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<1>
Accession Number
2028914893
Title
Anterior versus posterior mediastinal reconstruction after esophagectomy
in esophageal cancer patients: a systematic review and meta-analysis.
Source
Langenbeck's Archives of Surgery. 409(1) (no pagination), 2024. Article
Number: 88. Date of Publication: December 2024.
Author
Yoshida S.; Fujii Y.; Hoshino N.; Tokoro Y.; Tsunoda S.; Obama K.;
Watanabe N.
Institution
(Yoshida, Fujii, Hoshino, Tokoro, Tsunoda, Obama) Department of Surgery,
Kyoto University Hospital, 54, Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto
606-8507, Japan
(Watanabe) Department of Health Promotion and Human Behavior, Kyoto
University School of Public Health, Kyoto, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Esophagectomy is the primary surgical treatment for esophageal
cancer, although other treatment approaches are often incorporated,
including preoperative chemotherapy and chemoradiotherapy. The two major
routes of esophageal reconstruction after esophagectomy are the anterior
mediastinal (retrosternal, heterotopic) and posterior mediastinal
(prevertebral, orthotopic) routes. However, which of these two routes of
reconstruction is the most appropriate remains controversial. This
systematic review aimed to compare the efficacy and safety of anterior
mediastinal reconstruction with those of posterior mediastinal
reconstruction after esophagectomy in esophageal cancer. <br/>Method(s):
In January 2022, a literature search of the CENTRAL, MEDLINE, and EMBASE
databases was conducted to identify all published and unpublished
randomized controlled trials, regardless of language. Eight studies were
included for quantitative synthesis. <br/>Result(s): Postoperative death
(9/129 and 4/125, risk ratio [RR]: 2.07, 95% confidence interval [CI]:
0.65-6.64) and incidence of anastomotic leak (24/208 and 26/208, RR: 0.95,
95% CI: 0.56-1.62) were not significantly different between the two
mediastinal reconstructions. We could not perform a meta-analysis for
quality of life, loss of body weight, or postoperative hospital stay due
to data limitations. <br/>Conclusion(s): Overall, there was low-quality
evidence to suggest that the outcomes of the anterior and posterior
mediastinal routes of reconstruction are not significantly different in
patients with esophageal cancer.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2024.

<2>
Accession Number
2030789615
Title
Nociception level index-guided antinociception versus routine care during
remifentanil-propofol anaesthesia for moderate-to-high risk cardiovascular
surgery.
Source
European Journal of Anaesthesiology. 40(10) (pp 790-793), 2023. Date of
Publication: 01 Oct 2023.
Author
Coeckelenbergh S.; Sessler D.I.; Doria S.; Patricio D.; Jaubert L.;
Huybrechts I.; Stefanidis C.; Kapessidou P.; Tuna T.; Engelman E.; Barvais
L.; Perrin L.
Institution
(Coeckelenbergh, Doria, Patricio, Jaubert, Huybrechts, Tuna, Engelman,
Barvais, Perrin) The Department of Anaesthesia and Resuscitation, Erasme
University Hospital, Universite Libre de Bruxelles, Brussels, Belgium
(Coeckelenbergh) Department of Anaesthesiology and Intensive Care, Paul
Brousse Hospital, Hepatobiliary Centre, Assistance Publique - Hopitaux de
Paris, Universite Paris-Saclay, Villejuif, France
(Coeckelenbergh, Sessler) Outcomes Research Consortium, Cleveland, OH,
United States
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Stefanidis) Department of Cardiac Surgery, Erasme University Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Kapessidou) Department of Anaesthesiology, Saint Pierre University
Hospital, Universite Libre de Bruxelles, Brussels, Belgium
(Engelman) EW Data Analysis, Brussels, Belgium
Publisher
Lippincott Williams and Wilkins

<3>
Accession Number
2030604536
Title
Burosumab vs Phosphate/Active Vitamin D in Pediatric X-Linked
Hypophosphatemia: A Subgroup Analysis by Dose Level.
Source
Journal of Clinical Endocrinology and Metabolism. 108(11) (pp 2990-2998),
2023. Date of Publication: 01 Nov 2023.
Author
Imel E.A.; Glorieux F.H.; Whyte M.P.; Portale A.A.; Munns C.F.; Nilsson
O.; Simmons J.H.; Padidela R.; Namba N.; Cheong H.I.; Pitukcheewanont P.;
Sochett E.; Hogler W.; Muroya K.; Tanaka H.; Gottesman G.S.; Biggin A.;
Perwad F.; Chen A.; Roberts M.S.; Ward L.M.
Institution
(Imel) Departments of Medicine and Pediatrics, Indiana University School
of Medicine, Indianapolis, IN 46202, United States
(Glorieux) Emeritus Director of Research, Shriners Hospitals for
Children-Canada, Montreal, QC H4A 0A9, Canada
(Whyte, Gottesman) Center for Metabolic Bone Disease and Molecular
Research, Shriners Hospitals for Children-St. Louis, St Louis, MO 63110,
United States
(Portale, Perwad) Department of Pediatrics, University of California, San
Francisco, San Francisco, CA 94115, United States
(Munns) University of Queensland, Queensland Children's Hospital, South
Brisbane, QLD 4101, Australia
(Nilsson) Division of Pediatric Endocrinology, Center for Molecular
Medicine, Department of Women's and Children's Health, Karolinska
Institutet, University Hospital, Stockholm 171 64, Sweden
(Nilsson) School of Medical Sciences, Department of Pediatrics, Orebro
University, University Hospital, Orebro 701 85, Sweden
(Simmons) Department of Pediatrics, Vanderbilt University Medical Center,
Nashville, TN 37232, United States
(Padidela) Paediatric Endocrinology, Royal Manchester Children's Hospital,
Faculty of Biology, Medicine and Health, University of Manchester,
Manchester M13 9PL, United Kingdom
(Namba) Department of Pediatrics, Osaka Hospital, Japan Community
Healthcare Organization, Osaka 553-0003, Japan
(Namba) Department of Pediatrics, Osaka University Graduate School of
Medicine, Suita 565-0871, Japan
(Cheong) Department of Pediatrics, Hallym University Sacred Heart
Hospital, Gyeonggi-do, Anyang-si, South Korea
(Pitukcheewanont) Children's Hospital Los Angeles, Los Angeles, CA and
Keck School of Medicine of USC, Los Angeles, CA 90027, United States
(Sochett) Department of Endocrinology, Hospital for Sick Children,
Toronto, ON M5G 1X8, Canada
(Hogler) Department of Pediatrics and Adolescent Medicine, Johannes Kepler
University Linz, Linz 4040, Austria
(Hogler) Institute of Metabolism and Systems Research, University of
Birmingham, Birmingham B15 2TT, United Kingdom
(Muroya) Kanagawa Children's Medical Center, Yokohama 232-0066, Japan
(Tanaka) Okayama Saiseikai General Hospital, Okayama 700-0021, Japan
(Gottesman) Washington University School of Medicine, St Louis, MO 63110,
United States
(Biggin) Children's Hospital Westmead, Westmead 2145, Australia
(Chen, Roberts) Ultragenyx Pharmaceutical Inc, Novato, CA 94949, United
States
(Ward) Department of Pediatrics, University of Ottawa, Children's Hospital
of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
Publisher
Endocrine Society
Abstract
Context: In an open-label, randomized, controlled, phase 3 trial in 61
children aged 1 to 12 years with X-linked hypophosphatemia (XLH),
burosumab improved rickets vs continuing conventional therapy with active
vitamin D and phosphate. <br/>Objective(s): We conducted an analysis to
determine whether skeletal responses differed when switching to burosumab
vs continuing higher or lower doses of conventional therapy.
<br/>Method(s): Conventional therapy dose groups were defined as
higher-dose phosphate [greater than 40 mg/kg] (HPi), lower-dose phosphate
[40 mg/kg or less] (LPi), higher-dose alfacalcidol [greater than 60 ng/kg]
or calcitriol [greater than 30 ng/kg] (HD), and lower-dose alfacalcidol
[60 ng/kg or less] or calcitriol [30 ng/kg or less] (LD). <br/>Result(s):
At week 64, the Radiographic Global Impression of Change (RGI-C) for
rickets was higher (better) in children randomly assigned to burosumab vs
conventional therapy for all prebaseline dose groups: HPi (+1.72 vs
+0.67), LPi (+2.14 vs +1.08), HD (+1.90 vs +0.94), LD (+2.11 vs +1.06). At
week 64, the RGI-C for rickets was also higher in children randomly
assigned to burosumab (+2.06) vs conventional therapy for all on-study
dose groups: HPi (+1.03), LPi (+1.05), HD (+1.45), LD (+0.72). Serum
alkaline phosphatase (ALP) also decreased in the burosumab-treated
patients more than in the conventional therapy group, regardless of
on-study phosphate and active vitamin D doses. <br/>Conclusion(s): Prior
phosphate or active vitamin D doses did not influence treatment response
after switching to burosumab among children with XLH and active
radiographic rickets. Switching from conventional therapy to burosumab
improved rickets and serum ALP more than continuing either higher or lower
doses of phosphate or active vitamin D.<br/>Copyright &#xa9; The Author(s)
2023. Published by Oxford University Press on behalf of the Endocrine
Society.

<4>
Accession Number
2030464891
Title
Optimal lesion preparation before implantation of a Magmaris bioresorbable
scaffold in patients with coronary artery stenosis: Rationale, design and
methodology of the OPTIMIS study.
Source
Contemporary Clinical Trials Communications. 38 (no pagination), 2024.
Article Number: 101260. Date of Publication: April 2024.
Author
Hansen K.N.; Maehara A.; Noori M.; Troan J.; Fallesen C.O.; Hougaard M.;
Ellert-Gregersen J.; Veien K.T.; Junker A.; Hansen H.S.; Lassen J.F.;
Jensen L.O.
Institution
(Hansen, Noori, Troan, Fallesen, Hougaard, Ellert-Gregersen, Veien,
Junker, Hansen, Lassen, Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Hansen, Noori, Hansen, Lassen, Jensen) University of Southern Denmark,
Odense, Denmark
(Maehara) Cardiovascular Research Foundation, New York Presbyterian
Hospital, New York, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Percutaneous coronary intervention with implantation of a
bioresorbable scaffold (BRS) provide the vessel support for a limited
period allowing the vessel to restore normal vasomotion after degradation
of the BRS, opposed to treatment with drug-eluting stents where the metal
persist in the vessel wall. Late lumen loss and reduction in lumen area
after implantation have been reported. The purpose of this study was to
investigate whether intense pre-dilatation before BRS implantation
resulted in less reduction of minimal lumen area at 6- and 12-month
follow-up after implantation of a Magmaris BRS (MgBRS). Coronary imaging
with optical coherence tomography (OCT) and intravascular ultrasound
(IVUS) was assessed to track changes in lumen and vessel dimensions.
<br/>Method(s): The prospective Optimal lesion PreparaTion before
Implantation of the Magmaris bioresorbable scaffold In patients with
coronary artery Stenosis (OPTIMIS) study randomly assigned eighty-two
patients with chronic coronary syndrome to two pre-dilatation treatment
strategies. Patients were randomized in a 1:1 ratio to pre-dilatation with
either a non-compliant scoring balloon or a standard non-compliant balloon
prior to implantation of a MgBRS. The treated segment was evaluated with
OCT and IVUS at baseline, after 6 and 12 months to assess changes in lumen
and vessel dimensions. The hypothesis was that more intense pre-dilatation
with a non-compliant scoring balloon before MgBRS implantation can reduce
the risk of late lumen reduction compared to standard pre-dilatation. The
power calculation used expected MLA after 6 months (6.22 mm²
for the scoring balloon and 5.01 mm² for the standard
non-compliant balloon), power of 80 %, significance level of 0.05 and
expected drop-out rate of 15 %, requiring 82 patients to be enrolled.
<br/>Result(s): Eighty-two patients were included in the study. Enrollment
was from December 2020 to September 2023. <br/>Conclusion(s): The
hypothesis was that more intense pre-dilatation with a non-compliant
scoring balloon before MgBRS implantation can reduce the risk of late
lumen reduction compared to standard pre-dilatation.<br/>Copyright &#xa9;
2024

<5>
Accession Number
2030243308
Title
The role of gut microbial symbiosis in Heart Failure: A systematic review.
Source
Journal of Cardiovascular Disease Research. 15(2) (pp 60-77), 2024. Date
of Publication: 2024.
Author
Yalaga S.; Srihari B.; Nageswararao V.G.; Reddy T.
Institution
(Yalaga, Srihari, Nageswararao) Dept Of Cardiology, Siddhartha Medical
College, Vijayawada, India
(Reddy) Dept of Cardiology, SLNHC Hospital, Bellary, India
Publisher
EManuscript Technologies
Abstract
Heart failure (HF) is a significant factor in the global burden of
cardiovascular health. Recent studies have revealed that patients with
heart failure exhibit distinct alterations in their gut flora, which in
turn impact immunological balance and metabolism. This systematic
literature review aims to determine the influence of gut dysbiosis on
heart failure. We employed the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) criteria to carry out our systematic
review. We conducted a comprehensive search of the literature using
databases such as PubMed, PubMed Central (PMC), and Medline. A total of
ten papers were selected for the purpose of review. Heart failure shown
notable disparities in the composition of the gut microbiota. The
Ruminococcus gnavus, Escherichia Shigella, Streptococcus sp, Veillonella
sp, and Actinobacteria are relatively more abundant, while Eubacterium,
Prevotella, Faecalibacterium, SMB53, and Megamonas are more depleted. The
composition differed based on age, stage of heart failure, and extent of
decompensation. The composition remained unchanged in relation to the
ejection fraction. There was an upregulation of genes involved in the
metabolism of amino acids, carbohydrates, choline trimethylamine-lyase
(TMA-lyase), lipopolysaccharide (LPS) production, tryptophan, and lipid
metabolism. The resulting alterations impacted the concentrations of
metabolites, including trimethylamine N-oxide (TMAO), indoxyl sulfate
(IS), and LPS, as well as inflammatory markers in both feces and plasma,
hence contributing to the development of heart failure. These biomarkers
associated with heart failure could be utilized as focal points for the
prevention and treatment of heart failure. Individuals suffering from
heart failure possess a distinct combination of gut bacteria that directly
impact the development and progression of heart failure. Additional
research is required to comprehend the causal connection between dysbiosis
and heart failure.<br/>Copyright &#xa9; 2024 EManuscript Technologies. All
rights reserved.

<6>
Accession Number
2030907121
Title
Bariatric surgery and drugs: Review of the literature and Adverse Drug
Reactions analysis in French National Pharmacovigilance Database.
Source
Therapies. (no pagination), 2024. Date of Publication: 2024.
Author
Nicol C.; Jacquot J.; Chebane L.; Combret S.; Pecquet P.-E.; Massy N.;
Bagheri H.
Institution
(Nicol, Jacquot, Chebane, Bagheri) Service de pharmacologie medicale,
centre de pharmacovigilance de Toulouse, CIC1436, faculte de medecine, CHU
de Toulouse, Toulouse 31000, France
(Combret) Centre regional de pharmacovigilance de Bourgogne, CHU de Dijon,
Dijon 21000, France
(Pecquet) Service de pharmacologie clinique, centre de pharmacovigilance
d'Amiens, CHU d'Amiens, Amiens 80000, France
(Massy) Centre regional de pharmacovigilance de Rouen, CHU de Rouen, Rouen
76000, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Bariatric surgery is the only treatment for severe obesity
(BMI > 35 kg/m²) currently recognized as effective both in
achieving tangible and lasting weight loss, and in improving
obesity-related comorbidities such as type 2 diabetes, hypertension, and
cardiovascular complications. Bariatric surgery, like any other surgery of
the digestive tract, can have an impact on nutrient absorption, as well as
on drug absorption. The literature on drug management in bariatric surgery
patients concerned mainly of case reports and retrospective studies
involving a small number of patients. No official guidelines are
available. <br/>Method(s): We conducted a literature search on the
consequences of bariatric surgery in terms of drug bioavailability and/or
effect. The Medline (PubMed) database was searched using the following
keywords: "bariatric surgery", "bioavailability", "gastric bypass", and
"obesity". We completed this review with an analysis of reports of adverse
drug reactions (ADRs) in post-bariatric surgery patients for obesity
registered in the National pharmacovigilance database (PVDB). We selected
all cases with the mention of "bariatric surgery and/or gastrectomy" as
"medical history". After reading the cases, we excluded those in which the
patient had undergone surgery for an indication other than obesity, where
the route of administration was other than oral, and cases in which ADRs
resulted from voluntary overdose, attempted suicide, allergy, switch to
Levothyrox new formulation, meningioma under progestative drugs,
inefficacy related to generic substitution and medication error.
<br/>Result(s): The literature search identified mainly "case report"
about the impact of bariatric surgery on so-called "narrow therapeutic
window" drugs. We identified 66 informative cases out of a total of 565
cases selected (11%) in the PVDB. Nevertheless, the information does not
allow a clear relationship between the occurrence of the ADR and the
influence of bariatric surgery. <br/>Conclusion(s): There is a lack of
official information and/or recommendations on medication use in subjects
who have undergone bariatric surgery. Apart from under-reporting, ADRs
reports remain largely uninformative. Health professional and patients
would be awareness for improving, quantitatively and qualitatively the
reporting of ADRs in this population.<br/>Copyright &#xa9; 2024 Societe
francaise de pharmacologie et de therapeutique

<7>
Accession Number
2030905468
Title
Hemodynamic Monitoring In The Cardiac Surgical Patient: Comparison of
Three Arterial Catheters.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Bui D.; Hayward G.; Chen T.H.; Apruzzese P.; Asher S.; Maslow M.; Gorgone
M.; Hunter C.; Flaherty D.; Kendall M.; Maslow A.
Institution
(Bui, Hayward, Chen, Apruzzese, Asher, Gorgone, Hunter, Flaherty, Kendall,
Maslow) Departments of Anesthesiology, Rhode Island Hospital, Providence,
RI, United States
(Maslow) St. Lawrence University, Canton, NY, United States
Publisher
W.B. Saunders
Abstract
Objective: Systemic systolic (SAP) and mean (MAP) arterial pressure
monitoring is the cornerstone in hemodynamic management of the cardiac
surgical patient, and the radial artery is the most common site of
catheter placement. The present study compared 3 different arterial line
procedures. It is hypothesized that a 20-G 12.7- cm catheter inserted into
the radial artery will be equal to a 20-G 12.7- cm angiocath placed in the
brachial artery, and superior to a 20-G 5.00 cm angiocath placed in the
radial artery. <br/>Design(s): A prospective randomized control study was
performed. <br/>Setting(s): Single academic university hospital.
<br/>Participant(s): Adult patients >=18 years old undergoing nonemergent
cardiac surgery using cardiopulmonary bypass (CPB). <br/>Intervention(s):
After approval by the Rhode Island Hospital institutional review board, a
randomized prospective control study to evaluate 3 different peripheral
intraarterial catheter systems was performed: (1) Radial Short (RS): 20-G
5- cm catheter; (2) Radial Long (RL): 20-G 12- cm catheter; and (3)
Brachial Long (BL): 20-G 12- cm catheter. Measurements and Results:
Gradients between central aortic and peripheral catheters (CA-P) were
compared and analyzed before CPB and 2 and 10 minutes after separation
from CPB. The placement of femoral arterial lines and administration of
vasoactive medications were recorded. After exclusions, 67 BL, 61 RL, and
66 RS patients were compared. Before CPB, CA-P SAP and MAP gradients were
not significant among the 3 groups. Two minutes after CPB, the CA-P SAP
gradient was significant for the RS group (p = 0.005) and insignificant
for BL (p = 0.47) and RL (p = 0.39). Two-group analysis revealed that CA-P
SAP gradients are similar between BL and RL (p = 0.84), both of which were
superior to RS (p = 0.02 and p = 0.04, respectively). At 10 minutes after
CPB, the CA-P SAP gradient for RS remained significant (p = 0.004) and
similar to the gradient at 2 minutes. The CA-P SAP gradients increased
from 2 to 10 minutes for BL (p = 0.13) and RL (p = 0.06). Two minutes
after CPB, the CA-P MAP gradients were significant for the BL (p = 0.003),
RL (p < 0.0001), and RS (p < 0.0001) groups. Two-group analysis revealed
that the CA-P MAP gradients were lower for the BL group compared with the
RL (p = 0.054) and RS (p< 0.05) groups. Ten minutes after CPB, the CA-P
MAP gradients in the RL and RS groups remained significant (p < 0.0001)
and both greater than the BL group (p = 0.002). A femoral arterial line
was placed more frequently in the RS group (8/66 = 12.1%) than in the RL
group (3/61 = 4.9%) and the BL group (2/67 = 3.0%). Vasopressin was
administered significantly more frequently in the RS group.
<br/>Conclusion(s): Regarding CA-P SAP gradients, the RL group performed
equally to the BL group, both being superior to RS. Regarding CA-P MAP
gradients, BL was superior to RL and RS. Clinically, femoral line
placement and vasopressin administration were fewer for the BL and RL
groups when compared with the RS group. This study demonstrated the
benefits of a long (12.7 cm) 20- G angiocath placed in the radial
artery.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<8>
Accession Number
2030905324
Title
Prolonged Non-Steroidal Anti-Inflammatory Drug Exposure After Pleurodesis
Increases Pneumothorax Recurrence: A Retrospective Cohort Study.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Brookes J.D.L.; Cochrane A.D.; Smith J.A.
Institution
(Brookes, Cochrane, Smith) Department of Cardiothoracic Surgery, Monash
Health, Clayton, VIC, Australia
(Brookes, Cochrane, Smith) Department of Surgery, School of Clinical
Sciences at Monash Health, Monash University, Clayton, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Introduction: The use of non-steroidal anti-inflammatory drugs (NSAID) in
patients undergoing pleurodesis remains controversial. Although many
surgeons are comfortable prescribing NSAIDs post-operatively, some oppose
this practice due to concerns of suppressing the inflammatory response and
quality of pleurodesis. Only a small body of inconsistent publications
exists with respect to guiding therapy in this common clinical scenario.
<br/>Method(s): A retrospective cohort study was undertaken assessing
effect of NSAID exposure on pleurodesis outcomes. An institutional
thoracic surgery database was reviewed yielding 147 patients who underwent
pleurodesis for pneumothorax between 2010 and 2018. Medical records and
imaging were reviewed for patient characteristics, NSAID exposure,
recurrent pneumothorax and other adverse events. <br/>Result(s): There was
no overall difference between rates of recurrence and procedural failure
of pleurodesis (Relative Risk [RR] 1.67 [95% CI 0.74-3.77]). However,
NSAID exposure of >48 hours was associated with increased risk of
recurrent pneumothorax (RR 2.16 [95% CI 1.05-4.45]). There was no
increased rate of other adverse events related to NSAID usage.
<br/>Conclusion(s): NSAID exposure does not increase failure rates or
other adverse events following pleurodesis for pneumothorax. However,
prolonged NSAID exposure post-pleurodesis may increase procedural failure
rates. Further large volume randomised control trials are
required.<br/>Copyright &#xa9; 2024 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<9>
Accession Number
2028931541
Title
Sex differences in the outcomes after transcatheter aortic valve
replacement with newer generation devices: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2024.
Date of Publication: 2024.
Author
El Sherbini A.H.; Servito M.; Zidan A.; Elsherif S.; Ko G.; Elgendy I.Y.;
Ya'Qoub L.
Institution
(El Sherbini, Zidan, Ko) Department of Internal Medicine Faculty of Health
Sciences, Queen's University, Kingston, ON, Canada
(Servito) Division of Cardiac Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Elsherif) Department of Internal Medicine Faculty of Health Sciences,
McMaster University, Hamilton, ON, Canada
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Ya'Qoub) Division of Cardiovascular Medicine, University of California
San Francisco, San Francisco, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a reasonable
therapeutic approach among patients with symptomatic severe aortic
stenosis irrespective of surgical risk. Data regarding sex-specific
differences in the outcomes with newer generation valves are limited.
<br/>Method(s): Electronic databases were searched for studies assessing
sex differences in the outcomes of patients undergoing TAVR with newer
generation valves (SAPIEN 3 or Evolut). Random effects model was
constructed for summary estimates. <br/>Result(s): Four observational
studies with 4522 patients (44.8% women) were included in the
meta-analysis. Women were older and had a lower prevalence of coronary
artery disease and mean EuroScore. Women had a higher incidence of
short-term mortality (up to 30 days) (risk ratio [RR]: 1.60, 95%
confidence interval [CI]: 1.14-2.25), but no difference in 1-year
mortality (RR: 0.92, 95% CI: 0.72-1.17). There was no significant
difference in the incidence of major bleeding (RR: 1.16, 95% CI:
0.86-1.57), permanent pacemaker (PPM) (RR: 0.80, 95% CI: 0.62-1.04), or
disabling stroke (RR: 1.16, 95% CI: 0.54-2.45). <br/>Conclusion(s): In
this meta-analysis, we found that women undergoing TAVR with
newer-generation devices were older but had a lower prevalence of
comorbidities. Women had a higher incidence of short-term mortality but no
difference in the 1-year mortality, bleeding, PPM, or stroke compared with
men. Future studies are required to confirm these findings.<br/>Copyright
&#xa9; 2024 Wiley Periodicals LLC.

<10>
Accession Number
2028927564
Title
The Ross-Konno Procedure With or Without Mitral Valve Surgery: A
Systematic Review With Individual Data Pooling.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2024. Date of Publication: 2024.
Author
Dib N.; Ducruet T.; Poirier N.; Khairy P.
Institution
(Dib, Khairy) Department of Medicine, Montreal Heart Institute, Universite
de Montreal, Montreal, QC, Canada
(Dib, Poirier) Division of Cardiac Surgery, Department of Surgery,
Sainte-Justine Hospital, Universite de Montreal, Montreal, QC, Canada
(Ducruet) Unite de Recherche Clinique Appliquee, Sainte-Justine Hospital,
Universite de Montreal, Montreal, QC, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: The Ross-Konno procedure is a technically demanding surgical
option to treat multilevel left ventricular outflow tract obstruction.
<br/>Method(s): A systematic review with pooled analyses was conducted
according to PRISMA criteria on studies published between January 2000 and
May 2022 that assessed outcomes following the Ross-Konno intervention in
children. Individual patient data were extracted from published
Kaplan-Meier curves using digitalization software. Overall survival and
freedom from reintervention were assessed by time-to-event approaches.
Determinants of one-year survival were investigated by meta-regression
analyses. <br/>Result(s): Ten studies with a total population of 274
patients were included. The overall pooled early (<=30 days) survival rate
was 86.9% (95% CI [87.6%-78.4%]). Five-year survival rates in patients
without and with (N = 50 [18.2%] of 274 total patients) concomitant mitral
valve surgery were 82.5% (95% CI [87.6%-77.4%]) versus 56.1% (95% CI
[74.1%-38.1%]), hazard ratio 2.67, 95% CI (1.44-4.93), P <.0001. Five- and
ten-year freedom from pulmonary autograft reoperation rates were 93.5% and
90.9%, respectively. Five- and ten-year freedom from right ventricular
outflow tract reoperation rates were 74.3% and 57.3%, respectively. By
meta-regression analysis, resection of endocardial fibroelastosis (N = 32
[11.7%] of 274 total patients) was associated with superior one-year
survival (P =.027). <br/>Conclusion(s): The Ross-Konno procedure is
associated with substantial early mortality and gradual attrition
thereafter. Mortality is higher in patients with concomitant mitral valve
surgery. Resection of endocardial fibroelastosis is associated with
superior survival. Right ventricular outflow tract reinterventions are
common.<br/>Copyright &#xa9; The Author(s) 2024.

<11>
Accession Number
2025680574
Title
Randomized Comparison of the Outcome of Single Versus Multiple Arterial
Grafts trial (ROMA):Women-a trial dedicated to women to improve coronary
bypass outcomes.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(4) (pp 1316-1321),
2024. Date of Publication: April 2024.
Author
Gaudino M.; Bairey Merz C.N.; Sandner S.; Creber R.M.; Ballman K.V.;
O'Brien S.M.; Harik L.; Perezgrovas-Olaria R.; Mehran R.; Safford M.M.;
Fremes S.E.
Institution
(Gaudino, Harik, Perezgrovas-Olaria) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Bairey Merz) Barbra Streisand Women's Heart Center, Cedars-Sinai Medical
Center, Smidt Heart Institute, Los Angeles, Calif, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Creber) Columbia University School of Nursing, New York, NY, United
States
(Ballman) Alliance Statistics and Data Center, Weill Medical College of
Cornell University, New York, NY, United States
(O'Brien) Duke Clinical Research Institute, Durham, NC, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Safford) Department of Medicine, Weill Cornell Medicine, New York, NY,
United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Canada
Publisher
Elsevier Inc.

