be
achieved through pragmatic trial designs. A systematic comparison of trial
costs across different designs has not been previously performed.
 Method(s): We conducted a study to compare the current Steroids to
Reduce Systemic inflammation after infant heart surgery (STRESS)
registry-based RCT vs. two established designs: pragmatic RCT and
explanatory RCT. The primary outcome was total RCT design costs. Secondary
outcomes included: RCT duration and personnel hours. Costs were estimated
using the Duke Clinical Research Institute's pricing model.
 Result(s): The Registry-Based RCT estimated duration was 31.9 weeks
greater than the other designs (259.5 vs. 227.6 weeks). This delay was
caused by the Registry-Based design's periodic data harvesting that
delayed site closing and statistical reporting. Total personnel hours were
greatest for the Explanatory design followed by the Pragmatic design and
the Registry-Based design (52,488 vs 29,763 vs. 24,480 h, respectively).
Total costs were greatest for the Explanatory design followed by the
Pragmatic design and the Registry-Based design ($10,140,263 vs. $4,164,863
vs. $3,268,504, respectively). Thus, Registry-Based total costs were 32 %
of the Explanatory and 78 % of the Pragmatic design. Conclusion(s):
Total costs for the STRESS RCT with a registry-based design were less than
those for a pragmatic design and much less than an explanatory design.
Cost savings reflect design elements and leveraging of registry resources
to improve cost efficiency, but delays to trial completion should be
considered. Copyright © 2024 The Authors

<22>
Accession Number
2029718444
Title
Clinical characteristics and surgical outcomes of cardiac myxoma: A
meta-analysis of worldwide experience.
Source
European Journal of Surgical Oncology. 50(2) (no pagination), 2024.
Article Number: 107940. Date of Publication: February 2024.
Author
Oktaviono Y.H.; Saputra P.B.T.; Arnindita J.N.; Afgriyuspita L.S.;
Kurniawan R.B.; Pasahari D.; Milla C.; Wungu C.D.K.; Susilo H.; Multazam
C.E.C.Z.; Alkaff F.F.
Institution
(Oktaviono, Saputra, Pasahari) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Airlangga - General Academic
Hospital Dr. Soetomo, Surabaya, Indonesia
(Oktaviono, Saputra, Arnindita) Cardiovascular Research and Innovation
Center, Universitas Airlangga, Surabaya, Indonesia
(Arnindita, Afgriyuspita, Kurniawan, Milla) Faculty of Medicine,
Universitas Airlangga, Indonesia
(Wungu) Department of Physiology and Medical Biochemistry, Faculty of
Medicine, Universitas Airlangga, Surabaya, Indonesia
(Wungu) Institute of Tropical Disease, Universitas Airlangga, Surabaya,
Indonesia
(Susilo) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Airlangga - Universitas Airlangga Hospital, East
Java, Surabaya, Indonesia
(Multazam) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, Groningen, Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
W.B. Saunders Ltd
Abstract
Cardiac myxoma is the most common primary cardiac tumor. However, existing
literature mainly consists of single-center experiences with limited
subjects. This systematic review aimed to provide data on clinical
characteristics and surgical outcomes of cardiac myxoma. We performed a
thorough literature search on May 23, 2023 on PubMed, ProQuest,
ScienceDirect, Scopus, and Web of Science. The inclusion criteria were
English full-text, observational studies, and included >20 subjects. From
the search, 112 studies with a total of 8150 patients were included in the
analysis. The mean age was 51 years (95 % confidence interval [95%CI] =
49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8
%]). The most common clinical manifestation was cardiovascular symptoms.
Echocardiography can diagnose almost all cases (98.1 % [95 % CI =
95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 %
[95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6
% [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent,
with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality
rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate
at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is
warranted in a timely manner once the cardiac myxoma diagnosis is
established. Copyright © 2023 The Authors

<23>
Accession Number
2027988087
Title
Factors associated with early, late, and very late stent thrombosis among
patients with acute coronary syndrome undergoing coronary stent placement:
analysis from the ATLAS ACS 2-TIMI 51 trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1269011. Date of Publication: 2023.
Author
Chi G.; AlKhalfan F.; Lee J.J.; Montazerin S.M.; Fitzgerald C.; Korjian
S.; Omar W.; Barnathan E.; Plotnikov A.; Gibson C.M.
Institution
(Chi, AlKhalfan, Montazerin, Fitzgerald, Korjian, Omar, Gibson) Division
of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Lee) Department of Trial Design and Development, Baim Institute for
Clinical Research, Boston, MA, United States
(Barnathan, Plotnikov) Cardiovascular, Metabolism, Retina and Pulmonary
Hypertension, Johnson & Johnson Pharmaceutical Research and Development,
Raritan, NJ, United States
Publisher
Frontiers Media SA
Abstract
Background: Stent thrombosis (ST) is an uncommon but serious complication
of stent implantation. This study aimed to explore factors associated with
early, late, and very late ST to help guide risk assessment and clinical
decision-making on ST. Method(s): The analysis included patients who
received stent placement for the index acute coronary syndrome (ACS).
Cumulative incidence of ST was assessed at 30 days (early ST), 31-360 days
(late ST), 361-720 days (very late ST), and up to 720 days. Cox
proportional hazards models were used to assess associations between ST
and various factors, including patient characteristics [i.e., age, sex,
ACS presentation, history of hypertension, smoking, diabetes, prior
myocardial infarction (MI), heart failure, prior ischemic stroke, and
cancer], laboratory tests [i.e., positive cardiac biomarker, hemoglobin,
platelet count, white blood cell (WBC) count], and treatment [i.e.,
drug-eluting stent (DES) vs. bare-metal stent (BMS) and anticoagulant with
rivaroxaban vs. placebo]. Result(s): Among the 8,741 stented
patients, 155 ST events (2.25%) occurred by Day 720. The cumulative
incidences of early, late, and very late ST were 0.80%, 0.81%, and 0.77%,
respectively. After multivariable adjustment, age >= 75 [hazard ratio (HR)
= 2.13 (95% confidence interval, CI: 1.26-3.60)], a history of prior MI
[HR = 1.81 (95% CI: 1.22-2.68)], low hemoglobin level [HR = 2.34 (95% CI:
1.59-3.44)], and high WBC count [HR = 1.58 (95% CI: 1.02-2.46)] were
associated with a greater risk of overall ST, whereas DES [HR = 0.56 (95%
CI: 0.38-0.83)] and rivaroxaban therapy [HR = 0.63 (95% CI: 0.44-0.88)]
were associated with a lower risk of overall ST up to 720 days. Low
hemoglobin level and high WBC count were associated with early ST (low
hemoglobin: HR = 2.35 [95% CI: 1.34-4.12]; high WBC count: HR = 2.11 [95%
CI: 1.17-3.81]). Low hemoglobin level and prior MI were associated with a
greater risk of late ST (low hemoglobin: HR = 2.32 [95% CI: 1.26-4.27];
prior MI: HR = 2.98 [95% CI: 1.67-5.31]), whereas DES was associated with
a lower risk of late ST [HR = 0.33 (95% CI: 0.16-0.67)]. Age >=75 years
was associated with very late ST. Conclusion(s): The study identified
positive and negative associations with early, late, and very late ST.
These variables may be useful in constructing risk assessment models for
ST. Clinical Trial Registration: http://www.clinicaltrials.gov, identifier
NCT00809965. Copyright 2024 Chi, Alkhalfan, Lee, Montazerin,
Fitzgerald, Korjian, Omar, Barnathan, Plotnikov and Gibson.

<24>
Accession Number
2027806767
Title
Temporary mechanical circulatory support with Impella in cardiac surgery:
A systematic review.
Source
International Journal of Cardiology. 396 (no pagination), 2024. Article
Number: 131418. Date of Publication: 01 Feb 2024.
Author
Pieri M.; D'Andria Ursoleo J.; Nardelli P.; Ortalda A.; Ajello S.; Delrio
S.; Fominskiy E.; Scandroglio A.M.
Institution
(Pieri, D'Andria Ursoleo, Nardelli, Ortalda, Delrio, Fominskiy,
Scandroglio) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
(Pieri) Vita-Salute San Raffaele University, Via Olgettina 58, Milan
20132, Italy
(Ajello) Department of Cardiology, IRCCS San Raffaele Scientific
Institute, Via Olgettina 60, Milan 20132, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Perioperative cardiogenic shock (CS) in cardiac surgery is
still burdened by a high mortality risk. The introduction of Impella pumps
in the therapeutic armory of temporary mechanical circulatory support
(tMCS) has potential implications to improve the management of complex
cases, although it has never been systematically addressed. We performed a
systematic review of the reported use of tMCS with Impella in cardiac
surgery. Method(s): We searched PubMed for all original studies on
the Impella use in adult patients in cardiac surgery. Result(s):
Nineteen studies (out of 151 identified by search string) were included.
All studies were observational and all but one (95%) were retrospective.
Seven studies focused on the implantation of Impella in the pre-operative
setting (coronary or valvular surgery), either as a prophylactic device in
high-risk cases (3 studies) or in patients with CS as stabilization tool
prior to cardiac surgery procedure (4 studies). Three studies reported the
use of Impella as periprocedural support for percutaneous valvular
procedure, three as bridge to heart replacement, and six for
postcardiotomy CS. Impella support had a low complication rate and was
successful in supporting hemodynamics pre-, intra- and postoperatively.
Most consistently reported data were left-ventricular ejection fraction at
implant, short-term survival and weaning rate. Conclusion(s): tMCS
with Impella in cardiac surgery patients is feasible and successful. It
can be applied in selected cardiac surgery patients and presents
advantages over other types of support. Systematic prospective studies are
needed to standardize indications for implant and management of surgical
issues, and to identify which patients may benefit. Copyright ©
2023 Elsevier B.V.

<25>
Accession Number
2027673053
Title
Renal Impact of Culprit-Only versus Multi-Vessel Revascularization for
Cardiogenic Shock Complicating Acute Myocardial Infarction: Systematic
Review and Meta-Analysis.
Source
Acta Cardiologica Sinica. 39(6) (pp 817-830), 2023. Date of Publication:
November 2023.
Author
Kao T.-W.; Huang C.-C.; Tsai C.-H.; Chen J.-Y.; Huang T.-M.; Lin T.-T.;
Hung C.-S.; Wu V.-C.; Kao H.-L.; Chen W.-J.; Lin Y.-H.
Institution
(Kao) Department of Internal Medicine, National Taiwan University
Hospital, Taiwan (Republic of China)
(Huang, Lin, Hung, Kao, Chen, Lin) Division of Cardiology, Department of
Internal Medicine, National Taiwan University Hospital, College of
Medicine, National Taiwan University, Cardiovascular Center, National
Taiwan University Hospital, Taiwan (Republic of China)
(Tsai) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital, College of Medicine, National Taiwan
University, National Taiwan University Hospital, Taipei, Taiwan (Republic
of China)
(Chen) Division of Nephrology, Department of Internal Medicine, Chi Mei
Medical Center, Taiwan (Republic of China)
(Chen) Department of Health and Nutrition, Chia Nan University of Pharmacy
and Science, Tainan, Taiwan (Republic of China)
(Huang, Wu) Division of Nephrology, Department of Internal Medicine,
National Taiwan University Hospital, College of Medicine, National Taiwan
University, Taiwan (Republic of China)
(Huang, Wu) NSARF: National Taiwan University Hospital Study Group on
Acute Renal Failure, Taipei, Taiwan (Republic of China)
Publisher
Republic of China Society of Cardiology
Abstract
Background: The optimal strategy of percutaneous coronary intervention
(PCI) for acute myocardial infarction (MI) complicated with cardiogenic
shock (CS) remains controversial. We aimed to elucidate the renal and
cardiovascular impact of culprit-only (C) revascularization versus
additional interventions on non-infarct-related arteries. Method(s):
PubMed, Embase, MEDLINE, and Cochrane Library were searched for relevant
literature. A total of 96,812 subjects [C-PCI: 69,986; multi-vessel
(MV)-PCI: 26,826] in nine studies (one randomized control trial; eight
observational cohort studies) were enrolled. Result(s): MV-PCI was
associated with a higher kidney event rate [relative risk (RR): 1.29, 95%
confidence interval (CI): 1.12-1.49; p < 0.001]. However, the all-cause
mortality rate was comparable both during admission (RR: 1.07, 95% CI:
0.94-1.22; p = 0.30) and at one year (RR: 0.96, 95% CI: 0.79-1.16; p =
0.65). MV-PCI was associated with a greater risk of stroke (RR: 1.19, 95%
CI: 1.08-1.32; p < 0.001) and bleeding events (RR: 1.27, 95% CI:
1.07-1.51; p = 0.006), but reduced risk of recurrent MI (RR: 0.89, 95% CI:
0.82-0.97; p = 0.009) and repeat revascularization (RR: 0.34, 95% CI:
0.16-0.71; p = 0.004). No increased risk of coronary artery bypass
grafting was present (RR: 1.09, 95% CI: 0.38-3.17; p = 0.87).
 Conclusion(s): C-PCI was associated with a lower rate of renal
dysfunction but not all-cause mortality in patients with CS complicating
acute MI. Copyright © 2023, Republic of China Society of
Cardiology. All rights reserved.

<26>
Accession Number
2026671641
Title
A systematic review of contrast-enhanced computed tomography calcium
scoring methodologies and impact of aortic valve calcium burden on TAVI
clinical outcomes.
Source
Journal of Cardiovascular Computed Tomography. 17(6) (pp 373-383), 2023.
Date of Publication: 01 Nov 2023.
Author
Flores-Umanzor E.; Keshvara R.; Reza S.; Asghar A.; Rashidul Anwar M.;
Cepas-Guillen P.L.; Osten M.; Halankar J.; Abrahamyan L.; Horlick E.
Institution
(Flores-Umanzor, Keshvara, Osten, Horlick) Toronto Congenital Cardiac
Centre for Adults, Peter Munk Cardiac Centre, University Health Network,
Toronto, ON, Canada
(Reza, Asghar, Rashidul Anwar, Abrahamyan) Toronto General Hospital
Research Institute, University Health Network (UHN), Toronto, ON, Canada
(Reza, Asghar, Rashidul Anwar, Abrahamyan) Institute for Health Policy,
Management, and Evaluation, University of Toronto, ON, Canada
(Cepas-Guillen) Cardiology Department, Cardiovascular Institute, Hospital
Clinic, University of Barcelona, Spain
(Halankar) Joint Department of Medical Imaging, Toronto General Hospital,
Peter Munk Cardiac Centre, University Health Network, University of
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Different methodologies have been used to assess the role of AV
calcification (AVC) on TAVI outcomes. This systematic review aims to
describe the burden of AVC, synthesize the different methods of calcium
score quantification, and evaluate the impact of AVC on outcomes after
TAVI. We included studies of TAVI patients who had reported AV calcium
scoring by contrast-enhanced multidetector CT and the Agatston method. The
impact of calcification on TAVI outcomes without restrictions on follow-up
time or outcome type was evaluated. Results were reported descriptively,
and a meta-analysis was conducted when feasible. Sixty-eight articles were
included, with sample sizes ranging from 23 to 1425 patients.
Contrast-enhanced calcium scoring was reported in 30 studies, calcium
volume score in 28 studies, and unique scoring methods in two. All studies
with calcium volume scores had variable protocols, but most utilized a
modified Agatston method with variable attenuation threshold values of
300-850 HU. Eight studies used the Agatston method, with the overall mean
AV calcium score in studies published from 2010 to 2012 of 3342.9 AU
[95%CI: 3150.4; 3535.4, I2 = 0%]. The overall mean score was lower and
heterogenous in studies published from 2014 to 2020 (2658.9 AU [95% CI:
2517.3; 2800.5, I2 = 79%]. Most studies reported a positive association
between calcium burden and increased risk of adverse outcomes, including
implantation of permanent pacemaker (7/8 studies), paravalvular leak
(13/13 studies), and risk of aortic rupture (2/2 studies). AVC
quantification methodology with contrast-enhanced CT is still variable.
AVC negatively impacts TAVI outcomes independently of the quantification
method. Copyright © 2023

<27>
Accession Number
2023904612
Title
The effects of ergonomic sleep mask use on sleep quality and comfort in
intensive care patients.
Source
Journal of Sleep Research. 33(1) (no pagination), 2024. Article Number:
e13966. Date of Publication: February 2024.
Author
Altintas S.; Celik S.; Karahan E.
Institution
(Altintas, Celik, Karahan) Department of Nursing, Bartin University
Faculty of Health Sciences, Bartin, Turkey
Publisher
John Wiley and Sons Inc
Abstract
This study was conducted to determine the effects of the use of ergonomic
sleep mask on sleep quality and comfort in intensive care patients. This
randomised controlled experimental study was completed with 128 surgical
intensive care patients (control = 64, experimental = 64). During the
second night of their stay in the unit, ergonomic sleep masks were given
to the patients in the experimental group, and earplugs and eye masks were
given to the patients in the control group. A Patient information form,
Visual analogue scale for discomfort, and the Richard-Campbell sleep
questionnaire were used to collect data. While 51.6% of the patients were
female, the mean age of the patients was 63.87 +/- 14.94 years. The
highest rates of patients had undergone cardiovascular surgery (28.9%) and
general anaesthesia (57.8%). It was determined that the sleep quality of
the patients in the experimental group was statistically and clinically
significantly higher after the intervention (50.86 +/- 21.46 vs 37.64 +/-
14.97, t = -5.355, Cohen's d = 0.450, p < 0.001). Likewise, the patients
who used ergonomic sleep masks had a statistically significantly lower
mean VAS for Discomfort score, and their comfort level was higher (p <
0.001), but the difference was not clinically significant (Cohen's d =
0.208). The results of this study showed that the use of ergonomic sleep
masks in surgical intensive care patients had a more positive effect on
both the sleep quality and comfort levels of patients compared with
earplugs and eye masks. The use of an ergonomic sleep mask is recommended
in the early period to facilitate sleep and rest in surgical intensive
care patients. Copyright © 2023 European Sleep Research Society.

<28>
Accession Number
2018413714
Title
Concurrent valvular procedures during left ventricular assist device
implantation and outcomes: A comprehensive analysis of the Multicenter
Study of MagLev Technology in Patients Undergoing Mechanical Circulatory
Support Therapy With HeartMate 3 trial portfolio.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(6) (pp 1684-1694.e18),
2023. Date of Publication: December 2023.
Author
John R.; Kanwar M.K.; Cleveland J.C.; Uriel N.; Naka Y.; Salerno C.;
Horstmanshof D.; Hall S.A.; Cowger J.A.; Heatley G.; Somo S.I.; Mehra M.R.
Institution
(John) Department of Surgery, University of Minnesota Medical Center,
Minneapolis, Minn, United States
(Kanwar) Cardiovascular Institute, Allegheny Health Network, Pittsburgh,
PA, United States
(Cleveland) Surgery-Cardiothoracic, University of Colorado School of
Medicine, Aurora, Colo, United States
(Uriel) Advanced Heart Failure and Cardiac Transplantation, Columbia
University College of Physicians and Surgeons and New York-Presbyterian
Hospital, New York, NY, United States
(Naka) Cardiac Surgery, Weill Cornell Medical College, New York, NY,
United States
(Salerno) Department of Surgery, University of Chicago Medical Center,
Chicago, Ill, United States
(Horstmanshof) Advanced Cardiac Care, Integris Baptist Medical Center,
Oklahoma City, Okla, United States
(Hall) Transplant Cardiology and Mechanical Support/Heart Failure, Baylor
University Medical Center, Dallas, Tex, United States
(Cowger) Mechanical Circulatory Support Team, Henry Ford Health System,
Detroit, Mich, United States
(Heatley, Somo) Heart Failure, Abbott, Lake Forest, Ill, United States
(Mehra) Center for Advanced Heart Disease, Brigham and Women's Hospital
and Harvard Medical School, Boston, Mass, United States
Publisher
Elsevier Inc.
Abstract
Background: Correction of valvular disease is often undertaken during left
ventricular assist device (LVAD) implantation with uncertain benefit. We
analyzed clinical outcomes with HeartMate 3 (HM3; Abbott) LVAD
implantation in those with various concurrent valve procedures (HM3+VP)
with those with an isolated LVAD implant (HM3 alone). Method(s): The
study included 2200 patients with HM3 implanted within the Multicenter
Study of MagLev Technology in Patients Undergoing Mechanical Circulatory
Support Therapy with HeartMate 3 (MOMENTUM 3) trial portfolio who
underwent 820 concurrent procedures among which 466 (21.8%) were HM3+VP.
VPs included 101 aortic, 61 mitral, 163 tricuspid; 85 patients had
multiple VPs. Perioperative complications, major adverse events, and
survival were analyzed. Result(s): Patients who underwent HM3+VP had
higher-acuity Interagency Registry for Mechanically Assisted Circulatory
Support (INTERMACS) profiles (1-2: 41% vs 31%) compared with no VPs (P <
.05). The cardiopulmonary bypass time (124 vs 76 minutes; P < .0001) and
hospital length of stay (20 vs 18 days; P < .0001) were longer in HM3+VP.
A higher incidence of stroke (4.9% vs 2.4%), bleeding (33.9% vs 23.8%),
and right heart failure (41.5% vs 29.6%) was noted in HM3+VP at 0 to 30
days (P < .01), with no difference in 30-day mortality (3.9% vs 3.3%) or
2-year survival (81.7% vs 80.8%). Analysis of individual VP showed no
differences in survival compared to HM3 alone. No differences were noted
among patients with either significant mitral (moderate or worse) or
tricuspid (moderate or worse) regurgitation with or without corrective
surgery. Conclusion(s): Concurrent VPs, commonly performed during
LVAD implantation, are associated with increased morbidity during the
index hospitalization, with no effect on short- and long-term survival.
There is sufficient equipoise to consider a randomized trial on the
benefit of commonly performed VPs (such as mitral or tricuspid
regurgitation correction), during LVAD implantation. Copyright ©
2022 The American Association for Thoracic Surgery

<29>
Accession Number
2029158859
Title
Intravenous albumin in cardiac and vascular surgery: a systematic review
and meta-analysis.
Source
British Journal of Anaesthesia. 132(2) (pp 237-250), 2024. Date of
Publication: February 2024.
Author
Skubas N.J.; Callum J.; Bathla A.; Keshavarz H.; Fergusson D.; Wu B.;
Stanworth S.; Shehata N.
Institution
(Skubas) Department of Cardiothoracic Anaesthesiology, Anaesthesiology
Institute, Cleveland Clinic, and Cleveland Clinic, Lerner College of
Medicine of Case Western Reserve University, Cleveland, OH, United States
(Callum) Department of Pathology and Molecular Medicine, Queen's
University and Kingston Health Sciences Centre, Kingston, ON, Canada
(Bathla) Canadian Blood Services, Toronto, Canada
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Wu) Department of Internal Medicine, School of Medicine, Loma Linda
University, Loma Linda, CA, United States
(Stanworth) NHS Blood and Transplant, Bristol, United Kingdom
(Shehata) Departments of Medicine, Laboratory Medicine and Pathobiology,
Institute of Health Policy Management and Evaluation, University of
Toronto, Division of Hematology, Mount Sinai Hospital, Toronto, ON, Canada
(Keshavarz) Canadian Blood Services, Ottawa, Canada
Publisher
Elsevier Ltd
Abstract
Background: Intravenous albumin is commonly utilised in cardiovascular
surgery for priming of the cardiopulmonary bypass circuit, volume
replacement, or both, although the evidence to support this practice is
uncertain. The aim was to compare i.v. albumin with synthetic colloids and
crystalloids for paediatric and adult patients undergoing cardiovascular
surgery for all-cause mortality and other perioperative outcomes.
 Method(s): A systematic review and meta-analysis of randomised
controlled trials (RCTs) of i.v. albumin compared with synthetic colloids
and crystalloids on the primary outcome of all-cause mortality was
conducted. Secondary outcomes included renal failure, blood loss, duration
of hospital or intensive care unit stay, cardiac index, and blood
component use; subgroups were analysed by age, comparator fluid, and
intended use (priming, volume, or both). We searched MEDLINE, Embase, and
Cochrane Central Register of Controlled Trials (CCRT) from 1946 to
November 23, 2022. Result(s): Of 42 RCTs, mortality was assessed in
15 trials (2711 cardiac surgery patients) and the risk difference was
0.00, 95% confidence interval (CI) -0.01 to 0.01, I2=0%. Among
secondary outcomes, i.v. albumin resulted in smaller fluid balance, mean
difference -0.55 L, 95% CI -1.06 to -0.4, I2=90% (nine studies,
1975 patients) and higher albumin concentrations, mean difference 7.77 g
L-1, 95% CI 3.73-11.8, I2=95% (six studies, 325
patients). Conclusion(s): Intravenous albumin use was not associated
with a difference in morbidity and mortality in patients undergoing
cardiovascular surgery, when compared with comparator fluids. The lack of
improvement in important outcomes with albumin and its higher cost
suggests it should be used restrictively. Systematic review protocol:
PROSPERO; CRD42020171876. Copyright © 2023 British Journal of
Anaesthesia

<30>
Accession Number
2027945903
Title
Clinical study of thoracoscopic assisted different surgical approaches for
early thymoma: a meta-analysis.
Source
BMC Cancer. 24(1) (no pagination), 2024. Article Number: 92. Date of
Publication: December 2024.
Author
Wang J.; Tong T.; Zhang K.; Guo H.; Liu Y.; Li J.; Zhang H.; Li Q.; Zhang
Z.; Zhao Y.
Institution
(Wang, Tong, Guo, Li, Zhang, Li, Zhang, Zhao) Department of Thoracic
Surgery, the Second Hospital of Jilin University, Jilin, China
(Zhang) Jilin Provincial Key Laboratory on Molecular and Chemical
Genetics, Kun Zhang, The Second Hospital of Jilin University, Jilin,
Changchun 130041, China
(Liu) Department of Cardiac Surgery, the First Affiliated Hospital of
Harbin Medical University, Harbin, China
Publisher
BioMed Central Ltd
Abstract
Objective: The efficacy and safety of subxiphoid thoracoscopic thymectomy
(SVATS) for early thymoma are unknown. The purposes of this meta-analysis
were to evaluate the effectiveness and safety of SVATS for early thymoma,
to compare it with unilateral intercostal approach video thoracoscopic
surgery (IVATS) thymectomy, and to investigate the clinical efficacy of
modified subxiphoid thoracoscopic thymectomy (MSVATS) for early anterior
mediastinal thymoma. Method(s): Original articles describing
subxiphoid and unilateral intercostal approaches for thoracoscopic
thymectomy to treat early thymoma published up to March 2023 were searched
from PubMed, Embase, and the Cochrane Library. Standardized mean
differences (SMDs) and 95% confidence intervals (CIs) were calculated and
analyzed for heterogeneity. Clinical data were retrospectively collected
from all Masaoka stage I and II thymoma patients who underwent modified
subxiphoid and unilateral intercostal approach thoracoscopic thymectomies
between September 2020 and March 2023. The operative time, intraoperative
bleeding, postoperative drainage, extubation time, postoperative hospital
stay, postoperative visual analog pain score (VAS), and postoperative
complications were compared, and the clinical advantages of the modified
subxiphoid approach for early-stage anterior mediastinal thymoma were
analyzed. Result(s): A total of 1607 cases were included in the seven
studies in this paper. Of these, 591 cases underwent SVATS thymectomies,
and 1016 cases underwent IVATS thymectomies. SVATS thymectomy was compared
with IVATS thymectomy in terms of age (SMD = - 0.09, 95% CI: -0.20 to -
0.03, I2 = 20%, p = 0.13), body mass index (BMI; SMD = - 0.10,
95% CI: -0.21 to - 0.01, I2 = 0%, p = 0.08), thymoma size (SMD
= - 0.01, 95% CI: -0.01, I2 = 0%, p = 0.08), operative time
(SMD = - 0.70, 95% CI: -1.43-0.03, I2 = 97%, p = 0.06),
intraoperative bleeding (SMD = - 0.30. 95% CI: -0.66-0.06, I2 =
89%, p = 0.10), time to extubation (SMD = - 0.34, 95%CI: -0.73-0.05,
I2 = 91%, p = 0.09), postoperative hospital stay (SMD = - 0.40,
95% CI: -0.93-0.12, I2 = 93%, p = 0.13), and postoperative
complications (odds ratio [OR] = 0.94, 95% CI: 0.42-2.12, I2 =
57%, p = 0.88), which were not statistically significantly different
between the SVATS and IVATS groups. However, the postoperative drainage in
the SVATS group was less than that in the IVATS group (SMD = - 0.43,
95%CI: -0.84 to - 0.02, I2 = 88%, p = 0.04), and the difference
was statistically significant. More importantly, the postoperative VAS was
lower in the SVATS group on days 1 (SMD = - 1.73, 95%CI: -2.27 to - 1.19,
I2 = 93%, p < 0.00001), 3 (SMD = - 1.88, 95%CI: -2.84 to -
0.81, I2 = 97%, p = 0.0005), and 7 (SMD = - 1.18, 95%CI: -2.28
to - 0.08, I2 = 97%, p = 0.04) than in the IVATS group, and
these differences were statistically significant. A total of 117 patients
undergoing thoracoscopic thymectomy for early thymoma in the Department of
Thoracic Surgery of the Second Hospital of Jilin University were
retrospectively collected and included in the analysis, for which a
modified subxiphoid approach was used in 42 cases and a unilateral
intercostal approach was used in 75 cases. The differences between the two
groups (MSVATS vs. IVATS) in general clinical characteristics such as age,
sex, tumor diameter, Masaoka stage, Word Health Organization (WHO) stage,
and intraoperative and postoperative conditions, including operative time,
postoperative drainage, extubation time, postoperative hospital stay, and
postoperative complication rates, were not statistically significant (p >
0.05), while BMI, intraoperative bleeding, and VAS on postoperative days
1, 3, and 7 were all statistically significant (p < 0.05) in the MSVATS
group compared with the IVATS group. Conclusion(s): The meta-analysis
showed that the conventional subxiphoid approach was superior in terms of
postoperative drainage and postoperative VAS pain scores compared with the
unilateral intercostal approach. Moreover, the modified subxiphoid
approach had significant advantages in intraoperative bleeding and
postoperative VAS pain scores compared with the unilateral intercostal
approach. These results indicate that MSVATS can provide more convenient
operation conditions, a better pleural cavity view, and a more complete
thymectomy in the treatment of early thymoma, indicating that is a safe
and feasible minimally invasive surgical method. Copyright ©
2024, The Author(s).

<31>
Accession Number
2026641918
Title
The Use of Sodium-Glucose Cotransporter-2 Inhibitors in Coronary
Revascularization: Where Are We Now? A Systematic Review.
Source
American Journal of Cardiovascular Drugs. 24(1) (pp 55-69), 2024. Date of
Publication: January 2024.
Author
EL-Andari R.; Fialka N.M.; Kang J.; Bozso S.J.; Nagendran J.
Institution
(EL-Andari, Fialka, Kang, Bozso, Nagendran, Nagendran) Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Mazankowski Alberta
Heart Institute, 4-108A Li Ka Shing Health Research Centre, 8602-112
Street, Edmonton, AB T6G 2E1, Canada
Publisher
Adis
Abstract
Introduction: Diabetes and coronary artery disease are two common
conditions that often co-exist. In recent years, sodium-glucose
cotransporter 2 inhibitors (SGLT2i) have been demonstrated to provide
significant cardioprotective benefits, especially among patients with
heart failure. Objective(s): In this systematic review, we look to
identify the outcomes SGLT2i use in patients undergoing coronary
revascularization. Method(s): Pubmed and Embase were systematically
searched for articles describing the outcomes of patients taking SGLT2i
and undergoing coronary revascularization. 834 titles and abstracts were
screened, 42 full texts were reviewed, and 18 studies were found to meet
the inclusion criteria and were included in this review. Result(s):
For patients undergoing coronary artery bypass grafting and percutaneous
coronary intervention, the use of SGLT2i resulted in reductions in
mortality, hospitalization for heart failure, and improved blood glucose;
however, these benefits were not consistently reported in the literature.
Reduced inflammatory markers and positive cardiac remodeling were
identified among patients taking SGLT2i. Conclusion(s):
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been demonstrated
to provide benefits for patients with heart failure along with a host of
positive modulatory effects on the cardiovascular system, including
reductions in inflammatory properties, hypertension, and left ventricular
volume load. Given the clear benefit provided by SGLT2i to patients with
cardiovascular disease and a host of positive properties that are expected
to be protective for patients with ischemic heart disease, future
investigation into the relationship between SGLT2i and outcomes for
patients undergoing revascularization is imperative. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<32>
Accession Number
2026207153
Title
Intravenous Diltiazem Versus Metoprolol in Acute Rate Control of Atrial
Fibrillation/Flutter and Rapid Ventricular Response: A Meta-Analysis of
Randomized and Observational Studies.
Source
American Journal of Cardiovascular Drugs. 24(1) (pp 103-115), 2024. Date
of Publication: January 2024.
Author
Bolton A.; Paudel B.; Adhaduk M.; Alsuhaibani M.; Samuelson R.; Schweizer
M.L.; Hodgson-Zingman D.
Institution
(Bolton) Department of Epidemiology, College of Public Health, University
of Iowa, Iowa City, IA 52242, United States
(Paudel, Adhaduk) Department of General Internal Medicine, University of
Iowa Hospitals and Clinics, Iowa City, IA, United States
(Alsuhaibani) Department of Pediatrics, King Faisal Specialist Hospital
and Research Centre, Riyadh, Saudi Arabia
(Alsuhaibani) College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
(Samuelson) Hardin Library for the Health Sciences, University of Iowa,
Iowa City, IA, United States
(Schweizer) Division of Infectious Disease, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Hodgson-Zingman) Department of Cardiology, University of Iowa Hospitals
and Clinics, Iowa City, IA, United States
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) and/or atrial flutter (AFL) with
rapid ventricular response (RVR) is a condition that often requires urgent
treatment. Although guidelines have recommendations regarding chronic rate
control therapy, recommendations on the best choice for acute heart rate
(HR) control in RVR are unclear. Method(s): A systematic search
across multiple databases was performed for studies evaluating the outcome
of HR control (defined as HR less than 110 bpm and/or 20% decrease from
baseline HR). Included studies evaluated AF and/or AFL with RVR in a
hospital setting, with direct comparison between intravenous (IV)
diltiazem and metoprolol and excluded cardiac surgery and catheter
ablation patients. Hypotension (defined as systolic blood pressure less
than 90 mmHg) was measured as a secondary outcome. Two authors performed
full-text article review and extracted data, with a third author mediating
disagreements. Random effects models utilizing inverse variance weighting
were used to calculate odds ratios (OR) and 95% confidence intervals (CI).
Heterogeneity was assessed using the I 2 test. Result(s):
A total of 563 unique titles were identified through the systematic
search, of which 16 studies (7 randomized and 9 observational) were
included. In our primary analysis of HR control by study type, IV
diltiazem was found to be more effective than IV metoprolol for HR control
in randomized trials (OR 4.75, 95% CI 2.50-9.04 with I 2 =
14%); however, this was not found for observational studies (OR 1.26, 95%
CI 0.89-1.80 with I 2 = 55%). In an analysis of observational
studies, there were no significant differences between the two drugs in
odds of hypotension (OR 1.12, 95% CI 0.51-2.45 with I 2 = 18%).
 Conclusion(s): While there was a trend toward improved HR control
with IV diltiazem compared with IV metoprolol in randomized trials, this
was not seen in observational studies, and there was no observed
difference in hypotension between the two drugs. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<33>
Accession Number
2024792744
Title
Confirmation of Safety of Titanium Wire in Sternotomy Closure, A
Randomized Prospective Study.
Source
Thoracic and Cardiovascular Surgeon. 72(1) (pp 70-76), 2022. Date of
Publication: 05 Dec 2022.
Author
Eraqi M.; Diab A.H.; Matschke K.; Alexiou K.
Institution
(Eraqi) Klinikum Bayreuth GmbH, Bayreuth, Germany
(Eraqi, Diab, Matschke, Alexiou) Department of Cardiac Surgery, Heart
Center Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
Publisher
Georg Thieme Verlag
Abstract
Background There are many factors that are known to increase the risk of
sternal wound infection (SWI); some studies have reported that nickel is a
risk factor for SWI. Titanium wires have only been used as an alternative
to steel wires in patients with known allergy to nickel. However, there is
a paucity of literature regarding the safety of using titanium wires
compared to that on the safety of steel wires for sternum closure after
cardiac surgery. Therefore, this study aimed to demonstrate the
noninferiority of titanium wires, even in patients without a known
allergy. Methods A total of 322 patients who underwent elective full
median sternotomy were randomly assigned to sternal closure either by
titanium wires (n = 161) or by stainless steel wires. Results Fourteen
patients had sternal instability, six (3.7%) patients in the titanium
group and eight (5%) patients in the stainless steel group (p = 0.585).
There was no statistically significant difference between both groups in
terms of postoperative wound infection (p = 0.147). Patients in the
titanium group experienced statistically significant lower postoperative
pain than those in the stainless steel group (p = 0.024). The wire type
was not an independent risk factor for SI, as shown by univariate and
logistic regression analyses. Conclusion Titanium wires are a good
alternative and have been proven to be safe and effective for sternal
closure. The surgeon should be aware of the possibility of developing an
allergic reaction to the wires, especially in patients with previous
multiple allergic histories. Copyright © 2022 Georg Thieme
Verlag. All rights reserved.

