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<1>
Accession Number
370416217
Title
Using mobile technology for cardiac rehabilitation: A review and framework
for development and evaluation.
Source
Journal of the American Heart Association. 2(6) (no pagination), 2013.
Article Number: e000568. Date of Publication: December 2013.
Author
Fukuoka Y.; Beatty A.L.; Whooley M.A.
Institution
(Fukuoka) Institute for Health and Aging, Department of Social and
Behavioral Sciences, University of California, San Francisco, CA, United
States
(Beatty, Whooley) Department of Medicine, University of California, San
Francisco, CA, United States
(Whooley) Department of Epidemiology and Biostatistics, University of
California, San Francisco, CA, United States
(Whooley) Veterans Affairs Medical Center, San Francisco, CA, United
States
Publisher
John Wiley and Sons Inc

<2>
Accession Number
2030218556
Title
Effect of lung rehabilitation training combined with nutritional
intervention on patients after thoracoscopic resection of lung cancer.
Source
Oncology Letters. 27(3) (no pagination), 2024. Article Number: 118. Date
of Publication: March 2024.
Author
Li J.; Zheng J.
Institution
(Li) Department of Cardiothoracic Surgery, Banan Hospital Affiliated to
Chongqing Medical University, Chongqing 401320, China
(Zheng) Department of Operations Management, Banan Hospital Affiliated to
Chongqing Medical University, Chongqing 401320, China
Publisher
Spandidos Publications
Abstract
Thoracoscopic lobectomy is the main type of surgical treatment for lung
cancer. Postoperative patients have complications and decreased pulmonary
function, which affects their discharge time and quality of life. Lung
venti- lator training has been shown to promote the postoperative recovery
of patients; however, no specific treatment plan has been approved to
enhance lung rehabilitation. Therefore, it is necessary to explore methods
to promote the postoperative rehabilitation of patients with lung cancer.
The patients with lung cancer who were admitted to Banan Hospital
Affiliated to Chongqing Medical University (Chongqing, China) between
January 2022 and January 2023, and who planned to undergo a thoracoscopic
lobectomy, were randomly categorized into two groups. The experimental
group began lung rehabilitation training 2 weeks before the operation and
received individual- ized nutrition programs. The control group did not
receive lung rehabilitation training and nutrition programs. The quality
of life, lung function, 6-min walking distance (6MWD), nutri- tional
status, postoperative complications, hospital expenses and hospital stay
between the two groups were compared. Finally, 86 and 83 patients were
included in the test and control groups, respectively. Regarding the
postoperative indicators, the patients in the test group scored higher in
all areas of quality of life, exhibited higher lung function and 6MWD, and
had significantly higher serum total protein, albumin and hemoglobin
levels, and body mass index, compared with the control group. Furthermore,
the incidence of postoperative pulmonary complications, the duration of
hospitalization and the hospitalization costs were lower in the
experimental group. In conclusion, lung rehabilitation training combined
with nutritional intervention can promote the postoperative rehabilitation
of patients with lung cancer. The research has been duly registered in the
Chinese Clinical Trial Register platform (registration no.
ChiCTR2300078681; registered Dec 15, 2023). Copyright © 2024 Li
and Zheng.

<3>
Accession Number
2030123803
Title
Effect of Cold Application on Pain After Chest Tube Removal in Patients
Undergoing Bypass Surgery.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 29(4) (pp
204-210), 2023. Date of Publication: 2023.
Author
Karalar E.; Erdogan H.
Institution
(Karalar) Department of Cardiovascular Service, Acibadem Altunizade
Hospital, Istanbul, Turkey
(Erdogan) Department of Nursing, Maltepe University, Istanbul, Turkey
Publisher
Turkish Anaesthesiology and Intensive Care Society
Abstract
Objectives: This study investigated the effect of cold application on pain
after chest tube removal in patients undergoing bypass surgery.
 Method(s): Data of 56 patients who underwent bypass surgery between
August 2021 and November 2021 (46 males, 10 females; mean age: 62.8+/-9.2
years) were analyzed. The patients were divided into two groups: the
intervention group (n=28) with cold application and the control group
(n=28) without cold application. Demographic characteristics, pain, and
vital signs of the patients were compared. Result(s): The groups
mostly felt pain in the tube site 20 min before cold application, during
the procedure, and 20 min after the procedure, and a significant
difference in pain quality was observed between the groups (p<0.05). No
significant differences in pain severity and skin and body temperatures
were observed between the two groups 20 min before the procedure. Pain
intensity and skin and body temperatures of the intervention group
decreased during and 20 min after the procedure. No significant
differences in systolic blood pressure, diastolic blood pressure, heart
rate, and respiration were observed between the two groups (p>0.05). In
the control group, systolic and diastolic blood pressures and pulse rate
increased during the procedure. The SpO<inf>2</inf> level of the
intervention group was higher. Conclusion(s): Cold application was
effective in managing pain after chest tube removal in patients undergoing
bypass surgery. Copyright © 2023 Turkish Anaesthesiology and
Intensive Care Society. All rights reserved.

<4>
Accession Number
2029791624
Title
Efficacy of electroacupuncture on myocardial protection and postoperative
rehabilitation in patients undergoing cardiac surgery with cardiopulmonary
bypass: a systematic review and Meta-analysis.
Source
Journal of Traditional Chinese Medicine. 44(1) (pp 1-15), 2024. Date of
Publication: 2024.
Author
Qin X.; Wang C.; Xue J.; Zhang J.; Lu X.; Ding S.; Ge L.; Wang M.
Institution
(Qin, Zhang, Lu, Ding) The First Clinical Medical College, Gansu
University of Chinese Medicine, Lanzhou 730030, China
(Wang, Xue) Department of Anesthesiology, Gansu Provincial Hospital of
Traditional Chinese Medicine, Lanzhou 730050, China
(Ge) Evidence-based Medicine Center, Lanzhou University, Lanzhou 730030,
China
(Wang) Institute of Epidemiology and Statistics, School of Public Health,
Lanzhou University, Lanzhou 730030, China
Publisher
Journal of Traditional Chinese Medicine
Abstract
OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA)
intervention on myocardial protection and postoperative rehabilitation in
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
 METHOD(S): Eight databases, including PubMed, Embase, the Cochrane
Library, Web of Science, Chinese BioMedical Literature Database, China
National Knowledge Infrastructure Database, Wanfang Data, China Science
and Technology Journal Database, and two clinical trial registries, were
searched. All randomized controlled trials (RCTs) related to EA
intervention in cardiac surgery with CPB were collected. Based on the
inclusion and exclusion criteria, two researchers independently screened
articles and extracted data. After the quality evaluation, RevMan 5.3
software was used for analysis. RESULT(S): Fourteen RCTs involving
836 patients were included. Compared with the control treatment, EA
significantly increased the incidence of cardiac automatic rebeat after
aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI)
(1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic
unclamping, EA significantly increased the superoxide dismutase
[standardized mean difference (SMD) = 0.96, 95% CI (0.32, 1.61), P < 0.05;
low], and interleukin (IL)-2 [SMD = 1.33, 95% CI (0.19, 2.47), P < 0.05;
very low] expression levels and decreased the malondialdehyde [SMD =
-1.62, 95% CI (-2.15, -1.09), P < 0.05; moderate], tumour necrosis
factor-alpha [SMD = -1.28, 95% CI (-2.37, -0.19), P < 0.05; moderate], and
cardiac troponin I [SMD = - 1.09, 95% CI (- 1.85, - 0.32), P < 0.05; low]
expression levels as well as the inotrope scores [SMD = -0.77, 95% CI
(-1.22, -0.31), P < 0.05; high]. There was no difference in IL-6 and IL-10
expression levels. The amount of intraoperative sedative [SMD = -0.31, 95%
CI (- 0.54, - 0.09), P < 0.05; moderate] and opioid analgesic [SMD =
-0.96, 95% CI (-1.53, -0.38), P < 0.05; low] medication was significantly
lower in the EA group than in the control group. Moreover, the
postoperative tracheal intubation time [SMD = -0.92, 95% CI (-1.40,
-0.45), P < 0.05; low] and intensive care unit stay [SMD = -1.71, 95% CI
(-3.06, -0.36), P < 0.05; low] were significantly shorter in the EA group
than in the control group. There were no differences in the time to get
out of bed for the first time, total days of antibiotic use after surgery,
or postoperative hospital stay. No adverse reactions related to EA were
reported in any of the included studies. CONCLUSION(S): In cardiac
surgery with CPB, EA may be a safe and effective strategy to reduce
myocardial ischaemia-reperfusion injury and speed up the recovery of
patients after surgery. These findings must be interpreted with caution,
as most of the evidence was of low or moderate quality. More RCTs with
larger sample sizes and higher quality are needed to provide more
convincing evidence. Copyright © 2024 JTCM. All rights reserved.

<5>
Accession Number
2029760308
Title
The impact of early in-hospital use of PCSK9 inhibitors on cardiovascular
outcomes in acute coronary syndrome patients: A systematic review and
meta-analysis.
Source
International Journal of Cardiology. 399 (no pagination), 2024. Article
Number: 131775. Date of Publication: 15 Mar 2024.
Author
Yifan D.; Yue M.; Yubin Z.; Jiapei G.; Xun S.; Shenghu H.; Li Z.; Jing Z.
Institution
(Yifan, Yue, Yubin, Jiapei, Xun, Shenghu, Li, Jing) Clinical Medical
College, Yangzhou University, Yangzhou 225001, China
(Yifan, Li) Taizhou People's Hospital affiliated to Nanjing Medical
University, Tai zhou 225300, China
(Yifan, Jiapei) Medical College of Yangzhou University, Yang zhou 225001,
China
(Yue) Medical School of Nanjing University, Nanjing 21000, China
(Yubin, Xun) Dalian Medical University, Dalian 116000, China
(Shenghu, Jing) Department of Cardiology, Northern Jiangsu People's
Hospital, Yangzhou 225001, China
Publisher
Elsevier Ireland Ltd
Abstract
Objective: To explore the safety and assess the cardiovascular impact of
early in-hospital administration of PCSK9 inhibitors in patients with
acute coronary syndrome (ACS). Method(s): A systematic search of
PubMed, Web of Science, and Embase databases was conducted for studies
involving the use of PCSK9 inhibitors in ACS patients from inception to
October 2023. Two independent researchers screened the literature,
extracted data, and assessed the risk of bias in the included studies.
Meta-analysis was performed using STATA 16.0 software. Result(s):
Nine studies, encompassing a total of 2896 ACS patients, were included in
the analysis. When compared to statin monotherapy, early administration of
PCSK9 inhibitors during hospitalization for ACS proved effective in
reducing the incidence of major adverse cardiovascular events (MACEs).
This encompassed a decrease in coronary revascularization [Relative Risk
(RR) = 0.78, 95% CI (0.62, 0.98), P < 0.05], recurrent ACS [RR = 0.62, 95%
CI (0.42, 0.94), P < 0.05], readmissions due to unstable angina [RR =
0.71, 95% CI (0.59, 0.85), P < 0.01], and strokes [RR = 0.31, 95% CI
(0.09, 1.04), P = 0.058]. There was no significant difference in the
incidence of death between the two groups.The use of PCSK9 inhibitors
notably hastened the reduction of LDL-C, TG, and Non HDL-C levels in the
short term. Additionally, it increased HDL-C levels and the number of
individuals meeting LDL-C compliance criteria. Importantly, the risk of
adverse drug events, such as ALT increase >3xULN, allergies, and
musculoskeletal pain, did not significantly elevate with PCSK9 inhibitor
use. Conclusion(s): The early administration of PCSK9 inhibitors has
been found to safely and effectively lower diverse lipid levels in
patients with ACS. This reduction is associated with a noteworthy decrease
in MACEs, encompassing revascularization, recurrent ACS, and hospital
readmissions. Copyright © 2024 Elsevier B.V.

<6>
Accession Number
2029159332
Title
The Role of Speckle-Tracking Echocardiography in Predicting Mortality and
Morbidity in Patients With Congenital Heart Disease: A Systematic Review
and Meta-analysis.
Source
Journal of the American Society of Echocardiography. 37(2) (pp 216-225),
2024. Date of Publication: February 2024.
Author
Dorobantu D.M.; Amir N.H.; Wadey C.A.; Sharma C.; Stuart A.G.; Williams
C.A.; Pieles G.E.
Institution
(Dorobantu, Wadey, Williams) Children's Health and Exercise Research
Centre, University of Exeter, Exeter, United Kingdom
(Dorobantu, Amir, Stuart) Department of Population and Translational
Health Science, University of Bristol, Bristol, United Kingdom
(Amir) Faculty of Sport Science and Recreation, Universiti Teknologi
Majlis Amanah Rakyat, Arau, Malaysia
(Sharma, Stuart, Pieles) Congenital Heart Unit, Bristol Heart Institute
and Royal Hospital for Children, Bristol, United Kingdom
(Pieles) Institute of Sport, Exercise and Health, University College
London, London, United Kingdom
(Pieles) Athlete Health and Performance Research Centre and the Sports
Medicine Department, Aspetar Qatar Orthopaedic and Sports Medicine
Hospital, Doha, Qatar
Publisher
Elsevier Inc.
Abstract
Background: Speckle-tracking echocardiography (STE) is now routinely
included in cardiac evaluations, but its role in predicting mortality and
morbidity in congenital heart disease (CHD) is not well described. We
conducted a systematic review to evaluate the prognostic value of STE in
patients with CHD. Method(s): The EMBASE, Medline, Web of Science,
Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL)
databases were searched from inception to January 2023 for terms related
to all CHD, STE, and prognosis. Meta-analysis of association of right
ventricle and left ventricle strain (RV S<inf>l</inf> and LV
S<inf>l</inf>, respectively) with major adverse cardiovascular events
(MACEs) was performed in atrial switch transposition of the great arteries
(asTGA)/congenitally corrected TGA (ccTGA), tetralogy of Fallot (ToF), and
congenital aortic stenosis (cAS)/bicuspid aortic valve (BAV). P-value
combination analysis was additionally performed for all CHD groups.
 Result(s): A total of 33 studies (30 cohorts, n = 8,619 patients,
children, and adults) were included. Meta-analysis showed the following
parameters as being associated with MACE: RV S<inf>l</inf> in asTGA/ccTGA
(hazard ratio [HR] = 1.1/%; CI, [1.03; 1.18]), RV S<inf>l</inf> and LV
S<inf>l</inf> in ToF (HR = 1.14/%; CI, [1.03; 1.26] and HR = 1.14/%; CI,
[1.08; 1.2], respectively), and LV S<inf>l</inf> in cAS/BAV (HR = 1.19/%;
CI, [1.15; 1.23]). The RV S<inf>l</inf> and strain rate were associated
with outcomes also in single ventricle/hypoplastic left heart syndrome (at
all palliation stages except before Norwood stage 1) and LV S<inf>l</inf>
in Ebstein's anomaly. Conclusion(s): This systematic review and
meta-analysis showed that biventricular strain and strain rate were
associated with outcomes in a variety of CHD, highlighting the need for
updated recommendations on the use of STE in the current guidelines,
specific to disease types. Copyright © 2023 American Society of
Echocardiography

<7>
Accession Number
2028459705
Title
The effect of haloperidol's perioperative application on postoperative
delirium in elderly patients: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Date of Publication:
December 2024.
Author
Liu M.; Su J.; Wang B.; Yu D.; Li J.; Cao X.
Institution
(Liu, Su, Yu, Li, Cao) Department of Anaesthesiology, Hebei General
Hospital, Shijiazhuang 050051, China
(Wang) Department of Gynaecology, Hebei General Hospital, Shijiazhuang
050051, China
(Cao) Graduate School of Hebei Medical University, Hebei Province,
Shijiazhuang 050011, China
Publisher
BioMed Central Ltd
Abstract
Objectives: To systematically review the evidence about the effect of
haloperidol on postoperative delirium in elderly patients. Method(s):
PubMed, Embase, the Cochrane Library and China National Knowledge
Infrastructure were used to find concerned studies for meta-analysis. The
main outcome was the incidence of postoperative delirium, and the
secondary outcomes were side effects of haloperidol and the length of
hospital stay. The meta-analyses were conducted using the Review Manager
Version 5.1. This study was conducted based on the PRISMA statement.
 Result(s): Eight RCTs (1569 patients) were included in the
meta-analysis. There was a significant difference in the incidence of
postoperative delirium between haloperidol and control groups (OR = 0.62,
95%CI 0.48-0.80, P = 0.0002, I2 = 20%). In addition, side
effects of haloperidol and the duration of hospitalization were comparable
(OR = 0.58, 95%CI 0.25-1.35, P = 0.21, I2 = 0%; MD =-0.01,
95%CI -0.16-0.15, P = 0.92, I2 = 28%). Subgroup analysis
implied the effect of haloperidol on postoperative delirium might vary
with the dose (5 mg daily: OR = 0.40, 95%CI 0.22-0.71, P = 0.002,
I2 = 0%; <5 mg daily: OR = 0.72, 95%CI 0.42-1.23, P = 0.23,
I2 = 0%). Conclusion(s): The meta-analysis revealed
perioperative application of haloperidol could decrease the occurrence of
postoperative delirium without obvious side effects in elderly people, and
high-dose haloperidol (5 mg daily) possessed a greater positive
effect. Copyright © The Author(s) 2024.

<8>
Accession Number
2027778163
Title
Driveline infection according to driveline positioning in left ventricular
assist device implant recipients.
Source
International Journal of Artificial Organs. 47(2) (pp 118-121), 2024. Date
of Publication: February 2024.
Author
Lauenroth V.; Zittermann A.; Lucke S.; Gummert J.F.; Morshuis M.
Institution
(Lauenroth, Zittermann, Lucke, Gummert, Morshuis) Clinic for Thoracic and
Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University
Bochum, North Rhine-Westphalia, Bad Oeynhausen, Germany
Publisher
SAGE Publications Ltd
Abstract
We conducted a prospective, open-labeled, clinical trial, with a
two-by-two factorial design, of argon cold plasma application and two
different types of driveline positioning for the prevention of driveline
infection (DLI) in 80 patients with a left ventricular assist device
(LVAD) implant. Here, we present the results of intracorporeal loop
positioning (n = 40) versus no intracorporeal loop positioning (n = 40).
Patients were followed up for 1 year. According to the Driveline Expert
STagINg and carE grading (DESTINE) system, a DLI was considered in case of
a stage 2 or higher graded infection. During follow-up, 29 (36%) patients
experienced a DLI, 16 in the group with intracorporeal loop positioning
and 13 in the group with no intracorporeal loop positioning. Kaplan-Meier
estimates of freedom from DLI showed no statistically significant
difference between study groups during follow-up (p = 0.33). In detail,
30-day freedom from DLI was for the groups with and without intracorporeal
loop positioning 92 and 92%, respectively, and 1-year freedom from DLI was
51 and 62%, respectively. In conclusion, this controlled clinical trial
was unable to show a statistically significant difference in freedom from
DLI during one year of follow-up in groups with or without intracorporeal
loop positioning. However, larger trials have to confirm these
results. Copyright © The Author(s) 2024.

