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<1>
Accession Number
2030521322
Title
The effect of fibrates on lowering low-density lipoprotein cholesterol and
cardiovascular risk reduction: a systemic review and meta-analysis.
Source
European Journal of Preventive Cardiology. 31(3) (pp 291-301), 2024. Date
of Publication: 01 Feb 2024.
Author
Kim K.A.; Kim N.J.; Choo E.H.
Institution
(Kim, Choo) Division of Cardiology, Department of Internal Medicine, Seoul
St.Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero,
Seocho-gu, Seoul 06591, South Korea
(Kim) Medical Library, The Catholic University of Korea, 222 Banpo-daero,
Seocho-gu, Seoul 06591, South Korea
Publisher
Oxford University Press
Abstract
Aims The effect of fibrate treatment on cardiovascular risk is
inconsistent. This meta-analysis aimed to assess the effect of fibrates on
major adverse cardiovascular outcome (MACE) reduction. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Methods
PubMed, Embase, and Cochrane library databases were searched up to
February 2023 for randomized controlled trials and results comparing
fibrate therapy against placebo and reporting cardiovascular outcomes and
lipid profile changes. The primary outcome was the clinical outcomes of
each trial that most closely corresponding to MACE, a composite of
cardiovascular death, acute myocardial infarction, stroke, and coronary
revascularization. A pre-specified meta-regression analysis to examine the
relationship between the changes in lipid levels after fibrate treatment
and the risk of MACE was also performed. Twelve trials were selected for
final analysis, with 25 781 patients and 2741 MACEs in the fibrate group
and 27 450 patients and 3754 MACEs in the control group. Overall, fibrate
therapy was associated with decreased risk of MACE [RR 0.87, 95%
confidence interval (CI) 0.81-0.94] with moderate heterogeneity
(I2 = 47%). In meta-regression analysis, each 1 mmol/L
reduction in low-density lipoprotein cholesterol (LDL-C) after fibrate
treatment reduced MACE (RR 0.71, 95% CI 0.49-0.94, P = 0.01), while
triglyceride level changes did not show a significant association (RR per
1mmol/L reduction 0.96, 95% CI 0.53-1.40, P = 0.86). A sensitivity
analysis with the composite outcome of cardiovascular death or acute
myocardial infarction produced similar results. . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusion Treatment
with fibrates was associated with decreased risk of MACE. The reduction in
MACE risk with fibrate therapy appears to be attributable to LDL-C
reduction rather than a decrease in triglyceride levels. - Lay
summary <inf>*</inf> A systematic review and meta-analysis including
12 trials and 53 231 patients were performed to investigate the effect of
fibrates on lowering cardiovascular risk. Overall, fibrate therapy was
associated with significantly decreased risk of cardiovascular events. In
further analysis, the decrease in cardiovascular risk achieved with
fibrate treatment was found to be largely attributable to low-density
lipoprotein cholesterol reduction. Copyright © The Author(s)
2023. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<2>
Accession Number
2030545340
Title
response to interleukin-1 blockade with anakinra in women and men with
ST-segment elevation myocardial infarction.
Source
Minerva Cardiology and Angiology. 72(1) (pp 67-75), 2024. Date of
Publication: February 2024.
Author
Corona G.; Golino M.; Talasaz A.H.; Moroni F.; Del Buono M.G.; Damonte
J.I.; Chiabrando J.G.; Mbualungu J.; Trankle C.R.; Thomas G.K.; Markley
R.; Canada J.M.; Turlington J.; Agatiello C.R.; van Tassell B.; Abbate A.
Institution
(Corona, Golino, Trankle, Thomas, Markley, Canada, Turlington, van
Tassell) division of Cardiology, department of internal Medicine, VCU
Pauley Heart Center, Virginia Commonwealth University, Richmond, VA,
United States
(Corona, Damonte, Chiabrando, Agatiello) department of interventional
Cardiology, Hospital italiano de Buenos aires, Buenos aires, Argentina
(Golino) department of Medicine and Surgery, University of insubria,
Varese, Italy
(Talasaz, van Tassell) department of Pharmacotherapy and outcomes
Sciences, Virginia Commonwealth University, Richmond, VA, United States
(Moroni) department of internal Medicine, University of Virginia, Va,
Charlottesville, United States
(Moroni) department of Medicine, University of Milano-Bicocca, Milan,
Italy
(Del Buono) department of Cardiovascular Medicine, irCCS a. gemelli
University Polyclinic Foundation, italy, Italy
(Mbualungu, Abbate) division of Cardiology, robert M. Berne Cardiovascular
research Center, University of Virginia, Va, Charlottesville, United
States
Publisher
Edizioni Minerva Medica
Abstract
BaCKgroUNd: interleukin-1 blockade with anakinra reduces high-sensitivity
C-reactive protein (hsCrP) levels and prevents heart failure (HF) events
after ST-segment myocardial infarction (STeMi). Sex-based differences in
STeMi patients have been reported, but no data are available regarding
response to anakinra. METHOD(S): We analyzed the systemic
inflammation and composite end-point of new-onset HF or death in women and
men with STeMi treated with anakinra from three different Virginia
Commonwealth University anakinra response Trial (VCUarT) randomized
clinical trials. reSUlTS: We analyzed 139 patients, 29 (21%) were women
while 110 (79%) were men. Baseline hsCrP was higher in women compared to
men (8.9 [5.2-13.5] vs. 4.2 [2.1-7.7] mg/l, P<0.001). eighty-four patients
were treated with anakinra (22 [75%] women and 62 [56%] men). The area
under the curve of hsCrP (hsCrP-aUC) after 14 days was numerically lower
in patients receiving anakinra versus placebo both in men (86 [37-130] vs.
223 [119-374] mg day/l) and in women (73 [46-313] vs. 242 [102-988] mg
day/l) (P<0.001 for multiple groups, P for interaction 0.22). The
incidence of the composite endpoint was also numerically lower in the
anakinra group compared to placebo, both in men (4 [6.4%] vs. 14 [29.1%])
and in women (3 [13.6%] vs. 2 [28.5%]) (P=0.019 for multiple groups, P for
interaction 0.44). There were no statistically significant differences
between women and men in hsCRP-AUC and death or HF events when comparing
separately the anakinra and placebo groups (all P>0.05). CoNClUSioNS:
Women were underrepresented in the VCUarT trials, they appeared to have
higher hsCrP levels at time of presentation, yet to benefit similar to men
by treatment with anakinra in STEMI. Copyright © 2024 Edizioni
Minerva Medica. All rights reserved.

<3>
Accession Number
2030508128
Title
Children Anxiety and Pain while Performing Interim Therapeutic
Restorations with Hand Instruments compared to Rotary Instruments: A
Randomised Clinical Trial.
Source
Journal of Clinical and Diagnostic Research. 18(1) (pp ZC59-ZC62), 2024.
Date of Publication: January 2024.
Author
Felemban O.M.; Bannan A.M.; Alqadi R.M.; Bamashmous N.O.
Institution
(Felemban) Department of Paediatric Dentistry, King Abdulaziz University,
Jeddah, Saudi Arabia
(Bannan) Department of Public Health, King Abdulaziz University, Jeddah,
Saudi Arabia
(Alqadi) Department of Dental, King Abdullah Medical Complex, Jeddah,
Saudi Arabia
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Children with dental anxiety may avoid visiting the dentist
until a more serious and painful condition develops. Dentists could use
less stressful techniques, like Interim Therapeutic Restorations (ITR), to
treat dental cavities in difficult or young patients. ITR performed with
hand tools may be preferred due to the absence of handpiece vibration,
sound, or smell. Aim(s): To assess the anxiety and pain levels
experienced by children during ITR procedures performed with hand
instruments compared to rotary instruments. Material(s) and
Method(s): The present randomised clinical trial was conducted in the
Department of Pediatric Dentistry at King Abdulaziz University Dental
Hospital in Jeddah, Saudi Arabia. The inclusion criteria consisted of
children aged 3-12 years visiting the dental clinic for the first time and
having a carious primary anterior (incisor or canine) tooth. Patients were
recruited from the paediatric screening clinic and randomly assigned to
either the "Hand instrument group" or the "Rotary instrument group."
Caries excavation was performed using a hand instrument in the former
group, while a low-speed handpiece was used in the latter group. Anxiety
levels were assessed using Venham's anxiety rating scale before and after
the procedure. Heart rate was measured using pulse oximetry every two
minutes. Pain levels were evaluated using the Wong-Baker Faces Pain Rating
Scale after completing the procedure. Result(s): The study included
60 patients, with a mean age of 5.87+/-2.09 years. The anxiety score after
the procedure was significantly lower in the hand instrument group
compared to the rotary instrument group (p=0.007). Although the heart rate
was lower in the hand instrument group compared to the rotary instrument
group, the difference was not statistically significant. The subjects in
the hand instrument group reported lower pain levels compared to those in
the rotary instrument group (p=0.029). conclusion: Performing ITR using
hand instruments resulted in reduced anxiety and pain levels among young
children compared to ITR performed using rotary handpieces. Copyright
© 2024 JCDR Research and Publications Pvt Ltd. All rights reserved.

<4>
Accession Number
2030476912
Title
Effects of RBT-1 on preconditioning response biomarkers in patients
undergoing coronary artery bypass graft or heart valve surgery: a
multicentre, double-blind, randomised, placebo-controlled phase 2 trial.
Source
eClinicalMedicine. 68 (no pagination), 2024. Article Number: 102364. Date
of Publication: February 2024.
Author
Lamy A.; Chertow G.M.; Jessen M.; Collar A.; Brown C.D.; Mack C.A.;
Marzouk M.; Scavo V.; Washburn T.B.; Savage D.; Smith J.; Bennetts J.;
Assi R.; Shults C.; Arghami A.; Butler J.; Devereaux P.J.; Zager R.; Wang
C.; Snapinn S.; Browne A.; Rodriguez J.; Ruiz S.; Singh B.; Chertow G.;
Brown C.; Mack C.; Tedesco D.; MacArthur J.; Praetor J.; Gandhi D.;
Corvera J.
Institution
(Lamy, Devereaux, Browne) Department of Perioperative Medicine and
Surgery, Population Health Research Institute, Hamilton, ON, Canada
(Chertow) Departments of Medicine and Epidemiology and Population Health,
Stanford University School of Medicine, Stanford, CA, United States
(Jessen) Department of Cardiovascular and Thoracic Surgery, University of
Texas Southwestern Medical Center, Dallas, TX, United States
(Collar) Department of Thoracic Surgery and Vascular Surgery, MyMichigan
Health, Midland, MI, United States
(Brown) Department of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, NB, Canada
(Mack) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Marzouk) Department of Cardiac Surgery, Quebec Heart and Lung Institute,
Quebec, Quebec, Canada
(Scavo) Department of Cardiovascular and Thoracic Surgery, Lutheran
Medical Group, Fort Wayne, IN, United States
(Washburn) Department of Cardiothoracic Surgery, Huntsville Hospital Heart
Center, Huntsville, AL, United States
(Savage) Department of Cardiothoracic Surgery, Indiana University Health,
Bloomington, IN, United States
(Smith) Department of Surgery (School of Clinical Sciences at Monash
Health), Monash University and Department of Cardiothoracic Surgery,
Monash Health, Melbourne, VIC, Australia
(Bennetts) Department of Cardiothoracic Surgery, Flinders Medical Centre,
Southern Adelaide Local Health Network, Adelaide, Australia
(Assi) Department of Cardiac Surgery, Yale University School of Medicine,
New Haven, CT, United States
(Shults) Department of Cardiac Surgery, MedStar Heart and Vascular
Institute, Washington, DC, United States
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Butler) Department of Medicine, University of Mississippi, Jackson, MS,
United States
(Zager, Rodriguez, Ruiz, Singh) Department of Drug Development & Medical
Affairs, Renibus Therapeutics Inc, Southlake, TX, United States
(Wang) Pharma Data Associates LLC, Piscataway, NJ, United States
(Snapinn) Seattle-Quilcene Biostatistics LLC, Seattle, WA, United States
(Bennetts) Department of Surgery, College of Medicine and Public Health,
Flinders University, Adelaide, Australia
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
Publisher
Elsevier Ltd
Abstract
Background: RBT-1 is a combination drug of stannic protoporfin (SnPP) and
iron sucrose (FeS) that elicits a preconditioning response through
activation of antioxidant, anti-inflammatory, and iron-scavenging
pathways, as measured by heme oxygenase-1 (HO-1), interleukin-10 (IL-10),
and ferritin, respectively. Our primary aim was to determine whether RBT-1
administered before surgery would safely and effectively elicit a
preconditioning response in patients undergoing cardiac surgery.
 Method(s): This phase 2, double-blind, randomised,
placebo-controlled, parallel-group, adaptive trial, conducted in 19
centres across the USA, Canada, and Australia, enrolled patients scheduled
to undergo non-emergent coronary artery bypass graft (CABG) and/or heart
valve surgery with cardiopulmonary bypass. Patients were randomised
(1:1:1) to receive either a single intravenous infusion of high-dose RBT-1
(90 mg SnPP/240 mg FeS), low-dose RBT-1 (45 mg SnPP/240 mg FeS), or
placebo within 24-48 h before surgery. The primary outcome was a
preoperative preconditioning response, measured by a composite of plasma
HO-1, IL-10, and ferritin. Safety was assessed by adverse events and
laboratory parameters. Prespecified adaptive criteria permitted early
stopping and enrichment. This trial is registered with ClinicalTrials.gov,
NCT04564833. Finding(s): Between Aug 4, 2021, and Nov 9, 2022, of 135
patients who were enrolled and randomly allocated to a study group (46
high-dose, 45 low-dose, 44 placebo), 132 (98%) were included in the
primary analysis (46 high-dose, 42 low-dose, 44 placebo). At interim, the
trial proceeded to full enrollment without enrichment. RBT-1 led to a
greater preconditioning response than did placebo at high-dose (geometric
least squares mean [GLSM] ratio, 3.58; 95% CI, 2.91-4.41; p < 0.0001) and
low-dose (GLSM ratio, 2.62; 95% CI, 2.11-3.24; p < 0.0001). RBT-1 was
generally well tolerated by patients. The primary drug-related adverse
event was dose-dependent photosensitivity, observed in 12 (26%) of 46
patients treated with high-dose RBT-1 and in six (13%) of 45 patients
treated with low-dose RBT-1 (safety population). Interpretation(s):
RBT-1 demonstrated a statistically significant cytoprotective
preconditioning response and a manageable safety profile. Further research
is needed. A phase 3 trial is planned. Funding(s): Renibus
Therapeutics, Inc. Copyright © 2023 The Author(s)

<5>
Accession Number
2029976397
Title
A Systematic Review of Delayed High-Grade Atrioventricular Block After
Transcatheter Aortic Valve Implantation.
Source
CJC Open. Part A. 6(2) (pp 86-95), 2024. Date of Publication: February
2024.
Author
Rao K.; Chan B.; Baer A.; Hansen P.; Bhindi R.
Institution
(Rao, Chan, Hansen, Bhindi) Department of Cardiology, Royal North Shore
Hospital, Sydney, Australia
(Rao, Baer, Hansen, Bhindi) Department of Cardiology, North Shore Private
Hospital, Sydney, Australia
(Rao, Chan, Bhindi) University of Sydney, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Background: High-grade atrioventricular block (HGAVB) is common after
transcatheter aortic valve implantation (TAVI), often necessitating
permanent pacemaker (PPM) implantation. Delayed HGAVB has varying
definitions but typically refers to onset 48 hours after TAVI or following
discharge and may cause syncope and sudden cardiac death. This review
estimates the incidence of delayed HGAVB and identifies limitations of
current literature. Method(s): A systematic review was performed of
the following online databases: Medline, Cochrane, Web of Science, and
Scopus. Studies that labelled the outcome of "delayed" or "late"
atrioventricular block after TAVI were included; patients with previous
PPM or aortic valve surgery were excluded. Initial search yielded 775
studies, which, after screening, was narrowed to 19 studies.
 Result(s): Nineteen studies with 14,898 patients were included. Mean
age was 81.7 years, and 46.3% were male. Mean Society of Thoracic Surgeons
(STS) score was 5.6%, and 31.3% of patients had known atrial fibrillation.
The most common access site was transfemoral (84.8%), whereas
balloon-expandable valves were used in 62.1%, self-expanding valves in
34.0%, and mechanically expanding valves in 3.9% of cases. The incidence
of delayed HGAVB ranged from 1.7% to 14.6%, with significant methodologic
heterogeneity noted among the included studies. Conclusion(s):
Delayed HGAVB is a common and potentially serious complication of TAVI,
with similar risk factors to acute HGAVB. With a move toward an early
discharge strategy post-TAVI, further prospective study of delayed HGAVB
is warranted to improve understanding of predisposing factors, incidence,
timing, and implications. Copyright © 2023 The Authors

<6>
Accession Number
2029781259
Title
Preoperative Levosimendan in Patients With Severe Left Ventricular
Dysfunction Undergoing Isolated Coronary Artery Bypass Grafting: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(3) (pp 649-659),
2024. Date of Publication: March 2024.
Author
Ayala R.; Gewehr D.M.; Godoi A.; Velasquez C.; Fernandez M.; Carvalho
P.E.P.; Goebel N.
Institution
(Ayala, Goebel) Department of Cardiovascular Surgery, Robert Bosch
Hospital, Stuttgart, Germany
(Gewehr) Curitiba Heart Institute, Parana, Curitiba, Brazil
(Godoi) Cardiff University School of Medicine, Wales, United Kingdom
(Velasquez) University of Texas Medical Branch, Galveston, TX, United
States
(Fernandez) Bahiana School of Medicine and Public Health, Bahia, Salvador,
Brazil
(Carvalho) Department of Medicine, Federal University of Minas Gerais,
Belo Horizonte, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To verify the impact of preoperative levosimendan on patients
with severe left ventricular dysfunction (ejection fraction <35%)
undergoing isolated coronary artery bypass grafting. Design(s): A
meta-analysis. Setting(s): Hospitals. Participant(s): The
authors included 1,225 patients from 6 randomized controlled trials.
 Intervention(s): None. Measurements and Main Results: The
authors performed a meta-analysis of trials that compared preoperative
levosimendan with placebo or no therapy, reporting efficacy and safety
endpoints. Statistical analyses used mean differences and risk ratios
(RR), with a random effects model. Six studies were included, comprising
1,225 patients, of whom 615 (50.2%) received preoperative levosimendan,
and 610 (49.8%) received placebo/no therapy. Preoperative levosimendan
showed a lower risk of all-cause mortality (RR 0.31; 95% CI 0.16-0.60; p <
0.01; I2 = 0%), postoperative acute kidney injury (RR 0.44; 95%
CI 0.25-0.77; p < 0.01; I2 = 0%), low-cardiac-output syndrome
(RR 0.45; 95% CI 0.30-0.66; p < 0.001; I2 = 0%), and
postoperative atrial fibrillation (RR 0.49; 95% CI 0.25-0.98; p = 0.04;
I2 = 85%) compared to control. Moreover, levosimendan
significantly reduced the need for postoperative inotropes and increased
the cardiac index at 24 hours postoperatively. There were no differences
between groups for perioperative myocardial infarction, hypotension, or
any adverse events. Conclusion(s): Preoperative levosimendan in
patients with severe left ventricular dysfunction undergoing isolated
coronary artery bypass grafting was associated with reduced all-cause
mortality, low-cardiac-output syndrome, acute kidney injury, postoperative
atrial fibrillation, and the need for circulatory support without
compromising safety. Copyright © 2023 Elsevier Inc.

<7>
Accession Number
2029414946
Title
Comparison of Erector Spinae Plane Block and Pectointercostal Facial Plane
Block for Enhanced Recovery After Sternotomy in Adult Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(3) (pp 691-700),
2024. Date of Publication: March 2024.
Author
Elbardan I.M.; Abdelkarime E.M.; Elhoshy H.S.; Mohamed A.H.; ElHefny D.A.;
Bedewy A.A.
Institution
(Elbardan, Elhoshy, Mohamed) Department of Anesthesia and Surgical
Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt
(Abdelkarime) Department of Anesthesia and ICU, Mansoura University,
Mansoura, Egypt
(ElHefny) Department of Anesthesia and Surgical Intensive Care,
Kafrelsheikh University, Kafr El-Sheikh, Egypt
(Bedewy) Department of Anesthesia and Surgical Intensive Care, Helwan
University, Helwan, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to investigate and compare the effects of the
pectointercostal fascial plane block (PIFPB) and the erector spinae plane
block (ESPB) on enhancing the recovery of patients who undergo cardiac
surgery. Design(s): A randomized, controlled, double-blinded study.
 Setting(s): The operating rooms and intensive care units of
university hospitals. Participant(s): One hundred patients who were
American Society of Anesthesiologists class II to III aged 18-to-70 years
scheduled for elective cardiac surgery. Intervention(s): Patients
were randomly assigned to undergo either ultrasound-guided bilateral PIFPB
or ESPB. Measurements and Main Results: Patients shared comparable
baseline characteristics. Time to extubation, the primary outcome, did not
demonstrate a statistically significant difference between the groups,
with median (95% confidence interval) values of 115 (90-120) minutes and
110 (100-120) minutes, respectively (p = 0.875). The ESPB group had a
statistically significant reduced pain score postoperatively. The median
(IQR) values of postoperative fentanyl consumption were statistically
significantly lower in the ESPB group than in the PIFPB group (p < 0.001):
4 (4-5) versus 9 (9-11) microg/kg, respectively. In the ESPB group, the
first analgesia request was given 4 hours later than in the PIFPB group (p
< 0.001). Additionally, 12 (24%) patients in the PIFPB group reported
nonsternal wound chest pain, compared with none in the ESPB group. The
median intensive care unit length of stay for both groups was 3 days (p =
0.428). Conclusion(s): Erector spinae plane block and PIFPB were
found to equally affect recovery after cardiac surgery, with comparable
extubation times and intensive care unit length of stay. Copyright
© 2023 Elsevier Inc.

<8>
Accession Number
2029353960
Title
Deep Parasternal Intercostal Plane Block for Intraoperative Pain Control
in Cardiac Surgical Patients for Sternotomy: A Prospective Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(3) (pp 683-690),
2024. Date of Publication: March 2024.
Author
Wong H.M.K.; Chen P.Y.; Tang G.C.C.; Chiu S.L.C.; Mok L.Y.H.; Au S.S.W.;
Wong R.H.L.
Institution
(Wong, Chen, Tang, Mok, Au) Department of Anesthesia and Intensive Care,
Prince of Wales Hospital, New Territories, Hong Kong, Hong Kong
(Chiu) Department of Anesthesia and Intensive Care, the Chinese University
of Hong Kong, Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong, Hong Kong
Publisher
W.B. Saunders
Abstract
Objectives: Sternotomy pain is common after cardiac surgery. The deep
parasternal intercostal plane (DPIP) block is a novel technique that
provides analgesia to the anterior chest wall. The aim of this study was
to investigate the analgesic effect of bilateral DPIP blocks on
intraoperative pain control in cardiac surgery. Design(s): This is a
double-blinded, prospective randomized controlled trial (Oct 2020-Dec
2022). Setting(s): This study was conducted in a single institution,
which is an academic university hospital. Participant(s): Eighty-six
elective cardiac surgical patients with median sternotomy were recruited.
 Intervention(s): Patients were randomly divided into DPIP or control
group. Either 20ml 0.25% levobupivacaine or 0.9% normal saline was
injected for the DPIP under ultrasound guidance after induction of general
anaesthesia. Measurements and Main Results: The primary outcome was
intraoperative opioids consumption and hemodynamic changes at sternotomy.
Secondary outcomes included postoperative morphine consumption,
postoperative pain and time to tracheal extubation. Intraoperative opioids
requirement was reduced from a median (IQR) intravenous morphine
equivalence of 21.4mg (13.8-24.3mg) in control group to 9.5mg (7.3-11.2mg)
in the DPIP group (P<0.001). Hemodynamic parameters were more stable in
DPIP group at sternotomy, as evidenced by lower percentage increase in
systolic, diastolic and mean arterial blood pressure from baseline. No
difference was observed in time to tracheal extubation, postoperative
morphine consumption, postoperative pain score and spirometry.
 Conclusion(s): Bilateral DPIP block provides effective intraoperative
analgesia and opioid-sparing. It may be included as part of the multimodal
analgesia for enhanced recovery in cardiac surgery. Copyright ©
2023 The Author(s)

<9>
Accession Number
2028644581
Title
Analgesic effect of the ultrasound-guided thoracolumbar paravertebral
block in patients undergoing robot-assisted laparoscopic nephrectomy: a
randomized controlled trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 69. Date
of Publication: December 2024.
Author
Yin G.; Li Y.; Wei P.; Ma X.; Li B.; Gan G.; Song X.
Institution
(Yin, Li, Gan, Song) Department of Anesthesiology, General Hospital of
Central Theater Command of People's Liberation Army, Wuhan 430070, China
(Li) The First School of Clinical Medicine, Southern Medical University,
Guangzhou 510515, China
(Wei, Ma) General Hospital Base of Central Theater Command of People's
Liberation Army, Hubei University of Medicine, Wuhan 430070, China
Publisher
BioMed Central Ltd
Abstract
Background: Paravertebral block has similar effect as epidural anesthesia,
and has good somatic and visceral analgesic effect. Paravertebral block is
widely used in thoracic surgery, but rarely used in abdominal surgery.
 Aim(s): This study aimed to evaluate the analgesic effect of
thoracolumbar paravertebral block in patients undergoing robot-assisted
laparoscopic nephrectomy. Method(s): One hundred patients undergoing
elective robot-assisted laparoscopic nephrectomy were included in this
study. Based on whether the thoracolumbar paravertebral block was
performed, the patients were randomly divided into the thoracolumbar
paravertebral block combined with general anesthesia group (TL-PVB group)
and simple general anesthesia group (NO-PVB group). Oxycodone was
administered for patient-controlled intravenous analgesia (PCIA). The
primary outcomes included the amount of remifentanil used during surgery,
the amount of oxycodone used in 24 and 48 h after surgery. Secondary
outcomes included the changes of heart rate (HR) and mean arterial
pressure (MAP), time for the first analgesia administration, visual analog
score (VAS) of pain during rest and movement, and time of postoperative
recovery. Result(s): Compared to the NO-PVB group, the amount of
remifentanil used during surgery in patients with TL-PVB group was
significantly reduced (1.78 +/- 0.37 mg vs. 3.09 +/- 0.48 mg, p < 0.001),
the amount of oxycodone used 24 h after surgery was significantly reduced
(8.70 +/- 1.70 mg vs. 13.79 +/- 2.74 mg, p < 0.001), and the amount of
oxycodone used 48 h after surgery was remarkably reduced (21.83 +/- 4.28
mg vs. 27.27 +/- 4.76 mg, p < 0.001). There were significant differences
in the changes of HR and MAP between the two groups (p < 0.001). The first
analgesic requirement time of TL-PVB group was significantly longer than
that of NO-PVB group (468.56 +/- 169.60 min vs. 113.48 +/- 37.26 min, p <
0.001). The postoperative VAS during rest and movement of TL-PVB group
were significantly lower than that of NO-PVB group (p < 0.01). Compared
with NO-PVB group, patients in TL-PVB group needed shorter time to awaken
from anesthesia, leave the operating room, anal exhaust, get out of bed,
and had shorter length of postoperative hospital stay (p < 0.001). The
incidence of postoperative adverse reactions were lower in the TL-PVB
group than that in the NO-PVB group (p < 0.05). Conclusion(s):
Ultrasound-guided thoracolumbar paravertebral block significantly reduces
intraoperative and postoperative opioid consumption, and provides better
analgesia in patients undergoing robot-assisted laparoscopic nephrectomy,
which is a recommendable combined anesthesia technique. Trial
registration: ChiCTR2200061326, 21/06/2022. Copyright © The
Author(s) 2024.

<10>
Accession Number
2028636378
Title
Comparison of high-flow nasal cannula oxygenation and non-invasive
ventilation for postoperative pediatric cardiac surgery: a meta-analysis.
Source
BMC Pulmonary Medicine. 24(1) (no pagination), 2024. Article Number: 92.
Date of Publication: December 2024.
Author
Zhou S.-J.; Chen X.-H.; Liu Y.-Y.; Chen Q.; Zheng Y.-R.; Zhang Q.-L.
Institution
(Zhou, Chen, Liu, Chen, Zheng, Zhang) Department of Cardiac Surgery,
Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical
Center), College of Clinical Medicine for Obstetrics & amp; Gynecology and
Pediatrics, Fujian Medical University, Fuzhou, China
Publisher
BioMed Central Ltd
Abstract
Objective: To evaluate the efficacy of high-flow nasal cannula oxygenation
(HFNC) versus non-invasive ventilation (NIV) in pediatric patients
post-congenital heart surgery (CHS) through a meta-analysis.
 Method(s): A comprehensive literature search was conducted across the
Chinese biomedical literature database, Vip database, CNKI, Wanfang,
PubMed, Embase, Cochrane Library, and Web of Science until December 20,
2022. We selected RCTs or cohort studies that met inclusion criteria for a
meta-analysis using RevMan 5.4 software. Result(s): Our search
yielded five publications, comprised of one randomized controlled trial
and four cohort studies. Meta-analysis revealed a significant reduction in
reintubation rates in children post-CHS treated with HFNC as compared to
NIV [RR = 0.36, 95%CI(0.25 ~ 0.53), P < 0.00001]. There was also a notable
reduction in the duration of ICU stay [MD = -4.75, 95%CI (-9.38 ~ -0.12),
P = 0.04]. No statistically significant differences were observed between
HFNC and NIV in terms of duration of mechanical ventilation, 24 h
PaO<inf>2</inf>, and PaCO<inf>2</inf> post-treatment (P > 0.05).
Furthermore, both groups showed no significant difference in the duration
of extracorporeal circulation [MD = -8.27, 95%CI(-17.16 ~ 0.62), P =
0.07]. Conclusion(s): For pediatric patients post-CHS, HFNC appears
to be more effective than NIV in reducing reintubation rates and
shortening the CICU stay. Copyright © The Author(s) 2024.

<11>
Accession Number
2028626131
Title
Preemptive deep parasternal intercostal plane block for perioperative
analgesia in coronary artery bypass grafting with sternotomy: a
randomized, observer-blind, controlled study.
Source
Annals of Medicine. 55(2) (no pagination), 2023. Article Number: 2302983.
Date of Publication: 2023.
Author
Chen Y.; Li Q.; Liao Y.; Wang X.; Zhan M.-Y.; Li Y.-Y.; Liu G.-J.; Xiao L.
Institution
(Chen, Li, Liao, Wang, Zhan, Li, Xiao) Department of Anesthesiology, The
First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
(Liu) Department of Anesthesiology, Shenzhen Second People's Hospital,
Shenzhen, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: The precise characteristics of deep parasternal intercostal
plane block (DPIP), which is useful for providing analgesia during open
heart surgery, have not yet been thoroughly elucidated. In this study, we
aimed to establish the efficacy, define the cutaneous sensory block area,
and determine the duration of preemptive DPIP block at the T3-4 or T4-5
intercostal spaces in patients undergoing coronary artery bypass grafting
(CABG) via sternotomy. Design(s): A prospective, single-blind,
randomized controlled trial. Setting(s): Patients were randomly
divided into three cohorts, each containing thirty patients.
 Participant(s): Ninety patients who underwent elective CABG via
sternotomy were included in this study. Intervention(s): The T3-4 and
T4-5 groups received a preoperative single-shot DPIP block at the
respective intercostal spaces. The principal objective of the study was to
ascertain the optimal dosage of sufentanil administered during surgical
procedures involving either a DPIP block or its absence, and to conduct a
comparative analysis thereof across distinct injection sites, specifically
T3-4 and T4-5. Secondary factors considered were the dosage of
postoperative analgesics, the extent of sensory block on the skin, pain
levels after extubation, time of recovery from anesthesia (time to
extubation), duration of the block, and the occurrence of nausea and
vomiting. Measurements & Main Results: Preemptive DPIP block significantly
reduced intraoperative sufentanil requirement compared to the control
group (T3-4:0.38 +/- 0.1, T4-5:0.32 +/- 0.10, vs. Control:0.88 +/- 0.3
mug/kg/h, p < 0.001). It also resulted in decreased analgesic consumption
and numeric rating scale scores on the day of surgery (p < 0.01 compared
to the control group). The DPIP block provided accurate anesthetic
coverage of the dermatomes in the sternal region and reduced the time to
extubation and postoperative nausea. However, the injection point (either
via the T3-4 intercostal or the T4-5 intercostal) did not affect the
efficacy. Preoperative DPIP block failed to provide adequate analgesia
beyond 24 h post-surgery. Conclusion(s): Preemptive bilateral DPIP
block provided effective analgesia in patients undergoing CABG during
surgery and in the early postoperative period. The analgesic effects of
the DPIP block in the T3-4 and T4-5 intercostal spaces were
comparable. Copyright © 2024 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis Group.