<34>
Accession Number
2024497414
Title
Risk Prediction Models for Long-Term Survival after Cardiac Surgery: A
Systematic Review.
Source
Thoracic and Cardiovascular Surgeon. 72(1) (pp 29-39), 2022. Date of
Publication: 23 Jun 2022.
Author
Argus L.; Taylor M.; Ouzounian M.; Venkateswaran R.; Grant S.W.
Institution
(Argus) The University of Manchester, Manchester, United Kingdom
(Taylor, Venkateswaran) Department of Cardiothoracic Surgery, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Grant) Division of Cardiovascular Sciences, University of Manchester,
Manchester, United Kingdom
(Grant) Academic Cardiovascular Unit, South Tees Hospitals NHS Foundation
Trust, Middlesborough, United Kingdom
Publisher
Georg Thieme Verlag
Abstract
Background The reporting of alternative postoperative measures of quality
after cardiac surgery is becoming increasingly important as in-hospital
mortality rates continue to decline. This study aims to systematically
review and assess risk models designed to predict long-term outcomes after
cardiac surgery. Methods The MEDLINE and Embase databases were searched
for articles published between 1990 and 2020. Studies developing or
validating risk prediction models for long-term outcomes after cardiac
surgery were included. Data were extracted using checklists for critical
appraisal and systematic review of prediction modeling studies. Results
Eleven studies were identified for inclusion in the review, of which nine
studies described the development of long-term risk prediction models
after cardiac surgery and two were external validation studies. A total of
70 predictors were included across the nine models. The most frequently
used predictors were age (n = 9), peripheral vascular disease (n = 8),
renal disease (n = 8), and pulmonary disease (n = 8). Despite all models
demonstrating acceptable performance on internal validation, only two
models underwent external validation, both of which performed poorly.
Conclusion Nine risk prediction models predicting long-term mortality
after cardiac surgery have been identified in this review. Statistical
issues with model development, limited inclusion of outcomes beyond 5
years of follow-up, and a lack of external validation studies means that
none of the models identified can be recommended for use in contemporary
cardiac surgery. Further work is needed either to successfully externally
validate existing models or to develop new models. Newly developed models
should aim to use standardized long-term specific reproducible outcome
measures. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<35>
Accession Number
2024497413
Title
Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A
Prospective Randomized Study.
Source
Thoracic and Cardiovascular Surgeon. 72(1) (pp 11-20), 2022. Date of
Publication: 14 Sep 2022.
Author
Ak K.; Dericioglu O.; Midi A.; Kararmaz A.; Er Z.; Dogusan Z.; Arsan S.
Institution
(Ak) Department of Cardiovascular Surgery, Marmara University School of
Medicine, Marmara Uninersitesi Hastanesi Mimar Sinan, Cad. Fevzi Cakmak
Mah. Ust Kaynarca Kalp ve Damar Cerrahisi Bolumu Pendik, Istanbul, Turkey
(Dericioglu, Arsan) Department of Cardiovascular Surgery, Marmara
University School of Medicine, Istanbul, Turkey
(Midi) Department of Pathology, Bahcesehir University, School of Medicine,
Istanbul, Turkey
(Kararmaz) Department of Anesthesiology and Reanimation, Marmara
University School of Medicine, Istanbul, Turkey
(Er) Department of Cardiovascular Surgery, Bozok University Faculty of
Medicine, Ringgold Standard Institution, Yozgat, Yozgat, Turkey
(Dogusan) Department of Pathology, Bone Marrow Transplantation Unite, Yeni
Yuzyll University School of Medicine, Istanbul, Turkey
Publisher
Georg Thieme Verlag
Abstract
Background We compared the effect of intermittent blood and
histidine-tryptophan-ketoglutarate (HTK) solution of Bretschneider on
myocardial histopathology and perioperative outcome. Methods Forty adult
cardiac surgery patients were grouped into two (n = 20 for each): (1)
Intermittent blood cardioplegia (IBC): had repeated cold 4:1 blood
cardioplegia and (2) HTK: had a single dose of cold HTK for
cardioprotection. Creatine kinase (CK)-MB, Troponin-I (cTn-I), pH, and
lactate were studied in coronary sinus blood before and after aortic
cross-clamping (AXC) and systemic blood at postoperative 6 th,
24 th, and 48 thhours. Myocardial biopsy was
performed before and after AXC for light microscopy. Vacuolation,
inflammation, edema, and glycogen were graded semiquantitatively (from 0
to 3). The myocardial apoptotic index was evaluated via the terminal
deoxynucleotidyl transferase dUTP nick end labeling. Results There were no
differences in perioperative clinical outcomes between the groups. The
coronary sinus samples after AXC were more acidotic (7.15 +/- 0.14 vs.
7.32 +/- 0.07, p = 0.001) and revealed higher CK-MB (21.0 +/- 12.81 vs.
12.60 +/- 11.80, p = 0.008) in HTK compared with IBC. The HTK had
significantly a higher amount of erythrocyte suspension intraoperatively
compared with IBC (0.21 +/- 0.53 vs. 1.68 +/- 0.93 U, p = 0.001).
Microscopically, myocardial edema was more pronounced in HTK compared with
IBC after AXC (2.25 +/- 0.91 vs. 1.50 +/- 0.04, p = 0.013). While a
significant increase in the apoptotic index was seen after AXC in both
groups (p = 0.001), no difference was detected between the groups (p =
0.417). Conclusion IBC and HTK have a similar clinical outcome and
protective effect, except for more pronounced myocardial edema and
increased need for intraoperative transfusion with HTK. Copyright
© 2022 Georg Thieme Verlag. All rights reserved.

<36>
Accession Number
638213977
Title
Influence on Depression, Anxiety, and Satisfaction of the Relatives' Visit
to Intensive Care Units prior to Hospital Admission for Elective Cardiac
Surgery: A Randomized Clinical Trial.
Source
International journal of clinical practice. 2022 (pp 1746782), 2022. Date
of Publication: 2022.
Author
Gonzalez-Martin S.; Becerro-de-Bengoa-Vallejo R.; Rodriguez-Garcia M.;
Losa-Iglesias M.E.; Mazoteras-Pardo V.; Palomo-Lopez P.; Rodriguez-Sanz
D.; Calvo-Lobo C.; Lopez-Lopez D.
Institution
(Gonzalez-Martin, Becerro-de-Bengoa-Vallejo, Rodriguez-Garcia,
Rodriguez-Sanz, Calvo-Lobo) Faculty of Nursing, Physiotherapy and
Podiatry, Universidad Complutense de Madrid, Madrid, Spain
(Losa-Iglesias) Faculty of Health Sciences, Universidad Rey Juan Carlos,
Mostoles, Spain
(Mazoteras-Pardo) Department of Nursing, Physiotherapy and Occupational
Therapy, School of Physiotherapy and Nursing, University of Castilla-La
Mancha, Toledo, Spain
(Palomo-Lopez) University Center of Plasencia, Universidad de Extremadura,
Plasencia, Spain
(Lopez-Lopez) Research, Health and Podiatry Group, Department of Health
Sciences, Faculty of Nursing and Podiatry, Universidade da Coruna,
Industrial Campus of Ferrol, A Coruna, Spain
Publisher
NLM (Medline)
Abstract
Background: Intensive care units (ICUs) may produce stress on the
relatives of patients that have long-term physiological and psychological
implications. Objective(s): This study aimed to evaluate the effects
of the relatives' visit prior to hospital admission(s) on the patient's
scheduled cardiac surgery regarding depression, anxiety, and satisfaction
of the patient's family in an ICU. Method(s): A randomized clinical
trial [NCT03605420] was carried out according to the CONSORT criteria.
Thirty-eight relatives of ICU patients were recruited at an ICU and
randomized into study groups. Experimental group participants (n=19)
consisted of relatives who received 1 ICU visit prior to the patient's
admission. Control group participants (n=19) consisted of patients'
relatives who received standard care alone. A self-report test battery,
including the Impact of Event Scale-Revised (IES-R) and the Hospital
Anxiety and Depression Scale (HADS), was completed by the patient's
relative prior to the patient's ICU admission and again three and 90days
after ICU discharge. Furthermore, the Family Satisfaction with Care in the
Intensive Care Unit (FS-ICU) and Critical Care Family Needs Inventory
(CCFNI) were administered to help determine the respondents' satisfaction
three days after the patient's ICU discharge. Result(s):
Statistically significant differences in FS-ICU results were found between
control and experimental groups; no statistically significant differences
were found in IES-R, HADS, and CCFNI results. Thus, members in the control
group were more satisfied with the time elapsed to raise their concerns
(p=0.005), emotional support provided (p=0.020), quality of care
(p=0.035), opportunities to express concerns and ask questions (p=0.005),
and general satisfaction with the ICU's decision-making (p=0.003).
 Conclusion(s): Relatives' satisfaction during patients' ICU admission
may be impaired after their prior visit to the hospital admission.
Relative's anxiety and depression scores did not seem to be significantly
affected. Relatives' visit prior to elective cardiac surgery hospital
admission impaired their satisfaction in an ICU and may not be advisable
for healthcare practice. Copyright © 2022 Sara Gonzalez-Martin et
al.

<37>
Accession Number
636641506
Title
Preoperative Sucrosomial Iron Supplementation Increases Haemoglobin and
Reduces Transfusion Requirements in Elective Heart Surgery Patients: A
Prospective Randomized Study.
Source
Surgical technology international. 39 (pp 321-328), 2021. Date of
Publication: 28 Oct 2021.
Author
Pierelli L.; De Rosa A.; Falco M.; Papi E.; Rondinelli M.B.; Turani F.;
Weltert L.
Institution
(Pierelli) Dipartimento di Medicina Sperimentale, Sapienza University,
Rome, Italy
(Pierelli, De Rosa, Rondinelli) Transfusion Medicine, San Camillo
Forlanini Hospital, Rome, Italy
(Falco, Papi) Department of Anesthesiology, European Hospital, Rome, Italy
(Papi, Turani) Department of Anesthesiology, Aurelia Hospital, Rome, Italy
(Papi, Weltert) San Camillus International University for Health Sciences,
Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low preoperative haemoglobin is frequently observed in heart
surgery patients and is associated with a significant decrease in
haemoglobin between post-operative days 2 and 3, known as haemoglobin
drift. Overall, these patients tend to receive many RBC transfusions.
Since iron homeostasis is often impaired in these patients, restoration of
iron availability might override iron-restricted erythropoiesis. However,
reduced tolerance to oral iron salts has limited this strategy to
intravenous iron administration. STUDY DESIGN AND METHODS: The purpose of
this study was to assess whether preoperative supplementation with oral
sucrosomial iron, a new iron-delivery technology with improved tolerance
and bioavailability, might be an effective strategy for this patient
population. One thousand consecutive patients were randomized and received
either a one-month course of sucrosomial iron (60 mg/day) or no treatment
prior to elective heart surgery at a single high-volume centre
(ClinicalTrials.gov NCT03560687). Primary end-points were haemoglobin
concentration on the day of hospital admittance and number of blood
transfusions. Secondary end-points were haemoglobin drift, tolerance of
treatment and cost-effectiveness of sucrosomial iron administration.
 RESULT(S): Baseline haemoglobin in the treatment group was higher (by
0.67 g/dL; p<0.001) than that in the control group. The percentage of
patients in the treatment group who required transfusion (35.4%) was half
that in the control group (64.6%). The average number of transfused units
per operation was 0.95 vs. 2.03 in the treatment and control groups,
respectively. Haemoglobin drift was substantially similar in the two
groups, and the tolerability of treatment was excellent (98%). The overall
cost of treatment was 156 Euros less in the treatment group, expressed as
a raw cost of transfusion. CONCLUSION(S): In elective heart surgery,
routine preoperative sucrosomial iron administration seems to be a safe,
well-tolerated and cost-effective strategy to increase preoperative
haemoglobin and reduce the need for allogeneic blood transfusions.

<38>
Accession Number
2028013550
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement for pure aortic regurgitation: a systematic review and
meta-analysis of 33,484 patients.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
65. Date of Publication: December 2024.
Author
Elkasaby M.H.; Khalefa B.B.; Yassin M.N.A.; Alabdallat Y.J.; Atia A.;
Altobaishat O.; Omar I.; Hussein A.
Institution
(Elkasaby, Hussein) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Yassin) Faculty of Medicine, Helwan University, Cairo, Egypt
(Alabdallat) Faculty of Medicine, Hashemite University, Zarqa, Jordan
(Atia) Faculty of Medicine, Cairo University, Cairo, Egypt
(Altobaishat) Faculty of Medicine, Jordan University of Science and
Technology, Irbid, Jordan
(Omar) Faculty of Pharmacy, South Valley University, Qena, Egypt
(Elkasaby, Khalefa, Yassin, Alabdallat, Atia, Altobaishat, Omar, Hussein)
Medical Research Group of Egypt (MRGE), Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Introduction: The published studies comparing transcatheter aortic valve
implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure
aortic regurgitation (AR) are conflicting. We conducted this systematic
review and meta-analysis to compare TAVI with SAVR in pure AR.
 Method(s): We searched PubMed, Embase, Web of Science (WOS), Scopus,
and the Cochrane Library Central Register of Controlled Trials (CENTRAL)
from inception until 23 June 2023. Review Manager was used for statistical
analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used
to compare dichotomous outcomes. Continuous outcomes were compared using
the mean difference (MD) and 95% CI. The inconsistency test
(I2) assessed the heterogeneity. We used the Newcastle-Ottawa
scale to assess the quality of included studies. We evaluated the strength
of evidence using the Grading of Recommendations Assessment, Development,
and Evaluation (GRADE) scale. Result(s): We included six studies with
5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality
was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P =
0.63) (I2 = 86%, P < 0.001). TAVI was favored over SAVR
regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001)
(I2 = 11%, P = 0.34), in-hospital acute kidney injury (RR =
0.56; 95% CI: [0.41, 0.76], P < 0.001) (I 2 = 91%, P < 0.001),
major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I
2 = 78%, P < 0.001), and shorter hospital say (MD = - 4.76
days; 95% CI: [- 5.27, - 4.25], P < 0.001) (I 2 = 88%, P <
0.001). In contrast, TAVI was associated with a higher rate of pacemaker
implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I 2
= 0% P = 0.83). Conclusion(s): TAVI reduces in-hospital stroke and is
associated with better safety outcomes than SAVR in patients with pure
AR. Copyright © 2024, The Author(s).

<39>
Accession Number
2028011084
Title
Thoracic paravertebral block for perioperative lung preservation during
VATS pulmonary surgery: study protocol of a randomized clinical trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 74. Date of
Publication: December 2024.
Author
Zhu J.; Wei B.; Wu L.; Li H.; Zhang Y.; Lu J.; Su S.; Xi C.; Liu W.; Wang
G.
Institution
(Zhu, Wu, Li, Zhang, Xi, Wang) Department of Anaesthesiology, Beijing
Tongren Hospital, Capital Medical University, Beijing 100730, China
(Wei, Liu) Department of Anaesthesiology, Beijing Chest Hospital, Capital
Medical University, Beijing 101100, China
(Lu) Department of Anaesthesiology, Beijing Renhe Hospital, Beijing
102600, China
(Su) Central Laboratory, Beijing Obstetrics and Gynecology Hospital,
Capital Medical University, Chaoyang, Beijing 100026, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative pulmonary complications (PPCs) extend the length
of stay of patients and increase the perioperative mortality rate after
video-assisted thoracoscopic (VATS) pulmonary surgery. Thoracic
paravertebral block (TPVB) provides effective analgesia after VATS
surgery; however, little is known about the effect of TPVB on the
incidence of PPCs. The aim of this study is to determine whether TPVB
combined with GA causes fewer PPCs and provides better perioperative lung
protection in patients undergoing VATS pulmonary surgery than simple
general anaesthesia. Method(s): A total of 302 patients undergoing
VATS pulmonary surgery will be randomly divided into two groups: the
paravertebral block group (PV group) and the control group (C group).
Patients in the PV group will receive TPVB: 15 ml of 0.5% ropivacaine will
be administered to the T4 and T7 thoracic paravertebral spaces before
general anaesthesia induction. Patients in the C group will not undergo
the intervention. Both groups of patients will be subjected to a
protective ventilation strategy during the operation. Perioperative
protective mechanical ventilation and standard fluid management will be
applied in both groups. Patient-controlled intravenous analgesia is used
for postoperative analgesia. The primary endpoint is a composite outcome
of PPCs within 7 days after surgery. Secondary endpoints include blood gas
analysis, postoperative lung ultrasound score, NRS score, QoR-15 score,
hospitalization-related indicators and long-term prognosis indicators.
 Discussion(s): This study will better evaluate the impact of TPVB on
the incidence of PPCs and the long-term prognosis in patients undergoing
VATS lobectomy/segmentectomy. The results may provide clinical evidence
for optimizing perioperative lung protection strategies. Trial
registration: ClinicalTrials.gov NCT05922449 . Registered on June 25,
2023. Copyright © 2024, The Author(s).

<40>
Accession Number
2029882104
Title
Aerosolized lidocaine to reduce tracheal suction-associated pain after
pediatric congenital heart surgery: A randomized, double-blind,
placebo-controlled trial.
Source
Progress in Pediatric Cardiology. 72 (no pagination), 2024. Article
Number: 101679. Date of Publication: March 2024.
Author
da Silva T.H.; Carmona F.
Institution
(da Silva, Carmona) Universidade de Sao Paulo, Faculdade de Medicina de
Ribeirao Preto, Departamento de Puericultura e Pediatria, Sao Paulo,
Ribeirao Preto 14049-900, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Background: In children undergoing heart surgery for congenital heart
disease (CHD), postoperative pain is associated with changes in the
respiratory system that can lead to complicated courses and poor outcomes.
Respiratory therapy (RT) can restore respiratory function through manual
techniques and tracheal suction (TS). However, TS itself can cause pain,
leading to hemodynamic and respiratory manifestations, such as
tachycardia, hyper- or hypotension, tachypnea, increased
work-of-breathing, patient-ventilator asynchrony, among others.
 Objective(s): The aim of this study was to investigate whether RT/TS
increases pain and whether inhaled lidocaine can attenuate pain increase
in infants and children undergoing surgery for CHD. Method(s):
Double-blind, randomized, placebo-controlled trial at a pediatric
intensive care unit in a Brazilian tertiary-care university hospital.
Patients <18 years submitted to open-heart surgery for CHD were included
and randomized to receive either aerosolized lidocaine (1 mg/kg) or
placebo before RT/TS. Pain was assessed by the Face, Legs, Activity, Cry,
Consolability pain scale - revised (FLACC-R), along with hemodynamic and
ventilatory parameters, before and 10 min after RT/TS start on
postoperative days 1, 3, and 7 given they were on mechanical ventilation.
 Result(s): 119 patients were included. RT/TS induced minor changes in
pain, which were not attenuated by lidocaine (confirmed in multivariate
analysis). RT/TS also caused minor, clinically not relevant effects in
hemodynamic and ventilatory parameters, which were also not modified by
lidocaine. Conclusion(s): Respiratory therapy with tracheal suction
did not increase postoperative pain in ventilated children after
congenital heart surgery until the 7th day, nor did aerosolized lidocaine
exhibit any clinically significant effect on pain or other hemodynamic or
ventilatory parameters. Registered at REBEC: RBR-10vtd55m. Copyright
© 2023 Elsevier B.V.

<41>
Accession Number
2029904505
Title
Association of Glutamate Infusion with Risk of Acute Kidney Injury after
Coronary Artery Bypass Surgery: A Pooled Analysis of 2 Randomized Clinical
Trials.
Source
JAMA Network Open. (pp E2351743), 2024. Date of Publication: 2024.
Author
Holm J.; Vanky F.; Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Unit of Cardiovascular Medicine, Linkoping University, Linkoping, Sweden
Publisher
American Medical Association
Abstract
Importance: Acute kidney injury (AKI) after cardiac surgery is associated
with increased morbidity and mortality, and measures to prevent AKI have
had limited success. Glutamate has been reported to enhance natural
postischemic recovery of the heart, but not among animals and humans with
diabetes. Objective(s): To summarize pooled results from the
GLUTAMICS (Glutamate for Metabolic Intervention in Coronary Surgery)
trials regarding the effect of glutamate on postoperative AKI among
patients without diabetes undergoing coronary artery bypass graft (CABG)
surgery. Design, Setting, and Participant(s): Data on a total of 791
patients without diabetes from 2 prospective, randomized, double-blind
multicenter trials performed at 5 cardiac surgery centers in Sweden
between October 4, 2005, and November 12, 2009, and between November 15,
2015, and September 30, 2020, were pooled. Patients had acute coronary
syndrome, left ventricular ejection fraction of 0.30 or less, or a
European System for Cardiac Risk Evaluation II score of 3.0 or more and
underwent CABG with or without additional valve procedure. Statistical
analysis was performed from May to November 2023. Intervention(s):
Intravenous infusion of 0.125-M l-glutamic acid or saline at 1.65 mL/kg/h
for 2 hours during reperfusion, after which the infusion rate was halved
and an additional 50 mL was given. Main Outcomes and Measures: The
primary end point was AKI, defined as postoperative increase of plasma
creatinine of 50% or more, corresponding to the Risk stage or higher in
the Risk, Injury, Failure, Loss, and End-Stage kidney disease (RIFLE)
criteria. Result(s): A total of 791 patients without diabetes (391
who received glutamate [mean (SD) age, 69.3 (9.1) years; 62 women (15.9%)]
and 400 controls [mean (SD) age, 69.6 (9.5) years; 73 women (18.3%)]) were
randomized. Baseline data did not differ between groups. Glutamate was
associated with a significantly lower risk of AKI (relative risk, 0.49
[95% CI, 0.29-0.83]). Dialysis was required for 2 patients in the
glutamate group and 5 patients in the control group. In multivariable
analysis, glutamate remained significantly associated with a protective
effect against AKI (odds ratio, 0.47 [95% CI, 0.26-0.86]). In the
glutamate and control groups, the rate of postoperative mortality at 30
days or less was 0.5% (2 of 391) vs 1.0% (4 of 400), and the rate of
stroke at 24 hours or less was 0.8% (3 of 391) vs 1.8% (7 of 400).
 Conclusions and Relevance: In this pooled analysis of 2 randomized
clinical trials, infusion of glutamate was associated with a markedly
lower risk of AKI after CABG among patients without diabetes. The findings
are exploratory and need to be confirmed in prospective trials. Trial
Registration: ClinicalTrials.gov Identifiers: NCT00489827 and
NCT02592824. Copyright © 2024 American Medical Association. All
rights reserved.

<42>
Accession Number
2029904499
Title
Impact of Bempedoic Acid on Total Cardiovascular Events: A Prespecified
Analysis of the CLEAR Outcomes Randomized Clinical Trial.
Source
JAMA Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Nicholls S.J.; Nelson A.J.; Lincoff A.M.; Brennan D.; Ray K.K.; Cho L.;
Menon V.; Li N.; Bloedon L.; Nissen S.E.
Institution
(Nicholls, Nelson) The Victorian Heart Institute, Monash University,
Melbourne, VIC, Australia
(Lincoff, Brennan, Cho, Menon, Nissen) Cleveland Clinic Coordinating
Center for Clinical Research, Cleveland, OH, United States
(Ray) School of Public Health, Imperial College London, London, United
Kingdom
(Li, Bloedon) Esperion Therapeutics, Ann Arbor, MI, United States
Publisher
American Medical Association
Abstract
Importance: The ATP citrate lyase (ACL) inhibitor, bempedoic acid, reduces
low-density lipoprotein cholesterol (LDL-C) level and major adverse
cardiovascular events (MACE) by 13% in patients at high cardiovascular
risk with intolerance of statin and high-intensity statin medications. The
effects of bempedoic acid on total cardiovascular events remain unknown.
 Objective(s): To determine the impact of bempedoic acid on the total
incidence of MACE. Design, Setting, and Participant(s): Included in
this prespecified analysis of the Cholesterol Lowering via Bempedoic Acid,
an ACL-Inhibiting Regimen (CLEAR) Outcomes trial were patients with, or at
high risk for, cardiovascular disease, with hypercholesterolemia and
inability to take guideline-recommended statins. Study data were analyzed
from December 2016 to November 2022. Intervention(s): Patients were
randomly assigned to treatment with bempedoic acid or placebo daily.
 Main Outcomes and Measures: The primary end point was the time to
first event for a composite of cardiovascular death, nonfatal myocardial
infarction, nonfatal stroke, or coronary revascularization (MACE-4). The
key secondary end point was time to first event for cardiovascular death,
nonfatal myocardial infarction, and nonfatal stroke (MACE-3). This
prespecified analysis compared the total number of cardiovascular events
in the treatment groups. Result(s): A total of 13970 patients (mean
[SD] age, 65 [9] years; 7230 male [51.8%]) were included in the study. A
total of 9764 participants (69.9%) had prior atherosclerotic
cardiovascular disease and a baseline LDL-C level of 139 mg/dL; treatment
with bempedoic acid resulted in a 21% reduction in LDL-C level and a 22%
reduction in high-sensitivity C-reactive protein (hsCRP) level at 6
months. Median (IQR) follow-up was 3.4 (3.1-3.9) years. A total of 1746
positively adjudicated first MACE-4 events and 915 additional MACE events
in 612 patients were recorded, with coronary revascularization
representing 32.8% (573 of 1746) of first events and 69.4% (635 of 915) of
additional events. For the total incidence of cardiovascular events,
treatment with bempedoic acid was associated with a reduction in risk of
MACE-4 (hazard ratio [HR], 0.80; 95% CI, 0.72-0.89; P <.001), MACE-3 (HR,
0.83; 95% CI, 0.73-0.93; P =.002), myocardial infarction (HR, 0.69; 95%
CI, 0.58-0.83; P <.001), and coronary revascularization (HR, 0.78; 95% CI,
0.68-0.89; P <.001), although no statistically significant difference was
observed for stroke (HR, 0.80; 95% CI, 0.63-1.03). A lower HR for
protection with bempedoic acid was observed with increasing number of MACE
events experienced by patients. Conclusion and Relevance: Lowering LDL-C
level with bempedoic acid reduced the total number of cardiovascular
events in patients with high cardiovascular risk, statin therapy
intolerance, and elevated LDL-C levels.. Copyright © 2024
American Medical Association. All rights reserved.

<43>
Accession Number
629369791
Title
Perioperative beta-blockers for preventing surgery-related mortality and
morbidity in adults undergoing cardiac surgery.
Source
Cochrane Database of Systematic Reviews. 2019(9) (no pagination), 2019.
Article Number: CD013435. Date of Publication: 23 Sep 2019.
Author
Blessberger H.; Lewis S.R.; Pritchard M.W.; Fawcett L.J.; Domanovits H.;
Schlager O.; Wildner B.; Kammler J.; Steinwender C.
Institution
(Blessberger, Kammler, Steinwender) Department of Cardiology, Med Campus
III, Kepler University Hospital, Medical Faculty of the Johannes Kepler
University Linz, Linz, Austria
(Lewis, Pritchard, Fawcett) Lancaster Patient Safety Research Unit, Royal
Lancaster Infirmary, Lancaster, United Kingdom
(Domanovits) Department of Emergency Medicine, Vienna General Hospital,
Medical University of Vienna, Vienna, Austria
(Schlager) Department of Internal Medicine II, Division of Angiology,
Vienna General Hospital, Medical University of Vienna, Vienna, Austria
(Wildner) Information Retrieval Office, University Library of the Medical
University of Vienna, Vienna, Austria
Publisher
John Wiley and Sons Ltd
Abstract
Background Randomized controlled trials (RCTs) have yielded conflicting
results regarding the ability of beta-blockers to influence perioperative
cardiovascular morbidity and mortality. Thus routine prescription of these
drugs in unselected patients remains a controversial issue. A previous
version of this review assessing the effectiveness of perioperative
beta-blockers in cardiac and non-cardiac surgery was last published in
2018. The previous review has now been split into two reviews according to
type of surgery. This is an update and assesses the evidence in cardiac
surgery only. Objectives To assess the effectiveness of perioperatively
administered beta-blockers for the prevention of surgery-related mortality
and morbidity in adults undergoing cardiac surgery. Search methods We
searched CENTRAL, MEDLINE, Embase, CINAHL, Biosis Previews and Conference
Proceedings Citation Index-Science on 28 June 2019. We searched clinical
trials registers and grey literature, and conducted backward-and
forward-citation searching of relevant articles. Selection criteria We
included RCTs and quasi-randomized studies comparing beta-blockers with a
control (placebo or standard care) administered during the perioperative
period to adults undergoing cardiac surgery. We excluded studies in which
all participants in the standard care control group were given a
pharmacological agent that was not given to participants in the
intervention group, studies in which all participants in the control group
were given a beta-blocker, and studies in which beta-blockers were given
with an additional agent (e.g. magnesium). We excluded studies that did
not measure or report review outcomes. Data collection and analysis Two
review authors independently assessed studies for inclusion, extracted
data, and assessed risks of bias. We assessed the certainty of evidence
with GRADE. Main results We included 63 studies with 7768 participants;
six studies were quasi-randomized and the remaining were RCTs. All
participants were undergoing cardiac surgery, and in most studies, at
least some of the participants were previously taking beta-blockers. Types
of beta-blockers were: propranolol, metoprolol, sotalol, esmolol,
landiolol, acebutolol, timolol, carvedilol, nadolol, and atenolol. In
twelve studies, beta-blockers were titrated according to heart rate or
blood pressure. Duration of administration varied between studies, as did
the time at which drugs were administered; in nine studies this was before
surgery, in 20 studies during surgery, and in the remaining studies
beta-blockers were started postoperatively. Overall, we found that most
studies did not report sufficient details for us to adequately assess risk
of bias. In particular, few studies reported methods used to randomize
participants to groups. In some studies, participants in the control group
were given beta-blockers as rescue therapy during the study period, and
all studies in which the control was standard care were at high risk of
performance bias because of the open-label study design. No studies were
prospectively registered with clinical trials registers, which limited the
assessment of reporting bias. We judged 68% studies to be at high risk of
bias in at least one domain. Study authors reported few deaths (7 per 1000
in both the intervention and control groups), and we found low-certainty
evidence that beta-blockers may make little or no difference to all-cause
mortality at 30 days (risk ratio (RR) 0.95, 95% confidence interval (CI)
0.47 to 1.90; 29 studies, 4099 participants). For myocardial infarctions,
we found no evidence of a difference in events (RR 1.05, 95% CI 0.72 to
1.52; 25 studies, 3946 participants; low-certainty evidence). Few study
authors reported cerebrovascular events, and the evidence was uncertain
(RR 1.37, 95% CI 0.51 to 3.67; 5 studies, 1471 participants; very
low-certainty evidence). Based on a control risk of 54 per 1000, we found
low-certainty evidence that beta-blockers may reduce episodes of
ventricular arrhythmias by 32 episodes per 1000 (RR 0.40, 95% CI 0.25 to
0.63; 12 studies, 2296 participants). For atrial fibrillation or flutter,
there may be 163 fewer incidences with beta-blockers, based on a control
risk of 327 incidences per 1000 (RR 0.50, 95% CI 0.42 to 0.59; 40 studies,
5650 participants; low-certainty evidence). However, the evidence for
bradycardia and hypotension was less certain. We found that beta-blockers
may make little or no difference to bradycardia (RR 1.63, 95% CI 0.92 to
2.91; 12 studies, 1640 participants; low-certainty evidence), or
hypotension (RR 1.84, 95% CI 0.89 to 3.80; 10 studies, 1538 participants;
low-certainty evidence). We used GRADE to downgrade the certainty of
evidence. Owing to studies at high risk of bias in at least one domain, we
downgraded each outcome for study limitations. Based on effect size
calculations in the previous review, we found an insufficient number of
participants in all outcomes (except atrial fibrillation) and, for some
outcomes, we noted a wide confidence interval; therefore, we also
downgraded outcomes owing to imprecision. The evidence for atrial
fibrillation and length of hospital stay had a moderate level of
statistical heterogeneity which we could not explain, and we, therefore,
downgraded these outcomes for inconsistency. Authors' conclusions We found
no evidence of a difference in early all-cause mortality, myocardial
infarction, cerebrovascular events, hypotension and bradycardia. However,
there may be a reduction in atrial fibrillation and ventricular
arrhythmias when beta-blockers are used. A larger sample size is likely to
increase the certainty of this evidence. Four studies awaiting
classification may alter the conclusions of this review. Copyright
© 2019 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<44>
Accession Number
2029801532
Title
NEUROLOGICAL COMPLICATIONS FOLLOWING PEDIATRIC CONGENITAL CARDIAC SURGERY:
A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Asian Journal of Pharmaceutical and Clinical Research. 17(1) (pp 147-152),
2024. Date of Publication: January 2024.
Author
Yadav M.A.; Assadi R.A.; Kudumula N.K.
Institution
(Yadav) Department of Cardiac Anaesthesia, Sri Padmavathi Children's Heart
Centre, Andhra Pradesh, Tirupathi, India
(Assadi) Balaji Clinic, Tamil Nadu, Chennai, India
(Kudumula) Clinical Trials Unit, University Hospital Limerick, Ireland
Publisher
Innovare Academics Sciences Pvt. Ltd
Abstract
Objectives: The study was designed to ascertain the incidence of
neurological complications in children following cardiac surgery for
congenital heart defects (CHD). Method(s): An extensive search was
conducted using Medical Subject Headings in the Cochrane Controlled Trials
databases, PubMed, and Embase in July 2023. Data extraction was done using
a customized data extraction sheet, adhering to Cochrane's standard
methodological procedures. As the heterogeneity was high among the
included studies, random-effect models were employed during the
meta-analysis. Result(s): Seventeen articles were included in our
analysis, encompassing a total sample size of 23,930 pediatric patients
who underwent congenital cardiac surgeries. The calculated incidence of
neurological complications following these procedures was found to be 0.21
(95% confidence interval: 0.14-0.28). A random-effects model employing the
DerSimonian-Laird estimator was utilized for the meta-analysis. The
assessment of heterogeneity revealed Tau of 0.134, an I2 value
of 99.63%, and an H2 value of 267.078, indicating heterogeneity
(p<0.001). Conclusion(s): The study highlights the substantial
incidence of neurological complications following congenital cardiac
surgery, with infants <1 year old being at a higher risk. Copyright
© 2024 The Authors. Published by Innovare Academic Sciences Pvt Ltd.
This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/) DOI:
http://dx.doi.org/10.22159/ajpcr.2024v17i1.50257. Journal homepage:
https://innovareacademics.in/journals/index.php/ajpcr.

