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

<2>
Accession Number
2027946167
Title
Surgical site infection outcomes of two different closed incision negative
pressure therapy systems in cardiac surgery: Systematic review and
meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14599. Date of Publication: January 2024.
Author
Loubani M.; Cooper M.; Silverman R.; Bongards C.; Griffin L.
Institution
(Loubani) Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull
University Teaching Hospital, Hull, United Kingdom
(Cooper, Silverman, Griffin) Medical Solutions Division, 3M Health Care,
St. Paul, MN, United States
(Bongards) Medical Solutions Division, 3M Deutschland GmBH, Neuss, Germany
Publisher
John Wiley and Sons Inc
Abstract
Closed incision negative pressure therapy (ciNPT) system use compared with
standard of care dressings (SOC) on surgical site infection (SSI) in
cardiac surgery was assessed. A systematic literature review was
conducted. Risk ratios (RR) and random effects models were used to assess
ciNPT with foam dressing (ciNPT-F) or multilayer absorbent dressing
(ciNPT-MLA) versus SOC. Health economic models were developed to assess
potential per patient cost savings. Eight studies were included in the
ciNPT-F analysis and four studies were included in the ciNPT-MLA analysis.
For ciNPT-F, a significant reduction in SSI incidence was observed (RR:
0.507, 95% confidence interval [CI]: 0.362, 0.709; p < 0.001). High-risk
study analysis reported significant SSI reduction with ciNPT-F use (RR:
0.390, 95% CI: 0.205, 0.741; p = 0.004). For ciNPT-MLA, no significant
difference in SSI rates were reported (RR: 0.672, 95% CI: 0.276, 1.635; p
= 0.381). Health economic modelling estimated a per patient cost savings
of $554 for all patients and $3242 for the high-risk population with
ciNPT-F use. Health economic modelling suggests ciNPT-F may provide a
cost-effective solution for sternotomy incision management. However,
limited high-quality literature exists. More high-quality evidence is
needed to fully assess the impact of ciNPT use following cardiac
surgery. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<3>
Accession Number
2027733817
Title
A systematic review of present and future pharmaco-structural therapies
for hypertrophic cardiomyopathy.
Source
Clinical Cardiology. 47(1) (no pagination), 2024. Article Number: e24207.
Date of Publication: January 2024.
Author
Sawan M.A.; Prabakaran S.; D'Souza M.; Behbahani-Nejad O.; Gold M.E.;
Williams B.R.; Bilen O.
Institution
(Sawan, D'Souza, Gold, Williams, Bilen) Division of Cardiology, Emory
University School of Medicine, Atlanta, GA, United States
(Prabakaran, Behbahani-Nejad) Department of Internal Medicine, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Hypertrophic cardiomyopathy (HCM) is a common contemporary, treatable,
genetic disorder that can be compatible with normal longevity. While
current medical therapies are ubiquitous, they are limited by a lack of
solid evidence, are often inadequate, poorly tolerated, and do not alter
the natural disease course. As such, there has long been a need for
effective, evidence-based, and targeted disease-modifying therapies for
HCM. In this review, we redefine HCM as a treatable condition, evaluate
current strategies for therapeutic intervention, and discuss novel myosin
inhibitors. The majority of patients with HCM have elevated left
ventricular outflow tract gradients, which predicts worse symptoms and
adverse outcomes. Conventional pharmacological therapies for symptomatic
HCM can help improve symptoms but are often inadequate and poorly
tolerated. Septal reduction therapies (surgical myectomy and alcohol
septal ablation) can safely and effectively reduce refractory symptoms and
improve outcomes in patients with obstructive HCM. However, they require
expertise that is not universally available and are not without risks.
Currently, available therapies do not alter the disease course or the
progressive cardiac remodeling that ensues, nor subsequent heart failure
and arrhythmias. This has been regarded as an unmet need in the care of
HCM patients. Novel targeted pharmacotherapies, namely cardiac myosin
inhibitors, have emerged to reverse key pathophysiological changes and
alter disease course. Their favorable outcomes led to the early Food and
Drug Administration approval of mavacamten, a first-in-class myosin
modulator, changing the paradigm for the pharmacological treatment of
HCM. Copyright © 2024 The Authors. Clinical Cardiology published
by Wiley Periodicals LLC.

<4>
Accession Number
2029932686
Title
Intrathecal Morphine for Cardiac Surgery: A Systematic Review and
Meta-Analysis of Randomized Controlled Trials.
Source
Annals of Cardiac Anaesthesia. 27(1) (pp 3-9), 2024. Date of Publication:
2024.
Author
Ciconini L.E.; Ramos W.A.; Lima Fonseca A.C.; Nooli N.P.; Gosling A.F.
Institution
(Ciconini) SUNY Downstate Health Sciences University, United States
(Ramos) Department of Internal Medicine, University UNINTA-Ceara, Brazil
(Lima Fonseca) Positivo University, Anhembi Morumbi University, Brazil
(Nooli, Gosling) Cardiac Anesthesia and Critical Care Medicine, University
of Alabama, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Cardiac surgeries often result in significant postoperative pain, leading
to considerable use of opioids for pain management. However, excessive
opioid use can lead to undesirable side effects and chronic opioid use.
This systematic review and meta-analysis aimed to evaluate whether
preoperative intrathecal morphine could reduce postoperative opioid
consumption in patients undergoing cardiac surgery requiring sternotomy.
We conducted a systematic search of Cochrane, EMBASE, and MEDLINE
databases from inception to May 2022 for randomized controlled trials that
evaluated the use of intrathecal morphine in patients undergoing cardiac
surgery. Studies that evaluated intrathecal administration of other
opioids or combinations of medications were excluded. The primary outcome
was postoperative morphine consumption at 24 h. Secondary outcomes
included time to extubation and hospital length of stay. The final
analysis included ten randomized controlled trials, with a total of 402
patients. The results showed that postoperative morphine consumption at 24
h was significantly lower in the intervention group (standardized mean
difference -1.43 [-2.12, -0.74], 95% CI, P < 0.0001). There were no
significant differences in time to extubation and hospital length of stay.
Our meta-analysis concluded that preoperative intrathecal morphine is
associated with lower postoperative morphine consumption at 24 h following
cardiac surgeries, without prolonging the time to extubation. The use of
preoperative intrathecal morphine can be considered part of a multimodal
analgesic and opioid-sparing strategy in patients undergoing cardiac
surgery. Copyright © 2024 Wolters Kluwer Medknow Publications.
All rights reserved.

<5>
Accession Number
2029920359
Title
ANALYSING THE STRESS RESPONSE DURING PEDIATRIC CARDIAC SURGERY: A
COMPARISON OF CAUDAL FENTANYL AND CAUDAL DEXMEDETOMIDINE.
Source
International Journal of Academic Medicine and Pharmacy. 6(1) (pp
253-256), 2023. Date of Publication: 2023.
Author
Sridevi C.; Mahalingam S.; Dhanalakshmi B.
Institution
(Sridevi, Mahalingam, Dhanalakshmi) Department of Anaesthesiology,
Institute of child health and research institute, Chennai, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Paediatric patients who undergo open-heart procedures on
cardiopulmonary bypass experience a sharp increase in inflammatory
response. In our study, we hypothesised that dexmedetomidine, as an
adjuvant in the caudal direction, modulates the stress response after open
heart surgery. Material(s) and Method(s): In a prospective,
randomised, double-blind study, 25 of 50 patients were administered either
a single dose of caudal dexmedetomidine (1mcg/kg dexmedetomidine + 0.25%
bupivacaine) or a single dose of caudal fentanyl (1mcg/kg fentanyl + 0.25%
bupivacaine) with a total volume of 1.5 ml/ kg. To assess the inflammatory
response, serum cortisol and blood glucose levels were measured before
sternotomy (baseline), during sternotomy, and after the procedure. The
haemodynamic variables, HR and BP, were periodically recorded, and the
FACES pain score and extubation time were monitored in the PACU.
 Result(s): A comparison of demographic variables such as age, weight,
aortic cross-clamp time, CPB (Cardiopulmonary bypass) time, and duration
of surgery were statistically insignificant. The dexmedetomidine group
showed significantly reduced serum cortisol and blood glucose levels than
the caudal fentanyl group. The haemodynamic response, postoperative
analgesia, and extubation time were significantly better in the caudal
dexmedetomidine group. Extubation time was shorter in the BD group than in
the BF group. Early extubation decreases ventilator-associated
complications during the postoperative period and the length of ICU stay.
 Conclusion(s): Using caudal dexmedetomidine could decrease the stress
response to surgical stimuli and give superior postoperative analgesia and
expedited extubation, shortening ICU (Intensive care unit)
stays. © Copyright by International Academic Publishing House
(IAPH)

<6>
Accession Number
2027801116
Title
Benefits of metabolic surgery on macrovascular outcomes in adult patients
with type 2 diabetes: a systematic review and meta-analysis.
Source
Surgery for Obesity and Related Diseases. 20(2) (pp 202-212), 2024. Date
of Publication: February 2024.
Author
Obeso-Fernandez J.; Millan-Alanis J.M.; Saenz-Flores M.;
Rodriguez-Bautista M.; Medrano-Juarez S.; Oyervides-Fuentes S.;
Gonzalez-Cruz D.; Manzanares-Gallegos D.M.; Gonzalez-Gonzalez J.G.;
Rodriguez-Gutierrez R.
Institution
(Obeso-Fernandez, Millan-Alanis, Saenz-Flores, Rodriguez-Bautista,
Medrano-Juarez, Oyervides-Fuentes, Gonzalez-Cruz, Manzanares-Gallegos,
Gonzalez-Gonzalez, Rodriguez-Gutierrez) Plataforma INVEST Medicina UANL,
KER Unit Mayo Clinic (KER Unit Mexico), Universidad Autonoma de Nuevo
Leon, Monterrey, Mexico
(Gonzalez-Gonzalez, Rodriguez-Gutierrez) Endocrinology Division,
Department of Internal Medicine, University Hospital "Dr. Jose E.
Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
Publisher
Elsevier Inc.
Abstract
Type 2 diabetes (T2D) is a chronic metabolic disorder that affects
millions of individuals associated with an increased risk of mortality and
macrovascular complications. We aimed to synthesize the benefit of
metabolic surgery (MS) on macrovascular outcomes in adult patients with
T2D.We included both cohort studies and randomized controlled trials
(RCTs) that evaluated MS added to medical therapy compared with medical
therapy alone in the treatment of adult patients with T2D. Studies must
have evaluated the incidence of any macrovascular complication of the
disease for a period of at least 6 months. We performed our search using
PubMed, Scopus, EMBASE, Web of Science, and COCHRANE Central database
which was performed from inception date until March 2022. The trial
protocol was previously registered at PROSPERO (CRD42021243739). A total
of 6338 references were screened throughout the selection process from
which 16 studies involving 179,246 participants fulfilled inclusion
criteria. MS reduced the risk of any cardiovascular event by 44% (relative
risk .56 [95% CI, .42-.75]; P = < .001), myocardial infarction by 54% (.46
[95% CI, .26-.83]; P = .009), coronary artery disease by 40% (.60 [95% CI,
.42-.85]; P = .004) and heart failure by 71% (.29 [95% CI, .14-.61]; P =
.001). It also provided a risk reduction of stroke by 29% (.71 [95% CI,
.51-.99]; P = .04) and 38% (.62 [95% CI, .46-.85]; P = .001) for
cerebrovascular events. On mortality, MS yields a risk reduction of 55%
(.45 [95% CI, .36-.57]; P <.001) in overall mortality and 69% in
cardiovascular mortality (relative risk .31 [95% CI, .22-.42]; P < .001).
Peripheral vascular disease risk was also reduced. MS in adult patients
with T2D can reduce the risk of mortality and of any macrovascular
outcomes. However, there is a need for the planning of randomized clinical
trials to further analyze and confirm the results. Copyright ©
2024 American Society for Metabolic and Bariatric Surgery

<7>
Accession Number
2028055517
Title
Dexmedetomidine and magnesium sulfate in preventing junctional ectopic
tachycardia after pediatric cardiac surgery.
Source
Paediatric Anaesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Hassan P.F.; ElHaddad A.M.
Institution
(Hassan, El Haddad) Intensive Care, and Pain Management, Kasr Al Aini
Hospital, Cairo University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Background: Junctional ectopic tachycardia (JET) is a serious
tachyarrhythmia following pediatric cardiac surgery. It isn't easy to
treat and better to be prevented. This study aimed to examine the
prophylactic effects of dexmedetomidine, MgSO<inf>4</inf>, or their
combination in reducing JET following pediatric open cardiac surgery.
 Method(s): Hundred and twenty children under 5 years, weighing more
than 5 kg, who were scheduled for corrective acyanotic cardiac surgeries
were randomized into three groups. Group MD
(Dexmedetomidine-MgSO<inf>4</inf> group): received dexmedetomidine 0.5
mug/kg IV over 20 min after induction, then infusion 0.5 mug/kg/h for 72
h, and 50 mg/kg bolus of MgSO<inf>4</inf> with aortic cross-clamp release,
then continued administration for 72 h postoperatively at a dose of 30
mg/kg/day. Group D (the dexmedetomidine group) received the same
dexmedetomidine as the MD group in addition to normal saline instead of
MgSO<inf>4</inf>. Group C (control group): received normal saline instead
of dexmedetomidine and MgSO<inf>4</inf>. The primary outcome was the
detection of JET incidence; the secondary outcomes were hemodynamic
parameters, ionized Mg, vasoactive-inotropic score, extubation time, PCCU
and hospital stay, and perioperative complications. Result(s): The
incidence of JET was significantly reduced in Group MD and Group D (p
=.007) compared to Group C. Ionized Mg was significantly higher in Group
MD than in Groups D and C during rewarming and in the ICU (p <.001).
Better hemodynamic profile in Group MD compared to Group D and Group C
throughout surgery and in the ICU, the predictive indexes were
significantly better in Group MD than in Groups D and C (p <.001).
Including the extubation time, PCCU, and hospital stay.
 Conclusion(s): Dexmedetomidine alone or combined with
MgSO<inf>4</inf> had a therapeutic role in the prevention of JET in
children after congenital heart surgery. Copyright © 2024 John
Wiley & Sons Ltd.

<8>
Accession Number
2028055114
Title
Clinical impact of cerebral protection during transcatheter aortic valve
implantation.
Source
European Journal of Clinical Investigation. (no pagination), 2024. Date
of Publication: 2024.
Author
Boccuto F.; Carabetta N.; Cacia M.A.; Kanagala S.G.; Panuccio G.; Torella
D.; DeRosa S.
Institution
(Boccuto, Carabetta, Cacia, Panuccio, De Rosa) Department of Medical and
Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
(Kanagala) Department of Internal Medicine, Metropolitan Hospital Center,
New York, NY, United States
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Embolization of debris can complicate transcatheter aortic
valve implantation (TAVI) causing stroke. Cerebral embolism protection
(CEP) devices can divert or trap debris. Purpose(s): To evaluate the
efficacy of CEP during TAVI vs the standard procedure. Data Sources:
PubMed, SCOPUS and DOAJ 1/01/2014-04/12/2023. Study Selection: Randomized
and observational studies comparing CEP versus standard TAVI, according to
PRISMA. Primary Outcome: stroke. Secondary Outcomes: death,
bleeding, vascular access complications, acute kidney injury and infarct
area. Data Extraction: Two investigators independently assessed study
quality and extracted data. Data Synthesis: Twenty-six articles were
included (540.247 patients). The primary endpoint was significantly lower
(RR = 0.800 95%CI:0.682-0.940; p = 0.007) with CEP. Similarly, death rates
were significantly lower with CEP (RR = 0.610 95%CI:0.482-0.771; p <
0.001). No difference was found for bleeding (RR = 1.053
95%CI:0.793-1.398; p = 0.721), vascular complications (RR = 0.937
95%CI:0.820-1.070; p = 0.334) or AKI (RR = 0.982 95%CI:0.754-1.279; p =
0.891). Conclusion(s): Use of CEP during TAVI is associated with
improved outcomes. Future studies will identify patients who benefit most
from CEP. Copyright © 2024 The Authors. European Journal of
Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<9>
Accession Number
2025580386
Title
Effects of negative pressure wound therapy on surgical site wound
infections after cardiac surgery: A meta-analysis.
Source
International Wound Journal. 21(2) (no pagination), 2024. Article Number:
e14398. Date of Publication: February 2024.
Author
Tao Y.; Zhang Y.; Liu Y.; Tang S.
Institution
(Tao) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Zhang) Interventional Surgery of Radiology, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Liu) Department of Scientific Research Division, The First Affiliated
Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang,
China
(Tang) Department of Anaesthesia, The First Affiliated Hospital of Guizhou
University of Traditional Chinese Medicine, Guiyang, China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a comprehensive analysis to evaluate the benefits of negative
pressure wound therapy (NPWT) versus traditional dressings in preventing
surgical site infections in patients undergoing cardiac surgery. We
thoroughly examined several databases, including PubMed, EMBASE, Cochrane
Library, China National Knowledge Infrastructure (CNKI), VIP, Chinese
Biomedical Literature Database (CBM) and Wanfang, from inception until
July 2023. Two independent researchers were responsible for the literature
screening, data extraction and quality assessment; analyses were performed
using RevMan 5.4 software. Thirteen studies comprising 8495 patients were
deemed relevant. A total of 2685 patients were treated with NPWT, whereas
5810 received conventional dressings. The findings revealed that NPWT was
more effective in reducing surgical site infections after cardiac surgery
than conventional dressings (4.88% vs. 5.87%, odds ratio [OR]: 0.50, 95%
confidence intervals [CIs]: 0.40-0.63, p < 0.001). Additionally, NPWT was
more effective in reducing deep wound infections (1.48% vs. 4.15%, OR:
0.36, 95% CI: 0.23-0.56, p < 0.001) and resulted in shorter hospital stays
(SMD: -0.33, 95% CIs: -0.54 to -0.13, p = 0.001). However, the rate of
superficial wound infections was not significantly affected by the method
of wound care (3.72% vs. 5.51%, OR: 0.63, 95% CI: 0.32-1.23, p = 0.180).
In conclusion, NPWT was shown to be advantageous in preventing
postoperative infections and reducing hospital stay durations in patients
undergoing cardiac surgery. Nonetheless, given the limitations in the
number and quality of the included studies, further research is
recommended to validate these findings. Copyright © 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<10>
Accession Number
2028153085
Title
Management and outcomes of spontaneous coronary artery dissection: a
systematic review of the literature.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1276521. Date of Publication: 2024.
Author
Petrovic M.; Miljkovic T.; Ilic A.; Kovacevic M.; Cankovic M.; Dabovic D.;
Stojsic Milosavljevic A.; Cemerlic Maksimovic S.; Jarakovic M.; Andric D.;
Golubovic M.; Bjelobrk M.; Bjelic S.; Tadic S.; Slankamenac J.;
Apostolovic S.; Djurovic V.; Milovancev A.
Institution
(Petrovic, Miljkovic, Ilic, Kovacevic, Cankovic, Dabovic, Stojsic
Milosavljevic, Jarakovic, Andric, Golubovic, Bjelobrk, Bjelic, Tadic,
Milovancev) Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
(Petrovic, Miljkovic, Ilic, Kovacevic, Cankovic, Dabovic, Stojsic
Milosavljevic, Cemerlic Maksimovic, Jarakovic, Andric, Golubovic,
Bjelobrk, Bjelic, Tadic, Milovancev) Institute of Cardiovascular Diseases
of Vojvodina, Sremska Kamenica, Serbia
(Slankamenac) Faculty of Sport and Physical Education, University of Novi
Sad, Novi Sad, Serbia
(Apostolovic) Medical Faculty, University of Nis, Nis, Serbia
(Apostolovic) Clinical Center of Nis, Cardiology Clinic, Nis, Serbia
(Djurovic) Clinic of Nephrology and Clinical Immunology, University
Clinical Center of Vojvodina, Novi Sad, Serbia
Publisher
Frontiers Media SA
Abstract
Background: Contemporary management of spontaneous coronary artery
dissection (SCAD) is still controversial. This systematic review of the
literature aims to explore outcomes in the patients treated with
conservative management vs. invasive strategy. Method(s): The PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
guidelines were followed when we extensively searched three electronic
databases: PubMed, ScienceDirect, and Web of Science, for studies that
compared conservative vs. invasive revascularization treatment outcomes
for patients with SCAD from 2003 to 2023. The outcomes of interest were
all-cause death and major adverse cardiovascular events (MACE), including
acute coronary syndrome (ACS), heart failure (HF), need for additional
revascularization, target vessel revascularization (TVR), SCAD recurrence,
and stroke. Result(s): The systematic review included 13
observational studies evaluating 1,801 patients with SCAD. The overall
mean age was 49.12 +/- 3.41, and 88% were females. The overall prevalence
of arterial hypertension was 33.2%, hyperlipidemia, 26.9%, smoking, 17.8%,
and diabetes, 3.9%. Approximately 48.5% of the patients were diagnosed
with non-ST elevated myocardial infarction (NSTEMI), 36.8% with ST
elevated myocardial infarction (STEMI), 3.41% with unstable angina, 0.56%
with stable angina, and 0.11% were diagnosed with various types of
arrhythmias. The left anterior descending artery (LAD) was the most common
culprit lesion in 51% of the patients. There were initially 65.2% of
conservatively treated patients vs. 33.4% that underwent percutaneous
coronary intervention (PCI) or 1.28% that underwent coronary artery bypass
graft (CABG). SCAD-PCI revascularization was associated with a variable
range of PCI failure. The most common complications were hematoma
extension and iatrogenic dissection. SCAD-PCI revascularization frequently
required three or more stents and had residual areas of dissection. The
overall reported in-hospital and follow-up mortality rates were 1.2% and
1.3%, respectively. The follow-up range across studies was 7.3-75.6
months. The authors reported variable prevalence of MACE, recurrent SCAD
up to 31%, ACS up to 27.4%, TVR up to 30%, repeat revascularization up to
14.7%, UA up to 13.3%, HF up to 17.4%, and stroke up to 3%.
 Conclusion(s): Our results highlight that conservative treatment
should be the preferred method of treatment in patients with SCAD. PCI
revascularization is associated with a high prevalence of periprocedural
complications. SCAD poses a considerable risk of MACE, mainly associated
with TVR, ACS, and recurrent SCAD. Copyright 2024 Petrovic, Miljkovic,
Ilic, Kovacevic, Cankovic, Dabovic, Stojsic Milosavljevic, Cemerlic
Maksimovic, Jarakovic, Andric, Golubovic, Bjelobrk, Bjelic, Tadic,
Slankamenac, Apostolovic, Djurovic and Milovancev.

<11>
Accession Number
2028106399
Title
Inhaled Pulmonary Vasodilators for the Treatment of Right Ventricular
Failure in Cardio-Thoracic Surgery: Is One Better than the Others?.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
564. Date of Publication: January 2024.
Author
Benedetto M.; Piccone G.; Gottin L.; Castelli A.; Baiocchi M.
Institution
(Benedetto, Castelli, Baiocchi) Cardio-Thoracic and Vascular Anesthesia
and Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Via Albertoni 15, Bologna 40138, Italy
(Piccone, Gottin) Cardiothoracic and Vascular Intensive Care Unit,
Hospital and University Trust of Verona, P. le A. Stefani, Verona 37124,
Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Right ventricular failure (RFV) is a potential complication following
cardio-thoracic surgery, with an incidence ranging from 0.1% to 30%. The
increase in pulmonary vascular resistance (PVR) is one of the main
triggers of perioperative RVF. Inhaled pulmonary vasodilators (IPVs) can
reduce PVR and improve right ventricular function with minimal systemic
effects. This narrative review aims to assess the efficacy of inhaled
nitric oxide and inhaled prostacyclins for the treatment of perioperative
RVF. The literature, although statistically limited, supports the clinical
similarity between them. However, it failed to demonstrate a clear benefit
from the pre-emptive use of inhaled nitric oxide in patients undergoing
left ventricular assist device implantation or early administration during
heart-lung transplants. Additional concerns are related to cost safety and
IPV use in pathologies associated with pulmonary venous congestion. The
largest ongoing randomized controlled trial on adults (INSPIRE-FLO) is
addressing whether inhaled Epoprostenol and inhaled nitric oxide are
similar in preventing RVF after heart transplants and left ventricular
assist device placement, and whether they are similar in preventing
primary graft dysfunction after lung transplants. The preliminary analysis
supports their equivalence. Several key points may be achieved by the
present narrative review. When RVF occurs in the setting of elevated PVR,
IPV should be the preferred initial treatment and they should be
preventively used in patients at high risk of postoperative RVF. If severe
refractory postoperative RVF occurs, IPVs should be combined with
complementary pharmacology (inotropes and inodilators). If unsuccessful,
right ventricular mechanical support should be established. Copyright
© 2024 by the authors.

<12>
Accession Number
643344175
Title
Mesenchymal stem cells and thermal annular procedures for discogenic pain:
a systematic review with pooled analysis.
Source
Pain management. (no pagination), 2024. Date of Publication: 26 Jan 2024.
Author
DesRochers J.; DesRochers R.; Patel D.; Andruszka C.; Manchanda S.;
Ernazarov A.; Mobley A.
Institution
(DesRochers, DesRochers, Patel, Andruszka, Manchanda, Ernazarov)
Rowan-Virtua School of Osteopathic Medicine, Stratford, United States
(Mobley) Rowan Medicine NeuroMusculoskeletal Institute, Stratford, United
States
Abstract
Aim: Compare the effectiveness of mesenchymal stem cell injection
therapies (MSC) and thermal annular procedures for the treatment of
discogenic lower back pain. Material(s) and Method(s): A systematic
review was performed following PRISMA 2020 guidelines. Pooled analysis was
performed using patients' pain scores at baseline and at 12 months
post-intervention. Result(s): Effect sizes based on change in pain
score from baseline to 12 month follow-up revealed clinically significant
improvement in pain score across all interventions. Conclusion(s):
Minimally invasive interventions provide meaningful relief in discogenic
back pain, with results suggesting promise for MSC injection therapies as
a treatment model.

<13>
Accession Number
643343810
Title
Cardiovascular Symptoms, Dysautonomia, and Quality of Life in Adult and
Pediatric Patients with Hypermobile Ehlers-Danlos Syndrome: A Brief
Review.
Source
Current cardiology reviews. (no pagination), 2024. Date of Publication:
24 Jan 2024.
Author
Hertel A.; Black W.R.; Malloy Walton L.; Martin J.; Jones J.
Institution
(Hertel) University of Kansas School of Medicine, University of Kansas
Medical Center, Kansas City, KS, United States
(Black, Malloy Walton, Jones) Department of Pediatrics, University of
Kansas School of Medicine, Kansas City, KS, United States
(Black) Center for Children's Healthy Lifestyles and Nutrition, Children's
Mercy Kansas City, Kansas City, MO, United States
(Black) Center for Biobehavioral Health, Abigail Wexner Research Institute
at Nationwide Children's Hospital, Ohio State University
(Malloy Walton, Martin, Jones) Department of Pediatrics, Children's Mercy
Kansas City, Kansas City, MO, United States
(Malloy Walton, Jones) Department of Pediatrics, University of Missouri-
Kansas City School of Medicine, Kansas City, MO, United States
Abstract
BACKGROUND: Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective
tissue disorder characterized by joint hypermobility and other systemic
manifestations, such as cardiovascular symptoms, musculoskeletal pain, and
joint instability. Cardiovascular symptoms, such as lightheadedness and
palpitations, and types of dysautonomia, including postural orthostatic
tachycardia syndrome (POTS), are frequently reported in adults with hEDS
and have been shown to negatively impact quality of life (QoL).
 OBJECTIVE(S): This brief review will be an overview of co-occurring
symptoms in POTS and hEDS to inform potential cardiovascular screening
procedures. RESULT(S): While many patients with hEDS report
cardiovascular symptoms, few have structural abnormalities, suggesting
that dysautonomia is likely responsible for these symptoms. One validated
screening measure for dysautonomia symptom burden is the Composite
Autonomic Symptom Scale (COMPASS-31). Studies have found that adults with
POTS, hEDS, and both POTS and hEDS have higher COMPASS-31 scores than the
general population, suggesting a high symptom burden due to dysautonomia,
which leads to impaired QoL. CONCLUSION(S): While studies have
examined cardiovascular symptoms and the impact of dysautonomia in adults
with and without hEDS, there is scant literature on dysautonomia in
pediatric patients with hEDS. Therefore, more studies on cardiovascular
symptoms and dysautonomia, as they relate to the quality of life in
pediatric patients with hEDS, are needed. This brief review summarizes the
current literature on dysautonomia and cardiovascular symptoms in
pediatric and adult populations with hEDS. Copyright© Bentham
Science Publishers; For any queries, please email at
epub@benthamscience.net.