<9>
Accession Number
2027323338
Title
Treatment Strategies for Chronic Coronary Heart Disease with Left
Ventricular Systolic Dysfunction or Preserved Ejection Fraction-A
Systematic Review and Meta-Analysis.
Source
Pathophysiology. 30(4) (pp 640-658), 2023. Date of Publication: December
2023.
Author
Golukhova E.Z.; Slivneva I.V.; Kozlova O.S.; Berdibekov B.S.; Skopin I.I.;
Merzlyakov V.Y.; Baichurin R.K.; Sigaev I.Y.; Keren M.A.; Alshibaya M.D.;
Marapov D.I.; Arzumanyan M.A.
Institution
(Golukhova) A.N. Bakulev National Medical Scientific Center for
Cardiovascular Surgery, Moscow 121552, Russian Federation
(Slivneva, Kozlova, Baichurin, Arzumanyan) Department of Cardiovascular
and Comorbid Pathology, A.N. Bakulev National Medical Scientific Center
for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Berdibekov) Department of Non-Invasive Arrhythmology and Surgical
Treatment of Combined Pathology, A.N. Bakulev National Medical Scientific
Center for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Skopin) Department of Reconstructive Surgery of Heart Valves and Coronary
Arteries, Bakulev National Medical Research Center for Cardiovascular
Surgery, A.N, Moscow 121552, Russian Federation
(Merzlyakov, Baichurin) Department of Surgical Treatment of Ischemic Heart
Disease and Minimally Invasive Coronary Surgery, Bakulev National Medical
Research Center for Cardiovascular Surgery, A.N, Moscow 121552, Russian
Federation
(Sigaev, Keren) Department of Surgical Treatment of Coronary and Great
Arteries Combined Diseases, A.N. Bakulev National Medical Scientific
Center for Cardiovascular Surgery, Moscow 121552, Russian Federation
(Alshibaya) Department of Surgical Treatment of Ischemic Heart Disease,
A.N. Bakulev National Medical Scientific Center for Cardiovascular
Surgery, Moscow 121552, Russian Federation
(Marapov) Department of Public Health, Economics and Health Care
Management, Kazan State Medical Academy, Branch Campus of the Federal
State Budgetary Educational Institution of Further Professional Education,
Russian Medical Academy of Continuous Professional Education, Kazan
420012, Russian Federation
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
In this meta-analysis, we examine the advantages of invasive strategies
for patients diagnosed with chronic coronary heart disease (CHD) and
preserved left ventricular (LV) function, as well as those with
significant LV systolic dysfunction (LV ejection fraction (EF) < 45%).
 Material(s) and Method(s): We conducted a systematic search to
identify all randomized trials directly comparing invasive strategies with
optimal medical therapy (OMT) in patients diagnosed with chronic CHD. Data
from these trials were pooled using a random-effects meta-analysis. The
primary outcome assessed was the all-cause mortality, while secondary
endpoints included cardiovascular (CV) death, stroke, myocardial
infarction (MI), and unplanned revascularization. This study was designed
to assess the benefits of both invasive strategies and OMT in patients
with preserved LV function and in those with LV systolic dysfunction. The
statistical analysis of the data was conducted using the Review Manager
(RevMan) software, version 5.4.1 (The Cochrane Collaboration, 2020).
 Result(s): Twelve randomized studies enrolling 13,912 patients were
included in the final analysis. Among the patients with chronic CHD and
preserved LV systolic function, revascularization did not demonstrate a
reduction in all-cause mortality (8.52% vs. 8.45%, p = 0.45), CV death
(3.41% vs. 3.62%, p = 0.08), or the incidence of MI (9.88% vs. 10.49%, p =
0.47). However, the need for unplanned myocardial revascularization was
significantly lower in the group following the initial invasive approach
compared to patients undergoing OMT (14.75% vs. 25.72%, p < 0.001). In
contrast, the invasive strategy emerged as the preferred treatment
modality for patients with ischemic LV systolic dysfunction. This approach
demonstrated lower rates of all-cause mortality (40.61% vs. 46.52%, p =
0.004), CV death (28.75% vs. 35.82%, p = 0.0004), and MI (8.19% vs. 10.8%,
p = 0.03). Conclusion(s): In individuals diagnosed with chronic CHD
and preserved LV EF, the initial invasive approach did not demonstrate a
clinical advantage over OMT. Conversely, in patients with ischemic LV
systolic dysfunction, myocardial revascularization was found to reduce the
risks of CV events and enhance the overall outcomes. These findings hold
significant clinical relevance for optimizing treatment strategies in
patients with chronic CHD, contingent upon myocardial contractility
status. Copyright © 2023 by the authors.

<10>
Accession Number
2030287812
Title
Comparison of Multiple Injection Costotransverse Block and Erector Spinae
Plane Block for Post-Sternotomy Pain Relief in Pediatric Patients
Undergoing Cardiac Surgery: A Prospective Randomized Comparative Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Somani S.; Makhija N.; Chauhan S.; Bhoi D.; Das S.; Bandi S.G.; Rajashekar
P.; Bisoi A.K.
Institution
(Somani, Makhija, Chauhan, Das) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
(Bhoi) Department of Anaesthesiology, Pain Medicine and Critical Care, All
India Institute of Medical Sciences, New Delhi, India
(Bandi, Rajashekar, Bisoi) Department of Cardiothoracic and Vascular
Surgery, All India Institute of Medical Sciences, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: The aim of this study was to evaluate the efficacy of
ultrasound-guided multiple injection costotransverse block (MICB) and
compare it with erector spinae plane block (ESPB) for poststernotomy pain
relief in pediatric cardiac surgical patients. Design(s): A
prospective, randomized, double-blind, comparative study. Setting(s):
At a single institution tertiary referral cardiac center.
 Participant(s): A total of 90 children with acyanotic congenital
heart disease requiring surgery via sternotomy. Intervention(s):
Children were allocated randomly to 1 of the 3 following groups: ESPB
(group 1), MICB (group 2), or Control (group 3). Participants in groups 1
and 2 received 4 mg/kg of 0.2% ropivacaine for bilateral ultrasound-guided
block after induction of anesthesia. Postoperatively, intravenous
paracetamol was used for multimodal analgesia, and fentanyl/tramadol was
used for rescue analgesia. Measurements and Main Results: The
modified objective pain score (MOPS) was evaluated at 0, 1, 2, 4, 6, 8,
10, and 12 hours postextubation. After all exclusions, 84 patients were
analyzed. The MOPS score was found to be significantly lower in ESPB and
MICB groups compared to the control group until 10 hours postextubation (p
< 0.05), with no statistically significant difference at the 12th hour (p
= 0.2198). The total intraoperative fentanyl consumption (p = 0.0005),
need for fentanyl supplementation on incision (p < 0.0001), and need for
rescue opioid requirement in the postoperative period (p = 0.034) were
significantly lower in both the ESPB and MICB groups than the control
group. There were no statistically significant differences in both primary
and secondary outcomes between the ESPB and MICB groups.
 Conclusion(s): Ultrasound-guided MICB was effective and comparable to
ESPB for post-sternotomy pain management in pediatric cardiac surgical
patients. Copyright © 2023 Elsevier Inc.

<11>
Accession Number
2029596346
Title
Effect of six month's treatment with omega-3 acid ethyl esters on
long-term outcomes after acute myocardial infarction: The OMEGA-REMODEL
randomized clinical trial.
Source
International Journal of Cardiology. 399 (no pagination), 2024. Article
Number: 131698. Date of Publication: 15 Mar 2024.
Author
Bernhard B.; Heydari B.; Abdullah S.; Francis S.A.; Lumish H.; Wang W.;
Jerosch-Herold M.; Harris W.S.; Kwong R.Y.
Institution
(Bernhard, Heydari, Abdullah, Jerosch-Herold, Kwong) Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Heydari) Stephenson Cardiac Imaging Center, University of Calgary,
Calgary, AB, Canada
(Abdullah) VA North Texas Medical Center and University of
Texas-Southwestern Medical School, Dallas, TX, United States
(Francis) Department of Cardiovascular Medicine, Maine Medical Center,
Portland, United States
(Lumish) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center, New York, NY, United States
(Wang) Division of Sleep Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Harris) Fatty Acid Research Institute, Sioux Falls, SD 57106, United
States
(Harris) Sanford School of Medicine, University of South Dakota, Sioux
Falls, SD 57105, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Omega-3 polyunsaturated fatty acids (O3-FA) have been shown to
reduce inflammation and adverse cardiac remodeling after acute myocardial
infarction (AMI). However, the impact of O3-FA on long-term clinical
outcomes remains uncertain. Aim(s): To investigate the impact of
O3-FA on adverse cardiac events in long-term follow up post AMI in a
pilot-study. Method(s): Consecutive patients with AMI were randomized
1:1 to receive 6 months of O3-FA (4 g/daily) or placebo in the
prospective, multicenter OMEGA-REMODEL trial. Primary endpoint was a
composite of major adverse cardiovascular events (MACE) encompassing
all-cause death, heart failure hospitalizations, recurrent acute coronary
syndrome, and late coronary artery bypass graft (CABG). Result(s): A
total of 358 patients (62.8% male; 48.1 +/- 16.1 years) were followed for
a median of 6.6 (IQR: 5.0-9.1) years. Among those receiving O3-FA (n =
180), MACE occurred in 65 (36.1%) compared to 62 (34.8%) of 178 assigned
to placebo. By intention-to-treat analysis, O3-FA treatment assignment did
not reduce MACE (HR = 1.014; 95%CI = 0.716-1.436; p = 0.938), or its
individual components. However, patients with a positive response to O3-FA
treatment (n = 43), defined as an increase in the red blood cell omega-3
index (O3[sbnd]I) >=5% after 6 months of treatment, had lower annualized
MACE rates compared to those without (2.9% (95%CI = 1.2-5.1) vs 7.1%
(95%CI = 5.7-8.9); p = 0.001). This treatment benefit persisted after
adjustment for baseline characteristics (HR<inf>adjusted</inf> = 0.460;
95%CI = 0.218-0.970; p = 0.041). Conclusion(s): In long-term
follow-up of the OMEGA-REMODEL randomized trial, O3-FA did not reduce MACE
after AMI by intention to treat principle, however, patients who achieved
a >= 5% increase of O3[sbnd]I subsequent to treatment had favorable
outcomes. Copyright © 2023 Elsevier B.V.

<12>
Accession Number
2029450013
Title
Impact of carotid artery stenosis on outcomes of transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
International Journal of Cardiology. 399 (no pagination), 2024. Article
Number: 131670. Date of Publication: 15 Mar 2024.
Author
Caetano L.; Gibicoski T.B.; Rodriguez F.; Scabello I.; da Silva Neto E.P.;
Iplinski B.
Institution
(Caetano) Department of Medicine, Federal University of Paraiba, Joao
Pessoa, Brazil
(Gibicoski, Rodriguez) Federal University of Health Sciences of Porto
Alegre, Porto Alegre, Brazil
(Scabello) Joao Pessoa University Center, Joao Pessoa, Brazil
(da Silva Neto) Santo Amaro Hospital, Recife, Brazil
(Iplinski) Santa Casa de Misericordia Hospital, Porto Alegre, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Carotid Artery Stenosis (CAS) is common in elderly patients
undergoing Transcatheter Aortic Valve Replacement (TAVR). However, the
impact of CAS on the outcomes of TAVR is unclear. Purpose(s): This
systematic review and meta-analysis aimed to compare the clinical and
periprocedural outcomes in patients with and without CAS undergoing TAVR.
 Method(s): PubMed, Embase, and Cochrane databases were searched until
February 2023. We included studies that performed a direct comparison of
outcomes of TAVR in CAS versus non-CAS patients. Data was extracted from
published reports and the ROBINS-I tool was utilized for quality
assessment. The R studio software (version 4.2.2) was adopted for
statistical analysis. Result(s): Five observational studies and
111.915 patients were included. The mean age was 80.7 +/- 8.2 years and
46.3% were female. The risk of stroke or transient ischemic attack was
elevated in the group of patients with CAS (OR 1.44; 95% CI 1.07-1.95; p =
0.016). In contrast, myocardial infarction (OR 1.24; 95% CI 1.05-1.47; p =
0.074) and all-cause mortality (OR 0.99; 95% CI 0.73-1.35; p = 0.95) were
not significantly different between CAS and non-CAS groups. Acute kidney
injury and new pacemaker implantation did not differ between patients with
and without CAS. Conclusion(s): Our findings suggest that CAS is
significantly associated with cerebrovascular events in patients
undergoing TAVR, without significantly impacting all-cause mortality.
Further prospective studies are needed for a more granular assessment of
additional determinants of this association, such as unilateral vs.
bilateral involvement and whether there is a threshold of CAS severity for
increased risk. Copyright © 2023 Elsevier B.V.

<13>
Accession Number
2028061486
Title
Transcatheter aortic valve durability, predictors of bioprosthetic valve
dysfunction, longer-term outcomes-a review.
Source
Expert Review of Medical Devices. 21(1-2) (pp 15-26), 2024. Date of
Publication: 2024.
Author
Solc A.J.; Linkova H.; Tousek P.
Institution
(Solc, Linkova) Third Faculty of Medicine, Charles University, Prague,
Czechia
(Solc, Linkova) Department of Cardiology, University Hospital Kralovske
Vinohrady, Prague, Czechia
(Tousek) Department of Cardiology, Third Faculty of Medicine, University
Hospital Kralovske Vinohrady, Charles University, Prague, Czechia
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is one of the
most significant inventions in cardiology, as it provides a viable
minimally invasive treatment option for patients with aortic stenosis, the
most common valvular disease in the developed world and one with a poor
prognosis when left untreated. Using data available to date, this review
aims to discuss and identify possible predictors of TAVI valve
durability-an essential requirement for the device's wide-spread use,
especially in younger patients. Areas covered: This article explores the
main causes of bioprosthetic valve dysfunction (BVD) based on
pathophysiology and available data, and reviews possible predictors of BVD
including prosthesis-related, procedure-related, and patient-related
factors. An emphasis is made on affectable predictors, which could
potentially be targeted with prevention management and improve valve
durability. A literature search of online medical databases was conducted
using relevant key words and dates; significant clinical trials were
identified. A brief overview of important randomized controlled trials
with mid to long-term follow-up is included in this article. Expert
opinion: Identifying modifiable predictors of valve dysfunction presents
an opportunity to enhance and predict valve durability-a necessity as
patients with longer life-expectancies are being considered for the
procedure. Copyright © 2023 Informa UK Limited, trading as Taylor
& Francis Group.

<14>
Accession Number
2026333633
Title
Effects of perioperative vitamin E and zinc co-supplementation on systemic
inflammation and length of stay following coronary artery bypass graft
surgery: a randomized controlled trial.
Source
European Journal of Clinical Nutrition. 78(2) (pp 120-127), 2024. Date of
Publication: February 2024.
Author
Makiabadi E.; Nakhaeizadeh R.; Soleimani M.; Nasrollahzadeh J.
Institution
(Makiabadi, Nasrollahzadeh) Department of Clinical Nutrition & Dietetics,
Faculty of Nutrition Sciences and Food Technology, National Nutrition and
Food Technology Research Institute, Shahid Beheshti University of Medical
Sciences, No. 7, Hafezi St., Farahzadi Blvd., Qods Town, Tehran, Iran,
Islamic Republic of
(Nakhaeizadeh) Department of Surgery, School of Medicine, Shafa Hospital,
Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Soleimani) Department of Cardiac Intensive Care Unit, School of Medicine,
Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran,
Islamic Republic of
Publisher
Springer Nature
Abstract
Objectives: Coronary artery bypass graft (CABG) surgery has been reported
to be associated with lower postoperative plasma antioxidant and zinc
levels. We hypothesized that perioperative supplementation of vitamin E
and zinc might improve short-term postoperative outcomes. Method(s):
In this placebo-controlled double-blind, randomized study, patients
undergoing CABG performed with cardiopulmonary bypass were recruited. The
intervention group received zinc and vitamin E supplementation (1200 IU
vitamin E and 120 mg elemental zinc) the day before surgery, followed by
postoperative daily supplementation of 30 mg zinc and 200 IU vitamin E
from the 2nd day after surgery to 3 weeks. The control group received
placebos. Length of stay (LOS) in the intensive care unit and hospital,
sequential organ failure assessment score on 3rd day after surgery, and
plasma inflammatory markers on days 3 and 21 post-surgery were evaluated.
 Result(s): Seventy-eight patients completed the study (40 in the
intervention group and 38 in the placebo group). The hospital LOS was
significantly shorter (p < 0.05) in the intervention group. Postoperative
changes in plasma albumin levels were not different between the two
groups. The plasma zinc level was higher (p < 0.0001), but plasma
C-reactive protein (p = 0.01), pentraxin 3 (p < 0.0001), interferon gamma
(p < 0.05), malondialdehyde (p < 0.05), and aspartate aminotransferase (p
< 0.01) were lower in the intervention group compared to the placebo
group. Conclusion(s): Perioperative vitamin E and zinc
supplementation significantly reduced hospital LOS and the inflammatory
response in CABG surgery patients. In these patients, the optimal
combination and dose of micronutrients need further study but could
include zinc and vitamin E. Clinical trial registry: This trial was
registered at ClinicalTrials.gov website (NCT05402826). Copyright
© The Author(s), under exclusive licence to Springer Nature Limited
2023.