<45>
Accession Number
2029792075
Title
Prognostic differences between physiology-guided percutaneous coronary
intervention and optimal medical therapy in coronary artery disease: A
systematic review and meta-analysis.
Source
American Heart Journal Plus: Cardiology Research and Practice. 38 (no
pagination), 2024. Article Number: 100362. Date of Publication: February
2024.
Author
Islam U.; Sabbah M.; Ozbek B.T.; Madsen J.M.; Lonborg J.T.; Engstrom T.
Institution
(Islam, Sabbah, Ozbek, Madsen, Lonborg, Engstrom) The Heart Center,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Intracoronary physiology, particularly fractional flow reserve
(FFR), has been used as a guide for revascularization for patients with
coronary artery disease (CAD). The optimal treatment in the physiological
grey-zone area has been unclear and remains subject to ongoing debate.
 Method(s): We conducted a systematic review of randomized controlled
trials and observational studies comparing the prognostic effect of
percutaneous coronary revascularization (PCI) and optimal medical therapy
(OMT) in patients with CAD. Studies were identified by medical literature
databases. The outcomes of interest were major adverse cardiac events
(MACE) and its components, death, myocardial infarction (MI), and repeat
revascularization. Result(s): A total of 16 studies with 27,451
patients were included. The pooled analysis demonstrated that PCI was
associated with a prognostic advantage over OMT in patients with FFR value
<=0.80 (RR: 0.64, 95 % CI: 0.45-0.90, p < 0.01). Patients with an FFR
value >0.80 were shown to benefit more from OMT (RR 1.38, 95 % CI
1.24-1.53, p < 0.01). The analysis also showed that there was no
significant difference in MACE in the grey-zone area (FFR 0.75-0.80) (RR
0.64, 95 % CI: 0.35-1.16, p = 0.14), but a significant reduction in repeat
revascularization (RR 0.54, 95 % CI, 0.31-0.91, p < 0.01) when patients
were treated with PCI. Conclusion(s): Among patients with CAD and FFR
values >0.80, OMT was associated with favorable outcomes over PCI in
reducing the risk of MACE. However, among patients with FFR values <=0.80,
revascularization was superior in terms of reducing MACE. The available
evidence supports the guideline-recommended use of an FFR cut-off of
<=0.80. Copyright © 2024 The Authors

<46>
Accession Number
2029767462
Title
Residual leaks following percutaneous left atrial appendage occlusion and
outcomes: a meta-analysis.
Source
European Heart Journal. 45(3) (pp 214-229), 2024. Date of Publication: 14
Jan 2024.
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
Publisher
Oxford University Press
Abstract
Background and Residual leaks are not infrequent after left atrial
appendage occlusion. However, there is still uncertainty regarding their
Aims prognostic implications. The aim of this study is to evaluate the
impact of residual leaks after left atrial appendage occlusion. Methods 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. Results 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). Conclusions 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. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<47>
Accession Number
2029767449
Title
Quality and transparency of evidence for implantable cardiovascular
medical devices assessed by the CORE-MD consortium.
Source
European Heart Journal. 45(3) (pp 161-177), 2024. Date of Publication: 14
Jan 2024.
Author
Siontis G.C.M.; Coles B.; Haner J.D.; McGovern L.; Bartkowiak J.; Coughlan
J.J.; Spirito A.; Galea R.; Haeberlin A.; Praz F.; Tomii D.; Melvin T.;
Frenk A.; Byrne R.A.; Fraser A.G.; Windecker S.
Institution
(Siontis, Haner, Bartkowiak, Galea, Haeberlin, Praz, Tomii, Frenk,
Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Freiburgstrasse 18, Bern CH-3010,
Switzerland
(Coles) Velindre University NHS Trust Library and Knowledge Service,
Cardiff, United Kingdom
(McGovern, Coughlan, Byrne) Department of Cardiology, Cardiovascular
Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland
(Coughlan) School of Pharmacy and Biomolecular Sciences, RCSI University
of Medicine and Health Sciences, Dublin, Ireland
(Spirito) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Melvin) School of Medicine, Trinity College, Dublin, Ireland
(Fraser) Department of Cardiology, University Hospital of Wales, Cardiff,
United Kingdom
Publisher
Oxford University Press
Abstract
Background and The European Union Medical Device Regulation 2017/745
challenges key stakeholders to follow transparent and rigorous Aims
approaches to the clinical evaluation of medical devices. The purpose of
this study is a systematic evaluation of published clinical evidence
underlying selected high-risk cardiovascular medical devices before and
after market access in the European Union (CE-marking) between 2000 and
2021. Methods Pre-specified strategies were applied to identify published
studies of prospective design evaluating 71 high-risk cardiovascular
devices in seven different classes (bioresorbable coronary scaffolds, left
atrial appendage occlusion devices, transcatheter aortic valve
implantation systems, transcatheter mitral valve repair/replacement
systems, surgical aortic and mitral heart valves, leadless pacemakers,
subcutaneous implantable cardioverter-defibrillator). The search time span
covered 20 years (2000-21). Details of study design, patient population,
intervention(s), and primary outcome(s) were summarized and assessed with
respect to timing of the corresponding CE-mark approval. Results At least
one prospective clinical trial was identified for 70% (50/71) of the
pre-specified devices. Overall, 473 reports of 308 prospectively designed
studies (enrolling 97 886 individuals) were deemed eligible, including 81%
(251/308) prospective non-randomized clinical trials (66 186 individuals)
and 19% (57/308) randomized clinical trials (31 700 individuals).
Pre-registration of the study protocol was available in 49% (150/308)
studies, and 16% (48/308) had a peer-reviewed publicly available protocol.
Device-related adverse events were evaluated in 82% (253/308) of studies.
An outcome adjudication process was reported in 39% (120/308) of the
studies. Sample size was larger for randomized in comparison to
non-randomized trials (median of 304 vs. 100 individuals, P < .001). No
randomized clinical trial published before CE-mark approval for any of the
devices was identified. Non-randomized clinical trials were predominantly
published after the corresponding CE-mark approval of the device under
evaluation (89%, 224/251). Sample sizes were smaller for studies published
before (median of 31 individuals) than after (median of 135 individuals)
CE-mark approval (P < .001). Clinical trials with larger sample sizes (>50
individuals) and those with longer recruitment periods were more likely to
be published after CE-mark approval, and were more frequent during the
period 2016-21. Conclusions The quantity and quality of publicly available
data from prospective clinical investigations across selected categories
of cardiovascular devices, before and after CE approval during the period
2000-21, were deemed insufficient. The majority of studies was
non-randomized, with increased risk of bias, and performed in small
populations without provision of power calculations, and none of the
reviewed devices had randomized trial results published prior to CE-mark
certification. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<48>
Accession Number
2029740308
Title
Behavioural and psychological telehealth support for people with cardiac
conditions: randomized trial of the 'back on track' self-management
programme.
Source
European Journal of Cardiovascular Nursing. 23(1) (pp 42-54), 2024. Date
of Publication: 01 Jan 2024.
Author
Rogerson M.C.; Jackson A.C.; Navaratnam H.S.; Le Grande M.R.; Higgins
R.O.; Clarke J.; Murphy B.M.
Institution
(Rogerson, Jackson, Navaratnam, Le Grande, Higgins, Clarke, Murphy)
Australian Centre for Heart Health, 75-79 Chetwynd St, PO Box 2137, North
Melbourne, VIC 3051, Australia
(Jackson, Le Grande, Murphy) Melbourne School of Psychological Sciences,
University of Melbourne, Melbourne, VIC, Australia
(Jackson) Centre on Behavioral Health, University of Hong Kong, Pokfulam,
Hong Kong
(Jackson) PRC Faculty of Health, Deakin University, Geelong, VIC,
Australia
(Higgins) Department of Psychology, Deakin University, Geelong, Australia
(Higgins) Department of Physiotherapy, University of Melbourne, Melbourne,
VIC, Australia
Publisher
Oxford University Press
Abstract
Aims Behaviour modification and mood management are essential to recovery
after a cardiac event. Recent times have seen a major shift to remote
delivery of cardiac services. This study assessed behavioural and
psychological outcomes of the Back on Track online self-management
programme, comparing the programme undertaken alone (self-directed) vs.
with telephone support (supported). Relevance for people with depression
was also assessed. Methods Participants with cardiac conditions (n = 122)
were randomly assigned to self-directed or supported groups and given
access and results to the online programme for 2 months. The programme
addressed depression, anxiety, physical activity, and healthy eating.
Supported group participants also received two telephone sessions
facilitated by a trained counsellor to further enhance their
self-management skills and engagement with the online modules. The Patient
Health Questionnaire-9, Generalized Anxiety Disorder-7, and Active
Australia Survey and Diet Quality Tool were administered at baseline, 2,
and 6 months. chi2 tests were used to compare self-directed and
supported groups. Cochrane's Q tests assessed changes over time in
depression, anxiety, and physical activity (PA) and healthy diet guideline
achievement. Participants in both groups showed reduced depression rates
(self-directed, P < 0.05) and increased PA after programme completion
(both groups, P < 0.05). Amongst those classified as depressed at
baseline, significantly fewer were classified as depressed over time (P <
0.001) and significantly more were achieving the PA guidelines (P < 0.01)
compared to those who were not depressed at baseline. Conclusions The Back
on Track telehealth programme was effective in assisting with behavioural
and emotional recovery after a cardiac event. The programme may be
particularly beneficial for those who are depressed early in their
recovery period. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<49>
Accession Number
2029699272
Title
Systematic review and meta-analysis of early aortic valve replacement
versus conservative therapy in patients with asymptomatic aortic valve
stenosis with preserved left ventricle systolic function.
Source
Open Heart. 11(1) (no pagination), 2024. Article Number: e002511. Date of
Publication: 08 Jan 2024.
Author
Senguttuvan N.B.; Srinivasan N.V.; Panchanatham M.; Abdulkader R.S.;
Anandaram A.; Polareddy D.R.; Ramesh S.; Singh H.; Yallanki H.;
Kaliyamoorthi D.; Chidambaram S.; Ramalingam V.; Rajendran R.;
Muralidharan T.R.; Rao R.; Seth A.; Claessen B.; Krishnamoorthy P.
Institution
(Senguttuvan, Panchanatham, Polareddy, Ramesh, Singh, Muralidharan)
Department of Cardiology, SRIHER (Deemed to Be University), Tamil Nadu,
Chennai, India
(Srinivasan, Anandaram) Department of Clinical Research, SRIHER (Deemed to
Be University), Tamil Nadu, Chennai, India
(Abdulkader) Department of Statistics, National Institute of Epidemiology,
Tamil Nadu, Chennai, India
(Yallanki) Department of Medicine, SRIHER (Deemed to Be University), Tamil
Nadu, Chennai, India
(Kaliyamoorthi) Cardiology, Apollo Hospitals, Tamil Nadu, Chennai, India
(Chidambaram) Department of Cardiology, Kauvery Hospital, Chennai, India
(Ramalingam) Department of Cardiology, Velammal Medical College Hospital
and Research Institute, Tamil Nadu, Madurai, India
(Rajendran) Department of Cardiology, Apollo Hospitals, Tamil Nadu,
Trichy, India
(Rao) Department of Cardiology, Rajasthan University of Health Sciences,
Rajasthan, Jaipur, India
(Seth) Department of Cardiology, Fortis Escorts Heart Institute and
Research Centre, Delhi, New Delhi, India
(Claessen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Krishnamoorthy) Cardiology, Icahn School of Medicine at Mount Sinai Zena,
Michael A Wiener Cardiovascular Institute, New York, NY, United States
Publisher
BMJ Publishing Group
Abstract
Background A quarter of patients with severe aortic stenosis (AS) were
asymptomatic, and only a third of them survived at the end of 4 years.
Only a select subset of these patients was recommended for aortic valve
replacement (AVR) by the current American College of Cardiology/American
Heart Association guidelines. We intended to study the effect of early AVR
(eAVR) in this subset of asymptomatic patients with preserved left
ventricle function. Methods and results We searched PubMed and Embase for
randomised and observational studies comparing the effect of eAVR versus
conservative therapy in patients with severe, asymptomatic AS and normal
left ventricular function. The primary outcome was all-cause mortality.
The secondary outcomes were composite major adverse cardiac events (MACE)
(study defined), myocardial infarction (MI), stroke, cardiac death, sudden
death, the development of symptoms, heart failure hospitalisations and
major bleeding. We used GRADEPro to assess the certainty of the evidence.
In the randomised controlled trial (RCT) only analysis, we found no
significant difference in all-cause mortality between the early aortic
intervention group versus the conservative arm (CA) (incidence rate ratio,
IRR (CI): 0.5 (0.2 to 1.1), I 2 =31%, p=0.09). However, in the overall
cohort, we found mortality benefit for eAVR over CA (IRR (CI): 0.4 (0.3 to
0.7), I 2 =84%, p<0.01). There were significantly lower MACE, cardiac
death, sudden death, development of symptoms and heart failure
hospitalisations in the eAVR group. We noticed no difference in MI, stroke
and major bleeding. Conclusion We conclude that there is no reduction in
all-cause mortality in the eAVR arm in patients with asymptomatic AS with
preserved ejection fraction. However, eAVR reduces heart failure related
hospitalisations and death or heart failure hospitalisations. PROSPERO
registration number CRD42022306132. Copyright © Author(s) (or
their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<50>
Accession Number
2029159129
Title
P2Y<inf>12</inf> Inhibitor Loading Time Before Elective PCI and the
Prevention of Myocardial Necrosis.
Source
Canadian Journal of Cardiology. 40(1) (pp 31-39), 2024. Date of
Publication: January 2024.
Author
Roule V.; Beygui F.; Cayla G.; Range G.; Motovska Z.; Delarche N.; Jourda
F.; Goube P.; Guedeney P.; Zeitouni M.; El Kasty M.; Laredo M.; Dumaine
R.; Ducrocq G.; Derimay F.; Van Belle E.; Manigold T.; Cador R.; Combaret
N.; Vicaut E.; Montalescot G.; Silvain J.
Institution
(Roule, Guedeney, Zeitouni, Laredo, Montalescot, Silvain) ACTION Study
Group, Sorbonne Universite, INSERM UMRS1166, Hopital Pitie-Salpetriere
(AP-HP), Paris, France
(Roule, Beygui) Departement de Cardiologie, CHU de Caen, Caen, France
(Cayla) Cardiology Department, Nimes University Hospital, Montpellier
University, ACTION Study Group, Nimes, France
(Range) Departement de Cardiologie, CH de Chartres, Chartres, France
(Motovska) Cardiocentre, 3rd Faculty of Medicine, Charles University and
University Hospital Kralovske Vinohrady, Prague, Czechia
(Delarche) Departement de Cardiologie, CH Francois Mitterrand, Pau, France
(Jourda) Service de Cardiologie, CH Auxerre, Auxerre, France
(Goube) Service de Cardiologie, Centre Hospitalier Sud-Francilien,
Corbeil-Essonnes, France
(El Kasty) Department of Cardiology, Grand Hopital de l'Est Francilien,
Jossigny, France
(Dumaine) Les Grands Pres Cardiac Rehabilitation Centre, Villeneuve St
Denis, France
(Ducrocq) Universite de Paris, AP-HP, French Alliance for Cardiovascular
Trials (FACT), INSERM U1148, Paris, France
(Derimay) Service de Cardiologie Interventionnelle, Hospices Civils de
Lyon and CARMEN INSERM 1060, Lyon, France
(Van Belle) CHU Lille, Institut Coeur Poumon, Cardiology, and Department
of Interventional Cardiology for Coronary, Valves and Structural Heart
Diseases, INSERM U1011, Institut Pasteur de Lille, EGID, Universite de
Lille, Lille, France
(Manigold) Cardiology Department, CHU Nantes, Nantes, France
(Cador) Department of Cardiology Saint Joseph Hospital, Paris, France
(Combaret) Department of Cardiology, Clermont-Ferrand University Hospital,
CNRS, Universite Clermont Auvergne, Clermont-Ferrand, France
(Vicaut) Unite de Recherche Clinique, ACTION Study Group, Hopital Fernand
Widal (AP-HP), Paris, France and SAMM (Statistique, Analyse et
Modelisation Multidisciplinaire) EA 4543, Universite Paris 1 Pantheon,
Sorbonne, France
Publisher
Elsevier Inc.
Abstract
Background: There are dated and conflicting data about the optimal timing
of initiation of P2Y<inf>12</inf> inhibitors in elective percutaneous
coronary intervention (PCI). Peri-PCI myocardial necrosis is associated
with poor outcomes. We aimed to assess the impact of the P2Y<inf>12</inf>
inhibitor loading time on periprocedural myocardial necrosis in the
population of the randomized Assessment of Loading With the
P2Y<inf>12</inf> Inhibitor Ticagrelor or Clopidogrel to Halt Ischemic
Events in Patients Undergoing Elective Coronary Stenting (ALPHEUS) trial,
which compared ticagrelor with clopidogrel in high-risk patients who
received elective PCI. Method(s): The ALPHEUS trial divided 1809
patients into quartiles of loading time. The ALPHEUS primary outcome was
used (type 4 [a or b] myocardial infarction or major myocardial injury) as
well as the main secondary outcome (type 4 [a or b] myocardial infarction
or any type of myocardial injury). Result(s): Patients in the first
quartile group (Q1) presented higher rates of the primary outcome (P =
0.01). When compared with Q1, incidences of the primary outcome decreased
in patients with longer loading times (adjusted odds ratio [adjOR], 0.70
[0.52.-0.95]; P = 0.02 for Q2; adjOR 0.65 [0.48-0.88]; P < 0.01 for Q3;
adjOR 0.66 [0.49-0.89]; P < 0.01 for Q4). Concordant results were found
for the main secondary outcome. There was no interaction with the study
drug allocated by randomization (clopidogrel or ticagrelor). Bleeding
complications (any bleeding ranging between 4.9% and 7.3% and only 1 major
bleeding at 48 hours) and clinical ischemic events were rare and did not
differ among groups. Conclusion(s): In elective PCI, administration
of the oral P2Y<inf>12</inf> inhibitor at the time of PCI could be
associated with more frequent periprocedural myocardial necrosis than an
earlier administration. The long-term clinical consequences remain
unknown. Copyright © 2023 Canadian Cardiovascular Society

<51>
Accession Number
2028974238
Title
Viability and Outcomes with Revascularization or Medical Therapy in
Ischemic Ventricular Dysfunction: A Prespecified Secondary Analysis of the
REVIVED-BCIS2 Trial.
Source
JAMA Cardiology. 8(12) (pp 1154-1161), 2023. Date of Publication: 13 Dec
2023.
Author
Perera D.; Ryan M.; Morgan H.P.; Greenwood J.P.; Petrie M.C.; Dodd M.;
Weerackody R.; O'Kane P.D.; Masci P.G.; Nazir M.S.; Papachristidis A.;
Chahal N.; Khattar R.; Ezad S.M.; Kapetanakis S.; Dixon L.J.; De Silva K.;
McDiarmid A.K.; Marber M.S.; McDonagh T.; McCann G.P.; Clayton T.C.;
Senior R.; Chiribiri A.
Institution
(Perera, Ryan, Morgan, Papachristidis, Ezad, Marber, McDonagh) British
Heart Foundation Centre of Research Excellence, School of Cardiovascular
and Metabolic Medicine & Sciences, King's College London, London, United
Kingdom
(Perera, Kapetanakis, De Silva, Chiribiri) Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Greenwood) Leeds Institute for Cardiometabolic Medicine, University of
Leeds, Leeds, United Kingdom
(Petrie) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, Glasgow, United Kingdom
(Dodd, Clayton) London School of Hygiene & Tropical Medicine, London,
United Kingdom
(Weerackody) Barts Health NHS Trust, London, United Kingdom
(O'Kane) University Hospitals Dorset NHS Foundation Trust, Bournemouth,
United Kingdom
(Masci, Nazir, Chiribiri) School of Biomedical Engineering and Imaging
Sciences, King's College London, London, United Kingdom
(Nazir, Khattar, Senior) Royal Brompton Hospital, London, United Kingdom
(Papachristidis, McDonagh) King's College Hospital NHS Foundation Trust,
London, United Kingdom
(Chahal) London Northwest Health NHS Trust, London, United Kingdom
(Dixon) Belfast Health and Social Care NHS Trust, Belfast, United Kingdom
(De Silva) University Hospitals Bristol NHS Foundation Trust, Bristol,
United Kingdom
(McDiarmid) Newcastle Hospitals NHS Foundation Trust, Newcastle, United
Kingdom
(McCann) University of Leicester, NIHR Leicester Biomedical Research
Centre, Leicester, United Kingdom
Publisher
American Medical Association
Abstract
Importance: In the Revascularization for Ischemic Ventricular Dysfunction
(REVIVED-BCIS2) trial, percutaneous coronary intervention (PCI) did not
improve outcomes for patients with ischemic left ventricular dysfunction.
Whether myocardial viability testing had prognostic utility for these
patients or identified a subpopulation who may benefit from PCI remained
unclear. Objective(s): To determine the effect of the extent of
viable and nonviable myocardium on the effectiveness of PCI, prognosis,
and improvement in left ventricular function. Design, Setting, and
Participant(s): Prospective open-label randomized clinical trial
recruiting between August 28, 2013, and March 19, 2020, with a median
follow-up of 3.4 years (IQR, 2.3-5.0 years). A total of 40 secondary and
tertiary care centers in the United Kingdom were included. Of 700 randomly
assigned patients, 610 with left ventricular ejection fraction less than
or equal to 35%, extensive coronary artery disease, and evidence of
viability in at least 4 myocardial segments that were dysfunctional at
rest and who underwent blinded core laboratory viability characterization
were included. Data analysis was conducted from March 31, 2022, to May 1,
2023. Intervention(s): Percutaneous coronary intervention in addition
to optimal medical therapy. Main Outcomes and Measures: Blinded core
laboratory analysis was performed of cardiac magnetic resonance imaging
scans and dobutamine stress echocardiograms to quantify the extent of
viable and nonviable myocardium, expressed as an absolute percentage of
left ventricular mass. The primary outcome of this subgroup analysis was
the composite of all-cause death or hospitalization for heart failure.
Secondary outcomes were all-cause death, cardiovascular death,
hospitalization for heart failure, and improved left ventricular function
at 6 months. Result(s): The mean (SD) age of the participants was
69.3 (9.0) years. In the PCI group, 258 (87%) were male, and in the
optimal medical therapy group, 277 (88%) were male. The primary outcome
occurred in 107 of 295 participants assigned to PCI and 114 of 315
participants assigned to optimal medical therapy alone. There was no
interaction between the extent of viable or nonviable myocardium and the
effect of PCI on the primary or any secondary outcome. Across the study
population, the extent of viable myocardium was not associated with the
primary outcome (hazard ratio per 10% increase, 0.98; 95% CI, 0.93-1.04)
or any secondary outcome. The extent of nonviable myocardium was
associated with the primary outcome (hazard ratio, 1.07; 95% CI,
1.00-1.15), all-cause death, cardiovascular death, and improvement in left
ventricular function. Conclusions and Relevance: This study found
that viability testing does not identify patients with ischemic
cardiomyopathy who benefit from PCI. The extent of nonviable myocardium,
but not the extent of viable myocardium, is associated with event-free
survival and likelihood of improvement of left ventricular function. Trial
Registration: ClinicalTrials.gov Identifier: NCT01920048. Copyright
© 2023 American Medical Association. All rights reserved.

<52>
Accession Number
2027916851
Title
Early tirofiban versus heparin for bridging dual antiplatelet therapy in
patients undergoing coronary endarterectomy combined with coronary artery
bypass grafting: a multicenter randomized controlled trial protocol (the
THACE-CABG trial).
Source
Trials. 25(1) (no pagination), 2024. Article Number: 52. Date of
Publication: December 2024.
Author
Chen L.; Gao M.-X.; Du X.; Wang C.; Yu W.-Y.; Liu H.-L.; Ding X.-H.; Wang
B.-L.; Zhang K.; Xu D.; Han Z.; Xie B.-D.; Dong R.; Yu Y.
Institution
(Chen, Gao, Yu, Liu, Ding, Wang, Zhang, Dong, Yu) Department of
Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical
University, No.2 Anzhen Road, Chaoyang District, Beijing, China
(Chen) Department of Cardiovascular Surgery, Shanghai Deltahealth
Hospital, Shanghai, China
(Du) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Du) National Clinical Research Centre for Cardiovascular Diseases,
Beijing, China
(Du) The George Institute for Global Health, University of New South
Wales, Sydney, NSW, Australia
(Du, Wang) Heart Health Research Center, Beijing, China
(Xu) Department of Cardiovascular Surgery, Beijing Tiantan Hospital,
Capital Medical University, Beijing, China
(Han) Department of Cardiovascular Surgery, Peking University Shenzhen
Hospital, Guangdong Province, Shenzhen, China
(Xie) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Harbin Medical University, Heilongjiang Province, Harbin, China
Publisher
BioMed Central Ltd
Abstract
Background: For complete revascularization, patients with diffuse coronary
artery disease should have a coronary endarterectomy and a coronary artery
bypass graft (CE-CABG). Sadly, CE can lead to a lack of endothelium, which
raises the risk of thrombotic events. Even though daily dual antiplatelet
therapies (DAPT) have been shown to reduce thrombotic events, the risk of
perioperative thrombotic events is high during the high-risk period after
CE-CABG, and there is no consistent protocol to bridge DAPT. This trial
aims to compare safety and efficacy between tirofiban and heparin as DAPT
bridging strategies after CE-CABG. Method(s): In phase I, 266
patients undergoing CE-CABG will be randomly assigned to tirofiban and
heparin treatment groups to compare the two treatments in terms of the
primary safety endpoint, chest tube drainage in the first 24 h. If the
phase I trial shows tirofiban non-inferiority, phase II will commence, in
which an additional 464 patients will be randomly assigned. All 730
patients will be studied to compare major cardiovascular and
cerebrovascular events (MACCEs) between the groups in the first 30 days
after surgery. Discussion(s): Given the possible benefits of
tirofiban administration after CE-CABG, this trial has the potential to
advance the field of adult coronary heart surgery. Trial registration:
chictr.org.cn, ChiCTR2200055697. Registered 6 January 2022.
https://www.chictr.org.cn/com/25/showproj.aspx?proj=149451 . Current
version: 20,220,620. Copyright © 2024, The Author(s).

<53>
Accession Number
2027791775
Title
Comparison of the negative effect of remimazolam and propofol on cardiac
contractility: Analysis of a randomised parallel-group trial and a
preclinical ex vivo study.
Source
Clinical and Experimental Pharmacology and Physiology. 51(3) (no
pagination), 2024. Article Number: e13840. Date of Publication: March
2024.
Author
Yoshikawa Y.; Oura S.; Kanda M.; Chaki T.; Hirata N.; Edanaga M.; Yamakage
M.
Institution
(Yoshikawa, Oura, Chaki, Edanaga, Yamakage) Department of Anaesthesiology,
Sapporo Medical University School of Medicine, Sapporo, Japan
(Kanda) Department of Rheumatology and Clinical Immunology, Sapporo
Medical University School of Medicine, Sapporo, Japan
(Hirata) Department of Anaesthesiology, Kumamoto University, Kumamoto,
Japan
Publisher
John Wiley and Sons Inc
Abstract
Remimazolam is a newly developed ultra-short-acting benzodiazepine that
exerts sedative effects. This study aimed to clarify the effects of
remimazolam on cardiac contractility. In a randomised-parallel group
trial, haemodynamic parameters were compared between propofol (n = 11) and
remimazolam (n = 12) groups during the induction of general anaesthesia in
patients undergoing non-cardiac surgery. In a preclinical study, the
direct effects of remimazolam on cardiac contractility were also evaluated
using isolated rat hearts. RNA sequence data obtained from rat and human
hearts were analysed to assess the expression patterns of the cardiac
gamma-aminobutyric acid type A (GABA<inf>A</inf>) receptor subunits. In a
clinical study, the proportional change of the maximum rate of arterial
pressure rise was milder during the study period in the remimazolam group
(propofol: -52.6 [10.2] (mean [standard deviation])% vs. remimazolam:
-39.7% [10.5%], p = 0.007). In a preclinical study, remimazolam did not
exert a negative effect on left ventricle developed pressure, whereas
propofol did exert a negative effect after bolus administration of a high
dose (propofol: -26.9% [3.5%] vs. remimazolam: -1.1 [6.9%], p < 0.001).
Analysis of the RNA sequence revealed a lack of gamma subunits, which are
part of the major benzodiazepine binding site of the GABA<inf>A</inf>
receptor, in rat and human hearts. These results indicate that remimazolam
does not have a direct negative effect on cardiac contractility, which
might contribute to its milder effect on cardiac contractility during the
induction of general anaesthesia. The expression patterns of cardiac
GABA<inf>A</inf> receptor subunits might be associated with the unique
pharmacokinetics of benzodiazepines in the heart. Copyright ©
2024 John Wiley & Sons Australia, Ltd.

<54>
Accession Number
2026782586
Title
Non-Invasive Cardiac Output Measurement Using Inert Gas Rebreathing Method
during Cardiopulmonary Exercise Testing-A Systematic Review.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7154. Date of Publication: November 2023.
Author
Chwiedz A.; Minarowski L.; Mroz R.M.; Razak Hady H.
Institution
(Chwiedz, Razak Hady) I Department of General and Endocrine Surgery,
Medical University of Bialystok, Bialystok 15-276, Poland
(Chwiedz, Minarowski, Mroz) II Department of Lung Diseases and
Tuberculosis, Medical University of Bialystok, Bialystok 15-540, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The use of inert gas rebreathing for the non-invasive cardiac
output measurement has produced measurements comparable to those obtained
by various other methods. However, there are no guidelines for the inert
gas rebreathing method during a cardiopulmonary exercise test (CPET). In
addition, there is also a lack of specific standards for assessing the
non-invasive measurement of cardiac output during CPET, both for healthy
patients and those suffering from diseases and conditions. Aim(s):
This systematic review aims to describe the use of IGR for a non-invasive
assessment of cardiac output during cardiopulmonary exercise testing and,
based on the information extracted, to identify a proposed CPET report
that includes an assessment of the cardiac output using the IGR method.
 Method(s): This systematic review was conducted by PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta Analyses) guidelines.
PubMed, Web of Science, Scopus, and Cochrane Library databases were
searched from inception until 29 December 2022. The primary search
returned 261 articles, of which 47 studies met the inclusion criteria for
this review. Results and Conclusion(s): This systematic review
provides a comprehensive description of protocols, indications, technical
details, and proposed reporting standards for a non-invasive cardiac
output assessment using IGR during CPET. It highlights the need for
standardized approaches to CPET and identifies gaps in the literature. The
review critically analyzes the strengths and limitations of the studies
included and offers recommendations for future research by proposing a
combined report from CPET-IGR along with its clinical
application. Copyright © 2023 by the authors.

