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

<2>
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.

<3>
Accession Number
2027807825
Title
Perioperative Outcome and Cost-utility of Mesh Fixation vs Non-fixation in
Laparoscopic Transabdominal Preperitoneal Inguinal Hernioplasty: A
Prospective Randomized Controlled Trial.
Source
World Journal of Laparoscopic Surgery. 16(3) (pp 169-172), 2023. Date of
Publication: September-December 2023.
Author
Awad S.S.; Qahtani F.H.; Alsulaimani F.S.; Khalid A.H.; Alharthi Q.M.;
Althomali M.A.; Alamri N.G.; Alshamrani A.A.; Alsufyani A.H.; Alorabi
F.A.; Alghuraybi A.A.; Almalki A.A.; Alghamdi A.S.; Alzahrani A.;
Almogathali M.F.; Alkhammash S.A.; Alotaibi A.F.; Alhassan T.M.; Altalhi
A.M.; Abdulshafi M.R.; Sheishaa M.S.A.
Institution
(Awad, Abdulshafi, Sheishaa) Department of General Surgery, Mansoura
University Hospitals, Mansoura, Egypt
(Awad) King Faisal Medical Complex, Taif, Saudi Arabia
(Qahtani, Alsulaimani, Khalid, Alharthi, Althomali, Alamri, Alshamrani,
Alsufyani, Alorabi, Alghuraybi, Almalki, Alghamdi, Alzahrani, Almogathali,
Alkhammash, Alotaibi, Alhassan, Altalhi) Department of General Surgery,
King Faisal Medical Complex, Taif, Saudi Arabia
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Aim: To analyze laparoscopic transabdominal preperitoneal (TAPP) mesh
fixation and non-fixation in the perioperative outcome and cost-utility
for inguinal hernia repair. Patients with groin hernias were introduced to
laparoscopic TAPP repair to reduce the possibility of recurrence and other
complications. Postoperative pain and nerve injury may be exacerbated by
mesh fixation. Following preperitoneal inguinal hernia repair, there is
controversy as to whether mesh should be fixed to prevent recurrences.
 Material(s) and Method(s): From the month of February 2017 to January
2018, 60 patients with inguinal hernias were studied prospectively. Using
the TAPP approach under general anesthesia (GA) by the same team, thirty
hernias were selected randomly and repaired with the fixation of mesh, and
the other thirty ones were repaired without mesh fixation with no
attention to the type of hernia (direct or indirect) or the size of the
defect. Routine clinical examinations were performed for 6 months on all
patients as a regular follow-up. Result(s): The operative time ranged
from 37 to 92 minutes, (with a mean time of 60.44 minutes) in the mesh
fixation group and from 40 to 83 minutes (with a mean time of 54.9
minutes). In the mesh fixation group, 15 cases were Rt indirect inguinal
hernias. In the mesh non-fixation group, 18 cases were Rt indirect
inguinal hernia. The length of the hospital stays ranges from 1 to 3 days
with no significance. No statistical significance was noted as regards
operative time, intraoperative injury, hospital stay, mesh migration,
nerve entrapment, and postoperative analgesia. The significance was
observed in cost-utility which represented the cost of trackers mainly.
 Conclusion(s): No recorded significance as regards operative time,
intraoperative injury, hospital stay, mesh migration, nerve entrapment,
and postoperative analgesia within the analysis of laparoscopic TAPP mesh
fixation and non-fixation. Clinical significance: Mesh without fixation is
a viable method and less costly that has the same benefits and excludes
risks of fixation. Copyright © The Author(s). 2023.

<4>
Accession Number
2027798113
Title
A new opportunity for patient selection and optimization: Systematic
review of cognitive frailty in patients undergoing left ventricular assist
device implantation.
Source
Geriatrics and Gerontology International. 24(2) (pp 204-210), 2024. Date
of Publication: February 2024.
Author
Yu J.; Petersen M.R.; Meece L.E.; Jeng E.I.; Al-Ani M.A.; Parker A.M.;
Vilaro J.R.; Aranda J.M.; Ahmed M.M.
Institution
(Yu) Sidney Kimmel Medical College, Thomas Jefferson University,
Philadelphia, PA, United States
(Petersen) Department of Medicine, University of Florida, Gainesville, FL,
United States
(Meece, Al-Ani, Parker, Vilaro, Aranda, Ahmed) Division of Cardiovascular
Medicine, University of Florida, Gainesville, FL, United States
(Jeng) Division of Thoracic and Cardiovascular Surgery, University of
Florida, Gainesville, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
The prognostic implication of cognitive frailty assessment in patients
undergoing left ventricular assist device (LVAD) implantation remains
unclear. We conducted a systematic review to evaluate assessment
strategies and their significance for patients undergoing LVAD
implantation. A comprehensive search of PubMed, Embase, and the Cumulative
Index to Nursing and Allied Health Literature from inception until
September 2022 and a review of meeting proceedings were performed
following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. Studies that investigated the prognostic value
of cognitive frailty or any related cognition-based assessment in patients
undergoing LVAD implantation were included. Study characteristics, patient
demographics, and type of cognitive assessment were extracted. Primary
outcomes included length of stay, readmissions, and all-cause mortality.
Of 664 records retrieved, 12 (4 prospective, 8 retrospective) involving 16
737 subjects (mean age, 56.9 years; 78.3% men) met inclusion criteria; 67%
of studies used the Montreal Cognitive Assessment to assess cognitive
frailty. Outcomes reported were highly variable, with 42% reporting
readmission, 33% reporting LOS, and 83% reporting mortality data; only two
studies provided data on all three. Cognitive frailty was associated with
prolonged length of stay in 75% of studies reporting this outcome. Only
40% and 60% of studies that reported readmissions and mortality outcomes,
respectively, suggested a predictive association. Pre-LVAD cognitive
frailty is likely associated with worse outcomes postimplant. However, the
heterogenous reporting of outcomes data and lack of consistent definitions
in the literature limit its prognostic value. Additional research on
markers for cognitive frailty and improved standards of reporting may
allow for future analyses and enhance preoperative risk assessment and
patient care. Geriatr Gerontol Int 2024; 24: 204-210. Copyright ©
2024 Japan Geriatrics Society.

<5>
Accession Number
2027793890
Title
The Effect of Proton-Pump Inhibitors the on Development of Arrhythmia and
Hypomagnesemia After Off-Pump Coronary Artery Bypass Surgery.
Source
Journal of Kerman University of Medical Sciences. 30(6) (pp 344-348),
2024. Date of Publication: November-December 2024.
Author
Abbaspour H.; Yazdi A.P.; Vakili V.; Purafzali Firuzabadi S.J.; Abbasi
Tashnizi M.; Amini S.
Institution
(Abbaspour, Yazdi, Amini) Department of Anesthesiology and Critical Care,
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Vakili) Department of Family Medicine, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Purafzali Firuzabadi) Department of Anesthesiology and Critical Care and
Student Research Committee, Faculty of Medicine, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Abbasi Tashnizi) Department of Cardiac Surgery, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Kerman University of Medical Sciences
Abstract
Background: Long-term use of proton-pump inhibitors (PPI) can result in
hypomagnesemia and arrhythmia. This study aimed to compare the effect of
PPI and histamine 2-receptor antagonists (H<inf>2</inf> RA) on the
incidence of hypomagnesemia and arrhythmia in patients following off-pump
coronary artery bypass surgery (CABG). Method(s): In this
randomized-controlled clinical trial 290 patients admitted to the ICU
after off-pump CABG were randomly divided into two groups of H<inf>2</inf>
RA (n = 145) and PPI (n = 145). For patients in the H<inf>2</inf> RA
group, 50 mg intravenous ranitidine was prescribed every 8 hours after the
nothing by mouth (NPO) period, followed by 40 mg famotidine tablets after
starting the oral regimen (PO). The PPI group received 40 mg pantozol IV
injections every 12 hours during the NPO period and 40 mg pantozol tablets
once daily after becoming PO. The patients were investigated for the
development of hypomagnesemia and associated arrhythmia. Result(s):
In total 271 patients with a mean age of 59.3 +/- 10 years completed the
study (female/male = 32.8%). Hypomagnesemia occurred in 60.1% of the
patients, 76 (56.7%) in the H<inf>2</inf> RA group and 87 (63.5%) in the
PPI group (P = 0.245), whereas arrhythmia had a prevalence of 12 (9.6%)
and 15 (11.1%) cases, respectively (P = 0.690). The mean time of
occurrence of hypomagnesemia and arrhythmia was 1.75 +/- 1.08 and 3.0 +/-
0.9 days after the operation in the H<inf>2</inf> RA group (P = 0.111) and
1.47 +/- 0.7 and 2.9 +/- 1.5 days in the PPI group (P = 0.897),
respectively. Conclusion(s): Our study revealed that the short-term
use of PPIs does not result in higher rates of hypomagnesemia and
associated arrhythmia in comparison to H<inf>2</inf> RA consumption after
off-pump CABG. Copyright © 2023 The Author(s).

<6>
Accession Number
2027156199
Title
Prehabilitation programs - a systematic review of the economic evidence.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1281843.
Date of Publication: 2023.
Author
Ke Y.; Ng R.R.G.; Elangovan S.; Leong Y.H.; Goh Z.H.; Graves N.; Shannon
N.B.; Abdullah H.R.
Institution
(Ke, Ng, Leong, Goh, Abdullah) Department of Anaesthesiology and
Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
(Elangovan, Graves, Abdullah) Health Services & Systems Research, Duke-NUS
Medical School, Singapore, Singapore
(Shannon) Duke-NUS Medical School, Singapore, Singapore
(Shannon) Department of General Surgery, Singapore General Hospital,
Singapore, Singapore
Publisher
Frontiers Media SA
Abstract
Introduction: Prehabilitation, which involves improving a patient's
physical and psychological condition before surgery, has shown potential
benefits but has yet to be extensively studied from an economic
perspective. To address this gap, a systematic review was conducted to
summarize existing economic evaluations of prehabilitation interventions.
 Method(s): The PRISMA Protocols 2015 checklist was followed. Over
16,000 manuscripts were reviewed, and 99 reports on preoperative
interventions and screening tests were identified, of which 12 studies
were included in this analysis. The costs are expressed in Pounds (GBP, )
and adjusted for inflation to December 2022. Result(s): The studies
were conducted in Western countries, focusing on specific surgical
subspecialties. While the interventions and study designs varied, most
studies demonstrated cost savings in the intervention group compared to
the control group. Additionally, all cost-effectiveness analysis studies
favored the intervention group. However, the review also identified
several limitations. Many studies had a moderate or high risk of bias, and
critical information such as time horizons and discount rates were often
missing. Important components like heterogeneity, distributional effects,
and uncertainty were frequently lacking as well. The misclassification of
economic evaluation types highlighted a lack of knowledge among physicians
in prehabilitation research. Conclusion(s): This review reveals a
lack of robust evidence regarding the economics of prehabilitation
programs for surgical patients. This suggests a need for further research
with rigorous methods and accurate definitions. Copyright © 2023
Ke, Ng, Elangovan, Leong, Goh, Graves, Shannon and Abdullah.

<7>
Accession Number
2025513944
Title
Standardized Treatment and Diagnostic Approach to Reduce Disease burden in
the early postoperative phase in children with congenital heart
defects-STANDARD study: a pilot randomized controlled trial.
Source
European Journal of Pediatrics. 182(12) (pp 5325-5340), 2023. Date of
Publication: December 2023.
Author
Vogt A.; Meyer S.; Schafers H.-J.; Weise J.J.; Wagenpfeil S.; Abdul-Khaliq
H.; Poryo M.
Institution
(Vogt) Medical School, University of Saarland, Homburg/Saar, Germany
(Meyer) Franz-Lust Klinik fur Kinder- und Jugendmedizin, Stadtisches
Klinikum Karlsruhe, Karlsruhe, Germany
(Schafers) Department of Thoracic and Cardiovascular Surgery, Saarland
University Medical Center, Homburg/Saar, Germany
(Weise, Wagenpfeil) Institute for Medical Biometry, Epidemiology and
Medical Informatics, Saarland University Medical Center, Homburg/Saar,
Germany
(Abdul-Khaliq, Poryo) Department of Pediatric Cardiology, Saarland
University Medical Center, Kirrberger Strase, Building 9, Homburg/Saar
D-66421, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
To explore the effect of a daily goal checklist on pediatric cardiac
intensive care unit (PCICU) length of stay (LOS) after congenital heart
surgery. This study is a prospective randomized single-center study. Group
characteristics were as follows: STANDARD group: n = 30, 36.7% female,
median age 0.9 years; control group: n = 33, 36.4% female, median age 1.1
years. Invasive ventilation time, STAT categories, mean
vasoactive-inotropic score (VIS)<inf>24h</inf>, maximal (max.)
VIS<inf>24h</inf>, mean VIS<inf>24-48h</inf>, max. VIS<inf>24-48h</inf>,
VIS category, number of sedatives, analgesics, diuretics, number of
deployed diagnostic modalities, morbidities, and mortality did not differ
between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus
101.5 h (control group) (p = 0.63). In the overall cohort, univariate
regression analysis identified age at surgery (b = -0.02), STAT category
(b = 18.3), severity of CHD (b = 40.6), mean VIS<inf>24h</inf> (b = 3.5),
max. VIS<inf>24h</inf> (b = 2.2), mean VIS<inf>24-48h</inf> (b = 6.5), and
VIS category (b = 13.8) as significant parameters for prolonged PCICU LOS.
In multivariate regression analysis, age at surgery (b = -0.2), severity
of CHD (b = 44.0), and mean VIS<inf>24h</inf> (b = 6.7) were of
significance. Within the STANDARD sub-group, univariate regression
analysis determined STAT category (b = 32.3), severity of CHD (b = 70.0),
mean VIS<inf>24h</inf> (b = 5.0), mean VIS<inf>24-48h</inf> (b = 5.9),
number of defined goals (b = 2.6), number of achieved goals (b = 3.3),
number of not achieved goals (b = 10.8), and number of unevaluated goals
(b = 7.0) as significant parameters for prolonged PCICU LOS. Multivariate
regression analysis identified the number of defined goals (b = 2.5) and
the number of unevaluated goals (b = -3.0) to be significant parameters.
 Conclusion(s): The structured realization and recording of daily
goals is of advantage in patients following pediatric cardiac surgery by
reducing PCICU LOS. What is known: * Communication errors are the most
frequent reasons for adverse events in intensive care unit patients. *
Improved communication can be achieved by discussion and documentation of
the patients' goals during daily rounds. What is new: * In the overall
cohort age at surgery, severity of congenital heart defect and mean
vasoactive inotropic score within the first 24 hours had significant
impact on pediatric cardiac intensive care unit (PCICU) length of stay
(LOS). * In the intervention group, the number of defined goals and the
number of unevaluated goals were significant parameters for prolonged
PCICU LOS. Copyright © 2023, The Author(s).

<8>
Accession Number
2027736322
Title
Considering alternatives to transcatheter heart valves for managing
patients with severe aortic valve stenosis.
Source
Expert Review of Medical Devices. 21(1-2) (pp 109-120), 2024. Date of
Publication: 2024.
Author
Elzomor H.; Elkoumy A.; Hothi S.S.; Soliman O.
Institution
(Elzomor, Elkoumy, Soliman) Department of Cardiology, Saolta Group, Galway
University Hospital, Galway, Ireland
(Elzomor, Elkoumy, Soliman) CORRIB Core Lab, University of Galway, Galway,
Ireland
(Elzomor, Elkoumy, Soliman) Islamic Center of Cardiology, Al-Azhar
University, Nasr City, Cairo, Egypt
(Elzomor, Elkoumy) CURAM, SFI Research Centre for Medical Devices, Galway,
Ireland
(Elzomor, Hothi, Soliman) Department of Cardiology, Royal Wolverhampton
NHS Trust, Wolverhampton, United Kingdom
(Hothi) College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Hothi) Centre for Sport, Exercise and Life Sciences, Coventry University,
Coventry, United Kingdom
(Soliman) Euro Heart Foundation, Rotterdam, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is becoming
the standard of care for severe symptomatic aortic stenosis (AS). Yet,
some patients with AS are not indicated/eligible for TAVI. Several
noninvasive, catheter-based or surgical alternatives exist, and other
therapeutic options are emerging. Areas covered: This review provides an
overview of non-TAVI options for severe AS. Non-invasive, transcatheter,
and alternative surgical strategies are discussed, emphasizing their
backgrounds, techniques, and outcomes. Expert opinion: Alternative
therapies to TAVI, whether device-based or non-device-based, continue to
evolve or emerge and provide either alternative treatments or a bridge to
TAVI, for patients not meeting indications for, or having
contraindications to TAVI. Although TAVI and SAVR are the current dominant
therapies, there are still some patients that could benefit in the future
from other alternatives. Data on alternative options for such patients are
scarce. Many advantages and disadvantages arise when selecting a specific
treatment strategy for individual patients. Head-to-head comparison
studies could guide physicians toward better patient selection and
procedural planning. Awareness of therapeutic options, indications,
techniques, and outcomes should enable heart teams to achieve optimized
patient selection. Furthermore, it can increase the use of these
alternatives to optimize the management of AS among different patient
populations. Copyright © 2024 Informa UK Limited, trading as
Taylor & Francis Group.

<9>
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. 65(2) (no pagination),
2024. Date of Publication: 01 Feb 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: The aim of this study was to evaluate the association between
statin use after surgical aortic valve replacement for aortic stenosis and
long-term risk for major adverse cardiovascular events (MACEs) in a large
population-based, nationwide cohort. METHOD(S): All patients who
underwent isolated surgical aortic valve replacement due to aortic
stenosis in Sweden 2006-2020 and survived 6 months after discharge were
included. Individual patient data from 5 nationwide registries were
merged. Primary outcome is MACE (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 10 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 MACE [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.

<10>
Accession Number
2028239813
Title
Hereditary Aortic Aneurysmal Disease: Surgical Therapies and Outcomes.
Source
Annals of Vascular Surgery. Conference: Vascular and Endovascular Surgery
Society, USA - Winter 2023 meeting. Whistler Canada. 97 (pp 286-287),
2023. Date of Publication: November 2023.
Author
Challa A.S.; Bornak A.; Forghani I.
Publisher
Elsevier Inc.
Abstract
Funding: None. Key words: Connective Tissue Diseases, Genetic Mutations,
Endovascular Aortic Repair, Aortic Aneurysms Synopsis: Weakened structural
integrity of the arterial wall due to altered extracellular matrix
proteins or regulatory cytokines is thought to contribute to the
development of aortic aneurysms (AAs). Several treatment modalities have
been outlined for AAs in patients with genetic mutations underlying AAs,
including open and endovascular repair. However, effective management of
heritable aneurysmal disease remains challenging due to unsatisfactory
short and long term outcomes. Method(s): A literature review of the
primary genetic etiologies of AAs was performed. We summarize the latest
advances in the surgical management of patients with hereditary aortic
pathologies, and evaluate treatment outcomes. Result(s): Mutations in
FBN-1, COL3A1, SMAD2, SMAD3, TGFB2, TGFB3, TGFBR1, or TGFBR2, ACTA2, and
MYH11 genes are associated with Marfan Syndrome (MFS), Vascular
Ehlers-Danlos Syndrome (vEDS), Loeys-Dietz Syndrome (LDS), and Familial
Thoracic Aortic Aneurysms, respectively. In patients with connective
tissue disorders (CTDs), endovascular aortic repair remains controversial.
Progressive degeneration of the aorta can lead to endoleaks and
subsequently rapid aneurysm degeneration and rupture. The mortality rate
is reportedly at an all-time high of 43% despite early surgical
intervention, and 44% of these minimally invasive procedures in cases of
MFS result in life-threatening complications such as pseudoaneurysms or
aortic rupture, necessitating open conversion. In type vEDS patients, the
overall mortality rate is 63%, with 19% dying during the perioperative
period. Endovascular repair is generally contraindicated in LDS due to
stent-graft failure secondary to progressive degeneration. In a review of
251 patients that underwent surgery for thoracic aortic diseases,
including nine patients with ACTA2 mutations characteristic of familial
thoracic AAs, histological studies revealed cystic medial necrosis in most
cases with the absence of aortic dilatation for seven years after thoracic
endovascular aortic repair. Other postoperative outcomes include sepsis,
multiorgan failure, paraplegia, and myocardial infarction.
 Conclusion(s): Research catered to the unique genetic predisposition
underlying AAs is necessary to yield personalized identification and
management strategies. Institution: University of Miami Miller School of
Medicine Copyright © 2023

<11>
Accession Number
2029272144
Title
One-year mortality and cause of death after stereotactic radiation therapy
for refractory ventricular arrhythmias.
Source
Archives of Cardiovascular Diseases. Conference: JESFC 2024. Paris France.
117(1 Supplement) (pp S92-S93), 2024. Date of Publication: January 2024.
Author
Benali K.; Kautzner J.; Lloyd M.; Ninni S.; Guenancia C.; Rigal L.; Simon
A.; Bellec J.; De Crevoisier R.; Zei P.; Da Costa A.; Martins R.P.
Institution
(Benali, Da Costa) Cardiologie, CHU Nord Saint-Etienne,
Saint-Priest-en-Jarez, France
(Kautzner) Cardiologie, IKEM - pavilon S2 PPK, Prague, Czechia
(Lloyd) Cardiologie, universite Emory, Atlanta, United States
(Ninni) Cardiologie, Institut Coeur Poumon, Lille
(Guenancia) Laboratoire pec2, universite de Bourgogne, Dijon, France
(Rigal, Simon) IMPACT, LTSI (laboratoire traitement du signal et de
l'image), Rennes, France
(Bellec) Medical Physics Department, centre Eugene Marquis, Rennes, France
(De Crevoisier) Department of Radiotherapy, centre Eugene Marquis, Rennes,
France
(Zei) Cardiologie, Brigham and Women's Hospital, Boston, United States
(Martins) Cardiologie, CHU de Rennes - hopital Pontchaillou, Rennes,
France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Patients treated with cardiac stereotactic body radiation
therapy (SBRT) for refractory ventricular arrhythmias (VAs) are patients
with advanced structural heart disease and significant comorbidities.
However, data regarding 1-year mortality after the procedure are scarce.
 Objective(s): This systematic review and pooled analysis aimed at
determining 1-year mortality after cardiac SBRT for refractory VAs and
investigating leading causes of death in this specific population.
 Method(s): MEDLINE/EMBASE databases were searched up to January 2023
for studies including patients undergoing cardiac SBRT for the treatment
of refractory VAs. The quality of included trials was assessed using the
NIH Tool for Case Series Studies (PROSPERO CRD42022379713).
 Result(s): A total of 1,151 references were retrieved and evaluated
for relevance. Data were extracted from 16 studies, with a total of 157
patients undergoing cardiac SBRT for refractory VAs. Pooled 1-year
mortality was 32% (95%CI: 23-41), with almost half of the deaths occurring
within three months after treatment. Among the 157 patients, 46 died
within the year following cardiac SBRT. Worsening HF appeared to be the
leading cause of death (52%), although non-cardiac mortality remained
substantial (41%) in this population (Figure 1). Age >= 70yo was
associated with a significantly higher 12-month all-cause mortality (P <
0.022). Neither target volume size nor SBRT modality appeared to be
associated with the 1-year mortality (P = 0.465 and P = 0.199,
respectively). Conclusion(s): One-year mortality in patients
undergoing cardiac SBRT for refractory ventricular arrhythmias is high
(~32%), with more than one third of these deaths occurring within the
first 3 months after the procedure. Worsening heart failure and
non-cardiac causes accounted for the majority of deaths in this
population. Neither target volume size nor SBRT modality appeared to be
associated with the 1-year mortality. Multicenter prospective studies will
be need to confirm these results. Copyright © 2023

<12>
Accession Number
2029090036
Title
Effects of low dose colchicine in patients of Coronary artery disease
undergoing percutaneous coronary intervention.
Source
Indian Heart Journal. Conference: 75th annual conference 2023. Kolkata
India. 75(Supplement 1) (pp S16-S17), 2023. Date of Publication: December
2023.
Author
Sellakannu S.; Sharma Y.P.; Panda P.K.; Mehrotra S.; Rana S.; Sharma S.;
Ahluwalia J.
Institution
(Sellakannu, Sharma, Panda, Mehrotra) Department of Cardiology, Post
Graduate Institute of Medical Education and Research, Chandigarh, India
(Rana) Department of Gastroenterology, Post Graduate Institute of Medical
Education and Research, Chandigarh, India
(Sharma) Department of Biochemistry, Post Graduate Institute of Medical
Education and Research, Chandigarh, India
(Ahluwalia) Department of Hematopathology, Post Graduate Institute of
Medical Education and Research, Chandigarh, India
Publisher
Elsevier B.V.
Abstract
Background: In the availability of clinical and experimental evidence to
Experimental and clinical evidence support the role of inflammation in
atherosclerosis and its complications. Colchicine is an orally
administered, potent anti-inflammatory medication that is indicated for
the treatment of gout and pericarditis. Aim(s): The study aims to
assess the MACE events and safety of this novel approach with low dose
colchicine in patients of coronary artery disease undergoing percutaneous
intervention. Methods and Results: We performed a randomized,
patient-blinded trial involving patients recruited within 1day after a
myocardial infarction. The patients were randomly assigned to receive
either low-dose colchicine (0.5 mg once daily) or placebo. The primary
efficacy end point was a composite of death from cardiovascular causes,
resuscitated cardiac arrest, myocardial infarction, stroke, or urgent
hospitalization for angina leading to coronary revascularization. The
secondary endpoints were adverse drug outcome and change in inflammatory
biomarkers. A total of 205 patients were enrolled; 102 patients were
assigned to the colchicine group, and 103 to the placebo group. Patients
were followed for 6 months. The primary end points event occurred in 3
patients (3.6%) in the colchicine group and in 1 patient (1%) in the
placebo group (incidence, 3.5 vs. 1.03 events per 100 person-years;
relative risk 3.42; 95% confidence interval [CI], 0.363 to 32.27; P
0.466). A key secondary end-point event occurred in inflammatory
biomarkers as there was a significant reduction in IL-6, hs-CRP, ESR,
Ferritin, uric acid in colchicine group than in the placebo group. And,
there was a significant association between colchicine group and
development of dysesthesia: numbness and tingling. But fatigability,
myalgia, GI symptoms didn't have significant association. The incidence
rates of spontaneous myocardial infarction or ischemia driven coronary
revascularization (composite end point), cardiovascular death or
spontaneous myocardial infarction (composite end point) were also lower
with placebo than with colchicine, but which is not statistically
significant. The incidence of death from Non cardiovascular causes was
higher in the control group than in the case group (incidence, 3.093
events per 100 person-years vs no non-CV death in case group). [Formula
presented] Conclusion(s): In a randomized trial involving patients
with chronic coronary disease who undergone PCI, the risk of
cardiovascular events was not significantly lowered by among those who
received 0.5 mg of colchicine once daily than among those who received
placebo. (CTRI Registry number, CTRI/2022/05/042760.) Key words:
colchicine; inflammation; myocardial infarction; percutaneous coronary
intervention; MACE events; biomarker. Copyright © 2023

<13>
Accession Number
2029022344
Title
A Case Series of Thrombolysis in Prosthetic Valve Thrombosis.
Source
Indian Heart Journal. Conference: 75th annual conference 2023. Kolkata
India. 75(Supplement 1) (pp S91-S93), 2023. Date of Publication: December
2023.
Author
Manju Bhargav B.R.; Radhakrishnan V.V.; Sivaprasad K.
Institution
(Manju Bhargav, Radhakrishnan, Sivaprasad) Government Medical College,
Thiruvananthapuram, India
Publisher
Elsevier B.V.
Abstract
Background: Prosthetic Valve Thrombosis(PVT) is characterised by thrombus
formation over the prosthetic valve resulting in valve dysfunction (PVD)
with or without thromboembolism. The incidence of PVT is as high as 6.1%
within 6 months of surgery in developing countries despite therapeutic
levels of INR! [1] There are 3 main mechanisms for PVT, based
on Virchow's Triad namely hypercoagubility of blood, hemodynamic
changes(stasis, turbulence) and endothelial injury, the most common being
hypercoagubility due to inadequate anticoagulation. American College of
Cardiology 2020 recommended urgent thrombolysis for those who present with
symptoms of left-sided mechanical valve obstruction either with slow
infusion of low-dose fibrinolytic therapy or emergency
surgery[2]. Recent European Society of Cardiology 2021
guidelines advised to suspect PVT in those with recent onset dyspnea or an
embolic event and emergency surgery is recommended for obstructive
thrombus in critically ill patients without serious comorbidities.
Fibrinolysis using Streptokinase i.e. 2.5 lakh IU as a loading dose over
30 minutes followed by 1 lakh IU per hour for 12 hours should be
considered when surgery is not readily available or to those with very
high risk, or for those with thrombosis of right side
prosthesis.[3] We present three cases of PVT, who presented
with stuck valves and were thrombolysed with Streptokinase. Case Summary
Case 1: A 41-year-old lady, with a known case of Rheumatic Heart Disease
(RHD) since 2015, had mitral Valve replacement (MVR) with St.Jude
bi-leaflet mechanical prosthetic valve in March 2022 for Severe Mitral
Stenosis, presented with worsening breathlessness FC III, orthopnea for 2
weeks and acute febrile illness of one-week duration. She had bibasal
crepitations with Hypertensive urgency of 210/120mmHg and ECG showed Sinus
Tachycardia of 140bpm. She was on regular follow-ups with periodic Echo,
regular anticoagulation with Acenocoumarin and had an INR of 2.26 with the
recent follow up few days before admission. Clinical suspicion of
PVD/Infective Endocarditis was made. However, 2D Echo showed a high
gradient across the prosthetic valve, with a mean gradient of 34mmHg and a
visible thrombus over one of the leaflets which caused the valve leaflet
to get stuck leading to PVD. Her INR at admission was 1.42 and also had
Severe Anaemia and elevated Total count with Neutrophil predominance. She
was treated with Heparin infusion with Acenocoumarin to attain optimal
apt/INR and IV Antibiotics, IV Iron for anaemia correction, and IV
Diuretics for one week in ICCU. There was a dramatic response both
clinically and Echocardiographically as there was some decrease in
transmitral gradient to 20mmHg; However, the gradient persisted despite
Heaprinization and INR titration to 3.5. Cine Fluoroscopy confirmed a
stuck valve and hence planned for Thrombolysis with Streptokinase. She was
infused with 2.5lakh IU as a loading dose over 30 mins and 1 lakh IU/hour
for 12 hours and thrombolysis was uneventful. Follow-up echoes showed a
gradual reduction of transvalvular gradients and at the end of 6 hours,
the mean gradient came down to 3mmHg. Post Thrombolysis cine-fluoroscopy
showed optimal excursion of both valve leaflets. The patient was
discharged on oral anticoagulants with advice to maintain a higher
therapeutic INR. [Formula presented] Case 2: A 27-year-old gentleman, with
a known case of Rheumatic Heart Disease (RHD) since 2022, had Dual Valve
Replacement with Meril Bileaflet Mechanical heart valve- Mitral (25mm) and
Aortic(16mm) in March 2023 for Severe MR, Moderate MS, Moderate AR,
presented with acute onset breathlessness FC IV and cardiogenic shock for
which he was intubated and inotropic supports were given. He had extensive
lung crepitations with poor hemodynamics and ECG showed Sinus Tachycardia
of 144bpm. He was on regular follow-ups with periodic Echo, regular
Anticoagulation with Acenocoumarin and had an INR of <2 with the last
follow-up in May 2023. However, he had stopped OAC 3 days before admission
due to vomiting. Clinical suspicion of PVD was made and confirmed by 2D
Echo which showed a stuck valve with a slight movement of only one leaflet
and a visible thrombus over the Prosthetic mitral valve. There was no
significant gradient across the Aortic valve. His INR at admission was
1.17 and was decided for urgent Thrombolysis with Streptokinase. Post
thrombolysis there was a slight improvement in the hemodynamics where the
inotropic supports were lowered, however, follow-up Echo/Cine fluoroscopy
was not performed due to logistical reasons as he was intubated. Worsening
of CNS functions was detected clinically and CT Brain revealed Acute
Intraparenchymal haemorrhage with Mid-line shift. Neurosurgical
interventions were not entertained due to coagulopathy post-thrombolysis.
Subsequently, Multi-organ dysfunction set in and he succumbed after 7 days
of hospital stay. Case 3 A 32-year-old lady had post Mitral Valve
replacement with Meril Bileaflet Mechanical heart valve for RHD-Severe MS
in May 2023. She was on regular follow-up post-surgery and was doing
fairly well with the last INR at follow-up being 1.12 on Acitrom 3mg, a
month back. She had acute onset pain abdomen with vomiting which made her
skip OAC for 3 days and she was admitted with Dyspnea NYHA III which led
to the suspicion of Prosthetic Valve thrombosis, which was confirmed by
Echocardiography. The Transmitral Gradient was 44mmHg with a stuck mitral
leaflet along with Severe PAH. On admission, she was found to have an INR
of 1 and deranged LFT which probably explains Right Heart failure and
congestive Liver. Immediate Fluoroscopy revealed a stuck mitral valve
leaflet. She was started with Streptokinase Thrombolysis, but after 2
hours of starting the infusion, she collapsed suddenly and could not be
revived and succumbed within 4 hours of initiating thrombolysis. [Formula
presented] Discussion The first case had suboptimal therapeutic INR at
presentation and her symptoms could be attributed to thrombus due to
inadequate anticoagulation, which was relieved by thrombolysis. She had an
excellent response to thrombolysis as evidenced by the fluoroscopic motion
of the leaflets and normal transmitral gradient. However, the second case
had very low INR at presentation due to the recent stoppage of OAC which
led to a heavy thrombus burden at the mitral valve leading to cardiogenic
shock. Though he was an ideal candidate for redo surgery, mobilizing the
surgeons, procedure feasibility was challenging and thrombolysis looked
impressive as recent evidence favours thrombolysis due to its
effectiveness, safety profile, availability and low cost. The brunt of the
thrombolysis was taken by the brain rather than the thrombus at the
prosthetic valve. Post thrombolysis, Intracranial bleed occurred followed
by MODS and no other intervention could be offered due to worsened patient
profile. The third case also had sub-optimal INR at follow-ups and
defaulted OAC which led to a heavy thrombus burden at the Mitral valve.
Though Thrombolysis was started immediately she succumbed within 4 hours
of lysis, which could explain the embolic events caused by fragmentation
of heavy thrombus load. There is abundant data available regarding
streptokinase (STK) as an agent of thrombolysis for PVT but with an
increased risk of bleeding. Low-dose tissue plasminogen activator has a
shown remarkably low incidence of embolic and hemorrhagic complications
due to slow lysis and is more effective due to fibrin selectivity than
STK. When thrombolysis was compared to surgery in a meta-analysis reported
by Karthikeyan et al. surgery resulted in complete success with
significantly lesser complications[4] but another meta-analysis revealed
significantly lower mortality with thrombolysis arm compared to
surgery[5]. However, there is a need for adequate PT/ INR values to
prevent thrombosis of the prosthetic valves, emphasizing the need for
close supervision of INR levels coupled with periodic echocardiographic
follow-up. Cardiac CT is considered a better imaging modality to evaluate
prosthetic valve dysfunction and to differentiate between pannus and
thrombus. Conclusion Prosthetic valve thrombosis can be a nightmare for
cardiologists. Early diagnosis and prompt treatment lead to better
outcomes with short in-hospital stays and fewer complications. Low-dose
rt-PA slow infusion has shown excellent outcomes along with very low
thromboembolic and bleeding complications. The non-availability of rt-PA
should not stop the use of STK as a thrombolytic agent. Patient education
in terms of regular INR checks and adherence to medication carry equal
importance to prevent recurrences. ACC 2020 guidelines suggest that
thrombolysis should be considered whenever emergency surgery is not
feasible. ESC 2021 guidelines suggest emergency surgery for those with
Dyspnea NYHA IV with obstructive thrombus or recent onset embolic event in
a critically ill patient. References: 1. Nishimura RA, Otto CM, Bonow RO,
et al. American college of cardiology/ American heart association task
force on practice guidelines. 2014 AHA/ACC guideline for the management of
patients with valvular heart disease: executive summary: a report of the
American College of Cardiology/American Heart Association Task Force on
practice guidelines. J Am Coll Cardiol. 2014;63(22): 2438e2488. 2.
Vahanian A, Beyersdorf F, Praz F, et al. ESC/EACTS Scientific Document
Group. /EACTS Guidelines for the management of valvular heart disease. Eur
Heart J. 2021 Aug 28, ehab395. 3. Otto CM, Nishimura RA, Bonow RO, et al.
2020 ACC/AHA guideline for the management of patients with valvular heart
disease: a report of the American College of Cardiology/American Heart
Association Joint Committee on clinical practice guidelines. J Am Coll
Cardiol. 2021 Feb 2;77(4):e25ee197. 4. Karthikeyan G, Senguttuvan NB,
Joseph J, Devasenapathy N, Bahl VK, Airan B. Urgent surgery compared with
fibrinolytic therapy for the treatment of left-sided prosthetic heart
valve thrombosis: a systematic review and meta-analysis of observational
studies. Eur Heart J. 2013;34:1557e1566 5. Castilho FM, De Sousa MR,
Mendonca AL, Ribeiro AL, C_aceres-L_origa FM.Thrombolytic therapy or
surgery for valve prosthesis thrombosis: systematic review and
meta-analysis. J Thromb Haemostasis. 2014;8:1218e1228. Copyright
© 2023

