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<1>
Accession Number
2028997633
Title
Effect of preinitiated glucose-insulin-potassium strategy for patients
with undergoing planned percutaneous coronary intervention: a systematic
review and meta-analysis.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e073557. Date of
Publication: 07 Dec 2023.
Author
Liu H.; Liu R.; Yang Z.; Xu F.; Li C.
Institution
(Liu, Liu, Yang, Xu, Li) Department of Emergency Medicine and Chest Pain
Centre, Qilu Hospital of Shandong University, Shandong, Jinan, China
(Liu, Liu, Yang, Xu, Li) Key Laboratory of Emergency and Critical Care
Medicine of Shandong Province, Qilu Hospital of Shandong University,
Shandong, Jinan, China
Publisher
BMJ Publishing Group
Abstract
Objectives Whether the glucose-insulin-potassium (GIK) should be used as
an adjuvant therapy for ischaemic myocardial disease remains controversial
nowadays reperfusion era. This meta-analysis aimed to assess the effects
of preinitiated GIK for patients undergoing planned percutaneous coronary
intervention (PCI). Design Systematic review and meta-analysis. Data
sources PubMed, Web of science, MEDLINE, Embase, Cochrane Library and
ClinicalTrials.gov were searched through 27 November 2022. Eligibility
criteria Only randomised controlled trials involving participants
preinitiated with GIK or placebo before planned PCI were included. Data
extraction and synthesis Two independent reviewers used standardised
methods to search, screen and code included trials. Risk of bias was
assessed with the Cochrane tool. Pooled analysis was conducted using
random or effects models according to the heterogeneity. Subgroup analyses
were carried out for dosage of GIK and if with ongoing myocardial
ischaemia. Results 13 randomised controlled trials (RCTs) including 3754
participants were evaluated. We found patients preconditioned with GIK
before PCI showed a significant increase in Thrombolysis in Myocardial
Infarction 3 flow events after angioplasty (OR 1.59, 95% CI 1.03 to 2.46,
p=0.04), also revealed improved in-hospital left ventricular ejection
fraction (weighed mean difference, WMD 1.62, 95% CI 0.21 to 3.03, p=0.02)
and myocardial salvage index (WMD 0.09, 95% CI 0.01 to 0.16, p=0.03).
Nevertheless, no benefit was observed in all-cause mortality neither on
30-day (OR 0.81, 95% CI 0.59 to 1.11, p=0.18) nor 6 months (OR 1.02, 95%
CI 0.42 to 2.46, p=0.97). Furthermore, GIK intervention was associated
with higher occurrences of complications such as phlebitis (OR 10.13, 95%
CI 1.74 to 59.00, p=0.01) and hypoglycaemia (OR 10.43, 95% CI 1.32 to
82.29, p=0.03), but not hyperkalaemia (OR 9.36, 95% CI 0.50 to 175.27,
p=0.13), liquid overload (OR 1.02, 95% CI 0.25 to 4.13, p=0.98) or
in-hospital heart failure (OR 0.42, 95% CI 0.06 to 2.96, p=0.39).
Conclusions Our study shows preconditioning GIK exhibits myocardial
reperfusion and cardiac function benefits for patients planning to receive
PCI intervention, while also some complications such as phlebitis and
hypoglycaemia accompany. PROSPERO registration number
CRD42022326334.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<2>
Accession Number
2029192955
Title
Efficacy and outcomes of Bempedoic acid versus placebo in patients with
statin-intolerance: A pilot systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102236. Date of Publication: February 2024.
Author
Goyal A.; Changez M.I.K.; Tariq M.D.; Mushtaq F.; Shamim U.; Sohail A.H.;
Mahalwar G.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Changez) Department of Surgery, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Tariq) Department of Internal Medicine, Foundation University Medical
College, Islamabad, Pakistan
(Mushtaq) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Shamim) Department of Internal Medicine Aga Khan University Hospital,
Karachi, Pakistan
(Sohail) Department of Surgery, University of New Mexico Health Sciences,
Albuquerque, NM, United States
(Mahalwar) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Bempedoic acid (BA) has shown significant progress in
reducing cholesterol levels and is relatively free from the many side
effects encountered with the use of other hyperlipidemic drugs such as
statins. However, its efficacy in patients with statin intolerance is
controversial with inconsistent results among studies. <br/>Material(s)
and Method(s): An electronic literature search was performed using various
databases such as Medline, Google Scholar, and the International Registry
of Clinical Trials. The primary endpoint was the change in LDL-C levels.
The secondary endpoints included changes in HDL-C, non-HDL-C,
triglycerides (TG), clinical outcomes such as MACE, all-cause mortality
(ACM), cardiovascular mortality, myocardial infarction (MI), and
additional safety outcomes. The least-square mean (LSM) percent change for
assessing changes in lipid parameter levels from the baseline and the risk
ratio (RR) were used for the evaluation of binary endpoints, with
statistical significance set at p<0.05. Random-effects meta-analyses were
performed for all the outcomes. <br/>Result(s): Our analysis included 5
randomized controlled trials (RCTs) with a total of 18,848 participants.
BA showed a significant reduction in LDL-C [LSM difference in %: -25.24;
95 % CI: -30.79 to -19.69; p < 0.00001], total cholesterol [LSM difference
in %:-21.28; 95 % CI:-30.58 to-11.98; p < 0.00001], non-HDL-C [LSM
difference in %: -23.27; 95 % Cl: -29.80 to -16.73 p < 0.00001], and HDL-C
[LSM difference in %:-3.37, 95 % CI:-3.73 to-3.01, p < 0.00001] compared
to placebo. In terms of clinical efficacy, BA was associated with a lower
risk of coronary revascularization [RR:0.81; 95 % CI:0.66 to 0.99; p =
0.04], hospitalization for unstable angina [RR:0.67; 95 % CI:0.50 to 0.88;
p = 0.005], and myocardial infarction [RR:0.76; 95 % CI:0.66 to 0.88;p =
0.0004]. No significant difference was observed in MACE [RR:0.81; p =
0.15], ACM [RR:0.86; p = 0.46], cardiovascular-related mortality [RR:0.79;
p = 0.44], and stroke [RR:0.83; p = 0.08] between the two groups. In terms
of safety efficacy, the risk for myalgia was significantly lower in
BA-treated patients than in placebo [RR:0.80; p = 0.0002], while the risk
for gout [RR:1.46; p < 0.0001] and hyperuricemia [RR:1.93; p < 0.00001]
was higher for BA than for placebo. The risks for other adverse effects,
such as neurocognitive disorder, nasopharyngitis urinary tract infection,
upper respiratory infection, muscular disorder, and worsening
hyperglycemia/DM were comparable between the two groups.
<br/>Conclusion(s): Our analysis demonstrated that BA significantly
reduced the levels of LDL-C, total cholesterol, non-HDL-C, HDL-C, ApoB,
and hs-CRP compared with the placebo group. Additionally, patients who
received BA had a lower likelihood of coronary revascularization and
hospitalization due to unstable angina, MI, and myalgia. Further
large-scale RCTs are required to generate more robust
evidence.<br/>Copyright &#xa9; 2023

<3>
Accession Number
2029033897
Title
Periprocedural continuation versus interruption of oral anticoagulant
drugs during transcatheter aortic valve implantation: rationale and design
of the POPular PAUSE TAVI trial.
Source
EuroIntervention. 19(9) (pp 766-771), 2023. Date of Publication: November
2023.
Author
van Ginkel D.J.; Bor W.L.; Dubois C.L.F.; Aarts H.M.; Rooijakkers M.J.P.;
van Bergeijk K.H.; Rosseel L.; Veenstra L.; De Backer O.; Van Mieghem
N.M.; van der Kley F.; Wilgenhof A.; Leonora R.; Halim J.; Schotborgh C.;
Barbato E.; Van Der Heyden J.A.S.; Frambach P.; Ferdinande B.; Mylotte D.;
Fabris E.; Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer J.;
Nijenhuis V.J.; Peper J.; Vriesendorp P.A.; de Laat B.; Ninivaggi M.;
Stragier H.; Voskuil M.; IJsselmuiden A.J.J.; Hermanides R.S.; Agostoni
P.; van 't Hof A.W.J.; Wykrzykowska J.J.; van Royen N.; Delewi R.; ten
Berg J.M.
Institution
(ten Berg) Department of Cardiology, St Antonius Hospital, Koekoekslaan 1,
Nieuwegein 3435 CM, Netherlands
(van Ginkel, Bor, Rensing, Timmers, Swaans, Brouwer, Nijenhuis, Peper, ten
Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Dubois) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Aarts, Wilgenhof, Delewi) Department of Cardiology, Amsterdam UMC,
Amsterdam, Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Rooijakkers, van Royen) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(Rosseel) Department of Cardiology, Algemeen Stedelijk Hospital Aalst,
Aalst, Belgium
(Veenstra, Vriesendorp, van 't Hof) Department of Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(De Backer) The Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Van Mieghem, Voskuil) Department of Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(van der Kley, Agostoni) Department of Cardiology, Leiden University
Medical Center, Leiden, Netherlands
(Wilgenhof) Department of Cardiology, Hospital Network Antwerp (ZNA)
Middelheim, Antwerp, Belgium
(Leonora, Hermanides) Department of Cardiology, Isala Hospital, Zwolle,
Netherlands
(Halim, IJsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Barbato) Cardiovascular Center Aalst, Onze Lieve Vrouwe Hospital, Aalst,
Netherlands
(Van Der Heyden) Department of Cardiology, Sint-Jan Hospital, Brugge,
Belgium
(Frambach) Department of Cardiology, Institut National de Chirurgie
Cardiaque et de Cardiologie Interventionnelle, Luxembourg City, Luxembourg
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(de Laat, Ninivaggi) Department of Functional Coagulation, Synapse
Research Institute, Maastricht, Netherlands
(Stragier) Department of Anesthesiology, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium
(Stragier, van 't Hof, ten Berg) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
Publisher
Europa Group
Abstract
About one-third of patients undergoing transcatheter aortic valve
implantation (TAVI) use oral anticoagulants (OAC), mainly due to atrial
fibrillation. General guidelines advise interrupting OAC in patients with
a high risk of bleeding undergoing interventions. However, preliminary
observational data suggest that the continuation of OAC during TAVI is
safe and may reduce the risk of periprocedural thromboembolic events. The
Periprocedural Continuation Versus Interruption of Oral Anticoagulant
Drugs During Transcatheter Aortic Valve Implantation (POPular PAUSE TAVI)
is a multicentre, randomised clinical trial with open-label treatment and
blinded endpoint assessment. Patients are randomised 1:1 to periprocedural
continuation versus interruption of OAC and are stratified for vitamin K
antagonist or direct oral anticoagulant use. The primary endpoint is a
composite of cardiovascular mortality, all stroke, myocardial infarction,
major vascular complications and type 2-4 bleeding within 30 days after
TAVI, according to the Valve Academic Research Consortium-3 criteria.
Secondary endpoints include separate individual and composite outcomes,
quality of life and cost-effectiveness. Since continuation of OAC is
associated with the ancillary benefit that it simplifies periprocedural
management, the primary outcome is first analysed for non-inferiority; if
non-inferiority is proven, superiority will be tested. Recruitment started
in November 2020, and the trial will continue until a total of 858
patients have been included and followed for 90 days. In summary, POPular
PAUSE TAVI is the first randomised clinical trial to assess the safety and
efficacy of periprocedural continuation versus interruption of OAC in
patients undergoing TAVI.<br/>Copyright &#xa9; Europa Digital & Publishing
2023. All rights reserved.

<4>
Accession Number
2027351862
Title
The Safety and Efficacy of Phage Therapy for Infections in Cardiac and
Peripheral Vascular Surgery: A Systematic Review.
Source
Antibiotics. 12(12) (no pagination), 2023. Article Number: 1684. Date of
Publication: December 2023.
Author
Simpson E.A.; MacLeod C.S.; Stacey H.J.; Nagy J.; Jones J.D.
Institution
(Simpson, Jones) Medical Microbiology, Ninewells Hospital, NHS Tayside,
Dundee DD2 1SG, United Kingdom
(MacLeod, Nagy) Department of Vascular Surgery, Ninewells Hospital, NHS
Tayside, Dundee DD2 1SG, United Kingdom
(MacLeod) Division of Systems Medicine, School of Medicine, University of
Dundee, Ninewells Hospital, Dundee DD2 1SG, United Kingdom
(Stacey) Public Health, Kings Cross Hospital, NHS Tayside, Clepington
Road, Dundee DD3 8EA, United Kingdom
(Jones) Infection Medicine, Edinburgh Medical School: Biomedical Sciences,
University of Edinburgh, Chancellor's Building, 49 Little France Crescent,
Edinburgh EH16 4SB, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
New approaches to managing infections in cardiac and peripheral vascular
surgery are required to reduce costs to patients and healthcare providers.
Bacteriophage (phage) therapy is a promising antimicrobial approach that
has been recommended for consideration in antibiotic refractory cases. We
systematically reviewed the clinical evidence for phage therapy in
vascular surgery to support the unlicensed use of phage therapy and inform
future research. Three electronic databases were searched for articles
that reported primary data about human phage therapy for infections in
cardiac or peripheral vascular surgery. Fourteen reports were eligible for
inclusion, representing 40 patients, among which an estimated 70.3% of
patients (n = 26/37) achieved clinical resolution. A further 10.8% (n =
4/37) of patients showed improvement and 18.9% (n = 7/37) showed no
improvement. Six of the twelve reports that commented on the safety of
phage therapy did not report adverse effects. No adverse effects
documented in the remaining six reports were directly linked to phages but
reflected the presence of manufacturing contaminants or release of
bacterial debris following bacterial lysis. The reports identified by this
review suggest that appropriately purified phages represent a safe and
efficacious treatment option for infections in cardiac and peripheral
vascular surgery.<br/>Copyright &#xa9; 2023 by the authors.

<5>
Accession Number
2028974110
Title
Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for
Minimally Invasive Thoracic Surgery: A Randomized Clinical Trial.
Source
JAMA Surgery. 158(12) (pp 1255-1263), 2023. Date of Publication: 13 Dec
2023.
Author
Chenesseau J.; Fourdrain A.; Pastene B.; Charvet A.; Rivory A.; Baumstarck
K.; Bouabdallah I.; Trousse D.; Boulate D.; Brioude G.; Gust L.; Vasse M.;
Braggio C.; Mora P.; Labarriere A.; Zieleskiewicz L.; Leone M.; Thomas
P.A.; D'Journo X.-B.
Institution
(Chenesseau, Fourdrain, Bouabdallah, Trousse, Boulate, Brioude, Gust,
Vasse, Braggio, Thomas, D'Journo) Department of Thoracic Surgery Diseases
of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille
University, Assistance Publique-Hopitaux de Marseille, Marseille, France
(Pastene, Charvet, Rivory, Mora, Labarriere, Zieleskiewicz, Leone)
Department of Anesthesiology and Intensive Care Medicine, North Hospital,
Aix Marseille University, Assistance Publique-Hopitaux de Marseille,
Marseille, France
(Baumstarck) Departement of Biostatistics, Aix Marseille University,
Assistance Publique-Hopitaux de Marseille, Marseille, France
Publisher
American Medical Association
Abstract
Importance: In minimally invasive thoracic surgery, paravertebral block
(PVB) using ultrasound (US)-guided technique is an efficient postoperative
analgesia. However, it is an operator-dependent process depending on
experience and local resources. Because pain-control failure is highly
detrimental, surgeons may consider other locoregional analgesic options.
<br/>Objective(s): To demonstrate the noninferiority of PVB performed by
surgeons under video-assisted thoracoscopic surgery (VATS), hereafter
referred to as PVB-VATS, as the experimental group compared with PVB
performed by anesthesiologists using US-guided technique (PVB-US) as the
control group. <br/>Design, Setting, and Participant(s): In this
single-center, noninferiority, patient-blinded, randomized clinical trial
conducted from September 8, 2020, to December 8, 2021, patients older than
18 years who were undergoing a scheduled minimally invasive thoracic
surgery with lung resection including video-assisted or robotic approaches
were included. Exclusion criteria included scheduled open surgery, any
antalgic World Health Organization level greater than 2 before surgery, or
a medical history of homolateral thoracic surgery. Patients were randomly
assigned (1:1) to an intervention group after general anesthesia. They
received single-injection PVB before the first incision was made in the
control group (PVB-US) or after 1 incision was made under thoracoscopic
vision in the experimental group (PVB-VATS). <br/>Intervention(s):
PVB-VATS or PVB-US. <br/>Main Outcomes and Measures: The primary end point
was mean 48-hour post-PVB opioid consumption considering a noninferiority
range of less than 7.5 mg of opioid consumption between groups. Secondary
outcomes included time of anesthesia, surgery, and operating room
occupancy; 48-hour pain visual analog scale score at rest and while
coughing; and 30-day postoperative complications. <br/>Result(s): A total
of 196 patients were randomly assigned to intervention groups: 98 in the
PVB-VATS group (mean [SD] age, 64.6 [9.5] years; 53 female [54.1%]) and 98
in the PVB-US group (mean [SD] age, 65.8 [11.5] years; 62 male [63.3%]).
The mean (SD) of 48-hour opioid consumption in the PVB-VATS group (33.9
[19.8] mg; 95% CI, 30.0-37.9 mg) was noninferior to that measured in the
PVB-US group (28.5 [18.2] mg; 95% CI, 24.8-32.2 mg; difference: -5.4 mg;
95% CI, - to -0.93; noninferiority Welsh test, P <=.001). Pain score at
rest and while coughing after surgery, overall time, and postoperative
complications did not differ between groups. <br/>Conclusions and
Relevance: PVB placed by a surgeon during thoracoscopy was noninferior to
PVB placed by an anesthesiologist using ultrasonography before incision in
terms of opioid consumption during the first 48 hours. Trial Registration:
ClinicalTrials.gov Identifier: NCT04579276.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<6>
Accession Number
2027608398
Title
Inhaled iloprost in off-pump coronary artery bypass surgery: a randomized
controlled trial.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Ko S.H.; Shim J.-K.; Song J.-W.; Soh S.; Kwak Y.-L.
Institution
(Ko, Shim, Song, Soh, Kwak) Department of Anesthesiology and Pain
Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro,
Seodaemun-gu, Seoul 03722, South Korea
(Ko, Shim, Song, Soh, Kwak) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
Publisher
Springer
Abstract
Purpose: Mechanical cardiac constraint during off-pump coronary artery
bypass surgery (OPCAB) causes right ventricle (RV) compression and
increased pulmonary artery pressure (PAP), which may further compromise RV
dysfunction. We aimed to assess the effect of inhaled iloprost, a potent
selective pulmonary vasodilator, on the cardiac index (CI) during
mechanical constraint. The secondary aim was to determine the resultant
changes in the hemodynamic and respiratory parameters. <br/>Method(s): A
total of 100 adult patients with three-vessel coronary artery disease who
had known risk factors for hemodynamic instability (congestive heart
failure, mean PAP >= 25 mm Hg, RV systolic pressure >= 50 mm Hg on
preoperative echocardiography, left ventricular ejection fraction < 50%,
myocardial infarction within one month of surgery, redo surgery, and left
main disease) were enrolled in a randomized controlled trial. The patients
were randomly allocated to the control or iloprost groups at a 1:1 ratio,
in which saline and iloprost (20 mug) were inhaled for 15 min after
internal mammary artery harvesting, respectively. Cardiac index was
measured by pulmonary artery catheterization. <br/>Result(s): There were
no significant intergroup differences in CI during grafting (P = 0.36).
The mean PAP had a significant group-time interaction (P = 0.04) and was
significantly lower in the iloprost group at circumflex grafting (mean
[standard deviation], 26 [3] mm Hg vs 24 [3] mm Hg; P = 0.01). The
remaining hemodynamic parameters were similar between the groups.
<br/>Conclusion(s): Inhaled iloprost showed a neutral effect on
hemodynamic parameters, including the CI and pulmonary vascular resistance
index, during OPCAB. Trial registration: ClinicalTrials.gov (NCT04598191);
first submitted 12 October 2020.<br/>Copyright &#xa9; 2023, Canadian
Anesthesiologists' Society.

<7>
Accession Number
2027607878
Title
Effect of preoperative moderate-dose statin and duration on acute kidney
injury after cardiac surgery: a retrospective cohort study.
Source
Current Medical Research and Opinion. (no pagination), 2023. Date of
Publication: 2023.
Author
Jiang J.; Liu X.; Cheng Z.; Liu Q.; Xing W.
Institution
(Jiang, Liu, Xing) Department of Big Data Center for Cardiovascular
Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital,
Central China Fuwai Hospital of Zhengzhou University, China
(Cheng, Liu) Department of Cardiovascular Surgery, Henan Provincial
People's Hospital, Central China Fuwai Hospital, Central China Fuwai
Hospital of Zhengzhou University, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: The impact of preoperative statin use on postoperative acute
kidney injury (AKI) is uncertain. We aimed to examine the association of
statin therapy before cardiac surgery with postoperative AKI.
<br/>Method(s): The retrospective cohort study consisted of 1581 patients
undergoing cardiac surgery. Postoperative AKI were identified by the
modified KDIGO definition. Propensity-score matching was employed to
control for selection bias, and logistic regression was used to control
for confounders. Subgroup and interaction analyses were performed to
evaluate the robustness of the findings. <br/>Result(s): The overall
incidence of postoperative AKI and severe AKI were 42.19% and 12.27%,
respectively. Preoperative moderate-dose statin was significantly
associated with a reduced incidence of postoperative AKI (28.9% vs 43.0%,
OR (95%CI): 0.54 (0.38, 0.77), p < 0.001) and severe AKI (6.9% vs 13.7%,
OR (95%CI): 0.46 (0.26, 0.83), p = 0.009). The beneficial effect on
postoperative AKI persisted after adjusting for major confounding factors
(OR (95%CI): 0.47 (0.34, 0.66)). Decreased risk of postoperative AKI was
observed in patients with preoperative statin duration of 7 ~ 14 days (OR
(95%CI): 0.41 (0.25, 0.65)) and over 14 days (OR (95%CI): 0.43 (0.28,
0.65)), but not in those with preoperative statin duration of <7 days.
Similar favorable effects were noted in most subgroup patients, except for
those with high-risk factors such as diabetes mellitus, previous
congestive cardiac failure, arrhythmia, preoperative ACEI/ARB, aortic
cross-clamping or IABP. <br/>Conclusion(s): Preoperative moderate-dose
statin was significantly related to a decreased risk of postoperative AKI,
especially in patients who received statins for a longer duration. Further
large-scale multicenter randomized controlled trials are needed to
ascertain the impact of statin dose, duration, and timing on postoperative
AKI in cardiac surgery patients.<br/>Copyright &#xa9; 2023 Informa UK
Limited, trading as Taylor & Francis Group.

<8>
Accession Number
2027607360
Title
Posterior Annulus Elevation Technique in Reducing Residual Regurgitation
During Mitral Valve Repair in Children: A Randomized Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2023. Date of Publication: 2023.
Author
Rahmat B.; Siswanto B.B.; Fakhri D.; Sakidjan I.; Murni T.W.; Timan I.S.;
Kekalih A.; Kurniawati Y.; Fardhani D.G.; Arya Wardana P.W.
Institution
(Rahmat) Doctoral Program in Medical Sciences, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Rahmat, Fakhri, Fardhani) Pediatric and Congenital Heart Surgery Unit,
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Siswanto, Sakidjan, Kurniawati) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Indonesia, National
Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
(Murni) Cardiothoracic Surgery Division, Department of Surgery, Hasan
Sadikin Hospital, Jawa Barat, Indonesia
(Timan) Human Genetic Research Center IMERI-FKUI, Universitas Kristen
Krida Wacana, Jakarta, Indonesia
(Kekalih) Community Medicine Department, Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Arya Wardana) Department of Thoracic, Cardiac and Vascular Surgery,
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: The current technique used in severe mitral regurgitation in
children can occasionally lead to residual regurgitation. To address this
issue, the posterior annulus elevation technique was developed to enhance
coaptation and reduce residual lesions. This study aims to evaluate the
effectiveness of this technique in reducing residual regurgitation during
mitral valve repair in children. <br/>Method(s): A total of 64 patients
aged <18 years old undergoing mitral valve repair were randomized into two
groups: the intervention (with posterior annulus elevation) group and the
control group, which underwent conventional repair techniques. Various
parameters, including coaptation area, residual mitral regurgitation,
clinical outcomes, metabolic, and hemolytic markers, were measured on days
0, 5, 2 weeks, and 3 months after surgery. <br/>Result(s): The
intervention group (n = 32) showed a significant reduction in residual
mitral regurgitation compared with the control group (n = 32) on each
evaluation. At three months after surgery, we found that the posterior
annulus elevation technique could be a protective factor that reduces the
chance of residual regurgitation compared with the control group (RR =
0.31; confidence interval: 0.18-0.54; P <=.001). Coaptation length and
index were also found to be significantly higher in the intervention group
(P <=.001). Clinical outcomes, metabolic markers, and hemolysis marker did
not show any significant differences between the two groups.
<br/>Conclusion(s): The posterior annulus elevation technique demonstrated
effectiveness in reducing residual mitral regurgitation and improving
coaptation area in pediatric mitral valve repair. This technique showed
better short-term surgical outcomes in children with mitral regurgitation
compared with the conventional technique.<br/>Copyright &#xa9; The
Author(s) 2023.

<9>
[Use Link to view the full text]
Accession Number
641443999
Title
Transversus thoracic muscle plane block for pain during cardiac surgery: a
systematic review and meta-analysis.
Source
International journal of surgery (London, England). 109(8) (pp 2500-2508),
2023. Date of Publication: 01 Aug 2023.
Author
Xue J.-J.; Cui Y.-Y.; Busse J.W.; Ge L.; Zhou T.; Huang W.-H.; Ding S.-S.;
Zhang J.; Yang K.-H.
Institution
(Xue, Yang) Evidence-based Medicine Center, School of Basic Medical
Science, Lanzhou University
(Xue) Department of Anesthesiology, Gansu Province Hospital of Traditional
Chinese Medicine, China
(Xue) Gansu Clinical Research Center of Integrative Anesthesiology
(Cui, Zhou, Huang, Ding, Zhang) First School of Clinical Medicine, Gansu
University of Chinese Medicine, Chengguan District
(Busse) Department of Anesthesia
(Busse) The Michael G. DeGroote National Pain Centre, McMaster University,
Hamilton, Ontario, Canada
(Ge) Key Laboratory of Evidence Based Medicine and Knowledge Translation
of Gansu Province
(Ge, Yang) Evidence-Based Social Science Research Center, School of Public
Health, Lanzhou University, Lanzhou, China
Publisher
NLM (Medline)
Abstract
STUDY OBJECTIVE: The role of transversus thoracic muscle plane blocks
(TTMPBs) during cardiac surgery is controversial. We conducted a
systematic review to establish the effectiveness of this procedure.
DESIGN: Systematic review. We searched PubMed, Embase, Web of Science,
CENTRAL, WanFang Data, and the China National Knowledge Infrastructure to
June 2022, and followed the GRADE approach to evaluate the certainty of
evidence. STUDY ELIGIBILITY CRITERIA: Eligible studies enrolled adult
patients scheduled to undergo cardiac surgery and randomized them to
receive a TTMPB or no block/sham block. MAIN RESULTS: Nine trials that
enrolled 454 participants were included. Compared to no block/sham block,
moderate certainty evidence found that TTMPB probably reduces
postoperative pain at rest at 12 h [weighted mean difference (WMD) -1.51
cm on a 10 cm visual analogue scale for pain, 95% CI -2.02 to -1.00; risk
difference (RD) for achieving mild pain or less (<=3 cm), 41%, 95% CI
17-65) and 24 h (WMD -1.07 cm, 95% CI -1.83 to -0.32; RD 26%, 95% CI
9-37). Moderate certainty evidence also supported that TTMPB probably
reduces pain during movement at 12 h (WMD -3.42 cm, 95% CI -4.47 to -2.37;
RD 46%, 95% CI 12-80) and at 24 h (WMD -1.73 cm, 95% CI -3.24 to -0.21; RD
32%, 95% CI 5-59), intraoperative opioid use [WMD -28 milligram morphine
equivalent (MME), 95% CI -42 to -15], postoperative opioid consumption
(WMD -17 MME, 95% CI -29 to -5), postoperative nausea and vomiting
(absolute risk difference 255 less per 1000 persons, 95% CI 140-314), and
intensive care unit (ICU) length of stay (WMD -13 h, 95% CI -21 to -6).
<br/>CONCLUSION(S): Moderate certainty evidence showed TTMPB during
cardiac surgery probably reduces postoperative pain at rest and with
movement, opioid consumption, ICU length of stay, and the incidence of
nausea and vomiting.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<10>
Accession Number
641122990
Title
Paravertebral block combined with serratus anterior plane block after
video-assisted thoracic surgery: a prospective randomized controlled
trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(1) (no pagination),
2023. Date of Publication: 03 Jul 2023.
Author
Dusseaux M.-M.; Grego V.; Baste J.-M.; Besnier E.; Boujibar F.; Koscianski
G.; Ben Yahia M.M.; Compere V.; Clavier T.; Vannier M.; Selim J.
Institution
(Dusseaux, Grego, Besnier, Koscianski, Ben Yahia, Compere, Clavier, Selim)
Department of Anaesthesiology and Critical Care, CHU Rouen, Rouen F-76000,
France
(Baste, Besnier, Boujibar, Clavier, Selim) Univ Rouen Normandy INSERM EnVI
UMR 1096, Rouen F-76000, France
(Baste, Boujibar) Department of Thoracic Surgery, CHU Rouen, Rouen
F-76000, France
(Vannier) Department of Biostatistics, Rouen University Hospital, Rouen
F-76000, France
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Adequate pain management after thoracoscopic surgery is a
major issue in the prevention of respiratory complications. The
combination of the paravertebral block (PVB) with the serratus anterior
plane block (SAPB) may decrease postoperative pain. The objective of this
study was to evaluate the impact of the combination of PVB and SAPB on the
consumption of morphine and pain after video- or robot-assisted thoracic
surgery. <br/>METHOD(S): The main objective of this randomized controlled
trial was to compare the cumulative postoperative morphine consumption at
24 h between a group having PVB (PVB group) and a group having PVB and
SAPB (PV-SAPB group). Postoperative pain at 6 and 24 h and
morphine-related complications were also assessed. <br/>RESULT(S): A total
of 112 patients were included with 56 in each group. There was no
difference in median cumulative morphine consumption at 24 h between the 2
groups (P=0.1640). At 6 h, the median postoperative pain was higher in the
PVB group compared to the PV-SAPB group (3 [0; 4] vs 2 [0; 3], P=0.0231).
There were no differences between the 2 groups for pain at 24 h and
morphine-related complications. <br/>CONCLUSION(S): We did not find any
difference in morphine consumption between the 2 groups. Our results
suggest that the combination of PVB and SAPB for video-assisted thoracic
surgery or robot-assisted thoracic surgery is safe effective and reliable
and could be an alternative to PVB alone in certain
indications.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<11>
Accession Number
643109137
Title
Abstracts Swiss Anaesthesia 2023, Joint Annual Meeting Swiss Society for
Anaesthesiology and Perioperative Medicine Swiss Association for
Anaesthesia Nursing.
Source
Swiss Medical Weekly. Conference: Annual Meeting Swiss Society for
Anaesthesiology and Perioperative Medicine, SSAPM and Swiss Association
for Anaesthesia Nursing, SIGA/FSIA. Lausanne Switzerland. 153(Supplement
273) (no pagination), 2023. Date of Publication: November 2023.
Author
Anonymous
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
The proceedings contain 35 papers. The topics discussed include:
trajectories of pain and opioid use up to 12 months after surgery;
sevoflurane postconditioning protects from an early neurological deficit
after subarachnoid hemorrhage. results of a randomized laboratory study in
rats; the postoperative analgesic efficacy of liposomal bupivacaine versus
long-acting local anesthetics for peripheral nerve and field blocks: a
systematic review and meta-analysis, with trial sequential analysis;
copeptin for the prediction of all-cause mortality following cardiac
surgery; preoperative gastric ultrasound in patients at risk for
aspiration - toward a new standard of care to improve perioperative
patient safety: a prospective observational study in 2003 patients; and
inspired oxygen fraction of 80% aggravates segmental left ventricular
diastolic dysfunction in anesthetized patients with coronary artery
disease.

<12>
Accession Number
643109060
Title
Perioperative predictors of postoperative delirium after non-cardiac
surgery: An individual patient data metaanalysis.
Source
Swiss Medical Weekly. Conference: Annual Meeting Swiss Society for
Anaesthesiology and Perioperative Medicine, SSAPM and Swiss Association
for Anaesthesia Nursing, SIGA/FSIA. Lausanne Switzerland. 153(Supplement
273) (pp 6S), 2023. Date of Publication: November 2023.
Author
Sadeghirad B.; Dodsworth B.T.; Schmutz Gelsomino N.; Goettel N.; Falco L.;
Spence J.; Buchan T.A.; Crandon H.; Mbuagbaw L.
Institution
(Sadeghirad, Buchan, Mbuagbaw) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, Canada
(Sadeghirad, Spence, Mbuagbaw) Department of Anesthesia, McMaster
University, Hamilton, Canada
(Sadeghirad, Crandon) Michael G. DeGroote Institute for Pain Research and
Care, McMaster University, Hamilton, Canada
(Dodsworth, Schmutz Gelsomino) PIPRA AG, Zurich, Switzerland
(Goettel) Department of Anesthesiology, University of Florida, College of
Medicine, Gainesville, United States
(Goettel) Department of Clinical Research, University of Basel, Basel,
Switzerland
(Falco) Zuhlke Engineering AG, Zurcherstrasse 39J, Schlieren 8952,
Switzerland
(Mbuagbaw) Centre for Development of Best Practices in Health (CDBPH),
Yaounde Central Hospital, Yaounde, Cameroon
(Mbuagbaw) Division of Epidemiology and Biostatistics, Department of
Global Health, Stellenbosch University, Cape Town, South Africa
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Background and Objectives: Delirium is a common and serious complication
after surgery, associated with adverse patient and healthcare system
outcomes. We performed an individual patient data (IPD) meta-analysis to
identify perioperative prognostic factors associated with postoperative
delirium (POD) and assessed their relative predictive value among adults
undergoing non-cardiac surgery. <br/>Method(s): We searched MEDLINE,
EMBASE, and CINAHL from inception to May 2020 and included studies that:
(1) enrolled adult patients undergoing non-cardiac surgery, (2) assessed
perioperative risk factors for POD, and (3) measured the incidence of
delirium using a validated delirium assessment tool. Among 14,973 unique
studies, 714 were assessed in full text, and 192 met our eligibility
criteria, from which we successfully acquired individual patient data from
21 studies. We pooled IPD from 21 studies and performed one-stage
meta-analysis using multilevel mixed-effects logistic regression after a
multivariable imputation via chained equations model to impute missing
data. Our end point of interest was POD diagnosed up to 10 days post
procedure. <br/>Finding(s): The probability of developing POD was 17.7%
among 8,382 patients in our analysis. In the final adjusted model, male
sex, older age, being underweight, less educated, currently smoking,
having a past history of delirium, being institutionalized, having a
greater number of co-morbidities, prescribed >5 medications, having a
higher Charlson comorbidity index, higher preoperative serum C-reactive
protein level, ASA status III or IV, and longer duration of
surgery/anesthesia were independent prognostic factors for POD.
<br/>Interpretation(s): Prognostic factors found to be important in this
study can be used in clinical practice to inform patients and care givers
about the expected risk of developing delirium after surgery and to
explain which features should prompt clinicians to consider perioperative
preventive strategies to optimise patient outcomes.