<12>
Accession Number
2028102931
Title
Rationale and Design of the mTECH-Rehab Randomized Controlled Trial:
Impact of a Mobile Technology Enabled Corrie Cardiac Rehabilitation
Program on Functional Status and Cardiovascular Health.
Source
Journal of the American Heart Association. 13(2) (no pagination), 2024.
Article Number: e030654. Date of Publication: 16 Jan 2024.
Author
Isakadze N.; Kim C.H.; Marvel F.A.; Ding J.; Macfarlane Z.; Gao Y.;
Spaulding E.M.; Stewart K.J.; Nimbalkar M.; Bush A.; Broderick A.;
Gallagher J.; Molello N.; Commodore-Mensah Y.; Michos E.D.; Dunn P.;
Hanley D.F.; McBee N.; Martin S.S.; Mathews L.
Institution
(Isakadze, Kim, Marvel, Ding, Macfarlane, Gao, Spaulding, Stewart,
Nimbalkar, Bush, Broderick, Gallagher, Michos, Martin, Mathews) Division
of Cardiology, Department of Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Isakadze, Kim, Marvel, Ding, Macfarlane, Gao, Spaulding, Michos, Martin,
Mathews) Digital Health Innovation Laboratory, Ciccarone Center for the
Prevention of Cardiovascular Disease, Division of Cardiology, Department
of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Isakadze, Kim, Marvel, Ding, Macfarlane, Gao, Spaulding, Michos, Martin,
Mathews) Center for Mobile Technologies to Achieve Equity in
Cardiovascular Health (mTECH Center), Baltimore, MD, United States
(Spaulding, Commodore-Mensah) Johns Hopkins University School of Nursing,
Baltimore, MD, United States
(Molello, Commodore-Mensah, Martin, Mathews) Johns Hopkins Center for
Health Equity, Baltimore, MD, United States
(Michos, Mathews) Welch Center for Prevention, Epidemiology, and Clinical
Research, Johns Hopkins University, Baltimore, MD, United States
(McBee) Ginsburg Institute for Health Equity, Nemours Children's Health,
Orlando, FL, United States
(Dunn) Center for Health Technology and Innovation, American Heart
Association, Dallas, TX, United States
(Dunn, Hanley, McBee) Department of Neurology, Division of Neurosurgery,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
(Hanley) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based,
guideline-recommended intervention for patients recovering from a cardiac
event, surgery or procedure that improves morbidity, mortality, and
functional status. CR is traditionally provided in-center, which limits
access and engagement, most notably among underrepresented racial and
ethnic groups due to barriers including cost, scheduling, and
transportation access. This study is designed to evaluate the Corrie
Hybrid CR, a technology-based, multicomponent health equity-focused
intervention as an alternative to traditional in-center CR among patients
recovering from a cardiac event, surgery, or procedure compared with usual
care alone. METHOD(S): The mTECH-Rehab (Impact of a Mobile Technology
Enabled Corrie CR Program) trial will randomize 200 patients who either
have a diagnosis of type 1 myocardial infarction or who undergo coronary
artery bypass grafting surgery, percu-taneous coronary intervention, heart
valve repair, or replacement presenting to 4 hospitals in a large academic
health system in Maryland, United States, to the Corrie Hybrid CR program
combined with usual care CR (intervention group) or usual care CR alone
(control group) in a parallel arm, randomized controlled trial. The Corrie
Hybrid CR program leverages 5 compo-nents: (1) a patient-facing mobile
application that encourages behavior change, patient empowerment, and
engagement with guideline-directed therapy; (2) Food and Drug
Administration-approved smart devices that collect health metrics; (3) 2
upfront in-center CR sessions to facilitate personalization,
self-efficacy, and evaluation for the safety of home exercise, followed by
a combination of in-center and home-based sessions per participant
preference; (4) a clinician dashboard to track health data; and (5) weekly
virtual coaching sessions delivered over 12 weeks for education,
encouragement, and risk factor modification. The primary outcome is the
mean difference between the intervention versus control groups in distance
walked on the 6-minute walk test (ie, functional capacity) at 12 weeks
post randomization. Key secondary and exploratory outcomes include
improvement in a composite cardiovascular health metric, CR engagement,
quality of life, health factors (including low-density
lipoprotein-cholesterol, hemoglobin A1c, weight, diet, smoking cessation,
blood pressure), and psychosocial factors. Approval for the study was
granted by the local institutional review board. Results of the trial will
be published once data collection and analysis have been completed.
 CONCLUSION(S): The Corrie Hybrid CR program has the potential to
improve functional status, cardiovascular health, and CR engagement and
advance equity in access to cardiac rehabilitation. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT05238103. Copyright © 2024 The Authors.

<13>
Accession Number
2026770455
Title
Hygiene with wet wipes in bedridden patients to prevent
catheter-associated urinary tract infection in cardiac surgery: A
randomized controlled trial.
Source
Infection Control and Hospital Epidemiology. 45(2) (pp 227-230), 2024.
Date of Publication: 24 Feb 2024.
Author
Castella L.; Casas I.; Gimenez M.; Reina D.; Sopena N.; Garcia-Quesada
M.-J.
Institution
(Castella, Reina, Garcia-Quesada) Infection Control Nursing, Infection
Control Team, Germans Trias i Pujol University Hospital, Badalona, Spain
(Castella, Casas, Sopena, Garcia-Quesada) Germans Trias i Pujol Research
Institute (IGTP), Germans Trias i Pujol University Hospital, Badalona,
Spain
(Castella, Reina, Garcia-Quesada) NURECARE-IGTP Nursing Research Group,
Germans Trias i Pujol Research Institute, Badalona, Spain
(Casas) Preventive Medicine Department, Infection Control Team, Germans
Trias i Pujol University Hospital, Badalona, Spain
(Casas, Sopena) Universitat Autonoma de Barcelona, Cerdanyola Del Valles,
Barcelona, Spain
(Gimenez, Sopena) Microbiology Department, Infection Control Team, North
Metropolitan Clinical Laboratory, Germans Trias i Pujol University
Hospital, Badalona, Spain
(Gimenez, Sopena) Infectious Diseases Department, Infection Control Team,
Germans Trias i Pujol University Hospital, Badalona, Spain
(Gimenez, Sopena) CIBERES, Instituto de Salud Carlos III, Madrid, Spain
Publisher
Cambridge University Press
Abstract
We assessed hygiene with wet wipes in bedridden patients with urinary
catheters for catheter-associated urinary tract infection (CAUTI)
prevention. CAUTIs occurred in 16.5% of the control group compared to 5.9%
of the intervention group (P =.035). Hygiene with wet wipes can substitute
for conventional hygiene for preventing CAUTI. Copyright © The
Author(s), 2023. Published by Cambridge University Press on behalf of The
Society for Healthcare Epidemiology of America.

<14>
Accession Number
2028657765
Title
The role of dexmedetomidine administered via intravenous infusion as
adjunctive therapy to mitigate postoperative delirium and postoperative
cognitive dysfunction in elderly patients undergoing regional anesthesia:
a meta-analysis of randomized controlled trials.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 73. Date
of Publication: December 2024.
Author
Wang D.; He X.; Li Z.; Tao H.; Bi C.
Institution
(Wang, Li, Tao, Bi) Department of Anesthesiology, Dalian Municipal Central
Hospital Affiliated to Dalian University of Technology, Dalian, Liaoning,
China
(Wang, He, Li) Dalian Medical University, Dalian, China
Publisher
BioMed Central Ltd
Abstract
Study objective: This meta-analysis aimed to assess whether continuous
intravenous administration of DEX during surgery can be part of the
measures to prevent the onset of postoperative delirium and postoperative
cognitive dysfunction in elderly individuals following regional
anesthesia. Method(s): We searched the databases of PubMed, Embase,
the Cochrane Library and China National Knowledge Infrastructure (by June
1, 2023) for all available randomized controlled trials assessing whether
intravenous application of dexmedetomidine can help with postoperative
delirium and postoperative cognitive dysfunction in the elderly with
regional anesthesia. Subsequently, we carried out statistical analysis and
graphing using Review Manager software (RevMan version 5.4.1) and STATA
software (Version 12.0). Main Result(s): Within the scope of this
meta-analysis, a total of 18 randomized controlled trials were included.
Among them, 10 trials aimed to assess the incidence of postoperative
delirium as the primary outcome, while the primary focus of the other 8
trials was on the incidence of postoperative cognitive dysfunction. The
collective evidence from these 10 studies consistently supports a positive
relationship between the intravenous administration of dexmedetomidine and
a decreased risk of postoperative delirium (RR: 0.48; 95%CI: 0.37 to 0.63,
p < 0.00001, I2 = 0%). The 8 literature articles and
experiments evaluating postoperative cognitive dysfunction showed that
continuous intravenous infusion of dexmedetomidine during the entire
surgical procedure exhibited a positive preventive effect on cognitive
dysfunction among the elderly population with no obvious heterogeneity
(RR: 0.35; 95%CI: 0.25 to 0.49,p < 0.00001, I2 = 0%).
 Conclusion(s): Administering dexmedetomidine intravenously during
surgery can potentially play a significant role in preventing
postoperative delirium and postoperative cognitive dysfunction in patients
older than 60 years with regional anesthesia according to this
meta-analysis. Copyright © The Author(s) 2024.

<15>
Accession Number
2027253959
Title
Goal-Directed Therapy in Cardiogenic Shock: No Magical Recipe.
Source
Current Anesthesiology Reports. 14(1) (pp 90-100), 2024. Date of
Publication: March 2024.
Author
Lescroart M.; Piccoli J.; Hebert J.-L.; Kimmoun A.
Institution
(Lescroart, Kimmoun) CHRU de Nancy, Medecine Intensive et Reanimation
Brabois, Universite de Lorraine, FCRIN INI-CRCT, Nancy, France
(Lescroart, Kimmoun) Universite de Lorraine, INSERM U1116, Nancy, France
(Piccoli) Departement de chirurgie cardiaque et transplantation, CHRU de
Nancy, Universite de Lorraine, Nancy, France
(Hebert) Institut de Cardiologie, AP-HP, CHU Pitie-Salpetriere, Sorbonne
Universite, Paris, France
Publisher
Springer
Abstract
Purpose of Review: Cardiogenic shock (CS) remains a critical condition
associated with a high mortality rate. Early and appropriate management
may prevent or reverse multiple organ failure. Various strategies have
been proposed to appropriately manage CS, but no goal-directed therapy has
yet been validated. Recent Findings: In this narrative review, we propose
a physiological-based goal-directed therapy that relies on both flow and
pressure monitoring to adapt the titration of inotropic and vasopressor
drugs. Along with addressing the initial trigger, these physiological
endpoints should serve as the benchmark for accurately adjusting
therapeutics up to veno-arterial extracorporeal membrane oxygenation
implementation if necessary. Summary: The ultimate challenge is to
define early in the trajectory of patients with cardiogenic shock, whether
it is a bridge to recovery or, if eligible, a bridge to heart
transplantation or a long-term assistance device. Graphical Abstract:
(Figure presented.) MAP, mean arterial pressure; RAP, right atrial
pressure; RV, right ventricle; mPAP, mean pulmonary artery pressures;
PCWP, pulmonary capillary wedge pressures; HTx, heart transplantation;
TTE, transthoracic echocardiography; LVOT VTI, left ventricular outflow
tract velocity time integral; IVC, inferior vena cava; LVFP, left
ventricular filling pressures; CS, cardiogenic shock; CO, cardiac output;
PAC, pulmonary artery catheter; PICCO, pulse index continuous cardiac
output; CRT, capillary refill time. Copyright © The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2023.

<16>
Accession Number
2026731126
Title
Effect of 5% albumin on endothelial glycocalyx degradation during off-pump
coronary artery bypass.
Source
Canadian Journal of Anesthesia. 71(2) (pp 244-253), 2024. Date of
Publication: February 2024.
Author
Nan Z.; Soh S.; Shim J.-K.; Kim H.B.; Yang Y.S.; Kwak Y.L.; Song J.W.
Institution
(Nan, Soh, Shim, Yang, Kwak) Department of Anesthesiology and Pain
Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Nan, Soh, Shim, Kwak) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Song) Department of Anesthesiology and Pain Medicine, Anesthesia and Pain
Research Institute, Yonsei Cardiovascular Hospital, Yonsei University
College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
Publisher
Springer
Abstract
Purpose: The integrity of the endothelial glycocalyx (EG), a critical
player in vascular homeostasis, reportedly influences the outcomes of
critically ill patients. We investigated the effect of 5% albumin, which
preserved EG integrity in preclinical studies, vs balanced crystalloid
solution on EG degradation in patients undergoing off-pump coronary
surgery. Method(s): Patients were randomized to receive either 5%
albumin (N = 51) or balanced crystalloid solution (Plasma-Lyte [Baxter
Incorporated, Seoul, Republic of Korea]; N = 53) for intravenous volume
replacement during surgery (double-blinded). The primary outcome was
plasma syndecan-1 concentration, a marker of EG degradation, measured
after anesthetic induction (baseline), completion of grafting, and sternal
closure. Secondary outcomes were atrial natriuretic peptide (ANP), tumour
necrosis factor (TNF)-alpha, soluble thrombomodulin, and perioperative
fluid balance. Result(s): The mean (standard deviation) fluid
requirements were 833 (270) mL and 1,323 (492) mL in the albumin and
Plasma-Lyte group, respectively (mean difference, -489 mL; 95% confidence
interval [CI], -643 to -335; P < 0.001). Plasma syndecan-1 concentration
increased after completion of grafting (median difference, 116
ng.mL-1; 95% CI, 67 to 184; P < 0.001) and sternal closure
(median difference, 57 ng.mL-1; 95% CI, 36 to 80; P < 0.001)
compared with those at baseline, without any intergroup differences.
Atrial natriuretic peptide, TNF-alpha, and soluble thrombomodulin
concentrations were similar between the two groups. The amount of chest
tube drainage was greater in the albumin group than that in the
Plasma-Lyte group (median difference, 190 mL; 95% CI, 18 to 276; P =
0.03). Conclusion(s): Off-pump coronary surgery was associated with
significant EG degradation. Yet, intraoperative fluid therapy with 5%
albumin could not ameliorate EG degradation when compared with balanced
crystalloid solution. Trial registration: ClinicalTrials.gov
(NCT03699462); first posted 9 October 2018. Copyright © Canadian
Anesthesiologists' Society 2023.

<17>
Accession Number
2030632178
Title
Erratum: Correlation between second and first primary cancer: systematic
review and meta-analysis of 9 million cancer patients (British Journal of
Surgery (2024) 111:1 (znad377) DOI: 10.1093/bjs/znad377).
Source
British Journal of Surgery. 111(2) (no pagination), 2024. Article Number:
znae044. Date of Publication: 01 Feb 2024.
Author
Anonymous
Publisher
Oxford University Press
Abstract
This is a corrigendum to: Xinyu Wang, Meiyuan Zeng, Xueming Ju, Anqi Lin,
Chaozheng Zhou, Junyi Shen, Zaoqu Liu, Bufu Tang, Quan Cheng, Youyu Wang,
Jian Zhang, Peng Luo, Correlation between second and first primary cancer:
systematic review and meta-analysis of 9 million cancer patients, British
Journal of Surgery, Volume 111, Issue 1, January 2024, znad377,
https://doi.org/10.1093/bjs/znad377 In the originally published version of
this manuscript, authors Xueming Ju and Youyu Wang's affiliations required
correction. Xueming Ju's affiliation, "Department of Utrasound, Sichuan
Provincial People's Hospital, University of Electronic Science and
Technology of China, Chengdu, China", contained a typographical error.
This has been corrected. Youyu Wang's correct affiliation is "Department
of Thoracic Surgery, Sichuan Provincial People's Hospital, University of
Electronic Science and Technology of China, Chengdu, China". This
affiliation has been added to the manuscript. Subsequent affiliations in
the affiliation list have been renumbered accordingly in view of this
change. Copyright © The Author(s) 2024.

<18>
Accession Number
2030632208
Title
Early and mid-term outcomes after aortic valve replacement using a novel
tissue bioprosthesis: a systematic review.
Source
European Journal of Cardio-thoracic Surgery. 65(2) (no pagination), 2024.
Article Number: ezae045. Date of Publication: 01 Feb 2024.
Author
Sef D.; Thet M.S.; Klokocovnik T.; Luthra S.
Institution
(Sef) Department of Cardiac Surgery, University Hospitals of Leicester,
Leicester, United Kingdom
(Thet) Faculty of Medicine, Department of Surgery and Cancer, Imperial
College London, Imperial College Healthcare NHS Trust, London, United
Kingdom
(Klokocovnik) Department of Cardiac Surgery, General Hospital Celje,
Celje, Slovenia
(Luthra) Department of Cardiac Surgery, Wessex Cardiothoracic Centre,
University Hospital of Southampton, Southampton, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: While current data show a clear trend towards the use of
bioprosthetic valves during aortic valve replacement (AVR), durability of
bioprosthetic valves remains the most important concern. We conducted a
1st systematic review of all available evidence that analysed early and
mid-term outcomes after AVR using the Inspiris RESILIATM bioprosthesis.
 METHOD(S): A systematic literature search was performed to identify
all relevant studies evaluating early and mid-term outcomes after AVR
using the Inspiris RESILIA bioprosthesis and including at least 20
patients with no restriction on the publication date. Subgroup
meta-analysis was performed to compare Inspiris RESILIA and PERIMOUNT
Magna Ease bioprosthesis and to pool the early postoperative mortality and
stroke rates. RESULT(S): A total of 416 studies were identified, of
which 15 studies met the eligibility criteria. The studies included a
total of 3202 patients with an average follow-up of up to 5.3years. The
average age of patients across the studies was 52.2-75.1years. Isolated
AVR was performed in 39.0-86.4% of patients. In-hospital or 30-day
postoperative mortality was 0-2.8%. At the mid-term follow-up, freedom
from all-cause mortality was up to 85.4%. Among studies with mid-term
follow-up, trace/mild paravalvular leak was detected in 0-3.0%, while
major paravalvular leak was found only in up to 2.0% of patients. No
statistically significant differences in terms of mortality (P 0.98, odds
ratio 1.02, 95% confidence interval 0.36-2.83) and stroke (P 0.98, odds
ratio 1.01, 95% confidence interval 0.38-2.73) between the Inspiris
RESILIA bioprosthesis and PERIMOUNT Magna Ease bioprosthesis were observed
in the subgroup meta-analysis. CONCLUSION(S): Mid-term data on the
safety and haemodynamic performance of the novel aortic bioprosthesis are
encouraging. Further comparative studies with other bioprostheses and
longer follow-up are still required to endorse durability and safety of
the novel bioprosthesis. Copyright © 2024 European Association
for Cardio-Thoracic Surgery. All rights reserved.

<19>
Accession Number
2014442177
Title
A randomized clinical study using optical coherence tomography to evaluate
the short-term effects of high-intensity interval training on cardiac
allograft vasculopathy: a HITTS substudy.
Source
Clinical Transplantation. 36(1) (no pagination), 2022. Article Number:
e14488. Date of Publication: January 2022.
Author
Rafique M.; Solberg O.G.; Gullestad L.; Bendz B.; Holm N.R.; Neghabat O.;
Dijkstra J.; Nytroen K.; Rolid K.; Lunde K.
Institution
(Rafique, Solberg, Gullestad, Bendz, Nytroen, Rolid, Lunde) Department of
Cardiology, Oslo University Hospital, Oslo, Rikshospitalet, Norway
(Rafique, Gullestad, Nytroen, Rolid) Institute of Clinical Medicine,
Faculty of Medicine, University of Oslo, Oslo, Norway
(Gullestad) KG Jebsen Center for Cardiac Research, University of Oslo,
Norway and Center for Heart Failure Research, Oslo University Hospital,
Oslo, Norway
(Holm, Neghabat) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Dijkstra) Division of Image Processing, Leiden University Medical Center,
Leiden, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Cardiac allograft vasculopathy (CAV) remains a leading cause of long-term
mortality after heart transplantation. Both preventive measures and
treatment options are limited. This study aimed to evaluate the short-term
effects of high-intensity interval training (HIT) on CAV in de novo heart
transplant (HTx) recipients as assessed by optical coherence tomography
(OCT). The study population was a subgroup of the 81-patient HITTS study
in which HTx recipients were randomized to HIT or moderate intensity
continuous training (MICT) for nine consecutive months. OCT images from
baseline and 12 months were compared to assess CAV progression. The
primary endpoint was defined as the change in the mean intima area. Paired
OCT data were available for 56 patients (n = 23 in the HIT group and n =
33 in the MICT group). The intima area in the entire study population
increased by 25% [from 1.8+/-1.4 mm2 to 2.3+/-2.0
mm2, P <.05]. The change was twofold higher in the MICT group
(.6+/-1.2 mm2) than in the HIT group (.3+/-.6 mm2).
However, the treatment effect of HIT was not significant (treatment effect
= -.3 mm2, 95% CI [-.825 to.2 mm2] P =.29). These
results suggest that early initiation of HIT compared with MICT does not
attenuate CAV progression in de novo HTx recipients. Copyright ©
2021 The Authors. Clinical Transplantation published by John Wiley & Sons
Ltd.

<20>
Accession Number
2012329853
Title
Meta-analysis comparing valve-in-valve TAVR and redo-SAVR in patients with
degenerated bioprosthetic aortic valve.
Source
Catheterization and Cardiovascular Interventions. 98(5) (pp 940-947),
2021. Date of Publication: 01 Nov 2021.
Author
Saleem S.; Ullah W.; Syed M.A.; Megaly M.; Thalambedu N.; Younas S.; Zahid
S.; Alam M.; Virani S.S.; Verma D.R.; Abdul-Waheed M.; Fischman D.L.
Institution
(Saleem, Abdul-Waheed) Cardiovascular Medicine, University of Kentucky,
Bowling Green, KY, United States
(Ullah, Fischman) Cardiovascular Medicine, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
(Syed, Megaly, Verma) Cardiovascular Medicine, Banner Health, University
of Arizona, Phoenix, AZ, United States
(Thalambedu) Internal Medicine, Abington Jefferson Health, Abington, PA,
United States
(Younas) Internal Medicine, Rochester General Hospital, New York, NY,
United States
(Zahid) Internal Medicine, Khyber Medical College, Peshawar, Pakistan
(Alam, Virani) Cardiovascular Medicine, Baylor College of Medicine,
Houston, TX, United States
(Virani) Michael E, DeBakey Veterans Affairs Medical Center, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The comparative efficacy and safety of valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) and redo-surgical AVR
(redo-SAVR) in patients with degenerated bioprosthetic aortic valves
remain unknown. Method(s): Digital databases were searched to
identify relevant articles. Unadjusted odds ratios for dichotomous
outcomes were calculated using a random effect model. A total of 11
studies comprising 8326 patients (ViV-TAVR = 4083 and redo-SAVR = 4243)
were included. Result(s): The mean age of patients undergoing
ViV-TAVR was older, 76 years compared to 73 years for those undergoing
SAVR. The baseline characteristics for patients in ViV-TAVR vs. redo-SAVR
groups were comparable. At 30-days, the odds of all-cause mortality (OR
0.45, 95% CI 0.30-0.68, p =.0002), cardiovascular mortality (OR 0.44, 95%
CI 0.26-0.73, p =.001) and major bleeding (OR 0.29, 95% CI 0.15-0.54, p
=.0001) were significantly lower in patients undergoing ViV-TAVR compared
to redo-SAVR. There were no significant differences in the odds of
cerebrovascular accidents (OR 0.91, 95% CI 0.52-1.58, p =.74), myocardial
infarction (OR 0.92, 95% CI 0.44-1.92, p =.83) and permanent pacemaker
implantation (PPM) (OR 0.54, 95% CI 0.27-1.07, p =.08) between the two
groups. During mid to long-term follow up (6-months to 5-years), there
were no significant differences between ViV-TAVR and redo-SAVR for
all-cause mortality, cardiovascular mortality and stroke. ViV-TAVR was,
however, associated with higher risk of prosthesis-patient mismatch and
greater transvalvular pressure gradient post-implantation.
 Conclusion(s): ViV-TAVR compared to redo-SAVR appears to be
associated with significant improvement in short term mortality and major
bleeding. For mid to long-term follow up, the outcomes were similar for
both groups. Copyright © 2021 Wiley Periodicals LLC.

<21>
Accession Number
2015956093
Title
Robotic-assisted thoracic surgery reduces perioperative complications and
achieves a similar long-term survival profile as posterolateral
thoracotomy in clinical N2 stage non-small cell lung cancer patients: A
multicenter, randomized, controlled trial.
Source
Translational Lung Cancer Research. 10(11) (pp 4281-4292), 2021. Date of
Publication: November 2021.
Author
Huang J.; Tian Y.; Li C.; Shen Y.; Li H.; Lv F.; Lin H.; Lu P.; Lin J.;
Lau C.; Terra R.M.; Jiang L.; Luo Q.
Institution
(Huang, Tian, Lin, Lu, Jiang, Luo) Shanghai Lung Cancer Center, Shanghai
Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
(Li) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School
of Medicine, Tongji University, Shanghai, China
(Shen) Department of Anesthesiology, Shanghai Chest Hospital, Shanghai
Jiao Tong University, Shanghai, China
(Li) Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong
University, School of Medicine, Shanghai, China
(Lv) Department of Thoracic Surgery, The Affiliated Huadong Hospital,
Fudan University, Shanghai, China
(Lin) Department of Surgery, Section of Thoracic Surgery, University of
Michigan Medical Center, Ann Arbor, MI, United States
(Lau) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Terra) Thoracic Surgery Division, Heart Institute (InCor) do Hospital das
Clinicas da Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo,
Brazil
Publisher
AME Publishing Company
Abstract
Background: Our previous study demonstrated the safety and short-term
efficacy of robotic-assisted thoracic surgery (RATS) in clinical N2 (c-N2)
stage non-small cell lung cancer (NSCLC) patients. From this, the present
study was devised, in which the follow-up time and sample size were both
extended to explore the long-term efficacy and potential benefit in
survival of RATS compared with lobectomy in c-N2 stage NSCLC patients.
 Method(s): Patients with c-N2 NSCLS were randomly assigned in a 1:1
ratio to accept operation through thoracotomy or RATS. The da Vinci
Surgical System (Si/Xi) was applied in the RATS group, while conventional
lobectomy with a rib-spreading incision was applied in the posterolateral
thoracotomy group. Primary endpoint was defined as disease free survival
and overall survival (OS) of all recruited patients. Result(s):
Compared with posterolateral thoracotomy group (N=72), the RATS group
(N=76) had a reduced blood loss (P<0.001), decreased drainage duration
(P=0.002), and decreased postoperative pain visual analog score (all
P<0.001), but increased overall cost (P<0.001). Meanwhile, no difference
in the other postoperative complications (such as air leakage,
subcutaneous emphysema, atrial fibrillation etc.) was found between the
RATS group and the posterolateral thoracotomy group (all P>0.05).
Regarding long-term outcome, no difference in disease-free survival (DFS;
P=0.925) or OS (P=0.853) was observed between the RATS group and
posterolateral thoracotomy group. Subgroup analyses and multivariable Cox
regression analyses also found no difference in DFS or OS between the RATS
group and posterolateral thoracotomy groups. Conclusion(s): RATS
reduced intraoperative bleeding, drainage duration, postoperative pain,
and achieved similar long-term survival outcomes compared with
posterolateral thoracotomy in c-N2 stage NSCLC patients. Copyright
© 2021 AME Publishing Company. All rights reserved.

<22>
Accession Number
643573694
Title
Use of high-flow nasal cannula versus other noninvasive ventilation
techniques or conventional oxygen therapy for respiratory support
following pediatric cardiac surgery: A systematic review and
meta-analysis.
Source
Paediatric anaesthesia. (no pagination), 2024. Date of Publication: 22
Feb 2024.
Author
Elmitwalli I.; Abdelhady E.; Kalsotra S.; Gehred A.; Tobias J.D.; Olbrecht
V.A.
Institution
(Elmitwalli, Kalsotra, Tobias, Olbrecht) Department of Anesthesiology and
Pain Medicine, Nationwide Children's Hospital, Columbus, OH, United States
(Abdelhady) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Gehred) Grant Morrow III Library, Nationwide Children's Hospital and The
Ohio State University, Columbus, OH, United States
(Tobias, Olbrecht) Department of Anesthesiology and Pain Medicine, Ohio
State University College of Medicine, Columbus, OH, United States
Abstract
INTRODUCTION: Noninvasive respiratory support may be provided to decrease
the risk of postextubation failure following surgery. Despite these
efforts, approximately 3%-27% of infants and children still experience
respiratory failure after tracheal extubation following cardiac surgery.
This systematic review evaluates studies comparing the efficacy of
high-flow nasal cannula to conventional oxygen therapy such as nasal
cannula and other noninvasive ventilation techniques in preventing
postextubation failure in this patient population. METHOD(S): A
systematic and comprehensive search was conducted in major databases
including MEDLINE, EMBASE, Web of Science, and Central. The search
encompassed articles focusing on the prophylactic use of high-flow nasal
cannula following tracheal extubation in pediatric patients undergoing
cardiac surgery for congenital heart disease. The inclusion criteria for
this review consisted of randomized clinical trials as well as
observational, cohort, and case-control studies. RESULT(S): A total
of 1295 studies were screened and 12 studies met the inclusion criteria.
These 12 studies included a total of 1565 children, classified into three
groups: seven studies compared high-flow nasal cannula to noninvasive
ventilation techniques, four studies compared high-flow nasal cannula to
conventional oxygen therapy, and one observational single-arm study
explored the use of high-flow nasal cannula with no control group. There
was no significant difference in the incidence of tracheal reintubation
between high-flow nasal cannula and conventional oxygen therapy (risk
ratio [RR]=0.67, 95% confidence interval [CI]: 0.24-1.90, p=.46). However,
there was a lower incidence of tracheal reintubation in patients who were
extubated to high-flow nasal cannula versus those extubated to noninvasive
ventilation techniques (RR=0.45, 95% CI: 0.32-0.63, p<.01). The high-flow
nasal cannula group also demonstrated a lower mortality rate compared to
the noninvasive ventilation techniques group (RR=0.31, 95% CI: 0.16-0.61,
p<.01) as well as a shorter postoperative length of stay (mean
difference=-8.76days, 95% CI: -13.08 to -4.45, p<.01) and shorter
intensive care length of stay (mean difference=-4.63days, 95% CI: -9.16 to
-0.11, p=.04). CONCLUSION(S): High-flow nasal cannula is more
effective in reducing the rate of postextubation failure compared to other
forms of noninvasive ventilation techniques following surgery for
congenital heart disease in pediatric-aged patients. high-flow nasal
cannula is also associated with lower mortality rates and shorter length
of stay. However, when comparing high-flow nasal cannula to conventional
oxygen therapy, the findings were inconclusive primarily due to a limited
number of scientific studies available on this specific comparison. Future
study is needed to further define the benefit of high-flow nasal cannula
compared to conventional oxygen therapy and various types of noninvasive
ventilation techniques. Copyright © 2024 John Wiley & Sons Ltd.

<23>
Accession Number
643575407
Title
Sugammadex shortens operation time and improves operation turnover
efficacy in VATS.
Source
Journal of the Chinese Medical Association : JCMA. (no pagination), 2024.
Date of Publication: 23 Feb 2024.
Author
Lin Y.-T.; Ting C.-K.; Hsu H.-S.
Institution
(Lin, Ting, Hsu) Institute of Emergency and Critical Care Medicine, School
of Medicine, National Yang Ming Chiao Tung University, ROC, Taipei, Taiwan
(Republic of China)
(Lin) Nursing Department, Taipei Veterans General Hospital, ROC, Taipei,
Taiwan (Republic of China)
(Ting) Department of Anesthesiology, Taipei Veterans General Hospital,
ROC, Taipei, Taiwan (Republic of China)
(Ting, Hsu) Department of Anesthesiology, School of Medicine, National
Yang Ming Chiao Tung University, ROC, Taipei, Taiwan (Republic of China)
Abstract
BACKGROUND: This study compared Sugammadex and Neostigmine as agents for
routine neuromuscular blockade reversal in video-assisted thoracoscopic
surgery (VATS) to determine the optimal choice that achieves a shorter
operation time and improved turnover efficiency while enhancing
postoperative outcomes and ensuring patient safety during thoracic
surgery. METHOD(S): This prospective study, conducted from July 2022
to March 2023, compared the effect of Sugammadex and Neostigmine on
operation time and turnover efficiency in VATS, involving 60 participants
randomly assigned to either group, with the primary objective of
identifying the optimal anesthesia reversal choice for improved outcomes
and patient safety during thoracic surgery. RESULT(S): In the study,
the Sugammadex group showed a significantly shorter total operation room
occupancy time (130+/-7 vs. 157+/-7 mins; p=0.009) than the Neostigmine
group. Patients in the Neostigmine group had higher mean pulse rates when
leaving the operation room (85+/-3 vs.73+/-3 beats/min; p=0.002) and
120min later in the Post-anesthesia Care Unit (76+/-2 vs. 68+/-2;
p=0.016). CONCLUSION(S): This study's findings suggest that
Sugammadex may enhance total operating room occupancy time, operation
turnover efficacy, and respiratory recovery outcomes in VATS, potentially
improving patient care and anesthesia management. Copyright ©
2024, the Chinese Medical Association.