<14>
Accession Number
643343718
Title
Statin treatment after surgical aortic valve replacement for aortic
stenosis is associated with better long-term outcome.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 25 Jan 2024.
Author
Pan E.; Nielsen S.J.; Landenhed-Smith M.; Torngren C.; Bjorklund E.;
Hansson E.C.; Jeppsson A.; Martinsson A.
Institution
(Pan) University of Turku, Turku, Finland
(Pan) Department of Surgery, Central Finland Hospital Nova, Jyvaskyla,
Finland
(Nielsen, Landenhed-Smith, Torngren, Bjorklund, Hansson, Jeppsson,
Martinsson) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Nielsen, Landenhed-Smith, Torngren, Hansson, Jeppsson) Department of
Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg,
Sweden
(Bjorklund) Department of Medicine, Southern Alvborg Hospital, Boras,
Sweden
(Martinsson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Abstract
OBJECTIVES: To evaluate the association between statin use after surgical
aortic valve replacement for aortic stenosis and long-term risk for major
adverse cardiovascular events in a large population-based, nationwide
cohort. METHOD(S): All patients that underwent isolated surgical
aortic valve replacement due to aortic stenosis in Sweden 2006-2020 and
survived six months after discharge were included. Individual patient data
from five nationwide registries were merged. Primary outcome is major
adverse cardiovascular event (defined as all-cause mortality, myocardial
infarction, or stroke). Multivariable Cox regression model adjusted for
age, sex, comorbidities, valve type, operation year, and secondary
prevention medications is used to evaluate the association between
time-updated dispense of statins and long-term outcome in the entire study
population, and in subgroups based on age, sex and comorbidities.
 RESULT(S): A total of 11,894 patients were included. Statins were
dispensed to 49.8% (5918/11894) of patients at baseline, and 51.0%
(874/1713) after ten years. At baseline, 3.6% of patients were dispensed
low dose, 69.4% medium dose and 27.0% high dose statins. After
adjustments, ongoing statin treatment was associated with a reduced risk
for major adverse cardiovascular event [adjusted hazard ratio 0.77 (95%
confidence interval 0.71-0.83). p<0.001], mainly driven by a reduction in
all-cause mortality [adjusted hazard ratio, 0.70 (0.64-0.76)], p<0.001.
The results were consistent in all subgroups. CONCLUSION(S): The
results suggest that statin therapy might be beneficial for patients
undergoing surgical aortic valve replacement for aortic stenosis.
Randomized controlled trials are warranted to establish causality between
statin treatment and improved outcome. Copyright © The Author(s)
2024. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<15>
Accession Number
2028013550
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement for pure aortic regurgitation: a systematic review and
meta-analysis of 33,484 patients.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
65. Date of Publication: December 2024.
Author
Elkasaby M.H.; Khalefa B.B.; Yassin M.N.A.; Alabdallat Y.J.; Atia A.;
Altobaishat O.; Omar I.; Hussein A.
Institution
(Elkasaby, Hussein) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Yassin) Faculty of Medicine, Helwan University, Cairo, Egypt
(Alabdallat) Faculty of Medicine, Hashemite University, Zarqa, Jordan
(Atia) Faculty of Medicine, Cairo University, Cairo, Egypt
(Altobaishat) Faculty of Medicine, Jordan University of Science and
Technology, Irbid, Jordan
(Omar) Faculty of Pharmacy, South Valley University, Qena, Egypt
(Elkasaby, Khalefa, Yassin, Alabdallat, Atia, Altobaishat, Omar, Hussein)
Medical Research Group of Egypt (MRGE), Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Introduction: The published studies comparing transcatheter aortic valve
implantation (TAVI) and surgical aortic valve replacement (SAVR) in pure
aortic regurgitation (AR) are conflicting. We conducted this systematic
review and meta-analysis to compare TAVI with SAVR in pure AR.
 Method(s): We searched PubMed, Embase, Web of Science (WOS), Scopus,
and the Cochrane Library Central Register of Controlled Trials (CENTRAL)
from inception until 23 June 2023. Review Manager was used for statistical
analysis. The risk ratio (RR) with a 95% confidence interval (CI) was used
to compare dichotomous outcomes. Continuous outcomes were compared using
the mean difference (MD) and 95% CI. The inconsistency test
(I2) assessed the heterogeneity. We used the Newcastle-Ottawa
scale to assess the quality of included studies. We evaluated the strength
of evidence using the Grading of Recommendations Assessment, Development,
and Evaluation (GRADE) scale. Result(s): We included six studies with
5633 patients in the TAVI group and 27,851 in SAVR. In-hospital mortality
was comparable between TAVI and SAVR (RR = 0.89, 95% CI [0.56, 1.42], P =
0.63) (I2 = 86%, P < 0.001). TAVI was favored over SAVR
regarding in-hospital stroke (RR = 0.50; 95% CI [0.39, 0.66], P < 0.001)
(I2 = 11%, P = 0.34), in-hospital acute kidney injury (RR =
0.56; 95% CI: [0.41, 0.76], P < 0.001) (I 2 = 91%, P < 0.001),
major bleeding (RR = 0.23; 95% CI: [0.17, 0.32], P < 0.001) (I
2 = 78%, P < 0.001), and shorter hospital say (MD = - 4.76
days; 95% CI: [- 5.27, - 4.25], P < 0.001) (I 2 = 88%, P <
0.001). In contrast, TAVI was associated with a higher rate of pacemaker
implantation (RR = 1.68; 95% CI: [1.50, 1.88], P < 0.001) (I 2
= 0% P = 0.83). Conclusion(s): TAVI reduces in-hospital stroke and is
associated with better safety outcomes than SAVR in patients with pure
AR. Copyright © 2024, The Author(s).

<16>
Accession Number
2029951874
Title
Use of sacubitril/valsartan early after CABG.
Source
Open Heart. 11(1) (no pagination), 2024. Article Number: e002492. Date of
Publication: 18 Jan 2024.
Author
Nurzhanova M.; Musagaliyeva A.; Zhakypova R.; Senkibayeva D.; Rakisheva A.
Institution
(Nurzhanova, Musagaliyeva, Zhakypova, Senkibayeva, Rakisheva) Scientific
Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
(Nurzhanova) Kazakhstan Medical University, Graduate School of Public
Health, Almaty, Kazakhstan
Publisher
BMJ Publishing Group
Abstract
Background Heart failure (HF) remains a major public health problem with a
high mortality and morbidity worldwide. Currently, there is no optimal
revascularisation strategy for patients with ischaemic cardiomyopathy
despite suggestions that coronary artery bypass graft (CABG) may be
superior to medical therapy in improving survival. However, CABG may be
associated with substantial risk in HF subjects. We therefore aimed to
evaluate the safety and efficacy of the early initiation of
sacubitril/valsartan in haemodynamically stabilised patients with HF with
reduced ejection fraction (HFrEF) after early CABG. Methods This was an
open-label study in which ~80 patients after CABG were randomised either
to the early or late initiation of the sacubitril-valsartan. The study
included patients >40 years with left ventricular ejection fraction <45%
and New York Heart Association (NYHA) class II-IV at the early stage after
CABG. Patients underwent intervention, the starting dose of
sacubitril/valsartan (24/26 mg or 49/51 mg two times per day). The
follow-up took place every 4 weeks except the first visit, which took
place in 2 weeks after initiation. The primary endpoint assessed the key
safety outcomes, the secondary endpoints were: the quality of life
measured, the N-terminal pro-B-type natriuretic peptide (NT-proBNP)
changes and 6 min walk test (6MWT). Results In total, 83 patients were
screened and 77 patients were enrolled. The majority of patients (84.4%)
were in the NYHA class III at randomisation. The number of patients who
discontinued the study was low in both groups (2.5%, 5.2%), and renal
function, hyperkalaemia and symptomatic hypotension rarely seen in both
groups did not differ significantly. The improvement in quality of life
and distance at the 6MWT in both groups was significant (p<0.001). The
NT-proBNP concentration decreased in both groups, the significant
reduction was in the early group (p<0.001) versus the postdischarge group.
Conclusions The early initiation of sacubitril/valsartan in patients after
CABG with HFrEF is safe and effective. Adverse events and permanent
discontinuation were low. The NT-proBNP concentration reduced
significantly with the early in-hospital initiation. Copyright ©
2024 BMJ Publishing Group. All rights reserved.

<17>
[Use Link to view the full text]
Accession Number
2029835520
Title
Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for
Thoracic Ligamentous Ossification: A Systematic Review and Meta-Analysis.
Source
Spine. 49(3) (pp 197-207), 2024. Date of Publication: 01 Feb 2024.
Author
Ye J.; Guo W.; Hu Y.; Fan X.
Institution
(Ye, Guo, Hu, Fan) Department of Orthopedics, Hospital of Chengdu
University of Traditional Chinese Medicine, Chengdu, China
(Ye, Guo, Hu) Clinical School of Medicine, Chengdu University of
Traditional Chinese Medicine, Chengdu, China
Publisher
Wolters Kluwer Health
Abstract
Study Design. A systematic review and meta-analysis. Objective. This study
systematically reviewed and evaluated the safety and efficacy of spinal
endoscopic techniques as a treatment for thoracic ligamentum flavum
ossification (TOLF). Summary of Background Data. The use of spinal
endoscopic techniques for the treatment of TOLF has increased in recent
years. The present study is the first comprehensive systematic review and
meta-analysis focused on the use of spinal endoscopic techniques for TOLF.
Materials and Methods. The Cochrane Central, PubMed, Web of Science, and
Embase databases were systematically searched for studies focused on
patients undergoing spinal endoscopic techniques to treat symptomatic
TOLF. Results. This meta-analysis included 23 studies. We included 323
patients (177 males, 146 females) with a mean age of 58.40+/-10.06 years,
with 304 total recorded lesion locations of which 245 were located in the
lower thoracic spine. Complications affected 35/323 patients, and the mean
operative duration for 305 patients was 108.15+/-47.34 minutes. For 187
patients, the mean operative bleeding was 25.13+/-12.54 mL, while for 87
patients the mean duration of hospitalization was 4.59+/-1.93 days. At
last follow-up, functional assessment was performed for 260 patients, of
whom 200 were in excellent condition, visual analog scale (VAS) scores
were assessed for 160 patients, with a mean improvement of 4.40 (3.95,
4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115
patients, with a mean improvement of 3.49 (2.79,4.18), and modified
Japanese Orthopedic Association (mJOA) scores were recorded for 208
patients, with a mean improvement of 3.62 (2.89,4.35). Conclusions. These
results support several advantages of spinal endoscopic techniques for the
treatment of symptomatic TOLF. These include low complication rates, rapid
postoperative recovery, and good functional recovery when used for
single-segment, non-nodular ossification and no combined dural
ossification. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<18>
Accession Number
2028809316
Title
Opioid-free anaesthesia reduces postoperative nausea and vomiting after
thoracoscopic lung resection: a randomised controlled trial.
Source
British Journal of Anaesthesia. 132(2) (pp 267-276), 2024. Date of
Publication: February 2024.
Author
Feng C.-D.; Xu Y.; Chen S.; Song N.; Meng X.-W.; Liu H.; Ji F.-H.; Peng K.
Institution
(Feng, Xu, Song, Meng, Ji, Peng) Department of Anaesthesiology, First
Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China
(Feng, Song, Meng, Ji, Peng) Institute of Anaesthesiology, Soochow
University, Jiangsu, Suzhou, China
(Xu) Department of Anaesthesiology, Suzhou Xiangcheng People's Hospital,
Jiangsu, Suzhou, China
(Chen) Department of Thoracic Surgery, First Affiliated Hospital of
Soochow University, Jiangsu, Suzhou, China
(Liu) Department of Anaesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Intraoperative opioid use has a positive relationship with
postoperative nausea and vomiting (PONV), and opioid-free anaesthesia
(OFA) might reduce PONV. We investigated whether OFA compared with
opioid-based anaesthesia would reduce PONV during the first 2
postoperative days among patients undergoing thoracoscopic lung resection.
 Method(s): In this randomised controlled trial, 120 adult patients
were randomly assigned (1:1, stratified by sex) to receive either OFA with
esketamine, dexmedetomidine, and sevoflurane, or opioid-based anaesthesia
with sufentanil and sevoflurane. A surgical pleth index (SPI) of 20-50 was
applied for intraoperative analgesia provision. All subjects received PONV
prophylaxis (dexamethasone and ondansetron) and multimodal analgesia
(flurbiprofen axetil, ropivacaine wound infiltration, and
patient-controlled sufentanil). The primary outcome was the occurrence of
PONV during the first 48 h after surgery. Result(s): The median age
was 53 yr and 66.7% were female. Compared with opioid-based anaesthesia,
OFA significantly reduced the incidence of PONV (15% vs 31.7%; odds ratio
[OR]=0.38, 95% confidence interval [CI], 0.16-0.91; number needed to
treat, 6; P=0.031). Secondary and safety outcomes were comparable between
groups, except that OFA led to a lower rate of vomiting (OR=0.23, 95% CI,
0.08-0.77) and a longer length of PACU stay (median difference=15.5 min,
95% CI, 10-20 min). The effects of OFA on PONV did not differ in the
prespecified subgroups of sex, smoking status, and PONV risk scores.
 Conclusion(s): In the context of PONV prophylaxis and multimodal
analgesia, SPI-guided opioid-free anaesthesia halved the incidence of PONV
after thoracoscopic lung resection, although it was associated with a
longer stay in the PACU. Clinical trial registration: Chinese Clinical
Trial Registry (ChiCTR2200059710). Copyright © 2023 British
Journal of Anaesthesia

<19>
Accession Number
2028011084
Title
Thoracic paravertebral block for perioperative lung preservation during
VATS pulmonary surgery: study protocol of a randomized clinical trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 74. Date of
Publication: December 2024.
Author
Zhu J.; Wei B.; Wu L.; Li H.; Zhang Y.; Lu J.; Su S.; Xi C.; Liu W.; Wang
G.
Institution
(Zhu, Wu, Li, Zhang, Xi, Wang) Department of Anaesthesiology, Beijing
Tongren Hospital, Capital Medical University, Beijing 100730, China
(Wei, Liu) Department of Anaesthesiology, Beijing Chest Hospital, Capital
Medical University, Beijing 101100, China
(Lu) Department of Anaesthesiology, Beijing Renhe Hospital, Beijing
102600, China
(Su) Central Laboratory, Beijing Obstetrics and Gynecology Hospital,
Capital Medical University, Chaoyang, Beijing 100026, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative pulmonary complications (PPCs) extend the length
of stay of patients and increase the perioperative mortality rate after
video-assisted thoracoscopic (VATS) pulmonary surgery. Thoracic
paravertebral block (TPVB) provides effective analgesia after VATS
surgery; however, little is known about the effect of TPVB on the
incidence of PPCs. The aim of this study is to determine whether TPVB
combined with GA causes fewer PPCs and provides better perioperative lung
protection in patients undergoing VATS pulmonary surgery than simple
general anaesthesia. Method(s): A total of 302 patients undergoing
VATS pulmonary surgery will be randomly divided into two groups: the
paravertebral block group (PV group) and the control group (C group).
Patients in the PV group will receive TPVB: 15 ml of 0.5% ropivacaine will
be administered to the T4 and T7 thoracic paravertebral spaces before
general anaesthesia induction. Patients in the C group will not undergo
the intervention. Both groups of patients will be subjected to a
protective ventilation strategy during the operation. Perioperative
protective mechanical ventilation and standard fluid management will be
applied in both groups. Patient-controlled intravenous analgesia is used
for postoperative analgesia. The primary endpoint is a composite outcome
of PPCs within 7 days after surgery. Secondary endpoints include blood gas
analysis, postoperative lung ultrasound score, NRS score, QoR-15 score,
hospitalization-related indicators and long-term prognosis indicators.
 Discussion(s): This study will better evaluate the impact of TPVB on
the incidence of PPCs and the long-term prognosis in patients undergoing
VATS lobectomy/segmentectomy. The results may provide clinical evidence
for optimizing perioperative lung protection strategies. Trial
registration: ClinicalTrials.gov NCT05922449 . Registered on June 25,
2023. Copyright © 2024, The Author(s).

<20>
Accession Number
2027607878
Title
Effect of preoperative moderate-dose statin and duration on acute kidney
injury after cardiac surgery: a retrospective cohort study.
Source
Current Medical Research and Opinion. 40(2) (pp 229-238), 2024. Date of
Publication: 2024.
Author
Jiang J.; Liu X.; Cheng Z.; Liu Q.; Xing W.
Institution
(Jiang, Liu, Xing) Department of Big Data Center for Cardiovascular
Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital,
Central China Fuwai Hospital of Zhengzhou University, China
(Cheng, Liu) Department of Cardiovascular Surgery, Henan Provincial
People's Hospital, Central China Fuwai Hospital, Central China Fuwai
Hospital of Zhengzhou University, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: The impact of preoperative statin use on postoperative acute
kidney injury (AKI) is uncertain. We aimed to examine the association of
statin therapy before cardiac surgery with postoperative AKI.
 Method(s): The retrospective cohort study consisted of 1581 patients
undergoing cardiac surgery. Postoperative AKI were identified by the
modified KDIGO definition. Propensity-score matching was employed to
control for selection bias, and logistic regression was used to control
for confounders. Subgroup and interaction analyses were performed to
evaluate the robustness of the findings. Result(s): The overall
incidence of postoperative AKI and severe AKI were 42.19% and 12.27%,
respectively. Preoperative moderate-dose statin was significantly
associated with a reduced incidence of postoperative AKI (28.9% vs 43.0%,
OR (95%CI): 0.54 (0.38, 0.77), p < 0.001) and severe AKI (6.9% vs 13.7%,
OR (95%CI): 0.46 (0.26, 0.83), p = 0.009). The beneficial effect on
postoperative AKI persisted after adjusting for major confounding factors
(OR (95%CI): 0.47 (0.34, 0.66)). Decreased risk of postoperative AKI was
observed in patients with preoperative statin duration of 7 ~ 14 days (OR
(95%CI): 0.41 (0.25, 0.65)) and over 14 days (OR (95%CI): 0.43 (0.28,
0.65)), but not in those with preoperative statin duration of <7 days.
Similar favorable effects were noted in most subgroup patients, except for
those with high-risk factors such as diabetes mellitus, previous
congestive cardiac failure, arrhythmia, preoperative ACEI/ARB, aortic
cross-clamping or IABP. Conclusion(s): Preoperative moderate-dose
statin was significantly related to a decreased risk of postoperative AKI,
especially in patients who received statins for a longer duration. Further
large-scale multicenter randomized controlled trials are needed to
ascertain the impact of statin dose, duration, and timing on postoperative
AKI in cardiac surgery patients. Copyright © 2023 Informa UK
Limited, trading as Taylor & Francis Group.

<21>
Accession Number
2026913308
Title
Minimally invasive, surgical, and transcatheter aortic valve replacement:
A network meta-analysis.
Source
Journal of Cardiology. 83(3) (pp 177-183), 2024. Date of Publication:
March 2024.
Author
Awad A.K.; Ahmed A.; Mathew D.M.; Varghese K.S.; Mathew S.M.; Khaja S.;
Newell P.C.; Okoh A.K.; Hirji S.
Institution
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Ahmed, Mathew, Varghese, Mathew, Khaja) City University of New York
School of Medicine, New York, NY, United States
(Newell, Hirji) Division of Thoracic and Cardiac Surgery, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Okoh) Emory University, Atlanta, GA, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has evolved as
an alternative to surgical aortic valve replacement (SAVR). In addition to
full-sternotomy (FS), recent reports have shown successful
minimally-invasive SAVR approaches, including mini-sternotomy (MS) and
mini-thoracotomy (MT). This network-meta-analysis (NMA) seeks to provide
an outcomes comparison based on these different modalities (MS, MT, TAVR)
compared with FS as a reference arm for the management of aortic valve
disease. Method(s): A comprehensive literature search was performed
to identify studies that compared minimally-invasive SAVR (MS/MT) to
conventional FS-SAVR, and/or TAVR. Bayesian NMA was performed using the
random effects model. Outcomes were pooled as risk ratios (RR) with their
95 % confidence intervals (CIs). Our primary outcomes included 30-day
mortality, stroke, acute kidney injury (AKI), major bleeding, new
permanent pacemaker (PPM), and paravalvular leak (PVL). We also assessed
long-term mortality at the latest follow-up. Result(s): A total of
27,117 patients (56 studies) were included; 10,397 patients had FS SAVR,
9523 had MS, 5487 had MT, and 1710 had TAVR. Compared to FS, MS was
associated with statistically-significantly lower rates of 30-day
mortality (RR, 0.76, 95%CI 0.59-0.98), stroke (RR, 0.84, 95%CI 0.72-0.97),
AKI (RR, 0.76, 95%CI 0.61-0.94), and long-term mortality (RR 0.84, 95%CI
0.72-0.97) at a weighted mean follow-up duration of 10.4 years, while MT
showed statistically-significantly higher rates of 30-day PVL (RR, 3.76,
95%CI 1.31-10.85) and major bleeding (RR 1.45; 95%CI 1.08-1.94). TAVR had
statistically significant lower rates of 30-day AKI (RR 0.49, 95%CI
0.31-0.77), but showed statistically-significantly higher PPM (RR 2.50;
95%CI 1.60-3.91) and 30-day PVL (RR 12.85, 95%CI 5.05-32.68) compared to
FS. Conclusion(s): MS was protective against 30-day mortality,
stroke, AKI, and long-term mortality compared to FS; TAVR showed higher
rates of 30-day PVL and PPM but was protective against AKI. Conversely, MT
showed higher rates of 30-day PVL and major bleeding. With the emergence
of TAVR, the appropriate benchmarks for SAVR comparison in future trials
should be the minimally-invasive SAVR approaches to provide clinical
equipoise. Copyright © 2023 Elsevier Ltd

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

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

<24>
Accession Number
2029997706
Title
Effect of Retrograde Autologous Priming on Coagulation Assessed by
Rotation Thromboelastometry in Patients Undergoing Valvular Cardiac
Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Ko S.H.; Nan Z.; Soh S.; Shim J.-K.; Lee H.W.; Kwak Y.L.; Song J.W.
Institution
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Department of Anesthesiology and
Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Anesthesia and Pain Research
Institute, Yonsei University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of retrograde autologous priming
(RAP) on coagulation function using rotation thromboelastometry (ROTEM) in
patients undergoing valvular cardiac surgery. Design(s): A
prospective, randomized, patient- and outcome assessor-blinded study.
 Setting(s): At a single-center university hospital.
 Participant(s): Patients aged 20 years or older undergoing valvular
cardiac surgery. Intervention(s): A total of 104 patients were
allocated to the RAP or control group (1:1 ratio). In the RAP group, the
prime was displaced into the collection bag before bypass initiation.
ROTEM was performed at the induction of anesthesia, at the beginning of
rewarming, and after the reversal of heparinization. Allogeneic plasma
products and platelet concentrates were transfused according to
ROTEM-based algorithms. Measurements and Main Results: An average
volume of 635 +/- 114 mL was removed using RAP (from the 1,600 mL initial
prime volume). The hematocrit 10 minutes after cardiopulmonary bypass
(CPB) was 24.7 +/- 3.5% in the control group, and 26.1 +/- 4.1% in the RAP
group (p = 0.330). ROTEM, including EXTEM, INTEM, and FIBTEM, showed
prolonged clotting time and decreased maximal clot firmness after CPB in
both groups without intergroup differences. The number of patients who
received intraoperative erythrocytes (27% v 25%, control versus RAP, p =
0.823), fresh frozen plasma (14% v 8%, control versus RAP, p = 0.339),
cryoprecipitate (21% v 12%, control versus RAP, p = 0.185), or platelet
concentrate transfusion (19% v 12%, control versus RAP, p = 0.277) did not
differ between the groups. Conclusion(s): Cardiopulmonary bypass
induced impaired coagulation function on ROTEM. However, RAP did not
improve coagulation function when compared with conventional priming in
patients undergoing valvular cardiac surgery. Copyright © 2023
Elsevier Inc.

<25>
Accession Number
2028251914
Title
Trimethoprim-sulfamethoxazole significantly reduces the risk of
nocardiosis in solid organ transplant recipients: systematic review and
individual patient data meta-analysis.
Source
Clinical Microbiology and Infection. 30(2) (pp 170-177), 2024. Date of
Publication: February 2024.
Author
Passerini M.; Nayfeh T.; Yetmar Z.A.; Coussement J.; Goodlet K.J.; Lebeaux
D.; Gori A.; Mahmood M.; Temesgen Z.; Murad M.H.
Institution
(Passerini, Gori) Department of Pathophysiology and Transplantation,
University of Milano, Milan, Italy
(Passerini, Gori) Department of Infectious Disease, ASST FBF SACCO
Fatebenefratelli, Lombardia, Milan, Italy
(Nayfeh, Yetmar, Mahmood, Temesgen, Murad) Division of Public Health,
Infectious Diseases and Occupational Medicine, Department of Medicine,
Mayo Clinic, Rochester, MN, United States
(Yetmar) Department of Infectious Diseases, Respiratory Institute,
Cleveland Clinic Foundation, Cleveland, OH, United States
(Coussement) Sir Peter MacCallum Department of Oncology, The University of
Melbourne, Melbourne, VIC, Australia
(Coussement) Service de Maladies Infectieuses et Tropicales, Centre
Hospitalier Universitaire de Guadeloupe, Guadeloupe, Les Abymes, France
(Goodlet) Department of Pharmacy Practice, Midwestern University,
Glendale, AZ, United States
(Goodlet) Norton Thoracic Institute, Dignity Health - St. Joseph's
Hospital and Medical Center, Phoenix, AZ, United States
(Lebeaux) Institut Pasteur, Universite Paris Cite, CNRS, Genetics of
Biofilms Laboratory, UMR, Paris 6047, France
(Lebeaux) Departement de Maladies Infectieuses et Tropicales, Hopital
Saint-Louis, AP-HP, Lariboisiere, Paris, France
(Gori) Centre for Multidisciplinary Research in Health Science (MACH),
University of Milan, Milan, Italy
Publisher
Elsevier B.V.
Abstract
Background: Whether trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis
prevents nocardiosis in solid organ transplant (SOT) recipients is
controversial. Objective(s): To assess the effect of TMP-SMX in the
prevention of nocardiosis after SOT, its dose-response relationship, its
effect on preventing disseminated nocardiosis, and the risk of TMP-SMX
resistance in case of breakthrough infection. Method(s): A systematic
review and individual patient data meta-analysis. Data sources: MEDLINE,
Embase, Cochrane Central Register of Controlled Trials, Cochrane Database
of Systematic Reviews, Web of Science Core Collection, and Scopus up to 19
September 2023. Study eligibility criteria: (a) Risk of nocardiosis
between SOT recipients with and without TMP-SMX prophylaxis, or (b)
sufficient details to determine the rate of TMP-SMX resistance in
breakthrough nocardiosis. Participant(s): SOT recipients.
 Intervention(s): TMP-SMX prophylaxis versus no prophylaxis.
Assessment of risk of bias: Risk Of Bias In Non-randomized Studies-of
Exposure (ROBINS-E) for comparative studies; dedicated tool for
non-comparative studies. Methods of data synthesis: For our primary
outcome (i.e. to determine the effect of TMP-SMX on the risk of
nocardiosis), a one-step mixed-effects regression model was used to
estimate the association between the outcome and the exposure. Univariate
and multivariable unconditional regression models were used to adjust for
the potential confounding effects. Certainty of evidence was assessed
using Grading of Recommendations Assessment, Development and Evaluation
(GRADE) approach. Result(s): Individual data from three case-control
studies were obtained (260 SOT recipients with nocardiosis and 519
uninfected controls). TMP-SMX prophylaxis was independently associated
with a significantly decreased risk of nocardiosis (adjusted OR = 0.3, 95%
CI 0.18-0.52, moderate certainty of evidence). Variables independently
associated with an increased risk of nocardiosis were older age, current
use of corticosteroids, high calcineurin inhibitor concentration, recent
acute rejection, lower lymphocyte count, and heart transplant.
Breakthrough infections (66/260, 25%) were generally susceptible to
TMP-SMX (pooled proportion 98%, 95% CI 92-100). Conclusion(s): In SOT
recipients, TMP-SMX prophylaxis likely reduces the risk of nocardiosis.
Resistance appears uncommon in case of breakthrough
infection. Copyright © 2023 The Author(s)

<26>
Accession Number
2026813312
Title
The effects of bariatric surgery on cardiac function: a systematic review
and meta-analysis.
Source
International Journal of Obesity. 48(2) (pp 166-176), 2024. Date of
Publication: February 2024.
Author
Sargsyan N.; Chen J.Y.; Aggarwal R.; Fadel M.G.; Fehervari M.; Ashrafian
H.
Institution
(Sargsyan, Chen, Aggarwal, Fadel, Fehervari, Ashrafian) Department of
General Surgery, Imperial College Healthcare NHS Foundation Trust, London,
United Kingdom
(Fadel, Fehervari, Ashrafian) Department of Surgery and Cancer, Imperial
College London, London, United Kingdom
Publisher
Springer Nature
Abstract
Introduction: Obesity is associated with alterations in cardiac structure
and haemodynamics leading to cardiovascular mortality and morbidity.
Culminating evidence suggests improvement of cardiac structure and
function following bariatric surgery. Objective(s): To evaluate the
effect of bariatric surgery on cardiac structure and function in patients
before and after bariatric surgery. Method(s): Systematic review and
meta-analysis of studies reporting pre- and postoperative cardiac
structure and function parameters on cardiac imaging in patients
undergoing bariatric surgery. Result(s): Eighty studies of 3332
patients were included. Bariatric surgery is associated with a
statistically significant improvement in cardiac geometry and function
including a decrease of 12.2% (95% CI 0.096-0.149; p < 0.001) in left
ventricular (LV) mass index, an increase of 0.155 (95% CI 0.106-0.205; p <
0.001) in E/A ratio, a decrease of 2.012 mm (95% CI 1.356-2.699; p <
0.001) in left atrial diameter, a decrease of 1.16 mm (95% CI 0.62-1.69; p
< 0.001) in LV diastolic dimension, and an increase of 1.636% (95% CI
0.706-2.566; p < 0.001) in LV ejection fraction after surgery.
 Conclusion(s): Bariatric surgery led to reverse remodelling and
improvement in cardiac geometry and function driven by metabolic and
haemodynamic factors. Copyright © 2023, The Author(s).