<13>
Accession Number
643118922
Title
Aortic valve replacement with mechanical prosthesis in small aortic
annulus: Keep it simple!.
Source
Asian cardiovascular & thoracic annals. 32(1) (pp 66-67), 2024. Date of
Publication: 01 Jan 2024.
Author
Garatti A.; Menicanti L.
Institution
(Garatti, Menicanti) Departement of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Abstract
We read with great interest the systematic review from Agarwal and
colleagues, comparing the results of sutureless valves versus conventional
aortic valve replacement (AVR) with aortic root enlargement in patients
with aortic stenosis and small aortic annulus. We herein comment on the
review trying to highlight some major issues. Based on some recent
literature's evidences and on the authors' personal experience, we suggest
to consider AVR with mechanical valve as a still viable option, especially
in small aortic annulus. Indeed, root enlargement techniques are not
always easy to perform and sutureless valve is still burdened by higher
rate of PM implantation.

<14>
[Use Link to view the full text]
Accession Number
2029349541
Title
Stroke Prevention in Atrial Fibrillation: Our Current Failures and
Required Research.
Source
Stroke. 55(1) (pp 214-225), 2024. Date of Publication: 01 Jan 2024.
Author
Gurol M.E.; Wright C.B.; Janis S.; Smith E.E.; Gokcal E.; Reddy V.Y.;
Merino J.G.; Hsu J.C.
Institution
(Gurol, Gokcal) Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, United States
(Wright, Janis) Division of Clinical Research, NINDS, Bethesda, MD, United
States
(Smith) Department of Clinical Neurosciences, University of Calgary, AB,
Canada
(Reddy) Helmsley Trust Electrophysiology Center, Icahn School of Medicine,
Mount Sinai, NY, United States
(Merino) Department of Neurology, Georgetown University, Medical Center,
United States
(Hsu) Department of Cardiology, University of California, San Diego,
United States
Publisher
Wolters Kluwer Health
Abstract
Nonvalvular atrial fibrillation is a common rhythm disorder of middle-aged
to older adults that can cause ischemic strokes and systemic embolism.
Lifelong use of oral anticoagulants reduces the risk of these ischemic
events but increases the risk of major and clinically relevant
hemorrhages. These medications also require strict compliance for
efficacy, and they have nontrivial failure rates in higher-risk patients.
Left atrial appendage closure is a nonpharmacological method to prevent
ischemic strokes in atrial fibrillation without the need for lifelong
anticoagulant use, but this procedure has the potential for complications
and residual embolic events. This workshop of the Roundtable of Academia
and Industry for Stroke Prevention discussed future research needed to
further decrease the ischemic and hemorrhagic risks among patients with
atrial fibrillation. A direct thrombin inhibitor, factor Xa inhibitors,
and left atrial appendage closure are FDA-approved approaches whereas
factor XIa inhibitors are currently being studied in phase 3 randomized
controlled trials for stroke prevention. The benefits, risks, and
shortcomings of these treatments and future research required in different
high-risk patient populations are reviewed in this consensus
statement.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<15>
[Use Link to view the full text]
Accession Number
2029349540
Title
Atrial Fibrillation Detection and Load: Knowledge Gaps Related to Stroke
Prevention.
Source
Stroke. 55(1) (pp 205-213), 2024. Date of Publication: 01 Jan 2024.
Author
Smith E.E.; Yaghi S.; Sposato L.A.; Fisher M.; Broderick J.; Das A.S.;
Elkind M.S.V.; Goldstein L.B.; Gurol M.E.; Kamel H.; Morgan J.R.;
Ovbiagele B.; Savitz S.; Selim M.; Wadhwa M.
Institution
(Smith, Broderick, Das, Elkind, Goldstein, Gurol, Kamel, Morgan,
Ovbiagele, Savitz, Selim, Wadhwa) University of Calgary, AB, Canada
(Yaghi) Brown University, Providence, RI, United States
(Sposato) Western University, London, ON, Canada
(Fisher) Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, United States
Publisher
Wolters Kluwer Health
Abstract
Atrial fibrillation is a major cause of ischemic stroke. Technological
advances now support prolonged cardiac rhythm monitoring using either
surface electrodes or insertable cardiac monitors. Four major randomized
controlled trials show that prolonged cardiac monitoring detects
subclinical paroxysmal atrial fibrillation in 9% to 16% of patients with
ischemic stroke, including in patients with potential alternative causes
such as large artery disease or small vessel occlusion; however, the
optimal monitoring strategy, including the target patient population and
the monitoring device (whether to use an event monitor, insertable cardiac
monitor, or stepped approach) has not been well defined. Furthermore, the
clinical significance of very short duration paroxysmal atrial
fibrillation remains controversial. The relevance of the duration of
monitoring, burden of device-detected atrial fibrillation, and its
proximity to the acute ischemic stroke will require more research to
define the most effective methods for stroke prevention in this patient
population.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<16>
Accession Number
2029398341
Title
Incidence of Cerebral Microemboli in Single-Dose vs. Multidose
Cardioplegia in Adult Cardiac Surgery.
Source
Journal of Extra-Corporeal Technology. 50(3) (pp 143-148), 2018. Date of
Publication: 01 Sep 2018.
Author
Mukdad L.; Toppen W.; Sanaiha Y.; Mantha A.; Bland S.; Shemin R.;
Benharash P.
Institution
(Mukdad, Toppen, Sanaiha, Mantha, Bland, Shemin, Benharash) Department of
Cardiac Surgery, David Geffen School of Medicine, University of California
Los Angeles, Los Angeles, CA, United States
Publisher
EDP Sciences
Abstract
Cerebral microemboli have been associated with neurocognitive deficits
after cardiac operations using cardiopulmonary bypass (CPB). Interventions
by the perfusionist and alterations in blood flow account for a large
proportion of previously unexplained microemboli. This study compared the
incidence of microemboli during cardiac operations using conventional
(multidose) and del Nido (single-dose) cardioplegia delivery. Transcranial
Doppler ultrasonography was used to detect microemboli in bilateral middle
cerebral arteries of 30 adult patients undergoing cardiac operations using
CPB and aortic clamping. Multidose conventional blood cardioplegia (CBC)
was used in 15 patients and single-dose del Nido cardioplegia (DNC) in 15.
Manual count of microemboli during cross-clamp and during administration
of cardioplegia was performed. Baseline preoperative characteristics were
similar between groups. There were no differences in the ascending aortic
atheroma grade (1.4 +/-.4 CBC vs. 1.6 +/-.7 DNC, p =.44), bypass times
(141 +/- 36 minutes CBC vs. 151 +/- 33 minutes DNC, p =.64), and
cross-clamp times (118 +/- 32 minutes CBC vs. 119 +/- 45 minutes DNC, p
=.95). The use of multidose CBC was associated with a seven-fold increase
in the number of microemboli per minute of bypass (1.65 +/- 1 vs..24
+/-.18 emboli/min DNC, p =.0004). In this prospective pilot study, we
found that the use of single-dose cardioplegia strategy led to fewer
cerebral microemboli when compared with the traditional multidose
approach. Our findings warrant further investigation of various
cardioplegia strategies and neurologic outcomes in larger cohorts.
<br/>Copyright &#xa9; 2018 AMSECT.

<17>
Accession Number
2029398323
Title
STS/SCA/AmSECT Clinical Practice Guidelines: Anticoagulation during
Cardiopulmonary Bypass.
Source
Journal of Extra-Corporeal Technology. 50(1) (pp 5-18), 2018. Date of
Publication: 01 Mar 2018.
Author
Shore-Lesserson L.; Baker R.A.; Ferraris V.; Greilich P.E.; Fitzgerald D.;
Roman P.; Hammon J.
Institution
(Shore-Lesserson) Department of Anesthesiology, Hofstra Northwell School
of Medicine, New Hyde Park, NY, United States
(Baker) Cardiac Surgery Research and Perfusion, Flinders University,
Flinders Medical Centre, Adelaide, SA, Australia
(Ferraris) Division of Cardiovascular and Thoracic Surgery, University of
Kentucky, Lexington, KY, United States
(Greilich) Department of Anesthesiology & Pain Management, University of
Texas-Southwestern Medical Center, Dallas, TX, United States
(Fitzgerald) Division of Cardiovascular Perfusion, Medical University of
South Carolina, Charleston, SC, United States
(Roman) Department of Anesthesiology, Saint Anthony Hospital, Lakewood,
CO, United States
(Hammon) Department of Cardiothoracic Surgery, Wake Forest University
School of Medicine, Winston-Salem, NC, United States
Publisher
EDP Sciences
Abstract
Despite more than a half century of "safe"cardiopulmonary bypass (CPB),
the evidence base surrounding the conduct of anticoagulation for CPB has
not been organized into a succinct guideline. For this and other reasons,
there is enormous practice variability relating to the use and dosing of
heparin, monitoring heparin anticoagulation, reversal of anticoagulation,
and the use of alternative anticoagulants. To address this and other gaps,
the Society of Thoracic Surgeons (STS), the Society of Cardiovascular
Anesthesiologists (SCA), and the American Society of Extracorporeal
Technology (AmSECT) developed an Evidence Based Workgroup. This was a
group of interdisciplinary professionals gathered together to summarize
the evidence and create practice recommendations for various aspects of
CPB. To date, anticoagulation practices in CPB have not been standardized
in accordance with the evidence base. This clinical practice guideline was
written with the intent to fill the evidence gap and to establish best
practices in anticoagulation for CPB using the available evidence. To
identify relevant evidence a systematic review was outlined and literature
searches were conducted in PubMed using standardized MeSH terms from the
National Library of Medicine list of search terms. Search dates were
inclusive of January 2000 to December 2015. The search yielded 833
abstracts which were reviewed by two independent reviewers. Once accepted
into the full manuscript review stage, two members of the writing group
evaluated each of 286 full papers for inclusion eligibility into the
guideline document. Ninety-six manuscripts were included in the final
review. In addition, 17 manuscripts published prior to 2000 were included
to provide method, context, or additional supporting evidence for the
recommendations as these papers were considered sentinel publications.
Members of the writing group wrote and developed recommendations based on
review of the articles obtained and achieved more than two thirds
agreement on each recommendation. The quality of information for a given
recommendation allowed assessment of the level of evidence as recommended
by the AHA/ACCF Task Force on Practice Guidelines. Recommendations were
written in the three following areas 1) Heparin dosing and monitoring for
initiation and maintenance of CPB, 2) Heparin contraindications and
heparin alternatives, 3) Reversal of anticoagulation during cardiac
operations. It is hoped that this guideline will serve as a resource and
will stimulate investigators to conduct more research and expand upon the
evidence base on the topic of anticoagulation for CPB. <br/>Copyright
&#xa9; 2018 AMSECT.

<18>
Accession Number
2029398234
Title
Blood Conservation-A Team Sport.
Source
Journal of Extra-Corporeal Technology. 48(3) (pp 99-104), 2016. Date of
Publication: 01 Sep 2016.
Author
Likosky D.S.; Dickinson T.A.; Paugh T.A.
Institution
(Likosky, Paugh) Section of Health Services Research and Quality,
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI,
United States
(Dickinson) Specialty Care Nashville Tennessee, The Michigan Society of
Thoracic and Cardiovascular Surgeons, The Perfusion Measures and Outcomes
(PERForm) Registry, United States
Publisher
EDP Sciences
Abstract
Cardiac surgery accounts for between 15% and 20% of all blood product
utilization in the United States. A body of literature suggests that
patients who are exposed to even small quantities of blood have an
increased risk of morbidity and mortality, even after adjusting for
pre-operative risk. Despite this body of literature supporting a
restrictive blood management strategy, wide variability in transfusion
rates exist across institutions. Recent blood management guidelines have
shed light on a number of potentially promising blood management
strategies, including acute normovolemic hemodilution (ANH) and retrograde
autologous priming (RAP). We evaluated the literature concerning ANH and
RAP, and the use of both techniques among centers participating in the
Perfusion Measures and outcomes (PERForm) registry. We leveraged data
concerning ANH and RAP among 10,203 patients undergoing isolated coronary
artery bypass grafting (CABG) procedures from 2010 to 2014 at 27 medical
centers. Meta-analyses have focused on the topic of ANH, with few studies
focusing specifically on cardiac surgery. Two meta-analyses have been
conducted to date on RAP, with many reporting higher intra-operative
hematocrits and reduced transfusions. The rate of red blood cell
transfusions in the setting of CABG surgery is 34.2%, although varied
across institutions from 16.8% to 57.6%. Overall use of ANH was 11.6%,
although the utilization varied from.0% to 75.7% across institutions. RAP
use was 71.4%, although varied from.0% to 99.0% across institutions. A
number of blood conservation strategies have been proposed, with varying
levels of evidence from meta-analyses. This uncertainty has likely
contributed to center-level differences in the utilization of these
practices as evidenced by our multi-institutional database. Perfusion
databases, including the PERForm registry, serve as a vehicle for
perfusionist's to track their practice, and contribute to
multidisciplinary team efforts aimed at assessing and improving the value
of cardiac surgical care. <br/>Copyright &#xa9; 2016 AMSECT.

<19>
Accession Number
2029398201
Title
Factor V Leiden and Cardiopulmonary Bypass.
Source
Journal of Extra-Corporeal Technology. 47(4) (pp 223-227), 2015. Date of
Publication: 01 Dec 2015.
Author
Uppal V.; Rosin W.; Marcoux J.-A.; Olson M.; Bezaire J.; Dalshaug G.
Institution
(Uppal, Rosin, Marcoux, Olson, Bezaire, Dalshaug) Royal University
Hospital, Saskatoon, SK, Canada
(Uppal, Rosin, Marcoux, Olson, Bezaire, Dalshaug) Royal University
Hospital, 103 Hospital Drive, Saskatoon, SK S7S 1E1, Canada
Publisher
EDP Sciences
Abstract
We present a case of a patient with factor V Leiden with an antithrombin
III activity of 67% who received a successful aortic valve replacement
supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation
was achieved by monitoring activated clotting time (ACT) and heparin
concentration ensuring adequate anticoagulation throughout the procedure.
Results from ACT, heparin dose response, heparin protamine titration, and
thrombelastography are given. Factor V Leiden patients can be safely
anti-coagulated using heparin for CPB procedures when monitored with ACT,
heparin protamine titration, and thrombelastography. Postoperative chest
tube losses were 360 mL, less than half our institutional average.
Anticoagulation for the pre-and post-operative phase is also
discussed.<br/>Copyright &#xa9; 2015 American Society of Extra-Corporeal
Technology. All rights reserved.

<20>
Accession Number
2029398199
Title
Comparison of Warm Blood Cardioplegia Delivery With or Without the Use of
a Roller Pump.
Source
Journal of Extra-Corporeal Technology. 47(4) (pp 209-216), 2015. Date of
Publication: 01 Dec 2015.
Author
Faber M.M.; Noordzij P.G.; Hennink S.; Kelder H.; De Vroege R.; Waanders
F.G.; Daeter E.; Stehouwer M.C.
Institution
(Faber, Waanders, Stehouwer) Department of Extracorporeal Circulation, St.
Antonius Hospital, Nieuwegein, Netherlands
(Noordzij, Hennink) Department of Anaesthesiology, Intensive Care and Pain
Management, St. Antonius Hospital, Nieuwegein, Netherlands
(Kelder) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(De Vroege) Department of Extracorporeal Circulation, Haga Hospital, The
Hague, Netherlands
(Daeter) Department of Cardiothoracic Surgery, St. Antonius Hospital,
Nieuwegein, Netherlands
Publisher
EDP Sciences
Abstract
Various techniques for administration of blood cardioplegia are used
worldwide. In this study, the effect of warm blood cardioplegia
administration with or without the use of a roller pump on perioperative
myocardial injury was studied in patients undergoing coronary artery
bypass grafting using minimal extra-corporeal circuits (MECCs).
Sixty-eight patients undergoing elective coronary bypass surgery with an
MECC system were consecutively enrolled and randomized into a pumpless
group (PL group: blood cardioplegia administration without roller pump) or
roller pump group (RP group: blood cardioplegia administration with roller
pump). No statistically significant differences were found between the PL
group and RP group regarding release of cardiac biomarkers. Maximum
postoperative biomarker values reached at T1 (after arrival intensive care
unit) for heart-type fatty acid binding protein (2.7 [1.5; 6.0] ng/mL PL
group vs. 3.2 [1.6; 6.3] ng/mL RP group, p =.63) and at T3 (first
postoperative day) for troponin T high-sensitive (22.0 [14.5; 29.3] ng/L
PL group vs. 21.1 [15.3; 31.6] ng/L RP group, p =.91), N-terminal
pro-brain natriuretic peptide (2.1 [1.7; 2.9] ng/mL PL group vs. 2.6 [1.6;
3.6] ng/mL RP group, p =.48), and C-reactive protein (138 [106; 175]
mug/mL PL group vs. 129 [105; 161] mug/mL RP group, p =.65). Besides this,
blood cardioplegia flow, blood cardioplegia line pressure, and aortic root
pressure during blood cardioplegia administration were similar between the
two groups. Administration of warm blood cardioplegia with or without the
use of a roller pump results in similar clinically acceptable myocardial
protection.<br/>Copyright &#xa9; 2015 American Society of Extra-Corporeal
Technology. All rights reserved.

<21>
Accession Number
2029398187
Title
The History of Goal-Directed Therapy and Relevance to Cardiopulmonary
Bypass.
Source
Journal of Extra-Corporeal Technology. 47(2) (pp 90-94), 2015. Date of
Publication: 01 Jun 2015.
Author
Dijoy L.; Dean J.S.; Bistrick C.; Sistino J.J.
Institution
(Dijoy, Dean, Bistrick, Sistino) Medical University of South Carolina
Division of Cardiovascular Perfusion, College of Health Professions,
Charleston, SC, United States
Publisher
EDP Sciences
Abstract
Goal-directed therapy is a patient care strategy that has been implemented
to improve patient outcomes. The strategy includes aggressive patient
management and monitoring during a period of critical care. Goal-directed
therapy has been adapted to perfusion and has been designated
goal-directed perfusion (GDP). Since this is a new concept in perfusion,
the purpose of this study is to review goal-directed therapy research in
other areas of critical care management and compare that process to
improving patient outcomes following cardiopulmonary bypass. Various areas
of goal-directed therapy literature were reviewed, including fluid
administration, neurologic injury, tissue perfusion, oxygenation, and
inflammatory response. Data from these studies was compiled to document
improvements in patient outcomes. Goal-directed therapy has been
demonstrated to improve patient outcomes when performed within the optimal
time frame resulting in decreased complications, reduction in hospital
stay, and a decrease in morbidity. Based on the successes in other
critical care areas, GDP during cardiopulmonary bypass would be expected
to improve outcomes following cardiac surgery. <br/>Copyright &#xa9; 2015
American Society of Extra-Corporeal Technology. All rights reserved.

<22>
Accession Number
2029398160
Title
Influence of Two Colloidal Extracorporeal Primes on Coagulation of Cardiac
Surgical Patients: A Prospectively Randomized Open-Label Pilot Trial.
Source
Journal of Extra-Corporeal Technology. 46(4) (pp 293-299), 2014. Date of
Publication: 01 Dec 2014.
Author
Bethlehem I.; Wierda K.; Visser C.; Jekel L.; Koopmans M.; Kuiper M.A.
Institution
(Bethlehem, Wierda, Visser) Departments of Extracorporeal Circulation,
Netherlands
(Jekel) Departments of Cardiothoracic Surgery, Netherlands
(Koopmans, Kuiper) Departments of Intensive Care, Medical Centre
Leeuwarden, Leeuwarden, Netherlands
Publisher
EDP Sciences
Abstract
The search for the ideal priming fluid continues as more evidence is
discovered about side effects of volume expanders. With the availability
of modern, balanced hydroxyethyl starch (HES) solutions with less side
effects than former HES solutions, we considered to replace our gelatin-
(modified gelatin) based extracorporeal circuit prime for a HES (130/.42)
prime. Therefore, we studied the influence of two colloidal priming fluids
on postoperative coagulation in patients undergoing cardiac surgery. The
primary endpoint was to compare clot formation time between the HES group
and the gelatin group with rotational thromboelastometry (ROTEM).
Additionally we compared colloid osmotic pressure and fluid balance of
both groups. Forty patients, undergoing elective first time coronary
artery bypass grafting or single-valve surgery, were included in this
prospectively randomized open-label pilot study. Laboratory data and ROTEM
data were collected and analyzed for differences between the two groups.
ROTEM data show significantly more prolongation in Extem clot formation
time and significant more decrease in Extem alpha in the HES group. Fibtem
maximum clot firmness was significantly smaller in the HES group; this was
consistent with fibrinogen concentration measurement, which decreased more
in the HES group than in the gelatin group and recovered more over time in
the gelatin group. We found no significant difference in colloid osmotic
pressure between the groups. In this trial, HES (130/.42) impairs
coagulation significantly more compared with gelatin. These differences in
influence on coagulation did not lead to a difference in blood loss or
fluid balance, so clinical relevance could not be proven.<br/>Copyright
&#xa9; 2014 American Society of Extra-Corporeal Technology. All rights
reserved.

<23>
Accession Number
2029398104
Title
Classic Pages of the Journal of Extracorporeal Technology: Mean Arterial
Blood Pressure during Cardiopulmonary Bypass.
Source
Journal of Extra-Corporeal Technology. 45(3) (pp 195-206), 2013. Date of
Publication: 01 Sep 2013.
Author
Riley J.B.
Institution
(Riley) Mayo Clinic, Rochester, MN, United States
Publisher
EDP Sciences
Abstract
Our classic "The Efficacy and Safety of a Pharmacologic Protocol for
Maintaining Coronary Artery Bypass Patients at a Higher Mean Arterial
Pressure during Cardiopulmonary Bypass" was published in JECT in 1998 by
the Cornell Coronary Artery Bypass (CAB) Outcomes Trial Group from the New
York Hospital Cornell Medical Center (1). The authors of the JECT classic
published the pharmacologic protocols used to control the mean arterial
blood pressure (MAP) in a randomized clinical trial (RCT) published in the
Journal of Thoracic and Cardiovascular Surgery in 1995 (2). The authors of
the 1995 RCT reported that patients maintained at a MAP of greater than 80
mmHg had significantly less morbidity and mortality than those maintained
at 50 60 mmHg. Furthermore, they presented evidence that maintaining blood
pressure greater than 80 mmHg can be achieved in a safe
manner.<br/>Copyright &#xa9; 2013 American Society of Extra-Corporeal
Technology. All rights reserved.

<24>
Accession Number
2029398086
Title
Has the New USP Assay for Heparin Affected Dosage for Patients Undergoing
Cardiopulmonary Bypass?.
Source
Journal of Extra-Corporeal Technology. 45(2) (pp 112-115), 2013. Date of
Publication: 01 Jun 2013.
Author
Anderson D.A.; Holt D.W.
Institution
(Anderson) Concord Hospital, Concord, NH, United States
(Anderson) The University of Nebraska Medical Center, Omaha, NE, United
States
(Holt) University of Nebraska Medical Center, Clinical Perfusion
Education, Omaha, NE, United States
Publisher
EDP Sciences
Abstract
In October 2009, the U.S. Pharmacopoeia (USP) changed the monograph for
heparin to bring USP units in line with international units for heparin.
The result was a 10% decrease in potency as measured by in vitro
laboratory tests. This decrease led to questions regarding dosing
guidelines. There existed a need for an in vivo study to determine the
practical changes that may need to be implemented in regard to heparin
administration for cardiopulmonary bypass in the clinical setting. A
retrospective study was conducted to determine the heparin dose
administered and the corresponding effect on patients undergoing coronary
artery bypass grafting surgery using cardiopulmonary bypass. The study
compared the heparin dose requirements and activated clotting time (ACT)
results using the heparin before and after the USP changes. An analysis of
the data was performed to determine the increased heparin dose required to
achieve the same effect as before the USP change. This new heparin dosing
protocol was instituted at Concord Hospital, Concord, NH. A prospective
study was then preformed to verify the effects of the dosing change. In
the new heparin group, the postheparin ACT fell by 9.1% (p =.028) and the
patients achieving an ACT > 479 seconds fell by 12.8% as compared with the
old heparin group. After adjustment of the loading dose calculation for
heparin, the prospective study demonstrated the postheparin ACT (p =.684)
and the percentage of patients achieving an ACT > 479 seconds (p = 1.000)
to be similar to the values obtained before the USP change. An increase of
the loading dose of approximately 12% is needed to achieve the patient
effects seen before the UPS change. <br/>Copyright &#xa9; 2013 AMSECT.

<25>
Accession Number
2029398067
Title
Psychological Depression and Cardiac Surgery: A Comprehensive Review.
Source
Journal of Extra-Corporeal Technology. 44(4) (pp 224-232), 2012. Date of
Publication: 01 Dec 2012.
Author
Tully P.J.
Institution
(Tully) Department of Surgery, Flinders Medical Centre, Flinders
University of South Australia, Bedford Park, SA, Australia
(Tully) The School of Psychology, The University of Adelaide, Adelaide,
Australia
(Tully) The Discipline of Psychiatry, The University of Adelaide,
Adelaide, SA, Australia
(Tully) The Heart Failure Self Management Program Ambulatory and Primary
Healthcare Directorate, Hampstead Rehabilitation Centre, Northfield,
Australia
Publisher
EDP Sciences
Abstract
The psychological and neurological impact of cardiac surgery has been of
keen empirical interest for more than two decades although reports showing
the prognostic influence of depression on adverse outcomes lag behind the
evidence documented in heart failure, myocardial infarction, and unstable
angina. The paucity of research to date is surprising considering that
some pathophysiological mechanisms through which depression is
hypothesized to affect coronary heart disease (e.g., platelet activation,
the inflammatory system, dysrhythmias) are known to be substantially
influenced by the use of cardiopulmonary bypass. As such, cardiac surgery
may provide a suitable exemplar to better understand the psychiatric
mechanisms of cardiopathogenesis. The extant literature is comprehensively
reviewed with respect to the deleterious impact of depression on cardiac
and neuropsychological morbidity and mortality. Research to date indicates
that depression and major depressive episodes increase major
cardiovascular morbidity risk after cardiac surgery. The association
between depressive disorders and incident delirium is of particular
relevance to cardiac surgery staff. Contemporary treatment intervention
studies are also described along with suggestions for future cardiac
surgery research. <br/>Copyright &#xa9; 2012 AMSECT.

<26>
Accession Number
2029398066
Title
Improvements in Survival and Neurodevelopmental Outcomes in Surgical
Treatment of Hypoplastic Left Heart Syndrome: A Meta-Analytic Review.
Source
Journal of Extra-Corporeal Technology. 44(4) (pp 216-223), 2012. Date of
Publication: 01 Dec 2012.
Author
Sistino J.J.; Bonilha H.S.
Institution
(Sistino, Bonilha) College of Health Professions, Medical University of
South Carolina, Charleston, SC, United States
Publisher
EDP Sciences
Abstract
The purpose of this study was to analyze the changes over the past two
decades in hospital survival and neurodevelopmental outcomes after
surgical treatment for hypoplastic left heart syndrome. The hypothesis for
this study is that increasing hospital survival following the Stage I
Norwood (S1N) procedure is associated with improvements in
neurodevelopmental outcomes. Studies included in the meta-analysis were
identified by searching Ovid MEDLINE from January 1980 to October 2010. A
total of 72 articles were identified. Fifteen single-center study articles
were appropriate for obtaining survival data and 14 were used for
neurodevelopmental outcomes. Wechsler Intelligence Test IQ scores and the
Bayley II Mental Development (MDI) and Psychomotor Development Indices
(PDI) were the primary neurodevelopmental outcomes included in this
meta-analysis. Metaregression analysis using a mixed-effects model
compared the percent survival and neurodevelopmental scores with the year
of surgery. Hospital survival for the S1N operation increased
significantly from 1996 to 2007 (p <.05). The overall mean survival during
this time period was 80.05% (95% confidence interval [CI], 76.4-84.0%).
Standardized Wechsler IQ scores increased significantly from 1989 to 1999
(p <.05) and the mean IQ was 85.09 (95% CI, 82.3-89.5). The Bayley II MDI
increased significantly from 1998 to 2005 (p <.05) with a mean MDI of 86.9
(95% CI, 84.9-88.9). The Bayley II PDI increased significantly from 1998
to 2005 (p <.05) with a mean PDI of 73.4 (95% CI, 71.2-75.5). Increased
survival has been associated with improved but below normal
neurodevelopmental outcomes. <br/>Copyright &#xa9; 2012 AMSECT.

<27>
Accession Number
2029398039
Title
Impact of a Phosphorylcholine-Coated Cardiac Bypass Circuit on Blood Loss
and Platelet Function: A Prospective, Randomized Study.
Source
Journal of Extra-Corporeal Technology. 44(1) (pp 5-9), 2012. Date of
Publication: 01 Mar 2012.
Author
Marguerite S.; Levy F.; Quessard A.; Dupeyron J.-P.; Gros C.; Steib A.
Institution
(Marguerite, Levy, Quessard, Dupeyron, Gros, Steib) Department of Surgical
Anesthesia and Intensive Care, Civil Hospital, Strasbourg University
Hospital, Strasbourg, France
Publisher
EDP Sciences
Abstract
Platelet dysfunction due to cardiopulmonary bypass (CPB) surgery increases
the risk of bleeding. This study analyzed the effect of a
phosphorylcholine (PC)-coated CPB circuit on blood loss, transfusion
needs, and platelet function. We performed a prospective, randomized study
at Strasbourg University Hospital, which included 40 adults undergoing
coronary artery bypass graft surgery (CABG) (n = 20) or mitral valve
repair (n = 20) using CPB. Patients were randomized either to PC-coated
CPB or uncoated CPB (10 CABG patients and 10 mitral valve repair patients
in each group). Blood loss and transfusion needs were evaluated intra- and
postoperatively. Markers of platelet activation and thrombin generation
were measured at anesthesia induction, at the beginning and end of CPB, on
skin closure, and on days 0, 1, and 5. Comparisons were made by Student s
t test or covariance analysis (significance threshold p <= .05). Blood
loss was significantly lower in the PC group during the first 6
postoperative hours (171 +/- 102 vs. 285 +/- 193 mL, p = .024), at the
threshold of significance from 6 24 hours (p = .052), and similar in both
groups after 24 hours. During CPB, platelet count decreased by 48% in both
groups. There was no difference in markers of platelet activation,
thrombin generation, or transfusion needs between the two groups.
Norepinephrine use was more frequent in the control group (63% vs. 33%)
but not significantly. PC-coating of the CPB surface reduced early
postoperative bleeding, especially in CABG patients, but had no
significant effect on platelet function because of large interindividual
variations that prevented the establishment of a causal
relationship.<br/>Copyright &#xa9; 2012 American Society of
Extra-Corporeal Technology. All rights reserved.

<28>
Accession Number
2029398033
Title
A Meta-Analysis of Renal Benefits to Pulsatile Perfusion in Cardiac
Surgery.
Source
Journal of Extra-Corporeal Technology. 44(1) (pp 10-14), 2012. Date of
Publication: 01 Mar 2012.
Author
Sievert A.; Sistino J.
Institution
(Sievert, Sistino) Medical University of South Carolina, Charleston, SC,
United States
Publisher
EDP Sciences
Abstract
Multiple studies have evaluated the efficacy of pulsatile flow during
cardiopulmonary bypass (CPB) showing controversial results. Suggested
benefits to pulsatile perfusion include reducing the systemic inflammatory
response syndrome associated with bypass, decreased need for inotropic
support, shortened hospital stay, and superior organ preservation. This
study aims to compare prior studies to determine if there is a significant
difference in post-operative renal function with pulsatile perfusion
compared to non-pulsatile perfusion during cardiac surgery. Studies
included in the analysis were identified by searching keywords - pulsatile
perfusion, pulse, pulsatile flow, cardiopulmonary bypass, and cardiac
surgery. To maintain a homogenous sample, manuscripts were included if
they met the following criteria: research was prospective in nature,
subjects were human, paper contained documented baseline demographics,
outcome data included markers of renal function. A meta-analysis was
performed to compare post-op renal function between pulsatile and
non-pulsatile perfusion groups. A total of 298 articles were screened. Ten
articles met the criteria, of these, 477 patients underwent non-pulsatile
perfusion while 708 received pulsatile perfusion during CPB. There was
insufficient evidence to show a difference in mean postoperative
creatinine or BUN between the groups, however, the pulsatile perfusion
group had significantly higher creatinine clearance (standardized
difference in means = 2.48, p =.004) and lower serum lactate levels
(standardized difference in means = 2.08, p =.012) in the intensive care
unit. This study found that there is great variability among pulsatile
perfusion research. The methods to create and assess effective pulsatility
on bypass varied widely among manuscripts. This analysis suggests that
pulsatile perfusion during CPB is beneficial in renal preservation and
should be considered. <br/>Copyright &#xa9; 2012 AMSECT.