<24>
Accession Number
2030655480
Title
Five Year Results of Endovascular versus Medical Therapy in Acute Type B
Aortic Intramural Haematoma: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European Journal of Vascular and Endovascular Surgery. (no pagination),
2024. Date of Publication: 2024.
Author
Sa M.P.; Jacquemyn X.; Tasoudis P.; Dufendach K.; Singh M.J.; de la Cruz
K.I.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Dufendach, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Dufendach, Singh, Serna-Gallegos, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Centre, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Tasoudis) Department of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Singh) Division of Vascular Surgery, University of Pittsburgh Medical
Centre, Pittsburgh, PA, United States
(de la Cruz) Division Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
W.B. Saunders Ltd
Abstract
Objective: To evaluate outcomes in the follow up of thoracic endovascular
aortic repair (TEVAR) vs. medical therapy in patients with acute type B
aortic intramural haematoma (IMH). Data Sources: The following
sources were searched for articles meeting the inclusion criteria and
published by July 2023: PubMed/MEDLINE, EMBASE, CENTRAL/CCTR (Cochrane
Controlled Trials Register). Review Methods: This systematic review with
pooled meta-analysis of time to event data followed the Preferred
Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
reporting guidelines, and its protocol was registered on the public
platform PROSPERO (CRD42023456222). The following were analysed: overall
survival (all cause mortality), aortic related mortality, and restricted
mean survival time. Certainty of evidence was evaluated through the
Grading of Recommendations, Assessment, Development, and Evaluations
(GRADE) tool. Result(s): Eight studies met the eligibility criteria,
including 1 015 patients (440 in the TEVAR group and 575 in the medical
therapy group). All studies were observational, and the pooled cohort had
a median follow up of 5.1 years. Compared with patients who received
medical therapy alone, those who underwent TEVAR had a statistically
significantly lower risk of all cause death (HR 0.44, 95% CI 0.30 - 0.65;
p < .001; GRADE certainty: low), lower risk of aortic related death (HR
0.04, 95% CI 0.01 - 0.31; p = .002; GRADE certainty: low) and lifetime
gain (restricted mean survival time was overall 201 days longer with
TEVAR; p < .001). Conclusion(s): Thoracic endovascular aortic repair
may be associated with lower risk of all cause and aortic related death
compared with medical therapy in patients with acute type B IMH; however,
the underlying data are not strong enough to draw robust clinical
conclusions. Randomised controlled trials with large sample sizes and
longer follow up are warranted to elucidate this question. Copyright
© 2023 European Society for Vascular Surgery

<25>
Accession Number
2026748415
Title
Impact of Complete Revascularization in the ISCHEMIA Trial.
Source
Journal of the American College of Cardiology. 82(12) (pp 1175-1188),
2023. Date of Publication: 19 Sep 2023.
Author
Stone G.W.; Ali Z.A.; O'Brien S.M.; Rhodes G.; Genereux P.; Bangalore S.;
Mavromatis K.; Horst J.; Dressler O.; Poh K.K.; Nath R.K.; Moorthy N.;
Witkowski A.; Dwivedi S.K.; Bockeria O.; Chen J.; Smanio P.E.P.; Picard
M.H.; Chaitman B.R.; Berman D.S.; Shaw L.J.; Boden W.E.; White H.D.;
Fremes S.E.; Rosenberg Y.; Reynolds H.R.; Spertus J.A.; Hochman J.S.;
Maron D.J.; Boden W.; Harrington R.; Williams D.; Alexander K.P.; Berger
J.; Mark D.; Ballantyne C.; Beyar R.; Bhargava B.; Buller C.; Carvalho
A.T.; Diaz R.; Doerr R.; Dzavik V.; Goodman S.; Gosselin G.; Hachamovitch
R.; Hamm C.; Held C.; Helm M.; Huber K.; Jiang L.; Keltai M.; Kohsaka S.;
Lang I.; Lopes R.; Maggioni A.; Mancini J.; Bairey Merz C.N.; Min J.;
Peterson E.; Ruzyllo W.; Selvanayagam J.; Senior R.; Sharir T.; Steg G.;
Szwed H.; Van de Werf F.; Weintraub W.; White H.; Calfas K.; Champagne
M.A.; Davidson M.; Fleg J.; McCullough P.A.; Newman J.; Stone P.; Menasche
P.; Fremes S.; Guyton R.; Mack M.; Mohr F.; Rao A.; Sabik J.; Shapira O.;
Taggart D.; Tatoulis J.; Blankenship J.; Brener S.; Colombo A.; de Bruyne
B.; Kereiakes D.; Lefevre T.; Moses J.; Mahaffey K.; Cruz-Flores S.;
Danchin N.; Feen E.; Garcia M.J.; Hauptman P.; Laddu A.A.; Passamani E.;
Pina I.L.; Simoons M.; Skali H.; Thygesen K.; Waters D.; Endsley P.;
Esposito G.; Kanters J.; Pownall J.; Stournaras D.; Friedrich M.; Kwong
R.; Oliver D.; Harrell F.; Blume J.; Lee K.; Kullo I.; McManus B.; Newby
K.; Cohen D.; Bugiardini R.; Celutkiene J.; Escobedo J.; Hoye A.;
Lyubarova R.; Mattina D.; Peteiro J.; Smanio P.; Berman D.; Leipsic J.;
Mathew R.; Sidhu M.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Gibson
C.M.; Lamas G.; Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.;
Kirby R.; Jeffries N.; Denaro J.E.; Mavromichalis S.; Chan K.; Cobb G.;
Contreras A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.;
Naumova A.; Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison
C.; Hogan I.; Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.;
Lang B.; Mohamed S.; Esquenazi-Karonika S.; Mathews P.; Setang V.; Xavier
M.; Bagai A.; Broderick S.; Crowder M.; Cyr D.; Garg J.; Gu X.; Hatch L.;
Heath A.; Huang Z.; Leimberger J.; Marcus J.; Page C.; Parker W.; Pennachi
W.; Rockhold F.; Stevens S.; Stone A.; Thompson O.; Ussery S.; White J.;
Williams M.K.; Xing W.; Zhu S.; Anstrom K.; Baloch K.; Blount J.; Cowper
P.; Davidson-Ray L.; Drew L.; Harding T.; Knight J.D.; Minshall Liu D.;
O'Neal B.; Redick T.; Jones P.; Nugent K.; Jingyan Wang G.; Phillips L.;
Goyal A.; Hetrick H.; Hayes S.W.; Friedman J.D.; Gerlach R.J.; Hyun M.;
Miranda-Peats R.; Slomka P.; Thomson L.; Mongeon F.P.; Michael S.; Hung
J.; Scherrer-Crosbie M.; Zeng X.; Eckstein J.; Guruge B.; Streif M.;
Alfonso M.A.; Corral M.P.; Garcia J.J.; Jankovic I.; Konigstein M.; Lustre
M.B.; Peralta Y.; Sanchez R.; Arsanjani R.; Budoff M.; Elmore K.; Gomez
M.; Hague C.; Hindoyan N.; Mancini G.J.; Nakanishi R.; Srichai-Parsia
M.B.; Yeoh E.; Youn T.; Maggioni A.P.; Bianchini F.; Ceseri M.; Lorimer
A.; Magnoni M.; Orso F.; Sarti L.; Tricoli M.; Carvalho A.; Barbosa L.M.;
Bello Duarte T.; Colaiacovo Soares T.; de Aveiro Morata J.; Carvalho P.;
de Carvalho Maffei N.; Egydio F.; Kawakami A.; Oliveira J.; Restelli
Piloto E.; Pozzibon J.; Camara D.; Mowafy N.; Spindler C.; Dai H.; Feng
F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.; Zhang J.; Zhang L.; Zhang N.;
Zhong H.; Escobar C.; Martin M.E.; Pascual A.; Lopez-Sendon J.; Moraga P.;
Hernandez V.; Castro A.; Posada M.; Fernandez S.; Narro Villanueva J.L.;
Selgas R.; Abergel H.; Juliard J.M.; Alsweiler C.; Claes K.; Goetschalckx
K.; Luyten A.; Robesyn V.; Selvanayagam J.B.; Murphy D.; Garcevic N.;
Stojkovic J.; Ahmed A.; Bhatt R.; Chadha N.; Kumar V.; Lubna S.; Naik P.;
Pandey S.; Ramasamy K.; Saleem M.; Sharma P.; Siddaram H.
Institution
(Stone, Shaw) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Ali) St Francis Hospital, Roslyn, NY, United States
(Ali, Horst, Dressler) Cardiovascular Research Foundation, New York, NY,
United States
(O'Brien, Rhodes) Duke Clinical Research Institute, Durham, NC, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine, New York,
NY, United States
(Mavromatis) Emory University School of Medicine, Atlanta, GA, United
States
(Poh) National University Heart Center Singapore and the Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Nath) Dr Ram Manohar Lohia Hospital, New Delhi, India
(Moorthy) Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bangalore-Karnataka, India
(Witkowski) National Institute of Cardiology, Warsaw, Poland
(Dwivedi) King George Medical University, Lucknow Up, India
(Bockeria) National Research Center for Cardiovascular Surgery, Moscow,
Russian Federation
(Chen) Guangdong Provincial People's Hospital, Guangdong, China
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Picard) Massachusetts General Hospital and Harvard Medical School,
Boston, MA, United States
(Chaitman) St Louis University School of Medicine Center for Comprehensive
Cardiovascular Care, St Louis, MO, United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Boden) Boston University School of Medicine, Boston, MA, United States
(White) Auckland City Hospital Green Lane Cardiovascular Services and
University of Auckland, Auckland, New Zealand
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Rosenberg) National Heart, Lung, and Blood Institute, Washington, DC,
United States
(Spertus) Saint Luke's Mid America Heart Institute and the University of
Missouri, Kansas City, Kansas City, MO, United States
(Maron) Department of Medicine, Stanford School of Medicine, Stanford, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Anatomic complete revascularization (ACR) and functional
complete revascularization (FCR) have been associated with reduced death
and myocardial infarction (MI) in some prior studies. The impact of
complete revascularization (CR) in patients undergoing an invasive (INV)
compared with a conservative (CON) management strategy has not been
reported. Objective(s): Among patients with chronic coronary disease
without prior coronary artery bypass grafting randomized to INV vs CON
management in the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial, we examined the
following: 1) the outcomes of ACR and FCR compared with incomplete
revascularization; and 2) the potential impact of achieving CR in all INV
patients compared with CON management. Method(s): ACR and FCR in the
INV group were assessed at an independent core laboratory.
Multivariable-adjusted outcomes of CR were examined in INV patients.
Inverse probability weighted modeling was then performed to estimate the
treatment effect had CR been achieved in all INV patients compared with
CON management. Result(s): ACR and FCR were achieved in 43.4% and
58.4% of 1,824 INV patients. ACR was associated with reduced 4-year rates
of cardiovascular death or MI compared with incomplete revascularization.
By inverse probability weighted modeling, ACR in all 2,296 INV patients
compared with 2,498 CON patients was associated with a lower 4-year rate
of cardiovascular death or MI (difference -3.5; 95% CI: -7.2% to 0.0%). In
comparison, the event rate difference of cardiovascular death or MI for
INV minus CON in the overall ISCHEMIA trial was -2.4%. Results were
similar but less pronounced with FCR. Conclusion(s): The outcomes of
an INV strategy may be improved if CR (especially ACR) is achieved.
(International Study of Comparative Health Effectiveness With Medical and
Invasive Approaches [ISCHEMIA]; NCT01471522) Copyright © 2023
American College of Cardiology Foundation

<26>
Accession Number
364404550
Title
The outcome of thoracic epidural anesthesia in elderly patients undergoing
coronary artery bypass graft surgery.
Source
Saudi Journal of Anaesthesia. 6(1) (pp 16-21), 2012. Date of Publication:
January-March 2012.
Author
El-Morsy G.Z.; El-Deeb A.
Institution
(El-Morsy, El-Deeb) Department of Anesthesia, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Thoracic epidural anesthesia (TEA) improves analgesia and
outcomes after a cardiac surgery. As aging is a risk factor for
postoperative pulmonary complications, TEA is of particular importance in
elderly patients undergoing coronary artery bypass graft (CABG).
 Method(s): Fifty patients aged 65-75 years; ASA II and III scheduled
for elective CABG were included in the study. Patients were randomized to
receive either general anesthesia (GA) group alone or GA combined with TEA
group. Heart rate (HR), mean arterial pressure (MAP), and central venous
pressure were recorded. Total dose of fentanyl g/kg, aortic cross
clamping, cardiopulmonary bypass (CPB) time, time to first awaking and
extubation, arterial blood gases, visual analog scale (VAS) score in
intensive care unit were reported. Postoperative pulmonary function tests
were done. Result(s): TEA showed a significant HR and lower MAP
compared with the GA group. The total dose of intraoperative fentanyl and
nitroglycerine were significantly lower in the TEA. Patients in TEA group
have statistically significantly higher PaO <inf>2</inf>, lower PaCO
<inf>2</inf>, increase in Forced Vital Capacity (FVC) and Forced
Expiratory Volume in one second (FEV <inf>1</inf>) Conclusion(s): TEA
reduced severity of postoperative pulmonary function and restoration was
faster in TEA group in elderly patients undergoing CABG. Also, it resulted
in earlier extubation and awakening, better analgesia, lower VAS.

<27>
Accession Number
2030500211
Title
Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of
atrial fibrillation: results of multicentre randomized controlled trial.
Source
Europace. 26(2) (no pagination), 2024. Article Number: euae040. Date of
Publication: 01 Feb 2024.
Author
Bulava A.; Wichterle D.; Mokracek A.; Osmancik P.; Budera P.; Kacer P.;
Veteskova L.; Nemec P.; Skala T.; Santavy P.; Chovancik J.; Branny P.;
Rizov V.; Kolesar M.; Safarikova I.; Rybar M.
Institution
(Bulava, Mokracek, Safarikova) Faculty of Health and Social Sciences,
University of South Bohemia in Ceske Budejovice and Cardiac Centre, Ceske
Budejovice Hospital, B. Nemcove 54, Ceske Budejovice 370 01, Czechia
(Wichterle, Budera) Cardiology Department, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Osmancik, Kacer) Third Faculty of Medicine, Charles University,
University Hospital Kralovske Vinohrady, Prague, Czechia
(Veteskova, Nemec) Centre of Cardiovascular Surgery and Transplantation,
Brno, Czechia
(Skala, Santavy) Faculty of Medicine and Dentistry, Palacky University,
University Hospital Olomouc, Olomouc, Czechia
(Chovancik, Branny) Cardilogy Department, Hospital Agel Trinec-Podlesi,
Trinec, Czechia
(Rizov, Kolesar) Cardilogy Department, Masaryk Hospital, Usti nad Labem,
Czechia
(Rybar) Faculty of Biomedical Engineering, Czech Technical University in
Prague, Kladno, Czechia
Publisher
Oxford University Press
Abstract
Aims Data on the hybrid atrial fibrillation (AF) treatment are lacking in
patients with structural heart disease undergoing concomitant CryoMaze
procedures. The aim was to assess whether the timely pre-emptive catheter
ablation would achieve higher freedom from AF or atrial tachycardia (AT)
and be associated with better clinical outcomes than surgical ablation
alone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . Methods The trial investigated patients with non-paroxysmal AF
undergoing coronary artery bypass grafting and/or valve repair/ and
results replacement with mandatory concomitant CryoMaze
procedure who were randomly assigned to undergo either radiofrequency
catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery
Group). The primary efficacy endpoint was the first recurrence of AF/AT
without class I or III antiarrhythmic drugs as assessed by implantable
cardiac monitors. The primary clinical endpoint was a composite of
hospitalization for arrhythmia recurrence, worsening of heart failure,
cardioembolic event, or major bleeding. We analysed 113 and 116 patients
in the Hybrid and Surgery Groups, respectively, with a median follow-up of
715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly
reduced in the HG [41.1% vs. 67.4%, hazard ratio (HR) = 0.38, 95%
confidence interval (CI): 0.26-0.57, P < 0.001] as well as the primary
clinical endpoint (19.9% vs. 40.1%, HR = 0.51, 95% CI: 0.29-0.86, P =
0.012). The trial groups did not differ in all-cause mortality (10.6% vs.
8.6%, HR = 1.17, 95%CI: 0.51-2.71, P = 0.71). The major complications of
catheter ablation were infrequent (1.9%). . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . Conclusion
Pre-emptively performed catheter ablation after the CryoMaze procedure was
safe and associated with higher freedom from AF/AT and improved clinical
outcomes. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<28>
Accession Number
2030487867
Title
A meta-analysis of the American college of surgeons risk calculator's
predictive accuracy among different surgical sub-specialties.
Source
Surgery in Practice and Science. 16 (no pagination), 2024. Article Number:
100238. Date of Publication: March 2024.
Author
Goodwin A.M.; Kurapaty S.S.; Inglis J.E.; Divi S.N.; Patel A.A.; Hsu W.K.
Institution
(Goodwin, Kurapaty, Inglis, Divi, Patel, Hsu) Department of Orthopaedic
Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
60611, United States
Publisher
Elsevier Ltd
Abstract
Background: The American College of Surgeons National Surgical Quality
Improvement Program (ACS-NSQIP) provides risk estimates of postoperative
complications. While several studies have examined the accuracy of the
ACS-Surgical Risk Calculator (SRC) within a single specialty, the
respective conclusions are limited by sample size. We sought to conduct a
meta-analysis to determine the accuracy of the ACS-SRC among various
surgical specialties. Study design: Clinical studies that utilized the
ACS-SRC, predicted complication rates compared to actual rates, and
analyzed at least one metric reported by ACS-SRC met the inclusion
criteria. Data for each specialty were pooled using the DerSimonian and
Laird random-effect models and analyzed with the binary random-effect
model to produce risk difference (RD) and 95 % confidence intervals (CIs)
using Open Meta[Analyst]. Result(s): The initial search yielded 281
studies and, after applying inclusion and exclusion criteria, a total of
53 studies remained with a total sample of 30,134 patients spanning 10
surgical specialties. When considering any complication and death, the
ACS-SRC significantly underpredicted complications for: Orthopaedic
Surgery (RD -0.067, p = 0.008), Spine (RD -0.027, p < 0.001), Urology (RD
-0.03, p < 0.001), Surgical Oncology (RD -0.045, p < 0.001), and
Gynecology (RD -0.098, p = 0.01). Conclusion(s): The ACS-SRC proved
useful in General, Acute Care, Colorectal, Otolaryngology, and
Cardiothoracic Surgery, but significantly underpredicted complication
rates in Spine, Orthopaedics, Urology, Surgical Oncology, and Gynecology.
These data indicate the ACS-SRC is a reliable predictor in some
specialties, but its use should be cautioned in the remaining specialties
evaluated here. Copyright © 2024

<29>
Accession Number
2030479176
Title
The effect of pectointercostal fascial block on stress response in open
heart surgery.
Source
Saudi Journal of Anaesthesia. 18(1) (pp 70-76), 2024. Date of Publication:
January 2024.
Author
Fadhlurrahman A.F.; Setiawan P.; Sumartono C.; Perdhana F.; Husain T.A.
Institution
(Fadhlurrahman) Department of Anesthesiology and Intensive Therapy,
Medical Faculty of Airlangga University, Surabaya, Indonesia
(Fadhlurrahman) Department of Anesthesiology and Intensive Therapy,
Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General
Hospital, Malang, Indonesia
(Setiawan, Perdhana, Husain) Division of Cardiovascular and Thoracic
Anesthesia, Department of Anesthesiology and Intensive Therapy, Faculty of
Medicine, Airlangga University, Dr. Soetomo General Hospital, Indonesia
(Sumartono) Division of Regional Anesthesia, Department of Anesthesiology
and Intensive Theraoy, Faculty of Medicine, Airlangga University, Dr.
Soetomo General Hospital, Surabaya, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Activation of the hypothalamus-pituitary-adrenal (HPA) axis
and inflammatory processes are common forms of stress response. The
increased stress response is associated with a higher chance of
complications. Open hearth surgery is one of the procedures with a
high-stress response. Pectointercostal fascial block (PIFB), as a new pain
management option in sternotomy, has the potential to modulate the stress
response. Objective(s): To determine the effect of PIFB on stress
response in open heart surgery. Method(s): This study was a
Randomized Controlled Trial on 40 open heart surgery. Patients were
divided into two groups, control (20 patients) and PIFB (20 patients).
Primary parameters included basal and postoperative TNF-alpha, basal and
post sternotomy ACTH, and basal, 0, and 24 hours postoperative NLR.
Secondary parameters include the amount of opioid use, length of the
post-operative ventilator, length of ICU stay, and Numeric Rating Scale
(NRS) 6, 12, 24, and 48 hours postoperative. Result(s): The PIFB
group had a decrease in ACTH levels with an average change that was not
significantly different from the control group (-57.71 +/- 68.03 vs.
-129.78 +/- 140.98). The PIFB group had an average change in TNFalpha
levels and an average increase in NLR 0 hours postoperative that was not
significantly lower than the control group (TNFalpha: -0.52 +/- 1.31 vs.
0.54 +/- 1.76; NLR: 12.80 +/- 3.51 vs. 14.82 +/- 4.23). PIFB significantly
reduced the amount of opioid use during surgery, NRS at 6, 12, and 24
hours, and the length of post-operative ventilator use (P < 0.05, CI:
95%). Conclusion(s): PIFB has a good role in reducing the stress
response of open heart surgery and producing good clinical
outcomes. Copyright © 2024 Wolters Kluwer Medknow Publications.
All rights reserved.

<30>
[Use Link to view the full text]
Accession Number
2030372728
Title
Effect of Remifentanil on Acute and Chronic Postsurgical Pain in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Clinical Journal of Pain. 40(3) (pp 187-195), 2024. Date of Publication:
06 Mar 2024.
Author
Zhang B.; Cai C.; Pan Z.; Zhuang L.; Qi Y.
Institution
(Zhang, Cai, Pan, Zhuang, Qi) Department of Anesthesia, Ningbo Medical
Center, Li Huili Hospital, Zhejiang, Ningbo, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Our purpose was to explore the effect of remifentanil on acute
and chronic postsurgical pain after cardiac surgery. Material(s) and
Method(s): 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.

<31>
Accession Number
2029954432
Title
Protein and Exercise to Reverse Frailty in Older Men and Women Undergoing
Transcatheter Aortic Valve Replacement: Design of the PERFORM-TAVR Trial.
Source
Canadian Journal of Cardiology. 40(2) (pp 267-274), 2024. Date of
Publication: February 2024.
Author
Fountotos R.; Lauck S.; Piazza N.; Martucci G.; Arora R.; Asgar A.;
Forcillo J.; Kouz R.; Labinaz M.; Lamy A.; Peterson M.; Wijeysundera H.;
Masse L.; Ouimet M.-C.; Polderman J.; Webb J.; Afilalo J.
Publisher
Elsevier Inc.
Abstract
Despite the high procedural success of transcatheter aortic valve
replacement (TAVR), 2 out of 5 older adults report poor physical
performance and health-related quality of life (HRQOL) in the ensuing
months, particularly those with frailty. There has yet to be a trial
examining the synergistic effects of exercise and protein supplementation
to counteract frailty and improve patient-centred outcomes following TAVR.
The PERFORM-TAVR trial is a multicentre parallel-group randomised clinical
trial that is enrolling 200 frail older adults >= 70 years of age
undergoing TAVR. Patients will be randomly allocated to 1 of 2 treatment
groups: standard-of-care lifestyle education (control group) or
protein-rich oral nutritional supplement for 4 weeks before TAVR with the
addition of home-based supervised exercise sessions for 12 weeks after
TAVR (intervention group). The primary outcome will be physical
performance as measured by a blinded observer using the Short Physical
Performance Battery at 3 months. Secondary outcomes at 3, 6, and 12 months
will include HRQOL, as measured by the Short-Form 36 Physical and Mental
Component summary scores, and a composite safety end point. The
PERFORM-TAVR trial is testing a novel frailty intervention in older adults
undergoing TAVR to optimise recovery and downstream HRQOL. This represents
a potential paradigm shift that highlights the value of assessing and
treating patients' frailty in parallel with their underlying heart valve
disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov.
Unique identifier: NCT03522454. Copyright © 2023 Canadian
Cardiovascular Society

<32>
Accession Number
2028630082
Title
Transesophageal echocardiography: A bibliometric analysis from 1979 to
2022.
Source
Echocardiography. 41(2) (no pagination), 2024. Article Number: e15759.
Date of Publication: February 2024.
Author
Pan S.; Li Z.; Wang Y.; Bing H.; Song H.; Chu Q.
Institution
(Pan, Li, Wang, Bing, Chu) Department of Anesthesiology and Perioperative
Medicine, Zhengzhou Center Hospital Affiliated to Zhengzhou University,
Henan, Zhengzhou, China
(Song) Department of Anesthesiology, West China Hospital of Sichuan
University, Sichuan, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: Heart disease poses a significant global health challenge.
Transesophageal echocardiography (TEE) has gained prominence in clinical
practice because of advancements in visual medicine. The present
bibliometric analysis provides an overview of TEE research, identifies
trends, and highlights emerging topics. Method(s): A comprehensive
search of TEE-related literature from the establishment of the Web of
Science Core Collection (WOSCC) until 2022 was conducted. Utilizing the
CiteSpace software, we performed an in-depth analysis of the literature
data encompassing disciplines, publication years, countries, institutions,
authors, journals, cited references, and keywords. Result(s): A total
of 17 032 TEE-related articles were included in this study. The most
active disciplines in TEE research were Cardiac & Cardiovascular Systems,
Anesthesiology, and Respiratory System. The number of publications
displayed a consistent upward trajectory over the years. Notably, research
contributions predominantly originated from developed countries, mainly
Europe and North America, with the United States, Germany, Italy, and
Japan leading the way. Analysis of institutions, authors, and journals
revealed the United States' significant role in TEE research. Furthermore,
the analysis of cited references and keywords identified the treatment of
patent foramen ovale and its association with stroke as emerging hot
topics in recent years. Conclusion(s): This study highlights that TEE
remains a research hotspot, with the United States at the forefront.
Future research should investigate the relationship between heart disease
and brain function. Copyright © 2024 Wiley Periodicals LLC.

<33>
Accession Number
2028626047
Title
Esketamine combined with sufentanil versus sufentanil in
patient-controlled intravenous analgesia: a meta-analysis.
Source
Frontiers in Pharmacology. 15 (no pagination), 2024. Article Number:
1247646. Date of Publication: 2024.
Author
Yao M.; Fang B.; Yang J.; Chen P.; Chen F.
Institution
(Yao, Fang, Yang, Chen) Sinopharm Dongfeng General Hospital, Hubei
University of Medicine, Hubei, Shiyan, China
(Yao, Chen) School of Pharmaceutical Sciences, Hubei University of
Medicine, Hubei, Shiyan, China
(Chen) Renmin Hospital of Wuhan University, Hubei, Wuhan, China
Publisher
Frontiers Media SA
Abstract
Objective: Patient-controlled intravenous analgesia (PCIA) can alleviate
pain to some extent, and several randomized controlled trials (RCTs) have
examined the efficacy of esketamine-assisted sufentanil in postoperative
PCIA. In this research, we conducted a meta-analysis of relevant RCTs to
compare the effect and safety of esketamine-sufentanil versus sufentanil
alone for postoperative PCIA. Method(s): We systematically searched
the Cochrane Library, PubMed, Embase, Web of Science, CNKI, and other
libraries up to December 2023 to screen out RCTs examining the use of
esketamine combined with sufentanil for PCIA. We analysed analgesia
scores, sedation scores, adverse drug reactions and postpartum depression
scores as outcome indicators. Result(s): This meta-analysis included
32 RCTs. The results of the meta-analysis were as follows. 1) Visual
Analog Scale: The VAS scores at 6, 12, 24, and 48 h were lower in the
esketamine-sufentanil group than in the sufentanil alone group, and
significant differences were found at all time points (p < 0.05). 2)
Ramsay Sedation Scale: The sedation score of the esketamine-sufentanil
group at 48 h after surgery was higher than that of the sufentanil group
alone [mean difference (MD) = -0.09 points, confidence interval (CI):
(-0.26, -0.07), p = 0.27], but this difference was not significant (p >
0.05). 3) Safety: Compared with sufentanil alone, the incidence rates of
postoperative nausea-vomiting, dizziness-headache, skin pruritus and
respiratory depression were significantly lower in the
esketamine-sufentanil group. 4) Postartum depression: The reduction in
postpartum depression scores were significantly greater in the
esketamine-sufentanil group than in the sufentanil alone group at 3 days
[MD = -1.35 points, CI: (-1.89, -0.81), p < 0.00001] and 7 days [MD =
-1.29 points, CI: (-2.42, -0.16), p = 0.03]. Conclusion(s): The
meta-analysis showed that the use of esketamine combined with sufentanil
for postoperative PCIA could improve postoperative analgesia, alleviate
postpartum depression and reduce the rate of postoperative adverse
reactions, but there was no significant difference in
sedation. Copyright © 2024 Yao, Fang, Yang, Chen and Chen.

<34>
Accession Number
2028598817
Title
Predictors of left ventricular ejection fraction in high-risk percutaneous
coronary interventions.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1342409. Date of Publication: 2024.
Author
Panoulas V.F.; Escaned J.; Hill J.M.; Barker E.; Butler K.; Almedhychy A.;
Tsintzos S.I.; O'Neill W.W.
Institution
(Panoulas) Department of Cardiology, Harefield Hospital, Royal Brompton
and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust,
London, United Kingdom
(Escaned) Department of Interventional Cardiology, Hospital Clinico San
Carlos, Madrid, Spain
(Hill) Department of Cardiology, Royal Brompton Hospital, Royal Brompton
and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust,
London, United Kingdom
(Barker, Butler) York Health Economics Consortium, University of York,
York, United Kingdom
(Almedhychy) Medical Affairs, Abiomed Inc., Danvers, MA, United States
(Tsintzos) Health Economics and Market Access, Abiomed Europe GmbH,
Aachen, Germany
(O'Neill) Centre for Structural Heart Disease, Henry Ford Hospital,
Detroit, MI, United States
Publisher
Frontiers Media SA
Abstract
Revascularization completeness after percutaneous coronary intervention
(PCI) is associated with improved long-term outcomes. Mechanical
circulatory support [intra-aortic balloon pump (IABP) or Impella] is used
during high-risk PCI (HR-PCI) to enhance peri-procedural safety and
achieve more complete revascularization. The relationship between
revascularization completeness [post-PCI residual SYNTAX Score (rSS)] and
left ventricular ejection fraction (LVEF) in HR-PCI has not been
established. We investigated LVEF predictors at 90 days post-PCI with
Impella or IABP support. Individual patient data (IPD) were analyzed from
PROTECT II (NCT00562016) in the base case. IPD from PROTECT II and
RESTORE-EF (NCT04648306) were naively pooled in the sensitivity analysis.
Using complete cases only, linear regression was used to explore the
predictors of LVEF at 90 days post-PCI. Models were refined using stepwise
selection based on Akaike Information Criterion and included: treatment
group (Impella, IABP), baseline characteristics [age, gender, race, New
York Heart Association Functional Classification, LVEF, SYNTAX Score
(SS)], and rSS. Impella treatment and higher baseline LVEF were
significant predictors of LVEF improvement at 90 days post-PCI (p <=
0.05), and a lower rSS contributed to the model (p = 0.082). In the
sensitivity analysis, Impella treatment, higher baseline LVEF, and lower
rSS were significant predictors of LVEF improvement at 90 days (p <=
0.05), and SS pre-PCI contributed to the model (p = 0.070). Higher
baseline LVEF, higher SS pre-PCI, lower rSS (i.e. completeness of
revascularization), and Impella treatment were predictors of post-PCI LVEF
improvement. The findings suggest potential mechanisms of Impella include
improving the extent and quality of revascularization, and intraprocedural
ventricular unloading. Copyright 2024 Panoulas, Escaned, Hill, Barker,
Butler, Almedhychy, Tsintzos and O'Neill.