<14>
Accession Number
2028867225
Title
Evaluating the effect of a nutrition pathway developed by Delphi consensus
on improving growth in infants with congenital heart disease (CHD) before
surgery.
Source
Clinical Nutrition ESPEN. Conference: ESPEN 2023. Lyon France. 58 (pp
711), 2023. Date of Publication: December 2023.
Author
Fandinga C.; Marino L.; Young A.; Johnson M.; Beattie R.M.
Institution
(Fandinga) University Hospital Southampton, Southampton, United Kingdom
(Marino) PICU, University Hospital Southampton
(Young) University of Southampton
(Johnson) NNU/NICU
(Beattie) Paediatric Gastroenterology, University Hospital Southampton,
Southampton, United Kingdom
Publisher
Elsevier Ltd
Abstract
Rationale: CHD is the most common congenital anomaly, occurring in around
1% of live births worldwide (1-3). To improve nutritional and surgical
outcomes amongst infants with CHD before surgery, a consensus based
pre-operative nutrition pathway was developed and implemented in a
regional cardiac service in 2017 (4). This study aims to use data science
and growth modelling techniques to explore the impact of implementing a
standardised nutrition pathway on growth outcomes in infants with CHD.
 Method(s): Anthropometrical data extracted from electronic patient
records for pre/post-nutrition-pathway epochs 2013-2016 and 2017-2023.
Moderate malnutrition defined as <=-2 z scores using WHO Anthro software
version 3.3.3 2011 (5). Growth curves of infants with CHD in the two
cohorts will be constructed using the SuperImposition by Translation And
Rotation (SITAR) method. Result(s): Over 25000 measurements were
extracted from electronic records. The pre-pathway group included weight
measures from 573 infants (<12months age) (54.5% male (n=312/573), mean
age 2.8+/-3 months. In the post-pathway group weights measures from 157
infants were studied (58.6% male (n=92/157) mean age 3.2+/-3.8. Following
the implementation of the nutrition pathway there was a significant
difference in WAZ in infants <12 months of age with pre-pathway WAZ of
1.1+/-2.8 compared to post pathway WAZ of -1.4+/-1.5 (p=<0.05).
 Conclusion(s): Overall growth improved in infants who followed the
pre-operative nutritional-pathway, suggesting the use of a consensus-based
nutritional pathway, including nutrient energy dense feed and regular
monitoring by a dietitian, is associated with improved growth amongst
infants with CHD. References: van der Linde D, Konings EE, Slager MA,
Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of
congenital heart disease worldwide: a systematic review and meta-analysis.
Journal of the American College of Cardiology. 2011;58(21):2241-7. Bernier
PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of
congenital heart disease worldwide: epidemiologic and demographic facts.
Seminars in thoracic and cardiovascular surgery Pediatric cardiac surgery
annual. 2010;13(1):26-34. Hoffman JI, Kaplan S. The incidence of
congenital heart disease. Journal of the American College of Cardiology.
2002;39(12):1890-900. Marino LV, Johnson MJ, Hall NJ, Davies NJ, Kidd CS,
Daniels ML, et al. The development of a consensus-based nutritional
pathway for infants with CHD before surgery using a modified Delphi
process. Cardiology in the young. 2018;28(7):938-48. WHO WHO. WHO Anthro
(version 3.2.2, January 2011). 2015. Disclosure of Interest: None
declared Copyright © 2023

<15>
Accession Number
2027998519
Title
OUTCOMES IN DONATION AFTER CIRCULATORY DEATH CARDIAC TRANSPLANTATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S72), 2023. Date of Publication: November 2023.
Author
Basha A.; Singh R.; Paneitz D.; Osho A.
Institution
(Basha, Singh, Paneitz, Osho) Calgary, Alberta
Publisher
Elsevier B.V.
Abstract
BACKGROUND: Donation After Circulatory Death (DCD) donors represent a
valued source of donor organs in the current setting of organ shortage.
Historically, DCD donors were less preferred than Donation After Brain
Death (DBD) donors for cardiac transplantation due to a warm ischemic
period in the procurement process. However, recent evidence suggests that
with increasing surgeon experience, improved perfusion techniques, and
novel organ-care systems, DCD cardiac transplantation may be associated
with similar outcomes when compared to DBD donors. METHODS AND RESULTS: A
systematic literature search for relevant articles was performed of the
MEDLINE, EMBASE, Cochrane CENTRAL, and CINAHL databases from inception to
January 1, 2023. Furthermore, searching of the Web of Science and Scopus
registries was completed. Gray literature searches of major conference
abstracts between 2021 and 2023 and of the citations of included articles
were completed. Identified articles underwent independent two-stage
screening for inclusion (Covidence, Veritas Health Innovation, Melbourne,
Australia). Articles reporting the same patient cohorts were grouped and
the most informative publication was used in this meta-analysis. Following
extraction, Stata 17 (College Station, TX, USA) was applied to conduct
pairwise and proportional random-effects meta-analyses. For pairwise
comparisons, weighted pooled estimates from the random-effects models were
calculated with the DerSimonian-Laird method. Pooled estimates of
continuous outcomes were reported as standardized mean differences
(Hedge's G). Proportional meta-analyses involved logit transformation of
continuous outcomes, inverse variance weighting, and DerSimonian-Laird
estimation of the between-study variance (tau2) and subsequently the
pooled effect size. Estimates of hetereogeneity were based on
Mantel-Haenszel weights and these included inspection of funnel plots, the
I2 statistics, and Cochran's Q tests where applicable. The search
identified 9 studies comprising 443 DCD and 691 DBD isolated orthotopic
cardiac transplant recipients (n=1134); 2 studies with pairwise
comparisons were included. An additional 15 studies, though relevant, were
excluded due to reporting of the same patient cohorts. Compared to DBD
donors, DCD cardiac transplantation was associated with similar 30-day
mortality (Risk Ratio [RR] 0.752, 95% Confidence Interval [CI]:
0.304-1.863, p=0.539), mortality at last available follow-up (RR 1.153,
95%CI: 0.655-2.030, p=0.622), and postoperative organ rejection (RR 1.225,
95%CI: 0.664-2.260, p=0.516). No significant difference in hospital length
of stay was found (Hedge's G: -0.167, 95%CI: -1.305-0.971, p=0.774).
 CONCLUSION(S): DCD cardiac transplantation is associated with similar
acute outcomes as cardiac transplantation from DBD donors. Additional
evidence is needed to understand the role of donor type in cardiac
transplantation and further randomized comparisons of donor types are
required. [Formula presented] [Formula presented] Copyright ©
2023

<16>
Accession Number
2027992039
Title
LONG-TERM RECURRENCE OF NEW-ONSET POST-OPERATIVE AF IN CARDIAC SURGERY
PATIENTS AS DETECTED BY AN IMPLANTABLE LOOP RECORDER: A SYSTEMATIC REVIEW
AND INDIVIDUAL PARTICIPANT DATA META-ANALYSIS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S29-S30), 2023. Date of Publication: November 2023.
Author
Kaur H.; Tao B.; Silverman M.; Healey J.; Belley-Cote E.; Whitlock R.;
Devereaux P.; Conen D.; Bidar E.; Kawczynski M.; Ayala-Paredes F.;
Ayala-Valani L.; Sandgren E.; El-Chami M.; Jorgensen T.; Thyregod H.;
Sabbag A.; McIntyre W.
Institution
(Kaur, Tao, Silverman, Healey, Belley-Cote, Whitlock, Devereaux, Conen,
Bidar, Kawczynski, Ayala-Paredes, Ayala-Valani, Sandgren, El-Chami,
Jorgensen, Thyregod, Sabbag, McIntyre) Markham, Ontario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: New-onset post-operative atrial fibrillation (POAF) occurs in
25-50% of patients after cardiac surgery. In some patients, POAF is a
transient entity, while in others it represents a first presentation of
paroxysmal or persistent AF. The long-term AF recurrence rate in patients
with POAF is unknown. This study estimates the AF recurrence rate in
patients with new-onset POAF following cardiac surgery as evaluated with
an implantable loop recorder (ILR). METHODS AND RESULTS: We searched
MEDLINE, Embase and Cochrane CENTRAL to April 2, 2023 for studies of adult
patients without a history of AF, who had POAF detected following cardiac
surgery and received an ILR. We defined POAF as AF occurring in the first
30 days postoperatively and AF recurrence as occurring after 30 days. We
contacted authors of eligible studies to request individual participant
time-to-event data on AF recurrence. When individual data were not
available, we estimated events from study figures. We constructed a
Kaplan-Meier curve illustrating the time to first recurrence. From 8111
screened citations, we identified 8 eligible studies (Table 1). All
studies were single-centre prospective cohorts from 7 countries including
the United States of America (2), Canada, Denmark, Israel, The
Netherlands, Russia and Sweden. Two studies defined AF recurrence as
lasting >= 30 seconds, four defined AF recurrence as lasting >= 2 minutes,
one defined AF recurrence as lasting >= 5 minutes and one defined AF
recurrence as lasting >= 6 minutes. We received data from 6 studies and
estimated events for one study; data were not available from one study. We
pooled data from a total of 186 participants, with a median follow-up of
1.7 (interquartile range (IQR): 1.3 - 2.8) years. Overall, 19.7% of
participants were female, 79.8% of participants had isolated CABG, and the
median (IQR) CHA2DS2-VASc was 3 (1 - 6). Rates of AF recurrence beginning
after the 30-day post-operative period were: 15.1% (95% CI 10.5% - 21.2%)
at 3 months, 23.9% (95% CI 18.1% - 31.0%) at 6 months, 30.7% (95% CI 24.1%
- 38.1%) at 12 months and 39.2% (95% CI 32.0% - 47.0%) at 18 months
(Figure 1, wherein the shaded area indicates the 95% CI).
 CONCLUSION(S): For patients with new-onset POAF following cardiac
surgery, AF recurrence, as detected by an ILR, is common, with
approximately 1 in 3 experiencing recurrence in the first year after
surgery. The optimal strategy for monitoring for recurrence, its clinical
sequelae, and appropriate management in this population remains uncertain.
[Formula presented] [Formula presented] Copyright © 2023

<17>
Accession Number
2027991008
Title
THE USE OF PRE-OPERATIVE NT-PROBNP/B-TYPE NATRIURETIC PEPTIDE FOR RISK
STRATIFICATION IN CARDIAC SURGERY PATIENTS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S74-S75), 2023. Date of Publication: November 2023.
Author
Hossain F.; MacLeod J.; D'Souza K.; Legare J.; Hassan A.
Institution
(Hossain, MacLeod, D'Souza, Legare, Hassan) Saint John, New Brunswick
Publisher
Elsevier B.V.
Abstract
BACKGROUND: Brain/B-type natriuretic peptide (BNP) and NT-proBNP are
released by ventricular myocytes during cardiac stress. Elevated NT-proBNP
has been associated with adverse outcomes in patients with heart failure,
acute coronary syndrome, and undergoing major non-cardiac surgery. Few
studies have looked at the prognostic value of NT-proBNP in cardiac
surgery patients. The purpose of the study was to determine if
preoperative NT-proBNP could be used to risk stratify patients undergoing
cardiac surgery. METHODS AND RESULTS: All patients undergoing first time,
non-emergent CABG and/or valve surgery between November 2021 and July 2022
were considered. Patients were excluded if a preoperative NT-proBNP value
could not be obtained. Receiver operating characteristic (ROC) curve
analysis was used to evaluate preoperative NT-proBNP as a predictor of an
in-hospital composite outcome. Youden's index was used to determine
optimal cut point and define two groups: "elevated" and "low" preoperative
NT-proBNP. Unadjusted comparisons were made on the basis of baseline and
intraoperative variables, and in-hospital outcomes. The independent effect
of preoperative NT-proBNP on the composite outcome was determined using
multivariable regression modeling. A total of 324 patients were included.
NT-proBNP, as a predictor of the composite outcome, exhibited an AUC of
0.65 (95% CI: 0.60-0.71). 153 ng/l was determined as the optimal cut point
and used to stratify patients into two groups: low (n=110) and elevated
(n=214) (Figure 1). Preoperatively, elevated patients had increased rates
of atrial fibrillation (1.8% vs. 8.4%, p= 0.026), cerebrovascular disease
(1.8 vs. 8.4, p=0.026), NYHA class IV symptoms (35.5 vs. 47.7, p=0.048),
and ejection fraction (LVEF) < 40% (2.7 vs. 17.8, p < 0.0001). Patients
with elevated NT-proBNP underwent more isolated valve procedures (12.7 vs.
32.7, p=0.001) and had increased inotropic support following surgery (5.5
vs. 17.3, p=0.003). Rate of in-hospital outcomes were significantly higher
in elevated NT-pro BNP patients (Table 1). Following risk adjustment,
elevated preoperative NT-proBNP was found to be an independent predictor
of the composite outcome (OR 2.60, 95% CI 1.53-4.44, p= 0.0004).
 CONCLUSION(S): Elevated pre-operative NT-proBNP, as determined by
optimal cut point, was associated with increased likelihood of adverse
events following cardiac surgery. This suggests that preoperative
NT-proBNP may be used to help risk stratify cardiac surgery patients.
[Formula presented] [Formula presented] Copyright © 2023

<18>
Accession Number
2027990920
Title
LAAOS III SUBSTUDY: ADDITION OF LEFT ATRIAL APPENDAGE OCCLUSION IN AORTIC
VALVE CLINIC DISCUSSIONS TO AID IN DECISIONS BETWEEN SAVR AND TAVR IN
PATIENTS WITH AORTIC STENOSIS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S176-S177), 2023. Date of Publication: November 2023.
Author
Alboom M.; Belley-Cote E.; Whitlock R.
Institution
(Alboom, Belley-Cote, Whitlock) Hamilton, Ontario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: The choice of proceeding with surgical aortic valve
replacement (SAVR) versus transcatheter aortic valve replacement (TAVR) is
based on multiple factors including the surgical risk, patient frailty,
comorbid conditions, and patient preferences and values. LAAOS III was a
large randomized controlled trial that demonstrated concomitant left
atrial appendage occlusion (LAAO) in patients undergoing cardiac surgery
for another indication reduces the risk of stroke/systemic embolism (HR
0.67, 95% CI 0.53-0.85, P=0.001). The results specific to patients
requiring aortic valve intervention have not been described. METHODS AND
RESULTS: This LAAOS III substudy included 1736 patients from 105 centers
in 27 countries in the trial who underwent surgical aortic valve
replacement: 856 (49.3%) patients had concomitant LAAO and 880 (50.7%) did
not. We defined the primary outcome as the first occurrence of ischemic
stroke or type uncertain stroke or systemic arterial embolism over a mean
follow-up of 3.8 years, which occurred in 50 participants (2.9%) in the
LAAO group and in 79 (4.6%) in the no LAAO group (hazard ratio [HR], 0.64;
95% confidence interval, 0.45 to 0.91; P=0.01). The secondary outcome was
the first occurrence of hospital readmission for heart failure during a
mean follow-up of 3.8 years, which occurred in 74 (8.6%) in the LAAO group
and 59 (6.7%) in the no LAAO group (unadjusted HR, 1.29; 95% CI 0.92-1.81,
P=0.15), and the adjusted HR which accounted for sex, age, hypertension,
smoking, ablation, CHA2DS2VASc, LVEF grade (adjusted HR, 1.32; 95% CI
0.94-1.86, P=0.11). CONCLUSION(S): The benefit of LAAO on ischemic
stroke and systemic embolism was consistent among the subset of patients
who underwent surgical aortic valve replacement in LAAOS III. Heart teams
and patients should consider these results when deciding between TAVR and
SAVR in patients with atrial fibrillation requiring aortic valve
replacement. [Formula presented] [Formula presented] Copyright ©
2023

<19>
Accession Number
2027762585
Title
TCT-444 Mid to Long-Term Outcomes of Transcatheter vs Surgical Aortic
Valve Replacement in Low-Risk Patients With Severe Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B178-B179),
2023. Date of Publication: 24 Oct 2023.
Author
Afzal M.A.; Khalid N.; Abdullah M.; Hasan S.; Hassan M.; Elkattawy S.;
Lipat K.; Vasudev R.
Institution
(Afzal) St Joseph's University Medical Center, Saddle Brook, NJ, United
States
(Khalid) St. Joseph's University Medical center, Paterson, NJ, United
States
(Abdullah) Shaikh Zayed Hospital, Lahore, Pakistan
(Hasan, Elkattawy, Vasudev) St Joseph's University Medical Center,
Paterson, NJ, United States
(Hassan) Howard University Hospital, Washington, DC, United States
(Lipat) St. Joseph's University Medical Center, Newark, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an
established alternative to surgical aortic valve replacement (SAVR) for
high-risk surgical patients with severe aortic stenosis (AS). Recently,
TAVR has been extended to low-risk patients, but there are limited pooled
data on its long-term outcomes. We conducted a meta-analysis, including
the mid-term and long-term results of ongoing randomized control trials
(RCTs) comparing TAVR vs SAVR outcomes in low-risk patients.
 Method(s): We comprehensively searched MEDLINE, Cochrane, Embase, and
clinicaltrials.gov. After the screening, the included RCTs were analyzed
using the random-effects model. Odds ratios with 95% CIs were calculated
for the outcomes. Follow-up was classified as short (30 days), mid (1-2
years), and long-term (>2 years). Result(s): Four RCTs with 2,812
participants were included, with follow-up ranging from 1 year to 5 years.
The results showed that TAVR was non-inferior to SAVR regarding both mid
to long-term and short-term all-cause mortality. TAVR reduced the odds of
atrial fibrillation significantly as compared with SAVR. However, the odds
of permanent pacemaker implantation were significantly higher for TAVR as
compared with SAVR. The odds for aortic valve reintervention,
endocarditis, myocardial infarction, and stroke after the intervention
were insignificant. [Formula presented] Conclusion(s): Our
meta-analysis suggests that TAVR is a prospective treatment for low-risk
patients with severe AS. TAVR demonstrated comparable cardiovascular
outcomes and safety profiles to SAVR. Nevertheless, further studies with
long-term outcomes are necessary to confirm these findings. Categories:
STRUCTURAL: Valvular Disease: Aortic Copyright © 2023

<20>
Accession Number
2027761964
Title
TCT-211 Intentional Coronary Revascularization Versus Conservative Therapy
in Patients, Who Underwent Successful Peripheral Artery Revascularization
due to Critical Limb Ischemia: The INCORPORATE Randomized Clinical Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B81), 2023.
Date of Publication: 24 Oct 2023.
Author
Toth G.G.; Brodmann M.; Schnur S.K.; Bartus S.; Vrsalovic M.; Krestianinov
O.; Kala P.; Bil J.; Gil R.; Di Serafino L.; Kanovsky J.; Paolucci L.;
Barbato E.; Mangiacapra F.; Ruzsa Z.
Institution
(Toth) University Heart Center Graz, Medical University Graz, Graz,
Austria
(Brodmann) Medical University Graz, Graz, Austria
(Schnur) University Heart Center Graz, Graz, Austria
(Bartus) Jagiellonian University, Krakow, Poland
(Vrsalovic) Sestre Milosrdnice University Hospital, Zagreb, Croatia
(Krestianinov) Interventional Cardiology, NRTCP Novosibirisk, Russian
Federation
(Kala, Kanovsky) University Hospital Brno, Brno, Czechia
(Bil) Centre of Postgraduate Medical Education, Lesznowola, Poland
(Gil) National Medical Institute of the Internal Affairs and
Administration Ministry, Warsaw, Poland
(Di Serafino) OLV Clinic, Capaccio, Italy
(Paolucci) Uni Rome, Rome, Italy
(Barbato) Sapienza University of Rome, Rome, Italy
(Mangiacapra) Unknown, Rome, Italy
(Ruzsa) University of Szeged, Invasive Cardiology Division, Szeged,
Hungary
Publisher
Elsevier Inc.
Abstract
Background: Severe peripheral artery disease is associated with increased
cardiovascular risk. The INCORPORATE trial was designed to evaluate
whether a default invasive approach with coronary angiography (CA) and
ischemia-targeted revascularization is superior compared with a
conventional conservative approach in terms of spontaneous myocardial
infarction and mortality at 12 months in patients with treated critical
limb ischemia (CLI) (NCT03712644). Method(s): INCORPORATE trial is an
open-label, prospective 1:1 randomized multicentric trial, recruiting
patients, who underwent successful peripheral revascularization due to
CLI. Patients were randomized to conservative vs invasive approach
regarding possible concomitant coronary artery disease. Conservative group
received optimal medical therapy alone. Invasive group underwent default
CA and fractional flow reserve-guided revascularization regardless of
cardiac symptoms. Result(s): Due to COVID-19 pandemic-related
burdens, recruitment had to be halted prematurely. In total, 185 patients
were enrolled (mean age 69 years; 66% male). Baseline cardiac symptoms
were scarce, with 92% of patients being asymptomatic. Eighty-nine patients
were randomized to the Invasive group, of whom 73 underwent per-protocol
CA. Thirty-four percent had single-vessel disease and 26% multivessel
disease. Functionally complete revascularization was achieved in 90% of
cases. All patients completed 1-year follow-up. Conservative and Invasive
groups had similar incidence of combined primary endpoint of death and
myocardial infarction at 1 year (11% vs 10%; HR: 1.21 [95% CI: 0.49 to
2.98]). Major adverse cardiac and cerebrovascular events trended for
hazard, associated with the conservative approach (20% vs 10%; HR: 1.94
[95% CI: 0.90 to 4.19]). In per-protocol analysis, primary endpoint
remained nonsignificantly different (11% vs 7%; HR: 2.01 [95% CI: 0.72 to
5.57]), while an increased risk of major adverse cardiac and
cerebrovascular events was shown for the conservative approach (20% vs 7%;
HR: 2.88 [95% CI: 1.24 to 6.68]). Conclusion(s): Despite scarce
cardiac symptoms, the incidence of significant coronary artery disease is
high in patients with CLI. This study is the first to show that default CA
and functionally guided revascularization might be beneficial. Categories:
ENDOVASCULAR: Peripheral Vascular Disease and Intervention Copyright
© 2023

<21>
Accession Number
2027761138
Title
TCT-436 Outcomes of Renin-Angiotensin Inhibitors Following Transcatheter
Aortic Valve Implantation.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B175-B176),
2023. Date of Publication: 24 Oct 2023.
Author
Gupta R.; Hosseinpour A.; Al-Mohamad T.; Patel N.
Institution
(Gupta) Lehigh Valley Health Network, Macungie, PA, United States
(Hosseinpour) Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Al-Mohamad) Lehigh Valley Health Network, Allentown, PA, United States
(Patel) Lehigh Valley Heart Institute, Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Recently, several clinical studies have investigated the
effects of renin-angiotensin system (RAS) inhibitors in patients with
aortic stenosis (AS) undergoing transcatheter aortic valve implantation
(TAVI). We sought to investigate the impact of RAS inhibitors following
TAVI on clinical outcomes and long-term (>=1 year) survival in patients
with AS. Method(s): In a systematic approach, we searched digital
databases to find the studies comparing clinical outcomes of AS patients
undergoing TAVI between patients prescribed an RAS inhibitor and the ones
who were not prescribed. Data were analyzed using random-effect analysis
and presented as relative risk (RR) and 95% confidence interval (CI).
 Result(s): Data from 9 articles with 36,322 AS patients undergoing
TAVI were included for meta-analysis. Our results demonstrated that taking
RAS inhibitors was associated with lower all-cause mortality (RR: 0.73;
95% CI: 0.62-0.85; P = 0.0016), cardiac-related mortality (RR: 0.66; 95%
CI: 0.57-0.76; P = 0.0029), and rehospitalization rate (RR: 0.83; 95% CI:
0.77-0.90; P = 0.0024). Prescription of RAS inhibitors following TAVI did
not reduce stroke, myocardial infarction, acute kidney injury, and new
pacemaker implantation. [Formula presented] Conclusion(s): RAS
inhibitors could result in prolonged survival and lower rehospitalization
rate. However, they did not significantly affect other postprocedural
outcomes such as stroke, infarction, kidney injury, and pacemaker
implantation. Categories: OTHER: Diabetes, Lipid Disorders, and Risk
Factor Management Copyright © 2023

<22>
Accession Number
2027760909
Title
TCT-612 Comparing Direct Oral Anticoagulants to Vitamin K Antagonists in
Atrial Fibrillation Patients With Bioprosthetic Valves: A Comprehensive
Evaluation Through Systematic Review and Network Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B246), 2023.
Date of Publication: 24 Oct 2023.
Author
Suppah M.; Kamal A.; Saadoun R.; Baradeiya A.; Abraham B.; Alsidawi S.;
Sorajja D.; Fortuin F.D.; Arsanjani R.
Institution
(Suppah, Abraham, Alsidawi, Sorajja, Fortuin, Arsanjani) Mayo Clinic,
Phoenix, AZ, United States
(Kamal) University of Pittsburgh, Pittsburgh, PA, United States
(Saadoun) University of Pittsburgh, Mannheim, Germany
(Baradeiya) Baylor College of Medicine, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Direct oral anticoagulants (DOACs) are a newer class of
anticoagulants that inhibit Factor Xa or Factor IIa, and include drugs
such as rivaroxaban, apixaban, edoxaban, betrixaban, and dabigatran.
Although vitamin K antagonists (VKAs) have been traditionally used to
prevent thromboembolic events, DOACs have gained popularity caused by
their faster onset and offset of action and reduced need for monitoring.
We aim to provide more data for anticoagulants in atrial fibrillation (AF)
patients with bioprosthetic heart valves (BHVs) by incorporating all
available trials to date. Method(s): A search was performed across 5
electronic databases to identify relevant studies. We analyzed data using
pooled risk ratio for categorical outcomes and used the I2 test to
determine heterogeneity. Our study included a frequentist network
meta-analysis of the aggregate data to obtain network estimates for the
outcomes of interest. Result(s): We retrieved 28 studies with a total
of 74,660 patients with BHVs included. Our meta-analysis significantly
showed that DOACs decrease the risk of all-cause bleeding (RR: 0.80; 95%
CI: [0.75-0.85]; P > 0.00001), stroke and systemic embolization (RR: 0.89;
95% CI: [0.80-0.99]; P = 0.03), and intracranial bleeding outcomes (RR:
0.62; 95% CI: [0.45-0.86]; P = 0.004) compared to VKA. in contrast, there
was no significant difference between the compared groups in major
bleeding (RR: 0.92; 95% CI: [0.84-1.02]; P = 0.10) and all-cause mortality
outcomes (RR: 0.96; 95% CI: [0.85-1.07]; P = 0.43), respectively.
Additionally, network meta-analysis results did not favor any of the
studied interventions over each other (P < 0.05) regarding all-cause
bleeding, mortality, stroke and systemic embolization, and major bleeding
outcomes. Conclusion(s): Our study found that DOACs are more
effective in reducing the risk of bleeding, stroke, systemic embolism, and
intracranial bleeding when compared with VKAs. However, no significant
difference was observed in the incidence of gastrointestinal bleeding,
major bleeding, thromboembolic events, and all-cause mortality.
Additionally, our network meta-analysis did not identify any specific DOAC
treatment as more favorable than others. Categories: STRUCTURAL: Valvular
Disease: Aortic Copyright © 2023

<23>
Accession Number
2027760845
Title
TCT-586 Comparing Left Ventricular Pacing Versus Right Ventricular Pacing
in Patients Undergoing TAVI.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B235), 2023.
Date of Publication: 24 Oct 2023.
Author
Kaur A.; Balboul Y.; Dhaliwal A.; Dominguez A.C.; Basman C.
Institution
(Kaur, Balboul) Icahn School of Medicine at Mount Sinai Morningside/West,
New York, NY, United States
(Dhaliwal) Icahn School of Medicine at Mount Sinai Morningside/West, New
York, NY, United States
(Dominguez) Mount Sinai Morningside, New York, NY, United States
(Basman) Lenox Hill Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Rapid ventricular pacing is crucial during transcatheter
aortic valve implantation (TAVI) to ensure cardiac standstill for optimal
valve deployment and positioning. Conventionally, this is achieved by
temporary transvenous right ventricle pacing (RVP), which needs additional
venous access. Hence, this approach increases risk of vascular
complications, prolongs procedure time, and can lead to myocardial
perforation, pericardial effusion, and cardiac tamponade. Left ventricular
pacing (LVP) using guidewire is becoming increasingly popular; however,
the evidence on its efficacy and safety is still limited. Therefore, we
performed a meta-analysis comparing LVP vs RVP during TAVI.
 Method(s): A comprehensive review of electronic databases (PubMed,
Embase, Scopus, Cochrane) was performed using keywords Ventricular Pacing
and TAVR from inception through July 2023. The primary efficacy outcome
was mean procedure time (minutes). Safety outcomes include major vascular
complications (VARC-2), cardiac tamponade, and in-hospital mortality. A
random-effects analysis was used to estimate the pooled risk ratio (RR),
with a 95% confidence interval (CI) using Revman 5.4.1. Heterogeneity was
assessed using the Higgins I2. Result(s): Three eligible studies (1
RCT, 2 observational) were identified, including 1,672 patients (LVP n =
989, RVP n = 683).The mean age was 82.2 +/- 0.9 years. There was a
statistically significant difference in the primary efficacy outcome of
mean procedure time (MD: -8.27; CI: -11.31 to -5.23; P < 0.05;
I2 = 46%) between LVP vs RVP in those undergoing TAVI. Safety
outcomes of major vascular complications (RR: 0.37; CI: 0.15-0.89; P <
0.05; I2 = 0%) were also significantly lower in LVP vs RVP
group. However, there was no statistically significant difference in the
safety outcomes for cardiac tamponade (RR: 0.55; CI: 0.27-1.13; P > 0.05;
I2 = 0%) and in-hospital mortality (RR: 0.51; CI: 0.26-1.01; P
= 0.05; I2 = 0%) between LVP vs RVP in patients undergoing
TAVI. Conclusion(s): Compared with RVP, LVP is associated with
significantly shorter procedure time, and fewer vascular complications.
However, there was no statistically significant reduction in cardiac
tamponade and in-hospital mortality. Categories: STRUCTURAL: Valvular
Disease: Aortic Copyright © 2023

