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<1>
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Accession Number
2028397994
Title
Timing of Complete Revascularization with Multivessel PCI for Myocardial
Infarction.
Source
New England Journal of Medicine. 389(15) (pp 1368-1379), 2023. Date of
Publication: 2023.
Author
Stahli B.E.; Varbella F.; Linke A.; Schwarz B.; Felix S.B.; Seiffert M.;
Kesterke R.; Nordbeck P.; Witzenbichler B.; Lang I.M.; Kessler M.; Valina
C.; Dibra A.; Rohla M.; Moccetti M.; Vercellino M.; Gaede L.; Bott-Flugel
L.; Jakob P.; Stehli J.; Candreva A.; Templin C.; Schindler M.;
Wischnewsky M.; Zanda G.; Quadri G.; Mangner N.; Toma A.; Magnani G.;
Clemmensen P.; Luscher T.F.; Munzel T.; Schulze P.C.; Laugwitz K.-L.;
Rottbauer W.; Huber K.; Neumann F.-J.; Schneider S.; Weidinger F.;
Achenbach S.; Richardt G.; Kastrati A.; Ford I.; Maier W.; Ruschitzka F.
Institution
(Stahli, Kesterke, Jakob, Stehli, Candreva, Templin, Schindler,
Wischnewsky, Maier, Ruschitzka) Department of Cardiology, University Heart
Center, University Hospital Zurich, The Center for Translational and
Experimental Cardiology, Faculty of Medicine, Switzerland
(Luscher) Center for Molecular Cardiology, University of Zurich, Zurich,
Switzerland
(Rohla) Department of Cardiology, Bern University Hospital, University of
Bern, Bern, Switzerland
(Moccetti) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Varbella, Zanda, Quadri) Department of Internal Medicine, Cardiology
Unit, Rivoli Hospital, Turin, Italy
(Vercellino) Department of Internal Medicine, Santi Antonio e Biagio e
Cesare Arrigo Hospital, Alessandria, Italy
(Magnani) Division of Cardiology, Parma University Hospital, Parma, Italy
(Linke, Mangner) Technische Universitat Dresden, Department of Internal
Medicine and Cardiology, Herzzentrum Dresden, University Clinic, Dresden,
Germany
(Schwarz, Richardt) Heart Center, Segeberger Kliniken, Academic Teaching
Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg,
Germany
(Felix) Department of Internal Medicine B, University Medicine Greifswald,
The German Center for Cardiovascular Research (DZHK) Partner Site
Greifswald, Greifswald, Germany
(Seiffert, Clemmensen) Department of Cardiology, University Heart and
Vascular Center Hamburg, Center for Population Health Innovation,
University Clinic Hamburg-Eppendorf, Dzhk Partner Site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Nordbeck) Department of Internal Medicine, University Hospital Wurzburg,
Wurzburg, Germany
(Witzenbichler) Department of Cardiology and Pneumology, Helios
Amper-Klinikum, Dachau, Germany
(Gaede, Achenbach) Department of Cardiology,
Friedrich-Alexander-University Erlangen Nurnberg, Erlangen, Germany
(Bott-Flugel) Cardiology and Pneumology, Klinikum Landkreis Erding,
Erding, Germany
(Wischnewsky) Fb Mathematics and Computer Science, University of Bremen,
Bremen, Germany
(Kessler, Rottbauer) Department of Cardiology, Ulm University Heart
Center, Ulm, Germany
(Valina, Neumann) Department of Cardiology and Angiology, University of
Freiburg Medical Center, The Faculty of Medicine, University of Freiburg,
Freiburg, Germany
(Munzel) Department of Cardiology, University Medical Center Mainz, The
Center for Cardiovascular Research, Johannes Gutenberg University Partner
Site Rhine Main, Mainz, Germany
(Schulze) Department of Internal Medicine, Division of Cardiology,
Pneumology, and Angiology, The Intensive Medical Care, University Hospital
Jena, Friedrich-Schiller-University, Jena, Germany
(Laugwitz) Clinic and Policlinic Internal Medicine I, Cardiology and
Angiology, Klinikum Rechts der Isar, Germany
(Kastrati) Klinik fur Herz und Kreislauferkrankungen, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Dzhk, partner site
Munich Heart Alliance, Munich, Germany
(Schneider) Institut fur Herzinfarktforschung, Ludwigshafen, Germany
(Lang, Toma) Department of Internal Medicine Ii, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Rohla, Huber) 3rd Department of Medicine, Cardiology, and Intensive Care
Medicine, Clinic Ottakring and Sigmund Freud University Medical School,
Vienna, Austria
(Weidinger) 2nd Medical Department with Cardiology and Intensive Care
Medicine, Klinik Landstrasse, Vienna, Austria
(Dibra) Department of Cardiovascular Diseases, University of Medicine,
University Hospital Mother Teresa, Tirana, Albania
(Clemmensen) Department of Medicine, Nykobing Falster Hospital, Nykobing
Falster, Denmark
(Luscher) Heart Division, Royal Brompton and Harefield Hospitals, National
Heart and Lung Institute, Imperial College London, London, United Kingdom
(Ford) Robertson Centre for Biostatistics, University of Glasgow, Glasgow,
United Kingdom
Publisher
Massachussetts Medical Society
Abstract
Background In patients with ST-segment elevation myocardial infarction
(STEMI) with multivessel coronary artery disease, the time at which
complete revascularization of nonculprit lesions should be performed
remains unknown. Methods We performed an international, open-label,
randomized, noninferiority trial at 37 sites in Europe. Patients in a
hemodynamically stable condition who had STEMI and multivessel coronary
artery disease were randomly assigned to undergo immediate multivessel
percutaneous coronary intervention (PCI; immediate group) or PCI of the
culprit lesion followed by staged multivessel PCI of nonculprit lesions
within 19 to 45 days after the index procedure (staged group). The primary
end point was a composite of death from any cause, nonfatal myocardial
infarction, stroke, unplanned ischemia-driven revascularization, or
hospitalization for heart failure at 1 year after randomization. The
percentages of patients with a primary or secondary end-point event are
provided as Kaplan-Meier estimates at 6 months and at 1 year. Results We
assigned 418 patients to undergo immediate multivessel PCI and 422 to
undergo staged multivessel PCI. A primary end-point event occurred in 35
patients (8.5%) in the immediate group as compared with 68 patients
(16.3%) in the staged group (risk ratio, 0.52; 95% confidence interval,
0.38 to 0.72; P<0.001 for noninferiority and P<0.001 for superiority).
Nonfatal myocardial infarction and unplanned ischemia-driven
revascularization occurred in 8 patients (2.0%) and 17 patients (4.1%),
respectively, in the immediate group and in 22 patients (5.3%) and 39
patients (9.3%), respectively, in the staged group. The risk of death from
any cause, the risk of stroke, and the risk of hospitalization for heart
failure appeared to be similar in the two groups. A total of 104 patients
in the immediate group and 145 patients in the staged group had a serious
adverse event. Conclusions Among patients in hemodynamically stable
condition with STEMI and multivessel coronary artery disease, immediate
multivessel PCI was noninferior to staged multivessel PCI with respect to
the risk of death from any cause, nonfatal myocardial infarction, stroke,
unplanned ischemia-driven revascularization, or hospitalization for heart
failure at 1 year. (Supported by Boston Scientific; MULTISTARS AMI
ClinicalTrials.gov number, NCT03135275.)<br/>Copyright &#xa9; 2023
Massachusetts Medical Society.

<2>
Accession Number
2027692979
Title
Reported outcomes in patients with iron deficiency or iron deficiency
anemia undergoing major surgery: a systematic review of outcomes.
Source
Systematic Reviews. 13(1) (no pagination), 2024. Article Number: 5. Date
of Publication: December 2024.
Author
Stangl S.; Popp M.; Reis S.; Sitter M.; Saal-Bauernschubert L.; Schiesser
S.; Kranke P.; Choorapoikayil S.; Weibel S.; Meybohm P.
Institution
(Stangl, Popp, Reis, Sitter, Saal-Bauernschubert, Schieser, Kranke,
Weibel, Meybohm) Department for Anaesthesiology, Intensive Care, Emergency
and Pain Medicine, University Hospital Wurzburg, Oberdurrbacher Strase 6,
Wurzburg 97080, Germany
(Choorapoikayil) Department for Anaesthesiology, Intensive Care and Pain
Therapy, Goethe University, University Hospital Frankfurt, Frankfurt,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Iron deficiency (ID) is the leading cause of anemia worldwide.
The prevalence of preoperative ID ranges from 23 to 33%. Preoperative
anemia is associated with worse outcomes, making it important to diagnose
and treat ID before elective surgery. Several studies indicated the
effectiveness of intravenous iron supplementation in iron deficiency with
or without anemia (ID(A)). However, it remains challenging to establish
reliable evidence due to heterogeneity in utilized study outcomes. The
development of a core outcome set (COS) can help to reduce this
heterogeneity by proposing a minimal set of meaningful and standardized
outcomes. The aim of our systematic review was to identify and assess
outcomes reported in randomized controlled trials (RCTs) and observational
studies investigating iron supplementation in iron-deficient patients with
or without anemia. <br/>Method(s): We searched MEDLINE, CENTRAL, and
ClinicalTrials.gov systematically from 2000 to April 1, 2022. RCTs and
observational studies investigating iron supplementation in patients with
a preoperative diagnosis of ID(A), were included. Study characteristics
and reported outcomes were extracted. Outcomes were categorized according
to an established outcome taxonomy. Quality of outcome reporting was
assessed with a pre-specified tool. Reported clinically relevant
differences for sample size calculation were extracted. <br/>Result(s):
Out of 2898 records, 346 underwent full-text screening and 13 studies
(five RCTs, eight observational studies) with sufficient diagnostic
inclusion criteria for iron deficiency with or without anemia (ID(A)) were
eligible. It is noteworthy to mention that 49 studies were excluded due to
no confirmed diagnosis of ID(A). Overall, 111 outcomes were structured
into five core areas including nine domains. Most studies (92%) reported
outcomes within the 'blood and lymphatic system' domain, followed by
"adverse event" (77%) and "need for further resources" (77%). All of the
latter reported on the need for blood transfusion. Reported outcomes were
heterogeneous in measures and timing. Merely, two (33%) of six prospective
studies were registered prospectively of which one (17%) showed no signs
of selective outcome reporting. <br/>Conclusion(s): This systematic review
comprehensively depicts the heterogeneity of reported outcomes in studies
investigating iron supplementation in ID(A) patients regarding exact
definitions and timing. Our analysis provides a systematic base for
consenting to a minimal COS. Systematic review registration: PROSPERO
CRD42020214247<br/>Copyright &#xa9; 2023, The Author(s).

<3>
Accession Number
2027008144
Title
Drug-coated balloons versus drug-eluting stents in patients with acute
myocardial infarction undergoing percutaneous coronary intervention: an
updated meta-analysis with trial sequential analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
605. Date of Publication: December 2023.
Author
Abdelaziz A.; Hafez A.; Atta K.; Elsayed H.; Abdelaziz M.; Elaraby A.;
Kadhim H.; Mechi A.; Ezzat M.; Fadel A.; Nasr A.; Bakr A.; Ghaith H.S.
Institution
(Abdelaziz, Hafez, Atta, Elsayed, Abdelaziz, Elaraby, Ezzat, Fadel, Bakr,
Ghaith) Medical Research Group of Egypt (MRGE), Cairo, Egypt
(Abdelaziz, Abdelaziz, Elaraby, Bakr, Ghaith) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Hafez, Atta) Institute of Medicine, National Research Mordovia State
University, Saransk, Russian Federation
(Elsayed) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Kadhim) Al Muthanna University College of Medicine, Samawah, Iraq
(Mechi) Medicine College, Internal Medicine Department, University of
Kufa, Najaf, Iraq
(Ezzat) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Fadel) Faculty of Medicine, Sohag University, Sohag, Egypt
(Nasr) Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Drug-coated balloons (DCBs) are an established strategy for
coronary artery disease. However, the new generation drug-eluting stent
(DES) is recommended for patients with Acute myocardial infarction (AMI)
for coronary artery revascularization. Our aim is to provide a
comprehensive appraisal of the efficacy of DCBs in patients with AMI
undergoing PCI. <br/>Method(s): We searched the WOS, PubMed, Scopus, and
Cochrane CENTRAL till March 2023, for studies that compared DCBs versus
DES in patients with AMI undergoing PCI. We used a random-effects model to
compare major adverse cardiac events (MACE), cardiac death, all-cause
death, myocardial infarction, target lesion revascularization (TLR), stent
thrombosis, Late lumen Loss (LLL), and minimum lumen diameter (MLD)
between the two groups. <br/>Result(s): Thirteen studies comprising 2644
patients were included. The pooled OR showed non-inferiority of DCB over
DES in terms of MACE (OR = 0.89, 95% CI [0.57 to 1.40], p = 0.63). When we
defined MACE as a composite of cardiac death, MI, and TLR; the pooled OR
favored DCB over DES (OR = 0.50, 95% CI [0.28 to 0.9], p = 0.02).
Moreover, DCB was not inferior to DES in terms of all-cause mortality (OR
= 0.88, 95% CI: 0.43 to 1.8, p = 0.73), cardiac mortality, (OR = 0.59, 95%
CI: 0.22 to 1.56, p = 0.29), MI (OR = 0.88, 95% CI: 0.34 to 2.29, p =
0.79), stent thrombosis (OR = 1.21, 95% CI: 0.35 to 4.23, p = 0.76), TLR
(OR = 0.9, 95% CI: 0.43 to 1.93, p = 0.8), LLL (MD = -0.6, 95% CI: -0.3 to
0.19, p = 0.64), or MLD (MD = -0.4, 95% CI: -0.33 to 0.25, p = 0.76).
<br/>Conclusion(s): Our meta-analysis indicated that DCB intervention was
not inferior to DES in the PCI setting in patients with AMI, and can be
recommended as a feasible strategy in AMI. PROSPERO registration:
CRD42023412757.<br/>Copyright &#xa9; 2023, The Author(s).

<4>
Accession Number
2029515287
Title
Influence of sex on efficacy of exercise training for patients with
symptomatic atrial fibrillation: insights from the ACTIVE-AF randomized
controlled trial.
Source
European Journal of Preventive Cardiology. 30(18) (pp 2006-2014), 2023.
Date of Publication: 01 Dec 2023.
Author
Verdicchio C.V.; Mahajan R.; Middeldorp M.E.; Gallagher C.; Mishima R.S.;
Lau D.H.; Sanders P.; Elliott A.D.
Institution
(Verdicchio, Mahajan, Middeldorp, Gallagher, Mishima, Lau, Sanders,
Elliott) Centre for Heart Rhythm Disorders, University of Adelaide, South
Australian Health & Medical Research Institute, North Terrace, Adelaide,
SA 5000, Australia
(Verdicchio) Faculty of Medicine & Health, University of Sydney, Sydney,
Australia
(Mahajan) Department of Cardiology, Lyell McEwin Health Service, Adelaide,
Australia
(Middeldorp, Gallagher, Mishima, Lau, Elliott) Department of Cardiology,
Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia
Publisher
Oxford University Press
Abstract
Aims Exercise training reduces recurrence of arrhythmia and symptom
severity amongst patients with symptomatic, non-permanent atrial
fibrillation (AF). However, there is little evidence on whether this
effect is modified by patient sex. In a sub-analysis from the ACTIVE-AF (A
Lifestyle-based, PhysiCal AcTIVity IntErvention for Patients With
Symptomatic Atrial Fibrillation) randomized controlled trial, we compared
the effects of exercise training on AF recurrence and symptom severity
between men and women. Methods and results The ACTIVE-AF study randomized
120 patients (69 men, 51 women) with paroxysmal or persistent AF to
receive an exercise intervention combining supervised and home-based
aerobic exercise over 6 months or to continue standard medical care.
Patients were followed over a 12-month period. The co-primary outcomes
were recurrence of AF, off anti-arrhythmic medications and without
catheter ablation, and AF symptom severity scores. By 12 months,
recurrence of AF was observed in 50 (73%) men and 34 (67%) women. In an
intention-to-treat analysis, there was a between-group difference in
favour of the exercise group for both men [hazard ratio (HR) 0.52, 95%
confidence interval (CI): 0.29-0.91, P = 0.022] and women (HR 0.47, 95%
CI: 0.23-0.95, P = 0.035). At 12 months, symptom severity scores were
lower in the exercise group compared with controls amongst women but not
for men. Conclusion An exercise-based intervention reduced arrhythmia
recurrence for both men and women with symptomatic AF. Symptom severity
was reduced with exercise in women at 12 months. No difference was
observed in symptom severity for men.<br/>Copyright &#xa9; The Author(s)
2023.

<5>
Accession Number
2029490224
Title
Subclinical thyroid dysfunction and the risk of incident atrial
fibrillation: A systematic review and meta-analysis.
Source
PLoS ONE. 19(1 January) (no pagination), 2024. Article Number: e0296413.
Date of Publication: January 2024.
Author
Singh H.; Shahid M.Z.; Harrison S.L.; Lane D.A.; Lip G.Y.H.; Logantha
S.J.R.J.
Institution
(Singh, Shahid, Harrison, Lane, Lip, Logantha) Liverpool Centre for
Cardiovascular Science, University of Liverpool, Liverpool John Moores
University, Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Singh, Shahid, Harrison, Lane, Lip, Logantha) Department of
Cardiovascular and Metabolic Medicine, Institute of Life Course and
Medical Sciences, University of Liverpool, Liverpool, United Kingdom
(Shahid) Geriatric Medicine, Airedale General Hospital, Airedale Hospital
Trusts, Bradford, United Kingdom
(Lane, Lip) Danish Center for Health Services Research, Department of
Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark
Publisher
Public Library of Science
Abstract
Background Thyroid hormones act on the cardiovascular system directly by
modulating its function and indirectly by transcriptional regulation of
gene expression in the heart and the vasculature. Studies have shown
associations between overt and subclinical thyroid disorders and
cardiovascular outcomes. The aim of this study was to perform a systematic
review and meta-analysis to assess the potential relationships between
subclinical hyper- and hypothyroidism and risk of atrial fibrillation
(AF), and post-operative AF. Methods MEDLINE and Scopus databases were
searched from inception to 18^th February 2023 for randomised
controlled trials, case-control studies, and cohort studies which assessed
the relationship between subclinical thyroid dysfunction and incident AF
events. Risk of bias and the quality of evidence were assessed using the
RoBANS tool and GRADE approach, respectively. Meta-analysis was conducted
in Review Manager 5.4 using the Mantel-Haenszel statistical method and a
random-effects model. Data are presented as risk ratios with 95%
confidence intervals. Statistical heterogeneity amongst studies was
assessed by the chi-squared (chi²) test and I²
statistic. p<=0.05 were considered significant. Results A total of 6467
records were identified, of which 10 cohort studies met the inclusion
criteria. Both subclinical hyperthyroidism and subclinical hypothyroidism
were associated with an increased risk of incident AF (risk ratio (RR),
1.99; 95% confidence interval (CI), 1.43-2.77; n = 5 studies; p<0.0001 and
RR, 1.19; CI, 1.03-1.39; n = 7 studies; p = 0.02, respectively). Subgroup
analysis for post-operative AF revealed marked heterogeneity between
studies (I² = 84%) and association with subclinical
hypothyroidism was not significant (RR, 1.41; CI, 0.89-2.22; n = 3
studies; p = 0.15). Conclusions The current evidence suggests that both
subclinical hyperthyroidism and subclinical hypothyroidism are associated
with increased risk of incident AF. Further investigation is required to
determine potential causal links that would guide future clinical
practice.<br/>Copyright: &#xa9; 2024 Singh et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<6>
Accession Number
2029145412
Title
Enhancement of bicycle exercise capacity in patients with chronotropic
incompetence through closed-loop stimulation: a randomized crossover
trial.
Source
Europace. 25(12) (no pagination), 2023. Article Number: euad358. Date of
Publication: 01 Dec 2023.
Author
Chua S.-K.; Chen W.-L.; Chen L.-C.; Shyu K.-G.; Hung H.-F.; Lee S.-H.;
Wang T.-L.; Lai W.-T.; Chen K.-J.; Liao Z.-Y.; Chuang C.-Y.; Chou C.-Y.
Institution
(Chua, Chen) School of Medicine, College of Medicine, Fu Jen Catholic
University, 510 Zhongzheng Road, Xinzhuang District, New Taipei City
24205, Taiwan (Republic of China)
(Chua, Chen, Shyu, Hung, Lee, Wang, Lai, Chen, Liao, Chuang, Chou)
Division of Cardiology, Department of Internal Medicine, Shin Kong Wu
Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih-Lin District, Taipei
11101, Taiwan (Republic of China)
(Chen) Department of Physical Medicine and Rehabilitation, Shin Kong Wu
Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih-Lin District, Taipei
11101, Taiwan (Republic of China)
Publisher
Oxford University Press
Abstract
Aims This study aimed to investigate the effectiveness of closed-loop
stimulation (CLS) pacing compared with the traditional DDD mode in
patients with chronotropic incompetence (CI) using bicycle-based
cardiopulmonary exercise testing (CPET). Methods This single-centre,
randomized crossover trial involved 40 patients with CI. Patients were
randomized to receive either and ^results DDD-CLS or DDD mode
pacing for 2 months, followed by a crossover to the alternative mode for
an additional 2 months. Bicycling-based CPET was conducted at the 3- and
5-month follow-up visits to assess exercise capacity. Other
cardiopulmonary exercise outcome measures and health-related quality of
life (QoL) were also assessed. DDD-CLS mode pacing significantly improved
exercise capacity, resulting in a peak oxygen uptake (14.8 +/- 4.0 vs.
12.0 +/- 3.6 mL/kg/min, P < 0.001) and oxygen uptake at the ventilatory
threshold (10.0 +/- 2.2 vs. 8.7 +/- 1.8 mL/kg/min, P < 0.001) higher than
those of the DDD mode. However, there were no significant differences in
other cardiopulmonary exercise outcome measures such as ventilatory
efficiency of carbon dioxide production slope, oxygen uptake efficiency
slope, and end-tidal carbon dioxide between the two modes. Patients in the
DDD-CLS group reported a better QoL, and 97.5% expressed a preference for
the DDD-CLS mode. ^Conclusion DDD-CLS mode pacing demonstrated
improved exercise capacity and QoL in patients with CI, highlighting its
potential as an effective pacing strategy for this patient
population.<br/>Copyright &#xa9; The Author(s) 2023.