<27>
Accession Number
2026207153
Title
Intravenous Diltiazem Versus Metoprolol in Acute Rate Control of Atrial
Fibrillation/Flutter and Rapid Ventricular Response: A Meta-Analysis of
Randomized and Observational Studies.
Source
American Journal of Cardiovascular Drugs. 24(1) (pp 103-115), 2024. Date
of Publication: January 2024.
Author
Bolton A.; Paudel B.; Adhaduk M.; Alsuhaibani M.; Samuelson R.; Schweizer
M.L.; Hodgson-Zingman D.
Institution
(Bolton) Department of Epidemiology, College of Public Health, University
of Iowa, Iowa City, IA 52242, United States
(Paudel, Adhaduk) Department of General Internal Medicine, University of
Iowa Hospitals and Clinics, Iowa City, IA, United States
(Alsuhaibani) Department of Pediatrics, King Faisal Specialist Hospital
and Research Centre, Riyadh, Saudi Arabia
(Alsuhaibani) College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
(Samuelson) Hardin Library for the Health Sciences, University of Iowa,
Iowa City, IA, United States
(Schweizer) Division of Infectious Disease, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Hodgson-Zingman) Department of Cardiology, University of Iowa Hospitals
and Clinics, Iowa City, IA, United States
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) and/or atrial flutter (AFL) with
rapid ventricular response (RVR) is a condition that often requires urgent
treatment. Although guidelines have recommendations regarding chronic rate
control therapy, recommendations on the best choice for acute heart rate
(HR) control in RVR are unclear. Method(s): A systematic search
across multiple databases was performed for studies evaluating the outcome
of HR control (defined as HR less than 110 bpm and/or 20% decrease from
baseline HR). Included studies evaluated AF and/or AFL with RVR in a
hospital setting, with direct comparison between intravenous (IV)
diltiazem and metoprolol and excluded cardiac surgery and catheter
ablation patients. Hypotension (defined as systolic blood pressure less
than 90 mmHg) was measured as a secondary outcome. Two authors performed
full-text article review and extracted data, with a third author mediating
disagreements. Random effects models utilizing inverse variance weighting
were used to calculate odds ratios (OR) and 95% confidence intervals (CI).
Heterogeneity was assessed using the I 2 test. Result(s):
A total of 563 unique titles were identified through the systematic
search, of which 16 studies (7 randomized and 9 observational) were
included. In our primary analysis of HR control by study type, IV
diltiazem was found to be more effective than IV metoprolol for HR control
in randomized trials (OR 4.75, 95% CI 2.50-9.04 with I 2 =
14%); however, this was not found for observational studies (OR 1.26, 95%
CI 0.89-1.80 with I 2 = 55%). In an analysis of observational
studies, there were no significant differences between the two drugs in
odds of hypotension (OR 1.12, 95% CI 0.51-2.45 with I 2 = 18%).
 Conclusion(s): While there was a trend toward improved HR control
with IV diltiazem compared with IV metoprolol in randomized trials, this
was not seen in observational studies, and there was no observed
difference in hypotension between the two drugs. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<28>
Accession Number
643318953
Title
Risk factors for postoperative delirium in patients with Stanford type A
aortic dissection: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 16), 2024. Date of
Publication: 22 Jan 2024.
Author
Lu S.; Jiang Y.; Meng F.; Xie X.; Wang D.; Su Y.
Institution
(Lu, Xie, Wang, Su) Department of Thoracic and Cardiovascular Surgery,
Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,
Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu 210008, China
(Jiang) Department of Cardiovascular Surgery, Nanjing Drum Tower Hospital,
Chinese Academy of Medical Science & Peking Union Medical College, Nanjing
210008, China
(Meng) Nanjing University, Nanjing 210008, China
Abstract
BACKGROUND: Delirium is a common postoperative complication among patients
who undergo Stanford Type A aortic dissection (TAAD). It is associated
with increased mortality, as well as other serious surgical outcomes. This
study aimed to analyze the risk factors for delirium in TAAD patients.
 METHOD(S): Pubmed, Web of science, Embase, the Cochrane Library and
CINAHL were searched by computer to collect literatures on risk factors
for postoperative delirium (POD) after TAAD. The retrieval period was from
the establishment of the database to September 2022. After literature
screening, two reviewers independently assessed the quality of the
included studies using the Newcastle-Ottawa Scale (NOS). Data were
extracted according to standard protocols, and then meta-analysis was
performed using Revman 5.3 software. RESULT(S): A total of 9
articles, comprising 7 case-control studies and 2 cohort studies, were
included in this analysis. The sample size consisted of 2035 patients. POD
was associated with increased length of ICU stay (MD 3.24, 95% CI
0.18-6.31, p=0.04) and length of hospital stay (MD 9.34, 95% CI
7.31-11.37, p<0.0001) in TAAD patients. Various perioperative risk factors
were identified, including age (MD 4.40, 95% CI 2.06-6.73, p=0.0002),
preoperative low hemoglobin levels (MD -4.44, 95% CI -7.67 to -1.20,
p=0.007), body mass index (MD 0.92, 95% CI 0.22-1.63, p=0.01), history of
cardiac surgery (OR 3.06, 95% CI 1.20-7.83, p=0.02), preoperative renal
insufficiency (OR 2.50, 95% CI 1.04-6.04, p=0.04), cardiopulmonary bypass
(CPB) duration (MD 19.54, 95% CI 6.34-32.74, p=0.004), surgery duration
(MD 44.88, 95% CI 5.99-83.78, p=0.02), mechanical ventilation time (SMD
1.14, 95% CI 0.34-1.94, p=0.005), acute physiology and chronic health
evaluation (APACHE II) score (MD 2.67, 95% CI 0.37-4.98, p=0.02),
postoperative renal insufficiency (OR 2.82, 95% CI 1.40-5.68, p=0.004),
electrolyte disturbance (OR 6.22, 95% CI 3.08-12.54, p<0.0001) and
hypoxemia (OR 3.56, 95% CI 1.70-7.44, p=0.0007). CONCLUSION(S): POD
can prolong ICU stay and hospital stay in TAAD patients. This study
identified a number of risk factors for POD after TAAD, suggesting the
possibility of early identification of high-risk patients using relevant
data. Copyright © 2024. The Author(s).

<29>
[Use Link to view the full text]
Accession Number
642303081
Title
Comparative efficacy on outcomes of C-CABG, OPCAB, and ONBEAT in coronary
heart disease: a systematic review and network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). 109(12) (pp
4263-4272), 2023. Date of Publication: 01 Dec 2023.
Author
Zhu L.; Li D.; Zhang X.; Wan S.; Liu Y.; Zhang H.; Luo J.; Luo Y.; An P.;
Jiang W.
Institution
(Zhu, Zhang, Wan, Luo, Luo, An) Department of Nutrition and Health,
Beijing Advanced Innovation Center for Food, Nutrition and Human Health,
Key Laboratory of Precision Nutrition and Food, Quality, China
Agricultural University, China
(Li, Liu, Zhang, Jiang) Department of Cardiac Surgery, Beijing Anzhen
Hospital
(Li, Liu, Zhang, Jiang) Beijing Advanced Innovation Center for Big
Data-based Precision Medicine, Capital Medical University
(Li, Liu, Zhang, Jiang) Beijing Lab for Cardiovascular Precision Medicine
(Li, Liu, Zhang, Jiang) Key Laboratory of Medical Engineering for
Cardiovascular Disease, Beijing, China
Abstract
IMPORTANCE: Coronary artery bypass grafting (CABG) remains the gold
standard for the treatment of multivessel and left main coronary heart
disease. However, the current evidence about the optimal surgical
revascularization strategy is inconsistent and is not sufficient to allow
for definite conclusions. Thus, this topic needs to be extensively
discussed. OBJECTIVE(S): The aim of this present study was to compare
the clinical outcomes of off-pump CABG (OPCAB), conventional on-pump CABG
(C-CABG), and on-pump beating heart (ONBEAT) CABG via an updated
systematic review and network meta-analysis of randomized controlled
trials. DATA SOURCES: PubMed, Web of Science, and the Cochrane Central
Registry were searched for relevant randomized controlled trials that were
published in English before 1 December 2021. STUDY SELECTION: Published
trials that included patients who received OPCAB, C-CABG, and ONBEAT CABG
were selected. DATA EXTRACTION AND SYNTHESIS: Two authors independently
screened the search results, assessed the full texts to identify eligible
studies and the risk of bias of the included studies, and extracted data.
All processes followed the Preferred Reporting Items for Systematic Review
and Meta-analysis of Individual Participant Data. MAIN OUTCOMES AND
MEASURES: The primary outcome was postoperative mortality in patients who
underwent C-CABG, OPCAB, or ONBEAT CABG. The secondary outcomes were
postoperative myocardial infarction, stroke, and renal impairment in the
three groups. The time point for analysis of outcomes was all time periods
during the postoperative follow-up. RESULT(S): A total of 39 385
patients (83 496.2 person-years) in 65 studies who fulfilled the
prespecified criteria were included. In the network meta-analysis, OPCAB
was associated with an increase of 12% in the risk of all-cause mortality
when compared with C-CABG [odds ratio (OR): 1.12; 95% CI: 1.04-1.21], a
reduction of 49% in the risk of myocardial infarction when compared with
ONBEAT (OR: 0.51; 95% CI: 0.26-0.99), a reduction of 16% in the risk of
stroke when compared with C-CABG (OR: 0.84; 95% CI: 0.72-0.99) and a
similar risk of renal impairment when compared with C-CABG and ONBEAT.
CONCLUSIONS AND RELEVANCE: OPCAB was associated with higher all-cause
mortality but lower postoperative stroke compared with C-CABG. OPCAB was
associated with a lower postoperative myocardial infarction than that of
ONBEAT. Early mortality was comparable among OPCAB, ONBEAT, and
C-CABG. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<30>
[Use Link to view the full text]
Accession Number
640577255
Title
A commentary on 'A comparison of regional anesthesia techniques in
patients undergoing video-assisted thoracic surgery: A network
meta-analysis'.
Source
International journal of surgery (London, England). 109(3) (pp 498-499),
2023. Date of Publication: 01 Mar 2023.
Author
Zhao Y.; Cheng C.; Jiao X.; Guo L.
Institution
(Zhao, Guo) Department of Anesthesiology
(Cheng, Jiao) Intensive Care Unit, Shanxi Province Cancer Hospital, Shanxi
Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical
Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Shanxi
Province, Taiyuan, China
Publisher
NLM (Medline)

<31>
Accession Number
640073453
Title
Transcatheter versus surgical aortic valve replacement in lower-risk and
higher-risk patients: a meta-analysis of randomized trials.
Source
European heart journal. 44(10) (pp 836-852), 2023. Date of Publication: 07
Mar 2023.
Author
Ahmad Y.; Howard J.P.; Arnold A.D.; Madhavan M.V.; Cook C.M.; Alu M.; Mack
M.J.; Reardon M.J.; Thourani V.H.; Kapadia S.; Thyregod H.G.H.;
Sondergaard L.; Jorgensen T.H.; Toff W.D.; Van Mieghem N.M.; Makkar R.R.;
Forrest J.K.; Leon M.B.
Institution
(Ahmad, Forrest) Yale School of Medicine, Yale University, CT 06510, 135
College Street, New Haven, United States
(Howard, Arnold) National Heart and Lung Institute, Imperial College
London, Du Cane Road, London W120HS, United Kingdom
(Madhavan, Leon) Division of Cardiology, Department of Medicine, Columbia
University Medical Center/New York-Presbyterian Hospital, W. 168th St. New
York, NY 10032, United States
(Madhavan, Alu, Leon) Clinical Trials Center, The Cardiovascular Research
Foundation, 1700 Broadway, New York, NY 10019, USA
(Cook) Essex Cardiothoracic Center, Nether Mayne, Basildon SS16 5NL,
United Kingdom
(Mack) Department of Cardiovascular Disease, Baylor Scott and White
Health, 4700 Alliance Blvd, Plano, United States
(Reardon) Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin
St Suite 1901, Houston TX 77030, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart and Vascular Institute, 95 Collier Rd NW Suite 5015,
Atlanta, United States
(Kapadia) Cleveland Clinic OH 44195, United States
(Thyregod, Sondergaard, Jorgensen) Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Blegdamsvej 9 ,2100 Copenhagen O, Section
2151, Denmark
(Toff) Department of Cardiovascular Sciences, University of Leicester and
NIHR Leicester Biomedical Research Centre, Glenfield Hospital ,University
Rd, Leicester LE1 7RH, United Kingdom
(Van Mieghem) Department of Interventional Cardiology, Thoraxcenter,
Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(Makkar) Cedars-Sinai Medical Center, Smidt Heart Institute, S San Vicente
Blvd, Los Angeles, CA 90048, USA
Publisher
NLM (Medline)
Abstract
AIMS: Additional randomized clinical trial (RCT) data comparing
transcatheter aortic valve implantation (TAVI) with surgical aortic valve
replacement (SAVR) is available, including longer term follow-up. A
meta-analysis comparing TAVI to SAVR was performed. A pragmatic risk
classification was applied, partitioning lower-risk and higher-risk
patients. METHODS AND RESULTS: The main endpoints were death, strokes, and
the composite of death or disabling stroke, occurring at 1 year (early) or
after 1 year (later). A random-effects meta-analysis was performed. Eight
RCTs with 8698 patients were included. In lower-risk patients, at 1 year,
the risk of death was lower after TAVI compared with SAVR [relative risk
(RR) 0.67; 95% confidence interval (CI) 0.47 to 0.96, P = 0.031], as was
death or disabling stroke (RR 0.68; 95% CI 0.50 to 0.92, P = 0.014). There
were no differences in strokes. After 1 year, in lower-risk patients,
there were no significant differences in all main outcomes. In higher-risk
patients, there were no significant differences in main outcomes.
New-onset atrial fibrillation, major bleeding, and acute kidney injury
occurred less after TAVI; new pacemakers, vascular complications, and
paravalvular leak occurred more after TAVI. CONCLUSION(S): In
lower-risk patients, there was an early mortality reduction with TAVI, but
no differences after later follow-up. There was also an early reduction in
the composite of death or disabling stroke, with no difference at later
follow-up. There were no significant differences for higher-risk patients.
Informed therapy decisions may be more dependent on the temporality of
events or secondary endpoints than the long-term occurrence of main
clinical outcomes. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<32>
Accession Number
633318176
Title
Metoprolol for prophylaxis of postoperative atrial fibrillation in cardiac
surgery patients: systematic review and meta-analysis.
Source
BMJ open. 10(10) (pp e038364), 2020. Date of Publication: 31 Oct 2020.
Author
Norhayati M.N.; Shaiful Bahari I.; Zaharah S.; Nik Hazlina N.H.; Mohammad
Aimanazrul Z.; Irfan M.
Institution
(Norhayati) Department of Family Medicine, School of Medical Sciences,
University Sains Malaysia, Health CampusKubang Kerian, Malaysia
(Shaiful Bahari, Mohammad Aimanazrul) Department of Family Medicine,
School of Medical Sciences, University Sains Malaysia, Health CampusKubang
Kerian, Malaysia
(Zaharah, Nik Hazlina, Irfan) Women's Health Development Unit, School of
Medical Sciences, University Sains Malaysia, Health CampusKubang Kerian,
Malaysia
(Irfan) Department of Zoology, Pir Mehr Ali Shah, Arid Agriculture
University, Rawalpindi, Pakistan
Publisher
NLM (Medline)
Abstract
PURPOSE: Postoperative atrial fibrillation (POAF) is a potentially lethal
and morbid complication after open heart surgery. This systematic review
and meta-analysis aimed to investigate metoprolol compared with other
treatments for prophylaxis against POAF. METHOD(S): We searched
CENTRAL, MEDLINE, EMBASE and trial registries for randomised controlled
trials that evaluated metoprolol for preventing the occurrence of POAF
after surgery against other treatments or placebo. Random-effects model
was used for estimating the risk ratios (RRs) and mean differences with
95% CIs. RESULT(S): Nine trials involving 1570 patients showed
metoprolol reduced POAF compared with placebo (416 patients; RR 0.46, 95%
CI 0.33 to 0.66; I2=21%; risk difference (RD) -0.19, 95% CI -0.28 to
-0.10). However, metoprolol increased the risk of POAF compared with
carvedilol (159 patients; RR 1.59, 95% CI 1.20 to 2.12; I2=4%; RD 0.13,
95% CI 0.06 to 0.20). There was no difference when compared with sotalol
or amiodarone. The occurrence of cardiovascular conditions after drugs
administration or death between the groups was not different. The overall
quality of evidence was moderate to high. Subgroup analysis and funnel
plot were not performed. CONCLUSION(S): Metoprolol is effective in
preventing POAF compared with placebo and showed no difference with class
III antiarrhythmic drugs. Death and thromboembolism are associated with
open heart surgery, but not significant in relation to the use of
metoprolol. PROSPERO REGISTRATION NUMBER: CRD42019131585. Copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<33>
Accession Number
633225626
Title
The Effect of Melatonin on the Serum Level of Interleukin 6 and
Interleukin 9 in Coronary Artery Bypass Grafting Surgery.
Source
Asian journal of anesthesiology. 58(1) (pp 35-44), 2020. Date of
Publication: 01 Mar 2020.
Author
Jouybar R.; Setoodeh M.; Saravi Z.F.; Ahmadi S.; Karami A.; Khademi S.;
Izadpanah A.; Jannati M.; Shafa M.; Asadpour E.; Masih F.; Malekzadeh M.
Institution
(Jouybar, Karami) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Science, Shiraz, Iran, Islamic Republic of
(Setoodeh, Izadpanah) Anesthesiology and Critical Care Research Center,
Shiraz University of Medical Science, Shiraz, Iran, Islamic Republic of
(Saravi) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Science, Shiraz, Iran, Islamic Republic of
(Ahmadi) Fasa University of Medical Science, Fasa, Iran, Islamic Republic
of
(Khademi) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Science, Shiraz, Iran, Islamic Republic of
(Jannati, Shafa) Assosiated Professor of Cardiovascular Surgery,
Cardiovascular Research Center, Shiraz University of Medical Science,
Shiraz, Iran, Islamic Republic of
(Asadpour) Assosiated Professor of Pharmacology, Anesthesiology and
Critical Care Research Center, Shiraz University of Medical Science,
Shiraz, Iran, Islamic Republic of
(Masih) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Science, Shiraz, Iran, Islamic Republic of
(Malekzadeh) Shiraz Institute for Cancer Research, School of Medicine,
Shiraz University of Medical Science, Shiraz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Cardiopulmonary bypass has been recognized as one of the main
causes of systemic inflammatory response syndrome, leading to
post-operative complications. The aim of this study was to investigate the
effect of melatonin on the serum levels of interleukin 6 (IL-6) and IL-9
in patients undergoing coronary artery bypass grafting surgery.
 METHOD(S): Forty-four patients undergoing elective coronary artery
bypass surgery were randomly allocated into two study groups of melatonin
(n = 23) and placebo (n = 21). Patients in the melatonin group received
two melatonin tablet, 5 mg daily for 3 days before surgery, 10 mg tablet
(two doses of 5 mg) 1 h before induction of anesthesia and finally, 10 mg
melatonin tablet in the intensive care unit, placebo group patients
received placebo at the same time periods. Serum levels of IL-9 and IL-6
were measured as baseline (T1), before induction of anesthesia (T2), 6 and
24 h after off pump (T3, T4). Data were analyzed using SPSS 23 software
(IBM Corp., Armonk, NY, USA). RESULT(S): The mean serum level of IL-6
was significantly lower in the melatonin group at T3 and T4 (p < 0.05).
Also, in both groups, serum levels of IL-6 in T3 showed a significant
increase compared to T1. Serum levels of IL-9 had no significant
difference between the two groups at T1, T2, T3, and T4.
 CONCLUSION(S): The results of this study showed that pre-operative
melatonin administration could modify inflammatory cytokines secretion
such as IL-6 while it has no significant effect on the serum levels of IL-
9. Neither of the changes was clinically significant.

<34>
[Use Link to view the full text]
Accession Number
632870677
Title
Meta-Analysis of Perioperative Stroke and Mortality in CABG Patients With
Carotid Stenosis.
Source
The neurologist. 25(5) (pp 113-116), 2020. Date of Publication: 01 Sep
2020.
Author
Roy P.; Brahme I.; Reddy R.P.; Wechsler L.; Gleason T.; Thirumala P.D.
Institution
(Roy, Brahme, Reddy, Thirumala) Departments of Neurological Surgery
(Wechsler, Gleason) Cardiothoracic Surgery
(Thirumala) Neurology, University of Pittsburgh Medical Center,
Pittsburgh, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass grafting (CABG) is a proven approach in
the treatment of coronary heart disease, but the surgery has several
complications, including stroke and death. Though it has been established
that perioperative stroke is associated with higher rates of long-term
mortality, the relationship between stroke and mortality in the
perioperative period has not yet been systematically examined.
 METHOD(S): Online databases of peer-reviewed literature were searched
to retrieve articles concerning mortality and stroke after CABG in
patients with carotid stenosis. Six studies (n=3786) were included for
analysis. This study was conducted at a single University hospital system,
University of Pittsburgh Medical Center, on patients who underwent CABG.
The data obtained from peer-reviewed literature originated from several
sources, primarily single institution hospitals. RESULT(S):
Consistent with current literature, the incidence of stroke in CABG
patients with significant carotid stenosis was 2.1%. Data were further
analyzed to generate a summary odds ratio of stroke-related mortality
after CABG, which showed that patients who died within 30 days of CABG
were 7.3 times more likely to have had a perioperative stroke (95%
confidence interval, 4.1-13.2). The 30-day mortality rate among
perioperative stroke victims was 14.4% versus 2.3% for nonstroke patients.
 CONCLUSION(S): Together, these data suggest an association between
stroke and mortality in the perioperative period in patients undergoing
CABG, demonstrating a need for improved monitoring, screening, and
treatment of stroke before, during, and shortly after surgery.

<35>
Accession Number
2028106407
Title
Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic
Valve Replacement: A Systematic Review with Meta-Analysis.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
455. Date of Publication: January 2024.
Author
Antiochos P.; Kirsch M.; Monney P.; Tzimas G.; Meier D.; Fournier S.;
Ferlay C.; Nowacka A.; Rancati V.; Abellan C.; Skalidis I.; Muller O.; Lu
H.
Institution
(Antiochos, Monney, Tzimas, Meier, Fournier, Ferlay, Skalidis, Muller, Lu)
Division of Cardiology, Lausanne University Hospital, University of
Lausanne, Lausanne 1011, Switzerland
(Kirsch, Ferlay, Nowacka) Division of Cardiovascular Surgery, Lausanne
University Hospital, University of Lausanne, Lausanne 1011, Switzerland
(Ferlay) Adult Intensive Care Unit, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
(Rancati) Division of Anesthesiology, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
(Abellan) Division of Internal Medicine, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
A growing body of evidence suggests that extrathoracic vascular accesses
for transcatheter aortic valve replacement (TAVR) yield favorable outcomes
and can be considered as primary alternatives when the gold-standard
transfemoral access is contraindicated. Data comparing the transcaval
(TCv) to supra-aortic (SAo) approaches (transcarotid, transsubclavian, and
transaxillary) for TAVR are lacking. We aimed to compare the outcomes and
safety of TCv and SAo accesses for TAVR as alternatives to transfemoral
TAVR. A systematic review with meta-analysis was performed by searching
PubMed/MEDLINE and EMBASE databases for all articles comparing TCv-TAVR
against SAo-TAVR published until September 2023. Outcomes included
in-hospital or 30-day all-cause mortality (ACM) and postoperative
complications. A total of three studies with 318 TCv-TAVR and 179 SAo-TAVR
patients were included. No statistically significant difference was found
regarding in-hospital or 30-day ACM (relative risk [RR] 1.04, 95%
confidence interval [CI] 0.47-2.34, p = 0.91), major bleeding, the need
for blood transfusions, major vascular complications, and acute kidney
injury. TCv-TAVR was associated with a non-statistically significant lower
rate of neurovascular complications (RR 0.39, 95%CI 0.14-1.09, p = 0.07).
These results suggest that both approaches may be considered as first-line
alternatives to transfemoral TAVR, depending on local expertise and
patients' anatomy. Additional data from long-term cohort studies are
needed. Copyright © 2024 by the authors.

<36>
Accession Number
2028105189
Title
Transcatheter Aortic Valve Replacement: Current Status and Future
Indications.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
373. Date of Publication: January 2024.
Author
Vinayak M.; Leone P.P.; Tanner R.; Dhulipala V.; Camaj A.; Makhija R.R.K.;
Hooda A.; Kini A.S.; Sharma S.K.; Khera S.
Institution
(Vinayak, Leone, Tanner, Dhulipala, Camaj, Makhija, Hooda, Kini, Sharma,
Khera) Mount Sinai Heart, Mount Sinai Hospital, New York, NY 10029, United
States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
In the past two decades, transcatheter aortic valve replacement (TAVR) has
transformed the management of aortic stenosis and has become the standard
of care regardless of surgical risk levels. Advances in transcatheter
valve design across newer generations, improved imaging, greater operator
expertise, and technical enhancements have collectively contributed to
increased safety and a decline in procedural complications over this
timeframe. The application of TAVR has progressively expanded to include
younger patients with lower risks, who have longer life expectancies. This
article offers an up-to-date review of the latest innovations in
transcatheter delivery systems, devices, and its possible future
indications. Copyright © 2024 by the authors.

<37>
Accession Number
2028104070
Title
The Ross Procedure: Imaging, Outcomes and Future Directions in Aortic
Valve Replacement.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
630. Date of Publication: January 2024.
Author
Galzerano D.; Kholaif N.; Al Amro B.; Al Admawi M.; Eltayeb A.; Alshammari
A.; Di Salvo G.; Al-Halees Z.Y.
Institution
(Galzerano, Kholaif, Al Amro, Al Admawi, Eltayeb, Alshammari, Al-Halees)
Heart Center Department, King Faisal Specialist Hospital and Research
Center, Riyadh 11564, Saudi Arabia
(Galzerano, Kholaif, Al Amro) College of Medicine, Alfaisal University,
Riyadh 11533, Saudi Arabia
(Di Salvo) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, Medical School, University of Padua, Padua 35122, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The Ross procedure is gaining recognition as a significant option for
aortic valve replacement (AVR), and is particularly beneficial in specific
patient groups. Although categorized as a class IIb recommendation in the
2020 American College of Cardiology (ACC)/American Heart Association
(AHA), and the European Society of Cardiology (ESC) management guidelines
on valvular heart disease, recent studies bolster its credibility.
Research, including a propensity-matched study, underlines the Ross
procedure's association with enhanced long-term survival and reduced
adverse valve-related events compared to other AVR types. This positions
the Ross procedure as a primary option for AVR in young and middle-aged
adults within specialized centers, and potentially the only choice for
children and infants requiring AVR. This review meticulously examines the
Ross procedure, covering historical perspectives, surgical techniques,
imaging, and outcomes, including hemodynamic performance and quality of
life, especially focusing on pediatric and young adult patients. It
explores contemporary techniques and innovations like minimally invasive
approaches and tissue engineering, underscoring ongoing research and
future directions. A summarization of comparative studies and
meta-analyses reiterates the Ross procedure's superior long-term outcomes,
valve durability, and preservation of the left ventricular function,
accentuating the crucial role of patient selection and risk
stratification, and pinpointing areas for future research. Copyright
© 2024 by the authors.