<15>
Accession Number
2017861659
Title
The impact of perioperative stroke and delirium on outcomes after surgical
aortic valve replacement.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(2) (pp 624-633.e4),
2024. Date of Publication: February 2024.
Author
Messe S.R.; Overbey J.R.; Thourani V.H.; Moskowitz A.J.; Gelijns A.C.;
Groh M.A.; Mack M.J.; Ailawadi G.; Furie K.L.; Southerland A.M.; James
M.L.; Gupta L.; Voisine P.; Perrault L.P.; Bowdish M.E.; Gillinov A.M.;
O'Gara P.T.; Ouzounian M.; Whitson B.A.; Mullen J.C.; Miller M.A.; Gammie
J.S.; Pan S.; Erus G.; Browndyke J.N.; Taddei-Peters W.C.; Jeffries N.O.;
Buxton D.; Geller N.L.; Gordon D.; Burke C.; Lee A.; Smith T.; Moy C.S.;
Gombos I.K.; Weisel R.; Gardner T.J.; Rose E.A.; Parides M.K.; Ascheim
D.D.; Bagiella E.; Moquete E.; Shah K.; Chang H.; Chase M.; Goldfarb S.;
Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Santos M.; Ye X.; Mack
M.; Winkle R.; Boswell H.; Fenlon A.; Johnson M.; Jones J.; Kolb M.; Lam
S.; Miranda L.; Ward J.; Whitman R.; Zingler B.; Ryan W.; Smith R.L.;
Grayburn P.; Nosnik P.; Blackstone E.H.; Moazami N.; Starling R.C.;
Barzilai B.; Grimm R.A.; Soltesz E.G.; Katzan I.; Strippy B.; Smith S.;
Garcia M.; Alice bowman M.; Geither C.; Wang R.; Argenziano M.; Borger M.;
Takayama H.; Leon M.B.; Goldsmith L.; Schwartz A.; Sookraj N.;
McCright-Gill T.; Sreekanth S.; McCullough J.N.; Iribarne A.; DeSimone
J.P.; DiScipio A.W.; Stokes H.; Ivany A.S.; Petty G.; Smith P.K.;
Alexander J.H.; Milano C.A.; Glower D.D.; Huber J.; Morganlander J.;
Mathew J.P.; Welsh S.; Casalinova S.; Johnson V.; Lane K.; Smith D.;
Tipton G.; Berry M.F.; Williams J.B.; Englum B.; Hartwig M.; Guyton R.;
Lattouf O.; Chen E.; Vega J.D.; Baer J.; Nguyen D.; Halkos M.; Baio K.;
Prince T.; Cook N.; Neill A.A.; Senechal M.; Dagenais F.; Laforce R.;
O'Connor K.; Dussault G.; Caouette M.; Tremblay H.; Gagne N.; Dumont J.;
Landry P.; Trichon B.H.; Binns O.A.; Ely S.W.; Johnson A.M.; Hansen T.H.;
Short J.G.; Taylor R.D.; Mangusan R.; Nanney T.; Aubart H.; Cross K.;
McPeters L.; Riggsbee C.; Rixey L.; Michler R.E.; DeRose J.J.; Goldstein
D.J.; Bello R.A.; Taub C.; Spevack D.; Kirchoff K.; Meli R.; Garcia J.;
Goldenberg J.; Kealy L.; Bouchard D.; Tanguay J.F.; O'Meara E.; Lacharite
J.; Robichaud S.; Horvath K.A.; Corcoran P.C.; Siegenthaler M.P.; Murphy
M.; Iraola M.; Greenberg A.; Kumkumian G.; Milner M.; Nadareishvili Z.;
Hasan A.; McDavid A.; Fadorsen D.; Yau T.; Farkouh M.; Woo A.; Cusimano
R.J.; David T.; Feindel C.; Fumakia N.; Christie S.; Bissonauth A.; Hripko
A.; Noor Z.; Mackowick K.; Deasey S.; Al-Suqi M.; Collins J.; Acker M.A.;
Messe S.; Kirkpatrick J.; Mayer M.L.; McDonald C.; Fok H.; Maffei B.;
Cresse S.; Gepty C.; Bowdish M.; Starnes V.A.; Shavalle D.; Heck C.;
Hackmann A.; Baker C.; Fleischman F.; Cunningham M.; Lozano E.; Hernandez
M.; Kron I.L.; Johnston K.; Ghanta R.K.; Dent J.M.; Kern J.; Yarboro L.;
Ragosta M.; Annex B.; Bergin J.; Burks S.; Cosner M.; Green C.; Loya S.;
Kim H.R.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Gottesman R.;
Haigney M.; Holubkov R.; Iadecola C.; Jacobs A.; Meslin E.M.; Murkin J.M.;
Spertus J.A.; Sellke F.; McDonald C.L.; Canty J.; Dickert N.; Ikonomidis
J.S.; Kim K.; Williams D.O.; Yancy C.W.; Chaturvedi S.; Chimowitz M.; Fang
J.C.; Richenbacher W.; Rao V.; Miller R.; Cook J.; D'Alessandro D.; Han
F.; Pinney S.; Walsh M.N.; Greer D.; Ishida K.; Stapf C.; Hung J.; Zeng
X.; Hung D.; Satitthummanid S.; Billelo M.; Davatzikos C.; Karpf L.;
Desiderio L.; Toulgoat-Dubois Y.; Brassard R.; Virmanu R.; Romero M.E.;
Braumann R.
Institution
(Messe) Department of Stroke and Neurocritical Care, Perelman School of
Medicine University of Pennsylvania, Philadelphia, Pa, United States
(Overbey, Moskowitz, Gelijns, Gupta, Pan) International Center for Health
Outcomes and Innovation Research (InCHOIR), The Department of Population
Health Science and Policy, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Thourani) Marcus Valve Center, Department of Cardiovascular Surgery,
Piedmont Heart Institute, Atlanta, Ga, United States
(Groh) Asheville Heart, Mission Health and Hospitals, Asheville, NC,
United States
(Mack) Cardiovascular Surgery, Baylor Scott & White Health, Plano, Tex,
United States
(Ailawadi) Departments of Cardiac Surgery and Surgery, University of
Michigan Health System, Ann Arbor, Mich, United States
(Furie) Department of Neurology, Alpert Medical School of Brown
University, Providence, RI, United States
(Southerland) Division of Vascular Neurology, University of Virginia
Health System, Charlottesville, VA, United States
(James) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(James) Department of Neurology, Duke University Medical Center, Durham,
NC, United States
(Moy) Division of Clinical Research, National Institute of Neurological
Disorders and Stroke, National Institutes of Health, Bethesda, Md, United
States
(Voisine) Department of Surgery, Institut de Cardiologie et Pneumologie de
Quebec, Quebec, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Quebec, Canada
(Bowdish) Surgery and Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, Calif, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
Mass, United States
(Ouzounian) Division of Cardiac Surgery, Department of Surgery, Peter Munk
Cardiac Centre, UHN-Toronto General Hospital, Toronto, ON, Canada
(Whitson) Division of Cardiac Surgery, Department of Surgery, The Ohio
State University, Columbus, OH, United States
(Mullen) Division of Cardiac Surgery, University of Alberta, Edmonton, AB,
Canada
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, Md, United
States
(Gammie) Department of Cardiac Surgery, Johns Hopkins Heart and Vascular
Institute, Baltimore, Md, United States
(Erus) Department of Radiology, Perelman School of Medicine University of
Pennsylvania, Philadelphia, Pa, United States
(Browndyke) Department of Psychiatry & Behavioral Sciences, Duke
University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Objective: The effects of stroke and delirium on postdischarge cognition
and patient-centered health outcomes after surgical aortic valve
replacement (SAVR) are not well characterized. Here, we assess the impact
of postoperative stroke and delirium on these health outcomes in SAVR
patients at 90 days. Method(s): Patients (N = 383) undergoing SAVR
(41% received concomitant coronary artery bypass graft) enrolled in a
randomized trial of embolic protection devices underwent serial neurologic
and delirium evaluations at postoperative days 1, 3, and 7 and magnetic
resonance imaging at day 7. Outcomes included 90-day functional status,
neurocognitive decline from presurgical baseline, and quality of life.
 Result(s): By postoperative day 7, 25 (6.6%) patients experienced
clinical stroke and 103 (28.5%) manifested delirium. During index
hospitalization, time to discharge was longer in patients experiencing
stroke (hazard ratio, 0.62; 95% confidence interval [CI], 0.42-0.94; P =
.02) and patients experiencing delirium (hazard ratio, 0.68; 95% CI,
0.54-0.86; P = .001). At day 90, patients experiencing stroke were more
likely to have a modified Rankin score >2 (odds ratio [OR], 5.9; 95% CI,
1.7-20.1; P = .01), depression (OR, 5.3; 95% CI, 1.6-17.3; P = .006), a
lower 12-Item Short Form Survey physical health score (adjusted mean
difference -3.3 +/- 1.9; P = .08), and neurocognitive decline (OR, 7.8;
95% CI, 2.3-26.4; P = .001). Delirium was associated with depression (OR,
2.2; 95% CI, 0.9-5.3; P = .08), lower 12-Item Short Form Survey physical
health (adjusted mean difference -2.3 +/- 1.1; P = .03), and
neurocognitive decline (OR, 2.2; 95% CI, 1.2-4.0; P = .01).
 Conclusion(s): Stroke and delirium occur more frequently after SAVR
than is commonly recognized, and these events are associated with
disability, depression, cognitive decline, and poorer quality of life at
90 days postoperatively. These findings support the need for new
interventions to reduce these events and improve patient-centered
outcomes. Copyright © 2022 The American Association for Thoracic
Surgery

<16>
Accession Number
642942129
Title
Effect of Remifentanil on Acute and Chronic Postsurgical Pain in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
The Clinical journal of pain. 40(3) (pp 187-195), 2024. Date of
Publication: 01 Mar 2024.
Author
Zhang B.; Cai C.; Pan Z.; Zhuang L.; Qi Y.
Institution
(Zhang) Department of Anesthesia, Ningbo Medical Center, Li Huili
Hospital, Ningbo, Zhejiang, China
Abstract
OBJECTIVES: Our purpose was to explore the effect of remifentanil on acute
and chronic postsurgical pain after cardiac surgery. MATERIALS AND
METHODS: Randomized controlled trials were retrieved from electronic
databases, such as PubMed, Cochrane Library, China National Knowledge
Internet databases, Scopus, and Web of Science. A systematic review,
meta-analysis, and trial sequential analysis (TSA) were performed. Basic
information and outcomes were extracted from the included studies. The
primary outcome was chronic postsurgical pain. Secondary outcomes were
scores of postsurgical pain and morphine consumption within 24 hours after
cardiac surgery. Risk of bias (ROB) assessment was based on the Cochrane
ROB tool version 2. The overall quality of the evidence was rated using
the Grading of Recommendations Assessment, Development, and Evaluation
(GRADE) system. RESULT(S): Seven studies consisting of 658 patients
were enrolled in the meta-analysis. A single study had a high ROB and 2
studies had a moderate ROB. The incidence of chronic postsurgical pain (4
studies [415 patients]; risk ratio: 1.02 [95% CI: 0.53 to 1.95]; P = 0.95;
I2 = 59%; TSA-adjusted CI: 0.78 to 1.20) and the postsurgical pain score
(2 studies [196 patients]; mean difference: 0.09 [95% CI: -0.36 to 0.55];
P = 0.69; I2 = 0%; TSA-adjusted CI: -0.36 to 0.55) were not statistically
different between the 2 groups. However, morphine consumption (6 studies
[569 patients]; mean difference: 6.94 [95% CI: 3.65 to 10.22]; P < 0.01;
I2 = 0%; TSA-adjusted CI: 0.00 to 0.49) was higher in the remifentanil
group than in the control group. CONCLUSION(S): There was not enough
evidence to prove that remifentanil can increase the incidence of chronic
postsurgical pain after cardiac surgery, but interestingly, the results
tended to support a trend toward increased complications in the
intervention group. However, there was moderate certainty evidence that
the use of remifentanil increases the consumption of morphine for
analgesia, and more direct comparison trials are needed to inform clinical
decision-making with greater confidence. Copyright © 2023 Wolters
Kluwer Health, Inc. All rights reserved.

<17>
Accession Number
369781301
Title
Letter to the editor: "pET scan contribution in chest tumors management: A
systematic review for thoracic surgeons".
Source
Tumori. 99(1) (pp 121), 2013. Date of Publication: January-February 2013.
Author
Salvati F.
Institution
(Salvati) FONICAP-Forza Operativa Nazionale Interdisciplinare Contro Il
CArcinoma Polmonare, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.

<18>
Accession Number
359354096
Title
Hemodynamic effects of the combination of dexmedetomidine-fentanyl versus
midazolam-fentanyl in children undergoing cardiac surgery with
cardiopulmonary bypass.
Source
Revista Brasileira de Anestesiologia. 60(4) (pp 350-362), 2010. Date of
Publication: July-August 2010.
Author
Klamt J.G.; Vicente W.V.D.A.; Garcia L.V.; Ferreira C.A.
Institution
(Klamt, Garcia) Department of Biomechanics, Medicine, and Rehabilitation
of the Locomotor System, FMRP-USP, Brazil
(Vicente) Department of Surgery and Anatomy, FMRP-USP, Brazil
(Vicente) Cardiothoracic Surgery Department, FMRP-USP, Brazil
(Garcia) FMRP-USP, Brazil
(Ferreira) Hospital Das Clinicas, Brazil
(Ferreira) Surgery and Anatomy Department, FMRP-USP, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background and objectives: To evaluate the efficacy of the combined
infusion of dexmedetomidine and fentanyl on the hemodynamic response
during cardiac surgery with cardiopulmonary bypass (CPB) in children.
 Method(s): Thirty-two children, ages 1 month to 10 years, scheduled
for cardiac surgery with cardiopulmonary bypass were randomly divided in
two groups: the MDZ Group received midazolam 0.2
mg.kg-1.h-1, while the DEX group received
dexmedetomidine 1 mug.kg-1.h-1 during one hour
followed be a reduction by half in the rate of infusion in both groups.
Both groups received fentanyl 10 mug.kg-1, midazolam 0.2 mg.h
-1, and vecuronium 0.2 mg.kg-1 for anesthesia
induction. The same doses of fentanyl and vecuronium used during induction
were infused during the first hour after induction, followed by a
reduction to half. Infusions were initiated immediately after induction
and maintained until the end of the surgery. Isoflurane was administered
for a short time to control the hyperdynamic response to incision and
sternotomy. Result(s): In both groups, systolic blood pressure and
heart rate reduced significantly after one hour of anesthetic infusion,
but the increase in systolic and diastolic pressure and heart rate to skin
incision were significantly lower in the DEX Group. A significantly lower
number of patients demanded supplementation with isoflurane in the DEX
Group. After CPB, patients in both groups had similar hemodynamic
responses. Conclusion(s): Infusion of dexmedetomidine without bolus
seems to be an effective adjuvant to fentanyl on the promotion of sedation
and control of hemodynamic responses during surgery for congenital
cardiopathies in children. ©Elsevier Editora Ltda.

<19>
Accession Number
358226547
Title
Nonsteroidal anti-inflammatory drug treatment for postoperative
pericardial effusion: A multicenter randomized, double-blind trial.
Source
Annals of Internal Medicine. 152(3) (pp 137-143), 2010. Date of
Publication: 02 Feb 2010.
Author
Meurin P.; Tabet J.Y.; Thabut G.; Cristofini P.; Farrokhi T.; Fischbach
M.; Pierre B.; Ben Driss A.; Renaud N.; Iliou M.C.; Weber H.
Institution
(Meurin, Tabet, Ben Driss, Renaud, Weber) Les Grands Pres, 27 rue Sainte
Christine, 77174 Villeneuve Saint Denis, France
(Thabut) Service de Pneumologie, Hopital Bichat, 46 rue Huchard, 75018
Paris, France
(Cristofini, Iliou) Hopital Broussais, 96 rue Didot, 75014 Paris, France
(Farrokhi) Hopital Bligny, 91640 Briis-sous-Forges, France
(Fischbach) Chateau Lemoine, 70 Rue du Marechal Gallieni, 33150 Cenon,
France
(Pierre) IRIS, 271 Rue des Sources, 69280, Marcy l'Etoile, France
Publisher
American College of Physicians
Abstract
Background: The incidence of asymptomatic pericardial effusion is high
after cardiac surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) are
widely prescribed in this setting, but no study has assessed their
efficacy. Objective(s): To assess whether the NSAID diclofenac is
effective in reducing postoperative pericardial effusion volume.
 Design(s): Multicenter randomized, double-blind, placebo-controlled
study. (Clinical trials.gov registration number: NCT00247052) Setting: 5
postoperative cardiac rehabilitation centers. Patient(s): 196
patients at high risk for tamponade because of moderate to large
persistent pericardial effusion (grade 2, 3, or 4 on a scale of 0 to 4, as
measured by echocardiography) more than 7 days after cardiac surgery.
 Intervention(s): Random assignment at each site in blocks of 4 to
diclofenac, 50 mg, or placebo twice daily for 14 days. Measurements: The
main end point was change in effusion grade after 14 days of treatment.
Secondary end points included frequency of late cardiac tamponade.
 Result(s): The initial mean pericardial effusion grade was 2.58 (SD,
0.73) for the placebo group and 2.75 (SD, 0.81) for the diclofenac group.
The 2 groups showed similar mean decreases from baseline after treatment
(-1.08 grades [SD, 1.20] for the placebo group vs. -1.36 (SD, 1.25) for
the diclofenac group). The mean difference between groups was -0.28 grade
(95% CI, -0.63 to 0.06 grade; P = 0.105). Eleven cases of late cardiac
tamponade occurred in the placebo group and 9 in the diclofenac group (P =
0.64). These differences persisted after adjustment for grade of
pericardial effusion at baseline, treatment site, and type of surgery.
 Limitation(s): The sample was not large enough to find small
beneficial effects of diclofenac or assess the cardiovascular tolerance of
diclofenac. Conclusion(s): In patients with pericardial effusion
after cardiac surgery, diclofenac neither reduced the size of the
effusions nor prevented late cardiac tamponade. Primary Funding Source:
French Society of Cardiology. © 2010 American College of Physicians.