<7>
Accession Number
2027356724
Title
Scoping review of percutaneous mechanical aspiration for valvular and
cardiac implantable electronic device infective endocarditis.
Source
Clinical Microbiology and Infection. 29(12) (pp 1508-1515), 2023. Date of
Publication: December 2023.
Author
Mourad A.; Hillenbrand M.; Skalla L.A.; Holland T.L.; Zwischenberger B.A.;
Williams A.R.; Turner N.A.
Institution
(Mourad, Hillenbrand, Holland, Turner) Department of Medicine, Division of
Infectious Diseases, Duke University Medical Center, Durham, NC, United
States
(Skalla) Duke University Medical Center Library & Archives, Duke
University School of Medicine, Durham, NC, United States
(Zwischenberger, Williams) Department of Surgery, Division of
Cardiovascular and Thoracic Surgery, Duke University Medical Center,
Durham, NC, United States
Publisher
Elsevier B.V.
Abstract
Background: Percutaneous mechanical aspiration (PMA) of intravascular
vegetations is a novel strategy for management of patients with infective
endocarditis (IE) who are at high risk of poor outcomes with conventional
cardiac surgery. However, clear indications for its use as well as patient
outcomes are largely unknown. <br/>Objective(s): To conduct a scoping
review of the literature to summarize patient characteristics and outcomes
of those undergoing PMA for management of IE. <br/>Method(s): Two
independent reviewers screened abstracts and full text for inclusion and
independently extracted data. Data sources: MEDLINE, Embase, and Web of
Science. Study eligibility criteria: Studies published until February 21,
2023, describing the use of PMA for management of patients with cardiac
implantable electronic device (CIED) or valvular IE were included.
Assessment of risk of bias: As this was a scoping review, risk of bias
assessment was not performed. Methods of data synthesis: Descriptive data
was reported. <br/>Result(s): We identified 2252 titles, of which 1442
abstracts were screened, and 125 full text articles were reviewed for
inclusion. Fifty-one studies, describing a total of 294 patients who
underwent PMA for IE were included in our review. Over 50% (152/294) of
patients underwent PMA to debulk cardiac implantable electronic device
lead vegetations prior to extraction (152/294), and 38.8% (114/294) of
patients had a history of drug use. Patient outcomes were inconsistently
reported, but few had procedural complications, and all-cause in-hospital
mortality was 6.5% (19/294). <br/>Conclusion(s): While PMA is a promising
advance in the care of patients with IE, higher quality data regarding
patient outcomes are needed to better inform the use of this
procedure.<br/>Copyright &#xa9; 2023 European Society of Clinical
Microbiology and Infectious Diseases

<8>
Accession Number
2029586078
Title
Effectiveness of general anaesthesia with remimazolam tosilate on
intraoperative haemodynamics and postoperative recovery: Study protocol
for a randomised, positive-controlled, pragmatic clinical trial (GARTH
trial).
Source
BMJ Open. 14(1) (no pagination), 2024. Article Number: e073024. Date of
Publication: 04 Jan 2024.
Author
Lu C.; Kang Y.; Luo Q.; Zhong F.; Cai Y.; Zhang G.; Guo Z.; Zhang S.; Ma
J.; Shu H.
Institution
(Lu, Kang, Luo, Cai, Zhang, Guo, Zhang, Ma, Shu) Department of
Anesthesiology, Guangdong Provincial People's Hospital, Southern Medical
University, Guangzhou, China
(Lu) Department of Anesthesiology, Shenzhen Traditional Chinese Medicine
Hospital, The Fourth Clinical Medical College of Guangzhou University of
Chinese Medicine, Shenzhen, China
(Zhong) Global Health Research Center, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Guo, Shu) Guangdong Cardiovascular Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Zhang) Department of Anesthesiology, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Shu) School of Medicine, South China University of Technology, Guangzhou,
China
Publisher
BMJ Publishing Group
Abstract
Introduction It is encouraged to estimate the effectiveness of components
within the enhanced recovery after surgery (ERAS) protocol through
patient-reported outcomes, alongside doctor-reported outcomes and length
of hospital stay. At present, studies on the contributions of optimal
anaesthetic drugs within the ERAS protocol to patient-reported and
doctor-reported outcomes are limited. Therefore, this study aims to
pragmatically evaluate the effectiveness and safety of general anaesthesia
(GA) with remimazolam tosilate within the ERAS protocol on intraoperative
haemodynamics and postoperative recovery in adults undergoing elective
surgeries, compared with propofol. Methods and analysis This study is a
single-centre, randomised, blinded, positive-controlled, pragmatic
clinical trial. A total of 900 patients, aged >=18 years old, scheduled
for an elective surgical procedure under GA will be included. Patients
will be randomised in a 1:1 ratio to the remimazolam group (the GA with
remimazolam tosilate within the ERAS protocol group) or propofol group
(the GA with propofol within the ERAS protocol group), stratified by
general surgery, thoracic surgery and other surgeries (including
urological surgery and otolaryngology surgery). The primary outcomes
include the 24-hour postoperative quality of recovery-40 score and the
rate of intraoperative hypotension. Secondary endpoints include the rate
of sedative hypotension requiring treatment, the haemodynamic profiles,
the 72-hour postoperative quality of recovery-40 score, the functional
anaesthetic capability, adverse events and complications, quality of life
within 3 months as well as economic health outcomes. Ethics and
dissemination This study protocol has been approved by the ethics
committee of Guangdong Provincial People's Hospital (KY-H-2022-005-03-08).
Dissemination plans will be presented at scientific meetings and in
scientific publications. Trial registration number
ChiCTR2200062520.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<9>
Accession Number
2029295273
Title
Acute kidney injury in the critically unwell patient.
Source
Anaesthesia and Intensive Care Medicine. 25(1) (pp 56-62), 2024. Date of
Publication: January 2024.
Author
Slattery L.; Flood L.
Institution
(Slattery, Flood) St Vincent's University Hospital, Dublin, Ireland
(Slattery, Flood) Tallaght University Hospital, Dublin, Ireland
Publisher
Elsevier Ltd
Abstract
Acute kidney injury (AKI) is commonly encountered in the critical care
setting. It is associated with prolonged hospitalization, progression to
chronic kidney disease and is an independent risk factor for mortality in
the critical care setting. There are multiple possible aetiologies for AKI
in the critical care population including sepsis, major surgery, low
cardiac output states and nephrotoxic agents. There are a number of
classification systems for AKI which we will consider in this article.
Many supportive therapies are employed to minimize the degree of renal
impairment once recognized: maintenance of an adequate mean arterial
pressure to enable adequate renal perfusion pressure is the cornerstone of
treatment. However, if renal failure becomes established, then renal
replacement therapy (RRT) may be needed to maintain homeostasis. The
timing of initiation and cessation of RRT and dosing practices have been
subject to numerous randomized controlled trials, however there is no
consensus guideline in this respect; we will discuss the pros and cons of
the various options.<br/>Copyright &#xa9; 2023

<10>
Accession Number
2027776128
Title
Short-term antiplatelet versus anticoagulant therapy after left atrial
appendage closure: a systematic review and meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2024. Date of
Publication: 2024.
Author
Zhou Q.; Liu X.; Gu Z.-C.; Yang X.; Huang X.-H.; Wu Y.-Z.; Tao Y.-Y.; Wei
M.
Institution
(Zhou, Huang, Wu, Tao, Wei) Department of Clinical Pharmacy, Jinling
Hospital, Medical School of Nanjing University, Nanjing 210002, China
(Liu) Department of Pharmacy and Traditional Chinese Pharmacy, Jiangsu
College of Nursing, Huaian, China
(Gu) Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Yang) Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated
Hospital of Nanjing University Medical School, Nanjing, China
Publisher
Springer
Abstract
This meta-analysis compared the efficacy and safety of different
antithrombotic regimens after left atrial appendage closure (LAAC).
PubMed, Embase, Medline, Cochrane Library databases were systematically
searched from their inception to March 2023. Patients were divided into
short-term oral anticoagulation (OAC) group and antiplatelet therapy (APT)
group. The incidence of events were performed using RevMan 5.4. The events
including device-related thrombus (DRT), ischemic stroke/systemic
embolization (SE), major bleeding, any bleeding, any major adverse event
and all-cause mortality. Subgroup analysis were based on OAC alone or OAC
plus single antiplatelet therapy (SAPT) in OAC group. Oral anticoagulants
include warfarin and direct oral anticoagulant (DOAC). Fourteen studies
with 35,166 patients were included. We found that the incidence of DRT (OR
= 0.49, 95% CI 0.36-0.66, P<0.0001) and all-cause mortality (OR = 0.71,
95% CI 0.57-0.89, P = 0.002) were significantly lower in OAC group than
APT group. However, there was no statistical differences in the incidence
rates of ischemic stroke/SE (OR = 0.77, 95% CI 0.49-1.20, P = 0.25), major
bleeding (OR = 0.84, 95% CI 0.55-1.27, P = 0.84), any bleeding (OR = 0.83,
95% CI 0.56-1.22, P = 0.34) and any major adverse event (OR = 0.56, 95% CI
0.30-1.03, P = 0.06) in the two groups. Subgroup analysis found that the
incidence of DRT, all-cause mortality and any major adverse event in OAC
monotherapy were lower than that in APT group (P<0.05), but not
statistically different from other outcome. The incidence of DRT,
all-cause mortality, any major adverse event and any bleeding in DOAC were
significantly better than APT group (P<0.05). While warfarin only has
better incidence of DRT than APT (P<0.05), there was no statistical
difference between the two groups in other outcome (P>0.05). The incidence
of DRT was significantly lower than APT group (P<0.05), major bleeding
were higher, and the rest of the outcome did not show any statistically
significant differences(P>0.05) when OAC plus SAPT. Based on the existing
data, short-term OAC may be favored over APT for patients who undergo
LAAC. DOAC monotherapy may be favored over warfarin monotherapy or OAC
plus APT, when selecting anticoagulant therapies.<br/>Copyright &#xa9;
2023, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<11>
Accession Number
643172937
Title
The efficacy of pregabalin for pain control after thoracic surgery: a
meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 4), 2024. Date of
Publication: 03 Jan 2024.
Author
Zhang L.; Zhang H.
Institution
(Zhang) Anesthesia Department Operating Room, Chongqing Liangjiang New
Area People's Hospital, Chongqing, China
(Zhang) Anesthesia Department Operating Room, Chongqing Liangjiang New
Area People's Hospital, Chongqing, China
Abstract
BACKGROUND: Pregabalin may have some potential in alleviating pain after
thoracic surgery, and this meta-analysis aims to explore the impact of
pregabalin on pain intensity for patients undergoing thoracic surgery.
<br/>METHOD(S): PubMed, EMbase, Web of science, EBSCO and Cochrane library
databases were systematically searched, and we included randomized
controlled trials (RCTs) assessing the effect of pregabalin on pain
intensity after thoracic surgery. <br/>RESULT(S): Five RCTs were finally
included in the meta-analysis. Overall, compared with control intervention
for thoracic surgery, pregabalin was associated with significantly reduced
pain scores at 0 h (mean difference [MD]=-0.70; 95% confidence interval
[CI]=-1.10 to -0.30; P=0.0005), pain scores at 24 h (MD=-0.47; 95%
CI=-0.75 to -0.18; P=0.001) and neuropathic pain (odd ratio [OR]=0.24; 95%
CI=0.12 to 0.47; P<0.0001), but demonstrated no obvious impact on the
incidence of dizziness (OR=1.07; 95% CI=0.15 to 7.46; P=0.95), headache
(OR=1.00; 95% CI=0.30 to 3.35; P=1.00) or nausea (OR=1.24; 95% CI=0.46 to
3.35; P=0.68). <br/>CONCLUSION(S): Pregabalin may be effective to
alleviate the pain after thoracic surgery.<br/>Copyright &#xa9; 2023. The
Author(s).

<12>
Accession Number
643165982
Title
Randomized controlled trial of remote ischemic preconditioning in children
having cardiac surgery.
Source
Journal of cardiothoracic surgery. 19(1) (pp 5), 2024. Date of
Publication: 03 Jan 2024.
Author
Law Y.M.; Hsu C.; Hingorani S.R.; Richards M.; McMullan D.M.; Jefferies
H.; Himmelfarb J.; Katz R.
Institution
(Law, Hingorani, Richards, McMullan, Jefferies) Pediatric Cardiology,
Department of Pediatrics, Seattle Children's Hospital ,4800 Sand Point Way
NE, Seattle, WA 98105, United States
(Law, Hingorani, Richards, McMullan, Jefferies, Himmelfarb, Katz)
University of Washington School of Medicine, Seattle, WA 98115, United
States
(Hsu) SeattleWA 98105, United States
Abstract
BACKGROUND: Children undergoing cardiac surgery are at risk for acute
kidney injury (AKI) and cardiac dysfunction. Opportunity exists in
protecting end organ function with remote ischemic preconditioning. We
hypothesize this intervention lessens kidney and myocardial injury.
<br/>METHOD(S): We conducted a randomized, double blind, placebo
controlled trial of remote ischemic preconditioning in children undergoing
cardiac surgery. Pre-specified end points are change in creatinine,
estimated glomerular filtration rate, development of AKI, B-type
natriuretic peptide and troponin I at 6, 12, 24, 48, 72 h post separation
from bypass. <br/>RESULT(S): There were 45 in the treatment and 39
patients in the control group, median age of 3.5 and 3.8 years,
respectively. There were no differences between groups in creatinine,
cystatin C, eGFR at each time point. There was a trend for a larger rate
of decrease, especially for cystatin C (p=0.042) in the treatment group
but the magnitude was small. AKI was observed in 21 (54%) of control and
16 (36%) of treatment group (p=0.094). Adjusting for baseline creatinine,
the odds ratio for AKI in treatment versus control was 0.31 (p=0.037);
adjusting for clinical characteristics, the odds ratio was 0.34 (p=0.056).
There were no differences in natriuretic peptide or troponin levels
between groups. All secondary end points of clinical outcomes were not
different. <br/>CONCLUSION(S): There is suggestion of RIPC delivering some
kidney protection in an at-risk pediatric population. Larger, higher risk
population studies will be required to determine its efficacy. Trial
registration and date: Clinicaltrials.gov NCT01260259; 2021.<br/>Copyright
&#xa9; 2023. The Author(s).

<13>
Accession Number
643157400
Title
Outcomes of minimally invasive versus conventional sternotomy for redo
mitral valve surgery according to Mitral Valve Academic Research
Consortium: A systematic review and meta-analysis.
Source
Asian journal of surgery. 47(1) (pp 35-42), 2024. Date of Publication: 01
Jan 2024.
Author
Hanafy D.A.; Melisa S.; Andrianto G.A.; Suwatri W.T.; Sugisman
Institution
(Hanafy, Melisa, Andrianto, Suwatri, Sugisman) Division of Thoracic,
Cardiac, Vascular Surgery, University of Indonesia, Harapan Kita National
Heart Center, Jakarta, Indonesia
Abstract
A minimally invasive approach through right mini-thoracotomy for redo
mitral valve surgery may improve patients' outcomes compared to median
sternotomy. This study aims to evaluate the outcomes of both procedures
according to the Mitral Valve Academic Research Consortium (MVARC). This
systematic review and meta-analysis were performed in accordance with
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA). Literature searching was performed in several databases
including PubMed, EBSCOhost, Scopus, and Proquest up to 28 February 2022.
Meta-analysis using proportions or means was applied. A total of 13
retrospective cohort articles were included in this study. The incidence
of in-hospital mortality (3% vs 9.2%, OR = 0.35; 95% CI: 0.21-0.58; P <=
0.0001), reintervention for bleeding (3.8% vs 5.9%, OR = 0.56; 95% CI:
0.32-0.97; P = 0.04), and acute renal failure (5% vs 12%, OR = 0.29; 95%
CI: 0.23-0.65; P = 0.0003) was significantly lower in mini-thoracotomy
(MINI) group compared to median sternotomy (STER) group. The incidence of
neurologic events (3.4% vs 5.5%, OR = 0.66; 95% CI: 0.4-1.08; P = 0.1) and
arrhythmia (19.5% vs 25.5%, OR = 0.64; 95% CI: 0.38-1.09; P = 0.1) were
also lower in MINI group compared to STER group but was not significant
statistically. No significant differences were found in myocardial infarct
(1% vs 1%, OR = 0.71; 95% CI: 0.06-8.85; P = 0.79) between MINI and STER
group. A minimally invasive surgery through right mini-thoracotomy is
associated with a lower incidence of in-hospital mortality, reintervention
for bleeding, and acute renal failure. It is a safe alternative to median
sternotomy for redo mitral valve surgery.<br/>Copyright &#xa9; 2023 Asian
Surgical Association and Taiwan Robotic Surgery Association. Published by
Elsevier B.V. All rights reserved.

<14>
Accession Number
642887013
Title
Preoperative respiratory muscle training reduces the risk of pulmonary
complications and the length of hospital stay after cardiac surgery: a
systematic review.
Source
Journal of physiotherapy. 70(1) (pp 16-24), 2024. Date of Publication: 01
Jan 2024.
Author
Cursino de Moura J.F.; Oliveira C.B.; Coelho Figueira Freire A.P.; Elkins
M.R.; Pacagnelli F.L.
Institution
(Cursino de Moura, Oliveira) Faculty of Medicine, University of Western
Sao Paulo (UNOESTE), Presidente Prudente, Brazil
(Coelho Figueira Freire) Department of Health Sciences, Central Washington
University, Ellensburg, United States
(Elkins) Faculty of Medicine and Health, University of Sydney, Sydney,
Australia; Sydney Education, Sydney Local Health District, Sydney,
Australia
(Pacagnelli) Physiotherapy Department, University of Western Sao Paulo
(UNOESTE), Presidente Prudente, Brazil
Abstract
QUESTIONS: What is the effect of preoperative respiratory muscle training
(RMT) on the incidence of postoperative pulmonary complications (PPCs)
after open cardiac surgery? What is the effect of RMT on the duration of
mechanical ventilation, postoperative length of stay and respiratory
muscle strength? DESIGN: Systematic review of randomised trials with
meta-analysis. PARTICIPANTS: Adults undergoing elective open cardiac
surgery. INTERVENTION: The experimental groups received preoperative RMT
and the comparison groups received no intervention. OUTCOME MEASURES: The
primary outcomes were PPCs, length of hospital stay, respiratory muscle
strength, oxygenation and duration of mechanical ventilation. The
methodological quality of studies was assessed using the PEDro scale and
the overall certainty of the evidence was assessed using the GRADE
approach. <br/>RESULT(S): Eight trials involving 696 participants were
included. Compared with the control group, the respiratory training group
had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44,
95% CI 0.25 to 0.78), shorter hospital stay (MD -1.7 days, 95% CI -2.4 to
-1.1) and higher maximal inspiratory pressure values at the end of the
training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical
ventilation time was similar in both groups. The quality of evidence was
high for pneumonia, length of hospital stay and maximal inspiratory
pressure. <br/>CONCLUSION(S): Preoperative RMT reduced the risk of PPCs
and pneumonia after cardiac surgery. The training also improved the
maximal inspiratory pressure and reduced hospital stay. The effects on
PPCs were large enough to warrant use of RMT in this population.
REGISTRATION: CRD42021227779.<br/>Copyright &#xa9; 2023 Australian
Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

<15>
Accession Number
642431349
Title
Effectiveness of acupuncture for postoperative gastrointestinal recovery
in patients undergoing thoracoscopic surgery: a prospective randomized
controlled study.
Source
Acupuncture in medicine : journal of the British Medical Acupuncture
Society. 42(1) (pp 14-22), 2024. Date of Publication: 01 Feb 2024.
Author
Zhang Y.; Ou C.; Luo X.; Kang Y.; Jiang L.; Wu S.; Ouyang H.
Institution
(Zhang, Ou, Luo, Kang, Wu, Ouyang) Department of Anesthesiology, State Key
Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer
Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou,
China
(Jiang) Department of Integrative Medicine, State Key Laboratory of
Oncology in Southern China, Sun Yat-sen University Cancer Center,
Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
Abstract
BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) is one of the
most common complications among patients who have undergone thoracic
surgery. Acupuncture has long been used in traditional Chinese medicine to
treat gastrointestinal diseases and has shown benefit as an alternative
therapy for the management of digestive ailments. This study aimed to
explore the therapeutic effectiveness of acupuncture as a means to aid
postoperative recovery of gastrointestinal function in patients undergoing
thoracoscopic surgery. <br/>METHOD(S): In total, 112 patients aged
18-70years undergoing thoracoscopic surgery between 15 June 2022 and 30
August 2022 were randomized into two groups. Patients in the acupuncture
group (AG) first received acupuncture treatment 4h after surgery, and
treatment was repeated at 24 and 48h. Patients in the control group (CG)
did not receive any acupuncture treatment. Both groups received the same
anesthetic protocol. Ultrasound-guided thoracic paravertebral block (TPVB)
was performed in the paravertebral spaces between T4 and T5 with
administration of 20mL of 0.33% ropivacaine. All patients received
patient-controlled intravenous analgesia (PCIA) after surgery.
<br/>RESULT(S): Median time to first flatus [interquartile range] in the
AG was significantly less than in the CG (23.25 [18.13, 29.75] vs 30.75
[24.13, 45.38]h, p<0.001). Time to first fluid intake after surgery was
significantly less in the AG, as compared with the CG (4 [3, 7] vs 6.5
[4.13, 10.75]h, p=0.003). Static pain, measured by visual analog scale
(VAS) score, was significantly different on the third day after surgery
(p=0.018). Dynamic pain VAS scores were lower in the AG versus CG on the
first three postoperative days (p=0.014, 0.003 and 0.041, respectively).
<br/>CONCLUSION(S): Addition of acupuncture appeared to improve recovery
of postoperative gastrointestinal function and alleviate posteoperative
pain in patients undergoing thoracoscopic surgery. Acupuncture may
represent a feasible strategy for the prevention of PGD occurrence. TRIAL
REGISTRATION NUMBER: ChiCTR2200060888 (Chinese Clinical Trial Registry).

<16>
[Use Link to view the full text]
Accession Number
641747021
Title
Relative efficacy and safety of several regional analgesic techniques
following thoracic surgery: a network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). 109(8) (pp 2404-2413),
2023. Date of Publication: 01 Aug 2023.
Author
Li J.; Sun Q.; Zong L.; Li D.; Jin X.; Zhang L.
Institution
(Li) Department of Thoracic Surgery, Xinjiang Medical University, First
Affiliated Hospital, Urumqi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: This network meta-analysis was performed to assess the
relative efficacy and safety of various regional analgesic techniques used
in thoracic surgery. MATERIALSAND METHODS: Randomized controlled trials
evaluating different regional analgesic methods were retrieved from
databases, including PubMed, Embase, Web of Science, and the Cochrane
Library, from inception to March 2021. The surface under the cumulative
ranking curve) was estimated to rank the therapies based on the Bayesian
theorem. Moreover, sensitivity and subgroup analyses were performed on the
primary outcomes to obtain more reliable conclusions. <br/>RESULT(S):
Fifty-four trials (3360 patients) containing six different methods were
included. Thoracic paravertebral block and erector spinae plane block
(ESPB) were ranked the highest in reducing postoperative pain. As for
total adverse reactions and postoperative nausea and vomiting,
postoperative complications, and duration of hospitalization, ESPB was
found to be superior to other methods. It should be noted that there were
few differences between various methods for all outcomes.
<br/>CONCLUSION(S): Available evidence suggests that ESPB might be the
most effective and safest method for relieving pain after thoracic
surgery, shortening the length of hospital stay and reducing the incidence
of postoperative complications.<br/>Copyright &#xa9; 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<17>
[Use Link to view the full text]
Accession Number
628941195
Title
Donor Simvastatin Treatment in Heart Transplantation.
Source
Circulation. 140(8) (pp 627-640), 2019. Date of Publication: 20 Aug 2019.
Author
Nykanen A.I.; Holmstrom E.J.; Tuuminen R.; Krebs R.; Dhaygude K.;
Kankainen M.; Jokinen J.J.; Lommi J.; Helantera I.; Raisanen-Sokolowski
A.; Syrjala S.O.; Lemstrom K.B.
Institution
(Nykanen, Holmstrom, Tuuminen, Krebs, Dhaygude, Syrjala, Lemstrom)
Transplantation Laboratory (A.I.N., R.T., University of Helsinki and
Helsinki University Hospital, S.O.S, Finland
(Nykanen, Syrjala, Lemstrom) Department of Cardiothoracic Surgery (A.I.N.,
University of Helsinki and Helsinki University Hospital, S.O.S, Finland
(Nykanen, Holmstrom, Tuuminen, Krebs, Dhaygude, Kankainen, Syrjala,
Lemstrom) Translational Immunology Program Research Programs Unit (A.I.N.,
R.T., University of Helsinki and Helsinki University Hospital, S.O.S,
Finland
(Kankainen) Medical and Clinical Genetics (M.K.), University of Helsinki
and Helsinki University Hospital, Finland
(Kankainen) Institute for Molecular Medicine Finland, University of
Helsinki (M.K.)
(Jokinen) Department of Cardiology (J.L.), University of Helsinki and
Helsinki University Hospital, Finland
(Jokinen) Paijat-Hame Central Hospital, Department of Surgery, Finland
(J.J.J.), Lahti, Finland
(Helantera) Transplantation and Liver Surgery (I.H.), University of
Helsinki and Helsinki University Hospital, Finland
(Raisanen-Sokolowski) Pathology (A.R.-S.), University of Helsinki and
Helsinki University Hospital, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Ischemia-reperfusion injury may compromise the short-term and
long-term prognosis after heart transplantation. Experimental studies show
that simvastatin administered to the organ donor is vasculoprotective and
inhibits cardiac allograft ischemia-reperfusion injury. <br/>METHOD(S):
Eighty-four multiorgan donors were randomly assigned to receive 80 mg of
simvastatin (42 donors) via nasogastric tube after declaration of brain
death and upon acceptance as a cardiac donor, or to receive no simvastatin
(42 donors). The primary efficacy end point was postoperative plasma
troponin T and I levels during the first 24 hours after heart
transplantation. Secondary end points included postoperative hemodynamics,
inflammation, allograft function, rejections and rejection treatments, and
mortality. Results: Organ donor simvastatin treatment significantly
reduced the heart recipient plasma levels of troponin T by 34% (14900 +/-
12100 ng/L to 9800 +/- 7900 ng/L, P=0.047), and troponin I by 40% (171000
+/- 151000 ng/L to 103000 +/- 109000 ng/L, P=0.023) at 6 hours after
reperfusion, the levels of NT-proBNP (N-terminal pro-B-type natriuretic
peptide) by 36% (32800 +/- 24300 ng/L to 20900 +/- 15900 ng/L; P=0.011) at
1 week, and the number of rejection treatments with hemodynamic compromise
by 53% within the first 30 days (P=0.046). Donor simvastatin treatment did
not affect donor lipid levels but was associated with a specific
transplant myocardial biopsy gene expression profile, and a decrease in
recipient postoperative plasma levels of CXCL10 (C-X-C motif chemokine
10), interleukin-1alpha, placental growth factor, and platelet-derived
growth factor-BB. Postoperative hemodynamics, biopsy-proven acute
rejections, and mortality were similar. No adverse effects were seen in
recipients receiving noncardiac solid organ transplants from
simvastatin-treated donors. <br/>CONCLUSION(S): Donor simvastatin
treatment reduces biomarkers of myocardial injury after heart
transplantation, and-also considering its documented general safety
profile-may be used as a novel, safe, and inexpensive adjunct therapy in
multiorgan donation. CLINICAL TRIAL REGISTRATION: URL:
https://www.clinicaltrials.gov. Unique identifier: NCT01160978.

<18>
Accession Number
643161923
Title
Validation of self-reported smoking cessation through salivary cotinine
levels before general anaesthesia.
Source
Anesthesia and Analgesia. Conference: 4th National Anaesthesia Research
Symposium 2023. Virtual. 138(5 Supplement 1) (pp 40), 2024. Date of
Publication: January 2024.
Author
Nazir M.; Munir T.; Shah Khan M.; Afshan G.
Institution
(Nazir, Munir, Shah Khan, Afshan) Department of Anaesthesiology, Aga Khan
University, Karachi, Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Smoking cessation before surgery is generally determined
through self-reported smoking status. This study was aimed to validate
self-reported smoking cessation period among patients scheduled for
elective non-cardiac surgeries. Methodology: This validation study was
nested in our previously published cohort study, conducted at the Aga Khan
University Hospital Karachi, Pakistan. Approximately 30% (80 out of 256)
of patients from the primary cohort were randomly selected for validation
study using a systematic sampling approach, including every third
recruited patient. Subsequently, salivary cotinine measurement was
performed on 80 collected samples using a commercially available Human
Cotinine ELISA kit. <br/>Result(s): A statistically insignificant positive
correlation was observed between preoperative smoking cessation and
salivary cotinine levels i.e. (R = 0.14, p=0.25), as well as salivary
cotinine level and intensity level (R = 0.20, p=0.087). The correlation
between salivary cotinine and smoking cessation was also insignificant in
minor to intermediate surgeries (R = 0.22, p=0.160) and major and complex
surgeries (R = -0.10, p=0.610). Furthermore, educational levels showed a
low negative correlation at the professional (R = -0.05, p=0.70), a
non-significant positive correlation at the basic level (R = 0.21,
p=0.860), and a highly significant positive correlation at the
intermediate level (R = 0.84, p<0.001). <br/>Conclusion(s): The validation
of self-reported smoking cessation using salivary cotinine levels revealed
that cotinine level was not a robust parameter. However, in major
surgeries and among highly educated patients, a weak but negative
correlation was observed.