<24>
Accession Number
2027760837
Title
TCT-278 Impact of Mitral Annular Calcification and Concomitant Mitral
Valve Disease on Transcatheter Aortic Valve Replacement Outcomes: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B109-B110),
2023. Date of Publication: 24 Oct 2023.
Author
Ahmad S.; Yousaf A.; Ghumman G.M.; Dvalishvili M.; Ahsan M.J.; Dilibe A.;
Reis H.; Qavi A.H.; Szerlip M.; Goldsweig A.
Institution
(Ahmad) University of Nebraska Medical Center (UNMC/UNO), Omaha, NE,
United States
(Yousaf) McLaren Flint/Michigan State University, Flint, MI, United States
(Ghumman) Mercy Health Saint Vincent Medical Center, Toledo, OH, United
States
(Dvalishvili, Dilibe, Reis, Qavi) East Carolina University, Greenville,
NC, United States
(Ahsan) Iowa Heart Center, MercyOne, West Des Moines, IA, United States
(Szerlip) Baylor Scott & White The Heart Hospital-Plano, Plano, TX, United
States
(Goldsweig) Baystate Medical Center, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Mitral annular calcification (MAC) and concomitant mitral
valve dysfunction (MVD) are prevalent among patients undergoing
transcatheter aortic valve replacement (TAVR), but their impact on TAVR
outcomes is not fully understood. Method(s): An extensive search of
MEDLINE, Embase, Google Scholar, Scopus, and ClinicalTrials.gov was
performed for relevant studies through March 20, 2023. The random-effects
Mantel-Haenszel method was utilized to estimate pooled risk ratios (RRs)
and their associated 95% CIs for all binary outcomes. Severe MAC was
defined as >4 mm maximum calcium thickness and MVD as moderate-severe
mitral valve stenosis or regurgitation. Result(s): Our analysis
included 6 studies with a total of 5,822 patients; 2,541 had MAC (583 with
severe MAC, 1,958 with non severe MAC; 400 with MVD, 1,071 without MVD).
Compared with the non-MAC group, patients with MAC had similar mortality,
stroke, and permanent pacemaker implantation at 30 days and 1 year.
However, MAC with MVD was associated with a higher risk of all-cause
mortality at 30 days (RR: 3.43; 95% CI: 2.04-5.76; P < 0.00001) and at 1
year (RR: 2.44; 95% CI: 1.85-3.20; P < 0.00001) compared with MAC without
MVD. Patients with MAC and MVD also had a higher risk of cardiovascular
mortality (RR: 2.77; 95% CI: 1.89-4.06; P < 0.00001). Lastly, patients
with severe MAC had a higher risk of major bleeding at 30 days (RR: 1.33;
95% CI: 1.04-1.69; P = 0.02). [Formula presented] Conclusion(s): MAC
with concomitant MVD was associated with decreased survival in TAVR
patients. Additionally, severe MAC was associated with a higher risk of
major bleeding following TAVR. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2023

<25>
Accession Number
2030161511
Title
Ticagrelor vs Clopidogrel for Complex Percutaneous Coronary Intervention
in Chronic Coronary Syndrome.
Source
JACC: Cardiovascular Interventions. 17(3) (pp 359-370), 2024. Date of
Publication: 12 Feb 2024.
Author
Lattuca B.; Mazeau C.; Cayla G.; Ducrocq G.; Guedeney P.; Laredo M.;
Dumaine R.; El Kasty M.; Kala P.; Nejjari M.; Hlinomaz O.; Morel O.;
Varenne O.; Leclercq F.; Payot L.; Spaulding C.; Beygui F.; Range G.;
Motovska Z.; Portal J.-J.; Vicaut E.; Collet J.-P.; Montalescot G.;
Silvain J.
Institution
(Lattuca, Cayla, Guedeney, Laredo, Collet, Montalescot, Silvain) Sorbonne
Universite, ACTION Study Group, INSERM UMRS1166, Hopital Pitie-Salpetriere
(AP-HP), Paris, France
(Lattuca, Mazeau, Cayla) Cardiology Department, Nimes University Hospital,
Montpellier University, ACTION Study Group, Nimes, France
(Ducrocq) Cardiology Department, Universite de Paris, Hopital Bichat,
AP-HP, French Alliance for Cardiovascular Trials (FACT), INSERM U1148,
Paris, France
(Dumaine) Les Grands Pres Cardiac Rehabilitation Centre, Villeneuve St
Denis, France
(El Kasty) Departement de Cardiologie, Grand Hopital de l'Est Francilien
site Marne-La-Vallee, Marne-la-Vallee, France
(Kala, Hlinomaz) University Hospital Brno, Medical Faculty of Masaryk
University Brno, Brno, Czechia
(Nejjari) Cardiology Department, Centre Cardiologique du Nord, Paris,
France
(Morel) Division of Cardiovascular Medicine, Nouvel Hopital Civil,
Strasbourg University Hospital, Strasbourg, France
(Varenne) Department of Cardiology, Cochin Hospital, Hopitaux
Universitaire Paris Centre, Assistance Publique des Hopitaux de Paris,
Paris, France
(Leclercq) Department of Cardiology, Arnaud de Villeneuve Hospital,
Montpellier University, Montpellier, France
(Payot) Cardiology Department, General Hospital Yves Le Foll,
Saint-Brieuc, France
(Spaulding) Department of Cardiology, European Hospital Georges Pompidou,
Assistance Publique-Hopitaux de Paris, Paris Cite University, Sudden
Cardiac Death Expert Center, INSERM U 971, PARCC, Paris, France
(Beygui) Cardiology Department, Caen University Hospital, ACTION Study
Group, Caen, France
(Range) Cardiology Department, Chartres Hospital, Chartres, France
(Motovska) Cardiocenter, Third Faculty of Medicine, Charles University and
University Hospital Kralovske Vinohrady, Prague, Czechia
(Portal, Vicaut) ACTION Study Group, Unite de Recherche Clinique, Hopital
Fernand Widal (AP-HP), EA 4543, Universite Paris 1 Pantheon-Sorbonne
Paris, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Whether ticagrelor in chronic coronary syndrome patients
undergoing complex percutaneous coronary intervention (PCI) can prevent
cardiovascular events is unknown. Objective(s): The authors sought to
evaluate outcomes of complex PCI and the efficacy of ticagrelor vs
clopidogrel in stable patients randomized in the ALPHEUS (Assessment of
Loading with the P2Y<inf>12</inf> inhibitor ticagrelor or clopidogrel to
Halt ischemic Events in patients Undergoing elective coronary Stenting)
trial. Method(s): All PCI procedures were blindly reviewed and
classified as complex if they had at least 1 of the following criteria:
stent length >60 mm, 2-stent bifurcation, left main, bypass graft, chronic
total occlusion, use of atherectomy or guiding catheter extensions,
multiwire technique, multiple stents. The primary endpoint was a composite
of type 4a or b myocardial infarction (MI) and major myocardial injury
during the 48 hours after PCI. We compared the event rates according to
the presence or not of complex PCI criteria and evaluated the interaction
with ticagrelor or clopidogrel. Result(s): Among the 1,866 patients
randomized, 910 PCI (48.3%) were classified as complex PCI. The primary
endpoint was more frequent in complex PCI (45.6% vs 26.6%; P < 0.001)
driven by higher rates of type 4 MI and angiographic complications (12.2%
vs 4.8 %; P < 0.001 and 19.3% vs 8.6%; P < 0.05, respectively). The
composite of death, MI, and stroke at 48 hours (12.7% vs 5.1 %; P < 0.05)
and at 30 days (13.4% vs 5.3%; P < 0.05) was more frequent in complex PCI.
No interaction was found between PCI complexity and the randomized
treatment for the primary endpoint (P<inf>interaction</inf> = 0.47) nor
the secondary endpoints. Conclusion(s): In chronic coronary syndrome,
patients undergoing a complex PCI have higher rates of periprocedural and
cardiovascular events that are not reduced by ticagrelor as compared with
clopidogrel. Copyright © 2024 American College of Cardiology
Foundation

<26>
Accession Number
2030218234
Title
Comparative evaluation of dexamethasone and dexmedetomidine as adjuvants
for bupivacaine in ultrasound guided PEC blocks in patients undergoing
modified radical mastectomy under general anaesthesia: A prospective
randomized control trial.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
12(4) (pp 1122-1126), 2023. Date of Publication: October 2023.
Author
Mallikarjuna; Deshpande N.; Alwandikar V.; Hatti P.; Gowda V.B.
Institution
(Mallikarjuna, Hatti) Department of Anaesthesiology, VTSM Peripheral
Cancer Centre, Branch of Kidwai Memorial Institute of Oncology, Bangalore,
Kalaburagi, India
(Deshpande) Department of Anaesthesiology, K.B.N University, Faculty of
Medical Sciences, Kalaburagi, India
(Alwandikar) Department of Anaesthesiology, Gulbarga Insititute of Medical
Sciences, Kalaburagi, India
(Gowda) Department of Anesthesiology, Kidwai Memorial Institute of
Oncology, Karnataka, Bangalore, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: The most common surgical procedure for breast cancer is
modified radical mastectomy (MRM), associated with severe acute
postoperative pain. With the advent of ultrasonography regional
anaesthesia techniques have developed considerably. Present study was
aimed to compare dexamethasone and dexmedetomidine as adjuvants for
Bupivacaine in ultrasound guided PEC blocks in patients undergoing
Modified Radical Mastectomy under General anaesthesia at a tertiary
hospital. Material(s) and Method(s): Present study was single-center,
prospective, clinical study, conducted in patients aged between 18 - 65
years, belonging to ASA Grade l and ll, underwent Modified Radical
Mastectomy under General anaesthesia, followed by ultrasound guided PEC
blocks. 60 patients were randomly distributed in two groups (30 patients
each) by random chit method as group A (Bupivacaine with Dexamethasone) &
group B (Bupivacaine with Dexmedetomidine). Result(s): In present
study, 60 patients were divided in group A (n=30) & group B (n=30).
General characteristics such as age (years), ASA (I/II), weight (kg),
height (cm), BMI (kg/m2), mean duration of surgery (min), baseline heart
rate & baseline MAP were comparable among both groups & difference was not
statistically significant. In present study, group B (dexmedetomidine) had
prolonged duration of analgesia, late requirement of rescue analgesia as
compared to group A (dexamethasone), and difference was statistically
significant. The VAS pain score was lower in patients of group A as
compared to patients in group B up to at 6th postoperative hour and this
difference in pain score was statistically significant. Increased
incidence of postoperative nausea and vomiting was noted in group B as
compared to group A, difference was not statistically significant
(p-0.407). Conclusion(s): Dexmedetomidine has advantages over
dexamethasone regarding longer duration of the block and lesser rescue
analgesic requirement. Copyright © 2023Int. J.
LifeSci.Biotechnol.Pharma.Res.

<27>
Accession Number
2030212158
Title
One-year mortality and causes of death after stereotactic radiation
therapy for refractory ventricular arrhythmias: A systematic review and
pooled analysis.
Source
Trends in Cardiovascular Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Benali K.; Zei P.C.; Lloyd M.; Kautzner J.; Guenancia C.; Ninni S.; Rigal
L.; Simon A.; Bellec J.; Vlachos K.; Sacher F.; Hammache N.; Sellal J.-M.;
de Crevoisier R.; Da Costa A.; Martins R.
Institution
(Benali, Da Costa) Section of Cardiac Electrophysiology, Saint-Etienne
University, Saint-Etienne, France
(Benali, Vlachos, Sacher) IHU LIRYC, Electrophysiology and Heart Modeling
Institute, Bordeaux, France
(Benali, Rigal, Simon, Martins) INSERM-LTSI, Rennes U1099, France
(Zei) Department of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, United States
(Lloyd) Section of Cardiac Electrophysiology, Emory University, Atlanta,
United States
(Kautzner) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Guenancia) Section of Cardiac Electrophysiology, Dijon University, Dijon,
France
(Ninni) Heart and Lung Institute, Lille University, Lille, France
(Bellec, de Crevoisier) Department of Radiation Oncology, Centre Eugene
Marquis, Rennes, France
(Hammache, Sellal) Section of Cardiac Electrophysiology, Nancy University,
Nancy, France
(Martins) Section of Cardiac Electrophysiology, Rennes University, Rennes,
France
Publisher
Elsevier Inc.
Abstract
Patients treated with cardiac stereotactic body radiation therapy
(radioablation) for refractory ventricular arrhythmias are patients with
advanced structural heart disease and significant comorbidities. However,
data regarding 1-year mortality after the procedure are scarce. This
systematic review and pooled analysis aimed at determining 1-year
mortality after cardiac radioablation for refractory ventricular
arrhythmias and investigating leading causes of death in this population.
MEDLINE/EMBASE databases were searched up to January 2023 for studies
including patients undergoing cardiac radioablation for the treatment of
refractory ventricular arrhythmias. Quality of included trials was
assessed using the NIH Tool for Case Series Studies (PROSPERO
CRD42022379713). A total of 1,151 references were retrieved and evaluated
for relevance. Data were extracted from 16 studies, with a total of 157
patients undergoing cardiac radioablation for refractory ventricular
arrhythmias. Pooled 1-year mortality was 32 % (95 %CI: 23-41), with almost
half of the deaths occurring within three months after treatment. Among
the 157 patients, 46 died within the year following cardiac radioablation.
Worsening heart failure appeared to be the leading cause of death (52 %),
although non-cardiac mortality remained substantial (41 %) in this
population. Age>=70yo was associated with a significantly higher 12-month
all-cause mortality (p<0.022). Neither target volume size nor radiotherapy
device appeared to be associated with 1-year mortality (p = 0.465 and p =
0.199, respectively). About one-third of patients undergoing cardiac
stereotactic body radiation therapy for refractory ventricular arrhythmias
die within the first year after the procedure. Worsening heart failure
appears to be the leading cause of death in this population. Copyright
© 2023

<28>
Accession Number
643406796
Title
TransCatheter Aortic Valve Implantation and Fractional Flow Reserve-Guided
Percutaneous Coronary Intervention versus Conventional Surgical Aortic
Valve Replacement and Coronary Bypass Grafting for Treatment of Patients
with Aortic Valve Stenosis and Multivessel or Advanced Coronary Disease -
The TransCatheter Valve and Vessels Trial (TCW Trial): Design and
Rationale.
Source
American heart journal. (no pagination), 2024. Date of Publication: 01
Feb 2024.
Author
Kedhi E.; Rroku A.; Hermanides R.S.; Dambrink J.H.; Singh S.; Berg J.T.;
van Winkel D.-J.; Hudec M.; Amoroso G.; Amat-Santos I.J.; Andreas M.;
Teles R.C.; Bonnet G.; Van Belle E.; Conradi L.; van Garsse L.; Wojakowski
W.; Voudris V.; Sacha J.; Cervinka P.; Lipsic E.; Somi S.; Nombela-Franco
L.; Postma S.; Piayda K.; De Luca G.; Malinofski K.; Modine T.
Institution
(Kedhi) McGill University Health Center, Montreal, Quebec, Canada;
Department of Cardiology and Structural Heart Disease, Medical University
of Silesia, Katowice, Poland
(Rroku) Deutsches Herzzentrum der Charite, Charite - Universitatsmedizin
Berlin, corporate member of Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Department of Cardiology, Hindenburgdamm
30, 12203 Berlin, Germany; DZHK (German Centre for Cardiovascular
Research), Partner site Berlin, Potsdamer Strase 58, 10785 Berlin, Germany
(Hermanides, Dambrink) Isala Heart Center, Department of Cardiology,
Zwolle, Netherlands
(Singh) Isala Heart Center, Department of Thoracic Surgery, Zwolle,
Netherlands
(Berg, van Winkel) St.Antonius Ziekenhuis, Nieuwegein, the Netherlands and
University Medical Center Maastricht, Maastricht, the Netherlands
(Hudec) Slovak Republic
(Amoroso) Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam,
Netherlands
(Amat-Santos) Centro de Investigacion Biomdica en Red, Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clinico Universitario
de Valladolid, Valladolid, Spain
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Austria
(Teles) Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental,
Lisbon, Portugal
(Bonnet, Modine) Medico-Surgical Department (Valvulopathies, Cardiac
Surgery, Hopital Cardiologique de Haut-Leveque, Bordeaux University
Hospital 33604, France
(Van Belle) Department of Cardiology, Department of Interventional
Cardiology for Coronary, Valves and Structural Heart Diseases, Inserm,
Institut Pasteur de Lille, Universite de Lille, CHU Lille, Lille U1011,
France
(Conradi) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Germany
(van Garsse) Department of Cardiothoracic Surgery, Radboud University
Medical Centre, Geert Grooteplein Zuid 10, GA Nijmegen 6525, Netherlands
(Wojakowski) Department of Cardiology and Structural Heart Disease,
Medical Univ. Silesia, Katowice, Poland
(Voudris) Interventional Department of Cardiology, Onassis Cardiac Surgery
Center, Athens 17674, Greece
(Sacha) Department of Cardiology, University Hospital, Institute of
Medical Sciences, University of Opole, Opole, Poland; Faculty of Physical
Education and Physiotherapy, Opole University of Technology, Opole, Poland
(Cervinka) Department of Cardiology, Krajska Zdravotni a.s., Masaryk
Hospital and UJEP Usti nad Labem, Czechia
(Lipsic) Department of Cardiology, University Medical Center Groningen,
University of Groningen, Hanzeplein 1 ,PO Box 30.001, Groningen,
Netherlands
(Somi) Department of Cardiology, Haga Hospital, The Hague, Netherlands
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos
IdISSC, Madrid, Spain
(Postma) Diagram Research, Zwolle, Netherlands
(Piayda) Department of Cardiology and Vascular Medicine, Medical Faculty,
Justus-Liebig-University Giessen, Giessen, Germany
(De Luca) Division of Clinical and Experimental Cardiology, AOU Sassari,
University of Sassari, Sassari, Italy
(Malinofski) Center for Digital Medicine and Robotics, Jagiellonian
University Medical College, Krakow, Poland; Department of Bioinformatics
and Telemedicine, Faculty of Medicine, Jagiellonian University Medical
College, Krakow, Poland
Abstract
BACKGROUND: Patients with severe aortic stenosis (AS) frequently present
with concomitant obstructive coronary artery disease (CAD). In those,
current guidelines recommend combined coronary artery bypass grafting
(CABG) and surgical aortic valve replacement (SAVR) as the preferred
treatment option, although this surgical approach is associated with a
high rate of clinical events. Combined transcatheter aortic valve
implantation (TAVI) and percutaneous coronary intervention (PCI) with or
without FFR have evolved as a valid alternative for cardiac surgery in
patients with AS and multivessel or advanced CAD. To date, no dedicated
trial has prospectively evaluated the outcomes of a percutaneous versus
surgical treatment for patients with both severe AS and CAD. AIMS: To
investigate whether fractional-flow reserve (FFR)-guided PCI and TAVI is
non-inferior to combined CABG and SAVR for the treatment of severe AS and
multivessel or advanced CAD. METHOD(S): The Transcatheter Valve and
Vessels (TCW) trial (clinicaltrial.gov: NCT03424941) is a prospective,
randomized, controlled, open label, international trial. Patients >= 70
years with severe AS and multivessel (>= 2 vessels) or advanced CAD,
deemed feasible by the heart team for both; a full percutaneous or
surgical treatment, will be randomised in a 1:1 fashion to either
FFR-guided PCI followed by TAVI (intervention arm) vs. CABG and SAVR
(control arm). The primary endpoint is a patient-oriented composite of
all-cause mortality, myocardial infarction, disabling stroke, unscheduled
clinically-driven target vessel revascularization, valve re-intervention,
and life threatening or disabling bleeding at one year. The TCW trial is
powered for non-inferiority, and if met, superiority will be tested.
Assuming a primary endpoint rate of 30% in the CABG-SAVR arm, with a
significance level alpha of 5%, a non-inferiority limit delta of 15% and a
loss to follow-up of 2%, a total of 328 patients are needed to obtain a
power of 90%. The primary endpoint analysis is performed on an
intention-to-treat basis. SUMMARY: The TCW Trial is the first prospective
randomized trial that will study if a less invasive percutaneous treatment
for severe AS and concomitant advanced CAD (i.e., FFR-guided PCI - TAVI)
is non-inferior to the guidelines recommended approach
(CABG-SAVR). Copyright © 2024. Published by Elsevier Inc.

<29>
Accession Number
643406691
Title
Retrospective aprotinin cardiac surgical studies and their limitations:
Time for a prospective RCT.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 03 Feb 2024.
Author
Erdoes G.; Koster A.; Levy J.H.
Institution
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital,
University of Bern, University Hospital Bern, Bern, Switzerland
(Koster) Clinics of Anesthesiology and Intensive Care Medicine, Sana
Herzzentrum Cottbus and Ruhr University of Bochum
(Levy) Departments of Anesthesiology, Critical Care, Surgery, Duke
University School of Medicine, Durham, NC, United States

<30>
Accession Number
2030258610
Title
Clinical outcomes associated with the use of sacubitril/valsartan in the
perioperative period of patients undergoing cardiac surgery: a systematic
review.
Source
REC: CardioClinics. (no pagination), 2024. Date of Publication: 2024.
Author
Gilon L.; Davila V.; Munoz O.; Garcia A.; Caceres E.
Institution
(Gilon, Davila, Munoz) Departamento de Medicina Interna, Pontificia
Universidad Javeriana, Bogota, Colombia
(Munoz) Departamento de Medicina Interna, Hospital Universitario San
Ignacio, Bogota, Colombia
(Garcia, Caceres) Unidad de Cardiologia, Hospital Universitario San
Ignacio, Bogota, Colombia
Publisher
Elsevier Espana S.L.U
Abstract
Introduction and objectives: Sacubitril/valsartan (SV) is recommended in
patients with heart failure, especially in reduced ejection fraction. So
far, the safety of its use in perioperative cardiac surgery is uncertain
but given its mechanism of action and possible blood pressure lowering
effect, some guidelines recommend discontinuation, without clear evidence.
This systematic review aims to assess clinical outcomes of use SV in the
perioperative period compared with never having used it or its withdrawal.
 Method(s): Systematic literature review in MedLine, Cochrane, EMBASE
and LILACs of studies published in English and Spanish. We included
randomized clinical trials and non-randomized studies evaluating adult
patients undergoing cardiac surgery that compared the use of SV up to the
day of surgery versus stopping or not starting it prior to the procedure.
In-hospital and 30-day mortality, length of stay in general ward and
intensive care unit stay, orotracheal intubation, postoperative vasoplegia
and need for renal replacement therapy were assessed. Quality was assessed
using the ROBINS tool. Result(s): Three non-randomized studies were
included, one single-arm. There were fewer cases of in-hospital and 30-day
mortality in the group in which SV was not discontinued, with no
statistically significant difference. There was no difference in length of
hospital or intensive care unit stay, orotracheal intubation, need for
renal replacement therapy, or frequency of postoperative vasoplegia (OR,
0.77; 95%CI, 0.23-2.98). Conclusion(s): The current evidence is
scarce and of low quality so a recommendation regarding the use of SV
prior to cardiac surgery cannot be generated, further studies are
required. Copyright © 2024 Sociedad Espanola de Cardiologia

<31>
Accession Number
2030118592
Title
Global Insights into Chronic Obstructive Pulmonary Disease and Coronary
Artery Disease: A Systematic Review and Meta-Analysis of 6,400,000
Patients.
Source
Reviews in Cardiovascular Medicine. 25(1) (no pagination), 2024. Article
Number: 25. Date of Publication: 2024.
Author
Zheng Y.; Hu Z.; Seery S.; Li C.; Yang J.; Wang W.; Qi Y.; Shao C.; Fu Y.;
Xiao H.; Tang Y.-D.
Institution
(Zheng, Li, Yang, Wang, Qi, Shao, Xiao, Tang) Department of Cardiology,
Institute of Vascular Medicine, Peking University Third Hospital, NHC Key
Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,
Key Laboratory of Molecular Cardiovascular Science, Ministry of Education,
Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing
100191, China
(Zheng, Xiao, Tang) Research Unit of Medical Science Research
Management/Basic and Clinical Research of Metabolic Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Beijing 100021, China
(Hu) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing 100005, China
(Seery) School of Humanities and Social Sciences, Chinese Academy of
Medical Science, Peking Union Medical College, Beijing 100005, China
(Seery) Faculty of Health and Medicine, Division of Health Research,
Lancaster University, Lancaster LA1 4YW, United Kingdom
(Fu) Department of Physiology and Pathophysiology, School of Basic Medical
Sciences, Peking University, Key Laboratory of Molecular Cardiovascular
Science, Ministry of Education, Beijing 100191, China
Publisher
IMR Press Limited
Abstract
Background: The high prevalence of chronic obstructive pulmonary disease
(COPD) in coronary artery disease (CAD) has been acknowledged over the
past decade, although the cause/s remain uncertain due to differences in
diagnoses. COPD has also become a leading CAD comorbidity, although again
little is known about its interactions. This meta-analysis explored COPD
prevalence in the global CAD population, as well as the influence of COPD
on CAD. Method(s): PubMed, Web of Science, Embase, and grey
literature were searched until 26th November 2021. The prevalence of COPD
was calculated, and data were grouped according to COPD diagnostic
methods, interventions, region, economic status, etc. Outcomes including
all-cause death, cardiac death, myocardial infarction, revascularization,
stroke, heart failure, and respiratory failure were analyzed. This study
was registered with PROSPERO (CRD No.42021293270). Result(s): There
was an average prevalence of 14.2% for COPD in CAD patients (95% CI:
13.3-15.1), with diagnostics of COPD through spirometry, International
Classification of the Diseases (ICD codes), and self-reported methods.
Comorbid COPD-CAD patients were more likely to be smokers and suffer from
cardiovascular and respiratory complications (all odds ratios [OR] >1).
COPD-CAD has higher mortality (hazard ratio [HR] 2.81, 95% CI: 2.40-3.29),
and myocardial infarction, stroke, and respiratory failure rates (all HR
>1). Coronary artery bypass graft (CABG) reduces the need for
revascularization (HR 0.43, 95% CI: 0.20-0.94) compared to percutaneous
coronary intervention (PCI), without increasing mortality.
 Conclusion(s): The global prevalence of COPD is particularly high in
CAD patients. COPD-CAD patients are more likely to encounter
cardiovascular and respiratory complications and endure poorer outcomes.
Limited evidence suggests that CABG may reduce the need for
revascularization without increasing mortality, although further research
is required to confirm these observations. Copyright: © 2024 The
Author(s). Published by IMR Press.

<32>
Accession Number
2030118585
Title
Intravascular Ultrasound versus Angiography Guided Drug Eluting Stent
Implantation in Patients with Left Main Coronary Artery Disease - A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 25(1) (no pagination), 2024. Article
Number: 32. Date of Publication: 2024.
Author
Karim K.; Akbar M.R.; Pramudyo M.; Martha J.W.
Institution
(Karim, Akbar, Pramudyo, Martha) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, University of Padjadjaran, Bandung 40161,
Indonesia
Publisher
IMR Press Limited
Abstract
Background: Several technical limitations exist in angiography procedures,
including suboptimal visualization of a particular location and
angiography only providing information about the contour of the vascular
lumen, while intravascular ultrasound (IVUS) provides information
regarding wall composition on coronary vascular lesions. With recent
trials demonstrating IVUS benefits over standard angiography, our
meta-analysis aimedto evaluate and summarize the current evidence on
whether IVUS-guided drug-eluting stent (DES) placement resulted in better
outcomes than the angiography-guided DES placement in patients with left
main coronary artery (LMCA) disease. This meta-analysis aimed to analyze
the current evidence on the IVUS-guided and angiography-guided
drug-eluting stent (DES) placement in patients with LMCA disease.
 Method(s): Literature searching was performed using Scopus, Embase,
PubMed, EuropePMC, and Clinicaltrials.gov using PRISMA guidelines. The
intervention group in our study are patients undergoing IVUS-guided
percutaneous coronary intervention (PCI) and the control group are
patients undergoing angiography alone-guided PCI. Cardiovascular
mortality, all-cause mortality, target lesion revascularization,
myocardial infarction, and stent thrombosis were compared between the two
groups. Result(s): There were 11 studies comprising 24,103 patients
included in this meta-analysis. IVUS-guided PCI was associated with lower
cardiovascular mortality (hazard ratio (HR) 0.39 [95% CI 0.26, 0.58], p <
0.001; I2: 75%, p < 0.001) and all-cause mortality (HR 0.59
[95% CI 0.53, 0.66], p < 0.001; I2: 0%, p = 0.45) compared to
angiography alone guided PCI. The group receiving IVUS guided PCI has a
lower incidence of myocardial infarction (HR 0.66 [95% CI 0.48, 0.90], p =
0.008; I2: 0%, p = 0.98), target lesion revascularization (HR
0.45 [95% CI 0.38, 0.54], p < 0.001; I2: 41%, p = 0.10) and
stent thrombosis (HR 0.38 [95% CI 0.26, 0.57], p < 0.001; I2:
0%, p = 0.50) compared to the control group. Conclusion(s): Our
meta-analysis demonstrated that IVUS-guided DES placement had lower
cardiovascular mortality, all-cause mortality, target lesion
revascularization, myocardial infarction, and stent thrombosis than
angiography-guided DES implantation. Copyright: © 2024 The
Author(s). Published by IMR Press.

<33>
Accession Number
2030118576
Title
Heart Rate Variability and Coronary Artery Bypass Grafting: A Systematic
Review.
Source
Reviews in Cardiovascular Medicine. 25(1) (no pagination), 2024. Article
Number: 36. Date of Publication: 2024.
Author
Matusik P.S.; Alomar O.; Hussain M.R.; Akrmah M.; Matusik P.T.; Chen D.M.;
Alomar M.; Stein P.K.
Institution
(Matusik) Jagiellonian University Medical College, University Hospital,
Krakow 30-688, Poland
(Alomar, Alomar, Stein) Heart Rate Variability Laboratory, Cardiovascular
Division, Department of Medicine, Washington University School of Medicine
in St. Louis, Saint Louis, MO 63130, United States
(Hussain) Icahn School of Medicine at Mount Sinai, New York, NY 10029,
United States
(Akrmah) Department of Pathology, Brigham and Women's Hospital, Boston, MA
02215, United States
(Matusik) Department of Electrocardiology, Institute of Cardiology,
Faculty of Medicine, Jagiellonian University Medical College, Krakow
31-202, Poland
(Matusik) Department of Electrocardiology, The John Paul II Hospital,
Krakow 31-202, Poland
(Chen) Feinberg School of Medicine, Northwestern University, Chicago, IL
60611, United States
Publisher
IMR Press Limited
Abstract
Background: Coronary artery bypass grafting (CABG) is a well-established
surgical procedure used to treat significant coronary artery disease.
Nevertheless, unfavorable cardiovascular events and complications,
including cardiac arrhythmias may be observed in patients after CABG.
Previous studies have revealed a relationship between risk of cardiac
arrhythmias and abnormal heart rate variability (HRV), which reflects
adverse alterations in cardiac autonomic functioning, that may occur in
patients after a CABG procedure. The aim of this article was to provide a
systematic review of the major research findings in this area.
 Method(s): A literature search was carried out using PubMed,
Cochrane, and Embase databases and relevant articles, published in
English, were analyzed in detail. Result(s): Studies performed so far
have shown time depending changes in HRV after CABG. Time and frequency
domain HRV decrease acutely after CABG but recover almost completely to
pre-operative values by 6 months after surgery. Some preoperative clinical
states such as: heart failure, type 2 diabetes mellitus and depression
adversely affect post-CABG HRV. Finally, post-CABG cardiac rehabilitation
appears to improve exercise capacity and speed up recovery of HRV.
 Conclusion(s): Generally, traditional time and frequency domain HRV
parameters fail to predict complications post-CABG. Altered non-linear
measures of HRV may identify subgroups of subjects at increased risk of
potential complications, including atrial fibrillation post-CABG. However,
data available currently does not appear to unequivocally support the
hypothesis that early HRV assessment in post-CABG patients predicts
long-term mortality. Copyright: © 2024 The Author(s). Published
by IMR Press.

<34>
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.

<35>
Accession Number
2025978909
Title
Effect of skeletonisation and pedicled bilateral internal mammary artery
grafting in coronary artery bypass surgery on post-operative wound
infection: A meta-analysis.
Source
International Wound Journal. 21(2) (no pagination), 2024. Article Number:
e14424. Date of Publication: February 2024.
Author
Nie C.; Deng Y.; Lu Y.
Institution
(Nie, Lu) Traditional Chinese Medicine University of Guangzhou, Guangzhou,
China
(Deng) Zhongnan University of Economics and Law, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The results showed that different internal thoracic artery (ITA) was
associated with the rate of postoperative wound infection and the severity
of pain following coronary artery bypass grafting (CABG). In order to
ascertain if there was any genuine difference in the rate of postoperative
infection and severity of the pain, we conducted a meta-analysis to
evaluate if there was any actual difference in the wound complication that
had been identified with the ITA method. Through EMBASE, Cochrane Library
and Pubmed, and so forth, we systematically reviewed the results by August
2023, which compared the impact of skeletonised versus pedicled internal
mammary artery (IMA) on wound complications following CABG. The trial data
have been pooled and analysed in order to determine if a randomisation or
fixed-effect model should be applied. The meta-analysis of data was
performed with Revman 5.3 software. The results of this meta-study
included 252 related articles from four main databases, and nine articles
were chosen to be extracted and analysed. A total of 3320 patients were
treated with coronary artery transplantation. Based on current data
analysis, we have shown that the rate of postoperative wound infections is
reduced by the use of the skeletonised internal mammary artery (SIMA) (OR,
1.84; 95% CI, 1.13, 3.01; p = 0.01). But the results showed that there
were no statistically significant differences in the post-operation pain
score of the patients (MD, 0.09; 95% CI, -0.58, 0.76; p = 0.79).
Furthermore, the duration of the operation was not significantly different
between the SIMA and pedicled internal mammary artery (PIMA) (MD, 3.30;
95% CI, -3.13, 9.73; p = 0.31). Overall, the SIMA decreased the rate of
postoperative wound infection in CABG patients than the
PIMA. Copyright © 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<36>
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.