<29>
Accession Number
2029398014
Title
Does Tight Glucose Control Prevent Myocardial Injury and Inflammation?.
Source
Journal of Extra-Corporeal Technology. 43(3) (pp 144-152), 2011. Date of
Publication: 01 Sep 2011.
Author
Brown J.R.; Furnary A.P.; Mackenzie T.A.; Duquette D.; Helm R.E.; Paliotta
M.; Ross C.S.; Malenka D.J.; O connor G.T.
Institution
(Brown, Mackenzie, Ross, Malenka, O connor) The Dartmouth Institute for
Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon,
NH, United States
(Brown, Mackenzie, Ross, Malenka, O connor) Section of Cardiology,
Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
(Furnary) Providence St. Vincent Medical Center, Starr-Wood Cardiac Group,
Portland, OR, United States
(Duquette, Helm, Paliotta) Portsmouth Regional Hospital, Portsmouth, NH,
United States
Publisher
EDP Sciences
Abstract
Hyperglycemia has been postulated to be cardiotoxic. We addressed the
hypothesis that uncontrolled blood glucose induces myocardial damage in
diabetic patients undergoing isolated coronary artery bypass graft surgery
receiving continuous insulin infusion in the immediate postoperative
period. Our primary aim was to assess the degree of tight glycemic control
for each patient and to link the degree of glycemic control to
intermediate outcome of myocardial damage. We prospectively enrolled 199
consecutive patients with diabetes undergoing isolated coronary artery
bypass graft surgery from October 2003 through August 2005. Preoperative
hemoglobin A 1 c and glucose measures were collected from the surgical
admission. We measured biomarkers of myocardial damage (cardiac troponin
I) and metabolic dysfunction (blood glucose and hemoglobin A 1 c) to
identify a difference among patients under tight (90 100% of glucose
measures delta50 mg/dL) or loose (<90%) glycemic control. All patients
received continuous insulin infusion in the immediate postoperative
period. We discovered 45.6% of the patients were in tight control. We
found tight glycemic control resulted in no significant difference in
troponin I release. Mean cardiac troponin I for tight and loose control
was 4.9 and 8.5 (ng/mL), p value .3. We discovered patients varied with
their degree of control, even with established protocols to maintain
glucose levels within the normal range. We were unable to verify tight
glycemic control compared to loose control was significantly associated
with decreased cardiac troponin I release. Future studies are needed to
evaluate the cardiotoxic mechanisms of hyperglycemia postulated in this
study.<br/>Copyright &#xa9; 2011 American Society of Extra-Corporeal
Technology. All rights reserved.

<30>
Accession Number
2029397988
Title
Hyaluronan Based Heparin Free Coated Open and Closed Extracorporeal
Circuits for High Risk Coronary Revascularization.
Source
Journal of Extra-Corporeal Technology. 42(4) (pp 286-292), 2010. Date of
Publication: 01 Dec 2010.
Author
Gunaydin S.; Ucar H.I.; Serter T.; McCusker K.; Ozcelik G.; Salman N.;
Yorgancioglu A.C.
Institution
(Gunaydin) University of Kirikkale-Turkey, Ankara, Turkey
(Ucar, Serter, Ozcelik, Salman, Yorgancioglu) Medicana Hospital
Ankara-Turkey, Ankara, Turkey
(McCusker) Portsmouth Regional Hospital, Portsmouth, NH, United States
Publisher
EDP Sciences
Abstract
This prospective randomized study compares the inflammatory response and
fibrinolytic activation of fully coated/uncoated and open/closed
extracorporeal circuits (ECC) in high risk patients. Over a 2-month
period, 48 patients with EuroSCOREs 6 or greater undergoing coronary
revascularization were pro spectively randomized to one of the four
perfusion protocols: Group 1: Closed and totally hyaluronan based heparin
free coated (Vision HFO-GBS-HF , Gish Biomedical, Rancho Santa Margarita,
CA) ECC with a soft-shell coated venous reservoir (SVR11S2-HFC , Gish
Biomedical ) and a hard-shell cardiotomy (CAPVRF44, Gish Biomedical) ( n =
12); Group 2: Closed and totally uncoated identical ECC with soft-shell
uncoated venous reservoir and a hard-shell cardiotomy ( n = 12); Group 3:
Open, totally hyaluronan based heparin free coated ECC ( n = 12); and
Group 4: Control-open, uncoated ECC ( n = 12). Blood samples were
collected at T1: Baseline; T2: 15 minutes after cardiopulmonary bypass
(CPB) initiation; T3: before cessation of CPB; T4: 15 minutes after
protamine reversal, and T5: in the intensive care unit . Serum IL-6 levels
were significantly lower at T2 in all study groups, at T3 for coated
groups, and T4 for closed+coated group ( p < .05 versus control). Creatine
kinase M-band (MB) levels in coronary sinus blood demonstrated well
preserved myocardium after CPB in both coated groups versus Control ( p <
.05). Neutrophil CD11b/CD18 levels were significantly lower for all study
groups versus control at T2, for both coated groups at T3 and only for
closed+coated group at T4 ( p < .05). Postoperative hemorrhage (mL) was
510 +/- 40 in closed+coated and 536 +/- 40 in open+coated groups (control:
784 +/- 48, p <= .05). No significant differences in thrombin-antithrombin
complex and free plasma hemoglobin were observed. Desorbed protein amount
on ECC (mg/dL) was 1.7 +/- .01 in closed+coated, 2.01 +/- .01 in
open+coated, and 3.3 +/- .015 in control groups ( p <= .05). Use of a
closed and completely heparin free coated ECC may reduce neutrophil
degradation, cytokine release characterized by improved clinical outcomes
including reduced blood loss, reduced requirement for inotropes, and
reduced atrial fibrillation.<br/>Copyright &#xa9; 2010 American Society of
Extra-Corporeal Technology. All rights reserved.

<31>
Accession Number
2027692213
Title
Transcatheter edge-to-edge mitral valve repair for mitral regurgitation in
patients with cardiogenic shock: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Saito T.; Kuno T.; Ueyama H.A.; Kampaktsis P.N.; Kolte D.; Misumida N.;
Takagi H.; Aikawa T.; Latib A.
Institution
(Saito) Department of Cardiology, Edogawa Hospital, Tokyo, Japan
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Kolte) Division of Cardiology, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Aikawa) Department of Cardiology, Juntendo University Urayasu Hospital,
Urayasu, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: There is currently little evidence for transcatheter
edge-to-edge mitral valve repair (TEER) for mitral regurgitation (MR) in
patients with cardiogenic shock (CS). Therefore, this study investigated
the characteristics and outcomes of CS patients who underwent TEER for MR.
<br/>Method(s): PubMed, EMBASE were searched in July 2023. Case series and
observational studies reporting clinical characteristics and outcomes in
CS patients with MR who underwent TEER were included. We performed a
one-group meta-analysis using a random effects model. <br/>Result(s): A
total of 4060 patients from 7 case series and 5 observational studies were
included. The mean age was 68.2 (95% confidence interval [CI]: 64.1-72.2)
years, and 41.4% of patients (95% CI: 39.1%-43.7%) were female. Pre-TEER,
severe MR was present in 85.3% (95% CI: 76.1%-91.3%) of patients. Mean
left ventricular ejection fraction was 36.7% (95% CI: 29.2%-44.2%), and
54.6% (95% CI: 36.9%-71.2%) of patients received mechanical circulatory
support. The severity of MR post-TEER was less than 2+ in 88% (95% CI:
87%-89%) of patients. In-hospital mortality was 11% (95% CI: 10%-13%),
whereas 30-day and 1-year mortality rates were 15% (95% CI: 13%-16%), and
36% (95% CI: 21%-54%), respectively. <br/>Conclusion(s): This systematic
review and meta-analysis assessed the clinical characteristics and
outcomes of TEER in CS patients with MR. TEER for MR in patients with CS
has been successful in reducing MR in most of the patients, but with a
high mortality rate. Randomized controlled trials of TEER for MR and CS
are needed.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<32>
Accession Number
2027658181
Title
Infarct-related structural disconnection and delirium in surgical aortic
valve replacement patients.
Source
Annals of Clinical and Translational Neurology. (no pagination), 2023.
Date of Publication: 2023.
Author
Browndyke J.N.; Tomalin L.E.; Erus G.; Overbey J.R.; Kuceyeski A.;
Moskowitz A.J.; Bagiella E.; Iribarne A.; Acker M.; Mack M.; Mathew J.;
O'Gara P.; Gelijns A.C.; Suarez-Farinas M.; Messe S.R.
Institution
(Browndyke) Division of Behavioral Medicine and Neurosciences, Department
of Psychiatry and Behavioral Sciences, Duke University Medical Center,
Durham, NC, United States
(Browndyke) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
(Tomalin, Overbey, Moskowitz, Bagiella, Gelijns, Suarez-Farinas)
Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Erus) Department of Radiology, University of Pennsylvania, Philadelphia,
PA, United States
(Kuceyeski) Department of Radiology, Weill Cornell Medical College, New
York, NY, United States
(Kuceyeski) Brain and Mind Research Institute, Weill Cornell Medical
College, New York, NY, United States
(Iribarne) Department of Cardiothoracic Surgery, Staten Island University
Hospital, Northwell Health Staten Island, New York, NY, United States
(Acker) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania School of Medicine, Philadelphia, PA, United
States
(Mack) Department of Cardiothoracic Surgery, Baylor Research Institute,
Baylor Scott and White Health, Plano, TX, United States
(Mathew) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(O'Gara) Cardiovascular Division, Department of Medicine, Brigham and
Women's Hospital, Boston, MA, United States
(Messe) Department of Neurology, University of Pennsylvania School of
Medicine, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Although acute brain infarcts are common after surgical aortic
valve replacement (SAVR), they are often unassociated with clinical stroke
symptoms. The relationship between clinically "silent" infarcts and
in-hospital delirium remains uncertain; obscured, in part, by how infarcts
have been traditionally summarized as global metrics, independent of
location or structural consequence. We sought to determine if infarct
location and related structural connectivity changes were associated with
postoperative delirium after SAVR. <br/>Method(s): A secondary analysis of
a randomized multicenter SAVR trial of embolic protection devices
(NCT02389894) was conducted, excluding participants with clinical stroke
or incomplete neuroimaging (N = 298; 39% female, 7% non-White, 74 +/- 7
years). Delirium during in-hospital recovery was serially screened using
the Confusion Assessment Method. Parcellation and tractography atlas-based
neuroimaging methods were used to determine infarct locations and cortical
connectivity effects. Mixed-effect, zero-inflated gaussian modeling
analyses, accounting for brain region-specific infarct characteristics,
were conducted to examine for differences within and between groups by
delirium status and perioperative neuroprotection device strategy.
<br/>Result(s): 23.5% participants experienced postoperative delirium.
Delirium was associated with significantly increased lesion volumes in the
right cerebellum and temporal lobe white matter, while diffusion weighted
imaging infarct-related structural disconnection (DWI-ISD) was observed in
frontal and temporal lobe regions (p-FDR < 0.05). Fewer brain regions
demonstrated DWI-ISD loss in the suction-based neuroprotection device
group, relative to filtration-based device or standard aortic cannula.
<br/>Interpretation(s): Structural disconnection from acute infarcts was
greater in patients who experienced postoperative delirium, suggesting
that the impact from covert perioperative infarcts may not be as
clinically "silent" as commonly assumed.<br/>Copyright &#xa9; 2023 The
Authors. Annals of Clinical and Translational Neurology published by Wiley
Periodicals LLC on behalf of American Neurological Association.

<33>
Accession Number
643117870
Title
Deep Parasternal Intercostal Plane Block for Intraoperative Pain Control
in Cardiac Surgical Patients for Sternotomy: A Prospective Randomized
Controlled Trial.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 30 Nov 2023.
Author
Wong H.M.K.; Chen P.Y.; Tang G.C.C.; Chiu S.L.C.; Mok L.Y.H.; Au S.S.W.;
Wong R.H.L.
Institution
(Wong, Chen, Tang, Mok, Au) Department of Anesthesia and Intensive Care,
Prince of Wales Hospital, New Territories, Hong Kong, China
(Chiu) Department of Anesthesia and Intensive Care, Chinese University of
Hong Kong, Hong Kong, China
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong, China
Abstract
OBJECTIVES: Sternotomy pain is common after cardiac surgery. The deep
parasternal intercostal plane (DPIP) block is a novel technique that
provides analgesia to the anterior chest wall. The aim of this study was
to investigate the analgesic effect of bilateral DPIP blocks on
intraoperative pain control in cardiac surgery. DESIGN: This is a
double-blinded, prospective randomized controlled trial (Oct 2020-Dec
2022). SETTINGS: This study was conducted in a single institution, which
is an academic university hospital. PARTICIPANTS: Eighty-six elective
cardiac surgical patients with median sternotomy were recruited.
INTERVENTIONS: Patients were randomly divided into DPIP or control group.
Either 20ml 0.25% levobupivacaine or 0.9% normal saline was injected for
the DPIP under ultrasound guidance after induction of general anaesthesia.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was intraoperative
opioids consumption and hemodynamic changes at sternotomy. Secondary
outcomes included postoperative morphine consumption, postoperative pain
and time to tracheal extubation. Intraoperative opioids requirement was
reduced from a median (IQR) intravenous morphine equivalence of 21.4mg
(13.8-24.3mg) in control group to 9.5mg (7.3-11.2mg) in the DPIP group
(P<0.001). Hemodynamic parameters were more stable in DPIP group at
sternotomy, as evidenced by lower percentage increase in systolic,
diastolic and mean arterial blood pressure from baseline. No difference
was observed in time to tracheal extubation, postoperative morphine
consumption, postoperative pain score and spirometry. <br/>CONCLUSION(S):
Bilateral DPIP block provides effective intraoperative analgesia and
opioid-sparing. It may be included as part of the multimodal analgesia for
enhanced recovery in cardiac surgery.<br/>Copyright &#xa9; 2023 The
Author(s). Published by Elsevier Inc. All rights reserved.

<34>
Accession Number
643117839
Title
Balloon pulmonary valvuloplasty: A systematic review.
Source
Indian heart journal. (no pagination), 2023. Date of Publication: 24 Dec
2023.
Author
Rao P.S.
Institution
(Rao) Children's Heart Institute, University of Texas-Houston McGovern
Medical School, Children's Memorial Hermann Hospital, Houston, TX, United
States
Abstract
There is conclusive evidence for relief of pulmonary valve obstruction
immediately after balloon pulmonary valvuloplasty (BPV) and at follow-up.
Development of infundibular obstruction is seen in more severe PS cases
and in older subjects. Reappearance of PS was observed in approximately 10
% of patients following BPV. The reasons for recurrence were found to be
balloon/annulus ratio less than 1.2 and immediate post-BPV pulmonary valve
peak gradients greater than 30 mmHg. Recurrent stenosis is successfully
addressed by repeating BPV with lager balloons than used initially.
Long-term results revealed continue relief of obstruction, but with
development of pulmonary insufficiency, some patients requiring
replacement of the pulmonary valve. It was concluded that BPV is the
treatment of choice in the management valvar PS and that balloon/annuls
ratio used for BPV should be lowered to 1.2 to 1.25. It was also suggested
that strategies should be developed to prevent/reduce pulmonary
insufficiency at long-term follow-up.<br/>Copyright &#xa9; 2023
Cardiological Society of India. Published by Elsevier, a division of RELX
India, Pvt. Ltd. All rights reserved.

<35>
Accession Number
643116292
Title
Five Year Results of Endovascular Versus Medical Therapy in Acute Type B
Aortic Intramural Haematoma: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European journal of vascular and endovascular surgery : the official
journal of the European Society for Vascular Surgery. (no pagination),
2023. Date of Publication: 23 Dec 2023.
Author
Sa M.P.; Jacquemyn X.; Tasoudis P.; Dufendach K.; Singh M.J.; de la Cruz
K.I.; Serna-Gallegos D.; Sultan I.
Institution
(Sa) Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, PA, USA; UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:
michel_pompeu@yahoo.com.br
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Tasoudis) Department of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Dufendach, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, USA; UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
(Singh) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, PA, USA; Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(de la Cruz) Division Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
Abstract
OBJECTIVE: To evaluate outcomes in the follow up of thoracic endovascular
aortic repair (TEVAR) vs. medical therapy in patients with acute type B
aortic intramural haematoma (IMH). DATA SOURCES: The following sources
were searched for articles meeting the inclusion criteria and published by
July 2023: PubMed/MEDLINE, EMBASE, CENTRAL/CCTR (Cochrane Controlled
Trials Register). REVIEW METHODS: This systematic review with pooled
meta-analysis of time to event data followed the Preferred Reporting Items
for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines,
and its protocol was registered on the public platform PROSPERO
(CRD42023456222). The following were analysed: overall survival (all-cause
mortality), aortic related mortality, and restricted mean survival time.
Certainty of evidence was evaluated through the Grading of
Recommendations, Assessment, Development, and Evaluations (GRADE) tool.
<br/>RESULT(S): Eight studies met the eligibility criteria, including a
total of 1 015 patients (440 in the TEVAR group and 575 in the medical
therapy group). All studies were observational, and the pooled cohort had
a median follow up of 5.1 years. Compared with patients who received
medical therapy alone, those who underwent TEVAR had a significantly lower
risk of all-cause death (HR 0.44, 95% CI 0.30 - 0.65; p < .001; GRADE
certainty: low), lower risk of aortic related death (HR 0.04, 95% CI 0.01
- 0.31; p = .002; GRADE certainty: low) and lifetime gain (restricted mean
survival time was overall 201 days longer with TEVAR; p < .001).
<br/>CONCLUSION(S): Thoracic endovascular aortic repair may be associated
with lower risk of all-cause and aortic related death when compared with
medical therapy in patients with acute type B IMH; however, the underlying
data are not strong enough to draw robust clinical conclusions. Randomised
controlled trials with large sample sizes and longer follow up are
warranted to elucidate this question.<br/>Copyright &#xa9; 2023 European
Society for Vascular Surgery. Published by Elsevier B.V. All rights
reserved.

<36>
Accession Number
2029230829
Title
The exercise aNd hEArt transplant (ENEA) trial - a registry-based
randomized controlled trial evaluating the safety and efficacy of cardiac
telerehabilitation after heart transplant.
Source
Contemporary Clinical Trials. 136 (no pagination), 2024. Article Number:
107415. Date of Publication: January 2024.
Author
Pedersini P.; Picciolini S.; Di Salvo F.; Toccafondi A.; Novembre G.;
Gualerzi A.; Cusmano I.; Garascia A.; Tavanelli M.; Verde A.; Masciocco
G.; Ricci C.; Mannini A.; Bedoni M.; Morici N.
Institution
(Pedersini, Picciolini, Di Salvo, Toccafondi, Novembre, Gualerzi, Cusmano,
Tavanelli, Mannini, Bedoni, Morici) IRCCS Fondazione Don Carlo Gnocchi,
Milan, Italy
(Garascia, Verde, Masciocco) Cardiology Department and De Gasperis Cardio
Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Ricci) Africa Unit for transdisciplinary Health Research, North-West
University, Potchefstroom, South Africa
Publisher
Elsevier Inc.
Abstract
Background: Heart transplant (HTx) is gold-standard therapy for patients
with end-stage heart failure. Cardiac rehabilitation (CR) is a
multidisciplinary intervention shown to improve cardiovascular prognosis
and quality of life. The aim in this randomized controlled trial is to
explore the safety and efficacy of cardiac telerehabilitation after HTx.
In addition, biomarkers of rehabilitation outcomes will be identified, as
data that will enable treatment to be tailored to patient phenotype.
<br/>Method(s): Patients after HTx will be recruited at IRCCS S. Maria
Nascente - Fondazione Don Gnocchi, Milan, Italy (n = 40). Consenting
participants will be randomly allocated to either of two groups (1:1): an
intervention group who will receive on-site CR followed by 12 weeks of
telerehabilitation, or a control group who will receive on-site CR
followed by standard homecare and exercise programme. Recruitment began on
20th May 2023 and is expected to continue until 20th May 2025.
Socio-demographic characteristics, lifestyle, health status,
cardiovascular events, cognitive function, anxiety and depression
symptoms, and quality of life will be assessed, as well as exercise
capacity and muscular endurance. Participants will be evaluated before the
intervention, post-CR and after 6 months. In addition, analysis of
circulating extracellular vesicles using Surface Plasmon Resonance imaging
(SPRi), based on a rehabilomic approach, will be applied to both groups
pre- and post-CR. <br/>Conclusion(s): This study will explore the safety
and efficacy of cardiac telerehabilitation after HTx. In addition, a
rehabilomic approach will be used to investigate biomolecular
phenotypization in HTx patients. Trial registration number:
ClinicalTrials.gov Identifier: NCT05824364.<br/>Copyright &#xa9; 2023 The
Authors

<37>
Accession Number
2027014469
Title
Risk Factors for Surgical Site Infection in Patients Undergoing Pediatric
Cardiac Surgery.
Source
Arquivos Brasileiros de Cardiologia. 120(12) (no pagination), 2023.
Article Number: e20220592. Date of Publication: 2023.
Author
Ribeiro A.C.L.; Siciliano R.F.; Lopes A.A.; Strabelli T.M.V.
Institution
(Ribeiro, Lopes) Instituto do Coracao do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo-Cardiologia Pediatrica
e Cardiopatias Congenitas do Adulto, SP, Sao Paulo, Brazil
(Siciliano, Strabelli) Equipe de Controle de Infeccao-Instituto do Coracao
do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao
Paulo, SP, Sao Paulo, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Surgical site infection is an important complication after
pediatric cardiac surgery, associated with increased morbidity and
mortality. <br/>Objective(s): We sought to identify risk factors for
surgical site infection after pediatric cardiac surgeries. <br/>Method(s):
A case-control study included patients aged between 1 year and 19 years
and 11 months of age, submitted to cardiac surgery performed at a tertiary
cardiac center from January 1^st, 2011, through December 31,
2018. Charts were reviewed for pre-, intra, and postoperative variables.
We identified two randomly selected control patients with the same
pathophysiological diagnosis and underwent surgery within thirty days of
each index case. Univariate and multivariate logistic regression analyses
were performed to identify risk factors. Statistical significance was
defined as p<0.05. <br/>Result(s): Sixty-six cases and 123 controls were
included. Surgical site infection incidence ranged from 2% to 3.8%. The
following risk factors were identified: Infant age (OR 3.19, 95% CI 1.26
to 8.66, p=0.014), presence of genetic syndrome (OR 6.20, CI 95% 1.70 to
21.65, p=0.004), categories 3 and 4 of RACHS-1 (OR 8.40, CI 95% 3.30 to
21.34, p<0.001), 48 h C-reactive protein level range was detected as a
protective factor for this infection (OR 0.85, 95% CI 0.73 to 0.98,
p=0.023). <br/>Conclusion(s): The risk factors defined in this study could
not be modified. Therefore, additional surveillance and new preventive
strategies need to be implemented to reduce the incidence of surgical site
infection. The increased CRP in the postoperative period was a protective
factor that needs further understanding.<br/>Copyright &#xa9; 2023,
Sociedade Brasileira de Cardiologia. All rights reserved.

<38>
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).
<br/>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.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<39>
Accession Number
2029239676
Title
Which should you choose for post operative atrial fibrillation, carvedilol
or metoprolol? A systemic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102220. Date of Publication: February 2024.
Author
Abouzid M.R.; Vyas A.; Eldahtoury S.; Anwar J.; Naccour S.; Elshafei S.;
Memon A.; Subramaniam V.; Bennett W.; Morin D.P.; Lavie C.J.; Nwaukwa C.
Institution
(Abouzid, Eldahtoury, Anwar, Naccour, Elshafei, Memon, Nwaukwa) Department
of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, TX,
United States
(Vyas, Subramaniam, Bennett, Morin, Lavie) Department of Cardiology,
Ochsner Medical Center, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
arrhythmic complication following cardiac surgery. Current guidelines
suggest beta-blockers for the prevention of POAF. In comparing metoprolol
succinate with carvedilol, the later has sparked interest in its usage as
an important medication for POAF prevention. <br/>Method(s): We considered
randomized controlled studies (RCTs) and retrospective studies that
evaluated the efficacy of carvedilol versus metoprolol for the prevention
of POAF. After literature search, data extraction, and quality evaluation,
pooled data were analyzed using either the fixed-effect or random-effect
model using Review Manager 5.3. The Cochrane risk of bias tool was used to
assess the bias of included studies. The incidence of POAF was the primary
endpoint, while mortality rate and bradycardia were secondary outcomes.
<br/>Result(s): In meta-analysis 5 RCTs and 2 retrospective studies with a
total of 1000 patients were included. The overall effect did not favor the
carvedilol over metoprolol groups in terms of mortality rate [risk ratio
0.45, 95 % CI (0.1-1.97), P=0.29] or incidence of bradycardia [risk ratio
0.63, 95 % CI (0.32-1.23), P=0.17]. However, the incidence of POAF was
lower in patients who received carvedilol compared to metoprolol [risk
ratio 0.54, 95 % CI (0.42-0.71), P < 0.00001]. <br/>Conclusion(s): In
patients undergoing cardiac surgery, carvedilol may minimize the
occurrence of POAF more effectively than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, a large-scale, well-designed
randomized controlled trials are required.<br/>Copyright &#xa9; 2023

<40>
Accession Number
2029072530
Title
Long-Term Outcomes After Hybrid Coronary Revascularization Versus Coronary
Artery Bypass Grafting: Meta-Analysis of Kaplan-Meier-Derived Data.
Source
American Journal of Cardiology. 212 (pp 13-22), 2024. Date of Publication:
01 Feb 2024.
Author
Shimamura J.; Miyamoto Y.; Hibino M.; Fukuhara S.; Takayama H.; Itagaki
S.; Takagi H.; Kuno T.
Institution
(Shimamura) Division of Cardiothoracic Surgery, Westchester Medical
Center, Valhalla, New York, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Hibino) Division of Cardiothoracic Surgery, Emory University, Atlanta,
Georgia
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Takayama) Division of Cardiothoracic Surgery, Department of Surgery, New
York Presbyterian Hospital, Columbia University Medical Center, New York,
New York, United States
(Itagaki) Department of Cardiovascular Surgery, Icahn School of Medicine
at Mount Sinai, New York, New York, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
Medical College, Bronx, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
Medical College, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Hybrid coronary revascularization (HCR) is an alternative option to
conventional coronary artery bypass grafting (CABG), but the long-term
outcomes of HCR versus CABG remain unclear. We aimed to analyze the
long-term outcomes after HCR and CABG for patients with multivessel
coronary artery disease using meta-analysis. A systemic literature search
of PubMed and EMBASE was performed from inception to March 2023. Studies
reporting Kaplan-Meier curves with follow-up >=1 year were included. The
primary outcome was all-cause mortality, and the secondary outcomes were
major adverse cardiac and cerebrovascular events (MACCEs) and repeat
revascularization. In total, 13 studies (1 randomized controlled trial and
12 propensity-score matched observational studies) were analyzed. The mean
follow-up period was 5.1 +/- 3.1 years. HCR was associated with similar
overall mortality (hazard ratio [HR] 1.09, 95% confidence interval [CI]
0.87 to 1.36), significantly higher incidence of MACCEs (HR 1.49, 95% CI
1.07 to 2.06), and repeat revascularization (HR 2.01, 95% CI 1.53 to 2.64)
compared with CABG. In phase-specific analysis, the mortality rate was
similar, and the incidence of repeat revascularization was higher in HCR
regardless of phases. The incidence of MACCEs was higher in HCR during the
mid-term phase (1 to 5 years), but it was similar during the long-term
phase (long-term: >=5 years). In conclusion, despite the higher incidence
of MACCEs and repeat revascularization compared with CABG, HCR offered a
similar long-term survival. Even longer-term follow-up and randomized
controlled trials with a large population are warranted to investigate the
role of HCR for multivessel coronary artery disease.<br/>Copyright &#xa9;
2023 Elsevier Inc.

<41>
Accession Number
2029010229
Title
Cardiovascular outcomes post bariatric surgery in patients with metabolic
dysfunction-associated steatotic liver disease - A systematic review and
meta-analysis.
Source
Clinics and Research in Hepatology and Gastroenterology. 48(1) (no
pagination), 2024. Article Number: 102261. Date of Publication: January
2024.
Author
Kumar J.; Mohsin S.; Hasan M.; Bilal A.R.; Ali K.M.; Umer A.; Hadi D.Z.M.;
Nandlal S.; Kumar S.
Institution
(Kumar, Kumar) School of Medicine, Wayne State University, Detroit, MI,
United States
(Mohsin, Hasan, Bilal, Umer, Nandlal) Ziauddin Medical College, 4/B,
Saharah-e-Ghalib, Block 6, Clifton, Sindh, Karachi 75600, Pakistan
(Ali, Hadi) Jinnah Sindh Medical University, Karachi, Pakistan
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Metabolic dysfunction-associated steatotic liver disease
(MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is
linked with an increased risk of adverse cardiovascular events. Studies
have suggested an association between the reduction of incident
cardiovascular events in patients with MASLD after bariatric surgery. This
systematic review and meta-analysis were performed to assess the influence
of bariatric surgery on cardiovascular outcomes in patients with diagnosed
MASLD by identifying all available cohort studies and pooling their data.
<br/>Method(s): PubMed and Google Scholar databases were searched till
July 2023 for published studies that assessed the effect of bariatric
surgery on cardiovascular outcomes in MASLD patients. Using a random
effects model, hazard ratios (HRs) with 95 % confidence intervals (CIs)
were pooled. <br/>Result(s): The systematic review identified three cohort
studies. The analysis of 240,516 MASLD patients found a significantly
reduced incidence of cardiovascular events. (HR 0.51; 95 % CI 0.48 to
0.54, P value <0.00001). <br/>Conclusion(s): Bariatric surgery in MASLD
patients significantly reduced the incidence of cardiovascular events,
suggesting that bariatric surgery is an effective therapeutic tool among
MASLD patients compared to non-surgical interventions.<br/>Copyright
&#xa9; 2023 Elsevier Masson SAS

<42>
Accession Number
2027271108
Title
Evaluation of the Safety and Effectiveness of Topical Intrapleural
Application of Tranexamic Acid in Thoracic Surgery: A Systematic Review
and Meta-Analysis of Randomized Controlled Trials.
Source
Clinical and Applied Thrombosis/Hemostasis. 29 (no pagination), 2023. Date
of Publication: January-December 2023.
Author
Alzahrani A.; Alkofide H.; Joharji H.; Korayem G.B.; Aljohani S.;
Alshareef H.; AlFaifi M.; Alalawi H.; Sulaiman K.A.
Institution
(Alzahrani) Division of Thoracic Surgery, Department of Surgery, London
Health Sciences Centre, Western University, London, ON, Canada
(Alzahrani, Joharji) King Faisal Specialist Hospital and Research Centre
Organ Transplant Center of Excellence, Riyadh, Saudi Arabia
(Alkofide) Department of Clinical Pharmacy, College of Pharmacy, King Saud
University, Riyadh, Saudi Arabia
(Alkofide) Drug Regulation Research Affairs Unit, College of Pharmacy,
King Saud University, Riyadh, Saudi Arabia
(Korayem) Department of Pharmacy Practice, College of Pharmacy, Princess
Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
(Aljohani) Department of Pharmaceutical Services, King Abdulaziz
University Hospital, Jeddah, Saudi Arabia
(Alshareef) Department of Pharmacy Practice, Faculty of Pharmacy,
University of Tabuk, Tabuk, Saudi Arabia
(AlFaifi) Pharmaceutical Care Department, King Saud Medical City, Riyadh,
Saudi Arabia
(Alalawi) Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi
Arabia
(Sulaiman) Pharmaceutical Care Department, King Abdulaziz Medical City,
Riyadh, Saudi Arabia
(Sulaiman) College of Pharmacy, King Saud bin Abdulaziz University for
Health Sciences, Riyadh, Saudi Arabia
(Sulaiman) King Abdullah International Medical Research Center, Riyadh,
Saudi Arabia
(Sulaiman) Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh,
Saudi Arabia
Publisher
SAGE Publications Inc.
Abstract
Objectives: Bleeding remains a common complication post-thoracic surgery.
Although intravenous tranexamic acid (TXA) has been shown to decrease
blood loss, its use has been associated with adverse effects. Accordingly,
topical TXA has been proposed as an alternative to reduce bleeding with
fewer systemic complications. <br/>Method(s): We searched Medline, Embase,
and Cochrane Central databases for randomized controlled trials (RCTs)
comparing topical TXA versus control (i.e., placebo) in patients
undergoing thoracic procedures. The primary outcome was total
postoperative blood loss at 24 hours. Secondary outcomes included were the
number of red blood cell (RBC) transfusions, and hospital length of stay
(LOS). Meta-analyses were pooled using mean difference with
inverse-variance weighting and random-effects. <br/>Result(s): Out of the
575 unique studies that were screened, we identified three randomized
controlled trials (RCTs) involving 399 patients. Out of the three RCTs
analyzed, two studies, accounting for 67% of the total, were found to have
a low risk of bias. The primary outcome of 24-h post-operative blood loss
was significantly lower in patients who received TXA (mean difference [MD]
-93.6 ml, 95% CI -121.8 to -65.4 ml, I²= 45%). In addition, the
need for RBC transfusion was significantly lower in the topical TXA group
compared to control (MD -0.5 units, 95% CI -0.8 to -0.3 units,
I²= 60%). However, there was no significant difference in the
hospital length of stay (LOS) (MD -0.3 days, 95% CI -0.9 to 0.4 days,
I²= 0%). These results remained consistent after several
sensitivity analyses. The use of topical intrapleural tranexamic acid has
also been found to be safe without any significant safety concerns.
<br/>Conclusion(s): Topical intrapleural TXA reduces blood loss and the
need for blood transfusions during thoracic surgery. In addition, there is
no evidence of the increased safety concerns associated with its use.
Larger trials are necessary to validate these findings and evaluate the
safety and efficacy of different dosages.<br/>Copyright &#xa9; The
Author(s) 2023.