<20>
Accession Number
355683167
Title
Systematic review: Comparative effectiveness and harms of combination
therapy and monotherapy for dyslipidemia.
Source
Annals of Internal Medicine. 151(9) (pp 622-630), 2009. Date of
Publication: 03 Nov 2009.
Author
Sharma M.; Ansari M.T.; Abou-Setta A.M.; Soares-Weiser K.; Ooi T.C.; Sears
M.; Yazdi F.; Tsertsvadze A.; Moher D.
Institution
(Sharma) Regional Stroke Program, Ottawa Hospital, Civic Campus, C2, 1053
Carling Avenue, Ottawa, ON K1Y 4E9, Canada
(Ansari, Yazdi, Tsertsvadze) University of Ottawa Evidence-based Practice
Center, CHEO-RI, 401 Smyth Road, Ottawa, ON K1H 8LI, Canada
(Abou-Setta) University of Alberta Evidence-based Practice Center, Alberta
Research Centre for Health Evidence, Aberhart Centre One, 11402 University
Avenue, Edmonton, AB T6G 2J3, Canada
(Soares-Weiser) Enhance Reviews, PO Box 137, Kfar-Saba, 44101, Israel
(Ooi) Division of Endocrinology and Metabolism, University of Ottawa,
Ottawa Hospital, 1967 Riverside Drive, Ottawa, ON K1H 7W9, Canada
(Sears) RR 1, Box 9012, Dunrobin, ON K0A 1T0, Canada
(Moher) University of Ottawa Evidence-based Practice Center, University of
Ottawa, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H
8L6, Canada
Publisher
American College of Physicians
Abstract
Background: Statin therapy effectively prevents vascular disease, but
treatment targets are often not achieved. Purpose(s): To compare the
benefits and harms of high-dose statin monotherapy with those of
combination therapy in adults at high risk for coronary disease. Data
Sources: English-language records from MEDLINE (1966 to 2009), EMBASE
(1980 to 2009), and the Cochrane Library (third quarter of 2008). Study
Selection: A reviewer screened records, and a second reviewer verified
selection of randomized, controlled trials in adult patients that compared
combinations of statins and bile-acid sequestrants, fibrates, ezetimibe,
niacin, or omega-3 fatty acids with statin monotherapy, as well as
nonrandomized comparative studies that were longer than 24 weeks and
reported clinical and harms outcomes. Data Extraction: Data were
abstracted for studies by using standardized forms, and study quality was
rated with a standardized scale and strength of evidence by using the
Grading of Recommendations Assessment, Development, and Evaluation
approach. Data Synthesis: 102 studies met eligibility criteria. The
main analysis compared combination therapy with high-dose statin
monotherapy in high-risk patients. Very-low-strength evidence showed that
statin-ezetimibe (2 trials; n = 439) and statin-fibrate (1 trial; n = 166)
combinations did not reduce mortality more than highdose statin
monotherapy. No trials compared the effect of combination therapy versus
high-dose statin monotherapy on the incidence of myocardial infarction,
stroke, or revascularization procedures. Two statin-ezetimibe trials (n =
295) demonstrated higher low-density lipoprotein cholesterol goal
attainment with combination therapy (odds ratio, 7.21 [95% CI, 4.30 to
12.08]). Trials in lower-risk patients did not show a difference in
mortality. Limitation(s): Studies were generally short, focused on
surrogate outcomes, and were heterogeneous in the sample's risk for
coronary disease. Few studies examined treatment combinations other than
statin-ezetimibe. Conclusion(s): Limited evidence suggests that
combinations of lipidlowering agents do not improve clinical outcomes more
than highdose statin monotherapy. Very-low-quality evidence favors
statin-ezetimibe treatment for attainment of low-density lipoprotein
cholesterol goals. Primary Funding Source: Agency for Healthcare Research
and Quality. © 2009 American College of Physicians.

<21>
[Use Link to view the full text]
Accession Number
355297677
Title
Stentless versus stented bioprosthetic aortic valves: A systematic review
and meta-analysis of controlled trials.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 4(2) (pp 61-73), 2009. Date of Publication: March-April 2009.
Author
Cheng D.; Pepper J.; Martin J.; Stanbridge R.; Ferdinand F.D.; Jamieson
W.R.E.; Stelzer P.; Berg G.; Sani G.
Institution
(Cheng) Department of Anesthesia and Perioperative Medicine, London Health
Sciences Centre, The University of Western Ontario, London, ON, Canada
(Pepper) Department of Cardiothoracic Surgery, Imperial College, Royal
Brompton Hospital, London, United Kingdom
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada
(Stanbridge) Department of Cardiothoracic Surgery, St. Mary's Hospital,
London, United Kingdom
(Ferdinand) Division of Thoracic and Cardiovascular Surgery, The Lankenau
Hospital, Wynnewood, PA, United States
(Jamieson) Division of Cardiovascular Surgery, St. Paul's Hospital,
University of British Columbia, Vancouver, BC, Canada
(Stelzer) Department of Cardiothoracic Surgery, Mount Sinai Medical
Center, Mount Sinai School of Medicine, NY, United States
(Berg) Golden Jubilee National Hospital, Clydebank, United Kingdom
(Sani) Department of Surgery, Siena University School of Medicine, Siena,
Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This meta-analysis sought to determine whether stentless
bioprosthetic valves improve clinical and resource outcomes compared with
stented valves in patients undergoing aortic valve replacement.
 Method(s): A comprehensive search was undertaken to identify all
randomized and nonrandomized controlled trials comparing stent-less to
stented bioprosthetic valves in patients undergoing aortic valve
replacement available up to March 2008. The primary outcomes were clinical
and resource outcomes in randomized controlled trial (RCT). Secondary
outcomes clinical and resource outcomes in nonrandomized controlled trial
(non-RCT). Odds ratios (OR), weighted mean differences (WMD), or
standardized mean differences and their 95% confidence intervals (CI) were
analyzed as appropriate. Accepted for publication February 15, 2009.
 Result(s): Seventeen RCTs published in 23 articles involving 1317
patients, and 14 non-RCTs published in 18 articles involving 2485 patients
were included in the meta-analysis. For the primary analysis of randomized
trials, mortality for stentless versus stented valve groups did not differ
at 30 days (OR 1.36, 95% CI 0.68-2.72), 1 year (OR 1.01, 95% CI
0.55-1.85), or 2 to 10 years follow-up (OR 0.82, 95% CI 0.50-1.33).
Aggregate event rates for all-cause mortality at 30 days were 3.7% versus
2.9%, at 1 year were 5.5% versus 5.9% and at 2 to 10 years were 17% versus
19% for stentless versus stented valve groups, respectively. Stroke or
neurologic complications did not differ between stentless (3.6%) and
stented (4.0%) valve groups. Risk of prosthesis-patient mismatch was
numerically lower in the stentless group (11.0% vs. 31.3%, OR 0.30, 95% CI
0.05-1.66), but this parameter was reported in few trials and did not
reach statistical significance. Effective orifice area index was
significantly greater for stentless aortic valve compared with stented
valves at 30 days (WMD 0.12 cm2/m2), at 2 to 6 months (WMD 0.15 cm2/m2),
and at 1 year (WMD 0.26 cm2/m2). Mean gradient at 1 month was
significantly lower in the stentless valve group (WMD -6 mm Hg), at 2 to 6
month follow-up (WMD -4 mm Hg,), at 1 year follow-up (WMD -3 mm Hg) and up
to 3 year follow-up (WMD - 3 mm Hg) compared with the stented valve group.
Although the left ventricular mass index was generally lower in the
stentless group versus the stented valve group, the aggregate estimates of
mean difference did not reach significance during any time period of
follow-up (1 month, 2-6 months, 1 year, and 8 years). Conclusion(s):
Evidence from randomized trials shows that subcoro-nary stentless aortic
valves improve hemodynamic parameters of effective orifice area index,
mean gradient, and peak gradient over the short and long term. These
improvements have not led to proven impact on patient morbidity,
mortality, and resource-related outcomes; however, few trials reported on
clinical outcomes beyond 1 year and definitive conclusions are not
possible until sufficient evidence addresses longer-term effects.
Copyright © 2009 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<22>
Accession Number
2029953578
Title
Outcomes According to Coronary Revascularization Modality in the ISCHEMIA
Trial.
Source
Journal of the American College of Cardiology. 83(5) (pp 549-558), 2024.
Date of Publication: 06 Feb 2024.
Author
Redfors B.; Stone G.W.; Alexander J.H.; Bates E.R.; Bhatt D.L.;
Biondi-Zoccai G.; Caldonazo T.; Farkouh M.; Rahouma M.; Puskas J.; Sandner
S.; Gaudino M.F.L.
Institution
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Gothenburg, Sweden
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Alexander) Division of Cardiology and the Duke Clinical Research
Institute, Duke University, Durham, NC, United States
(Bates) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Michigan, Ann Arbor, MI, United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Friedrich-Schiller-University Jena, Germany
(Caldonazo, Rahouma, Sandner, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Farkouh) Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar
Centre, University of Toronto, Toronto, ON, Canada
(Puskas) Department of Cardiovascular Surgery, Icahn School of Medicine at
Mount Sinai Cardiovascular Institute, New York, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Heart at Mount
Sinai Beth Israel, New York, NY, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
Publisher
Elsevier Inc.
Abstract
Background: In the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial, the risk of
ischemic events was similar in patients with stable coronary artery
disease treated with an invasive (INV) strategy of angiography and
percutaneous coronary intervention (PCI) or surgical (coronary artery
bypass grafting [CABG]) coronary revascularization and a conservative
(CON) strategy of initial medical therapy. Objective(s): The authors
analyzed separately the outcomes of INV patients treated with PCI or CABG.
 Method(s): Patients without preceding primary outcome events were
categorized as INV-PCI or INV-CABG from the time of revascularization. The
ISCHEMIA primary outcome (composite of cardiovascular death,
protocol-defined myocardial infarction or hospitalization for unstable
angina, heart failure, or resuscitated cardiac arrest) was used.
 Result(s): Among INV-CABG patients, primary outcome events occurred
in 84 of 512 (16.4%) at a median follow-up of 2.85 years; 48 events
(57.1%) occurred within 30 days after CABG, including 40 procedural MIs.
Among INV-PCI patients, primary outcome events occurred in 147 of 1,500
(9.8%) at median follow-up of 2.94 years; 31 of which (21.1%) occurred
within 30 days after PCI, including 24 procedural MIs. In comparison, 352
of 2,591 CON patients (13.6%) had primary outcome events at a median
follow-up of 3.2 years, 22 of which (6.3%) occurred within 30 days of
randomization. The adjusted primary outcome risks were higher after both
CABG and PCI within 30 days (HR: 16.25 [95% CI: 11.44-23.07] and HR: 2.99
[95% CI: 1.97-4.53]) and lower thereafter (0.63 [95% CI: 0.44-0.89] and
0.66 [95% CI: 0.53-0.82]). Conclusion(s): In ISCHEMIA, early
revascularization by PCI and CABG was associated with higher early risks
and lower long-term risks of cardiovascular events compared with CON. The
early risk was greatest after CABG, owing to protocol-defined procedural
MIs. Copyright © 2024 American College of Cardiology Foundation

<23>
Accession Number
2029654508
Title
Aortic valve leaflets are asymmetric and correlated with the origin of
coronary arteries.
Source
Translational Pediatrics. 12(12) (pp 2164-2178), 2023. Date of
Publication: December 2023.
Author
Koerner T.S.; Cunningham T.; Marshall M.E.; Talley L.S.; Childress M.;
Kharouf R.M.; Li W.; Salazar J.D.; Corno A.F.
Institution
(Koerner, Cunningham, Marshall, Talley, Childress, Kharouf, Salazar)
Children's Heart Institute, Memorial Hermann Children's Hospital, UTHealth
Science Center in Houston, McGovern Medical School, Houston, TX, United
States
(Li) Division of Clinical and Translational Sciences, Department of
Internal Medicine, Biostatistics/Epidemiology/Research Design Component,
Center for Clinical and Translational Sciences, UTHealth Science Center in
Houston, McGovern Medical School, Houston, TX, United States
(Corno) School of Engineering, University of Leicester, England,
Leicester, United Kingdom
Publisher
AME Publishing Company
Abstract
Background: Asymmetry of the aortic valve leaflets has been known since
Leonardo Da Vinci, but the relationship between size and shape and origin
of the coronary arteries has never been examined. Our aim was to evaluate
this anatomy in a population of pediatric patients using a cross-sectional
study design. Method(s): Consecutive pediatric patients with
trans-esophageal echocardiography (TEE), with or without trans-thoracic
echocardiography (TTE), were included in our study. Exclusion criteria:
(I) bicuspid aortic valve; (II) aortic valve stenosis; (III) hypoplasia of
aortic valve annulus, or aortic root; (IV) truncal valve; (V) coronary
artery atresia; (VI) previous surgery on aortic valve and/or coronary
arteries. In pre-operative TTE and intra-operative TEE inter-commissural
distance and length of aortic valve leaflets were measured in short axis
view in the isovolumic phase of systole. Echocardiography investigations,
anonymized and randomly coded, were independently reviewed by at least two
readers. Echocardiography, angiography, cardiac computed tomography (CT)
scan and magnetic resonance imaging (MRI), and operative notes were
reviewed to identify origin of coronary arteries. Result(s): Two
hundred sixty-one pediatric patients were identified, 93 excluded per our
criteria, leaving 168 patients, age 2.6+/-4.3 years, weight 12.87+/-17.34
kg, 128 (76%) with normal and 40 (24%) with abnormal coronary arteries. In
TTE and TEE measurements the non-coronary leaflet had larger area
(P<0.001), while the right and left had equal areas, but different shape,
with the left leaflet longer (P<0.001) and narrower (P=0.005) than the
right. With the major source of blood flow from the right coronary sinus,
the non-coronary leaflet was still the longest. However, there was no
statically significant difference between the size and shape previously
observed between the right and left leaflets. Conclusion(s): Our
study showed asymmetry of size and shape among aortic valve leaflets, and
a relationship with coronary artery origin. The complex aortic root
anatomy must be approximated to optimize function of any surgical repair.
These findings also may prove useful in the pre-operative definition of
coronary artery anatomy and in the recognition of coronary artery
anomalies. Copyright © 2023 AME Publishing Company. All rights
reserved.

<24>
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.

<25>
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

<26>
Accession Number
2027009840
Title
A Meta-Analysis of Short-Term Outcomes of TAVR versus SAVR in Bicuspid
Aortic Valve Stenosis and TAVR Results in Different Bicuspid Valve
Anatomies.
Source
Journal of Clinical Medicine. 12(23) (no pagination), 2023. Article
Number: 7371. Date of Publication: December 2023.
Author
Improta R.; Di Pietro G.; Kola N.; Birtolo L.I.; Colantonio R.; Bruno E.;
Tocci M.; Giansante A.; Sannino M.; Zullino V.; Monosilio S.; Cimino S.;
Maestrini V.; Severino P.; Badagliacca R.; Lavalle C.; Celli P.; Saade W.;
Musto C.; D'Ascenzo F.; Miraldi F.; Vizza C.D.; Sardella G.; Mancone M.
Institution
(Improta, Di Pietro, Kola, Birtolo, Colantonio, Bruno, Tocci, Giansante,
Sannino, Monosilio, Cimino, Maestrini, Severino, Badagliacca, Lavalle,
Saade, Miraldi, Vizza, Sardella, Mancone) Department of Clinical,
Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital,
Sapienza University of Rome, Roma 00161, Italy
(Zullino, Celli) Anesthesia and Resuscitation in Specialistic Surgeries
and Transplants, Umberto I Hospital, Roma 00161, Italy
(Musto) San Camillo-Forlanini Hospital, Rome 00152, Italy
(D'Ascenzo) Department of Medical Science, Division of Cardiology,
Molinette Hospital, Turin University, Torino 10126, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: To provide a comprehensive analysis of the current literature
comparing the outcomes of surgical aortic valve replacement (SAVR) and
transcatheter aortic valve replacement (TAVR) in patients with bicuspid
aortic stenosis (BAS), with particular attention to BAV morphology in
patients undergoing TAVR. Method(s): Following PRISMA guidelines, all
relevant articles with no design restrictions from PubMed, CCTR (Cochrane
Controlled Trials Register), and Google Scholar were screened for
inclusion. Studies were included if they reported clinical endpoints for
SAVR and TAVR or, in BAS treated with TAVR, for type 1 and non-type 1
morphology. Odds ratio and Cohen's D were considered as effect size
measurements for qualitative and quantitative variables, respectively.
 Result(s): A total of eight studies comparing short-term outcomes
between SAVR and TAVR and nine studies with outcomes data between type 1
and non-type 1 BAS treated with TAVR were considered for the final
analysis. No statistically significant difference was found for what
concerns the rates of death, stroke, and acute kidney injury between SAVR
and TAVR. In comparison to patients undergoing SAVR, the incidence of PPI
(permanent pacemaker implantation) was greater in the TAVR group (OR 0.35,
95% CI 0.15-0.79, p = 0.01), and the frequency of bleeding events was
found to be higher among patients undergoing SAVR (OR 4.3, 95% CI 2.9-6.4,
p < 0.001). The probabilities of 30-day mortality, stroke, and any
bleeding were not significantly affected by bicuspid valve morphology in
TAVR patients. PPI or development of new conduction anomalies was found to
be more frequent in type 1 anatomies (OR 0.46, 95% CI 0.30-0.70, p
<0.001). Mildly lower post-procedural transprothesic gradients were found
in patients with type 1 morphology. Conclusion(s): In BAS patients,
TAVR has comparable short-term outcomes rates with SAVR, but higher PPI
rates and lower incidence of bleeding events. In patients undergoing TAVR,
type 1 BAS is associated with lower postoperative transvalvular gradients
but higher PPI rates and conduction abnormalities. Copyright ©
2023 by the authors.