<19>
Accession Number
643161912
Title
Evaluation of hemodynamic response to laryngoscopy and endotracheal
intubation using conventional laryngoscope versus C-Mac video laryngoscope
in patients undergoing elective coronary artery bypass grafting (CABG)
surgery -A Randomized control trial.
Source
Anesthesia and Analgesia. Conference: 4th National Anaesthesia Research
Symposium 2023. Virtual. 138(5 Supplement 1) (pp 25), 2024. Date of
Publication: January 2024.
Author
Khan S.; Khan W.R.; Hameed M.; Samad K.
Institution
(Khan, Khan, Hameed, Samad) Department of Anaesthesiology, Aga Khan
University, Karachi, Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac patients have limited cardiac reserves, sympathetic
stimuli such as direct laryngoscopy and tracheal intubation can
precipitate adverse effects causing myocardial supply demand imbalance.
Recently, video laryngoscope has gained popularity for exerting less
mechanical force to align the laryngeal axis, producing less stress
response and better hemodynamics. The study aimed to compare hemodynamic
response upon endotracheal intubation using conventional laryngoscopy with
Macintosh blade versus C-MAC video laryngoscope in patients undergoing
elective coronary artery bypass grafting (CABG). Methodology: After
informed consent a randomized control trial was conducted at the Aga Khan
University Hospital Karachi. 86 patients scheduled for CABG were enrolled
and randomly allocated to Macintosh and C-MAC groups. After standard
induction technique, tracheal intubation was performed. Heart rate,
systolic arterial pressure, diastolic arterial pressure and mean arterial
pressure along with peripheral oxygen saturation, were recorded before
(T1) and after induction (T2), 1 minute after intubation (T3), 5 min (T4)
and 10 min (T5) post intubation. End-tidal carbon dioxide was recorded at
T2, T3, T4 and T5. <br/>Result(s): Time taken for successful endotracheal
intubation was higher in the VL group, but the results were statistically
not significant (i.e., 32.7+/-23.1 vs 37.5+/-25.8, P-value =0.0577). CL
(Cormack Lehane) and POGO (Percentage of glottic opening) were comparable
in both groups and statistically insignificant (P = 0.401, P =0.389
respectively). <br/>Conclusion(s): In our study the hemodynamic changes
were comparable in both groups (Macintosh and C- MAC) and there is no
advantage in terms of better hemodynamic in patients undergoing CABG.

<20>
Accession Number
643161161
Title
NONINVASIVE IMAGING METHODS TO ASSESS MYOCARDIAL VIABILITY: OLD PLAYERS IN
THE NEW WORLD.
Source
Journal of Nuclear Medicine. Conference: Society of Nuclear Medicine and
Molecular Imaging Annual Meeting, SNMMI 2022. Vancouver, BC Canada.
63(Supplement 2) (no pagination), 2023. Date of Publication: June 2023.
Author
Yadav S.; Parihar A.S.
Publisher
Society of Nuclear Medicine Inc.
Abstract
Introduction: The distinction between viable and non-viable myocardium in
patients with LV dysfunction is a clinically important issue among
possible candidates for myocardial revascularization. Several non-invasive
techniques are used to detect and assess ischemia and myocardial
viability. These techniques include echocardiography, dobutamine stress
echocardiography, cardiac magnetic resonance imaging (MRI) and SPECT and
PET cardiac imaging. In this systematic review We aim to : 1) Review the
current literature on the accuracy of these methods. 2) Summarize their
advantages and disadvantages 3) Provide representative images of various
testing modalities 4) Evaluate future directions for use of Novel PET
tracers and AI Algorithms. <br/>Method(s): During LV dysfunction due to
ischaemia, three possible effects can be seen on the myocardium:
non-viable myocardium, stunned myocardium and hibernating myocardium. We
describe the pathophysiology of irreversible and reversible ischemic
damage. Recent echocardiographic modalities like myocardial wall
deformation indices including tissue Doppler imaging (TDI), strain rate
imaging (SRI) and dobutamine stress echocardiography (DSE) were evaluated.
DSE relies on echocardiographic assessment of myocardial thickening and
endocardial excursion during administration of dobutamine. The four type
of responses noted are discussed along with it. Cardiovascular magnetic
resonance (CMR) is used along with gadolinium-chelated contrast studies to
provide information on global left ventricular function and regional wall
motion. The transmural extent of scarring is inversely correlated with
functional recovery of the dysfunctional myocardium post
revascularization, whereas an absence of late gadolinium enhancement in a
hypokinetic myocardium has been shown to be associated with functional
recovery. Nuclear Imaging tests - SPECT and PET myocardial viability
studies are the most frequently performed non-invasive techniques. Various
radioactive tracers used and their mechanism of localization are discussed
with a brief discussion on Novel PET/CT tracers and their
indications.Various modalities and their advantages and disadvantages are
analyzed and tabulated, along with representative images for each of them.
<br/>Result(s): It was observed in various studies that viability testing
can have a lower specificity. A number of studies have explored the low
specificity and NPV and have questioned the role of viability testing as
to having any benefit in predicting outcomes post revascularization. Some
studies observed that the presence of viable myocardium by 18F- FDG PET/CT
scan was not related to long-term survival in patients with ischemic
cardiomyopathy. After reviewing several studies and recent data available
we concluded that PET/CT has the highest sensitivity for the prediction of
regional ventricular function post revascularization, making it the
technique of choice as per our study. However, we found that there is only
limited understanding of the extent and severity of mismatched perfusion
and metabolism that are required to predict degrees of improvement in LV
function. Therefore defining and quantifying the myocardial viability
defects seen on 18F-FDG PET/CT is very much required in the present
scenario. <br/>Conclusion(s): It is imperative that the nuclear medicine
physicians are well versed with the diagnostic utility of these tests.
18F- FDG PET/CT imaging is concluded to be the best means for defining
viability and has proven useful in predicting regional and global recovery
of LV function following revascularization. With the information
presented, the physicians will be able to optimize the use of these
non-invasive modalities for optimal selection of patients who would
actually benefit from revascularization procedures.

<21>
Accession Number
643159595
Title
Fractional flow reserve vs. angiography alone guided revascularization
strategies in coronary artery disease: A meta-analysis and systematic
review.
Source
Kardiologia Polska. Conference: 27th International Congress of the Polish
Cardiac Society. Poznan Poland. 81(Supplement 2) (pp 11-13), 2023. Date of
Publication: 2023.
Author
Blaziak M.; Urban S.; Jura M.; Wietrzyk W.; Szymanski O.; Grzesiak M.;
Florek K.; Jedrasek A.; Stanczykiewicz B.; Ptaszkowski K.; Kuliczkowski W.
Institution
(Blaziak, Jura, Grzesiak, Kuliczkowski) Instytut Chorob Serca,
Uniwersytecki Szpital Kliniczny we Wroclawiu, Wroclaw, Poland
(Blaziak, Urban, Jura, Wietrzyk, Szymanski, Florek, Jedrasek,
Stanczykiewicz, Ptaszkowski) Uniwersytet Medyczny im. Piastow Slaskich we
Wroclawiu, Wroclaw, Poland
(Urban, Kuliczkowski) Instytut Chorob Serca, Uniwersytet Medyczny im.
Piastow Slaskich we Wroclawiu, Wroclaw, Poland
Publisher
Via Medica
Abstract
Subsequent randomized controlled trials (RCTs) comparing clinical outcomes
of fractional flow reserve-guided (FFR) versus angiography-guided alone
revascularization among patients with coronary artery disease (CAD)
yielded inconsistent results. The aim of the study is to assess whether
FFR-guided revascularization reduce rate of clinical endpoints such as
all-cause mortality, myocardial infarction, unplanned revascularization
and major adverse cardiovascular event (MACE) in comparison with
angiography-guided alone revascularization. The study design was
registered in PROSPERO with the number CRD42023402326. A systematic review
was conducted through February 2023 in Embase, Clinicaltrials.gov,
Cochrane Library and in EBSCO. Further, the backward snowballing of the
included records was performed. The review was conducted following PRISMA
guidelines We included only RCTs of patients presenting stable CAD or
acute myocardial infarction treated with optimal medical therapy,
percutaneous coronary interventions or coronary artery bypass grafting.
The meta-analysis was performed by pooling the risk ratio (RR) using
random effects model and the heterogeneity and sensitivity of the results
were assessed in RevMan 5.4.1. Meta-regression analysis was performed to
assess the effect modification of revascularization rates and clinical
presentation (stable vs. acute) for MACE. Finally, 11 054 records were
screened for relevant studies. A total of 11 RCTs with 6145 patients were
included in the meta-analysis. There were no differences between
FFR-guided and angio-guided revascularization in MACE (RR, 0.88 [95% CI,
0.74-1.05]; P = 0.17), all-cause mortality (RR, 0.95 [95% CI, 0.61-1.49];
P = 0.83) MI (RR, 0.82 [95% CI, 0.63-1.08]; P = 0.15), unplanned
revascularization (RR, 0.86 [95% CI, 0.69-1.07]; P = 0.18). FFR guidance
was associated with a significantly lower rate of revascularization
(standardized mean difference = -0.14, [95% CI, -0.23, -0.05]; P = 0.002).
Meta-regression analysis did not show effect modification for the MACE
with stable CAD, acute coronary syndrome and rate of revascularization
during index procedure. FFR-driven revascularization among patients with
CAD did not impact on all-cause mortality, MI and unplanned
revascularization, but significantly reduce the rate of revascularization
in comparison with angiography alone guidance. (Figure Presented).

<22>
Accession Number
643159277
Title
Anticoagulation management in patients tested for heparin-induced
thrombocytopenia in the cardio-thoracic intensive care unit diverges from
expert guidelines.
Source
American Journal of Clinical Pathology. Conference: American Society for
Clinical Pathology Annual Meeting, ASCP 2023. Long Beach, CA United
States. 160(Supplement 1) (pp S139), 2023. Date of Publication: November
2023.
Author
Spies N.; Jackups R.; Zaydman M.
Institution
(Spies, Jackups, Zaydman) Department of Pathology & Immunology, Washington
University, St. Louis, MO, United States
Publisher
Oxford University Press
Abstract
Heparin-induced thrombocytopenia (HIT) is a rare, life-threatening
complication in patients receiving heparin products. Clinical scoring
tools, such as the '4T' score, aim to help identify patients at risk for
HIT and are recommended by expert guidelines. For example, the American
Society of Hematology (ASH) recommends that patients with an intermediate
or high-risk 4T score are presumptively treated for HIT by withdrawing
heparin and starting an alternative anticoagulant. At our institution,
laboratory HIT testing involves an in-house latex immunoassay (LIA) that,
if positive, reflexes to a send-out serotonin release assay (SRA) at the
Blood Center of Wisconsin. This confirmation may take several days to
result, underscoring the importance of presumptive treatment. Anecdotally,
we have observed that clinicians have expressed reservations about the use
of the 4T score in the cardiothoracic intensive care unit (CTICU). These
reservations may lead to increased HIT testing in patients with low 4T
scores and delays in the initiation of alternative anticoagulants. We set
out to objectively determine if clinical practice in the CTICU is aligned
with ASH guidelines. To do so, we used anticoagulant usage as a proxy for
medical decisions made at the time of order for HIT laboratory testing.
Data was extracted from the electronic medical records of all patients who
were admitted to the CTICU between 5/2018 and 7/2022 and administered a
heparin product (n = 1,602). Patients that were not tested for HIT (n =
1,449) were excluded. The remaining patients' (n = 153) medication record
timings were normalized such that the time of their first LIA was set to
zero to allow for relative comparisons. 25 (16%) of the LIAs were
positive, of which 5 (20%) were confirmed by SRA. Of the 153 patients, 136
(89%) received heparin within 24 hours prior to LIA order, while 6 (4%)
were already on alternative antico-agulation (bivalirudin). Of the
patients on heparin prior to LIA, 18 (13%) were switched to bivalirudin
upon LIA order, 66 (49%) had heparin discontinued without an alternative,
and 52 (39%) were continued on heparin. Our results suggest that the
prevalence of HIT in this cohort is 3.3% by SRA, much lower than the
expected pretest probability estimated for intermediate- and high-risk 4T
scores in published meta-analyses. In addition, the observed
anticoagulation practices varied widely and diverged from ASH guidelines,
where only 17% of patients were on alternative anticoagulation when the
testing was ordered. Future work will investigate these patterns across
LIA positivity and 4T scores while attempting to address the clinical
outcomes of these treatment decisions.

<23>
[Use Link to view the full text]
Accession Number
2029550341
Title
Dexmedetomidine Withdrawal Syndrome in Children in the PICU: Systematic
Review and Meta-Analysis.
Source
Pediatric Critical Care Medicine. 25(1) (pp 62-71), 2024. Date of
Publication: 01 Jan 2024.
Author
Knapp T.; Dileonardo O.; Maul T.; Hochwald A.; Li Z.; Hossain J.; Lowry
A.; Parker J.; Baker K.; Wearden P.; Nelson J.
Institution
(Knapp) University of Central Florida, College of Medicine, Orlando, FL,
United States
(Dileonardo) Department of Medical Education, Nemours Children's Health,
Orlando, FL, United States
(Maul, Lowry, Parker, Baker, Wearden, Nelson) Department of Cardiovascular
Services, Nemours Children's Health, Florida, Orlando, FL, United States
(Hochwald, Li) Division of Clinical Trials and Biostatistics, Mayo Clinic,
Jacksonville, FL, United States
(Hossain) Department of Biomedical Research, Nemours Children's Health,
Wilmington, DE, United States
(Nelson) Department of Surgery, University of Central Florida College of
Medicine, Orlando, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To systematically review literature describing the clinical
presentation, risk factors, and treatment for dexmedetomidine withdrawal
in the PICU (PROSPERO: CRD42022307178). DATA SOURCES: MEDLINE/PubMed,
Cochrane, Web of Science, and Scopus databases were searched. STUDY
SELECTION: Eligible studies were published from January 2000 to January
2022 and reported clinical data for patients younger than 21 years old
following discontinuation of dexmedetomidine after greater than or equal
to 24 hours of infusion. DATA EXTRACTION: Abstracts identified during an
initial search were screened and data were manually abstracted after
full-text review of eligible articles. The Newcastle-Ottawa Scale was used
to assess study quality. Summary statistics were provided and Spearman
rank correlation coefficient was used to identify relationships between
covariates and withdrawal signs. A weighted prevalence for each withdrawal
sign was generated using a random-effects model. DATA SYNTHESIS:
Twenty-three studies (22 of which were retrospective cohort studies)
containing 28 distinct cohorts were included. Median cumulative
dexmedetomidine exposure by dose was 105.95 mug/kg (range, 30-232.7
mug/kg), median dexmedetomidine infusion duration was 131.75 hours (range,
20.5-525.6 hr). Weighted estimates for proportion (95% CI) of subjects
experiencing withdrawal signs across all cohorts were: hypertension 0.34
(range, 0.0-0.92), tachycardia 0.26 (range, 0.0-0.87), and agitation 0.26
(range, 0.09-0.77). Meta-analysis revealed no correlation between
dexmedetomidine exposure variables and withdrawal signs. A moderate
negative monotonic relationship existed between the proportion of patients
who had undergone cardiac surgery and the proportion experiencing
hypertension (correlation coefficient, -0.47; p = 0.048) and tachycardia
(correlation coefficient, -0.57; p = 0.008), indicating that in cohorts
with a higher proportion of patients who were postcardiac surgery, there
were fewer occurrences of hypertension and or tachycardia.
<br/>CONCLUSION(S): On review of the 2000-2022 literature, dexmedetomidine
withdrawal may be characterized by tachycardia, hypertension, or
agitation, particularly with higher cumulative doses or prolonged
durations. Since most studies included in the review were retrospective,
prospective studies are needed to further clarify risk factors, establish
diagnostic criteria, and identify optimal management
strategies.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<24>
Accession Number
2029543859
Title
Effect of intubation in lateral position on placement of a double-lumen
tube in patients undergoing unilateral video-assisted thoracic surgery: a
randomied clinical trial.
Source
eClinicalMedicine. 67 (no pagination), 2024. Article Number: 102402. Date
of Publication: January 2024.
Author
Zhang X.; Wang D.; Zhang Z.; Tang Y.; Zhang Q.; Tong F.; Hu Y.; Lu X.; Liu
H.; Hu S.
Institution
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, Huzhou Central Hospital, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Affiliated Huzhou Hospital, Zhejiang University School of
Medicine, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Fifth School of Clinical Medicine of Zhejiang Chinese
Medical University, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Affiliated Central Hospital, Huzhou University, Huzhou,
China
(Zhang) Department of Anaesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Approximately one-third of patients who undergo double-lumen
tube (DLT) intubation in the conventional supine position experience DLT
malposition. No randomized study investigates the effect of DLT intubation
in the lateral position. We therefore aimed to evaluate the effect of
intubation in lateral position on placement of a DLT compared to supine
intubation, and to test primary hypothesis that lateral DLT intubation
could reduce the incidence of DLT malposition. <br/>Method(s): We randomly
allocated 108 patients undergoing video-assisted thoracic surgery to
receive DLT intubation in the comfortable and surgically required lateral
position (lateral group) or in the supine position (supine group) from
October to December 2022. The primary outcome was the incidence of DLT
malposition defined as movement >1.0 cm to correct the DLT position. The
secondary outcomes included intubation time, the frequency and duration of
fibreoptic bronchoscopy, the need for re-intubation, intra-operative vital
signs, and post-operative recovery. This trial is registered with the
Chinese Clinical Trial Registry (ChiCTR2200060794). <br/>Finding(s): The
incidence of DLT malposition was significantly lower in the lateral group
(1/53 [2%]) than that in the supine group (16/53 [30%]; RR [95% confidence
interval] of 0.06 [0.01-0.46]; P < 0.001). Lateral DLT intubation
decreased the intubation time, the frequency and duration of fibreoptic
bronchoscopy. The incidence of hypotension, post-operative sore throat,
and upper-arm discomfort was lower in the lateral group. Other secondary
outcomes were similar between groups. <br/>Interpretation(s): Lateral DLT
intubation reduced the incidence of DLT malposition for patients
undergoing video-assisted thoracic surgery. These results support that
lateral DLT intubation offers more benefits and may be a superior option
compared to conventional supine intubation. <br/>Funding(s): National
Natural Science Foundation of China and of Zhejiang
Province.<br/>Copyright &#xa9; 2023 The Author(s)

<25>
Accession Number
2029585969
Title
Non-ischaemic preservation of the donor heart in heart transplantation:
protocol design and rationale for a randomised, controlled, multicentre
clinical trial across eight European countries.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e073729. Date of
Publication: 28 Dec 2023.
Author
Brouckaert J.; Dellgren G.; Wallinder A.; Rega F.
Institution
(Brouckaert, Rega) Cardiac Surgery, University Hospitals Leuven, Leuven,
Belgium
(Dellgren) Cardiothoracic Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Wallinder) XVIVO Perfusion AB, Gothenburg, Sweden
Publisher
BMJ Publishing Group
Abstract
Introduction Ischaemic cold static storage (ICSS) is the gold standard in
donor heart preservation. This ischaemic time frame renders a time
constraint and risk for primary graft dysfunction. Cold oxygenated heart
perfusion, known as non-ischaemic heart preservation (NIHP), theoretically
limits the ischaemic time, while holding on to the known advantage of
hypothermia and cardioplegia, a low metabolic rate. Methods and analysis
The NIHP 2019 study is an international, randomised, controlled, open,
multicentre clinical trial in 15 heart transplantation centres in 8
European countries and includes 202 patients undergoing heart
transplantation, allocated 1:1 to NIHP or ICSS. Enrolment is estimated to
be 30 months after study initiation. The patients are followed for 12
months after transplantation. The primary objective is to evaluate the
effect of NIHP on survival, allograft function and rejection episodes
within the first 30 days after transplantation. The secondary objectives
are to compare treatment groups with respect to survival, allograft
function, cardiac biomarkers, rejection episodes, allograft vasculopathy,
adverse events and adverse device effects within 12 months. Ethics and
dissemination This protocol was approved by the Ethics Committee (EC) for
Research UZ/KU Leuven, Belgium, the coordinating EC in Germany (Bei Der
LMU Munchen), the coordinating EC in the UK (West Midlands - South
Birmingham Research), the EC of Hospital Puerta de Hierro, Madrid, Spain,
the EC of Goteborg, Sweden, the coordinating EC in France, the EC of
Padova, Italy and the EC of the University of Vienna, Austria. This study
will be conducted in accordance with current local regulations and
international applicable regulatory requirements according to the
principles of the Declaration of Helsinki and ISO14155:2020. Main primary
and secondary outcomes will be published on modified intention-to-treat
population and per-protocol population. Trial registration number
NCT03991923.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<26>
Accession Number
2029596346
Title
Effect of six month's treatment with omega-3 acid ethyl esters on
long-term outcomes after acute myocardial infarction: The OMEGA-REMODEL
randomized clinical trial.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131698. Date of Publication: 2024.
Author
Bernhard B.; Heydari B.; Abdullah S.; Francis S.A.; Lumish H.; Wang W.;
Jerosch-Herold M.; Harris W.S.; Kwong R.Y.
Institution
(Bernhard, Heydari, Abdullah, Jerosch-Herold, Kwong) Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Heydari) Stephenson Cardiac Imaging Center, University of Calgary,
Calgary, AB, Canada
(Abdullah) VA North Texas Medical Center and University of
Texas-Southwestern Medical School, Dallas, TX, United States
(Francis) Department of Cardiovascular Medicine, Maine Medical Center,
Portland, United States
(Lumish) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center, New York, NY, United States
(Wang) Division of Sleep Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Harris) Fatty Acid Research Institute, Sioux Falls, SD 57106, United
States
(Harris) Sanford School of Medicine, University of South Dakota, Sioux
Falls, SD 57105, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Omega-3 polyunsaturated fatty acids (O3-FA) have been shown to
reduce inflammation and adverse cardiac remodeling after acute myocardial
infarction (AMI). However, the impact of O3-FA on long-term clinical
outcomes remains uncertain. <br/>Aim(s): To investigate the impact of
O3-FA on adverse cardiac events in long-term follow up post AMI in a
pilot-study. <br/>Method(s): Consecutive patients with AMI were randomized
1:1 to receive 6 months of O3-FA (4 g/daily) or placebo in the
prospective, multicenter OMEGA-REMODEL trial. Primary endpoint was a
composite of major adverse cardiovascular events (MACE) encompassing
all-cause death, heart failure hospitalizations, recurrent acute coronary
syndrome, and late coronary artery bypass graft (CABG). <br/>Result(s): A
total of 358 patients (62.8% male; 48.1 +/- 16.1 years) were followed for
a median of 6.6 (IQR: 5.0-9.1) years. Among those receiving O3-FA (n =
180), MACE occurred in 65 (36.1%) compared to 62 (34.8%) of 178 assigned
to placebo. By intention-to-treat analysis, O3-FA treatment assignment did
not reduce MACE (HR = 1.014; 95%CI = 0.716-1.436; p = 0.938), or its
individual components. However, patients with a positive response to O3-FA
treatment (n = 43), defined as an increase in the red blood cell omega-3
index (O3[sbnd]I) >=5% after 6 months of treatment, had lower annualized
MACE rates compared to those without (2.9% (95%CI = 1.2-5.1) vs 7.1%
(95%CI = 5.7-8.9); p = 0.001). This treatment benefit persisted after
adjustment for baseline characteristics (HR<inf>adjusted</inf> = 0.460;
95%CI = 0.218-0.970; p = 0.041). <br/>Conclusion(s): In long-term
follow-up of the OMEGA-REMODEL randomized trial, O3-FA did not reduce MACE
after AMI by intention to treat principle, however, patients who achieved
a >= 5% increase of O3[sbnd]I subsequent to treatment had favorable
outcomes.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<27>
Accession Number
643174551
Title
Application of eHealth Tools in Anticoagulation Management After Cardiac
Valve Replacement: Scoping Review Coupled With Bibliometric Analysis.
Source
JMIR mHealth and uHealth. 12 (pp e48716), 2024. Date of Publication: 05
Jan 2024.
Author
Wu Y.; Wang X.; Zhou M.; Huang Z.; Liu L.; Cong L.
Institution
(Wu) Center for Moral Culture, Hunan Normal University, Changsha, China
(Wu, Wang, Zhou, Huang, Cong) School of Medicine, Hunan Normal University,
Changsha, China
(Liu) Teaching and Research Section of Clinical Nursing, Xiangya Hospital
of Central South University, Changsha, China
Abstract
BACKGROUND: Anticoagulation management can effectively prevent
complications in patients undergoing cardiac valve replacement (CVR). The
emergence of eHealth tools provides new prospects for the management of
long-term anticoagulants. However, there is no comprehensive summary of
the application of eHealth tools in anticoagulation management after CVR.
<br/>OBJECTIVE(S): Our objective is to clarify the current state, trends,
benefits, and challenges of using eHealth tools in the anticoagulation
management of patients after CVR and provide future directions and
recommendations for development in this field. <br/>METHOD(S): This
scoping review follows the 5-step framework developed by Arksey and
O'Malley. We searched 5 databases such as PubMed, MEDLINE, Web of Science,
CINAHL, and Embase using keywords such as "eHealth," "anticoagulation,"
and "valve replacement." We included papers on the practical application
of eHealth tools and excluded papers describing the underlying mechanisms
for developing eHealth tools. The search time ranged from the database
inception to March 1, 2023. The study findings were reported according to
the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses extension for Scoping Reviews). Additionally, VOSviewer
(version 1.6.18) was used to construct visualization maps of countries,
institutions, authors, and keywords to investigate the internal relations
of included literature and to explore research hotspots and frontiers.
<br/>RESULT(S): This study included 25 studies that fulfilled the
criteria. There were 27,050 participants in total, with the sample size of
the included studies ranging from 49 to 13,219. The eHealth tools mainly
include computer-based support systems, electronic health records,
telemedicine platforms, and mobile apps. Compared to traditional
anticoagulation management, eHealth tools can improve time in therapeutic
range and life satisfaction. However, there is no significant impact
observed in terms of economic benefits and anticoagulation-related
complications. Bibliometric analysis suggests the potential for increased
collaboration and opportunities among countries and academic institutions.
Italy had the widest cooperative relationships. Machine learning and
artificial intelligence are the popular research directions in
anticoagulation management. <br/>CONCLUSION(S): eHealth tools exhibit
promise for clinical applications in anticoagulation management after CVR,
with the potential to enhance postoperative rehabilitation. Further
high-quality research is needed to explore the economic benefits of
eHealth tools in long-term anticoagulant therapy and the potential to
reduce the occurrence of adverse events.<br/>Copyright &#xa9;Ying Wu,
Xiaohui Wang, Mengyao Zhou, Zhuoer Huang, Lijuan Liu, Li Cong. Originally
published in JMIR mHealth and uHealth (https://mhealth.jmir.org),
05.01.2024.