<38>
Accession Number
2030093273
Title
Efficacy of exercise training-based cardiac rehabilitation programmes
after transcatheter aortic valve implantation: A systematic review and
meta-analysis.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
20 (no pagination), 2024. Article Number: 200238. Date of Publication:
March 2024.
Author
Hosseinpour A.; Azami P.; Hosseinpour H.; Attar A.; Koushkie Jahromi M.
Institution
(Hosseinpour, Azami, Attar) Department of Cardiovascular Medicine, School
of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Hosseinpour, Azami, Hosseinpour) School of Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Koushkie Jahromi) Department of Sports Sciences, Shiraz University,
Shiraz, Iran, Islamic Republic of
Publisher
Elsevier B.V.
Abstract
Background: The beneficial effects of exercise training-based cardiac
rehabilitation (CR) in different cardiac conditions have been previously
studied. In this meta-analysis, we focused on the potential impact of CR
on patients undergoing transcatheter aortic valve implantation (TAVI).
 Method(s): Multiple databases were searched in a systematic approach
to find the eligible studies. All the studies investigating the potential
impact of exercise training-based CR programmes on exercise capacity and
health-related quality of life in patients undergoing TAVI were retrieved.
The primary endpoint of interest was 6-min walk test (6MWT). The pooled
standardized mean difference (SMD) and 95 % confidence interval (CI) were
measured to compare the improvement or worsening the endpoints using a
random- or fixed-effects model, as appropriate. Result(s): A total of
eleven studies (685 patients) were considered eligible for quantitative
synthesis. The results showed that performing exercise training-based CR
after TAVI is associated with significant improvement in 6MWT (SMD 0.59,
95 % CI (0.48; 0.71), p < 0.01), Barthel index (SMD 0.73, 95 % CI (0.57;
0.89), p < 0.01), 12-item Short Form (SF-12) physical (SMD 0.30, 95 % CI
(0.08; 0.52), p < 0.01) and mental (SMD 0.27, 95 % CI (0.05; 0.49), p =
0.02) survey scores, and hospital anxiety and depression scale -
depression (HADS-D) score (SMD -0.26, 95 % CI (-0.42; -0.10), p < 0.01).
 Conclusion(s): Performing exercise training-based CR following TAVI
has significant benefits regarding physical capacity and health-related
quality of life irrespective of the programme duration. Copyright
© 2024 The Author(s)

<39>
Accession Number
2029542979
Title
Local versus General Anaesthesia for Transcatheter Aortic Valve
Implantation (TAVI): A Systematic Review, Meta-Analysis, and Trial
Sequential Analysis of Randomised and Propensity-Score Matched Studies.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102360. Date of Publication: March 2024.
Author
Jaffar-Karballai M.; Al-Tawil M.; Roy S.; Kayali F.; Vankad M.; Shazly A.;
Zeinah M.; Harky A.
Institution
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Roy) School of Medicine, Queen's University Belfast, Ireland, Northern,
United Kingdom
(Kayali) University Hospitals Sussex, Sussex, United Kingdom
(Vankad) University Hospitals Birmingham, Birmingham, United Kingdom
(Shazly) Essex Cardiothoracic Centre, Basildon University Hospital,
Basildon, United Kingdom
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Zeinah) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) is a common practice for
severe aortic stenosis, but the choice between general (GA) and local
anesthesia (LA) remains uncertain. We conducted a comprehensive literature
review until April 2023, comparing the safety and efficacy of LA versus GA
in TAVI procedures. Our findings indicate significant advantages of LA,
including lower 30-day mortality rates (RR: 0.69; 95% CI [0.58, 0.82]; p <
0.001), shorter in-hospital stays (mean difference: -0.91 days; 95% CI
[-1.63, -0.20]; p = 0.01), reduced bleeding/transfusion incidents (RR:
0.64; 95% CI [0.48, 0.85]; p < 0.01), and fewer respiratory complications
(RR: 0.56; 95% CI [0.42, 0.76], p<0.01). Other operative outcomes were
comparable. Our findings reinforce prior evidence, presenting a compelling
case for LA's safety and efficacy. While patient preferences and clinical
nuances must be considered, our study propels the discourse towards a more
informed anaesthesia approach for TAVI procedures. Copyright ©
2023

<40>
Accession Number
2030071833
Title
Self-expanding intra-annular versus commercially available transcatheter
heart valves in high and extreme risk patients with severe aortic stenosis
(PORTICO IDE): a randomised, controlled, non-inferiority trial.
Source
The Lancet. 396(10252) (pp 669-683), 2020. Date of Publication: 05 Sep
2020.
Author
Makkar R.R.; Cheng W.; Waksman R.; Satler L.F.; Chakravarty T.; Groh M.;
Abernethy W.; Russo M.J.; Heimansohn D.; Hermiller J.; Worthley S.; Chehab
B.; Cunningham M.; Matthews R.; Ramana R.K.; Yong G.; Ruiz C.E.; Chen C.;
Asch F.M.; Nakamura M.; Jilaihawi H.; Sharma R.; Yoon S.-H.; Pichard A.D.;
Kapadia S.; Reardon M.J.; Bhatt D.L.; Fontana G.P.
Institution
(Makkar, Cheng, Chakravarty, Nakamura, Yoon) Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Waksman, Satler) Washington Hospital Center, Washington, DC, United
States
(Groh, Abernethy) Mission Health and Hospitals, Asheville, NC, United
States
(Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Russo, Chen) Newark Beth Israel Medical Center, Newark, NY, United States
(Heimansohn, Hermiller) St Vincent Heart Center, Indianapolis, IN, United
States
(Worthley) Royal Adelaide Hospital, Adelaide, SA, Australia
(Worthley) Genesis Care, Sydney, NSW, Australia
(Chehab) Cardiovascular Research Institute of Kansas, Ascension Via
Christi Hospital, Wichita, KS, United States
(Cunningham, Matthews) University of Southern California, Los Angeles, CA,
United States
(Ramana) Advocate Christ Medical Center, Oak Lawn, IL, United States
(Ramana) Heart Care Centers of Illinois, Palos Park, IL, United States
(Yong) Fiona Stanley Hospital, Murdoch, WA, Australia
(Ruiz) Hackensack University Medical Center, Hackensack, NJ, United States
(Asch) MedStar Health Research Institute, Washington, DC, United States
(Jilaihawi) NYU Langone Health, New York, NY, United States
(Sharma) Stanford University Medical Center, Stanford, CA, United States
(Pichard) Abbott, Abbott Park, IL, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Reardon) Houston Methodist Hospital, Houston, TX, United States
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Fontana) Cardiovascular Institute, Los Robles Regional Medical Center,
Thousand Oaks, CA, United States
Publisher
Elsevier B.V.
Abstract
Background: Randomised trial data assessing the safety and efficacy of the
self-expanding intra-annular Portico transcatheter aortic valve system
(Abbott Structural Heart, St Paul, MN, USA) compared with any commercially
available valves are needed to compare performance among designs.
 Method(s): In this prospective, multicentre, non-inferiority,
randomised controlled trial (the Portico Re-sheathable Transcatheter
Aortic Valve System US Investigational Device Exemption trial [PORTICO
IDE]), high and extreme risk patients with severe symptomatic aortic
stenosis were recruited from 52 medical centres experienced in performing
transcatheter aortic valve replacement in the USA and Australia. Patients
were eligible if they were aged 21 years or older, in New York Heart
Association functional class II or higher, and had severe native aortic
stenosis. Eligible patients were randomly assigned (1:1) using permuted
block randomisation (block sizes of 2 and 4) and stratified by clinical
investigational site, surgical risk cohort, and vascular access method, to
transcatheter aortic valve replacement with the first generation Portico
valve and delivery system or a commercially available valve (either an
intra-annular balloon-expandable Edwards-SAPIEN, SAPIEN XT, or SAPIEN 3
valve [Edwards LifeSciences, Irvine, CA, USA]; or a supra-annular
self-expanding CoreValve, Evolut-R, or Evolut-PRO valve [Medtronic,
Minneapolis, MN, USA]). Investigational site staff, implanting physician,
and study participant were unmasked to treatment assignment. Core
laboratories and clinical event assessors were masked to treatment
allocation. The primary safety endpoint was a composite of all-cause
mortality, disabling stroke, life-threatening bleeding requiring
transfusion, acute kidney injury requiring dialysis, or major vascular
complication at 30 days. The primary efficacy endpoint was all-cause
mortality or disabling stroke at 1 year. Clinical outcomes and valve
performance were assessed up to 2 years after the procedure. Primary
analyses were by intention to treat and the Kaplan-Meier method to
estimate event rates. The non-inferiority margin was 8.5% for primary
safety and 8.0% for primary efficacy endpoints. This study is registered
with ClinicalTrials.gov, NCT02000115, and is ongoing. Finding(s):
Between May 30 and Sept 12, 2014, and between Aug 21, 2015, and Oct 10,
2017, with recruitment paused for 11 months by the funder, we recruited
1034 patients, of whom 750 were eligible and randomly assigned to the
Portico valve group (n=381) or commercially available valve group (n=369).
Mean age was 83 years (SD 7) and 395 (52.7%) patients were female. For the
primary safety endpoint at 30 days, the event rate was higher in the
Portico valve group than in the commercial valve group (52 [13.8%] vs 35
[9.6%]; absolute difference 4.2, 95% CI -0.4 to 8.8 [upper confidence
bound {UCB} 8.1%]; p<inf>non-inferiority</inf>=0.034,
p<inf>superiority</inf>=0.071). At 1 year, the rates of the primary
efficacy endpoint were similar between the groups (55 [14.8%] in the
Portico group vs 48 [13.4%] in the commercial valve group; difference
1.5%, 95% CI -3.6 to 6.5 [UCB 5.7%]; p<inf>non-inferiority</inf>=0.0058,
p<inf>superiority</inf>=0.50). At 2 years, rates of death (80 [22.3%] vs
70 [20.2%]; p=0.40) or disabling stroke (10 [3.1%] vs 16 [5.0%]; p=0.23)
were similar between groups. Interpretation(s): The Portico valve was
associated with similar rates of death or disabling stroke at 2 years
compared with commercial valves, but was associated with higher rates of
the primary composite safety endpoint including death at 30 days. The
first-generation Portico valve and delivery system did not offer
advantages over other commercially available valves. Funding(s):
Abbott. Copyright © 2020 Elsevier Ltd

<41>
Accession Number
643328420
Title
European Society of Cardiology Quality indicators for the care and
outcomes of adults undergoing transcatheter aortic valve implantation.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2024. Date of Publication: 23 Jan 2024.
Author
Ali N.; Aktaa S.; Younsi T.; Beska B.; Batra G.; Blackman D.J.; James S.;
Ludman P.; Mamas M.A.; Abdel-Wahab M.; Borregaard B.; Iung B.; Joner M.;
Kunadian V.; Modine T.; Neylon A.; Petronio A.S.; Pibarot P.; Popescu
B.A.; Sabate M.; Stortecky S.; Teles R.C.; Treede H.; Gale C.P.
Institution
(Ali, Aktaa, Younsi, Blackman, Gale) Department of Cardiology, Leeds
Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Aktaa, Gale) Leeds Institute for Cardiovascular and Metabolic Medicine,
University of Leeds, United Kingdom
(Beska) Translational and Clinical Research Institute, Newcastle
University Newcastle, United Kingdom
(Beska, Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon
Tyne Hospitals NHS Foundation Trust Newcastle, United Kingdom
(Batra, James) Department of medical sciences and Uppsala Clinical
research center Uppsala University, Sweden
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham,
United Kingdom
(Mamas) Keele Cardiovascular Research Group, Keele University, Keele,
United Kingdom
(Abdel-Wahab) Heart Center Leipzig at University of Leipzig, Leipzig,
Germany
(Borregaard) Department of Cardiology, Odense University Hospital,
Denmark. Department of Clinical Research, University of Southern Denmark,
Denmark
(Iung) Cardiology Department, Bichat Hospital, APHP, INSERM 1148, Paris,
France
(Joner) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich, Germany
(Joner) DZHK (German Centre for Cardiovascular Research), partner site
Munich Heart Alliance, Munich, Germany
(Modine) Hopital Cardiologique de Haut Leveque, Bordeaux, France
(Neylon) Galway University Hospital, SAOLTA Health Care Group, National
University of Ireland, Galway, Ireland
(Petronio) Cardiac Catheterization Laboratory, Cardiothoracic and Vascular
Department, Pisa University Hospital, Pisa 2-56100, Italy
(Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec/Quebec Heart and Lung Institute, Universite Laval, Quebec City,
Quebec, Canada
(Popescu) University of Medicine and Pharmacy Carol Davila, Bucharest,
Romania
(Sabate) Interventional Cardiology Department; Cardiovascular Institute;
Hospital Clinic; IDIBAPS; Barcelona; Spain
(Stortecky) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Teles) Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon,
Portugal
(Treede) Department of Cardiovascular Surgery, University Medical Center
Mainz, Mainz, Germany
(Gale) Leeds Institute for Data Analytics and Leeds Institute of
Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United
Kingdom
Abstract
BACKGROUND AND AIMS: To develop a suite of quality indicators (QIs) for
the evaluation of the care and outcomes for adults undergoing
transcatheter aortic valve intervention (TAVI). METHOD(S): We
followed the European Society of Cardiology (ESC) methodology for the
development of QIs. Key domains were identified by constructing a
conceptual framework for the delivery of TAVI care. A list of candidate
QIs were developed by conducting a systematic review of the literature. A
modified Delphi method was then used to select the final set of QIs.
Finally, we mapped the QIs to the EuroHeart Data Standards for TAVI to
ascertain the extent to which the EuroHeart TAVI registry captures
information to calculate the QIs. RESULT(S): We formed an
international group of experts in quality improvement and TAVI, including
representatives from the European Association of Percutaneous
Cardiovascular Interventions, the European Association of Cardiovascular
Imaging and the Association of Cardiovascular Nursing & Allied
Professions. In total, 27 QIs were selected across eight domains of TAVI
care, comprising 22 main (81%) and five secondary (19%) QIs. Of these,
19/27 (70%) are now being utilised in the EuroHeart TAVI registry.
 CONCLUSION(S): We present the 2023 ESC QIs for TAVI, developed using
a standard methodology and in collaboration with ESC Associations. The
EuroHeart TAVI registry allows calculation of the majority of the QIs,
which may be used for benchmarking care and quality improvement
initiatives. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<42>
Accession Number
643331307
Title
Impact of Surgical Positioning on the Occurrence of Postoperative
Ipilateral Shoulder Pain After Lung Resection by Video-Assisted
Thoracoscopy: A Randomized Trial.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 22 Dec 2023.
Author
Galvaing G.; Bussieres J.; Simard S.; Couture E.J.; Cournoyer C.; Conti
M.; Lacasse Y.; Laliberte A.S.
Institution
(Galvaing) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Multidisciplinary Department of Pulmonology and Thoracic Surgery,
Quebec City, Quebec, Canada; Jean Perrin Cancer Center, Department of
Thoracic and Endocrine Surgery, Clermont-Ferrand, France
(Bussieres, Couture, Cournoyer) Institut Universitaire de Cardiologie et
de Pneumologie de Quebec, Department of Anesthesiology, Quebec City,
Quebec, Canada
(Simard) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Research Center, Quebec City, Quebec, Canada
(Conti, Lacasse) Institut Universitaire de Cardiologie et de Pneumologie
de Quebec, Multidisciplinary Department of Pulmonology and Thoracic
Surgery, Quebec City, Quebec, Canada
(Laliberte) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Multidisciplinary Department of Pulmonology and Thoracic Surgery,
Quebec City, Quebec, Canada
Abstract
OBJECTIVE: The aim of this study was to evaluate the impact of the
ipsilateral arm position on ipsilateral shoulder pain after lung cancer
resection by video-assisted thoracic surgery. DESIGN: A prospective
randomized controlled trial. SETTING: A single academic center study.
PARTICIPANTS: Patients undergoing video-assisted thoracic surgery
pulmonary resection for cancer at the Institut Universitaire de
Cardiologie et de Pneumologie de Quebec from May 2020 to May 2022 were
included. INTERVENTIONS: Patients randomly were assigned with a 1:1 ratio
to a supported or suspended ipsilateral arm position. MEASUREMENTS AND
MAIN RESULTS: Ipsilateral shoulder pain incidence, pain score, and opioid
use were recorded in the postanesthesia care unit (PACU) on postoperative
days 1 and 2. One hundred thirty-three patients were randomized, 67 in the
suspended-arm group and 66 in the supported-arm group. Of the patients,
31% reported ipsilateral shoulder pain in the PACU with no difference
between groups (19/67 [28.4%] v 22/66 patients (33.3%), p = 0.5767). There
was no significant difference between the pain score in the PACU (3 [0-6]
v 4 [0-6], p = 0.9055) at postoperative day 1 (4 [2-6] v 3 [2-5], p =
0.4113) and at postoperative day 2 (2 [0-5] v 2 [1-4], p = 0.9508).
Ipsilateral shoulder pain score decreased rapidly on postoperative day 2.
There was no statistical difference in opioid and gabapentinoid use
between the groups. CONCLUSION(S): Ipsilateral arm position seems to
have no impact on ipsilateral shoulder pain. Crown Copyright ©
2023. Published by Elsevier Inc. All rights reserved.

<43>
Accession Number
2029877060
Title
Low-Flow, Low-Gradient Severe Aortic Stenosis in patients with preserved
or reduced ejection fraction: a systematic literature review.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102392. Date of Publication: March 2024.
Author
Aguilar-Molina O.; Barbosa-Balaguera S.; Campo-Rivera N.; Cabrales-Salcedo
Y.; Camacho-Garcia R.; Herrera-Escandon A.
Institution
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Herrera-Escandon)
Cardiology Unit, Universidad del Valle, Cali, Colombia
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Cabrales-Salcedo,
Herrera-Escandon) Hospital Universitario del Valle, Cali, Colombia
(Camacho-Garcia) Universidad de Cartagena, Cartagena, Colombia
Publisher
Elsevier Inc.
Abstract
OBJECTIVES: A systematic review of the literature was conducted to analyze
the current evidence on low-flow, low-gradient severe aortic stenosis.
This analysis aimed to differentiate between subgroups of patients with
reduced and preserved left ventricular ejection fraction (LVEF).
 Method(s): After conducting a systematic literature review, 35
observational studies were included. Out of these, 28 were prospective and
7 retrospective. The studies that included a mortality risk stratification
of low-flow, low-gradient aortic stenosis (LF- LG AS) with both preserved
and reduced LVEF were reviewed. Result(s): The importance of
considering multiple clinical and echocardiographic variables in
diagnostic evaluation and therapeutic decision-making was highlighted.
 Conclusion(s): LF- LG AS, in any of its subgroups, is a common and
challenging valve lesion. A careful assessment of severity and, in
specific scenarios, a thorough reclassification is important. More
high-quality studies are required to more precisely define the
classification and prognosis of this entity. Copyright © 2024
Elsevier Inc.

<44>
Accession Number
2029768085
Title
Rifampicin reduces plasma concentration of linezolid in patients with
infective endocarditis.
Source
Journal of Antimicrobial Chemotherapy. 78(12) (pp 2840-2848), 2023. Date
of Publication: 01 Dec 2023.
Author
Bock M.; Van Hasselt J.G.C.; Schwartz F.; Wang H.; Hoiby N.; Fuursted K.;
Ihlemann N.; Gill S.; Christiansen U.; Bruun N.E.; Elming H.; Povlsen
J.A.; Kober L.; Hofsten D.E.; Fosbol E.L.; Pries-Heje M.M.; Christensen
J.J.; Rosenvinge F.S.; Torp-Pedersen C.; Helweg-Larsen A.; Tonder N.;
Iversen K.; Bundgaard H.; Moser C.
Institution
(Bock, Schwartz, Wang, Hoiby, Moser) Department of Clinical Microbiology,
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
(Van Hasselt) Leiden Academic Centre for Drug Research, Leiden University,
Leiden, Netherlands
(Wang, Hoiby) Department of Immunology and Microbiology, University of
Copenhagen, Copenhagen, Denmark
(Fuursted) Department of Bacteria, Parasites and Fungi, Statens Serum
Institut, Copenhagen, Denmark
(Ihlemann) Department of Cardiology, Bispebjerg Hospital, Copenhagen,
Denmark
(Gill) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Christiansen) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Bruun) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Bruun, Elming) Department of Cardiology, Zealand University Hospital,
Roskilde, Denmark
(Bruun, Kober, Christensen, Iversen, Bundgaard) Department of Clinical
Medicine, University of Copenhagen, Copenhagen, Denmark
(Povlsen) Department of Cardiology, Aarhus University Hospital, Aarhus N,
Denmark
(Kober, Hofsten, Fosbol, Pries-Heje, Bundgaard) Department of Cardiology,
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
(Christensen) The Regional Department of Clinical Microbiology, Slagelse,
Region Zealand, Denmark
(Rosenvinge) Department of Clinical Microbiology, Odense University
Hospital, Odense, Denmark
(Rosenvinge) Research Unit of Clinical Microbiology, University of
Southern Denmark, Odense, Denmark
(Torp-Pedersen, Tonder) Department of Cardiology, Nordsjaellands Hospital,
Hillerod, Denmark
(Torp-Pedersen) Department of Public Health, University of Copenhagen,
Copenhagen, Denmark
(Helweg-Larsen) Department of Infectious Diseases, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Iversen) Department of Emergency Medicine, Copenhagen University
Hospital, Herlev-Gentofte, Copenhagen, Denmark
Publisher
Oxford University Press
Abstract
Background: Linezolid in combination with rifampicin has been used in
treatment of infective endocarditis especially for patients infected with
staphylococci. Objective(s): Because rifampicin has been reported to
reduce the plasma concentration of linezolid, the present study aimed to
characterize the population pharmacokinetics of linezolid for the purpose
of quantifying an effect of rifampicin cotreatment. In addition, the
possibility of compensation by dosage adjustments was evaluated.
 Patients and Methods: Pharmacokinetic measurements were performed in
62 patients treated with linezolid for left-sided infective endocarditis
in the Partial Oral Endocarditis Treatment (POET) trial. Fifteen patients
were cotreated with rifampicin. A total of 437 linezolid plasma
concentrations were obtained. The pharmacokinetic data were adequately
described by a one-compartment model with first-order absorption and
first-order elimination. Result(s): We demonstrated a substantial
increase of linezolid clearance by 150% (95% CI: 78%-251%), when combined
with rifampicin. The final model was evaluated by goodness-of-fit plots
showing an acceptable fit, and a visual predictive check validated the
model. Model-based dosing simulations showed that rifampicin cotreatment
decreased the PTA of linezolid from 94.3% to 34.9% and from 52.7% to 3.5%
for MICs of 2 mg/L and 4 mg/L, respectively. Conclusion(s): A
substantial interaction between linezolid and rifampicin was detected in
patients with infective endocarditis, and the interaction was stronger
than previously reported. Model-based simulations showed that increasing
the linezolid dose might compensate without increasing the risk of adverse
effects to the same degree. Copyright © 2023 Oxford University
Press. All rights reserved.

<45>
Accession Number
2029437599
Title
Hybrid Coronary Revascularization: Insights of Long-Term Outcomes.
Source
American Journal of Cardiology. 212 (pp 135-136), 2024. Date of
Publication: 01 Feb 2024.
Author
Jaswaney R.; Arora S.
Institution
(Jaswaney) Department of Cardiology, Temple University Hospital Heart and
Vascular Center, Philadelphia, Pennsylvania, United States
(Arora) University Hospitals Cleveland Medical Center, Harrington Heart
and Vascular Institute, Case Western Reserve University, Cleveland, Ohio,
United States
Publisher
Elsevier Inc.

<46>
Accession Number
2029226032
Title
Comparison of manual compression, Z-stitch, and suture-mediated vascular
closure device techniques in dogs undergoing percutaneous transvenous
intervention.
Source
Journal of Veterinary Cardiology. 51 (pp 124-137), 2024. Date of
Publication: February 2024.
Author
Fabella A.; Markovic L.E.; Coleman A.E.
Institution
(Fabella, Markovic, Coleman) Department of Small Animal Medicine and
Surgery, University of Georgia, College of Veterinary Medicine, Athens, GA
30602, United States
Publisher
Elsevier B.V.
Abstract
Introduction/objectives: Manual compression has been standard of care for
maintaining hemostasis after percutaneous endovascular intervention, but
can be time-consuming and associated with vascular complications.
Alternative closure methods include the figure-of-eight suture (Z-stitch)
and vascular closure device (VCD) techniques. We hypothesized that
compared to manual compression, Z-stitch and VCD would significantly
reduce time-to-hemostasis after transvenous access, and the proportion of
dogs with vascular patency would not differ significantly among
treatments. Animals: Forty-six client-owned dogs undergoing percutaneous
transvenous interventional procedures. Material(s) and Method(s):
Dogs with vessel diameter <5 mm were randomized to undergo manual
compression or Z-stitch, while those with vessel diameter >=5 mm were
randomized to undergo manual compression, Z-stitch, or VCD.
Time-to-hemostasis, bleeding scores, presence of vascular patency one day
and two to three months post-procedure, and complications were recorded.
Data are presented as median (95% confidence interval). Result(s): In
all 46 dogs, the right external jugular vein was used. Time-to-hemostasis
was significantly shorter in the Z-stitch (2.1 [1.8-2.9] minutes) compared
to VCD (8.6 [6.1-11.8] minutes; P<0.001) and manual compression (10.0
[10.0-20.0] minutes; P<0.001) groups. Time-to-hemostasis was significantly
shorter in the VCD, vs. manual compression, (P=0.027) group. Bleeding
scores were significantly greater at 5 and 10 min (P<0.001 and 0.013,
respectively) in manual compression, compared to Z-stitch group. There was
no difference in the proportion of dogs with vascular patency between
groups (P=0.59). Conclusion(s): Z-stitch and VCD are effective venous
hemostasis methods after percutaneous transvenous intervention, with
Z-stitch providing the most rapid time-to-hemostasis. Both Z-stitch and
VCD techniques have low complication rates and effectively maintain
vascular patency. Copyright © 2023 Elsevier B.V.

<47>
Accession Number
2027876486
Title
The effect of histidine-tryptophan-ketoglutarate cardioplegia alone or
combined with preoperative infusion of levosimendan on vasoactive
inotropic score in patients with poor cardiac function undergoing coronary
artery bypass grafting.
Source
Egyptian Journal of Anaesthesia. 40(1) (pp 89-95), 2024. Date of
Publication: 2024.
Author
Elkotb Ghoniem M.F.; Ali N.M.; Kamal M.M.; Abdelaziz F.K.E.; Haiba D.M.
Institution
(Elkotb Ghoniem, Ali, Kamal, Abdelaziz, Haiba) Department of
Anesthesiology, Intensive care and Pain Management, Faculty of Medicine,
Ain-Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Patients with poor left ventricular function undergoing
cardiac surgery frequently require inotropic drug support immediately
after cardiopulmonary bypass. Levosimendan is an effective agent that acts
via two complementary mechanisms. It enhances cardiac contractility and
reduces cardiac workload. Aim(s): to assess the effect of
histidine-tryptophan-ketoglutarate cardioplegia (HTK cardioplegia) alone
or combined with preoperative infusion of levosimendan on the vasoactive
inotropic score in patients with poor left ventricular function undergoing
coronary artery bypass grafting. Material(s) and Method(s): this
double-blinded randomized controlled trial was carried on 100 patients,
divided into two groups; Levosimendan group (n = 49): patients received
0.1ug/kg/min levosimendan without loading, 12 hours preoperatively and
continued for a total of 24 hours. Control group (n = 51): patients
received a placebo 12 hours before surgery and continued for a total 24
hours. Both groups received HTK cardioplegia after cross-clamping of the
aorta approximately 20 ml/kg into the ascending aorta over 6-8 minutes at
a temperature of 4-10degreeC. Result(s): Levosimendan group was
superior to control group with statistical significance regarding the need
of intraaortic balloon pump (IABP), vasoactive inotropic score over the
first 24 hours, troponin levels over the first 72 hours, ICU stays,
hospital stay, and cumulative hospital costs. Although the incidence of
postoperative low Cardiac output syndrome (LCOS), atrial fibrillation
(AF), acute kidney injury (AKI), and overall mortality was lower in
levosimendan group, but all were not statistically significant.
 Conclusion(s): Preoperative infusion of levosimendan combined with
HTK cardioplegia in patients with poor cardiac function decreased
vasoactive inotropic score and lowered the costs of hospital
stay. Copyright © 2024 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<48>
Accession Number
2024272696
Title
Bioprosthetic versus mechanical valves for mitral valve replacement in
patients < 70 years: an updated pairwise meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 72(2) (pp 95-103), 2024. Date
of Publication: February 2024.
Author
Ahmed A.; Awad A.K.; Varghese K.S.; Sehgal V.S.; Hisham K.; George J.;
Pandey R.; Vega E.; Polizzi M.; Mathew D.M.
Institution
(Ahmed, Varghese, Sehgal, Pandey, Vega, Polizzi, Mathew) CUNY School of
Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United States
(Awad, Hisham) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
Publisher
Springer
Abstract
Background: The ideal conduit for mitral valve replacement (MVR) remains
elusive, particularly among younger patients due to increased life
expectancy. We perform a pairwise meta-analysis comparing the use of
bioprosthetic valves (BPV) and mechanical mitral valves (MMV) in patients
< 70 years old undergoing MVR. Method(s): We comprehensively searched
medical databases to identify studies comparing the use of BPV and MMV in
patients < 70 years old undergoing MVR. Pairwise meta-analysis was
performed using the Mantel-Haenszel method in R version 4.0.2. Outcomes
were pooled using the random effect model as risk ratios (RR) with their
95% confidence intervals (95% CI). Result(s): 16,879 patients from 15
studies were pooled. Compared to MMV, BPV was associated with
significantly higher rates of 30-day mortality (RR 1.53, p = 0.0006) but
no difference in 30-day stroke (RR 0.70, p = 0.43). At a weighted mean
follow-up duration of 14.1 years, BPV was associated with higher rates of
long-term mortality (RR 1.28, p = 0.0054). No difference was seen between
the two groups for risk of long-term stroke (RR 0.92, p = 0.67),
reoperation(RR 1.72, p = 0.12), or major-bleeding (RR 0.57, p = 0.10) at a
weighted mean follow-up duration of 11.7, 11.3, and 11.9 years,
respectively. Conclusion(s): The use of MMV in patients < 70
undergoing MVR is associated with lower rates of 30-day/long-term
mortality compared to BPV. No significant differences were observed for
risk of 30-day/long-term stroke, long-term reoperation, and long-term
major bleeding. These findings support the use of MMV in younger patients,
although prospective, randomized trials are still needed. Copyright
© 2023, The Author(s), under exclusive licence to The Japanese
Association for Thoracic Surgery.

<49>
Accession Number
2028808293
Title
Peripheral Regional Anesthetic Techniques in Cardiac Surgery: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 403-416),
2024. Date of Publication: February 2024.
Author
Schmedt J.; Oostvogels L.; Meyer-Friessem C.H.; Weibel S.; Schnabel A.
Institution
(Schmedt, Oostvogels, Schnabel) Department of Anesthesiology, Intensive
Care and Pain Medicine, University Hospital of Muenster,
Albert-Schweitzer-Campus 1, Muenster, Germany
(Meyer-Friesem) Department of Anesthesiology, Intensive Care Medicine and
Pain Medicine, BG-Universitatsklinikum Bergmannsheil gGmbH, Medical
Faculty of Ruhr University Bochum, Burkle-de-la-Camp-Platz 1, Bochum,
Germany
(Weibel) Department of Anesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
Publisher
W.B. Saunders
Abstract
Objective: The aim of this systematic review was to investigate
postoperative pain outcomes and adverse events after peripheral regional
anesthesia (PRA) compared to no regional anesthesia (RA), placebo, or
neuraxial anesthesia in children and adults undergoing cardiac surgery.
 Design(s): A systematic review and meta-analysis with an assessment
of the risk of bias (Cochrane RoB 1) and certainty of evidence (Grading of
Recommendations, Assessment, Development, and Evaluation).
 Setting(s): Randomized controlled trials (RCTs). Participant(s):
Adults and children undergoing heart surgery. Intervention(s): Any
kind of PRA compared to no RA or placebo or neuraxial anesthesia.
 Measurements and Main Results: In total, 33 RCTs (2,044 patients)
were included-24 of these had a high risk of bias, and 28 were performed
in adults. Compared to no RA, PRA may reduce pain intensity at rest 24
hours after surgery (mean difference [MD] -0.81 points, 95% CI -1.51 to
-0.10; I2 = 92%; very low certainty evidence). Peripheral
regional anesthesia, compared to placebo, may reduce pain intensity at
rest (MD -1.36 points, 95% CI -1.59 to -1.13; I2 = 54%; very
low certainty evidence) and during movement (MD -1.00 points, 95% CI -1.34
to -0.67; I2 = 72%; very low certainty evidence) 24 hours after surgery.
No data after pediatric cardiac surgery could be meta-analyzed due to the
low number of included trials. Conclusion(s): Compared to no RA or
placebo, PRA may reduce pain intensity at rest and during movement.
However, these results should be interpreted cautiously because the
certainty of evidence is only very low. Copyright © 2023 Elsevier
Inc.

<50>
Accession Number
2028011438
Title
Post-TAVR conduction abnormalities leading to permanent pacemaker
implantation: Risk factors, prevention, and management.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Ghazal R.; Garabedian H.; Sawaya F.; Refaat M.M.
Institution
(Ghazal, Garabedian) Faculty of Medicine, American University of Beirut,
Beirut, Lebanon
(Sawaya) Structural Heart and Valve Division, American University of
Beirut Medical Center, Beirut, Lebanon
(Sawaya, Refaat) Internal Medicine Department, American University of
Beirut Medical Center, Beirut, Lebanon
(Refaat) Cardiac Electrophysiology Division, American University of Beirut
Medical Center, Beirut, Lebanon
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) often leads to conduction
abnormalities, necessitating pacemaker implantation. This review of 38
meta-analyses identified preexisting right bundle branch block (RBBB),
LAHB, and new-onset left bundle branch block as key risk factors, with a
higher PPM risk in male and older patients. Procedural factors like
transfemoral access and self-expandable valves also increase this risk.
Prevention focuses on tailoring TAVR to individual electrophysiological
and anatomical profiles. However, there's a lack of consensus in managing
these conduction disturbances post-TAVR, highlighting the need for further
research and standardized treatment strategies. Copyright © 2024
Wiley Periodicals LLC.