<37>
Accession Number
625591336
Title
Vascular response to percutaneous coronary intervention with
biodegradable-polymer vs. new-generation durable-polymer drug-eluting
stents: A meta-analysis of optical coherence tomography imaging trials.
Source
European Heart Journal Cardiovascular Imaging. 19(11) (pp 1294-1301),
2018. Date of Publication: 01 Nov 2018.
Author
Cassese S.; Xhepa E.; Ndrepepa G.; Kufner S.; Colleran R.; Giacoppo D.;
Koppara T.; Mankerious N.; Byrne R.A.; Laugwitz K.-L.; Schunkert H.;
Fusaro M.; Kastrati A.; Joner M.
Institution
(Cassese, Xhepa, Ndrepepa, Kufner, Colleran, Giacoppo, Mankerious, Byrne,
Schunkert, Fusaro, Kastrati, Joner) Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Lazarettstrasse 36, Munich, Germany
(Koppara, Laugwitz) 1. Medizinische Klinik, Klinikum Rechts der Isar,
Technische Universitat Munchen, Ismaningerstrasse 22, Munich, Germany
(Laugwitz, Schunkert, Kastrati, Joner) DZHK (German Centre for
Cardiovascular Research), Partner Site Munich Heart Alliance, Munich,
Germany
Publisher
Oxford University Press
Abstract
Aims Whether biodegradable-polymer drug-eluting stents (BP-DES) induce a
vascular response at follow-up more favourable than that of new-generation
durable-polymer drug-eluting stents (DP-DES) remains controversial. We
sought to evaluate the vascular response to percutaneous coronary
intervention (PCI) with BP-DES vs. new-generation DP-DES as assessed by
optical coherence tomography (OCT) imaging at follow-up. Methods and
results We undertook a meta-analysis of aggregate data by searching
electronic scientific databases for investigations of PCI-patients
receiving BP-DES vs. new-generation DP-DES and OCT imaging at follow-up.
The primary outcome was neointima hyperplasia (NIH) thickness. The
co-primary outcome was the incidence of lesions with uncovered struts. The
main secondary outcome was the incidence of lesions with malapposed
struts. Among 10 trials, a total of 544 PCI-patients were assigned to
BP-DES (n = 282) or new-generation DP-DES (n = 262). Of these, 447
participants with 480 treated lesions had analysable OCT imaging at a
weighted median follow-up of 7 months. Lesions treated with BP-DES vs.
new-generation DP-DES showed comparable NIH thickness [weighted mean
difference 95% confidence intervals (CI)= 11.37 (29.25, 6.52); P = 0.21].
However, thick-struts (>100 mum) BP-DES showed less NIH thickness as
compared to new-generation DP-DES [20.39 (33.83, 6.95); P = 0.003]. BP-DES
vs. new-generation DP-DES showed a higher risk for uncovered struts [odds
ratio 95% CI = 3.50 (1.69-7.26); P = 0.0008] and a trend towards higher
risk for malapposed struts [2.01 (0.98-4.12); P = 0.06]. Conclusion In
PCI-patients with available OCT imaging at follow-up, BP-DES with thicker
backbones delay vascular response as compared with new-generation DP-DES.
All rights reserved. Copyright © The Author(s) 2018.

<38>
Accession Number
2029475253
Title
In-Hospital influenza vaccination to prevent cardiorespiratory events in
the first 45 days after acute coronary syndrome: A prespecified analysis
of the VIP-ACS trial.
Source
Vaccine. 42(3) (pp 496-504), 2024. Date of Publication: 25 Jan 2024.
Author
Fonseca H.A.R.; Zimerman A.; Monfardini F.; Guimaraes H.P.; Pedrosa R.P.;
Patriota R.D.L.S.; Couto Patriota T.L.G.; Passos L.C.S.; Dall'Orto F.T.C.;
Hoffmann Filho C.R.; Nascimento B.R.; Baldissera F.A.; Pereira C.A.C.;
Caramori P.R.A.; Andrade P.B.; Okoshi M.P.; Polanczyk C.A.; Silveira F.S.;
Villacorta A.S.; Nicolau J.C.; Rizzo L.V.; Berwanger O.
Institution
(Fonseca, Monfardini, Guimaraes, Rizzo, Berwanger) Instituto Israelita de
Ensino e Pesquisa, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Zimerman) TIMI Study Group, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Pedrosa, Patriota) Pronto Socorro Cardiologico de Pernambuco PROCAPE,
Recife, Brazil
(Couto Patriota, Dall'Orto) Hospital Santa Lucia, Pocos de Caldas, Brazil
(Passos) Hospital Ana Nery, Salvador, Brazil
(Hoffmann Filho) Hospital Regional Hans Dieter Schmidt, Joinville, Brazil
(Nascimento) Hospital Universitario Ciencias Medicas, Belo Horizonte,
Brazil
(Baldissera) Instituto de Pesquisas Medicas de Itajai, Itajai, Brazil
(Pereira, Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas,
Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Caramori) Hospital Sao Lucas da PUCRS, Porto Alegre, Brazil
(Andrade) Irmandade da Santa Casa de Misericordia de Marilia, Marilia,
Brazil
(Okoshi) Botucatu Medical School, Sao Paulo State University, Botucatu,
Brazil
(Polanczyk) Hospital de Clinicas de Porto Alegre, Universidade Federal do
Rio Grande do Sul, Porto Alegre, Brazil
(Silveira) Centro de Pesquisa Clinica do Coracao, Aracaju, Brazil
(Villacorta) Instituto Estadual de Cardiologia Aloysio de Castro, Niteroi,
Brazil
Publisher
Elsevier Ltd
Abstract
Background: Influenza vaccination prevents major cardiovascular events in
individuals presenting a recent acute coronary syndrome (ACS), however the
early effect of an in-hospital double-dose vaccination strategy remains
uncertain. Method(s): The VIP-ACS was a randomized, pragmatic,
multicenter, open-label trial with a blinded-adjudication endpoint.
Patients with ACS <= 7 days of hospitalization were randomized to an
in-hospital double-dose quadrivalent inactivated influenza vaccine
(double-dose) or a standard-dose influenza vaccine at 30 days
post-randomization. The primary endpoint was a hierarchical composite of
death, myocardial infarction, stroke, hospitalization for unstable angina,
hospitalization for heart failure, urgent coronary revascularization, and
hospitalization for respiratory infections, analyzed with the win ratio
(WR) method in short-term follow-up (45-days after randomization).
 Result(s): The trial enrolled 1,801 patients (>=18 years old). Median
participant age was 57 years, 70 % were male. There were no significant
differences between groups on the primary hierarchical endpoint: there
were 5.7 % wins in the double-dose in-hospital group and 5.5 % wins in the
standard-dose delayed vaccination group (WR: 1.03; 95 % CI: 0.70---1.53; P
= 0.85). In a sensitivity analysis including COVID-19 infection in the
hospitalizations for respiratory infections endpoint, overall results were
maintained (WR: 1.03; 95 % CI 0.71---1.51; P = 0.87). Results were
consistent for major cardiovascular events only (WR: 0.82; 95 % CI:
0.48---1.39; P = 0.46). No serious adverse events were observed.
 Conclusion(s): In patients with recent ACS, in-hospital double-dose
influenza vaccination did not significantly reduce cardiorespiratory
events at 45 days compared with standard-dose vaccination at 30 days
post-randomization. Copyright © 2023

<39>
Accession Number
2029354298
Title
Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of
Clean Wounds: A Systematic Review and Meta-Analysis.
Source
Surgical Infections. 25(1) (pp 32-38), 2024. Date of Publication: 01 Feb
2024.
Author
Lin W.-L.; Wu L.-M.; Nguyen T.-H.-Y.; Lin Y.-H.; Chen C.-J.; Huang W.-T.;
Guo H.-R.; Chen Y.-H.; Chuang C.-H.; Chang P.-C.; Hung H.-K.; Chen S.-H.
Institution
(Lin, Chen) Center for Quality Management, Chi Mei Medical Center,
Liouying, Taiwan (Republic of China)
(Huang) Division of Hematology and Oncology, Department of Internal
Medicine, Chi Mei Medical Center, Liouying, Taiwan (Republic of China)
(Lin) Infection Control Center, Chi Mei Medical Center, Liouying, Taiwan
(Republic of China)
(Chen) Pharmacy Department, Chi Mei Medical Center, Liouying, Taiwan
(Republic of China)
(Chuang) Division of General Surgery, Department of Surgery, Chi Mei
Medical Center, Liouying, Taiwan (Republic of China)
(Chang) Department of Infectious Diseases, Chi Mei Medical Center,
Liouying, Taiwan (Republic of China)
(Hung) Division of Plastic Surgery, Department of Surgery, Chi Mei Medical
Center, Liouying, Taiwan (Republic of China)
(Lin, Wu) School of Nursing, Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Wu) Department of Medical Research, Kaohsiung Medical University
Hospital, Kaohsiung, Taiwan (Republic of China)
(Nguyen, Guo) Department of Environmental and Occupational Health,
National Cheng Kung University Hospital, Tainan, Taiwan (Republic of
China)
(Guo) Department of Occupational and Environmental Medicine, National
Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
(Chen) National Institute of Cancer Research, National Health Research
Institutes, Tainan, Taiwan (Republic of China)
(Chen) Department of Oncology, National Cheng Kung University Hospital,
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Topical antibiotic agents are not generally indicated for
preventing of surgical site infections (SSIs) in clean incisions, and the
drug concentrations that should be delivered to local incision sites
remain uncertain. The aim of this study was to critically assess the
efficacy of topical antibiotic agents in comparison with non-antibiotic
agents for preventing SSIs in clean incisions by performing a systematic
review and meta-analysis. Method(s): We conducted a search of
literature in PubMed, Embase, and Cochrane Databases and included
randomized controlled trials (RCTs) on topical antibiotic use for patients
with clean post-surgical incisions. The primary outcome was the incidence
of SSI, presented as the event rate. Eleven RCTs were included.
 Result(s): Using random-effects modeling, the pooled risk ratio (RR)
of developing a post-surgical incisions infection was 0.83 (95% confidence
interval [CI], 0.61-1.16; I2, 0%). In subgroup analyses, no
reductions in SSI were observed when topical antibiotic agents were used
to treat incisions due to spinal (RR, 0.75; 95% CI, 0.40-1.38;
I2, 0%), orthopedic (RR, 0.69; 95% CI, 0.37-1.29;
I2, 0%), dermatologic (RR, 0.77; 95% CI, 0.39-1.55;
I2, 65%), or cardiothoracic surgeries (RR, 1.31; 95% CI,
0.83-2.06; I2: 0%). The incidence of SSI across different
operative phases did not differ for the application of topical antibiotic
agents compared with non-antibiotic agents (RR, 0.80; 95% CI, 0.56-1.14;
I2, 0%). Conclusion(s): The results of this meta-analysis
show that topical antibiotic agents provide no clinical benefit for
preventing SSI in clean incisions. Copyright © Mary Ann Liebert,
Inc.

<40>
Accession Number
2028215280
Title
Robot-assisted surgery in thoracic and visceral indications: an updated
systematic review.
Source
Surgical Endoscopy. (no pagination), 2024. Date of Publication: 2024.
Author
Grossmann-Waniek N.; Riegelnegg M.; Gassner L.; Wild C.
Institution
(Grossmann-Waniek, Riegelnegg, Gassner, Wild) Austrian Institute for
Health Technology Assessment (AIHTA), Garnisongasse 7/20, Vienna 1090,
Austria
Publisher
Springer
Abstract
Background: In surgical advancements, robot-assisted surgery (RAS) holds
several promises like shorter hospital stays, reduced complications, and
improved technical capabilities over standard care. Despite extensive
evidence, the actual patient benefits of RAS remain unclear. Thus, our
systematic review aimed to assess the effectiveness and safety of RAS in
visceral and thoracic surgery compared to laparoscopic or open surgery.
 Method(s): We performed a systematic literature search in two
databases (Medline via Ovid and The Cochrane Library) in April 2023. The
search was restricted to 14 predefined thoracic and visceral procedures
and randomized controlled trials (RCTs). Synthesis of data on critical
outcomes followed the Grading of Recommendations, Assessment, Development,
and Evaluation methodology, and the risk of bias was evaluated using the
Cochrane Collaboration's Tool Version 1. Result(s): For five out of
14 procedures, no evidence could be identified. A total of 20 RCTs and
five follow-up publications met the inclusion criteria. Overall, most
studies had either not reported or measured patient-relevant endpoints.
The majority of outcomes showed comparable results between study groups.
However, RAS demonstrated potential advantages in specific endpoints
(e.g., blood loss), yet these findings relied on a limited number of
low-quality studies. Statistically significant RAS benefits were also
noted in some outcomes for certain indications-recurrence, quality of
life, transfusions, and hospitalisation. Safety outcomes were improved for
patients undergoing robot-assisted gastrectomy, as well as rectal and
liver resection. Regarding operation time, results were contradicting.
 Conclusion(s): In summary, conclusive assertions on RAS superiority
are impeded by inconsistent and insufficient low-quality evidence across
various outcomes and procedures. While RAS may offer potential advantages
in some surgical areas, healthcare decisions should also take into account
the limited quality of evidence, financial implications, and environmental
factors. Furthermore, considerations should extend to the ergonomic
aspects for maintaining a healthy surgical environment. Graphical
abstract: (Figure presented.) Copyright © The Author(s) 2024.

<41>
Accession Number
2028143730
Title
The Use of Brief Mindfulness Interventions in the Context of Perioperative
Care.
Source
American Surgeon. (no pagination), 2024. Date of Publication: 2024.
Author
Palmer Kelly E.; McGee J.; Klatt M.; Beckers G.; Pawlik T.M.
Institution
(Palmer Kelly, Beckers, Pawlik) The Ohio State University Wexner Medical
Center, The James Comprehensive Cancer Center, Department of Surgery,
Columbus, OH, United States
(McGee) Department of Surgery, Tulane University School of Medicine, New
Orleans, LA, United States
(Klatt) Center for Integrative Health, Department of Family and Community
Medicine, The Ohio State University College of Medicine, Columbus, OH,
United States
Publisher
SAGE Publications Inc.
Abstract
The purpose of this review was to synthesize and categorize the literature
on the use of brief mindfulness interventions for both patients and
physicians across the spectrum of perioperative care. Web-based discovery
services and discipline-specific databases were queried. Brief mindfulness
interventions were defined as sessions lasting 30 min or less on any
single occasion, with a total practice accumulation not exceeding 100 min
per week, and a duration of up to 4 weeks. Study screening and data
extraction were facilitated through the Covidence software platform. After
screening 1047 potential studies, 201 articles were identified based on
initial abstract and title screening; 10 studies ultimately met inclusion
criteria. All ten studies were published between 2019 and 2023; most (n =
9) reports focused on patients (total joint arthroplasty, n = 3;
stereotactic breast biopsy, n = 2; minimally invasive foregut surgery, n =
1; septorhinoplasty, n = 1; cardiac surgery, n = 1; and other/multiple
procedures, n = 1); one studied investigated mindfulness interventions
among surgeons. The duration of the interventions varied (3 min to 29
min). The most common issue that the mindfulness intervention aimed to
address was pain (n = 6), followed by narcotic use (n = 3), anxiety (n =
2), delirium (n = 1), or patient satisfaction (n = 1). While most studies
included a small sample size and had inconclusive results, brief
mindfulness interventions were noted to impact various health-related
outcomes, including mental health outcomes, anxiety, and pain perception.
Mindfulness interventions may be a scalable, low-cost, time-limited
intervention that has the potential to optimize well-being and surgical
outcomes broadly construed. Copyright © The Author(s) 2024.

<42>
Accession Number
2027198512
Title
Cost-Effectiveness and Budget Impact Analyses of Patient Blood Management
in a Cardiovascular Surgery Department at Ankara Bilkent City Hospital in
Turkey.
Source
Advances in Therapy. 41(2) (pp 716-729), 2024. Date of Publication:
February 2024.
Author
Sanal L.; Gunaydin S.; Tatar M.
Institution
(Sanal) Transfusion Center, Ministry of Health, Ankara Bilkent City
Hospital Campus, Ankara, Turkey
(Gunaydin) Department of Cardiovascular Surgery, University of Health
Sciences, Ankara Bilkent City Hospital Campus, Ankara, Turkey
(Tatar) Vitale Health Economics, Policy and Consultancy, London, United
Kingdom
Publisher
Adis
Abstract
Introduction: Anemia and transfusion of blood products are risk factors
associated with poor patient outcomes across all elective surgeries.
Patient blood management (PBM) is a patient-centered approach to optimize
patient's endogenous red cell mass, to minimize blood loss in patients
undergoing surgery, and to harness and optimize patient-specific
physiological tolerance to anemia. This study aimed to assess (1) the
impact of PBM on blood product usage in cardiovascular surgeries in a
state hospital setting, (2) cost-effectiveness of PBM with a model based
on transfusion of red blood cells (RBCs) in cardiovascular surgeries, and
(3) the budget impact of PBM implementation based on transfusion of RBCs.
 Method(s): Cost-effectiveness and budget impact models, based on the
numbers of avoided transfusions and avoided complications after
implementation of the PBM program, were compared between pre- and post-PBM
periods at the cardiovascular surgery department of Ankara Bilkent City
Hospital between February 11, 2019 and July 24, 2022. The probabilities of
transfusions and complications with and without PBM were taken from recent
meta-analyses. Data from the Ankara Bilkent City Hospital transfusion
center informed the pre- and post-PBM calculations. Costs were calculated
from the Social Security Institution's perspective. Result(s): There
was a 21% decrease in the use of RBCs and a 23.7% decrease in use of all
blood products after the implementation of PBM. The number of RBC packs
per patient reduced by 0.88 packs (21%). The cost saving from reduction of
RBC transfusions per patient was 518.68 Turkish lira (TRY) and for the
hospital it was 1,635,948 TRY. Fewer complications and lower costs in
favor of the post-PBM arm were demonstrated in the cost-effectiveness
analysis. On the basis of the budget impact model, in 20 months, the
hospital's cardiovascular surgery department saved 6,596,934 TRY
(342,302). Conclusion(s): This hospital-based study demonstrated that
PBM is a budget-saving and cost-effective option in Turkey.
When undergoing elective surgery, patients who develop anemia or who need
a transfusion of blood products may develop further complications. This
study aimed to understand the impact of patient blood management on blood
usage in cardiovascular surgeries. Patient blood management is a
patient-centered approach that aims to optimize a patient's red cell mass,
minimize blood loss in patients undergoing surgery, and maximize a
patient's tolerance to anemia. In addition, this study assessed the
cost-effectiveness of patient blood management using an economic model
based on red blood cells in cardiovascular surgeries and assessed the
impact of patient blood management on budget. The patient blood management
program resulted in a 21% decrease in use of red blood cells and 23.7%
decrease in use of all blood products. The cost savings from reduction of
red blood cells transfusions per patient were 518.68 Turkish lira and cost
savings for the hospital were 1,635,948 Turkish lira. Fewer complications
and lower costs were demonstrated after implementation of patient blood
management in the cost-effectiveness analysis. Between December 2020 and
July 2022, the hospital's cardiovascular surgery department saved
6,596,934 Turkish lira (342,302). Overall, this hospital-based study has
shown that patient blood management is a budget-saving and cost-effective
option in Turkey. Copyright © The Author(s) 2023.

<43>
Accession Number
643372179
Title
A systematic review and meta-analysis on outcomes of valvular heart
surgery in Africa.
Source
World journal of surgery. 48(1) (pp 228-239), 2024. Date of Publication:
01 Jan 2024.
Author
Akintoye O.; Musa A.; Gyau-Ampong C.; Usamah B.; Olakanmi D.
Institution
(Akintoye, Musa, Gyau-Ampong, Usamah, Olakanmi) Cardiothoracic Surgery,
Surgery Interest Group of Research, Lagos, Nigeria
Abstract
INTRODUCTION: The prevalence of valvular heart diseases remain
considerably high in Africa, largely but not solely due to rheumatic heart
disease. Valvular heart surgeries have emerged as the cornerstone in their
management. While several studies have reported data on outcomes following
heart valve surgery in many developed countries, there is a staggering
paucity of data and evidence reporting the outcomes in the Africa
population. The aim of this study is to report the perioperative outcomes
following valvular heart surgery in Africa. METHOD(S): The Preferred
Reporting Items for Systematic Reviews and Meta-analysis guideline was
utilized. Electronic searches were performed using PubMed, African journal
online, and Research gate from inception to June 2023. The primary
endpoints were overall mortality and 30-day mortality, and secondary
endpoints included postoperative complications, length of hospital, and
intensive care stays. The outcome data were pooled together and analyzed
with the random effect model for proportions and mean for meta-analysis
using the R software. RESULT(S): This systematic review identified 31
studies that fulfilled the study eligibility criteria and all were
observational studies. The countries in which these studies were carried
out include South Africa, Ethiopia, Egypt, Mali, Rwanda, Nigeria,
Cameroon, Ghana, Senegal, Tanzania, and Kenya. Statistical analysis
reported a pooled overall mortality of 10.48% and a pooled 30-day
mortality of 4.59%. CONCLUSION(S): Several obstacles, such as lack of
financial resources and inadequate infrastructure, continue to impede
valvular heart surgery practice in many parts of Africa. Future studies
need to focus on identifying factors associated with this poor early
mortality. Copyright © 2023 International Society of
Surgery/Societe Internationale de Chirurgie (ISS/SIC).

<44>
Accession Number
643288983
Title
The provision and impact of rehabilitation provided by physiotherapists in
children and young people with congenital heart disease following cardiac
surgery: a scoping review.
Source
Physiotherapy. 122 (pp 47-56), 2024. Date of Publication: 01 Mar 2024.
Author
Clarke S.L.; Milburn N.C.; Menzies J.C.; Drury N.E.
Institution
(Clarke) Department of Physiotherapy, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Milburn) Department of Physiotherapy, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Menzies) Paediatric Intensive Care, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Drury) Department of Paediatric Cardiac Surgery, Birmingham Children's
Hospital, Steel House Lane, Birmingham B4 6NH, UK; Institute of
Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham
B15 2TT, UK
Abstract
INTRODUCTION: Children with congenital heart disease (CHD) are at risk of
delayed motor development with increased risk for those requiring cardiac
surgical intervention. We conducted a scoping review to identify the
provision and impact of physiotherapy-delivered rehabilitation in children
and young people with CHD following cardiac surgery. METHOD(S):
CINAHL, EMBASE, PUBMED, AHMED, EMCARE, Cochrane Database of Systematic
Reviews, NHS Evidence databases were searched (2000-2022). Included
studies were published in full, in English and reported the use of
physiotherapy in CHD (participants 0-18years) post-surgical procedure.
Articles were screened by title and abstract and through full-text review
with results structured in accordance with the PAGER framework and PRISMA-
ScR checklist. RESULT(S): Seven full text peer reviewed papers
published 2014-2021 were identified from 5747 papers screened. Included
papers were predominantly non-randomised cohort studies with a sample size
of between one and 247. Study participants ranged from eight days to 16
years, with a variety of congenital heart defects and surgical procedures.
The provision of physiotherapy varied with a range of rehabilitation
formats and physiotherapeutic interventions utilised. Physiotherapy
provision appeared to have a positive impact on functional/ developmental
outcomes and muscle strength. DISCUSSION: Assessing the impact and
provision of physiotherapy in CHD post-surgical intervention is
challenging based on the published literature, due to small sample sizes,
lack of control groups, heterogeneous demographics and variable
intervention and formats delivered. Further research is required to
identify the optimum format of physiotherapy provision and establish the
potential impact of physiotherapy delivered rehabilitation on motor
function and development. CONTRIBUTION OF THE PAPER. Copyright ©
2023 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All
rights reserved.

<45>
Accession Number
642425178
Title
Removal of Wires for Sternal Internal Fixation After Cardiac Surgery in
Adolescents.
Source
Alternative therapies in health and medicine. 30(1) (pp 351-357), 2024.
Date of Publication: 01 Jan 2024.
Author
Dong Y.; Tian L.; Li X.; Cui Y.
Abstract
Objective: The objective of this study was to assess the safety and
patient satisfaction of sternal wire removal surgery, rendering reference
for clinical practice in the future. Method(s): A total of 70
adolescent patients with completely healed sternum and no other diseases
or able to receive surgery were randomly selected and subjected to sternal
wire removal surgery. Besides, relevant data including patient age,
gender, wire rupture, reason for wire removal, postoperative wire
residuals, patient satisfaction, age at cardiac surgery, waiting time
after cardiac surgery, and removal duration were recorded. Result(s):
Raptured wire group exhibited higher proportions of males and chest pain
cases and longer operative time than unruptured wire group. The demand for
wire removal had no relation to gender, but patients receiving surgery due
to chest pain were mainly aged 12-15 years old, those undergoing surgery
due to employment and further education were mainly aged 9-12 years old,
and those subjected to surgery sue to ruptures found in physical
examinations were mainly aged 6-9 years old. According to statistics of
wire rupture position, the rupture of the 4th wire accounted for the
largest proportion, and rupture of multiple wires was found in some
patients. No statistically significant differences were found in gender,
age, age at cardiac surgery, and waiting time after cardiac surgery
between patients with only one wire ruptured and those with multiple wires
ruptured. Patients were grouped based on the absence and presence of chest
pain, and it was found that chest pain group had a longer removal
duration, but comparable age at cardiac surgery and waiting time after
cardiac surgery, and the waiting time after cardiac surgery was a risk
factor for chest pain. The waiting time after cardiac surgery was
positively correlated with operative time, so we recommend that if there
were symptoms of chest discomfort, it should be removed as soon as
possible. However, due to the needs of the patients, no control group was
set up, which is the limitation of this study. In the next step, we will
conduct more long-term observation of the patients to confirm whether the
chest pain can be relieved by itself without removing the wire.
 Conclusion(s): This study found that for adolescent patients with
chest pain or other life troubles after cardiac surgery, removing the
sternal internal fixation wire can quickly and effectively relieve the
troubles, and is a safe and reliable treatment means. Therefore, if it is
necessary to remove the wire, it should be removed as soon as possible to
avoid wire breakage and increase the difficulty of surgery.

<46>
Accession Number
643323813
Title
Prehabilitation for people undergoing cardiac surgery.
Source
Cochrane Database of Systematic Reviews. 2024(1) (no pagination), 2024.
Article Number: CD015336. Date of Publication: 29 Jan 2024.
Author
Skorupska N.; Perry R.; Collis P.; Dawson S.; Taylor R.S.; Cleland J.G.F.;
Akowuah E.; Gibbison B.; Murphy G.J.; Levett D.Z.; Grocott M.P.W.;
Atkinson C.; McConnachie A.; Pufulete M.
Institution
(Skorupska) University Hospitals Bristol and Weston NHS Foundation Trust,
Bristol, United Kingdom
(Perry, Atkinson) NIHR Bristol Biomedical Research Centre, University
Hospitals Bristol NHS Foundation Trust and the University of Bristol,
Bristol, United Kingdom
(Collis) Patient Advisory Group, British Heart Foundation, London, United
Kingdom
(Dawson) University of Bristol Population Health Sciences, University of
Bristol, Bristol, United Kingdom
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
(Cleland) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Akowuah) South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Gibbison) Department of Cardiac Anaesthesia and Intensive Care, Bristol
Heart Institute / University Hospitals Bristol NHS FT, Bristol, United
Kingdom
(Murphy) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Levett) Anaesthesia and Critical Care Research Unit, University Hospital
Southampton NHS Foundation Trust, Southampton, United Kingdom
(Levett, Grocott) Perioperative and Critical Care Research Theme,
Southampton NIHR Biomedical Research Centre, University Hospital
Southampton NHS Foundation Trust / University of Southampton, Southampton,
United Kingdom
(McConnachie) Robertson Centre for Biostatistics, School of Health and
Wellbeing, University of Glasgow, Glasgow, United Kingdom
(Pufulete) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. The overarching aim of this review is to
determine the benefits and harms of prehabilitation on postoperative
outcomes in people undergoing cardiac surgery. The specific objectives
are:. to identify and describe all prehabilitation interventions that have
been administered prior to cardiac surgery (urgent and elective pathways);
to compare the effectiveness of the different interventions against no
intervention or usual care on postoperative and long-term outcomes
(general and cardiac surgery-specific); and to identify the harms
associated with prehabilitation interventions. Copyright © 2024
The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<47>
Accession Number
2028105131
Title
Utility of Coronary Computed Tomography Angiography in Patients Undergoing
Transcatheter Aortic Valve Implantation: A Meta-Analysis and
Meta-Regression Based on Published Data from 7458 Patients.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
631. Date of Publication: January 2024.
Author
Diller G.-P.; Gerwing M.; Boroni Grazioli S.; De-Torres-Alba F.; Radke
R.M.; Vormbrock J.; Baumgartner H.; Kaleschke G.; Orwat S.
Institution
(Diller, Boroni Grazioli, De-Torres-Alba, Radke, Vormbrock, Baumgartner,
Kaleschke, Orwat) Department of Cardiology III, Adult Congenital and
Valvular Heart Disease, University Hospital Muenster, Muenster 48149,
Germany
(Gerwing) Clinic of Radiology, University Hospital Muenster, Muenster
48149, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Coronary CT angiography (CCTA) may detect coronary artery
disease (CAD) in transcatheter aortic valve implantation (TAVI) patients
and may obviate invasive coronary angiography (ICA) in selected patients.
We assessed the diagnostic accuracy of CCTA for detecting CAD in TAVI
patients based on published data. Method(s): Meta-analysis and
meta-regression were performed based on a comprehensive electronic search,
including relevant studies assessing the diagnostic accuracy of CCTA in
the setting of TAVI patients compared to ICA. The sensitivity,
specificity, positive predictive value (PPV), and negative predictive
value (NPV), were calculated on a patient and per segment level.
 Result(s): Overall, 27 studies (total of 7458 patients) were
included. On the patient level, the CCTA's pooled sensitivity and NPV were
95% (95% CI: 93-97%) and 97% (95% CI: 95-98%), respectively, while the
specificity and PPV were at 73% (95% CI: 62-82%) and 64% (95% CI: 57-71%),
respectively. On the segmental coronary vessel level, the sensitivity and
NPV were 90% (95% CI: 79-96%) and 98% (95% CI: 97-99%).
 Conclusion(s): This meta-analysis highlights CCTA's potential as a
first-line diagnostic tool although its limited PPV and specificity may
pose challenges when interpreting heavily calcified arteries. This study
underscores the need for further research and protocol standardization in
this area. Copyright © 2024 by the authors.

<48>
Accession Number
2030113442
Title
Acute Hemodynamic Compromise After Transcatheter Aortic Valve Replacement
Due to Dynamic Left Ventricle Obstruction: A Systematic Review.
Source
American Journal of Cardiology. 214 (pp 125-135), 2024. Date of
Publication: 01 Mar 2024.
Author
Barzallo D.; Torrado J.; Benites-Moya C.J.; Sturla M.; Echarte-Morales J.;
Scotti A.; Kharawala A.; Terre J.A.; Sugiura T.; Wiley J.; Goldberg Y.;
Latib A.
Institution
(Barzallo, Benites-Moya, Kharawala) Department of Internal Medicine,
Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Torrado, Sturla, Echarte-Morales, Scotti, Latib) Department of
Cardiology, Montefiore Medical Center, Bronx, NY, United States
(Terre, Wiley) Section of Cardiology, Department of Medicine, Tulane
University School of Medicine, New Orleans, Louisiana, United States
(Sugiura) Department of Cardiothoracic Surgery, Montefiore Medical Center,
Bronx, NY, United States
(Goldberg) Section of Structural Echocardiography, Department of
Cardiology, Lenox Hill Hospital and Western Region, Northwell Health, New
York, New York, United States
Publisher
Elsevier Inc.
Abstract
Acute hemodynamic compromise after transcatheter aortic valve replacement
(TAVR) because of dynamic left ventricle (LV) obstruction (LVO), also
known as suicide LV, is an infrequent but severe complication of TAVR that
is poorly defined in previous studies. Understanding this complication is
essential for its prompt diagnosis and optimal treatment. We conducted a
systematic literature review using PubMed, Embase, Web of Science, and
Medline databases for studies describing acute hemodynamic compromise
after TAVR because of dynamic LVO or suicide LV. Each study was reviewed
by 2 authors individually for eligibility, and a third author resolved
disagreements. From a total of 506 studies, 25 publications were
considered for the final analysis. The majority of patients with this
condition were women demonstrating a hypertrophic septum, a small
ventricle, and hyperdynamic contractility on pre-TAVR echocardiographic
assessment. An intraventricular gradient before TAVR was found in half of
the cases. Acute hemodynamic compromise after TAVR because of dynamic LVO
manifested mainly as significant hypotension and occurred most often
immediately after valve deployment. The LV outflow tract was the most
common site of obstruction. Advanced therapies were required in nearly 65%
of the cases. In conclusion, acute hemodynamic compromise after TAVR
because of dynamic LVO occurred almost invariably in women.
Echocardiography before TAVR may offer essential information to anticipate
this complication. LV outflow tract obstruction appears to carry the
highest risk of developing this phenomenon. Advanced therapies should be
promptly considered as a bailout strategy in patients with hemodynamic
collapse refractory to medical therapy. Copyright © 2023 Elsevier
Inc.