<12>
Accession Number
2020319841
Title
Complete transcatheter versus surgical approach to aortic stenosis with
coronary artery disease: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(4) (pp 1305-1313.e9),
2024. Date of Publication: April 2024.
Author
Sakurai Y.; Yokoyama Y.; Fukuhara S.; Takagi H.; Kuno T.
Institution
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, WVa, United States
(Yokoyama) Department of Surgery, St Luke's University Health Network, Pa,
United States
(Fukuhara) Department of Cardiothoracic Surgery, University of Michigan,
Ann Arbor, Mich, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: This meta-analysis aimed to evaluate outcomes of transcatheter
aortic valve replacement (TAVR) with percutaneous coronary intervention
(PCI) versus surgical aortic valve replacement (SAVR) with coronary artery
bypass grafting (CABG). <br/>Method(s): The MEDLINE, EMBASE, and Cochrane
Library databases were searched through November 2021 to identify studies
comparing TAVR + PCI and SAVR + CABG for severe aortic stenosis with
concurrent coronary artery disease. Outcomes of interest were all-cause
mortality, repeat coronary intervention, rehospitalization, myocardial
infarction, and stroke during follow-up, and 30-day periprocedural
outcomes. <br/>Result(s): Two randomized controlled trials and 6
observational studies including a total of 104,220 patients (TAVR + PCI, n
= 5004; SAVR + CABG, n = 99,216) were included. The weighted mean
follow-up period was 30.2 months. TAVR + PCI was associated with greater
all-cause mortality and coronary reintervention during follow-up period
(hazard ratio, 1.35; 95% confidence interval [CI], 1.11-1.65; P = .003,
hazard ratio, 4.14; 95% CI, 1.74-9.86; P = .001, respectively), 30-day
permanent pacemaker implantation rate (odds ratio [OR], 3.79; 95% CI,
1.61-8.95; P = .002), and periprocedural vascular complications (OR, 6.97;
95% CI, 1.85-26.30; P = .004). In contrast, TAVR + PCI was associated with
a lower rate of 30-day acute kidney injury (OR, 0.32; 95% CI, 0.20-0.50; P
= .0001). Rehospitalization, myocardial infarction, stroke during
follow-up, and other periprocedural outcomes including 30-day mortality
were similar in both groups. <br/>Conclusion(s): In patients with severe
aortic stenosis and coronary artery disease, TAVR + PCI was associated
with greater all-cause mortality at follow-up compared with SAVR + CABG.
Heart Team approach to assess TAVR candidacy remains
imperative.<br/>Copyright &#xa9; 2022 The American Association for
Thoracic Surgery

<13>
Accession Number
641520741
Title
The Effect of Combination Prayer Therapy and Education on Pre-operative
Coronary Artery Bypass Graft Anxiety.
Source
Journal of holistic nursing : official journal of the American Holistic
Nurses' Association. 42(1) (pp 15-23), 2024. Date of Publication: 01 Mar
2024.
Author
Awaludin S.; Nurachmah E.; Novitasari D.
Institution
(Awaludin) School of Nursing, Faculty of Health Sciences, Jenderal
Soedirman University, Purwokerto, Indonesia
(Nurachmah) Faculty of Nursing, University of Indonesia, Jakarta,
Indonesia
(Novitasari) Faculty of Health, Harapan Bangsa University, Purwokerto,
Indonesia
Abstract
Background: Anxiety is a problem that most often occurs in the
pre-operative coronary artery bypass graft surgery stage. The combination
of prayer therapy with education is expected to be able to overcome
anxiety. The combination of prayer and education therapy have been
researched as a potential holistic intervention for reducing anxiety in
coronary artery bypass graft surgery. <br/>Purpose(s): This study compares
the effect of combination therapy with the golden standard of therapy in
hospitals. <br/>Method(s): A true-experimental design was used. Fifty
participants were randomly assigned to two groups. Data were collected
using a State-Trait Anxiety Inventory questionnaire from Spielberger.
<br/>Finding(s): Most respondents were elderly, male, high school
graduates in the treatment group, and bachelor graduates in the control
group. Prayer therapy and education have an effect of 63.8% on reducing
anxiety. An increase of 1 constant in the provision of prayer therapy and
education can reduce anxiety by 0.772. <br/>Conclusion(s): The combination
of prayer therapy and education becomes the holistic nursing modality that
can reduce anxiety in pre-operative coronary artery bypass graft patients.

<14>
Accession Number
630724427
Title
Percutaneous mitral commissurotomy versus surgical commissurotomy for
rheumatic mitral stenosis: a systematic review and meta-analysis of
randomised controlled trials.
Source
Heart. 106(14) (pp 1094-1101), 2020. Date of Publication: 23 Jan 2020.
Author
Singh A.D.; Mian A.; Devasenapathy N.; Guyatt G.; Karthikeyan G.
Institution
(Singh) Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Mian) Oncology, Cleveland Clinic Foundation, Cleveland, OH, United States
(Devasenapathy) Indian Institute of Public Health, Delhi, Gurgaon, India
(Guyatt) Clinical Epidemiology and Biostatistics, McMaster University,
Hamilton, ON, Canada
(Karthikeyan) All India Institute of Medical Sciences, New Delhi, India
Publisher
BMJ Publishing Group
Abstract
Aim Patients with severe mitral stenosis (MS) and their clinicians
typically choose percutaneous transvenous mitral commissurotomy (PTMC)
over surgical commissurotomy (SC). However, the durability of PTMC
relative to SC is uncertain. We compared the efficacy, safety and
durability of PTMC with SC for the treatment of MS. Methods We searched
EMBASE, MEDLINE and WHO ICTRP registers for randomised controlled trials
(RCTs) comparing PTMC, and open and/or closed mitral commissurotomy. The
principal outcomes were rate of re-intervention and symptomatic
improvement as inferred from the surrogate measures of immediate
postprocedural mitral valve area (MVA), MVA at >=6month follow-up,
incidence of mitral regurgitation (MR) and restenosis. We calculated
weighted mean differences (WMD) for continuous outcomes, relative risks
(RR) for binary outcomes and pooled outcomes using random-effects models
and assessed the quality of evidence using the Grading of Recommendations,
Assessment, Development and Evaluation (GRADE) approach. Results Seven
RCTs with 553 patients proved eligible. Pooled estimates showed no
convincing difference in the risk of restenosis or re-intervention (15/100
fewer with PTMC, 95%CI (-20 to +8); quality of evidence: moderate) or in
symptoms as inferred from immediate MVA (WMD 0.15, 95%CI (-0.18 to 0.48):
very low), from the incidence of postprocedural severe MR (3/100 more with
PTMC, 95%CI (-1 to +10): moderate) or from MVA at 30 months. Conclusion
Until data demonstrating convincing superiority of SC over PTMC become
available, our results support the current practice of recommending PTMC
to young patients with MS and favourable valve morphology, as it is
associated with lower peri-procedural morbidity. <br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2019. No commercial re-use. See rights
and permissions. Published by BMJ.

<15>
Accession Number
643704238
Title
In-hospital initiation of a PCSK9 inhibitor in patients with acute
coronary syndrome: A systematic review and meta-analysis of randomized
controlled trials.
Source
Medicine. 103(10) (pp e37416), 2024. Date of Publication: 08 Mar 2024.
Author
Shi W.; Xu Y.; Zhou L.; Wang W.; Huang W.; Zhou B.
Institution
(Shi, Xu, Zhou) Department of Cardiology, Sixth People's Hospital of
Chengdu, Chengdu 610000, China
(Wang) Department of Cardiac Ultrasound, Peking Union Medical College
Hospital, Beijing 100005, China
(Huang, Zhou) Department of Cardiology, First Affiliated Hospital of
Chongqing Medical University, Chongqing 400016, China
Abstract
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9)
inhibitors have been shown to be effective and safe in patients with
stable angina and previous myocardial infarction. However, evidence for
initiating their use in patients hospitalized with acute coronary syndrome
(ACS) is limited. This systematic review and meta-analysis was performed
to provide more clinical evidence. <br/>METHOD(S): PubMed, Embase, OVID,
Cochrane Library and ClinicalTrials.gov were systematically searched for
eligible randomized controlled trials up to March 20, 2023. The risk
ratios, standardized mean differences and 95% confidence intervals were
calculated for primary and secondary outcomes. The bias risk of the
included studies was assessed using the Cochrane RoB 2 criteria.
<br/>RESULT(S): About 8 randomized controlled trials involving 1255
inpatients with ACS were included. PCSK9 inhibitor treatment significantly
reduced low-density lipoprotein cholesterol (LDL-C) (SMD -1.28, 95% CI
-1.76 to -0.8, P = .001), triglycerides (TG) (SMD -0.93, 95% CI -1.82 to
-0.05, P = .03), total cholesterol (SMD -1.36, 95% CI -2.01 to -0.71, P =
.001), and apolipoprotein B (Apo B) (SMD -0.81, 95% CI -1.09 to -0.52, P =
.001) within approximately 1 month. PCSK9 inhibitor treatment
significantly reduced the total atheroma volume (TAV) (SMD -0.33, 95% CI
-0.59 to -0.07, P = .012). It also significantly increased minimum fibrous
cap thickness (FCT) (SMD 0.41, 95% CI 0.22-0.59, P = .001) in long-term
follow-up (>6 months). PCSK9 inhibitor treatment significantly reduced the
risk of readmission for unstable angina (RR 0.32, 95% CI 0.12-0.91, P =
.032) in short-term follow-up (<6 months). There were no significant
differences in all-cause mortality, cardiovascular death, myocardial
infarction, ischemic stroke, coronary revascularization or heart failure.
Only nasopharyngitis (RR 1.71, 95% CI 1.01-2.91, P = .047) adverse events
were significantly observed in the PCSK9 inhibitor group.
<br/>CONCLUSION(S): Application of a PCSK9 inhibitor in hospitalized
patients with ACS reduced lipid profiles and plaque burdens and was well
tolerated with few adverse events.<br/>Copyright &#xa9; 2024 the
Author(s). Published by Wolters Kluwer Health, Inc.

<16>
[Use Link to view the full text]
Accession Number
2030264351
Title
One-Year Outcomes After Amulet or Watchman Device for Percutaneous Left
Atrial Appendage Closure: A Prespecified Analysis of the SWISS-APERO
Randomized Clinical Trial.
Source
Circulation. 149(6) (pp 484-486), 2024. Date of Publication: 06 Feb 2024.
Author
Galea R.; Meneveau N.; De Marco F.; Aminian A.; Heg D.; Chalkou K.; Grani
C.; Anselme F.; Franzone A.; Vranckx P.; Fischer U.; Bedogni F.; Raber L.;
Valgimigli M.
Institution
(Galea, Grani, Raber, Valgimigli) Department of Cardiology, Bern
University Hospital, Department of Clinical Research, Switzerland
(Heg, Chalkou, Fischer) Department of Neurology, Bern University Hospital,
Department of Clinical Research, Switzerland
(Meneveau) CTU Bern, University of Bern, Switzerland, Besancon University
Hospital, University of Burgundy Franche-Comte, Besancon, France
(De Marco) Department of Cardiology, Monzino Cardiology Center, Milan,
Italy
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Belgium
(Anselme) Department of Cardiology, University Hospital of Rouen, France
(Franzone) Department of Advanced Biomedical Sciences, University Federico
II University, Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Belgium
(Bedogni) Department of Cardiology, IRCCS Policlinico San Donato, San
Donato Milanese, Milan, Italy
(Valgimigli) Cardiocentro Ticino Institute, Universita della Svizzera
Italiana (USI), Lugano, Switzerland
Publisher
Lippincott Williams and Wilkins

<17>
Accession Number
2028939574
Title
Nonintubated spontaneous ventilation versus intubated mechanical
ventilation anesthesia for video-assisted thoracic surgery in terms of
perioperative complications and practitioners' workload assessments: a
pilot randomized control study.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 99. Date
of Publication: December 2024.
Author
Kong X.-G.; Wang K.; Wei Y.-T.; Sun B.; Gao G.-D.; Song C.-W.; Li C.-W.
Institution
(Kong, Wang, Song) Department of Anesthesiology, Jining No. 1 People's
Hospital, No. 6 Jiankang Road, Rencheng District, Jining 272011, China
(Wei, Sun, Gao) Department of Thoracic Surgery, Jining No. 1 People's
Hospital, No. 6 Jiankang Road, Rencheng District, Jining 272011, China
(Li) Department of Anesthesiology, Beijing Friendship Hospital, Capital
Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050,
China
Publisher
BioMed Central Ltd
Abstract
Background: The use of nonintubated video-assisted thoracoscopic surgery
(NI-VATS) has been increasingly reported to yield favourable outcomes.
However, this technology has not been routinely used because its
advantages and safety have not been fully confirmed. The aim of this study
was to assess the safety and feasibility of nonintubated spontaneous
ventilation (NI-SV) anesthesia compared to intubated mechanical
ventilation (I-MV) anesthesia in VATS by evaluating of perioperative
complications and practitioners' workloads. <br/>Method(s): Patients who
underwent uniportal VATS were randomly assigned at a 1:1 ratio to receive
NI-SV or I-MV anesthesia. The primary outcome was the occurrence of
intraoperative airway intervention events, including transient MV,
conversion to intubation and repositioning of the double-lumen tube. The
secondary outcomes included perioperative complications and modified
National Aeronautics and Space Administration Task Load Index (NASA-TLX)
scores from anesthesiologists and surgeons. <br/>Result(s): Thirty-five
patients in each group were enrolled in the intention-to-treat analysis.
The incidence of intraoperative airway intervention events was greater in
the NI-SV group than in the I-MV group (12 [34.3%] vs. 3 [8.6%]; OR =
0.180; 95% CI = 0.045-0.710; p = 0.009). No significant difference was
found in the postoperative pulmonary complications between the groups (p >
0.05). The median of the anesthesiologists' overall NASA-TLX score was
37.5 (29-52) when administering the NI-SV, which was greater than the 25
(19-34.5) when the I-MV was administered (p < 0.001). The surgeons'
overall NASA-TLX score was comparable between the two ventilation
strategies (28 [21-38.5] vs. 27 [20.5-38.5], p = 0.814).
<br/>Conclusion(s): The NI-SV anesthesia was feasible for VATS in the
selected patients, with a greater incidence of intraoperative airway
intervention events than I-MV anesthesia, and with more surgical effort
required by anesthesiologists. Trial registration: Chinese Clinical Trial
Registry, ChiCTR2200055427.
https://www.chictr.org.cn/showproj.html?proj=147872 was registered on
January 09, 2022.<br/>Copyright &#xa9; The Author(s) 2024.

<18>
Accession Number
2030943378
Title
Estimated prevalence of frailty and prefrailty in patients undergoing
coronary artery or valvular surgeries/procedures: A systematic review and
proportional meta-analysis.
Source
Ageing Research Reviews. 96 (no pagination), 2024. Article Number: 102266.
Date of Publication: April 2024.
Author
Wong C.W.Y.; Li P.W.C.; Yu D.S.F.; Ho B.M.H.; Chan B.S.
Institution
(Wong, Li, Yu, Ho, Chan) School of Nursing, Li Ka Shing Faculty of
Medicine, The University of Hong Kong, Hong Kong
Publisher
Elsevier Ireland Ltd
Abstract
Background: The aging population has led to an increasing number of older
patients undergoing cardiac surgeries/procedures. Frailty and prefrailty
have emerged as important prognostic indicators among these patients. This
proportional meta-analysis estimated the prevalence of frailty and
prefrailty among patients undergoing cardiac surgery. <br/>Method(s): We
searched seven electronic databases for observational studies that used
validated measure(s) of frailty and reported prevalence data on frailty
and/or prefrailty in older patients undergoing coronary artery or valvular
surgeries or transcatheter procedures. Meta-analyses were performed using
a random-effects model. <br/>Result(s): One hundred and one articles
involving 626,863 patients were included. The pooled prevalence rates of
frailty and prefrailty were 28% (95% confidence interval [CI]: 23%-33%)
and 40% (95% CI: 31%-50%), respectively, for patients scheduled for
open-heart surgeries and 40% (95% CI: 36%-45%) and 43% (95% CI: 34%-53%),
respectively, for patients undergoing transcatheter procedures. Frailty
measured using a multidimensional approach identified a higher proportion
of frail patients when compared with measures solely focused on physical
frailty. Older age, female sex, and lower body mass index and hemoglobin
concentrations were significantly associated with higher frailty
prevalence. Moreover, countries with higher gross domestic product spent
on healthcare exhibited a higher frailty prevalence. <br/>Conclusion(s):
Frailty represents a considerable health challenge among patients
undergoing cardiac surgeries/procedures. Routine screening for frailty
should be considered during perioperative care planning.<br/>Copyright
&#xa9; 2024 Elsevier B.V.

<19>
Accession Number
2030939830
Title
Complete Coronary Revascularization and Outcomes in Patients Who Underwent
Coronary Artery Bypass Grafting: Insights from The REGROUP Trial.
Source
American Journal of Cardiology. 217 (pp 127-135), 2024. Date of
Publication: 15 Apr 2024.
Author
Belyayev L.; Stock E.M.; Hattler B.; Bakaeen F.G.; Kinlay S.; Quin J.A.;
Haime M.; Biswas K.; Zenati M.A.
Institution
(Belyayev, Zenati) Division of Thoracic and Cardiac Surgery, Brigham and
Women's Hospital, Boston, Massachusetts, United States
(Stock, Biswas) Cooperative Studies Program Coordinating Center, Office of
Research and Development, US Department of Veterans Affairs, Perry Point,
Maryland, United States
(Hattler) Division of Cardiology, Eastern Colorado Veterans Affairs
Healthcare System and University of Colorado, Aurora, Colorado, United
States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United States
(Kinlay) Divisions of Cardiology, Veterans Affairs Boston Healthcare
System, and Harvard Medical School, Boston, Massachusetts, United States
(Quin, Haime, Zenati) Cardiac Surgery, Veterans Affairs Boston Healthcare
System, and Harvard Medical School, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
There is growing evidence in support of coronary complete
revascularization (CR). Nonetheless, there is no universally accepted
definition of CR in patients who undergo coronary bypass grafting surgery
(CABG). We sought to investigate the outcomes of CR, defined as surgical
revascularization of any territory supplied by a suitable coronary artery
with >=50% stenosis. We performed a preplanned subanalysis in the
Randomized Trial of Endoscopic or Open Saphenous Vein Graft Harvesting
(REGROUP) clinical trial cohort. Of 1,147 patients who underwent CABG, 810
(70.6%) received CR. The primary outcome was a composite of major adverse
cardiac events (MACEs), including death from any cause, nonfatal
myocardial infarction, or repeat revascularization over a median 4.7 years
of follow-up. MACE occurred in 175 patients (21.6%) in the CR group and 86
patients (25.5%) in the incomplete revascularization (IR) group (hazard
ratio [HR] 0.87, 95% confidence interval [CI] 0.67 to 1.13, p = 0.29). A
total of 97 patients (12.0%) in the CR group and 48 patients (14.2%) in
the IR group died (HR 0.93, 95% CI 0.65 to 1.32, p = 0.67); nonfatal
myocardial infarction occurred in 49 patients (6.0%) in the CR group and
30 patients (8.9%) in the IR group (HR 0.76, 95% CI 0.48 to 1.2, p =
0.24), and repeat revascularization occurred in 62 patients (7.7%) in the
CR group and 39 patients (11.6%) in the IR group (HR 0.64; 95% CI 0.42 to
0.95, p = 0.027). In conclusion, in patients with a great burden of
co-morbidities who underwent CABG in the REGROUP trial over a median
follow-up period of a median 4.7 years, CR was associated with similar
MACE rates but a reduced risk of repeat revascularization. Longer-term
follow-up is warranted.<br/>Copyright &#xa9; 2024

<20>
Accession Number
2030930176
Title
CPAP may promote an endothelial inflammatory milieu in sleep apnoea after
coronary revascularization.
Source
eBioMedicine. 101 (no pagination), 2024. Article Number: 105015. Date of
Publication: March 2024.
Author
Peker Y.; Celik Y.; Behboudi A.; Redline S.; Lyu J.; Wei Y.; Gottlieb
D.J.; Jelic S.
Institution
(Peker, Celik) Koc University School of Medicine, Istanbul, Turkey
(Peker) University of Gothenburg, Gothenburg, Sweden
(Peker, Redline, Gottlieb) Brigham & Women's Hospital, Boston, MA, United
States
(Peker) University of Pittsburgh School of Medicine, Pittsburgh, PA,
United States
(Peker) Lund University, Lund, Sweden
(Celik, Lyu, Wei, Jelic) Columbia University Vagelos College of Physicians
and Surgeons, New York, NY, United States
(Behboudi) University of Skovde, Skovde, Sweden
(Gottlieb) VA Boston Healthcare System, Boston, MA, United States
Publisher
Elsevier B.V.
Abstract
Background: Continuous positive airway pressure (CPAP) has failed to
reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized
trials. CPAP increases angiopoietin-2, a lung distension-responsive
endothelial proinflammatory marker associated with increased
cardiovascular risk. We investigated whether CPAP has unanticipated
proinflammatory effects in patients with OSA and cardiovascular disease.
<br/>Method(s): Patients with OSA (apnoea-hypopnea index [AHI] >=15
events/h without excessive sleepiness) in the Randomized Intervention with
CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or
usual care following coronary revascularization. Changes in plasma levels
of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular
endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor
of advanced glycation end-products [sRAGE]) function from baseline to
12-month follow-up were compared across groups and associations with
cardiovascular morbidity and mortality assessed. <br/>Finding(s): Patients
with OSA (n = 189; 84% men; age 66 +/- 8 years, BMI 28 +/- 3.5
kg/m², AHI 41 +/- 23 events/h) and 91 patients without OSA
participated. Angiopoietin-2 remained elevated whereas VEGF-A declined
significantly over 12 months in the CPAP group (n = 91). In contrast,
angiopoietin-2 significantly declined whereas VEGF-A remained elevated in
the usual care (n = 98) and OSA-free groups. The changes in angiopoietin-2
and VEGF-A were significantly different between CPAP and usual care,
whereas Tie-2, sRAGE and E-selectin were similar. Greater 12-month levels
of angiopoietin-2 were associated with greater mortality. Greater CPAP
levels were associated with worse cardiovascular outcomes.
<br/>Interpretation(s): Greater CPAP levels increase proinflammatory, lung
distension-responsive angiopoietin-2 and reduce cardioprotective
angiogenic factor VEGF-A compared to usual care, which may counteract the
expected cardiovascular benefits of treating OSA. <br/>Funding(s):
National Institutes of Health/ National Heart, Lung, and Blood Institute;
Swedish Research Council; Swedish Heart-Lung Foundation; ResMed
Foundation.<br/>Copyright &#xa9; 2024 The Author(s)

<21>
[Use Link to view the full text]
Accession Number
2030916435
Title
Efficacy and Safety of Colchicine for the Prevention of Postoperative
Atrial Fibrillation Among Patients Undergoing Major Cardiothoracic
Surgery: A Meta-analysis and Meta-regression of Randomized Controlled
Trials.
Source
Journal of Cardiovascular Pharmacology. 83(3) (pp 265-270), 2024. Date of
Publication: 04 Mar 2024.
Author
Rivera F.B.; Cha S.W.; Aparece J.P.; Jariyatamkitti S.; Mamas M.A.
Institution
(Rivera) The Lincoln Medical Center, New York, NY, United States
(Cha) The Cebu Institute of Medicine, Cebu, Cebu City, Philippines
(Aparece) The Texas Tech University Health Sciences Center, El Paso, TX,
United States
(Jariyatamkitti) The Makarak Hospital, Kanchanaburi, Thailand
(Mamas) The Keele Cardiovascular Research Group, Center for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
The role of colchicine for the prevention of postoperative atrial
fibrillation (POAF) after cardiothoracic surgery is not well-established.
We aimed to evaluate its potential in preventing POAF using data from
randomized controlled trials (RCTs). A literature search was performed to
identify studies reporting POAF as an outcome after cardiac or thoracic
surgery in adult patients randomized to either colchicine or placebo.
Primary outcome measured was incidence of POAF. Secondary outcomes
included gastrointestinal (GI) adverse effects, sepsis, and length of
stay. Subgroup analyses based on treatment durations and type of surgery
were also performed, as well as regression analyses to control for
covariates. We identified a total of 5377 patients (colchicine = 2,689,
placebo = 2688). Although colchicine use was associated with a
significantly reduced risk of POAF, risk of GI adverse effects were
significantly higher. The rates of infection and length of stay were
similar across the groups. Subgroup analyses showed that colchicine was
effective for POAF prevention in cardiac surgery, but not in thoracic
surgery. Prevention of POAF and incidence of GI adverse effects were
similar in short-term and long-term colchicine treatment. Colchicine
significantly reduces the incidence of POAF in patients undergoing cardiac
surgery, but not in thoracic surgery.<br/>Copyright &#xa9; 2024 Wolters
Kluwer Health, Inc. All rights reserved.

<22>
Accession Number
2030911450
Title
Comparison of lactated Ringer's solution and Plasma-Lyte A as a base
solution for del Nido cardioplegia: a prospective randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 65(3) (no pagination), 2024.
Article Number: ezae018. Date of Publication: 01 Mar 2024.
Author
Kantathut N.; Krathong P.; Khajarern S.; Leelayana P.; Cherntanomwong P.
Institution
(Kantathut, Krathong, Khajarern, Leelayana, Cherntanomwong) Division of
Thoracic and Cardiovascular Surgery, Department of Surgery, Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The use of del Nido cardioplegia has been increasing in
popularity for adult cardiac surgery. However, the base solution,
Plasma-Lyte A, is not always available in many countries. This prospective
randomized controlled trial evaluated myocardial preservation and clinical
outcomes when using lactated Ringer's solution (LRS) compared to
Plasma-Lyte A as a base solution for del Nido cardioplegia.
<br/>METHOD(S): Adult patients undergoing first-time elective cardiac
surgery for acquired heart disease, including isolated coronary artery
bypass grafting, isolated valve surgery, combined valve surgery or
concomitant coronary artery bypass grafting and valve surgery were
randomized to receive either LRS (n = 100) or Plasma-Lyte A (n = 100).
<br/>RESULT(S): There were no significant differences between the 2 groups
in terms of age, comorbidities, Society of Thoracic Surgeons risk score
and type of procedures. The primary outcome, postoperative troponin-T at
24 h, was similar in both groups (0.482 vs 0.524 ng/ml; P = 0.464). Other
cardiac markers were also similar at all time points. The LRS group had a
lower pH (7.228 vs 7.246; P = 0.005) and higher calcium levels (0.908 vs
0.358 mmol/l; P < 0.001) in the delivered cardioplegia, but there were no
significant differences in clinical outcomes, such as ventricular
fibrillation, left ventricular ejection fraction, inotrope/vasopressor
requirement, intra-aortic balloon pump support, intensive care unit stay,
hospital stay, atrial fibrillation, red cell transfusion and
complications. <br/>CONCLUSION(S): The results suggest that LRS can be
used as an alternative to Plasma-Lyte A as the base solution for del Nido
cardioplegia, with similar myocardial preservation and clinical
outcomes.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<23>
Accession Number
2027982311
Title
Perioperative adverse cardiac events and mortality after non-cardiac
surgery: a multicenter study.
Source
Korean Journal of Anesthesiology. 77(1) (pp 66-76), 2024. Date of
Publication: Feb 2024.
Author
Choi B.; Oh A.R.; Park J.; Lee J.-H.; Yang K.; Lee D.Y.; Rhee S.Y.; Kang
S.-S.; Lee S.D.; Lee S.H.; Jeong C.W.; Park B.; Seol S.; Park R.W.; Lee S.
Institution
(Choi, Park, Yang, Lee, Park, Seol, Park) Department of Biomedical
Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
(Oh, Park, Lee) Department of Anesthesiology and Pain Medicine, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Oh) Department of Anesthesiology and Pain Medicine, Kangwon National
University Hospital, Chuncheon, South Korea
(Yang) Center for Health Promotion, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Rhee) Department of Endocrinology and Metabolism, Kyung Hee University
School of Medicine, Seoul, South Korea
(Kang) Department of Anesthesiology and Pain Medicine, Kangdong Sacred
Heart Hospital, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Gyeongsang
National University Hospital, Jinju, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Pusan
National University Hospital, Busan, South Korea
(Jeong) Central Research Center of Biomedical Research Institute, Wonkwang
University Hospital, Iksan, South Korea
(Park) Office of Biostatistics, Medical Research Collaborating Center,
Ajou Research Institute for Innovative Medicine, Ajou University Medical
Center, Suwon, South Korea
(Lee) Department of Cardiology, Wiltse Memorial Hospital, Suwon, South
Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Perioperative adverse cardiac events (PACE), a composite of
myocardial in-farction, coronary revascularization, congestive heart
failure, arrhythmic attack, acute pulmonary embolism, cardiac arrest, and
stroke during 30-day postoperative period, is associated with long-term
mortality, but with limited clinical evidence. We compared long-term
mortality with PACE using data from nationwide multicenter electronic
health re-cords. <br/>Method(s): Data from 7 hospitals, converted to
Observational Medical Outcomes Partner-ship Common Data Model, were used.
We extracted records of 277,787 adult patients over 18 years old
undergoing non-cardiac surgery for the first time at the hospital and had
medical records for more than 180 days before surgery. We performed
propensity score matching and then an aggregated meta-analysis.
<br/>Result(s): After 1:4 propensity score matching, 7,970 patients with
PACE and 28,807 patients without PACE were matched. The meta-analysis
showed that PACE was associated with higher one-year mortality risk
(hazard ratio [HR]: 1.33, 95% CI [1.10, 1.60], P = 0.005) and higher
three-year mortality (HR: 1.18, 95% CI [1.01, 1.38], P = 0.038). In
sub-group analysis, the risk of one-year mortality by PACE became greater
with higher-risk surgical procedures (HR: 1.20, 95% CI [1.04, 1.39], P =
0.020 for low-risk surgery; HR: 1.69, 95% CI [1.45, 1.96], P < 0.001 for
intermediate-risk; and HR: 2.38, 95% CI [1.47, 3.86], P = 0.034 for
high-risk). <br/>Conclusion(s): A nationwide multicenter study showed that
PACE was significantly associated with increased one-year mortality. This
association was stronger the older age group, emergency surgery group, and
high surgical risk group. Further studies to improve mortality associated
with PACE are needed.<br/>Copyright &#xa9; The Korean Society of
Anesthesiologists, 2024.