<51>
Accession Number
641885032
Title
Nociception level index-guided antinociception versus routine care during
remifentanil-propofol anaesthesia for moderate-to-high risk cardiovascular
surgery: A randomized trial.
Source
European journal of anaesthesiology. 40(10) (pp 790-793), 2023. Date of
Publication: 01 Oct 2023.
Author
Coeckelenbergh S.; Sessler D.I.; Doria S.; Patricio D.; Jaubert L.;
Huybrechts I.; Stefanidis C.; Kapessidou P.; Tuna T.; Engelman E.; Barvais
L.; Perrin L.
Institution
(Coeckelenbergh) From the Department of Anaesthesia and Resuscitation,
Erasme University Hospital, Universite Libre de Bruxelles, Brussels,
Belgium (SC, SD, DP, LJ, IH, TT, EE, LB, LP), Department of
Anaesthesiology and Intensive Care, Paul Brousse Hospital - Hepatobiliary
Centre, Assistance Publique - Hopitaux de Paris, Universite Paris-Saclay,
Villejuif, France (SC), Outcomes Research Consortium, Cleveland, OH,
United States (SC, DIS), Department of Outcomes Research, Anesthesiology
Institute, Cleveland Clinic, Cleveland, Ohio, United States (DIS),
Department of Cardiac Surgery, Erasme University Hospital, Universite
Libre de Bruxelles, Brussels, Belgium (CS), Department of Anaesthesiology,
Saint Pierre University Hospital, Universite Libre de Bruxelles, Brussels,
Belgium (PK), EW Data Analysis, Brussels, Belgium (EE)
Publisher
NLM (Medline)

<52>
[Use Link to view the full text]
Accession Number
641544698
Title
Meta-analysis of post-transcatheter aortic valve replacement outcomes in
patients with cardiac amyloidosis and aortic stenosis.
Source
International journal of surgery (London, England). 109(9) (pp 2872-2874),
2023. Date of Publication: 01 Sep 2023.
Author
Jaiswal V.; Joshi A.; Ishak A.; Nataraj M.; Ang S.P.; Khan N.; Daneshvar
F.; Aguilera-Alvarez V.H.; Verma D.; Shrestha A.B.; Sharma P.
Institution
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Joshi) Vydehi Institute of Medical Sciences and Research Centre,
Bangalore, India
(Ishak) European University Cyprus, School of Medicine, Nicosia, Cyprus
(Nataraj) Cardio-Pulmonary Physiotherapist and Research, Manipal,
Karnataka, India
(Ang) Division of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Khan) Jinnah Sindh Medical University, Karachi, Pakistan
(Daneshvar) Department of Cardiology, FL, United States
(Aguilera-Alvarez) Universidad Autonoma de Baja, CA, United States
(Verma) Janaki Medical College, Nepal
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Sharma) Division of Cardiology, Department of Internal Medicine, King
George's Medical University, India
Publisher
NLM (Medline)

<53>
Accession Number
639943676
Title
Risk of Bias in Randomized Clinical Trials Comparing Transcatheter and
Surgical Aortic Valve Replacement: A Systematic Review and Meta-analysis.
Source
JAMA network open. 6(1) (pp e2249321), 2023. Date of Publication: 03 Jan
2023.
Author
Barili F.; Brophy J.M.; Ronco D.; Myers P.O.; Uva M.S.; Almeida R.M.S.;
Marin-Cuartas M.; Anselmi A.; Tomasi J.; Verhoye J.-P.; Musumeci F.;
Mandrola J.; Kaul S.; Papatheodorou S.; Parolari A.
Institution
(Barili, Papatheodorou) Department of Epidemiology, Harvard T. H. Chan
School of Public Health, Boston, MA, United States
(Barili) Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
(Brophy) Department of Medicine, McGill Health University Center,
Montreal, QC, Canada
(Ronco, Parolari) Department of University Cardiac Surgery, IRCCS
Policlinico San Donato, Milan, Italy
(Myers) Division of Cardiac Surgery, CHUV-Lausanne University Hospital,
Lausanne, Switzerland
(Uva) Department of Cardiac Surgery, Hospital Santa Cruz, Carnaxide,
Portugal
(Uva) Department of Cardiac Surgery and Physiology, Porto University
Medical School, Porto, Portugal
(Almeida) University Center Assis Gurgacz Foundation, Cascavel, Parana,
Brazil
(Marin-Cuartas) University Department of Cardiac Surgery, Leipzig Heart
Center, Leipzig, Germany
(Anselmi, Tomasi, Verhoye) Department of Thoracic and Cardiovascular
Surgery, University Hospital of Rennes, Rennes, France
(Musumeci) Department of Cardiac Surgery and Heart Transplantation, San
Camillo Forlanini Hospital, Rome, Italy
(Mandrola) Baptist Health Louisville, Louisville, KY, United States
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
Publisher
NLM (Medline)
Abstract
Importance: Recent European Society of Cardiology/European Association for
Cardio-Thoracic Surgery (ESC/EACTS) guidelines highlighted some concerns
about the randomized clinical trials (RCTs) comparing transcatheter aortic
valve implantation (TAVI) and surgical aortic valve replacement (SAVR) for
aortic stenosis. Quantification of these biases has not been previously
performed. Objective(s): To assess whether randomization protects
RCTs comparing TAVI and SAVR from biases other than nonrandom allocation.
 Data Sources: A systematic review of the literature between January
1, 2007, and June 6, 2022, on MEDLINE, Embase, and Cochrane Central
Register of Controlled Trials was performed. Specialist websites were also
checked for unpublished data. Study Selection: The study included RCTs
with random allocation to TAVI or SAVR with a maximum 5-year follow-up.
Data Extraction and Synthesis: Data extraction was performed by 2
independent investigators following the PRISMA guidelines. A
random-effects meta-analysis was used for quantifying pooled rates and
differential rates between treatments of deviation from random assigned
treatment (DAT), loss to follow-up, and receipt of additional treatments.
 Main Outcomes and Measures: The primary outcomes were the proportion
of DAT, loss to follow-up, and patients who were provided additional
treatments and myocardial revascularization, together with their ratio
between treatments. The measures were the pooled overall proportion of the
primary outcomes and the risk ratio (RR) in the TAVI vs SAVR groups.
 Result(s): The search identified 8 eligible trials including 8849
participants randomly assigned to undergo TAVI (n=4458) or SAVR (n=4391).
The pooled proportion of DAT among the sample was 4.2% (95% CI,
3.0%-5.6%), favoring TAVI (pooled RR vs SAVR, 0.16; 95% CI, 0.08-0.36;
P<.001). The pooled proportion of loss to follow-up was 4.8% (95% CI,
2.7%-7.3%). Meta-regression showed a significant association between the
proportion of participants lost to follow-up and follow-up time (slope,
0.042; 95% CI, 0.017-0.066; P<.001). There was an imbalance of loss to
follow-up favoring TAVI (RR, 0.39; 95% CI, 0.28-0.55; P<.001). The pooled
proportion of patients who had additional procedures was 10.4% (95% CI,
4.4%-18.5%): 4.6% (95% CI, 1.5%-9.3%) in the TAVI group and 16.5% (95% CI,
7.5%-28.1%) in the SAVR group (RR, 0.27; 95% CI, 0.15-0.50; P<.001). The
imbalance between groups also favored TAVI for additional myocardial
revascularization (RR, 0.40; 95% CI, 0.24-0.68; P<.001). Conclusions
and Relevance: This study suggests that, in RCTs comparing TAVI vs SAVR,
there are substantial proportions of DAT, loss to follow-up, and
additional procedures together with systematic selective imbalance in the
same direction characterized by significantly lower proportions of
patients undergoing TAVI that might affect internal validity.

<54>
Accession Number
638091171
Title
Physiology or Angiography-Guided Coronary Artery Bypass Grafting: A
Meta-Analysis.
Source
Arquivos brasileiros de cardiologia. 117(6) (pp 1115-1123), 2021. Date of
Publication: 01 Dec 2021.
Author
Martins J.; Afreixo V.; Santos L.; Fernandes L.; Briosa A.
Institution
(Martins, Santos, Briosa) Baixo Vouga Hospital Centre, Portugal
(Afreixo) University of Aveiro, Portugal
(Fernandes) Centre for Health Economics, University of York, York - Reino
Unido
Publisher
NLM (Medline)

<55>
Accession Number
627594326
Title
New-Onset Atrial Fibrillation After Coronary Artery Bypass Graft and
Long-Term Risk of Stroke: A Meta-Analysis.
Source
Journal of the American Heart Association. 6(12) (no pagination), 2017.
Date of Publication: 22 Dec 2017.
Author
Megens M.R.; Churilov L.; Thijs V.
Institution
(Megens, Churilov, Thijs) Florey Institute of Neuroscience and Mental
Health, University of Melbourne, Melbourne, Victoria, Australia
(Megens, Churilov) School of Sciences, RMIT University, Melbourne,
Victoria, Australia
(Thijs) Department of Neurology, Austin Health, Heidelberg, Victoria,
Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: New-onset atrial fibrillation (NOAF) after coronary artery
bypass graft is related to an increased short-term risk of stroke and
mortality. We investigated whether the long-term risk of stroke is
increased. METHODS AND RESULTS: We performed a systematic review and
meta-analysis of studies that included patients who had coronary artery
bypass graft and who afterwards developed NOAF during their index
admission; these patients did not have previous atrial fibrillation. The
primary outcome was risk of stroke at 6 months or more in patients who
developed NOAF compared with those who did not. Odds ratios, relative
risk, and hazard ratios were considered equivalent; outcomes were pooled
on the log-ratio scale using a random-effects model and reported as
exponentiated effect-sizes. We included 16 studies, comprising 108 711
participants with a median follow-up period of 2.05 years. Average
participant age was 66.8 years, with studies including an average of 74.8%
males. There was an increased long-term risk of stroke in the presence of
NOAF (unadjusted studies effect-sizes=1.36, 95% confidence interval,
1.12-1.65, P=0.001, adjusted studies effect-sizes=1.25, 95% confidence
interval, 1.09-1.42, P=0.001). There was evidence of moderate effect
variation because of heterogeneity in studies reporting unadjusted
(P=0.021, I2=49.8%) and adjusted data (P=0.081, I2=49.1%), and publication
bias in the latter group (Egger's test, P=0.031). Sensitivity analysis on
unadjusted data by study quality, design, and surgery did not alter the
effect direction. CONCLUSION(S): Presence of NOAF in patients
post-coronary artery bypass graft is associated with increased long-term
risk of stroke compared with patients without NOAF. Further studies may
show whether the increased risk is mediated by atrial fibrillation and
whether anticoagulation reduces risk. Copyright © 2017 The
Authors. Published on behalf of the American Heart Association, Inc., by
Wiley.

<56>
Accession Number
2029636261
Title
Evidence-based Management of Left Main Coronary Artery Disease.
Source
European Cardiology Review. 18 (no pagination), 2023. Date of Publication:
2023.
Author
Torres-Ruiz G.; Mallofre-Vila N.; Rojas-Flores P.; Carrion-Montaner P.;
Bosch-Peligero E.; Valcarcel-Paz D.; Cardiel-Perez A.; Guindo-Soldevila
J.; Martinez-Rubio A.
Institution
(Torres-Ruiz, Mallofre-Vila, Rojas-Flores, Carrion-Montaner,
Bosch-Peligero, Valcarcel-Paz, Guindo-Soldevila, Martinez-Rubio)
Department of Cardiology, Parc Tauli Hospital Universitari, Sabadell,
Spain
(Torres-Ruiz, Mallofre-Vila, Rojas-Flores, Carrion-Montaner,
Bosch-Peligero, Valcarcel-Paz, Guindo-Soldevila, Martinez-Rubio)
Department of Medicine, Universitat Autonoma de Barcelona, Barcelona,
Spain
(Cardiel-Perez) Department of Gynaecology and Obstetrics, Hospital Clinic
i Provincial, Barcelona, Spain
Publisher
Radcliffe Medical Media
Abstract
Left main coronary artery disease (LMCAD) is associated with high
morbidity and mortality due to the large myocardial mass at risk. Although
medical treatment may be an option in selected low-risk patients,
revascularisation is recommended to improve survival in the majority of
patients presenting with a significant left main stenosis. In the past
decade, multiple randomised clinical trials and meta-analyses have
compared coronary artery bypass grafting surgery (CABG) versus
percutaneous coronary intervention (PCI), finding controversial results.
The strategy for LMCAD revascularisation is still challenging. Coronary
anatomy complexity, clinical features and patient preferences are key
elements to be considered by the heart team. The current guidelines define
CABG as standard therapy, but the continuous improvements in PCI
techniques, the use of intracoronary imaging and functional assessment
make PCI a feasible alternative in selected patients, particularly in
those with comorbidities and contraindications to CABG. This review
analyses the most important studies comparing CABG versus PCI in patients
with LMCAD. Copyright © The Author(s) 2023.

<57>
Accession Number
2029976397
Title
A Systematic Review of Delayed High-Grade Atrioventricular Block After
Transcatheter Aortic Valve Implantation.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Rao K.; Chan B.; Baer A.; Hansen P.; Bhindi R.
Institution
(Rao, Chan, Hansen, Bhindi) Department of Cardiology, Royal North Shore
Hospital, Sydney, Australia
(Rao, Baer, Hansen, Bhindi) Department of Cardiology, North Shore Private
Hospital, Sydney, Australia
(Rao, Chan, Bhindi) University of Sydney, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Background: High-grade atrioventricular block (HGAVB) is common after
transcatheter aortic valve implantation (TAVI), often necessitating
permanent pacemaker (PPM) implantation. Delayed HGAVB has varying
definitions but typically refers to onset 48 hours after TAVI or following
discharge and may cause syncope and sudden cardiac death. This review
estimates the incidence of delayed HGAVB and identifies limitations of
current literature. Method(s): A systematic review was performed of
the following online databases: Medline, Cochrane, Web of Science, and
Scopus. Studies that labelled the outcome of "delayed" or "late"
atrioventricular block after TAVI were included; patients with previous
PPM or aortic valve surgery were excluded. Initial search yielded 775
studies, which, after screening, was narrowed to 19 studies.
 Result(s): Nineteen studies with 14,898 patients were included. Mean
age was 81.7 years, and 46.3% were male. Mean Society of Thoracic Surgeons
(STS) score was 5.6%, and 31.3% of patients had known atrial fibrillation.
The most common access site was transfemoral (84.8%), whereas
balloon-expandable valves were used in 62.1%, self-expanding valves in
34.0%, and mechanically expanding valves in 3.9% of cases. The incidence
of delayed HGAVB ranged from 1.7% to 14.6%, with significant methodologic
heterogeneity noted among the included studies. Conclusion(s):
Delayed HGAVB is a common and potentially serious complication of TAVI,
with similar risk factors to acute HGAVB. With a move toward an early
discharge strategy post-TAVI, further prospective study of delayed HGAVB
is warranted to improve understanding of predisposing factors, incidence,
timing, and implications. Copyright © 2023 The Authors

<58>
Accession Number
643318857
Title
Long-term follow-up of balloon-expandable valves according to the
implantation strategy: insight from the DIRECTAVI trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 20
Jan 2024.
Author
Jammoul N.; Dupasquier V.; Akodad M.; Meunier P.-A.; Moulis L.; Soltani
S.; Macia J.-C.; Robert P.; Schmutz L.; Steinecker M.; Piot C.; Targosz
F.; Benkemoun H.; Lattuca B.; Roubille F.; Cayla G.; Leclercq F.
Institution
(Jammoul, Dupasquier, Meunier, Soltani, Macia, Steinecker, Leclercq)
Department of cardiology, Montpellier University, CHU Montpellier,
Montpellier, France
(Akodad) Institut cardiovasculaire Paris Sud, Massy, France
(Moulis) Epidemiological and Clinical Research Unit, CHU Montpellier,
France
(Robert, Schmutz, Lattuca, Cayla) Department of cardiology, CHU Nimes,
Montpellier University, Nimes, France
(Piot) MontpellierFrance
(Targosz) Perpignan hospital, France
(Benkemoun) St Pierre clinic, Perpignan, France
(Roubille) Department of cardiology, CHU Montpellier, Montpellier
University, Montpellier, France; PhyMedExp, INSERM U1046, CNRS UMR 9214,
Montpellier, France
Abstract
BACKGROUND: Safety and feasibility of transcatheter aortic valve
replacement (TAVR) without balloon aortic valvuloplasty (BAV) using the
SAPIEN 3 balloon-expandable device has been previously demonstrated. The
impact on long-term valve hemodynamic performances and outcomes remains
however unknown. We evaluate long-term clinical and hemodynamic results
according to the implant strategy (direct TAVR versus BAV pre TAVR) in
patients included in the DIRECTAVI randomized trial (NCT02729519).
 METHOD(S): Clinical and echocardiographic follow-up until January
2023 was performed for all patients included in the DIRECTAVI trial since
2016 (n=228). The primary endpoint was incidence of moderate/severe
hemodynamic valve deterioration (HVD), according to the Valve Academic
Research defined Consortium-3 criteria (increase in mean gradient >=10
mmHg resulting in a final mean gradient >=20 mmHg, or new/worsening aortic
regurgitation of 1 grade resulting in >= moderate aortic regurgitation).
 RESULT(S): Median follow-up was 3.8 (2.2-4.7) years. Mean age at
follow-up was 87 +/-6.7 years. No difference in incidence of HVD in the
direct implantation group compared to the BAV group was found (incidence
of 1.97 per 100 person-years and 1.45 per 100 person-years, respectively,
p=0.6). Prevalence of predicted prothesis-patient mismatch was low (n=13
[11.4%] in the direct TAVR group versus n=15 [13.2%] in BAV group) and
similar between both groups (p=0.7). Major outcomes including death,
stroke, hospitalization for heart failure and pacemaker implantation were
similar between both groups, (p=0.4, p=0.7, p=0.3 and p=0.3 respectively).
 CONCLUSION(S): Direct implantation of the balloon-expandable device
in TAVR was not associated with an increased risk of moderate/severe HVD
or major outcomes up to 6-year follow-up. These results guarantee wide use
of direct balloon-expandable valve implantation, when feasible. CLINICAL
TRIALS REGISTRATION NUMBER: NCT05140317. Copyright © 2024
Elsevier Ltd. All rights reserved.

<59>
Accession Number
628666964
Title
Acceptance and commitment therapy (ACT) for parents of children with a
chronic medical condition: A systematic review.
Source
Paediatrics and Child Health (Canada). Conference: 96th Annual Conference
of the Canadian Paediatric Society, CPS 2019. Toronto, ON Canada.
24(Supplement 2) (pp e10), 2019. Date of Publication: June 2019.
Author
Parmar A.; Morinis L.; Barreira L.; Miller D.; Major N.; Church P.; Cohen
E.; Orkin J.
Publisher
Oxford University Press
Abstract
BACKGROUND: Caring for a child with a chronic medical condition can
adversely affect parental health and well-being. Family-centered care
requires clinical teams to consider novel ways of providing holistic care
to the entire family by understanding the unique challenges of caring for
a child with a chronic medical condition. Addressing parental well-being
not only improves parental capacity to care for their child, but may also
optimize long-term health outcomes for the child themselves. Acceptance
and Commitment Therapy (ACT) is an established behavioural therapy that
has been used with caregivers in the paediatric setting. Through ACT,
individuals learn skills to increase psychological flexibility, cognitive
diffusion, and mindfulness. ACT aims to help with coping and adjustment,
but its impact has not been systematically appraised in parents of
children with chronic medical conditions. OBJECTIVE(S): To synthesize
available research evidence on the efficacy of ACT for parents of children
with medical conditions. DESIGN/METHODS: A comprehensive literature search
(December 2008 to October 2018) in PubMed, Cochrane Library, EMBASE, Web
of Science, and Google Scholar was conducted. Abstracts were included if:
1) they were original articles and 2) they assessed the efficacy and
outcomes of ACT on parents caring for children with chronic medical
conditions. RESULT(S): In total, 66 abstracts were identified. Nine
publications describing ACT as an intervention aimed at improving
parent-oriented outcomes met the final inclusion criteria. Five studies
were randomized control trials. Medical conditions included children with:
chronic pain (n=4), acquired brain injuries (n=2), autism spectrum
disorder (n=1), cerebral palsy (n=1), and life-threatening illness (cancer
or life-saving cardiac surgery) (n=1). All nine studies found improvements
in caregiver related outcomes following ACT treatment. Improvements were
seen in psychological flexibility (n=5), family functioning (n=3),
parenting (n=1), and depression (n=2). Significant, medium to large effect
sizes were found for measures of psychological flexibility, dysfunctional
parenting styles (laxness and over reactivity). A medium effect size was
found for family functioning. CONCLUSION(S): ACT improved outcomes
for parents caring for children with chronic medical conditions. The
majority of studies concentrated in paediatric patients with chronic pain
or neurologic conditions. Less is known about the efficacy of ACT in
improving parent-related outcomes in other paediatric disease groups
however, further research in this area is warranted.

<60>
Accession Number
2029882104
Title
Aerosolized lidocaine to reduce tracheal suction-associated pain after
pediatric congenital heart surgery: A randomized, double-blind,
placebo-controlled trial.
Source
Progress in Pediatric Cardiology. 72 (no pagination), 2024. Article
Number: 101679. Date of Publication: March 2024.
Author
da Silva T.H.; Carmona F.
Institution
(da Silva, Carmona) Universidade de Sao Paulo, Faculdade de Medicina de
Ribeirao Preto, Departamento de Puericultura e Pediatria, Sao Paulo,
Ribeirao Preto 14049-900, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Background: In children undergoing heart surgery for congenital heart
disease (CHD), postoperative pain is associated with changes in the
respiratory system that can lead to complicated courses and poor outcomes.
Respiratory therapy (RT) can restore respiratory function through manual
techniques and tracheal suction (TS). However, TS itself can cause pain,
leading to hemodynamic and respiratory manifestations, such as
tachycardia, hyper- or hypotension, tachypnea, increased
work-of-breathing, patient-ventilator asynchrony, among others.
 Objective(s): The aim of this study was to investigate whether RT/TS
increases pain and whether inhaled lidocaine can attenuate pain increase
in infants and children undergoing surgery for CHD. Method(s):
Double-blind, randomized, placebo-controlled trial at a pediatric
intensive care unit in a Brazilian tertiary-care university hospital.
Patients <18 years submitted to open-heart surgery for CHD were included
and randomized to receive either aerosolized lidocaine (1 mg/kg) or
placebo before RT/TS. Pain was assessed by the Face, Legs, Activity, Cry,
Consolability pain scale - revised (FLACC-R), along with hemodynamic and
ventilatory parameters, before and 10 min after RT/TS start on
postoperative days 1, 3, and 7 given they were on mechanical ventilation.
 Result(s): 119 patients were included. RT/TS induced minor changes in
pain, which were not attenuated by lidocaine (confirmed in multivariate
analysis). RT/TS also caused minor, clinically not relevant effects in
hemodynamic and ventilatory parameters, which were also not modified by
lidocaine. Conclusion(s): Respiratory therapy with tracheal suction
did not increase postoperative pain in ventilated children after
congenital heart surgery until the 7th day, nor did aerosolized lidocaine
exhibit any clinically significant effect on pain or other hemodynamic or
ventilatory parameters. Registered at REBEC: RBR-10vtd55m. Copyright
© 2023 Elsevier B.V.

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

<62>
[Use Link to view the full text]
Accession Number
2029752273
Title
The impact of preoperative interview and prospective nursing on
perioperative psychological stress and postoperative complications in
patients undergoing TACE intervention for hepatocellular carcinoma.
Source
Medicine (United States). 103(2) (pp E35929), 2024. Date of Publication:
12 Jan 2024.
Author
Gao L.; Chen W.; Qin S.; Yang X.
Institution
(Gao, Chen, Yang) Department of Radiology, Xingtai People's Hospital,
Interventional Catheter Room, Hebei, Xingtai, China
(Qin) Department of Neurosurgery, Xingtai People's Hospital, Hebei,
Xingtai, China
Publisher
Lippincott Williams and Wilkins
Abstract
TACE has become one of the main methods for the treatment of liver cancer.
The study aimed to investigate the effects of preoperative interview and
prospective nursing in patients with hepatic carcinoma undergoing
transcatheter chemoembolization (TACE). Eighty-six patients with
hepatocellular carcinoma who underwent TACE intervention treatment at our
hospital between 2020 and 2023 were selected and randomly assigned to 2
groups using computerized randomization. The control group (n = 43)
received routine nursing care, while the study group (n = 43) received
preoperative interviews in combination with prospective nursing during the
procedure. The patients' heart rate, mean arterial pressure, and blood
pressure variations were recorded, along with their mood changes after
intervention. The postoperative pain and satisfaction levels were compared
between the 2 groups of patients, and the incidence of postoperative
complications was observed. The heart rate, systolic blood pressure, and
diastolic blood pressure of the 2 groups of patients were compared 1 day
before the operation (P > .05). Compared to 1 day before the operation,
there was no significant change for the study group at 10 minutes after
entering the room. However, the control group showed an increase. Both
groups showed an increase in heart rate, systolic blood pressure, and
diastolic blood pressure after the operation, with the study group having
lower values than the control group (P < .05). The levels of tension,
fatigue, anxiety, energy, anger, depression, self-esteem, and POMS index
were compared between the 2 groups before intervention (P > .05). After
intervention, there were significant differences between the 2 groups(P <
.05). Immediately after the operation, the NRS scores of the 2 groups of
patients were compared (P > .05). Compared to the control group, the study
group showed a decrease in NRS scores at 12, 24, and 48 hours after the
operation (P < .05). The nursing satisfaction rate of the study group
patients was 97.67% (42/43), which was higher than the nursing
satisfaction rate of the control group of 76.74% (33/43) (P < .05).
Compared to routine nursing, preoperative visits and prospective nursing
interventions can effectively alleviate patients' psychological stress
reactions, relieve pain, reduce the incidence of complications, and
improve patients' satisfaction with nursing care. Copyright ©
2024 Lippincott Williams and Wilkins. All rights reserved.

<63>
Accession Number
2029726384
Title
Using noninvasive clinical parameters to predict mortality and morbidity
after cardiac interventions in patients with cirrhosis: A systematic
review.
Source
Saudi Journal of Gastroenterology. 30(1) (pp 14-22), 2024. Date of
Publication: 2024.
Author
Mathew C.; Patel A.; Cholankeril G.; Flores A.; Hernaez R.
Institution
(Mathew, Patel, Cholankeril, Flores, Hernaez) Department of Internal
Medicine, Baylor College of Medicine, Houston, TX, United States
(Cholankeril) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine, Baylor St. Luke's Medical Center,
Houston, TX, United States
(Flores, Hernaez) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine, Michael E DeBakey Veterans Affairs
Medical Center, Houston, TX, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Cardiovascular disease commonly affects advanced liver disease
patients. They undergo cardiac interventions to improve cardiac outcomes.
Cirrhosis increases complication risk, including bleeding, renal and
respiratory failure, and further decompensation, including death, posing a
clinical dilemma to proceduralists. Predicting outcomes is crucial in
managing patients with cirrhosis. Our aim was to systematically review
clinical parameters to assess the mortality and complication risk in
patients with cirrhosis undergoing cardiac interventions. Method(s):
We searched cirrhosis and cardiovascular intervention terminology in
PubMed and Excerpta Medica Database (EMBASE) from inception to January 8,
2023. We included studies reporting clinical scores (e.g. Model for
End-stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT), cardiovascular
interventions, mortality, and morbidity outcomes). We independently
abstracted data from eligible studies and performed qualitative summaries.
 Result(s): Eight studies met the inclusion criteria. Procedures
included tricuspid valve surgery, catheterization-related procedures,
aortic valve replacement (AVR), pericardiectomy, and left ventricular
assist device (LVAD) placement. MELD primarily predicted mortality (n =
4), followed by CPT (n = 2). Mortality is significantly increased for MELD
> 15 after tricuspid valve surgery. Albumin, creatinine, and MELD were
significantly associated with increased mortality after transcatheter AVR
(TAVR), although specific values lacked stratification. CPT was
significantly associated with increased mortality after cardiac
catheterization or pericardiectomy. In LVAD placement, increasing MELD
increased the unadjusted odds for perioperative mortality.
 Conclusion(s): Our systematic review showed that clinical parameters
predict mortality and morbidity risk in patients with cirrhosis undergoing
cardiac procedures. Copyright © 2023 Saudi Journal of
Gastroenterology.