<28>
Accession Number
643174873
Title
Cardiac Manifestation of Rosai-Dorfman Disease: A Case Report and a
Systematic Review.
Source
The heart surgery forum. 26(6) (pp E896-E904), 2023. Date of Publication:
28 Dec 2023.
Author
Samadzadeh Tabrizi N.; Dogar M.H.; Wilkinson D.; Stout P.; Neragi-Miandoab
S.; Samy S.
Institution
(Samadzadeh Tabrizi) The Department of Cardiothoracic Surgery, Albany
Medical Center, Albany, NY 12208, USA. samadzn@amc.edu
(Dogar) The Department of Cardiology, SUNY Downstate Medical Center,
Brooklyn, NY 11202, USA. hassanmd@gmail.com
(Wilkinson) The Department of Cardiothoracic Surgery, Albany Medical
Center, Albany, NY 12208, USA. wilkind2@amc.edu
(Stout, Neragi-Miandoab, Samy) The Department of Cardiothoracic Surgery,
Albany Medical Center, Albany, NY 12208, USA
Abstract
BACKGROUND: Rosai-Dorfman disease is a rare condition that typically
presents as a nodal disease. Cardiac involvement is extremely uncommon,
occurring in 0.1-0.2% of cases, which has hindered our understanding. We
report a case of Rosai-Dorfman disease (RDD) related cardiac manifestation
in a patient without nodal involvement. Further, we conduct a
comprehensive review of the literature to consolidate data on how patients
with cardiac manifestations of RDD are typically managed and treated.
<br/>METHOD(S): A systematic review of PubMed, Web of Science, and Embase
was conducted to identify cases of RDD with cardiac involvement. Out of
464 studies identified, 42 publications encompassing 43 patients met the
criteria and were incorporated in this review. We gathered data on patient
demographics, as well as their management and treatment approaches.
Additionally, we share our own experience with a patient who presented
with a cardiac mass related to RDD. <br/>RESULT(S): Out of the 43
patients, only 20.9% (n = 9) had a documented history of RDD prior to
cardiac manifestations. Nodal involvement was reported in 32.6% (n = 14),
while extranodal extracardiac involvement was reported in 46.5% (n = 20).
Upon presentation, the most prevalent symptoms were dyspnea (48.8%, n =
21), chest discomfort (41.9%, n = 18), and lower extremity edema (16.3%, n
= 7). Cardiac manifestations were most frequently found in the right
atrium (41.9%, n = 18) and pericardium (18.6%, n = 8). Treatment
encompassed systemic medical therapy (34.9%, n = 15) and cardiac surgery
(39.5%, n = 17). The median follow-up period was 12 months (with a range
of 1 to 36), and 8 patients (18.6%) experienced mortality. Our patient,
who had a cardiac mass in the left atrium, underwent resection and has
remained symptom-free without any recurrence for the past 5 years.
<br/>CONCLUSION(S): The frequency of cardiac related-RDD manifestations
may be greater than initially perceived. These results underscore the
significance of identifying RDD and its cardiac-related presentations,
facilitating timely diagnosis and treatment for affected individuals.

<29>
Accession Number
2029536878
Title
Respect Versus Resect Approaches for Mitral Valve Repair: A Meta-Analysis
of Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. 213 (pp 5-11), 2024. Date of Publication:
15 Feb 2024.
Author
Caldonazo T.; Sa M.P.; Jacquemyn X.; Van den Eynde J.; Kirov H.; Harik L.;
Fischer J.; Vervoort D.; Bonatti J.; Sultan I.; Doenst T.
Institution
(Caldonazo, Kirov, Fischer, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital, Jena, Germany
(Sa, Bonatti, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sa, Bonatti, Sultan) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Harik) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York City, New York, United States
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) has been associated with superior long-term
survival and freedom from valve-related complications compared with mitral
valve replacement for primary mitral regurgitation (MR). The 2 main
approaches for MVr are chordal replacement ("respect approach") and
leaflet resection ("resect approach"). We performed a systematic review
and a meta-analysis using 3 search databases to compare the long-term end
points between both approaches. The primary end point was long-term
survival. The secondary end points were long-term MR recurrence and
reoperation. After reconstruction of time-to-event data for the individual
survival analysis, pooled Kaplan-Meier curves for the end points were
generated. A total of 14 studies (5,565 patients) were included in the
analysis. The respect approach was associated with superior survival
compared with the resect approach in the overall sample (hazard ratio [HR]
0.73, 95% confidence interval [CI] 0.56 to 0.96, p = 0.024, n = 3,901
patients) but not in the risk-adjusted sample (HR 1.00, 95% CI 0.55 to
1.82, p = 0.991, n = 620 patients). There was no difference between the
approaches in the rate of MR recurrence in the overall sample (HR 1.39,
95% CI 0.92 to 2.08, p = 0.116, n = 1,882 patients) or in the
risk-adjusted sample (HR 1.62, 95% CI 0.76 to 3.47, p = 0.211, n = 288
patients). The data for reoperation were only available in the overall
sample and did not reveal a difference (HR 0.92, 95% CI 0.62 to 1.35, p =
0.663, n = 3,505 patients). In conclusion, the current evidence suggests
no difference in long-term mortality, MR recurrence, or reoperation
between the resect and respect approaches for MVr after adjusting for
patient risk factors. More long-term follow-up data are
warranted.<br/>Copyright &#xa9; 2023 The Author(s)

<30>
Accession Number
2029529947
Title
Atrial fibrillation therapy and stroke prevention in hemodialysis
patients.
Source
Kardiologia Polska. 81(12) (pp 1193-1204), 2023. Date of Publication:
2023.
Author
Melenovsky V.; Osmancik P.
Institution
(Melenovsky, Osmancik) Department of Cardiology, Kralovske Vinohrady
University Hospital, Prague, Czechia
(Melenovsky, Osmancik) Department of Cardiology, 3rd Faculty of Medicine,
Charles University, Prague, Czechia
Publisher
Via Medica
Abstract
The prevalence of atrial fibrillation (AF) in patients with chronic kidney
disease (CKD), especially on hemodialysis (HD) is higher compared to the
general population without CKD and reaches ~20%. The risk of ischemic
stroke in CKD patients is also significantly increased. However, since the
risk of bleeding is also significantly increased in CKD patients and the
number of bleeding events exceeds the number of thrombotic events, there
are great concerns regarding the routine use of anticoagulation in this
patient population. No randomized studies were performed to compare
anticoagulation with placebo in patients with advanced CKD and AF. This
lack of knowledge is reflected in international guidelines which refrain
from clear recommendations. The use of anticoagulation for stroke
prevention in HD patients with AF should be strictly individualized for
each patient. Anticoagulation for stroke prevention in HD patients with AF
seems justified only in selected patients with high stroke and low
bleeding risk. Reduced-dose direct oral anticoagulants (especially
apixaban) may prove beneficial. In patients with high thrombotic and
bleeding risk, left atrial appendage closure could be considered. In this
article, the results of the most relevant observational studies with
anticoagulation in CKD/HD patients with AF have been presented and
discussed. Furthermore, results of randomized studies comparing vitamin K
antagonists with non-vitamin K antagonists in CKD patients have been
discussed in detail. Finally, ongoing randomized studies with reduced
doses of apixaban, factor XI inhibitors, and left atrial appendage closure
in CKD patients are mentioned. A brief summary of rhythm control
strategies in AF is given.<br/>Copyright by the Author(s), 2023.

<31>
Accession Number
2027315833
Title
Evidence-based Practice Interventions for Reducing Postoperative Pulmonary
Complications: A Narrative Review.
Source
Open Respiratory Medicine Journal. 17 (no pagination), 2023. Article
Number: e18743064271499. Date of Publication: 2023.
Author
Dhillon G.; Buddhavarapu V.S.; Grewal H.; Munjal R.; Verma R.K.; Surani
S.; Kashyap R.
Institution
(Dhillon) Department of Internal Medicine, University of Maryland
Baltimore Washington Medical Center, Glen Burnie, MD, United States
(Buddhavarapu) Banner Baywood Medical Center, Banner Health, Mesa, AZ,
United States
(Grewal) Radiology Associates of Florida, Pensacola, FL, United States
(Munjal) Touro University College of Osteopathic Medicine, CA, United
States
(Verma) Department of Sleep Medicine, Parkview Health System, Fort Wayne,
IN, United States
(Surani) Department of Anesthesiology and Critical Care Medicine, Mayo
Clinic, Rochester, MN, United States
(Surani, Kashyap) Texas A&M, College Station, TX, United States
(Kashyap) Department of Research, WellSpan Health, York, PA, United States
Publisher
Bentham Science Publishers
Abstract
Background: Specific surgical procedures, such as upper abdominal and
thoracic surgery, are connected to an increased predisposition of
postoperative pulmonary complications (PPCs). The incidence of PPCs could
vary approximately between 20-90% with upper abdominal surgery, which can
be minimized by using treatment procedures that increase lung capacity and
encourage inspiration. This review aims to examine the effectiveness of
already existing evidence-based interventions that promote lung expansion,
thereby preventing PPCs. <br/>Method(s): We mainly focused on the existing
evidence of preoperative education on the incentive spirometer, early
mobilization, directed coughing, deep breathing exercises, chest
physiotherapy, and inspiratory muscle training (IMT) to prevent PPCs. The
literature search was limited to experimental, observational studies,
systemic reviews, and articles published in the last 15 years, January
2007-Dec. 2022, in PubMed and Google Scholar. <br/>Result(s): This initial
search yielded a total of 5301 articles. All articles with titles not
related to the topic were eliminated. 1050 records were screened, and the
final review was conducted with 22 articles, including 13 randomized
controlled trials (RCTs), four systemic reviews, one retrospective review,
three observational studies, and one non-experimental study. Our review
reveals mixed evidence for individual interventions, including but not
limited to incentive spirometry, inspiratory muscle training, early
mobilization, cough, deep breathing, etc. Some studies maintain that
intervention is effective; others imply there is no substantial difference
in the choice of intervention. <br/>Conclusion(s): The literature review
concluded that patients who received multiple interventions showed
significant improvement in pulmonary function postoperatively. However,
definitive studies need to be conducted to solidify this
conclusion.<br/>Copyright &#xa9; 2023 The Author(s).

<32>
Accession Number
643164995
Title
Remnant Cholesterol and Intensive Blood Pressure Control in Older Patients
with Hypertension: A Post hoc Analysis of the STEP Randomized Trial.
Source
European journal of preventive cardiology. (no pagination), 2024. Date of
Publication: 03 Jan 2024.
Author
Yang R.; Zhang J.; Yu X.; Yang G.; Cai J.
Institution
(Yang, Cai) Hypertension Center, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of
Medical Sciences, Beilishi Road 167, Xicheng District, Beijing 100037,
China
(Zhang) Center for Hypertension Care, First Hospital of Shanxi Medical
University, No. 85 Jiefang South RoadShanxi province, Taiyuan 030001,
China
(Yu) Department of Cardiology, Benxi Railway Hospital, Pingshan District,
No. 25 Yingchun streetLiaoning Province, Benxi 117000, China
(Yang) Institute of Prevention and Treatment of Cardiovascular Diseases in
Alpine Environment of Plateau, Characteristic Medical Center of the
Chinese People's Armed Police Forces, No. 220 Chenglin Road, Tianjin
300162, China
Abstract
AIMS: Emerging evidence shows a close relationship between remnant
cholesterol (RC) and hypertension. However, it is unknown whether RC is
associated with the effects of intensive systolic blood pressure (SBP)
lowering on cardiovascular outcomes. <br/>METHOD(S): We performed a
post-hoc analysis of the Strategy of Blood Pressure Intervention in the
Elderly Hypertensive Patients (STEP) trial. Participants were randomly
allocated to intensive (110 to <130 mmHg) or standard (130 to <150 mmHg)
treatment groups. The effects of intensive SBP lowering on the primary
composite outcome (stroke, acute coronary syndrome, acute decompensated
heart failure, coronary revascularization, atrial fibrillation or
cardiovascular death), the components thereof and all-cause mortality were
analyzed by tertile of baseline RC (lowest, middle, highest).
<br/>RESULT(S): We followed 8,206 patients for 3.33 years (median). The
adjusted hazard ratios (95% confidence interval) for the primary outcome
were 1.06 (0.73-1.56), 0.58 (0.38-0.87) and 0.67 (0.46-0.96) in the
lowest, middle and highest RC tertiles, respectively (P for
interaction=0.11). However, significant heterogeneity in the treatment
effects was observed when comparing the upper two tertiles with the lowest
tertile (P for interaction=0.033). For all-cause mortality, the adjusted
hazard ratios (95% confidence interval) were 2.48 (1.30-4.73), 1.37
(0.71-2.65) and 0.42 (0.22-0.80) in the lowest, middle and highest RC
tertiles, respectively (P for interaction<0.0001). <br/>CONCLUSION(S):
Baseline RC concentrations were associated with the effects of intensive
SBP lowering on the primary composite cardiovascular outcome and all-cause
mortality in hypertensive patients. These results are
hypothesis-generating and merit further study. REGISTRATION: STEP
ClinicalTrials.gov number, NCT03015311.<br/>Copyright &#xa9; The Author(s)
2024. 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.

<33>
Accession Number
643169152
Title
Post-sternotomy movement strategies in adults: a scoping review.
Source
European journal of cardiovascular nursing. (no pagination), 2024. Date
of Publication: 02 Jan 2024.
Author
Wiens K.; Hayden K.A.; Park L.; Colwell S.; Coltman C.; King-Shier K.M.
Institution
(Wiens, King-Shier) Faculty of Nursing, University of Calgary, 2500
University Dr NW, Calgary, AB T2N 1N4, Canada
(Wiens, Park, Colwell, Coltman) Foothills Medical Center, Alberta Health
Services, 1403 29 St NW, Calgary, AB T2N 2T9, Canada
(Wiens, Park, Colwell, Coltman, King-Shier) Libin Cardiovascular Institute
of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N
4N1, Canada
(Hayden) Libraries and Cultural Resources, University of Calgary, 2500
University Dr NW, Calgary, AB T2N 1N4, Canada
(King-Shier) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB T2N
1N4, Canada
Abstract
AIMS: Post-sternotomy movement strategies for adults should be an
evidence-informed approach and support a safe, independent return to daily
activity. Recent new movement strategies have emerged. The aim of this
scoping review was to identify and summarize the available evidence for
post-sternotomy movement strategies in adults. METHODS AND RESULTS: The
electronic databases searched included MEDLINE, Embase, Sport Discus,
CINAHL, Academic Search Complete, the Cochrane Library, Scopus, and PEDro.
The search did not have a date limit. After 2405 duplicates were removed,
2978 records were screened, and 12 were included; an additional 2 studies
were identified through reference searching for a total of 14 included
studies. A data extraction table was used, and the findings are summarized
in a tabular and narrative form. Three post-sternotomy movement strategies
were identified in the literature: sternal precautions (SP), modified SP,
and Keep Your Move in the Tube (KYMITTTM). The authors suggested that the
practice of SP was based on expert opinion and not founded in evidence.
However, the evidence from the identified articles suggested that new
movement strategies are safe and allow patients to choose an increased
level of activity that promotes improved functional status and confidence.
<br/>CONCLUSION(S): More prospective cohort studies and multi-centred
randomized control trials are needed; however, the current evidence
suggests that modified SP and KYMITTTM are as safe as SP and can promote a
patient-centred approach. REGISTRATION: University of Calgary's Digital
Repository PRISM http://hdl.handle.net/1880/115439.<br/>Copyright &#xa9;
The Author(s) 2024. 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.

<34>
Accession Number
2027792011
Title
Systematic review and meta-analysis comparing Manta device and Perclose
device for closure of large bore arterial access.
Source
Journal of Vascular Access. (no pagination), 2024. Date of Publication:
2024.
Author
Cheema T.; Venero C.; Champaneria S.; Younas S.; Hadeed Khan M.A.; Anjum
I.; Ijaz U.; Haider S.; Akbar M.S.; Abdul-Waheed M.; Saleem S.
Institution
(Cheema) West Suburban Medical Center, Oak Park, IL, United States
(Venero, Champaneria, Haider, Akbar, Abdul-Waheed, Saleem) University of
Kentucky College of Medicine, Lexington, KY, United States
(Younas, Ijaz) Khyber Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Hadeed Khan) Peshawar Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Anjum) Vassar Brothers Medical Center, Poughkeepsie, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Data comparing MANTA device with Perclose device for large bore arterial
access closure is limited. We performed meta-analysis to compare safety
and efficacy of the two devices in large (14 Fr sheath) arteriotomy
closure post-TAVR. Relevant studies were identified via PubMed, Cochrane,
and EMBASE databases until June, 2022. Data was analyzed using random
effect model to calculate relative odds of VARC-2 defined access-site
complications and short-term (in-hospital or 30-day) mortality. A total of
12 studies (2 RCT and 10 observational studies) comprising 2339 patients
were included. The odds of major vascular complications (OR 0.99, 95% CI
0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI
0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI
0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p =
0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma
formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis,
occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and
short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both
devices were similar. MANTA device has a similar efficacy and safety
profile compared to Perclose device.<br/>Copyright &#xa9; The Author(s)
2024.

<35>
Accession Number
643175099
Title
Efficacy and safety of colchicine for the prevention of postoperative
atrial fibrillation among patients undergoing major cardiothoracic
surgery: a meta-analysis and meta-regression of randomized controlled
trials.
Source
Journal of cardiovascular pharmacology. (no pagination), 2023. Date of
Publication: 28 Dec 2023.
Author
Rivera F.B.; Cha S.W.; Aparece J.P.; Jariyatamkitti S.; Mamas M.
Institution
(Rivera) Lincoln Medical Center, (NY), NY, United States
(Cha) Cebu Institute of Medicine, Cebu City, Philippines
(Aparece) Texas Tech University Health Sciences Center, El Paso, TX,
United States
(Jariyatamkitti) Makarak Hospital, Kanchanaburi, Thailand
(Mamas) Keele Cardiovascular Research Group, Center for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
Abstract
The role of colchicine for the prevention of postoperative atrial
fibrillation (POAF) following cardiothoracic surgery is not
well-established. We aimed to evaluate its potential in preventing POAF
using data from randomized controlled trials (RCTs). A literature search
was performed to identify studies reporting POAF as an outcome after
cardiac or thoracic surgery in adult patients randomized to either
colchicine or placebo. Primary outcome measured was incidence of POAF.
Secondary outcomes included gastrointestinal (GI) adverse effects, sepsis,
and length of stay (LOS). Subgroup analyses based on treatment durations
and type of surgery were also performed, as well as regression analyses to
control for covariates. We identified a total of 5,377 patients
(colchicine = 2,689, placebo = 2,688). While colchicine use was associated
with a significantly reduced risk for POAF, risk for GI adverse effects
were significantly higher. Rates of infection and LOS were similar across
the groups. Subgroup analyses showed that colchicine was effective for
POAF prevention in cardiac surgery but not in thoracic surgery. Prevention
of PAOF and incidence of GI adverse effects were similar in short-term and
long-term colchicine treatment. Colchicine significantly reduces the
incidence of POAF in patients undergoing cardiac surgery, but not in
thoracic surgery.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<36>
Accession Number
2027724402
Title
Effects of individualized positive end-expiratory pressure on
intraoperative oxygenation in thoracic surgical patients: study protocol
for a prospective randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 19. Date of
Publication: December 2024.
Author
Liu X.-M.; Chang X.-L.; Sun J.-Y.; Hao W.-W.; An L.-X.
Institution
(Liu, Chang, Sun, Hao, An) Department of Anesthesiology, Beijing
Friendship Hospital, Capital Medical University, No. 95 Yongan Road,
Xicheng District, Beijing 100050, China
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypoxemia and postoperative pulmonary
complications (PPCs) often occur in patients with one-lung ventilation
(OLV), due to both pulmonary shunt and atelectasis. It has been
demonstrated that individualized positive end-expiratory pressure (iPEEP)
can effectively improve intraoperative oxygenation, increase lung
compliance, and reduce driving pressure, thereby decreasing the risk of
developing PPCs. However, its effect during OLV is still unknown.
Therefore, we aim to investigate whether iPEEP ventilation during OLV is
superior to 5 cmH<inf>2</inf>O PEEP in terms of intraoperative oxygenation
and the occurrence of PPCs. <br/>Method(s): This study is a prospective,
randomized controlled, single-blind, single-center trial. A total of 112
patients undergoing thoracoscopic pneumonectomy surgery and OLV will be
enrolled in the study. They will be randomized into two groups: the static
lung compliance guided iPEEP titration group (Cst-iPEEP Group) and the
constant 5 cmH<inf>2</inf>O PEEP group (PEEP 5 Group). The primary outcome
will be the oxygenation index at 30 min after OLV and titration. Secondary
outcomes are oxygenation index at other operative time points, PPCs,
postoperative adverse events, ventilator parameters, vital signs, pH
value, inflammatory factors, and economic indicators. <br/>Discussion(s):
This trial explores the effect of iPEEP on intraoperative oxygenation
during OLV and PPCs. It provides some clinical references for optimizing
the lung protective ventilation strategy of OLV, improving patient
prognosis, and accelerating postoperative rehabilitation. Trial
registration: www.Chictr.org.cn ChiCTR2300073411 . Registered on 10 July
2023.<br/>Copyright &#xa9; 2023, The Author(s).

<37>
Accession Number
2029463858
Title
Health Status After Transcatheter Tricuspid-Valve Repair in Patients With
Severe Tricuspid Regurgitation.
Source
Journal of the American College of Cardiology. 83(1) (pp 1-13), 2024. Date
of Publication: 02 Jan 2024.
Author
Arnold S.V.; Goates S.; Sorajja P.; Adams D.H.; von Bardeleben R.S.;
Kapadia S.R.; Cohen D.J.
Institution
(Arnold) Saint Luke's Mid America Heart Institute and University of
Missouri-Kansas City, Kansas City, MO, United States
(Goates) Abbott, Sylmar, CA, United States
(Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Adams) Mount Sinai Health System, New York, NY, United States
(von Bardeleben) University Medical Center of Mainz, Mainz, Germany
(Kapadia) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: In the TRILUMINATE Pivotal (Trial to Evaluate Cardiovascular
Outcomes in Patients Treated with the Tricuspid Valve Repair System
Pivotal), tricuspid transcatheter edge-to-edge repair (T-TEER) reduced
tricuspid regurgitation (TR) and improved health status compared with
medical therapy alone with no benefit on heart failure hospitalizations or
survival. <br/>Objective(s): The purpose of this study was to better
understand the health status benefits of T-TEER within the TRILUMINATE
Pivotal trial. <br/>Method(s): TRILUMINATE randomized patients with severe
TR to T-TEER (n = 175) or medical therapy (n = 175). Health status was
assessed at baseline and at 1, 6, and 12 months with the Kansas City
Cardiomyopathy Questionnaire (KCCQ) (range 0-100; higher = better), which
was compared between treatment groups using mixed effects linear
regression. Alive and well was defined as KCCQ overall summary score >=60
and no decline from baseline of >10 points at 1 year. <br/>Result(s):
Compared with medical therapy, T-TEER significantly improved health status
at 1 month (mean between-group difference in KCCQ overall summary score
9.4 points; 95% CI: 5.3-13.4 points), with a small additional improvement
at 1 year (mean between-group difference 10.4 points; 95% CI: 6.3-14.6
points). T-TEER patients were more likely to be alive and well at 1 year
(T-TEER vs medical therapy: 74.8% vs 45.9%; P < 0.001), with a number
needed to treat of 3.5. Interaction analyses demonstrated that the benefit
of T-TEER diminished as baseline KCCQ overall summary score increased
(P<inf>int</inf> < 0.001). Exploratory analyses suggested that much of the
health status benefit of T-TEER could be explained by TR reduction and
that improvement in health status after T-TEER was strongly correlated
with reduced 1-year mortality and heart failure hospitalization.
<br/>Conclusion(s): T-TEER with the TriClip system resulted in substantial
and sustained health status improvement in patients with severe TR
compared with medical therapy alone.<br/>Copyright &#xa9; 2024 The Authors

<38>
Accession Number
2029329079
Title
Is single-catheter technique for coronary angiography an optimal tool for
beginners in interventional cardiology?-randomized controlled study TRACT
2: Transradial Coronary Angiography Trial 2.
Source
Cardiovascular Diagnosis and Therapy. 13(6) (pp 1019-1029), 2023. Date of
Publication: December 2023.
Author
Chyrchel M.; Bartus S.; Piechocki M.; Gladys K.; Januszek R.; Surdacki A.;
Rzeszutko L.
Institution
(Chyrchel, Bartus, Januszek, Surdacki, Rzeszutko) Department of Cardiology
and Cardiovascular Interventions, University Hospital, Krakow, Poland
(Chyrchel, Bartus, Surdacki, Rzeszutko) Second Department of Cardiology,
Faculty of Medicine, Institute of Cardiology, Jagiellonian University
Medical College, Krakow, Poland
(Piechocki, Gladys) Students' Scientific Group, Second Department of
Cardiology, Jagiellonian University Medical College, Krakow, Poland
(Januszek) Faculty of Medicine and Health Sciences, Andrzej Frycz
Modrzewski Cracow University, Krakow, Poland
Publisher
AME Publishing Company
Abstract
Background: Transradial coronary angiography can be performed using a
dual-catheter technique (DCT) or single-catheter technique (SCT). The
current study aimed to compare DxTerity SCT Ultra and the Trapease curve
SCT catheters with DCT catheters in procedures performed by young, less
experienced, interventional cardiologists. <br/>Method(s): For this
prospective, single-blinded, randomized study 107 were enrolled and
assigned to 1 of 3 groups. They underwent planned coronary angiography at
the Second Department of Cardiology Jagiellonian University in Krakow. In
groups 1 (n=37) and 2 (n=35), DxTerity SCT Ultra catheters and the
Trapease curve were used, respectively. In control group 3 (n=35),
standard DCT Judkins catheters were applied. One patient was excluded from
group 2, bringing the total number of cases analysed to 106. The study
endpoints comprised the percentage of optimal stability, proper ostial
artery engagement, a good quality angiogram, the duration of each
procedure stage, the amount of contrast and the radiation dose.
<br/>Result(s): The highest percentage of optimal stability was observed
in group 1 for the right coronary artery (RCA): 94%, and in group 3, for
the left coronary artery (LCA): 85%. The necessity to change the catheter
was most common in group 2. Group 1 was characterised by a shorter total
procedural time. The contrast volume was higher in group 2, while there
were no differences in radiation dose. <br/>Conclusion(s): SCT is at least
as adequate as DCT for young cardiologists. SCT was associated with lower
necessity of catheter exchange during RCA visualization. The DxTerity
Ultra curve catheter allows shortening the total procedure
time.<br/>Copyright &#xa9; 2023 AME Publishing Company. All rights
reserved.