<55>
Accession Number
2026782574
Title
Optimal Management of Patients with Phlegmonous Esophagitis: A Systematic
Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7147. Date of Publication: November 2023.
Author
Jin D.H.; Woo W.; Lee J.; Moon D.H.; Lee S.
Institution
(Jin, Woo, Lee, Moon, Lee) Department of Thoracic and Cardiovascular
Surgery, Gangnam Severance Hospital, Yonsei University College of
Medicine, Seoul 03722, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Goals: To assess the characteristics and prognosis-influencing factors of
phlegmonous esophagitis, a rare condition marked by suppurative
inflammation of the esophageal submucosa and muscular layers.
 Background(s): Effective management strategies for phlegmonous
esophagitis are lacking. This study aims to systematically review cases to
better understand the disease's features and prognostic determinants.
 Method(s): A systematic search was performed using PubMed/MEDLINE and
Google Scholar from inception to 20 April 2023. Phlegmonous esophagitis
case reports and studies with patient information were included; clinical
manifestations, laboratory results, imaging findings, other diagnostic
findings, and outcomes were analyzed. A pooled analysis was performed to
investigate mortality-related risk factors. Result(s): A total of 35
cases of phlegmonous esophagitis were selected from 31 case reports and 2
case series (median age, 57.0 years; male, 54.3%). The patients presented
various clinical symptoms, with neck-to-epigastric pain and dysphagia
being the most common. Comorbid diabetes mellitus was a major predisposing
factor; one-third of the patients had no previous medical history.
Computed tomography (CT) and endoscopic examinations were predominantly
used for phlegmonous esophagitis diagnosis. Radiological findings showed
that the upper and middle esophagus were most frequently involved.
Treatments included administration of broad-spectrum antibiotics and
drainage via endoscopy or surgery. There were three cases of mortality,
and non-survivors tended to have shorter hospital stays, indicating rapid
disease progression. In logistic regression, thoracic surgery was a
significant mortality-related risk factor (odds ratio, 19.30; 95%
confidence interval, 1.33-282.00, p = 0.03). Conclusion(s):
Advancements in CT and endoscopy have led to less-invasive diagnostic and
treatment methods for phlegmonous esophagitis. Endoscopic localized
abscess treatment is associated with positive outcomes. Copyright
© 2023 by the authors.

<56>
Accession Number
2026648722
Title
Propofol EC<inf>50</inf> for inducing loss of consciousness in patients
under combined epidural-general anesthesia or general anesthesia alone: a
randomized double-blind study.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1194077.
Date of Publication: 2023.
Author
Wang J.; Shen Y.; Guo W.; Zhang W.; Cui X.; Cai S.; Chen X.
Institution
(Wang, Shen, Chen) Department of Anesthesia, Women's Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Wang, Shen, Guo, Zhang, Cui, Cai) Department of Anesthesiology, Zhejiang
Cancer Hospital, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Combined epidural-general anesthesia (GA + EA) has been
recommended as a preferred technique for both thoracic and abdominal
surgery. The epidural anesthesia on the general anesthetic (GA)
requirements has not been well investigated. Therefore, we conducted the
present study to explore the predicted effect-site concentration of
propofol (Ce<inf>prop</inf>) required for achieving the loss of
consciousness (LOC) in 50% of patients (EC<inf>50</inf>) with or without
epidural anesthesia. Method(s): Sixty patients scheduled for
gastrectomy were randomized into the GA + EA group or GA alone group to
receive general anesthesia alone. Ropivacaine 0.375% was used for epidural
anesthesia to achieve a sensory level of T4 or above prior to the
induction of general anesthesia. The EC<inf>50</inf> of predicted
Ce<inf>prop</inf> for LOC was determined by the up-down sequential method.
The consumption of anesthetics, emergence time from anesthesia, and
postoperative outcomes were also recorded and compared. Result(s):
The EC<inf>50</inf> of predicted Ce<inf>prop</inf> for LOC was lower in
the GA + EA group than in the GA alone group [2.97 (95% CI: 2.63-3.31) vs.
3.36 (95% CI: 3.19-3.53) mug mL-1, (p = 0.036)]. The
consumption of anesthetics was lower in the GA + EA group than in the GA
alone group (propofol: 0.11 +/- 0.02 vs. 0.13 +/- 0.02 mg kg-1
min-1, p = 0.014; remifentanil: 0.08 +/- 0.03 vs. 0.14 +/- 0.04
mug kg-1 min-1, p < 0.001). The emergence time was
shorter in the GA + EA group than in the GA alone group (16.0 vs. 20.5
min, p = 0.013). Conclusion(s): Concomitant epidural anesthesia
reduced by 15% the EC<inf>50</inf> of predicted Ce<inf>prop</inf> for LOC,
decreased the consumptions of propofol and remifentanil during maintenance
of anesthesia, and fastened recovery from anesthesia. Clinical trial
registration: ClinicalTrials.gov, identifier: NCT05124704. Copyright
© 2023 Wang, Shen, Guo, Zhang, Cui, Cai and Chen.

<57>
Accession Number
2029781259
Title
Preoperative Levosimendan in Patients With Severe Left Ventricular
Dysfunction Undergoing Isolated Coronary Artery Bypass Grafting: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Ayala R.; Gewehr D.M.; Godoi A.; Velasquez C.; Fernandez M.; Carvalho
P.E.P.; Goebel N.
Institution
(Ayala, Goebel) Department of Cardiovascular Surgery, Robert Bosch
Hospital, Stuttgart, Germany
(Gewehr) Curitiba Heart Institute, Parana, Curitiba, Brazil
(Godoi) Cardiff University School of Medicine, Wales, United Kingdom
(Velasquez) University of Texas Medical Branch, Galveston, TX, United
States
(Fernandez) Bahiana School of Medicine and Public Health, Bahia, Salvador,
Brazil
(Carvalho) Department of Medicine, Federal University of Minas Gerais,
Belo Horizonte, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To verify the impact of preoperative levosimendan on patients
with severe left ventricular dysfunction (ejection fraction <35%)
undergoing isolated coronary artery bypass grafting. Design(s): A
meta-analysis. Setting(s): Hospitals. Participant(s): The
authors included 1,225 patients from 6 randomized controlled trials.
 Intervention(s): None. Measurements and Main Results: The
authors performed a meta-analysis of trials that compared preoperative
levosimendan with placebo or no therapy, reporting efficacy and safety
endpoints. Statistical analyses used mean differences and risk ratios
(RR), with a random effects model. Six studies were included, comprising
1,225 patients, of whom 615 (50.2%) received preoperative levosimendan,
and 610 (49.8%) received placebo/no therapy. Preoperative levosimendan
showed a lower risk of all-cause mortality (RR 0.31; 95% CI 0.16-0.60; p <
0.01; I2 = 0%), postoperative acute kidney injury (RR 0.44; 95%
CI 0.25-0.77; p < 0.01; I2 = 0%), low-cardiac-output syndrome
(RR 0.45; 95% CI 0.30-0.66; p < 0.001; I2 = 0%), and
postoperative atrial fibrillation (RR 0.49; 95% CI 0.25-0.98; p = 0.04;
I2 = 85%) compared to control. Moreover, levosimendan
significantly reduced the need for postoperative inotropes and increased
the cardiac index at 24 hours postoperatively. There were no differences
between groups for perioperative myocardial infarction, hypotension, or
any adverse events. Conclusion(s): Preoperative levosimendan in
patients with severe left ventricular dysfunction undergoing isolated
coronary artery bypass grafting was associated with reduced all-cause
mortality, low-cardiac-output syndrome, acute kidney injury, postoperative
atrial fibrillation, and the need for circulatory support without
compromising safety. Copyright © 2023 Elsevier Inc.

<58>
Accession Number
643260745
Title
Rationale and Design of the mTECH-Rehab Randomized Controlled Trial:
Impact of a Mobile Technology Enabled Corrie Cardiac Rehabilitation
Program on Functional Status and Cardiovascular Health.
Source
Journal of the American Heart Association. 13(2) (pp e030654), 2024. Date
of Publication: 16 Jan 2024.
Author
Isakadze N.; Kim C.H.; Marvel F.A.; Ding J.; MacFarlane Z.; Gao Y.;
Spaulding E.M.; Stewart K.J.; Nimbalkar M.; Bush A.; Broderick A.;
Gallagher J.; Molello N.; Commodore-Mensah Y.; Michos E.D.; Dunn P.;
Hanley D.F.; McBee N.; Martin S.S.; Mathews L.
Institution
(Isakadze, Kim, Marvel, Ding, MacFarlane, Gao, Spaulding, Stewart,
Nimbalkar, Bush, Broderick, Gallagher, Michos, Martin, Mathews) Division
of Cardiology, Department of Medicine Johns Hopkins University School of
Medicine Baltimore MD USA
(Isakadze, Kim, Marvel, Ding, MacFarlane, Gao, Spaulding, Michos, Martin,
Mathews) Digital Health Innovation Laboratory, Ciccarone Center for the
Prevention of Cardiovascular Disease, Division of Cardiology, Department
of Medicine Johns Hopkins University School of Medicine Baltimore MD USA
(Isakadze, Kim, Marvel, Ding, MacFarlane, Gao, Spaulding,
Commodore-Mensah, Michos, Martin, Mathews) Center for Mobile Technologies
to Achieve Equity in Cardiovascular Health (mTECH Center) Baltimore MD USA
(Spaulding, Commodore-Mensah) Johns Hopkins University School of Nursing
Baltimore MD USA
(Spaulding, Mathews) Welch Center for Prevention, Epidemiology, Clinical
Research Johns Hopkins University Baltimore MD USA
(Molello, Commodore-Mensah, Martin, Mathews) Johns Hopkins Center for
Health Equity Baltimore MD USA
(Dunn) Center for Health Technology and Innovation, American Heart
Association Dallas TX USA, United States
(Dunn, Hanley, McBee) Department of Neurology Johns Hopkins University
School of Medicine Baltimore MD USA
(Hanley) Division of Neurosurgery, Department of Surgery Johns Hopkins
University School of Medicine Baltimore MD USA
(Hanley) Department of Anesthesiology and Critical Care Medicine Johns
Hopkins University School of Medicine Baltimore MD USA
(McBee) Ginsburg Institute for Health Equity, Nemours Children's Health
Orlando FL USA
Abstract
BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based,
guideline-recommended intervention for patients recovering from a cardiac
event, surgery or procedure that improves morbidity, mortality, and
functional status. CR is traditionally provided in-center, which limits
access and engagement, most notably among underrepresented racial and
ethnic groups due to barriers including cost, scheduling, and
transportation access. This study is designed to evaluate the Corrie
Hybrid CR, a technology-based, multicomponent health equity-focused
intervention as an alternative to traditional in-center CR among patients
recovering from a cardiac event, surgery, or procedure compared with usual
care alone. METHOD(S): The mTECH-Rehab (Impact of a Mobile Technology
Enabled Corrie CR Program) trial will randomize 200 patients who either
have diagnosis of myocardial infarction or who undergo coronary artery
bypass grafting surgery, percutaneous coronary intervention, heart valve
repair, or replacement presenting to 4 hospitals in a large academic
health system in Maryland, United States, to the Corrie Hybrid CR program
combined with usual care CR (intervention group) or usual care CR alone
(control group) in a parallel arm, randomized controlled trial. The Corrie
Hybrid CR program leverages 5 components: (1) a patient-facing mobile
application that encourages behavior change, patient empowerment, and
engagement with guideline-directed therapy; (2) Food and Drug
Administration-approved smart devices that collect health metrics; (3) 2
upfront in-center CR sessions to facilitate personalization,
self-efficacy, and evaluation for the safety of home exercise, followed by
a combination of in-center and home-based sessions per participant
preference; (4) a clinician dashboard to track health data; and (5) weekly
virtual coaching sessions delivered over 12weeks for education,
encouragement, and risk factor modification. The primary outcome is the
mean difference between the intervention versus control groups in distance
walked on the 6-minute walk test (ie, functional capacity) at 12weeks post
randomization. Key secondary and exploratory outcomes include improvement
in a composite cardiovascular health metric, CR engagement, quality of
life, health factors (including low-density lipoprotein-cholesterol,
hemoglobin A1c, weight, diet, smoking cessation, blood pressure), and
psychosocial factors. Approval for the study was granted by the local
institutional review board. Results of the trial will be published once
data collection and analysis have been completed. CONCLUSION(S): The
Corrie Hybrid CR program has the potential to improve functional status,
cardiovascular health, and CR engagement and advance equity in access to
cardiac rehabilitation. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT05238103.

<59>
Accession Number
643265158
Title
Comparison of self and balloon-expandable THVs for TAVI in terms of
in-hospital and long-term outcomes: Single-center experience.
Source
Anatolian Journal of Cardiology. Conference: 39th National Cardiology
Congress. London United Kingdom. 27(Supplement 1) (pp S7-S8), 2023. Date
of Publication: December 2023.
Author
Hakgor A.
Institution
(Hakgor) Department of Cardiology, Medipol University, Faculty of
Medicine, Istanbul, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Background and Aim: Transcatheter aortic valve implantation (TAVI) is an
effective interventional therapy that has been used for many years for the
treatment of patients with severe aortic stenosis (AS) at high surgical
risk. To date, two different types of transcatheter heart valves (THVs)
have been used in TAVI: the self-expandable valve (SEV) and the
balloon-expandable valve (BEV). Although the efficacy and safety of each
of these valves are well established, there are not enough clinical
studies directly comparing the different valve types. In this study, we
compared in-hospital and 2-year long-term outcomes of patients who
underwent TAVI using 4 different THVs in our center. Method(s): The
study included 403 patients [mean age 78.2 +/- 8.4, female 205 (50.9%)]
who underwent TAVI using 4 different brands of THVs, BEV (SAPIEN S3/XT and
Myval) and SEV (CoreValve/EvolutR and Portico). Patients were divided into
2 groups, BEV (N=163, 40.4%) and SEV (N=240, 59.6%), and all analyses were
performed retrospectively. Result(s): Baseline demographic, clinical,
echocardiographic characteristics and STS scores did not differ between
the two groups (p>0.05 for all). All BEVs and SEVs were implanted from
transfemoral access under general anesthesia or conscious sedation with
high success rates (99.4% and 97.1%). SEVs were more frequently preferred
in valve-in-valve TAVI cases (6.3% vs. 1.2%, p=0.014). In terms of
implantation technique, predilatation did not differ between BEV (30.1%)
and SEV (30.4%), whereas the need for postdilatation was significantly
higher in the SEV (36.7%) group than in the BEV (6.7%) group (p<0.001). In
terms of periprocedural adverse events, in-hospital mortality was
significantly higher in the BEV (N=21, 12.9%) than in the SEV group (N=15,
6.3%), (p=0.022) whereas the rates of stroke, major and minor bleeding,
vascular complications, and permanent pacemaker implantation (PPI) did not
differ significantly between the two groups (p>0.05 for all). In the
post-procedure follow-up period, both the rates of mortality at follow-up
(N=28, 17.2% for BEV vs. N=25, 10.4%, for SEV p=0.049) and the 2-year
overall all cause mortality rates were higher in the BEV group (N=49,
30.1% for BEV vs. N=40, 16.7% for SEV, p=0.001). Mean transvalvular
gradients measured by echo at follow-up were lower in the SEV group (10.6
+/- 5.6 mmHg) than in the BEV group (12.7 +/- 8.6 mmHg), (p=0.005) but
rates of moderate-to severe paravalvular aortic regurgitation (PVAR) were
higher in the SEV group (27.5% vs. 17.8%, p=0.024). No statistically
significant differences were observed between the two THV groups with
respect to the composite endpoints of in-hospital death, stroke,
proton-pump inhibitors, and moderate-to severe PVAR (N=61, 37.4% for BEV,
N=82, 34.2%, p=0.502) (Table 1). Conclusion(s): Both BEV and SEV THVs
are feasable options for the treatment of severe AS with similar high
success and low complication rates. However, more randomized and
prospective studies are needed to demonstrate the superiority of these
THVs over each other. (Table Presented).

<60>
[Use Link to view the full text]
Accession Number
2029835520
Title
Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for
Thoracic Ligamentous Ossification: A Systematic Review and Meta-Analysis.
Source
Spine. 49(3) (pp 197-207), 2024. Date of Publication: 01 Feb 2024.
Author
Ye J.; Guo W.; Hu Y.; Fan X.
Institution
(Ye, Guo, Hu, Fan) Department of Orthopedics, Hospital of Chengdu
University of Traditional Chinese Medicine, Chengdu, China
(Ye, Guo, Hu) Clinical School of Medicine, Chengdu University of
Traditional Chinese Medicine, Chengdu, China
Publisher
Wolters Kluwer Health
Abstract
Study Design. A systematic review and meta-analysis. Objective. This study
systematically reviewed and evaluated the safety and efficacy of spinal
endoscopic techniques as a treatment for thoracic ligamentum flavum
ossification (TOLF). Summary of Background Data. The use of spinal
endoscopic techniques for the treatment of TOLF has increased in recent
years. The present study is the first comprehensive systematic review and
meta-analysis focused on the use of spinal endoscopic techniques for TOLF.
Materials and Methods. The Cochrane Central, PubMed, Web of Science, and
Embase databases were systematically searched for studies focused on
patients undergoing spinal endoscopic techniques to treat symptomatic
TOLF. Results. This meta-analysis included 23 studies. We included 323
patients (177 males, 146 females) with a mean age of 58.40+/-10.06 years,
with 304 total recorded lesion locations of which 245 were located in the
lower thoracic spine. Complications affected 35/323 patients, and the mean
operative duration for 305 patients was 108.15+/-47.34 minutes. For 187
patients, the mean operative bleeding was 25.13+/-12.54 mL, while for 87
patients the mean duration of hospitalization was 4.59+/-1.93 days. At
last follow-up, functional assessment was performed for 260 patients, of
whom 200 were in excellent condition, visual analog scale (VAS) scores
were assessed for 160 patients, with a mean improvement of 4.40 (3.95,
4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115
patients, with a mean improvement of 3.49 (2.79,4.18), and modified
Japanese Orthopedic Association (mJOA) scores were recorded for 208
patients, with a mean improvement of 3.62 (2.89,4.35). Conclusions. These
results support several advantages of spinal endoscopic techniques for the
treatment of symptomatic TOLF. These include low complication rates, rapid
postoperative recovery, and good functional recovery when used for
single-segment, non-nodular ossification and no combined dural
ossification. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<61>
Accession Number
2029854104
Title
Low- or standard-dose edoxaban versus antiplatelet therapy for leaflet
thrombus and cerebral thromboembolism after TAVR: A prespecified analysis
of randomized ADAPT-TAVR trial.
Source
American Heart Journal. 269 (pp 167-178), 2024. Date of Publication: March
2024.
Author
Kim M.; Ahn J.-M.; Kang D.-Y.; Kim M.-J.; Kim K.W.; Koo H.J.; Yang D.H.;
Jung S.C.; Kim B.; Wong Y.T.A.; Lam C.C.S.; Yin W.H.; Wei J.; Lee Y.-T.;
Kao H.-L.; Lin M.-S.; Yu Ko T.; Kim W.-J.; Kang S.H.; Lee S.-A.; Ko E.;
Kim D.-H.; Kang J.-W.; Lee J.-H.; Lee J.; Park J.; Kim H.; Choi Y.; Park
S.-J.; Park D.-W.
Institution
(Kim, Ahn, Kang, Lee, Kim, Lee, Park, Kim, Choi, Park, Park) Department of
Cardiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Kim) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Kim) Asan Image Metrics, Clinical Trial Center, Asan Institute for Life
Sciences, Asan Medical Center, Seoul, South Korea
(Koo, Yang, Jung, Kang) Department of Radiology Research Institute of
Radiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Kim) Department of Radiology, Anam Hospital, Korea University College of
Medicine, Seoul, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, University of
Hong Kong, Queen Mary Hospital, Hong Kong
(Yin, Wei, Lee) Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Kao, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Yu Ko) Division of Cardiology, Department of Internal Medicine, Hsin-Chu
Branch, National Taiwan University Hospital, Hsin-Chu, Taiwan (Republic of
China)
(Kim, Kang) Department of Cardiology, CHA Bundang Medical Center,
Seongnam, South Korea
(Ko) Department of Cardiology, Kokura Memorial Hospital, Fukuoka,
Kitakyushu, Japan
(Lee) Department of Neurology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
BACKGROUND: The risks of leaflet thrombosis and the associated cerebral
thromboembolism are unknown according to different anticoagulation dosing
after transcatheter aortic valve replacement (TAVR). The aim was to
evaluate the incidence of leaflet thrombosis and cerebral thromboembolism
between low-dose (30 mg) or standard-dose (60 mg) edoxaban and dual
antiplatelet therapy (DAPT) after TAVR. METHOD(S): In this
prespecified subgroup analysis of the ADAPT-TAVR trial, the primary
endpoint was the incidence of leaflet thrombosis on 4-dimensional computed
tomography at 6-months. Key secondary endpoints were new cerebral lesions
on brain magnetic resonance imaging and neurological and neurocognitive
dysfunction. RESULT(S): Of 229 patients enrolled in this study, 118
patients were DAPT group and 111 were edoxaban group (43 [39.1%] 60 mg vs
68 [61.3%] 30 mg). There was a significantly lower incidence of leaflet
thrombosis in the standard-dose edoxaban group than in the DAPT group
(2.4% vs 18.3%; odds ratio [OR] 0.11; 95% confidence interval [CI],
0.01-0.55; P =.03). However, no significant difference was observed
between low-dose edoxaban and DAPT (15.0% vs 18.3%; OR 0.79; 95% CI,
0.32-1.81; P =.58). Irrespective of different antithrombotic regiments,
the percentages of patients with new cerebral lesions on brain MRI and
worsening neurological or neurocognitive function were not significantly
different. CONCLUSION(S): In patients without an indication for
anticoagulation after TAVR, the incidence of leaflet thrombosis was
significantly lower with standard-dose edoxaban but not with low-dose
edoxaban, as compared with DAPT. However, this differential effect of
edoxaban on leaflet thrombosis was not associated with a reduction of new
cerebral thromboembolism and neurological dysfunction. Copyright
© 2023 Elsevier Inc.

<62>
Accession Number
2027969121
Title
Assessment of microcirculatory alteration by a vascular occlusion test
using near-infrared spectroscopy in pediatric cardiac surgery: effect of
cardiopulmonary bypass.
Source
Expert Review of Medical Devices. (no pagination), 2024. Date of
Publication: 2024.
Author
Savluk O.F.; Yilmaz A.A.; Yavuz Y.; Arisut S.; Ukil Isildak F.; Turkmen
Karaagac A.; Ozbek B.; Cine N.; Tuncer E.; Ceyran H.
Institution
(Savluk, Yavuz, Arisut, Ukil Isildak, Turkmen Karaagac) Anesthesiology and
Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital,
Istanbul, Turkey
(Yilmaz, Ozbek, Cine, Tuncer, Ceyran) Pediatric Cardiac Surgery Clinic,
Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Cardiopulmonary bypass cause microcirculatory alterations.
Near infrared spectroscopic measurement of tissue oxygen saturation and
vascular occlusion test are novel technologies for assessing the
microcirculatory function of peripheral tissue specifically in patients
undergoing cardiac surgery with cardiopulmonary bypass.Our study aimed to
evaluate dynamic microcirculatory function using the vascular occlusion
testing during cardiac surgery in pediatric patients. Method(s): 120
pediatric patients were scheduled. Children had continuous regional oxygen
saturation monitoring using near infrared spectroscopy and vascular
occlusion test. Vascular occlusion test was performed five times; before
induction (T1), after induction (T2), then during cardiopulmonary bypass
with full flow (T3), after the termination of CPB (T4) and after sternum
closure (T5). Result(s): Basal value was the lowest at T3 and this
value was significantly different among measurements (p < 0,01).Values for
maximum and minimum tissue oxygen saturation were the lowest at T3 (83,4
and 52,9%).The occlusion slope varied significantly among measurements (p
< 0,01).Reperfusion slopes were significantly different among measurements
(p < 0,01) with a further progressive decrease in reperfusion slope with
duration of cardiopulmonary bypass. Conclusion(s): Microcirculatory
function can assessed using VOT with forearm Near-infrared spectroscopy
derived variables during cardiopulmonary bypass in pediatric cardiac
surgery. Noninvasive assessment of microcirculatory perfusion during
cardiopulmonary bypass can further help evaluate and improve circulatory
support techniques. Trial Registration: The research Project was
registered at ClinicalTrials.gov (NCT06191913). Copyright © 2024
Informa UK Limited, trading as Taylor & Francis Group.

<63>
Accession Number
628120215
Title
Daily chlorhexidine bathing in general hospital units-results of the abate
infection trial (active bathing to eliminate infection).
Source
Open Forum Infectious Diseases. Conference: ID Week 2017. San Diego, CA
United States. 4(Supplement 1) (pp S35-S37), 2017. Date of Publication:
September 2017.
Author
Huang S.S.; Septimus E.; Kleinman K.; Moody J.; Hickok J.; Heim L.;
Gombosev A.; Avery T.; Hafenrefer K.; Shimelman L.; Hayden M.K.; Weinstein
R.A.; Spencer-Smith C.; Kaganov R.E.; Murphy M.V.; Forehand T.; Lankiewicz
J.; Coady M.H.; Portillo L.M.; Sarup J.P.; Jernigan J.A.; Perlin J.; Platt
R.
Institution
(Huang, Heim, Gombosev) Division of Infectious Diseases and Health Policy
Research Institute, University of California Irvine School of Medicine,
Irvine, CA, United States
(Septimus, Moody, Hickok, Spencer-Smith, Forehand, Perlin) Clinical
Services Group, HCA Inc., Nashville, TN, United States
(Kleinman) University of Massachusetts Amherst School of Public Health and
Health Sciences, Amherst, MA, United States
(Avery, Hafenrefer, Shimelman, Kaganov, Murphy, Lankiewicz, Coady, Platt)
Department of Population Medicine, Harvard Medical School and Harvard
Pilgrim Health Care Institute, Boston, MA, United States
(Hayden, Portillo, Sarup) Department of Internal Medicine, Division of
Infectious Diseases, Rush University Medical Center, Chicago, IL, United
States
(Weinstein) Cook County Health and Hospitals System, Chicago, IL, United
States
(Jernigan) Division of Healthcare Quality Promotion, Centers for Disease
Control and Prevention, Atlanta, GA, United States
Publisher
Oxford University Press
Abstract
Background. Universal decolonization with daily chlorhexidine (CHG)
bathing with and without nasal decolonization has significantly reduced
positive MRSA clinical cultures and bloodstream infections in adult ICUs
in several clinical trials. We evaluated whether decolonization was
similarly effective in a lower risk hospitalized population. Methods. We
conducted a 2 arm cluster-randomized trial involving a 1-year baseline
period (April 2013-March 2014) and a 21-month intervention period (June
2014-February 2016). All noncritical care units in a hospital were
assigned to the same strategy. These were (1) Routine Care: routine
bathing product and frequency and (2) Decolonization: CHG for routine
daily bathing (2% leave-on CHG) or showering (4% rinse-of CHG) for all
patients plus mupirocin for 5 days for known MRSA. Universal ICU
decolonization was in place in both arms by September 2013. Differences
between the arms in the outcome rates between the baseline and
intervention periods were assessed with proportional hazards models, using
shared frailties to account for clustering by hospital. The primary
analysis was as-randomized and unadjusted. Primary outcome was any MRSA or
VRE clinical isolate attributable to the unit. Secondary outcome was
all-cause bloodstream infections. Additional analyses adjusted for age,
gender, race, Medicaid insurer, surgery, and comorbidities. Results. We
randomized 53 hospitals in 15 states. There were 194 adult units with
189,616 admissions in the baseline period and 340,350 in the intervention
period. Common unit types included mixed medical surgical (30%), cardiac
(20%), step-down (11%), medical (10%), surgical (10%), and oncology (4%).
There were no significant Differences between arms in the relative hazards
for intervention vs. baseline for either outcome (Table and Figure).
Adjusted analyses yielded similar results. [Table Presented] [Figure
Presented] Conclusion. Universal daily CHG bathing or showering plus
targeted mupirocin for MRSA+ patients in non-critical care units did not
reduce the combination of positive MRSA and VRE clinical cultures or
bloodstream infections due to all pathogens. Further analyses to assess
for any differential effects in high-risk subpopulations will be
important.

<64>
[Use Link to view the full text]
Accession Number
625344046
Title
The outcome of checkpoint inhibitor therapy in patients with cancer and
solid organ transplant: A systematic review of the literature.
Source
Journal of Clinical Oncology. Conference: 2018 ASCO-SITC Clinical
Immuno-Oncology Symposium. San Francisco, CA United States. 36(5
Supplement 1) (no pagination), 2018. Date of Publication: February 2018.
Author
Hassan N.A.; Abudayyeh A.; Shah M.; Johnson D.H.; Suarez-Almazor M.E.;
Diab A.
Institution
(Hassan, Abudayyeh, Shah, Johnson, Suarez-Almazor, Diab) MD Anderson
Cancer Center, Houston, TX; The University of Texas MD Anderson Cancer
Center, Division of Internal Medicine, Section of Nephrology, Houston, TX;
The University of Texas MD Anderson Cancer Center, Houston, TX; LSU Health
Sciences Center in New Orleans Department of Hematology Oncology, New
Orleans, LA
Publisher
American Society of Clinical Oncology
Abstract
Background: Solid organ transplant recipients have been excluded from
Checkpoint inhibitors (CPI) clinical trials because of the concern of
allo-immunity and possible organ rejection. Method(s): We searched 5
databases through September 2017. Studies describing the use of CPI to
treat cancer in solid organ transplant Patients (pts), and provided
detailed description of each case were included. Result(s): Sixteen
publications met inclusion criteria, reporting on 19 cases. Median age of
pts was 59 (14-77) yrs and 74% were male. Cancer types included melanoma
(n=11), cutaneous squamous cell carcinoma (ca) (n=3), non-small cell lung
ca and hepatocellular ca (n=2 each), and duodenal ca (n=1). Median time to
start CPI after organ transplant was 11 (1-25) yrs. Nivolumab (nivo) was
used in 53%, ipilimumab (ipi) in 26%, and pembrolizumab (pem) in 21%. Most
pts were maintained on low dose prednisone (<= 10 mg), mTOR inhibitors,
and other immunosuppressives prior to initiating CPI. Graft rejection
occurred in 10 of 19 pts (7/12 kidney, 2/5 liver, and 1/2 heart
transplants), 90% after receiving anti PD-1, and CPI was discontinued.
Median time to rejection was 21 (5-60) days, and obtained biopsies were
suggestive of a T-cell mediated rejection process. Only a cardiac
transplant recipient with a bioposy proven cellular rejection after nivo,
had improved ejection fraction after pulse steroids. Aside from rejection
no other immune related adverse events (irAEs) reported. Nivo re-challenge
was recommended for a kidney recipient 12 weeks after the rejection
process, and the pt had partial tumor response but remained on
hemodialysis. Of the 9 pts who had no rejection, 4 had irAEs (hepatitis,
colitis, pneumonitis, and dermatitis), including 3 who required high-dose
steroids with subsequent improvement, and the remaining 5 pts did not
experience any irAEs. Clinical benefit rate was 57% of all pts. Two pts
with liver transplants died within 1 month of nivo treatment secondary to
acute liver rejection, and 2 others died because of progressive cancer.
 Conclusion(s): CPI seem to be associated with high rate of rejection.
Multi-institutional collaborative studies are warranted to enhance our
understanding of the pathogenesis and plan optiomal therapy that maintain
graft tolerance without dampening antitumor clinical benefits.

<65>
Accession Number
2027916585
Title
Efficacy and safety of add-on mirogabalin to conventional therapy for the
treatment of peripheral neuropathic pain after thoracic surgery: the
multicenter, randomized, open-label ADMIT-NeP study.
Source
BMC Cancer. 24(1) (no pagination), 2024. Article Number: 80. Date of
Publication: December 2024.
Author
Miyazaki T.; Matsumoto K.; Sato T.; Sano I.; Furukawa K.; Shimoyama K.;
Kamohara R.; Suzuki M.; Kondou M.; Ikeda N.; Tabata S.; Shiosakai K.;
Nagayasu T.
Institution
(Miyazaki, Matsumoto, Nagayasu) Department of Surgical Oncology, Nagasaki
University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto,
Nagasaki 852-8501, Japan
(Miyazaki) Department of Thoracic Surgery, Sasebo City General Hospital,
Sasebo, Japan
(Sato) Department of General Thoracic, Breast, and Pediatric Surgery,
Fukuoka University School of Medicine, Fukuoka, Japan
(Sano) Department of Respiratory Surgery, The Japanese Red Cross Nagasaki
Genbaku Hospital, Nagasaki, Japan
(Furukawa) Department of Thoracic Surgery, Ehime Prefectural Central
Hospital, Matsuyama, Japan
(Shimoyama) Chest Surgery, National Hospital Organization Nagasaki Medical
Center, Omura, Japan
(Kamohara) Department of Thoracic Surgery, Oita Prefectural Hospital,
Oita, Japan
(Suzuki) Department of Thoracic Surgery, Kumamoto University Hospital,
Kumamoto, Japan
(Kondou) Department of Thoracic and Breast Surgery, Ureshino Medical
Center, Ureshino, Japan
(Ikeda) Department of Surgery, Tokyo Medical University, Tokyo, Japan
(Tabata) Primary Medical Science Department, Daiichi Sankyo Co., Ltd,
Tokyo, Japan
(Shiosakai) Data Intelligence Department, Daiichi Sankyo Co., Ltd, Tokyo,
Japan
Publisher
BioMed Central Ltd
Abstract
Background: For chronic pain after thoracic surgery, optimal timing of its
diagnosis and effective treatment remains unresolved, although several
treatment options are currently available. We examined the efficacy and
safety of mirogabalin, in combination with conventional pain therapy
(nonsteroidal anti-inflammatory drugs and/or acetaminophen), for treating
peripheral neuropathic pain (NeP) after thoracic surgery. Method(s):
In this multicenter, randomized, open-label, parallel-group study,
patients with peripheral NeP were randomly assigned 1:1 to mirogabalin as
add-on to conventional therapy or conventional treatment alone.
 Result(s): Of 131 patients of consent obtained, 128 were randomized
(mirogabalin add-on group, 63 patients; conventional treatment group, 65
patients). The least squares mean changes (95% confidence interval [CI])
in Visual Analogue Scale (VAS) score for pain intensity at rest from
baseline to Week 8 (primary endpoint) were - 51.3 (- 54.9, - 47.7) mm in
the mirogabalin add-on group and - 47.7 (- 51.2, - 44.2) mm in the
conventional group (between-group difference: - 3.6 [95% CI: - 8.7, 1.5],
P = 0.161). However, in patients with Self-administered Leeds Assessment
of Neuropathic Symptoms and Signs (S-LANSS) score (used for the screening
of NeP) >= 12 at baseline, the greater the S-LANSS score at baseline, the
greater the decrease in VAS score in the mirogabalin add-on group, while
no such trend was observed in the conventional treatment group (post hoc
analysis). This between-group difference in trends was statistically
significant (interaction P value = 0.014). Chronic pain was recorded in
7.9% vs. 16.9% of patients (P = 0.171) at Week 12 in the mirogabalin
add-on vs. conventional treatment groups, respectively. Regarding
activities of daily living (ADL) and quality of life (QOL), changes in
Pain Disability Assessment Scale score and the EQ-5D-5L index value from
baseline to Week 8 showed significant improvement in the mirogabalin
add-on group vs. conventional treatment group (P < 0.001). The most common
adverse events (AEs) in the mirogabalin add-on group were dizziness
(12.7%), somnolence (7.9%), and urticaria (3.2%). Most AEs were mild or
moderate in severity. Conclusion(s): Addition of mirogabalin to
conventional therapy did not result in significant improvement in pain
intensity based on VAS scores, but did result in significant improvement
in ADL and QOL in patients with peripheral NeP after thoracic surgery.
Trial registration: Japan Registry of Clinical Trials jRCTs071200053
(registered 17/11/2020). Copyright © 2024, The Author(s).