<64>
Accession Number
2029606373
Title
Impact of xenon on postoperative outcomes in cardiac surgery: A systematic
review and meta-analysis of delirium incidence and associated clinical
parameters.
Source
Trends in Anaesthesia and Critical Care. 54 (no pagination), 2024. Article
Number: 101328. Date of Publication: February 2024.
Author
Ameer F.A.; Gumera A.; Ramadan A.; Al-Shammari A.S.; Gamal M.; Amin M.;
Alchamaley M.M.; Nawas R.; Mashkoor Y.; Shalabi L.; Hashim H.T.
Institution
(Ameer) University of Al-Qadisiyah College of Medicine, Iraq
(Gumera) Department of Surgery, University of Melbourne, Australia
(Ramadan) Faculty of Medicine, South Valley University, Qena, Egypt
(Al-Shammari) Imam Ali General Hospital, Baghdad, Iraq
(Gamal, Amin) Faculty of Medicine - Fayoum University, Fayoum, Egypt
(Alchamaley) Al-Zahra'a Hospital, Neurophysiology Department, Iraq
(Nawas) Al-Quds University, Medical College, Palestine
(Mashkoor) Dow Medical College, Sindh, Karachi, Pakistan
(Shalabi) Gharyan Faculty of Medicine, Libyan Arab Jamahiriya
(Hashim) University of Warith Al-Anbiyaa, College of Medicine, Iraq
Publisher
Churchill Livingstone
Abstract
Background: Postoperative delirium (POD) is a common complication after
cardiac surgery, leading to increased morbidity and hospital stays. The
anesthetic choice may affect POD incidence and related complications.
Xenon has emerged as a promising alternative for its cardio- and
neuroprotective effects; however, its effectiveness in preventing POD
following cardiac surgery remains unclear. Objective(s): To evaluate
the effectiveness of Xenon in preventing postoperative delirium in
patients undergoing cardiac surgery. Method(s): Articles were
searched using databases including PubMed, Medline, Scopus, Embase, Web of
Science, and the Cochrane Central Register of Controlled Trials (CENTRAL)
from the databases' inception until August 18, 2023. A total of five
randomized controlled trials were included in this systematic review and
meta-analysis. Six outcomes were extracted and assessed: postoperative
delirium incidence, respiratory disorder, duration of mechanical
ventilation, length of hospital stay, ICU stay length, and mortality.
 Result(s): There were no significant differences between the Xenon
and Control groups across six assessed outcomes: postoperative delirium
incidence (p = 0.46), respiratory disorder (p = 0.66), duration of
mechanical ventilation (p = 0.80), length of hospital stay (p = 0.93), ICU
stay length (p = 0.32), and mortality (p = 0.43). Pooled effect sizes
ranged from non-significant to moderately heterogeneous, with overall
effects constantly failing to reach statistical significance.
 Conclusion(s): These results suggest that Xenon does not display
clinically meaningful benefits over control groups for the assessed
outcomes. Copyright © 2023 Elsevier Ltd

<65>
Accession Number
2028015561
Title
Desmopressin to reduce periprocedural bleeding and transfusion: a
systematic review and meta-analysis.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 5.
Date of Publication: December 2024.
Author
Wang C.; Lebedeva V.; Yang J.; Anih J.; Park L.J.; Paczkowski F.; Roshanov
P.S.
Institution
(Wang, Roshanov) Department of Medicine, Western University, London, ON,
Canada
(Lebedeva) London Health Sciences Centre, London, ON, Canada
(Yang, Paczkowski, Roshanov) Schulich School of Medicine & Dentistry,
Western University, London, ON, Canada
(Anih) McMaster University, Hamilton, ON, Canada
(Park) Department of Surgery, Division of General Surgery, McMaster
University, Hamilton, ON, Canada
(Roshanov) Department of Epidemiology and Biostatistics, Western
University, London, ON, Canada
(Park, Roshanov) Population Health Research Institute, Hamilton, ON,
Canada
Publisher
BioMed Central Ltd
Abstract
We systematically reviewed the literature to investigate the effects of
peri-procedural desmopressin in patients without known inherited bleeding
disorders undergoing surgery or other invasive procedures. We included 63
randomized trials (4163 participants) published up to February 1, 2023.
Seven trials were published after a 2017 Cochrane systematic review on
this topic. There were 38 trials in cardiac surgery, 22 in noncardiac
surgery, and 3 in non-surgical procedures. Meta-analyses demonstrated that
desmopressin likely does not reduce the risk of receiving a red blood cell
transfusion (25 trials, risk ratio [RR] 0.95, 95% confidence interval [CI]
0.86 to 1.05) and may not reduce the risk of reoperation due to bleeding
(22 trials, RR 0.75, 95% CI 0.47 to 1.19) when compared to placebo or
usual care. However, we demonstrated significant reductions in number of
units of red blood cells transfused (25 trials, mean difference -0.55
units, 95% CI - 0.94 to - 0.15), total volume of blood loss (33 trials,
standardized mean difference - 0.40 standard deviations; 95% CI - 0.56 to
- 0.23), and the risk of bleeding events (2 trials, RR 0.45, 95% CI 0.24
to 0.84). The certainty of evidence of these findings was generally low.
Desmopressin increased the risk of clinically significant hypotension that
required intervention (19 trials, RR 2.15, 95% CI 1.36 to 3.41). Limited
evidence suggests that tranexamic acid is more effective than desmopressin
in reducing transfusion risk (3 trials, RR 2.38 favoring tranexamic acid,
95% CI 1.06 to 5.39) and total volume of blood loss (3 trials, mean
difference 391.7 mL favoring tranexamic acid, 95% CI - 93.3 to 876.7 mL).
No trials directly informed the safety and hemostatic efficacy of
desmopressin in advanced kidney disease. In conclusion, desmopressin
likely reduces periprocedural blood loss and the number of units of blood
transfused in small trials with methodologic limitations. However, the
risk of hypotension needs to be mitigated. Large trials should evaluate
desmopressin alongside tranexamic acid and enroll patients with advanced
kidney disease. Copyright © 2024, The Author(s).

<66>
Accession Number
2027945903
Title
Clinical study of thoracoscopic assisted different surgical approaches for
early thymoma: a meta-analysis.
Source
BMC Cancer. 24(1) (no pagination), 2024. Article Number: 92. Date of
Publication: December 2024.
Author
Wang J.; Tong T.; Zhang K.; Guo H.; Liu Y.; Li J.; Zhang H.; Li Q.; Zhang
Z.; Zhao Y.
Institution
(Wang, Tong, Guo, Li, Zhang, Li, Zhang, Zhao) Department of Thoracic
Surgery, the Second Hospital of Jilin University, Jilin, China
(Zhang) Jilin Provincial Key Laboratory on Molecular and Chemical
Genetics, Kun Zhang, The Second Hospital of Jilin University, Jilin,
Changchun 130041, China
(Liu) Department of Cardiac Surgery, the First Affiliated Hospital of
Harbin Medical University, Harbin, China
Publisher
BioMed Central Ltd
Abstract
Objective: The efficacy and safety of subxiphoid thoracoscopic thymectomy
(SVATS) for early thymoma are unknown. The purposes of this meta-analysis
were to evaluate the effectiveness and safety of SVATS for early thymoma,
to compare it with unilateral intercostal approach video thoracoscopic
surgery (IVATS) thymectomy, and to investigate the clinical efficacy of
modified subxiphoid thoracoscopic thymectomy (MSVATS) for early anterior
mediastinal thymoma. Method(s): Original articles describing
subxiphoid and unilateral intercostal approaches for thoracoscopic
thymectomy to treat early thymoma published up to March 2023 were searched
from PubMed, Embase, and the Cochrane Library. Standardized mean
differences (SMDs) and 95% confidence intervals (CIs) were calculated and
analyzed for heterogeneity. Clinical data were retrospectively collected
from all Masaoka stage I and II thymoma patients who underwent modified
subxiphoid and unilateral intercostal approach thoracoscopic thymectomies
between September 2020 and March 2023. The operative time, intraoperative
bleeding, postoperative drainage, extubation time, postoperative hospital
stay, postoperative visual analog pain score (VAS), and postoperative
complications were compared, and the clinical advantages of the modified
subxiphoid approach for early-stage anterior mediastinal thymoma were
analyzed. Result(s): A total of 1607 cases were included in the seven
studies in this paper. Of these, 591 cases underwent SVATS thymectomies,
and 1016 cases underwent IVATS thymectomies. SVATS thymectomy was compared
with IVATS thymectomy in terms of age (SMD = - 0.09, 95% CI: -0.20 to -
0.03, I2 = 20%, p = 0.13), body mass index (BMI; SMD = - 0.10,
95% CI: -0.21 to - 0.01, I2 = 0%, p = 0.08), thymoma size (SMD
= - 0.01, 95% CI: -0.01, I2 = 0%, p = 0.08), operative time
(SMD = - 0.70, 95% CI: -1.43-0.03, I2 = 97%, p = 0.06),
intraoperative bleeding (SMD = - 0.30. 95% CI: -0.66-0.06, I2 =
89%, p = 0.10), time to extubation (SMD = - 0.34, 95%CI: -0.73-0.05,
I2 = 91%, p = 0.09), postoperative hospital stay (SMD = - 0.40,
95% CI: -0.93-0.12, I2 = 93%, p = 0.13), and postoperative
complications (odds ratio [OR] = 0.94, 95% CI: 0.42-2.12, I2 =
57%, p = 0.88), which were not statistically significantly different
between the SVATS and IVATS groups. However, the postoperative drainage in
the SVATS group was less than that in the IVATS group (SMD = - 0.43,
95%CI: -0.84 to - 0.02, I2 = 88%, p = 0.04), and the difference
was statistically significant. More importantly, the postoperative VAS was
lower in the SVATS group on days 1 (SMD = - 1.73, 95%CI: -2.27 to - 1.19,
I2 = 93%, p < 0.00001), 3 (SMD = - 1.88, 95%CI: -2.84 to -
0.81, I2 = 97%, p = 0.0005), and 7 (SMD = - 1.18, 95%CI: -2.28
to - 0.08, I2 = 97%, p = 0.04) than in the IVATS group, and
these differences were statistically significant. A total of 117 patients
undergoing thoracoscopic thymectomy for early thymoma in the Department of
Thoracic Surgery of the Second Hospital of Jilin University were
retrospectively collected and included in the analysis, for which a
modified subxiphoid approach was used in 42 cases and a unilateral
intercostal approach was used in 75 cases. The differences between the two
groups (MSVATS vs. IVATS) in general clinical characteristics such as age,
sex, tumor diameter, Masaoka stage, Word Health Organization (WHO) stage,
and intraoperative and postoperative conditions, including operative time,
postoperative drainage, extubation time, postoperative hospital stay, and
postoperative complication rates, were not statistically significant (p >
0.05), while BMI, intraoperative bleeding, and VAS on postoperative days
1, 3, and 7 were all statistically significant (p < 0.05) in the MSVATS
group compared with the IVATS group. Conclusion(s): The meta-analysis
showed that the conventional subxiphoid approach was superior in terms of
postoperative drainage and postoperative VAS pain scores compared with the
unilateral intercostal approach. Moreover, the modified subxiphoid
approach had significant advantages in intraoperative bleeding and
postoperative VAS pain scores compared with the unilateral intercostal
approach. These results indicate that MSVATS can provide more convenient
operation conditions, a better pleural cavity view, and a more complete
thymectomy in the treatment of early thymoma, indicating that is a safe
and feasible minimally invasive surgical method. Copyright ©
2024, The Author(s).

<67>
Accession Number
2027731732
Title
Lower dose of sufentanil was associated with higher plasmatic level of
cortisol in patients undergoing elective cardiac surgery at the same depth
of anaesthesia: a prospective randomised pilot study. Do we overlook
''stress under the surface''?.
Source
Signa Vitae. 20(1) (pp 71-76), 2024. Date of Publication: January 2024.
Author
Rogozov V.; Vanek T.; Maly M.; Kacer P.; Musil V.
Institution
(Rogozov, Vanek, Kacer) 3rd Faculty of Medicine, Charles University,
Prague 100 00, Czechia
(Rogozov, Vanek, Kacer) Department of Cardiac Surgery, University Hospital
Kralovske Vinohrady, Prague 100 00, Czechia
(Maly) National Institute of Public Health, Prague 100 00, Czechia
(Musil) Centre of Scientific Information, 3rd Faculty of Medicine, Charles
University, Prague 100 00, Czechia
Publisher
Pharmamed Mado Ltd
Abstract
Objective monitoring of per-operative nociception remains an unanswered
challenge. Anaesthetists still mostly rely on signs of activation of the
sympathetic nervous system, e.g., an increase in heart rate and blood
pressure. These signs can be often blurred in cardiac surgery because of
medication influencing heart rate and blood pressure or by severe
hemodynamic disturbances. Such conditions create the potential for
incompletely checked nociception which can lead to unrecognised "under the
surface" stress reaction. We decided to investigate whether patients
undergoing cardiac surgery maintained at the same level of monitored depth
of anaesthesia would express differences in plasmatic level of stress
hormone cortisol when given a different dose of opioid sufentanil.
Nineteen patients undergoing elective cardiac surgery were included in our
prospective randomised trial. All patients were anaesthetised by a
standardised protocol (using midazolam, propofol, sevoflurane, sufentanil
and rocuronium) and were maintained within the same range of anaesthetic
depth monitored by monitor Conox (qCON 30-50). Patients were randomised in
two groups. Group LS (lower sufentanil), n = 9, recieved TCI (target
controlled infusion) sufentanil in dose of 0.25 ng/mL, group HS (higher
sufentanil), n = 10, in dose of 0.75 ng/mL. 15 minutes after sternotomy we
took blood samples for analysis of plasmatic levels of cortisol. Group LS
had significantly higher plasmatic cortisol levels, median 700 nm/L, than
HS, median 328 nm/L (p = 0.006). We conclude that a lower dose of
sufentanil was associated with higher plasmatic level of cortisol and thus
more significant activation of hypothalamic-pituitary-adrenal axis stress
response. We emphasise that activation of stress response can be
underestimated during cardiac surgery. Our result supports the need for
developing an objective monitoring method of per-operative
nociception. Copyright © 2024 The Author(s). Published by MRE
Press.

<68>
Accession Number
2027196790
Title
Transnasal humidified rapid-insufflation ventilator exchange compared with
laryngeal mask airway for endoscopic thoracic sympathectomy: a randomized
controlled trial.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1252586.
Date of Publication: 2023.
Author
Lin C.; Wang D.; Yan Y.; Zhong R.; Li C.; Zhang J.
Institution
(Lin, Wang, Yan, Zhong, Li, Zhang) Department of Anesthesiology, Huazhong
University of Science and Technology Union Shenzhen Hospital, Shenzhen,
China
Publisher
Frontiers Media SA
Abstract
Background: Transnasal humidified rapid-insufflation ventilator exchange
(THRIVE) has the characteristics of operating easily and maintaining
oxygenation and eliminating CO<inf>2</inf>, which makes it possible to be
used in endoscopic thoracic sympathectomy (ETS). The application of THRIVE
in ETS remains undefined. The purpose of this randomized controlled study
is to assess the efficacy between THRIVE and laryngeal mask airway (LMA)
for ETS. Method(s): In total, 34 patients from May 2022 to May 2023
in Huazhong University of Science and Technology Union Shenzhen Hospital
undergoing ETS were randomly divided into a THRIVE group (n = 17) and an
LMA group (n = 17). A serial arterial blood gas analysis was conducted
during the perioperative period. The primary outcome was the arterial
partial pressure of carbon dioxide (PaCO<inf>2</inf>) during the
perioperative period. The secondary outcome was arterial partial pressure
of oxygen (PaO<inf>2</inf>) during the perioperative period.
 Result(s): The mean (SD) highest PaCO<inf>2</inf> in the THRIVE group
and LMA group were 99.0 (9.0) mmHg and 51.7 (5.2) mmHg, respectively (p <
0.001). The median (inter-quartile range) time to PaCO<inf>2</inf> >= 60
mmHg in the THRIVE group was 26.0 min (23.2-28.8). The mean (SD)
PaO<inf>2</inf> was 268.8 (89.0) mmHg in the THRIVE group and 209.8 (55.8)
mmHg in the LMA group during surgery (p = 0.027). Conclusion(s):
CO<inf>2</inf> accumulation in the THRIVE group was higher than that of
the LMA group during ETS, but THRIVE exhibited greater oxygenation
capability compared to LMA. We preliminarily testified that THRIVE would
be a feasible non-intubated ventilation technique during ETS under
monitoring PaCO<inf>2.</inf> Copyright © 2023 Lin, Wang, Yan,
Zhong, Li and Zhang.

<69>
Accession Number
2026566856
Title
Combined Radiofrequency Ablation and Left Atrial Appendage Closure in
Atrial Fibrillation and Systolic Heart Failure.
Source
Diagnostics. 13(21) (no pagination), 2023. Article Number: 3325. Date of
Publication: November 2023.
Author
Sun J.; Zhang R.; Yang M.; Li W.; Zhang P.-P.; Mo B.-F.; Wang Q.-S.; Chen
M.; Li Y.-G.
Institution
(Sun, Zhang, Yang, Li, Zhang, Mo, Wang, Chen, Li) Xinhua Hospital, School
of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Managing patients with atrial fibrillation (AF) and comorbid
heart failure (HF) with reduced (HFrEF) or mildly reduced ejection
fraction (HFmrEF) is of clinical importance but a great challenge. This
study aimed to evaluate the clinical benefit of the combined
radiofrequency catheter ablation (RFCA) and left atrial appendage closure
(LAAC) procedure in AF patients complicated with systolic HF.
 Method(s): AF patients with HFrEF or HFmrEF who underwent the
combined RFCA and LAAC procedure were prospectively enrolled in the
LAACablation registry. The procedural complications and long-term outcomes
were evaluated. Another cohort of AF patients with systolic HF who did not
undergo either RFCA or LAAC were used for prognosis comparison.
 Result(s): Among 802 AF patients who underwent the combined
procedure, 65 patients were comorbid with systolic HF (25 with HFrEF and
40 with HFmrEF). The overall procedural complication rate was 9.2%, which
was mainly attributed to acute decompensated HF (6.2%). Accompanied with
markedly reduced AF burden (from median [25th, 75th percentile]: 100 [100,
100] to 0 [0, 1.2]%, p < 0.001), upward trajectories of cardiac function
were observed in 51 (78.4%) patients, showing improvement in New York
Heart Classification (p < 0.01), natriuretic peptide levels (from 1492
[809, 3259] to 413 [163, 880] pg/mL, p < 0.001) and left ventricular EF
(from 42.6 +/- 5.3 to 53.8 +/- 8.2%, p < 0.001). During the 27-month
follow-up period, death, thromboembolism, major bleeding, and HF
rehospitalization were observed in three, one, one, and four patients,
respectively. The observed event rates showed a significant reduction
compared with the non-procedure AF-HF cohort (n = 138; for composite
endpoint: hazard ratio: 2.509, 95% confidence interval: 1.415-4.449, p =
0.002) and with the respective rates predicted by risk scores.
 Conclusion(s): Combining RFCA and LAAC achieves acceptable safety and
credible long-term efficacy in AF patients with systolic HF. Further
randomized studies are warranted in a larger patient cohort. Copyright
© 2023 by the authors.

<70>
Accession Number
2026491700
Title
Use of MHT in women with cardiovascular disease: a systematic review and
meta-analysis.
Source
Climacteric. 27(1) (pp 93-103), 2024. Date of Publication: 2024.
Author
Bontempo S.; Yeganeh L.; Giri R.; Vincent A.J.
Institution
(Bontempo, Giri, Vincent) Department of Endocrinology, Monash Health,
Clayton, VIC, Australia
(Yeganeh, Vincent) Monash Centre for Health Research and Implementation,
Faculty of Medicine, Nursing and Health Sciences, Monash University,
Melbourne, VIC, Australia
Publisher
Taylor and Francis Ltd.
Abstract
This systematic review assesses the effect of menopausal hormone therapy
(MHT) on cardiovascular outcomes and risk factors in postmenopausal women
with cardiovascular disease (CVD). The Medline, Embase and Cochrane
databases were searched from inception to December 2022 for randomized
controlled trials (RCTs) and observational studies using methodology from
a previous Cochrane review. Quality assessment used the Cochrane risk of
bias tool and Newcastle-Ottawa scale, respectively. From 5647 studies
identified, 29 (23 RCTs and six observational studies) were included. Most
studies were conducted in North America or Europe and investigated oral
estrogens. Participants were older with varying frequency of cardiac risk
factors and underlying CVD. No significant difference was observed between
MHT users and controls regarding primary outcomes of non-fatal myocardial
infarction, cardiovascular death or stroke. No difference in frequency of
angina, heart failure and transient ischemic attacks was observed.
Inconsistent effects of MHT on angiographic progression were seen and
varied with glycemic status. Estradiol had a positive effect on
flow-mediated dilatation. Limited studies identified differing effects of
MHT on cardiac risk factors, varying with estrogen preparation. This study
confirms no benefit of MHT for secondary CVD prevention, highlighting
evidence limitations and the importance of shared decision-making when
managing menopausal symptoms in women with CVD. Copyright © 2023
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<71>
Accession Number
2029904505
Title
Association of Glutamate Infusion with Risk of Acute Kidney Injury after
Coronary Artery Bypass Surgery: A Pooled Analysis of 2 Randomized Clinical
Trials.
Source
JAMA Network Open. (pp E2351743), 2024. Date of Publication: 2024.
Author
Holm J.; Vanky F.; Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Unit of Cardiovascular Medicine, Linkoping University, Linkoping, Sweden
Publisher
American Medical Association
Abstract
Importance: Acute kidney injury (AKI) after cardiac surgery is associated
with increased morbidity and mortality, and measures to prevent AKI have
had limited success. Glutamate has been reported to enhance natural
postischemic recovery of the heart, but not among animals and humans with
diabetes. Objective(s): To summarize pooled results from the
GLUTAMICS (Glutamate for Metabolic Intervention in Coronary Surgery)
trials regarding the effect of glutamate on postoperative AKI among
patients without diabetes undergoing coronary artery bypass graft (CABG)
surgery. Design, Setting, and Participant(s): Data on a total of 791
patients without diabetes from 2 prospective, randomized, double-blind
multicenter trials performed at 5 cardiac surgery centers in Sweden
between October 4, 2005, and November 12, 2009, and between November 15,
2015, and September 30, 2020, were pooled. Patients had acute coronary
syndrome, left ventricular ejection fraction of 0.30 or less, or a
European System for Cardiac Risk Evaluation II score of 3.0 or more and
underwent CABG with or without additional valve procedure. Statistical
analysis was performed from May to November 2023. Intervention(s):
Intravenous infusion of 0.125-M l-glutamic acid or saline at 1.65 mL/kg/h
for 2 hours during reperfusion, after which the infusion rate was halved
and an additional 50 mL was given. Main Outcomes and Measures: The
primary end point was AKI, defined as postoperative increase of plasma
creatinine of 50% or more, corresponding to the Risk stage or higher in
the Risk, Injury, Failure, Loss, and End-Stage kidney disease (RIFLE)
criteria. Result(s): A total of 791 patients without diabetes (391
who received glutamate [mean (SD) age, 69.3 (9.1) years; 62 women (15.9%)]
and 400 controls [mean (SD) age, 69.6 (9.5) years; 73 women (18.3%)]) were
randomized. Baseline data did not differ between groups. Glutamate was
associated with a significantly lower risk of AKI (relative risk, 0.49
[95% CI, 0.29-0.83]). Dialysis was required for 2 patients in the
glutamate group and 5 patients in the control group. In multivariable
analysis, glutamate remained significantly associated with a protective
effect against AKI (odds ratio, 0.47 [95% CI, 0.26-0.86]). In the
glutamate and control groups, the rate of postoperative mortality at 30
days or less was 0.5% (2 of 391) vs 1.0% (4 of 400), and the rate of
stroke at 24 hours or less was 0.8% (3 of 391) vs 1.8% (7 of 400).
 Conclusions and Relevance: In this pooled analysis of 2 randomized
clinical trials, infusion of glutamate was associated with a markedly
lower risk of AKI after CABG among patients without diabetes. The findings
are exploratory and need to be confirmed in prospective trials. Trial
Registration: ClinicalTrials.gov Identifiers: NCT00489827 and
NCT02592824. Copyright © 2024 American Medical Association. All
rights reserved.

<72>
Accession Number
2028202776
Title
Safety and Efficacy of Albumin for Pump Priming in Cardiac Surgery: A
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 517-525),
2024. Date of Publication: February 2024.
Author
Yin J.; Sun M.; Zeng Y.; Cai M.; Liu H.; Jin Y.
Institution
(Yin, Zeng, Cai, Liu, Jin) Department of Pain Medicine, Jinling Hospital,
Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
(Sun) Department of Anesthesiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Sun) Institute of Anesthesia and Critical Care Medicine, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Sun) Key Laboratory of Anesthesiology and Resuscitation (Huazhong
University of Science and Technology), Ministry of Education, Wuhan, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the efficacy and safety of albumin as pump priming
fluid in cardiac surgery. Design(s): Meta-analysis of randomized
controlled trials. Setting(s): Each study was conducted in a surgical
center or intensive care unit. Participant(s): Adult and pediatric
patients undergoing cardiac surgery with cardiopulmonary bypass who
received circuit priming fluids. Intervention(s): Extracorporeal
circuit priming with either albumin or crystalloid. Measurements and
Results: Fourteen eligible randomized controlled trials with 741 patients
were included in the present meta-analysis. Albumin prime had lower
bleeding (CI -202.20 to -142.88 mL, p < 0.00001) and showed a greater
advantage in preserving platelet counts (CI 14.85-21.48 x 103
mm-3, p < 0.00001), maintaining colloid osmotic pressure and
sustaining negative fluid balance. No significant differences were found
in the remaining study outcomes. Conclusion(s): Albumin was shown to
be safe and efficacious in extracorporeal circulation perfusion. However,
its clinical advantages were not clearly highlighted, as there were no
significant differences in the number of deaths, length of hospital stay,
or intensive care unit duration. The results should be interpreted
cautiously, as most included studies were small in scale, and the total
number of participants was limited. Copyright © 2023

<73>
Accession Number
2026184321
Title
The Impact of Nasal Intubation on Feeding Outcomes in Neonates Requiring
Cardiac Surgery: A Randomized Control Trial.
Source
Pediatric Cardiology. 45(2) (pp 426-432), 2024. Date of Publication:
February 2024.
Author
Yildirim M.I.; Spaeder M.C.; Castro B.A.; Chamberlain R.; Fuzy L.; Howard
S.; McNaull P.; Raphael J.; Sharma R.; Vizzini S.; Wielar A.; Frank D.U.
Institution
(Yildirim) Division of Pediatric Cardiology, Department of Pediatrics,
Cleveland Clinic Children's Hospital, Cleveland, OH, United States
(Spaeder, Frank) Division of Pediatric Critical Care, Department of
Pediatrics, University of Virginia School of Medicine, Charlottesville,
VA, United States
(Castro, Howard, McNaull, Raphael, Sharma, Vizzini, Wielar) Division of
Pediatric Anesthesiology, Department of Anesthesiology, University of
Virginia School of Medicine, Charlottesville, VA, United States
(Chamberlain, Fuzy) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, University of Virginia School of Medicine,
Charlottesville, VA, United States
(Raphael) Department of Anesthesiology, Thomas Jefferson University
Hospital, Philadelphia, PA, United States
Publisher
Springer
Abstract
Neonates who require surgery for congenital heart disease (CHD) frequently
have difficulty with oral feeds post-operatively and may require a feeding
tube at hospital discharge. The purpose of this study was to determine the
effect of oral or nasal intubation route on feeding method at hospital
discharge. This was a non-blinded randomized control trial of 62 neonates
who underwent surgery for CHD between 2018 and 2021. Infants in the nasal
(25 patients) and oral (37 patients) groups were similar in terms of
pre-operative risk factors for feeding difficulties including completed
weeks of gestational age at birth (39 vs 38 weeks), birthweight (3530 vs
3100 g), pre-operative PO intake (92% vs 81%), and rate of pre-operative
intubation (22% vs 28%). Surgical risk factors were also similar including
Society of Thoracic Surgeons-European Association for Cardio-Thoracic
Surgery category (3.9 vs 4.1), shunt placement (32% vs 41%),
cardiopulmonary bypass time (181 vs 177 min), and cross-clamp time (111 vs
105 min). 96% of nasally intubated patients took full oral feeds by
discharge as compared with 78% of orally intubated infants (p = 0.05).
Nasally intubated infants reach full oral feeds an average of 3 days
earlier than their orally intubated peers. In this cohort of patients,
nasally intubated infants reach oral feeds more quickly and are less
likely to require supplemental tube feeding in comparison to orally
intubated peers. Intubation route is a potential modifiable risk factor
for oral aversion and appears safe in neonates. The study was approved by
the University of Virginia Institutional Review Board for Health Sciences
Research and was retrospectively registered on clinicaltrials.gov
(NCT05378685) on May 18, 2022. Copyright © 2023, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<74>
Accession Number
2022914673
Title
Role of supplemental regional blocks on postoperative neurocognitive
dysfunction after major non-cardiac surgeries: A systematic review and
meta-analysis of randomized controlled trials.
Source
Regional Anesthesia and Pain Medicine. 49(1) (pp 49-58), 2022. Date of
Publication: 19 Dec 2022.
Author
Singh N.P.; Makkar J.K.; Borle A.; Singh P.M.
Institution
(Singh) Department of Anesthesiology, Maharishi Markandeshwar Institute of
Medical Sciences and Research, Haryana, Ambala, India
(Makkar) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education and Research, Chandigarh 160012, India
(Borle, Singh) Department of Anesthesiology, Washington University in St
Louis School of Medicine, St Louis, MO, United States
Publisher
BMJ Publishing Group
Abstract
Background/importance Postoperative neurocognitive dysfunction (PNCD) is a
frequent and preventable complication after surgery. The large
high-quality evidence for the efficacy of supplemental regional analgesia
blocks (RAB) for preventing PNCD is still elusive. Objective The objective
of this meta-analysis was to evaluate the effect of RAB versus standard
anesthesia care on the incidence of PNCD in adult patients undergoing
major non-cardiac surgery. Evidence review PubMed, EMBASE, Scopus, and the
Cochrane Central Registers of Controlled Trials (CENTRAL) were searched
for randomized controlled trials (RCTs) from 2017 until June 2022. The
primary outcome was the incidence of PNCD within 1 month of surgery. A
random-effects model with an inverse variance method was used to pool
results, and OR and mean differences were calculated for dichotomous and
continuous outcomes. Various exploratory subgroup analyses were performed
to explore the possibility of the association between the various patient,
technique, and surgery-related factors. Grading of Recommendation,
Assessment, Development, and Evaluation guidelines were used to determine
the certainty of evidence. Findings Twenty-six RCTs comprizing 4414
patients were included. The RAB group was associated with a significant
reduction in the incidence of PNCD with an OR of 0.46 (95% CI 0.35 to
0.59; p<0.00001; I 2 =28%) compared with the control group (moderate
certainty). Subgroup analysis exhibited that the prophylactic efficacy of
RAB persisted for both delirium and delayed neurocognitive recovery.
Conclusions Current evidence suggests that supplemental RAB are beneficial
in preventing PNCD in patients after major non-cardiac surgery. PROSPERO
registration number CRD42022338820 Copyright © 2024 American
Society of Regional Anesthesia & Pain Medicine. Published by BMJ.