<35>
Accession Number
2028596617
Title
Reporting of social determinants of health in randomized controlled trials
conducted in the pediatric intensive care unit.
Source
Frontiers in Pediatrics. 12 (no pagination), 2024. Article Number:
1329648. Date of Publication: 2024.
Author
Huang E.; Albrecht L.; O'Hearn K.; Nicolas N.; Armstrong J.; Weinberg M.;
Menon K.
Institution
(Huang) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Albrecht, O'Hearn, Nicolas, Armstrong, Menon) Children's Hospital of
Eastern Ontario Research Institute, Ottawa, ON, Canada
(Weinberg) Faculty of Science, University of Ottawa, Ottawa, ON, Canada
(Menon) Department of Pediatrics, Children's Hospital of Eastern Ontario,
University of Ottawa, Ottawa, ON, Canada
Publisher
Frontiers Media SA
Abstract
Introduction: The influence of social determinants of health (SDOH) on
access to care and outcomes for critically ill children remains an
understudied area with a paucity of high-quality data. Recent publications
have highlighted the importance of incorporating SDOH considerations into
research but the frequency with which this occurs in pediatric intensive
care unit (PICU) research is unclear. Our objective was to determine the
frequency and categories of SDOH variables reported and how these
variables were defined in published PICU randomized controlled trials
(RCTs). Method(s): We searched Medline, Embase, Lilacs, and Central
from inception to Dec 2022. Inclusion criteria were randomized controlled
trials of any intervention on children or their families in a PICU. Data
related to study demographics and nine WHO SDOH categories were extracted,
and descriptive statistics and qualitative data generated. Result(s):
586 unique RCTs were included. Studies had a median sample size of 60
patients (IQR 40-106) with 73.0% of studies including <=100 patients and
41.1% including <=50 patients. A total of 181 (181/586, 30.9%) studies
reported >=1 SDOH variable of which 163 (163/586, 27.8%) reported them by
randomization group. The most frequently reported categories were food
insecurity (100/586, 17.1%) and social inclusion and non-discrimination
(73/586, 12.5%). Twenty-five of 57 studies (43.9%) investigating feeding
or nutrition and 11 of 82 (13.4%) assessing mechanical ventilation
reported baseline nutritional assessments. Forty-one studies investigated
interventions in children with asthma or bronchiolitis of which six
reported on smoking in the home (6/41, 14.6%). Discussion(s):
Reporting of relevant SDOH variables occurs infrequently in PICU RCTs. In
addition, when available, categorizations and definitions of SDOH vary
considerably between studies. Standardization of SDOH variable collection
along with consistent minimal reporting requirements for PICU RCT
publications is needed. Copyright 2024 Huang, Albrecht, O'Hearn,
Nicolas, Armstrong, Weinberg and Menon.

<36>
Accession Number
2028094512
Title
A SYSTEMIC REVIEW OF STUDY ON AFTEREFFECT & IT'S MANAGEMENT OF SUDDEN
DEATH OF PATIENT AT ONSET OF OPERATIVE PROCEDURE.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(2) (pp
535-544), 2024. Date of Publication: 2024.
Author
Awasthi A.; Awasthi R.; Singh A.
Institution
(Awasthi) Dept. of Forensic Medicine CIMS, Lucknow, India
(Awasthi) Dept. of Surgery CIMS, Lucknow, India
(Singh) Dept. of Anesthesia & Critical care, Johal Multispecialty
Hospital, Punjab, Jalandhar, India
Publisher
Codon Publications
Abstract
Death associated with anesthesia and surgeries are death which occur in
the operation theatre or before the patient has completely recovered from
the effect of anesthesia. It is called death in the operation room and
intra operative death. The use of opium like preparation in anesthesia is
recorded in the Ebers papyrus of 1500b.c. India and china pioneered use of
cannabis and aconite for anesthesia Sir Humphry Davy (1778-1829) used
nitrous oxide (laughing gas)as an anesthetic in 1799. Copyright ©
2024 Journal of Population Therapeutics and Clinical Pharmacology. All
rights reserved.

<37>
Accession Number
2028215280
Title
Robot-assisted surgery in thoracic and visceral indications: an updated
systematic review.
Source
Surgical Endoscopy. 38(3) (pp 1139-1150), 2024. Date of Publication: March
2024.
Author
Grossmann-Waniek N.; Riegelnegg M.; Gassner L.; Wild C.
Institution
(Grossmann-Waniek, Riegelnegg, Gassner, Wild) Austrian Institute for
Health Technology Assessment (AIHTA), Garnisongasse 7/20, Vienna 1090,
Austria
Publisher
Springer
Abstract
Background: In surgical advancements, robot-assisted surgery (RAS) holds
several promises like shorter hospital stays, reduced complications, and
improved technical capabilities over standard care. Despite extensive
evidence, the actual patient benefits of RAS remain unclear. Thus, our
systematic review aimed to assess the effectiveness and safety of RAS in
visceral and thoracic surgery compared to laparoscopic or open surgery.
 Method(s): We performed a systematic literature search in two
databases (Medline via Ovid and The Cochrane Library) in April 2023. The
search was restricted to 14 predefined thoracic and visceral procedures
and randomized controlled trials (RCTs). Synthesis of data on critical
outcomes followed the Grading of Recommendations, Assessment, Development,
and Evaluation methodology, and the risk of bias was evaluated using the
Cochrane Collaboration's Tool Version 1. Result(s): For five out of
14 procedures, no evidence could be identified. A total of 20 RCTs and
five follow-up publications met the inclusion criteria. Overall, most
studies had either not reported or measured patient-relevant endpoints.
The majority of outcomes showed comparable results between study groups.
However, RAS demonstrated potential advantages in specific endpoints
(e.g., blood loss), yet these findings relied on a limited number of
low-quality studies. Statistically significant RAS benefits were also
noted in some outcomes for certain indications-recurrence, quality of
life, transfusions, and hospitalisation. Safety outcomes were improved for
patients undergoing robot-assisted gastrectomy, as well as rectal and
liver resection. Regarding operation time, results were contradicting.
 Conclusion(s): In summary, conclusive assertions on RAS superiority
are impeded by inconsistent and insufficient low-quality evidence across
various outcomes and procedures. While RAS may offer potential advantages
in some surgical areas, healthcare decisions should also take into account
the limited quality of evidence, financial implications, and environmental
factors. Furthermore, considerations should extend to the ergonomic
aspects for maintaining a healthy surgical environment. Graphical
abstract: (Figure presented.) Copyright © The Author(s) 2024.

<38>
Accession Number
2028207340
Title
Antithrombotic Treatment After Transcatheter Valve Interventions: Current
Status and Future Directions.
Source
Clinical Therapeutics. 46(2) (pp 122-133), 2024. Date of Publication:
February 2024.
Author
Maznyczka A.; Pilgrim T.
Institution
(Maznyczka, Pilgrim) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: The optimal antithrombotic strategy after transcatheter valve
interventions is a subject of ongoing debate. Although there is evidence
from randomized trials in patients undergoing transcatheter aortic valve
replacement (TAVR), current evidence on optimal antithrombotic management
after transcatheter mitral or tricuspid valve interventions is sparse.
This article appraises the current evidence on this topic. Method(s):
This narrative review presents key research findings and guideline
recommendations, as well as highlights areas for future research.
 Finding(s): After TAVR, randomized trial evidence suggests that
single antiplatelet therapy is reasonable for patients without
pre-existing indications for oral anticoagulation (OAC). If there is a
concurrent indication for OAC, the addition of antiplatelet therapy
increases bleeding risk. Whether direct oral anticoagulants achieve better
outcomes than vitamin K antagonists is uncertain in this setting. Although
OAC has been shown to reduce subclinical leaflet thrombosis (which may
progress to structural valve degeneration), bleeding events are
unacceptably high. There is a lack of randomized trial data comparing
antithrombotic strategies after transcatheter mitral or tricuspid valve
replacement or after mitral or tricuspid transcatheter edge-to-edge
repair. Single antiplatelet therapy after mitral or tricuspid
transcatheter edge-to-edge repair may be appropriate, whereas at least 3
months of OAC is suggested after transcatheter mitral valve replacement or
transcatheter tricuspid valve replacement. Implications: Randomized
studies are warranted to address the knowledge gaps in antithrombotic
therapy after transcatheter valve interventions and to optimize
outcomes. Copyright © 2023 The Author(s)

<39>
Accession Number
641864614
Title
Concomitant tricuspid valve repair for mild-moderate tricuspid
regurgitation patients undergoing mitral valve surgery? A meta-analysis
and meta-regression.
Source
The Journal of cardiovascular surgery. 64(6) (pp 657-667), 2023. Date of
Publication: 01 Dec 2023.
Author
Awad A.K.; Sayed A.; Elbadawy M.A.; Ahmed A.; Ming Wang T.K.; Elgharably
H.
Institution
(Awad) Faculty of Medicine, Ain-shams University, Cairo, Egypt
(Sayed, Elbadawy) Faculty of Medicine, Ain-shams University, Cairo, Egypt
(Ahmed) CUNY School of Medicine, New York, NY, USA
(Ming Wang) Department of Cardiovascular Medicine, Heart Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Elgharably) Department of Thoracic and Cardiovascular Surgery, Heart
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
Abstract
The development of tricuspid regurgitation (TR) is a common complication
of mitral valve disease. Although severe TR is usually operated on at the
same time of mitral valve surgery (MVS), controversies remain regarding
whether mild to moderate TR patients should be operated. Concomitant
tricuspid valve repair with MVS for mild-moderate TR patients. Electronic
databases were searched from inception to November 20, 2022 to include any
observational or randomized controlled trials (RCT) that compare
concomitant tricuspid repair with MVS versus MVS alone. Mantel-Haenszel
method was used to pool study estimates and calculate odds ratios (OR)
with 95% confidence intervals (CI). A total of 9813 patients from 25
studies were included. Regarding primary outcomes, concomitant repair
group had significantly lower 30 days mortality (OR: 0.66; 95% CI 0.45 to
0.96), all-cause mortality-based on RCTs- (OR: 0.40; 95% CI 0.22 to 0.71),
cardiovascular mortality (OR: 0.53; 95% CI: 0.33 to 0.86) and heart
failure hospitalizations (OR: 0.41; 95% CI: 0.26 to 0.63). However, was
associated with higher permanent pacemaker implantation rates (OR: 2.09;
95% CI: 1.45 to 3.00). There were no significant differences in terms of
secondary outcomes: tricuspid valve reinterventions, stroke and acute
kidney injury. Furthermore, repair group showed lower risk for TR
progression degrees (OR 0.08; 95% CI 0.05 to 0.16) and decreased mean of
TR progression (MD -1.85; 95% CI -1.92 to -1.77). Concomitant tricuspid
valve repair in mild or moderate TR at time of MVS appears to reduce not
only 30 days but also long-term all-cause and cardiovascular mortality
weighed against the increased risk of pacemaker implantation.

<40>
Accession Number
2030418306
Title
Positive Airway Pressure therapy predicts lower mortality and Major
Adverse Cardiovascular Events incidence in medicare beneficiaries with
Obstructive Sleep Apnea.
Source
Sleep Medicine. Conference: 17th World Sleep Congress. Rio de Janeiro
Brazil. 115(Supplement 1) (pp 375-376), 2024. Date of Publication:
February 2024.
Author
Mazzotti D.; Waitman L.; Miller J.; Sundar K.; Stewart N.; Gozal D.; Song
X.
Institution
(Mazzotti) University of Kansas Medical Center, Internal Medicine, Kansas
City, United States
(Waitman, Song) University of Missouri-Columbia, Columbia, United States
(Miller) University of Nebraska Medical Center, Lincoln, United States
(Sundar) University of Utah, Salt Lake City, United States
(Stewart) University of Kansas Medical Center, Kansas City, United States
(Gozal) Marshall University, Huntington, United States
Publisher
Elsevier B.V.
Abstract
Introduction: Positive airway pressure (PAP) is the first line treatment
for obstructive sleep apnea (OSA). Randomized controlled trials (RCTs)
have established that PAP may be beneficial, in the short-term, to
cardiovascular functions. However, evidence on prevention of major adverse
cardiovascular events (MACE) is limited. RCTs are expensive and
time-consuming, leading to delayed changes in clinical guidelines. Causal
inference methods combined with availability of PAP therapy data enables
the design of observational studies that complement RCTs. Here, we applied
Inverse Probability of Treatment Weights (IPTW)-adjusted Cox proportional
hazard (PH) models using Medicare claims to examine causal associations
between PAP initiation or PAP adherence and incidence of MACE and
mortality. Material(s) and Method(s): Medicare beneficiaries (>65
years) with >=5 years of consecutive enrollment to part A and B and >=2
distinct OSA claims were collected from multi-state (KS, MO, IA, WI, NE,
MN, TX, UT, ND, SD, IN), multi-year (2011-2017) Medicare fee-for-service
claims data. Evidence of PAP initiation was based on PAP claims after
first OSA diagnosis. PAP adherence was based on total counts of PAP claims
in the first year since initiation. We explored multiple empirical
discretization techniques (e.g., quantiles of count distribution) to
approximate the degree of PAP adherence. Prescription time-distribution
matching was used to minimize immortal time bias. MACE was defined as the
first claim of myocardial infarction, coronary revascularization, stroke,
or heart failure. All-cause mortality was based on the Medicare
beneficiary summary file. We used doubly robust Cox PH models with
variations of IPTW (derived by generalized ordinal and Poisson regression
with regularizations) to control for measured confounders. We identified
11 covariates, including demographics, comorbidities, and proxies of
socio-economic status. Result(s): Our sample included 225,132
eligible Medicare beneficiaries with evidence of OSA (median [Q1, Q3] age
74 [71, 79] years; 45.3% women; median [Q1, Q3] follow-up 3 [1.9, 4.7]
years. Five-year cumulative MACE incidence rate was 40.6% and mortality
rate was 18.1%. In IPTW-adjusted models, OSA patients with evidence of PAP
initiation (50.1%) had significantly lower all-cause mortality risk (HR
[95%CI] 0.57 [0.56-0.59]) and MACE incidence risk (0.90 [0.88-0.92]).
Analysis of PAP adherence based on first-year claims distribution revealed
that higher quartiles (e.g., higher PAP utilization) were progressively
associated with lower mortality (Q2: 0.80 [0.75-0.86], Q3: 0.68
[0.64-0.72], Q4: 0.65 [0.61-0.70]) and MACE incidence risk (Q2: 0.91
[0.86-0.97], Q3: 0.87 [0.82-0.91], Q4: 0.85 [0.80-0.90]).
 Conclusion(s): PAP utilization based on claims was associated with
lower all-cause mortality and MACE incidence in Medicare beneficiaries
suffering from OSA. Results might inform future trials assessing the
importance of OSA therapy initiation and maintenance towards minimizing
cardiovascular risk and mortality in older adults. Acknowledgements:
American Heart Association (20CDA35310360), Patient-Centered Outcomes
Research Institute (RI-CRN-2020-003-IC); NIH CTSA NCATS Frontiers:
University of Kansas Clinical and Translational Science Institute
(UL1TR002366); Tier 2 grant, University of Missouri. Copyright ©
2023

<41>
Accession Number
643560480
Title
THE EFFECTS OF PREOPERATIVE AMINOPHYLLINE ON MYOCARDIUM AT THE BEATING
HEART CORONARY BYPASS SURGERY.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 195), 2020. Date of Publication: October 2020.
Author
Percin B.; Sacli H.
Institution
(Percin, Sacli) Sakarya University Research and Training Hospital,
Sakarya, Turkey
Publisher
Galenos Publishing House
Abstract
Objective: Coronary artery bypass surgery on the beating heart and its
advances have taken their place in modern surgery. We planned a
prospective, randomised, controlled, clinical study to determine the
effects of preoperative aminophylline usage on myocardial
ischemiareperfusion injury during the beating heart coronary artery bypass
surgery. Method(s): We randomized 30 patients into two groups who
were planned coronary artery bypass grafting electively. Daily dose of 200
mg aminophylline was applied to 15 patients at preoperative three
consecutive days in the aminophylline group (AG). 15 patients in the
control group (CG) had taken no extra medication. Measurements of serum
creatine kinase (CK), creatine kinase MB (CK-MB), troponin I (Tn-I)
concentrations were obtained before surgery, 5 minutes after the end of
surgery, and at the 1st, 124th, 48th hours postoperatively. Mean pulmonary
artery pressure, cardiac index, ejection fraction, operative data, and
morbidity were recorded in all patients preoperatively and
postoperatively. Result(s): Preoperative risk profiles and operative
variables were statistically similar in the comparison of two groups.
Serum concentrations of CK, CK- MB, Tn-I were increased after off-pump
coronary artery bypass surgery without any statistically significant
intergroup differences. Preoperative and postoperative cardiac index (CI)
measurements via echocardiography were statistically significant between
groups (p<0.05). Preoperatively we calculated 3.2+/-0.7
L/m2/min in AG and 3.2+/-0.6 L/m2/min in CG.
Postoperative values were 4+/-0.9 L/m2/min in AG and 3.6+/-0.8
L/m2/minin CG ( p<0.05 ). Conclusion(s): In this study, we
suggested that the usage of preoperative aminophylline decreases the
injury of the ischemia-reperfusion and myocardial protection during the
off-pump coronary artery bypass surgery. Key words: Aminophylline, cardiac
index, off-pump coronary artery bypass surgery, ischemia reperfusion
injury, myocardial protection.

<42>
Accession Number
643560444
Title
EFFECTIVITY OF DEXAMETHASONE IN PATIENTS UNDERGOING OFF PUMP CORONARY
ARTERY BYPASS GRAFTING SURGERY: A RANDOMIZED DOUBLE BLIND CONTROLLED
CLINICAL TRIAL.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 477), 2020. Date of Publication: October 2020.
Author
Hanafy D.A.; Adhi Parama Harta I.K.; Busroh P.W.; Aligheri S.D.; Tjubandi
A.; Herlambang B.; Soetisna T.W.
Institution
(Hanafy, Adhi Parama Harta, Busroh, Aligheri, Tjubandi, Herlambang,
Soetisna) National Cardiovascular Center Harapan Kita Hospital, Jakarta,
Indonesia
Publisher
Galenos Publishing House
Abstract
Background: Based on a pilot study in National Cardiovascular Center
Harapan Kita, systemic inflammatory response syndrome (SIRS) is more
common in OPCAB compared to on-pump CABG, 67% vs 33% (30 samples, 2017).
Based from this result, this research conducted a clinical trial to
provide dexamethasone in patients undergoing OPCAB surgery.
 Method(s): Samples were collected consecutively in Harapan Kita
between August 2018 - January 2019. Samples were randomized to
dexamethasone group (n = 30) and placebo group (n = 30). Intervention
using intravenous dexamethasone dose of 1 mg/KgBB (maximum 100 mg) or
placebo using normal saline (0.9% NaCl). Statistical analysis were used
independent t-test, Mann-Whitney test, fisher exact test and AUC.
 Result(s): Major Adverse Cardiovascular Events (MACE) incidence in
dexamethasone group compared to placebo group (RR 0.385, 95% CI:
0.157-0.945, p = 0.024). Clinical outcome of dexamethasone group was
better than placebo group in duration of mechanical ventilation (6 (5-16)
hours vs 8 (5-72 ) hours, p = 0.029), ICU length of stay (17.5 (12-32)
hours vs 19 (13-168) hours, p = 0.028), hospital length of stay (5 (5-8)
days vs 6.5 (5-30) days, p = 0.04) and VIS (0 (0-15) vs 5 (0-100), p =
0.045). As a result of the inflammatory markers, there was a significant
mean difference between dexamethasone group compared to the placebo group
in IL-6 (217.4 pg/mL, 95% CI: 107.9-326.8, p = 0.0001), PCT (3.41 mug/L,
95% CI: 2.1-4.71, p = 0.0001) and CRP (52.3 mg/L, 95% CI: 28.8-75.8, p =
0.0001). In the AUC analysis there was a significant association between
inflammatory markers with the incidence of MACE in IL-6 (AUC 0.728, 95%
CI: 0.585-0.871, p = 0.005) and PCT (AUC 0.723, 95% CI: 0.578-0.868, p =
0.007). Conclusion(s): Preoperative dexamethasone OPCAB is effective
to improving clinical outcome and controlling postoperative inflammatory
reactions compared to placebo.

<43>
Accession Number
643560371
Title
IS SERUM BASELINE MMP-9 LEVEL REALLY ASSOCIATED WITH IN-STENT RESTENOSIS?.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 336), 2020. Date of Publication: October 2020.
Author
Kalyoncuoglu M.; Ozkan A.A.; Gurmen T.
Institution
(Kalyoncuoglu) Haseki Egitim Ve Arastirma Hastanesi, Istanbul, Turkey
(Ozkan, Gurmen) Cardiology Institute, Istanbul University, Istanbul,
Turkey
Publisher
Galenos Publishing House
Abstract
Objective -In-stent restenosis (ISR) is an inflammatory response to
procedural trauma such as coronary stenting. Matrix metalloproteinase-9
(MMP-9) plays an important role in pathological vascular remodelling
processes. We aimed to investigate whether basal serum MMP-9 antigen
levels are associated with ISR in patients undergoing stent placement for
de novo lesions. Method(s): This was a prospective-case controlled
study. 170 consecutive patients who underwent elective percutaneous
coronary intervention (PCI) constituted the study population. PCIs were
performed by a team of experienced operators and control coronary
angiography was performed in all patients enrolled in the study 6-12
months after the index intervention. Primary endpoint was a
angiographically in-stent restenosis, defined as the presence of >= 50%
diameter narrowing either within the stent or within 5 mm proximally or
distally to the stent margin. Fasting venous blood samples were taken
directly from the antecubital vein before to PCI to determine MMP-9
levels, serum high-sensitivity C-reactive protein (hs-CRP), and other
biochemical parameters (fasting blood glucose, serum creatinine, etc.).
 Result(s): The median follow-up time was 7.17 months (+/-2.01) and
the during the follow-up period, 6 patients with stable angina pectoris
and 7 patients with acute coronary syndrome had coronary angiographies
earlier than scheduled but the remaining 152 patients underwent the
planned control coronary angiography. Sixty seven patients (40%) had
restenosis. Table 1 and table 2 show the baseline characteristics of
patients with and without restenosis. The serum basal MMP-9 levels were
median 68.9 [33.7-157] ng/ml and 73.3 [33.7- 157] ng/ml respectively, in
patients with and without restenosis. There was no significant association
between the serum basal MMP-9 concentrations and ISR (P = 0.91). Patients
with ISR had higher h-CRP concentrations compared to those without ISR
(median 3.8 [3.4-14.4] mg/L and 3.4 [3.4-5.3] mg/L ) but there was no an
association between hs-CRP levels and ISR (P = 0.17). When the
interventional and angiographic factors were evaluated, type of stent,
reference vessel diameter, and final vessel diameter were found to be
associated with ISR (Table 2). ISR was significantly lower in DES
implanted patients compared to BMS group (23% vs 43%, P = 0.03).
Multivariant analysis showed that stent type and final vessel diameter
significantly predicted ISR (respectively, P = 0.04, P = 0.02) (Table 3).
(Table Presented) Conclusion(s): Basal inflammatory status as
represented by hsCRP and basal MMP-9 levels are not predictive for ISR in
patients undergoing elective PCI for de novo lesions in contrast to
previously reported series. Final vessel diameter and stent type were
found to be strong predictors for ISR.

<44>
Accession Number
643560351
Title
ASSOCIATION OF OBSTRUCTIVE SLEEP APNEA WITH POSTOPERATIVE ATRIAL
FIBRILLATION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 469), 2020. Date of Publication: October 2020.
Author
Cetin S.; Thunstrom E.; Peker Y.
Institution
(Cetin) Okan University Hospital, Istanbul, Turkey
(Thunstrom) University of Gothenburg, Gothenburg, Sweden
(Peker) Koc University, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE Postoperative Atrial Fibrilation (POAF) is known to occur up to
33% after coronary artery bypass grafting (CABG) operations. Obesity is
suggested to be one of the contributing factors for POAF following CABG.
Obstructive sleep apnea (OSA) is also common in patients with coronary
artery disease (CAD), and may contribute to POAF, since obesity and OSA
co-exist. We aimed to adress the relationship between OSA and POAF in a
subcohort of revascularized CAD patients undergoing CABG. METHODS This was
a secondary analysis of the RICCADSA (Randomized Intervention with CPAP in
Coronary Artery Disease and Obstructive Sleep Apnoea) trial, conducted in
Sweden between 2005 and 2013. Among 511 revascularized CAD patients, 124
underwent CABG, followed by a home sleep study, in average 73+/-30 days
after the operation. OSA was defined as an apnea-hypopnea index (AHI) of
at least 15 events per hour, and non-OSA as an AHI below 5 events per
hour. Severe OSA was defined as an AHI of at least 30 events per hour.
Postoperative AF was defined as a new-onset AF occurring within 30 days
following the CABG. A logistic regression analysis was used to determine
variables associated with POAF, in which a stepwise backward model was
used (variables with P>0.20 were removed). RESULTS After excluding eight
patients with chronic AF, 116 remained as the final study population. In
all, 99 (85.3%) had OSA, and 17 (14.7%) no- OSA. POAF was observed among
42 (36.2%), of whom 40 in OSA (40.4%) vs 2 in no-OSA (11.8%) (p=0.023).
The frequency of POAF was higher with increasing OSA severity (48.9% in
severe OSA). There was significant association between OSA and POAF (Odds
Ratio [OR] 4.8, 95% Confidence Interval [CI] 1.0-22.6; p=0.048)
independent of age, gender, body-mass-index (BMI), current smoking,
hypertension, diabetes, and lung disease. Severe OSA was associated POAF
with an OR of 7.1 (95% CI 1.4-35.6; p=0.018) in multivariate analysis. Age
and diabetes mellitus, but not BMI and other variables, were associated
with POAF in this cohort. CONCLUSIONS Our results suggest that OSA may
contribute to POAF in patients undergoing CABG. Whether or not a sleep
study to screen patients who will undergo CABG for OSA, and subsequently
treat with continuous positive airway pressure before the surgical
intervention may decrease the risk for POAF needs to be further evaluated.
ClinicalTrialRegistration: clinicaltrials.gov NCT00519597.
Acknowledgements: The study was funded by the Swedish Research Council,
Swedish Heart and Lung Foundation, and ResMed Foundation.

<45>
Accession Number
643560262
Title
INVESTIGATION OF STUDIES IN TURKEY DELIRIUM RELATING TO THE HEART SURGERY.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 666), 2020. Date of Publication: October 2020.
Author
Ulus M.; Edeer A.D.
Institution
(Ulus) Dokuz Eylul Universitesi, Saglik Bilimleri Enstitusu, Cerrahi
Hastaliklari Hemsireligi Doktora Programi Ogrencisi, Izmir, Turkey
(Edeer) Dokuz Eylul Universitesi, Hemsirelik Fakultesi, Cerrahi
Hastaliklari Hemsireligi Ogretim Uyesi, Izmir, Turkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE: In this systematic review, in Turkey between the years
2010-2020 was carried out in order to examine the studies related delirium
in cardiac surgery. METHOD(S): In this literature review, Academic
Search Complete (EBSCO), MEDLINE, PubMed, Science Direct, National
Academic Network and Information Center (ULAKBIM), Google Academic Search
electronic databases were scanned. In the study, the studies that have
been published in the last ten years (2010-2020) using the keywords
'delirium and nursing', 'postoperative delirium', 'delirium after open
heart surgery', the publication language of which is Turkish or English
and whose full text has been reached, were selected. A total of 12
national and international studies and reviews were reached, and these
studies constituted the sample of the study. Result(s): The studies
were published 58.3% (n: 7) in Turkish and 41.6% (n: 5) in English. The
studies are 41.6% (n: 5) descriptive studies, 33.3% (n: 4) experimental
studies and 25% (n: 3) rewiev articles. It was determined that 25% (n: 3)
of the studies were done retrospectively and 53.8% (n: 7) were done
prospectively. A total of five studies, three of which are descriptive
research and two of which are rewiev, were conducted in nursing. In
studies of cardiac surgery associated with delirium in nursing in Turkey
it has not been demonstrated in experimental research. Publications in
Turkish; performed by doctors examining the frequency and risk factors of
delirium in open heart surgery, the effectiveness of dexmedetomidine in
delirium, the effect of on-pump and off-pump heart surgery on delirium
development, the relationship between delirium and nitrite oxide are
studies. Publications in English; examining the relationship between
cobalamin deficiency and delirium, the relationship between dopamine and
delirium, post-operative delirium incidence, prevalence and risk factors
are studies. In the reviews, risk groups for delirium in cardiac surgery,
delirium preventive interventions, nursing care of patients with delirium
before and after surgery, and delirium diagnosis methods were examined. In
general, the sample group of the studies consists of elderly patients.
 Conclusion(s): In the examination results of the majority of delirium
in cardiac surgery with studies performed in our country it was found to
be descriptive research. It has been found that there is no experimental
research in nursing. Therefore, it is thought that conducting experimental
studies on delirium in nursing in cardiac surgery will contribute to the
literature and clinical applications.

<46>
Accession Number
643560069
Title
EFFICACY OF POSTERIOR PERICARDIOTOMY IN PREVENTION OF ATRIAL FIBRILLATION
AND PERICARDIAL EFFUSION AFTER AORTIC VALVE REPLACEMENT: A RANDOMIZED
CONTROLLED TRIAL.
Source
E Journal of Cardiovascular Medicine. Conference: 16th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 8(1 Supplement) (pp 297), 2020. Date of Publication: October 2020.
Author
Kaleda V.; Boldyrev S.; Belash S.; Babeshko S.; Barbuhatti K.
Institution
(Kaleda) Central Clinical Hospital, Moscow, Russian Federation
(Boldyrev, Belash) Kuban State Medical University, Krasnodar, Russian
Federation
(Babeshko, Barbuhatti) Ochapowski Regional Hospital, Krasnodar, Russian
Federation
Publisher
Galenos Publishing House
Abstract
BACKGROUND Postoperative AFib is one of the most frequent complications in
cardiac surgery. Previously posterior pericardiotomy was shown to be an
effective method for prevention of postoperative AFib in patients
undergoing isolated CABG. The aim of this trial was to evaluate the
effectiveness of posterior pericardiotomy in the prevention of
postoperative AFib and pericardial effusion in patients undergoing
isolated primary aortic valve replacement. METHODS The trial was approved
by the local ethics committee. It included adult patients under 70 y.o.
who had signed the informed consent for participation in the study and who
were planned to undergo isolated primary aortic valve replacement.
Exclusion criteria were a history of AFib, hyperthyroidism, amiodarone
intake, severe chronic obstructive pulmonary disease, left ventricle
ejection fraction less than 30%, the size of the left atrium exceeding 50
mm, active infective endocarditis, the presence of adhesions in the
pericardium and/or left pleural cavity and mini-sternotomy. From October
2013 to April 2015 607 patients in our clinic underwent different aortic
valve procedures. 507 patients were excluded from the study because of the
inclusion and exclusion criteria. The remaining 100 patients were
randomized into two groups: 49 patients underwent posterior pericardiotomy
and 51 patients made up the control group. In both groups the frequency of
postoperative AFib, pericardial effusion greater than 5 mm,
surgery-discharge time, as well as posterior-pericardiotomy-related
complications were studied. RESULTS There were no deaths, stroke or
cardiac tamponade during the postoperative stay. Neither were there any
complications associated with the performance of posterior pericardiotomy.
The incidence of AFib, pericardial effusion and average duration of the
postoperative stay were similar in both groups: 16% in posterior
pericardiotomy group vs. 14% in the control group (p = 0.71), 10% in
posterior pericardiotomy group vs. 12% in the control group (p = 0.80) and
12.4+/-4.3 days in posterior pericardiotomy group vs. 11.9+/-4.1 days in
the control group (p = 0.27), respectively. CONCLUSIONS The trial did not
confirm the effectiveness of posterior pericardiotomy in preventing
postoperative AFib and pericardial effusion during the in-hospital period
after isolated primary aortic valve replacement in low risk patients.
However, further investigations are needed.

<47>
Accession Number
643562860
Title
PECTOINTERCOSTAL BLOCK MAY BE EFFECTIVE IN POSTOPERATIVE PAIN MANAGEMENT
FOLLOWING CARDIAC SURGERY; A PILOT STUDY.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 259), 2019. Date of Publication: March 2019.
Author
Ali I.; Turkmen S.; Okur O.; Turgut N.; Yucel C.; Gursoy M.; Kayalar N.
Institution
(Ali, Turkmen, Okur, Turgut, Yucel, Gursoy, Kayalar) Okmeydani Training
and Research Hospital, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
Introduction: Pectointercostal block (PIB) is used for regional analgesia
in thoracic diseases and interventions. Cardiac surgery is associated with
severe postoperative pain due to sternotomy and internal thoracic artery
harvesting. Parenteral narcotic analgesia is preferred approach which may
cause various side effects. We reported the results of the first ten
patients who had a PIB following cardiac surgery for postoperative pain
management. Material(s) and Method(s): Ethics commitee approval and
informed consents were gained. Ten consecutive patients ( 6 female, 4 male
) were included to the study. The same anesthesia team ( SK, IA )
performed ultrasound guided PIB to the patients at the end of the
procedure. Visual pain score (VPS)( postoperative 1st, 3rd, 6th,12th,
18th,24th hours ) and analgesia demand ( for 24 hours ) were recorded and
compared with control group who did not have PIB. Result(s): Mean age
and gender distribution were similar between groups. VPS was insignificant
at the 1st , 3rd , 24th hours. But mean VPS was lower in study group at
the 6th, 12th, and 18th hours. Analgesia demand was also found decreased.
 Conclusion(s): PIB may be effective in postoperative pain management
following cardiac surgery. Repeated administration may be used in demand
after 12th hours. A randomised prospective study is continue in our
department.