<66>
Accession Number
2029767353
Title
Surgical management of atrial fibrillation in patients undergoing cardiac
surgery: a systematic review of clinical practice guidelines and
recommendations.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 10(1) (pp
14-24), 2024. Date of Publication: 01 Jan 2024.
Author
Kumar N.S.; Khanji M.Y.; Patel K.P.; Ricci F.; Providencia R.; Chahal A.;
Sohaib A.; Awad W.I.
Institution
(Kumar, Khanji, Patel, Awad) Barts Heart Centre, St. Bartholomew's
Hospital, London, United Kingdom
(Kumar) National Medical Research Association, London, United Kingdom
(Khanji) Newham University Hospital, Barts Health NHS Trust, London,
United Kingdom
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Patel) Institute of Cardiovascular Sciences, University College London,
United Kingdom
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
G.d'Annunzio University of Chieti-Pescara, Chieti, Italy
(Providencia) Department of Cardiac Electrophysiology, Barts Heart Centre,
St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
(Chahal) Division of Cardiology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Sohaib) NHLI, Imperial College London, London, United Kingdom
(Awad) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Awad) University of South Wales, Cardiff, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Surgical ablation of atrial fibrillation (AF) has been demonstrated
to be a safe procedure conducted concomitantly alongside cardiac surgery.
However, there are conflicting guideline recommendations surrounding
indications for surgical ablation. We conducted a systematic review of
current recommendations on concomitant surgical AF ablation. Methods and
results We identified publications from MEDLINE and EMBASE between January
2011 and December 2022 and additionally searched Guideline libraries and
websites of relevant organizations in accordance with Preferred Reporting
Items for Systematic Reviews and Meta-Analyses guidelines. Of 895 studies
screened, 4 were rigorously developed (AGREE-II > 50%) and included. All
guidelines agreed on the definitions of paroxysmal, persistent, and
longstanding AF based on duration and refraction to current treatment
modalities. In the Australia-New Zealand (CSANZ) and European (EACTS)
guidelines, opportunistic screening for patients >65 years is recommended.
The EACTS recommends systematic screening for those aged >75 or at high
stroke risk (Class IIa, Level B). However, this was not recommended by
American Heart Association or Society of Thoracic Surgeons guidelines. All
guidelines identified surgical AF ablation during concomitant cardiac
surgery as safe and recommended for consideration by a Heart Team with
notable variation in recommendation strength and the specific indication
(three guidelines fail to specify any indication for surgery). Only the
STS recommended left atrial appendage occlusion (LAAO) alongside surgical
ablation (Class IIa, Level C). Conclusion Disagreements exist in
recommendations for specific indications for concomitant AF ablation and
LAAO, with the decision subject to Heart Team assessment. Further evidence
is needed to develop recommendations for specific indications for
concomitant AF procedures and guidelines need to be made
congruent. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<67>
Accession Number
2029766746
Title
Long-term surgical outcomes of congenital supravalvular aortic stenosis: a
systematic review, meta-analysis and microsimulation study.
Source
European Journal of Cardio-thoracic Surgery. 65(1) (no pagination), 2024.
Article Number: ezad360. Date of Publication: 01 Jan 2024.
Author
Meccanici F.; Notenboom M.L.; Meijssen J.; Smit V.; Van De Woestijne P.C.;
Van Den Bosch A.E.; Helbing W.A.; Bogers A.J.J.C.; Takkenberg J.J.M.;
Roos-Hesselink J.W.
Institution
(Meccanici, Meijssen, Smit, Van Den Bosch, Roos-Hesselink) Department of
Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands
(Notenboom, Van De Woestijne, Bogers, Takkenberg) Department of
Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam,
Netherlands
(Helbing) Department of Paediatrics, Division of Paediatric Cardiology,
Erasmus University Medical Centre, Rotterdam, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Congenital supravalvular aortic stenosis (SVAS) is a rare form
of congenital outflow tract obstruction and long-term outcomes are
scarcely reported. This study aims to provide an overview of outcomes
after surgical repair for congenital SVAS. METHOD(S): A systematic
review of published literature was conducted, including observational
studies reporting long-term clinical outcome (>2 years) after SVAS repair
in children or adults considering >20 patients. Early risks, late event
rates and time-to-event data were pooled and entered into a
microsimulation model to estimate 30-year outcomes. Life expectancy was
compared to the age-, sex- and origin-matched general population.
 RESULT(S): Twenty-three publications were included, encompassing a
total of 1472 patients (13 125 patient-years; pooled mean follow-up: 9.0
(6.2) years; median follow-up: 6.3 years). Pooled mean age at surgical
repair was 4.7 (5.8) years and the most commonly used surgical technique
was the single-patch repair (43.6%). Pooled early mortality was 4.2% (95%
confidence interval: 3.2-5.5%) and late mortality was 0.61% (95% CI:
0.45-0.83) per patient-year. Based on microsimulation, over a 30-year time
horizon, it was estimated that an average patient with SVAS repair (mean
age: 4.7 years) had an observed life expectancy that was 90.7% (95%
credible interval: 90.0-91.6%) of expected life expectancy in the matched
general population. The microsimulation-based 30-year risk of myocardial
infarction was 8.1% (95% credible interval: 7.3-9.9%) and reintervention
31.3% (95% credible interval: 29.6-33.4%), of which 27.2% (95% credible
interval: 25.8-29.1) due to repair dysfunction. CONCLUSION(S): After
surgical repair for SVAS, 30-year survival is lower than the
matched-general-population survival and the lifetime risk of
reintervention is considerable. Therefore, lifelong monitoring of the
cardiovascular system and in particular residual stenosis and coronary
obstruction is recommended. Copyright © 2023 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<68>
Accession Number
2029708566
Title
Ischemia testing and revascularization in patients with monomorphic
ventricular tachycardia: A relic of the past?.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102358. Date of Publication: March 2024.
Author
Milaras N.; Kordalis A.; Tsiachris D.; Sakalidis A.; Ntalakouras I.;
Pamporis K.; Dourvas P.; Apostolos A.; Sotiriou Z.; Arsenos P.;
Archontakis S.; Tsioufis K.; Gatzoulis K.; Sideris S.
Institution
(Milaras, Ntalakouras, Pamporis, Dourvas, Archontakis, Sideris) State
Department of Cardiology, "Hippokration" General Hospital of Athens,
Greece
(Milaras, Kordalis, Tsiachris, Sakalidis, Apostolos, Sotiriou, Arsenos,
Tsioufis, Gatzoulis) School of Medicine, National and Kapodistrian
University of Athens, Hippokration General Hospital, Vasilissis Sofias
114, Athens 11527, Greece
Publisher
Elsevier Inc.
Abstract
Testing for myocardial ischemia in patients presenting with sustained
monomorphic Ventricular Tachycardia(VT) even without evidence of acute
myocardial infarction is a tempting strategy that is frequently utilized
in clinical practice. Monomorphic VT is mainly caused by re-entry around
chronic myocardial scar and active ischemia has no role in its
pathogenesis, thus making testing for ischemia futile, at least in theory.
This systematic literature review sought to address the usefulness of
ischemia testing (mainly coronary angiography) in patients presenting with
monomorphic VT through 8 selected studies after evaluating a total of 130
published manuscripts. Particularly, we sought to unveil whether coronary
angiography and possibly concomitant revascularization leads to lesser
tachycardia recurrence. Our conclusion can be summarized as follows: this
approach whether combined with revascularization or not, does not seem to
reduce VT recurrence nor does it affect mortality in such patients. Even
though most of the published literature points at this direction,
validation from randomized controlled trials is imperative. Copyright
© 2023 Elsevier Inc.

<69>
[Use Link to view the full text]
Accession Number
2029637288
Title
Duration of Dual Antiplatelet Treatment after Percutaneous Coronary
Intervention in Patients with Diabetes: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiovascular Pharmacology. 83(1) (pp 64-72), 2024. Date of
Publication: 14 Jan 2024.
Author
Apostolos A.; Travlos C.; Tsioulos G.; Chlorogiannis D.-D.; Karanasos A.;
Papafaklis M.; Alexopoulos D.; Toutouzas K.; Davlouros P.; Tsigkas G.
Institution
(Apostolos, Karanasos, Toutouzas) First Department of Cardiology, Medical
School, National and Kapodistrian University of Athens, Hippokration
General Hospital of Athens, Athens, Greece
(Apostolos, Travlos, Tsioulos, Karanasos, Papafaklis, Davlouros, Tsigkas)
Department of Cardiology, Faculty of Medicine, University of Patras,
University Hospital of Patras, Patras, Greece
(Chlorogiannis) Department of Radiology, Brigham and Women's Hospital,
Boston, MA, United States
(Alexopoulos) Second Department of Cardiology, Medical School, National
and Kapodistrian University of Athens, Attikon University Hospital of
Patras, Athens, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Aim of our systematic review and meta-analysis is to compare shortened
(<=3 months) dual antiplatelet therapy (DAPT) with longer DAPT in diabetic
patients undergoing percutaneous coronary interventions.We systematically
screened 3 major databases (MEDLINE, Cochrane Central Register of
Controlled Trials, and Scopus) searching for randomized-controlled trials
or subanalyses of them, which compared shortened DAPT (S-DAPT) with longer
DAPT regimens of DAPT. Primary end point of systematic review and
meta-analysis is the net adverse clinical events (NACE), and secondary are
major adverse cardiac events (MACE), mortality, bleedings, myocardial
infarction, and stent thrombosis. Subgroup analyses included studies using
only ticagrelor-based regimens and 3-month duration of DAPT.A total of 8
studies and 12,665 patients were included in our analysis. Our
meta-analysis met its primary end point because S-DAPT was associated
significantly with a reduced risk ratio (RR) by 17% [RR: 0.83, 95%
confidence intervals (CI), 0.72-0.96]. Nonsignificant difference among the
rest end points was detected between the 2 groups. Subgroup analyses
showed that ticagrelor-based regimens were associated with a significant
reduction of mortality (RR: 0.67, 95% CI, 0.48-0.93) and 3-month DAPT
reduced furtherly NACE by 27% (RR: 0.73, 95% CI, 0.60-0.89).In conclusion,
our systematic review and meta-analysis showed that (i) S-DAPT was
significantly associated with a lower incidence of NACE, (ii)
ticagrelor-based S-DAPT was associated with decreased mortality rates, and
(iii) the benefit of 3-month duration of DAPT achieved an even greater
NACE reduction. Thus, S-DAPT could be considered as a safe and feasible
option in diabetic patients. Copyright © 2024 Lippincott Williams
and Wilkins. All rights reserved.

<70>
Accession Number
2029632752
Title
Comparison of Ticagrelor and Clopidogrel in Elective Coronary Stenting: A
Double Blind Randomized Clinical Trial.
Source
Journal of Interventional Cardiology. 2023 (no pagination), 2023. Article
Number: 5544440. Date of Publication: 2023.
Author
Mehdizadeh Parizi M.; Golchin Vafa R.; Ahmadi A.; Heydarzade R.; Sadeghi
M.; Khademolhossseini A.; Amiri F.; Khoshnood Mansorkhani S.; Tavan A.;
Hosseini N.; Montaseri M.; Hosseini S.A.; Kojuri J.
Institution
(Mehdizadeh Parizi, Golchin Vafa, Ahmadi, Heydarzade, Sadeghi,
Khademolhossseini, Amiri, Khoshnood Mansorkhani, Tavan, Hosseini,
Montaseri, Hosseini, Kojuri) Professor Kojuri Cardiology Clinic, Shiraz,
Iran, Islamic Republic of
(Kojuri) Cardiology Department, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Kojuri) Clinical Education Research Center, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Hindawi Limited
Abstract
Background. Dual antiplatelet therapy with a P2Y12 inhibitor (e.g.,
clopidogrel and ticagrelor) and aspirin is recommended for at least one
year after percutaneous coronary intervention (PCI) to prevent further
myocardial infarction and stent thrombosis as the major adverse effects of
PCI. Methods. This randomized clinical trial was conducted from October
2022 to March 2023. Patients who had undergone elective PCI were included
in the study. Patients were randomized into two different groups. One
group took ASA 80 mg and clopidogrel 75 mg once daily, while the other
took ASA 80 mg once daily and ticagrelor 90 mg twice daily. After six
months of close follow-up, patients were asked to score their dyspnea on a
10-point Likert scale. They were also asked about dyspnea on exertion,
paroxysmal nocturnal dyspnea (PND), bleeding, and the occurrence of major
adverse cardiovascular events (MACEs). Results. 223 patients were
allocated to the clopidogrel group and 214 to the ticagrelor group. In the
ticagrelor group, 95 patients (44.3%) reported dyspnea at rest, compared
with only 44 patients (19.7%) in the clopidogrel group (P < 0.001). MACEs
occurred in 7 patients (2.8%) in the ticagrelor group, compared with 16
(7.6%) in the clopidogrel group (P = 0.031). Eight patients (3.8%)
reported bleeding with ticagrelor, as did seven (3.2%) with clopidogrel (P
= 0.799). Conclusions. New-onset dyspnea was recorded more frequently with
ticagrelor than clopidogrel, yet fewer MACEs occurred with ticagrelor
(ClinicalTrials.gov number: NCT05858918). Copyright © 2023
Mohammadjavad Mehdizadeh Parizi et al.

<71>
Accession Number
2029490000
Title
Betamethasone as an Adjuvant in Paravertebral Block, A Double Blinded
Randomized Controlled Trial in Laparoscopic Cholecystectomy.
Source
Journal of Cardiovascular Disease Research. 14(8) (pp 2689-2697), 2023.
Date of Publication: 2023.
Author
Selvakumar R.; Sivaprasath S.; Sudhakar D.S.; Agalya I.
Institution
(Selvakumar) Department of Anaesthesiology, Government medical College
Hospital, Karur, India
(Sivaprasath) Department of Anaesthesiology, Madurai Medical College,
Madurai, India
(Sudhakar) Department of Anaesthesiology, Government Pudukottai Medical
College, Pudukottai, India
(Agalya) Kalaiyarkoil Government Hospital, Tamil Nadu, Sivagangai, India
Publisher
EManuscript Technologies
Abstract
Background: Despite its wide use in thoracic procedures, effectiveness of
unilateral paravertebral block for laparoscopic cholecystectomy yet to be
studied widely. This study is to assess the effectiveness of PVB with
additives for acute postoperative pain management. Materials And Methods:
Eligible patients were divided into two groups randomly. One group
received Ropivacaine alone and other group received Ropivacaine with
betamethasone. Both groups were given USG PVB at T7 level and induced
general anaesthesia. Primary outcome was to measure the duration of TPVB.
Secondary outcome was to assess post of pain relief, intra operative
hemodynamics and time to rescue analgesia. Result(s): The
betamethasone-Ropivacaine group had a much more prolonged duration pain
relief than the plain Ropivacaine group. The duration of analgesia was
significantly prolonged in group receiving betamethasone -Ropivacaine
thoracic paravertebral block. The amount of rescue analgesia, frequency of
analgesics and total dosage of drugs were significantly lower with
betamethasone Ropivacaine group when compared with Ropivacaine group.
 Conclusion(s): Betamethasone sodium phosphate with Ropivacaine in
ultrasound guided thoracic paravertebral block provides significantly
better analgesia postoperatively in laparoscopic cholecystectomy surgeries
in comparison with plain Ropivacaine. Copyright © 2023
EManuscript Technologies. All rights reserved.

<72>
Accession Number
2028334480
Title
Management of Adults With Anomalous Aortic Origin of the Coronary
Arteries: State-of-the-Art Review.
Source
Annals of Thoracic Surgery. 116(6) (pp 1124-1141), 2023. Date of
Publication: December 2023.
Author
Gaudino M.; Di Franco A.; Arbustini E.; Bacha E.; Bates E.R.; Cameron
D.E.; Cao D.; David T.E.; De Paulis R.; El-Hamamsy I.; Farooqi K.M.;
Girardi L.N.; Grani C.; Kochav J.D.; Molossi S.; Puskas J.D.; Rao S.V.;
Sandner S.; Tatoulis J.; Truong Q.A.; Weinsaft J.W.; Zimpfer D.; Mery C.M.
Institution
(Gaudino, Di Franco, Girardi) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, New York, United States
(Arbustini) Transplant Research Area and Centre for Inherited
Cardiovascular Diseases, Scientific Department, IRCCS and Polyclinic San
Matteo Foundation, Pavia, Italy
(Bacha) Division of Cardiac, Thoracic, and Vascular Surgery, Columbia
University Medical Center/New York-Presbyterian Hospital, New York, New
York, United States
(Bates) Cardiovascular Center, University of Michigan, Michigan Medicine,
Ann Arbor, MI, United States
(Cameron) Division of Cardiac Surgery, Corrigan Minehan Heart Center,
Massachusetts General Hospital, Boston, Massachusetts, United States
(Cao) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, New York, United States
(Cao) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(David) Department of Surgery, University of Toronto, Toronto, ON, Canada
(De Paulis) Department of Cardiac Surgery, European Hospital, Rome, Italy
(De Paulis) UniCamillus University, Rome, Italy
(El-Hamamsy, Puskas) Department of Cardiovascular Surgery, Mount Sinai
Hospital and Icahn School of Medicine at Mount Sinai, New York, New York,
United States
(Farooqi) Division of Pediatric Cardiology, New York-Presbyterian,
Columbia University Irving Medical Center, New York, New York, United
States
(Grani) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Kochav) Division of Cardiology, Columbia University Irving Medical
Center, New York, New York, United States
(Molossi) Division of Pediatric Cardiology, Texas Children's Hospital,
Baylor College of Medicine, Houston, Texas, United States
(Rao) Division of Interventional Cardiology, NYU Langone Health, New York,
New York, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, VIC, Australia
(Truong) Department of Radiology, New York Presbyterian, Weill Cornell
Medicine, New York, New York, United States
(Weinsaft) Greenberg Cardiology Division, Department of Medicine, Weill
Cornell Medical College, New York, New York, United States
(Zimpfer) Division of Cardiac Surgery, Department of Surgery, Medical
University of Graz, Graz, Austria
(Mery) Texas Center for Pediatric and Congenital Heart Disease, Dell
Medical School at The University of Texas at Austin/Dell Children's
Medical Center, Austin, Texas, United States
Publisher
Elsevier Inc.
Abstract
As a result of increasing adoption of imaging screening, the number of
adult patients with a diagnosis of anomalous aortic origin of the coronary
arteries (AAOCA) has grown in recent years. Existing guidelines provide a
framework for management and treatment, but patients with AAOCA present
with a wide range of anomalies and symptoms that make general
recommendations of limited applicability. In particular, a large spectrum
of interventions can be used for treatment, and there is no consensus on
the optimal approach to be used. In this paper, a multidisciplinary group
of clinical and interventional cardiologists and cardiac surgeons
performed a systematic review and critical evaluation of the available
evidence on the interventional treatment of AAOCA in adult patients. Using
a structured Delphi process, the group agreed on expert recommendations
that are intended to complement existing clinical practice
guidelines. Copyright © 2023 American College of Cardiology and
The Society of Thoracic Surgeons

<73>
Accession Number
2027930079
Title
The effect of pituitrin on postoperative outcomes in patients with
pulmonary hypertension undergoing cardiac surgery: a study protocol for a
randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1269624. Date of Publication: 2023.
Author
Kong L.; Lv M.; Qiao C.-L.; Sun X.-X.; Du W.-Y.; Li Q.
Institution
(Kong, Li) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Shandong First Medical University, Shandong Provincial
Qianfoshan Hospital, Shandong Engineering Research Center for Health
Transplant and Material, Shangdong Province, Jinan, China
(Kong) Shandong First Medical University, Shandong Academy of Medical
Sciences, Jinan, China
(Lv) Anesthesiology Department, Shandong Provincial Hospital Affiliated to
Shandong First Medical University, Shandong Province, Jinan, China
(Qiao, Du) Department of Anesthesiology, The First Affiliated Hospital of
Shandong First Medical University, Shandong Province, Jinan, China
(Sun) Shandong Provincial Third Hospital, Cheeloo College of Medicine,
Shandong University, Shandong Province, Jinan, China
Publisher
Frontiers Media SA
Abstract
Background: The vasoplegic syndrome is one of the major consequences of
cardiac surgery. If pulmonary hypertension is additionally involved with
vasoplegic syndrome, circulation management becomes much more complicated.
According to previous studies, pituitrin (a substitute for vasopressin,
which contains vasopressin and oxytocin) not only constricts systemic
circulation vessels and increases systemic circulation pressure but also
likely decreases pulmonary artery pressure and pulmonary vascular
resistance. The aim of this study is to investigate whether pituitrin is
beneficial for the postoperative outcomes in patients with pulmonary
hypertension undergoing cardiac surgery. Methods and analysis: The
randomized controlled trial will include an intervention group
continuously infused with 0.04 U/(kg h) of pituitrin and a control group.
Adult patients with pulmonary hypertension undergoing elective cardiac
surgery will be included in this study. Patients who meet the conditions
and give their consent will be randomly assigned to the intervention group
or the control group. The primary outcome is the composite endpoint of
all-cause mortality within 30 days after surgery or common complications
after cardiac surgery. Secondary outcomes include the incidence of other
postoperative complications, length of hospital stay, and so on.
 Discussion(s): Pituitrin constricts systemic circulation vessels,
increases systemic circulation pressure, and may reduce pulmonary artery
pressure and pulmonary vascular resistance, which makes it a potentially
promising vasopressor during the perioperative period in patients with
pulmonary hypertension. Therefore, evidence from randomized controlled
trials is necessary to elucidate whether pituitrin influences outcomes in
patients with pulmonary hypertension following cardiac
surgery. Copyright 2024 Kong, Lv, Qiao, Sun, Du and Li.

<74>
Accession Number
2027345636
Title
Ultrasound Guided Bilateral Transverse Thoracic Plane Block for Patient
Undergoing Cardiac Surgery.
Source
International Journal of Pharmaceutical and Clinical Research. 15(12) (pp
1321-1325), 2023. Date of Publication: 2023.
Author
Azmi N.; Bhalerao V.P.; Chouhan R.S.; Singh A.
Institution
(Azmi, Singh) Department of Anaesthesia, SAMC and PGI, MP, Indore, India
(Bhalerao) Department of Forensic Medicine, Government Medical College,
Maharashtra, Nagpur, India
(Chouhan) District Hospital, MP, Shivpuri, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background and Objectives: The management of postoperative pain in
patients following cardiac surgery mostly relied on opioids. However, the
desired outcomes could not be attained due to the adverse consequences
associated with opioids. The implementation of the multimodal analgesic
strategy has been developed to mitigate the undesirable consequences of
opioids and provide optimal pain relief. The objective of this study was
to assess the impact of ultrasound-guided bilateral thoracic plane block
on patients having cardiac surgery. Material(s) and Method(s): This
prospective, randomized, double-blind study was conducted in the
Department of Anesthesiology and Critical Care, Sri Aurobindo Institute of
Medical Sciences Hospital, Indore (M.P) among 100 Patients of 18-70 years
scheduled for elective cardiac surgeries. After explaining the protocol to
all patients, a written and informed consent was taken from all patients.
The patients were allocated into two groups using computer-generated
random numbers: the Intervention group [Group T], that had a bilateral
transversus thoracic muscle plane block guided by ultrasonography with
20ml of 0.25% ropivacaine, and the Control group [Group C], which
underwent a sham block. Primary outcome was to observe the pain score and
first need of rescue analgesic inj. Tramadol. The secondary outcomes were
pain score, Total analgesic requirement in 24 hr, time to extubation, and
ICU stays. Result(s): The control group had a considerably shorter
time prior to the first request for pain management (median 3 hours)
compared to group T (median 14 hours). Within the 0.5-24 hour period after
surgery, the group T observed a decrease of 1.86 units in pain scores at
rest. The estimated decrease was-1.80, with a 95% confidence interval
ranging from-2.14 to-1.45. The t-value was-10.323, and the p-value was
less than 0.0001. Postoperative tramadol consumption was found to be
significantly lower in Group T (p < 0.001). Conclusion(s): The
bilateral transversus thoracic muscle plane block (TTMPB) is a very
promising and successful method for minimizing opioid consumption and
managing post-sternotomy pain in patients who underwent cardiac
surgery. Copyright © 2023, Dr. Yashwant Research Labs Pvt. Ltd..
All rights reserved.

<75>
Accession Number
2026784247
Title
Endovascular Treatment of Type A Aortic Dissection: A Systematic Review
and Meta-Analysis Using Reconstructed Time-to-Event Data.
Source
Journal of Clinical Medicine. 12(22) (no pagination), 2023. Article
Number: 7051. Date of Publication: November 2023.
Author
Mylonas K.S.; Zoupas I.; Tasoudis P.T.; Vitkos E.; Stavridis G.T.;
Avgerinos D.V.
Institution
(Mylonas, Stavridis, Avgerinos) Department of Cardiac Surgery, Onassis
Cardiac Surgery Center, Athens 176 74, Greece
(Mylonas, Zoupas) School of Medicine, National and Kapodistrian University
of Athens, Mikras Asias Str. 75, Athens 115 27, Greece
(Zoupas, Tasoudis) Surgery Working Group, Society of Junior Doctors,
Athens 151 23, Greece
(Vitkos) Department of General Surgery, General Hospital of Katerini,
Katerini 601 00, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: The undisputed gold standard of treatment for type A aortic
dissections (TAAD) is open surgery. Anecdotal reports have assessed
thoracic endovascular aortic repair (TEVAR) as a last resort for highly
selected candidates. The present study aims to evaluate endovascular
outcomes in TAAD patients who are unsuitable for open surgery whilst
having TEVAR-compatible aortic anatomy. Method(s): A PRISMA-compliant
systematic search of the PubMed, Scopus, and Cochrane databases was
performed up to 19 May 2022. Time-to-event data were reconstructed using
Kaplan-Meier curves from the source literature. Result(s): In 20
eligible studies, 311 patients underwent TEVAR for acute, subacute, or
chronic TAAD. Mean age at the time of the operation was 60.70 +/- 8.00
years and 75.48% (95% Confidence Interval [CI], 60.33-88.46%) of the
included patients were males. Mean operative time was 169.40 +/- 30.70
min. Overall, 0.44% (95% CI, 0.00-4.83%) of the cases were converted to
salvage open surgery. Technical failure, stroke, and endoleaks occurred in
0.22%, 0.1%, and 8.52% of the cohort, respectively. Thirty-day
postoperative complication rate was 7.08% (95% CI, 1.52-14.97%), whereas
late complications developed in 16.89% (95% CI, 7.75-27.88%) of the
patients. One-, three-, and five-year survival rates were estimated at
87.15%, 82.52% and 82.31%, respectively. Reintervention was required in
8.38% of the cohort over a mean follow-up of 32.40 +/- 24.40 months.
 Conclusion(s): TEVAR seems to be feasible in highly selected patients
with TAAD who cannot tolerate open surgery. Overcoming technical
limitations and acquiring long-term data are warranted to safely define
the place of endovascular treatment in the armamentarium of TAAD
repair. Copyright © 2023 by the authors.

<76>
Accession Number
2026748805
Title
Computed tomography derived anatomical predictors of vascular access
complications following transfemoral transcatheter aortic valve
implantation: A systematic review.
Source
Catheterization and Cardiovascular Interventions. 103(1) (pp 169-185),
2024. Date of Publication: 01 Jan 2024.
Author
Androshchuk V.; Chehab O.; Prendergast B.; Rajani R.; Patterson T.;
Redwood S.
Institution
(Androshchuk, Chehab, Patterson, Redwood) School of Cardiovascular
Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College
London, London, United Kingdom
(Androshchuk, Chehab, Prendergast, Rajani, Patterson, Redwood) Department
of Cardiology, St Thomas' Hospital, King's College London, London, United
Kingdom
(Rajani) School of Biomedical Engineering and Imaging Sciences, Faculty of
Life Sciences & Medicine, King's College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Vascular complications after percutaneous transfemoral
transcatheter aortic valve implantation (TAVI) are associated with adverse
clinical outcomes and remain a significant challenge. Aim(s): The
purpose of this review is to synthesize the existing evidence regarding
the iliofemoral artery features predictive of vascular complications after
TAVI on pre-procedural contrast-enhanced multidetector computed tomography
(MDCT). Method(s): A systematic search was performed in Embase and
Medline (Pubmed) databases. Studies of patients undergoing transfemoral
TAVI with MDCT were included. Studies with only valve-in-valve TAVI,
planned surgical intervention and those using fluoroscopic assessment were
excluded. Data on study cohort, procedural characteristics and significant
predictors of vascular complications were extracted. Result(s): We
identified 23 original studies involving 8697 patients who underwent TAVI
between 2006 and 2020. Of all patients, 8514 (97.9%) underwent
percutaneous transfemoral-TAVI, of which 8068 (94.8%) had
contrast-enhanced MDCT. The incidence of major vascular complications was
6.7 +/- 4.1% and minor vascular complications 26.1 +/- 7.8%. Significant
independent predictors of major and minor complications related to vessel
dimensions were common femoral artery depth (>54 mm),
sheath-to-iliofemoral artery diameter ratio (>0.91-1.19),
sheath-to-femoral artery diameter ratio (>1.03-1.45) and sheath-to-femoral
artery area ratio (>1.35). Substantial iliofemoral vessel tortuosity
predicted 2-5-fold higher vascular risk. Significant iliofemoral
calcification predicted 2-5-fold higher risk. The iliac morphology score
was the only hybrid scoring system with predictive value.
 Conclusion(s): Independent iliofemoral predictors of access-site
complications in TAVI were related to vessel size, depth, calcification
and tortuosity. These should be considered when planning transfemoral TAVI
and in the design of future risk prediction models. Copyright ©
2023 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<77>
Accession Number
2026541939
Title
Five-Year Efficacy and Safety of TiNO-Coated Stents Versus Drug-Eluting
Stents in Acute Coronary Syndrome: A Meta-Analysis.
Source
Journal of Clinical Medicine. 12(21) (no pagination), 2023. Article
Number: 6952. Date of Publication: November 2023.
Author
Daoud F.C.; Catargi B.; Karjalainen P.P.; Gerbaud E.
Institution
(Daoud, Catargi) Endocrinology-Metabolic Diseases, Hopital Saint-Andre,
Bordeaux University, Bordeaux 33000, France
(Karjalainen) Cardiac Unit, Heart and Lung Center, Helsinki University
Hospital, Helsinki University, Helsinki 00280, Finland
(Gerbaud) Cardiology Intensive Care Unit and Interventional Cardiology,
Hopital Cardiologique du Haut-Leveque, Pessac 33604, France
(Gerbaud) Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux
University, Bordeaux 33076, France
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: Percutaneous coronary interventions (PCI) in patients with
acute coronary syndrome (ACS) are performed with
titanium-nitride-oxide-coated stents (TiNOSs) or drug-eluting stents
(DESs). The initial completion of this prospective systematic literature
review (SLR) of prospective randomized controlled trials (RCTs) showed
that TiNOSs are non-inferior to DESs in major adverse cardiac event (MACE)
rates and present a lower risk of recurrent myocardial infarction (MI) at
1-year follow-up. This iteration of the SLR protocol performs the critical
assessment of 5-year follow-up outcomes with clinical validity and
generalizability assessments. (2) Methods: The previously described SLR
and meta-analysis protocol, per PRISMA, Cochrane methods, and GRADE, was
applied to 5-year follow-up outcomes. (3) Results: Three RCTs were
eligible, comprising 1620 patients with TiNOS vs. 1123 with DES. The
pooled risk ratios (RRs) and 95% confidence intervals were MACE 0.82
[0.68, 0.99], MI 0.58 [0.44, 0.78], cardiac death (CD) 0.46 [0.28, 0.76],
ischemia-driven target lesion revascularization (TLR) 1.03 [0.79, 1.33],
probable or definite stent thrombosis (ST) 0.32 [0.21, 0.59], and
all-cause mortality (TD) 0.84 [0.63, 1.12]. The evidence certainty was
high in MACE, CD, MI, and ST, and moderate in TLR and TD. (4)
 Conclusion(s): TiNOSs in ACS at 5-year follow-up appear safer than
DESs and equally efficacious. The pooled RRs stratified by clinical
presentation and stent type will be required to test this meta-analysis's
clinical validity and generalize its results to patient populations with
varying proportions of clinical presentations and DES
options. Copyright © 2023 by the authors.

<78>
Accession Number
2026449270
Title
Impact of intracardiac echocardiography versus transesophageal
echocardiography guidance on left atrial appendage occlusion procedures: A
meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. 35(1) (pp 44-57), 2024. Date
of Publication: January 2024.
Author
Diaz J.C.; Bastidas O.; Duque M.; Marin J.E.; Aristizabal J.; Nino C.D.;
Hoyos C.; Matos C.D.; Gabr M.; Steiger N.A.; Kapur S.; Sauer W.H.; Romero
J.E.
Institution
(Diaz) Cardiac Arrhythmia and Electrophysiology Service, Universidad CES
Medical School, Division of Cardiology, Clinica Las Vegas, Medellin,
Colombia
(Bastidas, Nino) Cardiac Arrhythmia and Electrophysiology Service,
Hospital Pablo Tobon Uribe, Medellin, Colombia
(Duque, Aristizabal) Cardiac Electrophysiology Service, Hospital San
Vicente Fundacion, Rionegro, Colombia
(Marin) Department of Medicine, Cardiac Arrhythmia and Electrophysiology
Service, Division of Cardiology, Clinica Las Americas, Medellin, colombia,
Medellin, Colombia
(Hoyos, Matos, Gabr, Steiger, Kapur, Sauer, Romero) Cardiac Arrhythmia
Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Intracardiac echocardiography (ICE) is increasingly used
during left atrial appendage occlusion (LAAO) as an alternative to
transesophageal echocardiography (TEE). The objective of this study is to
evaluate the impact of ICE versus TEE guidance during LAAO on procedural
characteristics and acute outcomes, as well the presence of peri-device
leaks and residual septal defects during follow-up. Method(s): All
studies comparing ICE-guided versus TEE-guided LAAO were identified. The
primary outcomes were procedural efficacy and occurrence of
procedure-related complications. Secondary outcomes included lab
efficiency (defined as a reduction in in-room time), procedural time,
fluoroscopy time, and presence of peri-device leaks and residual
interatrial septal defects (IASD) during follow-up. Result(s): Twelve
studies (n = 5637) were included. There were no differences in procedural
success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p =.27; I2
= 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p =.25;
I2 = 0%) between the ICE-guided and TEE-guided groups. ICE
guidance reduced in in-room time (mean-weighted 28.6-min reduction in
in-room time) without differences in procedural time or fluoroscopy time.
There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27,
p = 0.64); however, an increased prevalence of residual IASD was observed
with ICE-guided versus TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI
1.05-4.75, p = 0.04). Conclusion(s): ICE guidance is associated with
similar procedural efficacy and safety, but could result in improved lab
efficiency (as established by a significant reduction in in-room time). No
differences in the rate of periprocedural leaks were found. A higher
prevalence of residual interatrial septal defects was observed with ICE
guidance. Copyright © 2023 Wiley Periodicals LLC.