<49>
Accession Number
2028458590
Title
Timing of diuretic administration effects on urine volume in hospitalized
patients.
Source
Frontiers in Physiology. 14 (no pagination), 2023. Article Number:
1208324. Date of Publication: 2023.
Author
McCullar K.S.; Abbaspour S.; Wang W.; Aguirre A.D.; Westover M.B.; Klerman
E.B.
Institution
(McCullar, Abbaspour, Westover, Klerman) Department of Neurology,
Massachusetts General Hospital, Boston, MA, United States
(McCullar, Abbaspour, Wang, Klerman) Division of Sleep Medicine, Harvard
Medical School, Boston, MA, United States
(Wang, Klerman) Division of Sleep and Circadian Disorders, Brigham and
Women's Hospital, Boston, MA, United States
(Aguirre) Department of Medicine, Massachusetts General Hospital, Boston,
MA, United States
Publisher
Frontiers Media SA
Abstract
Importance: Some medications have effects that depend on the time of day
they are given. Current knowledge of the time-of-day effects of specific
medications in hospitalized patients with cardiovascular disease is very
limited. In hospitalized patients, increased medication efficiency might
reduce dose (and associated side effects) and/or the length of time in the
Intensive Care Unit (ICU) or hospital-potentially improving patient
outcomes and patient and family quality of life and reducing financial
costs. We studied whether the time of day or night patients in Cardiac or
Intensive Care Units receive a diuretic affects urine volume.
 Method(s): In this observational study, data were collected from
7,685 patients (63% male, 18 to 98 years old) admitted to one hospital's
Acute Care Cardiac units, Cardiac ICUs, Cardiac Surgery ICUs, and/or
Non-cardiac ICUs who received intravenous furosemide (a diuretic), had
measurements of urine volume, were hospitalized for >=3 days between
January 2016 to July 2021 and were older than 18 years. The outcomes of
interest were urine volume normalized by the most recent (not older than
24 h) weight or body mass index (BMI), (i) in the hour after the time of
diuretic administration, and (ii) when no diuretics were administered for
the previous 3 h. Result(s): We identified diuretic medication
administration time 23:00-04:59 as a predictor of higher urine volume
response. For patients without recent diuretic medication, higher urine
volume was predicted 11:00-16:59 and 17:00-22:59. Other factors that
affected urine volume response to the diuretic were sex, age, medication
dose, creatinine concentration, diagnoses, and hospital unit.
 Discussion(s): Time-of-day of medication administration may be a
factor associated with increased medication efficiency. Randomized
controlled trials should be conducted to quantify the relative effect of
modifiable factors, such as time of medication administration, that may
affect short- and longer-term outcomes. Copyright © 2024
McCullar, Abbaspour, Wang, Aguirre, Westover and Klerman.

<50>
Accession Number
643398341
Title
Sequential Hybrid Ablation versus Surgical CryoMaze Alone for Treatment of
Atrial Fibrillation: Results of Multicentre Randomised Controlled Trial.
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. (no
pagination), 2024. Date of Publication: 02 Feb 2024.
Author
Bulava A.; Wichterle D.; Mokracek A.; Osmancik P.; Budera P.; Kacer P.;
Veteskova L.; Nemec P.; Skala T.; Santavy P.; Chovancik J.; Branny P.;
Rizov V.; Kolesar M.; Safarikova I.; Rybar M.
Institution
(Bulava, Mokracek, Safarikova) Faculty of Health and Social Sciences,
Ceske Budejovice Hospital, University of South Bohemia in Ceske Budejovice
and Cardiac CentreCzechia, Ceske Budejovice
(Wichterle, Budera) Institute for Clinical and Experimental Medicine,
Czechia, Prague, United States
(Osmancik, Kacer) 3rd Faculty of Medicine, Charles University and
University Hospital Kralovske Vinohrady, Czechia, Prague, United States
(Veteskova, Nemec) Centre of Cardiovascular Surgery and Transplantation,
Czechia, Brno
(Skala, Santavy) Faculty of Medicine and Dentistry, Palacky University and
University Hospital Olomouc, Czechia, Olomouc
(Chovancik, Branny) Hospital Agel Trinec - Podlesi, Czechia, Trinec
(Rizov, Kolesar) Masaryk Hospital, Czechia, Usti nad Labem
(Rybar) Faculty of Biomedical Engineering, Czech Technical University in
Prague, Czechia, Kladno
Abstract
BACKGROUND AND AIMS: Data on the hybrid atrial fibrillation (AF) treatment
are lacking in patients with structural heart disease undergoing
concomitant CryoMaze procedures. The aim was to assess whether the timely
pre-emptive catheter ablation would achieve higher freedom from AF or
atrial tachycardia (AT) and be associated with better clinical outcomes
than surgical ablation alone. METHOD(S): The trial investigated
patients with non-paroxysmal AF undergoing coronary artery bypass grafting
and/or valve repair/replacement with mandatory concomitant CryoMaze
procedure who were randomly assigned to undergo either radiofrequency
catheter ablation (Hybrid Group) or no further treatment (Surgery Group).
The primary efficacy endpoint was the first recurrence of AF/AT without
class I or III antiarrhythmic drugs as assessed by implantable cardiac
monitors. The primary clinical endpoint was a composite of hospitalisation
for arrhythmia recurrence, worsening of heart failure, cardioembolic
event, or major bleeding. RESULT(S): We analysed 113 and 116 patients
in the Hybrid and Surgery Groups, respectively, with a median follow-up of
715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly
reduced in the Hybrid Group (41.1% vs 67.4%, hazard ratio (HR)=0.38, 95%
confidence interval (CI): 0.26-0.57, P<0.001) as well as the primary
clinical endpoint (19.9% vs 40.1%, HR=0.51, 95% CI: 0.29-0.86, P=0.012).
The trial groups did not differ in all-cause mortality (10.6% vs 8.6%,
HR=1.17, 95%CI: 0.51-2.71, P=0.71). The major complications of catheter
ablation were infrequent (1.9%). CONCLUSION(S): Pre-emptively
performed catheter ablation after the CryoMaze procedure was safe and
associated with higher freedom from AF/AT and improved clinical
outcomes. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<51>
Accession Number
643396992
Title
The effects of video double-lumen tubes on intubation complications in
patients undergoing thoracic surgery: A randomised controlled study.
Source
European journal of anaesthesiology. (no pagination), 2024. Date of
Publication: 31 Jan 2024.
Author
Shui W.; Hu W.; Ma W.; Han Y.; Hao I.Y.; Sun Y.; Deng Z.; Gao Y.; Heng L.;
Zhu S.
Institution
(Shui) From the Jiangsu Province Key laboratory of Anaesthesiology, Xuzhou
Medical University (WS, WH, YS, ZD, SZ), Department of Anaesthesiology,
Xuzhou Cancer Hospital, Xuzhou (WM, YH, SZ, LH, SZ), California State
University, Los Angeles, USA (IYH) and Jiangsu University, Zhenjiang,
Jiangsu, China (YG)
Abstract
BACKGROUND: Tracheal injuries, vocal cord injuries, sore throat and
hoarseness are common complications of double-lumen tube (DLT) intubation.
 OBJECTIVE(S): This study aimed to evaluate the effects of 'video
double-lumen tubes' (VDLTs) on intubation complications in patients
undergoing thoracic surgery. DESIGN: A randomised controlled study.
SETTINGT: Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June
2023. PATIENTS: One hundred eighty-two patients undergoing elective
thoracic surgery with one-lung ventilation were randomised into two
groups: 90 in the DLT group and 92 in the VDLT group. INTERVENTION: VDLT
was selected for intubation in the VDLT group, and DLT was selected for
intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to
record tracheal and vocal cord injuries. MAIN OUTCOME MEASURES: The
primary outcomes were the incidence of moderate-to-severe tracheal injury
and the incidence of vocal cord injury. The secondary outcomes included
the incidence and severity of postoperative 24 and 48 h sore throat and
hoarseness. RESULT(S): The incidence of moderate-to-severe tracheal
injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT
group (P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence
of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT
groups, respectively (P = 0.449). The incidence of postoperative 24 h sore
throat and hoarseness was significantly higher in the VDLT group than in
the DLT group (for sore throat: P = 0.032, relative risk 1.63, 95% CI,
1.03 to 2.57; for hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06
to 2.06). CONCLUSION(S): There was no statistically significant
difference in the incidence of moderate-to-severe tracheal injury and
vocal cord injury between DLTs and VDLTs. While improving the
first-attempt success rate, intubation with VDLT increased the incidence
of postoperative 24 h sore throat and hoarseness. TRIAL REGISTRATION:
Chinese Clinical Trial Registry identifier:
ChiCTR2300067348. Copyright © 2024 The Author(s). Published by
Wolters Kluwer Health, Inc. on behalf of the European Society of
Anaesthesiology and Intensive Care.

<52>
Accession Number
643395006
Title
Esketamine: Less Drowsiness, More Analgesia.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 31
Jan 2024.
Author
Mion G.; Himmelseher S.
Institution
(Mion) From the Department of Anesthesia, Intensive Care and Perioperative
Medicine, GHU AP-HP Centre, Cochin Hospital, Paris, France
(Himmelseher) Department of Anesthesiology and Intensive Care Medicine,
Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
Abstract
Racemic ketamine is a 1:1 mixture of 2 enantiomers that turn light in
opposite direction: Dextrorotatory esketamine is approximately 4 times
more affine for the N-methyl-D-aspartate (NMDA) receptor than levorotatory
arketamine, which may explain why esketamine is about twice as potent as
an analgesic and anesthetic as the racemate. Esketamine has attracted
renewed interest in view of the opioid crisis, racemic ketamine's abuse,
and esketamine's approval for expanded use. We evaluated the anesthesia
literature concerning mental, cardiovascular, cerebral, and
antinociceptive effects of esketamine published in English between 1980
and 2022. The review shows that esketamine and racemic ketamine are not
"the same" at clinically equivalent analgesic and anesthetic dose:
Psychomimetic effects seem to be essentially related to NMDA receptor
blockade and esketamine is not devoid of unwanted mental impact. However,
it probably involves less cholinergic inhibition. Cognitive disturbances
during arousal, awakening, and recovery from the drug are less, and less
pronounced with esketamine. The drug allows for an approximately 50% dose
reduction in anesthesia and analgesia which goes along with a higher
clearance and shorter recovery time as compared to racemic ketamine. In
comparison of esketamine with placebo, esketamine shows cardiocirculatory
stabilizing and neuroprotective effects which can be seen in anesthesia
induction, cardiac surgery, and analgesia and sedation in brain injury.
Evidence of esketamine's antinociceptive efficacy is inconsistent,
although a recent meta-analysis reports improved pain relief after surgery
in a study with short observation time. To better define esketamine's
place, direct head-to-head comparison with the racemate at
equi-analgesic/anesthetic dose is warranted. Copyright © 2024
International Anesthesia Research Society.

<53>
Accession Number
643384583
Title
Peripheral nerve block and cognitive impairment after thoracic surgery: a
systematic review and meta-analysis.
Source
Minerva anestesiologica. (no pagination), 2024. Date of Publication: 30
Jan 2024.
Author
Zhang Y.; Liu M.; He J.; Zhang H.; Zhang M.; Li J.
Institution
(Zhang, Liu, He, Zhang, Zhang) Department of Anesthesiology, Hebei General
Hospital, Shijiazhuang, Hebei, China
(Zhang) Graduate Faculty, North China University of Science and
Technology, Tangshan, Hebei, China
(Li) Department of Anesthesiology, Hebei General Hospital, Shijiazhuang,
Hebei, China
Abstract
INTRODUCTION: Postoperative cognitive impairment is common in surgical
patients, including postoperative delirium and postoperative cognitive
dysfunction. Several studies investigating the association between
peripheral nerve block and the risk of cognitive impairment after thoracic
surgery showed conflicting results. Therefore, we conducted the current
systematic review and meta-analysis to determine the effects of peripheral
nerve block on postoperative cognitive impairment in thoracic surgical
patients. EVIDENCE ACQUISITION: Eligible randomized controlled trials were
retrieved from PubMed, Cochrane Library, Web of Science and Embase
databases. The primary outcomes were the incidence of postoperative
delirium or cognitive dysfunction and the MMSE scores. Furthermore, VAS
scores, levels of TNF-alpha and IL-6, as well as the duration of
hospitalization were analyzed as secondary outcomes. EVIDENCE SYNTHESIS:
Ten articles including 1279 participants were selected for this
meta-analysis. The results presented that peripheral nerve block could
lessen the incidence of postoperative delirium or cognitive dysfunction
(OR=0.39, 95% CI [0.27 to 0.56]), the scores of VAS (MD=-1.35 [95% CI:
-2.30 to -0.40]), the values of TNF-alpha (SMD=-1.13 [95% CI: -1.49 to
-0.76]) and IL-6 (SMD=-1.65 [95% CI: -1.87 to -1.42]), as well as the
length of hospitalization (MD=-0.70 [95% CI: -0.96 to -0.43]). In
addition, peripheral nerve block was linked to a significant increase in
MMSE scores (MD=2.16 [95% CI: 1.40 to 2.91]). CONCLUSION(S): This
meta-analysis revealed positive effects of peripheral nerve block on
improving postoperative cognitive impairment in patients following
thoracic surgery.

<54>
Accession Number
2028179844
Title
A systematic review of neurological airway respiratory cardiovascular
other-surgical severity (NARCO-SS) score as a pediatric perioperative
scoring system.
Source
Paediatric Anaesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Udupa A.N.; Majmudar A.A.; Tran L.
Institution
(Udupa) Queen Elizabeth Hospital, Central Adelaide Local Health Network,
Adelaide, SA, Australia
(Udupa, Majmudar, Tran) Faculty of Health and Medical Sciences, University
of Adelaide, Adelaide, SA, Australia
(Majmudar, Tran) Royal Adelaide Hospital, Central Adelaide Local Health
Network, Adelaide, SA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Objective: To systematically identify and synthesize the available
evidence of the neurological airway respiratory cardiovascular
other-surgical severity (NARCO-SS) score as compared to other pediatric
specific perioperative scoring systems. Design(s): This systematic
review was conducted in accordance with the Preferred Reporting Items for
Systematic Review and Meta-analysis (PRISMA) statement. All studies in all
languages comparing NARCO-SS with pediatric perioperative scoring systems
against outcomes were included. Records were screened and data were
extracted by three independent reviewers into standardized pilot-tested
extraction templates. Data Sources: Electronic searches were
performed in MEDLINE, Embase, Scopus, and CINAHL (from inception to
February 2023). Review Methods: The references were uploaded to a
validated software for systematic reviews (Rayyan) and screened against
the inclusion criteria. Full text of included studies were reviewed and
the available data were tabulated. We conducted Risk of Bias analysis on
the included studies using the Prediction model Risk Of Bias ASsessment
Tool (PROBAST). Result(s): A meta-analysis could not be performed due
to differences in outcome definitions across the included studies.
Correlations between NARCO-SS scores, ASA-PS scores and the predefined
outcomes of each study were presented as a narrative synthesis. The
included studies were determined to have a high risk of bias using the
PROBAST. Conclusion(s): This review has identified a need for
high-quality studies assessing NARCO-SS before recommendations for
clinical practice can be made. Addressing its limitations and enhancing
the NARCO-SS through targeted refinements of its individual descriptive
categories could potentially lead to improvement in its overall predictive
accuracy and facilitate wider adoption into clinical
practice. Copyright © 2024 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<55>
Accession Number
2030126571
Title
Canadian Cardiovascular Society/Canadian Association of Interventional
Cardiology 2023 Focused Update of the Guidelines for the Use of
Antiplatelet Therapy.
Source
Canadian Journal of Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Bainey K.R.; Marquis-Gravel G.; Belley-Cote E.; Turgeon R.D.; Ackman M.L.;
Babadagli H.E.; Bewick D.; Boivin-Proulx L.-A.; Cantor W.J.; Fremes S.E.;
Graham M.M.; Lordkipanidze M.; Madan M.; Mansour S.; Mehta S.R.; Potter
B.J.; Shavadia J.; So D.F.; Tanguay J.-F.; Welsh R.C.; Yan A.T.; Bagai A.;
Bagur R.; Bucci C.; Elbarouni B.; Geller C.; Lavoie A.; Lawler P.; Liu S.;
Mancini J.; Wong G.C.
Institution
(Bainey, Welsh) Mazankowski Alberta Heart Institute, University of
Alberta, Edmonton, AB, Canada
(Marquis-Gravel, Boivin-Proulx, Tanguay) Institut de Cardiologie de
Montreal, Universite de Montreal, Montreal, Quebec, Canada
(Belley-Cote, Mehta) Population Health Research Institute, McMaster
University, Hamilton Health Sciences, Hamilton, ON, Canada
(Turgeon) University of British Columbia, St Paul's Hospital PHARM-HF
Clinic, Vancouver, BC, Canada
(Ackman) Alberta Health Services, Edmonton, AB, Canada
(Babadagli) Pharmacy Services, Alberta Health Services, Mazankowski
Alberta Heart Institute, Edmonton, AB, Canada
(Bewick) Division of Cardiology, Department of Medicine, Dalhousie
University, Saint John Regional Hospital, Saint John, NB, Canada
(Cantor) Southlake Regional Health Centre, University of Toronto, Toronto,
ON, Canada
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Graham) Division of Cardiology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Lordkipanidze) Faculte de pharmacie, Universite de Montreal, Research
Center, Montreal Heart Institute, Montreal, Quebec, Canada
(Madan) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Mansour, Potter) Centre Hospitalier de l'Universite de Montreal,
Montreal, Quebec, Canada
(Shavadia) College of Medicine, University of Saskatchewan, Saskatoon, SK,
Canada
(So) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Yan) Division of Cardiology, Unity Health Toronto, St Michael's Hospital,
Toronto, ON, Canada
(Bagai) Terrence Donnelly Heart Centre, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Bagur) London Health Sciences Centre, Western University, London, ON,
Canada
(Bucci) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Elbarouni, Liu) Department of Medicine, St Boniface Hospital, University
of Manitoba, Winnipeg, MB, Canada
(Geller) University of Ottawa, Centretown Community Health Centre, Ottawa,
ON, Canada
(Lavoie) Prairie Vascular Research Inc, Regina, SK, Canada
(Lawler) Peter Munk Cardiac Centre, Toronto General Hospital, University
of Toronto, Toronto, ON, Canada
(Mancini, Wong) Division of Cardiology, Department of Medicine, University
of British Columbia, Vancouver, BC, Canada
Publisher
Elsevier Inc.
Abstract
Antiplatelet therapy (APT) is the foundation of treatment and prevention
of atherothrombotic events in patients with atherosclerotic cardiovascular
disease. Selecting the optimal APT strategies to reduce major adverse
cardiovascular events, while balancing bleeding risk, requires ongoing
review of clinical trials. Appended, the focused update of the Canadian
Cardiovascular Society/Canadian Association of Interventional Cardiology
guidelines for the use of APT provides recommendations on the following
topics: (1) use of acetylsalicylic acid in primary prevention of
atherosclerotic cardiovascular disease; (2) dual APT (DAPT) duration after
percutaneous coronary intervention (PCI) in patients at high bleeding
risk; (3) potent DAPT (P2Y<inf>12</inf> inhibitor) choice in patients who
present with an acute coronary syndrome (ACS) and possible DAPT
de-escalation strategies after PCI; (4) choice and duration of DAPT in ACS
patients who are medically treated without revascularization; (5)
pretreatment with DAPT (P2Y<inf>12</inf> inhibitor) before elective or
nonelective coronary angiography; (6) perioperative and longer-term APT
management in patients who require coronary artery bypass grafting
surgery; and (7) use of APT in patients with atrial fibrillation who
require oral anticoagulation after PCI or medically managed ACS. These
recommendations are all on the basis of systematic reviews and
meta-analyses conducted as part of the development of these guidelines,
provided in the Supplementary Material. Copyright © 2023 Canadian
Cardiovascular Society

<56>
Accession Number
2010489600
Title
Safety of different carotid artery revascularization strategies in the
coronary artery bypass graft population: Study protocol for a systematic
review and network meta-analysis.
Source
Annals of Translational Medicine. 8(23) (no pagination), 2020. Article
Number: 1605. Date of Publication: December 2020.
Author
Shen Y.; Jin S.; Lin C.; Shen J.; Hong Z.; Xue S.; Guo D.
Institution
(Shen, Lin, Xue, Guo) Department of Vascular Surgery, Institute of
Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
(Jin) Information and Technology Center, Taizhou Hospital of Zhejiang
Province, Wenzhou Medical University, Linhai, China
(Shen) Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang
Province, Wenzhou Medical University, Linhai, China
(Hong) Department of Orthopedics, Taizhou Hospital of Zhejiang Province,
Wenzhou Medical University, Linhai, China
Publisher
AME Publishing Company
Abstract
Background: Concomitant significant carotid artery occlusive diseases
(CAOD) increase the risk of perioperative stroke and death in patients who
undergo coronary artery bypass graft (CABG). Although several surgical
strategies can be used in the management of such patients, controversy
still surrounds which is the best option for CABG patients with
accompanying CAOD. Method(s): Literature searches will be conducted
covering articles published in PubMed, the Cochrane Central Register of
Controlled Trials, Web of Science, and Embase between January 1989 and
December 2019. Search results will be limited to articles published in
English. Six surgical strategies using carotid endarterectomy (CEA) or
carotid artery stenting (CAS) with different timings (i.e., before, after,
or combined with CABG) will be evaluated. Randomized controlled trials and
non-randomized studies comparing these strategies will be included. The
quality of studies will be critically appraised using the Cochrane
risk-of-bias tool or ROBINS-I tool. Since CEA and CAS have comparable
effectiveness for the treatment of significant CAOD, we will integrate
direct and indirect evidence using network meta-analysis (NMA) to create
hierarchies of the six surgical strategies based on their perioperative
safety. The primary outcomes will be the probability of perioperative
stroke and the probability of perioperative death. Additionally, we will
analyze the probability of perioperative myocardial infarction (MI) as a
secondary outcome. Pairwise meta-analyses and Bayesian network
meta-analyses will be performed for all related outcome measures. Subgroup
analyses, sensitivity analyses, and network meta-regression will be
conducted to assess the robustness of the findings. Discussion(s):
This NMA will summarize the direct and indirect evidence of perioperative
safety with the aim of providing a ranking of the various surgical
strategies. The results of this meta-analysis will provide useful
information on optimal surgical management of CABG patients with
concomitant significant CAOD. Copyright © Annals of Translational
Medicine. All rights reserved.

<57>
Accession Number
2027962108
Title
Regional anesthesia for transplantation surgery - A White Paper Part 2:
Abdominal transplantation surgery.
Source
Clinical Transplantation. 38(1) (no pagination), 2024. Article Number:
e15227. Date of Publication: January 2024.
Author
Ander M.; Mugve N.; Crouch C.; Kassel C.; Fukazawa K.; Isaak R.; Deshpande
R.; McLendon C.; Huang J.
Institution
(Ander, Mugve, McLendon) Department of Anesthesiology & Perioperative
Medicine, Loyola University Medical Center, Maywood, IL, United States
(Crouch) Department of Anesthesiology, University of Colorado Anschutz
Medical Campus, Aurora, CO, United States
(Kassel) Department of Anesthesiology, Nebraska Medical Center, Omaha, NE,
United States
(Fukazawa) Department of Anesthesiology, University of Washington School
of Medicine, Seattle, WA, United States
(Isaak) Department of Anesthesiology, UNC Hospitals, N2198 UNC Hospitals,
Chapel Hill, NC, United States
(Deshpande) Department of Anesthesiology, Yale University/Yale New Haven
Hospital, New Haven, CT, United States
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Transplantation surgery continues to evolve and improve through
advancements in transplant technique and technology. With the increased
availability of ultrasound machines as well as the continued development
of Enhanced Recovery after Surgery (ERAS) protocols, regional anesthesia
has become an essential component of providing analgesia and minimizing
opioid use perioperatively. Many centers currently utilize peripheral and
neuraxial blocks during transplantation surgery, but these techniques are
far from standardized practices. The utilization of these procedures is
often dependent on transplantation centers' historical methods and
perioperative cultures. To date, no formal guidelines or recommendations
exist which address the use of regional anesthesia in transplantation
surgery. In response, the Society for the Advancement of Transplant
Anesthesia (SATA) identified experts in both transplantation surgery and
regional anesthesia to review available literature concerning these
topics. The goal of this task force was to provide an overview of these
publications to help guide transplantation anesthesiologists in utilizing
regional anesthesia. The literature search encompassed most
transplantation surgeries currently performed and the multitude of
associated regional anesthetic techniques. Outcomes analyzed included
analgesic effectiveness of the blocks, reduction in other analgesic
modalities-particularly opioid use, improvement in patient hemodynamics,
as well as associated complications. The findings summarized in this
systemic review support the use of regional anesthesia for postoperative
pain control after transplantation surgeries. Part 1 of the manuscript
focused on regional anesthesia performed in thoracic transplantation
surgeries, and part 2 in abdominal transplantations. Specifically,
regional anesthesia in liver, kidney, pancreas, intestinal, and uterus
transplants or applicable surgeries are discussed. Copyright ©
2024 The Authors. Clinical Transplantation published by John Wiley & Sons
Ltd.

<58>
Accession Number
642857702
Title
Effects of virtual exercise on cardio-pulmonary performance and depression
in cardiac rehabilitation phase I: A randomized control trial.
Source
Physiotherapy research international : the journal for researchers and
clinicians in physical therapy. 29(1) (pp e2066), 2024. Date of
Publication: 01 Jan 2024.
Author
Yuenyongchaiwat K.; Boonkawee T.; Pipatsart P.; Tavonudomgit W.;
Sermsinsaithong N.; Songsorn P.; Charususin N.; Harnmanop S.; Namdaeng P.;
Kulchanarat C.; Thanawattano C.
Institution
(Yuenyongchaiwat, Boonkawee, Pipatsart, Tavonudomgit, Sermsinsaithong,
Songsorn, Charususin, Harnmanop, Namdaeng) Physiotherapy Department,
Faculty of Allied Health Sciences, Thammasat University, Thailand
(Yuenyongchaiwat, Songsorn, Charususin) Thammasat University Research Unit
for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat
University, Thailand
(Kulchanarat) Physical Therapy Center, Thammasat University Hospital,
Thailand
(Thanawattano) National Science and Technology Development Agency (NSTDA),
Thailand
Abstract
BACKGROUND: Cardiac rehabilitation is recommended for patients undergoing
open-heart surgery (OHS). During the hospital admission, these patients
suffer from reduced cardiopulmonary performance and decreased
psychological health, leading to poor physical function, depression, and
morbidity. To prevent post-operative pulmonary complications, a pre and
post-operative physical therapy intervention is recommended for patients
undergoing heart surgery. Virtual reality (VR) promotes the health status
of healthy individuals and those with health conditions. However, few
studies have reported the beneficial effects of VR exercise programs on
the pulmonary performance and mental health status of patients undergoing
OHS. OBJECTIVE(S): To determine whether by using training enhanced by
VR, patients who have undergone OHS can more effectively attain
cardiopulmonary performance and improve depression than through
conventional physical therapy. METHOD(S): 60 participants were
randomly assigned to a conventional physical therapy and VR exercise
program. Each session was conducted once daily until discharge from the
hospital. Cardiorespiratory performance and depression were evaluated
before surgery and at the time of discharge from the hospital. A two-way
mixed ANOVA was performed to compare within (i.e., pre and post-operation)
and between (i.e., VR and conventional physical therapy) groups.
 RESULT(S): No significant cardiopulmonary performance gains were
detected in patients receiving the VR exercise program when compared with
those who participated in conventional physical therapy prior to
post-operative OHS (p > 0.05). However, the conventional physical therapy
group showed significantly higher depression scores than the VR group
(4.00 +/- 0.98 vs. 1.68 +/- 0.92). However, cardiopulmonary performance
did not differ in both VR exercise and conventional physical
therapy. Copyright © 2023 John Wiley & Sons Ltd.

<59>
Accession Number
2026114026
Title
Effects of parasternal intercostal block on surgical site wound infection
and pain in patients undergoing cardiac surgery: A meta-analysis.
Source
International Wound Journal. 21(2) (no pagination), 2024. Article Number:
e14433. Date of Publication: February 2024.
Author
Li J.-Q.; Li Z.-H.; Dong P.; Liu P.; Xu Y.-Z.; Fan Z.-J.
Institution
(Li) Department of Cardiac Surgery, Yantai Yuhuangding Hospital, Yantai,
China
(Li, Xu) Department of Anesthesiology, Qingdao Fuwai Hospital, Qingdao,
China
(Dong) Department of Hematology, Yantai Yuhuangding Hospital, Yantai,
China
(Liu) Department of Cardiac Surgery ICU, Yantai Yuhuangding Hospital,
Yantai, China
(Fan) Department of Cardiac Surgery, Qingdao Fuwai Hospital, Qingdao,
China
Publisher
John Wiley and Sons Inc
Abstract
This study aimed to assess the effect of parasternal intercostal block on
postoperative wound infection, pain, and length of hospital stay in
patients undergoing cardiac surgery. PubMed, Embase, Cochrane Library,
China National Knowledge Infrastructure, VIP, and Wanfang databases were
extensively queried using a computer, and randomised controlled studies
(RCTs) from the inception of each database to July 2023 were sought using
keywords in English and Chinese language. Literature quality was assessed
using Cochrane-recommended tools, and the included data were collated and
analysed using Stata 17.0 software for meta-analysis. Ultimately, eight
RCTs were included. Meta-analysis revealed that utilising parasternal
intercostal block during cardiac surgery significantly reduced
postoperative wound pain (standardised mean difference [SMD] = -1.01, 95%
confidence intervals [CI]: -1.70 to -0.31, p = 0.005) and significantly
shortened hospital stay (SMD = -0.40, 95% CI: -0.77 to -0.04, p = 0.029),
though it may increase the risk of wound infection (OR = 5.03, 95%
CI:0.58-44.02, p = 0.144); however, the difference was not statistically
significant. The application of parasternal intercostal block during
cardiac surgery can significantly reduce postoperative pain and shorten
hospital stay. This approach is worth considering for clinical
implementation. Decisions regarding its adoption should be made in
conjunction with the relevant clinical indices and surgeon's
experience. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<60>
Accession Number
2029411687
Title
Lactate Clearance And Mortality After Heart Transplantation: A Systematic
Review And Meta-Analysis.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2023. Cleveland United States. 30(1) (pp
151), 2024. Date of Publication: January 2024.
Author
Khan M.I.; Morales J.A.; Lorente-Ros M.; Aguilar-Gallardo J.S.; Romeo F.J.
Institution
(Khan, Morales, Lorente-Ros, Aguilar-Gallardo, Romeo) Icahn School of
Medicine at Mount Sinai, New York, NY
(Lorente-Ros) MedStar Georgetown University Hospital, Washington, DC
(Aguilar-Gallardo) Tulane University, New Orleans, LA
(Romeo) University of Miami/ Jackson Memorial Hospital, New York, NY
Publisher
Elsevier B.V.
Abstract
Background: Lactic acidosis (LA) is common after heart transplantation
(HTX). Lactate clearance (LC) has been studied as a useful biomarker to
predict survival in different patient populations. However, the role of LC
after HTX remains unknown. In this systematic review and meta-analysis, we
aim to compare LC among survivors and non-survivors after HTX.
 Method(s): We conducted a systematic review and meta-analysis of
observational studies evaluating survival and blood lactate in patients
undergoing HTX by searching PubMed, Cochrane Central and Embase from
inception through February 2023. We reviewed the mean difference in LC at
6-hours and 24-hours between survivors and non-survivors. The results were
pooled and a meta-analysis was performed using a random effects model
comparing the mean difference in LC between survivors and non-survivors.
Statistical heterogeneity was assessed by I2 statistics:
I2 statistic >50% was considered substantial, and I2
>75% was considered considerable. The Review Manager Software version
5.3.5. (The Cochrane Collaboration, 2014) was used to calculate summary
statistics (mean difference with 95% confidence intervals [CIs]).
 Result(s): In total, three observational studies were selected for
inclusion with a total of 316 patients. The median patient age was 47.3
years (interquartile range [IQR] 26.5-49.3). Lactate levels were evaluated
at baseline, 6 hours and 24 hours after HTX. Of note, there was a
significant difference in lactate levels before HTX between survivors and
non-survivors (2.62+/-2.8 vs 4.3+/-5.4, p=0.003) respectively. Lactate
clearance is calculated using the following formula: lactate clearance =
(lactate<inf>initial</inf> - lactate<inf>delayed</inf>) /
lactate<inf>initial</inf> x 100. In studies that monitored lactate levels
at 6 hours, the median percentage lactate clearance was 79.0% and 56.0% in
survivors and non-survivors, respectively. When pooled, mean difference in
percentage lactate clearance at 6-hours was 7.02% (95% CI -16.78-30.82%;
p=0.56). The median percentage lactate clearance at 24-hours was 75.5% and
51.8% in survivors and non-survivors, respectively. When pooled, mean
difference in percentage lactate clearance at 24-hours was 15.83% (95% CI
1.84-29.81%; p=0.03). There was statistically significant evidence of
heterogeneity between studies that reported 6-hour lactate levels
(I2 = 68%); however, no significant statistical heterogeneity
was noted between studies reporting 24-hour lactate levels (I2
= 0%). Conclusion(s): Lactate clearance in patients undergoing HTX is
a useful prognosticator of mortality. Early post-operative LA seems a
benign finding, although delayed LC may lead to increased mortality.
Further studies should be designed to evaluate predictors of delayed LC in
patients undergoing HTX. Copyright © 2023