<43>
Accession Number
2013619355
Title
Intra-aortic balloon pump versus percutaneous Impella^&#xa9; in
emergency revascularisation for myocardial infarction and cardiogenic
shock: systematic review.
Source
Perfusion (United Kingdom). 39(1) (pp 45-59), 2024. Date of Publication:
January 2024.
Author
Frain K.; Rees P.
Institution
(Frain) Faculty of Medicine, University of St Andrews, St Andrews, United
Kingdom
(Rees) Academic Department of Military Medicine, Barts Heart Centre,
London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objectives: Mortality rates in patients with acute myocardial infarction
and cardiogenic shock (AMI-CS) remain persistently high despite advances
over the past decade in percutaneous mechanical circulatory support. This
systematic review aims to analyse the existing literature to compare
mortality outcomes in patients mechanically supported by intra-aortic
balloon pump or percutaneous Impella 2.5/CP^&#xa9; for AMI-CS
undergoing emergency revascularisation. <br/>Method(s): The following MeSH
terms were applied to the databases Ovid Medline, Ovid Embase, Cochrane
and Web of Science: 'Intra-aortic balloon pump', 'Impella', 'Cardiogenic
shock', 'Myocardial Infarction' and 'Mortality'. This yielded 2643
studies. Using predefined inclusion and exclusion criteria, the studies
were initially screened by title and abstract before full text analysis.
<br/>Result(s): Fourteen studies met eligibility criteria: two randomised
controlled trials (RCTs) and 12 observational studies. Data from a total
of 21,006 patients were included across the studies. Notably, one study
claimed reduced mortality with IABP versus control, and one study
concluded that Impella^&#xa9; improved survival rates over the
IABP. The average 30-day all-cause mortality in patients supported by IABP
was 38.1%, 54.3% in Impella^&#xa9; groups and 39.4% in control
groups. <br/>Conclusion(s): AMI-CS presents an important cohort of
patients in whom conducting RCTs is difficult. As a result, the literature
is limited. Analysis of the available literature suggests that there is
insufficient evidence to support superior survival in those supported by
IABP or Impella^&#xa9; when compared to control despite
suggestions that the Impella^&#xa9; offers superior haemodynamic
support. Limitations of the studies have been discussed to outline
suggestions for future research.<br/>Copyright &#xa9; The Author(s) 2021.

<44>
Accession Number
2028715953
Title
Intracranial Atherosclerosis Increases the Risk of Postoperative Stroke
After Cardiac Surgery: A Review and Meta-Analysis.
Source
Heart Lung and Circulation. 32(12) (pp 1417-1425), 2023. Date of
Publication: December 2023.
Author
Yang A.; Nguyenhuy M.; Seevanayagam S.
Institution
(Yang, Seevanayagam) Brian F. Buxton Department of Cardiac and Thoracic
Aortic Surgery, Austin Health, Melbourne, VIC, Australia
(Nguyenhuy) Department of Radiology, Western Health, Melbourne, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Postoperative stroke is a devastating complication of cardiac
surgery with high morbidity, mortality, and health care cost. Extracranial
carotid atherosclerosis (ECAS) is a known risk factor for stroke; however,
the impact of intracranial atherosclerosis (ICAS) remains unclear. To our
knowledge, this is the first literature review of ICAS in cardiac surgery.
We aimed to assess the prevalence, association with postoperative stroke,
and perioperative management of ICAS in cardiac surgery. <br/>Method(s): A
search was performed to identify studies reporting rates of ICAS and
stroke after cardiac surgery. Data extraction and primary outcomes for
meta-analysis included the prevalence of preoperative ICAS and the
association between ICAS and stroke. Risk ratios (RRs) and 95% confidence
intervals (CIs) were pooled by random-effects modelling. <br/>Result(s):
Seventeen studies were reviewed and seven were included in the
meta-analysis, comprising 4,936 patients. Prevalence of intracranial
atherosclerosis (ICAS) among cardiac surgery patients was 21% (95% CI
13%-32%). Patients with ICAS were more likely to develop postoperative
stroke (RR 3.61; 95% CI 2.30-5.67; p<0.001). ICAS was more closely
associated with stroke than ECAS. Preoperative brain perfusion
single-photon emission computed tomography with acetazolamide challenge,
staged intracerebral revascularisation, or conversion to off-pump coronary
artery bypass grafting are described management options for ICAS.
<br/>Conclusion(s): Patients with ICAS are 3.61 times more likely to
develop stroke after cardiac surgery. Known predictors for ICAS can be
used to develop risk stratification screening tools. Further research with
diverse cohorts is required to develop evidence-based guidelines for
screening and management of ICAS in cardiac surgery.<br/>Copyright &#xa9;
2023

<45>
Accession Number
2028460005
Title
A systematic review and meta-analysis of internal thoracic artery
harvesting techniques: Skeletonized vs pedicled.
Source
International Journal of Cardiology. 395 (no pagination), 2024. Article
Number: 131577. Date of Publication: 15 Jan 2024.
Author
Dimagli A.; Gemelli M.; Kumar N.; Mitra M.; Sinha S.; Fudulu D.; Harik L.;
Cancelli G.; Soletti G.; Olaria R.P.; Bonaros N.; Gaudino M.; Angelini
G.D.
Institution
(Dimagli, Harik, Cancelli, Soletti, Olaria, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Dimagli, Gemelli, Kumar, Mitra, Sinha, Fudulu, Angelini) Bristol Heart
Institute, University of Bristol, Bristol, United Kingdom
(Gemelli) Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular,
and Public Health Sciences, University of Padua, Padova, Italy
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Anichstr. 35, Innsbruck 6020, Austria
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: The aim of this meta-analysis was to compare clinical and
angiographic outcomes of skeletonized versus pedicled internal thoracic
artery for coronary artery bypass grafting. <br/>Method(s): A
comprehensive search on Ovid MEDLINE, Ovid EMBASE and Scopus was performed
from inception to December 2022. The primary outcome was follow-up
mortality and graft failure. Secondary outcomes were repeat
revascularization, cardiovascular death and operative mortality,
myocardial infarction, stroke, and sternal wound complications (SWCs).
Pooled estimate for follow-up outcomes was summarized as incidence rate
ratio (IRR) and 95% confidence interval (CI) while short-term outcomes
were pooled as odds ratio (OR) and 95% CI. For all outcomes, inverse
variance weighting was used for pooling. <br/>Result(s): Twenty-eight
studies, including 7 randomized trials and 21 observational studies, for a
total of 5664 patients in the skeletonized group and 7434 in the pedicled
group, were included in the analysis. At a mean weighted follow-up of 4.8
years, there was no difference in mortality between the two groups (IRR
1.14; 95% CI 0.59-2.20). However, the skeletonized group had a higher
incidence of graft failure compared to the pedicled group (IRR 1.87, 95%
CI 1.33-2.63) but a lower risk of SWCs (OR 0.42; 95% CI 0.30-0.60). There
was no difference in short-term outcomes. <br/>Conclusion(s): Compared to
the pedicled harvesting technique, skeletonization of the internal
thoracic artery is associated with higher rate of graft failure and lower
risk of SWCs without mortality difference.<br/>Copyright &#xa9; 2023

<46>
Accession Number
2028135682
Title
Coronary Artery Bypass Surgery to Treat Anomalous Origin of Coronary
Arteries in Adults: A Systematic Review.
Source
Heart Lung and Circulation. 32(12) (pp 1500-1511), 2023. Date of
Publication: December 2023.
Author
Alzghari T.; Sandner S.; Di Franco A.; Harik L.; Perezgorvas-Olaria R.;
Soletti G.; Dimagli A.; Cancelli G.; Demetres M.; Lau C.; Girardi L.N.;
Gaudino M.
Institution
(Alzghari, Di Franco, Harik, Perezgorvas-Olaria, Soletti, Dimagli,
Cancelli, Lau, Girardi, Gaudino) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
Publisher
Elsevier Ltd
Abstract
Objective: To review the available literature on the use of coronary
artery bypass grafting (CABG) as a treatment option for anomalous origin
of coronary artery in adults. <br/>Method(s): A systematic literature
search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase,
and the Cochrane Library databases) to identify studies reporting the use
of CABG in adult patients with anomalous origin of coronary artery.
<br/>Result(s): A total of 31 studies and 62 patients were included, 32
patients (52%) were women, and the mean age was 45.1+/-16.1 years. The
most common coronary anomaly was the right coronary artery arising from
the left coronary sinus in 26 patients (42%), followed by an anomalous
left coronary artery from the pulmonary artery in 23 patients (37%). A
total of 65 conduits were used in 61 patients, and 1 case report did not
report conduit type. Reported grafts included saphenous vein (23 of 65
[35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal
thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]);
right gastroepiploic artery and basilic vein were used once (1.5%) each.
Ligation of the native coronary artery was performed in 42 (67.7%)
patients. Patient follow-up was available in 19 studies with a mean of
31.2 months. Only 1 operative mortality was reported. <br/>Conclusion(s):
Based on the limited available data, CABG can be performed with good early
results. Use of arterial conduits and ligation of the native coronary
artery may improve long-term graft patency.<br/>Copyright &#xa9; 2023
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<47>
Accession Number
2028110783
Title
Comparison of Volatile Anesthetics Versus Propofol on Postoperative
Cognitive Function After Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 141-147),
2024. Date of Publication: January 2024.
Author
Han J.; Ryu J.-H.; Jeon Y.-T.; Koo C.-H.
Institution
(Han) Department of Anesthesiology and Pain Medicine, Chung-Ang University
College of Medicine, Seoul, South Korea
(Ryu, Jeon, Koo) Department of Anesthesiology and Pain Medicine, Seoul
National University Bundang Hospital, Seongnam, South Korea
(Ryu, Jeon, Koo) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: To compare the effects of volatile anesthetics and propofol on
neurocognitive function after cardiac surgery. <br/>Design(s): A
systematic review and meta-analysis of randomized controlled trials.
<br/>Setting(s): A literature search of PubMed, EMBASE, CENTRAL, CINAHL,
Scopus, and Web of Science databases was conducted. <br/>Participant(s): A
total of 10 randomized controlled trials comparing volatile anesthetics
and propofol in cardiac surgery were included in the study.
<br/>Intervention(s): The standardized mean difference and risk ratio were
calculated to estimate pooled effect sizes. <br/>Measurements and Main
Results: The primary outcome was the postoperative neurocognitive function
score, and the secondary outcome was the incidence of delirium after
cardiac surgery. The analysis did not show significant differences in
postoperative neurocognitive function scores (standardized mean difference
-0.06, 95% CI -0.81-0.69; p = 0.879). The incidences of delirium (risk
ratio 1.10, 95% CI 0.81-1.50) between the volatile anesthetics and
propofol groups were not significant (p = 0.533). <br/>Conclusion(s):
Unlike noncardiac surgery, there are no differences between volatile
anesthetics and propofol regarding postoperative neurocognitive
dysfunction after cardiac surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<48>
Accession Number
2027251779
Title
Preventive effect and mechanism of compound Danshen dripping pills on
contrast-induced nephropathy after percutaneous coronary interventional.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1211982. Date of Publication: 2023.
Author
Fu H.; Wang L.; Ying S.; Zhao Z.; Zhang P.
Institution
(Fu) Sir Run Run Shaw Hospital, Zhejiang University School of Medicine,
Hangzhou, China
(Fu, Zhao) Graduate School of Tianjin Medical University, Tianjin, China
(Wang) Sheng Jing Hospital Affiliated, China Medical University, Shenyang,
China
(Ying, Zhang) Department of Cardiology, Tianjin Chest Hospital, Tianjin
University, Tianjin, China
Publisher
Frontiers Media SA
Abstract
Background: Contrast-induced nephropathy (CIN) is one of the most common
complications after coronary stent implantation due to the extensive
development of coronary catheterization technology. Compound Danshen
dripping pills (CDDP) are clinically used as cardiovascular drugs,
relieving systemic inflammatory response. Previous studies have observed
that CDDP can decrease CIN incidence after coronary stent implantation
with uncertain effectiveness. <br/>Method(s): We conducted a prospective,
randomized, single-center, single-blind, controlled trial. We enrolled
patients 18 years and older with unstable angina pectoris and NSTEMI who
underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and
November 31, 2022, and followed for 30 days. Patients were randomized to
CDDP and hydration therapy (10 capsules three times/day; N = 411) or
hydration only (N = 411). The primary outcome was the contrast nephropathy
incidence, defined as an elevation in serum creatinine by more than 25% or
44 mumol/L from baseline within 48-72 h of contrast exposure. Secondary
outcomes included major adverse cardiovascular events post-surgery and
during follow-up. <br/>Result(s): After 48 h of operation, the two groups
had statistical significance in Scr and BUN values (80.0 +/- 12.59 vs.
84.43 +/- 13.49, P < 0.05; 6.22 +/- 1.01 vs. 6.40 +/- 0.93, P < 0.05). The
difference in Scr in 72 h between the two groups was statistically
significant (76.42 +/- 10.92 vs. 79.06 +/- 11.58, P < 0.05). The CIN
incidence was significantly lower in the CDDP group than in the hydration
group. The CIN risk was significantly elevated in patients with LVEF <50%,
contrast volume >=160 ml, and hypertension, after 48 and 72 h of
operation. The serum inflammation index levels NGAL, TNF-alpha, oxidative
stress indexes SOD, and MDA significantly differed between the two groups.
However, there was no significant difference in serum apoptosis indexes
Bax, Bcl-2, and Casepase-9. <br/>Conclusion(s): CDDP pre-treatment could
prevent contrast-induced nephropathy. Inflammatory response and oxidative
stress could be significant in the CDDP mechanism.<br/>Copyright 2023 Fu,
Wang, Ying, Zhao and Zhang.

<49>
Accession Number
2028222544
Title
Perioperative Implementation of Low-Dose Pregabalin in an Enhanced
Recovery After Cardiac Surgery Protocol: A Pre-Post Observational Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 183-188),
2024. Date of Publication: January 2024.
Author
Patel A.; Shah A.; Apigo A.; Lin H.-M.; Ouyang Y.; Huang K.; Friedman S.;
Yimen M.; Puskas J.D.; Bhatt H.V.
Institution
(Patel, Apigo, Bhatt) Department of Anesthesiology, Perioperative and Pain
Medicine, Mount Sinai Morningside Medical Center, New York, NY, United
States
(Shah, Huang) Department of Pharmacy, Mount Sinai Morningside Medical
Center, New York, NY, United States
(Shah, Friedman, Yimen, Puskas) Department of Cardiothoracic Surgery and
Critical Care, Mount Sinai Morningside Medical Center, New York, NY,
United States
(Lin) Department of Anesthesiology, Yale School of Medicine, New Haven,
CT, United States
(Ouyang) Department of Population Health Science and Policy, Mount Sinai
Hospital, New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objectives: Determine the effect of low-dose pregabalin in the
perioperative enhanced recovery after cardiac surgery protocol.
<br/>Design(s): Pre-post observational study. <br/>Setting(s): Tertiary
care hospital. <br/>Participant(s): Patients undergoing off-pump coronary
artery bypass graft procedures. <br/>Intervention(s): Pregabalin 75 mg BID
for 48 hours postoperatively versus no pregabalin in a perioperative
setting. <br/>Measurements and Main Results: Perioperative opioid use,
pain scores, length of stay, time to extubation, and mortality were all
measured. Descriptive data were presented as mean (SD), median (IQR), or N
(%). Ordinal and continuous data used the t-test or Kruskal-Wallis test.
Categorical data were compared between groups using the chi-square test or
Fisher's exact test, as appropriate. Low-dose pregabalin administration
(75 mg twice daily for 48 hours after surgery) was associated with a
clinically significant reduction in opioid consumption on postoperative
day 0 by 30.6%, with a median requirement of 318 (233, 397) morphine
milligram equivalents (MME) in the pregabalin group compared with 458
(375, 526) MME in the control group (p < 0.001). There was no significant
difference in pain scores between the groups with the exception at 0-to-12
hours, during which the pregabalin group had greater pain scores (median
3.32 [1.65, 4.36] v 2.0 [0, 3.25], p = 0.013) (Table 3). Moreover, there
was no significant difference in pain scores on postoperative day 1 (p =
0.492), day 2 (p = 0.442), day 3 (p = 0.237), and day 4 (p = 0.649). The
difference in average Richmond Agitation Sedation Score scores was also
not statistically significant between groups at 12 hours (p = 0.954) and
at 24 hours (p = 0.301). The pregabalin group had no increased incidence
of adverse events or any significant differences in intensive care unit
length of stay, time to extubation, or mortality. <br/>Conclusion(s): In
this evaluation of perioperative pregabalin administration for patients
requiring cardiac surgery, pregabalin reduced postoperative opioid use,
with significant reductions on postoperative day 0, and without any
significant increase in adverse reactions. However, no differences in
intensive care unit length of stay, time to extubation, or mortality were
noted. The implementation of low-dose perioperative pregabalin within an
Enhanced Recovery After Cardiac Surgery protocol may be effective at
reducing postoperative opioid use in the immediate postoperative period,
and may be safe with regard to adverse events. Ideal dosing strategies
have not been determined; thus, further randomized control trials with an
emphasis on limiting confounding factors need to be
conducted.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<50>
Accession Number
2026230770
Title
Evaluation of stable angina by coronary computed tomographic angiography
versus standard of care: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 59 (pp 67-75), 2024. Date of
Publication: February 2024.
Author
Palicherla A.; Ismayl M.; Thandra A.; Budoff M.; Shaikh K.
Institution
(Palicherla, Ismayl) Internal Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Thandra) Interventional Cardiology, Creighton University School of
Medicine, Omaha, NE, United States
(Budoff) David Geffen School of Medicine at UCLA, Los Angeles, United
States
(Shaikh) University of Tennessee, Knoxville, United States
Publisher
Elsevier Inc.
Abstract
Introduction: There is limited data comparing Coronary Computed Tomography
Angiography (CCTA) versus the usual Standard of care (SOC) in patients
with suspected stable coronary artery disease (CAD). We aimed to perform a
systematic review and meta-analysis to compare CCTA versus SOC in patients
with stable CAD. <br/>Method(s): We searched multiple databases for
randomized controlled trials (RCTs) comparing CCTA with SOC, which
included various functional testing approaches for evaluating stable CAD.
We used a random-effects model to calculate risk ratios (RRs) with 95 %
confidence intervals (CIs). Outcomes included all-cause mortality,
myocardial infarction (MI), hospitalization for unstable angina (UA),
invasive angiography, revascularization, percutaneous coronary
intervention (PCI), and coronary artery bypass grafting (CABG).
<br/>Result(s): We identified 6 RCTs with 19,881 patients with stable CAD,
of which 9995 underwent CCTA, and 9886 underwent SOC. There were no
significant differences between CCTA and SOC in terms of all-cause
mortality (RR: 0.91; 95 % CI: 0.70-1.19; p = 0.50), MI (RR: 0.78; 95 % CI:
0.58-1.05; p = 0.11), hospitalizations for UA (RR: 1.20; 95 % CI:
0.95-1.51;p = 0.12), invasive angiography (RR: 0.71; 95 % CI: 0.32-1.61; p
= 0.42), revascularization (RR:1.25; 95 % CI: 0.83-1.89; p = 0.29), PCI
(RR: 1.20; 95 % CI: 0.78-1.85; p = 0.40), and CABG rates (RR: 0.89; 95 %
CI: 0.530-1.49; p = 0.65). <br/>Conclusion(s): In patients with stable
CAD, CCTA is associated with similar outcomes compared to the usual
Standard of care. Given its potential to quickly rule out severe
obstructive disease, its ability to provide non-invasive physiology and
identify non-obstructive CAD with plaque information makes it an
attractive addition to the available armamentarium to evaluate chest
pain.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<51>
Accession Number
2025424427
Title
Discrepancies in Financial Conflicts of Interest in Robotic Cardiothoracic
Surgery Studies.
Source
Annals of Thoracic Surgery. 117(2) (pp 466-472), 2024. Date of
Publication: February 2024.
Author
Karamchandani M.M.; Tian T.; Hall R.; Nickel I.; Aalberg J.; Lassaletta
A.D.; Chatterjee A.; Walters D.M.
Institution
(Karamchandani, Tian, Hall, Nickel) Department of Surgery, Tufts Medical
Center, Boston, Massachusetts, United States
(Aalberg) Tufts University School of Medicine, Boston, Massachusetts,
United States
(Lassaletta, Walters) Division of Thoracic Surgery, Department of Surgery,
Tufts Medical Center, Boston, Massachusetts, United States
(Chatterjee) Division of Plastic and Reconstructive Surgery, Department of
Surgery, Tufts Medical Center, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Background: In academic surgery publications, self-reporting of conflicts
of interest (COI) has often proved to be inaccurate. Here, we review the
accuracy of COI disclosures for studies related to the use of robotic
technology in cardiothoracic surgery and evaluate factors associated with
increased discrepancies. <br/>Method(s): A literature search identified
robotic surgery-related studies with at least 1 American author published
between January 2015 and December 2020 from 3 major American
cardiothoracic surgery journals (The Journal of Thoracic and
Cardiovascular Surgery, The Annals of Thoracic Surgery, and Annals of
Cardiothoracic Surgery). Industry payments from Intuitive Surgical
(Intuitive) were collected with use of the Centers for Medicare and
Medicaid Open Payments database. COI discrepancies were identified by
comparing author declaration statements with payments found for the year
of publication and the year prior (24-month period). <br/>Result(s): A
total of 144 studies (764 authors) were identified. At least 1 author of
112 studies (78%) had received payments from Intuitive. At least 1 author
of 98 studies (68%) had received an undeclared payment from Intuitive.
Authors who accurately disclosed payments received significantly higher
median payments compared with authors who did not ($16,511 [interquartile
range, $6389-$159,035] vs $1762 [interquartile range, $338-$7500]; P <
.0001). Last authors were significantly more likely to have a COI
discrepancy compared with middle and first authors (P = .018; P = .0015).
<br/>Conclusion(s): Most studies investigating the use of robotic
technology in cardiothoracic surgery did not accurately declare COI with
Intuitive. This study highlights the need for improved accuracy of
reporting industry sponsorship by publishing authors.<br/>Copyright &#xa9;
2024 The Society of Thoracic Surgeons

<52>
Accession Number
2023562545
Title
Co-Occurrence of Sensorineural Hearing Loss and Congenital Heart Disease:
Etiologies and Management.
Source
Laryngoscope. 134(1) (pp 400-409), 2024. Date of Publication: January
2024.
Author
Yang T.; Fan X.; Fan Y.; Song W.; Liu X.; Wang J.; Chen X.
Institution
(Yang, Fan, Fan, Song, Wang, Chen) Department of Otolaryngology, Peking
Union Medical College Hospital, Chinese Academy of Medical Sciences,
Peking Union Medical College, Beijing, China
(Liu) Department of Cardiac Surgery, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives/Hypothesis: The co-occurrence of sensorineural hearing loss
(SNHL) and congenital heart disease (CHD) is a rare condition with complex
etiologies. The purpose of this study is to assess the etiologies,
clinical features, and outcomes of cochlear implant (CI) in this patient
population. <br/>Study Design: Case series and literature review.
<br/>Method(s): Clinical data of children who were diagnosed with SNHL and
CHD and received CIs at a tertiary hospital from 2016 to 2021 were
retrospectively analyzed. A literature review was performed to identify
patients with SNHL and CHD. <br/>Finding(s): Of the 382 children who
underwent cochlear implantation at our center, eight (2.1%) were diagnosed
with SNHL and CHD. A literature review identified 1525 patients from 254
studies; the database therefore consisted of 1533 patients. The most
common genetic etiologies of co-occurring SNHL and CHD were CHARGE
syndrome (36.3%), Turner syndrome (8.4%), 22q11.2 deletion (3.0%), Noonan
syndrome (2.9%), and Down syndrome (2.5%), whereas the most common
non-genetic etiologies were congenital rubella syndrome (22.9%) and SNHL
after early cardiac surgery (5.5%). Most of the patients presented with
congenital, bilateral, severe-profound SNHL requiring early
rehabilitation. Of the 126 children who received CIs at a median age of
2.5 years, half showed delayed speech development at last follow-up.
<br/>Conclusion(s): Co-occurring SNHL and CHD is a rare condition with
complex etiologies. Timely hearing intervention with long-term follow-up
and proper timing of heart surgery is essential for these children.
<br/>Level of Evidence: 4, case series Laryngoscope, 134:400-409,
2024.<br/>Copyright &#xa9; 2023 The Authors. The Laryngoscope published by
Wiley Periodicals LLC on behalf of The American Laryngological,
Rhinological and Otological Society, Inc.

<53>
Accession Number
643102905
Title
Effect of Prewarming on Perioperative Hypothermia in Patients Undergoing
Loco-Regional or General Anesthesia: A Randomized Clinical Trial.
Source
Medicina (Kaunas, Lithuania). 59(12) (no pagination), 2023. Date of
Publication: 27 Nov 2023.
Author
Recio-Perez J.; Miro Murillo M.; Martin Mesa M.; Silva Garcia J.;
Santonocito C.; Sanfilippo F.; Asunsolo A.
Institution
(Recio-Perez, Miro Murillo, Martin Mesa) Department of Anesthesia,
Torrejon University Hospital, 28850 Torrejon de Ardoz, Spain
(Silva Garcia) Department of Anesthesia, 12 Octubre Hospital, Madrid
28041, Spain
(Santonocito, Sanfilippo) Department of Anesthesia and Intensive Care,
University Hospital "Policlinico-San Marco", Catania 95124, Italy
(Sanfilippo) Department of Surgery and Medical-Surgical Specialties,
University of Catania, Catania 95124, Italy
(Asunsolo) Department of Public Health, Alcala University, Alcala de
Henares 28801, Spain
Abstract
Background and Objectives: Redistribution hypothermia occurs during
anesthesia despite active intraoperative warming. Prewarming increases the
heat absorption by peripheral tissue, reducing the central to peripheral
heat gradient. Therefore, the addition of prewarming may offer a greater
preservation of intraoperative normothermia as compared to intraoperative
warming only. <br/>Material(s) and Method(s): A single-center clinical
trial of adults scheduled for non-cardiac surgery. Patients were
randomized to receive or not a prewarming period (at least 10 min) with
convective air devices. Intraoperative temperature management was
identical in both groups and performed according to a local protocol. The
primary endpoint was the incidence, the magnitude and the duration of
hypothermia (according to surgical time) between anesthetic induction and
arrival at the recovery room. Secondary outcomes were core temperature on
arrival in operating room, surgical site infections, blood losses,
transfusions, patient discomfort (i.e., shivering), reintervention and
hospital stay. <br/>Result(s): In total, 197 patients were analyzed: 104
in the control group and 93 in the prewarming group. Core temperature
during the intra-operative period was similar between groups (p = 0.45).
Median prewarming lasted 27 (17-38) min. Regarding hypothermia, we found
no differences in incidence (controls: 33.7%, prewarming: 39.8%; p =
0.37), duration (controls: 41.6% (17.8-78.1), prewarming: 45.2%
(20.6-71.1); p = 0.83) and magnitude (controls: 0.19 degreeC . h-1
(0.09-0.54), prewarming: 0.20 degreeC . h-1 (0.05-0.70); p = 0.91).
Preoperative thermal discomfort was more frequent in the prewarming group
(15.1% vs. 0%; p < 0.01). The interruption of intraoperative warming was
more common in the prewarming group (16.1% vs. 6.7%; p = 0.03), but no
differences were seen in other secondary endpoints. <br/>Conclusion(s): A
preoperative prewarming period does not reduce the incidence, duration and
magnitude of intraoperative hypothermia. These results should be
interpreted considering a strict protocol for perioperative temperature
management and the low incidence of hypothermia in controls.

<54>
Accession Number
2028352207
Title
Deep Parasternal Intercostal Plane Block for Postoperative Analgesia After
Sternotomy for Cardiac Surgery-A Retrospective Cohort Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 189-196),
2024. Date of Publication: January 2024.
Author
Skojec A.J.; Christensen J.M.; Yalamuri S.M.; Smith M.M.; Arghami A.;
LeMahieu A.M.; Schroeder D.R.; Mauermann W.J.; Nuttall G.A.; Ritter M.J.
Institution
(Skojec, Christensen, Yalamuri, Smith, Mauermann, Nuttall, Ritter)
Department of Anesthesiology and Perioperative Medicine, Division of
Cardiothoracic Anesthesia, Mayo Clinic College of Medicine and Science,
Rochester, MN, United States
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(LeMahieu, Schroeder) Division of Biomedical Statistics and Informatics,
Mayo Clinic College of Medicine and Science, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Objective: To examine the analgesic efficacy of postoperative deep
parasternal intercostal plane (DPIP) blocks for patients having cardiac
surgery via median sternotomy. <br/>Design(s): This single-center
retrospective study compared patients receiving bilateral DPIP blocks with
a matched cohort of patients not receiving DPIP blocks. <br/>Setting(s):
Large quaternary referral center. <br/>Participant(s): Adult patients
admitted to the authors' institution from January 1, 2016, to August 14,
2020, for elective cardiac surgery via median sternotomy.
<br/>Intervention(s): Patients received ultrasound-guided bilateral DPIP
blocks. <br/>Measurements and Main Results: A total of 113 patients
received a DPIP block; 3,461 patients did not. The estimated
multiplicative change in cumulative opioid consumption through 24 hours
was 0.42 (95% CI 0.32-0.56; p < 0.001), indicating that patients receiving
DPIP blocks required 60% fewer opioids than patients who did not.
Proportional odds ratios for the average pain score on postoperative day
(POD) 0 was 0.46 (95% CI 0.32-0.65; p < 0.001), and POD 1 was 0.67 (95% CI
0.47-0.94; p = 0.021), indicating lower pain scores for patients receiving
blocks. The exploratory analysis identified an inverse correlation between
DPIP blocks and atrial fibrillation incidence (2% v 15%; inverse
probability of treatment weighting odds ratio 0.088, 95% CI 0.02-0.41; p =
0.002). <br/>Conclusion(s): The use of DPIP blocks in patients undergoing
cardiac surgery via median sternotomy was associated with less opioid use
and improved pain scores in the early postoperative period compared with
patients not receiving blocks. Prospective randomized controlled studies
should further elucidate the efficacy and risks of DPIP blocks in cardiac
surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<55>
Accession Number
2027995967
Title
Methylene Blue Reduces Mortality in Critically Ill and Perioperative
Patients: A Meta-Analysis of Randomized Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 268-274),
2024. Date of Publication: January 2024.
Author
Pruna A.; Bonaccorso A.; Belletti A.; Turi S.; Di Prima A.L.; D'amico F.;
Zangrillo A.; Kotani Y.; Landoni G.
Institution
(Pruna, Bonaccorso, Belletti, Turi, Di Prima, D'amico, Zangrillo, Kotani,
Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Zangrillo, Kotani, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
Publisher
W.B. Saunders
Abstract
Vasodilatory hypotension is common in critically ill and perioperative
patients, and is associated with adverse outcomes. As a nitric oxide
production inhibitor, methylene blue (MB) exerts its vasoconstrictor
property and is an adjuvant for catecholamine-refractory vasodilatory
shock. However, the effects of MB on clinically relevant outcomes remain
unclear. Therefore, the authors performed a meta-analysis of randomized
trials on MB in critically ill and perioperative patients. The authors
searched through databases for randomized trials on MB in critically ill
and perioperative patients, which yielded 11 studies consisting of 556
patients. The primary outcome was mortality at the longest follow-up.
Secondary outcomes included hemodynamic parameters and organ dysfunction
(PROSPERO: CRD42023409243). Nine out of the 11 included randomized trials
reported mortality, which was significantly lower in the MB group (risk
ratio, 0.60 [95% CI 0.43-0.84] p = 0.003), with findings confirmed in
septic shock and cardiac surgery subgroups. The authors found reduced
lengths of stay in the intensive care unit (mean difference [MD], -0.9
days [95% CI -1.06 to -0.77] p < 0.001) and in the hospital (MD, -2.2 days
[95% CI, -2.68 to -1.70] p < 0.001) in the MB group. MB was associated
with increased mean arterial pressure (MD, 8.4 mmHg [95% CI 5.01-11.75] p
< 0.001) and systemic vascular resistance (MD, 94.5 dyn/s/cm⁵
[95% CI 17.73-171.15] p = 0.02), with no difference in cardiac output
(standardized MD, 0.16 [95% CI, -0.25 to 0.57] p = 0.45). This
meta-analysis showed that MB reverses vasodilation in critically ill and
perioperative patients and might improve survival. Further adequately
powered randomized trials are needed to confirm these
findings.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<56>
Accession Number
2027271357
Title
Effect of intranasal insulin administration on postoperative delirium
prevention in elderly cardiac surgery patients: study protocol for a
multicenter, double-blind, randomized, controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 822. Date of
Publication: December 2023.
Author
Nakadate Y.; Yamada M.; Kusuyama N.; Ishii R.; Sato H.; Schricker T.;
Tanaka M.
Institution
(Nakadate, Yamada) Department of Anesthesiology, University of Tsukuba
Hospital, 2-1-1, Amakubo, Tsukuba, Ibaraki 305-8576, Japan
(Kusuyama) Department of Anesthesia, Tsukuba Medical Center Hospital,
Ibaraki, Japan
(Ishii) Department of Biostatistics, Faculty of Medicine, University of
Tsukuba, Ibaraki, Japan
(Sato, Schricker) Department of Anesthesia, McGill University Health
Centre Glen Site, Royal Victoria Hospital, Montreal, Canada
(Tanaka) Department of Anesthesiology, Faculty of Medicine, University of
Tsukuba, Ibaraki, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium (POD) is a complication after surgery
which leads to worse outcomes. The frequency of this syndrome is
increasing as more elderly patients undergo major surgery. The frequency
is around 10-25% but reaches as high as 50% for cardiac surgery. Although
intranasal insulin (INI) administration of up to 160 units in patients
with cognitive dysfunction and delirium has been shown to improve memory
function and brain metabolism without complications such as hypoglycemia,
it remains unknown whether INI prevents POD after cardiac surgery Methods:
A multicenter, double-blind, randomized, controlled trial will be
conducted at University of Tsukuba Hospital and Tsukuba Medical Center
Hospital, Japan, from July 1, 2023, to December 31, 2025. A total of 110
elderly patients (65 years old or older) undergoing cardiac surgery
requiring cardiopulmonary bypass will be enrolled and randomly allocated
to intranasal insulin or intranasal saline groups. The primary outcome is
the incidence of POD within 7 days after surgery. Secondary outcomes
include days and times of delirium, screening tests of cognitive function,
pain scores, duration of postoperative tracheal intubation, and length of
ICU stay. <br/>Discussion(s): The present objective is to assess whether
80 IU INI administration during surgery prevents POD after cardiac
surgery. The results may provide strategic choices to prevent POD in
patients with cardiac surgery requiring cardiopulmonary bypass. Trial
registration: The trial was registered with the Japan Registry for
Clinical Trials with identifier jRCTs031230047 on April 21,
2023.<br/>Copyright &#xa9; 2023, The Author(s).