<39>
Accession Number
2029145406
Title
Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for
Left Atrial Appendage Occlusion: a multicentre randomized controlled
trial.
Source
Europace. 25(12) (no pagination), 2023. Article Number: euad349. Date of
Publication: 01 Dec 2023.
Author
Hu F.; Xu B.; Qiao Z.; Cheng F.; Zhou Z.; Zou Z.; Zang M.; Ding S.; Hong
J.; Xie Y.; Zhou Y.; Huang J.; Pu J.
Institution
(Hu, Xu, Qiao, Cheng, Zhou, Zou, Zang, Ding, Xie, Zhou, Huang, Pu)
Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai
Jiao Tong University, 160# PuJian Road, Shanghai 200127, China
(Hong, Xie) Department of Cardiology, Ningbo Hangzhou Bay Hospital,
Zhejiang, Ningbo, China
(Zhou) Department of Cardiology, Punan Hospital, Pudong New District,
Shanghai, China
(Huang) Department of Cardiology, Dachang Hospital, Baoshan District,
Shanghai, China
Publisher
Oxford University Press
Abstract
Aims This study was performed to compare the usability, efficiency, and
safety of a modified angioplasty guidewire-assisted transseptal puncture
(TSP) technique vs. the conventional approach in facilitating access into
the left atrium during left atrial appendage occlusion (LAAO) procedures
for the treatment of atrial fibrillation. Methods The ADVANCE-LAAO trial
(Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for
Left Atrial and ^results Appendage Occlusion) was an
investigator-initiated, prospective, multicentre, randomized controlled
trial (NCT05125159). Patients with atrial fibrillation who underwent LAAO
were prospectively enrolled from four centres and randomly assigned to an
angioplasty guidewire-assisted TSP group (n = 131) or to a conventional
Brockenbrough needle TSP group (n = 132). The primary endpoint was the
one-time success rate of TSP. We also analysed the TSP procedure time,
failure rate of the assigned TSP type, radiation dose, contrast dose, and
procedural complications in both groups. All patients in the
guidewire-assisted group underwent successful TSP, whereas five in the
standard conventional group switched to the guidewire-assisted approach.
The guidewire-assisted puncture improved the one-time success rate (92.4
vs. 77.3%, P = 0.001), shortened the TSP procedure time (109.2 +/- 48.2
vs. 120.5 +/- 57.6 s, P = 0.023), and tended to have a higher rate of good
coaxial orientation of the sheath with the left atrial appendage during
the LAAO procedure (66.4 vs. 54.5%, P = 0.059). No TSP-related
complications occurred in the guidewire-assisted TSP group, whereas two
complications occurred in the conventional TSP group. There was no
significant difference in the failure rate of the assigned TSP type, the
total procedure time, the total radiation dose, the rate of successful
LAAO implantation, or the procedural complication rate between the two
groups (all P > 0.05). ^Conclusion This study confirmed that
angioplasty guidewire-assisted puncture can effectively improve the
success rate of TSP during LAAO procedures. This novel technique has high
potential for application in interventional therapies requiring
TSP.<br/>Copyright &#xa9; The Author(s) 2023.

<40>
Accession Number
2027736322
Title
Considering alternatives to transcatheter heart valves for managing
patients with severe aortic valve stenosis.
Source
Expert Review of Medical Devices. (no pagination), 2024. Date of
Publication: 2024.
Author
Elzomor H.; Elkoumy A.; Hothi S.S.; Soliman O.
Institution
(Elzomor, Elkoumy, Soliman) Department of Cardiology, Saolta Group, Galway
University Hospital, Galway, Ireland
(Elzomor, Elkoumy, Soliman) CORRIB Core Lab, University of Galway, Galway,
Ireland
(Elzomor, Elkoumy, Soliman) Islamic Center of Cardiology, Al-Azhar
University, Nasr City, Cairo, Egypt
(Elzomor, Elkoumy) CURAM, SFI Research Centre for Medical Devices, Galway,
Ireland
(Elzomor, Hothi, Soliman) Department of Cardiology, Royal Wolverhampton
NHS Trust, Wolverhampton, United Kingdom
(Hothi) College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Hothi) Centre for Sport, Exercise and Life Sciences, Coventry University,
Coventry, United Kingdom
(Soliman) Euro Heart Foundation, Rotterdam, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is becoming
the standard of care for severe symptomatic aortic stenosis (AS). Yet,
some patients with AS are not indicated/eligible for TAVI. Several
noninvasive, catheter-based or surgical alternatives exist, and other
therapeutic options are emerging. Areas covered: This review provides an
overview of non-TAVI options for severe AS. Non-invasive, transcatheter,
and alternative surgical strategies are discussed, emphasizing their
backgrounds, techniques, and outcomes. Expert opinion: Alternative
therapies to TAVI, whether device-based or non-device-based, continue to
evolve or emerge and provide either alternative treatments or a bridge to
TAVI, for patients not meeting indications for, or having
contraindications to TAVI. Although TAVI and SAVR are the current dominant
therapies, there are still some patients that could benefit in the future
from other alternatives. Data on alternative options for such patients are
scarce. Many advantages and disadvantages arise when selecting a specific
treatment strategy for individual patients. Head-to-head comparison
studies could guide physicians toward better patient selection and
procedural planning. Awareness of therapeutic options, indications,
techniques, and outcomes should enable heart teams to achieve optimized
patient selection. Furthermore, it can increase the use of these
alternatives to optimize the management of AS among different patient
populations.<br/>Copyright &#xa9; 2024 Informa UK Limited, trading as
Taylor & Francis Group.

<41>
Accession Number
2027694850
Title
Factors Influencing Unfractionated Heparin Pharmacokinetics and
Pharmacodynamics During a Cardiopulmonary Bypass.
Source
Clinical Pharmacokinetics. (no pagination), 2024. Date of Publication:
2024.
Author
Gibert A.; Lanoiselee J.; Gouin-Thibault I.; Pontis A.; Azarnoush K.;
Petrosyan A.; Grand N.; Molliex S.; Morel J.; Gergele L.; Hodin S.; Bin
V.; Chaux R.; Delavenne X.; Ollier E.
Institution
(Gibert, Lanoiselee, Hodin, Bin, Chaux, Delavenne, Ollier) INSERM, U1059,
Dysfonction Vasculaire et Hemostase, 20 Rue Camelinat, Saint-Etienne
42000, France
(Lanoiselee, Grand, Molliex, Morel, Gergele) Departement
d'Anesthesie-Reanimation, CHU de Saint-Etienne, Saint-Etienne, France
(Gouin-Thibault, Pontis) Laboratory of Hematology, Pontchaillou,
University Hospital of Rennes, University of Rennes, Inserm, EHESP, Irset
(Institut de Recherche en Sante, Environnement et Travail)-UMR_S 1085,
Rennes, France
(Azarnoush, Petrosyan) Service de Chirurgie Cardiaque, CHU de
Saint-Etienne, Saint-Etienne, France
(Chaux, Ollier) Unite de Recherche Clinique Innovation et Pharmacologie,
CHU de Saint-Etienne, Saint-Etienne, France
(Delavenne) Laboratoire de Pharmacologie Toxicologie Gaz du sang, CHU de
Saint-Etienne, Saint-Etienne, France
Publisher
Adis
Abstract
Background: Unfractionated heparin (UFH) is commonly used during cardiac
surgery with a cardiopulmonary bypass to prevent blood clotting. However,
empirical administration of UFH leads to variable responses.
Pharmacokinetic and pharmacodynamic modeling can be used to optimize UFH
dosing and perform real-time individualization. In previous studies, many
factors that could influence UFH pharmacokinetics/pharmacodynamics had not
been taken into account such as hemodilution or the type of UFH. Few
covariates were identified probably owing to a lack of statistical power.
This study aims to address these limitations through a meta-analysis of
individual data from two studies. <br/>Method(s): An individual patient
data meta-analysis was conducted using data from two single-center
prospective observational studies, where different UFH types were used for
anticoagulation. A pharmacodynamic/pharmacodynamic model of UFH was
developed using a non-linear mixed-effects approach. Time-varying
covariates such as hemodilution and fluid infusions during a
cardiopulmonary bypass were considered. <br/>Result(s): Activities of
UFH's anti-activated factor/anti-thrombin were best described by a
two-compartment model. Unfractionated heparin clearance was influenced by
body weight and the specific UFH type. Volume of distribution was
influenced by body weight and pre-operative fibrinogen levels.
Pharmacodynamic data followed a log-linear model, accounting for the
effect of hemodilution and the pre-operative fibrinogen level. Equations
were derived from the model to personalize UFH dosing based on the
targeted activated clotting time level and patient covariates.
<br/>Conclusion(s): The population model effectively characterized UFH's
pharmacokinetics/pharmacodynamics in cardiopulmonary bypass patients. This
meta-analysis incorporated new covariates related to UFH's
pharmacokinetics/pharmacodynamics, enabling personalized dosing regimens.
The proposed model holds potential for individualization using a Bayesian
estimation.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<42>
Accession Number
2023176109
Title
A Systematic Review and Meta-Analysis of Influences of Chronic Kidney
Disease on Patients after Percutaneous Coronary Intervention for Chronic
Total Occlusions.
Source
Computational and Mathematical Methods in Medicine. 2023 (no pagination),
2023. Article Number: 9450752. Date of Publication: 2023.
Author
Wu W.; Gao M.; Wu X.
Institution
(Wu, Gao, Wu) Department of Nephrology, Huzhou Central Hospital,
Affiliated Central Hospital Huzhou University, No. 1558, Sanhuan North
Road, Wuxing District, Zhejiang, Huzhou 313000, China
Publisher
Hindawi Limited
Abstract
Objective. Chronic kidney disease (CKD) is a clinical collective term for
kidney disease with glomerular filtration rate GFR<60 mL/min for more than
three months due to various factors and is usually associated with
coronary heart disease and is also an independent risk factor for coronary
heart disease. This study is aimed at systematically reviewing the
influence of CKD on the outcomes of patients after percutaneous coronary
intervention (PCI) for chronic total occlusions (CTOs). Methods. The
Cochrane Library, PubMed, Embase, China biomedical literature database
(SinoMed), China National Knowledge Infrastructure, and Wanfang database
were searched for case-control studies on the influence of CKD on outcomes
after PCI for CTOs. After screening the literature, extracting data, and
evaluating the quality of literature, RevMan 5.3 software was used for
meta-analysis. Results. There were 11 articles with a total of 558,440
patients included. Meta-analysis results indicated that left ventricular
ejection fraction (LVEF) level, diabetes, smoking, hypertension, coronary
artery bypass grafting, angiotensin converting enzyme inhibitor
(ACEI)/angiotensin receptor blocker (ARB), beta-blockers, age, and renal
insufficiency were the factors affecting outcomes after PCI for CTOs [risk
ratio and 95% confidence interval were: 0.88 (0.86, 0.90), 0.96 (0.95,
0.96), 0.76 (0.59, 0.98), 1.39 (0.89, 2.16), 0.73 (0.38, 1.40), 0.24
(0.02, 3.9), 0.78 (0.77, 0.79), 0.81 (0.80, 0.82), and 1.50 (0.47, 4.79)].
Conclusion. LVEF level, diabetes, smoking, hypertension, coronary artery
bypass grafting, ACEI/ARB, beta-blockers, age, renal insufficiency, etc.
are important risk factors for outcomes after PCI for CTOs. Controlling
these risk factors is of great significance for the prevention, treatment,
and prognosis of CKD.<br/>Copyright &#xa9; 2023 Weifei Wu et al.

<43>
Accession Number
619266041
Title
Risk of transmission of sporadic Creutzfeldt-Jakob disease by surgical
procedures: Systematic reviews and quality of evidence.
Source
Eurosurveillance. 22(43) (no pagination), 2017. Date of Publication: 26
Oct 2017.
Author
Lopez F.J.G.; Ruiz-Tovar M.; Almazan-Isla J.; Alcalde-Cabero E.; Calero
M.; de Pedro-Cuesta J.
Institution
(Lopez, Ruiz-Tovar, Almazan-Isla, Alcalde-Cabero, de Pedro-Cuesta)
National Epidemiology Centre, Carlos III Institute of Health, Madrid,
Spain
(Lopez, Ruiz-Tovar, Almazan-Isla, Alcalde-Cabero, Calero, de Pedro-Cuesta)
Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED),
Madrid, Spain
(Calero) Carlos III Institute of Health, Madrid, Spain
(Calero) Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia
Foundation Alzheimer Centre, Madrid, Spain
Publisher
European Centre for Disease Prevention and Control (ECDC)
Abstract
Background: Sporadic Creutzfeldt-Jakob disease (sCJD) is potentially
transmissible to humans. <br/>Objective(s): This study aimed to summarise
and rate the quality of the evidence of the association between surgery
and sCJD. Design and methods: Firstly, we conducted systematic reviews and
meta-analyses of case-control studies with major surgical procedures as
exposures under study. To assess quality of evidence, we used the Grading
of Recommendations, Assessment, Development and Evaluations (GRADE)
approach. Secondly, we conducted a systematic review of sCJD case reports
after sharing neurosurgical instruments. <br/>Result(s): Thirteen
case-control studies met the inclusion criteria for the systematic review
of case-control studies. sCJD was positively associated with heart
surgery, heart and vascular surgery and eye surgery, negatively associated
with tonsillectomy and appendectomy, and not associated with neurosurgery
or unspecified major surgery. The overall quality of evidence was rated as
very low. A single case-control study with a low risk of bias found a
strong association between surgery conducted more than 20 years before
disease onset and sCJD. Seven cases were described as potentially
transmitted by reused neurosurgical instruments. <br/>Conclusion(s): The
association between surgery and sCJD remains uncertain. Measures currently
recommended for preventing sCJD transmission should be strongly
maintained. Future studies should focus on the potential association
between sCJD and surgery undergone a long time previously.<br/>Copyright
&#xa9; The Authors, 2017.

<44>
Accession Number
2029446642
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. 64(6) (no pagination), 2023.
Article Number: ezad411. 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
Publisher
European Association for Cardio-Thoracic Surgery
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 1/4 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 # The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<45>
Accession Number
2029398491
Title
Efficacy of ferric carboxymaltose in heart failure with iron deficiency:
an individual patient data meta-analysis.
Source
European Heart Journal. 44(48) (pp 5077-5091), 2023. Date of Publication:
21 Dec 2023.
Author
Ponikowski P.; Mentz R.J.; Hernandez A.F.; Butler J.; Khan M.S.; Van
Veldhuisen D.J.; Roubert B.; Blackman N.; Friede T.; Jankowska E.A.; Anker
S.D.
Institution
(Ponikowski, Jankowska) Institute for Heart Diseases, Wroclaw Medical
University, Wroclaw, Poland
(Ponikowski, Jankowska) Institute for Heart Diseases, University Hospital,
Wroclaw, Poland
(Mentz) Division of Cardiology, Department of Medicine, Duke University,
School of Medicine, Durham, NC, United States
(Mentz, Hernandez) Duke Clinical Research Institute, Duke University
Medical Center, Durham, NC, United States
(Hernandez) Department of Medicine, Duke University, Durham, NC, United
States
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Butler) Department of Medicine, University of Mississippi, Jackson, MS,
United States
(Khan) Division of Cardiology, Duke University Medical Center, Durham, NC,
United States
(Van Veldhuisen) Department of Cardiology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Roubert) Research Development, and Sciences, Csl Vifor, Glattbrugg,
Switzerland
(Blackman) Quantitative Sciences, American Regent, Inc, Shirley, NY,
United States
(Friede) Department of Medical Statistics and Dzhk, German Center for
Cardiovascular Research, Partner Site Gottingen, University Medical Center
Gottingen, Gottingen, Germany
(Anker) Department of Cardiology (CVK) of German Heart Center
CharitCrossed D Sign&#xa9;, Institute of Health Center for Regenerative
Therapies (BCRT), German Centre for Cardiovascular Research (DZHK),
Partner Site Berlin, CharitCrossed D Sign&#xa9; Universitatsmedizin,
Berlin, Germany
Publisher
Oxford University Press
Abstract
Background and Aims: Whereas a beneficial effect of intravenous ferric
carboxymaltose (FCM) on symptoms and exercise capacity among patients with
iron deficiency and heart failure (HF) has been consistently demonstrated,
the effects of treatment on clinical events remain the subject of
research. This meta-analysis aimed to characterize the effects of FCM
therapy on hospitalizations and mortality. <br/>Method(s): Patient-level
data from randomized, placebo-controlled FCM trials including adults with
HF and iron deficiency with >=52 weeks follow-up were analysed. The
co-primary efficacy endpoints were (i) composite of total/recurrent
cardiovascular hospitalizations and cardiovascular death and (ii)
composite of total HF hospitalizations and cardiovascular death, through
52 weeks. Key secondary endpoints included individual composite endpoint
components. Event rates were analysed using a negative binomial model.
Treatment-emergent adverse events were also examined. <br/>Result(s):
Three FCM trials with a total of 4501 patients were included. Ferric
carboxymaltose was associated with a significantly reduced risk of
co-primary endpoint 1 (rate ratio 0.86; 95% confidence interval 0.75-0.98;
P =. 029; Cochran Q: 0.008), with a trend towards a reduction of
co-primary endpoint 2 (rate ratio 0.87; 95% confidence interval 0.75-1.01;
P =. 076; Cochran Q: 0.024). Treatment effects appeared to result from
reduced hospitalization rates, not improved survival. Treatment appeared
to have a good safety profile and was well tolerated. <br/>Conclusion(s):
In iron-deficient patients with HF with reduced left ventricular ejection
fraction, intravenous FCM was associated with significantly reduced risk
of hospital admissions for HF and cardiovascular causes, with no apparent
effect on mortality.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Oxford University Press on behalf of the European Society of Cardiology.

<46>
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.

<47>
Accession Number
2028201094
Title
Use of Low-Cost Task Trainer for Emergency Department Thoracotomy Training
in General Surgery Residency Program.
Source
Journal of Surgical Education. 81(1) (pp 134-144), 2024. Date of
Publication: January 2024.
Author
Misra A.; Chapman A.; Watson W.D.; Bach J.A.; Bonta M.J.; Elliott J.O.;
Dominguez E.P.
Institution
(Misra, Watson) OhioHealth Learning, Department of Medical Education,
Riverside Methodist Hospital, Columbus, OH, United States
(Chapman, Bach, Bonta, Dominguez) OhioHealth Trauma & Acute Care Surgery,
Riverside Methodist Hospital, Columbus, Ohio, United States
(Elliott) OhioHealth Research Institute, Columbus, OH, United States
Publisher
Elsevier Inc.
Abstract
OBJECTIVE: Emergency department thoracotomy (EDT) is an uncommon but
potentially lifesaving procedure that warrants familiarity with anatomy,
instruments, and indications necessary for completion. To address this
need, we developed a low-cost EDT trainer. The primary objective of this
study was to compare the effectiveness of a low-cost EDT trainer to teach
emergency department thoracotomy with a discussion-based teaching session.
Secondary objective was to study the face validity of the low-cost EDT
trainer. DESIGN: A prospective 2-phase randomized control study was
conducted. Participants were randomly divided into two groups. In phase
one, baseline medical knowledge for both groups was assessed using a
multiple-choice question pretest. In Group 1, each participant was taught
EDT using a one-on-one discussion with a trauma surgeon, whereas Group 2
used the EDT trainer and debriefing for training. In phase 2 (1 month
later), all participants completed a knowledge retention test and
performed a videoed EDT using our EDT trainer, the video recordings were
later reviewed by content experts blinded to the study participants using
a checklist with a maximum score of 22. The participants also completed a
reaction survey at the end of phase 2 of the study. SETTING: OhioHealth
Riverside Methodist Hospital, an urban tertiary care academic hospital in
Columbus, Ohio. PARTICIPANTS: Nine senior surgery residents from training
years 3 to 5. <br/>RESULT(S): The mean score for the performance of the
procedure for the simulation-based (Group 2) was significantly higher than
that of the discussion-based (Group 1) (Rater 1: 21.2 +/- 0.8 vs. 19.0 +/-
2.0, p = 0.05, Rater 2: 20.4 +/- 1.5 vs. 18.3+/-1.0, p = 0.04). Group 2
also was quicker than Group 1 in deciding to start the procedure by
approximately 56 seconds. When comparing the mean pretest knowledge score
to the mean knowledge retention score 30 days after training, the
discussion-based group improved from 58.33% to 81.25% (p = 0.01); the
simulation-trained group's scores remained at 68.33%. All the participants
agreed or strongly agreed that the simulator provided a realistic
opportunity to perform EDT and improved their confidence.
<br/>CONCLUSION(S): The results of this pilot study support our hypothesis
that using a low-cost EDT trainer effectively improves general surgery
residents' confidence and procedural skills scores in a simulated
environment. Further training with low-cost simulators may provide
surgical residents with deliberate practice opportunities and improve
performance when learning low-frequency procedures.<br/>Copyright &#xa9;
2023 Association of Program Directors in Surgery

<48>
Accession Number
2027243661
Title
The Endoscopic Lumbar Interbody Fusion: A Narrative Review, and Future
Perspective.
Source
Neurospine. 20(4) (pp 1224-1245), 2023. Date of Publication: Dec 2023.
Author
Pholprajug P.; Kotheeranurak V.; Liu Y.; Kim J.-S.
Institution
(Pholprajug) Department of Orthopaedics, Rayong Hospital, Rayong, Thailand
(Kotheeranurak) Department of Orthopaedics, Faculty of Medicine,
Chulalongkorn University, and King Chulalongkorn Memorial Hospital,
Bangkok, Thailand
(Liu, Kim) Spine Center, Department of Neurosurgery, Seoul St. Mary's
Hospital, College of Medicine, The Catholic University of Korea, Seoul,
South Korea
Publisher
Korean Spinal Neurosurgery Society
Abstract
Lumbar interbody fusion stands as a preferred surgical solution for
degenerative lumbar spine diseases. The procedure primarily aims to
establish lumbar segment stability, directly addressing patient symptoms
associated with spinal complications. Traditional open sur-gery, though
effective, is linked with notable morbidities and extended recovery time.
To mitigate these concerns, minimally invasive surgery (MIS) has garnered
significant popu-larity, presenting an appealing alternative with numerous
benefits such as reduced soft tissue trauma, decreased blood loss, and
expedited recovery. Among MIS procedures, full endoscopic spinal surgery,
characterized by its minimal invasiveness, holds the potential to further
minimize morbidities while enhancing surgical outcomes. Endoscopic lumbar
in-terbody fusion, a novel procedure within this paradigm, has gained
attention for offering advantages comparable to those of minimally
invasive transforaminal lumbar interbody fu-sion. However, the safety,
efficacy, and associated surgical techniques and instrument de-sign of
this method continue to be subjects of ongoing debate. This paper
critically reviews current evidence on the safety, efficacy, and
advantages of endoscopic lumbar spinal inter-body fusion, examining
whether it could indeed supersede existing mainstream
techniques.<br/>Copyright &#xa9; 2023 by the Korean Spinal Neurosurgery
Society.

<49>
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.