<24>
Accession Number
2030368897
Title
Left atrial appendage occlusion for patients with valvular diseases
without atrial fibrillation (the OPINION Study): study protocol for a
multicentre, randomised controlled trial.
Source
BMJ Open. 14(2) (no pagination), 2024. Article Number: e076688. Date of
Publication: 07 Feb 2024.
Author
Ju F.; Yuan X.; Sun H.
Institution
(Ju, Yuan, Sun) Department of Cardiac Surgery, Chinese Academy of Medical
Sciences, Peking Union Medical College Fuwai Hospital, Xicheng District,
Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Atrial fibrillation (AF) is a significant cause of
perioperative stroke in aortic and mitral valve surgeries. Although
several large studies have evaluated surgical left atrial appendage
occlusion (SLAAO) during cardiac surgeries, their retrospective nature and
an uncontrolled broad spectrum of conditions leave them subject to
potential residual confounding. This trial aims to test the hypothesis
that opportunistic SLAAO can prevent long-term stroke after cardiac
surgery in patients receiving mitral or aortic valve surgeries without a
history of AF and with a CHA2DS2-VASc score of 2 or higher. Methods and
design This study is a single-blinded, multicentre, randomised controlled
trial. A total of 2118 patients planning to undergo aortic or mitral
surgery without AF will be recruited and equally randomised into
intervention or control arms at a 1:1 ratio. In the intervention arm,
suture excision of the left atrial appendage (LAA) will be performed
during the operation in addition to the original surgery plan. In the
control arm, the operation will be performed according to the surgery plan
without any intervention on the LAA. The primary outcome is a composite of
newly occurred ischaemic stroke or transient ischaemic attack and
cardiovascular mortality during a 1-year follow-up. Secondary outcomes
include postoperative AF, cardiovascular mortality, newly occurred
ischaemic stroke, newly occurred transient ischaemic attack, newly
occurred haemorrhagic stroke, bleeding events, and AF-associated health
utilisation. Ethics and dissemination The Ethics Committee in Fuwai
Hospital approved this study. Patients will give informed consent to the
study. An information leaflet will be provided to participating patients
to introduce the SLAAO procedure. Patients and the public will not get
involved in developing the research hypothesis, study design or any other
part of this protocol. We plan to publish several papers in peer-reviewed
journals about the current research and these will include a description
of the study's development and the main findings of the study. Trial
registration number ChiCTR2100042238.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2024.

<25>
Accession Number
2028519612
Title
Differences in the Incidence of Hypotension and Hypertension between Sexes
during Non-Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(3) (no pagination), 2024. Article Number:
666. Date of Publication: February 2024.
Author
Bos E.M.E.; Tol J.T.M.; de Boer F.C.; Schenk J.; Hermanns H.; Eberl S.;
Veelo D.P.
Institution
(Bos, Tol, de Boer, Schenk, Hermanns, Eberl, Veelo) Department of
Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9,
Amsterdam 1105 AZ, Netherlands
(Schenk) Department of Intensive Care, Amsterdam UMC, University of
Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
(Schenk) Department of Epidemiology and Data Science, Amsterdam UMC,
University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Major determinants of blood pressure (BP) include sex and age.
In youth, females have lower BP than males, yet in advanced age, more
pronounced BP increases result in higher average BPs in females over 65.
This hypothesis-generating study explored whether age-related BP
divergence impacts the incidence of sex-specific intraoperative
hypotension (IOH) or hypertension. <br/>Method(s): We systematically
searched PubMed and Embase databases for studies reporting intraoperative
BP in males and females in non-cardiac surgery. We analyzed between-sex
differences in the incidence of IOH and intraoperative hypertension
(primary endpoint). <br/>Result(s): Among 793 identified studies, 14 were
included in this meta-analysis, comprising 1,110,636 patients (56%
female). While sex was not associated with IOH overall (females: OR 1.10,
95%CI [0.98-1.23], I² = 99%), a subset of studies with an
average age >=65 years showed increased exposure to IOH in females (OR
1.17, 95%CI [1.01-1.35], I² = 94%). One study reported
sex-specific differences in intraoperative hypertension, with a higher
incidence in females (31% vs. 28%). <br/>Conclusion(s): While sex-specific
reporting on intraoperative BP was limited, IOH did not differ between
sexes. However, an exploratory subgroup analysis offers the hypothesis
that females of advanced age may face an increased risk of IOH, warranting
further investigation.<br/>Copyright &#xa9; 2024 by the authors.

<26>
Accession Number
2027965334
Title
Effectiveness of Balloon Angioplasty Compared with Coronary Stenting in
Narrow Coronary Arteries.
Source
Medical Forum Monthly. 34(11) (pp 66-70), 2023. Date of Publication: 2023.
Author
Nawaz T.; Amin M.; Khan S.; Ali S.M.N.
Institution
(Nawaz, Amin, Khan, Ali) Department of Cardiology, Lady Reading Hospital,
Peshawar, Pakistan
Publisher
Medical Academic Foundation
Abstract
Objective: The study aimed to assess the effectiveness of balloon
angioplasty compared with coronary stenting in narrow coronary arteries.
<br/>Study Design: A comparative study Place and Duration of Study: This
study was conducted at the department of cardiology, Lady Reading Hospital
Peshawar. The study duration was one year from June 2022 to June 2023.
<br/>Method(s): This comparative study was carried out at the department
of cardiology, Lady Reading Hospital Peshawar. The study duration was one
year from June 2022 to June 2023. A total of 100 patients with lesions in
narrow coronary arteries were enrolled. Participants were randomly
allocated to get stent placement or traditional balloon angioplasty. Each
participant signed a written statement of informed permission. During a
year, the rates of clinical events were assessed. SPSS version 25 was used
for descriptive statistics. <br/>Result(s): Total 100 patients were
enrolled in this study. Male patients were 59(59%) and female patients
were 41 (41%). Each group consists of 50 patients with comparable baseline
demographics and angiography findings. Major adverse cardiac events and
the rate of success of angiography were equivalent, according to treatment
analysis: 5.4% and 95.6% in the case of coronary stenting and 5.6% and
93.5% in the case of balloon angioplasty. 3.8% of patients had significant
closure changes throughout the course of 30 days. At six months, stenting
substantially increased the lumen by1.52 mm and balloon angioplasty by
1.32 mm. (p=0.002) and the post-procedural lumen diameter was increased
2.31mm by stent and 1.82 mm by balloon angioplasty (p=0.002). The
restenosis incidence after coronary stenting and balloon angioplasty was
found to be 35% and 55%, respectively. The survival rates (event-free)
after coronary stenting and angioplasty were respectively 75% and 65%
(p=0.034). <br/>Conclusion(s): Our study concludes that lesions in narrow
coronary arteries may respond well to optimum balloon angioplasty with
subsequent stenting. The restenosis rates were reported to be 35% and 55%
in coronary stenting and balloon angioplasty respectively.<br/>Copyright
&#xa9; 2023, Medical Academic Foundation. All rights reserved.

<27>
Accession Number
2028467114
Title
Telemedical management in patients waiting for transcatheter aortic valve
implantation: the ResKriVer-TAVI study design.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1352592. Date of Publication: 2023.
Author
Mattig I.; Koehler K.; Barzen G.; Hiddemann M.; Kugel E.; Roemmelt C.;
Mauckisch V.; Vockeroth C.; Stangl K.; Hoppe T.; Koehler F.; Dreger H.
Institution
(Mattig, Koehler, Barzen, Hiddemann, Kugel, Roemmelt, Mauckisch,
Vockeroth, Stangl, Koehler) Deutsches Herzzentrum der Charite, Department
of Cardiology, Angiology and Intensive Care Medicine, Campus Charite
Mitte, Berlin, Germany
(Mattig, Koehler, Barzen, Hiddemann, Kugel, Roemmelt, Mauckisch,
Vockeroth, Stangl, Koehler, Dreger) Charite - Universitatsmedizin Berlin,
Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin,
Germany
(Mattig, Stangl, Koehler, Dreger) DZHK (German Centre for Cardiovascular
Research), Partner Site Berlin, Berlin, Germany
(Mattig) Berlin Institute of Health at Charite - Universitatsmedizin
Berlin, BIH Biomedical Innovation Academy, Berlin, Germany
(Koehler, Hiddemann, Mauckisch, Vockeroth, Koehler) Charite -
Universitatsmedizin Berlin, Freie Universitat Berlin, Humboldt-Universitat
zu Berlin, Berlin Institute of Health, Medical Department, Division of
Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Berlin,
Germany
(Hoppe) Fraunhofer FOKUS, Berlin, Germany
(Dreger) Deutsches Herzzentrum der Charite, Department of Cardiology,
Angiology and Intensive Care Medicine, Campus Virchow Klinikum, Berlin,
Germany
Publisher
Frontiers Media SA
Abstract
Aims: The majority of patients with severe aortic stenosis (AS) planned
for transcatheter aortic valve implantation (TAVI) are elective
outpatients. During the COVID-19 pandemic, the time between the heart
team's decision and TAVI increased due to limited healthcare resources. We
therefore implemented telemedical approaches to identify AS patients at
risk for clinical deterioration during the waiting time. The purpose of
the prospective, randomized, controlled ResKriVer-TAVI study
(DRKS00027842) is to investigate whether a digital concept of telemedical
interventional management (TIM) in AS patients waiting for TAVI improves
the clinical outcomes. In the present article, we report the study
protocol of the ResKriVer-TAVI trial. <br/>Method(s): ResKriVer-TAVI will
enroll AS patients planned for elective TAVI. Randomization to the TIM
group or standard care will be made on the day of the heart team's
decision. TIM will include a daily assessment of weight, blood pressure, a
2-channel electrocardiogram, peripheral capillary oxygen saturation, and a
self-rated health status until admission for TAVI. TIM will allow
optimization of medical therapy or an earlier admission for TAVI if
needed. Standard care will not include any additional support for patients
with AS. All patients of the TIM group will receive a rule-based TIM
including standard operating procedures when a patient is crossing
prespecified values of a vital sign. <br/>Result(s): The primary endpoint
consists of days lost due to cardiovascular hospitalization and death of
any cause within 180 days after the heart team's decision. Major secondary
endpoints include all-cause mortality within 365 days, the number of
telemedical interventions, and adherence to TIM. Follow-up visits will be
conducted at admission for TAVI as well as 6 and 12 months after the heart
team's decision. <br/>Conclusion(s): ResKriVer-TAVI will be the first
randomized, controlled trial investigating a telemedical approach before
TAVI in patients with AS. We hypothesize that primary and secondary
endpoints of AS patients with TIM will be superior to standard care. The
study will serve to establish TIM in the clinical routine and to increase
the resilience of TAVI centers in situations with limited healthcare
resources.<br/>Copyright 2024 Mattig, Koehler, Barzen, Hiddemann, Kugel,
Roemmelt, Mauckisch, Vockeroth, Stangl, Hoppe, Koehler and Dreger.

<28>
Accession Number
2030166075
Title
Development and validation of a nomogram for predicting intraoperative
hypotension in cardiac valve replacement.
Source
Biomarkers in Medicine. 17(20) (pp 849-858), 2023. Date of Publication: 01
Oct 2023.
Author
Wang L.; Xiao L.; Hu L.; Chen X.; Wang X.
Institution
(Wang, Xiao, Hu, Chen, Wang) Department of Thoracic & Cardiovascular
Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing,
China
Publisher
Newlands Press Ltd
Abstract
Background: Cardiac valve replacement risks include intraoperative
hypotension, endangering organ perfusion. Our nomogram predicted
hypotension risk in valve surgery, guiding early intervention.
<br/>Method(s): Analyzing 561 patients from July to November 2022, we
developed a nomogram to predict hypotension in valve replacement patients,
validated using data from December 2022 to January 2023 on 241 patients,
with robust statistical confirmation. <br/>Result(s): Our study identified
age, hypertension, left ventricular ejection fraction and serum creatinine
as hypotension predictors. The resulting nomogram, validated with high
concordance index and area under the curve scores, provided a clinically
useful tool for managing intraoperative risk. <br/>Conclusion(s): For
valve replacement patients, factors like age, hypertension, low left
ventricular ejection fraction and high serum creatinine predicted
hypotension risk. Our nomogram enabled clinicians to quantify this risk
and proactively manage it.<br/>Copyright &#xa9; 2023 Future Medicine Ltd..
All rights reserved.

<29>
Accession Number
2028951476
Title
Identification of Preoperative Risk Factors for the Development of Cardiac
Allograft Vasculopathy: A Systematic Review.
Source
Current Surgery Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Roberts W.S.; Pirovic A.; Ionescu A.; Ryan M.; Schaffer S.; Nguyen H.
Institution
(Roberts, Pirovic, Ionescu, Ryan, Schaffer) Osteopathic Medicine, Nova
Southeastern University Dr. Kiran C. Patel College of Osteopathic
Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL 33759, United States
(Nguyen) Foundational Sciences, Nova Southeastern University Dr. Kiran C.
Patel College of Osteopathic Medicine, Clearwater, United States
Publisher
Springer
Abstract
Purpose of Review: The purpose of this systematic review was to analyze
the current literature and identify all known preoperative risk factors
associated with an increased incidence of cardiac allograft vasculopathy.
Recent Findings: A total of 7 independent preoperative risk factors for
cardiac allograft vasculopathy were identified, namely T. gondii
seropositivity (HR 4.39, 1.26-15.62, p < 0.02), elevated body mass index
(HR 1.116, 1.015-1.23, p < 0.02), 2-1 haptoglobin phenotype (HR 2.73,
1.03-7.19, p < 0.01), elevated low-density lipoproteins (OR 2.14,
1.02-4.46, p < 0.04), single-nucleotide polymorphism -201 matching (HR
11.9, 4.3-32.9, p < 0.01), stroke cause of death (HR 1.47, 1.04-2.09, p <
0.03), and pre-transplant hemodynamic instability (HR 1.79, 1.15-2.77, p <
0.01). <br/>Summary: Cardiac allograft vasculopathy is the leading cause
of death in patients who survive more than a few years following
transplantation and is likely the limiting factor in expanding the average
life expectancy post-transplant. The development of therapeutics targeting
the multifactorial etiology of this vasculopathy would undoubtedly provide
hope for patients whose time is currently limited.<br/>Copyright &#xa9;
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<30>
Accession Number
2028946735
Title
External validation of the PC-ECMO score in postcardiotomy veno-arterial
extracorporeal membrane oxygenation.
Source
International Journal of Artificial Organs. (no pagination), 2024. Date
of Publication: 2024.
Author
Biancari F.; Juvonen T.; Cho S.-M.; Hernandez Perez F.J.; L'Acqua C.;
Arafat A.A.; AlBarak M.M.; Laimoud M.; Djordjevic I.; Samalavicius R.;
Alonso-Fernandez-Gatta M.; Sahli S.D.; Kaserer A.; Dominici C.; Makikallio
T.
Institution
(Biancari, Makikallio) Department of Medicine, South-Karelia Central
Hospital, University of Helsinki, Etela-Karjala, Lappeenranta, Finland
(Biancari, Juvonen) Heart and Lung Center, Helsinki University Hospital,
Uusimaa, Helsinki, Finland
(Juvonen) Research Unit of Surgery, Anesthesia and Intensive Care,
University of Oulu, Oulu, Finland
(Cho) Divisions of Neurosciences, Critical Care and Cardiac Surgery,
Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Hernandez Perez) Puerta de Hierro University Hospital, Madrid, Spain
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Lombardy, Milan, Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan, Italy
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Gharbia
Governorate, Tanta, Egypt
(AlBarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, King Faisal
Specialist Hospital and Research Center, Riyadh, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo,
Egypt
(Djordjevic) Department of Cardiothoracic Surgery, University Hospital
Cologne, Cologne, Germany
(Samalavicius) Second Department of Anesthesia, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Castilla y
Leon, Salamanca, Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid,
Spain
(Sahli, Kaserer) Institute of Anesthesiology, University and University
Hospital Zurich, Zurich, Switzerland
(Dominici) Department of Cardiac Surgery, Campus Biomedico, Lazio, Rome,
Italy
Publisher
SAGE Publications Ltd
Abstract
Reliable stratification of the risk of early mortality after
postcardiotomy veno-arterial extracorporeal membrane oxygenation
(V-A-ECMO) remains elusive. In this study, we externally validated the
PC-ECMO score, a specific risk scoring method for prediction of
in-hospital mortality after postcardiotomy V-A-ECMO. Overall, 614 patients
who required V-A-ECMO after adult cardiac surgery were gathered from an
individual patient data meta-analysis of nine studies on this topic. The
AUC of the logistic PC-ECMO score in predicting in-hospital mortality was
0.678 (95%CI 0.630-0.726; p < 0.0001). The AUC of the logistic PC-ECMO
score in predicting on V-A-ECMO mortality was 0.652 (95%CI 0.609-0.695; p
< 0.0001). The Brier score of the logistic PC-ECMO score for in-hospital
mortality was 0.193, the slope 0.909, the calibration-in-the-large 0.074
and the expected/observed mortality ratio 0.979. 95%CIs of the calibration
belt of fit relationship between observed and predicted in-hospital
mortality were never above or below the bisector (p = 0.072). The present
findings suggest that the PC-ECMO score may be a valuable tool in clinical
research for stratification of the risk of patients requiring
postcardiotomy V-A-ECMO.<br/>Copyright &#xa9; The Author(s) 2024.

<31>
Accession Number
2028517618
Title
Cerebral Embolic Protection in Transcatheter Aortic Valve Implantation
Using the Sentinel Cerebral Protection System: A Systematic Review and
Meta-Analysis.
Source
Cardiology and Therapy. (no pagination), 2024. Date of Publication: 2024.
Author
Harmouch W.; Karnkowska B.; Thakker R.; Rasmussen P.; Shalaby M.; Khalife
W.; Alwash H.; Motiwala A.; Kumfa P.; Gilani S.; Jneid H.; Rangasetty U.
Institution
(Harmouch, Karnkowska, Rasmussen) Department of Internal Medicine,
University of Texas Medical Branch, Galveston, TX, United States
(Thakker, Shalaby, Khalife, Alwash, Motiwala, Kumfa, Gilani, Jneid,
Rangasetty) Division of Cardiovascular Medicine, University of Texas
Medical Branch, Galveston, TX, United States
Publisher
Adis
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) plays a vital
role in patients with symptomatic aortic stenosis. Despite the mortality
benefit of TAVI, embolic stroke remains a feared complication. As a
result, transcatheter cerebral embolic protection (TCEP) devices have been
developed to reduce this risk. Given the ongoing debate of TCEP in TAVI,
we performed a systematic review and meta-analysis of all randomized
controlled trials to date to identify outcomes of periprocedural stroke
using the SentinelTM cerebral protection system (CPS). <br/>Method(s):
MEDLINE, Cochrane, and Scopus databases were utilized from inception until
12/2023. PRISMA criteria was utilized. Keywords included "cerebral embolic
protection", "sentinel cerebral protection system", "transcatheter aortic
valve implantation", and "transcatheter aortic valve replacement". Primary
outcome was periprocedural stroke. Secondary outcomes included
periprocedural disabling and non-disabling stroke, all-cause mortality,
transient ischemic attack, delirium, acute kidney injury, vascular
complications, bleeding, and pacemaker implantation. Risk ratios (RR) were
measured via Mantel-Haenszel method with fixed analysis. Heterogeneity was
assessed via chi-squared and Higgin's I² test. <br/>Result(s):
Four trials with 3528 patients were assessed. SAPIEN 3 was the most common
bioprosthetic valve used. The average age was 79.4 years with 41.9% of the
sample size being females. The most prevalent comorbidities were
hypertension, diabetes mellitus, and coronary artery disease. There was no
difference in periprocedural stroke in patients who underwent TAVI with
the SentinelTM CPS compared to no TCEP (RR 0.75, P = 0.12). Periprocedural
disabling strokes were less likely in those who underwent TAVI with the
SentinelTM CPS compared to no TCEP (RR 0.41, P = 0.02) with a number
needed to treat (NNT) of 123. All other outcomes did not reach statistical
significance. <br/>Conclusion(s): In our analysis, there was no difference
between TAVI with the SentinelTM CPS compared to TAVI without TCEP in
regard to risk of periprocedural stroke; however, it was associated with a
decreased risk of periprocedural disabling stroke.<br/>Copyright &#xa9;
The Author(s) 2024.

<32>
Accession Number
643469045
Title
Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in
Children Undergoing Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. (no pagination), 2024. Date of Publication: 09 Feb 2024.
Author
Ulrich E.H.; Bedi P.K.; Alobaidi R.; Morgan C.J.; Paulden M.; Zappitelli
M.; Bagshaw S.M.
Institution
(Ulrich, Morgan) Division of Pediatric Nephrology, Department of
Pediatrics, University of Alberta, Edmonton, AB, Canada
(Bedi) Department of Pediatrics, University of Manitoba, Winnipeg, MB,
Canada
(Alobaidi) Division of Pediatric Critical Care, Department of Pediatrics,
University of Alberta, Edmonton, AB, Canada
(Paulden) Health Economics, School of Public Health, University of
Alberta, Edmonton, AB, Canada
(Zappitelli) Division of Pediatric Nephrology, Department of Pediatrics,
University of Toronto, Toronto, ON, Canada
(Bagshaw) Department of Critical Care Medicine, Faculty of Medicine and
Dentistry, University of Alberta and Alberta Health Services, Edmonton,
AB, Canada
Abstract
OBJECTIVES: The objective of this Prospective Register of Systematic
Reviews (CRD42022384192) registered systematic review and meta-analysis
was to determine whether prophylactic peritoneal dialysis (PD) catheter
insertion at the time of pediatric cardiac surgery is associated with
improved short-term outcomes. DATA SOURCES: Databases search of the
MEDLINE, EMBASE, CINAHL, and Cochrane Library completed in April 2021 and
updated October 2023. STUDY SELECTION: Two reviewers independently
completed study selection, data extraction, and bias assessment. Inclusion
criteria were randomized controlled trials (RCTs) and observational
studies of children (<= 18 yr) undergoing cardiac surgery with
cardiopulmonary bypass. We evaluated use of prophylactic PD catheter
versus not. DATA EXTRACTION: The primary outcome was in-hospital
mortality, as well as secondary short-term outcomes. Pooled random-effect
meta-analysis odds ratio with 95% CI are reported. DATA SYNTHESIS:
Seventeen studies met inclusion criteria, including four RCTs. The non-PD
catheter group received supportive care that included diuretics and late
placement of PD catheters in the ICU. Most study populations included
children younger than 1 year and weight less than 10kg. Cardiac surgery
was most commonly used for arterial switch operation. In-hospital
mortality was reported in 13 studies; pooled analysis showed no
association between prophylactic PD catheter placement and in-hospital
mortality. There were mixed results for ICU length of stay and time to
negative fluid balance, with some studies showing shortened duration
associated with use of prophylactic PD catheter insertion and others
showing no difference. Overall, the studies had high risk for bias, mainly
due to small sample size and lack of generalizability. <br/>CONCLUSION(S):
In this meta-analysis, we have failed to demonstrate an association
between prophylactic PD catheter insertion in children and infants
undergoing cardiac surgery and reduced in-hospital mortality. Other
relevant short-term outcomes, including markers of fluid overload, require
further study.<br/>Copyright &#xa9; 2024 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies.

<33>
Accession Number
643441981
Title
Vascular Complications and Outcomes Following Transcatheter Aortic Valve
Replacement in Patients on Chronic Steroid Therapy. A meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 05 Feb 2024.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Hanif M.; Vadhera A.; Gautam S.; Raut A.;
Rafaqat S.; Borra V.R.; Khandait H.; Shrestha A.B.; Iglesias J.
Institution
(Ang) Department of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Chia) Department of Medicine, International Medical University, Malaysia
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
United States
(Vadhera) Department of Medicine, Maulana Azad Medical College, New Delhi,
India
(Gautam) Department of Internal Medicine, Maimonides Medical Center,
United States
(Raut) Department of Internal Medicine, Nepal Medical College, Nepal
(Rafaqat) Department of Zoology (Molecular Physiology), Lahore College for
Women University, Lahore, Pakistan
(Borra) University of Texas, Rio Grande Valley, United States
(Khandait) Department of Internal Medicine, Trinitas Regional Medical
Center/RWJ Barnabas Health, Elizabeth, NJ, United States
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Iglesias) Department of Critical Care, Rutgers Health/Community Medical
Center, NJ, United States
Abstract
BACKGROUND: Chronic steroid (CS) therapy was reportedly linked to
increased vascular complications following percutaneous coronary
intervention. However, its association with vascular complications after
transcatheter aortic valve replacement (TAVR) remained uncertain, with
conflicting results being reported. <br/>OBJECTIVE(S): We aimed to compare
the rate of vascular complications and outcomes between patients with and
without (CS) use after TAVR. <br/>METHOD(S): We conducted a comprehensive
literature search in PubMed, Embase and Cochrane databases from their
inception until 18th April 2022 for relevant studies. Endpoints were
described according to Valve Academic Research Consortium-2 definitions.
Effect sizes were pooled using DerSimonian and Laird random-effects model
as risk ratio (RR) with 95% confidence intervals (CI). <br/>RESULT(S): 5
studies with 6136 patients undergoing TAVR were included in the analysis.
The included studies were published between 2015 and 2022. The mean ages
of patients in both study groups were similar, with the CS group averaging
80 years and the non-steroid group averaging 82 years. Notably, a higher
proportion of patients in the CS group were female (56%) compared to the
non-steroid group (54%). CS use was associated with a significantly higher
risk of major vascular complications (12.5% vs. 6.7%, RR 2.32, 95% CI
1.73-3.11, P<0.001), major bleeding (16.8% vs. 13.1%, RR 1.61, 95% CI
1.27-2.05, P<0.001), and aortic annulus rupture (2.3% vs. 0.6%, RR 4.66,
95% CI 1.67-13.01, P<0.001). There was no significant difference in terms
of minor vascular complications (RR 1.43, 95% CI 1.00-2.04, P=0.05),
in-hospital mortality (2.3% vs. 1.4%, RR 1.86, 95% CI 0.74-4.70, P=0.19),
and 30-day mortality (2.9% vs. 3.1%, RR 1.14, 95% CI 0.53-2.46, P=0.74)
between both groups. <br/>CONCLUSION(S): Our study showed that CS therapy
is associated with increased major vascular complications, major bleeding,
and annulus rupture following TAVR. Further large multicenter studies or
randomized controlled trials are warranted to validate these
findings.<br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<34>
Accession Number
2030329892
Title
Impact of age on the relationship between cross-clamp time and mortality
in cardiac surgery.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Mukharyamov M.; Kirov H.; Caldonazo T.; Doenst T.
Institution
(Mukharyamov, Kirov, Caldonazo, Doenst) Department of Cardiothoracic
Surgery, Jena University Hospital, Friedrich Schiller University of Jena,
Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Age is an independent risk factor for mortality even if all known
comorbidities are considered. Thus, other factors may additionally
contribute to the age-associated risk. We performed a systematic
literature search and identified161 manuscripts, of which 32 studies
(18256 patients) were analyzed. Cross-clamp time correlated with observed
mortality. The increase in mortality risk with cross-clamp time was much
greater in older compared to younger patients. The log OR for age and
cross-clamp time were 0.07 and 0.01, respectively, which was highly
significant for both independent risk factors. <br/>Conclusion(s): Age
accelerates the increase in mortality risk with increasing aortic
cross-clamp times.<br/>Copyright &#xa9; 2023 Georg Thieme Verlag. All
rights reserved.

<35>
Accession Number
625325929
Title
Astaxanthin ameliorates cardiomyocyte apoptosis after coronary
microembolization by inhibiting oxidative stress via Nrf2/HO-1 pathway in
rats.
Source
Naunyn-Schmiedeberg's Archives of Pharmacology. 392(3) (pp 341-348), 2019.
Date of Publication: 05 Mar 2019.
Author
Xue Y.; Sun C.; Hao Q.; Cheng J.
Institution
(Xue, Sun, Hao, Cheng) Department of Cardiology, Tangdu Hospital, Air
Force Military Medical University, Xinsi Road, Xi'an 710000, China
Publisher
Springer Verlag
Abstract
Coronary microembolization (CME) caused by physical obstruction in
coronary microcirculation induces myocardial apoptosis and cardiac
dysfunction, and it was reported that the inactivation of the Nrf2/HO-1
signaling was involved in this process. Astaxanthin (AST) is a reddish
pigment that belongs to keto-carotenoids. It is also a potent antioxidant
and has been reported to activate Nrf2/HO-1 signaling in vein endothelial
cells. However, it is still unknown whether AST is able to activate
Nrf2/HO-1 signaling pathway to protect cardiac functions from CME in vivo.
To address this question, rats were orally administrated with AST or AST
plus Zinc protoporphyrin IX (ZnPP, a HO-1 inhibitor), followed by CME
modeling operation. Then, cardiac function was evaluated by
echocardiographic measurement. Myocardial infarction was measured by HBFP
staining, and apoptosis was assessed by TUNEL staining. The protein levels
and mRNA expressions of Bax and Bcl-2 were measured by Western blot and
qRT-PCR, respectively. ELISA was performed to measure the activity of
enzymes related to oxidative stress. AST pretreatment dramatically
attenuated CME-induced cardiac dysfunction, myocardial infarction, and
cardiomyocyte apoptosis. Mechanistically, AST suppressed CME-induced
oxidative stress by re-activating Nrf2/HO-1 signaling. HO-1 inhibitor ZnPP
completely eliminated the benefits of AST in CEM, supporting the critical
role of Nrf2/HO-1 signaling in mediating the cardioprotective function of
AST in CME. <br/>Conclusion(s): AST suppresses oxidative stress via
activating Nrf2/HO-1 pathway and thus prevents CME-induced cardiomyocyte
apoptosis and ameliorates cardiac dysfunction in rats.<br/>Copyright
&#xa9; 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

<36>
Accession Number
2030787101
Title
Positive end-expiratory pressure during one-lung ventilation for
preventing atelectasis after video-assisted thoracoscopic surgery: a
triple-arm, randomized controlled trial.
Source
Minerva Anestesiologica. 90(1-2) (pp 12-21), 2024. Date of Publication:
January 2024.
Author
Yoo S.; Yoon S.; Kim B.R.; Yoo H.K.; Seo J.-H.; Bahk J.-H.
Institution
(Yoo, Yoon, Yoo, Seo, Bahk) Department of anesthesiology and Pain
Medicine, seoul national University Hospital, seoul national 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
(Bahk) Department of anesthesiology and Pain Medicine, seoul national
University Hospital, seoul national University college of Medicine, 101
Daehak-ro, Jongno-gu, seoul 03080, South Korea
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: There is little evidence regarding the benefits of
lung-protective ventilation in patients undergoing one-lung ventilation
for thoracic surgery. this study aimed to determine the optimal level of
positive end-expiratory pressure (PeeP) during one-lung ventilation for
minimizing postoperative atelectasis through lung ultrasonography.
MetHoDs: a total of 142 adult patients scheduled for video-assisted
thoracoscopic surgery at seoul national University Hospital between May
2019 and February 2020 were enrolled in this study. Patients were randomly
assigned to different groups: 1) PeeP 3 cmH<inf>2</inf>o group; 2) PeeP 6
cmH<inf>2</inf>o group; and 3) PeeP 9 cmH<inf>2</inf>o group during
one-lung ventilation. the lung ultrasound score was used to evaluate lung
aeration using ultrasonography 1 hour after surgery. resUlts: the 1-hour
post-surgery lung ultrasound scores were 8.1+/-2.5, 6.8+/-2.6, and
5.9+/-2.6 in the PeeP 3, 6, and 9 cmH<inf>2</inf>o groups, respectively
(P<0.001). the PeeP 3 cmH<inf>2</inf>O group showed significantly higher
lung ultrasound scores than the PeeP 6 (adjusted P=0.034) and 9
cmH<inf>2</inf>o groups (adjusted P<0.001). the
Pao<inf>2</inf>/Fio<inf>2</inf> ratio measured at 10 minutes after the end
of one-lung ventilation was significantly lower in the PEEP 3
cmH<inf>2</inf>o group (392 [331 to 469]) than the PeeP 6 cmH<inf>2</inf>o
(458 [384 to 530], adjusted P=0.018) or PeeP 9 cmH<inf>2</inf>o groups
(454 [374 to 522], adjusted P=0.016). conclUsions: although the optimal
level of PeeP during one-lung ventilation was not determined, the
application of higher PeeP can prevent aeration loss in the ventilated
lung after video-assisted thoracoscopic surgery under one-lung
ventilation.<br/>Copyright &#xa9; 2024 Edizioni Minerva Medica. All rights
reserved.