<61>
Accession Number
2029343529
Title
Effects of percutaneous balloon mitral valvuloplasty on left ventricular
and right ventricular deformation in patients with isolated and severe
mitral stenosis: A speckle-tracking analysis.
Source
Archives of Cardiovascular Diseases. Conference: JESFC 2024. Paris France.
117(1 Supplement) (pp S69-S70), 2024. Date of Publication: January 2024.
Author
Fehri Z.F.; Agoumy Z.; Bensouda A.; Nadia F.; Rokya F.; Elhaitam N.;
Bendagha N.; Soufiani A.; Chaib A.
Institution
(Fehri, Bensouda, Nadia, Rokya, Elhaitam, Bendagha, Soufiani, Chaib)
Cardiologie, hopital Ibn-Sina, Rabat, Morocco
(Agoumy) Cardiologie, CHU de Souissi, Rabat, Morocco
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Previous studies have reported abnormal left ventricular
(LV) contraction in patients with mitral stenosis (MS), but presently we
do not have enough objective information about right ventricular
mechanics. Objective(s): The aim of our prospective single center
study was to explore the serial changes in left and right ventricular (RV)
mechanics in patients with severe MS undergoing balloon mitral
valvuloplasty (BMV) to understand the reversibility of the abnormal
contractile function. Method(s): The study included 30 patients with
severe MS and 15 age-matched healthy individuals. The mitral valve area
was measured by planimetry method. 2D speckle-tracking-based LV and RV
global longitudinal strain (GLS) measurements were performed for each
participant. In patients with MS, the same measurements were repeated 72
hours after BMV. Result(s): The mean age of patients with MS was 41
+/- 13 years (vs. 37 +/- 11 in the healthy control group) with a majority
of women (92%). Fifty-seven percent were in NYHA class II and 19% in class
III. The rate of atrial fibrillation was 61%. The mitral valve area was
0.9 +/- 0.2 cm2 vs. 1.8 +/- 0.2 cm2 respectively
before and after BMV. There were no significant differences between heart
rate and LV ejection fraction in patients with MS compared to control
group (P = 0.16) and between LV ejection fraction before and after BMV.
The magnitude of LV and RV GLS was significantly reduced in patients with
MS (P < 0.001 for each parameter) with a normal LV ejection fraction (61.5
+/- 4%). In the control group, the 2D LV and RV GLS were respectively -21
+/- 1.14% and -24 +/- 4.2%. After BMV, we note a significant improvement
in GLS: -13 +/- 2% vs. -15 +/- 3% (Fig. 1). There was no significant
modification of RV strain 72 hours after BMV (-15 +/- 4% vs -16 +/- 4%
with P = 0.3). On multivariate analysis, mitral area and LV end-diastolic
volume were independently correlated with baseline GLS. The mitral area
was a risk factor P = 0.004 and LV end-diastolic volume was a protector
factor P = 0.007, whereas increment in LV end-diastolic volume was the
only determinant of increased GLS after BMV (P = 0.049).
 Conclusion(s): LV GLS shows that BMV results in improvement of LV
deformation correlated with serial improvement in LV diastolic loading,
but not in the RV deformation. Copyright © 2023

<62>
Accession Number
2027992079
Title
OPTIMAL ANTITHROMBOTIC THERAPY AFTER TRANSCATHETER AORTIC VALVE
IMPLANTATION: A NETWORK META-ANALYSIS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S21), 2023. Date of Publication: November 2023.
Author
Barry A.; Turgeon R.; Ellis U.
Institution
(Barry, Turgeon, Ellis) VancouverBCUnited States
Publisher
Elsevier B.V.
Abstract
BACKGROUND: The optimal regimen of antithrombotic therapy in patients who
undergo transcatheter aortic valve implantation (TAVI) is unknown due to
the risk of both thrombotic and bleeding complications. We performed a
systematic review and network meta-analysis of randomized controlled
trials (RCTs) to compare different oral anticoagulant (OAC) and
antiplatelet regimens. METHODS AND RESULTS: We searched MEDLINE, Embase,
CENTRAL, and from inception to April 2023. The co-primary outcomes were
all-cause death and major bleeding. Secondary outcomes included
cardiovascular death, major adverse cardiovascular events, and minor
bleeding based on Valve Academic Research Consortium criteria. Included
were RCTs that compared any regimen of OAC and/or antiplatelet therapy and
reported 1 or more outcomes of interest. No language restrictions were
applied. Two reviewers independently screened articles, extracted data,
and performed quality assessments using the Cochrane risk-of-bias tool 2.
We performed Bayesian network meta-analyses to compare all interventions
simultaneously using the Markov-chain Monte Carlo method. We generated
odds ratios with 95% credible intervals from the medians and 2.5th and
97.5th percentiles of the posterior distributions using a hierarchical
Bayesian framework and random-effects model with informative priors. To
rank interventions for each outcome, we calculated the mean surface under
the cumulative ranking (SUCRA) curve. From 262 citations, 11 RCTs (N=6415)
were included. One RCT was unpublished. Overall risk of bias was low or
with some concerns. Ten RCTs were open-label and 1 was double-blind. Three
trials exclusively enrolled patients with an indication for OAC therapy.
Median age was 81 years. Median follow-up was 6 months. Compared to dual
antiplatelet therapy (DAPT), a direct-acting OAC plus single antiplatelet
therapy (DOAC+SAPT) had a higher risk of death, whereas there was no
difference between DAPT and SAPT. DOAC+SAPT increased the risk of major
bleeding compared to DAPT, while SAPT lowered the risk. DAPT and SAPT
ranked best for all-cause death (SUCRA 0.85 and 0.81, respectively). DAPT
ranked best for cardiovascular death (SUCRA 0.70) and major adverse
cardiovascular events (SUCRA 0.80). SAPT ranked best for major and minor
bleeding (SUCRA 0.98 and 0.88, respectively). DOAC+SAPT ranked worst for
all-cause death (SUCRA 0.19) and major bleeding (SUCRA 0.05). Results were
nearly identical in the subgroup of trials that included patients without
an indication for an OAC. CONCLUSION(S): In post-TAVI patients, DAPT
and SAPT ranked best for reducing death, whereas SAPT ranked best for
bleeding. SAPT may provide the optimal balance of reducing thrombotic
events while minimizing the risk of bleeding. [Formula presented] [Formula
presented] Copyright © 2023

<63>
Accession Number
2027989899
Title
INDUCTION THERAPY IN HEART TRANSPLANTATION: A SYSTEMATIC REVIEW AND
NETWORK META-ANALYSIS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S41-S42), 2023. Date of Publication: November 2023.
Author
Kugathasan L.; Rayner D.; Wang S.; Rodenas-Alesina E.; Orchanian-Cheff A.;
Stehlik J.; Gustafsson F.; Greig D.; McDonald M.; Bertolotti A.;
Demas-Clarke P.; Kozuszko S.; Foroutan F.; Alba A.
Institution
(Kugathasan, Rayner, Wang, Rodenas-Alesina, Orchanian-Cheff, Stehlik,
Gustafsson, Greig, McDonald, Bertolotti, Demas-Clarke, Kozuszko, Foroutan,
Alba) Toronto, Ontario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: The utility of induction therapy (IT) in heart transplantation
remains contested. Commissioned by a clinical-practice guidelines panel to
evaluate the effectiveness and safety of IT in adult heart transplantation
patients, we conducted this systematic review and network meta-analysis
(NMA) to assess the short and long-term outcomes. METHODS AND RESULTS: We
searched bibliographic databases for studies published from January 2000
to October 2022 that enrolled adult (at least 95% of the population >=18
years) de novo, single-organ heart transplantation recipients, and
reporting on the use of any IT agent and the impact on any
post-transplantation outcome. Based on patient-important outcomes informed
by our patient partners and clinicians, we performed frequentist NMAs
separately for RCTs, and observational studies with adjusted analyses. We
determined absolute effect estimates using MAGICapp, by determining
baseline risks reported in the studies and used the GRADE framework to
assess the certainty of evidence and summarize the findings. From 5,156
publications identified, we included 7 RCTs, and 12 observational studies
evaluating outcomes using multivariable analysis (Cox proportional hazards
models or logistic regression models), and report on the use of two
contemporarily-used IT agents - basiliximab and rATG. The RCTs provide
only very low certainty evidence, and thus proved uninformative of the
effect of the two agents versus no IT or one another. With low certainty
in the evidence from observational studies, basiliximab may increase
30-day (OR 1.13; 95%CI 1.06-1.20) and 1-year (OR 1.11; 95%CI 1.02-1.22)
mortality compared to no IT. With low certainty from observational
studies, rATG may decrease 5-year cardiac allograft vasculopathy (OR 0.82;
95%CI 0.74-0.90) compared to no IT, as well as 30-day (OR 0.85; 95%CI
0.80-0.92), 1-year (OR 0.87; 95%CI 0.79-0.96), and overall (HR 0.84; 95%CI
0.76-0.93) mortality compared to basiliximab. Tables 1a, 1b, and 1c
summarize the network estimates, absolute effect estimates, and certainty
of evidence. CONCLUSION(S): With low and very low certainty in the
synthetized evidence, these NMAs provide no compelling evidence for or
against the routine use of IT, and highlight the need for future studies.
Low certainty evidence suggests possible superiority of rATG versus
basiliximab. [Formula presented] Copyright © 2023

<64>
Accession Number
2027989826
Title
SAFETY AND EFFICACY OF POSTERIOR PERICARDIOTOMY AFTER CARDIAC SURGERY: A
SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Palais des congres de Montreal, Montreal Canada. 47(7 Supplement)
(pp S73), 2023. Date of Publication: November 2023.
Author
Tang X.; McEwen C.; Ibrahim O.; Kremic L.; Ginson B.; Lazzam D.; Karbassi
A.; Whitlock R.; McIntyre W.; Belley-Cote E.
Institution
(Tang, McEwen, Ibrahim, Kremic, Ginson, Lazzam, Karbassi, Whitlock,
McIntyre, Belley-Cote) Hamilton, Ontario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: Postoperative atrial fibrillation (AF) is a frequent
complication of cardiac surgery. Several randomized controlled trials
(RCTs) have assessed whether posterior pericardiotomy reduces AF. We
performed a systematic review and meta-analysis to summarize data on the
safety and efficacy of posterior pericardiotomy. METHODS AND RESULTS: We
searched MEDLINE, EMBASE, Web of Science, and the Cochrane Central
Register of Controlled Trials (CENTRAL) for RCTs from inception to March
11, 2023. We also searched the grey literature. In duplicate, reviewers
screened references and potentially eligible full-texts, collected data,
and assessed risk of bias. We pooled data using a random effects model.
After reviewing 2452 citations, we included 18 RCTs with a total of 3558
participants (1771 in the pericardiotomy group and 1787 in the control
group). Of participants, 13.3% (235/1771) and 25.2% (452/1787) developed
AF in the pericardiotomy and control groups, respectively. The incidence
of AF (RR = 0.53, 95% CI 0.40-0.70, I2 = 67%), pericardial effusion (RR =
0.36, 95% CI 0.17-0.73, I2 = 100%), and surgical re-exploration (RR =
0.61, 95% CI 0.41-0.91, I2 = 0%) were significantly lower in the
pericardiotomy group. In contrast, pleural effusion requiring intervention
(RR = 1.70, 95% CI 1.12-2.57, I2 = 15%) was significantly higher in the
pericardiotomy group. We found no significant difference in all-cause
mortality, hospital or ICU length of stay, time on bypass, and cross-clamp
time (Table 1). CONCLUSION(S): Posterior pericardiotomy is safe and
effective in preventing AF after cardiac surgery. [Formula
presented] Copyright © 2023

<65>
Accession Number
2027760852
Title
TCT-759 Comparative Efficacy and Safety of Transcatheter Edge-to-Edge
Mitral Valve Repair Versus Medical Therapy for Mitral Regurgitation: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fifth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Moscone
Center, San Francisco United States. 82(17 Supplement) (pp B305), 2023.
Date of Publication: 24 Oct 2023.
Author
Ramadan S.; Helmi A.; Elzankaly O.; Desouki M.; Hakim D.
Institution
(Ramadan) Faculty of Medicine Ain-Shams University, Cairo, Egypt
(Helmi) Faculty of Medicine Alexandria University, Alexandria, Egypt
(Elzankaly, Desouki) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Hakim) Brigham and Women's Hospital/Harvard Medical School, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge mitral valve repair (TEER) has
emerged as a promising therapy for patients with severe mitral valve
regurgitation who are not candidates for surgery. Although surgical
intervention remains the standard of care for patients with severe mitral
valve regurgitation, the efficacy of TEER compared with medical therapy is
not well established. This systematic review aims to evaluate the
available evidence on the clinical outcomes of TEER compared with medical
therapy in this patient population. Method(s): We followed the PRISMA
guidelines while preparing this systematic review and meta-analysis. A
computer literature search (PubMed, Web of Science, Scopes, Google
Scholar, and Cochrane Library) was carried out. We included RCT and
retrospective cohort studies, comparing the use of TEER with
guideline-directed medical therapy (GDMT) in patients having severe
symptomatic mitral valve regurgitation. Result(s): 8 RCTs (2,824
patients) were included in this analysis. The overall effect on 1-year
survival was in favor of guideline-directed medical (P =< 0.00001; 95% CI:
1.98-3.89). Regarding the other included metrics, the overall effect did
not show any benefit in either of the 2 groups in terms of death or
hospitalization caused by heart failure (P = 0.89; 95% CI: 0.76-1.27).
All-cause mortality (P = 0.30; 95% CI: 0.72-1.12). Cardiac death (P =
0.14; 95% CI: 0.58-1.08). Conclusion(s): Although TEER has been
considered a promising therapy for patients with severe mitral valve
disease in the last decade, there was no statistically significant
difference shown between its use compared with GDMT in severe mitral valve
regurgitation patients in terms of death and hospitalization for heart
failure, all-cause mortality, and cardiac death. Nevertheless, the 1-year
survival of mitral valve regurgitation patients favored GDMT Categories:
STRUCTURAL: Valvular Disease: Mitral Copyright © 2023

<66>
Accession Number
2030063339
Title
Non-pharmacological interventions to support coronary artery bypass graft
(CABG) patient recovery following discharge: Protocol for a scoping
review.
Source
BMJ Open. 14(1) (no pagination), 2024. Article Number: e075830. Date of
Publication: 11 Jan 2024.
Author
Billard J.N.; Wells R.; Farrell A.; Curran J.A.; Sheppard G.
Institution
(Billard, Sheppard) Faculty of Medicine, Memorial University of
Newfoundland and Labrador, Newfoundland and Labrador, St. John's, Canada
(Wells) Patient Partner, Ottawa, ON, Canada
(Farrell) Health Sciences Library, Memorial University of Newfoundland and
Labrador, Newfoundland and Labrador, St. John's, Canada
(Curran) School of Nursing, Dalhousie University, Halifax, NS, Canada
Publisher
BMJ Publishing Group
Abstract
Background In Canada, approximately 15 000 people undergo coronary artery
bypass grafting (CABG) each year. However, 9.5% of these patients are
urgently readmitted to hospital within 30 days of surgery. Postoperative
interventions following discharge play an important role in reducing
readmissions and improving CABG patient outcomes. Therefore, it is
important to determine effective interventions available to enhance CABG
patient recovery following postoperative discharge. Objectives Our scoping
review aims to identify non-pharmacological interventions available to
support recovery of patients who are discharged after CABG in the
community setting. Methods The methodological framework described by
Arksey and O'Malley will be applied to this review. Our search strategy
will include electronic databases (Medline, Embase, Cochrane Library and
CINAHL), and studies will be screened and reviewed by two independent
reviewers. Studies looking at non-pharmacological interventions targeting
patients who are discharged after CABG will be included. Preliminary
searches were conducted March 2022 and following abstract screening,
full-text screening was completed May 2023. Data extraction is planned to
begin September 2023 with an expected finish date of October 2023. The
study is expected to be completed by January 2024. Ethics and
dissemination This scoping review will retrieve and analyse previously
published studies in which informed consent was obtained by primary
investigators. Therefore, no ethical review or approval will be required.
This scoping review aims to enumerate available non-pharmacological
interventions to support recovery of patients who are discharged after
CABG and identify gaps in postoperative recovery after discharge to
support the development of innovative and targeted interventions. On
completion of this review, we will ensure broad dissemination of our
findings through peer-reviewed, open-access journals, conference
presentations and hold meetings to engage stakeholders, including
clinicians, policy makers and others. Copyright © 2024 Author(s).
Published by BMJ.

<67>
Accession Number
2030096251
Title
Safety and effectiveness of neuromuscular electrical stimulation in
cardiac surgery: A systematic review.
Source
World Journal of Cardiology. 16(1) (pp 27-39), 2024. Date of Publication:
26 Jan 2024.
Author
Kourek C.; Kanellopoulos M.; Raidou V.; Karatzanos E.; Dimopoulos S.;
Antonopoulos M.; Patsaki I.
Institution
(Kourek) Medical School of Athens, National and Kapodistrian University of
Athens, Athens 15772, Greece
(Kanellopoulos, Raidou, Karatzanos, Dimopoulos) Clinical Ergospirometry,
Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens
10676, Greece
(Dimopoulos, Antonopoulos) Intensive Care Unit, Onassis Cardiac Surgery
Center, Kallithea 17674, Greece
(Patsaki) Department of Physiotherapy, University of West Attica, Athens
12243, Greece
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Lack of mobilization and prolonged stay in the intensive care
unit (ICU) are major factors resulting in the development of ICU-acquired
muscle weakness (ICUAW). ICUAW is a type of skeletal muscle dysfunction
and a common complication of patients after cardiac surgery, and may be a
risk factor for prolonged duration of mechanical ventilation, associated
with a higher risk of readmission and higher mortality. Early mobilization
in the ICU after cardiac surgery has been found to be low with a
significant trend to increase over ICU stay and is also associated with a
reduced duration of mechanical ventilation and ICU length of stay.
Neuromuscular electrical stimulation (NMES) is an alternative modality of
exercise in patients with muscle weakness. A major advantage of NMES is
that it can be applied even in sedated patients in the ICU, a fact that
might enhance early mobilization in these patients. AIM To evaluate
safety, feasibility and effectiveness of NMES on functional capacity and
muscle strength in patients before and after cardiac surgery. METHODS We
performed a search on Pubmed, Physiotherapy Evidence Database (PEDro),
Embase and CINAHL databases, selecting papers published between December
2012 and April 2023 and identified published randomized controlled trials
(RCTs) that included implementation of NMES in patients before after
cardiac surgery. RCTs were assessed for methodological rigor and risk of
bias via the PEDro. The primary outcomes were safety and functional
capacity and the secondary outcomes were muscle strength and function.
RESULTS Ten studies were included in our systematic review, resulting in
703 participants. Almost half of them performed NMES and the other half
were included in the control group, treated with usual care. Nine studies
investigated patients after cardiac surgery and 1 study before cardiac
surgery. Functional capacity was assessed in 8 studies via 6MWT or other
indices, and improved only in 1 study before and in 1 after cardiac
surgery. Nine studies explored the effects of NMES on muscle strength and
function and, most of them, found increase of muscle strength and
improvement in muscle function after NMES. NMES was safe in all studies
without any significant complication. CONCLUSION NMES is safe, feasible
and has beneficial effects on muscle strength and function in patients
after cardiac surgery, but has no significant effect on functional
capacity. Copyright © 2024 Baishideng Publishing Group Co. All
rights reserved.

<68>
Accession Number
2029515281
Title
Individual lifetime benefit from low-dose colchicine in patients with
chronic coronary artery disease.
Source
European Journal of Preventive Cardiology. 30(18) (pp 1950-1962), 2023.
Date of Publication: 01 Dec 2023.
Author
Burger P.M.; Dorresteijn J.A.N.; Fiolet A.T.L.; Koudstaal S.; Eikelboom
J.W.; Nidorf S.M.; Thompson P.L.; Cornel J.H.; Budgeon C.A.; Westendorp
I.C.D.; Beelen D.P.W.; Martens F.M.A.C.; Steg P.G.; Asselbergs F.W.;
Cramer M.J.; Teraa M.; Bhatt D.L.; Visseren F.L.J.; Mosterd A.
Institution
(Burger, Dorresteijn, Visseren) Department of Vascular Medicine,
University Medical Centre Utrecht, Utrecht, Netherlands
(Fiolet, Asselbergs, Cramer) Department of Cardiology, University Medical
Centre Utrecht, Utrecht, Netherlands
(Fiolet, Koudstaal, Cornel, Martens, Mosterd) Dutch Cardiovascular
Research Network (WCN), Moreelsepark 1, Utrecht 3511 EP, Netherlands
(Koudstaal) Department of Cardiology, Green Heart Hospital, Gouda,
Netherlands
(Eikelboom) Department of Medicine, McMaster University, Hamilton, Canada
(Nidorf, Thompson) Department of Cardiology, GenesisCare Western
Australia, Perth, Australia
(Nidorf, Thompson) Heart Research Institute of Western Australia, Perth,
Australia
(Cornel) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Budgeon) School of Population and Global Health, University of Western
Australia, Perth, Australia
(Westendorp) Department of Cardiology, Red Cross Hospital, Beverwijk,
Netherlands
(Beelen) Department of Cardiology, IJsselland Hospital, Capelle aan den
IJssel, Netherlands
(Martens) Department of Cardiology, Deventer Hospital, Deventer,
Netherlands
(Steg) Assistance Publique-Hopitaux de Paris, Hopital Bichat, Universite
de Paris, Paris, France
(Teraa) Department of Vascular Surgery, University Medical Centre Utrecht,
Utrecht, Netherlands
(Bhatt) Mount Sinai Heart, Icahn School of Medicine, Mount Sinai Health
System, New York, United States
(Mosterd) Department of Cardiology, Meander Medical Centre, TZ Maatweg 3,
Amersfoort 3813, Netherlands
Publisher
Oxford University Press
Abstract
Aims Low-dose colchicine reduces cardiovascular risk in patients with
coronary artery disease (CAD), but absolute benefits ma vary between
individuals. This study aimed to assess the range of individual absolute
benefits from low-dose colchicine ac cording to patient risk profile.
Methods and results The European Society of Cardiology (ESC)
guideline-recommended SMART-REACH model was combined with the relative
treatment effect of low-dose colchicine and applied to patients with CAD
from the Low-Dose Colchicine 2 (LoDoCo2) trial and the Utrecht
Cardiovascular Cohort-Second Manifestations of ARTerial disease
(UCC-SMART) study (n = 10 830). Individual treatment benefits were
expressed as 10-year absolute risk reductions (ARRs) for myocardial
infarction, stroke, or cardiovascular death (MACE), and MACE-free
life-years gained. Predictions were also performed for MACE plus coronary
revascularization (MACE+), using a new lifetime model derived in the
REduction of Atherothrombosis for Continued Health (REACH) registry.
Colchicine was compared with other ESC guideline-recommended intensified
(Step 2) prevention strategies, i.e. LDL cholesterol (LDL-c) reduction to
1.4 mmol/L and systolic blood pressure (SBP) reduction to 130 mmHg. The
generalizability to other populations was assessed in patients with CAD
from REACH North America and Western Europe (n = 25 812). The median
10-year ARR from low-dose colchicine was 4.6% [interquartile range (IQR)
3.6-6.0%] for MACE and 8.6% (IQR 7.6-9.8%) for MACE+. Lifetime benefit was
2.0 (IQR 1.6-2.5) MACE-free years, and 3.4 (IQR 2.6-4.2) MACE+-free
life-years gained. For LDL-c and SBP reduction, respectively, the median
10-year ARR for MACE was 3.0% (IQR 1.5-5.1%) and 1.7% (IQR 0.0-5.7%), and
the lifetime benefit was 1.2 (IQR 0.6-2.1) and 0.7 (IQR 0.0-2.3) MACE-free
life-years gained. Similar results were obtained for MACE+ and in American
and European patients from REACH. Conclusion The absolute benefits of
low-dose colchicine vary between individual patients with chronic CAD.
They may be expected to be of at least similar magnitude to those of
intensified LDL-c and SBP reduction in a majority of patients already on
conventional lipid-lowering and blood pressure-lowering
therapy. Copyright © The Author(s) 2023.

<69>
Accession Number
643379579
Title
The American Association for Thoracic Surgery 2023 Expert Consensus
Document: Recommendation for the care of children with trisomy 13 or
trisomy 18 and a congenital heart defect.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 27 Jan 2024.
Author
St Louis J.D.; Bhat A.; Carey J.C.; Lin A.E.; Mann P.C.; Smith L.M.;
Wilfond B.S.; Kosiv K.V.; Sorabella R.A.; Alsoufi B.
Institution
(St Louis) Department of Surgery, Children's Hospital of Georgia, Augusta
University, Augusta, Ga, United States
(Bhat, Carey, Wilfond) Department of Pediatrics, Seattle Children's
Hospital and University of Washington, Seattle, United States
(Lin) Department of Pediatrics, Mass General Hospital for Children, Mass,
Boston, United States
(Mann) Department of Surgery, Children's Hospital of Georgia, Augusta
University, Augusta, Ga, United States
(Smith) Department of Pediatrics, Oregon Health and Science University,
Ore, Portland, Jamaica
(Kosiv) Department of Pediatrics, Yale University School of Medicine,
Hartford, United States
(Sorabella) Department of Surgery, University of Alabama at Birmingham,
Birmingham, Ala
(Alsoufi) Department of Surgery, University of Louisville and Norton
Children's Hospital, Louisville, Ky, United States
Abstract
OBJECTIVES: Recommendations for surgical repair of a congenital heart
defect in children with trisomy 13 or trisomy 18 remain controversial, are
subject to biases, and are largely unsupported with limited empirical
data. This has created significant distrust and uncertainty among parents
and could potentially lead to suboptimal care for patients. A working
group, representing several clinical specialties involved with the care of
these children, developed recommendations to assist in the decision-making
process for congenital heart defect care in this population. The goal of
these recommendations is to provide families and their health care teams
with a framework for clinical decision making based on the literature and
expert opinions. METHOD(S): This project was performed under the
auspices of the AATS Congenital Heart Surgery Evidence-Based Medicine
Taskforce. A Patient/Population, Intervention, Comparison/Control, Outcome
process was used to generate preliminary statements and recommendations to
address various aspects related to cardiac surgery in children with
trisomy 13 or trisomy 18. Delphi methodology was then used iteratively to
generate consensus among the group using a structured communication
process. RESULT(S): Nine recommendations were developed from a set of
initial statements that arose from the Patient/Population, Intervention,
Comparison/Control, Outcome process methodology following the groups'
review of more than 500 articles. These recommendations were adjudicated
by this group of experts using a modified Delphi process in a reproducible
fashion and make up the current publication. The Class (strength) of
recommendations was usually Class IIa (moderate benefit), and the overall
level (quality) of evidence was level C-limited data. CONCLUSION(S):
This is the first set of recommendations collated by an expert
multidisciplinary group to address specific issues around indications for
surgical intervention in children with trisomy 13 or trisomy 18 with
congenital heart defect. Based on our analysis of recent data, we
recommend that decisions should not be based solely on the presence of
trisomy but, instead, should be made on a case-by-case basis, considering
both the severity of the baby's heart disease as well as the presence of
other anomalies. These recommendations offer a framework to assist parents
and clinicians in surgical decision making for children who have trisomy
13 or trisomy 18 with congenital heart defect. Copyright © 2023
The American Association for Thoracic Surgery. Published by Elsevier Inc.
All rights reserved.

<70>
Accession Number
643372649
Title
Prognostic Implication of Preprocedural Pulmonary Hypertension in Patients
with Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-analysis.
Source
Cardiology in review. (no pagination), 2024. Date of Publication: 29 Jan
2024.
Author
Emami Meybodi M.; Bamarinejad A.; Bamarinejad F.; Abhari A.P.;
Fakhrolmobasheri M.; Khosravi Larijani F.; Nasiri S.; Shafie D.
Institution
(Emami Meybodi) From the Department of Cardiology, Afshar Hospital, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Bamarinejad, Bamarinejad, Abhari, Fakhrolmobasheri, Nasiri, Shafie) Heart
Failure Research Center, Isfahan Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Khosravi Larijani) Student Research Committee, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
Abstract
Pulmonary hypertension (PH) is a common comorbidity in patients with
aortic stenosis (AS) who are candidates for transcatheter aortic valve
implantation (TAVI). Herein, we sought to elucidate the prognostic value
of preprocedural PH on the early and late mortality after TAVI. The
Cochrane Library, Scopus, PubMed, Web of Science, Embase, and ProQuest
were screened using a predefined search query. We considered odds ratios
(ORs) as the measure of effect. Meta-regression analysis was applied to
investigate the potential impact of baseline characteristics on the
outcomes. Egger's and Begg's tests were used to assess the publication
bias. Thirty-three studies comprising 34 datasets representing 68,435
patients were included in the analysis. Regardless of the definition and
severity of PH, pooled data analysis indicated that preprocedural PH was
associated with higher cardiac and overall 30-day [OR, 1.45 (1.15-1.82)
and OR, 1.75 (1.42-2.17), respectively], and 1-year mortality [OR, 1.63
(1.35-1.96) and OR, 1.59 (1.38-1.82), respectively]. Meta-regression
analysis demonstrated that older age, higher New York Heart Association
function class, history of hypertension, diabetes, and lower left
ventricular ejection fraction were predictors of higher mortality rate
following TAVI. Moreover, we found that preprocedural PH is significantly
associated with higher in-hospital mortality and 30-day acute kidney
injury. Our results demonstrated that preprocedural PH is associated with
higher early and late cardiac and overall mortality following TAVI;
however, this finding is limited regarding the considerable inconsistency
in the definition of PH and PH severity among studies. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<71>
Accession Number
2028877656
Title
Individualised, perioperative open-lung ventilation strategy during
one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled
clinical trial.
Source
The Lancet Respiratory Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Pia Cantatore L.; Laforgia D.; Sonsoles Leal M.; Salazar C.J.; Morocho
D.R.; Spadaro S.; Scaramuzzo G.; Cervantes O.; Parera A.; Argilaga M.;
Herranz G.; Unzueta C.; Vives M.; Regi K.; Costa-Reverte M.; Leal M.S.;
Ramasco F.; Nieves-Alonso J.; Garcia E.; Suarez-Sipmann F.;
Rodriguez-Perez A.; Farina R.; Cabrera S.; Guerra E.; Gallego-Ligorit L.;
Herrero-Izquierdo A.; Valles-Torres J.; Pineiro P.; Garutti I.; Ramos S.;
Lopez-Herrera D.; De La Matta M.; Gokhan S.; Kucur E.; Mugarra A.; Belda
F.J.; Soro M.; Garcia L.; Sastre J.A.; Aguirre P.; Jimena-Salazar C.;
Ramos M.C.; Trespalacios R.; Ezequiel-Fernandez F.; Mirabella L.; Lamanna
A.; Cantatore L.P.; Laforogia D.; Bellas S.; Lopez C.; Carraminana A.;
Navarro-Ripoll R.; Vallverdu J.; Jacas A.; Ferrando C.; Yepes-Temino M.J.;
Librero J.; Tusman G.; Villar J.; Martinez S.; Azparren G.; Bausili M.;
Torres S.; Diaz M.; Ricart A.; Gasco I.; Parramon F.; Sanz-Iturbe M.;
Garcia-Ballester S.; Mendez-Arias E.; Cabadas R.; Grosso L.; Becerra A.;
Hussein Z.; Sanjuan-Villarreal T.A.; Puertolas M.; Izquierdo-Villarroya
B.; Almajano R.; Romero B.; Colomina L.; Quesada N.; Latorre J.A.; Franco
J.A.; Laval A.; Garcia-Tirado J.; Embun R.; Bueno C.; Jaren P.;
Martinez-Serrano R.; Garcia-Latasa B.; Baquedano S.; Motilva B.; Hernando
B.; Herrero M.; Oliver-Fornies P.; Recuero J.L.; Carbo-Espinosa F.; Lucas
A.; Munoz-Gonzalez N.; Lafuente N.; Acosta-Martinez J.; Ragazzi R.; Volta
C.A.; Maniscalco P.; Arribas M.P.; de Celis M.I.; Pascual M.J.; Martinez
P.; Martinez O.; Reparaz J.R.; Dominguez D.; Fernandez M.; Sanchez V.;
Perez-Lozana B.; Martin E.; Fernandez D.; Gonzalez A.; Pico J.; El-Hefny
D.A.; Armengol L.; Comino O.; Rovira I.; Arguis M.J.; Matute P.; Carretero
M.J.; Ibanez C.; Perdomo J.; Ruiz C.; Gonzalez N.; Gonzalez M.; Bolado A.;
Trabanco S.; Largo A.; Maestro A.; Pascual A.; Reyes A.I.; Bartolome M.J.;
Williams M.M.; del Olmo P.; Cimadevilla B.; Pardo S.; Sancho L.; Lascorz
L.; Carbonell J.A.; Hurtado L.; Florea R.; Martinez-Castro S.; Monleon B.;
Perez S.; Jurado A.; Barcena E.; Segura N.; Cuervo J.; Belmonte L.; Pardo
P.; Utrera E.; Serralta F.; Parra M.J.; Arocas B.; Gutierrez A.;
Cruz-Pardos P.; de la Gala-Garcia F.; Sanchez-Pedrosa G.; Duque-Gonzalez
P.; De La Fuente-Tornero E.; Puig-Ramos A.; Garcia-Hernandez S.;
Martinez-Gascuena D.; Calvo-Garcia C.A.; Reyes-Fierro A.; Novoa-Lago E.;
Anaya-Camacho R.; Monteserin-Matesanz C.; Martinez-Merino N.;
Arnalich-Montiel A.; Pizarro-Calderon A.G.; Ruiz-Ortega A.; Benito-Saz P.;
Rodriguez A.E.; Garcia-Bunger B.; Garcia-Ramos S.; Lopez-Gil E.;
Power-Esteban M.; Ramos-Fernandes R.; Sevilla-Bayon R.; Solchaga-Sanchez
I.; Tullo L.; Gambetti G.; Carrideo A.; Morelli A.; Aiello D.; Spiga S.
Institution
(Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain
(Ferrando) CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos
III, Madrid, Spain
(Carraminana, Navarro-Ripoll, Vallverdu, Jacas) Department of
Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona,
Spain
(Pineiro, Garutti, Ramos, Martinez) Department of Anesthesiology and
Critical Care, Hospital Universitario Gregorio Maranon, Madrid, Spain
(Mirabella, Lamanna, Pia Cantatore, Laforgia) Department of Medical and
Surgical Sciences, Universita Degli Studi di Foggia, Foggia, Italy
(Spadaro, Scaramuzzo) Department of Anesthesiology and Critical Care,
Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
(Librero) UPNA, REDISSEC Red de Investigacion en Servicios de Salud,
Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
(Ramasco, Nieves-Alonso, Garcia) Department of Anesthesiology and Critical
Care, Hospital Universitario de La Princesa, Madrid, Spain
(Cervantes) Department of Anesthesiology and Critical Care, Hospital
Universitario Germans Trias i Pujol, Barcelona, Spain
(Parera, Argilaga, Herranz, Unzueta) Department of Anesthesiology and
Critical Care, Hospital Universitario Santa Creu i Sant Pau, Barcelona,
Spain
(Vives, Regi) Department of Anesthesiology and Critical Care, Hospital
Universitario Josep Trueta, Girona, Spain
(Costa-Reverte) Department of Anesthesiology and Critical Care, Hospital
Universitario de Bellvitge, Barcelona, Spain
(Sonsoles Leal) Hospital Rivera Povisa, Vigo, Spain
(Rodriguez-Perez, Farina, Cabrera, Guerra) Department of Anesthesiology
and Critical Care, Hospital Universitario de Gran Canaria Dr Negrin, Gran
Canarias, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Department of
Anesthesiology and Critical Care, Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Instituto de
Investigacion Sanitaria Aragon IIS Aragon, Zaragoza, Spain
(Lopez-Herrera, De La Matta) Department of Anesthesiology and Critical
Care, Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Gokhan, Kucur) Department of Anesthesiology and Critical Care, Bakirkoy
Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
(Gokhan) Outcomes Research Consortium, Cleveland, OH, United States
(Mugarra, Soro, Garcia, Belda) Department of Anesthesiology and Critical
Care, Hospital Universitario Clinico de Valencia, Valencia, Spain
(Sastre) Department of Anesthesiology and Critical Care, Hospital
Universitario de Salamanca, Salamanca, Spain
(Aguirre) Department of Anesthesiology and Critical Care, Hospital Alvaro
Cunqueiro, Vigo, Spain
(Salazar, Ramos) Department of Anesthesiology and Critical Care, Hospital
Universitario Ntra Sra de Candelaria, Santa Cruz de Tenerife, Spain
(Morocho) Department of Anesthesiology, Hospital Eugenio Espejo, Quito,
Ecuador
(Trespalacios, Ezequiel-Fernandez) Department of Anesthesiology and
Critical Care, Hospital Universitario Central de Asturias, Oviedo, Spain
(Bellas) Department of Anesthesiology and Critical Care, Hospital
Universitario Fundacion Jimenez Diaz, Madrid, Spain
(Lopez) Department of Anesthesiology and Critical Care, Hospital
Universitario Marques de Valdecilla, Santander, Spain
(Yepes-Temino) Department of Anesthesiology and Critical Care, Clinica
Universidad de Navarra, Pamplona, Spain
(Tusman) Department of Anesthesiology, Hospital Privado de Comunidad,
Buenos Aires, Mar de Plata, Argentina
(Suarez-Sipmann) CIBER de Enfermedades Respiratorias CIBERES, Instituto de
Salud Carlos III, Madrid, Spain
(Suarez-Sipmann) Hedenstierna Laboratory, Department of Surgical Sciences,
Uppsala University, Uppsala, Sweden
(Villar) CIBER de Enfermedades Respiratorias, Madrid, Spain
(Villar) Hospital Universitario Dr Negrin, Las Palmas de Gran Canaria,
Spain
(Villar) Li Ka Shing Knowledge Institute for Medical Science, St Michael's
Hospital, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: It is uncertain whether individualisation of the perioperative
open-lung approach (OLA) to ventilation reduces postoperative pulmonary
complications in patients undergoing lung resection. We compared a
perioperative individualised OLA (iOLA) ventilation strategy with standard
lung-protective ventilation in patients undergoing thoracic surgery with
one-lung ventilation. Method(s): This multicentre, randomised
controlled trial enrolled patients scheduled for open or video-assisted
thoracic surgery using one-lung ventilation in 25 participating hospitals
in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age
>=18 years) were randomly assigned to receive iOLA or standard
lung-protective ventilation. Eligible patients (stratified by centre) were
randomly assigned online by local principal investigators, with an
allocation ratio of 1:1. Treatment with iOLA included an alveolar
recruitment manoeuvre to 40 cm H<inf>2</inf>O of end-inspiratory pressure
followed by individualised positive end-expiratory pressure (PEEP)
titrated to best respiratory system compliance, and individualised
postoperative respiratory support with high-flow oxygen therapy.
Participants allocated to standard lung-protective ventilation received
combined intraoperative 4 cm H<inf>2</inf>O of PEEP and postoperative
conventional oxygen therapy. The primary outcome was a composite of severe
postoperative pulmonary complications within the first 7 postoperative
days, including atelectasis requiring bronchoscopy, severe respiratory
failure, contralateral pneumothorax, early extubation failure (rescue with
continuous positive airway pressure, non-invasive ventilation, invasive
mechanical ventilation, or reintubation), acute respiratory distress
syndrome, pulmonary infection, bronchopleural fistula, and pleural
empyema. Due to trial setting, data obtained in the operating and
postoperative rooms for routine monitoring were not blinded. At 24 h, data
were acquired by an investigator blinded to group allocation. All analyses
were performed on an intention-to-treat basis. This trial is registered
with ClinicalTrials.gov, NCT03182062, and is complete. Finding(s):
Between Sept 11, 2018, and June 14, 2022, we enrolled 1380 patients, of
whom 1308 eligible patients (670 [434 male, 233 female, and three with
missing data] assigned to iOLA and 638 [395 male, 237 female, and six with
missing data] to standard lung-protective ventilation) were included in
the final analysis. The proportion of patients with the composite outcome
of severe postoperative pulmonary complications within the first 7
postoperative days was lower in the iOLA group compared with the standard
lung-protective ventilation group (40 [6%] vs 97 [15%], relative risk 0.39
[95% CI 0.28 to 0.56]), with an absolute risk difference of -9.23 (95% CI
-12.55 to -5.92). Recruitment manoeuvre-related adverse events were
reported in five patients. Interpretation(s): Among patients
subjected to lung resection under one-lung ventilation, iOLA was
associated with a reduced risk of severe postoperative pulmonary
complications when compared with conventional lung-protective ventilation.
 Funding(s): Instituto de Salud Carlos III and the European Regional
Development Funds. Copyright © 2023 Elsevier Ltd