<27>
Accession Number
2026919950
Title
Noninvasive respiratory support preventing reintubation after pediatric
cardiac surgery-A systematic review.
Source
Paediatric Anaesthesia. 34(3) (pp 204-211), 2024. Date of Publication:
March 2024.
Author
Kuitunen I.; Uimonen M.
Institution
(Kuitunen) University of Eastern Finland, Institute of Clinical Medicine
and Department of Pediatrics, Kuopio, Finland
(Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio,
Finland
(Uimonen) Department of Cardiothoracic Surgery, Tampere Heart Hospital,
Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Objective: To analyze the optimal postextubation respiratory support in
pediatric cardiac surgery patients. Design(s): Systematic review of
randomized controlled trials. Setting(s): Pediatric or neonatal
intensive care units. Participant(s): All aged children (<16 years)
having cardiac surgery and postoperative invasive ventilation.
 Intervention(s): Noninvasive respiratory support, including high flow
nasal cannula (HFNC), conventional oxygen therapy (COT), noninvasive
positive pressure ventilation (NIPPV), continuous positive pressure
(CPAP), and noninvasive high-frequency oscillatory ventilation (NHFOV).
Measurement and Main Results: Studies were not pooled for statistical
synthesis due to the limited number and quality of the included studies.
Risk ratios with 95% confidence intervals were calculated for individual
studies. A total of 167 studies were screened and six were included. The
risk of bias was low in one, high in one, and had some concerns in four of
the studies. Extubation failure (defined as reintubation) was the main
outcome of interest. Risk ratio for reintubation was 0.10 (CI 0.02-0.40)
and 1.07 (CI 0.16-7.26) in HFNC versus COT, 0.49 (CI 0.05-5.28) in HFNC
versus NIPPV, 0.40 (CI 0.08-1.94) in HFNOV versus CPAP, 0.75 (CI
0.26-2.18) in HFNOV versus NIPPV, and 1.37 (CI 0.33-5.73) in CPAP versus
NIPPV. Treatment durations did not differ between the groups.
 Conclusion(s): We did not find clear evidence of a difference in
reintubation rates and other clinical outcomes between different
noninvasive ventilation strategies. Evidence certainty was assessed to be
very low due to the risk of bias, the small number of included studies,
and high imprecision. Future quality studies are needed to determine the
optimal postextubation support in pediatric cardiac surgery
patients. Copyright © 2023 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<28>
Accession Number
2030253544
Title
Transcarotid versus transthoracic transcatheter aortic valve replacement:
A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Munguti C.; Ndunda P.; Vindhyal M.R.; Abukar A.; Abdel-Jawad M.; Fanari Z.
Institution
(Munguti, Ndunda, Vindhyal, Abdel-Jawad) Internal Medicine, University of
Kansas School of Medicine - Wichita, KS, United States
(Abdel-Jawad) Internal Medicine, Ascension Via Christi St Francis
Hospital, Wichita, KS, United States
(Abukar) Internal Medicine, University of California San Francisco, San
Francisco, CA, United States
(Fanari) Internal Medicine/Cardiology, University of California San
Francisco, Fresno, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transthoracic approaches may be contraindicated in some
patients and may be associated with poorer outcomes. Therefore other
alternative access routes are increasingly being performed. We conducted a
systematic review of the literature on Transcarotid transcatheter aortic
valve replacement (TC-TAVR) and meta-analysis comparing outcomes of
TC-TAVR and other access routes. Method(s): We comprehensively
searched for controlled randomized and non-randomized studies from 4
online databases. We presented data using risk ratios (95 % confidence
intervals) and measured heterogeneity using Higgins' I2.
 Result(s): Sixteen observational studies on Transcarotid TAVR were
included in the analysis; 4 studies compared 180 TC-TAVR patients vs 524
TT-TAVR patients. The mean age and STS score for patients undergoing
TC-TAVR were 80 years and 7.6 respectively. For TT-TAVR patients, the mean
age and STS score were 79.7 years and 8.7 respectively. TC-TAVR patients
had lower 30-day MACE [7.8 % vs 13.7 %; OR 0.54 (95 % CI 0.29-0.99, P =
0.05)] and major or life-threatening bleeding [4.0 % vs 14.2 %; OR 0.25
(95 % CI 0.09-0.67, P = 0.006)]. There was no significant difference in
30-day: mortality [5.0 % vs 8.6 %; OR 0.61 (95 % CI 0.29-1.30, P = 0.20)],
stroke or transient ischemic attack [2.8 % vs 4.0 %; OR 0.65 (95 % CI
0.25-1.73, P = 0.39)] and moderate or severe aortic valve regurgitation
[5.0 % vs 4.6 %; OR 1.14. (95 % CI 0.52-2.52, P = 0.75)]. There was a
trend towards fewer major vascular complications in TC-TAVR [3.0 % vs 7.8
%; OR 0.42 (95 % CI 0.16-1.12, P = 0.08)]. Conclusion(s): Compared
with transthoracic TAVR, TC-TAVR patients had lower odds of 30-day MACE
and life-threatening bleeding and no differences in 30-day mortality,
stroke or TIA, aortic valve regurgitation. Copyright © 2024

<29>
Accession Number
2029462697
Title
Preoperative B-Type Natriuretic Peptides to Predict Postoperative Atrial
Fibrillation in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 33(1) (pp 23-32), 2024. Date of Publication:
January 2024.
Author
Thet M.S.; Hlwar K.E.; Thet K.S.; Han K.P.P.; Oo A.Y.
Institution
(Thet) Department of Surgery and Cancer, Imperial College London, United
Kingdom
(Hlwar, Thet, Han) Department of Medicine, Mandalay General Hospital,
University of Medicine, Mandalay, Myanmar
(Oo) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Post-operative atrial fibrillation (AF) is the most common
complication following cardiac surgery. There has been extensive
exploration of clinical variables, imaging, and biomarkers to predict its
occurrence after cardiac surgery. In this study, we examine the emerging
biomarkers B-type natriuretic peptide (BNP) and N-terminal proBNP
(NT-proBNP) to assess their pre-operative values and correlations with the
occurrence of post-operative AF in patients undergoing cardiac surgery.
 Method(s): A comprehensive literature search was conducted using
PubMed, EMBASE, MEDLINE via Ovid, ClinicalTrials.Gov, Scopus, and Cochrane
Central Register of Controlled Trials (CENTRAL) to identify studies
published until March 2023. The studies were included if they reported
pre-operative BNP or NT-proBNP values and the development of
post-operative AF in cardiac surgery patients. Subsequently, data were
extracted, and a meta-analysis was performed using Review Manager 5.4 4
(The Cochrane Collaboration, 2020) and SPSS version 28 (IBM Corp, Armonk,
NY, USA) to assess the difference between pre-operative BNP and NT-proBNP
levels between patients with post-operative AF (AF group) and those
without (No-AF group) using a random-effect model. Further analysis was
performed in three subgroups: isolated coronary artery bypass grafting,
isolated valve, and combined/mixed surgery group. Result(s): A total
of 20 studies, including 9,079 participants were identified and included
in the systematic review and meta-analysis. Pre-operative BNP levels were
reported in 11 studies, and NT-proBNP levels were reported in 10 studies,
of which one study reported both BNP and NT-proBNP levels. There is an
overall significant difference between pre-operative levels of BNP
(p=0.03, I2=95%) and NT-proBNP (p<0.001, I2=65%)
when compared between AF and No-AF groups. Nonetheless, subgroup analysis
showed there is no significant difference in pre-operative BNP levels,
except in isolated valve surgery (p<0.001), whereas all subgroups showed
significantly different pre-operative levels of NT-proBNP.
 Conclusion(s): Elevated levels of both BNP and NT-proBNP were
observed in patients who developed post-operative AF after undergoing
cardiac surgery. In particular, pre-operative NT-proBNP levels were
elevated in all patients irrespective of the type of surgical procedure,
but elevated pre-operative BNP was only seen in valve surgery patients.
These findings suggest the potential usefulness of NT-proBNP as a
promising biomarker for predicting the occurrence of post-operative AF
following cardiac surgery. Copyright © 2023 The Author(s)

<30>
Accession Number
2025197275
Title
Cardiovascular events risk in patients with systemic autoimmune diseases:
a prognostic systematic review and meta-analysis.
Source
Clinical Research in Cardiology. 113(2) (pp 246-259), 2024. Date of
Publication: February 2024.
Author
Asenjo-Lobos C.; Gonzalez L.; Bulnes J.F.; Roque M.; Munoz Venturelli P.;
Rodriguez G.M.
Institution
(Asenjo-Lobos, Munoz Venturelli) Centro de Estudios Clinicos, Instituto de
Ciencias e Innovacion en Medicina (ICIM), Facultad de Medicina Clinica
Alemana Universidad de Desarrollo, Santiago, Chile
(Gonzalez) Centro de Imagenes Biomedicas, Departamento de Radiologia,
Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago,
Chile
(Gonzalez) Instituto Milenio de Ingenieria e Inteligencia Artificial para
la Salud, iHEALTH, Pontificia Universidad Catolica de Chile, Santiago,
Chile
(Bulnes, Rodriguez) Division de Enfermedades Cardiovasculares, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Roque) Iberoamerican Cochrane Centre, Sant Pau Biomedical Research
Institute (IIB-Sant Pau), Barcelona, Spain
(Munoz Venturelli) Faculty of Medicine, The George Institute for Global
Health, University of New South Wales, Sydney, NSW, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Chronic inflammation is considered a risk factor for the
development of atherosclerosis and cardiovascular (CV) events. We seek to
assess the risk of CV events in patients with Systemic autoimmune diseases
(SAD), such as Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis
(RA), Psoriasis (Ps) and Ankylosing Spondylitis (AS), compared with the
general population. Methods and Results: A systematic search of
MEDLINE from inception up to May 2021 was performed. Observational studies
including individuals with and without autoimmune diseases (SLE, RA, Ps,
AS), which reported a measure of association and variability for the
effect of SAD on CV events, were included. The random effects
meta-analysis was performed using the Hartung-Knapp-Sidik-Jonkman approach
to obtain the pooled estimates. Cardiovascular Events including CV
mortality, non-fatal myocardial infarction (MI), non-fatal stroke and
coronary revascularization were the main outcomes evaluated. Fifty-four
studies were selected, with a total of 24,107,072 participants. The
presence of SAD was associated with an increased risk of CV mortality (HR
1.49 [95% CI 1.10-2.03]), non-fatal MI (HR 1.42 [95% CI 1.23-1.62]), and
non-fatal stroke (HR 1.47 [95% CI 1.28-1.70]). RA, SLE, and Ps
(particularly with arthritis) were significantly associated with a higher
risk of MI and stroke. SAD was also associated with an increased risk of
Major Adverse Cardiovascular Events (MACE) (HR 1.45 [95% CI 1.16-1.83]).
 Conclusion(s): Patients with SAD present an increased risk of CV
morbidity and mortality, which should be considered when establishing
therapeutic strategies. These findings support the role of systemic
inflammation in the development of atherosclerosis-driven disease.
Graphical abstract: (Figure presented.) Copyright © The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023.

<31>
Accession Number
643436704
Title
The impact of goal-directed fluid therapy on postoperative pulmonary
complications in patients undergoing thoracic surgery: a systematic review
and meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 60), 2024. Date of
Publication: 05 Feb 2024.
Author
Han S.; Wu X.; Li P.; He K.; Li J.
Institution
(Han, Wu, Li, Li) Department of Anesthesiology, Hebei General Hospital,
Heping West Road, Shijiazhuang 050051, China
(He) Department of Anesthesiology, Fourth Hospital of Shijiazhuang, No.16
,Tangu North Street, Shijiazhuang 050051, China
Abstract
BACKGROUND: Pulmonary complications after thoracic surgery are common and
associated with significant morbidity and high cost of care. Goal-directed
fluid therapy (GDFT) could reduce the incidence of postoperative pulmonary
complications (PPCs) and facilitate recovery in patients undergoing major
abdominal surgery. However, whether GDFT could reduce the incidence of
PPCs in patients undergoing thoracic surgery was unclear. The present
meta-analysis was designed to assess the impact of Goal-directed Fluid
Therapy on PPCs in patients undergoing thoracic surgery. METHOD(S):
Randomized controlled trials (RCTs) comparing GDFT with other conventional
fluid management strategies in adult patients undergoing thoracic surgery
were identified. Databases searched included PubMed, Web of Science,
Embase, and Cochrane Library databases. Review Manager 5.4 (The Cochrane
Collaboration, Oxford, UK) software was used for statistical analysis.
Heterogeneity was analyzed using I2 statistics, and a standardized mean
difference with 95% CI and P value was used to calculate the treatment
effect for outcome variables. The primary study outcomes were the
incidence of PPCs. Secondary outcomes were the total volume infused, the
length of hospitalization, the incidence of cardiac complications, and the
incidence of renal dysfunction. Subgroup analysis was planned to verify
the definite role of GDFT. RESULT(S): A total of 6 RCTs consisting of
680 patients were included in this meta-analysis, which revealed that GDFT
did not reduce the incidence of PPCs in patients undergoing thoracic
surgery (RR, 0.57; 95% CI 0.29-1.14). However, GDFT decreased the total
intra-operative fluid input (MD,-244.40 ml; 95% CI-397.06 to -91.74).
There was no statistical difference in the duration of hospitalization
(MD; -1.31, 95% CI -3.00 to 0.38), incidence of renal dysfunction (RR,
0.62; 95% CI 0.29-1.35), and incidence of cardiac complications (RR, 0.62;
95% CI 0.27-1.40). CONCLUSION(S): The results of this meta-analysis
indicate that GDFT did not reduce the postoperative incidence of pulmonary
complications in individuals undergoing thoracic surgery. However,
considering the small number of contributing studies, these results should
be interpreted with caution. Copyright © 2024. The Author(s).

<32>
Accession Number
643436311
Title
Effects of virtual reality on chest tube removal pain management in
patients undergoing coronary artery bypass grafting: a randomized clinical
trial.
Source
Scientific reports. 14(1) (pp 2918), 2024. Date of Publication: 05 Feb
2024.
Author
Dalir Z.; Seddighi F.; Esmaily H.; Abbasi Tashnizi M.; Ramezanzade Tabriz
E.
Institution
(Dalir, Seddighi) Department of Medical Surgical Nursing, School of
Nursing and Midwifery, Mashhad University of Medical Sciences, Shahid Dr.
Kharazmi Educational Complex, Azadi SquarePO Box 9177949025, Mashhad,
Iran, Islamic Republic of
(Esmaily) Department of Biostatistics, School of Health, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Abbasi Tashnizi) Department of Cardiac Surgery, Imam Reza Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Ramezanzade Tabriz) Department of Medical Surgical Nursing, School of
Nursing and Midwifery, Mashhad University of Medical Sciences, Shahid Dr.
Kharazmi Educational Complex, Azadi SquarePO Box 9177949025, Mashhad,
Iran, Islamic Republic of
Abstract
The pain associated with chest tube removal (CTR) is one of the
significant complications of cardiac surgery. The management of this pain
is recognized as a vital component of nursing care. The application of
distraction techniques using virtual reality (VR) is an effective and
straightforward non-pharmacological approach to alleviate pain. This study
aimed to determine the impact of VR technology on the management of pain
caused by CTR following coronary artery bypass grafting (CABG). This
randomized clinical trial was conducted on 70 patients undergoing CABG at
Imam Reza and Qaem hospitals in Mashhad, Iran, in 2020. The patients were
randomly divided into two groups of 35. For the intervention group, a
360-degree video was played using VR glasses 5 min before the CTR
procedure. The pain intensity was measured before, immediately after, and
15 min after CTR, using the Visual Analogue Scale. Also, the Depression
Anxiety and Stress Scale-21 (DASS-21), and the Rhoten Fatigue Scale (RFS)
were used to evaluate intervention and control groups before the CTR
procedure. The collected data was analyzed using statistical tests, such
as Chi-square, independent t-test, and Mann-Whitney test. The patients
were homogeneous in terms of stress, anxiety, and fatigue levels before
CTR, and they did not show any significant differences (P>0.05). The
average pain intensity score of patients in the intervention group
significantly decreased immediately and 15 min after CTR, compared to the
control group (P<0.001). Given the positive impact of VR distraction on
the severity of pain associated with CTR in patients undergoing CABG, this
technique can serve as an effective, accessible, and cost-efficient
non-pharmacological approach for managing pain in these patients.Trial
registration: This study was registered in the Iranian Registry of
Clinical Trials (code: IRCT20190708044147N1; approval date,
08/26/2019). Copyright © 2024. The Author(s).

<33>
Accession Number
643434113
Title
Efficacy of Respiratory Muscle Training in the Immediate Postoperative
Period of Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 39(1) (pp e20220165), 2024.
Date of Publication: 05 Feb 2024.
Author
Aquino T.N.; Prado J.P.; Crisafulli E.; Clini E.M.; Galdino G.
Institution
(Aquino, Prado, Galdino) Instituto de Ciencias da Motricidade,
Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
(Aquino) Department of Rehabilitation and Cardiology, Hospital Santa
Lucia, Pocos de Caldas, Minas Gerais, Brazil
(Crisafulli) Department of Medicine and Surgery, Respiratory Disease and
Lung Function Unit, University of Parma, Parma, Italy
(Clini) Department of Medical and Surgical Sciences, University of Modena
and Reggio Emilia and University Hospital of Modena Policlinico, Modena,
Italy
Abstract
INTRODUCTION: This study aimed to evaluate the efficacy of respiratory
muscle training during the immediate postoperative period of cardiac
surgery on respiratory muscle strength, pulmonary function, functional
capacity, and length of hospital stay. METHOD(S): This is a
systematic review and meta-analysis. A comprehensive search on PubMed,
Excerpta Medica Database (or Embase), Cumulative Index of Nursing and
Allied Health Literature (or CINAHL), Latin American and Caribbean Health
Sciences Literature (or LILACS), Scientific Electronic Library Online (or
SciELO), Physiotherapy Evidence Database (or PEDro), and Cochrane Central
Register of Controlled Trials databases was performed. A combination of
free-text words and indexed terms referring to cardiac surgery, coronary
artery bypass grafting, respiratory muscle training, and clinical trials
was used. A total of 792 studies were identified; after careful selection,
six studies were evaluated. RESULT(S): The studies found significant
improvement after inspiratory muscle training (IMT) (n = 165, 95%
confidence interval [CI] 9.68, 21.99) and expiratory muscle training (EMT)
(n = 135, 95% CI 8.59, 27.07) of maximal inspiratory pressure and maximal
expiratory pressure, respectively. Also, IMT increased significantly (95%
CI 19.59, 349.82, n = 85) the tidal volume. However, no differences were
found in the peak expiratory flow, functional capacity, and length of
hospital stay after EMT and IMT. CONCLUSION(S): IMT and EMT
demonstrated efficacy in improving respiratory muscle strength during the
immediate postoperative period of cardiac surgery. There was no evidence
indicating the efficacy of IMT for pulmonary function and length of
hospital stay and the efficacy of EMT for functional capacity.

<34>
Accession Number
643286356
Title
Role of Cerebral Embolic Protection Devices in Patients Undergoing
Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Journal of the American Heart Association. 13(3) (pp e030587), 2024. Date
of Publication: 06 Feb 2024.
Author
Kaur A.; Dhaliwal A.S.; Sohal S.; Gwon Y.; Gupta S.; Bhatia K.; Dominguez
A.C.; Basman C.; Tamis-Holland J.
Institution
(Kaur, Gupta) Department of Medicine Icahn School of Medicine at Mount
Sinai Morningside/West- New York New York NY
(Dhaliwal) Population Health Science and Policy Icahn School of Medicine
at Mount Sinai- New York New York NY
(Sohal) Division of Cardiovascular Medicine Newark Beth Israel Medical
Center- Newark Newark NJ, Israel
(Gwon) Department of Biostatistics University of Nebraska Medical Center
Omaha NE
(Bhatia, Dominguez) Division of Cardiology Icahn School of Medicine at
Mount Sinai Morningside- New York New York NY
(Basman) Division of Cardiology Lenox Hill Hospital- New York New York NY
(Tamis-Holland) Department of Cardiovascular Medicine Cleveland Clinic
Main Campus Cleveland OH
Abstract
BACKGROUND: Cerebral embolic protection devices (CEPD) capture embolic
material in an attempt to reduce ischemic brain injury during
transcatheter aortic valve replacement. Prior reports have indicated mixed
results regarding the benefits of these devices. With new data emerging,
we performed an updated meta-analysis examining the effect of CEPD during
transcatheter aortic valve replacement on various clinical, neurological,
and safety parameters. METHODS AND RESULTS: A comprehensive review of
electronic databases was performed comparing CEPD and no-CEPD in
transcatheter aortic valve replacement. Primary clinical outcome was
all-cause stroke. Secondary clinical outcomes were disabling stroke and
all-cause mortality. Neurological outcomes included worsening of the
National Institutes of Health Stroke Scale score, Montreal Cognitive
Assessment score from baseline at discharge, presence of new ischemic
lesions, and total lesion volume on neuroimaging. Safety outcomes included
major or minor vascular complications and stage 2 or 3 acute kidney
injury. Seven randomized controlled trials with 4016 patients met the
inclusion criteria. There was no statistically significant difference in
the primary clinical outcome of all-cause stroke; secondary clinical
outcomes of disabling stroke, all-cause mortality, neurological outcomes
of National Institutes of Health Stroke Scale score worsening, Montreal
Cognitive Assessment worsening, presence of new ischemic lesions, or total
lesion volume on diffusion-weighted magnetic resonance imaging between
CEPD versus control groups. There was no statistically significant
difference in major or minor vascular complications or stage 2 or 3 acute
kidney injury between the groups. CONCLUSION(S): The use of CEPD in
transcatheter aortic valve replacement was not associated with a
statistically significant reduction in the risk of clinical, neurological,
and safety outcomes.