<37>
Accession Number
2030773120
Title
Effects of opioid-free anaesthesia compared with balanced general
anaesthesia on nausea and vomiting after video-assisted thoracoscopic
surgery: a single-centre randomised controlled trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e079544. Date of
Publication: 01 Mar 2024.
Author
Bao R.; Zhang W.-S.; Zha Y.-F.; Zhao Z.-Z.; Huang J.; Li J.-L.; Wang T.;
Guo Y.; Bian J.-J.; Wang J.-F.
Institution
(Bao, Zhang, Zha, Zhao, Huang, Li, Wang, Guo, Bian, Wang) Department of
Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai,
China
(Zha) Department of Anesthesiology, Huashan Hospital, Fudan University,
Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Objectives Opioid-free anaesthesia (OFA) has emerged as a promising
approach for mitigating the adverse effects associated with opioids. The
objective of this study was to evaluate the impact of OFA on postoperative
nausea and vomiting (PONV) following video-assisted thoracic surgery.
Design Single-centre randomised controlled trial. Setting Tertiary
hospital in Shanghai, China. Participants Patients undergoing
video-assisted thoracic surgery were recruited from September 2021 to June
2022. Intervention Patients were randomly allocated to OFA or traditional
general anaesthesia with a 1:1 allocation ratio. Primary and secondary
outcome measures The primary outcome measure was the incidence of PONV
within 48 hours post-surgery, and the secondary outcomes included PONV
severity, postoperative pain, haemodynamic changes during anaesthesia, and
length of stay (LOS) in the recovery ward and hospital. Results A total of
86 and 88 patients were included in the OFA and control groups,
respectively. Two patients were excluded because of severe adverse events
including extreme bradycardia and epilepsy-like convulsion. The incidence
and severity of PONV did not significantly differ between the two groups
(29 patients (33.0%) in the control group and 22 patients (25.6%) in the
OFA group; relative risk 0.78, 95% CI 0.49 to 1.23; p=0.285). Notably, the
OFA approach used was associated with an increase in heart rate (89+/-17
vs 77+/-15 beats/min, t-test: p<0.001; U test: p<0.001) and diastolic
blood pressure (87+/-17 vs 80+/-13 mm Hg, t-test: p=0.003; U test:
p=0.004) after trachea intubation. Conversely, the control group exhibited
more median hypotensive events per patient (mean 0.5+/-0.8 vs 1.0+/-2.0,
t-test: p=0.02; median 0 (0-4) vs 0 (0-15), U test: p=0.02) during
surgery. Postoperative pain scores, and LOS in the recovery ward and
hospital did not significantly differ between the two groups. Conclusions
Our study findings suggest that the implementation of OFA does not
effectively reduce the incidence of PONV following thoracic surgery when
compared with traditional total intravenous anaesthesia. The opioid-free
strategy used in our study may be associated with severe adverse
cardiovascular events. Trial registration number
ChiCTR2100050738.<br/>Copyright &#xa9; The Author(s) 2024.

<38>
Accession Number
2028266720
Title
Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing
Cardiac Surgery: Systematic Review with Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(2) (no pagination), 2024.
Article Number: e20230076. Date of Publication: 2024.
Author
Li J.-P.; Li Y.; Li B.; Bian C.-H.; Zhao F.
Institution
(Li) Medical Oncology, Zibo Municipal Hospital, Shandong, Zibo, China
(Li, Bian, Zhao) Department of Blood Transfusion, Zibo Municipal Hospital,
Shandong, Zibo, China
(Li) Thoracic and Cardiovascular Surgery, Zibo Municipal Hospital,
Shandong, Zibo, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: The purpose of present study was to comprehensively explore the
efficacy and safety of prothrombin complex concentrate (PCC) to treat
massive bleeding in patients undergoing cardiac surgery. <br/>Method(s):
PubMed, Embase, and Cochrane Library databases were searched for studies
investigating PCC administration during cardiac surgery published before
September 10, 2022. Mean difference (MD) with 95% confidence interval (CI)
was applied to analyze continuous data, and dichotomous data were analyzed
as risk ratio (RR) with 95% CI. <br/>Result(s): Twelve studies were
included in the meta-analysis. Compared with other non-PCC treatment
regimens, PCC was not associated with elevated mortality (RR=1.18, 95%
CI=0.86-1.60, P=0.30, I²=0%), shorter hospital stay (MD=-2.17
days; 95% CI=-5.62-1.28, P=0.22, I²=91%), reduced total
thoracic drainage (MD=-67.94 ml, 95% CI=-239.52-103.65, P=0.44,
I²=91%), thromboembolic events (RR=1.10, 95% CI=0.74-1.65,
P=0.63, I²=39%), increase in atrial fibrillation events
(RR=0.73, 95% CI=0.52-1.05, P=0.24, I²=29%), and myocardial
infarction (RR=1.10, 95% CI=0.80-1.51, P=0.57, I²=81%).
However, PCC use was associated with reduced intensive care unit length of
stay (MD=-0.81 days, 95% CI=-1.48--0.13, P=0.02, I²=0%),
bleeding (MD=-248.67 ml, 95% CI=-465.36--31.97, P=0.02,
I²=84%), and intra-aortic balloon pump/extracorporeal membrane
oxygenation (RR=0.65, 95% CI=0.42-0.996, P=0.05, I²=0%) when
compared with non-PCC treatment regimens. <br/>Conclusion(s): The use of
PCC in cardiac surgery did not correlate with mortality, length of
hospital stay, thoracic drainage, atrial fibrillation, myocardial
infarction, and thromboembolic events. However, PCC significantly improved
postoperative intensive care unit length of stay, bleeding, and
intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in
patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2024, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<39>
Accession Number
2030850946
Title
Transversus Thoracic Muscle Plane Block For Postoperative Pain in
Pediatric Cardiac Surgery: A Systematic Review And Meta-Analysis of
Randomized And Observational Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Cui Y.-Y.; Xu Z.-Q.; Hou H.-J.; Zhang J.; Xue J.-J.
Institution
(Cui) First School of Clinical Medicine, Gansu University of Chinese
Medicine, Chengguan District, Lanzhou, China
(Xu, Hou, Zhang, Xue) Department of Anesthesiology, Gansu Province
Hospital of Traditional Chinese Medicine, Lanzhou, China
(Xu, Hou, Zhang, Xue) Gansu Clinical Research Center of Integrative
Anesthesiology, Lanzhou, China
(Xue) Evidence-based Medicine Center, School of Basic Medical Science,
Lanzhou University, Gansu, Lanzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: Pediatric patients undergoing cardiac surgery usually
experience significant surgical pain. Additionally, the effect of poor
surgical analgesia creates a pain continuum that extends to the
postoperative period. Transversus thoracic muscle plane block (TTMPB) is a
novel plane block technique that can provide analgesia to the anterior
chest wall. The analgesic role of TTMPB in pediatric cardiac surgery is
still uncertain. A meta-analysis was conducted to determine the analgesic
efficacy of this procedure. Design and Setting: Systematic review and
meta-analysis. PubMed, Embase, Web of Science, CENTRAL, WanFang Data, and
the China National Knowledge Infrastructure were searched to November
2023, and the Grading of Recommendations Assessment, Development, and
Evaluation approach was followed to evaluate the certainty of evidence.
<br/>Participant(s): Eligible studies enrolled pediatric patients from 2
months to 12 years old scheduled to undergo cardiac surgery, and
randomized them to receive a TTMPB or no block/sham block.
<br/>Measurements and Main Results: Six studies that enrolled 601
pediatric patients were included. Low-certainty evidence from randomized
trials showed that, compared with no block or sham block, TTMPB in
pediatric patients undergoing cardiac surgery may reduce postoperative
modified objective pain score at 12 hours (weighted mean difference [WMD]
-2.20, 95% CI -2.73 to -1.68) and 24 hours (WMD -1.76, 95% CI -2.09 to
-1.42), intraoperative opioid consumption (WMD -3.83, 95% CI -5.90 to
-1.76 mug/kg), postoperative opioid consumption (WMD -2.51, 95% CI -2.84
to -2.18 mug/kg), length of intensive care unit (ICU) stay (WMD -5.56, 95%
CI -8.30 to -2.83 hours), and extubation time (WMD -2.13, 95% CI -4.21 to
-0.05 hours). Retrospective studies provided very low certainty that the
results were consistent with the randomized trials. <br/>Conclusion(s):
Very low- to low-certainty evidence showed that TTMPB in pediatric
patients undergoing cardiac surgery may reduce postoperative pain, opioid
consumption, ICU length of stay, and extubation time.<br/>Copyright &#xa9;
2024 Elsevier Inc.

<40>
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. 402 (no pagination), 2024. Article
Number: 131854. Date of Publication: 01 May 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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2024 Elsevier Ireland Ltd

<41>
Accession Number
2028914506
Title
Electroencephalographic guided propofol-remifentanil TCI anesthesia with
and without dexmedetomidine in a geriatric population:
electroencephalographic signatures and clinical evaluation.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2024. Date
of Publication: 2024.
Author
Mehler D.M.; Kreuzer M.; Obert D.P.; Cardenas L.F.; Barra I.; Zurita F.;
Lobo F.A.; Kratzer S.; Schneider G.; Sepulveda P.O.
Institution
(Mehler, Kreuzer, Obert, Kratzer, Schneider) Department of Anesthesiology
and Intensive Care, School of Medicine, Technical University of Munich,
Munich, Germany
(Obert) Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts's General Hospital, Boston, MA, United States
(Obert) Harvard Medical School, Boston, MA, United States
(Cardenas, Barra, Zurita, Sepulveda) Department of Anesthesiology,
Hospital Base San Jose, Osorno/Universidad Austral, Valdivia, Chile
(Lobo) Anesthesiology Institute, Cleveland Clinic Abu Dhabi, United Arab
Emirates, Abu Dhabi, United Arab Emirates
Publisher
Springer Science and Business Media B.V.
Abstract
Elderly and multimorbid patients are at high risk for developing
unfavorable postoperative neurocognitive outcomes; however, well-adjusted
and EEG-guided anesthesia may help titrate anesthesia and improve
postoperative outcomes. Over the last decade, dexmedetomidine has been
increasingly used as an adjunct in the perioperative setting. Its
synergistic effect with propofol decreases the dose of propofol needed to
induce and maintain general anesthesia. In this pilot study, we evaluate
two highly standardized anesthetic regimens for their potential to prevent
burst suppression and postoperative neurocognitive dysfunction in a
high-risk population. Prospective, randomized clinical trial with
non-blinded intervention. Operating room and post anesthesia care unit at
Hospital Base San Jose, Osorno/Universidad Austral, Valdivia, Chile. 23
patients with scheduled non-neurologic, non-cardiac surgeries with age >
69 years and a planned intervention time > 60 min. Patients were randomly
assigned to receive either a propofol-remifentanil based anesthesia or an
anesthetic regimen with dexmedetomidine-propofol-remifentanil. All
patients underwent a slow titrated induction, followed by a target
controlled infusion (TCI) of propofol and remifentanil (n = 10) or
propofol, remifentanil and continuous dexmedetomidine infusion (n = 13).
We compared the perioperative EEG signatures, drug-induced changes, and
neurocognitive outcomes between two anesthetic regimens in geriatric
patients. We conducted a pre- and postoperative Montreal Cognitive
Assessment (MoCa) test and measured the level of alertness postoperatively
using a sedation agitation scale to assess neurocognitive status. During
slow induction, maintenance, and emergence, burst suppression was not
observed in either group; however, EEG signatures differed significantly
between the two groups. In general, EEG activity in the propofol group was
dominated by faster rhythms than in the dexmedetomidine group. Time to
responsiveness was not significantly different between the two groups (p =
0.352). Finally, no significant differences were found in postoperative
cognitive outcomes evaluated by the MoCa test nor sedation agitation scale
up to one hour after extubation. This pilot study demonstrates that the
two proposed anesthetic regimens can be safely used to slowly induce
anesthesia and avoid EEG burst suppression patterns. Despite the patients
being elderly and at high risk, we did not observe postoperative
neurocognitive deficits. The reduced alpha power in the
dexmedetomidine-treated group was not associated with adverse
neurocognitive outcomes.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Nature B.V. 2024.

<42>
Accession Number
2028905038
Title
Goal setting among older adults starting mobile health cardiac
rehabilitation in the RESILIENT trial.
Source
Journal of the American Geriatrics Society. (no pagination), 2024. Date
of Publication: 2024.
Author
Shwayder E.; Dodson J.A.; Tellez K.; Johanek C.; Adhikari S.; Meng Y.;
Schoenthaler A.; Jennings L.A.
Institution
(Shwayder, Dodson) Leon H. Charney Division of Cardiology, Department of
Medicine, New York University Grossman School of Medicine, New York, NY,
United States
(Dodson, Tellez, Johanek) Division of Healthcare Delivery Science,
Department of Population Health, New York University Grossman School of
Medicine, New York, NY, United States
(Adhikari, Meng) Division of Biostatistics, New York University Grossman
School of Medicine, New York, NY, United States
(Schoenthaler) Institute for Excellence in Health Equity, New York
University Grossman School of Medicine, New York, NY, United States
(Jennings) Reynolds Section of Geriatrics and Palliative Medicine,
University of Oklahoma Health Sciences Center, Oklahoma City, OK, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is growing recognition that healthcare should align with
individuals' health priorities; however, these priorities remain
undefined, especially among older adults. The Rehabilitation Using Mobile
Health for Older Adults with Ischemic Heart Disease in the Home Setting
(RESILIENT) trial, designed to test the efficacy of mobile health cardiac
rehabilitation (mHealth-CR) in an older cohort, also measures the
attainment of participant-defined health outcome goals as a prespecified
secondary endpoint. This study aimed to characterize the health priorities
of older adults with ischemic heart disease (IHD) using goal attainment
scaling-a technique for measuring individualized goal achievement-in a
sample of 100 RESILIENT participants. <br/>Method(s): The ongoing
RESILIENT trial randomizes patients aged >=65 years with IHD (defined as
hospitalization for acute coronary syndrome and/or coronary
revascularization), to receive mHealth-CR or usual care. For the current
study, we qualitatively coded baseline goal attainment scales from
randomly selected batches of 20 participants to identify participants'
cardiac rehabilitation outcome goals and their perceptions of barriers and
action plans for goal attainment. We used a deductive framework (i.e., 4
value categories from Patient Priorities Care) and inductive approaches to
code and analyze interviews until thematic saturation. <br/>Result(s):
This sample of 100 older adults set diverse health outcome goals. Most
(54.6%) prioritized physical activity, fewer (17.1%) identified symptom
management, fewer still (13.7%) prioritized health metrics, mostly
comprised of weight loss goals (10.3%), and the fewest (<4%) were related
to clinical metrics such as reducing cholesterol or preventing hospital
readmission. Participants anticipated extrinsic (access to places to
exercise, time) and intrinsic (non-cardiac pain, motivation) barriers.
Action plans detailed strategies for exercise, motivation, accountability,
and overcoming time constraints. <br/>Conclusion(s): Using goal attainment
scaling, we elicited specific and measurable goals among older adults with
IHD beginning cardiac rehabilitation. Priorities were predominantly
functional, diverging from clinical metrics emphasized by clinicians and
healthcare systems.<br/>Copyright &#xa9; 2024 The American Geriatrics
Society.

<43>
Accession Number
2028903313
Title
Effects of positive end-expiratory pressure on regional cerebral oxygen
saturation in elderly patients undergoing thoracic surgery during one-lung
ventilation: a randomized crossover-controlled trial.
Source
BMC Pulmonary Medicine. 24(1) (no pagination), 2024. Article Number: 120.
Date of Publication: December 2024.
Author
Zhao L.; Lv S.; Xiao Q.; Zhang Y.; Yi W.; Bai Y.; Lu K.; Bermea K.C.;
Semel J.; Yang X.; Wu J.
Institution
(Zhao, Lv, Yi, Yang) Department of Anesthesiology, Qilu Hospital of
Shandong University, 107 #, Wenhua Xi Road, Shandong, Jinan 250012, China
(Zhao, Lv, Bai, Lu, Yang, Wu) School of Medicine, Cheeloo College of
Medicine, Shandong University, Jinan 250012, China
(Xiao) Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,
Hubei Province, Enshi 445000, China
(Wu) Department of Anesthesiology and Perioperative Medicine, Shandong
Institute of Anesthesia and Respiratory Critical Medicine, The First
Affiliated Hospital of Shandong First Medical University & amp; Shandong
Provincial Qianfoshan Hospital, 16766 #, Jingshi Road, Shandong, Jinan
250012, China
(Zhang) Clinical Epidemiology Unit, Qilu Hospital of Shandong University,
Shandong, Jinan 250012, China
(Bermea) Department of Medicine, Division of Cardiology, Johns Hopkins
University School of Medicine, Baltimore, MD 21205, United States
(Semel) Department of Biochemistry and Molecular Biology, Center for
Research on Cardiac Intermediate Filaments, Johns Hopkins University
School of Medicine, Baltimore, MD 21205, United States
Publisher
BioMed Central Ltd
Abstract
Background: A significant reduction in regional cerebral oxygen saturation
(rSO<inf>2</inf>) is commonly observed during one-lung ventilation (OLV),
while positive end-expiratory pressure (PEEP) can improve oxygenation. We
compared the effects of three different PEEP levels on rSO<inf>2</inf>,
pulmonary oxygenation, and hemodynamics during OLV. <br/>Method(s):
Forty-three elderly patients who underwent thoracoscopic lobectomy were
randomly assigned to one of six PEEP combinations which used a crossover
design of 3 levels of PEEP-0 cmH<inf>2</inf>O, 5 cmH<inf>2</inf>O, and 10
cmH<inf>2</inf>O. The primary endpoint was rSO<inf>2</inf> in patients
receiving OLV 20 min after adjusting the PEEP. The secondary outcomes
included hemodynamic and respiratory variables. <br/>Result(s): After
exclusion, thirty-six patients (36.11% female; age range: 60-76 year) were
assigned to six groups (n = 6 in each group). The rSO<inf>2</inf> was
highest at OLV(0) than at OLV(10) (difference, 2.889%; [95% CI, 0.573 to
5.204%]; p = 0.008). Arterial oxygen partial pressure (PaO<inf>2</inf>)
was lowest at OLV(0) compared with OLV(5) (difference, -62.639 mmHg; [95%
CI, -106.170 to -19.108 mmHg]; p = 0.005) or OLV(10) (difference, -73.389
mmHg; [95% CI, -117.852 to -28.925 mmHg]; p = 0.001), while peak airway
pressure (Ppeak) was lower at OLV(0) (difference, -4.222 mmHg; [95% CI,
-5.140 to -3.304 mmHg]; p < 0.001) and OLV(5) (difference, -3.139 mmHg;
[95% CI, -4.110 to -2.167 mmHg]; p < 0.001) than at OLV(10).
<br/>Conclusion(s): PEEP with 10 cmH<inf>2</inf>O makes rSO<inf>2</inf>
decrease compared with 0 cmH<inf>2</inf>O. Applying PEEP with 5
cmH<inf>2</inf>O during OLV in elderly patients can improve oxygenation
and maintain high rSO<inf>2</inf> levels, without significantly increasing
peak airway pressure compared to not using PEEP. Trial registration:
Chinese Clinical Trial Registry ChiCTR2200060112 on 19 May
2022.<br/>Copyright &#xa9; The Author(s) 2024.

<44>
Accession Number
2026470209
Title
Preoperative anemia and anemia treatment in cardiac surgery: a systematic
review and meta-analysis.
Source
Canadian Journal of Anesthesia. 71(1) (pp 127-142), 2024. Date of
Publication: January 2024.
Author
Lau M.P.X.L.; Low C.J.W.; Ling R.R.; Liu N.S.H.; Tan C.S.; Ti L.K.;
Kofidis T.; MacLaren G.; Ramanathan K.
Institution
(Lau, Low, Ling, Liu, Tan, Ti, Kofidis, MacLaren, Ramanathan) Yong Loo Lin
School of Medicine, National University of Singapore, National University
Health System, Singapore, Singapore
(Tan) Saw Swee Hock School of Public Health, National University of
Singapore, National University Health System, Singapore, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singapore, Singapore
(Kofidis) Department of Cardiac, Thoracic, and Vascular Surgery, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(MacLaren, Ramanathan) Cardiothoracic Intensive Care Unit, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Level 9, 1E Kent Ridge Road,
Singapore 119228, Singapore
Publisher
Springer
Abstract
Purpose: We aimed to conduct a systematic review and meta-analysis to
assess the effects of anemia and anemia severity on patient outcomes in
cardiac surgery and determine whether preoperative treatments confer
postoperative benefit. Source: We searched four international databases
for observational and randomized studies published until 1 October 2022.
Study quality was assessed via Newcastle-Ottawa scores and the Cochrane
Risk-of-Bias 2 tool and certainty of evidence was rated with the Grading
of Recommendations, Assessment, Development and Evaluations approach. We
conducted random-effects meta-analyses for our primary outcome of
mortality, for secondary outcomes including length of stay (LOS) in the
hospital and intensive care unit, and for postsurgical complications. As
part of a secondary analysis, we analyzed short-term preoperative anemia
treatments and conducted trial sequential analysis of randomized trials to
assess the efficacy of these treatment programs. Principal findings: We
included 35 studies (159,025 patients) in our primary meta-analysis.
Preoperative anemia was associated with increased mortality (odds ratio
[OR], 2.5; 95% confidence interval [CI], 2.2 to 2.9; P < 0.001, high
certainty). Study-level meta-regression revealed lower hemoglobin levels
and studies with lower proportions of male patients to be associated with
increased risk of mortality. Preoperative anemia was also associated with
an increase in LOS and postsurgical complications. Our secondary analysis
(seven studies, 1,012 patients) revealed short-term preoperative anemia
treatments did not significantly reduce mortality (OR, 1.1; 95% CI, 0.65
to 1.9; P = 0.69). Trial sequential analysis suggested that there was
insufficient evidence to conclude if treatment programs yield any benefit
or harm. <br/>Conclusion(s): Preoperative anemia is associated with
mortality and morbidity after cardiac surgery. More research is warranted
to test the efficacy of current anemia treatment programs. Study
registration: PROSPERO (CRD42022319431); first submitted 17 April
2023.<br/>Copyright &#xa9; Canadian Anesthesiologists' Society 2023.

<45>
Accession Number
643675923
Title
Outcomes of patients with suspected heparin-induced thrombocytopenia in a
contemporary cohort of patients.
Source
Hamostaseologie. Conference: GTH Congress 2024 - 68th Annual Meeting of
the Society of Thrombosis and Haemostasis Research - Building Bridges in
Coagulation. Vienna Austria. 44(Supplement 1) (pp S20-S21), 2024. Date of
Publication: February 2024.
Author
Nilius H.; Sinitsa E.; Studt J.-D.; Tsakiris D.A.; Greinacher A.; Mendez
A.; Schmidt A.; Wuillemin W.A.; Gerber B.; Kremer-Hovinga J.A.; Vishnu P.;
Graf L.; Bakchoul T.; Nagler M.
Institution
(Nilius, Sinitsa, Nagler) Inselspital, Bern University Hospital,
Department of Clinical Chemistry, Bern, Switzerland
(Nilius) University of Bern, Graduate School for Health Sciences, Bern,
Switzerland
(Studt) University and University Hospital of Zurich, Division of Medical
Oncology and Hematology, Zurich, Switzerland
(Tsakiris) Basel University Hospital, Diagnostic Haematology, Basel,
Switzerland
(Greinacher) Universitatsmedizin Greifswald, Institut fur Immunologie und
Transfusionsmedizin, Greifswald, Germany
(Mendez) Kantonsspital Aarau, Department of Laboratory Medicine, Aarau,
Switzerland
(Schmidt) Municipal Hospital Zurich Triemli, Clinic of Medical Oncology
and Hematology, Zurich, Switzerland
(Wuillemin) Cantonal Hospital of Lucerne and University of Bern, Division
of Hematology and Central Hematology Laboratory, Lucerne, Switzerland
(Gerber) Oncology Institute of Southern Switzerland, Clinic of Hematology,
Bellinzona, Switzerland
(Kremer-Hovinga) Inselspital, Bern University Hospital, Department of
Hematology and Central Hematology Laboratory, Bern, Switzerland
(Vishnu) CHI Franciscan Medical Group, Division of Hematology, Seattle,
United States
(Graf) Cantonal Hospital St. Gallen, Department of Hematology, St. Gallen,
Switzerland
(Bakchoul) University Hospital Tubingen, Centre for Clinical Transfusion
Medicine, Tubingen, Germany
(Nagler) University of Bern, Medical Faculty, Bern, Switzerland
Publisher
Georg Thieme Verlag
Abstract
Introduction Managing patients with suspected heparin-induced
thrombocytopenia (HIT) remains a major clinical challenge. Knowledge of
the effects of management decisions on clinical outcomes is sparse and
treatment recommendations are often based on low certainty. In a
prospective multicenter cohort study, we studied the treatment and
outcomes of patients with suspected HIT. Method We included consecutive
patients with suspected HIT and report the outcomes of (a) patients with
HIT, (b) patients without HIT but positive heparin/PF4 antibodies, and (c)
patients without HIT. Comprehensive clinical and laboratory data were
collected in detail and the washed-platelet heparininduced platelet
activation test (HIPA) served as the reference standard test defining HIT
Results Among 1393 patients included in 11 study centers (46 % female,
median age of 67), HIT was confirmed in 119 patients (prevalence 8.5 %).
The setting was intensive care unit (37 %) and cardiac surgery (32 %) in
the majority of patients. The predominant treatment was argatroban (70 %),
and complete platelet recovery was observed in 77 % of HIT patients. Of
the patients with HIT, 23 % developed subsequent venous thromboembolism
(TE), 9 % arterial TE, and 18 % died. Major bleeding occurred in 13 % of
HIT patients and did not differ significantly between drugs. Treatment
with argatroban, bivalirudin or DOAC markedly reduced the risk of
subsequent arterial TE. HIT-negative patients with and without H/PF4
antibodies did not differ with regard to any outcome (Graphical abstract)
(.Fig. 1). Conclusion Our results indicate that HIT is still a serious
disease with a high risk of major adverse events. In the absence of
randomized controlled trials, our results add further evidence on the
effectiveness of DOAC, argatroban, and bivalirudin treatment.

<46>
Accession Number
643690458
Title
Genome-Wide Association Study in 2,140 Patients and Subtype Meta-analyses
of Barlow's Disease and Fibroelastic Deficiency Identify Novel Risk Loci
for Mitral Valve Prolapse.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Feirer N.; Weber M.; Knoll K.; Miranda L.; Yu M.; Lahm H.; Kameric M.;
Doppler S.; Neb I.; Lichtner P.; Lek M.; Lange R.; Schunkert H.; Hagege
A.; Bouatia-Naji N.; Muller-Myhsok B.; Trenkwalder T.; Gruber P.; Krane
M.; Dressen M.
Institution
(Feirer, Weber, Knoll, Lahm, Kameric, Doppler, Neb, Lange, Schunkert,
Krane, Dresen) German Heart Center Munich, Munich, Germany
(Feirer, Weber) Institute for Translational Cardiac Surgery (INSURE),
German Heart Center Munich, Munich, Germany
(Miranda) Max Planck Institute of Biochemistry, Munich, Germany
(Yu) Fudan University, Shanghai, China
(Lichtner, Trenkwalder) Helmholtz Center Munich, Munich, Germany
(Lek, Gruber, Dresen) Yale School of Medicine, Division of Cardiac
Surgery, Yale, United States
(Lange, Schunkert, Trenkwalder, Krane) DZHK (German Center for
Cardiovascular Research), Partner Site Munich Heart Alliance, Munich,
Germany
(Hagege) European Hospital Georges Pompidou, Paris, France
(Hagege, Bouatia-Naji) Universite de Paris, Paris, France
(Muller-Myhsok, Krane) Department of Translational Research in Psychiatry,
Max Planck Institute of Psychiatry Munich, Munich, Germany
(Muller-Myhsok) Munich Cluster of Systems Biology, Munich, Germany
(Muller-Myhsok) University of Liverpool, Liverpool, United Kingdom
Publisher
Georg Thieme Verlag
Abstract
Background: Mitral valve prolapse (MVP) is a multifactorial cardiac valve
disease with a strong genetic component. Degenerative MVP subtypes range
from fibroelastic deficiency (FED) to Barlow's Disease (BD). This
genome-wide association study (GWAS) aims to shed light on the
associations of genetic variants with MVP, especially focusing on subtypes
FED and BD. <br/>Method(s): The cohort included all consecutive patients
who underwent mitral valve surgery for degenerative MVP at the Department
of Cardiovascular Surgery or presented with symptomatic MVP at the
Department of Cardiology at the German Heart Center Munich between March
2002 and January 2021. Surgery protocols as well as echocardiographic data
in accordance with current ESC/EACTS guidelines were used to identify
degenerative MVP cases. After DNA extraction and genome-wide genotyping,
standard per variant and per individuals quality control was applied. The
imputation of 4.8 million common SNPs was carried out using the 1000
Genomes Project phase 3 haplotype reference panel. Multidimensional
scaling was performed to adjust for population stratification. The GWAS
included 2,140 cases and 9,000 controls. Global meta-analysis included a
publicly available dataset published by Roselli et al. in 2022. For
subgroup analyses, the cohort was subdivided into FED and BD phenotype,
based on clinical and morphological characteristics. Intermediate
phenotypes were excluded from the subgroup analysis. Subgroups were
analyzed via GWAS and investigated in meta-analyses with GWAS datasets
stratified from data from the MVP France study. <br/>Result(s): Within
this large cohort of 2,140 MVP patients, 84.5% (n = 1,809) suffered from
severe mitral regurgitation that required surgery. Meta-analysis of this
cohort was performed with 4,884 cases and 434,649 controls from the
Roselli study. For MVP, 40 loci reached genome-wide significance (p < 5 x
10^-8). Subgroup analysis included FED (n = 997) and BD (n =
788) cases with 11,439 controls and yielded two loci associated with FED
on chromosome 5q35.2 and 10q26.12. In association with BD, eight highly
significant SNPs all located on chromosome 5q23.3 were identified.
<br/>Conclusion(s): This GWAS comprises the largest single-center cohort
of patients with degenerative MVP to date. Novel risk loci associated with
MVP were identified. For the first time, risk loci for the subtypes FED
and Barlow's Disease were detected and may pave the way towards novel,
patient-specific therapeutic approaches.