<48>
Accession Number
643562807
Title
RANDOMIZED TRIAL OF ENDOSCOPIC VERSUS OPEN RADIAL ARTERY HARVEST FOR
CORONARY REVASCULARIZATION.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 196), 2019. Date of Publication: March 2019.
Author
Tamim M.; Alkadi Y.; Alhassan D.
Institution
(Tamim, Alkadi, Alhassan) King Fahd Military Medical Complex, Dhaharn,
Saudi Arabia
Publisher
Galenos Publishing House
Abstract
Objectives Endoscopically harvested radial artery as a graft for coronary
revascularization had become a standard of care in many centers. The aim
of this randomized study was to assess graft quality 1 year after the
operation comparing open and endoscopically harvested radial artery.
Methods We followed 50 patients who underwent non emergent on-pump
coronary artery bypass grafting prospectively randomized to either
endoscopic radial artery harvest (ERA) or open radial artery harvest
(ORA). Follow-up 64-slice cardiac computed tomography, echocardiography
were utilized to assess wall motion abnormality and left ventricle
function at a 6 months and 1-year follow-up. In addition, the influencing
factors of radial artery graft patency were evaluated. One interventional
cardiologists and consultant radiologist assigned graft patency and
disease grades independently. Results Any patency of endoscopically
harvested radial artery grafts was 93% (48/50) and perfect patency was 83%
(45/50) 1 year after coronary revascularization. The implanting surgeon
and graft harvester, patient factors, graft properties, medication, and
target territory did not influence the patency rates of the radial artery
graft. The only significant and strong parameter to predict perfect graft
patency was the severity of the target vessel stenosis (P < .001). Patency
rates of endoscopically (82%) and conventionally (80%) harvested radial
arteries were not different (P = .822). Conclusions Patency rates 1 year
after endoscopic radial artery harvesting are comparable to the open
technique. On the basis of our results, we attempt to use the radial
artery as a bypass graft only for target coronary arteries with 90% or
greater stenosis. We recommend endoscopic harvesting as the technique of
choice to harvest the radial artery.

<49>
Accession Number
643562707
Title
EARLY OUTCOMES OF MINIMALLY INVASIVE LAD REVASCULARIZATION VS PCI IN
RANDOMIZED CLINICAL TRIAL.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 240), 2019. Date of Publication: March 2019.
Author
Popov V.; Malyshenko E.; Novikov M.; Edzhibiya G.; Revishvili A.
Institution
(Popov, Malyshenko, Novikov, Edzhibiya, Revishvili) A.V. Vishnevsky
National Medical Research Center of Surgery, Moscow, Russian Federation
Publisher
Galenos Publishing House
Abstract
BACKGROUND: To evaluate in-hospital results of prospective RCT ENPILA
(EndoACAB vs PCI for LAD Revascularization) METHODS: Our prospective RCT
includes 100 patients. Inclusion criterion is isolated critical LAD
lesions, suitable for either EndoACAB, or PCI revascularization. EndoACAB
(Endoscopic-Assisted Coronary Artery Bypass) consists of harvesting IMA
with endoscopic techniques and LAD direct vision anastomosis formation
through the anterolateral minithoracotomy 3-4 cm lenght using myocardium
stabilizer. There are 2 groups, 50 patients each. 1st group includes
patients, who underwent LAD EndoACAB procedure. 2nd group includes
patients, who underwent PCI to LAD. Postoperative check points in both
groups evaluated in 24 and 48 weeks. To evaluate the adequacy of
myocardial revascularization primal endpoints were analyzed, including
major adverse cardiovascular events (MACE), such as death, nonlethal MI,
recurrent revascularization; and secondary endpoints: conversion, bleeding
in perioperative period, pain, quality of life. This trial includes 52
patients by far, 1st group includes 25 patients and 2nd group includes 27
patients. RESULT(S): In 1st group EndoACAB procedure was successfully
performed in all patients (100%) from the 1st group. In PCI group no
complications have also occurred. There were no significant difference in
primary and secondary endpoints during in-hospital period in both groups.
All patients in early in-hospital period underwent coronaroangiography and
shuntography. Incomplete myocardial revascularization, technical
difficulties and other complications weren't detected. CONCLUSION(S):
Minimally invasive endoscopic-assisted myocardial revascularization
results were comparable to the PCI results during inhospital period.

<50>
Accession Number
643562706
Title
OFF-PUMP GRAFTING DOES NOT REDUCE POSTOPERATIVE PULMONARY DYSFUNCTION.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 99-100), 2019. Date of Publication: March
2019.
Author
Almohammad F.; Izzat M.B.
Institution
(Almohammad, Izzat) Damascus University Cardiac Surgery Hospital,
Damascus, Syrian Arab Republic
Publisher
Galenos Publishing House
Abstract
Background Pulmonary dysfunction is a recognized postoperative
complication that may be linked to use of cardiopulmonary bypass. The
off-pump technique of coronary artery bypass grafting aims to avoid some
of the complications that may be related to cardiopulmonary bypass. In
this study, we compared the influence of on-pump or off-pump coronary
artery bypass on pulmonary gas exchange following routine surgery. Methods
Fifty patients (mean age 60.4+/-8.4 years) with no preexisting lung
disease and good left ventricular function undergoing primary coronary
artery bypass grafting were prospectively randomized to undergo surgery
with or without cardiopulmonary bypass. Alveolar/arterial oxygen pressure
gradients were calculated prior to induction of anesthesia while patients
were breathing room-air, and were repeated postoperatively during
mechanical ventilation and after extubation while inspiring 3 specific
fractions of oxygen. Results Baseline preoperative arterial blood gases
and alveolar/arterial oxygen pressure gradients were similar in both
groups. At both postoperative stages, the partial pressure of arterial
oxygen and alveolar/arterial oxygen pressure gradients increased with
increasing fraction of inspired oxygen, but there were no statistically
significant differences between patients who underwent surgery with or
without cardiopulmonary bypass, either during ventilation or after
extubation. Conclusions Off-pump surgery is not associated with superior
pulmonary gas exchange in the early postoperative period following routine
coronary artery bypass grafting in patients with good left ventricular
function and no preexisting lung disease.

<51>
Accession Number
643562608
Title
AORTIC VALVE REPLACEMENT FOR PAPILLARY FIBROELASTOMA.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 555), 2019. Date of Publication: March 2019.
Author
Arikan A.A.; Omay O.; Aydin F.; Kanko M.; Gur S.; Dervis E.; Yilmaz C.E.;
Muezzinoglu B.
Institution
(Arikan) Derince Egitim Arastirma Hastanesi, Kocaeli, Turkey
(Omay, Kanko, Gur) Kocaeli University Medical Faculty, Department of
Cardiovascular Surgery, Kocaeli, Turkey
(Aydin) Eskisehir State Hospital, Departement of Cardiology, Eskisehir,
Turkey
(Dervis) Kocaeli University Medical Faculty, Departement of Cardiology,
Kocaeli, Turkey
(Yilmaz, Muezzinoglu) Kocaeli University Medical Faculty, Departement of
Pathology, Kocaeli, Turkey
Publisher
Galenos Publishing House
Abstract
Text Aortic Valve Replacement for Papillary Fibroelastoma Abstract:
Background and aim of the study: Cardiac surgery is indicated for
symptomatic patients with papillary fibroelastomas (PFE) on aortic valve.
The valve is commonly spared during tumor excision. Rarely, aortic valve
replacement (AVR) is needed. We present a case requiring AVR for aortic
valve PFE (avPFE) with a systematic review of literature to investigate
risk factors for failure of aortic valve sparing techniques in avPFE
cases. Method(s): A sixty-three years old woman with an aortic mass
is treated with AVR. A shave excision and valve repair is not attempted.
Pathologic diagnosis was consistent with PFE. To detect avPFE cases
treated with AVR a systemic review of literature using PubMed database is
performed. This review consists of data collected from 41 cases described
in 34 articles. Patients treated with AVR for aortic PFE with and without
concomitant aortic valve disease are enlisted. Age, gender, tumor size,
tumor localization, affected cusps, symptoms, additional cardiac
pathologies and operative features are analyzed. Result(s): 25
patients underwent AVR without structural disease on aortic valves. 16 had
concomitant valve disease. 58% of patients with normal valvular function
where female. 55% of the patients with normal functioning aortic valve had
a tumor greater than one centimeter. A smaller proportion is described in
literature for female gender and tumor size. Conclusion(s): Female
gender and larger tumors can be predictors of valve replacement in avPFE
surgery.

<52>
Accession Number
643562605
Title
DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION AFTER CORONARY ARTERY BYPASS
GRAFT (CABG) SURGERY: A SYSTEMATIC REVIEW.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 83), 2019. Date of Publication: March 2019.
Author
Elkaramany A.
Institution
(Elkaramany) National Heart Institute, Cairo, Egypt
Publisher
Galenos Publishing House
Abstract
Introduction: Myocardial infarction after coronary artery bypass grafting
is a serious complication and one of the most common causes of
perioperative morbidity and mortality. Multiple mechanisms have been
proposed to explain myocardial injury after CABG. Diagnosis will be
established according to creatine kinase (CK) values more than five times
the 99th percentile of the normal reference range during the first 72
hours following CABG, (or Troponin or CKMB more than ten time increase)
when associated with the appearance of new pathological Q-waves or new
left bundle-branch block (LBBB), or angiographically documented new graft
or native coronary artery occlusion, or imaging evidence of new loss of
viable myocardium, should be considered as diagnostic of a CABG related
MI. Objective(s): to identify the methods of diagnosis of post
coronary artery bypass graft (CABG) acute myocardial infarction. Data
sources: MEDLLINE (PubMed), EMBASE, Google Scholar and the Cochrane
Library and all materials available in the internet till 2017. Study
selection: this search presented 23 eligible studies which studied the
diagnostic methods for acute myocardial infarction after coronary artery
bypass graft (CABG) surgery. Data extraction: if the studies did not
fulfill the inclusion criteria, they were excluded. The methodological
quality of included studies was assessed using an adjusted QUADAS-tool.
Data synthesis: comparisons was made by structured review with the results
tabulated. CONCLUSION(S): Troponin I and T can both be used to
indicate myocardial damage, with the level correlating well with the level
of injury. However until issues such as a 'gold standard' for
peri-operative MI are addressed, one single cut-off point cannot be
recommended for either test.

<53>
Accession Number
643562553
Title
EUROSCORE IS THE ONLY PREDICTOR FOR EARLY MORTALITY AFTER AORTIC VALVE
REPLACEMT IN MIDDLE AGED RHEUMATIC PATIENTS.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 549), 2019. Date of Publication: March 2019.
Author
Sersar S.; Hassan E.
Institution
(Sersar) Mansoura University; Egypt, Mansoura, Egypt
(Hassan) Tanta University; Egypt, Tanta, Egypt
Publisher
Galenos Publishing House
Abstract
Text Introduction and aim of the work: Emergency AVR is a strong predictor
of early mortality in some meta analyses. Euroscore can give a good idea
about the mortality after cardiac surgeries. We aimed to review our
experience in AVR and determine the early mortality predictors.
 Patients and Methods: We collected the data of two hundreds of
rheumatic patients who had surgical standard AVR in 2 centres in Saudi
Arabia in the last 2 years. Median sternotomy and cardiopulmonary bypass
were used. We used 15 types of AV prostheses. Result(s): Our study
included 200 cases including 120 mechanical AVR. There were 130 males and
70 females. Twenty cases were redo. 8 were 2nd redoes. We used 15
different prostheses. F up Echoes were done in ICU, on discharge and 1
month after discharge. Nine patients died in the early postoperative
period( 6 months). Statistical analysis showed Euroscore as the only
significant predictor of early mortality. Conclusion Euroscore is a good
predictor for risk stratification for cases of AVR in rheumatic patients.

<54>
Accession Number
643562433
Title
THE USE OF ABLATION OF THE PULMONARY VEINS FOR THE PREVENTION OF ATRIAL
FIBRILLATION AFTER CABG.
Source
E Journal of Cardiovascular Medicine. Conference: 15th International
Congress of Update in Cardiology and Cardiovascular Surgery. Antalya
Turkey. 7(1 Supplement) (pp 5), 2019. Date of Publication: March 2019.
Author
Revishvili A.; Popov V.; Malyshenko E.; Anishchenko M.
Institution
(Revishvili, Popov, Malyshenko, Anishchenko) A.V. Vishnevsky National
Medical Research Center of Surgery, Moscow, Russian Federation
Publisher
Galenos Publishing House
Abstract
Background To evaluate in-hospital results in prospective RCT PULVAB
(Prophylactic Pulmonary Veins Ablation). Methods The RCT PULVAB had been
included 96 CAD patients. The study consists from hree groups. In 1st
group (n=34), only conventional CABG was performed. In 2nd group (n=29),
CABG was combined with prophylactic pulmonary vein(PV) bipolar ablation.
In 3rd group, CABG was combined with PV ablation and added with the
administration of amiodarone just after procedure. Results Prophylactic
pulmonary bipolar RF ablation did not lead to the increase of the
operation main stages length. The mean time of operation is 251 +/- 37.7
min in group 1; 250.4 +/- 42.5 min in 2nd group and 244.2 +/- 29 min in
3rd group, p = 0.114) and don't differ in the CPB time:88.6 +/- 19.2 min;
92 +/- 18.4 and 84.8 +/- 17.3 min (p = 0.08) respectively. We don't have
in-hospital mortality. Significant complications (bleeding, wound
complications, stroke and perioperative myocardial infarction) are not
observed. Postoperative atrial fibrillation (POAF) identified in 11
(32.4%) cases in the group 1; in 6 (20.7%) cases in the 2nd group and in 2
(6.1%) cases in the 3rd group. There were no significant differences
between 1st and 2nd groups (p = 0.298) and between 2nd and 3rd groups
(0.086) also. The statistical significant differences revealed between 1st
and 3rd groups (p = 0.0065), which indicates the effectiveness of
prevention of POAF with PV ablation+amiodarone administration. Atrial
fibrillation in 91% of patients had been occurred at 2-3 days of the
postoperative period. Sinus rhythm at discharge from hospital recorded in
97.1% cases in 1st group; in 96.7% cases in 2nd group and in 97% cases in
3rd group (p = 0.293). Conclusion A positive trend established in reducing
the frequency of POAF in patients undergoing preventive bipolar
radiofrequency ablation of the pulmonary veins. Combination of bipolar RFA
and amiodarone revealed significant positive results in the prevention of
POAF.

<55>
Accession Number
2028094428
Title
Effectiveness of Alprostadil for Ductal Patency.
Source
Journal of Pediatric Pharmacology and Therapeutics. 29(1) (pp 37-44),
2024. Date of Publication: 2024.
Author
Gordon C.M.; Tan J.T.; Carr R.R.
Institution
(Tan, Carr) Pharmacy Department, BC Women's and Children's Hospital,
Vancouver, BC, Canada
(Gordon) Lower Mainland Pharmacy Services, Vancouver General Hospital,
Vancouver, BC, Canada
Publisher
Pediatric Pharmacy Advocacy Group, Inc.
Abstract
OBJECTIVES This study aims to describe the effectiveness of low initial
alprostadil dosages to maintain a patent ductus arteriosus (PDA) in
infants with ductal-dependent congenital heart disease (DDCHD). Secondary
objectives were to describe any adverse drug events, describe prescribing
trends, describe ductus arteriosus diameter changes, and compare the
safety and efficacy of very low and low initial alprostadil dosage
regimens. METHODS This retrospective observational cohort study at the
British Columbia's Women's and Children's Hospital neonatal intensive care
unit and pediatric intensive care unit examined neonates admitted with
DDCHD who received alprostadil to maintain ductal patency. Very low-dose
alprostadil (less than 0.01 mcg/ kg/min) versus low-dose alprostadil
(equal to or greater than 0.01 mcg/kg/min) was examined. Effectiveness was
defined as survival and infants not requiring a resuscitation event
(cardiac arrest, cardiogenic shock, code blue, extracorporeal life
support, requirement for emergent cardiac surgery, and respiratory
acidosis). Adverse drug events with a Naranjo score of 3 or more were
included. RESULTS Alprostadil was effective for 88% of patients, with no
difference between the very low-dose and low-dose groups. Of the 75
patients included, 25 received very low-dose alprostadil. Adverse drug
events were common (51%) with neonates in the low-dose group experiencing
more apnea and pyrexia than neonates in the very low-dose group.
CONCLUSIONS Alprostadil therapy was effective in maintaining the PDA in
neonates with DDCHD with low-dosage regimens. Adverse drug events were
common with both dosage regimens; however, the very low dosage appeared to
have less apnea and pyrexia. ABBREVIATIONS ADE, adverse drug event; BC,
British Columbia; DA, ductus arteriosus; DDCHD, ductal-dependent
congenital heart disease; PDA, patent ductus arteriosus. Copyright
© Pediatric Pharmacy Association. All rights reserved.

<56>
Accession Number
2030647082
Title
TransCatheter aortic valve implantation and fractional flow reserve-guided
percutaneous coronary intervention versus conventional surgical aortic
valve replacement and coronary bypass grafting for treatment of patients
with aortic valve stenosis and multivessel or advanced coronary disease:
The transcatheter valve and vessels trial (TCW trial): Design and
rationale.
Source
American Heart Journal. 270 (pp 86-94), 2024. Date of Publication: April
2024.
Author
Kedhi E.; Rroku A.; Hermanides R.S.; Dambrink J.H.; Singh S.; Berg J.T.;
van Ginkel D.-J.; Hudec M.; Amoroso G.; Amat-Santos I.J.; Andreas M.;
Teles R.C.; Bonnet G.; Van Belle E.; Conradi L.; van Garsse L.; Wojakowski
W.; Voudris V.; Sacha J.; Cervinka P.; Lipsic E.; Somi S.; Nombela-Franco
L.; Postma S.; Piayda K.; De Luca G.; Malinofski K.; Modine T.
Institution
(Kedhi) McGill University Health Center, Montreal, QC, Canada
(Kedhi) Department of Cardiology and Structural Heart Disease, Medical
University of Silesia, Katowice, Poland
(Rroku) Department of Cardiology, Deutsches Herzzentrum der Charite,
Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Rroku) DZHK (German Centre for Cardiovascular Research), Berlin, Germany
(Hermanides, Dambrink) Isala Heart Center, Department of Cardiology,
Zwolle, Netherlands
(Singh) Isala Heart Center, Department of Thoracic Surgery, Zwolle,
Netherlands
(Berg, van Ginkel) St.Antonius Ziekenhuis, Nieuwegein, The Netherlands and
University Medical Center Maastricht, Maastricht, Netherlands
(Hudec) SUSCCH, A.S. Banska, Bystrica, Slovakia
(Amoroso) Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam,
Netherlands
(Amat-Santos) Centro de Investigacion Biomdica en Red, Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Amat-Santos) Hospital Clinico Universitario de Valladolid, Valladolid,
Spain
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Teles) Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental,
Lisbon, Portugal
(Bonnet, Modine) Medico-Surgical Department (Valvulopathies, Cardiac
Surgery, Adult Interventional Cardiology), Hopital Cardiologique de
Haut-Leveque, Bordeaux University Hospital, France
(Van Belle) CHU Lille, Department of Cardiology, Department of
Interventional Cardiology for Coronary, Valves and Structural Heart
Diseases, Institut Coeur Puomon, Inserm, U1011, Institut Pasteur de Lille,
EGIG, Universite de Lille, Lille, France
(Conradi) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Germany
(van Garsse) Department of Cardiothoracic Surgery, Radboud University
Medical Centre, Netherlands
(Wojakowski) Department of Cardiology and Structural Heart Disease,
Medical Univ. Silesia, Katowice, Poland
(Voudris) Interventional Department of Cardiology, Onassis Cardiac Surgery
Center, Athens, Greece
(Sacha) Department of Cardiology, University Hospital, Institute of
Medical Sciences, University of Opole, Opole, Poland
(Sacha) Faculty of Physical Education and Physiotherapy, Opole University
of Technology, Opole, Poland
(Cervinka) Department of Cardiology, Krajska Zdravotni A.S., Masaryk
Hospital and UJEP Usti nad Labem, Czechia
(Lipsic) Department of Cardiology, University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
(Somi) Department of Cardiology, Haga Hospital, The Hague, Netherlands
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos
IdISSC, Madrid, Spain
(Postma) Diagram Research, Zwolle, Netherlands
(Piayda) Department of Cardiology and Vascular Medicine, Medical Faculty,
Justus-Liebig-University Giessen, Giessen, Germany
(De Luca) Division of Clinical and Experimental Cardiology, AOU Sassari,
University of Sassari, Sassari, Italy
(Malinofski) Center for Digital Medicine and Robotics, Jagiellonian
University Medical College, Krakow, Poland
(Malinofski) Department of Bioinformatics and Telemedicine, Faculty of
Medicine, Jagiellonian University Medical College, Krakow, Poland
Publisher
Elsevier Inc.
Abstract
Background: Patients with severe aortic stenosis (AS) frequently present
with concomitant obstructive coronary artery disease (CAD). In those,
current guidelines recommend combined coronary artery bypass grafting
(CABG) and surgical aortic valve replacement (SAVR) as the preferred
treatment option, although this surgical approach is associated with a
high rate of clinical events. Combined transcatheter aortic valve
implantation (TAVI) and percutaneous coronary intervention (PCI) with or
without FFR have evolved as a valid alternative for cardiac surgery in
patients with AS and multivessel or advanced CAD. To date, no dedicated
trial has prospectively evaluated the outcomes of a percutaneous versus
surgical treatment for patients with both severe AS and CAD. Aim(s):
To investigate whether fractional-flow reserve (FFR)-guided PCI and TAVI
is noninferior to combined CABG and SAVR for the treatment of severe AS
and multivessel or advanced CAD. Method(s): The Transcatheter Valve
and Vessels (TCW) trial (clinicaltrial.gov: NCT03424941) is a prospective,
randomized, controlled, open label, international trial. Patients >= 70
years with severe AS and multivessel (>= 2 vessels) or advanced CAD,
deemed feasible by the heart team for both; a full percutaneous or
surgical treatment, will be randomised in a 1:1 fashion to either
FFR-guided PCI followed by TAVI (intervention arm) vs. CABG and SAVR
(control arm). The primary endpoint is a patient-oriented composite of
all-cause mortality, myocardial infarction, disabling stroke, unscheduled
clinically-driven target vessel revascularization, valve reintervention,
and life threatening or disabling bleeding at 1 year. The TCW trial is
powered for noninferiority, and if met, superiority will be tested.
Assuming a primary endpoint rate of 30% in the CABG-SAVR arm, with a
significance level alpha of 5%, a noninferiority limit delta of 15% and a
loss to follow-up of 2%, a total of 328 patients are needed to obtain a
power of 90%. The primary endpoint analysis is performed on an
intention-to-treat basis. The TCW Trial is the first prospective
randomized trial that will study if a less invasive percutaneous treatment
for severe AS and concomitant advanced CAD (i.e., FFR-guided PCI-TAVI) is
noninferior to the guidelines recommended approach
(CABG-SAVR). Copyright © 2024 The Author(s)

<57>
Accession Number
2028715227
Title
Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review.
Source
Diagnostics. 14(4) (no pagination), 2024. Article Number: 434. Date of
Publication: February 2024.
Author
Magon F.; Longhitano Y.; Savioli G.; Piccioni A.; Tesauro M.; Del Duca F.;
Napoletano G.; Volonnino G.; Maiese A.; La Russa R.; Di Paolo M.; Zanza C.
Institution
(Magon) Department of Anesthesia and Critical Care, Bicocca University of
Milano, Milano 20126, Italy
(Longhitano) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh, Pittsburgh, PA 15261, United States
(Savioli) Departement of Emergency, IRCCS Fondazione Policlinico San
Matteo, Pavia 27100, Italy
(Piccioni) Department of Emergency Medicine, Gemelli Hospital, Catholic
University of Rome, Rome 00168, Italy
(Tesauro) Department of Systems Medicine, University of Rome "Tor
Vergata", Rome 00133, Italy
(Tesauro, Zanza) Geriatric Medicine Residency Program, University of Rome
"Tor Vergata", Rome 00133, Italy
(Del Duca, Napoletano, Volonnino) Department of Anatomical, Forensic and
Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena
336, Rome, Histological 00161, Italy
(Maiese, Di Paolo) Department of Surgical Pathology, Medical, Molecular
and Critical Area, Institute of Legal Medicine, University of Pisa, Pisa
56126, Italy
(La Russa) Department of Clinical Medicine, Public Health, Life Sciences,
and Environmental Sciences, University of L'Aquila, Aquila 67100 L', Italy
(Zanza) Italian Society of Prehospital Emergency Medicine (SIS 118),
Taranto 74121, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool
available in emergency and intensive care units. In the context of cardiac
arrest, POCUS application can help assess cardiac activity, identify
causes of arrest that could be reversible (such as pericardial effusion or
pneumothorax), guide interventions like central line placement or
pericardiocentesis, and provide real-time feedback on the effectiveness of
resuscitation efforts, among other critical applications. Its use, in
addition to cardiovascular life support maneuvers, is advocated by all
resuscitation guidelines. The purpose of this narrative review is to
summarize the key applications of POCUS in cardiac arrest, highlighting,
among others, its prognostic, diagnostic, and forensic potential. We
conducted an extensive literature review utilizing PubMed by employing key
search terms regarding ultrasound and its use in cardiac arrest. Apart
from its numerous advantages, its limitations and challenges such as the
potential for interruption of chest compressions during image acquisition
and operator proficiency should be considered as well and are discussed
herein. Copyright © 2024 by the authors.

<58>
Accession Number
2030578848
Title
Pericardial Decompression Syndrome: A Comprehensive Review of a
Controversial Entity.
Source
International Journal of Angiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Sarode K.; Patel A.; Arrington K.; Makhija R.; Mukherjee D.
Institution
(Sarode, Patel, Arrington, Makhija, Mukherjee) Department of
Cardiovascular Medicine, Texas Tech University Health Sciences Center, El
Paso, TX, United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
Pericardial decompression syndrome is an ambiguous clinical entity which
has generated controversy regarding its existence. Following pericardial
decompression, patients experienced clinical deterioration ranging in
complications from pulmonary edema to death that could not be attributed
to any other distinct clinical pathology. Multiple theories have suggested
the pathophysiology behind pericardial decompression syndrome is related
to preload-afterload mismatch following pericardial decompression,
coronary microvascular ischemia, and stress from high adrenergic state.
Our review aims to describe this syndrome by analyzing demographics,
etiology of pericardial effusion, method of drainage, volume of
pericardial fluid removed, time to decompensation, and clinical outcomes.
A systematic review of MEDLINE/PubMed and Google Scholar literature
databases were queried for case reports, case series, review articles, and
abstracts published in English journals between 1983 and December 2022.
Each author's interpretation of echocardiographic and/or pulmonary
arterial catheterization data provided in the case reports was used to
characterize ventricular dysfunction. Based on our inclusion criteria, 72
cases of pericardial decompression syndrome were included in our review.
Our results showed that phenotypic heterogeneity was present based on
echocardiographic findings of right/left or biventricular failure with
similar proportions in each type of ventricular dysfunction. Time to
decompensation was similar between immediate, subacute, and acute cases
with presentation varying between hypoxic respiratory failure and shock.
This review article highlights theories behind the pathophysiology,
clinical outcomes, and therapeutic options in this high mortality
condition. Copyright © 2024 Thieme Medical Publishers, Inc.. All
rights reserved.

<59>
Accession Number
2030656193
Title
Concomitant transthyretin cardiac amyloidosis in patients undergoing TAVR
for aortic stenosis: A systemic review and meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131854. Date of Publication: 2024.
Author
Fatima K.; Uddin Q.S.; Tharwani Z.H.; Kashif M.A.B.; Javaid S.S.; Kumar
P.; Zia M.T.; Javed M.; Butt M.S.; Asim Z.
Institution
(Fatima, Uddin, Tharwani, Kashif, Kumar, Zia, Javed, Butt) Department of
Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Asim) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Javaid) Department of Medicine, Jinnah Sindh Medical University, Karachi,
Pakistan
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Transcatheter aortic valve replacement (TAVR) is a successful
treatment for aortic stenosis (AS) patients, and previous studies indicate
favorable outcomes for those with concomitant aortic stenosis and
transthyretin-associated cardiac amyloidosis (TTRCA-AS). However, the
impact of TAVR on more adverse outcomes in TTRCA-AS patients compared to
those with AS alone is still uncertain, with conflicting findings reported
in the literature. Method(s): PubMed and Scopus were extensively
searched from inception till August 2021. Studies were included if they
reported data for prevalence and outcomes including mortality and
cardiovascular-related hospitalization events in TTRCA-AS patients
referred for TAVR. The data for these outcomes were pooled using a random
effects model and forest plots were created. Result(s): After
initially screening 146 articles, 6 were shortlisted for inclusion in our
analysis. Pooled analysis demonstrated a 13.3% [95% CI: 10.9-16.5; p =
0.307] prevalence of TTRCA in patients with AS undergoing TAVR. The
incidence of mortality and cardiovascular (CV) hospitalization in patients
with TTRCA-AS undergoing TAVR were 28.3% [95% CI: 18.7-39.0, p = 0.478]
and 21.1% [95% CI: 10.2-34.5, p = 0.211], respectively.
 Conclusion(s): The overall pooled TTRCA-AS prevalence was reported to
be 13.3% in AS patients who underwent TAVR. Furthermore,
transthyretin-associated CA was found to be associated with an increased
risk of mortality and hospitalization. Large patient population studies
are required to assess the safety and efficacy of TAVR in TTRCA-AS
patients, as current research report data from small patient
cohorts. Copyright © 2024 Elsevier Ireland Ltd

<60>
Accession Number
2029822244
Title
Adherent skin barrier drape use is associated with a reduced risk of
cardiac implantable device infection: Results from a prospective study of
14,225 procedures.
Source
Heart Rhythm O2. 5(2) (pp 103-112), 2024. Date of Publication: February
2024.
Author
Golian M.; Berbenetz N.M.; Odabashian R.; Sadek M.M.; Corrales-Medina V.;
Aydin A.; Davis D.R.; Green M.S.; Klein A.; Nair G.M.; Nery P.B.; Ramirez
F.D.; Redpath C.; Hansom S.P.; Birnie D.H.
Institution
(Golian, Berbenetz, Odabashian, Sadek, Aydin, Davis, Green, Klein, Nair,
Nery, Ramirez, Redpath, Hansom, Birnie) University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Golian, Berbenetz, Odabashian, Sadek, Aydin, Davis, Green, Klein, Nair,
Nery, Ramirez, Redpath, Hansom, Birnie) Division of Cardiology, Department
of Medicine, University of Ottawa, Ottawa, ON, Canada
(Corrales-Medina) Division of Infectious Diseases, Department of Medicine,
University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
Publisher
Elsevier B.V.
Abstract
Background: Cardiac implantable electronic device (CIED) infection is a
costly and highly morbid complication. Perioperative interventions,
including the use of antibiotic pouches and intensified perioperative
antibiotic regimens, have demonstrated marginal efficacy at reducing CIED
infection. Additional research is needed to identify additional
interventions to reduce infection risk. Objective(s): We sought to
evaluate whether adherent skin barrier drape use is associated with a
reduction in CIED infection. Method(s): A prospective registry of all
CIED implantation procedures was established at our institution in January
2007. The registry was established in collaboration with our hospital
infection prevention team with a specific focus on prospectively
identifying all potential CIED infections. All potential CIED infections
were independently adjudicated by 2 physicians blinded to the use of an
adherent skin barrier drape. Result(s): Over a 13-year period, 14,225
procedures were completed (mean age 72 +/- 14 years; female 4,918 (35%);
new implants 10,005 (70%); pulse generator changes 2585 (18%); upgrades
1635 (11%). Of those, 2469 procedures (17.4%) were performed using an
adherent skin barrier drape. There were 103 adjudicated device infections
(0.73%). The infection rate in patients in the barrier use groups was 8 of
2469 (0.32%) as compared with 95 of 11,756 (0.8%) in the nonuse group (P =
.0084). In multivariable analysis, the use of an adherent skin barrier
drape was independently associated with a reduction in infection (odds
ratio 0.32; 95% confidence interval 0.154-0.665; P = .002).
 Conclusion(s): The use of an adherent skin barrier drape at the time
of cardiac device surgery is associated with a lower risk of subsequent
infection. Copyright © 2023 Heart Rhythm Society

<61>
Accession Number
2028106407
Title
Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic
Valve Replacement: A Systematic Review with Meta-Analysis.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
455. Date of Publication: January 2024.
Author
Antiochos P.; Kirsch M.; Monney P.; Tzimas G.; Meier D.; Fournier S.;
Ferlay C.; Nowacka A.; Rancati V.; Abellan C.; Skalidis I.; Muller O.; Lu
H.
Institution
(Antiochos, Monney, Tzimas, Meier, Fournier, Ferlay, Skalidis, Muller, Lu)
Division of Cardiology, Lausanne University Hospital, University of
Lausanne, Lausanne 1011, Switzerland
(Kirsch, Ferlay, Nowacka) Division of Cardiovascular Surgery, Lausanne
University Hospital, University of Lausanne, Lausanne 1011, Switzerland
(Ferlay) Adult Intensive Care Unit, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
(Rancati) Division of Anesthesiology, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
(Abellan) Division of Internal Medicine, Lausanne University Hospital,
University of Lausanne, Lausanne 1011, Switzerland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
A growing body of evidence suggests that extrathoracic vascular accesses
for transcatheter aortic valve replacement (TAVR) yield favorable outcomes
and can be considered as primary alternatives when the gold-standard
transfemoral access is contraindicated. Data comparing the transcaval
(TCv) to supra-aortic (SAo) approaches (transcarotid, transsubclavian, and
transaxillary) for TAVR are lacking. We aimed to compare the outcomes and
safety of TCv and SAo accesses for TAVR as alternatives to transfemoral
TAVR. A systematic review with meta-analysis was performed by searching
PubMed/MEDLINE and EMBASE databases for all articles comparing TCv-TAVR
against SAo-TAVR published until September 2023. Outcomes included
in-hospital or 30-day all-cause mortality (ACM) and postoperative
complications. A total of three studies with 318 TCv-TAVR and 179 SAo-TAVR
patients were included. No statistically significant difference was found
regarding in-hospital or 30-day ACM (relative risk [RR] 1.04, 95%
confidence interval [CI] 0.47-2.34, p = 0.91), major bleeding, the need
for blood transfusions, major vascular complications, and acute kidney
injury. TCv-TAVR was associated with a non-statistically significant lower
rate of neurovascular complications (RR 0.39, 95%CI 0.14-1.09, p = 0.07).
These results suggest that both approaches may be considered as first-line
alternatives to transfemoral TAVR, depending on local expertise and
patients' anatomy. Additional data from long-term cohort studies are
needed. Copyright © 2024 by the authors.