<50>
Accession Number
2025995268
Title
Left ventricular assist device implantation and concomitant mitral valve
surgery: A systematic review and meta-analysis.
Source
Artificial Organs. 48(1) (pp 16-27), 2024. Date of Publication: January
2024.
Author
ArjomandiRad A.; Fleet B.; Zubarevich A.; Nanchahal S.; Naruka V.;
SubbiahPonniah H.; Vardanyan R.; SardariNia P.; Loubani M.; Moorjani N.;
Schmack B.; Punjabi P.P.; Schmitto J.; Ruhparwar A.; Weymann A.
Institution
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford,
United Kingdom
(Arjomandi Rad, Nanchahal, Naruka, Subbiah Ponniah, Vardanyan) Department
of Surgery and Cancer, Imperial College London, London, United Kingdom
(Arjomandi Rad, Sardari Nia) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, Maastricht, Netherlands
(Fleet) School of Medicine, Lancaster University, Lancaster, United
Kingdom
(Zubarevich, Schmack, Schmitto, Ruhparwar, Weymann) Department of
Cardiothoracic Transplant and Vascular Surgery, Hannover Medical School,
Hannover, Germany
(Loubani) Department of Cardiothoracic Surgery, Hull University Teaching
Hospitals NHS Trust, Hull, United Kingdom
(Moorjani) Department of Cardiothoracic Surgery, Royal Papworth NHS Trust,
Cambridge, United Kingdom
(Punjabi) Department of Cardiothoracic Surgery, National Heart and Lung
Institute, Imperial College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: The management of concomitant valvular lesions in patients
undergoing left ventricular assist device (LVAD) implantation remains a
topic of debate. This systematic review and meta-analysis aimed to
evaluate the existing evidence on postoperative outcomes following LVAD
implantation, with and without concomitant MV surgery. <br/>Method(s): A
systematic database search was conducted as per PRISMA guidelines, of
original articles comparing LVAD alone to LVAD plus concomitant MV surgery
up to February 2023. The primary outcomes assessed were overall mortality
and early mortality, while secondary outcomes included stroke, need for
right ventricular assist device (RVAD) implantation, postoperative mitral
valve regurgitation, major bleeding, and renal dysfunction.
<br/>Result(s): The meta-analysis included 10 studies comprising 32 184
patients. It revealed that concomitant MV surgery during LVAD implantation
did not significantly affect overall mortality (OR:0.83; 95% CI: 0.53 to
1.29; p = 0.40), early mortality (OR:1.17; 95% CI: 0.63 to 2.17; p =
0.63), stroke, need for RVAD implantation, postoperative mitral valve
regurgitation, major bleeding, or renal dysfunction. These findings
suggest that concomitant MV surgery appears not to confer additional
benefits in terms of these clinical outcomes. <br/>Conclusion(s): Based on
the available evidence, concomitant MV surgery during LVAD implantation
does not appear to have a significant impact on postoperative outcomes.
However, decision-making regarding MV surgery should be individualized,
considering patient-specific factors and characteristics. Further research
with prospective studies focusing on specific patient populations and
newer LVAD devices is warranted to provide more robust evidence and guide
clinical practice in the management of valvular lesions in LVAD
recipients.<br/>Copyright &#xa9; 2023 The Authors. Artificial Organs
published by International Center for Artificial Organ and Transplantation
(ICAOT) and Wiley Periodicals LLC.

<51>
Accession Number
2028674342
Title
Sepsis in cardiothoracic surgery.
Source
Surgery (United States). (no pagination), 2023. Date of Publication:
2023.
Author
Napoli F.; Aleman R.; Zadneulitca N.; Navia J.; Brozzi N.A.
Institution
(Napoli, Aleman, Zadneulitca, Navia, Brozzi) Heart, Vascular & Thoracic,
Cleveland Clinic Florida, Weston, FL, United States
Publisher
Elsevier Inc.
Abstract
Sepsis is a life-changing condition that can occur in patients undergoing
cardiothoracic surgery. It is characterized by a dysregulated inflammatory
response to infection, often leading to higher rates of organ dysfunction
and mortality. The importance of early recognition and prompt intervention
in managing sepsis-related complications in cardiothoracic surgery is
pivotal to adequate surgical practice. Due to the multiple subsections
that construct the broad spectrum of cardiothoracic surgery, it is
important to address the presence of sepsis in elective cardiothoracic
surgery, urgent/emergency cardiothoracic surgery, solid organ
transplantation, and both temporary and permanent mechanical circulatory
support (ie, left ventricular assist devices, extracorporeal membrane
oxygenation, and percutaneous temporary devices [eg, Impella series]).
Exploring the incidence, prevalence, and risk factors of said subsections
can lead to improvement in postoperative outcomes. The impact of
accompanying infections can progress into further operative morbidity and
mortality. To this effect, the perioperative management of cardiothoracic
surgery transcends surgical techniques and should undergo additional
recognition of other occurrences such as wound infections, bloodstream
infections, urinary tract infections, and pneumonia. Sepsis remains a
concern in cardiothoracic surgery, as it can lead to devastating
consequences. Hence, there is an evident need for heightened vigilance,
early recognition, and effective management strategies to mitigate the
risk of sepsis in this patient population. The purpose of this article is
to provide an overview of sepsis in the different cardiothoracic surgery
areas.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<52>
Accession Number
2025945156
Title
A model for predicting postoperative persistent acute kidney injury (AKI)
in AKI after cardiac surgery patients with normal baseline renal function.
Source
Clinical Cardiology. 47(1) (no pagination), 2024. Article Number: e24168.
Date of Publication: January 2024.
Author
Chen Y.; Mo Z.; Chu H.; Hu P.; Fan W.; Wu Y.; Song L.; Zhang L.; Li Z.;
Liu S.; Ye Z.; Liang X.
Institution
(Chen, Mo, Wu, Song, Zhang, Li, Liu, Ye, Liang) Department of Nephrology,
Guangdong Provincial People's Hospital (Guangdong Academy of Medical
Sciences), Southern Medical University, Guangzhou, China
(Chu, Hu, Fan) Division of Nephrology, The Affiliated Yixing Hospital of
Jiangsu University, Jiangsu, Yixing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Persistent acute kidney injury (AKI) after cardiac surgery is
not uncommon and linked to poor outcomes. Hypothesis: The purpose was to
develop a model for predicting postoperative persistent AKI in patients
with normal baseline renal function who experienced AKI after cardiac
surgery. <br/>Method(s): Data from 5368 patients with normal renal
function at baseline who experienced AKI after cardiopulmonary bypass
cardiac surgery in our hospital were retrospectively evaluated. Among
them, 3768 patients were randomly assigned to develop the model, while the
remaining patients were used to validate the model. The new model was
developed using logistic regression with variables selected using least
absolute shrinkage and selection operator regression. <br/>Result(s): The
incidence of persistent AKI was 50.6% in the development group. Nine
variables were selected for the model, including age, hypertension,
diabetes, coronary heart disease, cardiopulmonary bypass time, AKI stage
at initial diagnosis after cardiac surgery, postoperative serum magnesium
level of <0.8 mmol/L, postoperative duration of mechanical ventilation,
and postoperative intra-aortic balloon pump use. The model's performance
was good in the validation group. The area under the receiver operating
characteristic curve was 0.761 (95% confidence interval: 0.737-0.784).
Observations and predictions from the model agreed well in the calibration
plot. The model was also clinically useful based on decision curve
analysis. <br/>Conclusion(s): It is feasible by using the model to
identify persistent AKI after cardiac surgery in patients with normal
baseline renal function who experienced postoperative AKI, which may aid
in patient stratification and individualized precision treatment
strategy.<br/>Copyright &#xa9; 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<53>
Accession Number
2027775781
Title
The protocol of Enhanced Recovery After Cardiac Surgery (ERACS) in
congenital heart disease: a stepped wedge cluster randomized trial.
Source
BMC Pediatrics. 24(1) (no pagination), 2024. Article Number: 22. Date of
Publication: December 2024.
Author
Dou D.; Jia Y.; Yuan S.; Wang Y.; Li Y.; Wang H.; Ding J.; Wu X.; Bie D.;
Liu Q.; An R.; Yan H.; Yan F.
Institution
(Dou, Jia, Yuan, Li, Wang, Ding, Wu, Bie, Liu, An, Yan, Yan) Department of
Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd,
Xicheng District, Beijing 100037, China
(Wang) Department of Medical Research & Biometrics Center, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking
Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing
100037, China
Publisher
BioMed Central Ltd
Abstract
Background: The Enhanced Recovery After Cardiac Surgery (ERACS) programs
are comprehensive multidisciplinary interventions to improve patients'
recovery. The application of the ERAS principle in pediatric patients has
not been identified completely. <br/>Method(s): This study is a
multicenter, stepwise design, cluster randomized controlled trial. 3030
patients presenting during control and intervention periods are eligible
if they are aged from 28 days to 6 years old and awaiting elective
correction surgery of congenital heart disease with cardiopulmonary
bypass. 5 centers are randomly assigned to staggered start dates for
one-way crossover from the control phase to the intervention phase. In the
intervention periods, patients will receive a bundle strategy including
preoperative, intraoperative, and postoperative approaches. During the
control phase, patients receive the usual care. The primary outcome
consists of major adverse cardiac and cerebrovascular events (MACCEs),
postoperative pulmonary complications (PPCs), and acute kidney injury
(AKI). <br/>Discussion(s): This study aims to explore whether the bundle
of ERAS measurements could improve patients' recovery in congenital heart
surgery. Trial registration: http://www.clinicaltrials.gov .
(NCT05914103).<br/>Copyright &#xa9; 2023, The Author(s).

<54>
Accession Number
643151725
Title
In noncardiac thoracic surgery, low-dose colchicine did not reduce AF or
myocardial injury after noncardiac surgery at 14 d.
Source
Annals of internal medicine. (no pagination), 2024. Date of Publication:
02 Jan 2024.
Author
Lopez J.; Borzak S.
Institution
(Lopez, Borzak) University of Miami Miller School of Medicine, JFK
Hospital, Atlantis, FL, Puerto Rico
Abstract
SOURCE CITATION: Conen D, Ke Wang M, Popova E, et al; COP-AF
Investigators. 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.
Lancet. 2023;402:1627-1635. 37640035.

<55>
Accession Number
643151777
Title
Preoperative CT-imaging with patient-specific computer simulation in
transcatheter aortic valve implantation: Design and rationale of the
GUIDE-TAVI trial.
Source
American heart journal. (no pagination), 2023. Date of Publication: 30
Dec 2023.
Author
Hegeman R.R.M.J.J.; van Ginkel D.-J.; Langle S.; Timmers L.; Rensing
B.J.W.M.; de Kroon T.L.; Sonker U.; Kelder J.C.; Mach M.; Andreas M.;
Swaans M.J.; Ten Berg J.M.; Klein P.
Institution
(Hegeman, de Kroon, Sonker, Klein) Department of Cardiothoracic Surgery,
Sint Antonius Hospital Nieuwegein, CM Nieuwegein 3435, Netherlands
(van Ginkel, Timmers, Rensing, Swaans) Department of Cardiology, Sint
Antonius Hospital Nieuwegein, CM Nieuwegein 3435, Netherlands
(Langle, Mach, Andreas) Department of Cardiothoracic Surgery, Medical
University of Vienna, Vienna 1090, Austria
(Kelder) Department of Epidemiology, Sint Antonius Hospital Nieuwegein, CM
Nieuwegein 3435, Netherlands
(Ten Berg) Department of Cardiology, Sint Antonius Hospital Nieuwegein,
3435 CM Nieuwegein, The Netherlands; Cardiovascular Research Institute
Maastricht, 6229 HX Maastricht, The Netherlands
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an
established treatment option for patients with severe aortic valve
stenosis, but is still associated with relatively high rates of pacemaker
implantation and paravalvular regurgitation. Routine preoperative computed
tomography (CT) combined with patient-specific computer modelling can
predict the interaction between the TAVI device and the patient's unique
anatomy, allowing physicians to assess the risk for paravalvular
regurgitation and conduction disorders in advance to the procedure. The
aim of this trial is to assess potential improvement in the procedural
outcome of TAVI by applying CT-based patient-specific computer simulations
in patients with suitable anatomy for TAVI. <br/>METHOD(S): The GUIDE-TAVI
trial is an international multicenter randomized controlled trial
including patients accepted for TAVI by the Heart Team. Patients enrolled
in the study will be randomized into two arms of each 227 patients. In
patients randomized to the use of FEops HEARTGuide (FHG), patient-specific
computer simulation with FHG is performed in addition to routine
preoperative CT imaging and results of the FHG are available to the
operator(s) prior to the scheduled intervention. In patients randomized to
no use of FHG, only routine preoperative CT imaging is performed. The
primary objective is to evaluate whether the use of FHG will reduce the
incidence of mild to severe PVR, according to the Valve Academic Research
Consortium 3. Secondary endpoints include the incidence of new conduction
disorders requiring permanent pacemaker implantation, the difference
between preoperative and final selected valve size, the difference between
target and final implantation depth, change of preoperative decision,
failure to implant valve, early safety composite endpoint and quality of
life. <br/>CONCLUSION(S): The GUIDE-TAVI trial is the first multicenter
randomized controlled trial to evaluate the value of three-dimensional
computer simulations in addition to standard pre-procedural planning in
TAVI procedures.<br/>Copyright &#xa9; 2023. Published by Elsevier Inc.

<56>
Accession Number
2029192956
Title
Long-Term Outcomes of Valve-in-Valve Transcatheter Aortic Valve
Implantation Versus Redo Surgical Aortic Valve Replacement: Meta-Analysis
of Kaplan-Meier-Derived Data.
Source
American Journal of Cardiology. 212 (pp 30-39), 2024. Date of Publication:
01 Feb 2024.
Author
Sa M.P.; Jacquemyn X.; Serna-Gallegos D.; Makani A.; Kliner D.; Toma C.;
West D.; Ahmad D.; Yousef S.; Brown J.A.; Yoon P.; Kaczorowski D.; Bonatti
J.; Chu D.; Sultan I.
Institution
(Sa, Serna-Gallegos, West, Ahmad, Yousef, Brown, Yoon, Kaczorowski,
Bonatti, Chu, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sa, Serna-Gallegos, Makani, Kliner, Toma, West, Ahmad, Yousef, Brown,
Yoon, Kaczorowski, Bonatti, Chu, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Makani, Kliner, Toma) Department of Interventional Cardiology, University
of Pittsburgh, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Valve-in-valve (ViV) transcatheter aortic valve implantation (ViV-TAVI) in
patients with failed bioprostheses arose as an alternative to redo
surgical aortic valve replacement (SAVR). To evaluate all-cause mortality
in ViV-TAVI versus redo-SAVR, we performed a study-level meta-analysis of
reconstructed time-to-event data from Kaplan-Meier curves of nonrandomized
studies published by August 2023. A total of 16 studies met our
eligibility criteria, with a total of 4,373 patients (2,204 patients
underwent ViV-TAVI and 2,169 patients underwent redo-SAVR). Pooling all
the studies, ViV-TAVI showed a lower risk of all-cause mortality in the
first 6 months (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.46
to 0.73, p <0.001), with an HR reversal after this time point favoring
redo-SAVR (HR 1.92, 95% CI 1.58 to 2.33, p <0.001). Pooling only the
matched populations (which represented 64.6% of the overall population),
ViV-TAVI showed a lower risk of all-cause mortality in the first 6 months
(HR 0.56, 95% CI 0.43 to 0.73, p <0.001], with a reversal after 6 months
favoring redo-SAVR (HR 1.55, 95% CI 1.25 to 1.93, p <0.001). The
meta-regression analyses revealed a modulating effect of the following
covariates: age, coronary artery disease, history of coronary artery
bypass graft surgery, and implanted valves <25 mm. In conclusion, ViV-TAVI
is associated with better survival immediately after the procedure than
redo-SAVR; however, this primary advantage reverses over time, and
redo-SAVR seems to offer better survival at a later stage. Because these
results are pooled data from observational studies, they should be
interpreted with caution, and randomized controlled trials are
warranted.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<57>
Accession Number
2028918341
Title
Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in
Noncardiac Surgery.
Source
Annals of Internal Medicine. 176(11) (pp 605-615), 2023. Date of
Publication: 01 Nov 2023.
Author
Marcucci M.; Painter T.W.; Conen D.; Lomivorotov V.; Sessler D.I.; Chan
M.T.V.; Borges F.K.; Leslie K.; Duceppe E.; Jose' Martinez-Zapata M.; Yin
Wang C.; Xavier D.; Ofori S.N.; Ke Wang M.; Efremov S.; Landoni G.;
Kleinlugtenbelt Y.V.; Szczeklik W.; Schmartz D.; Garg A.X.; Short T.G.;
Wittmann M.; Meyhoff C.S.; Amir M.; Torres D.; Patel A.; Ruetzler K.;
Parlow J.; Tandon V.; Fleischmann E.; Polanczyk C.A.; Lamy A.; Jayaram R.;
Astrakov S.V.; Ka Kei Wu W.; Chia Cheong C.; Ayad S.; Kirov M.; de Nadal
M.; Likhvantsev V.V.; Paniagua P.; Aguado H.J.; Maheshwari K.; Whitlock
R.P.; McGillion M.H.; Vincent J.; Copland I.; Kumar Balasubramanian;
Biccard B.M.; Srinathan S.; Ismoilov S.; Pettit S.; Stillo D.; Kurz A.;
Belley-Cote E.P.; Spence J.; McIntyre W.F.; Bangdiwala S.I.; Guyatt G.;
Yusuf S.; Devereaux P.J.
Publisher
American College of Physicians
Abstract
Background: Among patients having noncardiac surgery, perioperative
hemodynamic abnormalities are associated with vascular complications.
Uncertainty remains about what intraoperative blood pressure to target and
how to manage long-term antihypertensive medications perioperatively.
<br/>Objective(s): To compare the effects of a hypotension-avoidance and a
hypertension-avoidance strategy on major vascular complications after
noncardiac surgery. <br/>Design(s): Partial factorial randomized trial of
2 perioperative blood pressure management strategies (reported here) and
tranexamic acid versus placebo. (ClinicalTrials.gov: NCT03505723) Setting:
110 hospitals in 22 countries. <br/>Patient(s): 7490 patients having
noncardiac surgery who were at risk for vascular complications and were
receiving 1 or more long-term antihypertensive medications.
<br/>Intervention(s): In the hypotension-avoidance strategy group, the
intraoperative mean arterial pressure target was 80 mm Hg or greater;
before and for 2 days after surgery, renin-angiotensin-aldosterone system
inhibitors were withheld and the other long-term antihypertensive
medications were administered only for systolic blood pressures 130 mm Hg
or greater, following an algorithm. In the hypertension-avoidance strategy
group, the intraoperative mean arterial pressure target was 60 mm Hg or
greater; all antihypertensive medications were continued before and after
surgery. Measurements: The primary outcome was a composite of vascular
death and nonfatal myocardial injury after noncardiac surgery, stroke, and
cardiac arrest at 30 days. Outcome adjudicators were masked to treatment
assignment. <br/>Result(s): The primary outcome occurred in 520 of 3742
patients (13.9%) in the hypotension-avoidance group and in 524 of 3748
patients (14.0%) in the hypertension-avoidance group (hazard ratio, 0.99
[95% CI, 0.88 to 1.12]; P = 0.92). Results were consistent for patients
who used 1 or more than 1 antihypertensive medication in the long term.
<br/>Limitation(s): Adherence to the assigned strategies was suboptimal;
however, results were consistent across different adherence levels.
<br/>Conclusion(s): In patients having noncardiac surgery, our
hypotension-avoidance and hypertension-avoidance strategies resulted in a
similar incidence of major vascular complications.<br/>Copyright &#xa9;
2023 American College of Physicians. All rights reserved.

<58>
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

<59>
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.

<60>
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.

<61>
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.

<62>
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).

<63>
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.

<64>
Accession Number
2025244589
Title
Analgesic efficacy of erector spinae plane block versus paravertebral
block in lung surgeries-A non-inferiority randomised controlled trial.
Source
Acta Anaesthesiologica Scandinavica. 68(1) (pp 71-79), 2024. Date of
Publication: January 2024.
Author
Andrade Filho P.H.D.; Pereira V.E.; Sousa D.D.E.M.; Costa L.D.G.; Nunes
Y.P.; Taglialegna G.; de Paula-Garcia W.N.; Silva J.M.
Institution
(Andrade Filho, Sousa, Costa, Nunes, Silva) Department of Anaesthesiology,
Hospital do Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil
(Andrade Filho, Silva) Postgraduate Programme in Anaesthesiology, Surgical
Sciences, and Perioperative Medicine, University of Sao Paulo Faculty of
Medicine (FMUSP), Sao Paulo, Brazil
(Pereira, Taglialegna, de Paula-Garcia) Orthopedics and Anaesthesiology
Department, Ribeirao Preto Medical School, University of Sao Paulo
(FMRP-USP), Ribeirao Preto, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Pain management plays an essential role in postoperative
recovery after lung surgeries. The Erector Spinae Plane Block (ESPB) is a
widely used regional anaesthesia technique; however, few clinical trials
have compared this block to active control in thoracic surgeries. This
study evaluated the non-inferiority of the analgesia provided by ESPB when
compared to paravertebral block (PVB) in lung surgeries. <br/>Method(s):
Randomised, active-controlled, blinded for patients and assessors,
non-inferiority trial. Patients who underwent unilateral lung surgeries
were divided into two groups according to the regional anaesthesia
technique-continuous ESPB or PVB at the T5 level. The primary outcome was
to assess pain using a numerical rating scale (NRS) with a test of the
interaction of three measures over 24 h postoperatively. An NRS score >= 7
was considered analgesia failure, and the prespecified non-inferiority
margin was 10%. <br/>Result(s): In the interim analysis that terminated
this study, 120 participants were enrolled. ESPB patients reported higher
mean NRS general values over 24 h, 4.6 +/- 3.2 in the ESPB group versus
3.9 +/- 2.9 in the PVB group, with a difference of -0.67 (-15.2%) and
95%CI: -1.29 to -0.05 (p =.02), demonstrating not non-inferiority. In
addition, the ESPB group presented higher NRS failure of analgesia over 24
h (p <.01) and required more postoperative opioids (p =.01 over 24 h).
There was no difference in patient satisfaction between groups.
<br/>Conclusion(s): This trial demonstrated that a continuous erector
spinae plane block was not non-inferior to a continuous paravertebral
block for analgesia after lung surgery but resulted in higher levels of
postoperative pain and opioid consumption.<br/>Copyright &#xa9; 2023 Acta
Anaesthesiologica Scandinavica Foundation.