<72>
Accession Number
361572835
Title
Early vs. delayed invasive strategy in patients with acute coronary
syndromes without ST-segment elevation: A meta-analysis of randomized
studies.
Source
QJM: An International Journal of Medicine. 104(3) (pp 193-200), 2011. Date
of Publication: March 2011.
Author
Navarese E.P.; de Servi S.; Gibson C.M.; Buffon A.; Castriota F.; Kubica
J.; Petronio A.S.; Andreotti F.; de Luca G.
Institution
(Navarese, Buffon, Andreotti) Institute of Cardiology, Catholic University
of the Sacred Heart, Rome, Italy
(Navarese, de Servi) Department of Cardiovascular diseases, Civic
Hospital, Legnano, Italy
(Navarese, Gibson) Cardiovascular Division, Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, MA, United States
(Navarese, Castriota) GVM Care and Research, Interventional
Cardio-Angiology Unit, Cotignola, Italy
(Navarese, Kubica) Nicolaus Copernicus University, Bydgoszcz, Poland
(Petronio) Cardiothoracic Department, Azienda Ospedaliero-Universitaria
Pisana, Pisa, Italy
(de Luca) Division of Cardiology, Maggiore della Carita' Hospital, Eastern
Piedmont University A. Avogadro, Novara, Italy
Publisher
Oxford University Press
Abstract
Although early percutaneous coronary intervention has been demonstrated to
reduce the risk of mortality in patients with non-ST-segment elevation
acute coronary syndromes (NSTE-ACS), there are emerging conflicting data
as to whether the catheterization needs to be done very early or whether
it could be delayed while the patient receives medical therapy. The aim of
the current study was to perform a meta-analysis of randomized controlled
trials (RCTs) comparing early vs. delayed invasive strategies for NSTE-ACS
patients. Medline/CENTRAL and the Web were searched for RCTs comparing
early vs. delayed invasive strategies for NSTE-ACS patients. The primary
endpoint was all cause mortality, whereas myocardial infarction (MI),
coronary revascularizations and 30-day major bleeding complications were
secondary end points. Fixed or random effects models were used based on
statistical heterogeneity. As a sensitivity analysis, Bayesian random
effects meta-analysis was performed in addition to the classical random
effects metaanalysis. A total of 5 RCTs were finally included, enrolling
4155 patients. As compared with a delayed strategy, an early invasive
approach did not significantly reduce the rates of death [odds ratio (OR)
95% confidence interval (95% CI) = 0.81 (95% CI 0.60-1.09), P = 0.17], MI
[OR = 1.18 (95% CI 0.68-2.05), P=0.55] or revascularizations [OR=0.97
(0.77-1.24), P = 0.82]. There was a not significant trend toward fewer
major bleeding complications for the early invasive approach [OR (95% CI)
= 0.76 (0.55-1.04), P = 0.08]. The present meta-analysis shows that for
NSTE-ACS patients a routine early invasive strategy does not significantly
improve survival nor reduce MI and revascularization rates as compared
with a delayed approach. © The Author 2011. Published by Oxford
University Press on behalf of the Association of Physicians. All rights
reserved.

<73>
Accession Number
354999289
Title
Myocardial infarction after percutaneous coronary intervention: A
meta-analysis of troponin elevation applying the new universal definition.
Source
QJM: An International Journal of Medicine. 102(6) (pp 369-378), 2009. Date
of Publication: 2009.
Author
Testa L.; Van Gaal W.J.; Biondi Zoccai G.G.L.; Agostoni P.; Latini R.A.;
Bedogni F.; Porto I.; Banning A.P.
Institution
(Testa, Banning) Institute of Cardiology, John Radcliffe Hospital, Oxford,
United Kingdom
(Testa, Latini, Bedogni) Interventional Cardiology Department, Sant'
Ambrogio Clinical Institute, Milan, Italy
(Van Gaal) Institute of Cardiology, Northern Hospital, Melbourne, VIC,
Australia
(Biondi Zoccai) Institute of Cardiology, University of Turin, Turin, Italy
(Agostoni) Antwerp Cardiovascular Institute Middelheim, Antwerp, Belgium
(Porto) Institute of Cardiology, Catholic University, Rome, Italy
(Testa) Cardiology Ward, John Radcliffe Hospital, Headley Way, Oxford OX3
9DU, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: Elevation of Troponin after scheduled percutaneous coronary
intervention (PCI) is a recognized consequence. We sought to evaluate the
prognostic significance and impact of the newly published definition of
PCI-related myocardial infarction (MI) according to which any troponin
elevation >3 times the upper reference limit identify a peri-procedural
MI. Method(s): Search of BioMedCentral, CENTRAL, mRCT and PubMed
(updated May 2008). Outcomes of interest were: MACE [the composite of all
cause death, MI, repeat target vessel PCI (re-PCI) and coronary artery
bypass grafting (CABG)]; single end points were also assessed.
 Result(s): Fifteen studies have been included totalling 7578
patients. Troponin elevation occurred in 28.7% of the procedures. The
incidence of PCI-related MI according to the new definition was 14.5%.
During the hospitalization, any level of raised troponin was associated
with an increased risk of MACE [OR 11.29 (3.00-42.48), Number needed to
harm (NNH) 5], death [OR 7.16 (1.95-26.27), NNH = 100], MI [OR 30.85
(6.05-157.38), NNH = 4] and re-PCI [OR 4.13 (1.23-13.88), NNH = 50].
Patients with PCI-related MI had an increased risk of death [OR 17.25
(2.71-109.96), NNH = 100] and re-PCI [OR 10.86 (3.2-36.94), NNH = 25]. At
follow up of 18 months any troponin elevation was associated with an
increased risk of MACE [OR 1.48 (1.12-1.96), NNH = 20], death [OR 2.19
(1.59-3.00), NNH = 50], MI [OR 3.29 (2.71-6.31), NNH = 33] and re-PCI [OR
1.47 (1.06-2.03), NNH = 25]. In patients with PCI-related MI the risk of
MACE was further increased: OR 2.25 (1.26-4.00), NNH = 3. An increase of
the troponin level below the cut-off was not associated with MACE.
 Conclusion(s): A diagnosis of MI according to the new guidelines
applies to 15% of patients undergoing PCI and these patients are at high
risk of further adverse events both during the hospital stay and at 18
months. © The Author 2009. Published by Oxford University Press on
behalf of the Association of Physicians. All rights reserved.

<74>
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)

<75>
Accession Number
2030056603
Title
Safety and efficacy of glucagon-like peptide-1 receptor agonists on
cardiovascular events in overweight or obese non-diabetic patients.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102403. Date of Publication: March 2024.
Author
Singh S.; Garg A.; Tantry U.S.; Bliden K.; Gurbel P.A.; Gulati M.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Garg) Division of Cardiology, Ellis Hospital, NY, United States
(Tantry, Bliden) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, United States
(Gurbel) Division of Cardiology, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Gulati) Division of Cardiology, Smidt Heart Institute, Los Angeles, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Randomized controlled trials (RCTs) have shown variable
cardiovascular (CV) outcomes in overweight or obese patients without
diabetes mellitus (DM) who are treated with glucagon-like peptide-1
receptor agonists (GLP-1 RAs) vs. placebo. We conducted a meta-analysis of
the available studies. Method(s): Online databases were searched for
RCTs comparing GLP-1 RA to placebo in overweight or obese non-diabetic
patients. The clinical endpoints of interest were major adverse CV events
(MACE), CV death, all cause death, myocardial infarction (MI), stroke,
revascularization, total adverse events and their subtypes. Pooled odds
ratios (OR) and 95 % confidence intervals (CI) were calculated using a
random-effects model. Result(s): A total of 10 RCTs with 29,325
patients (n = 16,900 GLP-1 RA, n = 12,425 placebo) were included. The mean
age was 48 years and 34 % of patients were men. As compared with placebo,
the GLP-1 RA group was associated with significant reduction of MACE (OR
0.79, 95 % CI 0.71-0.89, p < 0.0001), all cause death (OR 0.80, 95 % CI
0.70-0.92, p = 0.002), MI (OR 0.72, 95 % CI 0.61-0.85, p = 0.0001) and
revascularization (OR 0.76, 95 % CI 0.67-0.86, p < 0.0001), without any
differences in CV death or stroke. Total adverse events, gastrointestinal
and gallbladder-related disorders were higher in the GLP-1 RA group, with
a similar rate of renal adverse events, malignant neoplasms and acute
pancreatitis to placebo. Conclusion(s): In overweight or obese
patients without DM, patients treated with GLP-1 RAs had significantly
reduced MACE, all cause death, MI and revascularization when compared with
placebo. Copyright © 2024 Elsevier Inc.

<76>
Accession Number
2030005792
Title
Handgrip exercise in patients scheduled for cardiac surgery to attenuate
troponin release: a feasibility study.
Source
American Journal of Physiology - Heart and Circulatory Physiology. 325(5)
(pp H1144-H1150), 2023. Date of Publication: November 2023.
Author
Hartman Y.A.W.; Konijnenberg L.S.F.; Dinnissen D.J.M.; Rodwell L.; Li
W.W.L.; Nijveldt R.; van Royen N.; Thijssen D.H.J.
Institution
(Hartman, Dinnissen, Thijssen) Department of Medical BioSciences, Radboud
University Medical Center, Nijmegen, Netherlands
(Konijnenberg, Nijveldt, van Royen) Department of Cardiology, Radboud
University Medical Center, Nijmegen, Netherlands
(Rodwell) Department of Epidemiology and Biostatistics, Radboud University
Medical Center, Nijmegen, Netherlands
(Li) Department of Cardiothoracic Surgery, Radboud University Medical
Center, Nijmegen, Netherlands
(Thijssen) Research Institute for Sport and Exercise Sciences, Liverpool
John Moores University, Liverpool, United Kingdom
Publisher
American Physiological Society
Abstract
Cardiac surgery, including surgical aortic valve repair (SAVR) and
coronary artery bypass grafting (CABG), are associated with
ischemia-reperfusion (I/R) injury. Single bouts of exercise, including
handgrip exercise, may protect against I/R injury. This study explored 1)
the feasibility of daily handgrip exercise in the week before SAVR and/or
CABG and 2) its impact on cardiac I/R injury, measured as postoperative
cardiac troponin-T (cTnT) release. Sixty-five patients undergoing elective
SAVR and/or CABG were randomized to handgrip exercise usual care
(intervention, n 1/4 33) or usual care alone (control, n 1/4 32). Handgrip
exercise consisted of daily 4 x 5-min handgrip exercise (30% maximal
voluntary contraction) for 2-7 days before cardiac surgery. Feasibility
was assessed using validated questionnaires. Postoperative cTnT release
was assessed at 0, 6, 12, 18, and 24 h [primary outcome area under the
curve (cTnT<inf>AUC</inf>)]. Most patients (93%) adhered to handgrip
exercise and 77% was satisfied with this intervention. Handgrip exercise
was associated with lower cTnT<inf>AUC</inf> (402,943 +/- 225,206 vs.
473,300 +/- 232,682 ng . min/L), which is suggestive of a medium effect
size (Cohen's d 0.31), and lower cTnT<inf>peak</inf> (313 [190-623] vs.
379 [254-699] ng/L) compared with controls. We found that preoperative
handgrip exercise is safe and feasible for patients scheduled for SAVR
and/or CABG and is associated with a medium effect size to reduce
postoperative cardiac I/R injury. This warrants future studies to assess
the potential clinical impact of exercise protocols before cardiac
surgery. NEW & NOTEWORTHY Daily handgrip exercise in the week before
elective cardiac surgery is safe and feasible. Handgrip exercise is
associated with a medium effect size for less troponin-T release. Future
larger-sized studies are warranted to explore the impact of (handgrip)
exercise prior to cardiac surgery on clinical outcomes and direct patient
benefits. Copyright © 2023 the American Physiological Society.

<77>
Accession Number
2029955301
Title
Diagnostic Performance of Diastolic Hyperemia-Free Ratio Compared With
Invasive Fractional Flow Reserve for Evaluation of Coronary Artery
Disease.
Source
American Journal of Cardiology. 214 (pp 55-58), 2024. Date of Publication:
01 Mar 2024.
Author
Vira A.; Balanescu D.-V.; George J.A.; Dixon S.R.; Hanson I.D.; Safian
R.D.
Institution
(Vira, Balanescu, George, Dixon, Hanson, Safian) Department of
Cardiovascular Medicine, William Beaumont University Hospital-Corewell
Health East, Royal Oak, MI, United States
Publisher
Elsevier Inc.
Abstract
Hyperemic and nonhyperemic pressure ratios are frequently used to assess
the hemodynamic significance of coronary artery disease and to guide the
need for myocardial revascularization. However, there are limited data on
the diagnostic performance of the diastolic hyperemia-free ratio (DFR). We
evaluated the diagnostic performance of the DFR compared with invasive
fractional flow reserve (FFR). We performed a prospective, single-center
study of 308 patients (343 lesions) who underwent DFR and FFR for
evaluation of visually estimated 40% to 90% stenoses. Diagnostic
performance of the DFR compared with FFR was evaluated using linear
regression, Bland-Altman analysis, and receiver operating characteristic
curves. The overall diagnostic accuracy of the DFR was 83%; the accuracy
rates were 86%, 40%, and 95% when the DFR was <0.86, 0.88 to 0.90, and
>0.93, respectively. The sensitivity, specificity, positive predicative
value, and negative predictive value were 60%, 91%, 71%, and 87%,
respectively. The Pearson correlation coefficient was 0.75 (p <0.05). The
Bland-Altman analysis showed a mean difference of 0.09, and the area under
the receiver operating characteristic curve was 0.88 (95% confidence
interval 0.84 to 0.92, p <0.05). In conclusion, the DFR has a good
diagnostic performance compared with FFR but 17% of the measurements were
discordant. The diagnostic accuracy of the DFR was only 40% when the DFR
was 0.88 to 0.90, suggesting that FFR may be useful in these
arteries. Copyright © 2024

<78>
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.

<79>
Accession Number
2029672569
Title
Cardiac Manifestation of Rosai-Dorfman Disease: A Case Report and a
Systematic Review.
Source
Heart Surgery Forum. 26(6) (pp E896-E897), 2023. Date of Publication:
2023.
Author
Tabrizi N.S.; Dogar M.H.; Wilkinson D.; Stout P.; Neragi-Miandoab S.; Samy
S.
Institution
(Tabrizi, Wilkinson, Stout, Neragi-Miandoab, Samy) The Department of
Cardiothoracic Surgery, Albany Medical Center, Albany, NY 12208, United
States
(Dogar) The Department of Cardiology, SUNY Downstate Medical Center,
Brooklyn, NY 11202, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Rosai-Dorfman disease is a rare condition that typically
presents as a nodal disease. Cardiac involvement is extremely uncommon,
occurring in 0.1-0.2% of cases, which has hindered our understanding. We
report a case of Rosai-Dorfman disease (RDD) related cardiac manifestation
in a patient without nodal involvement. Further, we conduct a
comprehensive review of the literature to consolidate data on how patients
with cardiac manifestations of RDD are typically managed and treated.
 Method(s): A systematic review of PubMed, Web of Science, and Embase
was conducted to identify cases of RDD with cardiac involvement. Out of
464 studies identified, 42 publications encompassing 43 patients met the
criteria and were incorporated in this review. We gathered data on patient
demographics, as well as their management and treatment approaches.
Additionally, we share our own experience with a patient who presented
with a cardiac mass related to RDD. Result(s): Out of the 43
patients, only 20.9% (n = 9) had a documented history of RDD prior to
cardiac manifestations. Nodal involvement was reported in 32.6% (n = 14),
while extranodal extracardiac involvement was reported in 46.5% (n = 20).
Upon presentation, the most prevalent symptoms were dyspnea (48.8%, n =
21), chest discomfort (41.9%, n = 18), and lower extremity edema (16.3%, n
= 7). Cardiac manifestations were most frequently found in the right
atrium (41.9%, n = 18) and pericardium (18.6%, n = 8). Treatment
encompassed systemic medical therapy (34.9%, n = 15) and cardiac surgery
(39.5%, n = 17). The median follow-up period was 12 months (with a range
of 1 to 36), and 8 patients (18.6%) experienced mortality. Our patient,
who had a cardiac mass in the left atrium, underwent resection and has
remained symptom-free without any recurrence for the past 5 years.
 Conclusion(s): The frequency of cardiac related-RDD manifestations
may be greater than initially perceived. These results underscore the
significance of identifying RDD and its cardiac-related presentations,
facilitating timely diagnosis and treatment for affected
individuals. Copyright © 2023 Forum Multimedia Publishing, LLC.

<80>
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

<81>
Accession Number
2029295395
Title
Secondary Prevention Therapies in Real-World Patients with Myocardial
Infarction: Eligibility Based on Randomized Trials Supporting European and
American Guidelines.
Source
American Journal of Medicine. 137(2) (pp 137-146.e10), 2024. Date of
Publication: February 2024.
Author
Mas-Llado C.; Rossello X.; Gonzalez-Del-Hoyo M.; Pocock S.; de Werf F.V.;
Chin C.T.; Danchin N.; Lee S.W.-L.; Medina J.; Huo Y.; Bueno H.
Institution
(Mas-Llado) Cardiology Department, Hospital de Manacor, Spain
(Mas-Llado, Rossello, Gonzalez-Del-Hoyo) Health Research Institute of the
Balearic Islands, Palma, Spain
(Mas-Llado, Rossello) Facultad de Medicina, Universitat de les Illes
Balears, Palma, Spain
(Rossello) Cardiology Department, Health Research Institute of the
Balearic Islands, Hospital Universitari Son Espases, Palma, Spain
(Rossello, Bueno) Centro Nacional de Investigaciones Cardiovasculares,
Madrid, Spain
(Pocock) London School of Hygiene and Tropical Medicine, United Kingdom
(de Werf) Department of Cardiovascular Sciences, University of Leuven,
Belgium
(Chin) National Heart Centre Singapore, Singapore
(Danchin) Hopital Europeen Georges Pompidou & Rene Descartes University,
France
(Lee) Queen Mary Hospital, China
(Medina) BioPharmaceuticals Medical, AstraZeneca, Spain
(Huo) Beijing University First Hospital, China
(Bueno) Cardiology Department, Hospital Universitario 12 de Octubre,
Instituto de Investigacion i+12, Madrid, Spain
(Bueno) Facultad de Medicina, Universidad Complutense de Madrid, Spain
(Bueno) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objective: We aimed to evaluate the applicability of the eligibility
criteria of randomized controlled trials (RCTs) cited in guideline
recommendations in a real-world cohort of patients receiving secondary
prevention after acute myocardial infarction from the EPICOR registries.
 Method(s): Recommendations provided by American and European
guidelines for acute myocardial infarction were classified into general
(applying to all patients) and specific (applying to patients with left
ventricular dysfunction or heart failure). Randomized controlled trials
cited in these recommendations were selected, and their entry criteria
were applied to our international cohort of 18,117 patients.
 Result(s): There were 91.5% patients eligible for beta blockers
(84.6% for general, and 5.9% for specific recommendations), 97.7% eligible
for renin-angiotensin system inhibitor (angiotensin-converting enzyme
inhibitors and angiotensin II receptor blockers [ACEI/ARB])
recommendations (69.9% for general, 27.9% for specific) and 4.1% eligible
for mineralocorticoid receptor antagonists (only specific
recommendations). The percentages of patients with eligibility criteria
who were discharged with a prescription of the recommended therapies were
80%-85% for beta blockers, 70%-75% for ACEI/ARB, and 29% for
mineralocorticoid receptor antagonists. There were large regional
variations in the percentage of eligible patients and in those receiving
the medications (eg, 95% in Northern Europe and 57% in Southeast Asia for
beta blockers). Conclusion(s): Most real-world acute myocardial
infarction patients are eligible for secondary prevention therapy in both
general and specific guideline recommendations, and the percentage of
those on beta blockers and ACEI/ARB at hospital discharge is high. There
are large regional variations in the proportion of patients receiving
recommended therapies. Local targeted interventions are needed for quality
improvement. Copyright © 2023

<82>
Accession Number
2029088900
Title
Balloon- vs Self-Expanding Transcatheter Valves for Failed Small Surgical
Aortic Bioprostheses: 1-Year Results of the LYTEN Trial.
Source
JACC: Cardiovascular Interventions. 16(24) (pp 2999-3012), 2023. Date of
Publication: 25 Dec 2023.
Author
Nuche J.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.; Regueiro
A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly S.;
Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Giuliani C.;
Pelletier-Beaumont E.; Pibarot P.; Rodes-Cabau J.
Institution
(Nuche, Mohammadi, Giuliani, Pelletier-Beaumont, Pibarot, Rodes-Cabau)
Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Abbas) Corewell Health East, William Beaumont University Hospital, Royal
Oak, MI, United States
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Regueiro, Rodes-Cabau) Clinic Cardiovascular Institute, Hospital Clinic
de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer,
University of Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott and White The Heart Hospital Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Associates, Syracuse, NY, United States
(Conradi) University Heart and Vascular Center, Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M Ross
Hospital, Columbus, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) field have been obtained
from retrospective studies. Objective(s): The authors sought to
compare the 1-year hemodynamic performance and clinical outcomes between
balloon-expandable valves (BEV) SAPIEN 3/ULTRA (Edwards Lifesciences) and
self-expanding valves (SEV) Evolut R/PRO/PRO+ (Medtronic) in ViV-TAVR.
 Method(s): Patients with a failed small (<=23 mm) surgical valve
undergoing ViV-TAVR were randomized to receive a SEV or a BEV. Patients
had a clinical and valve hemodynamic (Doppler echocardiography) evaluation
at 1-year follow-up. Study outcomes were defined according to
VARC-2/VARC-3 criteria. Intended performance of the valve was defined as
mean gradient <20 mm Hg, peak velocity <3 m/s, Doppler velocity index
>=0.25 and less than moderate AR. Result(s): A total of 98 patients
underwent ViV-TAVR (46 BEV, 52 SEV). At 1-year follow-up, patients
receiving a SEV had a lower mean transaortic gradient (22 +/- 8 mm Hg BEV
vs 14 +/- 7 mm Hg SEV; P < 0.001), and a higher rate of intended valve
performance (BEV: 30%, SEV:76%; P < 0.001). There were no cases of greater
than mild aortic regurgitation. There were no differences in functional
status (NYHA functional class >II, BEV: 7.3%, SEV: 4.1%; P = 0.505) or
quality of life (Kansas City Cardiomyopathy Questionnaire, BEV: 77.9 +/-
21.2, SEV: 81.8 +/- 14.8; P = 0.334). No differences in all-cause
mortality (BEV: 6.5%, SEV: 3.8; P = 0.495), heart failure hospitalization
(BEV: 6.5%, SEV: 1.9%; P = 0.214), stroke (BEV: 0%, SEV: 1.9%; P = 0.369),
myocardial infarction (BEV: 0%, SEV: 1.9%; P = 0.347), or pacemaker
implantation (BEV: 2.2%, SEV: 1.9%; P = 0.898) were found.
 Conclusion(s): In patients who underwent ViV-TAVR for failed small
aortic bioprostheses, those receiving a SEV exhibited a better valve
hemodynamic profile at 1-year follow-up. There were no differences between
SEV and BEV regarding functional status, quality of life, or clinical
outcomes. Copyright © 2023 American College of Cardiology
Foundation

<83>
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

<84>
Accession Number
2027692213
Title
Transcatheter edge-to-edge mitral valve repair for mitral regurgitation in
patients with cardiogenic shock: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 103(2) (pp 340-347),
2024. Date of Publication: 01 Feb 2024.
Author
Saito T.; Kuno T.; Ueyama H.A.; Kampaktsis P.N.; Kolte D.; Misumida N.;
Takagi H.; Aikawa T.; Latib A.
Institution
(Saito) Department of Cardiology, Edogawa Hospital, Tokyo, Japan
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
(Kuno) Division of Cardiology, Jacobi Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, New York City, NY, United States
(Kolte) Division of Cardiology, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Aikawa) Department of Cardiology, Juntendo University Urayasu Hospital,
Urayasu, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: There is currently little evidence for transcatheter
edge-to-edge mitral valve repair (TEER) for mitral regurgitation (MR) in
patients with cardiogenic shock (CS). Therefore, this study investigated
the characteristics and outcomes of CS patients who underwent TEER for MR.
 Method(s): PubMed, EMBASE were searched in July 2023. Case series and
observational studies reporting clinical characteristics and outcomes in
CS patients with MR who underwent TEER were included. We performed a
one-group meta-analysis using a random effects model. Result(s): A
total of 4060 patients from 7 case series and 5 observational studies were
included. The mean age was 68.2 (95% confidence interval [CI]: 64.1-72.2)
years, and 41.4% of patients (95% CI: 39.1%-43.7%) were female. Pre-TEER,
severe MR was present in 85.3% (95% CI: 76.1%-91.3%) of patients. Mean
left ventricular ejection fraction was 36.7% (95% CI: 29.2%-44.2%), and
54.6% (95% CI: 36.9%-71.2%) of patients received mechanical circulatory
support. The severity of MR post-TEER was less than 2+ in 88% (95% CI:
87%-89%) of patients. In-hospital mortality was 11% (95% CI: 10%-13%),
whereas 30-day and 1-year mortality rates were 15% (95% CI: 13%-16%), and
36% (95% CI: 21%-54%), respectively. Conclusion(s): This systematic
review and meta-analysis assessed the clinical characteristics and
outcomes of TEER in CS patients with MR. TEER for MR in patients with CS
has been successful in reducing MR in most of the patients, but with a
high mortality rate. Randomized controlled trials of TEER for MR and CS
are needed. Copyright © 2023 Wiley Periodicals LLC.

<85>
Accession Number
2027350777
Title
Assessment of Individualized Mean Perfusion Pressure Targets for the
Prevention of Cardiac Surgery-Associated Acute Kidney Injury-The
PrevHemAKI Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7746. Date of Publication: December 2023.
Author
Molina-Andujar A.; Rios J.; Pineiro G.J.; Sandoval E.; Ibanez C.; Quintana
E.; Matute P.; Andrea R.; Lopez-Sobrino T.; Mercadal J.; Reverter E.;
Rovira I.; Villar A.M.; Fernandez S.; Castella M.; Poch E.
Institution
(Molina-Andujar, Pineiro, Poch) Nephrology and Kidney Transplantation
Department, Hospital Clinic, Barcelona 08036, Spain
(Rios) Department of Clinical Farmacology, Hospital Clinic and Medical
Statistics Core Facility, Barcelona 08036, Spain
(Rios, Pineiro, Andrea, Lopez-Sobrino, Poch) Institut d'investigacions
Biomediques Agusti Pi i Sunyer (IDIBAPS), Barcelona 08036, Spain
(Rios) Faculty of Medicine, Universitat Autonoma de Barcelona, Barcelona
08193, Spain
(Sandoval, Quintana, Castella) Cardiovascular Surgery Department, Hospital
Clinic, Barcelona 08036, Spain
(Ibanez, Matute, Mercadal, Rovira) Anesthesiology Department, Hospital
Clinic, Barcelona 08036, Spain
(Andrea, Lopez-Sobrino) Cardiology Department, Hospital Clinic, Barcelona
08036, Spain
(Reverter) Liver and Digestive ICU, Liver Unit, Hospital Clinic, Barcelona
08036, Spain
(Villar) Perfusion Department, Hospital Clinic, Barcelona 08036, Spain
(Fernandez) Medical Intensive Care Unit, Hospital Clinic, Barcelona 08036,
Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Retrospective studies support that mean perfusion pressure
(MPP) deficit in cardiac surgery patients is associated with a higher
incidence of acute kidney injury (CS-AKI). The aim of our study was to
apply an algorithm based on MPP in the postoperative period to determine
whether management with an individualized target reduces the incidence of
CS-AKI. Method(s): Randomized controlled trial of patients undergoing
cardiac surgery with extracorporeal circulation. Adult patients submitted
to valve replacement and/or bypass surgery with a high risk of CS-AKI
evaluated by a Leicester score >30 were randomized to follow a target MPP
of >75% of the calculated baseline or a standard hemodynamic management
during the first postoperative 24 h. Result(s): Ninety-eight patients
with an eGFR of 54 mL/min were included. There were no differences in MAP
and MPP in the first 24 h between the randomized groups, although a higher
use of noradrenaline was found in the intervention arm (38.78 vs. 63.27, p
= 0.026). The percentage of time with MPP < 75% of measured baseline was
similar in both groups (10 vs. 12.7%, p = 0.811). MAP during surgery was
higher in the intervention group (73 vs. 77 mmHg, p = 0.008). The global
incidence of CS-AKI was 36.7%, being 38.6% in the intervention group and
34.6% in the control group (p = 0.40). There were no differences in
extrarenal complications between groups as well. Conclusion(s): An
individualized hemodynamic management based on MPP compared to standard
treatment in cardiac surgery patients was safe but did not reduce the
incidence of CS-AKI in our study. Copyright © 2023 by the
authors.