<57>
Accession Number
2027253652
Title
Medical graphics to improve patient understanding and anxiety in elderly
and cognitively impaired patients scheduled for transcatheter aortic valve
implantation (TAVI).
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Brand A.; Hornig C.; Crayen C.; Hamann A.; Martineck S.; Leistner D.M.;
Dreger H.; Sundermann S.; Unbehaun A.; Sherif M.; Haghikia A.; Bischoff
S.; Lueg J.; Kuhnle Y.; Paul O.; Squier S.; Stangl K.; Falk V.; Landmesser
U.; Stangl V.
Institution
(Brand, Hornig, Dreger, Bischoff, Lueg, Stangl, Stangl) Department of
Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum
der Charite, Campus Charite Mitte, Berlin, Germany
(Brand, Leistner, Haghikia, Landmesser) Department of Cardiology,
Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite,
Campus Benjamin Franklin, Berlin, Germany
(Brand, Leistner, Dreger, Sundermann, Haghikia, Falk, Landmesser, Stangl)
DZHK (German Centre for Cardiovascular Research), partner Site Berlin,
Berlin, Germany
(Crayen) Department of Education and Psychology, Freie Universitat Berlin,
Habelschwerdter Allee 45, Berlin 14195, Germany
(Hamann) Mintwissen-Science Communication Agency and Publishing House,
Paulusstr. 11, Dusseldorf 40237, Germany
(Martineck) Kollwitzstrase 52, Berlin 10405, Germany
(Sundermann, Unbehaun, Falk) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Sherif, Kuhnle, Paul) Department of Cardiology, Angiology and Intensive
Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum,
Berlin, Germany
(Squier) Brill Professor Emeritus of English and Women's, Gender and
Sexuality Studies, The Pennsylvania State University, University Park, PA
16802, United States
(Leistner) Department of Cardiology, Angiology and Intensive Care
Medicine, Goethe University Hospital, Universitares Herz- und
Gefasszentrum Frankfurt, Frankfurt am Main, Frankfurt 60590, Germany
(Leistner) DZHK (German Centre for Cardiovascular Research), partner site
Rhein-Main, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Anxiety and limited patient comprehension may pose significant
barriers when informing elderly patients about complex procedures such as
transcatheter aortic valve implantation (TAVI). <br/>Objective(s): We
aimed to evaluate the utility of medical graphics to improve the patient
informed consent (IC) before TAVI. <br/>Method(s): In this prospective,
randomized dual center study, 301 patients were assigned to a patient
brochure containing medical graphics (Comic group, n = 153) or sham
information (Control group, n = 148) on top of usual IC. Primary outcomes
were patient understanding of central IC-related aspects and
periprocedural anxiety assessed by the validated Spielberger State Trait
Anxiety Inventory (STAI), both analyzed by cognitive status according to
the Montreal Cognitive Assessment (MoCA). <br/>Result(s): Patient
understanding was significantly higher in the Comic group [mean number of
correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI
1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of
cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6)
in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI
score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8
points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score
decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired
patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive
function (p < 0.001 each). <br/>Conclusion(s): Our results prove
beneficial effects for using medical graphics to inform elderly patients
about TAVI by improving patient understanding and reducing periprocedural
anxiety (DRKS00021661; 23/Oct/2020). Graphical Abstract: Medical graphics
entailed significant beneficial effects on the primary endpoints, patient
understanding and periprocedural anxiety, compared to the usual patient
informed consent (IC) procedure. Patient understanding of IC-related
aspects was significantly higher in the Comic group, with a more
pronounced benefit in patients with cognitive impairment (p for IC method
and cognitive status < 0.001, respectively; p for IC method x MoCA
category interaction = 0.017). There further was a significant decline of
periprocedural anxiety in patients with and without cognitive impairment
(p for IC method x measuring time point < 0.001; p for IC method x MoCA
category x measuring time point interaction = 0.018) [Figure not
available: see fulltext.].<br/>Copyright &#xa9; 2023, The Author(s).

<58>
Accession Number
2027244814
Title
Rescue designs in analgesic trials from 0 to 2 years of age: scoping
review.
Source
Pediatric Research. (no pagination), 2023. Date of Publication: 2023.
Author
Haskes K.; Donado C.; Carbajal R.; Berde C.B.; Kossowsky J.
Institution
(Haskes, Donado, Berde, Kossowsky) Department of Anesthesiology, Critical
Care & Pain Medicine, Boston Children's Hospital, Boston, MA, United
States
(Donado, Berde, Kossowsky) Department of Anaesthesia, Harvard Medical
School, Boston, MA, United States
(Carbajal) Pediatric Emergency Department, Assistance Publique-Hopitaux de
Paris, Hopital Armand Trousseau-Sorbonne Universite, Paris, France
(Carbajal) Institut National de La Sante et de La Recherche Medicale,
Paris UMR1153, France
Publisher
Springer Nature
Abstract
Abstract: Pediatric analgesic trials are challenging, especially in
newborns and infants. Following an FDA-academic consensus meeting, we
analyzed pragmatic rescue designs in postoperative trials of local
anesthetics, acetaminophen, opioids, and NSAIDs involving children ages
0-2 years and assessed surgical volumes to provide trial design
recommendations. Searches of PubMed, Embase, CINAHL, The Cochrane Library,
and Web of Science were conducted. A scoping approach identified trends in
analgesic trials with an emphasis on randomized controlled trials (RCTs)
utilizing immediate rescue designs. Age-specific surgical volumes were
estimated from French national databases. Of 3563 studies identified, 23
RCTs used study medication(s) of interest and immediate rescue paradigms
in children ages 0-2 years. A total of 270 studies met at least one of
these criteria. Add-on and head-to-head designs were common and often used
sparing of non-opioid or opioid rescue medication as a primary outcome
measure. According to French national data, inguinal and penile surgeries
were most frequent in ages 1 month to 2 years; abdominal and thoracic
surgeries comprise approximately 75% of newborn surgeries. Analgesic
trials with rescue sparing paradigm are currently sparse among children
ages 0-2 years. Future trials could consider age-specific surgical
procedures and use of add-on or head-to-head designs. Impact: Clinical
trials of analgesic medications have been challenging in pediatrics,
especially in the group from newborns to 2 years of age. Following an
FDA-academic workshop, we analyzed features of completed analgesic trials
in this age group. Studies using immediate rescue in placebo control,
add-on, and head-to-head trial designs are pragmatic approaches that can
provide important information regarding clinical effectiveness, side
effects, and safety. Using a French national dataset with a granular
profile of inpatient, outpatient, and short-stay surgeries, we provide
information to future investigators on relative frequencies of different
operations in neonates and through the first 2 years of
life.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive licence to
the International Pediatric Research Foundation, Inc.

<59>
Accession Number
2027212261
Title
Transcatheter left atrial appendage occlusion in patients with chronic
kidney disease: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Flores-Umanzor E.; Asghar A.; Cepas-Guillen P.L.; Farrell A.; Keshvara R.;
Alvarez-Rodriguez L.; Osten M.; Freixa X.; Horlick E.; Abrahamyan L.
Institution
(Flores-Umanzor, Keshvara, Alvarez-Rodriguez, Osten, Horlick) Toronto
Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Asghar, Abrahamyan) Toronto General Hospital Research Institute,
University Health Network, 10th Floor Eaton North, Room 237, 200 Elizabeth
Street, Toronto, ON M5G 2C4, Canada
(Asghar, Abrahamyan) Institute for Health Policy, Management, and
Evaluation, University of Toronto, Toronto, ON, Canada
(Cepas-Guillen, Freixa) Cardiology Department, Cardiovascular Institute,
Hospital Clinic, University of Barcelona, Barcelona, Spain
(Farrell) Library and Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Chronic kidney disease (CKD) is a risk factor for embolic
stroke, and many nonvalvular atrial fibrillation (NVAF) patients have
concomitant CKD. Anticoagulation therapy can be challenging in CKD due to
increased bleeding risk, and left atrial appendage occlusion (LAAO) may be
a promising alternative. <br/>Objective(s): This systematic review aimed
to consolidate current evidence on the safety and effectiveness of
transcatheter LAAO in patients with CKD and end-stage renal disease
(ESRD). <br/>Method(s): Medline, Cochrane, and Embase databases were
searched from inception to September 2, 2022. We conducted a meta-analysis
if an outcome was evaluated in at least two similar studies.
<br/>Result(s): We included 15 studies with 77,780 total patients. Of the
15 studies, 11 had a cohort design (five prospective and six
retrospective), and four were case series. Patients with CKD were older
and had a higher prevalence of comorbidities than non-CKD patients. The
two groups did not differ in procedural failure rate, vascular
complications, or pericardial tamponade. CKD patients exhibited higher
odds of in-hospital acute kidney injury (AKI) and bleeding, longer-term
bleeding, and mortality than those without CKD. The risk of in-hospital
and longer-term cardioembolic events was similar between CKD and non-CKD
populations (odds ratio = 1.01 [95% CI 0.70-1.15] and 1.05 [95% CI
0.55-2.00], respectively). Patients with ESRD had higher odds of
in-hospital mortality and cardioembolic events than non-ESRD patients,
with no differences in risk of pericardial tamponade. <br/>Conclusion(s):
Based on observational studies, LAAO may be an effective option to prevent
cardioembolic events in CKD. However, CKD patients may have higher odds of
AKI and in-hospital and long-term bleeding and mortality. The adverse
clinical outcomes observed in CKD patients may be attributed to this
population's high burden of comorbidities, especially among those with
ERSD, rather than the LAAO procedure itself. To ensure maximum clinical
benefit, careful patient selection, management, and surveillance involving
multidisciplinary teams are essential for CKD patients undergoing LAAO.
Graphical abstract: Transcatheter Left Atrial Appendage Occlusion (laao)
Can Prevent Cardioembolic Events In Chronic Kidney Disease (ckd) Patients.
However, Ckd Patients, Particularly Those With End-stage Renal
Disease/dialysis (esrd), May Face Increased Odds Of Acute Kidney Injury,
In-hospital And Long-term Bleeding, And Mortality. Notably, These Adverse
Outcomes In Ckd Patients May Be Linked To Their High Comorbidity Burden,
Particularly In Those With Esrd, Rather Than The Laao Procedure Itself.
Careful Patient Selection, Management, And Surveillance Involving
Multidisciplinary Teams Are Essential For Ckd Patients Undergoing Laao To
Ensure Maximum Clinical Benefit Transcatheter left atrial appendage
occlusion (LAAO) can prevent cardioembolic events in chronic kidney
disease (CKD) patients. However, CKD patients, particularly those with
end-stage renal disease/dialysis (ESRD), may face increased odds of acute
kidney injury, in-hospital and long-term bleeding, and mortality. Notably,
these adverse outcomes in CKD patients may be linked to their high
comorbidity burden, particularly in those with ESRD, rather than the LAAO
procedure itself. Careful patient selection, management, and surveillance
involving multidisciplinary teams are essential for CKD patients
undergoing LAAO to ensure maximum clinical benefit.[Figure not available:
see fulltext.].<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany.

<60>
Accession Number
2027192664
Title
Intraoperative circulatory arrest secondary to high-risk pulmonary
embolism. Case series and updated literature review.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 415. Date
of Publication: December 2023.
Author
Cruz G.; Pedroza S.; Giraldo M.; Pena A.D.; Calderon C.A.; Quintero I.F.
Institution
(Cruz, Quintero) Departamento de anestesiologia, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Pedroza) Centro de investigaciones clinicas, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Giraldo) Departamento de cardiologia y hemodinamia, Fundacion Valle del
Lili, Cra 98 No. 18-49, Cali 760032, Colombia
(Pena) Departamento de cirugia cardiovascular, Fundacion Valle del Lili,
Cra 98 No. 18-49, Cali 760032, Colombia
(Calderon) Departamento de cardiologia, Fundacion Valle del Lili, Cra 98
No. 18-49, Cali 760032, Colombia
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative pulmonary embolism (PE) with cardiac arrest
(CA) represents a critical and potentially fatal condition. Available
treatments include systemic thrombolysis, catheter-based thrombus
fragmentation or aspiration, and surgical embolectomy. However, limited
studies are focused on the optimal treatment choice for this critical
condition. We present a case series and an updated review of the
management of intraoperative CA secondary to PE. <br/>Method(s): A
retrospective review of patients who developed high-risk intraoperative PE
was performed between June 2012 and June 2022. For the updated review, a
literature search on PubMed and Scopus was conducted which resulted in the
inclusion of a total of 46 articles. <br/>Result(s): A total of 196 174
major non-cardiac surgeries were performed between 2012 and 2022. Eight
cases of intraoperative CA secondary to high-risk PE were identified. We
found a mortality rate of 75%. Anticoagulation therapy was administered to
one patient (12.5%), while two patients (25%) underwent thrombolysis, and
one case (12.5%) underwent mechanical thrombectomy combined with thrombus
aspiration. Based on the literature review and our 10-year experience, we
propose an algorithm for the management of intraoperative CA caused by PE.
<br/>Conclusion(s): The essential components for adequate management of
intraoperative PE with CA include hemodynamic support, cardiopulmonary
resuscitation, and the implementation of a primary perfusion intervention.
The prompt identification of the criteria for each specific treatment
modality, guided by the individual patient's characteristics, is necessary
for an optimal approach.<br/>Copyright &#xa9; 2023, The Author(s).

<61>
Accession Number
2025513944
Title
Standardized Treatment and Diagnostic Approach to Reduce Disease burden in
the early postoperative phase in children with congenital heart
defects-STANDARD study: a pilot randomized controlled trial.
Source
European Journal of Pediatrics. 182(12) (pp 5325-5340), 2023. Date of
Publication: December 2023.
Author
Vogt A.; Meyer S.; Schafers H.-J.; Weise J.J.; Wagenpfeil S.; Abdul-Khaliq
H.; Poryo M.
Institution
(Vogt) Medical School, University of Saarland, Homburg/Saar, Germany
(Meyer) Franz-Lust Klinik fur Kinder- und Jugendmedizin, Stadtisches
Klinikum Karlsruhe, Karlsruhe, Germany
(Schafers) Department of Thoracic and Cardiovascular Surgery, Saarland
University Medical Center, Homburg/Saar, Germany
(Weise, Wagenpfeil) Institute for Medical Biometry, Epidemiology and
Medical Informatics, Saarland University Medical Center, Homburg/Saar,
Germany
(Abdul-Khaliq, Poryo) Department of Pediatric Cardiology, Saarland
University Medical Center, Kirrberger Strase, Building 9, Homburg/Saar
D-66421, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
To explore the effect of a daily goal checklist on pediatric cardiac
intensive care unit (PCICU) length of stay (LOS) after congenital heart
surgery. This study is a prospective randomized single-center study. Group
characteristics were as follows: STANDARD group: n = 30, 36.7% female,
median age 0.9 years; control group: n = 33, 36.4% female, median age 1.1
years. Invasive ventilation time, STAT categories, mean
vasoactive-inotropic score (VIS)<inf>24h</inf>, maximal (max.)
VIS<inf>24h</inf>, mean VIS<inf>24-48h</inf>, max. VIS<inf>24-48h</inf>,
VIS category, number of sedatives, analgesics, diuretics, number of
deployed diagnostic modalities, morbidities, and mortality did not differ
between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus
101.5 h (control group) (p = 0.63). In the overall cohort, univariate
regression analysis identified age at surgery (b = -0.02), STAT category
(b = 18.3), severity of CHD (b = 40.6), mean VIS<inf>24h</inf> (b = 3.5),
max. VIS<inf>24h</inf> (b = 2.2), mean VIS<inf>24-48h</inf> (b = 6.5), and
VIS category (b = 13.8) as significant parameters for prolonged PCICU LOS.
In multivariate regression analysis, age at surgery (b = -0.2), severity
of CHD (b = 44.0), and mean VIS<inf>24h</inf> (b = 6.7) were of
significance. Within the STANDARD sub-group, univariate regression
analysis determined STAT category (b = 32.3), severity of CHD (b = 70.0),
mean VIS<inf>24h</inf> (b = 5.0), mean VIS<inf>24-48h</inf> (b = 5.9),
number of defined goals (b = 2.6), number of achieved goals (b = 3.3),
number of not achieved goals (b = 10.8), and number of unevaluated goals
(b = 7.0) as significant parameters for prolonged PCICU LOS. Multivariate
regression analysis identified the number of defined goals (b = 2.5) and
the number of unevaluated goals (b = -3.0) to be significant parameters.
<br/>Conclusion(s): The structured realization and recording of daily
goals is of advantage in patients following pediatric cardiac surgery by
reducing PCICU LOS. What is known: * Communication errors are the most
frequent reasons for adverse events in intensive care unit patients. *
Improved communication can be achieved by discussion and documentation of
the patients' goals during daily rounds. What is new: * In the overall
cohort age at surgery, severity of congenital heart defect and mean
vasoactive inotropic score within the first 24 hours had significant
impact on pediatric cardiac intensive care unit (PCICU) length of stay
(LOS). * In the intervention group, the number of defined goals and the
number of unevaluated goals were significant parameters for prolonged
PCICU LOS.<br/>Copyright &#xa9; 2023, The Author(s).

<62>
Accession Number
642998872
Title
Perioperative outcomes of bi-pigtail catheter drainage strategy versus
conventional chest tube after uniportal video-assisted thoracic lung
surgery.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(6) (no pagination),
2023. Date of Publication: 01 Dec 2023.
Author
Song L.; Chen X.; Zhu L.; Qian G.; Xu Y.; Song Z.; Li J.; Chen T.; Huang
J.; Luo Q.; Cheng X.; Yang Y.
Institution
(Song, Chen, Song, Li, Chen, Huang, Luo, Cheng, Yang) Department of
Oncological Surgery, Shanghai Chest Hospital Affiliated to Shanghai
Jiaotong University School of Medicine, Shanghai, China
(Zhu) Department of Radiology, Shanghai Chest Hospital, Shanghai Chest
Hospital Affiliated to Shanghai Jiaotong University School of Medicine,
Shanghai, China
(Qian) Department of Thoracic Surgery, Zhangjiagang Third People's
Hospital, Suzhou, China
(Xu) Department of Thoracic Surgery, Zhejiang Hospital Affiliated to
Zhejiang University School of Medicine, Hangzhou, China
Abstract
OBJECTIVES: Chest tube (CT) drainage is a main cause of postoperative pain
in lung surgery. Here, we introduced a novel drainage strategy with
bi-pigtail catheters (PCs) and conducted a randomized controlled trial to
compare with conventional CT drainage after uniportal video-assisted
thoracic surgery lung surgery. <br/>METHOD(S): A single-centre,
prospective, open-labelled, randomized controlled trial (ChiCTR2000035337)
was conducted with a preplanned sample size of 396. The primary outcome
was the numerical pain rating scale (NPRS) on the first postoperative day.
Secondary outcomes included other indicators of postoperative pain,
drainage volume, duration of drainage, postoperative hospital stay,
incidence of postoperative complications, CT reinsertion and medical
costs. <br/>RESULT(S): A total number of 396 patients were randomized
between August 2020 and January 2021, 387 of whom were included in the
final analysis. The baseline and clinical characteristics of the patients
were well balanced between 2 groups. The NPRS on the first postoperative
day was significantly lower in the PC group than in the CT group
(2.40+/-1.27 vs 3.02+/-1.39, p<0.001), as well as the second/third-day
NPRS, the incidence of sudden severe pain (9/192, 4.7% vs 34/195, 17.4%,
P<0.001) and pain requiring intervention (19/192, 9.9% vs 46/195, 23.6%,
P<0.001). In addition, the medical cost in the PC group was lower
(US$7809+/-1646 vs US$8205+/-1815, P=0.025). Univariable and multivariable
analyses revealed that the drainage strategy was the only factor
influencing the incidence of pain requiring intervention.
<br/>CONCLUSION(S): The drainage strategy with bi-PCs in patients
undergoing uniportal video-assisted thoracic surgery lung surgery
alleviates postoperative pain with adequate safety and
efficacy.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<63>
Accession Number
642604613
Title
Clinical implementation of partial oral treatment in infective
endocarditis: the Danish POETry study.
Source
European heart journal. 44(48) (pp 5095-5106), 2023. Date of Publication:
21 Dec 2023.
Author
Pries-Heje M.M.; Hjulmand J.G.; Lenz I.T.; Hasselbalch R.B.; Povlsen J.A.;
Ihlemann N.; Kober N.; Tofterup M.L.; Ostergaard L.; Dalsgaard M.;
Faurholt-Jepsen D.; Wienberg M.; Christiansen U.; Bruun N.E.; Fosbol E.;
Moser C.; Iversen K.K.; Bundgaard H.
Institution
(Pries-Heje, Hjulmand, Lenz, Ostergaard, Fosbol, Bundgaard) Department of
Cardiology, Heart Centre, Copenhagen University Hospital-Rigshospitalet,
Copenhagen, Denmark
(Hasselbalch, Iversen) Department of Emergency Medicine, Copenhagen
University Hospital-Herlev and Gentofte Hospital, Herlev, Denmark
(Hasselbalch, Dalsgaard, Iversen) Department of Cardiology, Copenhagen
University Hospital-Herlev and Gentofte Hospital, Herlev, Denmark
(Povlsen) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Ihlemann, Tofterup) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Ihlemann, Kober) Department of Cardiology, Copenhagen University
Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Faurholt-Jepsen) Department of Infectious Diseases, Heart Centre,
Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
(Wienberg) Department of Cardiology, Copenhagen University Hospital-North
Zealand, Denmark
(Christiansen) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Bruun) Department of Cardiology, Zealand University Hospital, Roskilde,
Denmark
(Bruun) Department of Clinical Medicine, University of Aalborg, Aalborg,
Denmark
(Bruun, Iversen, Bundgaard) Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark
(Moser) Department of Clinical Microbiology, Copenhagen University
Hospital-Rigshospitalet, Copenhagen, Denmark
(Moser) Department of Immunology and Microbiology, University of
Copenhagen, Copenhagen, Denmark
Abstract
BACKGROUND AND AIMS: In the Partial Oral Treatment of Endocarditis (POET)
trial, stabilized patients with left-sided infective endocarditis (IE)
were randomized to oral step-down antibiotic therapy (PO) or conventional
continued intravenous antibiotic treatment (IV), showing non-inferiority
after 6 months. In this study, the first guideline-driven clinical
implementation of the oral step-down POET regimen was examined.
<br/>METHOD(S): Patients with IE, caused by Staphylococcus aureus,
Enterococcus faecalis, Streptococcus spp. or coagulase-negative
staphylococci diagnosed between May 2019 and December 2020 were possible
candidates for initiation of oral step-down antibiotic therapy, at the
discretion of the treating physician. The composite primary outcome in
patients finalizing antibiotic treatment consisted of embolic events,
unplanned cardiac surgery, relapse of bacteraemia and all-cause mortality
within 6 months. <br/>RESULT(S): A total of 562 patients [median age 74
years (IQR, interquartile range, 65-80), 70% males] with IE were possible
candidates; PO was given to 240 (43%) patients and IV to 322 (57%)
patients. More patients in the IV group had IE caused by S. aureus, or had
an intra-cardiac abscess, or a pacemaker and more were surgically treated.
The primary outcome occurred in 30 (13%) patients in the PO group and in
59 (18%) patients in the IV group (P = .051); in the PO group, 20 (8%)
patients died vs. 46 (14%) patients in the IV group (P = .024). PO-treated
patients had a shorter median length of stay [PO 24 days (IQR 17-36) vs.
IV 43 days (IQR 32-51), P < .001]. <br/>CONCLUSION(S): After clinical
implementation of the POET regimen almost half of the possible candidates
with IE received oral step-down antibiotic therapy. Patients in the IV
group had more serious risk factors for negative outcomes. At 6-month
follow-up, there was a numerically but not statistically significant
difference towards a lower incidence of the primary outcome, a lower
incidence of all-cause mortality and a reduced length of stay in the PO
group. Due to the observational design of the study, the lower mortality
may to some extent reflect selection bias and unmeasured confounding.
Clinical implementation of PO regimens seemed feasible and
safe.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<64>
Accession Number
2029288287
Title
EE436 Economic Evaluation of Transcatheter Versus Surgical Aortic Valve
Replacement in Low- and Intermediate-Risk Patients with Severe Aortic
Stenosis in China.
Source
Value in Health. Conference: ISPOR Europe 2023. Copenhagen Denmark. 26(12
Supplement) (pp S135), 2023. Date of Publication: December 2023.
Author
Peng J.; Jiang M.; Fang Y.; Yao X.; Ma Y.
Institution
(Peng) Xi'an Jiaotong University, Shaanxi, Xi'an, China
(Jiang, Yao, Ma) Xi'an Jiaotong University, Shaanxi, Xi'an, China
(Fang) Xi'an Jiaotong University, Xi'an, China
Publisher
Elsevier Ltd
Abstract
Objectives: Transcatheter aortic valve replacement is an alternative to
surgery in patients with severe aortic stenosis who are at intermediate-
and low-risk. There is no economic evaluation study on TAVR in China,
whether TAVR is cost-effective compared to SAVR in China is uncertain. We
aimed to evaluate the economic burden and effectiveness of TAVR compared
to SAVR in low-and intermediate-risk AS patients in China, including risk,
age, and valve type subgroups. <br/>Method(s): A decision-analytic model
was constructed to compare cost-effectiveness of different treatment
strategies from the Chinese healthcare system's perspective. Model inputs
were derived from published literatures, real-world data, our own
Meta-analysis results. The model simulated a hypothetical cohort of low-
and intermediate-risk patients (STS<=8%) with severe AS who underwent only
AVR during hospitalization. Outcomes included total costs, QALYs, ICER,
subgroup and sensitivity analyses were performed to examine robustness of
the model results. <br/>Result(s): In the base-case analysis, the total
lifetime costs after discounting were $28,042.77, $58,777.59, for SAVR,
TAVR groups, respectively. 5.9 QALYs, 6.52 QALYs were gained for SAVR,
SAVR respectively. In the low-risk population, TAVR was more expensive
than SAVR at an incremental cost of $30,810.09 and was associated with
benefits of 1.04 QALYs lived over a lifetime horizon. This yielded an ICER
of $29,542.6/QALY, which fell below the predetermined cost-effectiveness.
In probabilistic sensitivity analysis, the probability of SAVR being
cost-effective was 97.93%, with 3-fold GDP per capita as the
willingness-to-pay threshold. <br/>Conclusion(s): From the Chinese
healthcare perspective, in comparison with TAVR and individual therapy,
SAVR would be considered highly cost-effective for patients with severe
symptomatic AS including risk, age, and valve type subgroups. Contrary
conclusions emerge for subgroup of low-risk patients.<br/>Copyright &#xa9;
2023

<65>
Accession Number
2029286377
Title
EE158 Cost Effectiveness and Budget Impact of Patient Blood Management in
a Turkish State Hospital.
Source
Value in Health. Conference: ISPOR Europe 2023. Copenhagen Denmark. 26(12
Supplement) (pp S80-S81), 2023. Date of Publication: December 2023.
Author
Sanal L.; Ramirez de Arellano Serna A.; Gunaydin S.; Tatar M.
Institution
(Sanal, Gunaydin) Ankara City Hospital, Ankara, Turkey
(Ramirez de Arellano Serna) CSL Vifor, Zurich, Switzerland
(Tatar) Vitale Health Economics and Policy, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Objectives: Anemia and transfusion of blood products are risk factors
associated with poor patient outcomes across all elective surgeries.
Patient Blood Management (PBM) focuses on optimizing the patient's own
blood through evidence-based approaches. The objective of this study is to
explore the cost-effectiveness and budget impact of implementing PBM in
the cardiovascular surgery department of a state hospital in Turkey.
<br/>Method(s): A cost-effectiveness (decision tree) and budget impact
model, based on number of avoided red blood cell (RBC) transfusions and
complications before and after the implementation of the program was
developed. The endpoints of the cost-effectiveness study were avoided
transfusion-related complications (sepsis, renal failure, myocardial
infarction, and stroke), and results were presented as incremental cost
per incremental avoided complication. Blood usage data were obtained from
the transfusion center of the hospital from February 2019 to October 2020
(pre-PBM) and December 2020 to July 2022 (post-PBM). Results of recent
meta-analyses were used for probabilities of transfusion and complications
after transfusion. The major cost parameters in the model were cost of
PBM, cost of transfusion and cost of treating complications. Costs were
estimated from the Turkish healthcare payer perspective (SSI).
<br/>Result(s): There was a 21% decrease in the use of RBC after the
implementation of the program. This decrease alone saved 1,635,948 TRY. In
the cost-effectiveness model, implementation of PBM was estimated to avoid
68 complications. The post-PBM period dominated the pre-PBM period. The
hospital saved 8,232,882 TRY (404,725) in the given period by avoiding
transfusions and complications. Sensitivity analysis results have showed
that the findings of the study were robust. <br/>Conclusion(s): This study
from a hospital in Turkey indicates that PBM is a cost-effective and
budget saving approach. Broadening the program to other surgical
departments of the hospital and to other state hospitals is recommended to
the SSI.<br/>Copyright &#xa9; 2023

<66>
[Use Link to view the full text]
Accession Number
2029318536
Title
Hypoxemia in School-age Children Undergoing One-lung Ventilation: A
Retrospective Cohort Study from the Multicenter Perioperative Outcomes
Group.
Source
Anesthesiology. 140(1) (pp 25-37), 2024. Date of Publication: 01 Jan 2024.
Author
Templeton T.W.; Krol B.; Miller S.; Lee L.K.; Mathis M.; Vishneski S.R.;
Chatterjee D.; Gupta R.; Shroeder R.A.; Saha A.K.; Schonberger R.B.
Institution
(Templeton, Miller, Vishneski, Saha) Department of Anesthesiology, Wake
Forest School of Medicine, Winston-Salem, NC, United States
(Krol) Wake Forest School of Medicine, Winston-Salem, NC, United States
(Lee) Department of Anesthesiology, UCLA, Los Angeles, CA, United States
(Mathis, Gupta) Department of Anesthesiology, University of Michigan, Ann
Arbor, MI, United States
(Chatterjee) Department of Anesthesiology, University of Colorado, Denver,
CO, United States
(Shroeder) Department of Anesthesiology, Duke University, Durham, NC,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Risk factors for hypoxemia in school-age children undergoing
one-lung ventilation remain poorly understood. The hypothesis was that
certain modifiable and nonmodifiable factors may be associated with
increased risk of hypoxemia in school-age children undergoing one-lung
ventilation and thoracic surgery. <br/>Method(s): The Multicenter
Perioperative Outcomes Group database was queried for children 4 to 17 yr
of age undergoing one-lung ventilation. Patients undergoing vascular or
cardiac procedures were excluded. The original cohort was divided into two
cohorts: 4 to 9 and 10 to 17 yr of age inclusive. All records were
reviewed electronically for the primary outcome of hypoxemia during
one-lung ventilation, which was defined as an oxygen saturation measured
by pulse oximetry (Spo<inf>2</inf>) less than 90% for 3 min or longer
continuously, while severe hypoxemia was defined as Spo<inf>2</inf>less
than 90% for 5 min or longer. Potential modifiable and nonmodifiable risk
factors associated with these outcomes were evaluated using separate
multivariable least absolute shrinkage and selection operator regression
analyses for each cohort. The covariates evaluated included age, extremes
of weight, American Society of Anesthesiologists Physical Status of III or
higher, duration of one-lung ventilation, preoperative Spo<inf>2</inf>less
than 98%, approach to one-lung ventilation, right operative side,
video-assisted thoracoscopic surgery, lower tidal volume ventilation
(defined as tidal volume of 6 ml/kg or less and positive end-expiratory
pressure of 4 cm H<inf>2</inf>O or greater for more than 80% of the
duration of one-lung ventilation), and procedure type. <br/>Result(s): The
prevalence of hypoxemia in the 4- to 9-yr-old cohort and the 10- to
17-yr-old cohort was 24 of 228 (10.5% [95% CI, 6.5 to 14.5%]) and 76 of
1,012 (7.5% [95% CI, 5.9 to 9.1%]), respectively. The prevalence of severe
hypoxemia in both cohorts was 14 of 228 (6.1% [95% CI, 3.0 to 9.3%]) and
47 of 1,012 (4.6% [95% CI, 3.3 to 5.8%]). Initial Spo<inf>2</inf>less than
98% was associated with hypoxemia in the 4- to 9-yr-old cohort (odds
ratio, 4.20 [95% CI, 1.61 to 6.29]). Initial Spo<inf>2</inf>less than 98%
(odds ratio, 2.76 [95% CI, 1.69 to 4.48]), extremes of weight (odds ratio,
2.18 [95% CI, 1.29 to 3.61]), and right-sided cases (odds ratio, 2.33 [95%
CI, 1.41 to 3.92]) were associated with an increased risk of hypoxemia in
the older cohort. Increasing age (1-yr increment; odds ratio, 0.88 [95%
CI, 0.80 to 0.97]) was associated with a decreased risk of hypoxemia.
<br/>Conclusion(s): An initial room air oxygen saturation of less than 98%
was associated with an increased risk of hypoxemia in all children 4 to 17
yr of age. Extremes of weight, right-sided cases, and decreasing age were
associated with an increased risk of hypoxemia in children 10 to 17 yr of
age.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All rights
reserved.