<47>
Accession Number
643690396
Title
Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention in
Patients with Chronic Total Occlusion.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Kirov H.; Fischer J.; Caldonazo T.; Tasoudis P.; Soletti G.J.; Cancelli
G.; Dell A.M.; Mukharyamov M.; Doenst T.
Institution
(Kirov, Fischer, Caldonazo, Mukharyamov, Doenst)
Friedrich-Schiller-University, Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, Chapel Hill, United States
(Soletti, Cancelli, Dell) Weill Cornell Medicine, New York, United States
Publisher
Georg Thieme Verlag
Abstract
Background: Mechanisms of coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) differ as CABG provides surgical
collateralization and may prolong life by preventing future myocardial
infarctions (MI). However, CABG benefits are unclear in patients with
chronic total occlusion (CTO), where PCI has been used increasingly as a
lessinvasive alternative. <br/>Method(s): We performed a meta-analysis of
studies comparing outcomes in patients with CTO with/without multivessel
disease, who underwent CABG or PCI. Primary outcome was long-term
all-cause mortality (>=5 years). Secondary outcomes were long-term MI,
repeat revascularization, cardiac mortality, major adverse cardiovascular
events, and stroke, as well as short-term mortality (30-days/in-hospital)
and short-term stroke. A pooled Kaplan-Meier survival curve after
reconstruction analysis was generated. Random-effects models were used.
<br/>Result(s): Seven studies with 14,196 patients were included. In the
pooled Kaplan-Meier analysis CABG showed significantly lower risk of death
in the follow-up compared to PCI (HR = 2.08, 95% CI, 1.86-2.34, p <
0.001). CABG was also associated with lower rates of long-term MI (OR:
2.74, CI 95%, 1.96-3.83, p < 0.0001) and long-term repeat
revascularization (OR: 4.88, CI 95%, 1.99-11.91, p < 0.0001). The other
secondary endpoints did not show any significant difference.
<br/>Conclusion(s): CABG appears superior to PCI over time in patients
with CTO. This survival advantage may be associated with fewer events of
MI and repeat revascularization.

<48>
Accession Number
643690395
Title
3D printing Significantly Improves Procedural Understanding of Elective
Aortic Surgery Patients: A Prospective Randomized Cohort Trial.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Motekallemi A.; Esmaeili F.S.; Peivandi A.D.; Weber R.; Martens S.;
Rukosujew A.
Institution
(Motekallemi) Kassel Clinic, Kassel, Germany
(Motekallemi) Munster University Hospital, Munster, Germany
(Esmaeili, Martens) Klinik fur Herzchirurgie Munster, Munster, Germany
(Peivandi) University Hospital Muenster, Department of Cardiothoracic
Surgery, Muenster, France
(Weber, Rukosujew) Universitatsklinik Munster - Klinik fur Herzchirurgie
Munster, Munster, Germany
(Martens) Albert-Schweitzer-Campus 1, Munster, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: 3D printing is a rapidly evolving new technology with various
applications within cardiac surgery. It is mainly applied for individual
operational planning in complex congenital heart disease. Its impact on
procedural understanding of the patient has not yet been evaluated in a
structured manner. This is the first randomized cohort trial to evaluate
the value of patient-specific 3D printed models on procedural
understanding in patients for elective aortic surgery. <br/>Method(s): The
study was planned in collaboration with the Institute of Epidemiology and
Social Medicine and approved by the local ethics committee. Between April
2020 and June 2022 41 patients (21 females) for elective aortic procedures
were included and an intermediate analysis in accordance with the
previously defined power (>0.8) was performed. After randomization,
patients were informed with either conventional forms or with individual
3D models of their own aorta using a commercially available 3D printer.
Beside other factors, procedural understanding and localization of aortic
pathology were evaluated using a validated scoring system (based on the
illness perception questionnaire). General demographic data as well as the
educational and socio-economic background were surveyed separately. The
t-test was applied for comparison of means while the Mann-Whitney U-test
was applied for comparison of independent ordinal-scaled variables using
SPSS version 22.0 (IBM Corp, Armonk, NY). <br/>Result(s): This is the
first structured approach evaluating the (additional) value of 3D printing
on procedural understanding in aortic surgery patients. Mean age of the
patients in the 3D and conventional group was 63.6 years and 60.5 years
respectively. Patients informed with a 3D model of their aortic pathology
showed a significantly better understanding regarding their disease (p <
.001), operative procedure (p < 0.001) and localization of their pathology
(p = 0.015). The added value of the 3D model is independent of the
patient's gender, age, level of education or socio-economic background.
<br/>Conclusion(s): Within cardiac surgery, 3D printing has so far been
mainly used for procedure planning in complex (congenital) cases. However,
this study shows the potentials of this innovation for broader
applications beyond the singlecase mentality. This is the first
prospective randomized cohort trial to show a clear benefit of
individualized 3D printed models on patient illness and procedural
perception in aortic pathologies.

<49>
Accession Number
643690388
Title
Does Reduced Forced Expiratory Volume in One Second have an Influence on
Early Postoperative Outcomes after Minimally Invasive Mitral Valve
Surgery?.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Salman J.; Franz M.; Tavil S.; De Manna D.; Ius F.; Aburahma K.; Boethig
D.; Ruhparwar A.; Weymann A.
Institution
(Salman, Franz, Tavil, De Manna, Ius, Aburahma, Boethig, Ruhparwar,
Weymann) Hannover Medical School, Hannover, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Minimally invasive mitral valve surgery is the gold standard
surgical treatment for mitral valve pathologies. However, it is
technically challenging and demands longer surgery time and single lung
ventilation. This might impact the outcome of patients with impaired lung
function. We therefore investigated the early postoperative outcome of
patients with diminished forced expiratory volume in one second.
<br/>Method(s): In a retrospective cohort study, we compared patients with
a forced expiratory volume in one second (FEV1) of <80% and >=80% who
underwent minimally invasive mitral valve surgery. The primary endpoint
was 30-day mortality. Secondary endpoints were overall intubation time,
length of stay on intensive care unit as well as incidences of
postoperative respiratory insufficiency and pneumothorax. <br/>Result(s):
Data were collected from January 2011 until December 2022. A study group
(FEV1 <=80%, n = 297) and a control group (FEV1 >80%, n = 443) were
formed. Patients from the study group had a lower incidence of mitral
valve insufficiency (82% vs. 90%; p < 0.001) and a higher rate of mitral
valve stenosis (9% vs. 4%; p = 0.002). The repair rate was lower in the
study group (55% vs. 71%; p < 0.001). No difference was seen in surgery
time (208 vs. 207 minutes; p = 0.74) and time on cardiopulmonary bypass
(137 vs. 138 minutes; p = 0.72). Patients of the study group showed a
slightly higher incidence of postoperative wound healing disorder (10% vs.
5%; p = 0.016). No difference was seen in postoperative respiratory
insufficiency (8% vs. 5%; p = 0.068), arrhythmia (14% vs. 10%; p = 0.11),
pneumothorax (7% vs. 5%; p = 0.2), right ventricular failure (3% vs. 4%; p
= 0.84) and bleeding (10% vs. 6%; p = 0.085). Patients from the study
group had a longer intubation time (12 vs. 10 hours, p < 0.001) and time
on catecholamines (20 vs. 16 hours; p < 0.001). No difference was seen in
the 30-day mortality (2% vs. 2%; p = 1). <br/>Conclusion(s): Despite a
slightly longer intubation time and time on ICU, reduced FEV1 does not
affect the early postoperative outcome of patients undergoing minimally
invasive mitral valve surgery.

<50>
Accession Number
643690367
Title
Contemporary Surgical Aortic Valve Replacement in Elderly Patients.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Fischer Y.; Bhadra O.D.; Demal T.J.; Von D.H.I.; Hannen L.; Grundmann D.;
Voigtlander L.; Waldschmidt L.; Ludwig S.; Schirmer J.; Schofer N.; Pecha
S.; Blankenberg S.; Conradi L.; Reichenspurner H.; Seiffert M.; Schafer A.
Institution
(Fischer, Bhadra, Demal, Von, Hannen, Grundmann, Voigtlander, Waldschmidt,
Ludwig, Schirmer, Schofer, Pecha, Blankenberg, Conradi, Reichenspurner,
Seiffert, Schafer) University Heart and Vascular Center Hamburg, Hamburg,
Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Surgical Aortic Valve Replacement (SAVR) has steadily declined
in importance due to the increasing use of transcatheter Aortic Valve
Implantation (TAVI) in patients across all risk-strata. Due to large
randomized controlled trials comparing SAVR and TAVI current guidelines
still recommend SAVR for patients <75 years of age and at low surgical
risk. The aim of this study was to compare patients <75 years and >=75
years of age undergoing isolated SAVR in a single center patient cohort.
<br/>Method(s): From 03/2018 to 10/2022, 344 patients undergoing isolated
SAVR were enrolled in Hamburg Harbor registry. Of those, 275 patients were
<75 years of age (group 1, 62.5 +/- 10.9 years) and were compared to 69
patients >=75 years (group 2, 78.9 +/- 2.9 years, p <= 0.01). Acute
procedural and early clinical outcomes were adjudicated in accordance with
standardized VARC-3 definitions. Patients with acute endocarditis were
included. <br/>Result(s): Patients >=75 years presented a higher risk
profile according to STS risk stratification (group 1 vs. group 2, 0.9 +/-
1.1 vs. 1.8 +/- 1.6%, p <= 0.01). Aortic regurgitation as leading cause
for SAVR was significantly more present in patients <75 years of age (40.5
vs. 23.9%, p <= 0.01). No significant difference was found regarding
prevalence of infective endocarditis (13 vs. 12.7%, p = 1.0). Procedural
data revealed no differences in cardiopulmonary bypass time (98 +/- 45 vs.
89 +/- 25 minutes, p = 0.11) and cross clamp time (67 +/- 27 vs. 61 +/- 31
minutes, p = 0.18). Rates of stroke (2.17 vs. 1.31%, p = 1.0), acute renal
failure (5.5 vs. 7.0%, p = 0.77), new permanent pacemaker implantation
(PPI) (6.8 vs. 5.6%, p = 1.0) and intensive care unit stay (2 +/- 2.3 vs.
2 +/- 2.1 days, p = 1.0) were comparable between groups. Mean 30-day
aortic valve gradients (11.6 +/- 5.1 mmHg vs. 11.1 +/- 4.4 mmHg, p = 0.44)
and rates of paravalvular leakage >mild (0 vs. 1.4%, p = 0.2) showed
favorable hemodynamic results in both groups. Despite >10% of endocarditis
patients in both groups, rates of 30- day mortality were low (1.8 vs.
1.4%, p = 1.0). <br/>Conclusion(s): Both patient cohorts presented
excellent outcomes with low rates of mortality, stroke and PPI despite a
significant proportion of patients with infective endocarditis in both
groups. Decision to provide patients with SAVR or TAVI within a heart team
should be based on a multifactorial decision process including anatomical
parameters, clinical condition and considerations regarding lifetime
management of aortic valve disease.

<51>
Accession Number
643690322
Title
Long-Term Survival in Elderly Patients after Coronary Artery Bypass
Grafting Compared to the Age-Matched General Population-A Meta-analysis of
Reconstructed Time-to-event Data.
Source
Thoracic and Cardiovascular Surgeon. Conference: 53rd Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG. Hamburg
Germany. 72(Supplement 1) (no pagination), 2024. Date of Publication:
January 2024.
Author
Kirov H.; Caldonazo T.; Toshmatov S.; Tasoudis P.; Mukharyamov M.; Diab
M.; Doenst T.
Institution
(Kirov) Friedrich-Schiller-University, Jena, Germany
(Caldonazo, Toshmatov, Doenst) Jena University Hospital, Jena, Germany
(Tasoudis) University of North Carolina, Chapel Hill, United States
(Mukharyamov) University Hospital of Friedrich-Schiller, University Jena,
Jena, Germany
(Diab) Herz-Kreislauf-Zentrum Rotenburg a. d. Fulda, Rotenburg an der
Fulda, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Atherosclerotic coronary artery disease (CAD) limits life
expectancy compared to the general population. Myocardial infarctions (MI)
are the primary cause of death. The incidence of MI increases
progressively with age and most MI deaths occur in the population older
than 70 years. Coronary artery bypass grafting (CABG) may prevent the
occurrence of new MIs by bypassing most CAD lesions, providing downstream
"collateralization" to the diseased vessel. We systematically assessed the
survival-improving potential of CABG by comparing elderly CABG patients to
the age-matched general population. <br/>Method(s): Three databases were
assessed (MEDLINE, ScienceDirect and Cochrane Library). Primary and single
outcome was long-term all-cause mortality. Reconstruction of individual
patient survival data (IPD) was performed. As a sensitivity analysis,
summary hazard ratios (HR) and 95% confidence intervals (CI) for all
individual studies based on the reconstructed IPD were pooled for a
conventional two-stage meta-analysis. <br/>Result(s): A total of 1,352
studies were retrieved. Four studies and 6,917 patients were included in
the analysis. Elderly patients (>70 years) who underwent CABG had
significantly lower risk of death in the follow-up compared to the general
age-matched population in the one-stage (HR: 0.88, 95% CI: 0.83-0.94, p <
0.001) and in the two-stage survival analysis (HR 0.89, 95% CI 0.80-0.99,
p = 0.03). <br/>Conclusion(s): Elderly patients (>70 years) who undergo
CABG appear to have significantly better long-term survival compared to
the age-matched general population. This advantage becomes visible after
the first year and underscores the life-prolonging effect of bypass
surgery, which may eliminate the expected reduction in life expectancy
through CAD.

<52>
Accession Number
643673084
Title
Telemonitoring as an alternative to in-person follow-up for patients under
anticoagulation after cardiac surgery.
Source
Portuguese Journal of Public Health. Conference: 3rd Annual Summit of the
Comprehensive Health Research Centre, CHRC 2022. Lisbon Portugal.
41(Supplement 1) (pp 12), 2023. Date of Publication: May 2023.
Author
Silva T.; Coelho P.; Guede F.; Dias P.; Londral A.
Institution
(Silva, Coelho) Centro Hospitalar Universitario Lisboa Central, Lisboa,
Portugal
(Coelho, Londral) Comprehensive Health Research Centre (CHRC), NOVA
Medical School, Uiversidade NOVA de Lisboa, Lisbon, Portugal
(Guede, Dias, Londral) Value for Health CoLAB, Lisboa, Portugal
Publisher
S. Karger AG
Abstract
Objective: Growing medical indications for chronic anticoagulation has led
to an increase of patients under vitamin k antagonists. These patients
present a higher risk of complications, namely bleeding or thrombosis, due
to poor control. Periodical monitoring is required to reevaluate patients'
prescription. The goal is to assess whether a remote patient monitoring
service, based on the use of a coagulometer, provides a better control of
INR (International Normalized Ratio) values in patients undergoing
anticoagulant therapy after cardiac surgery, as compared to in-person
monitoring. <br/>Method(s): Prospective analysis of 30 patients, selected
to be followed-up both through a telemonitoring service and in-person, for
a period of six months for each monitoring method. <br/>Result(s):
Preliminary results for 20 patients show a high level of compliance and
patient satisfaction during the telemonitoring period, with patients
submitting their INR values in the online platform in 21 minutes average.
The median of absolute differences between the INR measurements and the
INR clinical goal decreased progressively during the telemonitoring
period. Concurrently, the TTR (Timing in Therapeutic Range) increased
progressively during the same period, from 40% in the first month to 70%
by the sixth month. The number of reported events was low but allowed for
the rapid assistance of patients when necessary. To date, only 5 patients
have completed both monitoring periods, with their TTR being higher during
the telemonitoring period. <br/>Conclusion(s): Increased TTR shows good
results from the telemonitoring method, with a high level of satisfaction
from patients. Telemonitoring is a feasible method to control INR values
in patients under anticoagulation after cardiac surgery, saving time and
costs.

<53>
Accession Number
2030924981
Title
The effect of CTCA guided selective invasive graft assessment on coronary
angiographic parameters and outcomes: Insights from the BYPASS-CTCA trial.
Source
Journal of Cardiovascular Computed Tomography. (no pagination), 2024.
Date of Publication: 2024.
Author
Kelham M.; Beirne A.-M.; Rathod K.S.; Andiapen M.; Wynne L.; Ramaseshan
R.; Learoyd A.E.; Forooghi N.; Moon J.C.; Davies C.; Bourantas C.V.;
Baumbach A.; Manisty C.; Wragg A.; Ahluwalia A.; Pugliese F.; Mathur A.;
Jones D.A.
Institution
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Baumbach, Wragg,
Ahluwalia, Mathur, Jones) Centre for Cardiovascular Medicine and Devices,
Faculty of Medicine & Dentistry, Queen Mary University of London, United
Kingdom
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Forooghi, Bourantas,
Baumbach, Wragg, Mathur, Jones) Barts Interventional Group, Barts Heart
Centre, Barts Health NHS Trust, London, United Kingdom
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Forooghi, Bourantas,
Baumbach, Manisty, Wragg, Ahluwalia, Pugliese, Mathur, Jones) NIHR Barts
Biomedical Research Centre, Barts Heart Centre and William Harvey Research
Institute, Queen Mary University of London, United Kingdom
(Learoyd, Ahluwalia, Jones) Barts Cardiovascular Clinical Trials Unit,
Faculty of Medicine & Dentistry, Queen Mary University of London, United
Kingdom
(Moon, Davies, Manisty, Pugliese) Department of Cardiac Imaging, Barts
Heart Centre, Barts Health NHS Trust, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Computed tomography cardiac angiography (CTCA) is recommended
for the evaluation of patients with prior coronary artery bypass graft
(CABG) surgery. The BYPASS-CTCA study demonstrated that CTCA prior to
invasive coronary angiography (ICA) in CABG patients leads to significant
reductions in procedure time and contrast-induced nephropathy (CIN),
alongside improved patient satisfaction. However, whether CTCA information
was used to facilitate selective graft cannulation at ICA was not protocol
mandated. In this post-hoc analysis we investigated the influence of CTCA
facilitated selective graft assessment on angiographic parameters and
study endpoints. <br/>Method(s): BYPASS-CTCA was a randomized controlled
trial in which patients with previous CABG referred for ICA were
randomized to undergo CTCA prior to ICA, or ICA alone. In this post-hoc
analysis we assessed the impact of selective ICA (grafts not invasively
cannulated based on the CTCA result) following CTCA versus non-selective
ICA (imaging all grafts irrespective of CTCA findings). The primary
endpoints were ICA procedural duration, incidence of CIN, and patient
satisfaction post-ICA. Secondary endpoints included the incidence of
procedural complications and 1-year major adverse cardiac events.
<br/>Result(s): In the CTCA cohort (n = 343), 214 (62.4%) patients had
selective coronary angiography performed, whereas 129 (37.6%) patients had
non-selective ICA. Procedure times were significantly reduced in the
selective CTCA + ICA group compared to the non-selective CTCA + ICA group
(-5.82min, 95% CI -7.99 to -3.65, p < 0.001) along with reduction of CIN
(1.5% vs 5.8%, OR 0.26, 95% CI 0.10 to 0.98). No difference was seen in
patient satisfaction with the ICA, however procedural complications (0.9%
vs 4.7%, OR 0.21, 95% CI 0.09-0.87) and 1-year major adverse cardiac
events (13.1% vs 20.9%, HR 0.55, 95% CI 0.32-0.96) were significantly
lower in the selective group. <br/>Conclusion(s): In patients with prior
CABG, CTCA guided selective angiographic assessment of bypass grafts is
associated with improved procedural parameters, lower complication rates
and better 12-month outcomes. Taken in addition to the main findings of
the BYPASS-CTCA trial, these results suggest a synergistic approach
between CTCA and ICA should be considered in this patient group.
Registration: ClinicalTrials.gov, NCT03736018.<br/>Copyright &#xa9; 2024
Society of Cardiovascular Computed Tomography

<54>
Accession Number
643691660
Title
Home-based mobile-guided exercise-based cardiac rehabilitation among
patients undergoing transcatheter aortic valve replacement (REHAB-TAVR):
protocol for a randomised clinical trial.
Source
BMJ open. 14(3) (pp e080042), 2024. Date of Publication: 07 Mar 2024.
Author
Shen Z.; Mi S.; Huang C.; Zhou D.; Pan W.; Xu X.; Lin Y.; Zhang Y.
Institution
(Shen, Huang, Xu) Department of Nursing, Zhongshan Hospital, Fudan
University, Shanghai, China
(Mi, Zhou, Pan) Department of Cardiology, Zhongshan Hospital, Fudan
University, Shanghai, China
(Lin) Department of Nursing, Zhongshan Hospital, Fudan University,
Shanghai, China
(Zhang) Department of Nursing, Zhongshan Hospital, Fudan University,
Shanghai, China
Abstract
INTRODUCTION: Transcatheter aortic valve replacement (TAVR) is a standard
treatment for aortic stenosis, particularly in older adults. Reduced
exercise capacity and frailty significantly impact outcomes in TAVR
patients, yet current management lacks strategies to address these issues.
This study aims to assess the effectiveness of home-based mobile-guided
exercise-based cardiac rehabilitation in TAVR patients, led by a
multidisciplinary team with clear progression milestones. METHODS AND
ANALYSIS: The study involves 90 patients aged 60-89 in a single centre who
will be randomised to a 3-month novel multidomain exercise intervention or
routine care. Outcome assessors will be blinded towards group allocation.
The primary outcome is the 6-min walk distance at month 3. The secondary
outcomes include the 6-min walk distance at month 6, physical function
measured by total Short Physical Performance Battery score and exercise
adherence measured by the Exercise Adherence Rating Scale at months 3 and
6. Additional outcome measures, including rehospitalisations, death,
handgrip strength, frailty (Fried Criteria and Essential Toolset),
cognitive function (Mini-Mental State Examination), quality of life
(EuroQol 5-Dimension 5-Level), nutritional status (Mini-Nutritional
Assessment), anxiety (General Anxiety Disorder-7), depression (Geriatric
Depression Scale), sleep (Pittsburgh Sleep Quality Index), functional
capacity (Duke Activity Status Index), clinical indices (body mass index,
symptoms, signs, left ventricular ejection fraction (LVEF), N-Terminal
Pro-Brain Natriuretic Peptide, etc) and social support (Lubben Social
Network Scale-6), along with comprehensive cost analysis, enhance the
study's significance. The study's findings hold crucial implications for
crafting an effective exercise-focused cardiac rehabilitation strategy for
TAVR patients. Community implementation not only deepens understanding but
also fosters the potential integration of exercise-based cardiac
rehabilitation into self-care, promising enhanced patient adherence and
overall cardiovascular health management. ETHICS AND DISSEMINATION:
Ethical approval was obtained from the Zhongshan Hospital, Fudan
University Ethics Committee (B2022-062R). Results will be disseminated to
local stakeholders and the research community through publications and
conferences. TRIAL REGISTRATION NUMBER: NCT05989594.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<55>
Accession Number
2030900409
Title
EFFECT OF DEXMEDETOMIDINE VERSUS LABETALOL FOR ATTENUATION OF HEMODYNAMIC
STRESS RESPONSE TO LARYNGOSCOPY AND INTUBATION.
Source
Journal of Cardiovascular Disease Research. 15(2) (pp 1596-1605), 2024.
Date of Publication: 2024.
Author
Reddy N.G.; Sekar R.G.; Spoorthi K.; Anusha S.; Deepak V.; Manisha B.
Institution
(Sekar) Department of Anesthesiology, Kamineni Institute of Medical
Sciences, Telangana, Narketpally, Nalgonda, India
Publisher
EManuscript Technologies
Abstract
Introduction: In the field of anaesthesiology, attenuation of pressor
response is one of the keenly researched subjects. As a standard practice
we use rigid laryngoscope to view the larynx and adjacent structures for
facilitating endotracheal intubation. This causes direct trauma to the
oropharynx and larynx and apart from this it also causes stimulation
resulting in a rise in heart rate, systolic blood pressure, diastolic
blood pressure, and mean arterial pressure. Tachycardia, hypertension, and
dysrhythmias all occur during laryngoscopy and intubations. <br/>Aim(s):
This study was done to compare the efficacy of dexmedetomidine 1 mug/kg;
and labetalol 0.3 mg/kg in attenuating the cardiovascular responses to
Laryngoscopy and Intubation, and to observe for adverse effects if any of
these two in the specified dosage. <br/>Material(s) and Method(s): This
randomized comparative double - blinded study was conducted in Kamineni
medical college in the year JAN-DEC 2023. After obtaining ethical
committee approval, the study population was chosen all the patients were
assessed preoperatively with history, clinical examination, and required
investigations, informed written consent was obtained from the patient.
The patients were randomly allocated into two groups. Group D (n: 45)
received Dexmedetomidine 1 mug/kg in 10ml normal saline IV. Over 10 min,
and subsequently 5min after induction of anesthesia was done. Group L (n:
45) received Labetalol 0.3 mg/kg 10 ml normal saline IV. over 10 min, 5
min prior to induction of anesthesia. All patients were pre medicated with
Inj. Midazolam 2 mg and Inj. Glycopyrrolate 0.2 mg IV. 45 min before
surgery Heart rate, systolic and diastolic blood pressure, and oxygen
saturation were recorded as the baseline value. <br/>Result(s): There was
a reduction in the heart rate and mean arterial pressure response to
intubation in both Dexmedetomidine and Labetalol groups, but when both the
groups were compared there was a statistically significant reduction of
heart rate and arterial pressure response to intubation in Dexmeditomidine
group (p< 0.05). There was no significant hypotension or bradycardia in
any of the groups. <br/>Conclusion(s): We conclude that Dexmeditomidine 1
mug/Kg given slowly over 10 minutes intravenously 5 minutes before
induction, attenuates the cardiovascular responses to laryngoscopy and
intubation in a better manner than Labetalol 0.3mg/Kg.<br/>Copyright
&#xa9; 2024 EManuscript Technologies. All rights reserved.

<56>
Accession Number
2030900352
Title
Postoperative acute kidney injury in major noncardiac surgery. Narrative
review.
Source
Colombian Journal of Anesthesiology. 52(2) (no pagination), 2024. Article
Number: e1098. Date of Publication: 2024.
Author
Patino A.P.B.; Tocancipa D.R.
Institution
(Patino, Tocancipa) Anesthesiology and Resuscitation, Universidad
Surcolombiana, Neiva, Colombia
(Tocancipa) Universidad Surcolombiana, Calle 9 No. 15-25, Neiva, Colombia
Publisher
Sociedad Colombiana de Anestesiologia y Reanimacion
Abstract
Postoperative acute kidney injury is an underdiagnosed condition. Its
incidence is variable and depends on demographic, clinical, and surgical
stress-associated factors; hence the pathophysiology is multifactorial. It
is extremely important to acknowledge those risk factors early and use
tools to estimate the risk of developing the condition, in order to adopt
perioperative measures to mitigate its occurrence and impact. Some of the
complications resulting from this condition include prolonged ICU stay,
higher susceptibility for infections, hospitalization-related
complications, progression to acute and chronic kidney failure, and even
the need for transient or permanent renal replacement therapies (RRT) in
addition to diseases that increase the cardiovascular risk, such as
systemic high blood pressure and/or coronary heart disease that result in
increased comorbidities and mortality, with subsequent increases in
healthcare costs, lower quality of life and increased burden of the
disease in the short and long term. A systematic search of the literature
was conducted in PubMed, Google Schoolar, and Lilacs, under the terms MeSh
and DeCs using Boolean operators; a review was conducted of the summary of
the articles identified and 57 of them were selected for their
comprehensive reading. This narrative review summarizes the relevant
information on this pathology for prevention and identification purposes,
for the adequate management of patients undergoing major non-cardiac
surgery.<br/>Copyright &#xa9; 2024 Sociedad Colombiana de Anestesiologia y
Reanimacion (S.C.A.R.E.). This is an open access article under the CC
BY-NC-ND license.