<62>
Accession Number
2028088915
Title
TEDOFA Trial Study Protocol: A Prospective Double-Blind, Randomized,
Controlled Clinical Trial Comparing Opioid-Free versus Opioid Anesthesia
on the Quality of Postoperative Recovery and Chronic Pain in Patients
Receiving Thoracoscopic Surgery.
Source
Journal of Pain Research. 17 (pp 635-642), 2024. Date of Publication:
2024.
Author
Song B.; Li X.; Yang J.; Li W.; Wan L.
Institution
(Song, Li, Yang, Li, Wan) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing 100050, China
Publisher
Dove Medical Press Ltd
Abstract
Introduction: Seeking effective multimodal analgesia and anesthetic
regimen is the basis for the success of ERAS. Opioid-free anesthesia (OFA)
is a multimodal anesthesia associating hypnotics, N-methyl-D-aspartate
(NMDA) antagonists, local anesthetics, anti-inflammatory drugs and alpha-2
agonists. Although previous studies have confirmed that OFA is safe and
feasible for VATS surgery, there is great heterogeneity in how to select
and combine anti-harm drugs to replace opioids. We hypothesized that the
reduced opioid use during and after surgery allowed by OFA compared with
standard of care will be associated with a reduction of postoperative
opioid-related adverse events and an improvement in the quality of
rehabilitation of patients after partial VATS lung resection.
Methods/Analysis: The TEDOFA Study is a prospective double-blind,
randomized, controlled clinical trial with a concealed allocation of
patients scheduled to undergo elective partial VATS pneumonectomy 1:1 to
receive either a standard anesthesia protocol or an OFA. A total of 146
patients were recruited in the study. Primary endpoint was the 15-item
recovery quality scale (QoR-15) at 24 hours after surgery. Ethics and
Dissemination: This trial has been approved by the Institutional Review
Board of Beijing Friendship Hospital of China Capital University. The
TEDOFA trial study protocol was approved on 27 February 2023. The trial
started recruiting patients after registered on the Chinese Clinical Trial
Registry. Trial Registration Number: ChiCTR2300069210;
Pre-results Copyright © 2024 Song et al.

<63>
Accession Number
2030586769
Title
Efficacy of avoiding chest drains after video-assisted thoracoscopic
surgery wedge resection: protocol for a randomised controlled trial.
Source
BMJ Open. 14(2) (no pagination), 2024. Article Number: e080573. Date of
Publication: 20 Feb 2024.
Author
Holbek B.L.; Huang L.; Christensen T.D.; Bendixen M.; Hansen H.J.; Kehlet
H.; Petersen R.H.
Institution
(Holbek, Huang, Hansen, Petersen) Department of Cardiothoracic Surgery,
Copenhagen University Hospital Rigshospitalet, Kobenhavn, Denmark
(Christensen, Bendixen) Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Aarhus, Denmark
(Christensen, Bendixen) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
(Kehlet) Section for Surgical Pathophysiology, Copenhagen University
Hospital Rigshospitalet, Kobenhavn, Denmark
(Petersen) Institute for Clinical Medicine, Faculty of Health and Medical
Sciences, Copenhagen University, Kobenhavn, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction The use of routine postoperative chest drains after
video-assisted thoracoscopic surgery (VATS) of the lung is a practice
based on tradition with the aim of draining fluid and air. However, new
evidence suggests that chest drains can be avoided in selected cases. With
this randomised controlled trial, we wish to establish the efficacy and
safety of avoiding postoperative chest drains compared with routine
postoperative chest drains. Methods and analysis This is a two-centre
randomised controlled trial without allocation concealment, but where
randomisation occurs after the end of procedure leaving operative
personnel blinded during surgery. The sample size is calculated to show a
difference in pain measurements using the Numeric Rating Scale under
different circumstances and at different time points to show superiority
of the intervention. The trial is pragmatic by design to reflect the daily
clinical scenario and with the aim of increasing the external validity of
the results. Ethics and dissemination Approval by the local ethics
committees has been obtained for both sites. The study was registered with
ClinicalTrials.gov (NCT05358158) prior to inclusion. The results of the
trial will be disseminated by publication in an international journal and
presentation at major international thoracic surgical meetings. Article
summary This is a randomised controlled trial estimating the effects of
avoiding a chest drain after VATS wedge resection of the lung on pain,
total morphine use, quality of life and complications. Copyright
© 2024 BMJ Publishing Group. All rights reserved.

<64>
Accession Number
2030513359
Title
Comparative Study Of Dexmedetomidine And Clonidine For Premedication And
Haemodynamic Changes In Patients Undergoing Intracranial Tumour Surgery.
Source
Research Journal of Pharmaceutical, Biological and Chemical Sciences.
15(1) (pp 320-326), 2024. Date of Publication: January 2024.
Author
Freeda G.; Thulasiraman R.
Institution
(Freeda, Thulasiraman) Department of Anesthesia & critical care,
Government Medical College & Hospital, Tamil Nadu, Vellore, India
Publisher
Research Journal of Pharmaceutical, Biological and Chemical Sciences
Abstract
Hemodynamic stability in the perioperative period is of prime importance
while providing general anesthesia in cranial tumor surgeries. Profound
surgical stimuli associated with craniotomy often result in sympathetic
activation and marked changes in arterial bloodpressure, cerebral blood
flow, and thereby changes in intracranial pressure and cerebral perfusion
pressure. The goals during neurosurgical anesthesia are intraoperative
hemodynamic stability with attenuation of sympathetic responses to avoid
intracranial hemorrhage. And to allow immediate neurological evaluation
upon emergence. The purpose of the study is to compare the effectiveness
of intravenous dexmedetomidine or Clonidine in attenuating the hemodynamic
response to intracranial tumour surgery.For the study,60 patients of the
age group 20-45 years with bodyweight 50-70kgs, GCS 13 to15, belonging to
ASA PS I and PS II were selected and divided into two groups D and C. The
study design was a prospective randomized comparative study done in
Government Vellore Medical College, Vellore, Tamil Nadu, India in the year
2019-2020. Based on standard dosing, 1mcg/kg of dexmedetomidine diluted to
100ml with 0.9% saline over 10 minutes was given before induction for
patients in group D. Patients randomized to group C received intravenous
clonidine 1mu/kg body weight 35mins prior surgery. Heart rate and mean
arterial pressure were comparable between the two groups during the study
and were recorded at the following intervals. We found that
dexmedetomidine is more effective in controlling the hemodynamic response
than Clonidine in during craniotomy. It was concluded that 1 mcg/kg of
dexmedetomidine infused slowly over 10 minutes is superior when compared
to clonidine in attenuating the hemodynamic response during craniotomy. By
attenuating the hemodynamic response, brain edema, increased intracranial
pressure and intracranial hemorrhage can be prevented. Copyright
© 2023 All Rights Reserved.

<65>
Accession Number
2028662184
Title
A Narrative Review of Preclinical In Vitro Studies Investigating microRNAs
in Myocarditis.
Source
Current Issues in Molecular Biology. 46(2) (pp 1413-1423), 2024. Date of
Publication: February 2024.
Author
Grodzka O.; Procyk G.; Wrzosek M.
Institution
(Grodzka) Department of Neurology, Faculty of Medicine and Dentistry,
Medical University of Warsaw, 80 Ceglowska St., Warsaw 01-809, Poland
(Grodzka, Procyk) Doctoral School, Medical University of Warsaw, 81 Zwirki
i Wigury St., Warsaw 02-091, Poland
(Procyk) 1st Chair and Department of Cardiology, Medical University of
Warsaw, 1A Banacha St., Warsaw 02-097, Poland
(Wrzosek) Department of Biochemistry and Pharmacogenomics, Medical
University of Warsaw, 1 Banacha St., Warsaw 02-097, Poland
(Wrzosek) Centre for Preclinical Research, Medical University of Warsaw,
1B Banacha St., Warsaw 02-097, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
According to the World Health Organization's statement, myocarditis is an
inflammatory myocardium disease. Although an endometrial biopsy remains
the diagnostic gold standard, it is an invasive procedure, and thus,
cardiac magnetic resonance imaging has become more widely used and is
called a non-invasive diagnostic gold standard. Myocarditis treatment is
challenging, with primarily symptomatic therapies. An increasing number of
studies are searching for novel diagnostic biomarkers and potential
therapeutic targets. Microribonucleic acids (miRNAs) are small, non-coding
RNA molecules that decrease gene expression by inhibiting the translation
or promoting the degradation of complementary mRNAs. Their role in
different fields of medicine has been recently extensively studied. This
review discusses all relevant preclinical in vitro studies regarding
microRNAs in myocarditis. We searched the PubMed database, and after
excluding unsuitable studies and clinical and preclinical in vivo trials,
we included and discussed 22 preclinical in vitro studies in this
narrative review. Several microRNAs presented altered levels in
myocarditis patients in comparison to healthy controls. Moreover,
microRNAs influenced inflammation, cell apoptosis, and viral replication.
Finally, microRNAs were also found to determine the level of myocardial
damage. Further studies may show the vital role of microRNAs as novel
therapeutic agents or diagnostic/prognostic biomarkers in myocarditis
management. Copyright © 2024 by the authors.

<66>
Accession Number
2028642804
Title
Spontaneous coronary artery dissection in women in the generative period:
clinical characteristics, treatment, and outcome-a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1277604. Date of Publication: 2024.
Author
Apostolovic S.; Ignjatovic A.; Stanojevic D.; Radojkovic D.D.; Nikolic M.;
Milosevic J.; Filipovic T.; Kostic K.; Miljkovic I.; Djokovic A.; Krljanac
G.; Mehmedbegovic Z.; Ilic I.; Aleksandric S.; Paradies V.
Institution
(Apostolovic, Stanojevic, Radojkovic, Nikolic, Milosevic, Kostic,
Miljkovic) Clinic for Cardiology, University Clinical Center Nis, Nis,
Serbia
(Apostolovic, Ignjatovic, Radojkovic, Filipovic) Medical Faculty,
University of Nis, Nis, Serbia
(Djokovic) Department of Cardiology, Clinical Hospital Bezanijska Kosa,
Belgrade, Serbia
(Djokovic, Krljanac, Mehmedbegovic, Ilic, Aleksandric) Medical Faculty,
University of Belgrade, Belgrade, Serbia
(Krljanac, Mehmedbegovic, Aleksandric) Clinic of Cardiology, University
Clinical Center of Serbia, Belgrade, Serbia
(Ilic) Department of Cardiology, Institute for Cardiovascular Diseases
Dedinje, Belgrade, Serbia
(Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
Publisher
Frontiers Media SA
Abstract
Introduction: Spontaneous coronary artery dissection (SCAD) is a
non-traumatic and non-iatrogenic separation of the coronary arterial wall.
 Material(s) and Method(s): This systematic review and meta-analysis
is reported following the PRISMA guidelines and is registered in the
PROSPERO database. A literature search was focused on female patients in
generative period (16-55 of age) with acute coronary syndrome (ACS) caused
by SCAD, and comparison from that database NP-SCAD (spontaneous coronary
artery dissection in non pregnant women) and P-SCAD (spontaneous coronary
artery dissection in pregnant women). Result(s): 14 studies with
2,145 females in the generative period with ACS caused by SCAD were
analyzed. The median age was 41 years (33.4-52.3 years). The most common
risk factor was previous smoking history in 24.9% cases. The most common
clinical presentation of ACS was STEMI in 47.4%. Conservative treatment
was reported in 41.1%. PCI was performed in 32.7%, and 3.8% of patients
had CABG surgery. LAD was the most frequently affected (50.5%). The
prevalence of composite clinical outcomes including mortality, non-fatal
MI and recurrent SCAD was 3.3% (95% CI: 1.4-5.1), 37.7% (95% CI: 1.9-73.4)
and 15.2% (95% CI: 9.1-21.3) of patients. P-SCAD compared to NP-SCAD
patients more frequently had STEMI (OR = 3.16; 95% CI: 2.30-4.34;
I2 = 64%); with the left main and LAD more frequently affected
[(OR = 14.34; 95% CI: 7.71-26.67; I2= 54%) and (OR = 1.57; 95%
CI: 1.06-2.32; I2= 23%)]; P-SCAD patients more frequently
underwent CABG surgery (OR = 6.29; 95% CI: 4.08-9.70; I2= 0%).
NP-SCAD compared to P-SCAD patients were more frequently treated
conservatevly (OR = 0.61; 95% CI: 0.37-0.98; I2= 0%). In P-SCAD
compared to NP-SCAD mortality rates (OR = 1.13; 95% CI: 0.06-21.16;
I2= not applicable) and reccurence of coronary artery
dissection (OR = 2.54; 95% CI: 0.97-6.61; I2= 0%) were not more
prevalent. Conclusion(s): The results of this meta-analysis indicated
that patients with P-SCAD more frequently had STEMI, and events more
frequently involved left main and LAD compared to NP-SCAD patients. Women
with NP-SCAD were significantly more often treated conservatively compared
to P-SCAD patients. P-SCAD compared to NP-SCAD patients did not have
significantly higher mortality rates or recurrent coronary
dissection. Copyright 2024 Apostolovic, Ignjatovic, Stanojevic,
Radojkovic, Nikolic, Milosevic, Filipovic, Kostic, Miljkovic, Djokovic,
Krljanac, Mehmedbegovic, Ilic, Aleksandric and Paradies.

<67>
Accession Number
2028606532
Title
Ultrasound-guided versus conventional lung recruitment manoeuvres in
thoracic surgery: a randomised controlled study.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2024. Date
of Publication: 2024.
Author
Wu L.; Yang L.; Yang Y.; Wu X.; Zhang J.
Institution
(Wu, Yang, Yang, Wu, Zhang) Department of Anesthesiology, Fudan University
Shanghai Cancer Center, No. 270, Dong'An Road, Xuhui District, Shanghai
200032, China
(Zhang) Department of Oncology, Shanghai Medical College, Fudan
University, No. 270, Dong'An Road, Xuhui District, Shanghai 200032, China
Publisher
Springer Science and Business Media B.V.
Abstract
Lung recruitment manoeuvres (RMs) during mechanical ventilation may reduce
atelectasis, however, the optimal recruitment strategy for patients
undergoing thoracic surgery remains unknown. Our study was designed to
investigate whether ultrasound-guided lung RMs is superior to conventional
RMs in reducing perioperative atelectasis during thoracic surgery with
one-lung ventilation. We conducted a randomised controlled clinical trial
from August 2022 to September 2022. Sixty patients scheduled for
video-assisted thoracoscopic surgery (VATS) under general anaesthesia were
enrolled. Subjects were randomly divided into the ultrasound-guided RMs
group (manual inflation guided by lung ultrasound) or conventional RMs
group (manual inflation with 30 cmH<inf>2</inf>O pressure). Lung
ultrasound were performed at three predefined time points (1 min after
anaesthetic induction; after RMs at the end of surgery; before discharge
from postanesthesia care unit [PACU]). The primary outcome was lung
ultrasound score before discharge from the PACU after extubation. In the
early postoperative period, lung aeration deteriorated in both groups even
after lung RMs. However, ultrasound-guided lung RMs had significantly
lower lung ultrasound scores when compared with conventional RMs in
bilateral lungs (2.0 [0.8-4.0] vs. 8.0 [3.8-10.3], P < 0.01) at the end of
surgery, which remained before patients discharged from the PACU.
Accordingly, the lower incidence of atelectasis was found in
ultrasound-guided RMs group than in conventional RMs group (7% vs. 53%; P
< 0.01) at the end of surgery. Ultrasound-guided RMs is superior to
conventional RMs in improving lung aeration and reducing the incidence of
lung atelectasis at early postoperative period in patients undergoing
VATS. The study protocol was approved by the Institutional Review Board of
the Fudan University Shanghai Cancer Center (No. 220,825,810; date of
approval: August 5, 2022) and registered on Chinese Clinical Trial
Registry (registration number: ChiCTR2200062761). Copyright © The
Author(s), under exclusive licence to Springer Nature B.V. 2024.

<68>
Accession Number
2030380469
Title
A comparative study to evaluate the efficacy between propofol and
etomidate as induction agent in geriatric cardiovascular disease patients
posted for non cardiovascular surgeries.
Source
Journal of Cardiovascular Disease Research. 15(1) (pp 2606-2614), 2024.
Date of Publication: 2024.
Author
Arunalatha P.S.; Saya R.P.; Charlu S.J.; Naik N.; Udayarani
Institution
(Arunalatha, Charlu, Naik, Udayarani) Department of Anaesthesiology, GMC,
Anantapuramu, India
(Saya) Department of Anaesthesiology, GMC, Kadapa, India
Publisher
EManuscript Technologies
Abstract
Back ground: In General Anaesthesia changes in Hemodynamic parameters
during induction is more common. In elderly patient with cardiovascular
diseases profound changes in hemodynamic parameters2. To alleviate the
profound changes in hemodynamic parameters we use either Propofol or
Thiopentone Sodium regularly as induction agent. But recently we use
Etomidate as choice of induction agent in cardiovascular patients.
 Aim(s): The aim of the study is to compare the haemodynamic effects
of Propofol and Etomidate during induction and intubation in geriatric
patients with cardiovascular disease for non-cardiovascular surgeries.
Materials and methods; The present study included 80 patients aged between
60-80 years of ASA grade III and IV scheduled for elective non cardiac
surgeries. The patients were randomly divided into two groups. Group P
received Inj. Propofol 1% (2mg/kg of body weight) and group E received
Inj. Etomidate (0.3mg/kg of body weight). The heart rate and mean arterial
pressure were monitored continuously and recorded before induction, at
induction and laryngoscopy followed by 1st, 3rd, 5th and 10th minutes
after intubation. Results; As compared to the Etomidate group, there were
significant changes in systolic blood pressure, diastolic blood pressure
and mean arterial pressure after intubation with Propofol induction1
Conclusion; The results showed that hemodynamic disturbances are more with
Propofol when compared to Etomidate. We infer that Etomidate has higher
hemodynamic stability as a result. Copyright © 2024 EManuscript
Technologies. All rights reserved.

<69>
Accession Number
2030345108
Title
Long-term follow-up of balloon-expandable valves according to the
implantation strategy: insight from the DIRECTAVI trial.
Source
American Heart Journal. 270 (pp 13-22), 2024. Date of Publication: April
2024.
Author
Jammoul N.; Dupasquier V.; Akodad M.; Meunier P.-A.; Moulis L.; Soltani
S.; Macia J.-C.; Robert P.; Schmutz L.; Steinecker M.; Piot C.; Targosz
F.; Benkemoun H.; Lattuca B.; Roubille F.; Cayla G.; Leclercq F.
Institution
(Jammoul, Dupasquier, Meunier, Soltani, Macia, Steinecker, Roubille,
Leclercq) Department of Cardiology, CHU Montpellier, Montpellier
University, Montpellier, France
(Akodad) Institut Cardiovasculaire Paris Sud, Hopital Prive
Jacques-Cartier, Massy, France
(Moulis) Epidemiological and Clinical Research Unit, CHU Montpellier,
Montpellier, France
(Robert, Schmutz, Lattuca, Cayla) Department of cardiology, CHU Nimes,
Montpellier University, Nimes, France
(Piot) Millenaire Clinic, Montpellier, France
(Targosz) Perpignan hospital, Perpignan, France
(Benkemoun) St Pierre Clinic, Perpignan, France
(Roubille) PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier, France
Publisher
Elsevier Inc.
Abstract
Background: Safety and feasibility of transcatheter aortic valve
replacement (TAVR) without balloon aortic valvuloplasty (BAV) using the
SAPIEN 3 balloon-expandable device has been previously demonstrated. The
impact on long-term valve hemodynamic performances and outcomes remains
however unknown. We evaluate long-term clinical and hemodynamic results
according to the implant strategy (direct TAVR vs BAV pre-TAVR) in
patients included in the DIRECTAVI randomized trial (NCT02729519).
 Method(s): Clinical and echocardiographic follow-up until January
2023 was performed for all patients included in the DIRECTAVI trial since
2016 (n = 228). The primary endpoint was incidence of moderate/severe
hemodynamic valve deterioration (HVD), according to the Valve Academic
Research defined Consortium-3 criteria (increase in mean gradient >=10
mmHg resulting in a final mean gradient >=20 mmHg, or new/worsening aortic
regurgitation of 1 grade resulting in >= moderate aortic regurgitation).
 Result(s): Median follow-up was 3.8 (2.2-4.7) years. Mean age at
follow-up was 87 +/- 6.7 years. No difference in incidence of HVD in the
direct implantation group compared to the BAV group was found (incidence
of 1.97 per 100 person-years and 1.45 per 100 person-years, respectively,
P = 0.6). Prevalence of predicted prothesis-patient mismatch was low (n =
13 [11.4%] in the direct TAVR group vs n = 15 [13.2%] in BAV group) and
similar between both groups (P = .7). Major outcomes including death,
stroke, hospitalization for heart failure and pacemaker implantation were
similar between both groups, (P = .4, P = .7, P = .3, and P = .3
respectively). Conclusion(s): Direct implantation of the
balloon-expandable device in TAVR was not associated with an increased
risk of moderate/severe HVD or major outcomes up to 6-year follow-up.
These results guarantee wide use of direct balloon-expandable valve
implantation, when feasible. Clinical trials registration number:
NCT05140317. Copyright © 2024 Elsevier Inc.

<70>
Accession Number
2030292671
Title
Alcohol septal ablation versus surgical septal myectomy of obstructive
hypertrophic cardiomyopathy: systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 63(3) (no pagination), 2023.
Article Number: ezad043. Date of Publication: 01 Mar 2023.
Author
Yokoyama Y.; Shimoda T.; Shimada Y.J.; Shimamura J.; Akita K.; Yasuda R.;
Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Shimoda) School of Medicine, University of Tsukuba, Ibaraki, Japan
(Shimada, Akita, Yasuda) Division of Cardiology, Department of Medicine,
Columbia University Irving Medical Center, New York, NY, United States
(Shimamura) Department of Surgery, Division of Cardiothoracic Surgery,
Emory University, Atlanta, GA, United States
(Takayama) Department of Surgery, Columbia University Irving Medical
Center, New York, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To elucidate the optimal septal reduction therapy for
obstructive hypertrophic cardiomyopathy, we conducted a metaanalysis
comparing alcohol septal ablation (ASA) and septal myectomy.
 METHOD(S): MEDLINE, EMBASE and Cochrane CENTRAL were searched to
identify studies investigating the outcomes of ASA and septal myectomy in
patients with obstructive hypertrophic cardiomyopathy in January 2023. The
primary outcome of interest was all-cause mortality in studies with >=1
year of follow-up. The secondary outcomes of interest comprised left
ventricular outflow tract (LVOT) pressure gradient reduction and
reoperations of LVOT. A subgroup analysis of all-cause mortality including
studies with follow-up >=5 years was performed. RESULT(S): 27
observational studies were included (15 968 patients). Analysis
demonstrated similar all-cause mortality [hazard ratio (HR) (95%
confidence interval) (CI) 1.24 (0.88-1.76); P = 0.21; I2 =
56%]. In contrast, ASA was associated with less reduction of LVOT pressure
gradient and a reoperation rate [weighted mean difference (95% CI)
11.04mmHg (5.60-16.48); P < 0.01; I2 = 64%, HR (95% CI) 9.14
(6.55-12.75); P < 0.001; I2 = 0%, respectively]. The subgroup
analysis with follow-up >=5 years revealed higher long-term mortality with
ASA [HR (95% CI) 1.50 (1.04-2.15); P = 0.03; I2 = 52%].
 CONCLUSION(S): Although both septal reduction therapies were
associated with similar all-cause mortality, ASA was associated with a
higher rate of reoperation and less reduction of LVOT pressure gradient.
Furthermore, all-cause mortality with follow-up >=5 years showed
favourable outcomes with septal myectomy, although the result is only
hypothesis-generating given a subgroup analysis. Copyright © 2023
European Association for Cardio-Thoracic Surgery. All rights reserved.

<71>
Accession Number
2029157674
Title
Effect of Mechanical Ventilation Mode Type on Postoperative Pulmonary
Complications After Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 437-444),
2024. Date of Publication: February 2024.
Author
Li X.-F.; Mao W.-J.; Jiang R.-J.; Zhang M.-Q.; Yu H.
Institution
(Li, Yu, Zhang, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Mao) Department of Anesthesiology, Jianyang People's Hospital, Jianyang,
China
(Jiang) Department of Anesthesiology, Chengdu Second People's Hospital,
Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: It is unknown whether there is a difference in pulmonary
outcome in different intraoperative ventilation modes for cardiac surgery
with cardiopulmonary bypass (CPB). The aim of this trial was to determine
whether patients undergoing cardiac surgery with CPB could benefit from
intraoperative optimal ventilation mode. Design(s): This was a
single-center, prospective, randomized controlled trial. Setting(s):
The study was conducted at a single-center tertiary-care hospital.
 Participant(s): A total of 1,364 adults undergoing cardiac surgery
with CPB participated in this trial. Intervention(s): Patients were
assigned randomly (1:1:1) to receive 1 of 3 ventilation modes:
volume-controlled ventilation (VCV), pressure-controlled ventilation
(PCV), and pressure-controlled ventilation-volume guaranteed (PCV-VG). All
arms of the study received the lung-protective ventilation strategy.
 Measurements and Main Results: The primary outcome was a composite of
postoperative pulmonary complications (PPCs) within the first 7
postoperative days. Pulmonary complications occurred in 168 of 455
patients (36.9%) in the PCV-VG group, 171 (37.6%) in the PCV group, and
182 (40.1%) in the VCV group, respectively. There was no statistical
difference in the risk of overall pulmonary complications among groups (p
= 0.585). There were no significant differences in the severity grade of
PPCs within 7 days, postoperative ventilation duration, intensive care
unit stay, postoperative hospital stay, or 30-day postoperative mortality.
 Conclusion(s): Among patients scheduled for cardiac surgery with CPB,
intraoperative ventilation mode type did not affect the risk of
postoperative pulmonary complications. Copyright © 2023

<72>
Accession Number
2028592410
Title
Risk factors and incidence of postoperative delirium after cardiac surgery
in children: a systematic review and meta-analysis.
Source
Italian Journal of Pediatrics. 50(1) (no pagination), 2024. Article
Number: 24. Date of Publication: December 2024.
Author
Fu M.; Yuan Q.; Yang Q.; Song W.; Yu Y.; Luo Y.; Xiong X.; Yu G.
Institution
(Fu, Yuan, Yang, Song, Yu, Luo, Xiong, Yu) Department of Nursing, Tongji
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, 1095 Jiefang Road, Qiaokou District, Hubei, Wuhan, China
(Fu, Yuan, Yang, Song, Yu) School of Nursing, Tongji Medical College,
Huazhong University of Science and Technology, Hubei, Wuhan, China
Publisher
BioMed Central Ltd
Abstract
Delirium, a form of acute cerebral dysfunction, is a common complication
of postoperative cardiac surgery in children. It is strongly associated
with adverse outcomes, including prolonged hospitalization, increased
mortality, and cognitive dysfunction. This study aimed to identify risk
factors and incidence of delirium after cardiac surgery in children to
facilitate early identification of delirium risk and provide a reference
for the implementation of effective prevention and management. A
systematic literature search was conducted in PubMed, Web of Science,
Embase, Cochrane Library, Scopus, CNKI, Sinomed, and Wanfang for studies
published in English or Chinese from the inception of each database to
November 2023. The PRISMA guidelines were followed in all phases of this
systematic review. The Risk of Bias Assessment for Nonrandomized Studies
tool was used to assess methodological quality. A total of twelve studies
were included in the analysis, with four studies classified as overall low
risk of bias, seven studies as moderate risk of bias, and one study as
high risk of bias. The studies reported 39 possible predictors of
delirium, categorized into four broad groups: intrinsic and parent-related
factors, disease-related factors, surgery and treatment-related factors,
and clinical scores and laboratory parameters. By conducting qualitative
synthesis and quantitative meta-analysis, we identified two definite
factors, four possible factors, and 32 unclear factors related to
delirium. Definite risk factors included age and mechanical ventilation
duration. Possible factors included developmental delay, cyanotic heart
disease, cardiopulmonary bypass time, and pain score. With only a few
high-quality studies currently available, well-designed and more extensive
prospective studies are still needed to investigate the risk factors
affecting delirium and explore delirium prevention strategies in high-risk
children. Copyright © The Author(s) 2024.

<73>
Accession Number
2028201416
Title
Valve-Sparing Aortic Root Replacement With Reimplantation vs Remodeling: A
Meta-analysis.
Source
Annals of Thoracic Surgery. 117(3) (pp 501-507), 2024. Date of
Publication: March 2024.
Author
Sa M.P.; Jacquemyn X.; Awad A.K.; Brown J.A.; Chu D.; Serna-Gallegos D.;
Kari F.A.; Sultan I.
Institution
(Sa, Brown, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Kari) Section of Pediatric and Congenital Cardiac Surgery, European
Pediatric Heart Center, Ludwig Maximilian University (LMU) University
Hospital and German Heart Center, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: Long-term outcomes of valve-sparing aortic root replacement
(VSARR) with reimplantation vs remodeling in patients undergoing aortic
root surgery remains a controversial subject. Method(s): This study
was a pooled meta-analysis of Kaplan-Meier-derived data from comparative
studies published by December 31, 2022. Result(s): Fifteen studies
met our eligibility criteria, comprising 3044 patients (1991 in the
reimplantation group and 2018 in the remodeling group). Patients who
underwent VSARR with remodeling had a higher risk of all-cause death
(hazard ratio [HR], 1.54; 95% CI, 1.16-2.03; P = .002, log-rank test P <
.001). Landmark analysis (with 4 years as the landmark time point)
demonstrated that survival was lower in patients who underwent VSARR with
remodeling (HR, 2.15; 95% CI, 1.43-3.24; P < .001) in the first 4 years.
Beyond the 4-year time point, no difference in survival was observed (HR,
1.04; 95% CI, 0.72-1.50; P = .822). The risk for need of aortic valve
and/or root reintervention was higher in patients undergoing VSARR with
remodeling (HR, 1.49; 95% CI, 1.07-2.07; P = .019, log-rank test P <
.001). We did not find statistically significant coefficients for the
covariates of age, female sex, connective tissue disorders, bicuspid
aortic valve, aortic dissection, coronary bypass surgery, total arch
replacement, or annular stabilization, which means that these covariates
did not modulate the effects observed in our pooled analyses.
 Conclusion(s): VSARR with reimplantation is associated with better
overall survival and lower risk of need for reintervention over time
compared with VSARR with remodeling. Regarding overall survival, we
observed a time-varying effect that favored the reimplantation technique
up to 4 years of follow-up, but not beyond this time point. Copyright
© 2024 The Society of Thoracic Surgeons

<74>
Accession Number
2028088365
Title
Effects of Tirofiban in Patients with Acute Myocardial Infarction and
Diabetes Mellitus undergoing Primary Percutaneous Coronary Intervention.
Source
Current Vascular Pharmacology. 22(1) (pp 41-49), 2024. Date of
Publication: 2024.
Author
Tang X.; Li R.
Institution
(Tang) Department of Cardiology, The First Hospital of QinHuangDao, HeBei,
QinHuangDao 066000, China
(Li) Department of Critical Care Medicine, People's Hospital of Yangjiang,
Guangdong, Yangjiang 529500, China
Publisher
Bentham Science Publishers
Abstract
Objective: This study evaluated the efficacy and safety of early vs. late
tirofiban administration in the treatment of patients with acute
ST-elevation myocardial infarction (STEMI) and diabetes mellitus (DM)
undergoing primary percutaneous coronary intervention (pPCI).
 Method(s): 120 patients with STEMI and DM treated with pPCI were
randomly divided into an observation group (n=60) and a control group
(n=60). The observation group and the control group were intravenously
injected with a bolus of tirofiban preoperatively or intraoperatively,
respectively; both groups were then given an intravenous infusion over 24
h at 0.15 microg/kg/min. Thrombolysis in myocardial infarction (TIMI)
grade flow, myocardial perfusion index, and functional heart parameters,
as well as major adverse cardiovascular events and bleeding, were compared
between the two groups. Result(s): Functional heart parameters,
including left ventricular ejection fraction and cardiac output, were
significantly improved in the observation group 6 months after discharge.
Thrombus aspiration, inflammatory factors, and cardiac troponin I (cTNI)
were more significantly decreased in the observation group than in the
control group. The sum-ST-segment elevation at 2 h after pPCI treatment in
the observation group was better than that in the control group. There was
no significant difference in the incidence of adverse reactions and
bleeding between the two groups. Conclusion(s): The administration of
tirofiban before reperfusion therapy compared with after reperfusion
therapy is more effective in reducing the hyperthrombotic load, thrombus
aspiration, inflammatory factors, and cTNI and can effectively improve
myocardial perfusion and heart function. Copyright © 2024 Bentham
Science Publishers.