<35>
Accession Number
642665183
Title
Metabolic syndrome and surgical complications: a systematic review and
meta-analysis of 13 million individuals.
Source
International journal of surgery (London, England). 110(1) (pp 541-553),
2024. Date of Publication: 01 Jan 2024.
Author
Norris P.; Gow J.; Arthur T.; Conway A.; Fleming F.J.; Ralph N.
Institution
(Norris) School of Nursing and Midwifery, University of Southern
Queensland, Australia
(Gow) School of Commerce, University of Southern Queensland, Toowoomba,
Australia
(Gow) Senior Research Associate, School of Accounting, Economics and
Finance, University of KwaZulu- Natal, Durban, South Africa
(Arthur) Department of Surgery and Adjunct Professor, Toowoomba Hospital,
Centre for Health Research, University of Southern Queensland, Toowoomba,
Australia
(Conway) Peter Munk Cardiac Centre, Lawrence S. Bloomberg Faculty of
Nursing, University of Toronto, University Health Network, Toronto, Canada
(Fleming) University of Rochester Medical Center, United States
(Ralph) University of Sunshine Coast, Moreton Bay, Australia
Abstract
BACKGROUND: Metabolic syndrome (MetS) is characterised by the presence of
at least three of the five following components: insulin resistance,
obesity, chronic hypertension, elevated serum triglycerides, and decreased
high-density lipoprotein cholesterol concentrations. It is estimated to
affect 1 in 3 people around the globe and is reported to affect 46% of
surgical patients. For people with MetS who undergo surgery, an emerging
body of literature points to significantly poorer postoperative outcomes
compared with nonaffected populations. The aim of this study is to review
the current evidence on the risks of surgical complications in patients
with MetS compared to those without MetS. METHOD(S): Systematic
review and meta-analysis using PRISMA and AMSTAR reporting guidelines.
 RESULT(S): The meta-analysis included 63 studies involving 1 919 347
patients with MetS and 11 248 114 patients without MetS. Compared to
individuals without the condition, individuals with MetS were at an
increased risk of mortality (OR 1.75 95% CI: 1.36-2.24; P <0.01); all
surgical site infection types as well as dehiscence (OR 1.64 95% CI:
1.52-1.77; P <0.01); cardiovascular complications (OR 1.56 95% CI:
1.41-1.73; P <0.01) including myocardial infarction, stroke, cardiac
arrest, cardiac arrythmias and deep vein thrombosis; increased length of
hospital stay (MD 0.65 95% CI: 0.39-0.9; P <0.01); and hospital
readmission (OR 1.55 95% CI: 1.41-1.71; P <0.01). CONCLUSION(S): MetS
is associated with a significantly increased risk of surgical
complications including mortality, surgical site infection, cardiovascular
complications, increased length of stay, and hospital readmission. Despite
these risks and the high prevalence of MetS in surgical populations there
is a lack of evidence on interventions for reducing surgical complications
in patients with MetS. The authors suggest prioritising interventions
across the surgical continuum that include (1) preoperative screening for
MetS; (2) surgical prehabilitation; (3) intraoperative monitoring and
management; and (4) postoperative rehabilitation and
follow-up. Copyright © 2023 The Author(s). Published by Wolters
Kluwer Health, Inc.

<36>
[Use Link to view the full text]
Accession Number
2028718420
Title
Association between Intraoperative Landiolol Use and In-Hospital Mortality
after Coronary Artery Bypass Grafting: A Nationwide Observational Study in
Japan.
Source
Anesthesia and Analgesia. 137(6) (pp 1208-1215), 2023. Date of
Publication: 01 Dec 2023.
Author
Iwasaki Y.; Ohbe H.; Nakajima M.; Sasabuchi Y.; Ikumi S.; Kaiho Y.;
Yamauchi M.; Fushimi K.; Yasunaga H.
Institution
(Iwasaki, Ikumi, Kaiho, Yamauchi) Department of Anesthesiology and
Perioperative Medicine, Tohoku University Graduate School of Medicine,
Miyagi, Japan
(Ohbe, Nakajima, Yasunaga) Department of Clinical Epidemiology and Health
Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
(Nakajima) Emergency Life-Saving Technique Academy of Tokyo, Foundation
for Ambulance Service Development, Tokyo, Japan
(Nakajima) Emergency and Critical Care Center, Tokyo Metropolitan Hiroo
Hospital, Tokyo, Japan
(Sasabuchi) Data Science Center, Jichi Medical University, Tochigi, Japan
(Fushimi) Department of Health Policy and Informatics, Tokyo Medical and
Dental University Graduate School of Medicine, Tokyo, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Ischemic heart disease is a leading cause of death worldwide,
and coronary artery bypass grafting (CABG) is a major treatment. Landiolol
is an ultra-short-acting beta-antagonist known to prevent postoperative
atrial fibrillation. However, the effectiveness of intraoperative
landiolol on mortality remains unknown. This study aimed to evaluate the
association between intraoperative landiolol use and the in-hospital
mortality in patients undergoing CABG. METHOD(S): To conduct this
retrospective cohort study, we used data from the Japanese Diagnosis
Procedure Combination inpatient database. All patients who underwent CABG
during hospitalization between July 1, 2010, and March 31, 2020, were
included. Patients who received intraoperative landiolol were defined as
the landiolol group, whereas the other patients were defined as the
control group. The primary outcome was in-hospital mortality. Propensity
score matching was used to compare the landiolol and control groups.
 RESULT(S): In total, 118,506 patients were eligible for this study,
including 25,219 (21%) in the landiolol group and 93,287 (79%) in the
control group. One-to-one propensity score matching created 24,893 pairs.
After propensity score matching, the in-hospital mortality was
significantly lower in the landiolol group than that in the control group
(3.7% vs 4.3%; odds ratio 0.85; 95% confidence interval 0.78 to 0.94; P
=.010). CONCLUSION(S): Intraoperative landiolol use was associated
with decreased in-hospital mortality in patients undergoing CABG. Further
randomized controlled trials are required to confirm these
findings. Copyright © 2023 Lippincott Williams and Wilkins. All
rights reserved.

<37>
Accession Number
2030126978
Title
Cardiac rehabilitation and acute aortic dissection: understanding and
addressing the evidence GAP a systematic review.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102348. Date of Publication: March 2024.
Author
Carbone A.; Lamberti N.; Manfredini R.; Trimarchi S.; Palladino R.; Savrie
C.; Marra A.M.; Ranieri B.; Crisci G.; Izzo R.; Esposito G.; Cittadini A.;
Manfredini F.; Rubenfire M.; Bossone E.
Institution
(Carbone) Unit of Cardiology, University of Campania Luigi Vanvitelli,
Naples, Italy
(Carbone, Palladino, Bossone) Department of Public Health, University of
Naples Federico II, Naples, Italy
(Lamberti, Savrie, Manfredini) Department of Neuroscience and
Rehabilitation, University of Ferrara, Ferrara, Italy
(Manfredini) Department of Medical Sciences, University of Ferrara,
Ferrara, Italy
(Trimarchi) Section of Vascular Surgery, Cardio Thoracic Vascular
Department, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico,
Milan, Italy
(Trimarchi) Department of Clinical Sciences and Community Health,
Universita degli Studi di Milano, Milan, Italy
(Ranieri) IRCCS SYNLAB SDN, Naples, Italy
(Marra, Crisci, Cittadini) Department of Translational Medical Sciences,
University of Naples Federico II, Naples, Italy
(Izzo, Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, University of Naples, Federico II, Naples, Italy
(Rubenfire) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Michigan Medical School, Ann Arbor, MI, United
States
Publisher
Elsevier Inc.
Abstract
Despite guideline recommendations, strategies for implementing cardiac
rehabilitation (CR) in patients with acute aortic dissection (AAD) are not
well established with little evidence to risk stratify prudent and
effective guidelines for the many required variables. We conducted a
systematic review of studies (2004-2023) reporting CR following type A
(TA) and type B (TB) AAD. Our review is limited to open surgical repair
for TA and medical treatment for TB. A total of 5 studies were included (4
TA-AAD and 1 TB-AAD) in the qualitative analysis. In general,
observational data included 311 patients who had an overall favorable
effect of CR in AAD consisting of a modestly improved exercise capacity
and work load during cycle cardiopulmonary exercise test (TB-AAD), and
improved quality of life (QoL). No adverse events were reported during
symptom limited pre-CR treadmill or cycle exercise VO<inf>2</inf> max or
CR. Given the overall potential in this high risk population without
adequate evidence for important variables such as safe time from post-op
to CR, intensity of training, duration and frequency of sessions and
followup it is time for a moderate sized well designed safe trial for
patients' post-op surgery for TA-AAD and medically treated TB-AAD who are
treated with standardized evidence based medical therapy and physical
therapy from discharge randomized to CR versus usual care. PROSPERO
registry ID: CRD42023392896. Copyright © 2024 The Author(s)

<38>
Accession Number
2030123750
Title
ANGIOGRAPHIC PROFILES IN YOUNG ADULTS WITH ACUTE CORONARY SYNDROME:
UNRAVELING THE UNIQUE CHARACTERISTICS AND IMPLICATIONS FOR DIAGNOSIS AND
MANAGEMENT - A SYSTEMATIC REVIEW.
Source
International Journal of Academic Medicine and Pharmacy. 6(1) (pp
353-360), 2023. Date of Publication: 2023.
Author
Kumar R.S.; Gopalakrishnan S.; Narendran M.; Aravazhi R.
Institution
(Kumar, Gopalakrishnan, Narendran, Aravazhi) Department of Cardiology,
Government Stanley Hospital, Medical College, Tamilnadu, India
(Kumar, Gopalakrishnan, Narendran, Aravazhi) Department of Cardiology
Government Stanley Medical College, Tamilnadu, India
(Kumar, Gopalakrishnan, Narendran, Aravazhi) Department of Cardiology
Government Theni Medical College, Tamilnadu, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Cardiovascular disease (CVD) is a leading cause of mortality
globally and in India, with a distinct epidemiological transition
contributing to the increasing prevalence of coronary artery disease (CAD)
among young adults. Limited data exist on the demographic and angiographic
characteristics of young patients with acute coronary syndrome (ACS). This
systematic review aimed to bridge this gap by evaluating recent studies to
identify ACS's clinical and angiographic profile. Aim(s): To
systematically review and analyse data from studies conducted between 2015
and 2023, focusing on angiographic characteristics in individuals aged
18-45 diagnosed with ACS. Material(s) and Method(s): A comprehensive
search was conducted using electronic databases, including PubMed,
MEDLINE, Embase, and the Cochrane Library. Eligible studies were published
in English from 2015-2023, addressing angiographic profiles in young
adults with ACS. Data synthesis and analysis followed the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Result(s): Six studies met the inclusion criteria and
presented recent findings on young Indian adults. Prevalent risk factors
include obesity, diabetes, hypertension, and smoking. Angiographic
profiles revealed Left Anterior Descending (LAD) artery involvement in the
majority of cases, with single-vessel disease (SVD) being the predominant
pattern. Obesity and diabetes are significantly associated with
triple-vessel disease (TVD). Conclusion(s): This systematic review
provides comprehensive insights into the angiographic profile of ACS in
young Indian adults. Obesity has emerged as a significant risk factor for
coronary involvement. The distinct angiographic patterns observed
underscore the need for tailored diagnosis and management
strategies. Copyright © 2023 Flora Montiberica. All rights
reserved.

<39>
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.

<40>
Accession Number
2029801281
Title
Exploration of cardiac rehabilitation nursing for elderly patients with
myocardial infarction based on individualized cardiac rehabilitation.
Source
World Journal of Clinical Cases. 12(2) (pp 256-266), 2024. Date of
Publication: 16 Jan 2024.
Author
Liu H.-N.; Gao B.
Institution
(Liu) Department of Geriatrics, General Hospital of the YangTze River
Shipping, Wuhan Brain Hospital, Hubei Province, Wuhan 430015, China
(Gao) Department of Cardiology, Suizhou Central Hospital, Affiliated
Hospital of Hubei University of Medicine, Hubei Province, Suizhou 441300,
China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Myocardial infarction is a high-risk condition prevalent among
the elderly population, often leading to adverse clinical manifestations
such as reduced cardiopulmonary function, anxiety, and depression
post-surgery. Consequently, cardiac rehabilitation holds immense
importance in mitigating these complications. AIM To evaluate the effect
of individualized cardiac rehabilitation on blood pressure variability
(BPV) and baroreflex sensitivity (BRS) in elderly patients with myocardial
infarction. METHODS A cohort of 74 elderly patients diagnosed with
myocardial infarction and admitted to our hospital between January 2021
and January 2022 were subjected to random selection. Subsequently, all
patients were divided into two groups, namely the research group (n = 37)
and the control group (n = 37), utilizing the number table method. The
control group received conventional drug treatment and nursing guidance
intervention, while the study group underwent individualized cardiac
rehabilitation in addition to the interventions received by the control
group. All patients were continuously intervened for 12 wk, and the BPV of
these two groups in the 1 st wk (T0), the 4 th wk (T1) and the 12th wk
(T2) were compared, BRS, changes in cardiopulmonary function measures, and
adverse cardiovascular events. RESULTS Of 24 h diastolic BPV, 24 h
systolic BPV, carbon dioxide ventilation equivalent slope of the research
group were lower than those of the control group at T1 and T2, BRS, peak
heart rate and systolic blood pressure product, 1 min heart rate recovery
were higher than those of the control group, and the incidence of adverse
events in the research group was lower than that of the control group, the
difference was statistically significant (P < 0.05). CONCLUSION In this
study, we found that after individualized cardiac rehabilitation in
elderly patients with myocardial infarction, BPV and BRS can be
effectively improved, cardiac function is significantly enhanced, and a
better prognosis is obtained. Copyright © The Author(s) 2024.
Published by Baishideng Publishing Group Inc. All rights reserved.

<41>
Accession Number
2028156609
Title
Early coronary angioplasty fails to lower all-cause mortality in patients
with out-of-hospital cardiac arrest without ST-segment elevation: A
systematic review and meta-analysis.
Source
Health Science Reports. 7(2) (no pagination), 2024. Article Number: e1379.
Date of Publication: February 2024.
Author
Rashid K.; Waheed M.A.; Ansar F.; Makram A.M.; Hasan A.; Ahmed S.; Khan
S.T.; Ubaid A.; Ibad A.A.; Basri R.; Makram O.M.; Khan Y.; Rashad N.;
Elzouki A.
Institution
(Rashid) Internal Medicine, James Cook University Hospital, Middlesbrough,
United Kingdom
(Waheed, Basri) Department of Medicine, Hamad Medical Corporation, Doha,
Qatar
(Ansar) Department of Medicine, Quaid e Azam International Hospital,
Islamabad, Pakistan
(Makram) Public health, School of Public Health, Imperial College London,
London, United Kingdom
(Makram) Department of Anesthesia and Intensive Care Medicine, October 6
University Hospital, Giza, Egypt
(Hasan) Department of Medicine, Mohammed Bin Rashid University of Medicine
and Health Sciences, Dubai, United Arab Emirates
(Ahmed) Medicine, King Abdullah Teaching Hospital, Mansehra, Pakistan
(Khan) Internal Medicine, Sunderland Royal Hospital, Sunderland, United
Kingdom
(Ubaid) Internal Medicine, University of Missouri Kansas City, Kansas
City, MO, United States
(Ibad) Internal Medicine, Bannu Medical College, Bannu, Pakistan
(Makram) Public health, Faculty of Public Health and Policy, London School
of Hygiene and Tropical Medicine, London, United Kingdom
(Makram) Medicine, Center for Health & Nature, Houston Methodist Hospital,
Houston, TX, United States
(Makram) Department of Cardiology, October 6 University Hospital, Giza,
Egypt
(Khan) Mardan Medical Complex, Mardan, Pakistan
(Rashad) Department of Medicine, Khyber Teaching Hospital, Peshawar,
Pakistan
(Elzouki) Department of Medicine, Hamad General Hospital, Weill Cornell
Medicine, Ar-Rayyan, Qatar
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Out-of-hospital cardiac arrest (OHCA) is defined as the loss
of functional mechanical activity of the heart in association with an
absence of systemic circulation, occurring outside of a hospital.
Immediate coronary angiography (CAG) with percutaneous coronary
intervention is recommended for OHCA with ST-elevation. We aimed to
evaluate the effect of early CAG on mortality and neurological outcomes in
OHCA patients without ST-elevation. Method(s): This meta-analysis and
systemic review was conducted as per principles of Preferred Reporting
Items for Systematic Reviews and Meta-analysis (PRISMA) group. A protocol
was registered with the International Prospective Register of Systematic
Reviews (PROSPERO, Ref No. = CRD42022327833). A total of 674 studies were
retrieved after scanning several databases (PubMed Central, EMBASE,
Medline, and Cochrane Central Register of Controlled Trials).
 Result(s): A total of 18 studies were selected for the final
analysis, including 6 randomized control trials and 12 observational
studies. Statistically, there was no significant difference in primary
outcome, i.e., mortality, between early and delayed CAG. In terms of the
grade of neurological recovery as a secondary outcome, early and delayed
CAG groups also showed no statistically significant difference.
 Conclusion(s): Early CAG has no survival benefits in patients with no
ST elevations on ECG after OHCA. Copyright © 2024 The Authors.
Health Science Reports published by Wiley Periodicals LLC.

<42>
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.