<75>
[Use Link to view the full text]
Accession Number
641291234
Title
Comparisons of different new-generation transcatheter aortic valve
implantation devices for patients with severe aortic stenosis: a
systematic review and network meta-analysis.
Source
International journal of surgery (London, England). 109(8) (pp 2414-2426),
2023. Date of Publication: 01 Aug 2023.
Author
Yang Y.-X.; Liu X.-M.; Fu Y.; Li C.; Wang H.-J.; Xu L.; Xia K.; Zhang
Z.-Y.; Zhong J.-C.; Chen M.-L.; Su P.-X.; Wang L.-F.
Institution
(Yang) Heart Center and Beijing Key Laboratory of Hypertension, Beijing
Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether there are differences among the new-generation
transcatheter aortic valve implantation (TAVI) devices for patients with
aortic stenosis remains unclear. The aim of the study was to compare the
efficiency and safety of different new-generation TAVI devices for
patients with aortic stenosis. MATERIALS AND METHODS: A comprehensive
search of PubMed, Embase and Web of Science from their inception to 1
February 2022. Randomized clinical trials and observational studies that
compared two or more different TAVI devices were enroled. Pairwise
meta-analysis and frequentist network meta-analysis were conducted to pool
the outcome estimates of interest. RESULT(S): A total of 79 studies
were finally included. According to the surface under the cumulative
ranking, the top two ranked valves for lower rates of events were as
follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate
of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality;
DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%)
and DFM (35.8%) for lower rates of major and life-threatening bleeding;
Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney
injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent
pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates
of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of
mean aortic valve gradients. CONCLUSION(S): The findings of the
present study suggested that the device success rates were comparable
among these new-generation valves except for DFM. After excluding DFM,
Sapien 3 might be the best effective for decreased mortality and stroke;
Lotus might be the best effective for decreased paravalvular leak; Evolut
might be the best effective for decreased major and life-threatening
bleeding and mean aortic valve gradients; Acurate and Portico might be the
best effective for decreased permanent pacemaker implantation and acute
kidney injury, respectively. Copyright © 2023 The Author(s).
Published by Wolters Kluwer Health, Inc.

<76>
Accession Number
639503985
Title
High-Sensitivity Cardiac Troponin I and T Kinetics Differ following
Coronary Bypass Surgery: A Systematic Review and Meta-Analysis.
Source
Clinical chemistry. 68(12) (pp 1564-1575), 2022. Date of Publication: 06
Dec 2022.
Author
Denessen E.J.; Heuts S.; Daemen J.H.; van Doorn W.P.; Vroemen W.H.; Sels
J.-W.; Segers P.; Van't Hof A.W.; Maessen J.G.; Bekers O.; Van Der Horst
I.C.; Mingels A.M.
Institution
(Denessen, van Doorn, Vroemen, Bekers, Mingels) Central Diagnostic
Laboratory, Maastricht University Medical Center+, Maastricht, Netherlands
(Denessen, van Doorn, Sels, Van't Hof, Maessen, Bekers, Van Der Horst,
Mingels) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Daemen) Department of Surgery, Division of General Thoracic Surgery,
Zuyderland Medical Center, Heerlen, Netherlands
(Sels, Van Der Horst) Department of Intensive Care Medicine, Maastricht
University Medical Center+, Maastricht, Netherlands
(Sels, Van't Hof) Department of Cardiology, Maastricht University Medical
Center+, Maastricht, Netherlands
(Van't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac troponin I and T are both used for diagnosing
myocardial infarction (MI) after coronary artery bypass grafting (CABG),
also known as type 5 MI (MI-5). Different MI-5 definitions have been
formulated, using multiples of the 99th percentile upper reference limit
(10x, 35x, or 70x URL), with or without supporting evidence. These
definitions are arbitrarily chosen based on conventional assays and do not
differentiate between troponin I and T. We therefore investigated the
kinetics of high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT)
following CABG. METHOD(S): A systematic search was applied to MEDLINE
and EMBASE databases including the search terms "coronary artery bypass
grafting" AND "high-sensitivity cardiac troponin." Studies reporting
hs-cTnI or hs-cTnT on at least 2 different time points were included.
Troponin concentrations were extracted and normalized to the
assay-specific URL. RESULT(S): For hs-cTnI and hs-cTnT, 17 (n = 1661
patients) and 15 studies (n = 2646 patients) were included, respectively.
Preoperative hs-cTnI was 6.1x URL (95% confidence intervals: 4.9-7.2) and
hs-cTnT 1.2x URL (0.9-1.4). Mean peak was reached 6-8 h postoperatively
(126x URL, 99-153 and 45x URL, 29-61, respectively). Subanalysis of
hs-cTnI illustrated assay-specific peak heights and kinetics, while
subanalysis of surgical strategies revealed 3-fold higher hs-cTnI than
hs-cTnT for on-pump CABG and 5-fold for off-pump CABG. CONCLUSION(S):
Postoperative hs-cTnI and hs-cTnT following CABG surpass most current
diagnostic cutoff values. hs-cTnI was almost 3-fold higher than hs-cTnT,
and appeared to be highly dependent on the assay used and surgical
strategy. There is a need for assay-specific hs-cTnI and hs-cTnT cutoff
values for accurate, timely identification of MI-5. Copyright @
American Association for Clinical Chemistry 2022.

<77>
Accession Number
636722208
Title
Incidence and prognosis of COVID-19 amongst heart transplant recipients: a
systematic review and meta-analysis.
Source
European journal of preventive cardiology. 29(6) (pp e224-e226), 2022.
Date of Publication: 06 May 2022.
Author
Ahmed F.; Abid M.; Maniya T.; Usman M.S.; Fudim M.
Institution
(Ahmed, Abid) Department of Medicine, Dow University of Health Sciences,
Mission Rd, Karachi 74200, Pakistan
(Maniya) Department of Medicine, Ziauddin University, Shahrah-e-Ghalib Rd,
Block 6 Clifton, Karachi 74200, Pakistan
(Usman) Department of Medicine, University of Mississippi Medical Center,
MS 39216, 2500 North State Street, Jackson, United States
(Fudim) Division of Cardiology, Duke University Medical Center, 2301 Ervin
Rd, Durham, United States
(Fudim) Duke Clinical Research Institute, Durham, United States
Publisher
NLM (Medline)

<78>
Accession Number
630596807
Title
Peritoneal dialysis for the prevention of fluid overload in infants after
cardiac surgery - A systematic review and meta-analysis.
Source
Saudi journal of kidney diseases and transplantation : an official
publication of the Saudi Center for Organ Transplantation, Saudi Arabia.
30(6) (pp 1222-1235), 2019. Date of Publication: 01 Nov 2019.
Author
Bhatt G.C.; Das R.R.; Chaudhary B.; Satapathy A.K.; Malik S.
Institution
(Bhatt, Malik) Department of Pediatrics, All India Institute of Medical
Sciences, Bhopal, Madhya Pradesh, India
(Das, Satapathy) Department of Pediatrics, All India Institute of Medical
Sciences, Bhubaneswar, Odisha, India
(Chaudhary) Department of Pediatrics, All India Institute of Medical
Sciences, Jodhpur, Rajasthan, India
Publisher
NLM (Medline)
Abstract
The objective is to compare peritoneal dialysis with standard care therapy
for the prevention of fluid overload in infants after cardiac surgery. We
searched published literature through the major database up to December
2017. Randomized controlled trials (RCTs), quasi-randomized trials, and
observational studies were included in the study. The primary outcome
measures were as follows: all-cause mortality and duration of
hospitalization. Of the 392-citation retrieved, full text of 7 was finally
assessed for eligibility. Of these, a total of five studies (RCTs = 3, and
observational studies = 2) were included. There was no significant
difference between the prophylactic PD and the standard therapy group for
any of the primary outcomes. The present systematic review shows that
prophylactic PD is not beneficial compared to standard care in infants
postcardiac surgery for congenital heart disease. The GRADE evidence
generated was of "very low quality."

<79>
Accession Number
629447588
Title
Annual number of candidates for transcatheter aortic valve implantation
per country: current estimates and future projections.
Source
European heart journal. 39(28) (pp 2635-2642), 2018. Date of Publication:
21 Jul 2018.
Author
Durko A.P.; Osnabrugge R.L.; Van Mieghem N.M.; Milojevic M.; Mylotte D.;
Nkomo V.T.; Pieter Kappetein A.
Institution
(Durko, Osnabrugge, Milojevic, Pieter Kappetein) Department of
Cardio-Thoracic Surgery, Erasmus University Medical Center, Netherlands
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Center, Netherlands
(Mylotte) Galway University Hospital, Newcastle Rd, Galway, Ireland
(Nkomo) Division of Cardiovascular Diseases, Mayo Clinic, 1216 2nd St SW
Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
Aims: The number of transcatheter aortic valve implantation (TAVI)
procedures is rapidly increasing. This has a major impact on health care
resource planning. However, the annual numbers of TAVI candidates per
country are unknown. The aim of this study was to estimate current and
future number of annual TAVI candidates in 27 European countries, the USA
and Canada. Methods and Results: Systematic literature searches and
meta-analyses were performed on aortic stenosis (AS) epidemiology and
decision-making in severe symptomatic AS. The incidence rate of severe AS
was determined. Findings were combined with population statistics and
integrated into a model employing Monte Carlo simulations to predict the
annual number of TAVI candidates. Various future scenarios and sensitivity
analyses were explored. Data from 37 studies (n=26402) informed the model.
The calculated incidence rate of severe AS was 4.4/year [95% confidence
interval (95% CI) 3.0-6.1] in patients>=65years. AS-related symptoms were
present in 68.3% (95% CI 60.8-75.9%) of patients with severe AS. Despite
having severe symptomatic AS, 41.6% (95% CI 36.9-46.3%) did not undergo
surgical aortic valve replacement. Of the non-operated patients, 61.7%
(95% CI 42.0-81.7%) received TAVI. The model predicted 114757 (95% CI
69380-172799) European and 58556 (95% CI 35631-87738) Northern-American
TAVI candidates annually. Conclusion(s): Currently, approximately
180000 patients can be considered potential TAVI candidates in the
European Union and in Northern-America annually. This number might
increase up to 270000 if indications for TAVI expand to low-risk patients.
These findings have major implications for health care resource planning
in the 29 individual countries.

<80>
[Use Link to view the full text]
Accession Number
628958029
Title
Quality of life in patients with advanced heart failure and an implanted
left ventricular assist device: an umbrella review protocol.
Source
JBI database of systematic reviews and implementation reports. 17(10) (pp
2115-2121), 2019. Date of Publication: 01 Oct 2019.
Author
Abrams D.; McNair M.
Institution
(Abrams, McNair) School of Nursing, University of Mississippi Medical
Center, Jackson, United States
(Abrams, McNair) Mississippi Centre for Evidence Based Practice: a Joanna
Briggs Institute Centre of Excellence
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This review aims to evaluate the effectiveness of implanted
left ventricular assist devices on quality of life in patients with
advanced heart failure. INTRODUCTION: Approximately 500,000 patients
worldwide are diagnosed with advanced heart failure. The preferred
treatment for patients who remain symptomatic after standard medical
treatment is heart transplantation. However, due to the shortage of donor
organs, left ventricular assist devices are increasingly used as an
alternative. This umbrella review is necessary to advise clinicians so
they may provide patients and families with clear information on standard
medical treatment, implanted left ventricular assist devices and heart
transplantation. INCLUSION CRITERIA: This umbrella review will consider
research syntheses that include patients 16 years or over with advanced
heart failure and an implanted left ventricular assist device. The primary
outcome is quality of life, and secondary outcomes include patient
survival rates and the New York Heart Association functional
classification changes. METHOD(S): An initial search of PubMed and
CINAHL has been undertaken to identify articles and create a search
strategy. Retrieved articles will be screened against the inclusion
criteria. Included studies will be critically appraised for methodological
quality according to JBI umbrella review methodology, and data will be
extracted using the standardized JBI data extraction tool. The results
will be presented in a Summary of Evidence, and a GRADE Summary of
Findings will be produced for grading the quality of the evidence.

<81>
Accession Number
625889456
Title
Clinical application and effect of dexmedetomidine in combination with
continuous positive airway pressure on one-lung ventilation in lung
surgery of elder patients.
Source
Pakistan journal of pharmaceutical sciences. 31(6) (pp 2879-2883), 2018.
Date of Publication: 01 Nov 2018.
Author
Lin J.; Li J.-B.; Lu Z.
Institution
(Lin, Li, Lu) Department of Anesthesiology, Zhangzhou Municipal Hospital
Affiliated to Fujian Medical University, Shengxi Road, Zhangzhou, Fujian,
China
Publisher
NLM (Medline)
Abstract
In this study, 126 elder patients who underwent thoracic surgery under
general anesthesia were divided into three groups randomly, i.e.
dexmedetomidine group, positive ventilation group and combination group.
All patients received varying strategies in addition to the one-lung
ventilation, and changes in oxidative stress and indicators of
inflammation at different time points were observed. In comparison to the
dexmedetomidine group and the positive ventilation group, patients in the
combination group at T2-3 had lower levels of malonaldehyde, cortisol,
C-reaction protein, interleukin-6 (IL-6) and tumor necrosis factor alpha
in serum (p<0.05); one day after surgery, the incidence of complications
in lungs of patients in the combination group was significantly lower than
those in the dexmedetomidine group and the positive ventilation group
(p<0.05). Dexmedetomidine in combination with continuous positive airway
pressure can alleviate the oxidative stress and inflammation of lung
tissues in one-lung ventilation during the thoracic surgery of elder
patients, thus, reducing the incidence of postoperative complications.

<82>
Accession Number
625207455
Title
Quality of life is not improved after mitral valve surgery combined with
epicardial left atrial cryoablation as compared with mitral valve surgery
alone: a substudy of the double blind randomized SWEDish Multicentre
Atrial Fibrillation study (SWEDMAF).
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 20(FI3)
(pp f343-f350), 2018. Date of Publication: 01 Nov 2018.
Author
Bagge L.; Probst J.; Jensen S.M.; Blomstrom P.; Thelin S.; Holmgren A.;
Blomstrom-Lundqvist C.
Institution
(Bagge, Probst, Blomstrom, Blomstrom-Lundqvist) Departments of Cardiology
and Medical Science, Uppsala University, Sweden
(Jensen) Faculty of Medicine, Department of Public Health and Clinical
Medicine (Heart centre) Umea University, SE-901 87 Umea, Sweden
(Thelin) Department of Cardiothoracic Surgery, Uppsala University, Uppsala
SE-751 85, Sweden
(Holmgren) Faculty of Medicine, Department of Public Health and Clinical
Medicine, Cardiology, Umea University, SE-901 87 Umea, Sweden
Publisher
NLM (Medline)
Abstract
Aims: Concomitant surgical ablation of atrial fibrillation (AF) in
patients undergoing mitral valve surgery (MVS) has almost become routine
despite lack of convincing information about improved quality-of-life
(QOL) and clinical benefit. Quality-of-life was therefore assessed after
MVS with or without epicardial left atrial cryoablation. Methods and
Results: Sixty-five patients with permanent AF randomized to MVS with or
without left atrial cryoablation, in the double-blinded multicentre
SWEDMAF trial, replied to the Short Form 36 QOL survey at 6 and 12months
follow-up. The QOL scores at 12month follow-up did not differ
significantly between patients undergoing MVS combined with cryoablation
vs. those undergoing MVS alone regarding Physical Component Summary mean
42.8 (95% confidence interval 38.3-47.3) vs. mean 44.0 (40.1-47.7),
P=0.700 or Mental Component Summary mean 53.1 (49.7-56.4) vs. mean 48.4
(44.6-52.2), P=0.075. All patients, irrespective of allocated procedure,
reached the same QOL after surgery as an age-matched Swedish general
population. The Physical Component Summary in patients with sinus rhythm
did also not differ from those in AF at 12months; mean 45.4 (42.0-48.7)
vs. mean 40.5 (35.5-45.6), P=0.096) nor was there a difference in Mental
Component Summary; mean 51.0 (48.0-54.1) vs. mean 49.6 (44.6-54.5),
P=0.581). Conclusion(s): Left atrial cryoablation added to MVS does
not improve health-related QOL in patients with permanent AF, a finding
that raises concerns regarding recommendations made for this combined
procedure.

<83>
Accession Number
643299316
Title
EFFECT OF PRE-OPERATIVE MULTIMEDIA PHYSICAL THERAPY PROGRAM IN OPEN HEART
SURGERY: A RANDOMIZED CONTROLLED STUDY.
Source
Cardiopulmonary Physical Therapy Journal. Conference: Combined Sections
Meeting of the American Physical Therapy Association, CSM 2024. Boston, MA
United States. 35(1) (pp a29-a30), 2024. Date of Publication: January
2024.
Author
Usupharach W.; Yasud M.; Songsaengrit B.; Donsom M.; Yasud P.; Chantawong
S.; Ekphaphan N.; Kittipanya-Ngam P.
Publisher
Lippincott Williams and Wilkins
Abstract
PURPOSE/HYPOTHESIS: Preoperative physical therapy is essential in
complication prevention and cardiopulmonary function improvement. However,
limited resources and medical personnel produce undesirable results. The
preoperative multimedia program would decrease these problems. Thus, this
study aimed to compare the effects of preoperative physical therapy
between multimedia and traditional programs in patients undergoing
open-heart surgery. NUMBER OF SUBJECTS: A pilot study with 20 participants
was done for sample size calculation. Thirty-five participants per group,
given a statistical power of 90%, were the number of participants in this
study. MATERIALS AND METHODS: This study was approved by the Center for
Ethics in Human Research, Khon Kaen University (HE631569). Physical
therapy preoperative multimedia was developed by the physical therapists
in cardiac rehabilitation team, and content was validated (IOC > 0.9) by
36 examiners, including physicians, physical therapists, and nurses.
Patients who planned open-heart surgery were included in the study.
Patients with lung disease, poor communication, and difficulties with
hearing or vision were excluded. Permuted block randomization with varying
sizes was used. Eligible patients were allocated into a self-learning
multimedia intervention and a traditional control group. All patients were
assessed for chest expansion (upper and lower chest expansion) by
measuring tape and medical history. Then patients in the intervention
group received a preoperative self-learning multimedia program, and
patients in the control group received a traditional preoperative program
from an experienced physical therapist. Patients in both groups received
the leaflet about breathing exercise, coughing/huffing with pillow
support, chest mobilization exercise, ankle pumping exercise, and early
mobilization. After completing the preoperative program, patients were
assessed for chest expansion and a preoperative knowledge questionnaire
for open heart surgery. Assessor was blinded in this study. The data
analysis was performed by IBM/SPSS version 28.0. The level of statistical
analysis was set as P < .05 for all analyses. RESULT(S): Seventy
patients were enrolled mean ages 58.1369.98 years and 64.3% male (35
patients per group). The upper and lower chest expansion pre-and post-
preoperative program showed significant increase within the control and
intervention groups (P < .001). There were no statistically significant
differences in mean difference between groups in upper chest expansion (P
= .59) and lower chest expansion (P = .42). The questionnaire's knowledge
score was not different between groups (P = .07). CONCLUSION(S): A
preoperative selflearning multimedia physical therapy program clinically
benefits patients who plan for open heart surgery. CLINICAL RELEVANCE:
Patients planning open heart surgery will get an effective preoperative
program in a hospital with limited staff or during a respiratory tract
infection outbreak. Moreover, the program can be learned and practiced as
often as needed at home.

<84>
Accession Number
2029951807
Title
Role of vitamin D supplementation in modifying outcomes after surgery: A
systematic review of randomised controlled trials.
Source
BMJ Open. 14(1) (no pagination), 2024. Article Number: e073431. Date of
Publication: 17 Jan 2024.
Author
Patel A.; Caruana E.J.; Hodson J.; Morrison R.; Khor B.; Gysling S.;
Trevis J.; Mangel T.; Benson R.; Zakeri R.; Manders J.; Vaja R.; Rogers
L.; Baker P.; Pournaras D.J.; Thickett D.; Hewison M.; Naidu B.; Lim E.
Institution
(Patel) Institute of Immunology and Immunotherapy, University of
Birmingham, Birmingham, United Kingdom
(Patel, Naidu) Department of Thoracic Surgery, University Hospitals
Birmingham, Birmingham, United Kingdom
(Caruana) Department of Thoracic Surgery, Glenfield Hospital, Leicester,
United Kingdom
(Hodson) Research Development and Innovation, University Hospitals
Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(Morrison, Baker) Department of Orthopaedic Surgery, South Tees NHS
Foundation Trust, Nottingham, United Kingdom
(Khor) Department of Colorectal Surgery, University Hospitals Birmingham,
Nottingham, United Kingdom
(Gysling) Department of Academic Colorectal Surgery, Nottingham University
Hospitals NHS Trust, Nottingham, United Kingdom
(Trevis) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom
(Mangel) Department of Cardiothoracic Surgery, Bart's Heart Centre,
London, United Kingdom
(Benson) Department of Vascular Surgery, University of Otago,
Christchurch, New Zealand
(Zakeri, Pournaras) Department of Upper GI Bariatric and Metabolic
Surgery, North Bristol NHS Trust, Westbury on Trym, United Kingdom
(Manders) University Hospitals Birmingham NHS Foundation Trust,
Birmingham, United Kingdom
(Vaja) Department of Cardiovascular Sciences Surgery, Imperial College
London, London, United Kingdom
(Rogers) Department of Cardiac Surgery, University Hospitals Bristol,
Bristol, United Kingdom
(Baker) University of Teeside, Middlesbrough, United Kingdom
(Thickett, Naidu) Institute of Inflammation and Ageing, University of
Birmingham, Birmingham, United Kingdom
(Hewison) Institute of Metabolism and Systems Research, University of
Birmingham, Birmingham, United Kingdom
(Lim) Department of Thoracic Surgery, Royal Brompton Hospital, London,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background There is increasing evidence to suggest vitamin D plays a role
in immune and vascular function; hence, it may be of biological and
clinical relevance for patients undergoing major surgery. With a greater
number of randomised studies being conducted evaluating the impact of
vitamin D supplementation on surgical patients, it is an opportune time to
conduct further analysis of the impact of vitamin D on surgical outcomes.
Methods MEDLINE, EMBASE and the Cochrane Trials Register were interrogated
up to December 2023 to identify randomised controlled trials of vitamin D
supplementation in surgery. The risk of bias in the included studies was
assessed using the Cochrane Risk of Bias tool. A narrative synthesis was
conducted for all studies. The primary outcome assessed was overall
postoperative survival. Results We screened 4883 unique studies, assessed
236 full-text articles and included 14 articles in the qualitative
synthesis, comprising 1982 patients. The included studies were highly
heterogeneous with respect to patient conditions, ranging from open heart
surgery to cancer operations to orthopaedic conditions, and also with
respect to the timing and equivalent daily dose of vitamin D
supplementation (range: 0.5-7500 mcg; 20-300 000 IU). No studies reported
significant differences in overall survival or postoperative mortality
with vitamin D supplementation. There was also no clear evidence of
benefit with respect to overall or intensive care unit length of stay.
Discussion Numerous studies have reported the benefits of vitamin D
supplementation in different surgical settings without any consistency.
However, this systematic review found no clear evidence of benefit, which
warrants the supposition that a single biological effect of vitamin D
supplementation does not exist. The observed improvement in outcomes in
low vitamin D groups has not been convincingly proven beyond chance
findings. Trial registration number CRD42021232067. Copyright ©
2024 Author(s). Published by BMJ.

<85>
Accession Number
2028066412
Title
Developments and Challenges in Durable Ventricular Assist Device
Technology: A Comprehensive Review with a Focus on Advancements in China.
Source
Journal of Cardiovascular Development and Disease. 11(1) (no pagination),
2024. Article Number: 29. Date of Publication: January 2024.
Author
Tu J.; Xu L.; Li F.; Dong N.
Institution
(Tu, Xu, Li, Dong) Department of Cardiovascular Surgery, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
1277 Jiefang Ave, Wuhan 430022, China
(Li) Fuwai Yunnan Cardiovascular Hospital, Kunming Medical University, 528
Shahebei Rd, Kunming 650500, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Heart transplantation is currently the most effective treatment for
end-stage heart failure; however, the shortage in donor hearts constrains
the undertaking of transplantation. Mechanical circulatory support (MCS)
technology has made rapid progress in recent years, providing diverse
therapeutic options and alleviating the dilemma of donor heart shortage.
The ventricular assist device (VAD), as an important category of MCS,
demonstrates promising applications in bridging heart transplantation,
destination therapy, and bridge-to-decision. VADs can be categorized as
durable VADs (dVADs) and temporary VADs (tVADs), according to the duration
of assistance. With the technological advancement and clinical application
experience accumulated, VADs have been developed in biocompatible,
lightweight, bionic, and intelligent ways. In this review, we summarize
the development history of VADs, focusing on the mechanism and application
status of dVADs in detail, and further discuss the research progress and
use of VADs in China. Copyright © 2024 by the authors.

<86>
Accession Number
2028066411
Title
Transcatheter Aortic Valve Implantation Access Sites: Same Goals, Distinct
Aspects, Various Merits and Demerits.
Source
Journal of Cardiovascular Development and Disease. 11(1) (no pagination),
2024. Article Number: 4. Date of Publication: January 2024.
Author
Katsaros O.; Apostolos A.; Ktenopoulos N.; Koliastasis L.; Kachrimanidis
I.; Drakopoulou M.; Korovesis T.; Karanasos A.; Tsalamandris S.; Latsios
G.; Synetos A.; Tsioufis K.; Toutouzas K.
Institution
(Katsaros, Apostolos, Ktenopoulos, Koliastasis, Kachrimanidis,
Drakopoulou, Korovesis, Karanasos, Latsios, Synetos, Tsioufis, Toutouzas)
First Department of Cardiology, National and Kapodistrian University of
Athens, Hippokration General Hospital of Athens, Athens 11527, Greece
(Koliastasis) Department of Cardiology, University of Brussels, CHU
Saint-Pierre, Brussels 1000, Belgium
(Tsalamandris) Department of Cardiology, Hippokration General Hospital of
Athens, Athens 11527, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation (TAVI) has been established as a
safe and efficacious treatment for patients with severe symptomatic aortic
stenosis (AS). Despite being initially developed and indicated for
high-surgical-risk patients, it is now offered to low-risk populations
based on the results of large randomized controlled trials. The most
common access sites in the vast majority of patients undergoing TAVI are
the common femoral arteries; however, 10-20% of the patients treated with
TAVI require an alternative access route, mainly due to peripheral
atherosclerotic disease or complex anatomy. Hence, to achieve successful
delivery and implantation of the valve, several arterial approaches have
been studied, including transcarotid (TCr), axillary/subclavian (A/Sc),
transapical (TAp), transaortic (TAo), suprasternal-brachiocephalic (S-B),
and transcaval (TCv). This review aims to concisely summarize the most
recent literature data and current guidelines as well as evaluate the
various access routes for TAVI, focusing on the indications, the various
special patient groups, and the advantages and disadvantages of each
technique, as well as their adverse events. Copyright © 2023 by
the authors.

<87>
Accession Number
2029622548
Title
Hybrid Cardiac Rehabilitation Program in a Low-Resource Setting A
Randomized Clinical Trial.
Source
JAMA Network Open. (no pagination), 2024. Article Number: e2350301. Date
of Publication: 2024.
Author
Seron P.; Oliveros M.J.; Marzuca-Nassr G.N.; Morales G.; Roman C.; Munoz
S.R.; Galvez M.; Latin G.; Marileo T.; Molina J.P.; Navarro R.; Sepulveda
P.; Lanas F.; Saavedra N.; Ulloa C.; Grace S.L.
Institution
(Seron, Oliveros, Marzuca-Nassr, Sepulveda, Ulloa) Facultad de Medicina,
Departamento de Ciencias de la Rehabilitacion, Universidad de La Frontera,
Temuco, Chile
(Seron, Oliveros, Lanas) Centro de Excelencia CIGES, Universidad de La
Frontera, Temuco, Chile
(Grace) York University, University Health Network, University of Toronto,
Toronto, ON, Canada
(Morales, Munoz) Facultad de Medicina, Departamento de Salud Publica,
Universidad de La Frontera, Temuco, Chile
(Roman) Facultad de Medicina, Escuela de Kinesiologia, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Galvez) Unidad de Kinesiologia, Complejo Hospitalario San Jose, Santiago,
Chile
(Latin) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico,
Hospital San Borja Arriaran, Santiago, Chile
(Marileo) Unidad de Rehabilitacion Cardiaca, Hospital Regional de
Antofagasta, Antofagasta, Chile
(Molina) Servicio de Medicina Fisica y Rehabilitacion, Hospital San Juan
de Dios, Santiago, Chile
(Navarro) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico
Universidad de Chile, Santiago, Chile
(Lanas) Facultad de Medicina, Departamento de Medicina Interna,
Universidad de La Frontera, Temuco, Chile
(Saavedra) Facultad de Medicina, Departamento de Ciencias Basicas,
Universidad de La Frontera, Temuco, Chile
Publisher
American Medical Association
Abstract
Importance: While effective, cardiovascular rehabilitation as
traditionally delivered is notwell implemented in lower-resource settings.
 Objective(s): To test the noninferiority of hybrid CR compared with
traditional CR in terms of cardiovascular events. Design, Setting,
and Participant(s): This pragmatic, multicenter, parallel arm, open-label
randomized clinical trial (the Hybrid Cardiac Rehabilitation Trial
[HYCARET]) with blinded outcome assessment was conducted at 6 referral
centers in Chile. Adults aged 18 years or older who had a cardiovascular
event or procedure, no contraindications to exercise, and access to a
mobile telephonewere eligible and recruited between April 1, 2019, and
March 15, 2020, with follow-up until July 29, 2021. Intervention(s):
Participants were randomized 1:1 in permuted blocks to the experimental
arm, which received 10 center-based supervised exercise sessions plus
counseling in 4 to 6 weeks and then were supported at home via telephone
calls and text messages through weeks 8 to 12, or the control arm, which
received the standard CR of 18 to 22 sessions with exercises and education
in 8 to 12 weeks. Main Outcomes and Measures: The primary outcome was
cardiovascular events or mortality. Secondary outcomes were quality of
life, return to work, and lifestyle behaviors measured with validated
questionnaires; muscle strength and functional capacity, measured through
physical tests; and program adherence and exercise-related adverse events,
assessed using checklists. Result(s): A total of 191 participants
were included (mean [SD] age, 58.74 [9.80] years; 145 [75.92%] male); 93
were assigned to hybrid CR and 98 to standard CR. At 1 year, events had
occurred in 5 unique participants in the hybrid CR group (5.38%) and 9 in
the standard CR group (9.18%). In the intention-to-treat analysis, the
hybrid CR group had 3.80% (95% CI, -11.13% to 3.52%) fewer cardiovascular
events than the standard CR group, and relative risk was 0.59 (95% CI,
0.20-1.68) for the primary outcome. In the per-protocol analysis at
different levels of adherence to the intervention, all 95% CIs crossed the
noninferiority boundary (eg, 20% adherence: absolute risk difference,
-0.35% [95% CI, -7.56% to 6.85%]; 80% adherence: absolute risk difference,
3.30% [95% CI, -3.70% to 10.31%]). No between-group differences were found
for secondary outcomes except adherence to supervised CR sessions (79.14%
[736 of 930 supervised sessions] in the hybrid CR group vs 61.46% [1201 of
1954 sessions] in the standard CR group). Conclusions and Relevance:
The results suggest that a hybrid CR program is noninferior to standard
center-based CR in a low-resource setting, primarily in terms of recurrent
cardiovascular events and potentially in terms of intermediate outcomes.
Hybrid CR may induce superior adherence to supervised exercise. Clinical
factors and patient preferences should inform CR model
allocation. Copyright © 2024 American Medical Association. All
rights reserved.