<57>
Accession Number
2030900285
Title
Risk of permanent pacemaker implantation following transcatheter aortic
valve replacement: Which factors are most relevant?.
Source
World Journal of Cardiology. 16(2) (pp 49-53), 2024. Date of Publication:
26 Feb 2024.
Author
Batta A.; Hatwal J.
Institution
(Batta) Department of Cardiology, Dayanand Medical College and Hospital,
Punjab, Ludhiana 141001, India
(Hatwal) Department of Internal Medicine, Post Graduate Institute of
Medical Education & Research, Chandigarh 160012, India
Publisher
Baishideng Publishing Group Inc
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as a formidable
treatment option for severe symptomatic aortic stenosis ahead of surgical
aortic valve replacement. The encouraging results from large randomized
controlled trials has resulted in an exponential rise in the use of TAVR
even in the low-risk patients. However, this is not without challenges.
Need for permanent pacemaker (PPM) post-TAVR remains the most frequent and
clinically relevant challenge. Naturally, identifying risk factors which
predispose an individual to develop high grade conduction block post-TAVR
is important. Various demographic factors, electrocardiographic features,
anatomic factors and procedural characteristics have all been linked to
the development of advanced conduction block and need for PPM following
TAVR. Amongst these electrophysiological variables, most notably a
prolonged QRS > 120 ms regardless of the type of conduction block seems to
be one of the strongest predictors on logistic regression models. The
index study by Nwaedozie et al highlights that patients requiring PPM
post-TAVR had higher odds of having a baseline QRS > 120 ms and were more
likely to be having diabetes mellitus that those who did not require
PPM.<br/>Copyright &#xa9; The Author(s) 2024. Published by Baishideng
Publishing Group Inc. All rights reserved.

<58>
Accession Number
2030881360
Title
Efficacy of Oral paracetamol-based postoperative analgesia in adult
cardiac surgery patients.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
13(2) (pp 340-343), 2024. Date of Publication: February 2024.
Author
Kumar S.; Singhal S.
Institution
(Kumar, Singhal) Department of Anaesthesia, FH Medical College and
Hospital, Etmadpur, UP, Agra, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: Following a sternotomy, chest tube insertion, and subsequent
leg vein incisions, patients undergoing heart surgery may experience pain
in the surrounding areas. The present study was conducted to assess the
effectiveness of oral paracetamol-based post-operative analgesia for adult
post-cardiac surgery patients post-extubation in the ICU. <br/>Material(s)
and Method(s): 120 adult patients undergoing Off-Pump Coronary Artery
Bypass Grafting (CABG) surgery of both genderswere divided into 2 groups.
When the patients in group I were on a ventilator and sponged the
following morning at approximately five in the morning, two 250 mg
suppositories of Paracetamol were given to them. Group II patients were
given placebos. Pain control was assessed in all patients using a Numeric
Rating Scale (NRS) of 0 to 10. <br/>Result(s): The mean weight was 70.4
kgs in group I and 75.8 kgs in group II. The mean height was 172.7 cm in
group I and 178.5 cm in group II. The ejection fraction was 63.4 in group
I and 61.2 in group II. Cardiopulmonary bypass time was 116.8 minutes in
group I and 113.5 minutes in group II. The duration of anesthesia was
312.4 minutes in group I and 328.6 minutes in group II. Aortic cross-clamp
time was 90.2 minutes in group I and 88.1 minutes in group II and
extubation time was 4.3 hours in group I and 5.2 hours in group II. The
difference was non- significant (P> 0.05). The mean pain score (VAS) at 12
hours was 3.7 in group I and 6 in group II, at 24 hours was 2.5 in group I
and 5.2 in group II, at 48 hours was 1.9 in group I and 3.5 in group II
and at 72 hours was 1.3 in group I and 2.2 in group II. The difference was
significant (P< 0.05). Morphine consumption was 55.4 mg in group I and
92.2 mg in group II. Rescue doses of morphine were needed in 13.4 patients
in group I and 25.3 patients in group II and PONV was seen in 7.5 in group
I and 2.4 in group II. The difference was significant (P< 0.05).
<br/>Conclusion(s): The analgesic effects were excellent, and the patients
felt at ease using the procedure. This straightforward postoperative
analgesic treatment is very affordable, easy to follow, and has no
significant adverse effects.<br/>Copyright &#xa9; 2024 Int. J. Life Sci.
Biotechnol. Pharma. Res.

<59>
Accession Number
2028938467
Title
Prevalence of spinal deformity development after surgical management of a
congenital heart disease among children: a systematic review and
meta-analysis.
Source
European Spine Journal. (no pagination), 2024. Date of Publication: 2024.
Author
Balubaid R.N.; Aljedani R.S.; Moglan A.; Hennawi Y.B.; Mousa A.H.;
Alosaimi M.
Institution
(Balubaid, Aljedani, Moglan, Alosaimi) College of Medicine, King Saud Bin
Abdulaziz University For Health Sciences, Jeddah, Saudi Arabia
(Hennawi) Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi
Arabia
(Mousa) College of Medicine and Surgery, Batterjee Medical College,
Jeddah, Saudi Arabia
(Balubaid, Aljedani, Moglan, Hennawi, Mousa, Alosaimi) King Abdullah
International Medical Research Center, Jeddah, Saudi Arabia
(Alosaimi) Department of Orthopedic, King Abdulaziz Medical City, Jeddah,
Saudi Arabia
(Alosaimi) King Khalid National Guard Hospital, King Abdulaziz Medical
City, National Guard, Jeddah, Saudi Arabia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Open heart surgery is the most common treatment for
congenital heart disease. Thoracotomy, sternotomy, or a combination of
both are the main approaches used in open heart surgeries. In cardiac
surgery, there have been concerns that these surgeries increase the
likelihood of spinal deformities. Therefore, this systematic review and
meta-analysis provided updated evidence on the prevalence of spinal
deformities following congenital heart surgery. <br/>Method(s): EMBASE,
Medline, ScienceDirect, and Google Scholar were used to search for studies
published until 2022. We include randomized clinical trials and
observational studies that reported the prevalence of spinal deformities
(scoliosis and kyphosis) after congenital heart surgery among participants
without these deformities before surgery. Two independent reviewers
independently screened literature identified from the databases. Two
reviewers independently conducted screening of studies identified during
the search, data extraction, and quality assessment of the included
studies. <br/>Result(s): In total, 688 studies were screened; 13
retrospective and one prospective cohort studies were included,
encompassing 2294 participants. The pooled prevalence of spinal
deformities (scoliosis and kyphosis) after open heart surgery performed on
skeletally immature patients was 23.1% (95% confidence interval [CI] =
23.1-35.3; I² = 97.5%). <br/>Conclusion(s): This review
suggests that the prevalence of spinal deformities was high among patients
who underwent sternotomy or thoracotomy.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature 2024.

<60>
Accession Number
643691511
Title
Impact of pre-admission physical activity on benefits of physiology-guided
complete revascularization in older patients with myocardial infarction:
insights from the FIRE trial.
Source
European journal of preventive cardiology. (no pagination), 2024. Date of
Publication: 07 Mar 2024.
Author
Pavasini R.; Campo G.; Serenelli M.; Tonet E.; Guiducci V.; Escaned J.;
Moreno R.; Casella G.; Cavazza C.; Varbella F.; Sacchetta G.; Arena M.;
Santos I.A.; Ibanes E.G.; Scarsini R.; D'Amico G.; Ruiz-Poveda F.L.; Diez
Gil J.L.; Pignatelli G.; Iannopollo G.; Colaiori I.; Santos R.C.; Marrone
A.; Fileti L.; Rigattieri S.; Barbato E.; Ocaranza-Sanchez R.; Biscaglia
S.
Institution
(Pavasini, Campo, Serenelli, Tonet, Marrone, Biscaglia) Cardiology Unit,
Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara
44124, Italy
(Guiducci, Pignatelli) Cardiology Unit, S. Maria Nuova Hospital, Viale
Risorgimento 80, Italy
(Escaned) Cardiovascular Department, Hospital Clinico San Carlos IDISCC,
Complutense University of Madrid, Calle del Prof Martin Lagos s/n, Madrid
28040, Spain
(Moreno) Interventional Cardiology, University Hospital La Paz, Paseo La
Castellana ,261, Madrid 28046, Spain
(Casella, Iannopollo) Cardiology Unit, Ospedale Maggiore ,Largo Nigrisoli
2, Bologna 40133, Italy
(Cavazza) Cardiovascular Department, Infermi Hospital, Viale Luigi
Settembrini 2, Rimini 47923, Italy
(Varbella) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Rivoli (TO)
10098, Italy
(Sacchetta) Cardiology Unit, Umberto I Hospital, ASP Siracusa, Via
Giuseppe Testaferrata, Siracusa 96100, Italy
(Arena) S.C. Cardiologia, Ospedale Sant'Andrea, La Spezia 19124, Italy
(Santos) Department of Cardiology, Centro de Investigacion Biomedica en
Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Clinico
Universitario, Valladolid 47003, Spain
(Ibanes) Department of Cardiology, Centro de Investigation Biomedica end
Red en Enfermedades Cardiovasculares, H. Universitario y Politecnico La
Fe, Valencia 46026, Spain
(Scarsini) Cardiovascular Department, Azienda Ospedaliero Universitaria
Integrata di Verona, Piazzale Aristide Stefani, 1 - 37126 Verona, Italy
(D'Amico) Interventional Cardiology, Department of Cardio-Thoracic and
Vascular Sciences, Ospedale dell'Angelo ,Via Paccagnella ,12, 35128 Mestre
(Venice), Italy
(Ruiz-Poveda) Cardiovascular Department, Hospital General Universitario de
Ciudad Real, Ciudad Real 13001, Spain
(Diez Gil) Cardiology Unit, Hospital San Giovanni di Dio, Azienda
Sanitaria Provinciale Agrigento, Agrigento 92100, Italy
(Colaiori) Cardiology Unit, Ospedale Santa Maria Goretti, Via Lucia
Scaravelli, Latina 04100, Italy
(Santos) Department of Interventional Cardiology, Complexo Hospitalario
Universitario A Coruna (CHUAC), As Xubias ,84, 15006 A Coruna, Spain
(Fileti) Cardiology Department, S. Maria delle Croci Hospital, Viale Randi
5, Ravenna 48121, Italy
(Rigattieri, Barbato) Department of Clinical and Molecular Medicine,
Sapienza University of Rome, Via di Grottarossa, Italy
(Ocaranza-Sanchez) Servicio de Cardiologia, Hospital Universitario Lucus
Augusti, Lugo 27001, Spain
Abstract
AIMS: The present analysis from the Functional Assessment in Elderly
Myocardial Infarction Patients with Multivessel Disease (FIRE) trial aims
to explore the significance of pre-admission physical activity and assess
whether the benefits of physiology-guided complete revascularization apply
consistently to sedentary and active older patients. METHODS AND RESULTS:
Patients aged 75 years or more with myocardial infarction (MI) and
multivessel disease were randomized to receive physiology-guided complete
revascularization or culprit-only strategy. The primary outcome was a
composite of death, MI, stroke, or any revascularization within a year.
Secondary endpoints included the composite of cardiovascular death or MI,
as well as single components of the primary endpoint. Pre-admission
physical activity was categorized into three groups: (i) absent
(sedentary), (ii) light, and (iii) vigorous. Among 1445 patients, 692
(48%) were sedentary, whereas 560 (39%) and 193 (13%) performed light and
vigorous physical activity, respectively. Patients engaging in light or
vigorous pre-admission physical activity exhibited a reduced risk of the
primary outcome compared with sedentary individuals [light hazard ratio
(HR) 0.70, 95% confidence interval (CI) 0.55-0.91 and vigorous HR 0.14,
95% CI 0.07-0.91, respectively]. These trends were also observed for
death, cardiovascular death, or MI. When comparing physiology-guided
complete revascularization vs. culprit-only strategy, no significant
interaction was observed for primary and secondary endpoints when
stratified by sedentary or active status. <br/>CONCLUSION(S): In older
patients with MI, pre-admission physical activity emerges as a robust and
independent prognostic determinant. Physiology-guided complete
revascularization stands out an effective strategy in reducing ischaemic
adverse events, irrespective of pre-admission physical activity status.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT03772743.<br/>Copyright
&#xa9; The Author(s) 2024. Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved. For
permissions, please e-mail: journals.permissions@oup.com.

<61>
Accession Number
643686019
Title
Effect of Esketamine on Postoperative Delirium in Patients Undergoing
Cardiac Valve Replacement with Cardiopulmonary Bypass: A Randomized
Controlled Trial.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 06
Mar 2024.
Author
Xiong X.; Shao Y.; Chen D.; Chen B.; Lan X.; Shi J.
Institution
(Xiong, Shao, Chen, Lan, Shi) From the Department of Anesthesiology,
Affiliated Hospital of Guizhou Medical University, Guiyang, China
(Chen) Department of Anesthesiology, West China Second Hospital, Sichuan
University, Chengdu, China
Abstract
BACKGROUND: The aim of this study was to investigate the effects of
esketamine on the risk of postoperative delirium (POD) in adults
undergoing on-pump cardiac valve surgery. <br/>METHOD(S): In this
randomized, triple-blind, controlled trial, 116 adult patients with an
American Society of Anesthesiologists (ASA) grade II or III and a New York
Heart Association (NYHA) grade II or III who underwent cardiac valve
surgery with cardiopulmonary bypass were included. Esketamine (0.25 mg/kg)
or normal saline was administered intravenously before anesthesia
induction. The primary outcome was POD, defined as a positive delirium
assessment according to the 3-minute confusion assessment method (CAM) or
the confusion assessment method for the intensive care unit (CAM-ICU) on a
twice-daily basis for 7 days after surgery. Delirium duration and the
delirium subtype were also recorded. The cognitive status of patients was
measured according to the Mini-Mental State Examination at baseline,
discharge, 30 days postoperatively and 3 months postoperatively.
<br/>RESULT(S): A total of 112 patients (mean age, 52 years; 53.6% female)
were enrolled; 56 were assigned to receive esketamine, and 56 were
assigned to receive placebo. POD occurred in 13 (23.2%) patients in the
esketamine group and in 25 (44.6%) patients in the placebo group (relative
risk [RR], 0.52, 95% confidence interval [CI], 0.28-0.91; P = .018).
Thirteen patients (23.2%) in the esketamine group and 24 (42.9%) patients
in the placebo group had multiple episodes of delirium (RR, 0.54, 95% CI,
0.28-0.92), and 13 (23.2%) vs 22 (39.3%) patients exhibited the
hyperactive subtype. <br/>CONCLUSION(S): A single dose of esketamine (0.25
mg/kg) injected intravenously before anesthesia induction reduced the
incidence of delirium in relatively young patients with ASA grade II or
III who underwent on-pump cardiac surgery.<br/>Copyright &#xa9; 2024
International Anesthesia Research Society.

<62>
Accession Number
643685860
Title
The effect of omentoplasty in various surgical operations: Systematic
review and meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 04 Mar 2024.
Author
Peng Y.; Xiong S.; Ding Y.; Xie L.; Wang Y.; Mei Y.; Liu W.; Deng T.
Institution
(Peng, Xiong, Ding, Xie, Wang, Mei, Deng) National Clinical Research
Center for Metabolic Diseases, Department of Metabolism and Endocrinology,
Second Xiangya Hospital of Central South University, Changsha, Hunan,
China
(Peng, Xiong, Ding, Xie, Wang, Mei, Deng) Key Laboratory of Diabetes
Immunology, Ministry of Education, Metabolic Syndrome Research Center,
Second Xiangya Hospital of Central South University, Changsha, Hunan,
China
(Liu) Department of Biliopancreatic Surgery and Bariatric Surgery, Second
Xiangya Hospital, Central South University, Changsha, Hunan, China
(Deng) Clinical Immunology Center, Second Xiangya Hospital of Central
South University, Changsha, Hunan, China
Abstract
BACKGROUND: Omentoplasty is commonly used in various surgeries. However,
its effectiveness is unsure due to lack of convincing data and research.
To clarify the impact of omentoplasty on postoperative complications of
various procedures, this systematic review and meta-analysis was
performed. <br/>METHOD(S): A systematic review of published literatures
from four databases: PubMed, Web of Science, Cochrane Library, and Embase
before July 14, 2022. We primarily included publications on five major
surgical operations performed in conjunction with omentoplasty: thoracic
surgery, esophageal surgery, gastrointestinal surgery, pelvi-perineal
surgery, and liver surgery. The protocol was registered in PROSPERO.
<br/>RESULT(S): This review included 25 273 patients from 91 studies (n=9
670 underwent omentoplasty). Omentoplasty was associated with a lower risk
of overall complications particularly in gastrointestinal (RR 0.53; 95%CI
0.39-0.72) and liver surgery (RR 0.54; 95%CI 0.39-0.74). Omentoplasty
reduced the risk of postoperative infection in thoracic (RR 0.38; 95%CI
0.18-0.78) and liver surgery (RR 0.39; 95%CI 0.29-0.52). In patients
undergoing esophageal (RR 0.89; 95%CI 0.80-0.99) and gastrointestinal (RR
0.28; 95%CI 0.23-0.34) surgery with a BMI greater than 25, omentoplasty is
significantly associated with a reduced risk of overall complications
compared to patients with normal BMI. No significant differences were
found in pelvi-perineal surgery, except infection in patients whose BMI
ranged from 25 kg/m2 to 29.9 kg/m2 (RR 1.25; 95%CI 1.04-1.50) and
anastomotic leakage in patients aged over 60 (RR 0.59; 95%CI-0.39-0.91).
<br/>CONCLUSION(S): Omentoplasty can effectively prevent postoperative
infection. It is associated with a lower incidence of multiple
postoperative complications in gastrointestinal and liver
surgery.<br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<63>
Accession Number
643685301
Title
Use of Intravenous Albumin: A Guideline from the International
Collaboration for Transfusion Medicine Guidelines.
Source
Chest. (no pagination), 2024. Date of Publication: 04 Mar 2024.
Author
Callum J.; Skubas N.J.; Bathla A.; Keshavarz H.; Clark E.G.; Rochwerg B.;
Fergusson D.; Arbous S.; Bauer S.R.; China L.; Fung M.; Jug R.; Neill M.;
Paine C.; Pavenski K.; Shah P.S.; Robinson S.; Shan H.; Szczepiorkowski
Z.M.; Thevenot T.; Wu B.; Stanworth S.; Shehata N.
Institution
(Callum) Department of Pathology and Molecular Medicine, Queen's
University and Kingston Health Sciences Centre, Canada
(Skubas) Department of Cardiothoracic Anesthesiology, Anesthesiology
Institute, Cleveland Clinic Lerner College of Medicine of Case Western
Reserve University, United States
(Bathla, Keshavarz) Canadian Blood Services, Canada
(Clark) Division of Nephrology, Department of Medicine, University of
Ottawa, Canada
(Rochwerg) Department of Medicine and Department of Health Research
Methods, Faculty of Health Sciences, McMaster University, Canada
(Fergusson) Ottawa Hospital Research Institute, Canada
(Arbous) Department of Critical Care, Leiden University Medical Center,
Netherlands
(Bauer) Department of Pharmacy, Cleveland Clinic, United States
(China) Department of Hepatology & ILDH, Royal Free NHS Trust, University
College London, London, United Kingdom
(Fung) Department of Pathology and Laboratory Medicine, University of
Vermont Medical Center, Burlington, VT, United States
(Jug) University of Cincinnati College of Medicine, Cincinnati, OH, United
States
(Neill) Patient representative
(Paine) Division of Nephrology, Department of Medicine, University of
Washington, United States
(Pavenski) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Canada
(Shah) Department of Clinical Haematology, NHS Foundation Trust, Guy's and
St Thomas, United Kingdom
(Robinson) Department of Pediatrics, Mount Sinai Hospital; Institute of
Health Policy, Management, and Evaluation, University of Toronto, Canada
(Shan) Department of Pathology, Stanford University School of Medicine,
United States
(Szczepiorkowski) Department of Pathology and Laboratory Medicine,
Dartmouth-Hitchcock Medical Center, NH, United States
(Thevenot) Service d'Hepatologie, Centre Hospitalier Regional et
Universitaire de Besancon, France
(Wu) Department of Internal Medicine, Graduate Medical Education, Loma
Linda University, Loma Linda, CA, United States
(Stanworth) NHS Blood and Transplant, Oxford, UK; Radcliffe Department of
Medicine, University of Oxford, Oxford, UK; Oxford University Hospitals
NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
(Shehata) Department of Medicine, University of Toronto; Transfusion
Medicine Laboratory, Mount Sinai Hospital, Canada
Abstract
BACKGROUND: Albumin is commonly employed across a wide range of clinical
settings to improve hemodynamics, facilitate fluid removal, and manage
complications of cirrhosis. The International Collaboration for
Transfusion Medicine Guidelines developed guidelines for the use of
albumin in patients requiring critical care, undergoing cardiovascular
surgery, kidney replacement therapy, or experiencing complications of
cirrhosis. <br/>METHOD(S): Co-chairs oversaw the guideline development
process and the panel included researchers, clinicians, methodologists,
and a patient representative. The evidence informing this guideline arises
from a systematic review of randomized clinical trials and systematic
reviews, in which multiple databases were searched (inception to November
23, 2022). The panel reviewed the data and formulated the guideline
recommendations using Grading of Recommendations Assessment, Development
and Evaluation (GRADE) methodology. The guideline was revised after public
consultation. <br/>RESULT(S): The panel made 14 recommendations on albumin
use in adult critical care (3 recommendations), pediatric critical care (1
recommendation), neonatal critical care (2 recommendations),
cardiovascular surgery (2 recommendations), kidney replacement therapy (1
recommendation), and complications of cirrhosis (5 recommendations). Of
the 14 recommendations, 2 had moderate certainty of evidence, 5 had low
certainty of evidence, and 7 had very low certainty of evidence. Two of
the 14 recommendations suggested conditional use of albumin for patients
with cirrhosis undergoing large volume paracentesis or with spontaneous
bacterial peritonitis. Twelve of 14 recommendations did not suggest
albumin use in a wide variety of clinical situations where albumin is
commonly transfused. <br/>CONCLUSION(S): There are currently few
evidence-based indications that support the routine use of albumin in
clinical practice to improve patient outcomes. This guideline provides
clinicians with actionable recommendations on the use of
albumin.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<64>
Accession Number
643685123
Title
New-onset post-operative AF recurrence after cardiac surgery detected by
implantable loop recorders: A systematic review and Meta-analysis.
Source
International journal of cardiology. (pp 131930), 2024. Date of
Publication: 04 Mar 2024.
Author
Kaur H.; Tao B.; Silverman M.; Healey J.S.; Belley-Cote E.P.; Islam S.;
Whitlock R.P.; Devereaux P.J.; Conen D.; Bidar E.; Kawczynski M.;
Ayala-Paredes F.; Ayala-Valani L.; Sandgren E.; El-Chami M.; Jorgensen
T.H.; Thyregod H.G.; Sabbag A.; McIntyre W.F.
Institution
(Kaur, Silverman) Michael G. DeGroote School of Medicine, Hamilton,
Ontario, Canada
(Tao) University of British Columbia, BC, Canada
(Healey, Belley-Cote, Islam, Whitlock, Devereaux, Conen, McIntyre)
Population Health Research Institute, ON, Canada
(Bidar, Kawczynski) Maastricht University Medical Centre (MUMC),
Maastricht, the Netherlands; CardioVascular Research Institute Maastricht
(CARIM), the Netherlands
(Ayala-Paredes, Ayala-Valani) Sherbrooke University, QC, Canada
(Sandgren) Department of Medicine, Halland Hospital Varberg, Varberg,
Sweden
(El-Chami) Department of Medicine, Emory University School of Medicine,
Atlanta, United States
(Jorgensen, Thyregod) Department of Cardiovascular Surgery, Copenhagen
University Hospital, Copenhagen, Denmark
(Sabbag) Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan and
the Faculty of Median, Tel-Aviv University, Israel
Abstract
BACKGROUND: Atrial fibrillation (AF) is one of the most common
complications after cardiac surgery. New-onset post-operative AF may
signal an elevated risk of AF and associated outcomes in long-term
follow-up. We aimed to estimate the rate of AF recurrence as detected by
an implantable loop recorder (ILR) in patients experiencing post-operative
AF within 30days after cardiac surgery. <br/>METHOD(S): We searched
MEDLINE, Embase and Cochrane CENTRAL to April 2023 for studies of adults
who did not have known AF, experienced new-onset AF within 30days of
cardiac surgery and received an ILR. We pooled individual participant data
on timing of AF recurrence using a random-effects model with a frailty
model applied to a Cox proportional hazard analysis. <br/>RESULT(S): From
8671 citations, 8 single-centre prospective cohort studies met eligibility
criteria. Data were available from 185 participants in 7 studies, with a
median follow-up of 1.7 (IQR: 1.3-2.8) years. All included studies were at
a low risk of bias. Pooled AF recurrence rates following 30 post-operative
days were 17.8% (95% CI 11.9%-23.2%) at 3months, 24.4% (17.7%-30.6%) at
6months, 30.1% (22.8%-36.7%) at 12months and 35.3% (27.6%-42.2%) at
18months. <br/>CONCLUSION(S): In patients who experience new-onset
post-operative AF after cardiac surgery, recurrence lasting at least 30s
occurs in approximately 1 in 3 in the first year after surgery. The
optimal frequency and modality to use for monitoring for AF recurrence in
this population remain uncertain.<br/>Copyright &#xa9; 2024. Published by
Elsevier B.V.

<65>
Accession Number
643680148
Title
A commentary on "Efficacy and safety of vitamin C for atrial fibrillation
after cardiac surgery: A meta-analysis with trial sequential analysis of
randomized controlled trials".
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 04 Mar 2024.
Author
Wang C.; Sun Z.; Zhou W.
Institution
(Wang) Graduate School of Tianjin University of Traditional Chinese
Medicine, Tianjin 301600, China
(Sun) School of Chinese Materia Medica, Beijing University of Chinese
Medicine, Beijing, China
(Zhou) Second Affiliated Hospital of Tianjin University of Traditional
Chinese Medicine, Tianjin 300000, China

<66>
Accession Number
643679655
Title
Outcomes by sex in the International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2024. Date of Publication: 05 Mar 2024.
Author
Gaudino M.; Alexander J.H.; Sandner S.; Harik L.; Kim J.; Stone G.W.;
Rahouma M.; O'Gara P.; Bhatt D.L.; Redfors B.
Institution
(Gaudino, Harik, Rahouma) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, USA
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Kim) Division of Biostatistics, Department of Population Health Sciences,
Weill Cornell Medicine, New York, NY, USA
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, USA
(O'Gara) Department of Medicine, Brigham and Women's Hospital, Boston, MA,
United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, USA
(Redfors) Department of Cardiology, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
Abstract
BACKGROUND: In the International Study of Comparative Health Effectiveness
With Medical and Invasive Approaches (ISCHEMIA) trial, among participants
with stable coronary artery disease, the risk of cardiac events was
similar between an invasive (INV) strategy of angiography and coronary
revascularisation and a conservative (CON) strategy of initial medical
therapy alone. Outcomes according to participant sex were not reported.
AIMS: We aimed to analyse the outcomes of ISCHEMIA by participant sex.
<br/>METHOD(S): We evaluated 1) the association between participant sex
and the likelihood of undergoing revascularisation for participants
randomised to the INV arm; 2) the risk of the ISCHEMIA primary composite
outcome (cardiovascular death, any myocardial infarction [MI] or
rehospitalisation for unstable angina, heart failure or resuscitated
cardiac arrest) by participant sex; and 3) the contribution of the
individual primary outcome components to the composite outcome by
participant sex. <br/>RESULT(S): Of 5,179 randomised participants, 1,168
(22.6%) were women. Female sex was independently associated with a lower
likelihood of revascularisation when assigned to the INV arm (adjusted
odds ratio 0.75, 95% confidence interval [CI]: 0.57-0.99; p=0.04). The INV
versus CON effect on the primary composite outcome was similar between
sexes (women: hazard ratio [HR] 0.96, 95% CI: 0.70-1.33; men: HR 0.90, 95%
CI: 0.76-1.07; pinteraction=0.71). The contribution of the individual
components to the composite outcome was similar between sexes except for
procedural MI, which was significantly lower in women (9/151 [5.9%]) than
men (67/519 [12.9%]; p=0.01). <br/>CONCLUSION(S): In ISCHEMIA, women
assigned to the INV arm were less likely to undergo revascularisation than
men. The effect of an INV versus CON strategy was consistent by sex, but
women had a significantly lower contribution of procedural MI to the
primary outcome.

<67>
Accession Number
643679335
Title
Enhanced recovery after surgery from 1997 to 2022: a bibliometric and
visual analysis.
Source
Updates in surgery. (no pagination), 2024. Date of Publication: 06 Mar
2024.
Author
Dong J.; Lei Y.; Wan Y.; Dong P.; Wang Y.; Liu K.; Zhang X.
Institution
(Dong, Wang) Department of Anesthesiology, Second Hospital & Clinical
Medical School, Lanzhou University, Lanzhou, Gansu, China
(Dong, Lei, Liu, Zhang) Department of Anesthesiology, Nanfang Hospital,
Southern Medical University, Guangdong Provincial Key Laboratory of
Precision Anaesthesia and Perioperative Organ Protection, 1838 Guangzhou
Avenue North, Guangzhou, Guangdong 510515, China
(Wan) Guangdong Provincial Key Laboratory of Proteomics, School of Basic
Medical Sciences, Southern Medical University, Guangzhou, China
(Dong) College of Anesthesiology, Southern Medical University, Guangzhou,
China
Abstract
Enhanced recovery after surgery (ERAS) is a multimodal perioperative
management concept, but there is no article to comprehensively review the
collaboration and impact of countries, institutions, authors, journals,
references, and keywords on ERAS from a bibliometric perspective. This
study assessed the evolution of clustering of knowledge structures and
identified hot trends and emerging topics. Articles and reviews related to
ERAS were retrieved through subject search from the Web of Science Core
Collection. We used the following strategy: "TS=Enhanced recovery after
surgery" OR "Enhanced Postsurgical Recovery" OR "Postsurgical Recoveries,
Enhanced" OR "Postsurgical Recovery, Enhanced" OR "Recovery, Enhanced
Postsurgical" OR "Fast track surgery" OR "improve surgical outcome".
Bibliometric analyses were conducted on Excel 365, CiteSpace, VOSviewer,
and Bibliometrics (R-Tool of R-Studio). Totally 3242 articles and reviews
from 1997 to 2022 were included. These publications were mainly from 684
journals in 78 countries, led by the United States and China. Kehlet H
published the most papers and had the largest number of co-citations.
Analysis of the journals with the most outputs showed that most journals
mainly cover Surgery and Oncology. The hottest keyword is "enhanced
recovery after surgery". Later appearing topics and keywords indicate that
the hotspots and future research trends include ERAS protocols for other
types of surgery and improving perioperative status, including "bariatric
surgery", "thoracic surgery", and "prehabilitation". This study reviewed
the research on ERAS using bibliometric and visualization methods, which
can help scholars better understand the dynamic evolution of ERAS and
provide directions for future research.<br/>Copyright &#xa9; 2024. Italian
Society of Surgery (SIC).