<43>
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

<44>
Accession Number
2027694850
Title
Factors Influencing Unfractionated Heparin Pharmacokinetics and
Pharmacodynamics During a Cardiopulmonary Bypass.
Source
Clinical Pharmacokinetics. 63(2) (pp 211-225), 2024. Date of Publication:
February 2024.
Author
Gibert A.; Lanoiselee J.; Gouin-Thibault I.; Pontis A.; Azarnoush K.;
Petrosyan A.; Grand N.; Molliex S.; Morel J.; Gergele L.; Hodin S.; Bin
V.; Chaux R.; Delavenne X.; Ollier E.
Institution
(Gibert, Lanoiselee, Hodin, Bin, Chaux, Delavenne, Ollier) INSERM, U1059,
Dysfonction Vasculaire et Hemostase, 20 Rue Camelinat, Saint-Etienne
42000, France
(Lanoiselee, Grand, Molliex, Morel, Gergele) Departement
d'Anesthesie-Reanimation, CHU de Saint-Etienne, Saint-Etienne, France
(Gouin-Thibault, Pontis) Laboratory of Hematology, Pontchaillou,
University Hospital of Rennes, University of Rennes, Inserm, EHESP, Irset
(Institut de Recherche en Sante, Environnement et Travail)-UMR_S 1085,
Rennes, France
(Azarnoush, Petrosyan) Service de Chirurgie Cardiaque, CHU de
Saint-Etienne, Saint-Etienne, France
(Chaux, Ollier) Unite de Recherche Clinique Innovation et Pharmacologie,
CHU de Saint-Etienne, Saint-Etienne, France
(Delavenne) Laboratoire de Pharmacologie Toxicologie Gaz du sang, CHU de
Saint-Etienne, Saint-Etienne, France
Publisher
Adis
Abstract
Background: Unfractionated heparin (UFH) is commonly used during cardiac
surgery with a cardiopulmonary bypass to prevent blood clotting. However,
empirical administration of UFH leads to variable responses.
Pharmacokinetic and pharmacodynamic modeling can be used to optimize UFH
dosing and perform real-time individualization. In previous studies, many
factors that could influence UFH pharmacokinetics/pharmacodynamics had not
been taken into account such as hemodilution or the type of UFH. Few
covariates were identified probably owing to a lack of statistical power.
This study aims to address these limitations through a meta-analysis of
individual data from two studies. Method(s): An individual patient
data meta-analysis was conducted using data from two single-center
prospective observational studies, where different UFH types were used for
anticoagulation. A pharmacodynamic/pharmacodynamic model of UFH was
developed using a non-linear mixed-effects approach. Time-varying
covariates such as hemodilution and fluid infusions during a
cardiopulmonary bypass were considered. Result(s): Activities of
UFH's anti-activated factor/anti-thrombin were best described by a
two-compartment model. Unfractionated heparin clearance was influenced by
body weight and the specific UFH type. Volume of distribution was
influenced by body weight and pre-operative fibrinogen levels.
Pharmacodynamic data followed a log-linear model, accounting for the
effect of hemodilution and the pre-operative fibrinogen level. Equations
were derived from the model to personalize UFH dosing based on the
targeted activated clotting time level and patient covariates.
 Conclusion(s): The population model effectively characterized UFH's
pharmacokinetics/pharmacodynamics in cardiopulmonary bypass patients. This
meta-analysis incorporated new covariates related to UFH's
pharmacokinetics/pharmacodynamics, enabling personalized dosing regimens.
The proposed model holds potential for individualization using a Bayesian
estimation. Copyright © The Author(s), under exclusive licence to
Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g.
a society or other partner) holds exclusive rights to this article under a
publishing agreement with the author(s) or other rightsholder(s); author
self-archiving of the accepted manuscript version of this article is
solely governed by the terms of such publishing agreement and applicable
law.

<45>
Accession Number
643421996
Title
Association between HbA1c and deep sternal wound infection after coronary
artery bypass: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 51), 2024. Date of
Publication: 04 Feb 2024.
Author
Zhao W.; Xie J.; Zheng Z.; Zhou H.; Ooi O.C.; Luo H.
Institution
(Zhao) School of Management, University of Science and Technology of
China, Hefei, China
(Xie, Zhou) School of Management, Technical University of Munich,
Heilbronn, Germany
(Xie) Munich Data Science Institute, Technical University of Munich,
Munich, Germany
(Zheng) Lee Kong Chian School of Business, Singapore Management
University, Singapore
(Ooi, Luo) Department of Cardiac, Thoracic & Vascular Surgery, National
University Hospital, Singapore
Abstract
BACKGROUND: Deep sternal wound infection (DSWI) constitutes a serious
complication after coronary artery bypass grafting (CABG) surgery. The aim
of this study is to evaluate the dose-response relationship between
glycated hemoglobin (HbA1c) level and the risk of DSWI after CABG.
 METHOD(S): PubMed, Scopus, and Cochrane Library databases were
searched to identify potentially relevant articles. According to rigorous
inclusion and exclusion criteria, fourteen studies including 15,570
patients were enrolled in our meta-analysis. Odds ratio (OR) with 95%
confidence intervals (CIs) was used as the summary statistic. The
robust-error meta-regression model was used to synthesize the
dose-response relationship. RESULT(S): Our meta-analysis shows that
among patients undergoing CABG, preoperative elevated HbA1c was associated
with the risk of developing DSWI (OR=2.67, 95% CI 2.00-3.58) but with low
prognostic accuracy (diagnostic OR=2.70, 95% CI 1.96-3.73; area under the
curve=0.66, 95% CI 0.62-0.70) for predicting postoperative DSWI. Subgroup
analyses showed the relationship became nonsignificant in patients without
diabetes and studies adopting lower HbA1c thresholds. Dose-response
analysis showed a significant nonlinear (p=0.03) relationship between
HbA1c and DSWI, with a significantly increased risk of DSWI when HbA1c was
>5.7%. CONCLUSION(S): An elevated HbA1c level of >5.7% was related to
a higher risk of developing DSWI after CABG, and the risk increased as the
HbA1c level grew. The association between HbA1c and DSWI was
nonsignificant among nondiabetic patients while significant among diabetic
patients. Copyright © 2024. The Author(s).

<46>
Accession Number
643424235
Title
13th ISMM World Congress on Mountain Medicine 2021.
Source
High Altitude Medicine and Biology. Conference: 13th ISMM World Congress
on Mountain Medicine 2021. Virtual. 23(1) (no pagination), 2022. Date of
Publication: March 2022.
Author
Anonymous
Publisher
Mary Ann Liebert Inc.
Abstract
The proceedings contain 10 papers. The topics discussed include:
acetazolamide cannot be recommended for Hape prevention after rapid and
active ascent to 4,559m; stress detection in hems operation with heart
rate variability; simulated acute hypobaric hypoxia effects on cognition
in helicopter emergency medical service (HEMS) personnel - a randomized,
controlled, single-blind, cross-over study; Nepalese diploma in mountain
medicine: an experience of a decade of mountain medicine education in
Nepal and the future challenges; an artificial air pocket device reduces
inspired level of carbon dioxide in participants completely buried in
avalanche debris: an experimental, randomized crossover study; and
transcription factors regulation in human peripheral white blood cells
during hypobaric hypoxia exposure: an in-vivo experimental study.

<47>
Accession Number
643425522
Title
Similarities in BPH study criteria on clinicaltrials.gov.
Source
Canadian Urological Association Journal. Conference: 73rd Annual Meeting
of the Northeastern Section of the AUA. Virtual. 15(9 Supplement 4) (pp
S191), 2021. Date of Publication: September 2021.
Author
Zipkin J.; Srivastava S.; Researcher S.; Welliver C.
Institution
(Zipkin, Srivastava, Researcher) Albany Medical College, Albany, NY,
United States
(Welliver) Albany Medical Center, Division of Urology, Albany, NY, United
States
Publisher
Canadian Urological Association
Abstract
Introduction: While a variety of study designs provide helpful medical
advancement, prospective and randomized clinical trials offer the
highest-grade evidence. Studies on benign prostatic hyperplasia (BPH) are
often single-center, retrospective studies with high attrition rates,
which yield studies with low grade evidence and often unreproducible
results. The US National Library of Medicine maintains clinicaltrials.gov
to allow providers and patients access to prospective trials on a variety
of diseases. Method(s): Interventional research with a known study
status on clinicaltrials.gov identified by a keyword search ?benign
prostatic hyperplasia? were examined. Inclusion/exclusion criteria,
primary outcomes, secondary outcomes, study status, study enrollment,
country of origin, intervention category, allocation, intervention model,
masking, total study duration, and primary purpose were assessed.
 Result(s): Of studies captured, 63% were completed, 19% were active,
and 18% were terminated/withdrawn. Median study enrollment was 111
patients (range 0-1177) and mean duration of study was 904 days.
International prostate symptom score (IPSS) was the primary outcome in 65%
of studies. Secondary outcomes included maximum/peak urine flow rate
(Qmax) (55% of studies) and postvoid residual (36%). The most common
minimum age for inclusion was 50 years (42% of studies). A specific IPSS
was used for inclusion in 73% of studies; the most common minimum IPSS was
13 (48%). Forty-eight percent of studies used specific Qmax for inclusion;
the most common maximum Qmax was 15 ml/sec (64%). Minimum time
experiencing BPH symptoms was used for inclusion in 32% (average of 5.5
months). Prostate volume was used for inclusion in 40%; the most common
minimum volume was 30 cc (40%). A history or suspicion of cancer was an
exclusion criterion in 78% of studies. In 50% of studies, undefined
medical conditions as determined by researchers were used for exclusion.
Other exclusion criteria included: urethral and/or bladder neck stenosis
(54% of studies), previous genitourinary surgery (52%), cardiac disease
(50%), renal function impairment (47%), and neurologic disease that may
affect genitourinary function (45%). Conclusion(s): BPH studies on
clinicaltrials.gov utilize similar and common inclusion/exclusion criteria
and outcomes. The homogeneity of these inclusion criteria may limit the
study of certain populations and reduce generalizability of study results
to patients outside of these criteria.

<48>
Accession Number
2030290396
Title
Respect Versus Resect Approaches for Mitral Valve Repair-A Meta-Analysis
of Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Rafael A.E.; Meyer D.M.
Institution
(Rafael, Meyer) Cardiovascular and Thoracic Surgery, Baylor University
Medical Center at Dallas, Dallas, Texas, United States
Publisher
Elsevier Inc.

<49>
Accession Number
2027791775
Title
Comparison of the negative effect of remimazolam and propofol on cardiac
contractility: Analysis of a randomised parallel-group trial and a
preclinical ex vivo study.
Source
Clinical and Experimental Pharmacology and Physiology. 51(3) (no
pagination), 2024. Article Number: e13840. Date of Publication: March
2024.
Author
Yoshikawa Y.; Oura S.; Kanda M.; Chaki T.; Hirata N.; Edanaga M.; Yamakage
M.
Institution
(Yoshikawa, Oura, Chaki, Edanaga, Yamakage) Department of Anaesthesiology,
Sapporo Medical University School of Medicine, Sapporo, Japan
(Kanda) Department of Rheumatology and Clinical Immunology, Sapporo
Medical University School of Medicine, Sapporo, Japan
(Hirata) Department of Anaesthesiology, Kumamoto University, Kumamoto,
Japan
Publisher
John Wiley and Sons Inc
Abstract
Remimazolam is a newly developed ultra-short-acting benzodiazepine that
exerts sedative effects. This study aimed to clarify the effects of
remimazolam on cardiac contractility. In a randomised-parallel group
trial, haemodynamic parameters were compared between propofol (n = 11) and
remimazolam (n = 12) groups during the induction of general anaesthesia in
patients undergoing non-cardiac surgery. In a preclinical study, the
direct effects of remimazolam on cardiac contractility were also evaluated
using isolated rat hearts. RNA sequence data obtained from rat and human
hearts were analysed to assess the expression patterns of the cardiac
gamma-aminobutyric acid type A (GABA<inf>A</inf>) receptor subunits. In a
clinical study, the proportional change of the maximum rate of arterial
pressure rise was milder during the study period in the remimazolam group
(propofol: -52.6 [10.2] (mean [standard deviation])% vs. remimazolam:
-39.7% [10.5%], p = 0.007). In a preclinical study, remimazolam did not
exert a negative effect on left ventricle developed pressure, whereas
propofol did exert a negative effect after bolus administration of a high
dose (propofol: -26.9% [3.5%] vs. remimazolam: -1.1 [6.9%], p < 0.001).
Analysis of the RNA sequence revealed a lack of gamma subunits, which are
part of the major benzodiazepine binding site of the GABA<inf>A</inf>
receptor, in rat and human hearts. These results indicate that remimazolam
does not have a direct negative effect on cardiac contractility, which
might contribute to its milder effect on cardiac contractility during the
induction of general anaesthesia. The expression patterns of cardiac
GABA<inf>A</inf> receptor subunits might be associated with the unique
pharmacokinetics of benzodiazepines in the heart. Copyright ©
2024 John Wiley & Sons Australia, Ltd.

<50>
Accession Number
2029762064
Title
Measurement properties of assessment tools of Kinesophobia in patients
with cardiovascular disease: A systematic review.
Source
International Journal of Nursing Sciences. 11(1) (pp 57-65), 2024. Date of
Publication: January 2024.
Author
Jia Y.; Cui N.; Jia T.; Jabbar Abdl Sattar Hamoudi H.; Song J.
Institution
(Jia, Song) Nursing Department, The Second Affiliated Hospital of Zhejiang
University School of Medicine, Hangzhou, China
(Jia) Nursing Department, Zhejiang University School of Medicine,
Hangzhou, China
(Cui) School of Nursing, Kunming Medical University, Kunming, China
(Jia) General Surgery Cadre Ward, Gansu Provincial People's Hospital,
Lanzhou, China
(Jabbar Abdl Sattar Hamoudi) Faculty of Clinical Medicine, Zhejiang
University School of Medicine, Hangzhou, China
Publisher
Chinese Nursing Association
Abstract
Objectives: This study aimed to evaluate the measurement properties and
methodological quality of assessment tools for Kinesophobia among patients
with cardiovascular disease and provide a reference for healthcare
professionals in selecting high-quality assessment tools. Method(s):
A systematic search was performed on specific databases: Embase, the
Cochrane Library, PubMed, Web of Science, China National Knowledge
Infrastructure, Wanfang database, China Biological Medicine disc, CINAHL,
and China Science and Technology Journal Database, from inception to April
1, 2023. The researchers retrieved studies on the measurement attributes
of the exercise fear scale in patients with cardiovascular diseases. They
also traced back the references of the included studies to supplement
relevant literature. According to the inclusion and exclusion criteria,
screening and data extraction were independently undertaken by two
reviewers. Two researchers individually used the Consensus-based Standards
for the selection of health Measurement Instruments (COSMIN) Risk of Bias
Checklist to assess the methodological quality of the scale, applied the
COSMIN criteria to evaluate the measurement properties of the scale, and
used a modified Grading, Recommendations, Assessment, Development, and
Evaluation system to assess the certainty of evidence. Result(s):
Seventeen studies were identified that reported the psychometric
properties of six patient reported outcome measurement tools (included
different languages version) The methodological quality of content
validity was adequate in only two studies, the remaining patient-reported
outcome measures demonstrated doubtful content validity. Limited
information on cross-cultural validity/measurement invariance, measurement
error, and responsiveness was retrieved. The Swedish version and the
Chinese version of the Tampa Scale for Kinesiophobia Heart were graded
"A." The remaining instruments were graded "B." Conclusion(s): The
methodological and measurement attributes of the Swedish and Chinese
versions of the Tampa Scale for Kinesiophobia Heart are relatively high
quality and can be tentatively recommended. The measurement properties of
the remaining scales remain to be verified. Copyright © 2024 The
Authors

<51>
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.

<52>
Accession Number
2026813312
Title
The effects of bariatric surgery on cardiac function: a systematic review
and meta-analysis.
Source
International Journal of Obesity. 48(2) (pp 166-176), 2024. Date of
Publication: February 2024.
Author
Sargsyan N.; Chen J.Y.; Aggarwal R.; Fadel M.G.; Fehervari M.; Ashrafian
H.
Institution
(Sargsyan, Chen, Aggarwal, Fadel, Fehervari, Ashrafian) Department of
General Surgery, Imperial College Healthcare NHS Foundation Trust, London,
United Kingdom
(Fadel, Fehervari, Ashrafian) Department of Surgery and Cancer, Imperial
College London, London, United Kingdom
Publisher
Springer Nature
Abstract
Introduction: Obesity is associated with alterations in cardiac structure
and haemodynamics leading to cardiovascular mortality and morbidity.
Culminating evidence suggests improvement of cardiac structure and
function following bariatric surgery. Objective(s): To evaluate the
effect of bariatric surgery on cardiac structure and function in patients
before and after bariatric surgery. Method(s): Systematic review and
meta-analysis of studies reporting pre- and postoperative cardiac
structure and function parameters on cardiac imaging in patients
undergoing bariatric surgery. Result(s): Eighty studies of 3332
patients were included. Bariatric surgery is associated with a
statistically significant improvement in cardiac geometry and function
including a decrease of 12.2% (95% CI 0.096-0.149; p < 0.001) in left
ventricular (LV) mass index, an increase of 0.155 (95% CI 0.106-0.205; p <
0.001) in E/A ratio, a decrease of 2.012 mm (95% CI 1.356-2.699; p <
0.001) in left atrial diameter, a decrease of 1.16 mm (95% CI 0.62-1.69; p
< 0.001) in LV diastolic dimension, and an increase of 1.636% (95% CI
0.706-2.566; p < 0.001) in LV ejection fraction after surgery.
 Conclusion(s): Bariatric surgery led to reverse remodelling and
improvement in cardiac geometry and function driven by metabolic and
haemodynamic factors. Copyright © 2023, The Author(s).

<53>
Accession Number
2018987144
Title
Staged treatment for pancreaticoduodenal artery aneurysm with coeliac
artery revascularisation: Case report and systematic review.
Source
Vascular. 32(1) (pp 162-178), 2024. Date of Publication: February 2024.
Author
Ghoneim B.; Nash C.; Akmenkalne L.; Cremen S.; Canning C.; Colgan M.P.;
O'Neill S.; Martin Z.; Madhavan P.; O'Callaghan A.
Institution
(Ghoneim, Ghoneim, Nash, Akmenkalne, Cremen, Canning, Colgan, O'Neill,
Martin, Madhavan, O'Callaghan) Department of Vascular Surgery, St James
Hospital, Dublin, Ireland
Publisher
SAGE Publications Ltd
Abstract
Background: Despite being rare, pancreaticoduodenal artery aneurysms
(PDAAs) carry a risk of rupture of up to 50% and are frequently associated
with coeliac artery occlusion. Method(s): PubMed and Embase databases
were searched using appropriate terms. The systematic review was conducted
according to PRISMA guidelines. Result(s): We present the case of a 2
cm pancreaticoduodenal artery aneurysm pre-operative angiography
demonstrated that the coeliac artery was occluded and the
pancreaticoduodenal artery was providing collateral blood supply to the
liver. Treatment was a staged hybrid intervention inclusive of an
aorto-hepatic bypass using a 6 mm graft, followed by coil embolisation of
the aneurysm. We also present a systematic review of the management of
PDAAs. Two hundred and ninety-two publications were identified initially
with 81 publications included in the final review. Of the 258
peripancreatic aneurysms included, 175 (61%) were associated with coeliac
artery disease either occlusion or stenosis. Abdominal pain was the main
presentation in 158 cases. Rupture occurred in 111 (40%) of patients with
only ten (3.8%) cases being unstable on presentation. Fifty (18%) cases
were detected incidentally while investigating another pathology. Over
half the cases (n=141/54.6%) were treated by trans arterial embolisation
(TAE) alone, while 37 cases had open surgery only. Twenty-one cases needed
TAE and a coeliac stent. Seventeen cases underwent hybrid treatment (open
and endovascular). Sixteen cases were treated conservatively and in 26
cases, treatment was not specified. Conclusion(s): PDAAs are commonly
associated with coeliac artery disease. The most common presentation is
pain followed by rupture. The scarcity of literature about true
peripancreatic artery aneurysms associated with CA occlusive disease makes
it difficult to assess the natural history or the appropriate treatment.
Revascularisation of hepatic artery is better done with bypass in setting
of median arcuate ligament compression and occluded celiac
trunk. Copyright © The Author(s) 2022.