<79>
Accession Number
2024226687
Title
The Added Value of Remote Technology in Cardiac Rehabilitation on Physical
Function, Anthropometrics, and Quality of Life: Cluster Randomized
Controlled Trial.
Source
Journal of Medical Internet Research. 25 (no pagination), 2023. Article
Number: e42455. Date of Publication: 2023.
Author
Lahtio H.; Heinonen A.; Paajanen T.; Sjogren T.
Institution
(Lahtio, Heinonen, Paajanen, Sjogren) Faculty of Sport and Health
Sciences, University of Jyvaskyla, Jyvaskyla, Finland
(Lahtio) LAB University of Applied Sciences, Lahti, Finland
(Paajanen) Finnish Institute for Health and Welfare, Helsinki, Finland
Publisher
JMIR Publications Inc.
Abstract
Background: Cardiovascular diseases (CVDs) cause most deaths globally and
can reduce quality of life (QoL) of rehabilitees with cardiac disease. The
risk factors of CVDs are physical inactivity and increased BMI. With
physical activity, it is possible to prevent CVDs, improve QoL, and help
maintain a healthy body mass. Current literature shows the possibilities
of digitalization and advanced technology in supporting independent
self-rehabilitation. However, the interpretation of the results is
complicated owing to the studies' high heterogeneity. In addition, the
added value of this technology has not been studied well, especially in
cardiac rehabilitation. Objective(s): We aimed to examine the
effectiveness of added remote technology in cardiac rehabilitation on
physical function, anthropometrics, and QoL in rehabilitees with CVD
compared with conventional rehabilitation. Method(s): Rehabilitees
were cluster randomized into 3 remote technology intervention groups
(n=29) and 3 reference groups (n=30). The reference group received
conventional cardiac rehabilitation, and the remote technology
intervention group received conventional cardiac rehabilitation with added
remote technology, namely, the Movendos mCoach app and Fitbit charge
accelerometer. The 12 months of rehabilitation consisted of three 5-day
in-rehabilitation periods in the rehabilitation center. Between these
periods were two 6-month self-rehabilitation periods. Outcome measurements
included the 6-minute walk test, body mass, BMI, waist circumference, and
World Health Organization QoL-BREF questionnaire at baseline and at 6 and
12 months. Between-group differences were assessed using 2-tailed t tests
and Mann-Whitney U test. Within-group differences were analyzed using a
paired samples t test or Wilcoxon signed-rank test. Result(s):
Overall, 59 rehabilitees aged 41 to 66 years (mean age 60, SD 6 years;
n=48, 81% men) were included in the study. Decrement in waist
circumference (6 months: 1.6 cm; P=.04; 12 months: 3 cm; P<.001) and
increment in self-assessed QoL were greater (environmental factors: 0.5;
P=.02) in the remote technology intervention group than the reference
group. Both groups achieved statistically significant improvements in the
6-minute walk test in both time frames (P=.01-.03). Additionally, the
remote technology intervention group achieved statistically significant
changes in the environmental domain at 0-6 months (P=.03) and waist
circumference at both time frames (P=.01), and reference group achieve
statistically significant changes in waist circumference at 0-6 months
(P=.02). Conclusion(s): Remote cardiac rehabilitation added value to
conventional cardiac rehabilitation in terms of waist circumference and
QoL. The results were clinically small, but the findings suggest that
adding remote technology to cardiac rehabilitation may increase beneficial
health outcomes. There was some level of systematic error during
rehabilitation intervention, and the sample size was relatively small.
Therefore, care must be taken when generalizing the study results beyond
the target population. To confirm assumptions of the added value of remote
technology in rehabilitation interventions, more studies involving
different rehabilitees with cardiac disease are required. Copyright
©Heli Lahtio, Ari Heinonen, Teemu Paajanen, Tuulikki Sjogren.
Originally published in the Journal of Medical Internet Research.

<80>
Accession Number
641751050
Title
Analgesic Efficacy of Combined Thoracic Paravertebral Block and Erector
Spinae Plane Block for Video-Assisted Thoracic Surgery: A Prospective
Randomized Clinical Trial.
Source
Medical science monitor : international medical journal of experimental
and clinical research. 29 (pp e940247), 2023. Date of Publication: 06 Jul
2023.
Author
Zhang L.; Hu Y.; Liu H.; Qi X.; Chen H.; Cao W.; Wang L.; Zhang Y.; Wu Y.
Institution
(Zhang, Hu, Qi, Chen, Zhang, Wu) Department of Anesthesiology and
Perioperative Medicine, Second Affiliated Hospital of Anhui Medical
University, Hefei, Anhui, China
(Liu) Department of Anesthesiology and Perioperative Medicine, University
of California Davis Health, Sacramento, CA, United States
(Cao) Department of Cardiothoracic Surgery, Second Affiliated Hospital of
Anhui Medical University, Hefei, Anhui, China
(Wang) Department of Radiology, Second Affiliated Hospital of Anhui
Medical University, Hefei, Anhui, China
Publisher
NLM (Medline)
Abstract
BACKGROUND Thoracic paravertebral block (TPVB) and erector spinae plane
block (ESPB) are widely used in video-assisted thoracic surgery (VATS).
However, they have corresponding adverse effects, including hypotension
for TPVB and unpredictable injectate spread in ESPB. An optimal
perioperative analgesic strategy remains controversial. We investigated
the effect of ultrasound-guided combined TPVB and ESPB (CTEB) for VATS.
MATERIAL AND METHODS A total of 120 patients scheduled for thoracic
surgery were randomized to receive either ultrasound-guided TPVB, ESPB, or
CTEB preoperatively. Postoperative analgesia was achieved with sufentanil
patient-controlled intravenous analgesia. The primary outcome was the
static pain score at 2 h after surgery. RESULTS The static pain score 2 h
postoperatively was significantly different among the 3 groups. This
difference was statistically significant for Group ESPB vs Group TPVB
(P=0.004), but not for Group ESPB vs Group CTEB (P=0.767), or Group TPVB
vs Group CTEB (P=0.117). Group TPVB exhibited the highest incidence of
hypotension among the 3 groups. More patients experienced a sensory loss
in Groups TPVB and CTEB 30 min after the block performance. Patients
receiving CTEB exhibited a lower incidence of chronic pain 6 months
postoperatively than those in Group ESPB. CONCLUSIONS CTEB does not
enhance the analgesic effect of ESPB in patients undergoing VATS; however,
it may induce a faster sensory loss after nerve block and reduce the
incidence of postoperative chronic pain compared with ESPB. CTEB may also
help to reduce the incidence of intraoperative hypotension compared with
TPVB.

<81>
Accession Number
641634237
Title
Safety and efficacy of colchicine for the prevention of post-operative
atrial fibrillation in patients undergoing cardiac surgery: a
meta-analysis of randomized controlled trials.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 25(7)
(no pagination), 2023. Date of Publication: 04 Jul 2023.
Author
Agarwal S.; Beard C.W.; Khosla J.; Clifton S.; Anwaar M.F.; Ghani A.;
Farhat K.; Pyrpyris N.; Momani J.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Jackman W.M.; Po S.; Asad Z.U.A.
Institution
(Agarwal, Beard, Khosla, Anwaar, Ghani, Farhat, Stavrakis, Jackman, Po,
Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, 800 Stanton L Young Blvd, Oklahoma City, OK 73104, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Pyrpyris) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration Hospital, Athens,
Greece
(Momani) Department of Internal Medicine, Alfaisal University, Riyadh,
Saudi Arabia
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: Colchicine is an anti-inflammatory drug that may
prevent post-operative atrial fibrillation (POAF). The effect of this drug
has been inconsistently shown in previous clinical trials. We aimed to
compare the efficacy and safety of colchicine vs. placebo to prevent POAF
in patients undergoing cardiac surgery. METHODS AND RESULTS: A systematic
search of EMBASE, MEDLINE, SCOPUS, ClinicalTrials.gov, and the Cochrane
Library for randomized controlled trials (RCTs) was conducted from
inception till April 2023. The primary outcome was the incidence of POAF
after any cardiac surgery. The secondary outcome was the rate of drug
discontinuation due to adverse events and adverse gastrointestinal events.
Risk ratios (RR) were reported using the Mantel Haenszel method. A total
of eight RCTs comprising 1885 patients were included. There was a
statistically significant lower risk of developing POAF with colchicine
vs. placebo (RR: 0.70; 95% CI: 0.59-0.82; P < 0.01, I2 = 0%), and this
effect persisted across different subgroups. There was a significantly
higher risk of adverse gastrointestinal events (RR: 2.20; 95% CI:
1.38-3.51; P < 0.01, I2 = 55%) with no difference in the risk of drug
discontinuation in patients receiving colchicine vs. placebo (RR: 1.33;
95% CI: 0.93-1.89; P = 0.11, I2 = 0%). CONCLUSION(S): This
meta-analysis of eight RCTs shows that colchicine is effective at
preventing POAF, with a significantly higher risk of adverse
gastrointestinal events but no difference in the rate of drug
discontinuation. Future studies are required to define the optimal
duration and dose of colchicine for the prevention of POAF. Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<82>
Accession Number
640418672
Title
Outcomes of Transcatheter Aortic Valve Implantation Comparing Medtronic's
Evolut PRO and Evolut R: A Systematic Review and Meta-Analysis of
Observational Studies.
Source
International journal of environmental research and public health. 20(4)
(no pagination), 2023. Date of Publication: 15 Feb 2023.
Author
Gozdek M.; Kuzma L.; Dabrowski E.J.; Janiak M.; Pietrzak M.; Skonieczna
K.; Woznica M.; Wydeheft L.; Makhoul M.; Matteucci M.; Litwinowicz R.;
Kowalowka A.; Wanha W.; Pasierski M.; Ronco D.; Massimi G.; Jiritano F.;
Fina D.; Martucci G.; Raffa G.M.; Suwalski P.; Lorusso R.; Meani P.;
Kowalewski M.
Institution
(Gozdek) Department of Cardiology, Hospital of the Ministry of Interior,
72-122 Bydgoszcz, Poland
(Gozdek, Janiak, Pietrzak, Skonieczna, Woznica, Wydeheft, Makhoul,
Matteucci, Litwinowicz, Kowalowka, Wanha, Pasierski, Ronco, Massimi,
Jiritano, Fina, Martucci, Raffa, Suwalski, Meani, Kowalewski) Thoracic
Research Centre, Collegium Medicum Nicolaus Copernicus University,
Innovative Medical Forum, Bydgoszcz 85-094, Poland
(Kuzma, Dabrowski) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok 15-540, Poland
(Makhoul) Department of Cardiac Surgery, Harefield Hospital, London UB9
6JH, United Kingdom
(Matteucci) Cardiac Surgery Unit, ASST dei Sette Laghi, Department of
Medicine and Surgery, University of Insubria, Varese 21100, Italy
(Matteucci, Ronco, Massimi, Lorusso, Kowalewski) Cardiothoracic Surgery
Department, Heart and Vascular Centre, Maastricht University Medical
Centre (MUMC), Cardiovascular Research Institute Maastricht (CARIM), ER
Maastricht 6229, Netherlands
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
86-300 Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Upper-Silesian Heart Center,
Katowice 40-752, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Medical University of Silesia, Katowice 40-752, Poland
(Wanha) Department of Cardiac Surgery, School of Medicine in Katowice,
Medical University of Silesia, Katowice 40-752, Poland
(Pasierski, Suwalski, Kowalewski) Department of Cardiac Surgery and
Transplantology, Central Clinical Hospital of the Ministry of Interior,
Centre of Postgraduate Medical Education, Warsaw 02-507, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro 88100, Italy
(Fina, Meani) Department of Cardiothoracic, Vascular Anesthesia and
Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico
(IRCCS) Policlinico, San Donato Milanese, 20097 Milan, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
(IRCCS-ISMETT), Palermo 90100, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, Istituto di Ricovero e Cura a
Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad
Alta Specializzazione (IRCCS-ISMETT), Palermo 90100, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a
broadly acceptable alternative to AV surgery in patients with aortic
stenosis (AS). New valve designs are becoming available to address the
shortcomings of their predecessors and improve clinical outcomes.
 METHOD(S): A systematic review and meta-analysis was carried out to
compare Medtronic's Evolut PRO, a new valve, with the previous Evolut R
design. Procedural, functional and clinical endpoints according to the
VARC-2 criteria were assessed. RESULT(S): Eleven observational
studies involving N = 12,363 patients were included. Evolut PRO patients
differed regarding age (p < 0.001), sex (p < 0.001) and STS-PROM estimated
risk. There was no difference between the two devices in terms of
TAVI-related early complications and clinical endpoints. A 35% reduction
of the risk of moderate-to-severe paravalvular leak (PVL) favoring the
Evolut PRO was observed (RR 0.66, 95%CI, [0.52, 0.86] p = 0.002; I2 = 0%).
Similarly, Evolut PRO-treated patients demonstrated a reduction of over
35% in the risk of serious bleeding as compared with the Evolut R (RR
0.63, 95%CI, [0.41, 0.96]; p = 0.03; I2 = 39%), without differences in
major vascular complications. CONCLUSION(S): The evidence shows good
short-term outcomes of both the Evolut PRO and Evolut R prostheses, with
no differences in clinical and procedural endpoints. The Evolut PRO was
associated with a lower rate of moderate-to-severe PVL and major bleeding.

<83>
Accession Number
638299167
Title
A randomized trial of non-fasting vs. fasting for cardiac implantable
electronic device procedures (Fast-CIED Study).
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 24(10)
(pp 1617-1626), 2022. Date of Publication: 13 Oct 2022.
Author
Bode K.; Gerhards M.; Doering M.; Lucas J.; Tijssen J.; Dagres N.; Hilbert
S.; Richter S.; Nedios S.; Lurz J.; Moscoso-Luduena C.; Arya A.; Shamloo
A.S.; Hindricks G.
Institution
(Bode, Gerhards, Doering, Lucas, Dagres, Hilbert, Richter, Nedios, Lurz,
Moscoso-Luduena, Arya, Shamloo, Hindricks) Department of
Electrophysiology, Heart Center Leipzig at University of Leipzig,
Naumburger Str. 76, Germany
(Bode) Department of Cardiology, Asklepios Clinic Weisenfels, Germany
(Tijssen, Shamloo) Leipzig Heart Institute, Leipzig, Germany
Publisher
NLM (Medline)
Abstract
AIMS: Data on safety and efficacy of a non-fasting strategy in minimal
invasive cardiac procedures are lacking. We assessed a non-fasting
strategy compared with a fasting strategy regarding patient's well-being
and safety in elective cardiac implantable electronic device (CIED)
procedures. METHODS AND RESULTS: In this randomized, single-blinded
clinical trial, 201 patients (non-fasting=100, fasting=101) with a mean
age of 72.0+/-11.6 years (66.7% male) were assigned to a non-fasting
strategy (solids/fluids allowed up to 1 h) or a fasting strategy (at least
6 h no solids and 2 h no fluids) before the procedure and analysed on an
intention-to-treat basis. The co-primary outcomes were patients'
well-being scores (based on numeric rating scale, 0-10) and incidence of
intra-procedural food-related adverse events, including vomiting,
perioperative pulmonary aspiration, and emergency intubation. Renal,
haematological, and metabolic blood parameters and 30-day follow-up data
were gathered. The summed pre-procedural patients' well-being score was
significantly lower in the non-fasting group [non-fasting: 13.1+/-9.6 vs.
fasting: 16.5+/-11.4, 95% confidence interval (CI) of mean difference (MD)
-6.35 to -0.46, P=0.029], which was mainly driven by significantly lower
scores for hunger and tiredness in the non-fasting group (non-fasting vs.
fasting; hunger: 0.9+/-1.9 vs. 3.1+/-3.2, 95% CI of MD -2.86 to -1.42,
P<0.001; tiredness: 1.6+/-2.3 vs. 2.6+/-2.7, 95% CI of MD -1.68 to -0.29,
P=0.023). No intra-procedural food-related adverse events were observed.
Relevant blood parameters and 30-day follow-up did not show significant
differences. CONCLUSION(S): These results showed that a non-fasting
strategy is beneficial to a fasting one regarding patient's well-being and
comparable in terms of safety for CIED procedures
(NCT04389697). Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<84>
[Use Link to view the full text]
Accession Number
626484353
Title
Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe
Ischemic Mitral Regurgitation: A Randomized Clinical Trial From the
Cardiothoracic Surgical Trials Network.
Source
Circulation. Cardiovascular quality and outcomes. 11(11) (pp e004466),
2018. Date of Publication: 14 Nov 2018.
Author
Ferket B.S.; Ailawadi G.; Gelijns A.C.; Acker M.; Hohmann S.F.; Chang
H.L.; Bouchard, D.; Meltzer D.O.; Michler R.E.; Moquete E.G.; Voisine P.;
Mullen J.C.; Lala A.; Mack M.J.; Gillinov A.M.; Thourani V.H.; Miller
M.A.; Gammie J.S.; Parides M.K.; Bagiella E.; Smith R.L.; Smith P.K.; Hung
J.W.; Gupta L.N.; Rose E.A.; O'Gara P.T.; Moskowitz A.J.; Cardiothoracic
Surgical Trials Network (CTSN) Investigators
Publisher
NLM (Medline)
Abstract
BACKGROUND: The CTSN (Cardiothoracic Surgical Trials Network) recently
reported no difference in left ventricular end-systolic volume index or in
survival at 2 years between patients with severe ischemic mitral
regurgitation (MR) randomized to mitral valve repair or replacement.
However, replacement provided more durable correction of MR and fewer
cardiovascular readmissions. Yet, costeffectiveness outcomes have not been
addressed. METHODS AND RESULTS: We conducted a cost-effectiveness analysis
of the surgical treatment of ischemic MR based on the CTSN trial (n=126
for repair; n=125 for replacement). Patient-level data on readmissions,
survival, qualityof- life, and US hospital costs were used to estimate
costs and quality-adjusted life years per patient over the trial duration
and a 10-year time horizon. We performed microsimulation for extrapolation
of outcomes beyond the 2 years of trial data. Bootstrap and deterministic
sensitivity analyses were done to address parameter uncertainty.
In-hospital cost estimates were $78 216 for replacement versus $72 761 for
repair (difference: $5455; 95% uncertainty interval [UI]: -7784-21 193)
while 2-year costs were $97 427 versus $96 261 (difference: $1166; 95% UI:
-16 253-17 172), respectively. Quality-adjusted life years at 2 years were
1.18 for replacement versus 1.23 for repair (difference: -0.05; 95% UI:
-0.17 to 0.07). Over 5 and 10 years, the benefits of reduction in
cardiovascular readmission rates with replacement increased, and survival
minimally improved compared with repair. At 5 years, cumulative costs and
quality-adjusted life years showed no difference on average, but by 10
years, there was a small, uncertain benefit for replacement: $118 023
versus $119 837 (difference: -$1814; 95% UI: -27 144 to 22 602) and
qualityadjusted life years: 4.06 versus 3.97 (difference: 0.09; 95% UI:
-0.87 to 1.08). After 10 years, the incremental cost-effectiveness of
replacement continued to improve. CONCLUSION(S): Our
cost-effectiveness analysis predicts potential savings in cost and gains
in quality-adjusted survival at 10 years when mitral valve replacement is
compared with repair for severe ischemic MR. These projected benefits,
however, were small and subject to variability. Efforts to further
delineate predictors of long-term outcomes in patients with severe
ischemic MR are needed to optimize surgical decisions for individual
patients, which should yield more cost-effective care. CLINICAL TRIAL
REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier:
NCT00807040. Copyright 2018 American Heart Association, Inc.

<85>
Accession Number
625563806
Title
Valve-Sparing Aortic Root Repair Compared to Composite Aortic Root
Replacement: A Systematic Review and Meta-Analysis.
Source
The Journal of heart valve disease. 26(6) (pp 632-638), 2017. Date of
Publication: 01 Nov 2017.
Author
Harky A.; Fok M.; Froghi S.; Bilal H.; Bashir M.
Institution
(Harky) Department of Vascular Surgery, Countess of Chester Hospital,
Chester, United Kingdom
(Fok) Department of Surgery, Peterborough City Hospital, Edith Cavell
Campus, Peterborough, United Kingdom
(Froghi) Department of General Surgery, Imperial College Healthcare NHS
Trust, St. Mary's Hospital, London, United Kingdom
(Bilal) Manchester Metropolitan University, Manchester, United Kingdom
(Bashir) Manchester Metropolitan University, United Kingdom. Electronic
correspondence:, Manchester, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Aortic root aneurysms represent a significant risk of
morbidity and mortality. Composite root replacement is the preferred
practice for repair, although recently valve-sparing replacement has
become a popular alternative. The study aim was to identify comparative
studies that simultaneously analyzed composite root and valve-sparing root
replacement outcomes. METHOD(S): A systematic review of the current
literature was performed through four major databases, from inception
until 2016. All comparative studies of valve-sparing versus composite root
replacement were identified. All studies were assessed by two reviewers
for their applicability and inclusion. RESULT(S): A total of 12
comparative papers was identified encompassing 2,352 patients (700
valve-sparing and 1,652 composite); the mean follow up was 3.7 +/- 1.7
years. Aortic cross-clamp and cardiopulmonary bypass times were lower in
the composite group (p <0.0001 and p<0.00001, respectively). In-hospital
mortality was low, but higher in the composite group (p = 0.002). Only one
study reported long-term follow up. In studies reporting reoperation,
there was slight difference favoring composite over valve-sparing
replacement (p = 0.05). CONCLUSION(S): Valve-sparing and composite
root replacement remain feasible options for replacement of the aortic
root. Long-term data of comparative studies are not yet available to
assess the viability of these procedures.

<86>
[Use Link to view the full text]
Accession Number
624600525
Title
Randomized Controlled Trial of Surgical Versus Catheter Ablation for
Paroxysmal and Early Persistent Atrial Fibrillation.
Source
Circulation. Arrhythmia and electrophysiology. 11(10) (pp e006182), 2018.
Date of Publication: 01 Oct 2018.
Author
Adiyaman A.; Buist T.J.; Beukema R.J.; Smit J.J.J.; Delnoy P.P.H.M.;
Hemels M.E.W.; Sie H.T.; Ramdat Misier A.R.; Elvan A.
Institution
(Adiyaman, Buist, Beukema, Smit, Delnoy, Hemels, Ramdat Misier, Elvan)
Department of Cardiology, Isala Heart Centre, Zwolle, Netherlands
(Sie) Department of Cardiothoracic Surgery, Isala Heart Centre, Zwolle,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current guidelines recommend both percutaneous catheter
ablation (CA) and surgical ablation in the treatment of atrial
fibrillation, with different levels of evidence. No direct comparison has
been made between minimally invasive thoracoscopic pulmonary vein
isolation with left atrial appendage ligation (surgical MIPI) versus
percutaneous CA comprising of pulmonary vein isolation as primary
treatment of atrial fibrillation. We, therefore, conducted a randomized
controlled trial comparing the safety and efficacy of these 2 treatment
modalities. METHOD(S): Eighty patients were enrolled in the study and
underwent implantable loop recorder implantation. Twenty-eight patients
did not reach randomization criteria. A total of 52 patients with
symptomatic paroxysmal or early persistent atrial fibrillation were
randomized, 26 to CA and 26 to surgical MIPI. The primary end point was
defined as freedom of atrial tachyarrhythmias, without the use of
antiarrhythmic drugs. The safety end point was freedom of complications.
 RESULT(S): Median age was 57 years (range, 37-75), and 78% were men.
Paroxysmal atrial fibrillation was present in 74%. Follow-up duration was
>=2 years in all patients. CA was noninferior to MIPI in terms of
single-procedure arrhythmia-free survival after 2 years of follow-up
(56.0% versus 29.2%; HR, 0.56; 95% CI, 0.26-1.20; log-rank P=0.059).
Procedure-related major adverse events occurred significantly more often
in MIPI than CA (20.8% versus 0%; P=0.029). CONCLUSION(S):
Percutaneous pulmonary vein isolation was noninferior to MIPI in terms of
efficacy and resulted in less complications. CLINICAL TRIAL REGISTRATION:
URL: https://www.clinicaltrials.gov . Unique identifier: NCT00703157.

<87>
[Use Link to view the full text]
Accession Number
2029752273
Title
The impact of preoperative interview and prospective nursing on
perioperative psychological stress and postoperative complications in
patients undergoing TACE intervention for hepatocellular carcinoma.
Source
Medicine (United States). 103(2) (pp E35929), 2024. Date of Publication:
12 Jan 2024.
Author
Gao L.; Chen W.; Qin S.; Yang X.
Institution
(Gao, Chen, Yang) Department of Radiology, Xingtai People's Hospital,
Interventional Catheter Room, Hebei, Xingtai, China
(Qin) Department of Neurosurgery, Xingtai People's Hospital, Hebei,
Xingtai, China
Publisher
Lippincott Williams and Wilkins
Abstract
TACE has become one of the main methods for the treatment of liver cancer.
The study aimed to investigate the effects of preoperative interview and
prospective nursing in patients with hepatic carcinoma undergoing
transcatheter chemoembolization (TACE). Eighty-six patients with
hepatocellular carcinoma who underwent TACE intervention treatment at our
hospital between 2020 and 2023 were selected and randomly assigned to 2
groups using computerized randomization. The control group (n = 43)
received routine nursing care, while the study group (n = 43) received
preoperative interviews in combination with prospective nursing during the
procedure. The patients' heart rate, mean arterial pressure, and blood
pressure variations were recorded, along with their mood changes after
intervention. The postoperative pain and satisfaction levels were compared
between the 2 groups of patients, and the incidence of postoperative
complications was observed. The heart rate, systolic blood pressure, and
diastolic blood pressure of the 2 groups of patients were compared 1 day
before the operation (P > .05). Compared to 1 day before the operation,
there was no significant change for the study group at 10 minutes after
entering the room. However, the control group showed an increase. Both
groups showed an increase in heart rate, systolic blood pressure, and
diastolic blood pressure after the operation, with the study group having
lower values than the control group (P < .05). The levels of tension,
fatigue, anxiety, energy, anger, depression, self-esteem, and POMS index
were compared between the 2 groups before intervention (P > .05). After
intervention, there were significant differences between the 2 groups(P <
.05). Immediately after the operation, the NRS scores of the 2 groups of
patients were compared (P > .05). Compared to the control group, the study
group showed a decrease in NRS scores at 12, 24, and 48 hours after the
operation (P < .05). The nursing satisfaction rate of the study group
patients was 97.67% (42/43), which was higher than the nursing
satisfaction rate of the control group of 76.74% (33/43) (P < .05).
Compared to routine nursing, preoperative visits and prospective nursing
interventions can effectively alleviate patients' psychological stress
reactions, relieve pain, reduce the incidence of complications, and
improve patients' satisfaction with nursing care. Copyright ©
2024 Lippincott Williams and Wilkins. All rights reserved.

<88>
Accession Number
2029791624
Title
Efficacy of electroacupuncture on myocardial protection and postoperative
rehabilitation in patients undergoing cardiac surgery with cardiopulmonary
bypass: a systematic review and Meta-analysis.
Source
Journal of Traditional Chinese Medicine. 44(1) (pp 1-15), 2024. Date of
Publication: 2024.
Author
Qin X.; Wang C.; Xue J.; Zhang J.; Lu X.; Ding S.; Ge L.; Wang M.
Institution
(Qin, Zhang, Lu, Ding) The First Clinical Medical College, Gansu
University of Chinese Medicine, Lanzhou 730030, China
(Wang, Xue) Department of Anesthesiology, Gansu Provincial Hospital of
Traditional Chinese Medicine, Lanzhou 730050, China
(Ge) Evidence-based Medicine Center, Lanzhou University, Lanzhou 730030,
China
(Wang) Institute of Epidemiology and Statistics, School of Public Health,
Lanzhou University, Lanzhou 730030, China
Publisher
Journal of Traditional Chinese Medicine
Abstract
OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA)
intervention on myocardial protection and postoperative rehabilitation in
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
 METHOD(S): Eight databases, including PubMed, Embase, the Cochrane
Library, Web of Science, Chinese BioMedical Literature Database, China
National Knowledge Infrastructure Database, Wanfang Data, China Science
and Technology Journal Database, and two clinical trial registries, were
searched. All randomized controlled trials (RCTs) related to EA
intervention in cardiac surgery with CPB were collected. Based on the
inclusion and exclusion criteria, two researchers independently screened
articles and extracted data. After the quality evaluation, RevMan 5.3
software was used for analysis. RESULT(S): Fourteen RCTs involving
836 patients were included. Compared with the control treatment, EA
significantly increased the incidence of cardiac automatic rebeat after
aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI)
(1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic
unclamping, EA significantly increased the superoxide dismutase
[standardized mean difference (SMD) = 0.96, 95% CI (0.32, 1.61), P < 0.05;
low], and interleukin (IL)-2 [SMD = 1.33, 95% CI (0.19, 2.47), P < 0.05;
very low] expression levels and decreased the malondialdehyde [SMD =
-1.62, 95% CI (-2.15, -1.09), P < 0.05; moderate], tumour necrosis
factor-alpha [SMD = -1.28, 95% CI (-2.37, -0.19), P < 0.05; moderate], and
cardiac troponin I [SMD = - 1.09, 95% CI (- 1.85, - 0.32), P < 0.05; low]
expression levels as well as the inotrope scores [SMD = -0.77, 95% CI
(-1.22, -0.31), P < 0.05; high]. There was no difference in IL-6 and IL-10
expression levels. The amount of intraoperative sedative [SMD = -0.31, 95%
CI (- 0.54, - 0.09), P < 0.05; moderate] and opioid analgesic [SMD =
-0.96, 95% CI (-1.53, -0.38), P < 0.05; low] medication was significantly
lower in the EA group than in the control group. Moreover, the
postoperative tracheal intubation time [SMD = -0.92, 95% CI (-1.40,
-0.45), P < 0.05; low] and intensive care unit stay [SMD = -1.71, 95% CI
(-3.06, -0.36), P < 0.05; low] were significantly shorter in the EA group
than in the control group. There were no differences in the time to get
out of bed for the first time, total days of antibiotic use after surgery,
or postoperative hospital stay. No adverse reactions related to EA were
reported in any of the included studies. CONCLUSION(S): In cardiac
surgery with CPB, EA may be a safe and effective strategy to reduce
myocardial ischaemia-reperfusion injury and speed up the recovery of
patients after surgery. These findings must be interpreted with caution,
as most of the evidence was of low or moderate quality. More RCTs with
larger sample sizes and higher quality are needed to provide more
convincing evidence. Copyright © 2024 JTCM. All rights reserved.

<89>
Accession Number
2027962108
Title
Regional anesthesia for transplantation surgery - A White Paper Part 2:
Abdominal transplantation surgery.
Source
Clinical Transplantation. 38(1) (no pagination), 2024. Article Number:
e15227. Date of Publication: January 2024.
Author
Ander M.; Mugve N.; Crouch C.; Kassel C.; Fukazawa K.; Isaak R.; Deshpande
R.; McLendon C.; Huang J.
Institution
(Ander, Mugve, McLendon) Department of Anesthesiology & Perioperative
Medicine, Loyola University Medical Center, Maywood, IL, United States
(Crouch) Department of Anesthesiology, University of Colorado Anschutz
Medical Campus, Aurora, CO, United States
(Kassel) Department of Anesthesiology, Nebraska Medical Center, Omaha, NE,
United States
(Fukazawa) Department of Anesthesiology, University of Washington School
of Medicine, Seattle, WA, United States
(Isaak) Department of Anesthesiology, UNC Hospitals, N2198 UNC Hospitals,
Chapel Hill, NC, United States
(Deshpande) Department of Anesthesiology, Yale University/Yale New Haven
Hospital, New Haven, CT, United States
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Transplantation surgery continues to evolve and improve through
advancements in transplant technique and technology. With the increased
availability of ultrasound machines as well as the continued development
of Enhanced Recovery after Surgery (ERAS) protocols, regional anesthesia
has become an essential component of providing analgesia and minimizing
opioid use perioperatively. Many centers currently utilize peripheral and
neuraxial blocks during transplantation surgery, but these techniques are
far from standardized practices. The utilization of these procedures is
often dependent on transplantation centers' historical methods and
perioperative cultures. To date, no formal guidelines or recommendations
exist which address the use of regional anesthesia in transplantation
surgery. In response, the Society for the Advancement of Transplant
Anesthesia (SATA) identified experts in both transplantation surgery and
regional anesthesia to review available literature concerning these
topics. The goal of this task force was to provide an overview of these
publications to help guide transplantation anesthesiologists in utilizing
regional anesthesia. The literature search encompassed most
transplantation surgeries currently performed and the multitude of
associated regional anesthetic techniques. Outcomes analyzed included
analgesic effectiveness of the blocks, reduction in other analgesic
modalities-particularly opioid use, improvement in patient hemodynamics,
as well as associated complications. The findings summarized in this
systemic review support the use of regional anesthesia for postoperative
pain control after transplantation surgeries. Part 1 of the manuscript
focused on regional anesthesia performed in thoracic transplantation
surgeries, and part 2 in abdominal transplantations. Specifically,
regional anesthesia in liver, kidney, pancreas, intestinal, and uterus
transplants or applicable surgeries are discussed. Copyright ©
2024 The Authors. Clinical Transplantation published by John Wiley & Sons
Ltd.