<67>
Accession Number
2029367980
Title
Dual vs. triple antithrombotic treatment after percutaneous coronary
intervention in patients with non-valvular atrial fibrillation: a
meta-analysis on current evidence.
Source
European Review for Medical and Pharmacological Sciences. 27(21) (pp
10716-10729), 2023. Date of Publication: 2023.
Author
Acconcia M.C.; Caretta Q.; Chiarotti F.; Tanzilli G.; Torromeo C.;
Pannarale G.; Gaudio C.
Institution
(Acconcia, Tanzilli, Torromeo, Pannarale, Gaudio) Department of Clinical,
Internal Medicine, Anesthesiological and Cardiovascular Sciences,
"Sapienza" University of Rome, Rome, Italy
(Caretta) The Department of Experimental and Clinical Medicine, University
of Florence, Florence, Italy
(Chiarotti) Center for Behavioral Sciences and Mental Health, Istituto
Superiore di Sanita, Rome, Italy
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Combination and duration of antithrombotic therapy in order to
prevent both stent thrombosis and thromboembolic complications after
coronary artery stenting (PCI) in non-valvular atrial fibrillation (AF) is
still debated. This uncertainty can be attributed mainly to the fact that
the reference trials were open-label and not adequately powered in order
to reach a definitive conclusion on ischemic endpoints (i.e., stent
thrombosis). On these grounds, data from real-life studies could support
evidence on dual antithrombotic treatment (DAT) safety (bleeding risk) and
efficacy (stent thrombosis prevention). The aim of the meta-analysis is to
investigate in both randomized controlled trials (RCTs) and observational
studies (Obs) the risks and/or benefits related to DAT vs. triple
antithrombotic treatment (TAT) regimens in patients affected by AF
undergoing PCI. MATERIALS AND METHODS: RCTs and Obs were retrieved through
PubMed database. The risk ratio with 95% confidence interval was used to
compare the primary and the safety endpoints. <br/>RESULT(S):
Meta-analysis demonstrated no significant differences between DAT vs. TAT
for mortality. However, a two-fold higher mortality rate was registered in
Obs than in RCTs. The Obs did not confirm the expected significant
reduction in bleeding risk shown by the RCTs; however, the bleeding rates
in Obs were more than three-fold those of RCTs. In Obs, a significant
greater risk for stent thrombosis was observed in DAT than in TAT.
<br/>CONCLUSION(S): The safety and efficacy outcomes observed in RCTs are
unrealistic with respect to the current clinical practice. So, more
evidence is needed to have more exhaustive guidelines based on RCTs with
homogeneous designs and protocols that should mimic real-life population
and practice.<br/>Copyright &#xa9; 2023 Verduci Editore s.r.l. All rights
reserved.

<68>
Accession Number
2029380368
Title
Clinical Efficacy of Two-Phase Leukocyte Filtration in High-Risk Patients
Undergoing Coronary Revascularization with Cardiopul monary Bypass.
Source
Journal of Extra-Corporeal Technology. 41(3) (pp 149-156), 2009. Date of
Publication: 01 Sep 2009.
Author
Gunaydin S.; Modine T.; Sari T.; Zorlutuna Y.; Gourlay T.
Institution
(Gunaydin) Department of Cardiovascular Surgery, University of Kirikkale,
Kirikkale, Turkey
(Modine) Hopital Cardiologique, Chru de Lille, Lille, France
(Sari, Zorlutuna) Bayindir Hospital, Ankara, Turkey
(Gourlay) Bioengineering Unit, University of Strathclyde, Glasgow, United
Kingdom
Publisher
EDP Sciences
Abstract
The purpose of this study was to investigate the clinical outcome,
inflammatory response and myocardial function in high-risk patients
undergoing three different leukocyte depletion strategies. Over a
four-month period, forty patients (EuroSCORE 6+) undergoing coronary
revascularization were prospectively randomized to one of the four
perfusion protocols: Group 1 (N = 10): Conventional circuits (ECC) + two
leukocyte filters (LG6B, Pall, USA) with the method of two-phase
(continuous + strategic) leukofiltration; Group 2 (N = 10): ECC + single
leukocyte filter with the method of continuous leukofiltration; Group 3 (N
= 10): ECC + single leukocyte filter with the method of strategic
leukofiltration; Group 4 (N = 10) Control: ECC without leukocyte
filtration. Blood samples were collected at T1: Baseline, T2: On CPB, T3:
X-Clamp, T4: Off CPB, T5: ICU24 and T6: ICU48. Perioperative follow-up was
thoroughly monitored. Leukocyte counts in double filter and strategic
filtration groups demonstrated significant differences at T4 (p <.05 vs.
control). TNF-alpha levels were significantly lower in Group 1 at T4 and
procalcitonin levels at T5 and T6 (p <.05 vs. control). CKMB levels
demonstrated well preserved myocardium in double filter group (p <.05 vs.
control). Brain natriuretic peptide levels in double filter group were
significantly lower at T5 and T6 with respect to Group 2 (p <.05) and
control (p <.001). Matrixmetallopeptidase 9 and D-Dimer levels in double
filter group were significantly lower at T5 and T6 (p <.05 vs. control).
Two-phase leukofiltration is associated with some compound benefit over
continuous deployment in high-risk patients. A larger more powerful study
than this pilot one is warranted for further evaluation.<br/>Copyright
&#xa9; 2009 American Society of Extra-Corporeal Technology. All rights
reserved.

<69>
Accession Number
2029380361
Title
Anti-Inflammatory Effect of Aprotinin: A Meta-Analysis.
Source
Journal of Extra-Corporeal Technology. 41(2) (pp 79-86), 2009. Date of
Publication: 01 Jun 2009.
Author
Brown J.R.; Toler A.W.J.; Kramer R.S.; Landis R.C.
Institution
(Brown, Toler) The Dartmouth Institute for Health Policy and Clinical
Practice and Dartmouth Medical School, Lebanon, NH, United States
(Kramer) Division of Cardiothoracic Surgery, Maine Medical Center,
Portland, ME, United States
(Landis) Edmund Cohen Laboratory for Vascular Research, University of the
West Indies, Barbados
Publisher
EDP Sciences
Abstract
It is important to define the extent, and any limitations, of potential
anti-inflammatory regimens used in cardiac surgery to guide the rational
combination of drugs to suppress the systemic inflammatory response.
Aprotinin (Trasylol) is an anti-fibrinolytic agent with reported
anti-inflammatory properties. In this study, we investigated the published
data on aprotinin's effect on acute phase protein and cytokine levels in
cardiac surgery patients. Randomized placebo-controlled trials of
aprotinin published between 1985 and 2007, in adult cardiac surgery using
cardiopulmonary bypass, reporting tumor necrosis factor-alpha (TNF-alpha),
interleukin-6 (IL-6), IL-8, and IL-10 levels were included for review. Two
independent reviewers graded each paper and collected information on
inflammatory markers. RevMan 4.3 statistical software was used to
calculate and plot the weighted mean difference between placebo and
aprotinin groups. Thirteen studies met the review criteria. None of the
inflammatory markers were reduced by high-dose aprotinin treatment.
Low-dose aprotinin significantly reduced IL-10 levels after protamine
administration (-41.3 pg/mL; 95% CI: -59.5, -23.1), but this result was
gone by the first post-operative day. These meta-analyses showed no
significant effect of aprotinin on acute phase proteins or systemic
cytokine markers of inflammation during clinical adult cardiac surgery
using cardiopulmonary bypass. While recognizing that other host defense
systems, such as coagulation and complement, contribute to the overall
systemic inflammatory response, the evidence presented here does not
support the clinical use of aprotinin as an anti-inflammatory agent on its
own.<br/>Copyright &#xa9; 2009 American Society of Extra-Corporeal
Technology. All rights reserved.

<70>
Accession Number
2029380347
Title
Increased Accuracy in Heparin and Protamine Administration Decreases
Bleeding: A Pilot Study.
Source
Journal of Extra-Corporeal Technology. 41(1) (pp 10-14), 2009. Date of
Publication: 01 Mar 2009.
Author
Runge M.; Moller C.H.; Steinbruchel D.A.
Institution
(Runge) Department of Clinical Perfusion, Copenhagen University Hospital,
Copenhagen, Denmark
(Moller, Steinbruchel) Department of Cardiothoracic Surgery,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Publisher
EDP Sciences
Abstract
Three to 5 percent of the patients undergoing cardiac surgery are
reoperated because of bleeding. When a surgical cause can be excluded,
heparin/protamine mismatch may be considered. Insufficient reversal of
heparin and overdosing of protamine may cause postoperative bleeding. The
purpose of the study was to evaluate whether a heparin- protamine
titration system, Hemochron RxDx, could reduce postoperative bleeding and
blood transfusion. Fifty-three patients were included prospectively over a
6-month period. The test group (RxDx group; 28 patients) received heparin
and protamine doses calculated using the Hemochron RxDx system, which
performs a baseline activated clotting time (ACT) value together with a
heparin response test. An accurate heparin dose was calculated based on
the Bull dose/response curve. Protamine doses were calculated by the same
method. In the control group (25 patients), heparin was administered based
on weight (3.5 mg/kg) and monitored by ACT. Heparin was reversed with
protamine (1 mg/1 mg of total heparin). Postoperative bleeding was
significantly lower in the RxDx group (375 mL; range, 125- 700 mL)
compared with the control group (600 mL; range, 250- 1920 mL; p =.018). A
reduced number of patients needed blood transfusions in the RxDx group,
although this was not statistically significant (19% vs. 38%,
respectively; p =.13). Initial heparin dose was significantly reduced in
the RxDx group (250 mg; range, 100- 375 mg) compared with the control
group (300 mg; range, 200- 350 mg; p =.04). The additional heparin during
cardiopulmonary bypass (CPB) was significantly lower as well 62 (range, 0-
185) vs. 100 mg (range, 0- 350 mg); p =.04. Initial protamine dose was
reduced in the RxDx group 200 (range, 75- 340) vs. 350 mg (range, 200- 500
mg); p =.0001. Satisfactory end ACT values were obtained in both groups.
Using the Hemochron RxDx, we observed a significant reduction in
postoperative blood loss, as well as the amount of heparin and initial
doses of protamine used during CPB. Individual patient managed
anticoagulation during cardiac surgery using dose/response curve
techniques based on in vitro analysis of heparin and protamine seems to
reduce bleeding.<br/>Copyright &#xa9; 2009 American Society of
Extra-Corporeal Technology. All rights reserved.

<71>
Accession Number
2029414946
Title
Comparison of Erector Spinae Plane Block and Pectointercostal Facial Plane
Block for Enhanced Recovery After Sternotomy in Adult Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Elbardan I.M.; Abdelkarime E.M.; Elhoshy H.S.; Mohamed A.H.; ElHefny D.A.;
Bedewy A.A.
Institution
(Elbardan, Elhoshy, Mohamed) Department of Anesthesia and Surgical
Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt
(Abdelkarime) Department of Anesthesia and ICU, Mansoura University,
Mansoura, Egypt
(ElHefny) Department of Anesthesia and Surgical Intensive Care,
Kafrelsheikh University, Kafr El-Sheikh, Egypt
(Bedewy) Department of Anesthesia and Surgical Intensive Care, Helwan
University, Helwan, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to investigate and compare the effects of the
pectointercostal fascial plane block (PIFPB) and the erector spinae plane
block (ESPB) on enhancing the recovery of patients who undergo cardiac
surgery. <br/>Design(s): A randomized, controlled, double-blinded study.
<br/>Setting(s): The operating rooms and intensive care units of
university hospitals. <br/>Participant(s): One hundred patients who were
American Society of Anesthesiologists class II to III aged 18-to-70 years
scheduled for elective cardiac surgery. <br/>Intervention(s): Patients
were randomly assigned to undergo either ultrasound-guided bilateral PIFPB
or ESPB. <br/>Measurements and Main Results: Patients shared comparable
baseline characteristics. Time to extubation, the primary outcome, did not
demonstrate a statistically significant difference between the groups,
with median (95% confidence interval) values of 115 (90-120) minutes and
110 (100-120) minutes, respectively (p = 0.875). The ESPB group had a
statistically significant reduced pain score postoperatively. The median
(IQR) values of postoperative fentanyl consumption were statistically
significantly lower in the ESPB group than in the PIFPB group (p < 0.001):
4 (4-5) versus 9 (9-11) microg/kg, respectively. In the ESPB group, the
first analgesia request was given 4 hours later than in the PIFPB group (p
< 0.001). Additionally, 12 (24%) patients in the PIFPB group reported
nonsternal wound chest pain, compared with none in the ESPB group. The
median intensive care unit length of stay for both groups was 3 days (p =
0.428). <br/>Conclusion(s): Erector spinae plane block and PIFPB were
found to equally affect recovery after cardiac surgery, with comparable
extubation times and intensive care unit length of stay.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<72>
Accession Number
2029414270
Title
Direct Oral Anticoagulant Use Early After Cardiac Surgery: A Retrospective
Cohort Study.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Wu J.-J.; Jiang J.; Ye J.; Turgeon R.D.; Wang E.H.Z.
Institution
(Wu) Department of Pharmacy, Ridge Meadows Hospital, and Faculty of
Pharmaceutical Sciences, Maple Ridge, BC, Canada
(Jiang) Department of Pharmacy, Vancouver General Hospital, and Faculty of
Pharmaceutical Sciences, Vancouver, BC, Canada
(Ye) Division of Cardiac Surgery, St. Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Turgeon, Wang) Department of Pharmacy, St. Paul's Hospital, and Faculty
of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC,
Canada
Publisher
Elsevier Inc.
Abstract
Background: There is limited literature guiding the prescribing of direct
oral anticoagulants (DOACs) early after cardiac surgery as this population
has been excluded from landmark randomized controlled trials. This study
aims to determine the rate of in-hospital DOAC use compared with warfarin
early after cardiac surgery, evaluate factors associated with DOAC use,
determine difference in postoperative length of stay, and characterize
bleeding events. <br/>Method(s): A retrospective cohort study was
conducted in adult patients with indications for anticoagulation and
receiving either a DOAC or warfarin after cardiac surgery during their
index hospitalization. Patients were excluded if they had any
contraindications to DOAC use. The primary outcome was the proportion of
patients discharged on a DOAC compared with warfarin. <br/>Result(s): Of
included 210 patients, 30% received DOACs and 70% received warfarin on
discharge. The most common DOAC used was apixaban (74.6%), and median
postoperative day of initiation was 5 days. Patients receiving DOACs were
older (70.8 vs 68.0 years), had less valvular heart disease (38.1% vs
63.9%), were more likely to be on DOACs preoperatively (50.8% vs 31.3%),
and were more likely to have undergone coronary artery bypass graft alone
(54.0% vs 24.5%) compared with those on warfarin. Postoperative length of
stay (7 vs 9 days; P = 0.59) and in-hospital bleeding (1.6% vs 2.0%; P =
1.00) did not differ between DOAC and warfarin groups. <br/>Conclusion(s):
At a quaternary referral centre for cardiac surgery, DOACs were used in
approximately one-third of patients with an indication for anticoagulation
early after cardiac surgery.<br/>Copyright &#xa9; 2023 The Authors

<73>
Accession Number
2029354298
Title
Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of
Clean Wounds: A Systematic Review and Meta-Analysis.
Source
Surgical Infections. (no pagination), 2023. Date of Publication: 2023.
Author
Lin W.-L.; Wu L.-M.; Nguyen T.-H.Y.; Lin Y.-H.; Chen C.-J.; Huang W.-T.;
Guo H.-R.; Chen Y.-H.; Chuang C.-H.; Chang P.-C.; Hung H.-K.; Chen S.-H.
Institution
(Lin, Chen) Center for Quality Management, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Lin, Wu) School of Nursing, Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Wu) Department of Medical Research, Kaohsiung Medical University
Hospital, Kaohsiung, Taiwan (Republic of China)
(Huang) Division of Hematology and Oncology, Department of Internal
Medicine, Department of Surgery, Chi Mei Medical Center, Liouying, Taiwan
(Republic of China)
(Nguyen, Guo) Department of Environmental and Occupational Health,
National Cheng Kung University Hospital, Tainan, Taiwan (Republic of
China)
(Guo) Department of Occupational and Environmental Medicine, National
Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
(Lin) Infection Control Center, Department of Surgery, Chi Mei Medical
Center, Liouying, Taiwan (Republic of China)
(Chen) Pharmacy Department, Department of Surgery, Chi Mei Medical Center,
Liouying, Taiwan (Republic of China)
(Chuang) Division of General Surgery, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Chang) Department of Infectious Diseases, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Hung) Division of Plastic Surgery, Department of Surgery, Chi Mei Medical
Center, Liouying, Taiwan (Republic of China)
(Chen) National Institute of Cancer Research, National Health Research
Institutes, Tainan, Taiwan (Republic of China)
(Chen) Department of Oncology, National Cheng Kung University Hospital,
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Topical antibiotic agents are not generally indicated for
preventing of surgical site infections (SSIs) in clean incisions, and the
drug concentrations that should be delivered to local incision sites
remain uncertain. The aim of this study was to critically assess the
efficacy of topical antibiotic agents in comparison with non-antibiotic
agents for preventing SSIs in clean incisions by performing a systematic
review and meta-analysis. <br/>Method(s): We conducted a search of
literature in PubMed, Embase, and Cochrane Databases and included
randomized controlled trials (RCTs) on topical antibiotic use for patients
with clean post-surgical incisions. The primary outcome was the incidence
of SSI, presented as the event rate. Eleven RCTs were included.
<br/>Result(s): Using random-effects modeling, the pooled risk ratio (RR)
of developing a post-surgical incisions infection was 0.83 (95% confidence
interval [CI], 0.61-1.16; I², 0%). In subgroup analyses, no
reductions in SSI were observed when topical antibiotic agents were used
to treat incisions due to spinal (RR, 0.75; 95% CI, 0.40-1.38;
I², 0%), orthopedic (RR, 0.69; 95% CI, 0.37-1.29;
I², 0%), dermatologic (RR, 0.77; 95% CI, 0.39-1.55;
I², 65%), or cardiothoracic surgeries (RR, 1.31; 95% CI,
0.83-2.06; I²: 0%). The incidence of SSI across different
operative phases did not differ for the application of topical antibiotic
agents compared with non-antibiotic agents (RR, 0.80; 95% CI, 0.56-1.14;
I², 0%). <br/>Conclusion(s): The results of this meta-analysis
show that topical antibiotic agents provide no clinical benefit for
preventing SSI in clean incisions.<br/>Copyright 2023, Mary Ann Liebert,
Inc., publishers.

<74>
Accession Number
2027215308
Title
Timing of Chest Tube Removal Following Adult Cardiac Surgery: A Cluster
Randomized Controlled Trial.
Source
Scandinavian Cardiovascular Journal. 58(1) (no pagination), 2024. Article
Number: 2294681. Date of Publication: 2024.
Author
El-Akkawi A.I.; Media A.S.; Eykens Hjornet N.; Nielsen D.V.; Modrau I.S.
Institution
(El-Akkawi, Media, Eykens Hjornet, Nielsen, Modrau) Department of
Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus,
Denmark
(Nielsen, Modrau) Department of Clinical Medicine, Aarhus University
Hospital, Aarhus, Denmark
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Early chest tube removal following cardiac surgery may be
associated with an increased risk of pleural or pericardial effusions
following cardiac surgery. This study compares the effects of two
fast-track chest tube removal protocols regarding the risk of pleural or
pericardial effusions, requirement of opioids, respiratory function, and
postoperative complications. <br/>Design(s): Prospective non-blinded
cluster-randomized study with alternating chest tube removal protocol in
adult patients undergoing elective cardiac surgery. Monthly changing
allocation to scheduled chest tube removal on the day of surgery (Day 0)
versus removal on the 1st postoperative day (Day 1) provided no air
leakage and output < 200 mL within the last four hours. <br/>Result(s): A
total of 527 patients were included in the study from September 1st 2020
until October 29th 2021 and randomly allocated to chest tube removal at
day 0 (n = 255), and day 1 (n = 272). More than every fourth patient
required drainage for pleural effusion with no significant difference
between the groups. Earlier removal of chest tubes did not reduce
requirement of analgesics, improve early respiratory function, or reduce
postoperative complications. The study was halted for futility after
halfway interim analysis showed insufficient promise of any treatment
benefit. <br/>Conclusion(s): Fast-track protocols with chest tube removal
within the first 24 h after cardiac surgery may be associated a high rate
of pleural effusions.<br/>Copyright &#xa9; 2023 The Author(s). Published
by Informa UK Limited, trading as Taylor & Francis Group.

<75>
Accession Number
2027544807
Title
The effect of type of anesthesia (general versus spinal) on postoperative
levels of brain natriuretic peptide in parturient women with
cardiovascular diseases undergoing cesarean section and related cardiac
impacts.
Source
Egyptian Journal of Anaesthesia. 40(1) (pp 10-17), 2024. Date of
Publication: 2024.
Author
Omar H.; Helmy M.H.; Wahib M.; Abdalla Mohamed A.; Marzouk S.; Abdelreheem
A.M.
Institution
(Omar, Helmy, Wahib, Abdalla Mohamed, Marzouk, Abdelreheem) Pain
Management and Surgical ICU, Faculty of Medicine, Cairo University, Cairo,
Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Dealing with parturient women with cardiac disease is still a
challenge for anesthesiologists due to the presence of physiologic burden
of pregnancy in addition to the already existing compromised
cardiovascular system. A variety of cardiac indices have been utilized to
forecast the risk of perioperative cardiac complications, yet limitations
in their predictive value exist. Perioperative brain natriuretic peptide
(BNP) level is used as a prognosticator of cardiac complications following
surgery in cardiac and non-cardiac individuals. Aim of study: To compare
the effect of general and spinal anesthesia during cesarean section in
parturient with cardiac disease on BNP levels and on predicting adverse
cardiac events. <br/>Method(s): Thirty cardiac parturient with cesarean
section were assigned randomly into two groups of equal size. Group A:
participants received general anesthesia (GA); Group B: participants
received spinal anesthesia. Preoperative and 2 and 24 h postoperative BNP
levels were measured. Intraoperative and 24 h postoperative cardiac
complications were observed. <br/>Result(s): Preoperative and 2 and 24 h
postoperative BNP mean levels were similar in the two groups. In each
group, the 2 and 24 h postoperative rise in BNP mean levels was
insignificant compared to the preoperative mean levels of BNP. Incidence
of complications was comparable in both groups, but it was associated with
the already high preoperative levels of BNP. <br/>Conclusion(s): The study
concludes that safely conducted certain type of anesthesia has no effect
on the perioperative BNP levels nor incidence of complications which is
associated with the already high preoperative BNP levels.<br/>Copyright
&#xa9; 2023 The Author(s). Published by Informa UK Limited, trading as
Taylor & Francis Group.

<76>
Accession Number
2027351046
Title
Antithrombotic Management for Transcatheter Aortic Valve Implantation.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7632. Date of Publication: December 2023.
Author
Ya'Qoub L.; Arnautovic J.; Sharkawi M.; AlAasnag M.; Jneid H.; Elgendy
I.Y.
Institution
(Ya'Qoub) Division of Structural Heart Disease, University of California
(San Francisco), San Francisco, CA 93106, United States
(Arnautovic) Division of Interventional Cardiology, Henry Ford Macomb
Hospital, Clinton Twp, MI 48038, United States
(Sharkawi) Division of Structural Heart Disease, Medical College of
Georgia, Augusta, GA 30912, United States
(AlAasnag) Department of Cardiology, King Fahd Medical Center, Jeddah
21589, Saudi Arabia
(Jneid) Department of Cardiology, Saint Luke's Baylor Medical Center,
Houston, TX 77030, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY 40506, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: There have been significant changes in the optimal
antithrombotic regimen post transcatheter aortic valve implantation (TAVI)
after the results of major clinical trials in the past few years. Given
the clinical importance of the optimal antithrombotic therapy post TAVI,
we performed a narrative description of the major clinical trials behind
the scientific evidence supporting these changes, as well the current
guideline recommendations and knowledge gaps. <br/>Method(s): We performed
a narrative description of the major clinical trials behind the scientific
evidence supporting these changes. We used PubMed as a major source to
collect the major clinical trials including the following key words:
"transcatheter aortic valve replacement", "transcatheter aortic valve
implantation", "antithrombotic", "antiplatelet" and "anticoagulation". We
selected the major clinical trials on this topic. This is not a systematic
review or meta-analysis. <br/>Result(s): We describe the results of the
major clinical trials on antithrombotic therapy post TAVI: POPULAR-TAVI A,
POPULAR-TAVI B, ENVISAGE-TAVI AF, GALILEO, ATLANTIS and ADAPT-TAVR trials.
Based on the results of these trials, single antiplatelet therapy is
recommended post TAVI in patients without concomitant indication for oral
anticoagulation or dual antiplatelet therapy, especially in elderly
patients. In younger patients, it is advised to evaluate the patient's
bleeding and thrombotic risk, and dual antiplatelet therapy may be
reasonable in patients with a high thrombotic risk and low bleeding risk.
In patients with a concurrent indication for oral anticoagulation or dual
antiplatelet therapy, it is recommended to continue oral anticoagulation
or dual antiplatelet therapy post TAVI. <br/>Conclusion(s): In most
patients without concomitant indication for oral anticoagulation, single
antiplatelet therapy is recommended post TAVI.<br/>Copyright &#xa9; 2023
by the authors.

<77>
Accession Number
2027350752
Title
The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive
Dysfunction following Thoracic Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7576. Date of Publication: December 2023.
Author
Kim S.Y.; Lee J.; Na H.-S.; Koo B.-W.; Lee K.O.; Shin H.-J.
Institution
(Kim, Lee, Na, Koo, Lee, Shin) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Seoul 13620, South
Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Regional nerve blocks (NBs) mitigate the occurrence of postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in adult
patients undergoing thoracic surgery. This study aimed to determine the
exact effect of NBs on POCD and POD. Electronic databases, including
PubMed, EMBASE, CINAHL, Scopus, and Web of Science, were searched for
studies. The primary outcome was the incidence of POD or POCD. The
secondary outcome was pain scores assessed 24 and 48 h postoperatively. We
calculated the log odds ratio (LOR) and standardized mean difference (SMD)
with 95% confidence intervals (CIs). The LOR was converted to an odds
ratio (OR). In the analysis of 1010 patients from seven randomized
controlled trials, POD and POCD rates were 14.1% and 16.7%, respectively,
in the NB group, and higher, at 27.3% and 35.2%, in the control group. NBs
reduced the incidence of POD (OR, 0.44; 95%CI 0.30 to 0.64; p < 0.001;
I² = 0.00%) and POCD (OR, 0.43; 95%CI 0.24 to 0.76; p < 0.001;
I² = 0.00%). NBs reduced pain scores at 24 h (SMD, -2.60; 95%CI
-3.90 to -1.30, p < 0.001; I² = 97.68%) and 48 h (SMD, -1.80;
95%CI -3.18 to -0.41, p = 0.01; I² = 98.14%) postoperatively.
NBs mitigated the occurrence of POD and POCD in adult patients after
thoracic surgery.<br/>Copyright &#xa9; 2023 by the authors.

<78>
Accession Number
643103005
Title
Thoracic Endovascular Aortic Repair for Hyperacute, Acute, Subacute and
Chronic Type B Aortic Dissection: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 22 Dec 2023.
Author
Pompeu Sa M.; Jacquemyn X.; Brown J.A.; Ahmad D.; Serna-Gallegos D.;
Arnaoutakis G.J.; Singh M.J.; Sultan I.
Institution
(Pompeu Sa, Brown, Ahmad, Serna-Gallegos, Sultan) Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh,
Pennsylvania, USA; UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Arnaoutakis) Division of Cardiovascular and Thoracic Surgery, Dell
Medical School, Austin, TX, United States
(Singh) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, Pennsylvania, USA; Division of Vascular
Surgery, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
Abstract
Since the optimal timing for thoracic endovascular aortic repair (TEVAR)
in the context of type B aortic dissections (TBAD) remains an open
question, we performed a systematic review with meta-analysis to evaluate
outcomes of TEVAR according to the phases of TBAD - hyperacute, acute,
subacute and chronic. We carried out a pooled meta-analysis of
time-to-event data extracted from studies published by June 2023 for the
following outcomes: all-cause mortality, aortic-related mortality, and
late aortic reinterventions. Thirteen studies met our eligibility
criteria, comprising 4,793 patients (10.3% hyperacute, 51.9% acute, 25.9%
subacute, 11.9% chronic). Considering the overall population, we observed
a statistically significant difference between the groups (Log-rank test,
P<0.0001) and the main differences were found in the following
comparisons: hyperacute versus acute (HR 1.61; 95%CI 1.21-2.13; P=0.001);
hyperacute versus chronic (HR 1.70; 95%CI 1.17-2.46; P=0.005); subacute
versus acute (HR 0.78; 95%CI 0.63-0.98; P=0.032). Considering the
population with uncomplicated TBAD, we also observed a statistically
significant difference for all-cause death between the groups (Log-rank
test, P<0.0001) and the main differences were found in the comparisons for
subacute versus acute (HR 0.72; 95%CI 0.58-0.88; P=0.002). Furthermore, we
observed statistically significant differences between the groups for
aortic-related death (Log-rank test, P<0.0001) and late aortic
reintervention (Log-rank test, P<0.0001), all favoring mostly the subacute
phase as the optimal timing for TEVAR. In conclusion, there seems to be a
timing-specific difference in the outcomes of TEVAR for TBAD pointing to
the subacute phase as the optimal timing to achieve better long-term
outcomes.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<79>
Accession Number
643099592
Title
Impact of carotid artery stenosis on outcomes of Transcatheter aortic
valve replacement: A systematic review and Meta-analysis.
Source
International journal of cardiology. (pp 131670), 2023. Date of
Publication: 21 Dec 2023.
Author
de Silva L.C.; Gibicoski T.B.; Rodriguez F.; Scabello I.; da Silva Neto
E.P.; Iplinski B.
Institution
(de Silva) Department of Medicine, Federal University of Paraiba, Joao
Pessoa, Brazil
(Gibicoski, Rodriguez) Federal University of Health Sciences of Porto
Alegre, Porto Alegre, Brazil
(Scabello) Joao Pessoa University Center, Joao Pessoa, Brazil
(da Silva Neto) Santo Amaro Hospital, Recife, Brazil
(Iplinski) Santa Casa de Misericordia Hospital, Porto Alegre, Brazil
Abstract
INTRODUCTION: Carotid Artery Stenosis (CAS) is common in elderly patients
undergoing Transcatheter Aortic Valve Replacement (TAVR). However, the
impact of CAS on the outcomes of TAVR is unclear. PURPOSE: This systematic
review and meta-analysis aimed to compare the clinical and periprocedural
outcomes in patients with and without CAS undergoing TAVR. <br/>METHOD(S):
PubMed, Embase, and Cochrane databases were searched until February 2023.
We included studies that performed a direct comparison of outcomes of TAVR
in CAS versus non-CAS patients. Data was extracted from published reports
and the ROBINS-I tool was utilized for quality assessment. The R studio
software (version 4.2.2) was adopted for statistical analysis.
<br/>RESULT(S): Five observational studies and 111.915 patients were
included. The mean age was 80.7+/-8.2years and 46.3% were female. The risk
of stroke or transient ischemic attack was elevated in the group of
patients with CAS (OR 1.44; 95% CI 1.07-1.95; p=0.016). In contrast,
myocardial infarction (OR 1.24; 95% CI 1.05-1.47; p=0.074) and all-cause
mortality (OR 0.99; 95% CI 0.73-1.35; p=0.95) were not significantly
different between CAS and non-CAS groups. Acute kidney injury and new
pacemaker implantation did not differ between patients with and without
CAS. <br/>CONCLUSION(S): Our findings suggest that CAS is significantly
associated with cerebrovascular events in patients undergoing TAVR,
without significantly impacting all-cause mortality. Further prospective
studies are needed for a more granular assessment of additional
determinants of this association, such as unilateral vs. bilateral
involvement and whether there is a threshold of CAS severity for increased
risk.<br/>Copyright &#xa9; 2023. Published by Elsevier B.V.

<80>
Accession Number
643089492
Title
Local versus General Anaesthesia for Transcatheter Aortic Valve
Implantation (TAVI): A Systematic Review, Meta-Analysis, and Trial
Sequential Analysis of Randomised and Propensity-Score Matched Studies.
Source
Current problems in cardiology. (pp 102360), 2023. Date of Publication:
19 Dec 2023.
Author
Jaffar-Karballai M.; Al-Tawil M.; Roy S.; Kayali F.; Vankad M.; Shazly A.;
Zeinah M.; Harky A.
Institution
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Roy) School of Medicine, Queen's University Belfast, Northern Ireland,
United Kingdom
(Kayali) University Hospitals Sussex, Sussex, United Kingdom
(Vankad) University Hospitals Birmingham, Birmingham, United Kingdom
(Shazly) Essex Cardiothoracic Centre, Basildon University Hospital,
Basildon, United Kingdom
(Zeinah) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, UK; Faculty of Medicine, Ain Shams University, Cairo,
Egypt
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, UK; Liverpool Centre for Cardiovascular Science,
University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool,
UK
Abstract
Transcatheter aortic valve implantation (TAVI) is a common practice for
severe aortic stenosis, but the choice between general (GA) and local
anesthesia (LA) remains uncertain. We conducted a comprehensive literature
review until April 2023, comparing the safety and efficacy of LA versus GA
in TAVI procedures. Our findings indicate significant advantages of LA,
including lower 30-day mortality rates (RR: 0.69; 95% CI [0.58, 0.82]; p <
0.001), shorter in-hospital stays (mean difference: -0.91 days; 95% CI
[-1.63, -0.20]; p=0.01), reduced bleeding/transfusion incidents (RR: 0.64;
95% CI [0.48, 0.85]; p < 0.01), and fewer respiratory complications (RR:
0.56; 95% CI [0.42, 0.76], p<0.01). Other operative outcomes were
comparable. Our findings reinforce prior evidence, presenting a compelling
case for LA's safety and efficacy. While patient preferences and clinical
nuances must be considered, our study propels the discourse towards a more
informed anaesthesia approach for TAVI procedures.<br/>Copyright &#xa9;
2023. Published by Elsevier Inc.