<65>
Accession Number
2026983450
Title
A Nationwide Evaluation of Cardiothoracic Resident Research Productivity.
Source
Annals of Thoracic Surgery. 117(2) (pp 449-455), 2024. Date of
Publication: February 2024.
Author
Narahari A.K.; Patel P.D.; Chandrabhatla A.S.; Wolverton J.; Lantieri
M.A.; Sarkar A.; Mehaffey J.H.; Wagner C.M.; Ailawadi G.; Pagani F.D.;
Likosky D.S.
Institution
(Narahari, Patel, Chandrabhatla, Lantieri, Sarkar) Department of Surgery,
University of Virginia School of Medicine, Charlottesville, VA, United
States
(Wolverton, Wagner, Ailawadi, Pagani, Likosky) Department of Cardiac
Surgery, Michigan Medicine, Ann Arbor, MI, United States
(Mehaffey) Department of Cardiovascular and Thoracic Surgery, West
Virginia University School of Medicine, Morgantown, WV, United States
Publisher
Elsevier Inc.
Abstract
Background: Evaluating the research productivity of cardiothoracic surgery
residents during their training and early career is crucial for tracking
their academic development. To this end, the training pathway of residents
and the characteristics of their program in relation to their productivity
were evaluated. <br/>Method(s): Alumni lists from integrated 6-year
thoracic surgery (I-6) and traditional thoracic surgery residency programs
were collected. A Python script was used to search PubMed for publications
and the iCite database for citations from each trainee. Publications
during a 20-year time span were stratified by the year of publication in
relation to the trainee's graduation from thoracic surgery residency.
Trainees were analyzed by training program type, institutional
availability of a cardiothoracic surgery T32 training grant, and protected
academic development time. <br/>Result(s): A total of 741 cardiothoracic
surgery graduates (I-6, 70; traditional, 671) spanning 1971 to 2021 from
57 programs published >23,000 manuscripts. I-6 trainees published
significantly more manuscripts during medical school and residency
compared with traditional trainees. Trainees at institutions with
cardiothoracic surgery T32 training grants published significantly more
manuscripts than those at non-T32 institutions (13 vs 9; P = .0048). I-6
trainees published more manuscripts at programs with dedicated academic
development time compared with trainees at programs without protected time
(22 vs 9; P = .004). <br/>Conclusion(s): I-6 trainees publish
significantly more manuscripts during medical school and residency
compared with their traditional colleagues. Trainees at institutions with
T32 training grants and dedicated academic development time publish a
higher number of manuscripts than trainees without those
opportunities.<br/>Copyright &#xa9; 2024 The Society of Thoracic Surgeons

<66>
Accession Number
2026748805
Title
Computed tomography derived anatomical predictors of vascular access
complications following transfemoral transcatheter aortic valve
implantation: A systematic review.
Source
Catheterization and Cardiovascular Interventions. 103(1) (pp 169-185),
2024. Date of Publication: 01 Jan 2024.
Author
Androshchuk V.; Chehab O.; Prendergast B.; Rajani R.; Patterson T.;
Redwood S.
Institution
(Androshchuk, Chehab, Patterson, Redwood) School of Cardiovascular
Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College
London, London, United Kingdom
(Androshchuk, Chehab, Prendergast, Rajani, Patterson, Redwood) Department
of Cardiology, St Thomas' Hospital, King's College London, London, United
Kingdom
(Rajani) School of Biomedical Engineering and Imaging Sciences, Faculty of
Life Sciences & Medicine, King's College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Vascular complications after percutaneous transfemoral
transcatheter aortic valve implantation (TAVI) are associated with adverse
clinical outcomes and remain a significant challenge. <br/>Aim(s): The
purpose of this review is to synthesize the existing evidence regarding
the iliofemoral artery features predictive of vascular complications after
TAVI on pre-procedural contrast-enhanced multidetector computed tomography
(MDCT). <br/>Method(s): A systematic search was performed in Embase and
Medline (Pubmed) databases. Studies of patients undergoing transfemoral
TAVI with MDCT were included. Studies with only valve-in-valve TAVI,
planned surgical intervention and those using fluoroscopic assessment were
excluded. Data on study cohort, procedural characteristics and significant
predictors of vascular complications were extracted. <br/>Result(s): We
identified 23 original studies involving 8697 patients who underwent TAVI
between 2006 and 2020. Of all patients, 8514 (97.9%) underwent
percutaneous transfemoral-TAVI, of which 8068 (94.8%) had
contrast-enhanced MDCT. The incidence of major vascular complications was
6.7 +/- 4.1% and minor vascular complications 26.1 +/- 7.8%. Significant
independent predictors of major and minor complications related to vessel
dimensions were common femoral artery depth (>54 mm),
sheath-to-iliofemoral artery diameter ratio (>0.91-1.19),
sheath-to-femoral artery diameter ratio (>1.03-1.45) and sheath-to-femoral
artery area ratio (>1.35). Substantial iliofemoral vessel tortuosity
predicted 2-5-fold higher vascular risk. Significant iliofemoral
calcification predicted 2-5-fold higher risk. The iliac morphology score
was the only hybrid scoring system with predictive value.
<br/>Conclusion(s): Independent iliofemoral predictors of access-site
complications in TAVI were related to vessel size, depth, calcification
and tortuosity. These should be considered when planning transfemoral TAVI
and in the design of future risk prediction models.<br/>Copyright &#xa9;
2023 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<67>
Accession Number
2024272698
Title
Ultrasound-guided erector spinae plane block in coronary artery bypass
surgery: the role of local anesthetic volume-a prospective, randomized
study.
Source
General Thoracic and Cardiovascular Surgery. 72(1) (pp 1-7), 2024. Date of
Publication: January 2024.
Author
Demir Z.A.; Aydin M.E.; Balci E.; Ozay H.Y.; Ozgok A.; Ahiskalioglu A.
Institution
(Demir, Balci, Ozay, Ozgok) Anesthesiology Department, Ankara City
Hospital, Health Sciences University, Ankara, Turkey
(Aydin, Ahiskalioglu) Department of Anaesthesiology and Reanimation,
Ataturk University School of Medicine, Erzurum 25070, Turkey
(Aydin, Ahiskalioglu) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum 25240, Turkey
Publisher
Springer
Abstract
Background: Erector spinae plane block has been shown to help with pain
management in different regions and many areas with different indications.
However, the effectiveness of this block in cardiac surgery has been shown
in the literature, the optimal volume remains unclear. The aim of this
study is to determine the analgesic efficacy of two different volumes of
local anesthetic injection used in ultrasound-guided bilateral-thoracic
erector spinae plane block in patients undergoing coronary artery bypass
graft. <br/>Method(s): This study was conducted on adult patients
undergoing surgery with coronary artery bypass graft, and 70 patients were
analyzed in each group. Group 20 received erector spinae plane block with
20 ml of 0.25% bupivacaine, Group 30 received 30 ml of 0.25% bupivacaine
bilaterally. Postoperative sternotomy and chest tube-related pain were
evaluated using the numerical rating scale (NRS) at rest and during
movement. <br/>Result(s): There were significant differences between the
groups regarding rescue tramadol consumption was higher in Group 20 than
in Group 30 (25/35 vs. 2/35, p < 0.001). In addition, there were
substantial differences between the two groups concerning the time of the
first-rescue analgesic requirement. The mean time +/- standard deviation
was 11.26 +/- 9.57 h and 24.03 +/- 4.12 h in Groups 20 and 30 (p < 0.001).
The median scores, both at sternotomy and chest tubes, were significantly
lower in Group 30 than in Group 20 at the different time points after the
surgery (p < 0.05). <br/>Conclusion(s): In coronary artery bypass graft
surgery, erector spinae plane block performed with 30 ml instead of 20 ml
on each side resulted in less pain in the sternum and chest tube region,
less need for rescue analgesics, and delayed first-rescue analgesic
requirement.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<68>
Accession Number
2029437773
Title
Incidence Of Adverse Events Is Higher When Heart Transplant Recipients Are
On High Versus Standard Dose Statin In Combination With Cyclosporine.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2023. Cleveland United States. 30(1) (pp
184), 2024. Date of Publication: January 2024.
Author
Diaz G.E.; Kashlan B.; Block C.; Negrelli J.; Fine M.; Newman J.; Yu M.D.;
Liebo M.
Institution
(Diaz, Kashlan, Block, Negrelli, Fine, Newman, Yu, Liebo) Loyola
University Medical Center, Maywood, IL, United States
Publisher
Elsevier B.V.
Abstract
Background: Heart transplant recipients receive a calcineurin inhibitor
(CNI) for immunosuppression. While tacrolimus is the CNI of choice,
switching to cyclosporine (CSA) may be necessary due to side effects.
Treatment with a statin decreases incidence of cardiac allograft
vasculopathy and mortality post-transplant. CSA interacts with statins by
increasing their levels, with high intensity statins often
contraindicated. Per the AHA, maximum recommended statin doses for heart
transplants on CSA include atorvastatin 10 mg, pravastatin 20 mg,
rosuvastatin 5 mg, and fluvastatin 40 mg. Data evaluating safety of the
CSA-statin interaction are conflicting, and primarily based on
pharmacokinetic studies. Pravastatin 40 mg however has been studied and
largely tolerated in randomized controlled trials in combination with CSA
in heart transplants. Dyslipidemia is a side effect of several
post-transplant medications often leading to utilization of higher statin
doses. The safety of statins among patients using CSA has not been
systematically evaluated. <br/>Method(s): This was a retrospective single
center study evaluating the safety of concomitant use of CSA and statins
at standard versus high dose as defined by the AHA, with any dose
simvastatin considered high. Heart transplants from 2009-2022 on CSA and a
statin were included. The primary outcome was incidence of adverse event
including, physician documented myalgia, hepatotoxicity (LFTs > 3 times
upper limit of normal), rhabdomyolysis (creatinine kinase >10 times upper
limit of normal), or statin discontinuation or dose reduction. Due to
existing literature with pravastatin, subanalyses were prespecified
assessing adverse events when pravastatin 30 mg or 40 mg were included in
the standard dose group and when pravastatin 30 mg or 40 mg were removed
from either group. <br/>Result(s): A total of 45 patients were included in
the study, with 13 in the standard and 32 in the high dose statin group.
The incidence of adverse events was higher in the high dose group, driven
by need for dose reduction (Table). The overall incidence of any event
remained higher in the high dose group in both secondary analyses.
<br/>Conclusion(s): High dose statins in combination with cyclosporine
leads to more adverse events, driven by dose reductions. The incidence
remains low when pravastatin 40 mg or less is considered a standard
dose.<br/>Copyright &#xa9; 2023

<69>
Accession Number
2029389668
Title
Balancing ischemic and hemorrhagic risk after ICH - Re-starting
antiplatelets and anticoagulants?.
Source
Journal of the Neurological Sciences. Conference: World Congress of
Neurology (WCN 2023). Montreal Canada. 455(Supplement) (no pagination),
2023. Article Number: 120893. Date of Publication: December 2023.
Author
Salman R.
Institution
(Salman) The University of Edinburgh, Centre for Clinical Brain Sciences,
Edinburgh, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: Adults with spontaneous intracranial haemorrhage (ICH) are at
risk of both haemorrhagic and ischaemic major adverse cardiovascular and
cerebrovascular events (MACE). However, patients with ICH were excluded
from randomised controlled trials (RCTs) that demonstrated the
effectiveness of non-enzymatic antiplatelet and anticoagulant
(antithrombotic) agents for preventing MACE. Physicians' consequent
uncertainty and concerns about patients' survival, frailty, risk of
recurrent bleeding, and polypharmacy have led to infrequent antithrombotic
agent use after ICH in clinical practice. Recent developments:
Meta-analyses of cohort studies of patients with ICH have found absent or
modest associations between the use of antiplatelet or anticoagulant
therapies and haemorrhagic MACE, alongside expected associations with
lower risks of ischaemic MACE. Case series of patients with atrial
fibrillation after intracranial haemorrhage have reported low risks of
haemorrhagic and ischaemic events after left atrial appendage occlusion.
However these observational studies were at high risk of selection bias
and confounding by indication. The REstart or STop Antithrombotics
Randomised Trial (RESTART) found that antiplatelet agents seemed safe and
might be beneficial after symptomatic stroke due to intracerebral
haemorrhage (Lancet 2019). The NASPAF-ICH, SoSTART (Lancet Neurol 2021)
and APACHE-AF (Lancet Neurol 2021) pilot phase trials found that
definitive main phase trials of oral anticoagulation for atrial
fibrillation after intracranial haemorrhage are justified. Where next?:
Eight ongoing RCTs are addressing these therapeutic dilemmas, and will be
included in a prospectively-planned patient-level meta-analysis by the
Collaboration of Controlled Randomised trials of Oral Antithrombotic
agents after intraCranial Haemorrhage (COCROACH).<br/>Copyright &#xa9;
2023

<70>
Accession Number
2029398023
Title
Randomized Trial of the Terumo Capiox FX05 Oxygenator with
Integral Arterial Filter versus Terumo Capiox Baby RX05 and
Terumo Capiox AF02 Arterial Filter in Infants Undergoing
Cardiopulmonary Bypass.
Source
Journal of Extra-Corporeal Technology. 43(4) (pp 207-214), 2011. Date of
Publication: 01 Dec 2011.
Author
Nuszkowski M.M.; Deutsch N.; Jonas R.A.; Zurakowski D.; Montague E.; Holt
D.W.
Institution
(Nuszkowski, Deutsch, Jonas, Zurakowski, Montague, Holt) Children's
National Medical Center, Washington, DC, United States
Publisher
EDP Sciences
Abstract
The purpose of this clinical trial was to evaluate the effect of the
Terumo Capiox FX05 oxygenator with integrated arterial filter
during cardiopulmonary bypass (CPB) compared with the Terumo
Capiox RX05 Baby RX and arterial filter on inflammatory
mediators and blood product utilization. Forty patients weighing less than
10 kg who underwent congenital heart surgery utilizing cardiopulmonary
bypass were randomized into either oxygenator group. The endpoints
included measuring inflammatory markers at six different time points
(preoperative baseline, CPB circuit being primed, 15 minutes after CPB
initiation, status post protamine administration, prior to transport to
intensive care unit, and within 12 to 24 hours post surgery), blood
product utilization, extubation time, and days until discharge. The
inflammatory mediators showed no significant differences between
oxygenators at any time points. However, looking at the inflammatory
mediators of both the FX and RX groups combined, a statistically
significant difference was seen in interleukin (IL)-6 at 12/24 hour post
surgery (p < .001) versus baseline and all other time points. IL-8 at
status post protamine (p < .001) and 12/24 hours post surgery (p < .001)
demonstrated significant differences versus all other time points, and
IL-10 at status post protamine (p < .001) and prior to leaving the
operating room (p < .001) were statistically different compared to all
other time points. Cardiopulmonary bypass stimulates the systemic
inflammatory response through various components of the extracorporeal
system. This investigation did not find significant differences in
cytokines interferon-g, IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10,
IL-12 p70, tumor necrosis factor (TNF)-a, and TNF-beta when comparing
these two oxygenators. It is well known that various mechanisms contribute
to the levels of cytokines circulating in a patient's blood volume and
many manipulations throughout cardiac surgery have the ability to
demonstrate anti-inflammatory interventions. Further investigation is
needed as to how modification of the extracorporeal circuit may minimize
increases in inflammatory mediators.<br/>Copyright &#xa9; 2011 American
Society of Extra-Corporeal Technology. All rights reserved.

<71>
Accession Number
2029463605
Title
Balloon pulmonary valvuloplasty: A systematic review.
Source
Indian Heart Journal. (no pagination), 2024. Date of Publication: 2024.
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
Publisher
Elsevier B.V.
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

<72>
Accession Number
2027776069
Title
Risk factors, clinical implications, and management of peridevice leak
following left atrial appendage closure: A systematic review.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2024. Date of Publication: 2024.
Author
Helal B.; Khan J.; AlJayar D.; Khan M.S.; Alabdaljabar M.S.; Asad Z.U.A.;
DeSimone C.V.; Deshmukh A.
Institution
(Helal, Khan, AlJayar, Khan) College of Medicine, Alfaisal University,
Riyadh, Saudi Arabia
(Alabdaljabar) Department of Internal Medicine, Mayo Clinic, Rochester,
MN, United States
(Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, 200 1St Street
SW, Rochester, MN 55905, United States
Publisher
Springer
Abstract
Background: Left atrial appendage closure (LAAC) is a treatment modality
for stroke prevention in patients with atrial fibrillation (AF). One of
the potential complications of LAAC is a peri-device leak (PDL), which
could potentially increase the risk of thromboembolism formation.
<br/>Method(s): This systematic review was done according to PRISMA
guidelines. Using four databases, all primary studies through April 2022
that met selection criteria were included. Outcomes of interest were
studies reporting on PDL characteristics, risk factors and management.
<br/>Result(s): A total of 116 studies met selection criteria (97 original
studies and 19 case reports/series). In the original studies (n = 30,133
patients), the weighted mean age was 72.0 +/- 7.4 years (57% females) with
a HAS-BLED and CHA2DS2-VASc weighted means of 2.8 +/- 1.1 and 3.8 +/- 1.3,
respectively. The most common definition of PDL was based on size; 5 mm:
major, 3-5 mm: moderate, < 1 mm minor, or trivial. Follow up time for PDL
detection was 7.15 +/- 9.0 months. 33% had PDL, irrespective of PDL
severity/size, and only 0.9% had PDL of greater than 5 mm. The main risk
factors for PDL development included lower degree of over-sizing, lower
left ventricular ejection fraction, device/LAA shape mismatch, previous
radiofrequency ablation, and male sex. The most common methods to screen
for PDL included transesophageal echocardiogram and cardiac CT. PDL
Management approaches include Amplatzer Patent Foramen Ovale occluder,
Hookless ACP, Amplatzer vascular plug II, embolic coils, and detachable
vascular coils; removal or replacement of the device; and left atriotomy.
<br/>Conclusion(s): Following LAAC, the emergence of a PDL is a
significant complication to be aware of. Current evidence suggests
possible risk factors that are worth assessing in-depth. Additional
research is required to assess suitable candidates, timing, and strategies
to managing patients with PDL.<br/>Copyright &#xa9; 2024, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<73>
Accession Number
2027606313
Title
Diagnostic efficacy of serum presepsin for postoperative infectious
complications: a meta-analysis.
Source
Frontiers in Immunology. 14 (no pagination), 2023. Article Number:
1320683. Date of Publication: 2023.
Author
Lu C.-Y.; Kao C.-L.; Hung K.-C.; Wu J.-Y.; Hsu H.-C.; Yu C.-H.; Chang
W.-T.; Feng P.-H.; Chen I.-W.
Institution
(Lu, Hung, Yu) Department of Anesthesiology, Chi Mei Medical Center,
Tainan, Taiwan (Republic of China)
(Kao) Department of Anesthesiology, I-Shou University, E-Da Hospital,
Kaohsiung, Taiwan (Republic of China)
(Wu) Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
(Republic of China)
(Hsu) Department of Otolaryngology, Kuang Tien General Hospital, Taichung,
Taiwan (Republic of China)
(Chang) School of Medicine and Doctoral Program of Clinical and
Experimental Medicine, College of Medicine and Center of Excellence for
Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University,
Kaohsiung, Taiwan (Republic of China)
(Chang) Division of Cardiology, Department of Internal Medicine, Chi Mei
Medical Center, Tainan, Taiwan (Republic of China)
(Chang) Department of Biotechnology, Southern Taiwan University of Science
and Technology, Tainan, Taiwan (Republic of China)
(Feng, Chen) Department of Anesthesiology, Chi Mei Medical Center,
Liouying, Tainan, Taiwan (Republic of China)
Publisher
Frontiers Media SA
Abstract
Background: Postoperative infectious complications (PICs) are major
concerns. Early and accurate diagnosis is critical for timely treatment
and improved outcomes. Presepsin is an emerging biomarker for bacterial
infections. However, its diagnostic efficacy for PICs across surgical
specialties remains unclear. <br/>Method(s): In this study, a systematic
search on MEDLINE, Embase, Google Scholar, and Cochrane Library was
performed on September 30, 2023, to identify studies that evaluated
presepsin for diagnosing PICs. PIC is defined as the development of
surgical site infection or remote infection. Pooled sensitivity,
specificity, and hierarchical summary receiver operating characteristic
(HSROC) curves were calculated. The primary outcome was the assessment of
the efficacy of presepsin for PIC diagnosis, and the secondary outcome was
the investigation of the reliability of procalcitonin or C-reactive
protein (CRP) in the diagnosis of PICs. <br/>Result(s): This meta-analysis
included eight studies (n = 984) and revealed that the pooled sensitivity
and specificity of presepsin for PIC diagnosis were 76% (95% confidence
interval [CI] 68%-82%) and 83% (95% CI 75%-89%), respectively. The HSROC
curve yielded an area under the curve (AUC) of 0.77 (95% CI 0.73-0.81).
Analysis of six studies on procalcitonin showed a combined sensitivity of
78% and specificity of 77%, with an AUC of 0.83 derived from the HSROC.
Meanwhile, data from five studies on CRP indicated pooled sensitivity of
84% and specificity of 79%, with the HSROC curve yielding an AUC of 0.89.
<br/>Conclusion(s): Presepsin exhibits moderate diagnostic accuracy for
PIC across surgical disciplines. Based on the HSROC-derived AUC, CRP has
the highest diagnostic efficacy for PICs, followed by procalcitonin and
presepsin. Nonetheless, presepsin demonstrated greater specificity than
the other biomarkers. Further study is warranted to validate the utility
of and optimize the cutoff values for presepsin. Systematic review
registration: https://www.crd.york.ac.uk/prospero/, identifier
CRD42023468358.<br/>Copyright &#xa9; 2023 Lu, Kao, Hung, Wu, Hsu, Yu,
Chang, Feng and Chen.

<74>
Accession Number
2029265837
Title
Acute and Chronic Cardiovascular Consequences of Acute Kidney Injury: A
Systematic Review and Meta-Analysis.
Source
CardioRenal Medicine. 13(1) (pp 26-33), 2023. Date of Publication: 18 Nov
2023.
Author
De Clercq L.; Ailliet T.; Schaubroeck H.; Hoste E.A.J.
Institution
(De Clercq, Ailliet, Schaubroeck, Hoste) Department of Intensive Care
Medicine, Department of Internal Medicine and Pediatrics, Ghent University
Hospital, Ghent University, Ghent, Belgium
(Hoste) Research Foundation-Flanders (FWO), Brussels, Belgium
Publisher
S. Karger AG
Abstract
Introduction: We examined whether patients with acute kidney injury (AKI)
have a higher risk of developing atrial fibrillation (AF), heart failure
(HF), acute coronary syndrome (ACS), and major adverse cardiac events
(MACE) in the short and long term compared to patients without AKI, and if
that risk is related to the severity of AKI. Furthermore, we investigated
the influence of a cardiac event following AKI on the risk of all-cause
mortality, length of stay in the intensive care unit and in the hospital.
<br/>Method(s): We included English and Dutch retrospective and
prospective cohort studies on adults (>=15 years) with AKI. Studies
lacking epidemiological data, studies not using the consensus definitions
(RIFLE, AKIN, KDIGO), animal studies, and studies on children were
excluded. Studies were identified using the PubMed and Embase search
engines. The last search was performed on the first of August 2021. For
assessment of method quality, Newcastle-Ottawa Scale (NOS) for assessing
risk of bias was used for cohort studies and heterogeneity was determined
by the I² statistic. Statistical analysis was performed using
the Cochrane Review Manager (RevMan 5.3). The risk ratio (RR) and 95%
confidence interval (CI) were calculated using the Mantel-Haenszel test.
Results were presented in a summary caterpillar plot. <br/>Result(s): We
evaluated 14 studies comprising 736,210 patients. AKI was defined
according to the RIFLE consensus in 1 article, to the AKIN criteria in 7,
and to the KDIGO guidelines in 6. Of the 14 included studies, 4 were
prospective and 10 were retrospective. In comparison with patients without
AKI, we found that patients with AKI had a 94% increased risk of
developing AF in the short term (RR: 1.94, 95% CI 1.35-2.79; p = 0.0004).
In the long term, patients with AKI stage 1 had a 59% increased risk of
developing HF and a 77% risk of developing ACS (RR: 1.59, 95% CI
1.07-2.34, p = 0.02 and RR: 1.77, 95% CI 1.68-1.88, p < 0.00001,
respectively). Patients with AKI stage 2 had a 45% increased risk of ACS
development (RR: 1.45, 95% CI 1.11-1.90, p = 0.006). AKI stage 3 was
associated with a 164% increased risk of HF and a 95% increased risk of
ACS development (RR: 2.64, 95% CI 1.71-4.08, p < 0.00001 and RR: 1.95, 95%
CI 1.35-2.82, p = 0.0004, respectively). Analysis of studies not
subdividing AKI into groups showed a 74% increased risk of HF, a 12%
increased risk of ACS, and a 30% increased risk of developing MACE (RR:
1.74, 95% CI 1.51-2.01, p < 0.00001, RR: 1.12, 95% CI 1.07-1.17, p <
0.00001 and RR: 1.30, 95% CI 1.25-1.35, p < 0.00001, respectively).
<br/>Conclusion(s): Patients who developed AKI have an increased risk of
developing AF at short-term follow-up and HF, ACS, and MACE beyond 30
days.<br/>Copyright &#xa9; 2023 S. Karger AG. All rights reserved.

<75>
Accession Number
2029084165
Title
Comparison of Clinical Outcomes Among Various Percutaneous Coronary
Intervention Strategies for Small Coronary Artery Disease.
Source
American Journal of Cardiology. 211 (pp 334-342), 2024. Date of
Publication: 15 Jan 2024.
Author
Kiyohara Y.; Aikawa T.; Kayanuma K.; Takagi H.; Kampaktsis P.N.; Wiley J.;
Kuno T.
Institution
(Kiyohara) Department of Medicine, The University of Tokyo Hospital,
Tokyo, Japan
(Aikawa) Department of Cardiology, Juntendo University Urayasu Hospital,
Urayasu, Japan
(Aikawa) Department of Radiology, Jichi Medical University Saitama Medical
Center, Saitama, Japan
(Aikawa, Kayanuma) Department of Cardiology, Hokkaido Cardiovascular
Hospital, Sapporo, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, New York, United States
(Wiley) Section of Cardiology, Department of Medicine, Tulane University
School of Medicine, New Orleans, Louisiana, United States
(Kuno) 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, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
It remains unclear which percutaneous coronary intervention (PCI) strategy
is the most preferable in patients with small-vessel coronary artery
disease (CAD). We sought to evaluate the clinical efficacy of various PCI
strategies for patients with small-vessel CAD through a network
meta-analysis of randomized controlled trials (RCTs). We searched multiple
databases for RCTs investigating the efficacy of the following PCI
strategies for small-vessel CAD (<3 mm in diameter): drug-coated balloons
(DCB), early-generation paclitaxel-eluting stents and sirolimus-eluting
stents (SES), newer-generation drug-eluting stents (DES), bare-metal
stents (BMS), cutting balloon angioplasty, and balloon angioplasty (BA).
The primary outcome was the trial-defined major adverse cardiovascular
events (MACE), mostly defined as a composite of death, myocardial
infarction, and revascularization. The secondary outcomes included each
component of MACE and angiographic binary restenosis. We performed a
sensitivity analysis for RCTs without BMS or first-generation DES. Our
search identified 29 eligible RCTs, including 8,074 patients among the 8
PCI strategies. SES significantly reduced MACE compared with BA (hazard
ratio 0.23, 95% confidence interval 0.10 to 0.54) with significant
heterogeneity (I² = 55.9%), and the rankogram analysis showed
that SES was the best. There were no significant differences between DCB
and newer-generation DES in any clinical outcomes, which was consistent in
the sensitivity analysis. BMS and BA were ranked as the worst 2 for most
clinical outcomes. In conclusion, SES was ranked as the best for reducing
MACE. There were no significant differences in clinical outcomes between
DCB and newer-generation DES. BMS and BA were regarded as the worst
strategies for small-vessel CAD.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<76>
Accession Number
2027882762
Title
Phase Angle as a Reliable Biomarker of Frailty to Predict Postoperative
Outcomes in Patients Undergoing Off-Pump Coronary Artery Grafting: A
Prospective Observational Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(1) (pp 109-117),
2024. Date of Publication: January 2024.
Author
Kwon J.-H.; Bang Y.J.; Kwon E.J.; Kim W.J.; Kim W.S.; Cho H.S.; Min J.-J.
Institution
(Kwon, Bang, Kwon, Kim, Cho, Min) Department of Anaesthesiology and Pain
Medicine, Samsung Medical Centre, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Kim) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: To elucidate the association between phase angle (PA) and a
composite adverse outcome in patients requiring off-pump coronary artery
bypass grafting (OPCAB). <br/>Design(s): A prospective observational
study. <br/>Setting(s): High-volume single center. <br/>Participant(s): A
total of 229 adult patients who underwent OPCAB from May 2019 to October
2020. <br/>Intervention(s): Each patient underwent bioelectrical impedance
analysis, including PA assessment before surgery (PA<inf>pre</inf>),
immediately postoperatively (PA<inf>post</inf>), and 1 day postoperatively
(PA<inf>POD1</inf>), using an Inbody S10. Frailty index and nutritional
assessments also were obtained before surgery. <br/>Measurements and Main
Results: Patient outcomes were assessed using a composite adverse outcome
comprising death, myocardial infarction, revascularization, new-onset
atrial fibrillation, acute kidney injury, stroke, postoperative pulmonary
complications, wound complications, sepsis, reoperation, and/or delirium
occurring during hospitalization and over the following year. Patients for
whom composite adverse outcomes were reported had lower PA<inf>pre</inf>
than those without complications (5.4 +/- 0.9 v 6.0 +/- 0.9, p < 0.001).
The PA was significantly associated with in-hospital and 1-year composite
postoperative outcomes. The odds ratios (OR, [95% confidence interval])
for PA<inf>pre</inf> by time were in-hospital complications (0.435 [0.314,
0.604], p < 0.001; 1-year complications: 0.459 [0.330, 0.638], p < 0.001)
and PA<inf>POD1</inf> (OR, in-hospital complications: 0.400 [0.277,
0.576], 1-year complications: 0.429 [0.298, 0.619], p < 0.001). The
PA<inf>pre</inf> was significantly associated with days alive and out of
hospital until 1 year. The cut-off value of PA<inf>pre</inf> for optimal
prediction of in-hospital complications was 6.0 (area under the curve:
0.691 [0.623-0.758], p < 0.001). <br/>Conclusion(s): Low PA as an
indicator of frailty is associated with adverse postoperative outcomes
after OPCAB. Low PA may be employed as a noninvasive and practical tool
for the prediction of prognosis in patients with coronary artery
disease.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<77>
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).