<68>
Accession Number
643679137
Title
Moderate ischemic mitral regurgitation in ischemic heart disease: to
operate or not? A meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2024. Date of
Publication: 06 Mar 2024.
Author
Alsuayri R.A.; Alassiri A.K.; Awad A.K.; Faleh M.N.; Baqays R.T.;
Porqueddu M.
Institution
(Alsuayri) Batterjee Medical College for Sciences and Technology, Jeddah,
Saudi Arabia
(Alassiri) Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi
Arabia
(Awad) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Faleh) College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
(Baqays, Porqueddu) Department of Cardiac Surgery, King Fahd Armed Forces
Hospital, Jeddah, Saudi Arabia
Abstract
INTRODUCTION: Deciding whether to perform coronary artery bypass grafting
(CABG) alone or in combination with mitral valve repair is a common
dilemma encountered by surgeons when treating patients with ischemic
mitral regurgitation, a common condition related to coronary artery
disease. Although ischemic mitral regurgitation after CABG has been linked
to unfavorable results, the benefits of including mitral valve repair are
still unknown. This discrepancy led us to undertake a systematic review
and meta-analysis to determine whether combining CABG with mitral valve
surgery leads to better clinical results than CABG alone. EVIDENCE
ACQUISITION: Studies comparing the results of CABG versus CABG with mitral
valve replacement were searched in the databases of PubMed and Google
Scholar. There were six randomized clinical trials included in this study.
EVIDENCE SYNTHESIS: We analyzed 852 patients' data. There were no
significant variations between patients who acquired CABG alone or
CABG+(MVR) in terms of their risk of death at one year, stroke, atrial
fibrillation, or hospitalization for heart failure. For recurrent/residual
mitral regurgitation; it revealed an RR=5.42, 95% CI, 0.77 to 37.98, and a
P-value of =0.065. According to the analysis of study heterogeneity, no
apparent heterogeneity was identified in the outcomes of death after one
year, stroke, atrial fibrillation, or hospitalization for heart failure.
However, the outcome of recurrent or residual mitral regurgitation showed
significant variation (I2=66%). <br/>CONCLUSION(S): Patients who underwent
CABG alone versus CABG plus MVR did not differ significantly from one
another. However, the comparison of CABG alone with CABG plus MVR
underlines the need for customized treatment plans based on the unique
characteristics of each patient.

<69>
Accession Number
2030773402
Title
More blood for patients with myocardial infarction and anaemia?.
Source
European Heart Journal. 45(9) (pp 651-652), 2024. Date of Publication: 01
Mar 2024.
Author
Pedicino D.; Vergallo R.
Institution
(Pedicino) Intensive Cardiac Care Unit, Department of Cardiovascular
Medicine, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Catholic
University of the Sacred Heart, Largo A. Gemelli 8, Rome 00168, Italy
(Vergallo) Interventional Cardiology Unit, Cardiothoracic and Vascular
Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova,
Italy
(Vergallo) Department of Internal Medicine and Medical Specialties (DIMI),
Universita di Genova, Genova, Italy
Publisher
Oxford University Press

<70>
Accession Number
2030773392
Title
Routine stress testing in diabetic patients after percutaneous coronary
intervention: the POST-PCI trial.
Source
European Heart Journal. 45(9) (pp 653-665), 2024. Date of Publication: 01
Mar 2024.
Author
Kim H.; Kang D.-Y.; Lee J.; Choi Y.; Ahn J.-M.; Kim S.; Yoon Y.-H.; Hur
S.-H.; Lee C.H.; Kim W.-J.; Kang S.H.; Park C.S.; Lee B.-K.; Suh J.-W.;
Choi J.W.; Kim K.-S.; Lee S.N.; Park S.-J.; Park D.-W.
Institution
(Kim, Kang, Lee, Choi, Ahn, Park, Park) Division of Cardiology, Asan
Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro
43-gil, Songpa-gu, Seoul 05505, South Korea
(Kim) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Yoon) Division of Cardiology, Chungnam National University Sejong
Hospital, Sejong, South Korea
(Hur, Lee) Division of Cardiology, Keimyung University Dongsan Hospital,
Daegu, South Korea
(Kim, Kang) Division of Cardiology, CHA Bundang Medical Center, Seongnam,
South Korea
(Park) Cardiovascular Center and Cardiology Division, Yeouido St. Mary's
Hospital, Seoul, South Korea
(Lee) Division of Cardiology, Kangwon National University Hospital,
Chuncheon, South Korea
(Suh) Cardiovascular Center, Seoul National University Bundang Hospital,
Seongnam, South Korea
(Choi) Division of Cardiology, Eulji General Hospital, Seoul, South Korea
(Kim) Division of Cardiology, Daegu Catholic University Medical Center,
Daegu, South Korea
(Lee) Division of Cardiology, St. Vincent's Hospital, Suwon, South Korea
Publisher
Oxford University Press
Abstract
Background and The optimal follow-up surveillance strategy for high-risk
diabetic patients with had undergone percutaneous coronary inter-Aims
vention (PCI) remains unknown. Methods The POST-PCI (Pragmatic Trial
Comparing Symptom-Oriented versus Routine Stress Testing in High-Risk
Patients Undergoing Percutaneous Coronary Intervention) study was a
randomized trial comparing a follow-up strategy of routine functional
testing at 1 year vs. standard care alone after high-risk PCI.
Randomization was stratified according to diabetes status. The primary
outcome was a composite of death from any cause, myocardial infarction, or
hospitalization for unstable angina at 2 years. Results Among 1706
randomized patients, participants with diabetes (n = 660, 38.7%) had more
frequent comorbidities and a higher prevalence of complex anatomical or
procedural characteristics than those without diabetes (n = 1046, 61.3%).
Patients with diabetes had a 52% greater risk of primary composite events
[hazard ratio (HR) 1.52; 95% confidence interval (CI) 1.02-2.27; P =
.039]. The 2-year incidences of the primary composite outcome were similar
between strategies of routine functional testing or standard care alone in
diabetic patients (7.1% vs. 7.5%; HR 0.94; 95% CI 0.53-1.66; P = .82) and
non-diabetic patients (4.6% vs. 5.1%; HR 0.89; 95% CI 0.51-1.55; P = .68)
(interaction term for diabetes: P = .91). The incidences of invasive
coronary angiography and repeat revascularization after 1 year were higher
in the routine functional-testing group than the standard-care group
irrespective of diabetes status. Conclusions Despite being at higher risk
for adverse clinical events, patients with diabetes who had undergone
high-risk PCI did not derive incremental benefit from routine surveillance
stress testing compared with standard care alone during
follow-up.<br/>Copyright &#xa9; 2024 Oxford University Press. All rights
reserved.

<71>
Accession Number
2030655824
Title
Intravascular imaging-guided coronary drug-eluting stent implantation: an
updated network meta-analysis.
Source
The Lancet. 403(10429) (pp 824-837), 2024. Date of Publication: 02 Mar
2024.
Author
Stone G.W.; Christiansen E.H.; Ali Z.A.; Andreasen L.N.; Maehara A.; Ahmad
Y.; Landmesser U.; Holm N.R.
Institution
(Stone) The Zena and Michael A Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Christiansen, Andreasen, Holm) Aarhus University Hospital, Aarhus,
Denmark
(Ali) St Francis Hospital, Roslyn, NY, United States
(Maehara) Cardiovascular Research Foundation, New York, NY, United States
(Maehara) Columbia University Medical Center, New York, NY, United States
(Ahmad) Yale School of Medicine, Yale University, New Haven, CT, United
States
(Landmesser) Deutsches Herzzentrum Charite, Charite Universitatsmedizin
Berlin, Berlin, Germany
(Landmesser) German Center for Cardiovascular Research (DZHK), Berlin,
Germany
Publisher
Elsevier B.V.
Abstract
Background: Previous meta-analyses have shown reduced risks of composite
adverse events with intravascular imaging-guided percutaneous coronary
intervention (PCI) compared with angiography guidance alone. However,
these studies have been insufficiently powered to show whether all-cause
death or all myocardial infarction are reduced with intravascular imaging
guidance, and most previous intravascular imaging studies were done with
intravascular ultrasound rather than optical coherence tomography (OCT), a
newer imaging modality. We aimed to assess the comparative performance of
intravascular imaging-guided PCI and angiography-guided PCI with
drug-eluting stents. <br/>Method(s): For this systematic review and
updated meta-analysis, we searched the MEDLINE, Embase, and Cochrane
databases from inception to Aug 30, 2023, for studies that randomly
assigned patients undergoing PCI with drug-eluting stents either to
intravascular ultrasound or OCT, or both, or to angiography alone to guide
the intervention. The searches were done and study-level data were
extracted independently by two investigators. The primary endpoint was
target lesion failure, defined as the composite of cardiac death, target
vessel-myocardial infarction (TV-MI), or target lesion revascularisation,
assessed in patients randomly assigned to intravascular imaging guidance
(intravascular ultrasound or OCT) versus angiography guidance. We did a
standard frequentist meta-analysis to generate direct data, and a network
meta-analysis to generate indirect data and overall treatment effects.
Outcomes were expressed as relative risks (RRs) with 95% CIs at the
longest reported follow-up duration. This study was registered with the
international prospective register of systematic reviews (PROSPERO, number
CRD42023455662). <br/>Finding(s): 22 trials were identified in which 15
964 patients were randomised and followed for a weighted mean duration of
24.7 months (longest duration of follow-up in each study ranging from 6 to
60 months). Compared with angiography-guided PCI, intravascular
imaging-guided PCI resulted in a decreased risk of target lesion failure
(RR 0.71 [95% CI 0.63-0.80]; p<0.0001), driven by reductions in the risks
of cardiac death (RR 0.55 [95% CI 0.41-0.75]; p=0.0001), TV-MI (RR 0.82
[95% CI 0.68-0.98]; p=0.030), and target lesion revascularisation (RR 0.72
[95% CI 0.60-0.86]; p=0.0002). Intravascular imaging guidance also reduced
the risks of stent thrombosis (RR 0.52 [95% CI 0.34-0.81]; p=0.0036), all
myocardial infarction (RR 0.83 [95% CI 0.71-0.99]; p=0.033), and all-cause
death (RR 0.75 [95% CI 0.60-0.93]; p=0.0091). Outcomes were similar for
OCT-guided and intravascular ultrasound-guided PCI.
<br/>Interpretation(s): Compared with angiography guidance, intravascular
imaging guidance of coronary stent implantation with OCT or intravascular
ultrasound enhances both the safety and effectiveness of PCI, reducing the
risks of death, myocardial infarction, repeat revascularisation, and stent
thrombosis. <br/>Funding(s): Abbott.<br/>Copyright &#xa9; 2024 Elsevier
Ltd

<72>
Accession Number
2030500215
Title
Use of Aprotinin versus Tranexamic Acid in Cardiac Surgery Patients with
High-Risk for Excessive Bleeding (APACHE) trial: a multicentre
retrospective comparative non-randomized historical study.
Source
European Journal of Cardio-thoracic Surgery. 65(2) (no pagination), 2024.
Article Number: ezae001. Date of Publication: 01 Feb 2024.
Author
Gallo E.; Gaudard P.; Provenchere S.; Souab F.; Schwab A.; Bedague D.; de
La Barre H.; de Tymowski C.; Saadi L.; Rozec B.; Cholley B.; Scherrer B.;
Fellahi J.-L.; Ouattara A.
Institution
(Gallo, Ouattara) Department of Cardiovascular Anaesthesia and Critical
Care, CHU Bordeaux, France
(Gaudard, Saadi) Department of Anaesthesia and Critical Care, Arnaud de
Villeneuve Hospital, Montpellier, France
(Provenchere, de Tymowski) Department of Anaesthesia and Critical Care,
Bichat Claude Bernard Hospital, Paris, France
(Souab, Rozec) Department of Anaesthesia and Critical Care, Hopital
Laennec, CHU Nantes, France
(Schwab, Fellahi) Department of Anaesthesia and Critical Care, Hospices
Civils de Lyon, France
(Bedague) Department of Anaesthesia and Critical Care, Grenoble-Alpes
University Hospital, France
(de La Barre, Cholley) Department of Anaesthesia and Critical Care,
Hopital Europeen Georges Pompidou, Paris, France
(Scherrer) Bruno Scherrer Conseil, Saint Arnoult en Yvelines, France
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Following the reintroduction of aprotinin into the European
market, the French Society of Cardiovascular and Thoracic
Anaesthesiologists recommended its prophylactic use at half-dose for
high-risk cardiac surgery patients. We examined whether the use of
aprotinin instead of tranexamic acid could significantly reduce severe
perioperative bleeding. <br/>METHOD(S): This multicentre, retrospective,
historical study included cardiac surgery patients treated with aprotinin
or tranexamic acid between December 2017 and September 2020. The primary
efficacy end point was the severe or massive perioperative bleeding (class
3-4 of the universal definition of perioperative bleeding). The safety
secondary end points included the occurrence of thromboembolic events and
all-cause mortality within 30 days after surgery. <br/>RESULT(S): Among
the 693 patients included in the study, 347 received aprotinin and 346
took tranexamic acid. The percentage of patients with severe or massive
bleeding was similar in the 2 groups (42.1% vs 43.6%, Adjusted odds ratio
[OR<inf>adj</inf>] 1/4 0.87, 95% confidence interval: 0.62-1.23, P 1/4
0.44), as was the perioperative need for blood products (81.0% vs 83.2%,
OR<inf>adj</inf> 1/4 0.75, 95% confidence interval: 0.48-1.17, P 1/4
0.20). However, the median (Interquartile range) 12 h postoperative blood
loss was significantly lower in the aprotinin group (383 ml [241-625] vs
450 ml [290-730], P < 0.01). Compared to tranexamic acid, the
intraoperative use of aprotinin was associated with increased risk for
thromboembolic events (adjusted Hazard ratio 2.30 [95% Cl: 1.06-5.30]; P
1/4 0.04). <br/>CONCLUSION(S): Given the modest reduction in blood loss at
the expense of a significant increase in thromboembolic adverse events,
aprotinin use in high-risk cardiac surgery patients should be based on a
carefully considered benefit-risk assessment.<br/>Copyright &#xa9; The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<73>
Accession Number
2028892048
Title
Use of induction therapy post-heart transplantation: Clinical practice
recommendations based on systematic review and network meta-analysis of
evidence.
Source
Clinical Transplantation. 38(3) (no pagination), 2024. Article Number:
e15270. Date of Publication: March 2024.
Author
Foroutan F.; Guyatt G.; Stehlik J.; Gustafsson F.; Greig D.; McDonald M.;
Bertolotti A.M.; Kugathasan L.; Rayner D.G.; Cuello C.A.; Cook A.;
Zlatanoski D.; Ram S.; Demas-Clarke P.; Kozuszko S.; Alba A.C.
Institution
(Foroutan, McDonald, Kugathasan, Cook, Zlatanoski, Ram, Kozuszko, Alba)
Ted Rogers Centre for Heart Research, University Health Network, Toronto,
ON, Canada
(Foroutan, Guyatt, Rayner, Cuello) Department of Health Research Methods,
Evidence, and Impact, McMaster, Hamilton, ON, Canada
(Stehlik) Department of Medicine, Division of Cardiovascular Medicine,
University of Utah School of Medicine, Salt Lake City, UT, United States
(Gustafsson) Rigshospitalet - Copenhagen University Hospital, Copenhagen,
Denmark
(Greig) Pontificia Universidad Catolica de Chile, Santiago, Chile
(Bertolotti) Cardiothoracic Surgery Department, Favaloro Foundation
University hospital, Buenos Aires, Argentina
(Demas-Clarke) Toronto General Hospital, University Health Network,
Toronto, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: The use of induction therapy (IT) agents in the early
post-heart transplant period remains controversial. The following
recommendations aim to provide guidance on the use of IT agents, including
Basiliximab and Thymoglobulin, as part of routine care in heart
transplantation (HTx). <br/>Method(s): We recruited an international,
multidisciplinary panel of 15 stakeholders, including patient partners,
transplant cardiologists and surgeons, nurse practitioners, pharmacists,
and methodologists. We commissioned a systematic review on benefits and
harms of IT on patient-important outcomes, and another on patients' values
and preferences to inform our recommendations. We used the GRADE framework
to summarize our findings, rate certainty in the evidence, and develop
recommendations. The panel considered the balance between benefits and
harms, certainty in the evidence, and patient's values and preferences, to
make recommendations for or against the routine post-operative use of
Thymoglobulin or Basiliximab. <br/>Result(s): The panel made
recommendations on three major clinical problems in HTx: (1) We suggest
against the routine post-operative use of Basiliximab compared to no IT,
(2) we suggest against the routine use of Thymoglobulin compared to no IT,
and (3) for those patients for whom IT is deemed desirable, we suggest for
the use of Thymoglobulin as compared to Basiliximab. <br/>Conclusion(s):
This report highlights gaps in current knowledge and provides directions
for clinical research in the future to better understand the clinical
utility of IT agents in the early post heart transplant period, leading to
improved management and care.<br/>Copyright &#xa9; 2024 The Authors.
Clinical Transplantation published by John Wiley & Sons Ltd.

<74>
Accession Number
2028886721
Title
Superficial parasternal intercostal plane blocks in cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Cameron M.J.; Long J.; Kardash K.; Yang S.S.
Institution
(Cameron, Long, Kardash, Yang) Faculty of Medicine, McGill University,
Montreal, QC, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, K1401-3755
Cote Sainte Catherine, Montreal, QC H3T 1E2, Canada
(Kardash, Yang) Department of Anesthesia, Jewish General Hospital,
Montreal, QC, Canada
(Cameron, Yang) Lady Davis Research Institute, Montreal, QC, Canada
Publisher
Springer
Abstract
Purpose: Traditional multimodal analgesic strategies have several
contraindications in cardiac surgery patients, forcing clinicians to use
alternative options. Superficial parasternal intercostal plane blocks,
anesthetizing the anterior cutaneous branches of the thoracic intercostal
nerves, are being explored as a straightforward method to treat pain after
sternotomy. We sought to evaluate the literature on the effects of
superficial parasternal blocks on pain control after cardiac surgery.
<br/>Method(s): We conducted a systematic review and meta-analysis of
randomized controlled trials (RCTs). We searched MEDLINE, Embase, CENTRAL,
and Web of Science databases for RCTs evaluating superficial parasternal
intercostal plane blocks in adult patients undergoing cardiac surgery via
midline sternotomy published from inception to 11 March 2022. The
prespecified primary outcome was opioid consumption at 12 hr. The risk of
bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and
the quality of evidence was evaluated using the grading of
recommendations, assessments, development, and evaluations. Outcomes were
analyzed with a random-effects model. All subgroups were prespecified.
<br/>Result(s): We reviewed 1,275 citations. Eleven RCTs, comprising 756
patients, fulfilled the inclusion criteria. Only one study reported the
prespecified primary outcome, precluding the possibility of meta-analysis.
This study reported a reduction in opioid consumption (-11.2 mg iv
morphine equivalents; 95% confidence interval [CI], -8.2 to -14.1) There
was a reduction in opioid consumption at 24 hr (-7.2 mg iv morphine
equivalents; 95% CI, -5.6 to -8.7; five trials; 436 participants; moderate
certainty evidence). All five studies measuring complications reported
that none were detected, which included a sample of 196 blocks.
<br/>Conclusion(s): The literature suggests a potential benefit of using
superficial parasternal blocks to improve acute postoperative pain control
after cardiac surgery via midline sternotomy. Future studies specifying
dosing regimens and adjuncts are required. Study registration: PROSPERO
(CRD42022306914); first submitted 22 March 2022.<br/>Copyright &#xa9;
Canadian Anesthesiologists' Society 2024.

<75>
[Use Link to view the full text]
Accession Number
2030863599
Title
Cardiac Rehabilitation - Challenges, Advances, and the Road Ahead.
Source
New England Journal of Medicine. 390(9) (pp 830-841), 2024. Date of
Publication: 29 Feb 2024.
Author
Thomas R.J.
Institution
(Thomas) The Division of Preventive Cardiology, Department of
Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN
55905, United States
Publisher
Massachussetts Medical Society
Abstract
Each year in the United States, more than 1 million persons enter the
turbulent waters of recovery after a cardiovascular event, such as
myocardial infarction, percutaneous coronary intervention (PCI),
coronary-artery bypass grafting (CABG), heart-valve surgery, or heart
transplantation.¹ Surprisingly, only approximately 25% of
patients who have had a cardiovascular event participate in cardiac
rehabilitation,^2,3 despite its multiple proven
benefits.⁴ Cardiac rehabilitation, which is also referred to as
cardiovascular rehabilitation, is a multidisciplinary, systematic, yet
personalized approach to providing evidence-based secondary prevention
therapies for persons with cardiovascular disease. The roots of cardiac
rehabilitation go back to innovative investigators who pushed past the
status quo of their time and established a new paradigm for patients with
cardiovascular disease. Further innovation is needed today to increase the
reach of cardiac rehabilitation to all eligible patients with
cardiovascular disease and to bridge the participation gap in cardiac
rehabilitation programs, one of the largest gaps in the quality of care in
cardiovascular medicine today.^2,5 This review addresses the
current science and practice of cardiac rehabilitation, as well as the
lessons learned from the past that will guide future directions in cardiac
rehabilitation.<br/>Copyright &#xa9; 2024 Massachussetts Medical Society.
All rights reserved.

<76>
[Use Link to view the full text]
Accession Number
2030843317
Title
The Shape of Things to Come? Is a Trial of Combined Interventional
Procedures Necessary in Today's World?.
Source
Circulation. 149(10) (pp 744-746), 2024. Date of Publication: 05 Mar 2024.
Author
Kleiman N.S.; Goel S.S.
Institution
(Kleiman, Goel) Houston Methodist DeBakey Heart and Vascular Center,
Houston, TX, United States
Publisher
Lippincott Williams and Wilkins

<77>
[Use Link to view the full text]
Accession Number
2030843316
Title
Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve
Replacement Among Patients With Atrial Fibrillation.
Source
Circulation. 149(10) (pp 734-743), 2024. Date of Publication: 05 Mar 2024.
Author
Kapadia S.R.; Krishnaswamy A.; Whisenant B.; Potluri S.; Iyer V.; Aragon
J.; Gideon P.; Strote J.; Leonardi R.; Agarwal H.; Larrain G.; Sanchez C.;
Panaich S.S.; Harvey J.; Vahl T.; Menon V.; Wolski K.; Wang Q.; Leon M.B.
Institution
(Kapadia, Krishnaswamy, Menon, Wolski, Wang) Cleveland Clinic, Cleveland,
OH, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Potluri) Baylor Scott and White The Heart Hospital, Plano, TX, United
States
(Iyer) University of Buffalo, NY, United States
(Aragon) Santa Barbara Cottage Hospital, CA, United States
(Gideon) Banner University Medical Center, Phoenix, AZ, United States
(Strote) Medical Center of the Rockies, Loveland, CO, United States
(Leonardi) Lexington Medical Heart and Vascular Center, West Columbia, SC,
United States
(Agarwal) CHI Health Research Center, Omaha, NE, United States
(Larrain) Aspirus Research Institute, Wausau, WI, United States
(Sanchez) Ohio Health Research Institute, Columbus, OH, United States
(Panaich) University of Iowa Hospitals & Clinics, Iowa City, IA, United
States
(Harvey) WellSpan York Hospital, York, PA, United States
(Vahl, Leon) Columbia University Medical Center, New York, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Atrial fibrillation (AF) is common in patients undergoing
transcatheter aortic valve replacement (TAVR) and is associated with
increased risk of bleeding and stroke. While left atrial appendage
occlusion (LAAO) is approved as an alternative to anticoagulants for
stroke prevention in patients with AF, placement of these devices in
patients with severe aortic stenosis, or when performed at the same time
as TAVR, has not been extensively studied. <br/>METHOD(S): WATCH-TAVR
(WATCHMAN for Patients with AF Undergoing TAVR) was a multicenter,
randomized trial evaluating the safety and effectiveness of concomitant
TAVR and LAAO with WATCHMAN in AF patients. Patients were randomized 1:1
to TAVR + LAAO or TAVR + medical therapy. WATCHMAN patients received
anticoagulation for 45 days followed by dual antiplatelet therapy until 6
months. Anticoagulation was per treating physician preference for patients
randomized to TAVR + medical therapy. The primary noninferiority end point
was all-cause mortality, stroke, and major bleeding at 2 years between the
2 strategies. <br/>RESULT(S): The study enrolled 349 patients (177 TAVR +
LAAO and 172 TAVR + medical therapy) between December 2017 and November
2020 at 34 US centers. The mean age of patients was 81 years, and the mean
scores for CHA2DS2-VASc and HAS-BLED (Hypertension, Abnormal renal/liver
function, Stroke, Bleeding history or predisposition, Labile INR, Elderly,
Drugs/alcohol concomitantly) were 4.9 and 3.0, respectively. At baseline,
85.4% of patients were taking anticoagulants and 71.3% patients were on
antiplatelet therapy. The cohorts were well-balanced for baseline
characteristics. The incremental LAAO procedure time was 38 minutes, and
the median contrast volume used for combined procedures was 119 mL versus
70 mL with TAVR alone. At the 24-month follow-up, 82.5% compared with
50.8% of patients were on any antiplatelet therapy, and 13.9% compared
with 66.7% of patients were on any anticoagulation therapy in TAVR + LAAO
compared with TAVR + medical therapy group, respectively. For the
composite primary end point, TAVR + LAAO was noninferior to TAVR + medical
therapy (22.7 versus 27.3 events per 100 patient-years for TAVR + LAAO and
TAVR + medical therapy, respectively; hazard ratio, 0.86 [95% CI,
0.60-1.22]; P<inf>noninferiority</inf><0.001). <br/>CONCLUSION(S):
Concomitant WATCHMAN LAAO and TAVR is noninferior to TAVR with medical
therapy in severe aortic stenosis patients with AF. The increased
complexity and risks of the combined procedure should be considered when
concomitant LAAO is viewed as an alternative to medical therapy for
patients with AF undergoing TAVR. <br/>Copyright &#xa9; 2023 American
Heart Association, Inc.

<78>
Accession Number
2030747073
Title
Transcarotid versus trans-axillary/subclavian transcatheter aortic valve
replacement (TAVR): A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102488. Date of Publication: May 2024.
Author
Dawadi S.; Oli P.R.; Shrestha D.B.; Shtembari J.; Pant K.; Shrestha B.;
Mattumpuram J.; Katz D.H.
Institution
(Dawadi) Department of Internal Medicine, Nepalese Army Institute of
Health Sciences, Kathmandu 44600, Nepal
(Oli) Department of Internal Medicine, Province Hospital, Birendranagar,
Karnali Province, Surkhet 21700, Nepal
(Shrestha, Shtembari) Department of Internal Medicine, Mount Sinai
Hospital, Chicago, IL 60608, United States
(Pant) Department of Internal Medicine, Division of Cardiovascular
Medicine, University of Illinois College of Medicine, OSF Healthcare,
Peoria, IL 61614, United States
(Shrestha, Katz) Division of Cardiology, Department of Internal Medicine,
Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY 13326, United States
(Mattumpuram) Division of Cardiology, Department of Internal Medicine,
University of Louisville School of Medicine, 550 S Jackson St, Louisville,
KY 40202, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) is the treatment
of choice in patients with severe aortic stenosis. Transcarotid (TCa) or
Trans-axillary/subclavian (TAx/Sc) are safer and less invasive non-femoral
approaches, where transfemoral access is difficult or impossible to
obtain. <br/>Method(s): This meta-analysis was performed based on PRISMA
guidelines after registering in PROSPERO (CRD42023482842). This
meta-analysis was performed to compare the safety of the transcarotid and
trans-axillary/subclavian approach for TAVR including studies from
inception to October 2023. <br/>Result(s): Seven studies with a total of
6227 patients were included in the analysis (TCa: 2566; TAx/Sc: 3661).
Transcarotid TAVR approach had a favorable trend for composite of stroke
and all-cause mortality (OR 0.79, CI 0.60-1.04), all-cause mortality,
stroke, major vascular complication, and new requirement of permanent
pacemaker though those were statistically insignificant. On sub-analysis
of the results of the studies based on the territory (USA vs French),
composite outcome of all cause mortality, stroke and major bleeding (OR
0.54, CI 0.54-0.81), composite of stroke and all cause mortality (OR 0.64,
CI 0.50-0.81), and stroke/TIA (OR 0.53, CI 0.39-0.73) showed lower odds of
occurrence among patient managed with TCa approach in the American cohort.
<br/>Conclusion(s): Overall, transcarotid approach had favorable though
statistically insignificant odds for composite (stroke and all-cause
mortality) and individual outcomes (stroke, all-cause mortality, etc.).
There are significant variations in observed outcomes based on study's
geographic location. Large prospective randomized clinical trials
comparing the two approaches with representative samples are necessary to
guide the clinicians in choosing among these approaches.<br/>Copyright
&#xa9; 2024 Elsevier Inc.