<90>
Accession Number
2029785806
Title
Preoperative computed tomography-imaging with patient-specific computer
simulation in transcatheter aortic valve implantation: Design and
rationale of the GUIDE-TAVI trial.
Source
American Heart Journal. 269 (pp 158-166), 2024. Date of Publication: March
2024.
Author
Hegeman R.R.M.J.J.; van Ginkel D.-J.; Laengle S.; Timmers L.; Rensing
B.J.W.M.; de Kroon T.L.; Sonker U.; Kelder J.C.; Mach M.; Andreas M.;
Swaans M.J.; ten Berg J.M.; Klein P.
Institution
(Hegeman, de Kroon, Sonker, Klein) Department of Cardiothoracic Surgery,
Sint Antonius Hospital, Nieuwegein, Netherlands
(van Ginkel, Timmers, Rensing, Swaans, ten Berg) Department of Cardiology,
Sint Antonius Hospital, Nieuwegein, Netherlands
(Laengle, Mach, Andreas) Department of Cardiothoracic Surgery, Medical
University of Vienna, Vienna, Austria
(Kelder) Department of Epidemiology, Sint Antonius Hospital, Nieuwegein,
Netherlands
(ten Berg) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Hegeman, Klein) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Mach) Department of Cardiovascular Surgery, Heart Center Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Germany
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an
established treatment option for patients with severe aortic valve
stenosis, but is still associated with relatively high rates of pacemaker
implantation and paravalvular regurgitation. Routine preoperative computed
tomography (CT) combined with patient-specific computer modelling can
predict the interaction between the TAVI device and the patient's unique
anatomy, allowing physicians to assess the risk for paravalvular
regurgitation and conduction disorders in advance to the procedure. The
aim of this trial is to assess potential improvement in the procedural
outcome of TAVI by applying CT-based patient-specific computer simulations
in patients with suitable anatomy for TAVI. Method(s): The GUIDE-TAVI
trial is an international multicenter randomized controlled trial
including patients accepted for TAVI by the Heart Team. Patients enrolled
in the study will be randomized into 2 arms of each 227 patients. In
patients randomized to the use of FEops HEARTGuide (FHG), patient-specific
computer simulation with FHG is performed in addition to routine
preoperative CT imaging and results of the FHG are available to the
operator(s) prior to the scheduled intervention. In patients randomized to
no use of FHG, only routine preoperative CT imaging is performed. The
primary objective is to evaluate whether the use of FHG will reduce the
incidence of mild to severe PVR, according to the Valve Academic Research
Consortium 3. Secondary endpoints include the incidence of new conduction
disorders requiring permanent pacemaker implantation, the difference
between preoperative and final selected valve size, the difference between
target and final implantation depth, change of preoperative decision,
failure to implant valve, early safety composite endpoint and quality of
life. Conclusion(s): The GUIDE-TAVI trial is the first multicenter
randomized controlled trial to evaluate the value of 3-dimensional
computer simulations in addition to standard preprocedural planning in
TAVI procedures. Copyright © 2023 Elsevier Inc.

<91>
Accession Number
2027946167
Title
Surgical site infection outcomes of two different closed incision negative
pressure therapy systems in cardiac surgery: Systematic review and
meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14599. Date of Publication: January 2024.
Author
Loubani M.; Cooper M.; Silverman R.; Bongards C.; Griffin L.
Institution
(Loubani) Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull
University Teaching Hospital, Hull, United Kingdom
(Cooper, Silverman, Griffin) Medical Solutions Division, 3M Health Care,
St. Paul, MN, United States
(Bongards) Medical Solutions Division, 3M Deutschland GmBH, Neuss, Germany
Publisher
John Wiley and Sons Inc
Abstract
Closed incision negative pressure therapy (ciNPT) system use compared with
standard of care dressings (SOC) on surgical site infection (SSI) in
cardiac surgery was assessed. A systematic literature review was
conducted. Risk ratios (RR) and random effects models were used to assess
ciNPT with foam dressing (ciNPT-F) or multilayer absorbent dressing
(ciNPT-MLA) versus SOC. Health economic models were developed to assess
potential per patient cost savings. Eight studies were included in the
ciNPT-F analysis and four studies were included in the ciNPT-MLA analysis.
For ciNPT-F, a significant reduction in SSI incidence was observed (RR:
0.507, 95% confidence interval [CI]: 0.362, 0.709; p < 0.001). High-risk
study analysis reported significant SSI reduction with ciNPT-F use (RR:
0.390, 95% CI: 0.205, 0.741; p = 0.004). For ciNPT-MLA, no significant
difference in SSI rates were reported (RR: 0.672, 95% CI: 0.276, 1.635; p
= 0.381). Health economic modelling estimated a per patient cost savings
of $554 for all patients and $3242 for the high-risk population with
ciNPT-F use. Health economic modelling suggests ciNPT-F may provide a
cost-effective solution for sternotomy incision management. However,
limited high-quality literature exists. More high-quality evidence is
needed to fully assess the impact of ciNPT use following cardiac
surgery. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<92>
Accession Number
2029265851
Title
Transcatheter Aortic Valve Replacement-Associated Acute Kidney Injury: An
Update.
Source
CardioRenal Medicine. 13(1) (pp 143-157), 2023. Date of Publication: 17
Feb 2023.
Author
Rivera F.B.; Al-Abcha A.; Ansay M.F.M.; Magalong J.V.U.; Tang V.A.S.; Ona
H.M.; Miralles K.A.; Sausa R.; Uy R.A.F.; Lerma E.V.; Collado F.M.S.;
McCullough P.A.; Volgman A.S.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, Bronx, NY, United
States
(Al-Abcha) Department of Cardiology, Mayo Clinic, Scottsdale, AZ, United
States
(Ansay) Ateneo de Manila School of Medicine and Public Health, Pasig City,
Philippines
(Magalong) Department of Medicine, San Beda University College of
Medicine, Manila, Philippines
(Tang) Department of Medicine, Philippine General Hospital, Manila,
Philippines
(Ona, Miralles, Sausa, Uy) University of the Philippines College of
Medicine, Manila, Philippines
(Lerma) Section of Nephrology, University of Illinois at Chicago College
of Medicine/Advocate Christ Medical Center, Oak Lawn, IL, United States
(Collado, Volgman) Department of Cardiology, Rush University Medical
Center, Chicago, IL, United States
(McCullough) Truth for Health Foundation, Tucson, AZ, United States
Publisher
S. Karger AG
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a relatively
novel minimally invasive procedure for the treatment of symptomatic
patients with severe aortic stenosis. Although it has been proven
effective in improving mortality and quality of life, TAVR is associated
with serious complications, such as acute kidney injury (AKI).
 Summary: TAVR-associated AKI is likely due to several factors such as
sustained hypotension, transapical approach, volume of contrast use, and
baseline low GFR. This narrative review aims to present an overview of the
latest literature and evidence regarding the definition of TAVR-associated
AKI, its risk factors, and its impact on morbidity and mortality. The
review used a systematic search strategy with multiple health-focused
databases (Medline, EMBASE) and identified 8 clinical trials and 27
observational studies concerning TAVR-associated AKI. Results showed that
TAVR-associated AKI is linked to several modifiable and nonmodifiable risk
factors and is associated with higher mortality. A variety of diagnostic
imaging modalities have the potential to identify patients at high risk
for development of TAVR-AKI; however, there are no existing consensus
recommendations regarding their use as of this time. The implications of
these findings highlight the importance of identifying high-risk patients
for which preventive measures may play a crucial role, and should be
maximized. Key Message: This study reviews the current understanding of
TAVR-associated AKI including its pathophysiology, risk factors,
diagnostic modalities, and preventative management for
patients. Copyright © 2023 Authors. All rights reserved.

<93>
Accession Number
2029265837
Title
Acute and Chronic Cardiovascular Consequences of Acute Kidney Injury: A
Systematic Review and Meta-Analysis.
Source
CardioRenal Medicine. 13(1) (pp 26-33), 2023. Date of Publication: 18 Nov
2023.
Author
De Clercq L.; Ailliet T.; Schaubroeck H.; Hoste E.A.J.
Institution
(De Clercq, Ailliet, Schaubroeck, Hoste) Department of Intensive Care
Medicine, Department of Internal Medicine and Pediatrics, Ghent University
Hospital, Ghent University, Ghent, Belgium
(Hoste) Research Foundation-Flanders (FWO), Brussels, Belgium
Publisher
S. Karger AG
Abstract
Introduction: We examined whether patients with acute kidney injury (AKI)
have a higher risk of developing atrial fibrillation (AF), heart failure
(HF), acute coronary syndrome (ACS), and major adverse cardiac events
(MACE) in the short and long term compared to patients without AKI, and if
that risk is related to the severity of AKI. Furthermore, we investigated
the influence of a cardiac event following AKI on the risk of all-cause
mortality, length of stay in the intensive care unit and in the hospital.
 Method(s): We included English and Dutch retrospective and
prospective cohort studies on adults (>=15 years) with AKI. Studies
lacking epidemiological data, studies not using the consensus definitions
(RIFLE, AKIN, KDIGO), animal studies, and studies on children were
excluded. Studies were identified using the PubMed and Embase search
engines. The last search was performed on the first of August 2021. For
assessment of method quality, Newcastle-Ottawa Scale (NOS) for assessing
risk of bias was used for cohort studies and heterogeneity was determined
by the I2 statistic. Statistical analysis was performed using
the Cochrane Review Manager (RevMan 5.3). The risk ratio (RR) and 95%
confidence interval (CI) were calculated using the Mantel-Haenszel test.
Results were presented in a summary caterpillar plot. Result(s): We
evaluated 14 studies comprising 736,210 patients. AKI was defined
according to the RIFLE consensus in 1 article, to the AKIN criteria in 7,
and to the KDIGO guidelines in 6. Of the 14 included studies, 4 were
prospective and 10 were retrospective. In comparison with patients without
AKI, we found that patients with AKI had a 94% increased risk of
developing AF in the short term (RR: 1.94, 95% CI 1.35-2.79; p = 0.0004).
In the long term, patients with AKI stage 1 had a 59% increased risk of
developing HF and a 77% risk of developing ACS (RR: 1.59, 95% CI
1.07-2.34, p = 0.02 and RR: 1.77, 95% CI 1.68-1.88, p < 0.00001,
respectively). Patients with AKI stage 2 had a 45% increased risk of ACS
development (RR: 1.45, 95% CI 1.11-1.90, p = 0.006). AKI stage 3 was
associated with a 164% increased risk of HF and a 95% increased risk of
ACS development (RR: 2.64, 95% CI 1.71-4.08, p < 0.00001 and RR: 1.95, 95%
CI 1.35-2.82, p = 0.0004, respectively). Analysis of studies not
subdividing AKI into groups showed a 74% increased risk of HF, a 12%
increased risk of ACS, and a 30% increased risk of developing MACE (RR:
1.74, 95% CI 1.51-2.01, p < 0.00001, RR: 1.12, 95% CI 1.07-1.17, p <
0.00001 and RR: 1.30, 95% CI 1.25-1.35, p < 0.00001, respectively).
 Conclusion(s): Patients who developed AKI have an increased risk of
developing AF at short-term follow-up and HF, ACS, and MACE beyond 30
days. Copyright © 2023 S. Karger AG. All rights reserved.

<94>
Accession Number
2016659566
Title
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney
Injury during Percutaneous Cardiovascular Procedures.
Source
CardioRenal Medicine. 12(1) (pp 11-19), 2022. Date of Publication: 14 Mar
2022.
Author
Peabody J.; Paculdo D.; Valdenor C.; McCullough P.A.; Noiri E.; Sugaya T.;
Dahlen J.R.
Institution
(Peabody, Paculdo, Valdenor) QURE Healthcare, San Francisco, CA, United
States
(Peabody) University of California, School of Medicine, San Francisco, CA,
United States
(Peabody) University of California, Fielding School of Public Health, Los
Angeles, CA, United States
(McCullough) Texas Christian University, The University of North Texas
Health Sciences Center School of Medicine, Dallas, TX, United States
(Noiri) Department of Nephrology and Endocrinology, The University of
Tokyo Hospital, Tokyo, Japan
(Noiri) National Center Biobank Network, National Center for Global Health
and Medicine, Tokyo, Japan
(Sugaya) Timewell Medical, Tokyo, Japan
(Sugaya) St. Marianna University School of Medicine, Kawasaki, Japan
(Dahlen) Hikari Dx, Inc., San Diego, CA, United States
Publisher
S. Karger AG
Abstract
Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major
clinical complication of percutaneous cardiovascular procedures requiring
iodinated contrast. Despite its relative frequency, practicing physicians
are unlikely to identify or treat this condition. Method(s): In a
2-round clinical trial of simulated patients, we examined the clinical
utility of a urine-based assay that measures liver-type fatty acid-binding
protein (L-FABP), a novel marker of CI-AKI. We sought to determine if
interventional cardiologists' ability to diagnose and treat potential
CI-AKI improved using the biomarker assay for 3 different patient types:
pre-procedure, peri-procedure, and post-procedure patients.
 Result(s): 154 participating cardiologists were randomly divided into
either control or intervention. At baseline, we found no difference in the
demographics or how they identified and treated potential complications of
AKI, with both groups providing less than half the necessary care to their
patients (46.4% for control vs. 47.6% for intervention, p = 0.250). The
introduction of L-FABP into patient care resulted in a statistically
significant improvement of 4.6% (p = 0.001). Compared to controls,
physicians receiving L-FABP results were 2.9 times more likely to
correctly identify their patients' risk for AKI (95% CI 2.1-4.0) and were
more than twice as likely to treat for AKI by providing volume expansion
and withholding nephrotoxic medications. We found the greatest clinical
utility in the pre-procedure and peri-procedure settings but limited value
in the post-procedure setting. Conclusion(s): This study suggests
L-FABP as a clinical marker for assessing the risk of potential CI-AKI,
has clinical utility, and can lead to more accurate diagnosis and
treatment. Copyright © 2022 S. Karger AG, Basel.

<95>
Accession Number
634093241
Title
A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial of
High-Dose, Short-Term Vitamin D Administration in the Prevention of Acute
Kidney Injury after Cardiac Surgery.
Source
CardioRenal Medicine. 11(1) (pp 52-58), 2021. Date of Publication:
February 2021.
Author
Eslami P.; Hekmat M.; Beheshti M.; Baghaei R.; Mirhosseini S.M.;
Pourmotahari F.; Ziai S.A.; Foroughi M.
Institution
(Eslami, Foroughi) Cardiovascular Research Center, Shahid Beheshti
University of Medical Sciences, Saadat Abad, Tehran 19987-34383, Iran,
Islamic Republic of
(Hekmat, Beheshti, Baghaei, Mirhosseini, Pourmotahari) Clinical Research
and Development Center, Shahid Modarres Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ziai) Department of Pharmacology, School of Medicine, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
S. Karger AG
Abstract
Background: Acute kidney injury (AKI) after cardiac surgery is a
relatively common complication affecting short- A nd long-term survival.
The renoprotective effect of vitamin D (VitD) has been confirmed in
several experimental models. This study was conducted to evaluate the
effect of high-dose VitD administration in patients with VitD
insufficiency on the incidence of postoperative AKI, the urinary level of
tubular biomarkers, and serum anti-inflammatory biomarker after coronary
artery bypass graft. Design and Method: In this randomized double-blind
controlled clinical trial, the patients were randomly allocated to either
the VitD group (n = 50), receiving 150,000 IU VitD tablets daily for 3
consecutive days before surgery or the control group (n = 61), receiving
placebo tablets. Result(s): There was no difference in the incidence
of postoperative AKI between the groups. Both of the urinary levels of
interleukin-18 and kidney injury molecule-1 were significantly increased
after the operation (p < 0.001, for both). Also, the serum level of
interleukin-10 was increased after 3 days of VitD supplementation (p =
0.001). In comparison with the control group, it remained on a higher
level after the operation (p < 0.001) and the next day (p = 0.03). The
patients with AKI had more postoperative bleeding and received more blood
transfusion. Conclusion(s): VitD pretreatment was unable to impose
any changes in the incidence of AKI and the urinary level of renal
biomarkers. However, high-dose administration of VitD may improve the
anti-inflammatory state before and after the operation. Further studies
are needed to assess the renoprotective effect of VitD on coronary surgery
patients. Copyright © 2021 S. Karger AG, Basel. All rights
reserved.

<96>
Accession Number
627373232
Title
Transcatheter versus surgical aortic valve replacement for severe aortic
stenosis in people with low surgical risk.
Source
Cochrane Database of Systematic Reviews. 2019(4) (no pagination), 2019.
Article Number: CD013319. Date of Publication: 27 Apr 2019.
Author
Kolkailah A.A.; Doukky R.; Pelletier M.P.; Kaneko T.; Nabhan A.F.
Institution
(Kolkailah) Department of Medicine, John H. Stroger, Jr. Hospital of Cook
County, Chicago, IL, United States
(Doukky) Division of Cardiology, John H. Stroger, Jr. Hospital of Cook
County, Chicago, IL, United States
(Pelletier, Kaneko) Division of Cardiac Surgery, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Nabhan) Department of Obstetrics and Gynaecology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Publisher
John Wiley and Sons Ltd
Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives
are as follows: To assess the benefits and harms of TAVR compared to SAVR
in people with severe AS and low surgical risk. Copyright © 2019
The Cochrane Collaboration.

<97>
Accession Number
626733829
Title
Multivessel coronary revascularization strategies in patients with chronic
kidney disease: A meta-analysis.
Source
CardioRenal Medicine. 9(3) (pp 145-159), 2019. Date of Publication: 01 Mar
2019.
Author
Wu P.; Luo F.; Fang Z.
Institution
(Wu, Luo, Fang) Department of Cardiovascular Medicine, Second Xiangya
Hospital, Central South University, Changsha, Hunan 410011, China
Publisher
S. Karger AG
Abstract
Background: Early revascularization can lead to better prognosis in
multivessel coronary artery disease (CAD) patients with chronic kidney
disease (CKD). However, whether coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) is better remains unknown.
 Method(s): We searched PubMed and the Cochrane Library database from
inception until December 9, 2017, for articles that compare outcomes of
CABG and PCI in multivessel CAD patients with CKD. We pooled the odds
ratios with a fixed-effects model when I2 < 50% or a
random-effects model when I2 > 75% and conducted heterogeneity
and quality assessments as well as publication bias analyses.
 Result(s): A total of 17 studies with 62,343 patients were included.
Compared with CABG, the pooled analysis showed that PCI had a lower risk
of short-term all-cause death (OR, 0.56; 95% CI, 0.37-0.84) and
cerebrovascular accidents (OR, 0.65; 95% CI, 0.53-0.79) but a higher risk
of cardiac death (OR, 1.29; 95% CI, 1.21-1.37), myocardial infarction (MI)
(OR, 1.73; 95% CI, 1.35-2.21), and repeat revascularization (RR) (OR, 3.9;
95% CI, 2.99-5.09). There was no significant difference in the risk of
long-term all-cause death (OR, 1.08; 95% CI, 0.95-1.23) and major adverse
cardiac and cerebrovascular events (MACCE) (OR, 1.58; 95% CI, 0.99-2.52)
between the PCI and CABG groups. A subgroup analysis restricted to
patients treated with dialysis or with PCI-drug-eluting stent yielded
similar results. Conclusion(s): PCI for patients with CKD and
multivessel disease (multivessel CAD) had advantages over CABG with regard
to short-term all-cause death and cerebrovascular accidents, but
disadvantages regarding the risk of myocardial death, MI, and RR; there
was no significant difference in the risk of long-term all-cause death and
MACCE. Large randomized controlled trials are needed to confirm our
findings. Copyright © 2019 S. Karger AG, Basel. All rights
reserved.

<98>
Accession Number
622035548
Title
Revascularization versus medical management of coronary artery disease in
prerenal transplant patients: A meta-analysis.
Source
CardioRenal Medicine. 8(3) (pp 192-198), 2018. Date of Publication: 01 Jul
2018.
Author
Kamran H.; Kupferstein E.; Sharma N.; Singh G.; Sowers J.R.;
Whaley-Connell A.; Yacoub M.; Marmur J.D.; Salifu M.O.; McFarlane S.I.
Institution
(Kamran, Kupferstein, Sharma, Singh, Marmur, Salifu, McFarlane) Divisions
of Cardiovascular Medicine, Nephrology and Endocrinology, Department of
Medicine, State University of New York Downstate Medical Center, 450
Clarkson Avenue, Brooklyn, NY 11203, United States
(Sowers, Whaley-Connell) Divisions of Nephrology and Endocrinology,
Department of Medicine, University of Missouri, Columbia, MO, United
States
(Yacoub) Department of Cardiology, Northside Hospital, St. Petersburg,
Florida, United States
Publisher
S. Karger AG
Abstract
Introduction: End-stage renal disease requiring renal transplantation
comprises a growing patient population at risk for cardiovascular disease
(CVD) morbidity and mortality in large part due to accelerated
atherosclerosis. Consequently, these patients are at even higher risk of
major surgical CVD mortality. A paucity of research has addressed the
posttransplantation CVD outcomes related to different treatment strategies
in this patient population and therefore, there are no specific
preoperative guidelines regarding management of coronary artery disease in
this high-risk population undergoing renal transplantation.
 Objective(s): Through meta-analysis we compare coronary
revascularization to medical management prior to renal transplantation in
patients who are found to have significant obstructive coronary artery
disease. Result(s): A total of 6 studies were deemed suitable out of
777 articles reviewed. This included 260 patients who received medical
management and 338 who received coronary revascularization. There were 36
events in the revascularization and 57 events in the medical management
group. One study only reported hazard ratios but no CVD outcomes.
Comprehensive Meta-Analysis software was used to calculate pooled odds
ratio with 95% confidence intervals (CI) for the fixed effects. The data
is presented as forest plots. The pooled odds ratio with 95% CI for the
fixed effects was 1.415 (95% CI 0.885-2.263), p = 0.147, indicating that
there is no difference in CVD outcomes between pretransplant treatment
strategy. This observation suggests that the CVD outcomes
posttransplantation are not affected when optimal medical therapy is used
instead of coronary revascularization. © 2018 S. Karger AG,
Basel. Copyright: All rights reserved.

<99>
Accession Number
610985461
Title
Evaluation of nephroprotective efficacy of hypoxic preconditioning in
patients undergoing coronary artery bypass surgery.
Source
CardioRenal Medicine. 6(4) (pp 328-336), 2016. Date of Publication: 01 Aug
2016.
Author
Vesnina Z.V.; Lishmanov Y.B.; Alexandrova E.A.; Nesterov E.A.
Institution
(Vesnina, Lishmanov) Laboratory of Nuclear Medicine, Federal State
Budgetary Scientific Institution, Research Institute for Cardiology,
Kievskaya Street, 111a, Tomsk RU-634012, Russian Federation
(Alexandrova) Department of Cardiovascular Surgery, Federal State
Budgetary Scientific Institution, Research Institute for Cardiology,
Tomsk, Russian Federation
(Vesnina, Lishmanov, Nesterov) National Research Tomsk Polytechnic
University, Tomsk, Russian Federation
Publisher
S. Karger AG
Abstract
Background: Nonpulsatile blood flow plays an important role in the
pathogenesis of renal dysfunction in patients with extracorporeal
circulation. In our opinion, hypoxic preconditioning (HP) can be used to
protect kidneys from postsurgical dysfunction. The aim of this study was
to evaluate nephroprotective efficacy of HP in myocardial
revascularization with extracorporeal circulation. Method(s): The
randomized, controlled trial was performed in 63 patients undergoing
coronary artery bypass grafting (CABG). Thirty-three patients were
subjected to HP during CABG; 30 patients were included in the comparison
group. All patients underwent dynamic renal scintigraphy with
99mc-diethylenetriaminepentaacetic acid and were subjected to
measuring the concentration of lipocalin in blood serum before and after
CABG. Result(s): After CABG, the mean values of the total glomerular
filtration rate (GFR) and GFR for each kidney significantly decreased only
in patients of the comparison group. Significant increases in the
concentration of serum neutrophil gelatinase-associated lipocalin occurred
5 h after surgery both in the group with HP (70.65 +/- 46.71 to 127.58 +/-
98.46 ng/ml) and in the comparison group (65.01 +/- 38.64 to 171.65 +/-
89.91 ng/ml). At the same time, the mean difference values between pre-
and postoperative lipocalin levels were 56.94 +/- 51.75 ng/ml in the study
group and 106.64 +/- 51.27 ng/ml in the comparison group; these
differences were highly statistically significant (0.004).
 Conclusion(s): The results of our study showed that (i) HP exerts
nephroprotection in patients undergoing on-pump CABG, and (ii)
determination of the lipocalin-2 level can be used for early diagnosis of
acute kidney injury in cardiac surgery patients. Copyright © 2016
S. Karger AG, Basel.

<100>
Accession Number
610739246
Title
Acute kidney injury in cardiorenal syndrome type 1 patients: A systematic
review and meta-analysis.
Source
CardioRenal Medicine. 6(2) (pp 116-128), 2015. Date of Publication: 2015.
Author
Vandenberghe W.; Gevaert S.; Kellum J.A.; Bagshaw S.M.; Peperstraete H.;
Herck I.; Decruyenaere J.; Hoste E.A.J.
Institution
(Vandenberghe, Peperstraete, Herck, Decruyenaere, Hoste) Departments of
Intensive Care Medicine, ICU, University Hospital Ghent, Ghent University,
Ghent BE 9000, Belgium
(Gevaert) Cardiology, Ghent University Hospital, Ghent University, Ghent,
Belgium
(Hoste) Research Foundation-Flanders (FWO), Brussels, Belgium
(Kellum) Centre for Critical Care Nephrology, University of Pittsburgh,
United States
(Kellum, Hoste) Clinical Research, Investigation, and Systems Modelling of
Acute Illness (CRISMA) Centre, Department of Critical Care Medicine,
University of Pittsburgh, School of Medicine, Pittsburgh, PA, United
States
(Bagshaw) Division of Critical Care Medicine, Faculty of Medicine and
Dentistry, University of Alberta, Edmonton, AL, Canada
Publisher
S. Karger AG
Abstract
Background: We evaluated the epidemiology and outcome of acute kidney
injury (AKI) in patients with cardiorenal syndrome type 1 (CRS-1) and its
subgroups: acute heart failure (AHF), acute coronary syndrome (ACS) and
after cardiac surgery (CS). Summary: We performed a systematic review
and meta-analysis. CRS-1 was defined by AKI (based on RIFLE, AKIN and
KDIGO), worsening renal failure (WRF) and renal replacement therapy (RRT).
We investigated the three most common clinical causes of CRS-1: AHF, ACS
and CS. Out of 332 potential papers, 64 were eligible - with AKI used in
41 studies, WRF in 25 and RRT in 20. The occurrence rate of CRS-1, defined
by AKI, WRF and RRT, was 25.4, 22.4 and 2.6%, respectively. AHF patients
had a higher occurrence rate of CRS-1 compared to ACS and CS patients
(AKI: 47.4 vs. 14.9 vs. 22.1%), but RRT was evenly distributed among the
types of acute cardiac disease. AKI was associated with an increased
mortality rate (risk ratio = 5.14, 95% CI 3.81-6.94; 24 studies and 35,227
patients), a longer length of stay in the intensive care unit
[LOS<inf>ICU</inf>] (median duration = 1.37 days, 95% CI 0.41-2.33; 9
studies and 10,758 patients) and a longer LOS in hospital
[LOS<inf>hosp</inf>] (median duration = 3.94 days, 95% CI 1.74-6.15; 8
studies and 35,227 patients). Increasing AKI severity was associated with
worse outcomes. The impact of CRS-1 defined by AKI on mortality was
greatest in CS patients. RRT had an even greater impact compared to AKI
(mortality risk ratio = 9.2, median duration of LOS<inf>ICU</inf> = 10.6
days and that of LOS<inf>hosp</inf> = 20.2 days). Key Messages: Of all
included patients, almost one quarter developed AKI and approximately 3%
needed RRT. AHF patients experienced the highest occurrence rate of AKI,
but the impact on mortality was greatest in CS patients. Copyright
© 2015 S. Karger AG, Basel.

<101>
Accession Number
609143452
Title
Risk factors for acute kidney injury after cardiovascular surgery:
Evidence from 2,157 cases and 49,777 controls - A meta-analysis.
Source
CardioRenal Medicine. 6(3) (pp 237-250), 2016. Date of Publication: 01 May
2016.
Author
Yi Q.; Li K.; Jian Z.; Xiao Y.-B.; Chen L.; Zhang Y.; Ma R.-Y.
Institution
(Yi, Jian, Xiao, Chen, Ma) Department of Cardiovascular Surgery, Xinqiao
Hospital, Third Military Medical University, 183 Xinqiao Street, Chongqing
400037, China
(Li) Department of Urologic Surgery, Daping Hospital, Third Military
Medical University, Chongqing, China
(Zhang) Department of Epidemiology, Third Military Medical University,
Chongqing, China
(Zhang) Evidence-Based Medicine and Clinical Epidemiology Center, Third
Military Medical University, Chongqing, China
Publisher
S. Karger AG
Abstract
Purpose: Cardiovascular surgery-associated acute kidney injury (AKI-CS)
contributes to mortality and morbidity. However, risk factors accelerating
its development are unclear. We identified risk factors for AKI-CS in
patients with cardiopulmonary bypass in the hospital surgical intensive
care unit to predict and minimize renal complication in future cardiac
surgery. Method(s): We analyzed data from 14 case-control studies
published prior to June 2014 and indexed in Science Citation Index,
PubMed, and other databases to determine the major risk factors for
AKI-CS. Result(s): Analyzed risk factors were divided into three
groups: preoperative, intraoperative and postoperative. Preoperative
factors included: age (OR, 4.87; 95% CI, 3.50-6.24), NYHA class III/IV
(OR, 2.53; 95% CI, 1.32-4.86), hypertension (OR, 1.68; 95% CI, 1.44-1.97),
preoperative creatinine (OR, 0.66; 95% CI, 0.18-1.14), peripheral vascular
disease (OR, 1.31 95% CI, 1.09-1.57), respiratory system disease (OR,
1.29; 95% CI, 1.10-1.50), diabetes mellitus (OR, 1.52; 95% CI, 1.07-2.16),
and cerebrovascular disease (OR, 2.13; 95% CI, 1.11-4.09). Intraoperative
factors were: cardiopulmonary bypass time (OR, 33.78; 95% CI,
23.15-44.41), aortic clamping time (OR, 13.24; 95% CI, 7.78-18.69), use of
intra-aortic balloon pump (OR, 4.44; 95% CI, 2.37-8.30), and type of
surgery (OR, 1.01; 95% CI, 0.43-2.39). Postoperative factors were:
infection (OR, 3.58; 95% CI, 1.43-8.97), redo operation (OR, 2.57; 95% CI,
1.75-3.78), emergency surgery (OR, 4.76; 95% CI, 3.05-7.43), and low
cardiac output (OR, 2.30; 95% CI, 1.05-5.04). Conclusion(s): Our
results support that preoperative, intraoperative, and postoperative
factors are associated with AKI-CS. Ejection fraction, BMI, acute
myocardial infarction, type of surgery, and congestive heart failure were
not absolutely associated with AKI. Copyright © 2016 S. Karger
AG, Basel.

<102>
Accession Number
603943404
Title
Heme oxygenase-1 and acute kidney injury following cardiac surgery.
Source
CardioRenal Medicine. 4(1) (pp 12-21), 2014. Date of Publication: 2014.
Author
Billings F.T.; Yu C.; Byrne J.G.; Petracek M.R.; Pretorius M.
Institution
(Billings, Pretorius) Department of Anesthesiology, Vanderbilt University,
School of Medicine, 1215 21st Avenue S., Nashville, TN 37232, United
States
(Yu) Departments of Biostatistics, Vanderbilt University School of
Medicine, Nashville, TN, United States
(Byrne, Petracek) Departments of Cardiac Surgery, Vanderbilt University
School of Medicine, Nashville, TN, United States
(Pretorius) Division of Clinical Pharmacology, Department of Medicine,
Vanderbilt University School of Medicine, Nashville, TN, United States
Publisher
S. Karger AG
Abstract
Background: Intraoperative hemolysis and inflammation are associated with
acute kidney injury (AKI) following cardiac surgery. Plasma-free
hemoglobin induces heme oxygenase-1 (HO-1) expression. HO-1 degrades heme
but increases in experimental models of AKI. This study tested the
hypothesis that plasma HO-1 concentrations are associated with
intraoperative hemolysis and are increased in patients that develop AKI
following cardiac surgery. Method(s): We measured plasma HO-1, free
hemoglobin, and inflammatory markers in 74 patients undergoing
cardiopulmonary bypass (CPB). AKI was defined as an increase in serum
creatinine concentration of 50% or 0.3 mg/dl within 72 h of surgery.
 Result(s): Twenty-eight percent of patients developed AKI. HO-1
concentrations increased from 4.2 +/- 0.2 ng/ml at baseline to 6.6 +/- 0.5
ng/ml on postoperative day (POD) 1 (p < 0.001). POD1 HO-1 concentrations
were 3.1 ng/ml higher (95% CI 1.1-5.1) in AKI patients, as was the change
in HO-1 from baseline to POD1 (4.4 +/- 1.3 ng/ml in AKI patients vs. 1.5
+/- 0.3 ng/ml in no-AKI patients, p = 0.006). HO-1 concentrations remained
elevated in AKI patients even after controlling for AKI risk factors and
preoperative drug therapy. Peak-free hemoglobin concentrations correlated
with peak HO-1 concentrations on POD1 in patients that developed AKI (p =
0.02). Duration of CPB and post-CPB IL-6 and IL-10 concentrations were
also associated with increased HO-1 on POD1. Conclusion(s): Plasma
HO-1 is increased in patients that develop AKI, and CPB duration,
hemolysis, and inflammation are associated with increased HO-1
concentrations following cardiac surgery. Strategies that alter hemolysis
and HO-1 expression during cardiac surgery may affect risk for
AKI. Copyright © 2014 S. Karger AG, Basel.