<86>
Accession Number
2027350745
Title
Anticoagulants versus Left Atrial Appendage Occlusion in Patients with
Atrial Fibrillation and Co-Morbid Thrombocytopenia.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7637. Date of Publication: December 2023.
Author
Kowalska W.; Mitrega K.; Olma A.; Podolecki T.; Kalarus Z.; Streb W.
Institution
(Kowalska) Doctoral School, Division of Medical Sciences in Zabrze,
Medical University of Silesia, Katowice 40-055, Poland
(Kowalska, Mitrega, Olma, Podolecki, Kalarus, Streb) Department of
Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze
41-800, Poland
(Podolecki, Kalarus, Streb) Department of Cardiology and Electrotherapy,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia,
Katowice 40-055, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Left atrial appendage closure (LAAC) is an alternative approach to
anticoagulants. Nonetheless, data regarding the outcomes of LAAC
procedures in patients with thrombocytopenia remain lacking. The primary
objective was to determine the incidence of the composite endpoint
comprising ischemic stroke, intracranial hemorrhage, major bleeding, and
cardiac cause of death among patients with atrial fibrillation (AF) and
thrombocytopenia who were either undergoing LAAC or receiving oral
anticoagulants. The secondary endpoint was the determination of total
mortality. Data from a prospective, single-center registry of patients
undergoing LAAC procedures were analyzed. A subset of 50 consecutive
patients with thrombocytopenia were selected. Thrombocytopenia was defined
as a thrombocyte count below 150,000. Subsequently, from patients
hospitalized with AF receiving oral anticoagulants, 50 patients were
further chosen based on propensity score matching, ensuring comparability
with the study group. The primary endpoint occurred in 2% of patients in
the LAAC group and 10% of patients in the non-LAAC group (p = 0.097).
Additionally, a significant difference was noted in the occurrence of the
secondary endpoint, which was observed in 0% of patients in the LAAC group
and 10% of patients in the non-LAAC group (p = 0.025). In patients with
thrombocytopenia the LAAC procedure improves prognosis compared with
continued anticoagulant treatment. Copyright © 2023 by the
authors.

<87>
Accession Number
2027009956
Title
Worth a Double Take? An In-Depth Review of Lung Retransplantation.
Source
Journal of Clinical Medicine. 12(23) (no pagination), 2023. Article
Number: 7418. Date of Publication: December 2023.
Author
Dawodu G.; Gulati S.; Bugacov H.; Laskey D.; Housman B.; Seethamraju H.;
Scheinin S.
Institution
(Dawodu, Laskey, Housman, Scheinin) Department of Thoracic Surgery, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, United States
(Dawodu, Laskey, Housman, Seethamraju, Scheinin) Division of Lung
Transplantation, Icahn School of Medicine at Mount Sinai, New York, NY
10029, United States
(Gulati, Bugacov) Icahn School of Medicine at Mount Sinai, 1 Gustave L.
Levy Pl, New York, NY 10029, United States
(Seethamraju) Department of Pulmonary Medicine and Critical Care, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Provided advancements in Lung Transplantation (LT) survival, the efficacy
of Lung Retransplantation (LRT) has often been debated. Decades of
retrospective analyses on thousands of LRT cases provide insight enabling
predictive patient criteria for retransplantation. This review used the
Preferred Reporting Items for Systematic Reviews and Meta Analyses
(PRISMA) guidelines. The PubMed search engine was utilized for articles
relating to LRT published through August 2023, and a systematic review was
performed using Covidence software version 2.0 (Veritas Health Innovation,
Australia). Careful patient selection is vital for successful LRT, and the
benefit leans in favor of those in optimal health following their initial
transplant. However, the lack of a standardized approach remains apparent.
Through an in-depth review, we will address considerations such as chronic
lung allograft dysfunction, timing to LRT, surgical and perioperative
complexity, and critical ethical concerns that guide the current practice
as it relates to this subset of patients for whom LRT is the only
therapeutic option available. Copyright © 2023 by the authors.

<88>
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.

<89>
Accession Number
2006071504
Title
Levels of evidence supporting drug, device, and other recommendations in
the American Heart Association/American College of Cardiology guidelines.
Source
American Heart Journal. 226 (pp 4-12), 2020. Date of Publication: August
2020.
Author
Fanaroff A.C.; Fudim M.; Califf R.M.; Windecker S.; Smith S.C.; Lopes R.D.
Institution
(Fanaroff) Penn Cardiovascular Outcomes, Quality and Evaluative Research
Center, Leonard Davis Institute, and Cardiovascular Medicine Division,
University of Pennsylvania, Philadelphia, PA, United States
(Fudim, Lopes) Division of Cardiology and Duke Clinical Research
Institute, Duke University, Durham, NC, United States
(Califf) Verily Life Sciences (Alphabet), South San Francisco, CA, United
States
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
(Smith) Division of Cardiology, University of North Carolina School of
Medicine, Chapel Hill, NC, United States
Publisher
Mosby Inc.
Abstract
Clinical guideline documents reflect the evidence supporting clinical
practice, but few recommendations in cardiovascular guidelines are
supported by evidence from randomized controlled trials (RCTs), the
highest level of evidence. Incentives for generating evidence from RCTs
differ by topic of guideline recommendation, and it is uncertain whether
evidence supporting guideline recommendations differs based on the topic
of the recommendation. Method(s): We abstracted recommendation
statements from current ACC/AHA guideline documents (2008-2019). Two
reviewers independently characterized each statement into categories based
on its primary topic: pharmaceutical, device, non-invasive or minimally
invasive therapeutic procedure, surgery, diagnostic invasive procedure or
non-invasive imaging, laboratory, care strategies, health services or
policy, history/physical examination, lifestyle or counseling. We
determined the number and proportion of recommendations in each category
characterized as level of evidence (LOE) A (supported by multiple RCTs), B
(supported by a single RCT or observational data), and C (supported by
expert opinion or limited data). Result(s): Of 2934 recommendations
from 29 clinical guideline documents, 784 (26.7%) were primarily about
pharmaceuticals, 503 (17.1%) diagnostic invasive procedure or non-invasive
imaging, 366 (12.5%) devices, 349 (11.9%) care strategies, 274 (9.3%)
surgery, 216 (7.4%) therapeutic procedures, 162 (5.5%) lifestyle
interventions or counseling, 160 (5.5%) health services, care delivery, or
policy, 83 (2.8%) laboratory, and 37 (1.3%) elements of the history and
physical. Across all recommendations, 257 (8.8%) were characterized as LOE
A, with considerable variability by topic. 25.9% of lifestyle/counseling
recommendations, 16.9% of lab recommendations, and 14.7% of drug
recommendations were classified as LOE A, but <8% of recommendations in
all other categories, including 5.5% of device recommendations, 6.0% of
therapeutic procedure recommendations, 2.6% of surgery recommendations,
and 5.0% of health services or policy recommendations. Conclusion(s):
Less than 10% of current ACC/AHA guideline recommendations are supported
by high quality evidence from RCTs, with substantial variability by topic
and multiple areas with very few recommendations supported by high-quality
evidence. Development and implementation of inexpensive methods for
generating a higher volume of RCT evidence to support clinical practice
are needed, especially in areas where there are not strong incentives to
conduct RCTs. Copyright © 2020 Elsevier Inc.

<90>
Accession Number
2005450568
Title
Congenital heart disease, prenatal diagnosis and management.
Source
Archivos Argentinos de Pediatria. 118 (pp E149-E161), 2020. Date of
Publication: 2020.
Author
Meller C.H.; Grinenco S.; Aiello H.; Cordoba A.; Saenz-Tejeira M.M.;
Marantz P.; Otano L.
Institution
(Meller, Aiello, Otano) Department of Obstetrics, Hospital Italiano de
Buenos Aires, Argentina
(Grinenco, Cordoba, Saenz-Tejeira, Marantz) Department of Pediatric
Cardiology, Hospital Italiano de Buenos Aires, Argentina
Publisher
Sociedad Argentina de Pediatria
Abstract
Among congenital malformations, heart defects are the most common type of
anomaly, and these are associated with a high perinatal, long-term
morbidity and mortality. The objective of this update was to review the
rate of prenatal detection,screeningcharacteristicsthroughoutthe
pregnancy, in both the first and second trimesters, indications for
advanced echocardiography, and to establish a management algorithm in case
of prenatal diagnosis of a congenital heart disease. Potential invasive
and non-invasive tests and obstetric follow-up will be discussed here.
Finally, the main characteristics of fetal therapy in heart anomalies will
be reviewed, both cardiac interventions and intrauterine treatment of
arrhythmias. Copyright © 2020 Sociedad Argentina de Pediatria.
All rights reserved.

<91>
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.

<92>
Accession Number
643300026
Title
Pharmacological interventions for vasoplegic syndrome after cardiac
surgery.
Source
Cochrane Database of Systematic Reviews. 2024(1) (no pagination), 2024.
Article Number: CD015257. Date of Publication: 26 Jan 2024.
Author
Peterslund P.; Molstrom S.; Jorgensen K.J.; Chew M.S.; Schmidt H.
Institution
(Peterslund, Molstrom, Schmidt) Anesthesiology and Intensive Care, Odense
University Hospital, Odense, Denmark
(Jorgensen) Rigshospitalet, dept. 7811, The Nordic Cochrane Centre,
Kobenhavn O, Denmark
(Chew) Faculty of Medicine, Linkoping University Hospital, Linkoping,
Sweden
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the benefits and harms of
pharmacological interventions targeting vasoplegic syndrome in
cardiothoracic surgery patients, compared to placebo or an active
pharmacological control intervention. Copyright ©2024The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<93>
Accession Number
2018974245
Title
Long-Term Outcomes of Ross Procedure versus Mechanical Aortic Valve
Replacement: Meta-Analysis of Reconstructed Time-To-Event Data.
Source
Trends in Cardiovascular Medicine. 34(1) (pp 29-36), 2024. Date of
Publication: January 2024.
Author
Sa M.P.; Van den Eynde J.; Jacquemyn X.; Tasoudis P.; Erten O.; McDonald
C.; Weymann A.; Ruhparwar A.; Clavel M.-A.; Pibarot P.; Calhoon J.;
Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Erten, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, Leuven,
KU Leuven, Belgium
(McDonald, Calhoon) Department of Cardiothoracic Surgery, University of
Texas Health Science Center at San Antonio, Long School of Medicine, San
Antonio, TX, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
In the era of lifetime management of aortic valve disease, the Ross
procedure emerged as an alternative to prosthetic heart valves for young
adults; however, more long-term data are warranted. We performed a
meta-analysis of reconstructed time-to-event data to compare long-term
outcomes between the Ross procedure and mechanical aortic valve
replacement (mAVR) in young adults. PubMed/MEDLINE, EMBASE and
GoogleScholar were searched for studies comparing Ross procedure with mAVR
that reported mortality/survival rates and/or reoperation rates
accompanied by at least one Kaplan-Meier curve for any of the outcomes.
Six observational studies (5 with propensity score matching) including
5024 patients (Ross: 1737; mAVR: 3287) met our inclusion criteria.
Patients who underwent Ross had a significantly lower risk of mortality in
the overall population (HR 0.38, 95%CI 0.30-0.49, P<0.001; median
follow-up of 7.2 years) and in the propensity score matched cohorts (HR
0.55, 95%CI 0.42-0.73, P<0.001; median follow-up of 10.2 years); however,
the incidence function for the cumulative risk of reoperation was higher
for the Ross procedure (HR 1.91, 95%CI 1.36-2.70, P<0.001; median
follow-up of 9.3 years). Data from observational studies suggest that the
Ross procedure is associated with lower all-cause mortality compared with
mAVR; however, there is a higher risk of reoperation. Besides serving as
basis to inform patients about benefits and risks involved in this choice,
these results call for further randomized clinical trials to determine
whether the Ross procedure can achieve its potential benefits in young
patients in need of AVR. Copyright © 2022

<94>
Accession Number
642191654
Title
Dexmedetomidine vs. propofol sedation reduces the duration of mechanical
ventilation after cardiac surgery - a randomized controlled trial.
Source
European review for medical and pharmacological sciences. 27(16) (pp
7644-7652), 2023. Date of Publication: 01 Aug 2023.
Author
Preveden M.; Zdravkovic R.; Vickovic S.; Vujic V.; Todic M.; Mladenovic
N.; Dracina N.; Drljevic Todic V.; Pantic T.; Okiljevic B.; Markovic N.;
Kovac A.; Zec R.; Preveden A.; Tatic M.
Institution
(Preveden) Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of our study was to compare the clinical effects of
sedation with dexmedetomidine vs. propofol in patients undergoing cardiac
surgery and analyze their effects on the duration of mechanical
ventilation (MV), length of stay in the intensive care unit (ICU), and
total hospital stay. PATIENTS AND METHODS: The study included 120
patients who were randomized in a 1:1 ratio into two groups of 60
patients. The first group was sedated with continuous dexmedetomidine in
doses 0.2-0.7 mcg/kg/h. The second group was sedated with propofol in
doses 1-2 mg/kg/h. RESULT(S): Patients sedated with dexmedetomidine
required 2.2 hours less time on MV (p<0.001). There was a positive
correlation between the duration of MV and the ICU length of stay
(r=0.368; p<0.001), as well as between the duration of MV and the total
hospital stay (r=0.204; p=0.025). Delirium occurred in the postoperative
period in 25% of patients sedated with propofol, while in the
dexmedetomidine group it was only 11.7% (p=0.059). Patients who developed
delirium had a significantly longer duration of MV (12.6+/-5.4 vs.
9.3+/-2.5 hours, p=0.010). CONCLUSION(S): Postoperative sedation with
dexmedetomidine, compared to propofol, reduces the duration of MV, but
does not influence the length of stay in the ICU and length of
hospitalization after open heart surgery.

<95>
Accession Number
640315252
Title
Alcohol septal ablation versus surgical septal myectomy of obstructive
hypertrophic cardiomyopathy: systematic review and meta-analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 63(3) (no pagination),
2023. Date of Publication: 01 Mar 2023.
Author
Yokoyama Y.; Shimoda T.; Shimada Y.J.; Shimamura J.; Akita K.; Yasuda R.;
Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Shimoda) School of Medicine, University of Tsukuba, Ibaraki, Japan
(Shimada, Akita, Yasuda) Division of Cardiology, Department of Medicine,
Columbia University Irving Medical Center, New York, NY, USA
(Shimamura) Department of Surgery, Division of Cardiothoracic Surgery,
Emory University, Atlanta, GA, United States
(Takayama) Department of Surgery, Columbia University Irving Medical
Center, New York, NY, USA
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To elucidate the optimal septal reduction therapy for
obstructive hypertrophic cardiomyopathy, we conducted a meta-analysis
comparing alcohol septal ablation (ASA) and septal myectomy.
 METHOD(S): MEDLINE, EMBASE and Cochrane CENTRAL were searched to
identify studies investigating the outcomes of ASA and septal myectomy in
patients with obstructive hypertrophic cardiomyopathy in January 2023. The
primary outcome of interest was all-cause mortality in studies with
>=1year of follow-up. The secondary outcomes of interest comprised left
ventricular outflow tract (LVOT) pressure gradient reduction and
reoperations of LVOT. A subgroup analysis of all-cause mortality including
studies with follow-up >=5years was performed. RESULT(S): 27
observational studies were included (15 968 patients). Analysis
demonstrated similar all-cause mortality [hazard ratio (HR) (95%
confidence interval) (CI) 1.24 (0.88-1.76); P=0.21; I2=56%]. In contrast,
ASA was associated with less reduction of LVOT pressure gradient and a
reoperation rate [weighted mean difference (95% CI) 11.04mmHg
(5.60-16.48); P<0.01; I2=64%, HR (95% CI) 9.14 (6.55-12.75); P<0.001;
I2=0%, respectively]. The subgroup analysis with follow-up >=5years
revealed higher long-term mortality with ASA [HR (95% CI) 1.50
(1.04-2.15); P=0.03; I2=52%]. CONCLUSION(S): Although both septal
reduction therapies were associated with similar all-cause mortality, ASA
was associated with a higher rate of reoperation and less reduction of
LVOT pressure gradient. Furthermore, all-cause mortality with follow-up
>=5years showed favourable outcomes with septal myectomy, although the
result is only hypothesis-generating given a subgroup
analysis. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<96>
Accession Number
634061522
Title
Comparison of Reusable Models in Pericardiocentesis Simulation Training.
Source
Annals of the Academy of Medicine, Singapore. 49(12) (pp 971-977), 2020.
Date of Publication: 01 Dec 2020.
Author
Lin Z.; Soh C.H.W.; Chua M.T.; Lin J.; Ho C.J.Y.; Lee J.Y.H.; Shen F.Y.T.;
Yau Y.W.; Kuan W.S.
Institution
(Lin) Emergency Medicine Department, National University Hospital,
National University Health System, Singapore
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Pericardiocentesis is a potentially life-saving procedure.
We compared two low-cost models-an agar-based model and a novel model,
Centesys-in terms of ultrasound image quality and realism, effectiveness
of the model, and learners' confidence and satisfaction after training.
 METHOD(S): In this pilot randomised 2x2 crossover trial stratified by
physician seniority, participants were assigned to undergo
pericardiocentesis training either with the agar-based or Centesys model
first, followed by the other model. Participants were asked to rate their
confidence in performing ultrasound-guided pericardiocentesis, clarity and
realism of cardiac structures on ultrasound imaging, and satisfaction on a
7-point Likert scale before and after training with each model.
 RESULT(S): Twenty participants with median postgraduate year of 4
(interquartile range [IQR] 3.75-6) years were recruited. Pre-training,
participants rated themselves a median score of 2.5 (IQR 2-4) for level of
confidence in performing pericardiocentesis, which improved to 5 (IQR 4-6)
post-training with Centesys (P=0.007). Centesys was recognised to be more
realistic in simulating cardiac anatomy on ultrasound (median 5 [IQR 4-5]
versus 3.5 [IQR 3-4], P=0.002) than the agar-based model. There was
greater satisfaction with Centesys (median 5 [IQR 5-6] versus 4 [IQR
3.75-4], P<0.001). All 20 participants achieved successful insertion of a
pericardial drain into the simulated pericardial sac with Centesys.
 CONCLUSION(S): Centesys achieved greater learner satisfaction as
compared to the agar-based model, and was an effective tool for teaching
ultrasound-guided pericardiocentesis and drain insertion.

<97>
Accession Number
629768985
Title
PREVENTION OF CEREBROVASCULAR MICRO-EMBOLIZATION DURING AORTA-CORONARY
BYPASS UNDER CONDITIONS OF ARTIFICIAL BLOOD CIRCULATION.
Source
Georgian medical news. (294) (pp 83-87), 2019. Date of Publication: 01 Sep
2019.
Author
Radiushin D.; Loskutov O.
Institution
(Radiushin, Loskutov) Shupyk National Medical Academy of Posgraduate
Education, Department of Anaesthesiology and Intensive Care, Kyiv; Odessa
Regional Clinical Hospital, Ukraine
Publisher
NLM (Medline)
Abstract
The aim of the research was to investigate the relationship between
cerebral microembolization and the development of postoperative cognitive
impairment in patients after coronary artery bypass grafting with and
without prophylactic administration of nitroglycerin at the end of
artificial blood circulation. The study included 72 patients (43 male and
29 female) who had ACBPS using an ABCA. The patients were randomized into
two clinical groups. The number of patients in the control group was 34
patients, in the study group - 38 patients. The study of the cognitive
sphere was performed using a battery of clinical tests that included MSA
and MMSE scales, Trail-making test, Grooved Pageboard, fine hands-motor
test, 10 words test by AR Luria, Wexler's test, Schultz tables. The
assessment was carried out on a day before the intervention and on the
fifth day after the surgical intervention. It was shown that by all
patients undergoing aorto-coronary bypass syrgery microembolization within
the cerebral blood flow had been determined. The vast majority of
microemboli is formed at the beginning of artificial blood circulation, at
the moment of clamping aorta, as well as during the restoration of
effective cardiac activity. Intraoperative microembolization of cerebral
blood flow in excess of 750 microemboli leads to clinically significant
deterioration of the brain functions in the early postoperative period.
When used as a peripheral vasodilator, nitroglycerin, at a dose of 8-10
mug/kg*min in high (120-130%) volume perfusion rate, decreases the number
of microemboluses in the basin of SMA by 2.4%.

<98>
Accession Number
629447639
Title
The incidence and prognostic implications of worsening right ventricular
function after surgical or transcatheter aortic valve replacement:
insights from PARTNER IIA.
Source
European heart journal. 39(28) (pp 2659-2667), 2018. Date of Publication:
21 Jul 2018.
Author
Cremer P.C.; Zhang Y.; Alu M.; Rodriguez L.L.; Lindman B.R.; Zajarias A.;
Hahn R.T.; Lerakis S.; Malaisrie S.C.; Douglas P.S.; Pibarot P.; Svensson
L.G.; Leon M.B.; Jaber W.A.
Institution
(Cremer, Rodriguez, Jaber) Department of Cardiovascular Imaging, Heart and
Vascular Institute, Cleveland Clinic, 9500 Euclid Ave: DeskJ1-5,
Cleveland, OH, USA
(Zhang, Leon) Cardiovascular Research Foundation, NY, NY, United States
(Alu, Hahn, Leon) Columbia University Medical Center, NY, NY, United
States
(Lindman) Vanderbilt University Medical Center, TN, Nashville, United
States
(Zajarias) Washington University School of Medicine, St. Louis, MO, USA
(Lerakis) Emory University, Atlanta, United States
(Malaisrie) Northwestern University, Chicago, United States
(Douglas) Duke University Medical Center and Duke Clinical Research
Institute, Durham, United States
(Pibarot) Department of Medicine, Universite Laval, QC, Canada
(Svensson) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
Publisher
NLM (Medline)
Abstract
Aims: In patients randomized to transcatheter or surgical aortic valve
replacement (TAVR, SAVR), we sought to determine whether SAVR is
associated with worsening right ventricular (RV) function and whether RV
deterioration is associated with mortality. Methods and Results: In
1376 patients from PARTNERIIA with paired baseline and 30-day core lab
echocardiograms, worsening RV function was defined as decline by at least
one grade from baseline to 30days. Our primary outcome was all-cause
mortality from 30days to 2years. Among 744 patients with TAVR, 62 (8.3%)
had worsening RV function, compared with 156 of 632 patients with SAVR
(24.7%) (P<0.0001). In a multivariable model, SAVR [odds ratio (OR) 4.05,
95% confidence interval (CI) 2.55-6.44], a dilated RV (OR 2.38, 95% CI
1.37-4.14), and more than mild tricuspid regurgitation (TR) (OR 2.58, 95%
CI 1.25-5.33) were associated with worsening RV function. There were 169
deaths, and patients with worsening RV function had higher all-cause
mortality [hazard ratio (HR) 1.98, 95% CI 1.40-2.79]. This association
remained robust after adjusting for clinical and echocardiographic
variables. Among patients with worsening RV function, there was no
mortality difference between TAVR and SAVR (HR 1.16, 95% CI 0.61-2.18).
The development of moderate or severe RV dysfunction from baseline normal
RV function conferred the worst prognosis (HR 2.87, 95% CI 1.40-5.89).
 Conclusion(s): After aortic valve replacement, worsening RV function
is more common in patients with baseline RV dilation, more than mild TR,
and in patients treated with SAVR. Worsening RV function and the magnitude
of deterioration have important prognostic implications.

<99>
Accession Number
627329750
Title
Anesthesia with propofol and sevoflurane on postoperative cognitive
function of elderly patients undergoing general thoracic surgery.
Source
Pakistan journal of pharmaceutical sciences. 30(3) (pp 1107-1110), 2017.
Date of Publication: 01 May 2017.
Author
Yu W.
Institution
(Yu) Fudan University, Shanghai, China
Publisher
NLM (Medline)
Abstract
This study is to analyze the effects and variations on cognitive function
for elderly patients undergoing general thoracic surgery, who accepted the
anesthesia with propofol and sevoflurane. A total of 500 elderly general
thoracic surgical patients were selected randomly, all receiving the
propofol anesthesia (Propofol group). Meanwhile, another totality of 500
patients in the same condition and period were selected and accepted the
sevoflurane anesthesia (Sevoflurane group). Mini-mental state examination
(MMSE) and recovery quality after anesthesia were compared among the
patients in both groups respectively at the time of pre-operation and 1 h,
6 h and 12 h after surgery. There was no statistic difference in
preoperative MMES of patients in both two groups (P<0.05); while the
results of postoperative MMSE showed that both Propofol group and
Sevoflurane group had a certain statistical difference, and that in
Propofol group was larger compared that in Sevoflurane group. Moreover,
P<0.05 was obtained on comparing the MMSE at the time of 1h, 6h and 12h
after surgery and that at pre-operation, revealing statistical
significance. Either propofol or sevoflurane, to certain extent, can
affect patients' cognitive function when they are applied in the general
thoracic surgery for elderly patients. However, the influence of propofol
on cognitive function is relatively smaller, which presents a better
application value.

<100>
[Use Link to view the full text]
Accession Number
624600751
Title
Effect of Everolimus Initiation and Calcineurin Inhibitor Elimination on
Cardiac Allograft Vasculopathy in De Novo Heart Transplant Recipients.
Source
Circulation. Heart failure. 11(9) (pp e004050), 2018. Date of Publication:
01 Sep 2018.
Author
Arora S.; Andreassen A.K.; Karason K.; Gustafsson F.; Eiskjaer H.; Botker
H.E.; Radegran G.; Gude E.; Ioanes D.; Solbu D.; Dellgren G.; Ueland T.;
Aukrust P.; Gullestad L.
Institution
(Arora, Andreassen, Gude, Gullestad) Department of Cardiology, Oslo
University Hospital, E.G., Rikshospitalet
(Arora) Center for Heart Failure Research, University of Oslo and Faculty
of Medicine, University of Oslo, Germany
(Karason, Ioanes) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Germany
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Eiskjaer, Botker) Department of Cardiology, Aarhus University Hospital,
Sweden
(Radegran) Section for Heart Failure and Valvular Disease, VO Heart and
Lung Medicine, Skane University Hospital and Department of Clinical
Sciences, Lund University, Denmark
(Solbu) Novartis Norge AS, Oslo, Norway
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Germany
(Ueland, Aukrust) Research Institute of Internal Medicine, Oslo University
Hospital, Rikshospitalet, Norway
(Ueland, Aukrust) K.G. Jebsen Inflammatory Research Center, Faculty of
Medicine, University of Oslo, Germany
(Ueland, Aukrust) K. G. Jebsen Thrombosis Research and Expertise Center,
University of Tromso
(Ueland, Aukrust, Gullestad) Faculty of Medicine, University of Oslo, P.A,
United States
(Aukrust) Section of Clinical Immunology and Infectious Diseases, Oslo
University Hospital, Rikshospitalet, Norway
Publisher
NLM (Medline)
Abstract
Background Cardiac allograft vasculopathy (CAV) limits survival after
heart transplantation, and the effect of different immunosuppressive
regimens on CAV is not fully understood. The randomized SCHEDULE trial
(Scandinavian Heart Transplant Everolimus De Novo Study With Early
Calcineurin Inhibitors Avoidance) evaluated whether initiation of the
proliferation signal inhibitor everolimus and early cyclosporine
elimination can reduce CAV development. Methods and Results The SCHEDULE
trial was a multicenter Scandinavian trial, where 115 de novo heart
transplantation recipients were randomized to everolimus with complete
cyclosporine withdrawal 7 to 11 weeks after heart transplantation or
standard cyclosporine-based immunosuppression. Seventy-six (66%) patients
had matched intravascular ultrasound examinations at baseline and 12 and
36 months. Intravascular ultrasound analysis evaluated maximal intimal
thickness, percent atheroma volume, and total atheroma volume. Qualitative
plaque analysis using virtual histology assessed fibrous, fibrofatty, and
calcified tissue as well as necrotic core. Serum inflammatory markers were
measured in parallel. The everolimus group (n=37) demonstrated
significantly reduced CAV progression as compared with the cyclosporine
group (n=39) at 36 months (DELTA maximal intimal thickness, 0.09+/-0.05
versus 0.15+/-0.16 mm [ P=0.03]; DELTA percent atheroma volume, 5.3+/-2.8%
versus 7.6+/-5.9% [ P=0.03]; and DELTA total atheroma volume, 33.9+/-71.2
versus 54.2+/-96.0 mm3 [ P=0.34], respectively]. At 36 months the number
of everolimus patients with rejection graded >=2R was 15 (41%) as compared
with 5 (13%) in the cyclosporine group ( P=0.01). Everolimus did not
affect CAV morphology or immune marker activity during the follow-up
period. Conclusions The SCHEDULE trial demonstrates that everolimus
initiation and early cyclosporine elimination significantly reduces CAV
progression at 12 months, and this beneficial effect is clearly sustained
at 36 months. Clinical trial registration URL:
https://www.clinicaltrials.gov . Unique identifier: NCT01266148.

<101>
[Use Link to view the full text]
Accession Number
2030082013
Title
Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for
Congenital Heart Disease: A Commentary on Recent Randomized Controlled
Trials.
Source
Pediatric Critical Care Medicine. 24(11) (pp 961-965), 2023. Date of
Publication: 01 Nov 2023.
Author
Schlapbach L.J.; Gibbons K.S.; Horton S.B.; Johnson K.; Long D.A.; Buckley
D.H.F.; Erickson S.; Festa M.; D'Udekem Y.; Alphonso N.; Winlaw D.S.;
Delzoppo C.; Van Loon K.; Jones M.; Young P.J.; Butt W.; Schibler A.; Hill
K.D.; Kannankeril P.J.; Jacobs J.P.; Scott Baldwi H.; Jacobs M.L.; O'Brien
S.M.; Bichel D.P.; Graham E.M.; Blasiole B.; Resheidat A.; Husain A.S.;
Ram Kumar S.; Kirchner J.L.; Gallup D.S.; Turek J.W.; Bleiweis M.; Mettler
B.; Benscoter A.; Wald E.; Karamlou T.; Van Bergen A.H.; Overman D.;
Eghtesady P.; Butts R.; Kim J.S.; Scott J.P.; Anderson B.R.; Swartz M.F.;
McConnell P.I.; Vener D.F.; Li J.S.
Institution
(Schlapbach, Gibbons) Child Health Research Centre, University of
Queensland, Brisbane, QLD, Australia
(Schlapbach) Department of Intensive Care and Neonatology, Children's
Research Center, University Children's Hospital Zurich, University of
Zurich, Zurich, Switzerland
(Butt) Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC,
Australia
(Butt) Department of Critical Care, Faculty of Medicine, Dentistry and
Health Sciences, University of Melbourne, Melbourne, VIC, Australia
(Kannankeril) Department of Pediatrics, Center for Pediatric Precision
Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville,
TN, United States
(Li, Hill) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
Publisher
Lippincott Williams and Wilkins

<102>
Accession Number
643348374
Title
Recent Advances in the Modification and Improvement of Bioprosthetic Heart
Valves.
Source
Small (Weinheim an der Bergstrasse, Germany). (pp e2309844), 2024. Date
of Publication: 26 Jan 2024.
Author
Tong Q.; Cai J.; Wang Z.; Sun Y.; Liang X.; Xu Q.; Mahamoud O.A.; Qian Y.;
Qian Z.
Institution
(Tong, Cai, Wang, Sun, Mahamoud, Qian) Department of Cardiovascular
Surgery, National Clinical Research Center for Geriatrics, West China
Hospital, Sichuan University, Chengdu, Sichuan 610041, China
(Liang, Qian) Department of Biotherapy, Cancer Center and State Key
Laboratory of Biotherapy, West China Hospital, Sichuan University,
Chengdu, Sichuan 610041, China
(Xu) School of Basic Medicine, Mudanjiang Medical University, Mudanjiang,
Heilongjiang 157011, China
Abstract
Valvular heart disease (VHD) has become a burden and a growing public
health problem in humans, causing significant morbidity and mortality
worldwide. An increasing number of patients with severe VHD need to
undergo heart valve replacement surgery, and artificial heart valves are
in high demand. However, allogeneic valves from donors are lacking and
cannot meet clinical practice needs. A mechanical heart valve can activate
the coagulation pathway after contact with blood after implantation in the
cardiovascular system, leading to thrombosis. Therefore, bioprosthetic
heart valves (BHVs) are still a promising way to solve this problem.
However, there are still challenges in the use of BHVs. For example, their
longevity is still unsatisfactory due to the defects, such as thrombosis,
structural valve degeneration, calcification, insufficient
re-endothelialization, and the inflammatory response. Therefore,
strategies and methods are needed to effectively improve the
biocompatibility and longevity of BHVs. This review describes the recent
research advances in BHVs and strategies to improve their biocompatibility
and longevity. Copyright © 2024 Wiley-VCH GmbH.

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