<54>
Accession Number
2005369319
Title
CHA2DS2-VASc and ATRIA Scores and Clinical Outcomes in Patients with Heart
Failure with Preserved Ejection Fraction.
Source
Cardiovascular Drugs and Therapy. 34(6) (pp 763-772), 2020. Date of
Publication: December 2020.
Author
Zhu W.; Wu Y.; Zhou Y.; Liang W.; Xue R.; Wu Z.; Dong Y.; Liu C.
Institution
(Zhu, Wu, Zhou, Liang, Xue, Wu, Dong, Liu) Department of Cardiology, the
First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong
510080, China
(Dong, Liu) NHC Key Laboratory of Assisted Circulation, Sun Yat-sen
University, Guangzhou 510080, China
(Dong, Liu) National-Guangdong Joint Engineering Laboratory for Diagnosis
and Treatment of Vascular Diseases, Guangzhou, China
Publisher
Springer
Abstract
Background: Heart failure (HF) patients have high risks of thromboembolic
events regardless of the category of left ventricular ejection fraction.
We sought to assess whether the CHA2DS2-VASc (congestive heart failure,
hypertension, age >= 75 years, diabetes mellitus, stroke, vascular
disease, age 65-74 years, and female sex) and ATRIA (anticoagulation and
risk factors in atrial fibrillation) scores could predict clinical
outcomes in HF patients with preserved ejection fraction (HFpEF).
 Method(s): We performed a retrospective analysis in a multicenter,
America-based population of 1766 HFpEF patients who were stratified
according to their baseline CHA2DS2-VASc or ATRIA scores. The CHA2DS2-VASc
and ATRIA scores were analyzed as a continuous or categorical variable.
The outcomes were stroke, all-cause death, cardiovascular death, any
hospitalization, and HF hospitalization. Result(s): When score was
considered as a continuous variable, each point increase in CHA2DS2-VASc
was associated with increased risks of stroke (hazard ratio (HR) 1.22, 95%
confidence interval (CI) = 1.06-1.41, C-index = 0.62), HF hospitalization
(HR 1.08, 95% CI = 1.01-1.17, C-index = 0.59), and any hospitalization (HR
1.06, 95% CI = 1.01-1.11, C-index = 0.57) whereas each point increase in
ATRIA was associated with increased risks of stroke (HR 1.11, 95% CI =
1.01-1.21, C-index = 0.62), all-cause death (HR 1.09, 95% CI = 1.05-1.14,
C-index = 0.61), cardiovascular death (HR 1.08, 95% CI = 1.02-1.14,
C-index = 0.59), HF hospitalization (HR 1.07, 95% CI = 1.03-1.12, C-index
= 0.58), and any hospitalization (HR 1.04, 95% CI = 1.01-1.06, C-index =
0.57). When score was regarded as a categorical variable, compared with
controls, CHA2DS2-VASc >= 4 was associated with increased risks of stroke
and hospitalization whereas ATRIA >= 8 was associated with increased risks
of stroke, death, and hospitalization. Conclusion(s): The
CHA2DS2-VASc and ATRIA scores are associated with risks of adverse
outcomes in HFpEF patients. However, the predictive abilities of
CHA2DS2-VASc and ATRIA are modest, and their clinical utility in HFpEF
remains to be determined. Clinical trial registration:
https://clinicaltrials.gov. Identifier: NCT00094302 Copyright ©
2020, Springer Science+Business Media, LLC, part of Springer Nature.

<55>
Accession Number
2030256123
Title
Methylprednisolone Does Not Enhance Paraoxonase 1 Activity During
Cardiopulmonary Bypass Surgery-A Randomized, Controlled Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Taleska Stupica G.; Sostaric M.; Jenko M.; Podbregar M.
Institution
(Taleska Stupica, Sostaric, Jenko, Podbregar) University Medical Center
Ljubljana, Clinical Department of Anesthesiology and Perioperative
Intensive Therapy, Ljubljana, Slovenia
(Taleska Stupica, Sostaric, Jenko, Podbregar) University of Ljubljana,
Faculty of Medicine, Ljubljana, Slovenia
(Podbregar) General Hospital Celje, Department of Internal Intensive
Medicine, Celje, Slovenia
Publisher
W.B. Saunders
Abstract
Objectives: Cardiopulmonary bypass (CPB) is linked to systemic
inflammatory responses and oxidative stress. Paraoxonase 1 (PON1) is an
antioxidant enzyme with a cardioprotective role whose activity is
decreased in systemic inflammation and in patients with acute myocardial
and global ischemia. Glucocorticoids counteract the effect of oxidative
stress by upregulating PON1 gene expression. The authors aimed to
determine the effect of methylprednisolone on PON1 activity during cardiac
surgery on CPB. Design(s): Prospective, randomized, controlled
clinical trial. Setting(s): The University Medical Center Ljubljana,
Slovenia. Participant(s): Forty adult patients who underwent complex
cardiac surgery on CPB between February 2016 and December 2017 were
randomized into methylprednisolone and control groups (n = 20 each).
 Intervention(s): Patients in the methylprednisolone group received 1
g of methylprednisolone in the CPB priming solution, whereas patients in
the control group were not given methylprednisolone during CPB.
 Measurements and Main Results: The effect of methylprednisolone from
the CPB priming solution was compared with standard care during CPB on
PON1 activity until postoperative day 5. Correlations of PON1 activity
with lipid status, mediators of inflammation, and hemodynamics were
analyzed also. No significant differences were found between study groups
for PON1 activity, high-density lipoprotein, and low-density lipoprotein
in any of the measurement intervals (p > 0.016). The methylprednisolone
group had significantly lower tumor necrosis factor alpha (p < 0.001) and
interleukin-6 (p < 0.001), as well as C-reactive protein and procalcitonin
(p < 0.016) after surgery. No significant difference was found between
groups for hemodynamic parameters. A positive correlation existed between
PON1 and lipid status, whereas a negative correlation was found between
PON1 activity and tumor necrosis factor alpha, interleukin-6, and CPB
duration. Conclusion(s): Methylprednisolone does not influence PON1
activity during cardiac surgery on CPB. Copyright © 2023 The
Author(s)

<56>
Accession Number
2028285085
Title
Literature Review of Handheld Articulating Instruments in Minimally
Invasive Surgery.
Source
Journal of Laparoendoscopic and Advanced Surgical Techniques. 34(1) (pp
47-54), 2024. Date of Publication: 01 Jan 2024.
Author
Mao R.; Gao L.; Gang W.; Wen L.
Institution
(Mao, Gao, Wen) Department of Medical Equipment, Sichuan Provincial
People's Hospital, School of Medicine, University of Electronic Science
and Technology of China, Chengdu, China
(Mao) School of Biological Science and Medical Engineering, Beihang
University, Beijing, China
(Gang) Hepatobiliary and Pancreatic Surgery Department, Sichuan Provincial
People's Hospital, Chengdu, China
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Minimally invasive surgery (MIS) using handheld articulating
instruments (HAIs) has emerged as an innovative approach, offering
enhanced dexterity and accessibility compared with conventional straight
tools. There has been a significant surge in market interest surrounding
HAIs. However, the question about the potential benefits of these devices
for surgeons and patients in clinical applications remains unclear.
 Method(s): We thoroughly searched relevant literature about the HAIs
with clinical applications. This article reviews the feasibility, safety,
outcomes, ergonomics, and learning curve associated with utilizing HAIs,
including notable commercial products FlexDex, ArtiSential, and HandX.
This study also investigates the comparisons of the use of HAIs with
traditional laparoscopy and the da Vinci robotic system in terms of
surgical outcomes and operational efficiency. Result(s): Early
clinical studies demonstrate the applicability of HAIs across
gastrointestinal, urologic, cardiothoracic, and general surgery, with
promising results and few complications reported. Comparisons with
conventional laparoscopy reveal no significant differences in surgical
outcomes. However, HAIs present a more prolonged learning curve than
robotic surgery for novice users. Combining three-dimensional
visualization techniques facilitate performance. Further research with
larger sample sizes is warranted to establish definitive superiority in
surgical efficiency and characterize optimal training methodology.
 Conclusion(s): Overall, the maneuverability and lower cost of HAIs
present new possibilities in MIS, potentially expanding accessibility for
smaller health care organizations and benefiting more
patients. Copyright © Mary Ann Liebert, Inc.

<57>
Accession Number
2030259898
Title
Wearable heart rate variability and atrial fibrillation monitoring to
improve clinically relevant endpoints in cardiac surgery -a systematic
review.
Source
mHealth. 10 (no pagination), 2024. Article Number: 8. Date of Publication:
30 Jan 2024.
Author
Zillner L.; Andreas M.; Mach M.
Institution
(Zillner, Andreas, Mach) Department of Cardiac Surgery, Medical University
of Vienna, Vienna, Austria
(Mach) Department of Cardiac Surgery, Medical University of Vienna,
Wahringer Gurtel 18-20, Vienna 1090, Austria
Publisher
AME Publishing Company
Abstract
Background: This systematic review aims to highlight the untapped
potential of heart rate variability (HRV) and atrial fibrillation (AF)
monitoring by wearable health monitoring devices as a critical diagnostic
tool in cardiac surgery (CS) patients. We reviewed established predictive
capabilities of HRV and AF monitoring in specific cardiosurgical scenarios
and provide a perspective on additional predictive properties of wearable
health monitoring devices that need to be investigated. Method(s):
After screening most relevant databases, we included 33 publications in
this review. Perusing these publications on HRV's prognostic value, we
could identify HRV as a predictor for sudden cardiac death, mortality
after acute myocardial infarction (AMI), and post operative atrial
fibrillation (POAF). With regards to standard AF assessment, which
typically includes extensive periods of unrecorded cardiac activity, we
demonstrated that continuous monitoring via wearables recorded significant
cardiac events that would otherwise have been missed. Result(s):
Photoplethysmography and single-lead electrocardiogram (ECG) were
identified as the most useful and convenient technical assessment
modalities, and their advantages and disadvantages were described in
detail. As a call to further action, we observed that the scientific
community has relatively extensively explored wearable AF screening,
whereas HRV assessment to improve relevant clinical outcomes in CS is
rarely studied; it still has great potential to be leveraged.
 Conclusion(s): Therefore, risk assessment in CS would benefit greatly
from earlier preoperative and postoperative AF detection, comprehensive
and accurate assessment of cardiac health through HRV metrics, and
continuous long-term monitoring. These should be achievable via
commercially available wearables. Copyright © mHealth. All rights
reserved.

<58>
Accession Number
2030255900
Title
Race and Ethnicity in Cardiac Surgery: A Missed Opportunity?.
Source
Annals of Thoracic Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Elfaki L.A.; Nwakoby A.; Keshishi M.; Vervoort D.; Yanagawa B.; Fremes
S.E.
Institution
(Elfaki, Nwakoby, Keshishi, Yanagawa) Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Vervoort, Yanagawa) Division of Cardiac Surgery, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Vervoort, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Vervoort, Fremes) Division of Cardiac Surgery, Sunnybrook Health Sciences
Centre, University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patients' race and/or ethnicity are increasingly being
associated with differential surgical access and outcomes in cardiac
surgery. However, deriving evidence-based conclusions that can inform
surgical care has been difficult because of poor diversity in study
populations and conflicting research methodology and findings. Using a
fictional patient example, this review identifies areas of concern in
research engagement, methodology, and analyses, as well as potential steps
to improve race and ethnicity considerations in cardiac surgical research.
 Method(s): A narrative literature review was performed using the
PubMed/MEDLINE and Google Scholar databases, with a combination of cardiac
surgery, race, ethnicity, and disparities keywords. Result(s): Less
than half of the published cardiac surgery randomized control trials
report the race and/or ethnicity of research participants. Racial and/or
ethnic minorities make up <20% of most study populations and are
significantly underrepresented relative to their proportions of the
general population. Further, race and/or ethnicity of research
participants is variably categorized based on ancestry, geographic
regions, cultural similarities, or minority status. There is growing
consideration of analyzing interrelated and confounding variables, such as
socioeconomic status, geographic location, or hospital quality, to better
elucidate racial and/or ethnic disparities; however, intersectionality
considerations remain limited in cardiac surgery research.
 Conclusion(s): Racial and/or ethnic disparities are increasingly
being reported in research engagement, cardiac pathologies, and surgical
outcomes. To promote equitable surgical care, tangible efforts are needed
to recruit racially and/or ethnically minoritized patients to research
studies, be transparent and consistent in their groupings, and elucidate
the impact of their intersectional social identities. Copyright ©
2023 The Society of Thoracic Surgeons

<59>
Accession Number
2030098029
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
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 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, Mann) 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, Wash, United States
(Lin) Department of Pediatrics, Mass General Hospital for Children,
Boston, Mass, United States
(Smith) Department of Pediatrics, Oregon Health and Science University,
Portland, Ore, United States
(Kosiv) Department of Pediatrics, Yale University School of Medicine,
Hartford, Conn, United States
(Sorabella) Department of Surgery, University of Alabama at Birmingham,
Birmingham, Ala, United States
(Alsoufi) Department of Surgery, University of Louisville and Norton
Children's Hospital, Louisville, Ky, United States
Publisher
Elsevier Inc.
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

<60>
Accession Number
643421762
Title
Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants in the
Prevention of Ischaemic Stroke in Patients with Atrial Fibrillation.
Source
Cerebrovascular diseases (Basel, Switzerland). (no pagination), 2024.
Date of Publication: 02 Feb 2024.
Author
Elsheikh S.; Alobaida M.; Bucci T.; Buckley B.J.R.; Gupta D.; Irving G.;
Hill A.M.; Lip G.Y.H.; Abdul-Rahim A.H.
Abstract
Introduction Existing randomised controlled trials assessing the safety
and efficacy of left atrial appendage occlusion (LAAO) in atrial
fibrillation (AF) were of relatively small sample size, or included
patients who could receive oral anticoagulant treatment after device
implantation. We compared the outcomes of patients with newly diagnosed AF
who received percutaneous LAAO or direct oral anticoagulants (DOAC)
treatment, in a large population from a global federated health network
(TriNetX). Methods Patients with AF treated with percutaneous LAAO were
matched with those treated with DOAC between 1st December 2010 and 1st
October 2018. Outcomes were all-cause mortality, ischaemic stroke and
intracranial haemorrhage (ICH) at 5 years. Results We included 200
patients with AF, who received either LAAO or DOAC. The risk of all-cause
mortality, ischaemic stroke and ICH at 5 years was not significantly
different between the two groups (Risk Ratio [RR] for all-cause mortality:
1.52, 95% confidence interval (CI): 0.97- 2.38, RR for ischaemic stroke:
1.09, 95% CI: 0.51- 2.36, and RR for ICH: 1.0, 95% CI: 0.44- 2.30).
Conclusion Patients newly diagnosed with AF, eligible for DOAC, showed
similar 5-year risk of death, ischemic stroke, and ICH when comparing
those who underwent percutaneous LAAO to those receiving DOAC. Future
randomised controlled trials are needed to confirm the findings and advise
changes in guidelines. Copyright S. Karger AG, Basel.

<61>
Accession Number
643416947
Title
Prognostic value of left ventricular systolic function before vascular
surgery: a systematic review.
Source
ANZ journal of surgery. (no pagination), 2024. Date of Publication: 02
Feb 2024.
Author
Zaka A.; Mutahar D.; Ponen K.; Abtahi J.; Mridha N.; Williams A.B.; Kamali
M.; Kovoor J.G.; Bacchi S.; Gupta A.K.; Psaltis P.J.; Bhamidipaty V.
Institution
(Zaka, Ponen, Abtahi, Williams, Kamali, Gupta, Bhamidipaty) Department of
Cardiology, Department of Vascular Surgery, Gold Coast University
Hospital, Gold Coast, QLD, Australia
(Zaka, Mutahar) Faculty of Health Sciences and Medicine, Bond University,
Gold Coast, QLD, Australia
(Mridha) Faculty of Medicine, University of Queensland, Brisbane,
Australia
(Kovoor, Gupta, Psaltis) Adelaide Medical School, University of Adelaide,
Adelaide, SA, Australia
(Bacchi) College of Medicine and Public Health, Flinders University,
Adelaide, SA, Australia
(Psaltis) Lifelong Health Theme, South Australian Health and Medical
Research Institute, Adelaide, Australia
Abstract
BACKGROUND: Vascular surgery carries a high risk of post-operative cardiac
complications. Recent studies have shown an association between
asymptomatic left ventricular systolic dysfunction and increased risk of
major adverse cardiovascular events (MACE). This systematic review aims to
evaluate the prognostic value of left ventricular function as determined
by left ventricular ejection fraction (LVEF) measured by resting
echocardiography before vascular surgery. METHOD(S): This review
conformed to PRISMA and MOOSE guidelines. PubMed, OVID Medline and
Cochrane databases were searched from inception to 27 October 2022.
Eligible studies assessed vascular surgery patients, with
multivariable-adjusted or propensity-matched observational studies
measuring LVEF via resting echocardiography and providing risk estimates
for outcomes. The primary outcomes measures were all-cause mortality and
congestive heart failure at 30days. Secondary outcome included the
composite outcome MACE. RESULT(S): Ten observational studies were
included (4872 vascular surgery patients). Studies varied widely in degree
of left ventricular systolic dysfunction, symptom status, and outcome
reporting, precluding reliable meta-analysis. Available data demonstrated
a trend towards increased incidence of all-cause mortality, congestive
heart failure and MACE in patients with pre-operative LVEF <50%.
Methodological quality of the included studies was found to be of moderate
quality according to the Newcastle Ottawa Checklist. CONCLUSION(S):
The evidence surrounding the prognostic value of LVEF measurement before
vascular surgery is currently weak and inconclusive. Larger scale,
prospective studies are required to further refine cardiac risk prediction
before vascular surgery. Copyright © 2024 Royal Australasian
College of Surgeons.

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