<81>
Accession Number
643086024
Title
Pulmonary vagus nerve transection for chronic cough after video-assisted
lobectomy: a randomized controlled trial.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 18 Dec 2023.
Author
Zhang Q.; Ge Y.; Sun T.; Feng S.; Zhang C.; Hong T.; Liu X.; Han Y.; Cao
J.-L.; Zhang H.
Institution
(Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou
Medical University, Xuzhou, Jiangsu 221009, China
(Zhang) Department of Anesthesiology, Yancheng Third People's Hospital,
Yancheng, Jiangsu 224000, China
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Thoracic Surgery Laboratory,
Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Department of Thoracic Surgery,
Affiliated Hospital of Xuzhou Medical University, Xuzhou, 99 West Huaihai
Road, Jiangsu 221006, China
(Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan
University, Shanghai 200031, China
(Cao) Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical
University, Xuzhou, 99 West Huaihai Road, Jiangsu 221006, China
Abstract
BACKGROUND: Chronic cough is common after lobectomy. Vagus nerves are part
of the cough reflex. Accordingly, transection of the pulmonary branches of
vagus nerve may prevent chronic cough. And there are no clear
recommendations on the management of the pulmonary branches of vagus in
any thoracic surgery guidelines. <br/>METHOD(S): This is a single-center,
randomized controlled trial. Adult patients undergoing elective
video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized
at a 1:1 ratio to undergo a sham procedure (control group) or transection
of the pulmonary branches of the vagus nerve that innervate the bronchial
stump plus the caudal-most large pulmonary branch of the vagus nerve. The
primary outcome was the rate of chronic cough, as assessed at three months
after surgery in the intent-to-treat population. <br/>RESULT(S): Between
February 1, 2020 and August 1, 2020, 116 patients (59.6 +/- 10.1 y of age;
45 men) were randomized (58 in each group). All patients received
designated intervention. The rate of chronic cough at 3 months was 19.0%
(11/58) in the vagotomy group versus 41.4% (24/58) in the control group
(OR=0.332, 95% CI: 0.143-0.767; P=0.009). In the 108 patients with
two-year assessment, the rate of persistent cough was 12.7% (7/55) in the
control and 1.9% (1/53) in the vagotomy group (P=0.032). The 2 groups did
not differ in postoperative complications and key measures of pulmonary
function, e.g., maximal voluntary ventilation, diffusing capacity of the
lungs for carbon monoxide and forced expiratory volume.
<br/>CONCLUSION(S): Transecting the pulmonary branches of vagus nerve that
innervate the bronchial stump plus the caudal-most large pulmonary branch
decreased the rate of chronic cough without affecting pulmonary function
in patients undergoing video-assisted lobectomy and
lymphadenectomy.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<82>
Accession Number
643069966
Title
Low- or Standard-dose Edoxaban versus Antiplatelet Therapy for Leaflet
Thrombus and Cerebral Thromboembolism after TAVR: A Pre-Specified Analysis
of Randomized ADAPT-TAVR trial.
Source
American heart journal. (no pagination), 2023. Date of Publication: 18
Dec 2023.
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) 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, National
Taiwan University Hospital, Hsin-Chu Branch, 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, Japan
(Lee) Department of Neurology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
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 (30mg) or standard-dose (60mg) edoxaban and dual
antiplatelet therapy (DAPT) after TAVR. <br/>METHOD(S): In this
pre-specified subgroup analysis of the ADAPT-TAVR trial, the primary
endpoint was the incidence of leaflet thrombosis on four-dimensional
computed tomography at 6-months. Key secondary endpoints were new cerebral
lesions on brain magnetic resonance imaging and neurological and
neurocognitive dysfunction. <br/>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=0.03). 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=0.58). 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. <br/>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.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<83>
Accession Number
643070809
Title
The outcomes of aortic arch repair between open surgical repair and
debranching endovascular hybrid surgical repair: A systematic review and
meta-analysis.
Source
Journal of vascular surgery. (no pagination), 2023. Date of Publication:
18 Dec 2023.
Author
Chen C.; Hu J.; Li Y.; Chen G.; Zhang W.; Chen X.
Institution
(Chen) Division of Liver surgery, Department of General Surgery, West
China Hospital, Sichuan University, Chengdu, China
(Hu) Division of Health Management Centre, West China Fourth Hospital of
Sichuan University, Chengdu, China
(Li, Chen, Chen) Division of Vascular surgery, Department of General
Surgery, West China Hospital, Sichuan University, Chengdu, China
(Zhang) Division of Vascular and Endovascular Surgery, Department of
Surgery, University of Washington and Puget Sound VA Health Care System,
Seattle, WA, United States
Abstract
BACKGROUND: At present, open surgical repair (OAR) and debranching hybrid
surgical repair (HAR) serve as significant therapeutic approaches for
aortic arch aneurysm or dissection. It remains unclear which technique is
preferable. Our study aimed to compare the short-term and long-term
outcomes of these two procedures. <br/>METHOD(S): To identify comparison
studies of debranching HAR and OAR, a systematic search in PubMed, Embase,
Web of Science and the Cochrane Library database from January 2002to April
2022. This study was registered on PROSPERO (CRD42020218080).
<br/>RESULT(S): Sixteen publications (1316 patients), including six
propensity score-matching analysis (PSM) papers, were included in this
study. Compared with the HAR group, the patient who underwent OAR were
younger (OAR vs HAR: 67.53 +/- 12.81vs.71.29 +/-11.0; P<0.00001), had less
coronary artery disease (OAR vs HAR: 22.45% vs. 32.6%; P=0.007), less
chronic obstructive pulmonary disease (OAR vs HAR: 16.16% vs. 23.92%;
P=0.001), lower rates of previous stroke (OAR vs HAR: 12.46% vs. 18.02%;
P=0.05) and a lower EuroSCORE (European System for Cardiac Operative Risk
Evaluation) score (OAR vs HAR: 6.27 +/- 1.04 vs. 6.9 +/-3.76; P<0.00001).
HAR was associated with less postoperative blood transfusion (OAR vs.
HAR:12.23% vs. 7.91%; P= 0.04), shorter length of ICU stays (OAR vs. HAR:
5.92+/-7.58 days vs. 4.02 +/- 6.60 days; P<0.00001) and hospital stays
(OAR vs. HAR: 21.59+/-17.54 days vs. 16.49 +/-18.45 days; P<0.0001), lower
incidence of reoperation for bleeding complications (OAR vs HAR:8.07% vs.
3.96%; P=0.01), fewer postoperative pulmonary complication (OAR vs.
HAR:14.75% vs. 5.02%; P<0.0001) and acute renal failure (OAR vs. HAR:7.54%
vs. 5.17%; P=0.03). In PSM (propensity score-matching) subgroup, the rates
of spinal cord ischemic (OAR vs. HAR:5.75% vs. 11.49%; P=0.02;), stroke
(OAR vs. HAR:5.1% vs. 17.35%; P=0.01) and permanent paraplegia (OAR vs.
HAR:2.79% vs. 6.08%; P=0.006) were lower in OAR group than that in HAR
group. Although there was no statistically significant difference in
1-year survival rates (HAR vs OAR: HR:1.54; P=0.10), the 3-year and 5-year
survival were significantly higher in OAR group than that in HAR group
(HAR vs OAR: HR:1.69; P=0.01; HAR vs OAR: HR:1.68; P=0.01). In PSM
subgroup, the OAR group was also significantly superior to HAR group in
terms of 3-year and 5-year survivals (HAR vs OAR: HR:1.73; P=0.04; HAR vs
OAR: HR:1.67; P=0.04). The reintervention rate of HAR group was
significantly higher than that in OAR group (OAR vs. HAR: 8.24% vs.
16.01%; P=0.01). The most common reintervention was postoperative bleeding
(8.07%) in OAR group and endoleak (9.67%) in HAR group.
<br/>CONCLUSION(S): Our meta-analysis revealed that debranching HAR was
associated with fewer perioperative complications than OAR group, except
for postoperative permanent paraplegia, reintervention, and stroke events.
The OAR group demonstrated better 3-year and 5-year survivals than
debranching HAR group. However, patients in the OAR group had fewer
comorbid factors and were younger than those in the HAR group.
High-quality studies and well-powered randomized trials are needed to
further evaluate this evolving field.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<84>
Accession Number
631756594
Title
Cardiovascular magnetic resonance native T<inf>2</inf> and T<inf>2</inf>
^* quantitative values for cardiomyopathies and heart
transplantations: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Magnetic Resonance. 22(1) (no pagination), 2020.
Article Number: 34. Date of Publication: 11 May 2020.
Author
Snel G.J.H.; Van Den Boomen M.; Hernandez L.M.; Nguyen C.T.; Sosnovik
D.E.; Velthuis B.K.; Slart R.H.J.A.; Borra R.J.H.; Prakken N.H.J.
Institution
(Snel, Van Den Boomen, Hernandez, Borra, Prakken) Department of Radiology,
University Medical Center Groningen, University of Groningen, Hanzeplein
1, Groningen 9713 GZ, Netherlands
(Van Den Boomen, Nguyen, Sosnovik) Department of Radiology, Athinoula A.
Martinos Center for Biomedical Imaging, Massachusetts General Hospital,
Harvard Medical School, 149 13th Street, Charlestown, MA 02129, United
States
(Nguyen, Sosnovik) Cardiovascular Research Center, Massachusetts General
Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129,
United States
(Sosnovik) Division of Health Sciences and Technology, Harvard-MIT, 7
Massachusetts Avenue, Cambridge, MA 02139, United States
(Velthuis) Department of Radiology, University Medical Center Utrecht,
Heidelberglaan 100, Utrecht 3584 CX, Netherlands
(Slart, Borra) Department of Nuclear Medicine and Molecular Imaging,
University Medical Center Groningen, University of Groningen, Hanzeplein
1, Groningen 9713 GZ, Netherlands
(Slart) Department of Biomedical Photonic Imaging, University of Twente,
Dienstweg 1, Enschede 7522 ND, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: The clinical application of cardiovascular magnetic resonance
(CMR) T<inf>2</inf> and T<inf>2</inf> ^* mapping is currently
limited as ranges for healthy and cardiac diseases are poorly defined. In
this meta-analysis we aimed to determine the weighted mean of
T<inf>2</inf> and T<inf>2</inf> ^* mapping values in patients
with myocardial infarction (MI), heart transplantation, non-ischemic
cardiomyopathies (NICM) and hypertension, and the standardized mean
difference (SMD) of each population with healthy controls. Additionally,
the variation of mapping outcomes between studies was investigated.
<br/>Method(s): The PRISMA guidelines were followed after literature
searches on PubMed and Embase. Studies reporting CMR T<inf>2</inf> or
T<inf>2</inf> ^* values measured in patients were included. The
SMD was calculated using a random effects model and a meta-regression
analysis was performed for populations with sufficient published data.
<br/>Result(s): One hundred fifty-four studies, including 13,804 patient
and 4392 control measurements, were included. T<inf>2</inf> values were
higher in patients with MI, heart transplantation, sarcoidosis, systemic
lupus erythematosus, amyloidosis, hypertrophic cardiomyopathy (HCM),
dilated cardiomyopathy (DCM) and myocarditis (SMD of 2.17, 1.05, 0.87,
1.39, 1.62, 1.95, 1.90 and 1.33, respectively, P < 0.01) compared with
controls. T<inf>2</inf> values in iron overload patients (SMD =-0.54, P =
0.30) and Anderson-Fabry disease patients (SMD = 0.52, P = 0.17) did both
not differ from controls. T<inf>2</inf> ^* values were lower in
patients with MI and iron overload (SMD of-1.99 and-2.39, respectively, P
< 0.01) compared with controls. T<inf>2</inf> ^* values in HCM
patients (SMD =-0.61, P = 0.22), DCM patients (SMD =-0.54, P = 0.06) and
hypertension patients (SMD =-1.46, P = 0.10) did not differ from controls.
Multiple CMR acquisition and patient demographic factors were assessed as
significant covariates, thereby influencing the mapping outcomes and
causing variation between studies. <br/>Conclusion(s): The clinical
utility of T<inf>2</inf> and T<inf>2</inf> ^* mapping to
distinguish affected myocardium in patients with cardiomyopathies or heart
transplantation from healthy myocardium seemed to be confirmed based on
this meta-analysis. Nevertheless, variation of mapping values between
studies complicates comparison with external values and therefore require
local healthy reference values to clinically interpret quantitative
values. Furthermore, disease differentiation seems limited, since changes
in T<inf>2</inf> and T<inf>2</inf> ^* values of most
cardiomyopathies are similar.<br/>Copyright &#xa9; 2020 The Author(s).

<85>
Accession Number
2029198732
Title
Commentary.
Source
Annals of Internal Medicine. 176(12) (pp JC135), 2023. Date of
Publication: 01 Dec 2023.
Author
Moreno R.
Institution
(Moreno) University Hospital La Paz, Idi PAZ, Universidad Autonoma de
Madrid, Madrid, Spain
Publisher
American College of Physicians

<86>
[Use Link to view the full text]
Accession Number
2029139685
Title
Outcomes Following Transcatheter Aortic Valve Replacement for Aortic
Stenosis in Patients with Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid
Aortic Valves.
Source
Circulation: Cardiovascular Interventions. 16(12) (pp E013083), 2023. Date
of Publication: 01 Dec 2023.
Author
He J.; Xiong T.-Y.; Yao Y.-J.; Peng Y.; Wei J.-F.; Zhao Z.-G.; Chen G.; Ou
Y.-W.; Liu Q.; Wang X.; Zhu Z.; Yang H.-R.; Jia K.; Mylotte D.; Piazza N.;
Prendergast B.; Feng Y.; Chen M.
Institution
(He, Xiong, Yao, Peng, Wei, Zhao, Ou, Liu, Wang, Zhu, Yang, Jia, Feng,
Chen) Department of Cardiology, West China Hospital, Sichuan University,
China
(Xiong, Zhao, Yang, Chen) Laboratory of Heart Valve Disease, West China
Hospital, Sichuan Univ., China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, China
(He) Cardiology Department, Hospital of Sun Yat-sen University, Guangzhou,
China
(Mylotte) Department of Cardiology, University Hospital Galway, Natl.
Univ. of Ireland, Ireland
(Piazza) Division of Cardiology, Department of Medicine, McGill University
Health Center, Montreal, QC, Canada
(Prendergast) Department of Cardiology, St. Thomas' Hospital, London,
United Kingdom
(Prendergast) Cleveland Clinic London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Data concerning the outcomes of transcatheter aortic valve
replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study
aims to compare the outcomes of transcatheter aortic valve replacement for
AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic
valve anatomy. <br/>METHOD(S): We enrolled consecutive patients undergoing
transcatheter aortic valve replacement for severe AS between 2012 and 2022
in this single-center retrospective cohort study. The primary outcome was
mortality, while secondary outcomes included in-hospital complications
such as stroke and pacemaker implantation and transcatheter heart valve
hemodynamic performance. <br/>RESULT(S): The number of patients with AS
with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy
was 328, 302, and 642, respectively. Self-expanding transcatheter heart
valves were used in the majority of patients (n=1160; 91.4%). In the
matched population, differences in mortality (30 days: 4.2% versus 1.7%
versus 1.7%, P<inf>overall</inf>=0.522; 1 year: 10% versus 2.3% versus
6.2%, P<inf>overall</inf>=0.099) and all stroke (30 days: 1.0% versus 0.9%
versus 0.0%, P<inf>overall</inf>=0.765; 1 year: 1.4% versus 1.6% versus
1.3%, P<inf>overall</inf>=NS) were nonsignificant, and the incidence of
overall in-hospital complications was comparable among groups. Ascending
aortic diameter was the single predictor of 1-year mortality in type 0
bicuspid patients (hazard ratio, 1.59 [95% CI, 1.03-2.44]; P=0.035). The
proportion of patients with a mean residual gradient >=20 mm Hg was the
highest in those with type 0 bicuspid anatomy, although the need for
permanent pacemaker implantation was the lowest in this group.
<br/>CONCLUSION(S): Major clinical outcomes of transcatheter aortic valve
replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and
tricuspid aortic valve anatomy are equivalent at short-and mid-term
follow-up. These observations merit further exploration in prospective
international registries and randomized controlled trials.<br/>Copyright
&#xa9; 2023 Lippincott Williams and Wilkins. All rights reserved.

<87>
Accession Number
2029044622
Title
emicizumab in acquired hemophilia A: pros and cons of a new approach to
the prevention and treatment of bleeding.
Source
Blood Transfusion. 21(6) (pp 549-556), 2023. Date of Publication: November
2023.
Author
Pasca S.; Zanon E.; Mannucci P.M.; Peyvandi F.
Institution
(Pasca) Biological Sciences Department (DSB), Padua University Hospital,
Padua, Italy
(Zanon) Hemophilia Center - General Medicine, Padua University Hospital,
Padua, Italy
(Mannucci, Peyvandi) Fondazione IRCCS Ca' Granda Ospedale Maggiore
Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and
Fondazione Luigi Villa, Milan, Italy
(Peyvandi) Universita degli Studi di Milano, Department of Pathophysiology
and Transplantation, Milan, Italy
Publisher
Edizioni SIMTI
Abstract
Emicizumab, a monoclonal bispecific antibody that mimics the function of
activated factor VIII (FVIII), is currently licensed for prophylactic use
in patients with congenital hemophilia A with and without inhibitors.
Acquired hemophilia A (AHA) is a very rare bleeding disorder caused by the
development of autoantibodies that inhibit FVIII activity in plasma; males
and females are equally affected. Therapeutic options for patients with
AHA currently include eradication of the inhibitor with immunosuppressive
treatments and management of acute bleeding with bypassing agents or
recombinant porcine FVIII. More recently, several reports described the
off-label use of emicizumab in patients with AHA and a phase III study is
ongoing in Japan. The aims of this review are to describe the 73 reported
cases, and to highlight the advantages and disadvantages of this novel
approach to the prevention and treatment of bleeding in AHA.<br/>Copyright
&#xa9; SIMTIPRO Srl.

<88>
Accession Number
2029002446
Title
A COMPARATIVE STUDY OF HAEMODYNAMIC EFFECTS OF PROPOFOL AND ETOMIDATE AS
INDUCTION AGENTS IN CARDIAC PATIENTS FOR NON CARDIAC SURGERIES. A
PROSPECTIVE RANDOMIZED CONTROLLED STUDY.
Source
International Journal of Academic Medicine and Pharmacy. 5(5) (pp
1248-1252), 2023. Date of Publication: 2023.
Author
Vasanthi B.; Periyasamy T.; Kumar D.S.
Institution
(Vasanthi, Kumar) Department of Anaesthesiology, Government Medical
College and ESI Hospital, Tamil Nadu, Coimbatore, India
(Periyasamy) Department of Anaesthesiology, Government Theni Medical
College, Tamil Nadu, Theni, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: The aim of the study was to compare the safety of propofol and
etomidate as induction agents of anaesthesia in cardiac patients for
non-cardiac surgeries in terms of haemodynamic parameters and side
effects. <br/>Material(s) and Method(s): The study was conducted in 40
adult Cardiac patients between 20 - 60 years of age group for elective
surgeries under general anaesthesia ASA III/IV by prospective randomized
study. We compared the outcome of the two groups in terms of haemodynamic
parameters and side effects. <br/>Result(s): There was no statistical
significance between the two groups in terms of age, sex, body weight,
oxygen saturation and heart rate changes post intubation. The systolic,
diastolic and mean arterial blood pressure were comparable between the two
groups. The decrease in systolic, diastolic and mean arterial pressure at
1,3,5.10 minutes was higher in propofol group I when compared to the
etomidate group II where the reduction was lower or almost nil and was
statistically significant with p<0.05 for decrease in systolic BP, p <
0.001 for decrease in diastolic BP for 1 min and 10 minutes and p<0.016,
p<0.004 for 3min and 5 minutes respectively. The p value was p< 0.001 for
decrease in MAP at 1,3,5. The incidence of pain on injection was higher
with propofol when compared to etomidate (p<0.05). <br/>Conclusion(s):
Etomidate was found to be an ideal induction agent for cardiac patients
undergoing non cardiac elective surgeries under general anaesthesia when
compared to protocol in terms of maintaining good haemodynamic stability
with lesser side effects.<br/>Copyright &#xa9; 2023 Society for Healthcare
and Research Development.

<89>
Accession Number
2028711245
Title
Prospective, Randomized Study of Fibrinogen Concentrate Versus
Cryoprecipitate for Correcting Hypofibrinogenemia in Cardiac Surgery
Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 80-85), 2024.
Date of Publication: January 2024.
Author
Ayaganov D.; Kuanyshbek A.; Vakhrushev I.; Li T.
Institution
(Ayaganov, Kuanyshbek, Vakhrushev, Li) NJSC "National Research Cardiac
Surgery Center", Astana, Kazakhstan
Publisher
W.B. Saunders
Abstract
Objective: Cardiac surgery with cardiopulmonary bypass (CPB) is associated
with hypofibrinogenemia and severe bleeding requiring transfusion.
Guidelines recommend cryoprecipitate or fibrinogen concentrate (FC) for
the treatment of acquired hypofibrinogenemia. This study compared
cryoprecipitate and FC for the correction of acquired hypofibrinogenemia
and the associated costs. <br/>Design(s): A single-center, prospective,
randomized study evaluating patients with hypofibrinogenemia after cardiac
surgery. The primary endpoint was direct treatment cost. Secondary
endpoints included the change in fibrinogen level after FC and/or
cryoprecipitate dosing. <br/>Setting(s): A single-center study in Astana,
Kazakhstan. <br/>Participant(s): Participants who underwent CPB from 2021
to 2022 and developed clinically significant bleeding and
hypofibrinogenemia. <br/>Intervention(s): Patients were randomized to
receive cryoprecipitate or FC. <br/>Measurements and Main Results:
Eighty-eight adult patients with acquired hypofibrinogenemia (<2.0 g/L)
after CPB were randomized to receive cryoprecipitate (N = 40) or FC (N =
48), with similar demographics between groups. Overall, mean +/- SD 9.33
+/- 0.94 units (range, 8-10) cryoprecipitate or 1.40 +/- 0.49 g (1-2) FC
was administered to the 2 groups. From before administration to 24 hours
after, mean plasma fibrinogen increased by a mean +/- SD of 125 +/- 65 and
96 +/- 65 mg/dL in the cryoprecipitate and FC groups, respectively. At 48
hours after administration, there was no significant difference in
fibrinogen levels between groups. The mean direct cost of treatment with
FC was significantly lower than with cryoprecipitate (p < 0.0001):
$1,505.06 +/- $152.40 and $631.75 +/- $223.67 per patient for
cryoprecipitate and FC, respectively. <br/>Conclusion(s): Analysis of
plasma fibrinogen concentration showed that cryoprecipitate and FC had
comparable effectiveness. However, FC is advantageous over cryoprecipitate
due to its ease of handling, lower cost, and high purity.<br/>Copyright
&#xa9; 2023 The Authors

<90>
Accession Number
2027198512
Title
Cost-Effectiveness and Budget Impact Analyses of Patient Blood Management
in a Cardiovascular Surgery Department at Ankara Bilkent City Hospital in
Turkey.
Source
Advances in Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Sanal L.; Gunaydin S.; Tatar M.
Institution
(Sanal) Transfusion Center, Ministry of Health, Ankara Bilkent City
Hospital Campus, Ankara, Turkey
(Gunaydin) Department of Cardiovascular Surgery, University of Health
Sciences, Ankara Bilkent City Hospital Campus, Ankara, Turkey
(Tatar) Vitale Health Economics, Policy and Consultancy, London, United
Kingdom
Publisher
Adis
Abstract
Introduction: Anemia and transfusion of blood products are risk factors
associated with poor patient outcomes across all elective surgeries.
Patient blood management (PBM) is a patient-centered approach to optimize
patient's endogenous red cell mass, to minimize blood loss in patients
undergoing surgery, and to harness and optimize patient-specific
physiological tolerance to anemia. This study aimed to assess (1) the
impact of PBM on blood product usage in cardiovascular surgeries in a
state hospital setting, (2) cost-effectiveness of PBM with a model based
on transfusion of red blood cells (RBCs) in cardiovascular surgeries, and
(3) the budget impact of PBM implementation based on transfusion of RBCs.
<br/>Method(s): Cost-effectiveness and budget impact models, based on the
numbers of avoided transfusions and avoided complications after
implementation of the PBM program, were compared between pre- and post-PBM
periods at the cardiovascular surgery department of Ankara Bilkent City
Hospital between February 11, 2019 and July 24, 2022. The probabilities of
transfusions and complications with and without PBM were taken from recent
meta-analyses. Data from the Ankara Bilkent City Hospital transfusion
center informed the pre- and post-PBM calculations. Costs were calculated
from the Social Security Institution's perspective. <br/>Result(s): There
was a 21% decrease in the use of RBCs and a 23.7% decrease in use of all
blood products after the implementation of PBM. The number of RBC packs
per patient reduced by 0.88 packs (21%). The cost saving from reduction of
RBC transfusions per patient was 518.68 Turkish lira (TRY) and for the
hospital it was 1,635,948 TRY. Fewer complications and lower costs in
favor of the post-PBM arm were demonstrated in the cost-effectiveness
analysis. On the basis of the budget impact model, in 20 months, the
hospital's cardiovascular surgery department saved 6,596,934 TRY
(342,302). <br/>Conclusion(s): This hospital-based study demonstrated that
PBM is a budget-saving and cost-effective option in Turkey.<br/>Copyright
&#xa9; 2023, The Author(s).

<91>
Accession Number
2029283541
Title
Budget Impact of Patient Blood Management in the Cardiovascular Surgery
Department of a Turkish Private Hospital.
Source
Value in Health. Conference: ISPOR Europe 2023. Copenhagen Denmark. 26(12
Supplement) (pp S51-S52), 2023. Date of Publication: December 2023.
Author
Tatar M.; Ramirez de Arellano Serna A.; Akdeniz C.S.; Zeybey U.; Sahin S.;
Ciftci C.
Institution
(Tatar) Vitale Health Economics and Policy, London, United Kingdom
(Ramirez de Arellano Serna) CSL Vifor, Zurich, Switzerland
(Akdeniz, Zeybey, Sahin, Ciftci) Demiroglu Bilim University, Istanbul,
Turkey
Publisher
Elsevier Ltd
Abstract
Objectives: The objective of this study is to predict the potential budget
impact of implementing patient blood management (PBM) in the
cardiovascular surgery department of a Turkish private hospital.
<br/>Method(s): Two budget impact models were developed: one based on
avoided complications (sepsis with pneumonia, sepsis without pneumonia,
renal failure, myocardial infarction and stroke) of patients suffering
from preoperative anemia. A second one based on avoided
transfusions-related complications (sepsis, renal failure, myocardial
infarction, stroke). Two hospital data sets were used in the analysis. The
first data set covered overall data from 302 operations undertaken in the
department between 2018-2022. These data were used in estimations for
number of anemic patients, number of red blood cell transfusions (RBC) and
length of stay in the hospital. The second data set covered the number of
operations between 2020-2022. Recent meta-analysis results were used to
estimate the number of avoided complications with the preoperative
treatment of anemic patients and the number of avoided complications due
to reduction in the use of RBC transfusions. Treatment costs of
complications were estimated with the reimbursement prices of the Turkish
healthcare payer (SSI). <br/>Result(s): Preoperative treatment of anemia
could have saved 4,189,802 TRY by avoiding anemia related complications.
Total budget savings from reduction of RBC transfusions were estimated as
6,174,434 TRY. These are underestimations of real savings as the public
prices of SSI were used in calculating the cost of treating complications.
In addition to these, the hospital could have treated 137 more patients in
the given period due to decreased length of stay. With these additional
patients, the hospital could have earned additional 4.544.002 TRY with the
floor prices of the Turkish Medical Association. <br/>Conclusion(s): PBM
is a budget saving option for both the SSI and hospital. Adopting PBM
programs in both public and private hospitals is
recommended.<br/>Copyright &#xa9; 2023

<92>
Accession Number
2029228058
Title
Correction to: Cardiovascular magnetic resonance native T<inf>2</inf> and
T<inf>2</inf>* quantitative values for cardiomyopathies and heart
transplantations: a systematic review and meta-analysis (Journal of
Cardiovascular Magnetic Resonance (2020) 22(1), (S1097664723002867),
(10.1186/s12968-020-00627-x)).
Source
Journal of Cardiovascular Magnetic Resonance. 22(1) (no pagination), 2020.
Article Number: 47. Date of Publication: 20 Jan 2020.
Author
Snel G.J.H.; van den Boomen M.; Hernandez L.M.; Nguyen C.T.; Sosnovik
D.E.; Velthuis B.K.; Slart R.H.J.A.; Borra R.J.H.; Prakken N.H.J.
Institution
(Snel, van den Boomen, Hernandez, Borra, Prakken) Department of Radiology,
University Medical Center Groningen, University of Groningen, Hanzeplein
1, GZ, Groningen 9713, Netherlands
(van den Boomen, Nguyen, Sosnovik) Department of Radiology, Athinoula A.
Martinos Center for Biomedical Imaging, Massachusetts General Hospital,
Harvard Medical School, 149 13th Street, Charlestown, MA 02129, United
States
(Nguyen, Sosnovik) Cardiovascular Research Center, Massachusetts General
Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129,
United States
(Sosnovik) Division of Health Sciences and Technology, Harvard-MIT, 7
Massachusetts Avenue, Cambridge, MA 02139, United States
(Velthuis) Department of Radiology, University Medical Center Utrecht,
Heidelberglaan 100, CX, Utrecht 3584, Netherlands
(Slart, Borra) Department of Nuclear Medicine and Molecular Imaging,
University Medical Center Groningen, University of Groningen, Hanzeplein
1, GZ, Groningen 9713, Netherlands
(Slart) Department of Biomedical Photonic Imaging, University of Twente,
Dienstweg 1, ND, Enschede 7522, Netherlands
Publisher
Elsevier B.V.
Abstract
An amendment to this paper has been published and can be accessed via the
original article.<br/>Copyright &#xa9; 2020 THE AUTHORS. Published by
Elsevier Inc on behalf of the Society for Cardiovascular Magnetic
Resonance

<93>
Accession Number
2027350777
Title
Assessment of Individualized Mean Perfusion Pressure Targets for the
Prevention of Cardiac Surgery-Associated Acute Kidney Injury-The
PrevHemAKI Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7746. Date of Publication: December 2023.
Author
Molina-Andujar A.; Rios J.; Pineiro G.J.; Sandoval E.; Ibanez C.; Quintana
E.; Matute P.; Andrea R.; Lopez-Sobrino T.; Mercadal J.; Reverter E.;
Rovira I.; Villar A.M.; Fernandez S.; Castella M.; Poch E.
Institution
(Molina-Andujar, Pineiro, Poch) Nephrology and Kidney Transplantation
Department, Hospital Clinic, Barcelona 08036, Spain
(Rios) Department of Clinical Farmacology, Hospital Clinic and Medical
Statistics Core Facility, Barcelona 08036, Spain
(Rios, Pineiro, Andrea, Lopez-Sobrino, Poch) Institut d'investigacions
Biomediques Agusti Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
(Rios) Faculty of Medicine, Universitat Autonoma de Barcelona, Barcelona
08193, Spain
(Sandoval, Quintana, Castella) Cardiovascular Surgery Department, Hospital
Clinic, Barcelona 08036, Spain
(Ibanez, Matute, Mercadal, Rovira) Anesthesiology Department, Hospital
Clinic, Barcelona 08036, Spain
(Andrea, Lopez-Sobrino) Cardiology Department, Hospital Clinic, Barcelona
08036, Spain
(Reverter) Liver and Digestive ICU, Liver Unit, Hospital Clinic, Barcelona
08036, Spain
(Villar) Perfusion Department, Hospital Clinic, Barcelona 08036, Spain
(Fernandez) Medical Intensive Care Unit, Hospital Clinic, Barcelona 08036,
Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Retrospective studies support that mean perfusion pressure
(MPP) deficit in cardiac surgery patients is associated with a higher
incidence of acute kidney injury (CS-AKI). The aim of our study was to
apply an algorithm based on MPP in the postoperative period to determine
whether management with an individualized target reduces the incidence of
CS-AKI. <br/>Method(s): Randomized controlled trial of patients undergoing
cardiac surgery with extracorporeal circulation. Adult patients submitted
to valve replacement and/or bypass surgery with a high risk of CS-AKI
evaluated by a Leicester score >30 were randomized to follow a target MPP
of >75% of the calculated baseline or a standard hemodynamic management
during the first postoperative 24 h. <br/>Result(s): Ninety-eight patients
with an eGFR of 54 mL/min were included. There were no differences in MAP
and MPP in the first 24 h between the randomized groups, although a higher
use of noradrenaline was found in the intervention arm (38.78 vs. 63.27, p
= 0.026). The percentage of time with MPP < 75% of measured baseline was
similar in both groups (10 vs. 12.7%, p = 0.811). MAP during surgery was
higher in the intervention group (73 vs. 77 mmHg, p = 0.008). The global
incidence of CS-AKI was 36.7%, being 38.6% in the intervention group and
34.6% in the control group (p = 0.40). There were no differences in
extrarenal complications between groups as well. <br/>Conclusion(s): An
individualized hemodynamic management based on MPP compared to standard
treatment in cardiac surgery patients was safe but did not reduce the
incidence of CS-AKI in our study.<br/>Copyright &#xa9; 2023 by the
authors.

<94>
Accession Number
2027350745
Title
Anticoagulants versus Left Atrial Appendage Occlusion in Patients with
Atrial Fibrillation and Co-Morbid Thrombocytopenia.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7637. Date of Publication: December 2023.
Author
Kowalska W.; Mitrega K.; Olma A.; Podolecki T.; Kalarus Z.; Streb W.
Institution
(Kowalska) Doctoral School, Division of Medical Sciences in Zabrze,
Medical University of Silesia, Katowice 40-055, Poland
(Kowalska, Mitrega, Olma, Podolecki, Kalarus, Streb) Department of
Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze
41-800, Poland
(Podolecki, Kalarus, Streb) Department of Cardiology and Electrotherapy,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia,
Katowice 40-055, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Left atrial appendage closure (LAAC) is an alternative approach to
anticoagulants. Nonetheless, data regarding the outcomes of LAAC
procedures in patients with thrombocytopenia remain lacking. The primary
objective was to determine the incidence of the composite endpoint
comprising ischemic stroke, intracranial hemorrhage, major bleeding, and
cardiac cause of death among patients with atrial fibrillation (AF) and
thrombocytopenia who were either undergoing LAAC or receiving oral
anticoagulants. The secondary endpoint was the determination of total
mortality. Data from a prospective, single-center registry of patients
undergoing LAAC procedures were analyzed. A subset of 50 consecutive
patients with thrombocytopenia were selected. Thrombocytopenia was defined
as a thrombocyte count below 150,000. Subsequently, from patients
hospitalized with AF receiving oral anticoagulants, 50 patients were
further chosen based on propensity score matching, ensuring comparability
with the study group. The primary endpoint occurred in 2% of patients in
the LAAC group and 10% of patients in the non-LAAC group (p = 0.097).
Additionally, a significant difference was noted in the occurrence of the
secondary endpoint, which was observed in 0% of patients in the LAAC group
and 10% of patients in the non-LAAC group (p = 0.025). In patients with
thrombocytopenia the LAAC procedure improves prognosis compared with
continued anticoagulant treatment.<br/>Copyright &#xa9; 2023 by the
authors.