<78>
Accession Number
2026433441
Title
Coral Reef Aorta: Literature Review and Analysis of the Published Cases in
the Last 20 Years.
Source
Annals of Vascular Surgery. 98 (pp 374-387), 2024. Date of Publication:
January 2024.
Author
Baldaia L.; Antunes L.F.; Silva M.; Silva E.; Nunes C.; Constancio V.;
Orelhas L.; Fonseca M.
Institution
(Baldaia, Antunes, Silva, Silva, Nunes, Constancio, Orelhas, Fonseca)
Department of Angiology and Vascular Surgery, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Antunes) Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Publisher
Elsevier Inc.
Abstract
Background: Coral reef aorta (CRA) is defined by the presence of heavily
calcified exophytic plaques that protrude into the aortic lumen. However,
the exact causes and development of this condition are still not fully
understood. When the aortic branches are affected, it can result in
various symptoms. Despite ongoing research, there is currently no
established consensus on the best treatment for CRA. This review aims to
examine the latest findings regarding the clinical presentation and
approach to treating patients with CRA. <br/>Method(s): We conducted a
systematic electronic search of the literature using the PubMed and Embase
databases. Throughout the search, we adhered to the guidelines outlined in
the PRISMA framework. From the identified publications, we extracted
information pertaining to patients' characteristics, symptoms, and types
of treatment from a total of 124 cases reported over the past 20 years.
The primary focus of our analysis was to assess the improvement of signs
and symptoms, as well as to evaluate any postoperative complications. To
achieve this, we performed both descriptive and inferential analyses on
the collected data. Additionally, we conducted subgroup analyses based on
treatment types and symptoms observed at presentation, presenting the
findings in the form of odds ratios (ORs). <br/>Result(s): After removing
duplicate articles, we carefully screened the titles of 67 retrieved
articles and excluded those that did not align with the purpose of our
study. Subsequently, we thoroughly analyzed the remaining 41 articles
along with their references, ultimately including 29 studies that were
deemed most relevant for our systematic review. We examined a total of 124
cases of patients diagnosed with CRA, comprising 77 (62.1%) females and 48
(38.7%) males, with a mean age of 59 years (range: 37-84). The predominant
signs and symptoms observed were intermittent claudication, reported in 57
(46.0%) patients, followed by refractory hypertension in 45 (36.3%)
patients, intestinal angina in 28 (22.6%) patients, and renal
insufficiency in 15 (12.1%) patients. Among the treated patients, 110
(88.7%) underwent open surgery repair (OSR), 11 (8.9%) received
endovascular treatment, and 3 (2.4%) underwent laparoscopy.
Postoperatively, a significant number of patients experienced substantial
relief or complete resolution of their symptoms, as well as improved
control of hypertension and renal function. In the group of patients
treated with OSR, the inhospital stay mortality rate was 10.9%, the
morbidity rate was 28.2%, and the reintervention rate was 15.5%. The high
mortality rate during hospital stays in this group may be associated with
such invasive procedures performed on patients who have substantial
cardiovascular burden and multiple comorbidities. Conversely, no
postoperative complications were reported in the group of patients treated
with endovascular procedures or laparoscopic surgery. <br/>Conclusion(s):
While coral reef aorta (CRA) is considered a rare condition, it is crucial
for the medical community to remain vigilant about its diagnosis,
particularly in patients presenting with symptoms such as intermittent
claudication, refractory hypertension, renal impairment, or intestinal
angina. Based on the findings of this review, both OSR and endovascular
treatment have shown promise as viable therapeutic options. Although
endovascular therapies may not always be feasible or may have reduced
durability in these calcified bulky lesions, they should be considered in
patients with multiple comorbidities, due to the high postoperative
mortality rates associated with more invasive approaches. Additionally,
these endoluminal procedures have demonstrated good patency rates during
the 18-month follow-up period. It is essential to emphasize that the
treatment strategy should be determined on a case-by-case basis, involving
a multidisciplinary team to tailor it to the specific needs of each
individual patient.<br/>Copyright &#xa9; 2023 The Author(s)

<79>
Accession Number
2029475253
Title
In-Hospital influenza vaccination to prevent cardiorespiratory events in
the first 45 days after acute coronary syndrome: A prespecified analysis
of the VIP-ACS trial.
Source
Vaccine. (no pagination), 2024. Date of Publication: 2024.
Author
Fonseca H.A.R.; Zimerman A.; Monfardini F.; Guimaraes H.P.; Pedrosa R.P.;
Patriota R.D.L.S.; Couto Patriota T.L.G.; Passos L.C.S.; Dall'Orto F.T.C.;
Hoffmann Filho C.R.; Nascimento B.R.; Baldissera F.A.; Pereira C.A.C.;
Caramori P.R.A.; Andrade P.B.; Okoshi M.P.; Polanczyk C.A.; Silveira F.S.;
Villacorta A.S.; Nicolau J.C.; Rizzo L.V.; Berwanger O.
Institution
(Fonseca, Monfardini, Guimaraes, Rizzo, Berwanger) Instituto Israelita de
Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Zimerman) TIMI Study Group, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Pedrosa, Patriota) Pronto Socorro Cardiologico de Pernambuco PROCAPE,
Recife, Brazil
(Couto Patriota, Dall'Orto) Hospital Santa Lucia, Pocos de Caldas, Brazil
(Passos) Hospital Ana Nery, Salvador, Brazil
(Hoffmann Filho) Hospital Regional Hans Dieter Schmidt, Joinville, Brazil
(Nascimento) Hospital Universitario Ciencias Medicas, Belo Horizonte,
Brazil
(Baldissera) Instituto de Pesquisas Medicas de Itajai, Itajai, Brazil
(Pereira, Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas,
Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Caramori) Hospital Sao Lucas da PUCRS, Porto Alegre, Brazil
(Andrade) Irmandade da Santa Casa de Misericordia de Marilia, Marilia,
Brazil
(Okoshi) Botucatu Medical School, Sao Paulo State University, Botucatu,
Brazil
(Polanczyk) Hospital de Clinicas de Porto Alegre, Universidade Federal do
Rio Grande do Sul, Porto Alegre, Brazil
(Silveira) Centro de Pesquisa Clinica do Coracao, Aracaju, Brazil
(Villacorta) Instituto Estadual de Cardiologia Aloysio de Castro, Niteroi,
Brazil
Publisher
Elsevier Ltd
Abstract
Background: Influenza vaccination prevents major cardiovascular events in
individuals presenting a recent acute coronary syndrome (ACS), however the
early effect of an in-hospital double-dose vaccination strategy remains
uncertain. <br/>Method(s): The VIP-ACS was a randomized, pragmatic,
multicenter, open-label trial with a blinded-adjudication endpoint.
Patients with ACS <= 7 days of hospitalization were randomized to an
in-hospital double-dose quadrivalent inactivated influenza vaccine
(double-dose) or a standard-dose influenza vaccine at 30 days
post-randomization. The primary endpoint was a hierarchical composite of
death, myocardial infarction, stroke, hospitalization for unstable angina,
hospitalization for heart failure, urgent coronary revascularization, and
hospitalization for respiratory infections, analyzed with the win ratio
(WR) method in short-term follow-up (45-days after randomization).
<br/>Result(s): The trial enrolled 1,801 patients (>=18 years old). Median
participant age was 57 years, 70 % were male. There were no significant
differences between groups on the primary hierarchical endpoint: there
were 5.7 % wins in the double-dose in-hospital group and 5.5 % wins in the
standard-dose delayed vaccination group (WR: 1.03; 95 % CI: 0.70---1.53; P
= 0.85). In a sensitivity analysis including COVID-19 infection in the
hospitalizations for respiratory infections endpoint, overall results were
maintained (WR: 1.03; 95 % CI 0.71---1.51; P = 0.87). Results were
consistent for major cardiovascular events only (WR: 0.82; 95 % CI:
0.48---1.39; P = 0.46). No serious adverse events were observed.
<br/>Conclusion(s): In patients with recent ACS, in-hospital double-dose
influenza vaccination did not significantly reduce cardiorespiratory
events at 45 days compared with standard-dose vaccination at 30 days
post-randomization.<br/>Copyright &#xa9; 2023

<80>
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.

<81>
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.

<82>
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.

<83>
Accession Number
641751214
Title
Reply to Sethuraman.
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.; Selim J.
Institution
(Dusseaux, Grego, Selim) Department of Anaesthesiology and Critical Care,
CHU Rouen, Rouen F-76000, France
(Baste, Selim) Univ Rouen Normandy INSERM EnVI UMR 1096, Rouen, France
(Baste) Department of Thoracic Surgery, CHU Rouen F-76000, France
Publisher
NLM (Medline)

<84>
[Use Link to view the full text]
Accession Number
641547913
Title
Tricuspid valve repair concomitant with mitral valve surgery: a systematic
review and meta-analysis.
Source
International journal of surgery (London, England). 109(7) (pp 2082-2095),
2023. Date of Publication: 01 Jul 2023.
Author
Yi K.; Xu J.; Zhang X.; Wang W.; Liu C.; Li X.; You T.
Institution
(Yi, You) Department of Cardiovascular Surgery, Gansu Provincial Hospital
(Yi, Xu, Zhang, Wang, You) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Gansu Province, Lanzhou, China
(Wang) Department of Cardiac Surgery, First Hospital of China Medical
University, Shenyang, Liaoning, China
(Xu) Evidence-Based Medicine Center, School of Basic Medical Sciences,
Lanzhou University
(Zhang, Wang) First School of Clinical Medicine of Gansu University of
Chinese Medicine, China
(Liu, Li) First Clinical Medical College of Lanzhou University, Lanzhou,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Uncertainties persist about whether to aggressively and
effectively treat tricuspid regurgitation (TR) during mitral valve (MV)
surgery. REVIEW METHODS: Systematic literature searches were performed in
five databases to collect all relevant studies published before May 2022
on whether the tricuspid valve was treated during MV surgery. Separate
meta-analyses were performed on data from unmatched studies and randomized
controlled trials (RCT)/adjusted studies. MAIN RESULTS: A total of 44
publications were included, of which eight were RCT studies and the rest
were retrospective studies. There was no difference in 30-day mortality
[odds ratio (OR): 1.00, 95% CI: 0.71-1.42, OR: 0.66, 95% CI: 0.30-1.41)]
or overall survival [hazard ratio (HR): 1.01, 95% CI: 0.85-1.19, HR: 0.77,
95% CI: 0.52-1.14] in unmatched studies and RCT/adjusted studies. Late
mortality (OR: 0.37, 95% CI: 0.21-0.64) and cardiac-related mortality (OR:
0.36, 95% CI: 0.21-0.62) were lower in the tricuspid valve repair (TVR)
group in the RCT/adjusted studies. In the unmatched studies, overall
cardiac mortality (OR: 0.48, 95% CI: 0.26-0.88) was lower in the TVR
group. In the late TR progression analysis, the late TR progression was
lower among patients in the concomitantly intervened tricuspid group, and
patients in the untreated tricuspid group were prone to TR progression in
both studies (HR: 0.30, 95% CI: 0.22-0.41, HR: 0.37, 95% CI: 0.23-0.58).
<br/>CONCLUSION(S): TVR concomitant with MV surgery is most effective in
patients with significant TR and dilated tricuspid annulus, especially
those with a significantly reduced risk of distant TR
progression.<br/>Copyright &#xa9; 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<85>
Accession Number
625889159
Title
Preoperative antiplatelet drugs on the hemorrhage and allogenic blood
transfusion condition after coronary artery bypass graft surgery.
Source
Pakistan journal of pharmaceutical sciences. 31(6) (pp 2819-2822), 2018.
Date of Publication: 01 Nov 2018.
Author
Zhu P.; Chen Y.; Wang H.; Song B.
Institution
(Zhu, Song) Department of Cardiovascular, First Clinical Medical College
of Lanzhou University (The First Hospital of Lanzhou University), Lanzhou,
China
(Chen, Wang) Department of Cardiovascular, Jinan Central Hospital
Affiliated to Shandong University, Ji'nan, China
Publisher
NLM (Medline)
Abstract
Aim of the study was to observe and evaluate the postoperative hemorrhage
and allogenic blood transfusion condition in patients who were exposed to
different levels of clopidogrel and aspirin beforeon-pump coronary artery
bypass graft surgery (CABG). A total of 180 patients underwent on-pump
CABG at our hospital were enrolled and divided into treatment group,
discontinuation group and control group based on their preoperative use of
clopidogrel and aspirin, with 60 patients in each group. And the
postoperative hemorrhage and allogenic blood transfusion condition were
observed and evaluated. Compared with the control group, the postoperative
total drainage and the occurrence of major bleeding were significantly
higher in the treatment group (p<0.05). The transfusion volume and
infusion rates of packed red blood cells and fresh frozen plasma and the
total blood transfusion rate were decreased progressively in accordance
with the treatment group, discontinuation group and control group. The
transfusion volume and infusion rates of packed red blood cells and fresh
frozen plasma, and the total blood transfusion rate were significantly
higher in the treatment group when compared with the control group
(p<0.05). And the total blood transfusion rate was significantly higher in
the treatment group when compared with the discontinuation group (p<0.05).
The postoperative hemorrhage and allogenic blood transfusion rate would be
significantly up-regulated when patients were exposed to clopidogrel and
aspirin in the week before on-pump CABG.

<86>
[Use Link to view the full text]
Accession Number
625595266
Title
The Ross Procedure: A Systematic Review, Meta-Analysis, and
Microsimulation.
Source
Circulation. Cardiovascular quality and outcomes. 11(12) (pp e004748),
2018. Date of Publication: 01 Dec 2018.
Author
Etnel J.R.G.; Grashuis P.; Huygens S.A.; Pekbay B.; Papageorgiou G.;
Helbing W.A.; Roos-Hesselink J.W.; Bogers A.J.J.C.; Mokhles M.M.;
Takkenberg J.J.M.
Institution
(Etnel, Grashuis, Huygens, Pekbay, Papageorgiou, Bogers, Mokhles,
Takkenberg) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P.,
G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
(Huygens) Erasmus School of Health Policy & Management
(Papageorgiou) Department of Biostatistics, Erasmus University Medical
Center, Rotterdam, Netherlands
(Helbing) Division of Cardiology, Department of Pediatrics, Erasmus
University Medical Center, Sophia Children's Hospital, Rotterdam,
Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus University Medical
Center, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: To support decision-making in aortic valve replacement in
children and adults, we provide a comprehensive overview of outcome after
the Ross procedure. METHODS AND RESULTS: A systematic search was conducted
for publications reporting clinical outcome after the Ross procedure,
published between January 1, 2000, and November 22, 2017. Reported event
rates and time-to-event data were pooled and entered into a
microsimulation model to calculate life expectancy and lifetime event
risk. Ninety-nine publications were included (13 129 patients; total
follow-up: 93 408 patient-years, pooled mean follow-up: 7.9+/-5.3 years).
Pooled mean age at surgery was 9.4+/-5.5 years for children and
41.9+/-11.4 for adults. For children and adults, respectively, pooled
early mortality risk was 4.19% (95% CI, 3.21-5.46) and 2.01% (95% CI,
1.44-2.82), late mortality rate was 0.54%/y (95% CI, 0.42-0.70) and
0.59%/y (95% CI, 0.46-0.76), autograft reintervention 1.28%/y (95% CI,
0.99-1.66) and 0.83%/y (95% CI, 0.68-1.01), and right ventricular outflow
tract reintervention 1.97%/y (95% CI, 1.64-2.36) and 0.47%/y (95% CI,
0.37-0.59). Pooled thromboembolism and bleeding rates were low and
comparable to the general population. Lifetime risks of autograft and
right ventricular outflow tract reintervention were, respectively, 94% and
100% for children and 49% and 19% for a 45-year-old. Estimated life
expectancy after surgery was 59 years for children (general population: 64
years) and 30 years for a 45 years old (general population: 31 years).
<br/>CONCLUSION(S): Through excellent survival and avoidance of the burden
of anticoagulation, the Ross procedure provides a unique opportunity for
patients whose preferences do not align with the outcome provided by
mechanical valve replacement and for growing children who also benefit
from autograft diameter increase along with somatic growth. On the
downside, almost all pediatric and many adult Ross patients will require a
reintervention in their lifetime.

<87>
Accession Number
2029426742
Title
Intra-operative anesthetic induced myocardial protection during
cardiothoracic surgery: a literature review.
Source
Journal of Thoracic Disease. 15(12) (pp 7042-7049), 2023. Date of
Publication: December 2023.
Author
Abraham A.S.; Elliott C.W.; Abraham M.S.; Ahuja S.
Institution
(Abraham, Elliott) Department of Cardiothoracic Anesthesiology, Cleveland
Clinic Foundation, Cleveland, OH, United States
(Abraham) School of Medicine, University of Leeds, Leeds, United Kingdom
(Ahuja) Department of Cardiothoracic Anesthesiology, Outcomes Research
Consortium, Cleveland Clinic Foundation, Cleveland, OH, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Myocardial protection involves limiting the
metabolic activity and oxygen consumption of the heart, thus enabling
surgery to proceed with minimal blood loss while reducing the level of
ischemic injury. It was this concept that allowed for the development of
the open-heart surgical technique. We know myocardial ischemia and
reperfusion injury are both detrimental, thus developing strategies to
mitigate this can help reduce peri-operative morbidity and mortality. In
this review, we will mainly be addressing the anesthetic considerations
for myocardial protection, along with discussing potential future research
which can help expand the field. <br/>Method(s): We searched the PubMed
database for relevant studies dating from 2004-2022. In total, 18 studies
were deemed suitable for this literature review. Key Content and Findings:
Studies have demonstrated cardioprotective effects with use of the
volatile agents and propofol, mainly with respect to lower levels of
inflammatory markers such as creatine kinase (CK)-MB and troponin I
(TnI)/troponin T (TnT). The data is lacking regarding protective effects
of dexmedetomidine and lidocaine, hence we cannot recommend either agent
at present. <br/>Conclusion(s): Myocardial protection with respect to the
anesthetic agents have been extensively studied over the past two decades,
some routinely used drugs such as the volatile agents, propofol and
opiates have demonstrated a cardioprotective role. The ideal dosing
regimen and duration are areas of research that can be studied further.
The data for the other anesthetic adjuncts such as lidocaine,
dexmedetomidine along with use of regional anesthesia is still equivocal.
Alongside advances in anesthesia, we believe surgical research looking
into optimal cardioplegia solutions will also help improve myocardial
protection in the future.<br/>Copyright &#xa9; Journal of Thoracic
Disease. All rights reserved.

<88>
Accession Number
2029397948
Title
Evaluation of Hemodynamic and Regional Tissue Perfusion Effects of
Minimized Extracorporeal Circulation (MECC).
Source
Journal of Extra-Corporeal Technology. 42(1) (pp 30-39), 2010. Date of
Publication: 01 Mar 2010.
Author
Bauer A.; Diez C.; Schubel J.; El-Shouki N.; Metz D.; Eberle T.; Hausmann
H.
Institution
(Bauer) Department of Cardiovascular Technology, MediClin Heart Centre
Coswig, Sachsen, Germany
(Diez) Department of Cardiothoracic and Vascular Surgery, University
Hospital of Regensburg, Regensburg, Germany
(Schubel, El-Shouki, Metz, Hausmann) Department of Cardiovascular Surgery,
MediClin Heart Centre Coswig, Sachsen, Germany
(Eberle) Department of Cardio - Anesthesiology, MediClin Heart Centre
Coswig, Sachsen, Germany
Publisher
EDP Sciences
Abstract
Minimized extracorporeal circulation (MECC, Maquet, Cardiopulmonary AG,
Hirrlingen, Germany) is an established procedure to perform coronary
revascularization. Studies showed positive effects of MECC compared to
conventional cardiopulmonary bypass (CCPB) procedures in terms of
transfusion requirements, less inflammation reactions, and neurological
impairments. Recent retrospective studies showed higher mean arterial
pressure (MAP) and a lower frequency of vasoactive drug use. We addressed
this issue in this study. The hypothesis was to find a higher MAP during
coronary bypass grafting surgery in patients treated with MECC systems. We
performed a prospective, controlled, randomized trial with 40 patients
either assigned to MECC (n = 18) or CCPB (n = 22) undergoing coronary
bypass grafting. Primary endpoints were the perioperative course of mean
arterial pressure, and the consumption of norepinephrine. Secondary
endpoints were the regional cerebral and renal oxygen saturation (rSO2) as
an indicator of area perfusion and the course of hematocrit. Clinical and
demographic characteristics did not significantly differ between both
groups. Thirty-day mortality was 0%. At four of five time points during
extracorporeal circulation (ECC) MAP values were significantly higher in
the MECC group compared to CCPB patients (after starting the ECC 60 +/- 11
mmHg vs. 49 +/- 10 mmHg, p =.002). MECC patients received significantly
less norepinephrine (MECC 22.5 +/- 35 mug vs. CCPB 60.5 +/- 75 mug, p
=.045). The rSO2 measured at right and left forehead and the renal area
was similar for both groups during ECC and significantly higher at CCPB
group 1 and 4 hours after termination of CPB. Minimized extracorporeal
circulation provides a higher mean arterial pressure during ECC and we
found a lower consumption of vasoactive drugs in the MECC group. There was
a decrease in regional tissue saturation at 1 and 4 hours post bypass in
the MECC group possibly due to increased systemic inflammation and
extravascular fluid shift in the CCPB group.<br/>Copyright &#xa9; 2010
American Society of Extra-Corporeal Technology. All rights reserved.

<89>
Accession Number
2029462697
Title
Preoperative B-Type Natriuretic Peptides to Predict Postoperative Atrial
Fibrillation in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Thet M.S.; Hlwar K.E.; Thet K.S.; Han K.P.P.; Oo A.Y.
Institution
(Thet) Department of Surgery and Cancer, Imperial College London, United
Kingdom
(Hlwar, Thet, Han) Department of Medicine, Mandalay General Hospital,
University of Medicine, Mandalay, Myanmar
(Oo) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Post-operative atrial fibrillation (AF) is the most common
complication following cardiac surgery. There has been extensive
exploration of clinical variables, imaging, and biomarkers to predict its
occurrence after cardiac surgery. In this study, we examine the emerging
biomarkers B-type natriuretic peptide (BNP) and N-terminal proBNP
(NT-proBNP) to assess their pre-operative values and correlations with the
occurrence of post-operative AF in patients undergoing cardiac surgery.
<br/>Method(s): A comprehensive literature search was conducted using
PubMed, EMBASE, MEDLINE via Ovid, ClinicalTrials.Gov, Scopus, and Cochrane
Central Register of Controlled Trials (CENTRAL) to identify studies
published until March 2023. The studies were included if they reported
pre-operative BNP or NT-proBNP values and the development of
post-operative AF in cardiac surgery patients. Subsequently, data were
extracted, and a meta-analysis was performed using Review Manager 5.4 4
(The Cochrane Collaboration, 2020) and SPSS version 28 (IBM Corp, Armonk,
NY, USA) to assess the difference between pre-operative BNP and NT-proBNP
levels between patients with post-operative AF (AF group) and those
without (No-AF group) using a random-effect model. Further analysis was
performed in three subgroups: isolated coronary artery bypass grafting,
isolated valve, and combined/mixed surgery group. <br/>Result(s): A total
of 20 studies, including 9,079 participants were identified and included
in the systematic review and meta-analysis. Pre-operative BNP levels were
reported in 11 studies, and NT-proBNP levels were reported in 10 studies,
of which one study reported both BNP and NT-proBNP levels. There is an
overall significant difference between pre-operative levels of BNP
(p=0.03, I²=95%) and NT-proBNP (p<0.001, I²=65%)
when compared between AF and No-AF groups. Nonetheless, subgroup analysis
showed there is no significant difference in pre-operative BNP levels,
except in isolated valve surgery (p<0.001), whereas all subgroups showed
significantly different pre-operative levels of NT-proBNP.
<br/>Conclusion(s): Elevated levels of both BNP and NT-proBNP were
observed in patients who developed post-operative AF after undergoing
cardiac surgery. In particular, pre-operative NT-proBNP levels were
elevated in all patients irrespective of the type of surgical procedure,
but elevated pre-operative BNP was only seen in valve surgery patients.
These findings suggest the potential usefulness of NT-proBNP as a
promising biomarker for predicting the occurrence of post-operative AF
following cardiac surgery.<br/>Copyright &#xa9; 2023 The Author(s)

<90>
Accession Number
2029450013
Title
Impact of carotid artery stenosis on outcomes of transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131670. Date of Publication: 2024.
Author
Caetano L.; Gibicoski T.B.; Rodriguez F.; Scabello I.; da Silva Neto E.P.;
Iplinski B.
Institution
(Caetano) 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
Publisher
Elsevier Ireland Ltd
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. <br/>Purpose(s): 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 +/- 8.2 years 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 Elsevier B.V.