<75>
Accession Number
2028081789
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) (no pagination), 2024.
Article Number: e030587. Date of Publication: 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, United States
(Dhaliwal) Population Health Science and Policy, Icahn School of Medicine
at Mount Sinai-New York, New York, NY, United States
(Sohal) Division of Cardiovascular Medicine, Newark Beth Israel Medical
Center-Newark, Newark, NJ, United States
(Gwon) Department of Biostatistics, University of Nebraska Medical Center,
Omaha, NE, United States
(Bhatia, Dominguez) Division of Cardiology, Icahn School of Medicine at
Mount Sinai Morningside-New York, New York, NY, United States
(Dominguez, Basman) Division of Cardiology, Lenox Hill Hospital New York,
New York, NY, United States
(Tamis-Holland) Department of Cardiovascular Medicine, Cleveland Clinic
Main Campus, Cleveland, OH, United States
Publisher
American Heart Association Inc.
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. Copyright © 2024 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<76>
Accession Number
2028062836
Title
Remifentanil is Superior to Propofol for Treating Emergence Agitation in
Adults After General Anesthesia.
Source
Drug Design, Development and Therapy. 18 (pp 341-350), 2024. Date of
Publication: 2024.
Author
Li J.; Zhu H.; Wang Y.; Chen J.; He K.; Wang S.
Institution
(Li) Cheeloo College of Medicine, Shandong University, Shandong, Jinan,
China
(Li, Zhu, Chen, He, Wang) Department of Anesthesiology, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Anhui, Hefei, China
(Wang) Department of Anesthesiology, The First Affiliated Hospital of
Soochow University, Soochow, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Emergence agitation (EA) is one of the most common
complications in clinical general anesthesia during recovery in adults.
Remifentanil and propofol can reduce the incidence of EA, but with no
randomized controlled trial to evaluate their effectiveness for treating
EA. This study aims to compare the effectiveness of remifentanil and
propofol for treating EA following general anesthesia. Patients and
Methods: Among 152 randomized patients with a mean of 49.5 years, and 99
(65.1%) of them being male, 149 were divided into two groups for
subsequent analysis. The remifentanil group (Group R, n = 74) received a
0.5mug kg-1 remifentanil infusion followed by a 0.05mug
kg-1 min-1 infusion until 15 minutes, after the
onset of agitation. The propofol group (Group P, n = 75) received a 1mg
kg-1 propofol infusion once agitation occurred. Emergence
agitation was assessed using the Riker Sedation Agitation Score, with a
score of >=5 defining emergence agitation. During the post-anesthesia care
unit (PACU), the recurrence of emergence agitation, time to extubation,
and discharge from PACU were evaluated. Result(s): The incidence of
reoccurring emergence agitation was lower in Group R (29.7%) compared with
Group P (49.3%), with an odds ratio of 0.44 (95% CI 0.22-0.85; P=0.014).
The time to extubation was shorter in Group R (mean 12min, range 8-15 min)
compared with Group P (mean 17min, range 13-21 min) (P<0.001), as was the
time discharge from the PACU (mean 30.5 min, range 25-40 min) vs Group P
(mean 37.5 min, range 31-50 min) (P=0.001). Conclusion(s): Treatment
of emergence agitation in adults with remifentanil infusion is more
effective than propofol, with a shorter time to extubation and discharge
from PACU. Copyright © 2024 Li et al. T.

<77>
Accession Number
2027022728
Title
Updates in the management of atrial fibrillation: Emerging therapies and
treatment.
Source
Disease-a-Month. 70(2) (no pagination), 2024. Article Number: 101633. Date
of Publication: February 2024.
Author
Bista I.; Al-Ezzi M.M.; Prajjwal P.; Al-Ezzi S.M.S.; Pattani H.H.; Amiri
B.; Marsool M.D.M.
Institution
(Al-Ezzi) Internal Medicine, Lugansk State Medical University, Lugansk,
Ukraine
(Bista) Mechi Eye Hospital, Birtamode, Nepal
(Al-Ezzi) Internal Medicine, October 6 University, Giza, Egypt
(Prajjwal) Internal Medicine, Bharati Vidyapeeth University Medical
College, Pune, India
(Al-Ezzi) Internal Medicine, Hashemite University of Jordan, Zarqa, Jordan
(Pattani) Internal Medicine, Narendra Modi Medical College, Gujarat
University, India
(Amiri) Tabriz University of Medical Sciences, Cardiovascular Research
Center, Tabriz, Iran, Islamic Republic of
(Marsool) Al-kindy College of Medicine/University of Baghdad, Iraq
Publisher
Elsevier Inc.
Abstract
Objective: The most common and clinically important cardiac arrhythmia is
atrial fibrillation (AF), which has a large negative impact on public
health due to higher fatalities, morbidity, and healthcare expenditure
rates. This study aims to provide valuable insights into the effectiveness
and outcomes of various treatment approaches and interventions for AF.
Study design: Systematic review. Method(s): The most pertinent
published research (original papers and reviews) in the scientific
literature were searched for and critically assessed using the online,
internationally indexed databases PubMed, Medline, and Cochrane Reviews.
These studies are summarised in this review. Keywords like "Atrial
Fibrillation", "emerging therapies", "treatment", "catheter ablation", and
"atrial appendage" were used to search the papers. The papers were
researched and examined to be relevant to the topic. Conclusion(s): A
lot of work has gone into enhancing AF management to deal with this
expanding public health concern. Significant developments and advances in
the treatment of AF during the past few years have aided clinicians in
giving AF patients better care. The most recent treatments for AF include
medication, catheter ablation, cryo-balloon ablation, and left atrial
appendage closure. Copyright © 2023 Elsevier Inc.

<78>
Accession Number
2030583084
Title
Prognostic Value of Qualitative and Quantitative Stress CMR in Patients
With Known or Suspected CAD.
Source
JACC: Cardiovascular Imaging. 17(3) (pp 248-265), 2024. Date of
Publication: March 2024.
Author
Yarahmadi P.; Forouzannia S.M.; Forouzannia S.A.; Malik S.B.; Yousefifard
M.; Nguyen P.K.
Institution
(Yarahmadi, Nguyen) Department of Medicine, Division of Cardiovascular
Medicine, Stanford University, Stanford, CA, United States
(Yarahmadi, Nguyen) Stanford Cardiovascular Institute, Stanford, CA,
United States
(Forouzannia) Department of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Forouzannia) Department of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Malik) Department of Radiology, Division of Cardiovascular Imaging,
Stanford University, Stanford, CA, United States
(Yousefifard) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background: Recent studies suggest that quantitative cardiac magnetic
resonance (CMR) may have more accuracy than qualitative CMR in coronary
artery disease (CAD) diagnosis. However, the prognostic value of
quantitative and qualitative CMR has not been compared systematically.
 Objective(s): The objective was to conduct a systematic review and
meta-analysis assessing the utility of qualitative and quantitative stress
CMR in the prognosis of patients with known or suspected CAD.
 Method(s): A comprehensive search was performed through Embase,
Scopus, Web of Science, and Medline. Studies that used qualitative
vasodilator CMR or quantitative CMR assessments to compare the prognosis
of patients with positive and negative CMR results were extracted. A
meta-analysis was then performed to assess: 1) major adverse
cardiovascular events (MACE) including cardiac death, nonfatal myocardial
infarction (MI), unstable angina, and coronary revascularization; and 2)
cardiac hard events defined as the composite of cardiac death and nonfatal
MI. Result(s): Forty-one studies with 38,030 patients were included
in this systematic review. MACE occurred significantly more in patients
with positive qualitative (HR: 3.86; 95% CI: 3.28-4.54) and quantitative
(HR: 4.60; 95% CI: 1.60-13.21) CMR assessments. There was no significant
difference between qualitative and quantitative CMR assessments in
predicting MACE (P = 0.75). In studies with qualitative CMR assessment,
cardiac hard events (OR: 7.21; 95% CI: 4.99-10.41), cardiac death (OR:
5.63; 95% CI: 2.46-12.92), nonfatal MI (OR: 7.46; 95% CI: 3.49-15.96),
coronary revascularization (OR: 6.34; 95% CI: 3.42-1.75), and all-cause
mortality (HR: 1.66; 95% CI: 1.12-2.47) were higher in patients with
positive CMR. Conclusion(s): The presence of myocardial ischemia on
CMR is associated with worse clinical outcomes in patients with known or
suspected CAD. Both qualitative and quantitative stress CMR assessments
are helpful tools for predicting clinical outcomes. Copyright ©
2024 American College of Cardiology Foundation

<79>
Accession Number
2030523951
Title
Analgaesic Effect of Erector Spinae Plane Block in Coronary Surgery: A
Randomised Controlled Trial.
Source
Journal of the College of Physicians and Surgeons Pakistan. 34(2) (pp
129-134), 2024. Date of Publication: February 2024.
Author
Disikirik A.; Bilgi M.; Turkoglu M.; Ucaroglu E.R.
Institution
(Disikirik, Bilgi, Turkoglu) Department of Anaesthesiology and
Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
(Ucaroglu) Department of Cardiovascular Surgery, Abant Izzet Baysal
University Medical School, Bolu, Turkey
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To investigate the effect of preemptive erector spinae plane
(ESP) block application on postoperative pain scores and opioid demand in
off-pump coronary artery bypass graft (CABG) surgery. Study Design:
Randomised-controlled trial. Place and Duration of the Study: Department
of Anaesthesiology and Reanimation, Abant Izzet Baysal University (AIBU)
Medical School, Bolu, Turkiye, from November 2020 to April 2021.
Methodology: Fifty patients between the ages of 50 and 75 years, received
CABG surgery. These participants who were at risk of the American Society
of Anesthesiologists (ASA) III were randomly divided into two groups: ESP
(Group E) and Control (Group C). Intervention in Group E was performed
bilaterally at the T5 level before the operation. In the study, the
primary outcome was postoperative opioid demand while the secondary
outcomes consisted of intraoperative opioid demand, visual analogue scale
scores, and the duration of hospital stay. Result(s): Tramadol demand
was significantly decreased in Group E at 0-1, 1-12, 12-24, and 0-48 hours
(p <0.05). Intraoperative fentanyl demand for Group E was also
statistically significantly decreased (p= 0.001). In Group E, the visual
analogue scale scores at 30 minutes, 1st, 2nd,
4th, 8th, 12th hour, and 16th
hour after postoperative extubation were observed to be significantly
lower than those of Group C (p <0.05). Conclusion(s): Preemptive ESP
block application in CABG surgery patients reduced postoperative tramadol
demand, intraoperative fentanyl demand, and postoperative pain
scores. Copyright © 2024 College of Physicians and Surgeons
Pakistan. All rights reserved.

<80>
Accession Number
2028110337
Title
Comparative Costs to Medicare and Medicare Beneficiaries of Alternative AF
Stroke Risk Reduction Strategies.
Source
ClinicoEconomics and Outcomes Research. 16 (pp 81-96), 2024. Date of
Publication: 2024.
Author
Reddy V.Y.; Zhong Y.; McGovern A.M.; Amorosi S.L.; Gavaghan M.B.; Hertz
D.S.; Low K.; Freeman S.; Holmes D.R.
Institution
(Reddy) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Zhong, McGovern, Amorosi) Health Economics and Market Access, Boston
Scientific, Marlborough, MA, United States
(Gavaghan, Hertz, Low, Freeman) Ipsos Healthcare, New York, NY, United
States
(Holmes) Mayo Clinic, Rochester, MN, United States
Publisher
Dove Medical Press Ltd
Abstract
Background: As healthcare costs are increasingly being shifted from payers
to patients, it is important to understand the economic consequences of
therapeutic strategies to both payers and patients. Objective(s): To
determine the relative costs to Medicare and Medicare beneficiaries
(patients) of warfarin, non-vitamin K oral anticoagulants (NOACs), and
left atrial appendage closure (LAAC) for stroke risk reduction in
nonvalvular atrial fibrillation. Method(s): An economic model was
developed to assess costs at 5 and 10 years. For warfarin and NOACs,
inputs were derived from published meta-analyses; for LAAC with the
Watchman device, inputs were derived from pooled 5-year PROTECT AF and
PREVAIL trial results. The model captured therapy costs vs clinical event
costs, including procedural complications and follow-up clinical outcomes.
Costs were based on 2023 Medicare reimbursement and copayment rates.
 Result(s): At 10 years, overall LAAC costs ($48,337) were lower than
those of NOACs ($81,198) and warfarin ($52,359). Overall LAAC costs were
lower than those of NOACs by year 5 and warfarin by year 9. At 5 years,
patient LAAC costs were lowest at $4,764, compared to $7,146 and $6,453
for NOACs and warfarin, respectively. LAAC patient costs were lower than
those of NOACs by year 3 and warfarin by year 4. Clinical events comprised
96% of overall warfarin costs vs 48% for LAAC and 40% for NOACs.
 Conclusion(s): LAAC yielded the lowest overall and patient costs.
Warfarin costs were largely driven by clinical events, which may represent
an unplanned financial burden for patients. These considerations should be
incorporated into shared decision-making discussions about stroke
prophylaxis strategies. Copyright © 2024 Reddy et al. This work
is published and licensed by Dove Medical Press Limited.

<81>
[Use Link to view the full text]
Accession Number
2030570221
Title
An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting:
STOPDAPT-3 Randomized Trial.
Source
Circulation. 149(8) (pp 585-600), 2024. Date of Publication: 20 Feb 2024.
Author
Natsuaki M.; Watanabe H.; Morimoto T.; Yamamoto K.; Obayashi Y.; Nishikawa
R.; Ando K.; Domei T.; Suwa S.; Ogita M.; Isawa T.; Takenaka H.; Yamamoto
T.; Ishikawa T.; Hisauchi I.; Wakabayashi K.; Onishi Y.; Hibi K.; Kawai
K.; Yoshida R.; Suzuki H.; Nakazawa G.; Kusuyama T.; Morishima I.; Ono K.;
Kimura T.
Institution
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Japan
(Watanabe, Takenaka, Yamamoto, Kimura) Division of Cardiology, Hirakata
Kohsai Hospital, Hirakata, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Nishinomiya, Japan
(Yamamoto, Ando, Domei) Department of Cardiology, Kokura Memorial
Hospital, Kitakyusyu, Japan
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Graduate
School of Medicine, Kyoto University, Japan
(Suwa, Ogita) Department of Cardiology, Juntendo University, Shizuoka
Hospital, Izunokuni, Japan
(Isawa) Department of Cardiology, Sendai Kousei Hospital, Japan
(Ishikawa, Hisauchi) Department of Cardiology, Dokkyo Medical University,
Saitama Medical Center, Koshigaya, Japan
(Wakabayashi) Department of Cardiology, Showa University, Koto Toyosu
Hospital, Tokyo, Japan
(Onishi) Department of Cardiology, Hiratsuka Kyosai Hospital, Japan
(Hibi) Division of Cardiology, Yokohama City University, Medical Center,
Japan
(Kawai) Division of Cardiology, Chikamori Hospital, Kochi, Japan
(Yoshida) Division of Cardiology, Japanese Red Cross Aichi Medical Center,
Nagoya Daini Hospital, Nagoya, Japan
(Suzuki) Division of Cardiology, Showa University, Fujigaoka Hospital,
Yokohama, Japan
(Nakazawa) Department of Cardiology, Kindai University, Faculty of
Medicine, Osakasayama, Japan
(Kusuyama) Division of Cardiology, Tsukazaki Hospital, Himeji, Japan
(Morishima) Department of Cardiology, Ogaki Municipal Hospital, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Bleeding rates on dual antiplatelet therapy (DAPT) within 1
month after percutaneous coronary intervention (PCI) remain high in
clinical practice, particularly in patients with acute coronary syndrome
or high bleeding risk. Aspirin-free strategy might result in lower
bleeding early after PCI without increasing cardiovascular events, but its
efficacy and safety have not yet been proven in randomized trials.
 METHOD(S): We randomly assigned 6002 patients with acute coronary
syndrome or high bleeding risk just before PCI either to prasugrel (3.75
mg/day) monotherapy or to DAPT with aspirin (81-100 mg/day) and prasugrel
(3.75 mg/day) after loading of 20 mg of prasugrel in both groups. The
coprimary end points were major bleeding (Bleeding Academic Research
Consortium 3 or 5) for superiority and cardiovascular events (a composite
of cardiovascular death, myocardial infarction, definite stent thrombosis,
or ischemic stroke) for noninferiority with a relative 50% margin.
 RESULT(S): The full analysis set population consisted of 5966
patients (no-aspirin group, 2984 patients; DAPT group, 2982 patients; age,
71.6+/-11.7 years; men, 76.6%; acute coronary syndrome, 75.0%). Within 7
days before randomization, aspirin alone, aspirin with P2Y12 inhibitor,
oral anticoagulants, and intravenous heparin infusion were given in 21.3%,
6.4%, 8.9%, and 24.5%, respectively. Adherence to the protocol-specified
antiplatelet therapy was 88% in both groups at 1 month. At 1 month, the
no-aspirin group was not superior to the DAPT group for the coprimary
bleeding end point (4.47% and 4.71%; hazard ratio, 0.95 [95% CI,
0.75-1.20]; P<inf>superiority</inf>=0.66). The no-aspirin group was
noninferior to the DAPT group for the coprimary cardiovascular end point
(4.12% and 3.69%; hazard ratio, 1.12 [95% CI, 0.87-1.45];
P<inf>non</inf><inf>inferiority</inf>=0.01). There was no difference in
net adverse clinical outcomes and each component of coprimary
cardiovascular end point. There was an excess of any unplanned coronary
revascularization (1.05% and 0.57%; hazard ratio, 1.83 [95%CI, 1.01-3.30])
and subacute definite or probable stent thrombosis (0.58% and 0.17%;
hazard ratio, 3.40 [95% CI, 1.26-9.23]) in the no-aspirin group compared
with the DAPT group. CONCLUSION(S): The aspirin-free strategy using
low-dose prasugrel compared with the DAPT strategy failed to attest
superiority for major bleeding within 1 month after PCI but was
noninferior for cardiovascular events within 1 month after PCI. However,
the aspirin-free strategy was associated with a signal suggesting an
excess of coronary events. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04609111. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<82>
Accession Number
2028701810
Title
Saving Lives in Thoracic Surgery: Balancing Oncological Radicality and
Functional Preservation, Transitioning from Standard Pneumonectomy to
Targeted Sublobar Resection.
Source
Cancers. 16(4) (no pagination), 2024. Article Number: 819. Date of
Publication: February 2024.
Author
Eguchi T.; Kumeda H.; Miura K.; Hamanaka K.; Shimizu K.
Institution
(Eguchi, Kumeda, Miura, Hamanaka, Shimizu) Division of General Thoracic
Surgery, Department of Surgery, Shinshu University School of Medicine,
Matsumoto 390-8621, Japan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This review chronicles the evolution of thoracic surgical interventions,
from the standardized pneumonectomy to the precise approach of sublobar
resections. It discusses the emergence and acceptance of minimally
invasive and robot-assisted surgical techniques, highlighting their impact
on improving outcomes beyond cancer and their influence on the surgical
management of early-stage lung cancer. Evaluating historical developments
alongside present methodologies, this review underscores the critical need
for meticulous surgical planning and execution to optimize both
oncological radicality and functional preservation. This evolution
portrayed not only technical advancements but also a shift in the clinical
approach towards tailored, organ-preserving methodologies, culminating in
a contemporary framework promoting sublobar resections as the standard for
specific patient profiles, signifying a new era of precision in thoracic
surgery. Copyright © 2024 by the authors.

<83>
Accession Number
2028658179
Title
Tuberculous Pericarditis in Childhood: A Case Report and a Systematic
Literature Review.
Source
Pathogens. 13(2) (no pagination), 2024. Article Number: 110. Date of
Publication: February 2024.
Author
Venuti L.; Condemi A.; Albano C.; Boncori G.; Garbo V.; Bagarello S.;
Cascio A.; Colomba C.
Institution
(Venuti, Condemi, Albano, Boncori, Garbo, Bagarello, Colomba) Department
of Health Promotion, Mother and Child Care, Internal Medicine and Medical
Specialties "G D'Alessandro", University of Palermo, Palermo 90127, Italy
(Cascio) Infectious and Tropical Disease Unit, Sicilian Regional Reference
Center for the Fight against AIDS, AOU Policlinico "P. Giaccone", Palermo
90127, Italy
(Colomba) Division of Paediatric Infectious Disease, "G. Di Cristina"
Hospital, ARNAS Civico Di Cristina Benfratelli, Palermo 90127, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Tuberculous pericarditis (TBP) is an important cause of pericarditis
worldwide while being infrequent in childhood, especially in
low-TB-incidence countries. We report a case of TBP and provide a
systematic review of the literature, conducted by searching PubMed,
Scopus, and Cochrane to find cases of TBP in pediatric age published in
the English language between the year 1990 and the time of the search. Of
the 587 search results obtained, after screening and a backward citation
search, 45 studies were selected to be included in this review, accounting
for a total of 125 patients. The main signs and symptoms were fever,
cough, weight loss, hepatomegaly, dyspnea, and increased jugular venous
pressure or jugular vein turgor. A definitive diagnosis of TBP was made in
36 patients, either thanks to microbiological investigations, histological
analysis, or both. First-line antitubercular treatment (ATT) was
administered in nearly all cases, and 69 children underwent surgical
procedures. Only six patients died, and only two died of TBP. TBP in
childhood is relatively uncommon, even in high-TB-prevalence countries.
Clinical manifestations, often suggestive of right-sided cardiac failure,
are subtle, and diagnosis is challenging. TBP has an excellent prognosis
in childhood; however, in a significant proportion of cases, invasive
surgical procedures are necessary. Copyright © 2024 by the
authors.

<84>
Accession Number
2030559802
Title
Challenges in acute postoperative pain management in thoracic surgery.
Source
Best Practice and Research: Clinical Anaesthesiology. (no pagination),
2024. Date of Publication: 2024.
Author
Makkad B.; Kachulis B.
Institution
(Makkad) Department of Anesthesiology, University of Cincinnati College of
Medicine, Cincinnati, OH 45267, United States
(Kachulis) Department of Anesthesiology, Columbia University, 622 W 168th
St, New York, NY 10032, United States
Publisher
Bailliere Tindall Ltd
Abstract
Effective pain control is crucial in the management of thoracic surgical
patients since it reduces postoperative morbidity and promotes recovery.
These patients have co-existing respiratory diseases and impaired
pulmonary function, which may be further impaired by surgery. With the
adoption of minimally invasive surgical techniques and an emphasis on
enhancing recovery after surgery, multimodal analgesia has gained
popularity as a way to reduce perioperative opioid use and its associated
adverse events such as respiratory depression. The literature related to
opioid-sparing analgesia in thoracic surgery is still evolving. This
review summarizes the latest research related to the use of various
intravenous, oral, and perineural pharmacological agents as a part of
multimodal analgesic regimen for pain relief in patients undergoing
thoracic surgery and provides a summary for their application in clinical
practice. Copyright © 2024 Elsevier Ltd

<85>
Accession Number
632515911
Title
Correlation between Age and Surgical Approach for Thoracic and Lumbar
Hemivertebra.
Source
Indian Journal of Neurosurgery. 9(2) (pp 115-121), 2020. Date of
Publication: 01 Aug 2020.
Author
Nikova A.; Chatzipaulou V.; Malkots B.; Mustafa R.M.; Valsamidou C.;
Birbilis T.
Institution
(Nikova, Chatzipaulou, Malkots, Mustafa, Valsamidou, Birbilis) Department
of Neurosurgery, Democritus University of Thrace Medical School, Dragana,
Alexandroupolis 68100, Greece
Publisher
Georg Thieme Verlag
Abstract
Objective Hemivertebra (HV) is a congenital defect of the formation of the
spinal vertebra, which can result in scoliosis or kyphosis along with the
related symptomatology of spine deformity. More often than not, it is
linked to other abnormalities and requires attention. Its management is
surgical and it is of great importance for the physician to choose the
right approach at the right time, due to its deteriorative prognosis.
Methods Due to the interest of the subject, the authors investigated the
world literature between 1990 and 2018 and found 45 articles, reporting
thoracic, thoracolumbar, and lumbar HV in children and its postsurgical
outcome, aiming to show whether the approaches are equal in terms of the
final outcome. Results The chosen surgical method depends much on the
level of the pathology. Despite this fact, after analyzing the included
data, we found that the surgical techniques are unequal with regard to the
purpose of achieving improvement. Age, caudal and cranial curves,
segmental kyphosis, and scoliosis are factors playing a major role in
this. Conclusion If not treated, HV leads to deterioration and
dysfunction. The most optimal result, however, is achieved only when the
surgical approach is applied according to age and rest of the accompanying
factors, which should be considered in future management
planning. Copyright © 2020 Neurological Surgeons' Society of
India.

<86>
Accession Number
2030443273
Title
Safety and efficacy of percutaneous Watchman 2.5 device versus Amplatzer
Amulet for left atrial appendage closure in patients with non-valvular
atrial fibrillation: A systematic review and study-level meta-analysis.
Source
PLoS ONE. 19(2 February) (no pagination), 2024. Article Number: e0295804.
Date of Publication: February 2024.
Author
Yasmin F.; Ali E.; Moeed A.; Zaidi F.; Umar M.; Virwani V.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Ali, Moeed, Zaidi) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Umar) IU Health Ball Memorial Hospital, Muncie, IN, United States
(Virwani) Medical College, Aga Khan University, Karachi, Pakistan
Publisher
Public Library of Science
Abstract
In patients with non-valvular atrial fibrillation (NVAF), mechanical
occlusion of the left atrial appendage (LAA) using a permanently implanted
device may be an effective alternative to oral anti-coagulants (OAC). To
facilitate left atrial appendage closure (LAAC), multiple percutaneous
devices have been proposed. Watchman Generation 2.5 and Amplatzer Amulet
are the two most popular used devices for preventing stroke in patients
with NVAF. We sought to compare safety and efficacy outcomes between
Watchman 2.5 and Amplatzer Amulet in patients undergoing LAAC procedure.
Methods We carried out a comprehensive and systematic search of the
databases PubMed and Scopus, for all studies that compared the safety and
efficacy of Watchman 2.5 and Amplatzer Amulet devices, from inception,
till June 2023. We performed the statistical analysis using Review Manager
(V.5.4.1 Cochrane Collaboration, London, United Kingdom). The safety
outcomes of interest included device success, device-related thrombus,
device embolization perioperatively and at follow-up, perioperative
pericardial perfusion events, and perioperative cardiac tamponade events.
Efficacy outcomes were all-cause mortality perioperatively and at
follow-up, cardiovascular (CV) mortality at follow-up, stroke, major and
minor bleeding events at follow-up, transient ischemic attack (TIA) in
follow-up period, thromboembolic events in follow-up period, and
peri-device leakage in perioperative period. All data was analysed using a
random-effects model, and presented as risk ratios (RRs) with 95%
confidence intervals (95%CIs). Results Regarding safety outcomes, device
success was non-significantly reduced in Watchman group when compared with
Amulet (RR 0.99, p = 0.57; I2 = 34%). In contrast,
device-related thrombus was non-significantly increased in Watchman 2.5
group in comparison to Amulet (RR 1.44, p = 0.11; I2 = 0%).
There was no significant difference between the devices in terms of device
embolization in the perioperative (RR 0.36, p = 0.38; I2 = 22%) and
followup (RR 2.24, p = 0.13; I2 = 0%) periods. Likewise, there
was no significant difference in the risks of pericardial effusion (RR
0.98, p = 0.98; I2 = 0%), and cardiac tamponade (RR 0.65, p =
0.76; I2 = 62%) perioperatively. Regarding efficacy outcomes, no
significant difference was observed in all-cause mortality between devices
perioperatively (RR 0.51, p = 0.32; I2 = 0%) and at follow-up
(RR 1.08, p = 0.56; I2 = 0%). CV-mortality was
non-significantly reduced in Watchman group when compared with Amulet (RR
0.57, p = 0.20; I2 = 0%). The Amulet device was not superior to
the Watchman device in terms of stroke at follow-up (RR 1.13, p = 0.63;
I2 = 0%). Sub-group analysis showed comparable ischaemic and
haemorrhagic stroke events between two devices. Furthermore, at follow-up,
there was no significant difference in major (RR 1.06, p = 0.63;
I2 = 0%) and minor bleeding events (RR 1.81, p = 0.17;
I2 = 0%) between the two devices. No difference was observed
for trans-ischemic attack (RR 1.89, p = 0.24; I2 = 0%) and
thromboembolic events (RR 0.96, p = 0.96; I2 = 0%) at
follow-up. No significant difference was observed between devices for
peri-device leakage in perioperative period (RR 2.16, p = 0.05;
I2 = 0%). Conclusion The data suggested that LAAC is safe and
efficacious procedure irrespective of device used, with generally low
complication rates. Watchman generation 2.5 remains non-superior to
Amplatzer Amulet in terms of safety and efficacy outcomes. Copyright:
© 2024 Yasmin et al.

<87>
Accession Number
2028851784
Title
Development and Validation of Scores to Predict Prolonged Mechanical
Ventilation after Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 430-436),
2024. Date of Publication: February 2024.
Author
O'Brien Z.; Bellomo R.; Williams-Spence J.; Reid C.M.; Coulson T.
Institution
(O'Brien, Bellomo, Coulson) Australian and New Zealand Intensive Care
Research Centre, School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(O'Brien, Bellomo, Coulson) Department of Critical Care, University of
Melbourne, Melbourne, VIC, Australia
(O'Brien, Bellomo) Department of Intensive Care, Austin Hospital,
Heidelberg, Melbourne, VIC, Australia
(Bellomo) Data Analytics, Research, and Evaluation Centre, Austin
Hospital, University of Melbourne, Melbourne, VIC, Australia
(Williams-Spence, Reid) Department of Epidemiology and Preventive
Medicine, Monash University, Melbourne, VIC, Australia
(Reid) School of Public Health, Curtin University, Perth, Australia
(Coulson) Department of Anaesthesia, The Alfred Hospital, Melbourne, VIC,
Australia
Publisher
W.B. Saunders
Abstract
Objectives: To optimize the early prediction of prolonged postoperative
mechanical ventilation after cardiac surgery (>24 hours postoperatively).
 Design(s): The authors performed a retrospective analysis.
 Setting(s): The Australian and New Zealand Society of Cardiac and
Thoracic Surgeons (ANZSCTS) database was utilized. Participant(s):
All patients included in the ANZSCTS database between January 2015 and
December 2018 were analyzed. Intervention(s): No interventions were
performed in this observational study. Measurements and Main Results:
A previously developed model was modified to allow retrospective risk
calculation and model assessment (Modified Hessels score). The database
was split into development and validation sets. A new risk model was
developed using forward and backward stepwise elimination (ANZ-PreVent
score). The authors assessed 48,382 patients, of whom 5004 (10.3%) were
ventilated mechanically for >24 hours post-operatively. The Modified
Hessels score demonstrated good performance in this database, with a
c-index of 0.78 (95% CI 0.77-0.78) and a Brier score of 0.08. The newly
developed ANZ-PreVent score demonstrated better performance (validation
cohort, n = 12,229), with a c-index of 0.84 (95% CI 0.83-0.85) (p <
0.0001) and a Brier score of 0.07. Both scores performed better than the
severity of illness scores commonly used to predict outcomes in intensive
care. Conclusion(s): The authors validated a modified version of an
existing prediction score and developed the ANZ-PreVent score, with
improved performance for identifying patients at risk of ventilation for
>24 hours. The improved score can be used to identify high-risk patients
for targeted interventions in future randomized controlled
trials. Copyright © 2023 The Authors

<88>
Accession Number
2028607267
Title
Systemic immune-inflammation index for predicting postoperative atrial
fibrillation following cardiac surgery: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1290610. Date of Publication: 2024.
Author
Chen Y.-C.; Liu C.-C.; Hsu H.-C.; Hung K.-C.; Chang Y.-J.; Ho C.-N.; Hsing
C.-H.; Yiu C.-Y.
Institution
(Chen, Hung, Chang, Ho, Hsing) Department of Anesthesiology, Chi Mei
Medical Center, Tainan, Taiwan (Republic of China)
(Liu) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung, Taiwan (Republic of China)
(Liu) Department of Nursing, College of Medicine, I-Shou University,
Kaohsiung, Taiwan (Republic of China)
(Liu) School of Medicine, I-Shou University, Kaohsiung, Taiwan (Republic
of China)
(Hsu) Department of Otolaryngology, Kuang Tien General Hospital, Taichung,
Taiwan (Republic of China)
(Chang) Department of Recreation and Health-Care Management, College of
Recreation and Health Management, Chia Nan University of Pharmacy and
Science, Tainan, Taiwan (Republic of China)
(Hsing) Department of Medical Research, Chi-Mei Medical Center, Tainan,
Taiwan (Republic of China)
(Yiu) Department of Otolaryngology, Chi Mei Medical Center, Liouying,
Tainan, Taiwan (Republic of China)
(Yiu) Department of Dental Laboratory Technology, Min-Hwei Junior College
of Health Care Management, Liouying, Tainan, Taiwan (Republic of China)
Publisher
Frontiers Media SA
Abstract
Background: Postoperative atrial fibrillation (POAF) is a frequent
complication that may increase morbidity and mortality risk following
cardiac surgery. The systemic immune-inflammation index (SII) is an
emerging biomarker that provides an integrated measure of inflammation by
incorporating neutrophil, lymphocyte, and platelet counts. Recent studies
have reported associations between elevated SII and increased POAF risk;
however, significant heterogeneity exists regarding its predictive
efficacy. This meta-analysis aimed to assess SII's diagnostic efficacy for
predicting POAF risk. Method(s): To synthesize existing evidence on
the ability of perioperative SII for predicting POAF in patients
undergoing cardiac surgery, a systematic review and meta-analysis was
conducted. In August 2023, a comprehensive literature search was performed
to identify relevant studies reporting SII cutoff values with
corresponding sensitivity and specificity. The primary aim was to evaluate
SII's diagnostic utility for predicting POAF, whereas secondary outcomes
included the pooled incidence of POAF and the relationship between the SII
and POAF. Result(s): Eight studies published between 2021 and 2023
with 3,245 patients were included. Six studies involved coronary artery
bypass grafting (CABG) surgery; one encompassed various cardiac
procedures, and another focused solely on mitral valve surgery. The pooled
incidence of POAF was 23.6% [95% confidence interval (CI), 18.7%-29.2%].
Elevated SII significantly increased the odds of POAF by 3.24-fold (odds
ratio, 3.24; 95% CI, 1.6-6.55; p = 0.001). SII's pooled sensitivity and
specificity for predicting POAF were 0.80 (95% CI, 0.68-0.89) and 0.53
(95% CI, 0.23-0.8), respectively. The SII had moderate predictive accuracy
based on a hierarchical summary receiver operating characteristic (HSROC)
area under the curve of 0.78 (95% CI, 0.74-0.81). Subgroup analyses,
whether focusing on CABG alone or CABG with cardiopulmonary bypass (CPB),
both indicated an area under the HSROC curve of 0.78 (95% CI, 0.74-0.81).
 Conclusion(s): Elevated SII is significantly correlated with an
increased POAF risk following cardiac surgery, highlighting its utility as
a predictive biomarker. Considering its moderate diagnostic accuracy,
further research is essential for clarifying SII's clinical effectiveness,
either as an independent predictor or combined with other risk factors,
for stratifying patients at high POAF risk. Systematic Review
Registration: https://www.crd.york.ac.uk/prospero/, identifier
[CRD42023456128]. Copyright 2024 Chen, Liu, Hsu, Hung, Chang, Ho,
Hsing and Yiu.