<103>
Accession Number
2029649264
Title
The impact of perioperative non-steroidal anti-inflammatory drugs use on
pleurodesis following thoracic surgery.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(5) (no
pagination), 2023. Article Number: ivad107. Date of Publication: 01 Nov
2023.
Author
Kutywayo K.; Habib A.A.; Caruana E.J.
Institution
(Kutywayo, Habib, Caruana) Department of Thoracic Surgery, Glenfield
Hospital, University Hospitals Leicester, Leicester, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was: in patients who have had
{visceral and parietal pleural symphysis}, {do NSAIDs reduce} {the
efficacy of pleurodesis}? Sixteen papers were discovered in the search. Of
these, 3 human studies were included in the analysis. None showed a
significantly higher rate of pleurodesis failure in patients given
perioperative NSAIDs. The results from the largest study met criteria for
noninferiority. Within the constraints of the study, the results suggest
that systemic administration of nonsteroidal anti-inflammatory medication
in the perioperative period does not necessarily attenuate effective
pleurodesis. However, further study is needed as there is a clear paucity
of human-based studies. Copyright © 2023 The Author(s).

<104>
Accession Number
2028944871
Title
Improving nutritional status of children using artificial
intelligence-based mobile application postsurgery: Randomised controlled
trial.
Source
BMJ Nutrition, Prevention and Health. 6(2) (pp 367-373), 2023. Date of
Publication: 01 Dec 2023.
Author
Zahid M.; Sughra U.; Mumtaz S.; Hassan M.
Institution
(Zahid, Mumtaz, Hassan) Armed Forces Institute of Cardiology, National
Institute of Heart Diseases, Rawalpindi, Pakistan
(Sughra) Al Shifa Research Centre, Al-Shifa Trust Eye Hospital Rawalpindi,
Rawalpindi, Pakistan
Publisher
BMJ Publishing Group
Abstract
Background Malnutrition is a common problem in children postsurgery
especially in low-middle-income countries. Health-based mobile apps play
an important role for better nutritional status. Methods This is a two-arm
randomised controlled trial, which was conducted at a tertiary care
hospital, Rawalpindi. The study duration was 6 months from February 2021
to July 2021. The sample size with power of 80% and significance level of
5% was calculated to be 88. The intervention group was given a
diet-related mobile app, and the usual care group was handed a pamphlet
with diet instructions on discharge. Findings The mean weight of all
participants was 15 (SD 5.7) kg at the time of discharge. However, at the
end of the 8th week, the mean weight of the participants in the usual care
group was 16.5 (SD 7.2) kg and that of the intervention group was 17.1 (SD
5) kg. The average calorie consumed by the usual care group was 972 (SD
252) kcal and 1000.75 (SD 210) kcal by the intervention group after 8
weeks of discharge. The average protein consumed by the usual care group
was 34.3 (SD 12.5) g and 39 (SD 6.4) g by the intervention group after 8
weeks of discharge. Interpretation This study showed strength for the
future of scalable modern technology for self-nutrition monitoring. There
was a slight increase in the weight and nutritional intake of both groups.
Trial registration number NCT04782635. Copyright © Author(s) (or
their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

<105>
Accession Number
2027353990
Title
Beyond the Vapor: Exploring Hemodynamic Parameters and Recovery
Characteristics in Valvular Cardiac Surgery with Sevoflurane and
Isoflurane.
Source
International Journal of Pharmaceutical and Clinical Research. 15(12) (pp
1498-1501), 2023. Date of Publication: 2023.
Author
Meena D.K.; Charan P.; Sharma A.; Somani M.
Institution
(Meena, Sharma) Department of Anaesthesiology, RVRS Government Medical
College, Rajasthan, Bhilwara, India
(Charan) Department of Anaesthesiology, SMS Medical College, Rajasthan,
Jaipur, India
(Somani) Department of Anaesthesiology, RNT Medical college, Rajasthan,
Udaipur, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: For patients with valvular heart disorders, valve cardiac
surgery is a vital intervention that requires careful evaluation of
anesthetic drugs to maximize perioperative results. This study
investigates how hemodynamic parameters and recovery characteristics
following valvular heart surgery are affected by sevoflurane and
isoflurane. Method(s): Seventy participants were randomly assigned to
receive either isoflurane (Group B) or sevoflurane (Group A) in a
hospital-based, randomized, comparative trial. Assessments were made of
hemodynamic parameters such as cardiac output, pulmonary vascular
resistance, and systemic vascular resistance. Sevoflurane or isoflurane
anesthesia regimes were customized to meet the needs of each individual
patient. Comprehensive research was done on recovery features such time to
extubation, emergence from anesthesia, and postoperative problems. The two
groups' findings were compared using statistical techniques.
 Result(s): Comparable hemodynamic stability was observed between the
isoflurane and sevoflurane groups, which is an important factor in
valvular heart surgery. There were no discernible variations in diastolic
blood pressure (D.B.P.) at different intervals, suggesting that both
medications could offer comparable intraoperative hemodynamic stability.
Furthermore, similar values were seen in the trend of stroke volume
variation (SVV), which confirms the hemodynamic neutrality of the drugs
during surgery. Conclusion(s): The present study provides significant
insights into the administration of sevoflurane and isoflurane during
valvular heart surgery. Similar hemodynamic stability was shown by both
drugs, highlighting the significance of customizing anesthetic regimes to
meet the demands of each patient. The thorough investigation of recovery
traits improves perioperative care tactics even more. These results will
help anesthesiologists make wise judgments that will eventually benefit
patients having valvular heart surgery. Copyright © Meena et al.

<106>
Accession Number
2026973300
Title
Inter-institutional analysis of the outcome after postcardiotomy
veno-arterial extracorporeal membrane oxygenation.
Source
International Journal of Artificial Organs. 47(1) (pp 25-34), 2024. Date
of Publication: January 2024.
Author
Biancari F.; Makikallio T.; Loforte A.; Kaserer A.; Ruggieri V.G.; Cho
S.-M.; Kang J.K.; Dalen M.; Welp H.; Jonsson K.; Ragnarsson S.; Hernandez
Perez F.J.; Gatti G.; Alkhamees K.; Fiore A.; Lechiancole A.; Rosato S.;
Spadaccio C.; Pettinari M.; Perrotti A.; Sahli S.D.; L'Acqua C.; Arafat
A.A.; Albabtain M.A.; AlBarak M.M.; Laimoud M.; Djordjevic I.; Krasivskyi
I.; Samalavicius R.; Jankuviene A.; Alonso-Fernandez-Gatta M.; Wilhelm
M.J.; Juvonen T.; Mariscalco G.
Institution
(Biancari, Juvonen) Heart and Lung Center, Helsinki University Hospital,
Helsinki, Finland
(Biancari, Makikallio) Department of Medicine, South-Karelia Central
Hospital, University of Helsinki, Helsinki, Finland
(Loforte) Department of Cardiothoracic, Transplantation and Vascular
Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
(Kaserer, Sahli) Institute of Anesthesiology, University and University
Hospital Zurich, Zurich, Switzerland
(Ruggieri) Division of Cardiothoracic and Vascular Surgery, Robert Debre
University Hospital, Reims, France
(Cho, Kang) Division of Neurosciences, Critical Care and Cardiac Surgery,
Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Dalen) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Karolinska University Hospital, Stockholm, Sweden
(Welp) Department of Cardiothoracic Surgery, Munster University Hospital,
Munster, Germany
(Jonsson) Department of Cardiac Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Ragnarsson) Department of Cardiothoracic Surgery, University of Lund,
Lund, Sweden
(Hernandez Perez) Puerta de Hierro University Hospital, Madrid, Spain
(Gatti) Division of Cardiac Surgery, Cardio-Thoracic and Vascular
Department, University Hospital of Trieste, Trieste, Italy
(Alkhamees) Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
(Fiore) Department of Cardiac Surgery, Hopitaux Universitaires Henri
Mondor, Creteil, France
(Lechiancole) Cardiothoracic Department, University Hospital of Udine,
Udine, Italy
(Rosato) Center for Global Health, Italian National Institute, Rome, Italy
(Spadaccio) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Pettinari) Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Perrotti) Department of Thoracic and Cardio-Vascular Surgery, University
Hospital Jean Minjoz, Besancon, France
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Milan, Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan, Italy
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt
(Albabtain) Cardiology Clinical Pharmacy, Prince Sultan Cardiac Center,
Riyadh, Saudi Arabia
(AlBarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, Faisal Specialist
Hospital and Research Center, King, Riyadh, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo,
Egypt
(Djordjevic, Krasivskyi) Department of Cardiothoracic Surgery, University
Hospital Cologne, Cologne, Germany
(Samalavicius, Jankuviene) II Department of Anesthesia, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Salamanca,
Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid,
Spain
(Wilhelm) Clinic for Cardiac Surgery, University Heart Center, University
and University Hospital Zurich, Zurich, Switzerland
(Juvonen) Research Unit of Surgery, Anesthesia and Intensive Care,
University of Oulu, Oulu, Finland
(Mariscalco) Department of Intensive Care Medicine and Cardiac Surgery,
Glenfield Hospital, University Hospitals of Leicester, Leicester, United
Kingdom
(Loforte) Department of Surgical Science, University of Turin, Turin,
Italy
Publisher
SAGE Publications Ltd
Abstract
Introduction: Patients requiring postcardiotomy veno-arterial
extracorporeal membrane oxygenation (V-A-ECMO) have a high risk of early
mortality. In this analysis, we evaluated whether any interinstitutional
difference exists in the results of postcardiotomy V-A-ECMO.
 Method(s): Studies on postcardiotomy V-A-ECMO were identified through
a systematic review for individual patient data (IPD) meta-analysis.
Analysis of interinstitutional results was performed using direct
standardization, estimation of observed/expected in-hospital mortality
ratio and propensity score matching. Result(s): Systematic review of
the literature yielded 31 studies. Data from 10 studies on 1269 patients
treated at 25 hospitals were available for the present analysis.
In-hospital mortality was 66.7%. The relative risk of in-hospital
mortality was significantly higher in six hospitals. Observed versus
expected in-hospital mortality ratio showed that four hospitals were
outliers with significantly increased mortality rates, and one hospital
had significantly lower in-hospital mortality rate. Participating
hospitals were classified as underperforming and overperforming hospitals
if their observed/expected in-hospital mortality was higher or lower than
1.0, respectively. Among 395 propensity score matched pairs, the
overperforming hospitals had significantly lower in-hospital mortality
(60.3% vs 71.4%, p = 0.001) than underperforming hospitals. Low annual
volume of postcardiotomy V-A-ECMO tended to be predictive of poor outcome
only when adjusted for patients' risk profile. Conclusion(s):
In-hospital mortality after postcardiotomy V-A-ECMO differed significantly
between participating hospitals. These findings suggest that in many
centers there is room for improvement of the results of postcardiotomy
V-A-ECMO. Copyright © The Author(s) 2023.

<107>
Accession Number
2026760173
Title
Enhanced recovery after thoracic surgery in low- and middle-income
countries: Feasibility and outcomes.
Source
Asian Cardiovascular and Thoracic Annals. 32(1) (pp 27-35), 2024. Date of
Publication: January 2024.
Author
Hentati A.; Ayed A.B.; Jdidi J.; Chaari Z.; Halima G.B.; Frikha I.
Institution
(Hentati, Ayed, Jdidi, Chaari, Halima, Frikha) University of Sfax, Faculty
of Medicine of Sfax, Sfax, Tunisia
(Hentati, Chaari, Halima, Frikha) Department of Cardiovascular and
Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
(Ayed) Surgery Department, Gabes University Hospital, Gabes, Tunisia
(Jdidi) Community Medicine Department, Hedi Chaker University Hospital,
Sfax, Tunisia
Publisher
SAGE Publications Inc.
Abstract
Background: Enhanced Recovery After Surgery (ERAS) applies multimodal,
perioperative, and evidence-based practices to decrease postoperative
morbi-mortality, the length of hospital stay, and hospitalization costs.
Implementing enhanced recovery after thoracic surgery (ERATS) in low- and
middle-income countries (LMIC) is problematic. This randomized controlled
trial evaluated the feasibility and effectiveness of an ERATS protocol
adapted to LMIC conditions in Tunisia. Material(s) and Method(s): We
conducted this randomized controlled trial between December 2015 and
August 2017 in the Thoracic and Cardiovascular Surgery Department at Habib
Bourguiba University Hospital of Sfax, Tunisia. Result(s): One
hundred patients undergoing thoracic surgery were randomly allocated to
the ERATS group or Control group. During the postoperative phase, 13
patients (13%) were excluded secondary. These complication rates were
lower in the ERATS group: lack of reexpansion (14.63% vs 16.10%: p =
0.72), pleural effusion (0% vs 10.86%, p = 0.05), and prolonged air leak
(17.07% vs 30.43%, p = 0.14). The pain level decreased significantly in
the ERATS group from postoperative H3 (p = 0.006). This difference was
significant at H6 (p = 0.001), H24 (p = 0.05), H48 (p = 0.01), discharge
(p = 0.002), and after 15 days (p = 0.01), with a decreased analgesic
consumption. The length of hospital stay was shorter in the ERAS group
(median six days vs seven days, p = 0.17). Conclusion(s): This study
provides an adapted ERATS protocol, applicable regardless of the surgical
approach or the type of resection and suitable for LMIC hospital's
conditions. This protocol can improve the postoperative outcomes of
thoracic surgery. Copyright © The Author(s) 2023.

<108>
Accession Number
2026525787
Title
Comparing the Efficacy and Safety of Galcanezumab Versus Rimegepant for
Prevention of Episodic Migraine: Results from a Randomized, Controlled
Clinical Trial.
Source
Neurology and Therapy. 13(1) (pp 85-105), 2024. Date of Publication:
February 2024.
Author
Schwedt T.J.; Myers Oakes T.M.; Martinez J.M.; Vargas B.B.; Pandey H.;
Pearlman E.M.; Richardson D.R.; Varnado O.J.; Cobas Meyer M.; Goadsby P.J.
Institution
(Schwedt) Mayo Clinic, Phoenix, AZ, United States
(Myers Oakes, Martinez, Vargas, Pandey, Pearlman, Richardson, Varnado,
Cobas Meyer) Eli Lilly and Company, Indianapolis, IN 46201, United States
(Goadsby) NIHR King's Clinical Research Facility and Headache Group,
Institute of Psychiatry, Psychology and Neuroscience, King's College
London, Wolfson SPRRC, London, United Kingdom
(Goadsby) Department of Neurology, University of California, Los Angeles,
CA, United States
Publisher
Adis
Abstract
Introduction: There have been no prior trials directly comparing the
efficacy of different calcitonin gene-related peptide (CGRP) antagonists
for migraine prevention. Reported are the results from the first
head-to-head study of two CGRP antagonists, galcanezumab (monoclonal
antibody) versus rimegepant (gepant), for the prevention of episodic
migraine. Method(s): In this 3-month, double-blind, double-dummy
study, participants were randomized (1:1) to subcutaneous (SC)
galcanezumab 120 mg per month (after a 240 mg loading dose) and a placebo
oral disintegrating tablet (ODT) every other day (q.o.d.) or to rimegepant
75 mg ODT q.o.d. and a monthly SC placebo. The primary endpoint was the
proportion of participants with a >= 50% reduction in migraine headache
days per month from baseline across the 3-month double-blind treatment
period. Key secondary endpoints were overall mean change from baseline in:
migraine headache days per month across 3 months and at month 3, 2, and 1;
migraine headache days per month with acute migraine medication use;
Migraine-Specific Quality of Life Questionnaire Role Function-Restrictive
domain score at month 3; and a >= 75% and 100% reduction from baseline in
migraine headache days per month across 3 months. Result(s): Of 580
randomized participants (galcanezumab: 287, rimegepant: 293; mean age: 42
years), 83% were female and 81% Caucasian. Galcanezumab was not superior
to rimegepant in achieving a >= 50% reduction from baseline in migraine
headache days per month (62% versus 61% respectively; P = 0.70). Given the
pre-specified multiple testing procedure, key secondary endpoints cannot
be considered statistically significant. Overall, treatment-emergent
adverse events were reported by 21% of participants, with no significant
differences between study intervention groups. Conclusion(s):
Galcanezumab was not superior to rimegepant for the primary endpoint;
however, both interventions demonstrated efficacy as preventive treatments
in participants with episodic migraine. The efficacy and safety profiles
observed in galcanezumab-treated participants were consistent with
previous studies. Trial registration: ClinTrials.gov-NCT05127486
(I5Q-MC-CGBD). Copyright © 2023, The Author(s).

<109>
Accession Number
2025620408
Title
Exploring the Use of Lung Ultrasonography to Assess Cardiac Surgery
Patients: A Scoping Review.
Source
Journal of Diagnostic Medical Sonography. 40(1) (pp 79-99), 2024. Date of
Publication: January 2024.
Author
Farrell C.; Cooper K.; Hayward S.; Walker C.
Institution
(Farrell, Cooper, Walker) School of Health Sciences, Robert Gordon
University, Aberdeen, United Kingdom
(Cooper) Scottish Centre for Evidence-Based, Multi-Professional Practice:
A JBI Centre of Excellence, Aberdeen, United Kingdom
(Hayward) Lancashire Cardiac Centre, Blackpool Victoria Hospital,
Blackpool, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Objective: Lung ultrasonography (LUS) is a safe, quick, and portable
diagnostic tool, which can accurately detect postoperative pulmonary
complications, postsurgically, without ionizing radiation. The aim of this
scoping review was to map the evidence base regarding the use of LUS to
assess cardiac surgery patients. Material(s) and Method(s): The JBI
methodology was used to conduct this particular scoping review.
 Result(s): In total, 90 publications were identified and of those, 73
were research studies, six were narrative reviews, and 11 were narrative,
opinion, and text articles. The studies that were included were
predominantly observational cohorts and aimed to determine or compare LUS
diagnostic ability, prognostic ability, or both. The LUS methods used with
patients were heterogeneous and variably reported. Conclusion(s):
Despite an increasing number of studies since 2014, standardized protocols
for the use of LUS are yet to be widely adopted and remain an important
area for further work. Future research should consider exploring
perceptions and experiences of LUS, the use of LUS in treatment outcome
measurement, and use by nonphysician health care
professionals. Copyright © The Author(s) 2023.

<110>
Accession Number
2024853251
Title
Effects of Triamterene in Hospitalized Patients with Heart Failure and
Diuretic Resistance: A Randomized Clinical Trial.
Source
Journal of Clinical Pharmacology. 63(12) (pp 1352-1358), 2023. Date of
Publication: December 2023.
Author
Taban-Sadeghi M.; Khani E.; Khezripour K.; Enamzadeh E.; Safaei N.;
Entezari-Maleki T.
Institution
(Taban-Sadeghi, Enamzadeh, Safaei, Entezari-Maleki) Cardiovascular
Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,
Islamic Republic of
(Khani, Khezripour, Entezari-Maleki) Department of Clinical Pharmacy,
Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran,
Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Due to the potential benefits of triamterene in diuretic resistance, this
study was performed to assess whether triamterene add-on to the standard
treatment of heart failure (HF)-related diuretic resistance improves
outcomes. A randomized clinical trial was performed on 45 hospitalized
patients with HF with reduced ejection fraction who had diuretic
resistance. Patients were randomized to receive either triamterene 50 mg
plus hydrochlorothiazide 25 mg (n = 23) or hydrochlorothiazide 50 mg alone
(n = 22) until hospital discharge. The primary outcomes were changes in
weight and fluid input-to-output ratio. Secondary outcomes were
respiratory rate, hospitalization duration, serum sodium and potassium,
estimated glomerular filtration rate, creatinine, and blood urea nitrogen
levels during the study period. The mean (standard deviation) of weight
changes was not significantly different in the intervention and the
control groups (-6.3 [4.8] vs -4.8 [2.4] kg, respectively; P =.1). No
significant differences were shown in input-to-output changes between the
2 groups (208.0 [243.4] in the intervention and 600.2 [250.3] in the
control group; P =.4). Although the respiratory rate of
triamterene-treated patients decreased, the difference did not reach
statistical significance (P =.2). Other secondary outcomes were also
similar in both groups. This study did not support the use of triamterene
as an add-on therapy for patients with HF-related diuretic
resistance. Copyright © 2023, The American College of Clinical
Pharmacology.

<111>
Accession Number
2018076864
Title
Negative pressure wound therapy in patients with diabetes undergoing left
internal thoracic artery harvest: A randomized control trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(1) (pp 256-268), 2024.
Date of Publication: January 2024.
Author
Jenkins S.; Komber M.; Mattam K.; Briffa N.
Institution
(Jenkins, Briffa) Department of Infection, Immunity, and Cardiovascular
Disease, The University of Sheffield, Sheffield, United Kingdom
(Komber, Mattam, Briffa) Department of Cardiothoracic Surgery, Sheffield
Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Patients with diabetes undergoing CABG are at risk of wound
infection. Incisional negative pressure wound therapy has been shown to be
effective in decreasing incidence of infection in high-risk wounds. Near
infrared spectroscopy (NIRS) can be used to assess wound oxygenation and
low values can predict infection. Objective(s): To evaluate utility
of NIRS to assess wound oxygenation, to assess effect of sternotomy, left
internal thoracic artery harvest, and wound dressing type on wound edge
oxygenation. Method(s): In this blinded randomized control trial,
patients with diabetes undergoing isolated coronary artery bypass grafting
with a left internal thoracic artery were randomized to receive either
incisional negative pressure wound therapy dressing or a standard
dressing. NIRS measurements were made on the left upper arm (control), and
left and right parasternal regions on day -1 (preoperative), day 5, and
week 6 after surgery. Results were analyzed using repeated measures
parametric methods. Result(s): Eighty patients with diabetes were
recruited, 40 to the incisional negative pressure wound therapy group and
40 to the standard dressing group. Adjusted NIRS readings dropped
significantly in all patients by day 5 and partially recovered by week 6.
In both groups, there was no difference between readings on the left and
right. At all time points and on both sides, there was no difference in
readings between patients in the 2 groups. Conclusion(s): NIRS can be
used to assess oxygenation adjacent to a sternotomy wound. Adjusted tissue
oxygen levels change with time after sternotomy and left internal thoracic
artery harvest in patients with diabetes. Wound dressing type does not
influence day 5 wound edge oxygenation. Copyright © 2022

<112>
Accession Number
643240188
Title
Experience And Its Implication For Reassessment Of The Transcatheter
Aortic Valve Implantation Using Real World Data.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2023. Adelaide, SA Australia. 39(Supplement 1) (pp S64-S65), 2023. Date of
Publication: December 2023.
Author
Park J.M.; Han S.J.; Kim K.H.
Publisher
Cambridge University Press
Abstract
Introduction: South Korea has introduced conditionality to coverage
decisions for certain difficult or high-risk procedures. The transcatheter
aortic valve implantation (TAVI) was included in the coverage with
evidence development (CED) in 2014. This study reviewed the results of
reassessment for the TAVI using real world data (RWD) and suggested its
implications. Method(s): Healthcare providers authorized to use the
promising technologies are required to collect the RWD for suitability
evaluation, safety monitoring, and cost-effectiveness, differing from the
general reassessment process. In 2021, 45 healthcare providers collected
clinical information for TAVI patients. Their registries were linked with
the national health insurance claims, which provided data on 19 items to
assess safety and effectiveness such as overall mortality, reoperation
rates, hospital readmission rates, and degree of functional improvement.
 Result(s): According to the Society of Thoracic Surgeons' predicted
risk of mortality (STS), 988 TAVI patients were classified into three
groups; high (STS >8 percent, n=347), intermediate (STS 4-8 percent,
n=272), and low (STS <4 percent, n=369); We compared main outcomes and
estimated survival probabilities between subgroups. Within 30 days, the
overall mortality rates were 4.9 percent (high), 2.6 percent
(intermediate), and 1.4 percent (low); major bleeding rates were 7.6
percent (high), 6.2 percent (intermediate),and 1.4 percent (low);
incidence of new atrial fibrillation were 6.8 percent (high), 4.2 percent
(intermediate), and 3.2 percent (low). Based on the quantitative results
using RWD and systematic review for the safety and effectiveness, TAVI is
reported to have essential benefits for high-risk group and elderly
patients (>80 years). Whereas, intermediate and low-risk groups have
out-of-pocket payment rates of 50 percent and 80 percent, respectively.
 Conclusion(s): The reassessment system through RWD accumulation
enabled the evidence-based evaluation for the TAVI. Based on the
transition to CED for essential benefits, a systematic framework such as
RWD collection from treatment commencement should be introduced to broaden
RWD use for benefit management of medical technologies with uncertain
levels of evidence. Therefore, this ensures overall quality of care and
effective coverage in health.

<113>
Accession Number
643239944
Title
Robotic-Assisted Thoracoscopic Surgery Versus Video-Assisted Thoracoscopic
Surgery And Open Thoracotomy: A Systematic Review And Meta-Analysis.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2023. Adelaide, SA Australia. 39(Supplement 1) (pp S77), 2023. Date of
Publication: December 2023.
Author
Lee J.; Jung Y.
Publisher
Cambridge University Press
Abstract
Introduction: Robot-assisted surgery is one of the minimally invasive
surgical approaches that has been increasingly utilized across a wide
range of surgeries. However, there is limited evidence of roboticassisted
thoracic surgery (RATS) for patients with lung cancer. This study aims to
evaluate the safety and effectiveness of RATS in lung cancer patients
compared with video-assisted thoracoscopic surgery (VATS) and open
thoracotomy. Method(s): A comprehensive search for studies that
compared RATS versus VATS or open thoracotomy published until 12 April
2022, was conducted. Two review authors independently assessed studies for
inclusion and risk of bias, and extracted data. We used results of
reported perioperative outcomes, oncological outcomes, and survival
outcomes. When more than two studies contributed data, metaanalyses were
performed. Result(s): Four randomized controlled trials (RCT) were
included. Firstly, three RCTs comparing RATS with VATS were identified.
Compared with the VATS group, the RATS group had significantly lower blood
loss, more harvested lymph nodes and lymph node stations. However, there
were no significant differences in operative time, transfusion rates,
hospital stay, drainage duration, reoperation, readmission, postoperative
pain, and postoperative complications. Survival outcomes were not
reported. Secondly, one RCT comparing RATS with open thoracotomy was
identified. Compared with open thoracotomy group, the RATS group had
significantly lower blood loss, less postoperative pain, and shorter chest
drainage duration. On the other hand, there were no significant
differences in operative time, hospital stay, postoperative complications,
number of harvested lymph nodes and lymph node stations, and survival
outcomes (disease-free survival, overall survival). Conclusion(s):
Evidence on the effectiveness and safety of RATS compared with VATS or
open thoracotomy for lung cancer is of low certainty, but we suggest that
RATS is a feasible and safe alternative to conventional thoracic surgeries
for lung cancer patients on the basis of current data. Additionally, more
and better studies are required to provide evidence on the benefits and
cost-effectiveness of RATS..

<114>
Accession Number
643239932
Title
Integrating Real-world Compliance In The Assessment Of Left Atrial
Appendage Closure Versus Anticoagulation Therapy In Non-valvular Atrial
Fibrillation.
Source
International Journal of Technology Assessment in Health Care. Conference:
Annual Meeting of the Health Technology Assessment International, HTAi
2023. Adelaide, SA Australia. 39(Supplement 1) (pp S52), 2023. Date of
Publication: December 2023.
Author
Pyne S.; Tilden D.; Calcino G.; Mudge M.
Publisher
Cambridge University Press
Abstract
Introduction: In patients with non-valvular atrial fibrillation (NVAF),
left atrial appendage closure (LAAC) has demonstrated non-inferior
efficacy and safety relative to life-long oral anticoagulation therapy
(OAT) in a four-year randomized controlled trial (RCT) (PRAGUE-17).
Sub-optimal compliance to OAT in the real-world setting (Simmons 2016) has
been associated with increased risk of stroke (Ozaki 2020) and may alter
efficacy estimates derived from RCTs in which compliance is generally
higher. The study aims to model disease outcomes in NVAF patients treated
with LAAC versus lifelong OAT when applying trial versus real world
compliance to OAT. Method(s): Real-world compliance to OAT in the
Australian setting was investigated in a 10 percent Pharmaceutical
Benefits Schedule (PBS) sample scripts analysis which measured treatment
adherence and persistence to new oral anticoagulants (NOACs) and warfarin.
Design of the 10 percent PBS analysis was informed by the compliance to
medicine working group report and included the longest follow-up of any
OAT compliance study identified in the literature. A Markov cohort model
was developed to estimate the expected numbers of strokes and major
bleeding events in NVAF patients. Result(s): Rates of NOAC
discontinuation in PRAGUE-17 was higher at 20 months median follow-up
(6.5%) versus compliance in the Australian setting (35.4% and 30.0%
according to 3 and 6 month ceasing rules at 20 months follow-up). Applying
sub-optimal compliance to lifelong OAT demonstrated in the Australian
setting resulted in higher numbers of strokes over a life time modelled
time horizon compared with LAAC. Conclusion(s): Real world compliance
to medicines should be a consideration in economic analysis comparing
lifelong medications to one-off surgical interventions.

<115>
Accession Number
643239558
Title
The utility of fetuin and common prognostic scales in predicting one-year
mortality of the patients with end-stage heart failure.
Source
Kardiologia Polska. Conference: 26th International Congress of the Polish
Cardiac Society. Katowice Poland. 80(Supplement 1) (pp 11-12), 2022. Date
of Publication: 2022.
Author
Szczurek W.; Skrzypek M.; Romuk E.; Kurkiewicz K.; Szygula-Jurkiewicz B.;
Gasior M.
Institution
(Szczurek) Oddzial Kliniczny Kardiologii, Slaskie Centrum Chorob Serca,
Zabrze, Poland
(Skrzypek) Zaklad Biostatystyki, Wydzial Zdrowia Publicznego w Bytomiu,
Slaski Uniwersytet Medyczny w Katowicach, Katowice, Poland
(Romuk) Katedra i Zaklad Biochemii, Wydzial Nauk Medycznych w Zabrzu,
Slaski Uniwersytet Medyczny w Katowicach, Katowice, Poland
(Kurkiewicz) Studenckie Kolo Naukowe, III Katedra i Oddzial Kliniczny
Kardiologii, Wydzial Nauk Medycznych w Zabrzu, Zabrze, Poland
(Szygula-Jurkiewicz, Gasior) III Katedra i Oddzial Kliniczny Kardiologii,
Wydzial Nauk Medycznych w Zabrzu, Slaski Uniwersytet Medyczny w
Katowicach, Zabrze, Poland
Publisher
Via Medica
Abstract
BACKGROUND Risk stratification is a critical component of selection
process of the patients with end-stage heart failure (HF) who are
considered for heart transplantation (HT). The aim of the study was to
determine the usefulness of fetuin and common prognostic scales in
predicting death in the patients with end-stage HF awaiting HT. MATERIAL
AND METHODS We prospectively analyzed the data of 279 adult hospitalised
patients with advanced HF. Fetuin serum concentrations were measured by
the sandwich enzyme-linked immunosorbent assay (ELISA) with the
commercially available kit (Human Fetuin ELISA, SunRedBio Technology Co,
Ltd, Shanghai, China). The Seattle Heart Failure Model (SHFM) and Meta-
Analysis Global Group in Chronic Heart Failure (MAGGIC) scores were
calculated for all patients. The end-point of the study was death during
one-year follow-up. The Medical University of Silesia's local
Institutional Review Board approved the study protocol. Written, informed
consent was obtained from all patients. RESULTS The median age was 56
(50-60) years, and 86.6% were male. During the follow-up period, 109
(39.06%) patients reached endpoint. The area under the curves (AUC) were
0.807 (95% CI, 0.758-0.856) for fetuin levels, 0.760 (95% CI, 0.704-0.816)
for MAGGIC and 0.783 (95% CI, 0.729-0.837) for SHFM. The differences
between the AUCs for fetuin and MAGGIC, as well as between fetuin and SHFM
were not statistically significant (0.047; 95% CI, -0.029-0.123; P = 0.226
and 0.024; 95% CI, -0.052-0.100; P = 0.537, respectively). CONCLUSIONS
SHFM and MAGGIC scores, as well as fetuin serum concentrations provide
effective methods of assessing the outcomes in analyzed group of patients.

<116>
Accession Number
2029606373
Title
Impact of xenon on postoperative outcomes in cardiac surgery: A systematic
review and meta-analysis of delirium incidence and associated clinical
parameters.
Source
Trends in Anaesthesia and Critical Care. 54 (no pagination), 2024. Article
Number: 101328. Date of Publication: February 2024.
Author
Ameer F.A.; Gumera A.; Ramadan A.; Al-Shammari A.S.; Gamal M.; Amin M.;
Alchamaley M.M.; Nawas R.; Mashkoor Y.; Shalabi L.; Hashim H.T.
Institution
(Ameer) University of Al-Qadisiyah College of Medicine, Iraq
(Gumera) Department of Surgery, University of Melbourne, Australia
(Ramadan) Faculty of Medicine, South Valley University, Qena, Egypt
(Al-Shammari) Imam Ali General Hospital, Baghdad, Iraq
(Gamal, Amin) Faculty of Medicine - Fayoum University, Fayoum, Egypt
(Alchamaley) Al-Zahra'a Hospital, Neurophysiology Department, Iraq
(Nawas) Al-Quds University, Medical College, Palestine
(Mashkoor) Dow Medical College, Sindh, Karachi, Pakistan
(Shalabi) Gharyan Faculty of Medicine, Libyan Arab Jamahiriya
(Hashim) University of Warith Al-Anbiyaa, College of Medicine, Iraq
Publisher
Churchill Livingstone
Abstract
Background: Postoperative delirium (POD) is a common complication after
cardiac surgery, leading to increased morbidity and hospital stays. The
anesthetic choice may affect POD incidence and related complications.
Xenon has emerged as a promising alternative for its cardio- and
neuroprotective effects; however, its effectiveness in preventing POD
following cardiac surgery remains unclear. Objective(s): To evaluate
the effectiveness of Xenon in preventing postoperative delirium in
patients undergoing cardiac surgery. Method(s): Articles were
searched using databases including PubMed, Medline, Scopus, Embase, Web of
Science, and the Cochrane Central Register of Controlled Trials (CENTRAL)
from the databases' inception until August 18, 2023. A total of five
randomized controlled trials were included in this systematic review and
meta-analysis. Six outcomes were extracted and assessed: postoperative
delirium incidence, respiratory disorder, duration of mechanical
ventilation, length of hospital stay, ICU stay length, and mortality.
 Result(s): There were no significant differences between the Xenon
and Control groups across six assessed outcomes: postoperative delirium
incidence (p = 0.46), respiratory disorder (p = 0.66), duration of
mechanical ventilation (p = 0.80), length of hospital stay (p = 0.93), ICU
stay length (p = 0.32), and mortality (p = 0.43). Pooled effect sizes
ranged from non-significant to moderately heterogeneous, with overall
effects constantly failing to reach statistical significance.
 Conclusion(s): These results suggest that Xenon does not display
clinically meaningful benefits over control groups for the assessed
outcomes. Copyright © 2023 Elsevier Ltd

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