<88>
Accession Number
2028061486
Title
Transcatheter aortic valve durability, predictors of bioprosthetic valve
dysfunction, longer-term outcomes-a review.
Source
Expert Review of Medical Devices. (no pagination), 2023. Date of
Publication: 2023.
Author
Solc A.J.; Linkova H.; Tousek P.
Institution
(Solc, Linkova) Third Faculty of Medicine, Charles University, Prague,
Czechia
(Solc, Linkova) Department of Cardiology, University Hospital Kralovske
Vinohrady, Prague, Czechia
(Tousek) Department of Cardiology, Third Faculty of Medicine, University
Hospital Kralovske Vinohrady, Charles University, Prague, Czechia
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is one of the
most significant inventions in cardiology, as it provides a viable
minimally invasive treatment option for patients with aortic stenosis, the
most common valvular disease in the developed world and one with a poor
prognosis when left untreated. Using data available to date, this review
aims to discuss and identify possible predictors of TAVI valve
durability-an essential requirement for the device's wide-spread use,
especially in younger patients. Areas covered: This article explores the
main causes of bioprosthetic valve dysfunction (BVD) based on
pathophysiology and available data, and reviews possible predictors of BVD
including prosthesis-related, procedure-related, and patient-related
factors. An emphasis is made on affectable predictors, which could
potentially be targeted with prevention management and improve valve
durability. A literature search of online medical databases was conducted
using relevant key words and dates; significant clinical trials were
identified. A brief overview of important randomized controlled trials
with mid to long-term follow-up is included in this article. Expert
opinion: Identifying modifiable predictors of valve dysfunction presents
an opportunity to enhance and predict valve durability-a necessity as
patients with longer life-expectancies are being considered for the
procedure. Copyright © 2023 Informa UK Limited, trading as Taylor
& Francis Group.

<89>
Accession Number
2029785806
Title
Preoperative computed tomography-imaging with patient-specific computer
simulation in transcatheter aortic valve implantation: Design and
rationale of the GUIDE-TAVI trial.
Source
American Heart Journal. 269 (pp 158-166), 2024. Date of Publication: March
2024.
Author
Hegeman R.R.M.J.J.; van Ginkel D.-J.; Laengle S.; Timmers L.; Rensing
B.J.W.M.; de Kroon T.L.; Sonker U.; Kelder J.C.; Mach M.; Andreas M.;
Swaans M.J.; ten Berg J.M.; Klein P.
Institution
(Hegeman, de Kroon, Sonker, Klein) Department of Cardiothoracic Surgery,
Sint Antonius Hospital, Nieuwegein, Netherlands
(van Ginkel, Timmers, Rensing, Swaans, ten Berg) Department of Cardiology,
Sint Antonius Hospital, Nieuwegein, Netherlands
(Laengle, Mach, Andreas) Department of Cardiothoracic Surgery, Medical
University of Vienna, Vienna, Austria
(Kelder) Department of Epidemiology, Sint Antonius Hospital, Nieuwegein,
Netherlands
(ten Berg) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Hegeman, Klein) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Mach) Department of Cardiovascular Surgery, Heart Center Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Germany
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an
established treatment option for patients with severe aortic valve
stenosis, but is still associated with relatively high rates of pacemaker
implantation and paravalvular regurgitation. Routine preoperative computed
tomography (CT) combined with patient-specific computer modelling can
predict the interaction between the TAVI device and the patient's unique
anatomy, allowing physicians to assess the risk for paravalvular
regurgitation and conduction disorders in advance to the procedure. The
aim of this trial is to assess potential improvement in the procedural
outcome of TAVI by applying CT-based patient-specific computer simulations
in patients with suitable anatomy for TAVI. Method(s): The GUIDE-TAVI
trial is an international multicenter randomized controlled trial
including patients accepted for TAVI by the Heart Team. Patients enrolled
in the study will be randomized into 2 arms of each 227 patients. In
patients randomized to the use of FEops HEARTGuide (FHG), patient-specific
computer simulation with FHG is performed in addition to routine
preoperative CT imaging and results of the FHG are available to the
operator(s) prior to the scheduled intervention. In patients randomized to
no use of FHG, only routine preoperative CT imaging is performed. The
primary objective is to evaluate whether the use of FHG will reduce the
incidence of mild to severe PVR, according to the Valve Academic Research
Consortium 3. Secondary endpoints include the incidence of new conduction
disorders requiring permanent pacemaker implantation, the difference
between preoperative and final selected valve size, the difference between
target and final implantation depth, change of preoperative decision,
failure to implant valve, early safety composite endpoint and quality of
life. Conclusion(s): The GUIDE-TAVI trial is the first multicenter
randomized controlled trial to evaluate the value of 3-dimensional
computer simulations in addition to standard preprocedural planning in
TAVI procedures. Copyright © 2023 Elsevier Inc.

<90>
Accession Number
2029692223
Title
Health-related quality of life following TAVI or cardiac surgery in
patients at intermediate and low risk: a systematic review and
meta-analysis.
Source
Clinical Medicine, Journal of the Royal College of Physicians of London.
23(6) (pp 594-605), 2023. Date of Publication: November 2023.
Author
Gonnah A.R.; Abdelwahab M.; Taylor R.; Labib A.; Masoud O.; Debski M.;
Abdelaziz H.K.; Roberts D.H.
Institution
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Abdelwahab) Boston University, Boston, MA, United States
(Taylor) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Labib) Southport and Ormskirk NHS Foundation Trust, Southport, United
Kingdom
(Masoud) University College London Hospitals NHS Foundation Trust, London,
United Kingdom
(Debski) University of East Anglia, Norwich, United Kingdom
(Debski) Norfolk and Norwich University Hospital, Norwich, United Kingdom
(Abdelaziz, Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) University of Liverpool, Merseyside, Liverpool, United Kingdom
Publisher
Royal College of Physicians
Abstract
Recent randomised trials have shown that clinical outcomes with
transcatheter aortic valve implantation (TAVI) are non-inferior to
surgical aortic valve replacement (SAVR) in patients with symptomatic
aortic stenosis at intermediate to low risk. Health-related quality of
life (HrQoL) outcomes in these patient groups remain uncertain. A
systematic search of the literature was conducted that included nine
trials and 11,295 patients. Kansas City Cardiomyopathy Questionnaire
(KCCQ), a heart-failure-specific measure and EuroQol-5D (EQ-5D) (a generic
health status tool) changes were the primary outcomes. New York Heart
Association (NYHA) classification was the secondary outcome. Improvement
in KCCQ scores was greater with TAVI (mean difference (MD)=13.56, 95%
confidence interval (CI) 11.67-15.46, p<0.001) at 1 month, as was the
improvement in EQ-5D (MD=0.07, 95% CI 0.05-0.08, p<0.001). There was no
difference in KCCQ (MD=1.05, 95% CI -0.11 to 2.21, p=0.08) or EQ-5D
(MD=-0.01, 95% CI -0.03 to 0.01), p=0.37) at 12 months. NYHA functional
class 3/4 was lower in patients undergoing TAVI at 1 month (MD=0.51, 95%
CI 0.34-0.78, p=0.002), but there was no difference at 12 months (MD=1.10;
95% CI 0.87-1.38, p=0.43). Overall, TAVI offers early benefit in HRQoL
outcomes compared with SAVR, but they are equivalent at 12
months. Copyright © Royal College of Physicians 2023. All rights
reserved.

<91>
Accession Number
2029626198
Title
Clinical application of esketamine-induced mild sedation technique in
outpatient oral surgery.
Source
Anaesthesia, Pain and Intensive Care. 27(6) (pp 715-720), 2023. Date of
Publication: 01 Dec 2023.
Author
Xin Z.; Yu T.; Wang L.L.; Qu W.; Wang N.; Yao M.
Institution
(Xin, Wang, Wang) Department of Anesthesiology, Yantai Stomatology
Hospital of Binzhou Medical University, Shandong, Yantai 264000, China
(Yu, Qu) Department of Oral and Maxillofacial Surgery, Yantai Stomatology
Hospital of Binzhou Medical University, Shandong, Yantai 264000, China
(Yao) Department of Clinical laboratory, Yantai Stomatology Hospital of
Binzhou Medical University, Shandong, Yantai 264000, China
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & Objective: Sedation is often required in outpatient surgical
procedures, performed under local analgesia, to allay the anxiety of the
patient, which may lead to involuntary movements of the patient, thus
interfering in the smooth course of the surgery. Various sedative drugs
have been used by the anesthetists. We compared the effects of mild
sedation techniques induced by remifentanil combined with propofol and
esketamine combined with propofol on the cardiopulmonary indices of
intraoperative patients, and to explore the application of mild sedation
techniques in oral outpatient surgery. Methodology: A total of 62 patients
undergoing oral surgery were randomly divided into a control group (31
cases, receiving remifentanil combined with propofol) and an observation
group (31 cases, receiving esketamine combined with propofol). The vital
signs of the patients were monitored at five time points: admission (T0),
anesthesia induction (T1), local anesthesia (T2), the beginning of surgery
(T3), and the end of surgery (T4), including heart rate (HR), mean
arterial pressure(MAP), bispectral index (BIS), respiratory rate, and
oxygen saturation(SPO2). Postoperative memory of each step was recorded,
and the sedative effect was evaluated by physician and patient using the
visual analogue scale (VAS). Result(s): During surgery, 6 patients in
the control group had SpO2 < 90%, and 8 patients experienced coughing or
tongue fall, while 1 patient in the observation group had a transient
increase in blood pressure. After intravenous administration, all patients
had a decrease in HR, and the decrease in the observation group was
significantly less than that in the control group (P < 0.05). The BIS
values in the observation group were significantly higher than those in
the control group during T2 and T3. Conclusion(s): In oral outpatient
surgery, the combination of propofol and esketamine-induced mild sedation
can stabilize the hemodynamic indices of patients during surgery, reduce
the incidence of complications, and improve patient
satisfaction. Copyright © 2023 Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<92>
Accession Number
2028352177
Title
Bioprosthetic leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Archives of Cardiovascular Diseases. 116(12) (pp 563-571), 2023. Date of
Publication: December 2023.
Author
Roule V.; Guedeney P.; Silvain J.; Beygui F.; Zeitouni M.; Sorrentino S.;
Kerneis M.; Barthelemy O.; Beaupre F.; Portal J.-J.; Vicaut E.;
Montalescot G.; Collet J.-P.
Institution
(Roule, Guedeney, Silvain, Zeitouni, Kerneis, Barthelemy, Beaupre,
Montalescot, Collet) ACTION Study Group, Sorbonne Universite, UMRS 1166,
Institut de Cardiologie, Pitie-Salpetriere Hospital (AP-HP), Paris 75013,
France
(Roule, Beygui) Service de Cardiologie, CHU de Caen Normandie, Normandie
Universite, Caen 14000, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Science, Magna Graecia University, Catanzaro 88100, Italy
(Portal, Vicaut) ACTION Study Group, Unite de Recherche Clinique,
Lariboisiere Hospital, AP-HP, Paris 75010, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Leaflet thrombosis and reduced leaflet motion have become a
concern with the expanding use of transcatheter aortic valve replacement
in lower-risk patients. Aim(s): To assess the proportions, predictors
and clinical impact of leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement. Method(s): We performed a
meta-analysis of studies assessing the proportions of and/or clinical
outcomes according to the presence of leaflet thrombosis after
transcatheter aortic valve replacement identified with computed tomography
and/or echocardiography. Result(s): Fifty-three studies, representing
25,258 patients undergoing transcatheter aortic valve replacement, were
considered. The proportion of leaflet thrombosis was 5.2% overall, and was
higher in computed tomography versus echocardiography (16.4% vs. 1.1%,
respectively); reduced leaflet motion was identified in 11% of patients
with four-dimensional computed tomography. Intra-annular bioprostheses
were associated with a higher proportion of leaflet thrombosis, whereas
chronic oral anticoagulation was protective for leaflet thrombosis in both
computed tomography and echocardiographic studies (9.7% vs. 17.5%;
relative risk [RR]: 0.51, 95% confidence interval [95% CI]: 0.37-0.71 and
0.9% vs. 2.7%; RR: 0.22, 95% CI: 0.06-0.79, respectively) and for reduced
leaflet motion (2.5% vs. 12.4%; RR: 0.32, 95% CI: 0.13-0.76). Leaflet
thrombosis was not associated with an increased risk of death, but with a
higher risk of stroke in computed tomography studies (2.8% vs. 2.4%; RR:
1.63, 95% CI: 1.05-2.55), a difference more pronounced when considering
reduced leaflet motion (3.5% vs. 1.7%; RR: 2.39, 95% CI: 0.63-8.34).
 Conclusion(s): The proportion of leaflet thrombosis is highly
variable according to the screening approach, the type of valve and the
use of oral anticoagulation. The occurrence of cerebral events is
increased when leaflet thrombosis and/or reduced leaflet motion are
diagnosed, but leaflet thrombosis has no impact on survival. Copyright
© 2023 Elsevier Masson SAS

<93>
Accession Number
2027984223
Title
Randomized evaluation of 5-month Ticagrelor monotherapy after 1-month
dual-antiplatelet therapy in patients with acute coronary syndrome treated
with drug-coated balloons: REC-CAGEFREE II trial rationale and design.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
62. Date of Publication: December 2024.
Author
Gao C.; Zhu B.; Liu J.; Jiang Z.; Hu T.; Wang Q.; Liu Y.; Yuan M.; Li F.;
Zhang R.; Xia J.; Onuma Y.; Wang D.; Serruys P.; Tao L.
Institution
(Gao, Zhu, Liu, Hu, Wang, Liu, Yuan, Li, Zhang, Tao) Department of
Cardiology, Xijing Hospital, Changle West Road, Xi'an 710032, China
(Jiang) Beijing KeyTech Statistical Consulting Co., Beijing 100015, China
(Xia) Department of Statistics, Air Force Medical University, Xi'an
710000, China
(Onuma, Serruys) Department of Cardiology, University of Galway, Galway
H91 TK33, Ireland
(Wang) Biostatistics Unit, Liverpool School of Tropical Medicine,
Liverpool L3 5QA, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Patients treated with drug-coated balloons (DCB) have the
theoretical advantage of adopting a low-intensity antiplatelet regimen due
to the absence of struts and polymers. Nevertheless, the optimal
antiplatelet strategy for patients undergoing DCB-only treatment remains a
topic of debate and has not been investigated in randomized trials.
 Method(s): The REC-CAGEFREE II is an investigator-initiated,
prospective, open-label, multi-center, randomized, non-inferiority trial
aimed to enroll 1908 patients from >= 40 interventional cardiology centers
in China to evaluate the non-inferiority of an antiplatelet regimen
consisting of Aspirin plus Ticagrelor for one month, followed by five
months Ticagrelor monotherapy, and then Aspirin monotherapy for six months
(Experimental group) compared to the conventional treatment of Aspirin
plus Ticagrelor for 12 months (Reference group) in patients with acute
coronary syndrome (ACS) who have undergone percutaneous coronary
intervention (PCI) using paclitaxel-coated balloons (DCB) exclusively.
Participants will be randomly assigned to the Experimental or Reference
group in a 1:1 ratio. The randomization will be stratified based on the
center and the type of lesion being treated (De novo or in-stent
restenosis). The primary endpoint is net adverse clinical events (NACE)
within 12 months of PCI, which includes the composite of all-cause death,
any stroke, any myocardial infarction, any revascularization and Bleeding
Academic Research Consortium (BARC) defined type 3 or 5 bleeding. The
secondary endpoint, any ischemic and bleeding event, which includes
all-cause death, any stroke, MI, BARC-defined type 3 bleeding, any
revascularization, and BARC-defined type 2 bleeding events, will be
treated as having hierarchical clinical importance in the above order and
analyzed using the win ratio method. Discussion(s): The ongoing
REC-CAGEFREE II trial aims to assess the efficacy and safety of a
low-intensity antiplatelet approach among ACS patients with DCB. If
non-inferiority is shown, the novel antiplatelet approach could provide an
alternative treatment for ACS patients with DCB. Trial registration:
ClinicalTrials.gov identifier: NCT04971356. Copyright © 2024, The
Author(s).

<94>
Accession Number
2027969467
Title
Efficacy of ultrasound-guided erector spinae plane block on analgesia and
quality of recovery after minimally invasive direct coronary artery bypass
surgery: protocol for a randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 65. Date of
Publication: December 2024.
Author
Xin L.; Wang L.; Feng Y.
Institution
(Xin, Wang, Feng) Department of Anesthesiology, Peking University People's
Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive direct coronary artery bypass (MIDCAB)
surgery offers an effective option for coronary artery disease (CAD)
patients with the avoidance of median sternotomy and fast postoperative
recovery. However, MIDCAB is still associated with significant
postoperative pain which may lead to delayed recovery. The erector spinae
plane block (ESPB) is a superficial fascial plane block. There have not
been randomized controlled trials evaluating the effects of ESPB on
analgesia and patient recovery following MIDCAB surgery. We therefore
designed a double-blind prospective randomized placebo-controlled trial,
aiming to prove the hypothesis that ESPB reduces postoperative pain scores
in patients undergoing MIDCAB surgery. Method(s): The study protocol
has been reviewed and approved by the Ethical Review Committee of Peking
University People's Hospital. Sixty adult patients of either sex scheduled
for MIDCAB surgery under general anesthesia (GA) will be included.
Patients will be randomly allocated to receive either a preoperative
single-shot ESPB with 30 mL of ropivacaine 0.5% (ESPB group) or normal
saline 0.9% (control group). The primary outcomes are the difference
between the two groups in numeric rating scale (NRS) scores at rest at
different time points (6, 12, 18, 24, 48 h) after surgery. The secondary
outcomes include NRS scores on deep inspiration within 48 h, postoperative
hydromorphone consumption, and quality of patient recovery at 24 h and 48
h, using the Quality of Recovery-15 (QoR-15) scale. The other outcomes
include intraoperative fentanyl requirements, the need for additional
postoperative rescue analgesics, time to tracheal extubation and chest
tube removal after surgery, incidence of postoperative nausea and vomiting
(PONV) and postoperative cognitive dysfunction (POCD), intensive care unit
(ICU) length of stay (LOS), hospital discharge time, and 30-day mortality.
Adverse events will be also evaluated. Discussion(s): This is a novel
randomized controlled study evaluating a preoperative ultrasound-guided
single-shot unilateral ESPB on analgesia and quality of patient recovery
in MIDCAB surgery. The results of this study will characterize the degree
of acute postoperative pain and clinical outcomes following MIDCAB. Our
study may help optimizing analgesia regimen selection and improving
patient comfort in this specific population. Trial registration: The study
was prospectively registered with the Chinese Clinical Trial Registry
(trial identifier: ChiCTR2100052810). Date of registration: November 5,
2021. Copyright © 2024, The Author(s).

<95>
Accession Number
2027819374
Title
Comparison of mid-term mortality after surgical, supported or unsupported
percutaneous revascularization in patients with severely reduced ejection
fraction: A direct and network meta-analysis of adjusted observational
studies and randomized-controlled.
Source
International Journal of Cardiology. 396 (no pagination), 2024. Article
Number: 131428. Date of Publication: 01 Feb 2024.
Author
Iannaccone M.; Barbero U.; Franchin L.; Montabone A.; De Filippo O.;
D'ascenzo F.; Boccuzzi G.; Panoulas V.; Hill J.; Brilakis E.S.; Chieffo A.
Institution
(Iannaccone, Montabone, Boccuzzi) Division of Cardiology, San Giovanni
Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, SS. Annunziata Savigliano, ASL CN 1,
Savigliano, Italy
(Franchin) Cardiothoracic Department, Division of Cardiology, Azienda
Sanitaria Universitaria Friuli Centrale, Udine, Italy
(De Filippo, D'ascenzo) Cardiovascular and Thoracic Department, Division
of Cardiology, A. O. U. Citta della Salute e della Scienza, Turin, Italy
(Panoulas, Hill) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital,
Harefield, London UB9 6BJ, United Kingdom
(Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Chieffo) Vita-Salute San Raffaele University, Milan, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: The optimal revascularization strategy in patients with
heart failure with reduced ejection fraction (HFrEF) remains to be
elucidated. The aim of this paper is to compare the mid-term mortality
rate among patients with severely reduced ejection fraction (EF) and
complex coronary artery disease who underwent coronary artery bypass
grafting (CABG), percutaneous coronary intervention (PCI) with Impella
support, or without. Method(s): Randomized control trials and
propensity-adjusted observational studies including patients with ischemic
cardiomyopathy (ICM) and severe EF reduction undergoing revascularization
were selected. Different revascularization strategies (CABG, supported
PCI, and PCI without Impella) were compared in pairwise and network
meta-analysis. The primary endpoint was mid-term mortality (within the
first year after revascularization). Result(s): Fifteen studies,
mostly observational (17,841 patients; 6779 patients treated with CABG,
8478 treated with PCI without Impella, and 2584 treated with
Impella-supported PCI) were included in this analysis. The median age was
67.8 years (IQR 65-70.1), 21.2% (IQR 16.4-26%) of patients were female
sex, and a high prevalence of cardiovascular risk factors was noted across
the entire population. At pairwise analysis, CABG and PCI without Impella
showed similar one-year all-cause mortality (10.6% [IQR 7.5-12.6%] vs 12%
[IQR 8.4-11.5%]) RR 0.85 CI 0.67-1.09, while supported PCI reduced
one-year all-cause mortality compared to PCI without Impella (9.4% [IQR
5.7-12.5%] vs 10.6% [IQR 8.9-10.7%]) RR 0.77 CI 0.6-0.89. At network
meta-analysis, supported PCI showed better results (RR 0.75, 95% CI
0.59-0.94) compared to CABG. Conclusion(s): Our analysis found that
supported PCI may have a benefit over standard PCI in patients in direct
comparison, and over CABG from indirect comparison, and with HFrEF
undergoing revascularization. Further RCTs are needed to confirm this
result. (PROSPERO CRD42023425667). Copyright © 2023 Elsevier B.V.

<96>
Accession Number
2029932692
Title
Comparative Effect of High-Frequency Nasal Cannula and Noninvasive
Ventilation on the Work of Breathing and Postoperative Pulmonary
Complication after Pediatric Congenital Cardiac Surgery: A Prospective
Randomized Controlled Trial.
Source
Annals of Cardiac Anaesthesia. 27(1) (pp 43-50), 2024. Date of
Publication: 2024.
Author
Goel A.; Kumar B.; Negi S.; Mahajan S.; Puri G.D.; Khan W.A.
Institution
(Goel, Kumar, Negi, Puri, Khan) Departments of Anesthesia and Intensive
Care, Postgraduate Institute of Medical Education and Research,
Chandigarh, India
(Mahajan) Cardiothoracic and Vascular Surgery, Postgraduate Institute of
Medical Education and Research, Chandigarh, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Various forms of commonly used noninvasive respiratory support
strategies have considerable effect on diaphragmatic contractile function
which can be evaluated using sonographic diaphragm activity parameters.
 Objective(s): To compare the magnitude of respiratory workload
decreased as assessed by thickening fraction of the diaphragm and
longitudinal diaphragmatic strain while using high-flow nasal cannula
(HFNC) and noninvasive ventilation (NIV) modes [nasal intermittent
positive pressure ventilation (NIPPV) and bilevel positive airway pressure
(BiPAP)] in pediatric patients after cardiothoracic surgery. Methodology:
This prospective randomized controlled trial was performed at a tertiary
care surgical intensive care unit in postcardiac surgery patients aged
between 1 and 48 months, who were randomly allocated into three groups: 1)
HFNC (with flows at 2 L/kg/min), 2) NIPPV via RAMS cannula in PSV mode
(pressure support 8 cmH<inf>2</inf>O, PEEP 5 cmH<inf>2</inf>O), and 3)
BiPAP in nCPAP mode (CPAP of 5 cmH<inf>2</inf>O). Measurements were
recorded at baseline after extubation (R0) and subsequently every 12
hourly (R1, R2, R3, R4, R5) at 12, 24, 36, 48, and 60 hours respectively
until therapy was discontinued. Result(s): Sixty patients were
included, with 20 patients each in the NIPPV group, HFNC group, and BiPAP
group. Longitudinal strain at crura of diaphragm was lower in the BiPAP
group as compared to HFNC group at R2-R4 [R2 (-4.27+/- -2.73 vs - 8.40+/-
-6.40, P = 0.031), R3 (-5.32+/- -2.28 vs -8.44+/- -5.6, P = 0.015), and R4
(-3.8+/- -3.42 vs -12.4+/- -7.12, P = 0.040)]. PFR was higher in HFNC than
NIPPV group at baseline and R1-R3[R0 (323 +/- 114 vs 264 +/- 80, P =
0.008), R1 (311 +/- 114 vs 233 +/- 66, P = 0.022), R2 (328 +/- 116 vs 237
+/- 4, P = 0.002), R3 (346 +/- 112 vs 238 +/- 54, P = 0.001)]. DTF and
clinical parameters of increased work of breathing remain comparable
between three groups. The rate of reintubation (within 48 hours of
extubation or at ICU discharge) was 0.06% (1 in NIPPV, 1 in BiPAP, 2 in
HFNC) and remain comparable between groups (P = 1.0). Conclusion(s):
BiPAP may provide better decrease in work of breathing compared to HFNC as
reflected by lower crural diaphragmatic strain pattern. HFNC may provide
better oxygenation compared to NIPPV group, as reflected by higher PFR
ratio. Failure rate and safety profile are similar among different methods
used. Copyright © 2024 Wolters Kluwer Medknow Publications. All
rights reserved.

<97>
Accession Number
643288026
Title
Associations Between Nonanemic Iron Deficiency and Postoperative Outcomes
in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 19
Jan 2024.
Author
Peri V.; Devlin P.; Perry L.; Richards T.; Miles L.F.
Institution
(Peri, Devlin, Miles) From the Department of Anaesthesia, Austin Health,
Melbourne, Australia
(Perry, Miles) Department of Critical Care, Melbourne Medical School,
University of Melbourne, Melbourne, Australia
(Richards) Department of Anaesthesiology and Perioperative Medicine,
Central Clinical School, Monash University, Melbourne, Australia
Abstract
BACKGROUND: Preoperative screening for iron deficiency is a part of
patient blood management protocols. This systematic review, meta-analysis,
and meta-regression reviews the association between nonanemic iron
deficiency and postoperative outcomes in patients undergoing cardiac
surgery. We aimed to determine whether preoperative screening for
nonanemic iron deficiency should be recommended in patients undergoing
cardiac surgery. METHOD(S): Electronic databases MEDLINE (Ovid),
Embase (Ovid), and Scopus were searched from inception until December 9,
2022. Studies were considered for inclusion if they (1) used an
observational study design; (2) enrolled adult patients undergoing cardiac
surgery; and (3) included an iron-deficient and iron-replete group,
defined using serum ferritin and/or transferrin saturation. The primary
outcome was the length of acute hospital stay. Secondary outcomes included
length of intensive care unit stay, requirement for allogeneic red blood
cell transfusion, number of red blood cell units transfused, days alive
and at home at postoperative days 30 and 90, all-cause postoperative
complications, postoperative infection, mortality, and hospital
readmission. Meta-regression was performed to assess the effects of study
and patient-level factors on the associations between nonanemic iron
deficiency and specific outcomes. Individual study quality was assessed
using the Risk of Bias in Non-Randomized Studies of Exposures (ROBINS-E)
tool. The Grading of Recommendations, Assessment, Development, and
Evaluations (GRADE) framework was used to determine the quality of
evidence for each outcome. RESULT(S): Eight studies (2683 patients)
were included. No significant association was observed between nonanemic
iron deficiency and any of the primary or secondary outcomes except for an
increased requirement for allogeneic red blood cell transfusion (odds
ratio [OR], 1.39 [95% confidence interval, CI, 1.16-1.68; P < .001; I2
2.8%]). Meta-regression did not identify any potential sources of
heterogeneity to explain variation in individual study results. The
quality of evidence was rated as "low" or "very low" for all outcomes.
 CONCLUSION(S): Few high-quality studies are available to assess
associations between nonanemic iron deficiency and outcomes after cardiac
surgery. Acknowledging these limitations, the presence of preoperative
nonanemic iron deficiency was not associated with a change in the primary
outcome of length of hospital stay, or any patient-centered secondary
outcome compared to those without iron deficiency. There was an
association with increased requirement for allogeneic red blood cell
transfusion, but this did not impact the reported patient-centered
outcomes. Copyright © 2024 International Anesthesia Research
Society.

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