<95>
Accession Number
2027350511
Title
Do We Still Need Aspirin in Coronary Artery Disease?.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7534. Date of Publication: December 2023.
Author
Maqsood M.H.; Levine G.N.; Kleiman N.D.; Hasdai D.; Uretsky B.F.; Birnbaum
Y.
Institution
(Maqsood) Department of Cardiology, DeBakey Heart and Vascular Center,
Methodist Hospital, Houston, TX 77030, United States
(Levine, Birnbaum) The Section of Cardiology, Baylor College of Medicine,
Houston, TX 77030, United States
(Kleiman) Department of Cardiology, Section of Interventional Cardiology,
Houston Methodist DeBakey Heart Center, Houston, TX 77030, United States
(Hasdai) Department of Cardiology, Rabin Medical Center, Tel Aviv
University, Petah Tikva 49200, Israel
(Uretsky) Central Arkansas Veterans Health System, University of Arkansas
for Medical Sciences, Little Rock, AR 72205, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Aspirin has for some time been used as a first-line treatment for acute
coronary syndromes, including ST-elevation myocardial infarction, for
secondary prevention of established coronary disease, and for primary
prevention in patients at risk of coronary artery disease. Although
aspirin has been in use for decades, the available evidence for its
efficacy largely predates the introduction of other drugs, such as statins
and P2Y12 inhibitors. Based on recent trials, the recommendation for
aspirin use as primary prevention has been downgraded. In addition, P2Y12
inhibitors given as a single antiplatelet therapy have been associated
with a lower incidence of bleeding than dual antiplatelet therapy in
combination with aspirin in patients with stable and unstable coronary
artery disease. The aim of this review is to discuss the role of aspirin
considering the available evidence for primary prevention, secondary
prevention for stable coronary artery disease or acute coronary syndromes,
and after percutaneous coronary intervention or coronary artery bypass
revascularization.<br/>Copyright &#xa9; 2023 by the authors.

<96>
Accession Number
2027323338
Title
Treatment Strategies for Chronic Coronary Heart Disease with Left
Ventricular Systolic Dysfunction or Preserved Ejection Fraction-A
Systematic Review and Meta-Analysis.
Source
Pathophysiology. 30(4) (pp 640-658), 2023. Date of Publication: December
2023.
Author
Golukhova E.Z.; Slivneva I.V.; Kozlova O.S.; Berdibekov B.S.; Skopin I.I.;
Merzlyakov V.Y.; Baichurin R.K.; Sigaev I.Y.; Keren M.A.; Alshibaya M.D.;
Marapov D.I.; Arzumanyan M.A.
Institution
(Golukhova) A.N. Bakulev National Medical Scientific Center for
Cardiovascular Surgery, Moscow 121552, Russian Federation
(Slivneva, Kozlova, Baichurin, Arzumanyan) Department of Cardiovascular
and Comorbid Pathology, A.N. Bakulev National Medical Scientific Center
for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Berdibekov) Department of Non-Invasive Arrhythmology and Surgical
Treatment of Combined Pathology, A.N. Bakulev National Medical Scientific
Center for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Skopin) Department of Reconstructive Surgery of Heart Valves and Coronary
Arteries, Bakulev National Medical Research Center for Cardiovascular
Surgery, A.N, Moscow 121552, Russian Federation
(Merzlyakov, Baichurin) Department of Surgical Treatment of Ischemic Heart
Disease and Minimally Invasive Coronary Surgery, Bakulev National Medical
Research Center for Cardiovascular Surgery, A.N, Moscow 121552, Russian
Federation
(Sigaev, Keren) Department of Surgical Treatment of Coronary and Great
Arteries Combined Diseases, A.N. Bakulev National Medical Scientific
Center for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Alshibaya) Department of Surgical Treatment of Ischemic Heart Disease,
A.N. Bakulev National Medical Scientific Center for Cardiovascular
Surgery, Moscow 121552, Russian Federation
(Marapov) Department of Public Health, Economics and Health Care
Management, Kazan State Medical Academy, Branch Campus of the Federal
State Budgetary Educational Institution of Further Professional Education,
Russian Medical Academy of Continuous Professional Education, Kazan
420012, Russian Federation
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
In this meta-analysis, we examine the advantages of invasive strategies
for patients diagnosed with chronic coronary heart disease (CHD) and
preserved left ventricular (LV) function, as well as those with
significant LV systolic dysfunction (LV ejection fraction (EF) < 45%).
<br/>Material(s) and Method(s): We conducted a systematic search to
identify all randomized trials directly comparing invasive strategies with
optimal medical therapy (OMT) in patients diagnosed with chronic CHD. Data
from these trials were pooled using a random-effects meta-analysis. The
primary outcome assessed was the all-cause mortality, while secondary
endpoints included cardiovascular (CV) death, stroke, myocardial
infarction (MI), and unplanned revascularization. This study was designed
to assess the benefits of both invasive strategies and OMT in patients
with preserved LV function and in those with LV systolic dysfunction. The
statistical analysis of the data was conducted using the Review Manager
(RevMan) software, version 5.4.1 (The Cochrane Collaboration, 2020).
<br/>Result(s): Twelve randomized studies enrolling 13,912 patients were
included in the final analysis. Among the patients with chronic CHD and
preserved LV systolic function, revascularization did not demonstrate a
reduction in all-cause mortality (8.52% vs. 8.45%, p = 0.45), CV death
(3.41% vs. 3.62%, p = 0.08), or the incidence of MI (9.88% vs. 10.49%, p =
0.47). However, the need for unplanned myocardial revascularization was
significantly lower in the group following the initial invasive approach
compared to patients undergoing OMT (14.75% vs. 25.72%, p < 0.001). In
contrast, the invasive strategy emerged as the preferred treatment
modality for patients with ischemic LV systolic dysfunction. This approach
demonstrated lower rates of all-cause mortality (40.61% vs. 46.52%, p =
0.004), CV death (28.75% vs. 35.82%, p = 0.0004), and MI (8.19% vs. 10.8%,
p = 0.03). <br/>Conclusion(s): In individuals diagnosed with chronic CHD
and preserved LV EF, the initial invasive approach did not demonstrate a
clinical advantage over OMT. Conversely, in patients with ischemic LV
systolic dysfunction, myocardial revascularization was found to reduce the
risks of CV events and enhance the overall outcomes. These findings hold
significant clinical relevance for optimizing treatment strategies in
patients with chronic CHD, contingent upon myocardial contractility
status.<br/>Copyright &#xa9; 2023 by the authors.

<97>
Accession Number
2027323197
Title
Mechanical Support Strategies for High-Risk Procedures in the Invasive
Cardiac Catheterization Laboratory: A State-of-the-Art Review.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7755. Date of Publication: December 2023.
Author
Groeneveld N.T.A.; Swier C.E.L.; Montero-Cabezas J.; Elzo Kraemer C.V.;
Klok F.A.; van den Brink F.S.
Institution
(Groeneveld) Department of Anesthesiology, Erasmus Medical Center, Dr.
Molewaterplein 40, Rotterdam 3015 GD, Netherlands
(Swier, Elzo Kraemer, van den Brink) Department of Intensive Care, Leiden
University Medical Center, Albinusdreef 2, Leiden 2333 ZA, Netherlands
(Montero-Cabezas) Department of Cardiology, Leiden University Medical
Center, Albinusdreef 2, Leiden 2333 ZA, Netherlands
(Klok) Department of Medicine-Thrombosis and Hemostasis, Leiden University
Medical Center, Albinusdreef 2, Leiden 2333 ZA, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Thanks to advancements in percutaneous cardiac interventions, an expanding
patient population now qualifies for treatment through percutaneous
endovascular procedures. High-risk interventions far exceed coronary
interventions and include transcatheter aortic valve replacement,
endovascular management of acute pulmonary embolism and ventricular
tachycardia ablation. Given the frequent impairment of ventricular
function in these patients, frequently deteriorating during percutaneous
interventions, it is hypothesized that mechanical ventricular support may
improve periprocedural survival and subsequently patient outcome. In this
narrative review, we aimed to provide the relevant evidence found for the
clinical use of percutaneous mechanical circulatory support (pMCS). We
searched the Pubmed database for articles related to pMCS and to pMCS and
invasive cath lab procedures. The articles and their references were
evaluated for relevance. We provide an overview of the clinically relevant
evidence for intra-aortic balloon pump, Impella, TandemHeart and ECMO and
their role as pMCS in high-risk percutaneous coronary intervention,
transcatheter valvular procedures, ablations and high-risk pulmonary
embolism. We found that the right choice of periprocedural pMCS could
provide a solution for the hemodynamic challenges during these procedures.
However, to enhance the understanding of the safety and effectiveness of
pMCS devices in an often high-risk population, more randomized research is
needed.<br/>Copyright &#xa9; 2023 by the authors.

<98>
Accession Number
643061582
Title
Association of mechanical energy and power with postoperative pulmonary
complications in lung resection surgery: A post hoc analysis of randomized
clinical trial data.
Source
Anesthesiology. (no pagination), 2023. Date of Publication: 18 Dec 2023.
Author
Yoon S.; Nam J.-S.; Blank R.S.; Ahn H.J.; Park M.; Kim H.; Kim H.J.; Choi
H.; Kang H.-U.; Lee D.-K.; Ahn J.
Institution
(Yoon) Department of Anesthesiology and Pain Medicine, Seoul National
University Hospital, University of Seoul National College of Medicine,
Seoul, South Korea
(Nam) Clinical assistant professor, Department of Anesthesiology and Pain
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Blank) Department of Anesthesiology, University of Virginia Health
System, Charlottesville, VA, United States
(Ahn) Department of Anesthesiology and Pain Medicine, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Park) Department of Anesthesiology and Pain Medicine, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Kim) Clinical assistant professor, Department of Anesthesiology and Pain
Medicine, Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, Seoul, South Korea
(Choi) Clinical assistant professor, Department of Anesthesiology and Pain
Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic
University of Korea, Seoul, South Korea
(Kang) Clinical instructor, Department of Anesthesiology and Pain
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Lee) Resident, Department of Anesthesiology and Pain Medicine, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Ahn) Statistician, Biomedical Statistics Center, Data Science Research
Institute, Research Institute for Future Medicine, Samsung Medical Center,
Seoul, South Korea
Abstract
BACKGROUND: Mechanical power (MP), the rate of mechanical energy (ME)
delivery, is a recently introduced unifying ventilator parameter
consisting of tidal volume, airway pressures, and respiratory rates, which
predicts pulmonary complications in several clinical contexts. However, ME
has not been previously studied in the perioperative context and neither
parameter has been studied in the context of thoracic surgery utilizing
one lung ventilation. <br/>METHOD(S): The relationships between mechanical
energy variables and postoperative pulmonary complications were evaluated
in this post hoc analysis of data from a multicenter randomized clinical
trial of lung resection surgery conducted between 2020 and 2021 (n=1,170).
Time-weighted average MP (MPTWA) and ME (the area under the MP time curve)
were obtained for individual patients. The primary analysis was the
association of MPTWA and ME with pulmonary complications within 7
postoperative days. Multivariable logistic regression was performed to
examine the relationships between energy variables and the primary
outcome. <br/>RESULT(S): In 1,055 patients analyzed, pulmonary
complications occurred in 41% (431/1055). The median (interquartile
ranges) ME and MPTWA in patients who developed postoperative pulmonary
complications (PPC) vs those who did not were 1,146 (811-1530) J vs 924
(730-1240) J (P<0.001), and 6.9 (5.5-8.7) J/min vs 6.7 (5.2-8.5) J/min
(P=0.091), respectively. ME was independently associated with PPCs (ORadj
1.44 [95%CI 1.16-1.80], P=0.001). However, the association between MPTWA
and PPCs was time dependent and MPTWA was significantly associated with
PPCs in cases utilizing longer periods of mechanical ventilation (>=210
minutes; ORadj 1.46 [95%CI 1.11-1.93], P=0.007). Normalization of ME and
MPTWA to either predicted body weight or to respiratory system compliance
did not alter these associations. <br/>CONCLUSION(S): ME and, in cases
requiring longer periods of mechanical ventilation, MP were independently
associated with PPC in thoracic surgery.<br/>Copyright &#xa9; 2023
American Society of Anesthesiologists. All Rights Reserved.

<99>
Accession Number
2029265778
Title
The Effect of Peri-Device Leaks on Ischaemic Stroke/Transient Ischaemic
Attack/Systemic Embolism after Left Atrial Appendage Closure: A Systematic
Review and Meta-Analysis.
Source
Cardiology (Switzerland). 148(6) (pp 581-592), 2023. Date of Publication:
01 Dec 2023.
Author
He Y.-G.; Yang S.-H.; Xu L.; Wang Y.; Qin X.-T.; Chen P.-P.; Zhao Y.-J.
Institution
(He, Yang, Xu, Wang, Qin, Chen, Zhao) Department of Cardiology, Zhengzhou
No. 7 People's Hospital, Zhengzhou, China
Publisher
S. Karger AG
Abstract
Background: Left atrial appendage closure (LAAC) is a safe and effective
method for preventing embolic events in patients with non-valvular atrial
fibrillation. However, peri-device leaks (PDLs) are sometimes unavoidable.
Controversy exists regarding whether PDLs lead to embolic events.
<br/>Objective(s): This study aimed to explore the association between
PDLs and embolic events, including ischaemic stroke, transient ischaemic
attacks (TIAs), and systemic embolism (SE). <br/>Method(s): We conducted a
systematic search of the PubMed, Web of Science, MEDLINE, and Cochrane
Library databases for studies published up to September 25, 2022, to
compare the rate of ischaemic stroke/TIA/SE between the PDL group and the
non-PDL group after LAAC. <br/>Result(s): Thirteen studies comprising
54,405 patients were included in the meta-analysis. The PDL group detected
by transoesophageal echocardiography (TEE) had a significantly higher rate
of ischaemic stroke/TIA/SE than the non-PDL group (OR: 1.20, 95% CI:
1.08-1.33, p = 0.0009). However, no difference in ischaemic stroke/TIA/SE
was found between the PDL and non-PDL subgroups of the cardiac computed
tomography angiography (CCTA) group (OR: 1.12, 95% CI: 0.51-2.50, p =
0.77). CCTA and TEE showed different rates of PDL detection, with the CCTA
group having a higher rate of PDL detection (p < 0.0001), especially for
trivial leaks. <br/>Conclusion(s): PDL detected by TEE increases the risk
of embolic events after LAAC. However, no association was found between
PDL and ischaemic stroke/TIA/SE in the CCTA group, which showed a higher
rate of PDL detection than TEE, particularly for trivial leaks. In the
future, CCTA may be used to explore the relationship between PDL size and
ischaemic stroke/TIA/SE.<br/>Copyright &#xa9; 2023 S. Karger AG. All
rights reserved.

<100>
Accession Number
2029191622
Title
Aortic valve repair in neonates, infants and children: a systematic
review, meta-analysis and microsimulation study.
Source
European Journal of Cardio-thoracic Surgery. 64(3) (no pagination), 2023.
Article Number: ezad284. Date of Publication: 01 Sep 2023.
Author
Notenboom M.L.; Rhellab R.; Etnel J.R.G.; van den Bogerd N.; Veen K.M.;
Taverne Y.J.H.J.; Helbing W.A.; van de Woestijne P.C.; Bogers A.J.J.C.;
Takkenberg J.J.M.
Institution
(Notenboom, Rhellab, Etnel, van den Bogerd, Veen, Taverne, van de
Woestijne, Bogers, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Helbing) Department of Paediatrics, Div. of Cardiology, Erasmus
University Medical Centre, Rotterdam, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To support clinical decision-making in children with aortic
valve disease, by compiling the available evidence on outcome after
paediatric aortic valve repair (AVr). <br/>METHOD(S): A systematic review
of literature reporting clinical outcome after paediatric AVr (mean age at
surgery <18 years) published between 1 January 1990 and 23 December 2021
was conducted. Early event risks, late event rates and time-to-event data
were pooled. A microsimulation model was employed to simulate the lives of
individual children, infants and neonates following AVr. <br/>RESULT(S):
Forty-one publications were included, encompassing 2 623 patients with 17
217 patient-years of follow-up (median follow-up: 7.3 years; range:
1.0-14.4 years). Pooled mean age during repair for aortic stenosis in
children (<18 years), infants (<1 year) or neonates (<30 days) was 5.2 +/-
3.9 years, 35 +/- 137 days and 11 +/- 6 days, respectively. Pooled early
mortality after stenosis repair in children, infants and neonates,
respectively, was 3.5% (95% confidence interval: 1.9-6.5%), 7.4%
(4.2-13.0%) and 10.7% (6.8-16.9%). Pooled late reintervention rate after
stenosis repair in children, infants and neonates, respectively, was
3.31%/year (1.66-6.63%/year), 6.84%/year (3.95-11.83%/year) and 6.32%/year
(3.04-13.15%/year); endocarditis 0.07%/year (0.03-0.21%/year), 0.23%/year
(0.07-0.71%/year) and 0.49%/year (0.18-1.29%/year); and valve thrombosis
0.05%/year (0.01-0.26%/year), 0.15%/year (0.04-0.53%/year) and 0.19%/year
(0.05-0.77%/year). Microsimulation-based mean life expectancy in the first
20 years for children, infants and neonates with aortic stenosis,
respectively, was 18.4 years (95% credible interval: 18.1-18.7 years;
relative survival compared to the matched general population: 92.2%), 16.8
years (16.5-17.0 years; relative survival: 84.2%) and 15.9 years
(14.8-17.0 years; relative survival: 80.1%). Microsimulation-based 20-year
risk of reintervention in children, infants and neonates, respectively,
was 75.2% (72.9-77.2%), 53.8% (51.9-55.7%) and 50.8% (47.0-57.6%).
<br/>CONCLUSION(S): Long-term outcomes after paediatric AVr for stenosis
are satisfactory and dependent on age at surgery. Despite a high hazard of
reintervention for valve dysfunction and slightly impaired survival
relative to the general population, AVr is associated with low
valve-related event occurrences and should be considered in children with
aortic valve disease.<br/>Copyright &#xa9; The Author(s) 2023. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<101>
Accession Number
2029145070
Title
Atrial fibrillation ablation improves outcomes in patients with end-stage
heart failure: is it all gold the glitter in the CASTLE?.
Source
European Heart Journal. 44(47) (pp 4907-4908), 2023. Date of Publication:
14 Dec 2023.
Author
Pedicino D.; Volpe M.
Institution
(Pedicino) Department of Cardiovascular Medicine, Fondazione Policlinico
Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, Rome 00168, Italy
(Volpe) Department of Clinical and Molecular Medicine, Sapienza University
of Rome and IRCCS San Raffaele, Rome, Italy
Publisher
Oxford University Press

<102>
Accession Number
2028539213
Title
Very long-term outlook of acute coronary syndromes after percutaneous
coronary intervention with implantation of polymer-free versus
durable-polymer new-generation dmg-eluting stents.
Source
Minerva Medica. 114(5) (pp 590-600), 2023. Date of Publication: 2023.
Author
Francesco V.; Sebastian K.; Salvatore C.; Michael J.; Katharina M.; Erion
X.; Tobias K.; Jens W.; Tareq I.; Karl-Ludwig L.; Heribert S.; Adnan K.;
Robert A.B.; Alessandra S.; Marco B.; Luigi S.; Giuseppe B.-Z.
Institution
(Francesco) UOCUTICEmodinamica E Cardiologia, Santa Maria Goretti
Hospital, Latina, Italy
(Sebastian, Salvatore, Michael, Katharina, Erion, Tobias, Jens, Heribert,
Adnan) Technische Universitat Munchen (TUM), Germany, Deutsches
Herzzentrum M nchen, Munich, Germany
(Michael, Karl-Ludwig, Heribert, Adnan) German Center for Cardiovascular
Research, Germany
(Tareq, Karl-Ludwig) Klinik Und Poliklinik Innere Medizin I, Kardiologie,
Angiologie und Pneumologie, Rechts der Isar Hospital, Technische Universit
t M nchen TUM, Angiologie und Pneumologie), Munich, Germany
(Robert) Dublin Cardiovascular Research Institute, Mater Private Hospital,
Dublin, Ireland
(Robert) School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Alessandra) Department of Public Health and Infectious Disease, Section
of BioMedical Statistics, Sapienza University, Rome, Italy
(Marco, Luigi) Department of Clinical, Internal Medicine, Anesthesiology
and Cardiovascular Sciences, Sapienza University, Rome, Italy
(Giuseppe) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University, Latina, Naples, Italy
(Giuseppe) Mediterranea Cardiocentro, Naples, Italy
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Detailed long-term follow-up data on patients with acute
coronary syndromes (ACS) in general, and those with ST-elevation
myocardial infarction (STEMI) in particular, are limited. We aimed to
appraise the long-term outlook of patients undergoing percutaneous
coronary intervention (PCI) with state-of-the-art coronary stents for
STEMI, other types of ACS and stable coronary artery disease (CAD), and
also explore the potential beneficial impact of new-generation
polymer-free drug-eluting stents (DES) in this setting. <br/>METHOD(S):
Baseline, procedural and very long-term outcome data on patients
undergoing PCIand randomized to implantation of new-generation
polymer-free vs. durable polymer DES were systematically collected,
explicitly distin guishing subjects with admission diagnosis of STEMI,
non-ST-elevation ACS (NSTEACS), and stable CAD. Outcomes of interest
included death, myocardial infarction, revascularization (i.e.
patient-oriented composite endpoints [POCE]), major adverse cardiac events
(MACE), and device-oriented composite endpoints (DOCE). <br/>RESULT(S):
Atotal of 3002 patients were included, 1770 (59.0%) with stable CAD, 921
(30.7%) with NSTEACS, and 311 (10.4%) with STEMI. At long-term follow-up
(7.5+/-3.1 years), all clinical events were significantly more common in
the NSTEACS group and, to a lesser extent, in the stable CADgroup (e.g.
POCEoccurred in, respectively, 637 [44.7%] vs. 964 [37.9%] vs. 133
[31.5%], P<0.001). While these differences were largely attributable to
adverse coexisting features in patients with NSTEACS (e.g. advanced age,
insulin-dependent diabetes, and extent of CAD), the unfavorable outlook of
patients presenting with NSTEACS persisted even after multivariable
adjustment including several prognostically relevant factors (hazard ratio
[HR] of NSTEACS vs. stable CAD 1.19 [95% confidence interval 1.03-1.38],
P=0.016). Notably, even after encompassing all prognostically impactful
features, no difference between polymer-free and perma nent polymer
drug-eluting stents appeared (HR=0.96 [0.84-1.10], P=0.560).
<br/>CONCLUSION(S): Unstable coronary artery disease, especially when
presenting without ST-elevation, represents an in formative marker of
adverse long-term prognosis in current state-of-the-art invasive
cardiology practice. Even consider ing admission diagnosis, and despite of
using no polymer, polymer-free DES showed similar results with regards to
safety and efficacy when compared with DES with permanent
polymer.<br/>Copyright &#xa9; 2023 Edizioni Minerva Medica. All rights
reserved.

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

<104>
Accession Number
2026316967
Title
Long-term outcomes after transcatheter aortic valve replacement:
Meta-analysis of Kaplan-Meier-derived data.
Source
Catheterization and Cardiovascular Interventions. 102(7) (pp 1291-1300),
2023. Date of Publication: 01 Dec 2023.
Author
Shimamura J.; Takemoto S.; Fukuhara S.; Miyamoto Y.; Yokoyama Y.; Takagi
H.; Kampaktsis P.N.; Kolte D.; Grubb K.J.; Kuno T.; Latib A.
Institution
(Shimamura, Grubb) Department of Surgery, Division of Cardiothoracic
Surgery, Emory University School of Medicine, Atlanta, GA, United States
(Takemoto) Department of Cardiovascular Surgery, Kyushu University
Hospital, Fukuoka, Japan
(Fukuhara, Yokoyama) Department of Cardiac Surgery, University of
Michigan, Ann Arbor, MI, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Kolte) Division of Cardiology, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical center, Albert
Einstein Medical College, New York City, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical center, Albert Einstein
Medical College, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is as an
alternative treatment to surgical AVR, but the long-term outcomes of TAVR
remain unclear. <br/>Aim(s): This study aimed to analyze long-term
outcomes following TAVR using meta-analysis. <br/>Method(s): A literature
search was performed with MEDLINE, EMBASE, Cochrane Library, Web of
Science, and Google Scholar through November 2022; studies reporting
clinical outcomes of TAVR with follow-up periods of >=8 years were
included. The outcomes of interest were overall survival and/or freedom
from structural valve deterioration (SVD). Surgical risk was assessed with
the Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM)
score. A subgroup analysis was conducted for intermediate-/high-surgical
risk patients only. <br/>Result(s): Eleven studies including 5458 patients
were identified and analyzed. The mean age was 82.0 +/- 6.5 years, and
mean STS PROM score ranged from 2.9 to 10.6%. Survival rate at 5 and 10
years was 47.7% +/- 1.4% and 12.1 +/- 2.0%. Five studies including 1509
patients were analyzed for SVD. Freedom from SVD at 5 and 8 years was 95.5
+/- 0.7% and 85.1 +/- 3.1%. Similar results for survival and SVD were
noted in the subgroup analysis of intermediate-/high-risk patients.
<br/>Conclusion(s): Following TAVR, approximately 88% of patients died
within 10 years, whereas 85% were free from SVD at 8 years. These date
suggest that baseline patient demographic have the greatest impact on
survival, and SVD does not seem to have a prognostic impact in this
population. Further investigations on longer-term outcomes of younger and
lower-risk patients are warranted.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<105>
Accession Number
2025298413
Title
Effects of berberine and barberry on selected inflammatory biomarkers in
adults: A systematic review and dose-response meta-analysis of randomized
clinical trials.
Source
Phytotherapy Research. 37(12) (pp 5541-5557), 2023. Date of Publication:
December 2023.
Author
Vahedi-Mazdabadi Y.; Shahinfar H.; Toushih M.; Shidfar F.
Institution
(Vahedi-Mazdabadi, Shahinfar) Student Research Committee, School of Public
Health, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Vahedi-Mazdabadi, Shahinfar, Shidfar) Department of Nutrition, School of
Public Health, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Toushih) Department of Physiology, Faculty of Medical Sciences, Tarbiat
Modares University, Tehran, Iran, Islamic Republic of
(Toushih) Cardiac Primary Prevention Research Center, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Shidfar) Colorectal Research Center, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Ltd
Abstract
The previous meta-analysis showed an advantageous effect of berberine
supplementation on interleukin 6 (IL-6), tumor necrosis factor-alpha
(TNF-alpha), and serum C-reactive protein (CRP) concentrations; however,
it is unknown the dosage that this component influences inflammatory
biomarkers. A comprehensive search was done in Scopus, PubMed, and Web of
Science until September 2022 to find randomized controlled trials (RCT)
that assessed the effects of berberine/barberry on IL-6, TNF-alpha, and
CRP in adults but not trials without a control group. Studies bias was
assessed using RoB 2. A random-effects model was performed to calculate
the weighted mean difference (WMD). A dose-dependent effect was
calculated. Eighteen clinical trials with 1600 participants were included
in the current meta-analysis. These interventions significantly mitigate
IL-6 levels (-1.18 pg/mL), TNF-alpha levels (-3.72 pg/mL), and CRP levels
(-1.33 mg/L). In addition, the non-linear analysis showed a significant
lowering effect of berberine/barberry on IL-6 and TNF-alpha levels in
doses <1000 mg/day and less than 5 weeks of intervention. There are
limitations to our findings, including low-quality studies and significant
heterogeneity. These interventions might be considered adjunct therapy to
managing inflammation status. However, more investigation and high-quality
evidence must be conducted to obtain more comprehensive and generalizable
results.<br/>Copyright &#xa9; 2023 John Wiley & Sons Ltd.

<106>
Accession Number
2028748967
Title
Recombinant Activated Factor VII (rFVIIa) for Bleeding After Thoracic
Aortic Surgery: A Scoping Review of Current Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 275-284),
2024. Date of Publication: January 2024.
Author
Navarro R.; Bojic S.; Fatima R.; El-Tahan M.; El-Diasty M.
Institution
(Navarro) Faculty of Medicine, Queen's University, Kingston, ON, Canada
(Bojic) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Fatima) Department of Surgery, Queen's University, Kingston, ON, Canada
(El-Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
(El-Diasty) Cardiac Surgery Department, Harrington Heart Institute,
University Hospitals, Cleveland, OH, United States
Publisher
W.B. Saunders
Abstract
Background: Bleeding after surgery on the thoracic aorta is a frequent
complication, and can be associated with a significant increase in
morbidity and mortality. Recombinant activated factor VII (rFVIIa) was
developed initially for treating patients with hemophilia; however, it has
been used increasingly "off-label" to achieve hemostasis after thoracic
aortic procedures. <br/>Objective(s): This scoping review aimed to present
the available literature on the role of rFVIIa in the management of
refractory postoperative bleeding after thoracic aortic surgery.
Methods/Results: An electronic database search was conducted using
Medline, Embase, Cochrane Library, and Google Scholar in June 2023. The
authors included studies that reported the use of rFVIIa in patients
undergoing surgical repair of ascending or descending aortic aneurysm or
dissection. Single-case reports were excluded. Ten publications with a
pooled number of 649 patients (319 patients received rFVIIa and 330 in the
control groups) were identified: 3 case series, 6 retrospective studies,
and 1 nonrandomized clinical trial. All studies reported the potential
role of rFVIIa in correcting coagulopathy and reducing postoperative blood
loss in this group of patients. Overall, there was not enough evidence to
suggest that rFVIIa was associated with higher rates of thromboembolic
complications or mortality. <br/>Conclusion(s): Limited evidence suggests
that rFVIIa may be useful in managing postoperative refractory bleeding in
patients undergoing thoracic aortic surgery. However, the impact of rFVIIa
on thromboembolic complications and mortality rates remains
unclear.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<107>
[Use Link to view the full text]
Accession Number
643060973
Title
A historical review of heart transplantation in Saudi Arabia: Trends,
progress, and heart valve utilization.
Source
Transplantation. Conference: 17th Congress of the International Society
for Organ Donation and Procurement, ISODP 2023. Las Vegas, NV United
States. 107(10 Supplement 1) (pp 101), 2023. Date of Publication: October
2023.
Author
Alyahya R.A.; Attar B.; Ahmed H.Z.; Kamal M.; Jokhadar H.F.; Algoufi T.T.
Institution
(Alyahya, Attar, Ahmed, Kamal, Jokhadar, Algoufi) Medical Department,
Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The landscape of heart transplantation in Saudi Arabia has
witnessed significant changes since its inception in 1986. This historical
review aims to highlight the trends, progress, and utilization of hearts
for valve transplantation in the country, without focusing on specific
transplant centers. <br/>Method(s): A retrospective analysis of heart
transplantation data in Saudi Arabia was conducted to assess the evolution
of transplantation activities and the utilization of hearts for valve
transplantation. Data on transplanted whole hearts, heart-for-valves
transplantations, collected heart valves, and the reasons for valve
discard were examined. <br/>Result(s): Since 1986, a total of 566 whole
hearts have been transplanted in Saudi Arabia, demonstrating consistent
progress with a steady growth. The 2000's saw a noticeable increased in
heart transplant activity, reflecting advancements in the field.
Additionally, 758 heart-for-valves transplantations have been performed.
In terms of heart valve transplantation, a total of 15 hearts were
collected specifically for this purpose. <br/>Conclusion(s): The
historical growth in heart transplantation and heart valves
transplantation in Saudi Arabia showcases the dedication and proficiency
of the nation's medical community in providing hope to heart transplant
recipients. However, optimization of donated heart valve utilization is
essential to ensure these valuable resources can be used to save and
improve lives. Continued efforts in addressing the challenges related to
heart valve transplantation and improving the overall transplantation
process are needed to maximize the impact of these life-saving
initiatives.

<108>
Accession Number
2029315917
Title
Retraction speed and chronic poststernotomy pain: A randomized controlled
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Phelan R.; Petsikas D.; Shelley J.; Hopman W.M.; DuMerton D.; Parry M.;
Payne D.; Allard R.; Cummings M.; Parlow J.L.; Tanzola R.; Wang L.T.S.;
Stewart C.; Saha T.K.
Institution
(Phelan, Shelley, DuMerton, Allard, Cummings, Parlow, Tanzola, Wang, Saha)
Department of Anesthesiology and Perioperative Medicine, Queen's
University, Kingston, ON, Canada
(Petsikas, Payne) Division of Cardiac Surgery, Department of Surgery,
Queen's University, Kingston, ON, Canada
(Hopman) Kingston General Health Research Institute, Kingston Health
Sciences Centre, Kingston, ON, Canada
(Hopman) Department of Public Health Sciences, Queen's University,
Kingston, ON, Canada
(Parry) Lawrence S. Bloomberg Faculty of Nursing, University of Toronto,
Toronto, ON, Canada
(Stewart) School of Medicine, Queen's University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: Approximately 30% of patients develop chronic poststernotomy
pain (CPSP) following cardiac surgery with sternal retraction. Risk
factors have been described but no causal determinants identified.
Investigators hypothesized that opening the sternum slowly would impart
less force (and thereby less nerve/tissue damage) and translate to a
reduced incidence of CPSP. The main objectives were to determine whether
or not slower sternal retraction would reduce the incidence of CPSP and
improve health-related quality of life. <br/>Method(s): Patients
undergoing coronary artery bypass graft surgery were recruited to this
randomized controlled trial. Patients were randomized to slow or standard
retraction (ie, sternum opened over 15 minutes vs 30 seconds,
respectively). Although the anesthesiologist and surgeon were aware of the
randomization, the patients, assessors, and postoperative nursing staff
remained blinded. Sternotomy pain and analgesics were measured in
hospital. At 3, 6, and 12 months postoperatively, all patients completed
the Medical Outcomes Survey Short Form and reported on CPSP and
complications requiring rehospitalization. Thirty-day rehospitalizations
and mortality were recorded. <br/>Result(s): In total, 326 patients
consented to participate and 313 were randomized to slow (n = 159) versus
standard retraction (n = 154). No clinically relevant differences were
detected in acute pain, analgesic consumption, or the incidence of CPSP or
health-related quality of life. Although the slow group had significantly
more hospitalizations at 3 and 12 months postoperatively, the reasons were
unrelated to retraction speed. No differences were observed in 30-day
rehospitalizations or mortality. <br/>Conclusion(s): All outcomes were
consistent with previous reports, but no clinically significant
differences were observed with retraction speed.<br/>Copyright &#xa9; 2023
The American Association for Thoracic Surgery