<89>
Accession Number
2028519706
Title
Comparison of the effects of transversus thoracic muscle plane block and
pecto-intercostal fascial block on postoperative opioid consumption in
patients undergoing open cardiac surgery: a prospective randomized study.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 63. Date
of Publication: December 2024.
Author
Mansour M.A.; Mahmoud H.E.; Fakhry D.M.; Kassim D.Y.
Institution
(Mansour, Mahmoud, Fakhry, Kassim) Department of Anesthesiology, Surgical
Intensive Care and Pain Management, Faculty of Medicine, Beni-Suef
University, Beni-Suef, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: There is an association exists between cardiac surgery,
performed through median sternotomy, and a considerable postoperative
pain. Objective(s): The aim of the current study is to compare the
effects of transversus thoracic muscle plane block (TTMPB) and
pecto-intercostal fascial plane block (PIFB) upon postoperative opioid
consumption among the patients who underwent open cardiac surgery.
 Method(s): The present prospective, randomized, comparative study was
conducted among 80 patients who underwent elective on-pump cardiac surgery
with sternotomy. The subjects were randomly assigned to two groups with
each group containing 40 individuals. For the TTMPB group, bilateral
ultrasound-guided TTMPB was adopted in which 20 ml of 0.25% bupivacaine
was used on each side. In case of PIFB group, bilateral ultrasound-guided
PIFB was adopted with the application of 20 ml of 0.25% bupivacaine on
each side. The researchers recorded the first time for rescue analgesia,
the overall dosage of rescue analgesia administered in the first 24 h
after the operation and the postoperative complications. Result(s):
The PIFB group took significantly longer time to raise the first request
for rescue analgesia (7.8 +/- 1.7 h) than the TTMPB group (6.7 +/- 1.4 h).
Likewise, the PIFB group subjects had a remarkably lower 'overall morphine
usage' in the first 24 h after the operation (4.8 +/- 1.0 mg) than TTMPB
group (7.8 +/- 2.0 mg). Conclusion(s): Bilateral ultrasound-guided
PIFB provided a longer time for the first analgesic demand than bilateral
ultrasound-guided TTMPB in patients undergoing open cardiac surgery. In
addition to this, the PIFB reported less postoperative morphine usage than
the TTMPB and increases satisfaction in these patients. Trial
registration: This study was registered at Clinical Trials.gov on
28/11/2022 (registration number: NCT05627869). Copyright © The
Author(s) 2024.

<90>
Accession Number
2028498688
Title
Procalcitonin for the diagnosis of postoperative bacterial infection after
adult cardiac surgery: a systematic review and meta-analysis.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 44. Date of
Publication: December 2024.
Author
Nicolotti D.; Grossi S.; Palermo V.; Pontone F.; Maglietta G.; Diodati F.;
Puntoni M.; Rossi S.; Caminiti C.
Institution
(Nicolotti, Grossi, Palermo, Pontone, Rossi) Department of Anesthesia and
Intensive Care Medicine, University Hospital of Parma, Parma, Italy
(Maglietta, Diodati, Puntoni, Caminiti) Clinical and Epidemiological
Research Unit, University Hospital of Parma, Parma, Italy
Publisher
BioMed Central Ltd
Abstract
Background and aims: Patients undergoing cardiac surgery are subject to
infectious complications that adversely affect outcomes. Rapid
identification is essential for adequate treatment. Procalcitonin (PCT) is
a noninvasive blood test that could serve this purpose, however its
validity in the cardiac surgery population is still debated. We therefore
performed a systematic review and meta-analysis to estimate the accuracy
of PCT for the diagnosis of postoperative bacterial infection after
cardiac surgery. Method(s): We included studies on adult cardiac
surgery patients, providing estimates of test accuracy. Search was
performed on PubMed, EmBase and WebOfScience on April 12th, 2023 and rerun
on September 15th, 2023, limited to the last 10 years. Study quality was
assessed with the QUADAS-2 tool. The pooled measures of performance and
diagnostic accuracy, and corresponding 95% Confidence Intervals (CI), were
calculated using a bivariate regression model. Due to the variation in
reported thresholds, we used a multiple-thresholds within a study random
effects model for meta-analysis (diagmeta R-package). Result(s):
Eleven studies were included in the systematic review, and 10 (2984
patients) in the meta-analysis. All studies were single-center with
observational design, five of which with retrospective data collection.
Quality assessment highlighted various issues, mainly concerning lack of
prespecified thresholds for the index test in all studies. Results of
bivariate model analysis using multiple thresholds within a study
identified the optimal threshold at 3 ng/mL, with a mean sensitivity of
0.67 (0.47-0.82), mean specificity of 0.73 (95% CI 0.65-0.79), and AUC of
0.75 (IC95% 0.29-0.95). Given its importance for practice, we also
evaluated PCT's predictive capability. We found that positive predictive
value is at most close to 50%, also with a high prevalence (30%), and the
negative predictive value was always > 90% when prevalence was < 20%.
 Conclusion(s): These results suggest that PCT may be used to help
rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL
identified in this work should be confirmed with large, well-designed
randomized trials that evaluate the test's impact on health outcomes and
on the use of antibiotic therapy. PROSPERO Registration number
CRD42023415773. Registered 22 April 2023. Graphical abstract: (Figure
presented.) Copyright © The Author(s) 2024.

<91>
Accession Number
2028034868
Title
Short term outcomes of carotid surgery: the real-world experience of a
single teaching center.
Source
Jornal Vascular Brasileiro. 23 (no pagination), 2024. Article Number:
e20230033. Date of Publication: 2024.
Author
Oliveira T.F.; Centellas C.D.R.; Dalio M.B.; Joviliano E.E.
Institution
(Oliveira, Centellas, Dalio, Joviliano) Universidade de Sao Paulo - USP,
Faculdade de Medicina de Ribeirao Preto, SP, Ribeirao Preto, Brazil
Publisher
Sociedade Brasileira de Angiologia e Cirurgia Vascular
Abstract
Background: Surgical treatment of symptomatic extracranial carotid
stenosis is well established for preventing neurological events and should
adhere to optimal quality standards. However, there is growing concern as
to whether results of controlled trials are replicable in real-world
settings. Objective(s): To assess a symptomatic carotid stenosis
population that underwent surgery and its short-term outcomes in a
real-world context at a professional training center. Method(s):
Observational study using data collected from medical records from January
2012 to January 2023. Patients undergoing operations for other carotid
diseases and with concomitant heart surgery were excluded. Result(s):
A total of 70 patients undergoing angioplasty or carotid endarterectomy
were included. Population subsets undergoing angioplasty or endarterectomy
were similar. Differences in anesthetic modality and a longer operative
time in the carotid endarterectomy subgroup were statistically
significant. There were 4 cases of stroke, only 3 of which (2 minor and 1
major) were related to the index lesion. Thus, the rate of major
operation-related stroke was 1.43% and the rate of any lesion-related
stroke was 4.29%. There was 1 case of AMI in the angioplasty group and
there were no deaths in the sample. The overall rate of major adverse
cardiovascular events was 5.71%. There were no statistical differences
between the endarterectomy and angioplasty groups regarding the main
outcomes. Conclusion(s): The rates of outcomes of ischemic stroke,
acute myocardial infarction, death, and major adverse cardiovascular
events at this center are in line with the rates reported by randomized
controlled trials, demonstrating the feasibility of carotid surgery in
centers with teaching programs. Copyright © 2024 The authors.

<92>
Accession Number
2027350752
Title
The Impact of Regional Nerve Blocks on Postoperative Delirium or Cognitive
Dysfunction following Thoracic Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7576. Date of Publication: December 2023.
Author
Kim S.Y.; Lee J.; Na H.-S.; Koo B.-W.; Lee K.O.; Shin H.-J.
Institution
(Kim, Lee, Na, Koo, Lee, Shin) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Seoul 13620, South
Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Regional nerve blocks (NBs) mitigate the occurrence of postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in adult
patients undergoing thoracic surgery. This study aimed to determine the
exact effect of NBs on POCD and POD. Electronic databases, including
PubMed, EMBASE, CINAHL, Scopus, and Web of Science, were searched for
studies. The primary outcome was the incidence of POD or POCD. The
secondary outcome was pain scores assessed 24 and 48 h postoperatively. We
calculated the log odds ratio (LOR) and standardized mean difference (SMD)
with 95% confidence intervals (CIs). The LOR was converted to an odds
ratio (OR). In the analysis of 1010 patients from seven randomized
controlled trials, POD and POCD rates were 14.1% and 16.7%, respectively,
in the NB group, and higher, at 27.3% and 35.2%, in the control group. NBs
reduced the incidence of POD (OR, 0.44; 95%CI 0.30 to 0.64; p < 0.001;
I2 = 0.00%) and POCD (OR, 0.43; 95%CI 0.24 to 0.76; p < 0.001;
I2 = 0.00%). NBs reduced pain scores at 24 h (SMD, -2.60; 95%CI
-3.90 to -1.30, p < 0.001; I2 = 97.68%) and 48 h (SMD, -1.80;
95%CI -3.18 to -0.41, p = 0.01; I2 = 98.14%) postoperatively.
NBs mitigated the occurrence of POD and POCD in adult patients after
thoracic surgery. Copyright © 2023 by the authors.

<93>
Accession Number
2013947873
Title
Hemodynamic impact of increasing time between fentanyl and propofol
administration during anesthesia induction: a randomised, clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(1) (no
pagination), 2024. Article Number: 744230. Date of Publication: 01 Jan
2024.
Author
Vullo P.A.; Real Navacerrada M.I.I.; Navarro Suay R.
Institution
(Vullo, Navarro Suay) Hospital Central de la Defensa G..mez Ulla-IMIDEF,
Critical Care and Pain Unit, Department of Anesthesia, Madrid, Spain
(Real Navacerrada) Hospital Universitario 12 de Octubre, Critical Care and
Pain Unit, Department of Anesthesia, Madrid, Spain
Publisher
Elsevier Editora Ltda
Abstract
Background and objective: Anesthesia induction can produce severe propofol
dose-dependent hypotension. Fentanyl coadministration reduces the
catecholaminergic response to orotracheal intubation allowing propofol
dose reduction. The aim of this study is to determine whether the
hemodynamic response is improved by increasing the time between fentanyl
and propofol administration and reducing the dose of the latter without
increasing the time to achieve optimal hypnosis. Method(s): After
approval by the Research Ethics Committee, patients undergoing non-cardiac
surgery with endotracheal intubation were randomized by a
computer-generated table into six time-dose groups (1 or 2...minutes/1,
1.5, or 2...mg.kg-1 of propofol). Patients with high
bronchoaspiration risk, a difficult airway, hemodynamic instability, or
anesthetic allergies were excluded. After giving intravenous fentanyl
(2.....g.kg-1), each group received different doses of propofol
after 1 or 2...minutes. Noninvasive blood pressure (BP) and heart rate
(HR) were measured at pre-induction, pre-intubation, and post-intubation.
Time to hypnosis (bispectral index < 60) was also recorded.
 Result(s): Of the 192 recruited patients, 186 completed the study
(1...min group n...=...94; 2...min group n...=...92). It was observed that
HR and BP decreased after propofol administration and increased after
intubation in all groups (p...<...0.0001). In patients over 55 years, the
2 min .. 2 mg.kg-1 group showed the greatest systolic BP
reduction (36........12%) at pre-intubation, while the
1...min.........1.5...mg.kg-1 group showed the least
hemodynamic alteration between pre- and post-intubation (-4........13%).
No significant differences were found in younger patients or in the time
to reach hypnosis between the six groups. While no cases of severe
bradycardia were recorded, 5,4% of the sample required vasopressors.
 Conclusion(s): Increasing the time between the administration of
fentanyl and propofol by up to two minutes results in greater hypotension
in patients over 55 years. Copyright © 2021 Sociedade Brasileira
de Anestesiologia

<94>
Accession Number
2030126571
Title
Canadian Cardiovascular Society/Canadian Association of Interventional
Cardiology 2023 Focused Update of the Guidelines for the Use of
Antiplatelet Therapy.
Source
Canadian Journal of Cardiology. 40(2) (pp 160-181), 2024. Date of
Publication: February 2024.
Author
Bainey K.R.; Marquis-Gravel G.; Belley-Cote E.; Turgeon R.D.; Ackman M.L.;
Babadagli H.E.; Bewick D.; Boivin-Proulx L.-A.; Cantor W.J.; Fremes S.E.;
Graham M.M.; Lordkipanidze M.; Madan M.; Mansour S.; Mehta S.R.; Potter
B.J.; Shavadia J.; So D.F.; Tanguay J.-F.; Welsh R.C.; Yan A.T.; Bagai A.;
Bagur R.; Bucci C.; Elbarouni B.; Geller C.; Lavoie A.; Lawler P.; Liu S.;
Mancini J.; Wong G.C.
Institution
(Bainey, Welsh) Mazankowski Alberta Heart Institute, University of
Alberta, Edmonton, AB, Canada
(Marquis-Gravel, Boivin-Proulx, Tanguay) Institut de Cardiologie de
Montreal, Universite de Montreal, Montreal, Quebec, Canada
(Belley-Cote, Mehta) Population Health Research Institute, McMaster
University, Hamilton Health Sciences, Hamilton, ON, Canada
(Turgeon) University of British Columbia, St Paul's Hospital PHARM-HF
Clinic, Vancouver, BC, Canada
(Ackman) Alberta Health Services, Edmonton, AB, Canada
(Babadagli) Pharmacy Services, Alberta Health Services, Mazankowski
Alberta Heart Institute, Edmonton, AB, Canada
(Bewick) Division of Cardiology, Department of Medicine, Dalhousie
University, Saint John Regional Hospital, Saint John, NB, Canada
(Cantor) Southlake Regional Health Centre, University of Toronto, Toronto,
ON, Canada
(Fremes) University of Toronto, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Graham) Division of Cardiology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Lordkipanidze) Faculte de pharmacie, Universite de Montreal, Research
Center, Montreal Heart Institute, Montreal, Quebec, Canada
(Madan) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Mansour, Potter) Centre Hospitalier de l'Universite de Montreal,
Montreal, Quebec, Canada
(Shavadia) College of Medicine, University of Saskatchewan, Saskatoon, SK,
Canada
(So) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Yan) Division of Cardiology, Unity Health Toronto, St Michael's Hospital,
Toronto, ON, Canada
(Bagai) Terrence Donnelly Heart Centre, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Bagur) London Health Sciences Centre, Western University, London, ON,
Canada
(Bucci) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Elbarouni, Liu) Department of Medicine, St Boniface Hospital, University
of Manitoba, Winnipeg, MB, Canada
(Geller) University of Ottawa, Centretown Community Health Centre, Ottawa,
ON, Canada
(Lavoie) Prairie Vascular Research Inc, Regina, SK, Canada
(Lawler) Peter Munk Cardiac Centre, Toronto General Hospital, University
of Toronto, Toronto, ON, Canada
(Mancini, Wong) Division of Cardiology, Department of Medicine, University
of British Columbia, Vancouver, BC, Canada
Publisher
Elsevier Inc.
Abstract
Antiplatelet therapy (APT) is the foundation of treatment and prevention
of atherothrombotic events in patients with atherosclerotic cardiovascular
disease. Selecting the optimal APT strategies to reduce major adverse
cardiovascular events, while balancing bleeding risk, requires ongoing
review of clinical trials. Appended, the focused update of the Canadian
Cardiovascular Society/Canadian Association of Interventional Cardiology
guidelines for the use of APT provides recommendations on the following
topics: (1) use of acetylsalicylic acid in primary prevention of
atherosclerotic cardiovascular disease; (2) dual APT (DAPT) duration after
percutaneous coronary intervention (PCI) in patients at high bleeding
risk; (3) potent DAPT (P2Y<inf>12</inf> inhibitor) choice in patients who
present with an acute coronary syndrome (ACS) and possible DAPT
de-escalation strategies after PCI; (4) choice and duration of DAPT in ACS
patients who are medically treated without revascularization; (5)
pretreatment with DAPT (P2Y<inf>12</inf> inhibitor) before elective or
nonelective coronary angiography; (6) perioperative and longer-term APT
management in patients who require coronary artery bypass grafting
surgery; and (7) use of APT in patients with atrial fibrillation who
require oral anticoagulation after PCI or medically managed ACS. These
recommendations are all on the basis of systematic reviews and
meta-analyses conducted as part of the development of these guidelines,
provided in the Supplementary Material. Copyright © 2023 Canadian
Cardiovascular Society

<95>
Accession Number
2029659901
Title
Conduit Choice in Coronary Artery Bypass Grafting: Insights From an Expert
Systematic Review Endorsed by the European Association for Cardio-Thoracic
Surgery and the Society of Thoracic Surgeons.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(3) (pp 604-607),
2024. Date of Publication: March 2024.
Author
Patel K.M.; Desai R.G.; Krishnan S.
Institution
(Patel, Desai) Adult Cardiothoracic Anesthesiology, Cooper University
Healthcare, Cooper Medical School of Rowan University, Camden, NJ, United
States
(Krishnan) Adult Cardiothoracic Anesthesiology, Wayne State University
School of Medicine, St. Joseph Mercy Oakland Medical Office Building,
Pontiac, MI, United States
Publisher
W.B. Saunders

<96>
Accession Number
2030540477
Title
Prevalence of Cardiovascular Risk Factors in Women With Obstructive
Coronary Disease Requiring Revascularization: A Meta-analysis.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Berbach L.; Nelsa Atongfor Nguefack C.; Potter B.J.; Pacheco C.; Forcillo
J.
Institution
(Berbach, Nelsa Atongfor Nguefack, Potter, Pacheco, Forcillo) Faculty of
Medicine, University of Montreal, Montreal, Quebec, Canada
(Berbach, Nelsa Atongfor Nguefack, Potter, Pacheco, Forcillo) Centre
hospitalier de l'Universite de Montreal Research Center (CRCHUM),
Montreal, Quebec, Canada
(Potter, Pacheco) Department of Medicine, Division of Cardiology, Centre
hospitalier de l'Universite de Montreal (CHUM), Montreal, Quebec, Canada
(Forcillo) Department of Surgery, Division of Cardiac Surgery, Centre
hospitalier de l'Universite de Montreal (CHUM), Montreal, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Introduction: Cardiovascular disease continues to be the primary cause of
premature mortality in women, who previously have been overlooked in
clinical trials. Several studies showed that women undergoing coronary
artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)
present more cardiovascular risk factors at baseline, develop more
postprocedural complications, and have a higher mortality rate than men.
The goal of this review is to analyze the difference between men and women
in terms of the prevalence of individual cardiovascular risk factors.
 Method(s): A meta-analysis was conducted of original investigations
with adult subjects who underwent surgical intervention or PCIs in which
cardiovascular risk factors were evaluated, using the MEDLINE, Cochrane,
Evidence-Based Medicine Reviews (EBMR), Ovid Embase, Google Scholar, and
PubMed databases. Result(s): Of the 4567 identified records found, 18
were retained for qualitative analysis. Prevalence of hypertension (CABG:
71% (95% confidence interval [CI] 64%, 78%]); PCI: (59% [95% CI 48%,70%]),
and diabetes (CABG: 48% [95% CI 38%, 57%]); PCI 43% (95% CI 27%, 59%]) was
high in women. Women who underwent either CABG or PCI had higher odds of
having hypertension (CABG: odds ratio [OR] 1.92 [95% CI 1.47-2.50], P <
0.05); PCI: OR 1.86 [95% CI 1.76-1.97], P < 0.05]), and diabetes (CABG: OR
1.94 [95% CI 1.55-2.42], P < 0.05; PCI: OR 1.97 [95% CI 1.54-2.53], P <
0.05)). However, the prevalence of smoking among women, compared to men,
was lower (CABG: 0.17 [95% CI 0.06-0.52], P < 0.05; PCI: 0.22 [95% CI
0.06-0.86], P < 0.03). Conclusion(s): The review shows that women who
underwent either surgical or percutaneous revascularization had higher
odds of hypertension and diabetes, compared to men. Copyright ©
2023 The Authors

<97>
Accession Number
2029999878
Title
Impact of Surgical Positioning on the Occurrence of Postoperative
Ipilateral Shoulder Pain After Lung Resection by Video-Assisted
Thoracoscopy: A Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Galvaing G.; Bussieres J.; Simard S.; Couture E.J.; Cournoyer C.; Conti
M.; Lacasse Y.; Laliberte A.S.
Institution
(Galvaing, Conti, Lacasse, Laliberte) Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Multidisciplinary Department of
Pulmonology and Thoracic Surgery, Quebec City, Quebec, Canada
(Galvaing) Jean Perrin Cancer Center, Department of Thoracic and Endocrine
Surgery, Clermont-Ferrand, France
(Bussieres, Couture, Cournoyer) Institut Universitaire de Cardiologie et
de Pneumologie de Quebec, Department of Anesthesiology, Quebec City,
Quebec, Canada
(Simard) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Research Center, Quebec City, Quebec, Canada
Publisher
W.B. Saunders
Abstract
Objective: The aim of this study was to evaluate the impact of the
ipsilateral arm position on ipsilateral shoulder pain after lung cancer
resection by video-assisted thoracic surgery. Design(s): A
prospective randomized controlled trial. Setting(s): A single
academic center study. Participant(s): Patients undergoing
video-assisted thoracic surgery pulmonary resection for cancer at the
Institut Universitaire de Cardiologie et de Pneumologie de Quebec from May
2020 to May 2022 were included. Intervention(s): Patients randomly
were assigned with a 1:1 ratio to a supported or suspended ipsilateral arm
position. Measurements and Main Results: Ipsilateral shoulder pain
incidence, pain score, and opioid use were recorded in the postanesthesia
care unit (PACU) on postoperative days 1 and 2. One hundred thirty-three
patients were randomized, 67 in the suspended-arm group and 66 in the
supported-arm group. Of the patients, 31% reported ipsilateral shoulder
pain in the PACU with no difference between groups (19/67 [28.4%] v 22/66
patients (33.3%), p = 0.5767). There was no significant difference between
the pain score in the PACU (3 [0-6] v 4 [0-6], p = 0.9055) at
postoperative day 1 (4 [2-6] v 3 [2-5], p = 0.4113) and at postoperative
day 2 (2 [0-5] v 2 [1-4], p = 0.9508). Ipsilateral shoulder pain score
decreased rapidly on postoperative day 2. There was no statistical
difference in opioid and gabapentinoid use between the groups.
 Conclusion(s): Ipsilateral arm position seems to have no impact on
ipsilateral shoulder pain. Copyright © 2023

<98>
Accession Number
643528289
Title
Impact of Adding Early Bedside Cycling to Inpatient Cardiac Rehabilitation
on Physical Function and Length of Stay after Heart Valve Surgery. A
Randomized Controlled Trial.
Source
Archives of physical medicine and rehabilitation. (no pagination), 2024.
Date of Publication: 15 Feb 2024.
Author
Ahmad A.M.; Abusarea S.A.; Fouad B.Z.; Guirguis S.A.; Shafie W.A.
Institution
(Ahmad) Department of Physical Therapy for Cardiovascular and Respiratory
Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
(Abusarea, Guirguis) Department of Physical Therapy for Cardiovascular and
Respiratory Disorders, Faculty of Physical Therapy, Cairo University,
Giza, Egypt
(Fouad) Department of Cardiology, National Heart Institute, Giza, Egypt
(Shafie) Intensive Care Unit, National Heart Institute, Giza, Egypt
Abstract
OBJECTIVE: To assess whether adding bedside cycling to inpatient cardiac
rehabilitation (CR) early after heart valve surgery could lead to better
physical function and shorter length of hospital stays. DESIGN: This is a
single-centered, randomized, controlled, parallel-group intervention
study. SETTINGS: This study was conducted at the National Heart Institute
from December 2022 to June 2023. PARTICIPANTS: Thirty-one heart valve
surgery patients completed this study after being randomized into two
groups: an intervention group (n1=16) and an active control group (n2=15).
Eligibility criteria were heart valve surgery with median sternotomy,
clinical stability, and age from 20 to 40. INTERVENTIONS: the intervention
group received early bedside cycling for the lower limbs, using a mini
bike, in addition to an inpatient CR program, and the control group
received the CR program alone. MAIN OUTCOME MEASURE: The primary outcome
was six-minute walk distance (6MWD). The secondary outcomes comprised
forced vital capacity (FVC), Barthel Index (BI), the length of ICU stay,
the total length of hospital stay, and the physical component summary
(PCS) of the 12-item Short Form (SF-12) Health Survey. RESULT(S):
Compared to the control group, the intervention group showed more
improvements in 6MWD (p<0.001), BI score (p<0.001), and FVC (p=0.006) at
hospital discharge, and shorter ICU stay (p=0.002) and total hospital stay
(0.015). At 1-month follow-up, the intervention group showed a
non-significantly better improvement in the PCS of the SF-12 compared to
the control group (p=0.057). CONCLUSION(S): Adding early bedside
cycling to a usual inpatient CR program after heart valve surgery could
induce significantly better short-term physical function as assessed by
6MWD and BI, higher pulmonary function as measured by FVC, and shorter
lengths of ICU and total hospital stays than the usual CR program alone.
TRIAL REGISTRATION: ClinicalTrial.gov (NCT05893433). Copyright ©
2024. Published by Elsevier Inc.

<99>
Accession Number
643525034
Title
Device innovation in cardiovascular medicine: a report from the European
Society of Cardiology Cardiovascular Round Table.
Source
European heart journal. (no pagination), 2024. Date of Publication: 16
Feb 2024.
Author
Windecker S.; Gilard M.; Achenbach S.; Cribier A.; Delgado V.; Deych N.;
Drossart I.; Eltchaninoff H.; Fraser A.G.; Goncalves A.; Hindricks G.;
Holborow R.; Kappetein A.P.; Kilmartin J.; Kurucova J.; Luscher T.F.;
Mehran R.; O'Connor D.B.; Perkins M.; Samset E.; von Bardeleben R.S.;
Weidinger F.
Institution
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Freiburgstrasse, Bern CH-3010,
Switzerland
(Gilard) Departement de Cardiologie, Hospital La Cavale Blanche, La Cavale
Blanche Hospital Boulevard Tanguy Prigent, Brest 29200, France
(Achenbach) Department of Cardiology, Erlangen-Nurnberg,
Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Germany
(Cribier) Department of Cardiology, Inserm U1096, Univ Rouen Normandie,
Rouen F-76000, France
(Delgado) Department of Cardiology, University Hospital Germans Trias i
Pujol, Badalona, Spain
(Deych) Regulatory Affairs, Edwards Lifesciences, Nyon, Switzerland
(Drossart) ESC Patient Forum, Sophia Antipolis, France
(Eltchaninoff) Department of Cardiology, University Hospital Charles
Nicolle, Rouen, France
(Fraser) Department of Cardiology, University Hospital of Wales, Cardiff,
United Kingdom
(Goncalves) Precision Diagnostics, Philips, Cambridge, MA, United States
(Goncalves) Department of Surgery and Physiology, Faculty of Medicine,
University of Porto Medical School, Porto, Portugal
(Hindricks) Department of Cardiology, German Heart Center Charite, Berlin,
Germany
(Holborow) British Standards Institute, Whitchurch, United Kingdom
(Kappetein) Medtronic Bakken Research Center, Maastricht, Netherlands
(Kilmartin) Regulatory Affairs, Medtronic, Galway, Ireland
(Kurucova) Transcatheter Heart Valve Division, Edwards Lifesciences, Nyon,
Switzerland
(Luscher) Department of Cardiology, Royal Brompton and Harefield Hospitals
and Imperial College and King's College, London, United Kingdom
(Luscher) Center for Molecular Cardiology, University of Zurich, Zurich,
Switzerland
(Mehran) Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
(O'Connor) Health Products Regulatory Authority (HPRA), Dublin, Ireland
(Perkins) GE Healthcare Cardiology Solutions, Harrogate, United Kingdom
(Samset) GE Healthcare Cardiology Solutions, Oslo, Norway
(Samset) Department of Informatics, University of Oslo, Oslo, Norway
(von Bardeleben) Department of Cardiology, Heart Valve Center, University
Medical Center, Mainz, Germany
(Weidinger) 2nd Medical Department with Cardiology and Intensive Care
Medicine, Klinik Landstrasse, Vienna, Austria
Abstract
Research performed in Europe has driven cardiovascular device innovation.
This includes, but is not limited to, percutaneous coronary intervention,
cardiac imaging, transcatheter heart valve implantation, and device
therapy of cardiac arrhythmias and heart failure. An important part of
future medical progress involves the evolution of medical technology and
the ongoing development of artificial intelligence and machine learning.
There is a need to foster an environment conducive to medical technology
development and validation so that Europe can continue to play a major
role in device innovation while providing high standards of safety. This
paper summarizes viewpoints on the topic of device innovation in
cardiovascular medicine at the European Society of Cardiology
Cardiovascular Round Table, a strategic forum for high-level dialogue to
discuss issues related to the future of cardiovascular health in Europe.
Devices are developed and improved through an iterative process throughout
their lifecycle. Early feasibility studies demonstrate proof of concept
and help to optimize the design of a device. If successful, this should
ideally be followed by randomized clinical trials comparing novel devices
vs. accepted standards of care when available and the collection of
post-market real-world evidence through registries. Unfortunately,
standardized procedures for feasibility studies across various device
categories have not yet been implemented in Europe. Cardiovascular imaging
can be used to diagnose and characterize patients for interventions to
improve procedural results and to monitor devices long term after
implantation. Randomized clinical trials often use cardiac imaging-based
inclusion criteria, while less frequently trials randomize patients to
compare the diagnostic or prognostic value of different modalities.
Applications using machine learning are increasingly important, but
specific regulatory standards and pathways remain in development in both
Europe and the USA. Standards are also needed for smart devices and
digital technologies that support device-driven biomonitoring. Changes in
device regulation introduced by the European Union aim to improve clinical
evidence, transparency, and safety, but they may impact the speed of
innovation, access, and availability. Device development programmes
including dialogue on unmet needs and advice on study designs must be
driven by a community of physicians, trialists, patients, regulators,
payers, and industry to ensure that patients have access to innovative
care. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

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