<79>
Accession Number
2030582603
Title
A Ten-Year Follow-Up Study of the Association Between Uric Acid and
Adverse Cardiovascular Events in Patients With Coronary Artery Disease.
Source
American Journal of Cardiology. 216 (pp 19-26), 2024. Date of Publication:
01 Apr 2024.
Author
Ndrepepa G.; Kufner S.; Cassese S.; Joner M.; Xhepa E.; Wiebe J.; Sager
H.B.; Kessler T.; Laugwitz K.-L.; Schunkert H.; Kastrati A.
Institution
(Ndrepepa, Kufner, Cassese, Joner, Xhepa, Wiebe, Sager, Kessler,
Schunkert, Kastrati) Department of Cardiology, Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Munich, Germany
(Joner, Sager, Kessler, Laugwitz, Schunkert, Kastrati) German Center for
Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance,
Munich, Germany
(Laugwitz) Medizinische Klinik und Poliklinik Innere Medizin I
(Kardiologie, Angiologie, Pneumologie), Klinikum rechts der Isar,
Technische Universitat Munchen, Munich, Germany
Publisher
Elsevier Inc.
Abstract
The association between uric acid (UA) and long-term mortality in patients
with coronary artery disease is poorly investigated. We assessed the
association between UA and 10-year mortality after percutaneous coronary
intervention (PCI) in 3,998 patients who underwent PCI. Patients were
categorized in groups according to UA tertiles: tertile 1 (UA <5.80 mg/100
ml, n = 1,347), tertile 2 (UA 5.80 to 7.04 mg/100 ml, n = 1,340), and
tertile 3 (UA >7.94 mg/100 ml, n = 1,311). The primary outcome was 10-year
all-cause mortality. All-cause deaths occurred in 1,200 patients: 320
deaths (26.5%) in patients with UA in the first tertile, 325 deaths
(26.9%) in patients with UA in the second tertile, and 555 deaths (46.0%)
in patients with UA in the third tertile (adjusted hazard ratio 1.22, 95%
confidence interval 1.17 to 1.27, p <0.001) for 1 mg/100 ml increment in
UA level. Cardiac deaths occurred in 748 patients: 194 deaths (16.5%) in
patients with UA in the first tertile, 202 deaths (17.0%) in patients with
UA in the second tertile, and 352 deaths (29.7%) in patients with UA in
the third tertile (adjusted hazard ratio 1.24 [1.17 to 1.32], p <0.001)
for 1 mg/100 ml increment in the UA level. The 10-year rates of target
lesion revascularization, target vessel revascularization, or nontarget
vessel revascularization did not differ significantly according to the UA
level. In conclusion, in patients with coronary artery disease treated
with PCI, increased UA level was associated with higher 10-year mortality.
Increased UA level was not associated with the progression of
atherosclerosis in nontreated coronary vessels or progression of intimal
hyperplasia in stented lesions requiring intervention.<br/>Copyright
&#xa9; 2024 The Author(s)

<80>
Accession Number
2030540477
Title
Prevalence of Cardiovascular Risk Factors in Women With Obstructive
Coronary Disease Requiring Revascularization: A Meta-analysis.
Source
CJC Open. Part B. 6(2) (pp 334-346), 2024. Date of Publication: February
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
Background: 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.
<br/>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. <br/>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). <br/>Conclusion(s): The review shows that women who
underwent either surgical or percutaneous revascularization had higher
odds of hypertension and diabetes, compared to men.<br/>Copyright &#xa9;
2023 The Authors

<81>
[Use Link to view the full text]
Accession Number
2030468068
Title
^Proteomic (N-terminal ^associations pro-B-type
natriuretic ^{of NT-proBNP} peptide) in heart failure with
preserved ejection fraction.
Source
Circulation: Heart Failure. 17(2) (pp E011146), 2024. Date of Publication:
01 Feb 2024.
Author
Azzo J.D.; Dib M.-J.; Zagkos L.; Zhao L.; Wang Z.; Chang C.-P.; Ebert C.;
Salman O.; Gan S.; Zamani P.; Cohen J.B.; van Empel V.; Richards A.M.;
Javaheri A.; Mann D.L.; Rietzschel E.R.; Schafer P.H.; Seiffert D.A.; Gill
D.; Burgess S.; Ramirez-Valle F.; Gordon D.A.; Cappola T.P.; Chirinos J.A.
Institution
(Azzo, Salman, Zamani, Cappola, Chirinos) University of Pennsylvania
Perelman School of Medicine, Philadelphia, United States
(Dib, Gan, Zamani, Cappola, Chirinos) Division of Cardiovascular Medicine,
Hospital of the University of Pennsylvania, Philadelphia, United States
(Zagkos, Zhao, Gill) Department of Epidemiology and Biostatistics, School
of Public Health, Imperial College London, United Kingdom
(Zhao, Wang, Chang, Ebert, Cohen, Schafer, Seiffert, Ramirez-Valle,
Gordon) Bristol Myers Squibb Company, Lawrenceville, NJ, United States
(Cohen) Renal-Electrolyte and Hypertension Division, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, United States
(van Empel) Department of Cardiology, Maastricht University Medical
Center, Netherlands
(Richards) Cardiovascular Research Institute, National University of
Singapore, Singapore
(Richards) Christchurch Heart Institute, University of Otago, CAN,
Christchurch, New Zealand
(Javaheri, Mann) Washington University School of Medicine, St. Louis, MO,
United States
(Javaheri) John J. Cochran Veterans Hospital, St. Louis, MO, United States
(Rietzschel) Department of Cardiovascular Diseases, Ghent University
Hospital, Belgium
(Burgess) Department of Public Health and Primary Care, University of
Cambridge, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels
are variably elevated in heart failure with preserved ejection fraction
(HFpEF), even in the presence of increased left ventricular filling
pressures. NT-proBNP levels are prognostic in HFpEF and have been used as
an inclusion criterion for several recent randomized clinical trials.
However, the underlying biologic differences between HFpEF participants
with high and low NT-proBNP levels remain to be fully understood.
<br/>METHOD(S): We measured 4928 proteins using an aptamer-based proteomic
assay (SOMAScan) in available plasma samples from 2 cohorts: (1)
Participants with HFpEF enrolled in the PHFS (Penn Heart Failure Study;
n=253); (2) TOPCAT (Treatment of Preserved Cardiac Function Heart Failure
With an Aldosterone Antagonist Trial) participants in the Americas
(n=218). We assessed the relationship between SOMAScan-derived plasma
NT-proBNP and levels of other proteins available in the SOMAScan assay
version 4 using robust linear regression, with correction for multiple
comparisons, followed by pathway analysis. <br/>RESULT(S): NT-proBNP
levels exhibited prominent proteome-wide associations in PHFS and TOPCAT
cohorts. Proteins most strongly associated with NT-proBNP in both cohorts
included SVEP1 (sushi, von Willebrand factor type-A, epidermal growth
factor, and pentraxin domain containing 1; beta<inf>TOPCAT</inf>=0.539;
P<0.0001; beta<inf>PHFS</inf>=0.516; P<0.0001) and ANGPT2 (angiopoietin 2;
beta<inf>TOPCAT</inf>=0.571; P<0.0001; beta<inf>PHFS</inf>=0.459;
P<0.0001). Canonical pathway analysis demonstrated consistent associations
with multiple pathways related to fibrosis and inflammation. These
included hepatic fibrosis and inhibition of matrix metalloproteases.
Analyses using cut points corresponding to estimated quantitative
concentrations of 360 pg/mL (and 480 pg/mL in atrial fibrillation)
revealed similar proteomic associations. <br/>CONCLUSION(S): Circulating
NT-proBNP levels exhibit prominent proteomic associations in HFpEF. Our
findings suggest that higher NT-proBNP levels in HFpEF are a marker of
fibrosis and inflammation. These findings will aid the interpretation of
NT-proBNP levels in HFpEF and may guide the selection of participants in
future HFpEF clinical trials.<br/>Copyright &#xa9; 2024 Lippincott
Williams and Wilkins. All rights reserved.

<82>
Accession Number
2028847647
Title
Effect of right internal mammary artery versus radial artery as a second
graft vessel in coronary artery bypass grafting on postoperative wound
infection in patients: A meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14592. Date of Publication: March 2024.
Author
Du H.; Gu X.; Zhang Z.; Dong Z.; Ran X.; Zhou L.
Institution
(Du, Gu, Zhang, Ran, Zhou) Department of Cardio Thoracic Surgery, No.988
Hospital of Joint Logistics Support Force, Jiaozuo, China
(Dong) Department of Cardio Surgery, WuHan Asia Cardiac Disease Hospital,
Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
Few studies have shown that radial artery (RA), which is used as a
secondary arterial graft, offers superior results compared with right
internal thoracic artery (RIMA) in coronary artery bypass grafting (CABG).
In a meta-analysis of observational studies starting in 2023, we looked at
the effect of re-operation on postoperative infection and haemorrhage in
CABG with RA vs. RIMA. The electronic database up to October 2023 was
examined in the course of the research. Analysis was carried out on the
clinical trials of postoperative wound infections and haemorrhage
re-surgery. Among 912 trials associated with CABG, we selected 8 trials to
be included in the final data analysis. The main results were secondary
wound infection and re-operation after surgery. The odds ratios (OR) and
confidence intervals (CIs) were computed on the basis of a randomized or
fixed-effect model of wound infection and re-operation. Seven trials
showed a significant reduction in the risk of wound infection in RA
treated as a secondary artery transplant compared with RIMA (OR, 1.60; 95%
CI, 1.03, 2.47 p = 0.04); Four trials showed that RIMA was not
significantly different from RA in the rate of re-operation for
postoperative bleeding (OR, 1.31; 95% CI, 0.60, 2.88 p = 0.50). In CABG,
RA is used as a secondary arterial conduit graft to lower the risk of
wound infection in CABG patients.<br/>Copyright &#xa9; 2024 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<83>
Accession Number
2028810040
Title
Effect of topical application of autologous platelet gel on sternal wound
infection after cardiac surgery: A meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14761. Date of Publication: March 2024.
Author
Li Y.; Wu Z.
Institution
(Li, Wu) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Following heart operation, a severe life-threatening complication has been
identified by investigators who have recently discovered that local
application of platelet-rich plasma (PRP) can lower the rate of wound
infection in heart surgery. Nevertheless, due to the low quality of these
trials, we have tried to perform high-quality meta-analyses to prove the
efficacy of PRP in heart surgery for post-operative wound infections. In
this study, five randomised controlled trials (RCTs) were chosen from
three databases, and there were 1005 studies to analyse the data. Among
181 cases, PRP was applied to the surgical site, and 205 in the control
group. Both the CI and the OR or the average difference (MD) were computed
with either a fixed or random-effect model. A meta-analysis of the data
was carried out with RevMan 5.3. The results showed that there were no
statistically significant differences in the incidence of post-operative
surgical site infection (SSI) in control group compared to those treated
with PRP gel (OR, 0.97; 95% CI, 0.38, 2.47; p = 0.95); In the heart
operation, the local application of PRP gel decreased the rate of drainage
after operation (MD, -217.82; 95% CI, -335.38, -100.26; p = 0.0003); The
operation time of the PRP gel was not significantly different from that of
the control group (MD, 12.65; 95% CI, -2.95, 28.24; p = 0.11). Contrary to
earlier research, the application of autoplatelet gel in heart surgery did
not seem to decrease operative site infections after the operation, but it
did decrease the amount of postoperative drainage. Nevertheless, because
of the limited number of RCTs in this meta-analysis, caution should be
exercised in their treatment. More high-quality randomised, large-sample
trials are required to further confirm the findings.<br/>Copyright &#xa9;
2024 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<84>
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.
<br/>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). <br/>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. <br/>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.<br/>Copyright 2024 Apostolovic, Ignjatovic, Stanojevic,
Radojkovic, Nikolic, Milosevic, Filipovic, Kostic, Miljkovic, Djokovic,
Krljanac, Mehmedbegovic, Ilic, Aleksandric and Paradies.

<85>
Accession Number
2028252244
Title
Effect of Gut Microbiota on Metabolic and Inflammatory Biomarkers in
Cardiovascular Surgery: A Systematic Review and Meta-Analysis.
Source
Razavi International Journal of Medicine. 12(1) (pp 10-16), 2024. Article
Number: e1310. Date of Publication: February 2024.
Author
Valaei M.; Sadeghi H.; Ghasemi R.; Hajipour F.; Yaghubi M.
Institution
(Valaei) Department of Gastroenterology and Hepatology, Imam Reza
Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Sadeghi) Department of Anesthesiology, Razavi Hospital, Mashhad, Iran,
Islamic Republic of
(Ghasemi) Department of Cardiology, 9 Dey Educational Hospital, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Hajipour) Department of Extra-Corporeal Circulation (ECC), Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Mashhad, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: The gastrointestinal microbiota is pivotal in cardiovascular
surgery outcomes. <br/>Objective(s): This systematic review and
meta-analysis aimed to synthesize current evidence regarding the impact of
gut microbiota on postoperative metabolomic markers and patient recovery.
<br/>Method(s): Following PRISMA guidelines, a comprehensive query was
conducted on MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's
CENTRAL databases. Studies involving patients undergoing cardiovascular
surgery and reporting on gut microbiota were included. Data extraction
focused on study characteristics and metabolomic outcomes. The
Newcastle-Ottawa Scale (NOS) assessed the risk of bias. <br/>Result(s):
Six studies met the inclusion criteria, involving 530 patients.
Meta-analysis revealed that a beneficial gut microbiota profile is
associated with less increase in LDL cholesterol (Mean Difference: 14.4
mg/dL, SE: 0.816), a smaller decrease in HDL cholesterol (Mean
Difference:-4.9 mg/dL, SE: 0.437), a lower rise in triglycerides (Mean
Difference: 11.2 mg/dL, SE: 0.552), and a reduced elevation in c-reactive
protein (CRP) levels (Mean Difference: 2.4 mg/L, SE: 0.291) post-surgery.
The overall risk of bias ranged from moderate to low across studies.
<br/>Conclusion(s): As evidenced by the obtained results, gut microbiota
composition significantly affected lipid metabolism and inflammatory
responses post-cardiovascular surgery. A favorable microbiota profile may
provide a protective effect against postoperative complications. These
insights underline the potential for microbiota-modulating interventions
in enhancing cardiovascular surgery outcomes.<br/>Copyright &#xa9; 2024,
Razavi International Journal of Medicine.

<86>
Accession Number
2028863805
Title
A Randomized Trial Comparing Standard of Care to Bayesian Warfarin Dose
Individualization.
Source
Clinical Pharmacology and Therapeutics. (no pagination), 2024. Date of
Publication: 2024.
Author
Xue L.; Ma G.; Holford N.; Qin Q.; Ding Y.; Hannam J.A.; Ding X.; Fan H.;
Ji Z.; Yang B.; Shen H.; Shen Z.; Miao L.
Institution
(Xue, Qin, Ding, Miao) Department of Pharmacy, The First Affiliated
Hospital of Soochow University, Suzhou, China
(Xue) Department of Pharmacology, Faculty of Medicine, University of the
Basque Country (UPV/EHU), Leioa, Spain
(Ma, Holford, Hannam) Department of Pharmacology and Clinical
Pharmacology, University of Auckland, Auckland, New Zealand
(Ding, Fan, Ji, Yang, Shen, Shen) Department of Cardiovascular Surgery,
The First Affiliated Hospital of Soochow University, Suzhou, China
(Ding, Fan, Ji, Yang, Shen, Shen) Institute for Cardiovascular Science,
Soochow University, Suzhou, China
(Miao) National Clinical Research Center for Hematologic Diseases, The
First Affiliated Hospital of Soochow University, Suzhou, China
(Miao) Institute for Interdisciplinary Drug Research and Translational
Sciences, Soochow University, Suzhou, China
Publisher
John Wiley and Sons Inc
Abstract
The quality of warfarin treatment may be improved if management is guided
by the use of models based upon pharmacokinetic-pharmacodynamic theory. A
prospective, two-armed, single-blind, randomized controlled trial compared
management aided by a web-based dose calculator (NextDose) with standard
clinical care. Participants were 240 adults receiving warfarin therapy
following cardiac surgery, followed up until the first outpatient
appointment at least 3 months after warfarin initiation. We compared the
percentage of time spent in the international normalized ratio acceptable
range (%TIR) during the first 28 days following warfarin initiation, and
%TIR and count of bleeding events over the entire follow-up period. Two
hundred thirty-four participants were followed up to day 28 (NextDose: 116
and standard of care: 118), and 228 participants (114 per arm) were
followed up to the final study visit. Median %TIR tended to be higher for
participants receiving NextDose guided warfarin management during the
first 28 days (63 vs. 56%, P = 0.13) and over the entire follow-up period
(74 vs. 71%, P = 0.04). The hazard of clinically relevant minor bleeding
events was lower for participants in the NextDose arm (hazard ratio: 0.21,
P = 0.041). In NextDose, there were 89.3% of proposed doses accepted by
prescribers. NextDose guided dose management in cardiac surgery patients
requiring warfarin was associated with an increase in %TIR across the full
follow-up period and fewer hemorrhagic events. A theory-based,
pharmacologically guided approach facilitates higher quality warfarin
anticoagulation. An important practical benefit is a reduced requirement
for clinical experience of warfarin management.<br/>Copyright &#xa9; 2024
The Authors. Clinical Pharmacology & Therapeutics published by Wiley
Periodicals LLC on behalf of American Society for Clinical Pharmacology
and Therapeutics.

<87>
Accession Number
2026287795
Title
Transcatheter aortic valve implantation versus sutureless aortic valve
replacement: a single-centre cost analysis.
Source
Acta Cardiologica. 79(1) (pp 30-40), 2024. Date of Publication: 2024.
Author
De Paepe J.; Lamberigts M.; Meuris B.; Jacobs S.; Adriaenssens T.; Dubois
C.; Verbrugghe P.
Institution
(De Paepe, Adriaenssens, Dubois) Department of Cardiology, UZ Leuven,
Leuven, Belgium
(Lamberigts, Meuris, Jacobs, Verbrugghe) Department of Cardiac Surgery, UZ
Leuven, Leuven, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Aims: Sutureless aortic valve replacement (SU-AVR) and transcatheter
aortic valve implantation (TAVI) are both viable therapeutic interventions
for aortic stenosis in elderly patients. Meta-analyses show similar
all-cause mortality for both techniques albeit with a different pattern of
adverse effects. This study means to compare costs and, to a lesser
extent, clinical outcomes of both techniques. <br/>Method(s): A
retrospective single-centre analysis was performed for patients receiving
SU-AVR or TAVI from 2008 to 2019. Perioperative clinical data were
collected from patient files. Costs were assessed by a cost allocation
tool. In an attempt to avoid confounding, propensity score matching was
carried out. <br/>Result(s): A total of 368 patients underwent either TAVI
(n = 100) or SU-AVR (n = 268). After matching, there were 61 patients per
treatment group. Length of stay was significantly longer in the SU-AVR
group. Excluding device costs, total expenses for SU-AVR (median: 11,630)
were significantly higher than TAVI (median: 9240). For both groups, these
costs were mostly incurred on intensive care units, followed by nursing
units. Non-medical staff was the largest contributor to expenses.
Including device costs, SU-AVR (median: 14,683) was shown to be
cost-saving compared to TAVI (median: 24,057). <br/>Conclusion(s): To
conclude, we found SU-AVR to be cost-saving compared to TAVI, largely due
to higher device costs associated with the latter. Excluding device costs,
TAVI was associated with lower expenses and shorter length of stay.
Non-medical staff was the largest source of costs, suggesting length of
stay to be a major financial determinant.<br/>Copyright &#xa9; 2023
Belgian Society of Cardiology.

<88>
Accession Number
2026195988
Title
Coronary endarterectomy combined with coronary artery bypass grafting
might decrease graft patency: A cohort study.
Source
Hellenic Journal of Cardiology. 76 (pp 40-47), 2024. Date of Publication:
01 Mar 2024.
Author
Tiemuerniyazi X.; Yang Z.; Song Y.; Xu F.; Zhao W.; Feng W.
Institution
(Tiemuerniyazi, Yang, Song, Xu, Zhao, Feng) Department of Cardiovascular
Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases,
National Clinical Research Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Publisher
Hellenic Cardiological Society
Abstract
Background: Little is known about the graft patency after coronary
endarterectomy (CE) combined with coronary artery bypass grafting (CABG).
This study aimed to investigate the graft patency after CABG + CE.
<br/>Method(s): Eligible patients hospitalized at our center during
September 2008 and July 2022 with complete follow-up coronary angiographic
data available were retrospectively enrolled. The primary end point was
the follow-up graft patency of CE targets. Logistic regression was
performed to explore the potential predictors of the CE-targeted graft
failure. <br/>Result(s): A total of 160 patients (age: 59.4 +/- 9.3 years,
male: 75.6%) were enrolled, and 560 grafts were anastomosed. CE was
performed on 166 sites, including LAD (36.1%), right coronary artery (RCA,
48.2%), left circumflex artery (9.6%), and diagonal branches (6.0%).
Postoperative myocardial infarction was observed in 7 (4.4%) of the
patients. During a median follow-up of 12.1 months, the CE-targeted graft
patency was 69.9%. The CE-targeted graft patency rate was much higher
among the LAD-CE patients than the non-LAD-CE patients (80.0% vs. 64.2%, P
= 0.032) but lower than non-endarterectomized LAD (80.0% vs. 92.9%, P =
0.013). No difference was observed regarding the graft patency between
off-pump and on-pump surgery (P = 0.585). In the logistic regression,
RCA-CE was associated with an increased risk of graft failure even after
multiple adjustments (odds ratio: 2.35, 95% confidence interval:
1.05-5.28, P = 0.028). <br/>Conclusion(s): CABG + CE might be associated
with decreased graft patency, especially in those who received RCA-CE,
irrespective of surgical technique or antiplatelet/anticoagulation
regimen. A multi-center prospective, possibly randomized study with a
larger sample size is warranted.<br/>Copyright &#xa9; 2023 Hellenic
Society of Cardiology

<89>
Accession Number
643652752
Title
One-month DAPT with ticagrelor and aspirin for patients undergoing
coronary artery bypass grafting: rationale and design of the randomised,
multicentre, double-blind, placebo-controlled ODIN trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
20(5) (pp e322-e328), 2024. Date of Publication: 04 Mar 2024.
Author
Sandner S.; Gaudino M.; Redfors B.; Angiolillo D.J.; Ben-Yehuda O.; Bhatt
D.L.; Fremes S.E.; Lamy A.; Marano R.; Mehran R.; Pocock S.; Rao S.V.;
Spertus J.A.; Weinsaft J.W.; Wells G.; Ruel M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, USA
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Ben-Yehuda) University of California San Diego, San Diego, CA, United
States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, USA
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, University of Toronto, Toronto, ON, Canada
(Lamy) Division of Cardiac Surgery and Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Marano) Department of Radiological and Hematological Sciences, Section of
Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Rao) New York University Langone Health System, New York, NY, USA
(Spertus) University of Missouri-Kansas City's Healthcare Institute for
Innovations in Quality, USA and Saint Luke's Mid America Heart Institute,
Kansas City, MO, United States
(Weinsaft) Department of Medicine, Greenberg Cardiology Division, Weill
Cornell Medical College, New York, NY, USA
(Wells) Heart Institute, School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Abstract
The optimal antiplatelet strategy after coronary artery bypass graft
(CABG) surgery in patients with chronic coronary syndromes (CCS) is
unclear. Adding the P2Y12 inhibitor, ticagrelor, to low-dose aspirin for 1
year is associated with a reduction in graft failure, particularly
saphenous vein grafts, at the expense of an increased risk of clinically
important bleeding. As the risk of thrombotic graft failure and ischaemic
events is highest early after CABG surgery, a better risk-to-benefit
profile may be attained with short-term dual antiplatelet therapy followed
by single antiplatelet therapy. The One Month Dual Antiplatelet Therapy
With Ticagrelor in Coronary Artery Bypass Graft Patients (ODIN) trial is a
prospective, randomised, double-blind, placebo-controlled, international,
multicentre study of 700 subjects that will evaluate the effect of
short-term dual antiplatelet therapy with ticagrelor plus low-dose aspirin
after CABG in patients with CCS. Patients will be randomised 1:1 to
ticagrelor 90 mg twice daily or matching placebo, in addition to aspirin
75-150 mg once daily for 1 month; after the first month, antiplatelet
therapy will be continued with aspirin alone. The primary endpoint is a
hierarchical composite of all-cause death, stroke, myocardial infarction,
revascularisation and graft failure at 1 year. The key secondary endpoint
is a hierarchical composite of all-cause death, stroke, myocardial
infarction, Bleeding Academic Research Consortium (BARC) type 3 bleeding,
revascularisation and graft failure at 1 year (net clinical benefit). ODIN
will report whether the addition of ticagrelor to low-dose aspirin for 1
month after CABG reduces ischaemic events and provides a net clinical
benefit in patients with CCS. (ClinicalTrials.gov: NCT05997693).

<90>
Accession Number
2030800007
Title
Effects of interval training on haemodynamic variables after coronary
artery bypass graft: A meta-analysis.
Source
Journal of the Pakistan Medical Association. 74(4) (pp 528-533), 2024.
Date of Publication: March 2024.
Author
Zehra F.; Aslam S.; Saeed M.
Institution
(Zehra) Jinnah University for Women, Karachi, Pakistan
(Aslam, Saeed) Department of Physical Therapy, Jinnah University for
Women, Karachi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Objective:To assess the combined impact of interval training programme on
haemodynamic variables, specifically blood pressure and heart rate, in
patients having undergone coronary artery bypass graft surgery.
<br/>Method(s):The meta-analysis was conducted from October to December
2022, and comprised search on PubMed, MEDLINE, Web of Science, PeDro,
EMBASE, Science Direct, Cochrane Central Register of Controlled Clinical
Trials, Google Scholar and Scopus electronic databases by two researchers
independently for literature published between 2009 and 2020 related to
the effects of interval training on coronary artery bypass graft patients.
Meta-analysis was then performed to analyse the effects of an interval
training on systolic blood pressure, diastolic blood pressure, and heart
rate. The meta-analysis was performed in line with the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis guidelines. <br/>Result(s):
Of the 122 studies initially located, 7 were related to the effects of
different forms of interval trainings and their impact on systolic and
diastolic blood pressure of the patients, and 5 studies analysing the
effects of interval trainings on heart rate. Interval training showed mild
improvement in decreasing SBP compared to control groups. Standardized
mean difference suggested an effect size of -0.226 in random effect model
(I2=52.01; p=0.064). Similarly, a small effect size of 0.136 (I2=39.19%,
p=0.14) was observed for diastolic blood pressure. Also, there was a small
effect size of 0.155 (I2= 28.08, p=0.23) observed for heart rate.
<br/>Conclusion(s): Interval training programmes, including high-intensity
interval training, low-volume interval training, and aerobic interval
training, had a small effect on systolic blood pressure, whereas
continuous training protocols had a similarly small effect size on
diastolic blood pressure and heart rate.<br/>Copyright &#xa9; 2024
Pakistan Medical Association. All rights reserved.

<91>
Accession Number
2030818235
Title
extract from the 2022 esc guidelines on cardiovascular assessment and
management of patients undergoing non-cardiac surgery - patient blood
management.
Source
Blood Transfusion. 22(2) (pp 122-129), 2024. Date of Publication: March
2024.
Author
Halvorsen S.; Mehilli J.; Choorapoikayil S.; Zacharowski K.
Institution
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval,
University of Oslo, Oslo, Norway
(Mehilli) Department of Cardiology, Pneumology and Intensive Medicine,
Hospital Landshut-Achdorf, Landshut, Germany
(Mehilli) Munich University Clinic, Ludwig-Maximilians University, Munich,
Germany
(Mehilli) German Centre for Cardiovascular Research (DZHK), partner site
Munich Heart Alliance, Munich, Germany
(Choorapoikayil, Zacharowski) Goethe University Frankfurt, University
Hospital Frankfurt, Department of Anaesthesiology, Intensive Care Medicine
and Pain Therapy, Frankfurt, Germany
Publisher
Edizioni SIMTI
Abstract
The 2022 Guidelines on cardiovascular assessment and management of
patients undergoing non-cardiac surgery of the European Society of
Cardiology are an update on the previous guidelines reported in 2014. The
revised guidelines provide standardized perioperative cardiovascular
management of surgical patients and emphasis on risk assessment of the
patient combined with the inherent risk of the surgical procedure. One of
the novelties in these guidelines is the Patient Blood Management
programme, which is based on a three pillar concept: preoperative
hemoglobin optimization, minimize iatrogenic blood loss and bleeding, and
harness tolerance to anemia in an effort to improve patient outcome. In
this review, we highlight the three pillars of Patient Blood Management
and recommendations made by the 2022 ESC Guidelines on cardiovascular
assessment and management of patients undergoing non-cardiac
surgery.<br/>Copyright &#xa9; SIMTIPRO Srl.

<92>
Accession Number
2030849585
Title
Correlation analysis between plasma biomarkers albumin, fibrinogen, and
their ratio with postoperative delirium in patients undergoing non-cardiac
surgery: a systematic review and meta-analysis.
Source
American Journal of Translational Research. 16(2) (pp 363-373), 2024. Date
of Publication: 29 Feb 2024.
Author
Lu Z.; Wang B.; Liu M.; Yu D.; Li J.
Institution
(Lu, Liu, Yu, Li) Department of Anesthesiology, Hebei General Hospital,
Hebei, Shijiazhuang 050051, China
(Wang) Department of Gynaecology, Hebei General Hospital, Hebei,
Shijiazhuang 050051, China
Publisher
E-Century Publishing Corporation
Abstract
Objectives: This meta-analysis aimed to investigate the correlation
between plasma biomarkers, such as albumin and fibrinogen, and their ratio
with postoperative delirium (POD) in patients undergoing non-cardiac
surgery. <br/>Method(s): Relevant observational cohort studies were
systematically searched in PubMed, EMBASE, CINAHL, and the Cochrane
Library databases as of March 2023. This meta-analysis was conducted using
RevMan 5.4.1 and Stata 15.0 software. For continuous variables with
non-uniform units, the standardized mean difference (SMD) and 95%
confidence intervals (CIs) were used; otherwise, the mean difference (MD)
and 95% CIs were employed. The Newcastle-Ottawa Scale (NOS) was applied to
assess the quality of included literature. <br/>Result(s): Eighteen
studies encompassing 7,011 patients were included. The meta-analysis
revealed significantly lower albumin levels (sixteen studies, 5,813
patients, SMD = -0.45, 95% CI = -0.64 to -0.26, P < 0.00001,
I²= 80%) and albumin-fibrinogen ratio (AFR) (four studies, 824
patients, MD = -0.62, 95% CI = -0.76 to -0.48, P = 0.56, I²=
0%) in the delirious group. Conversely, higher fibrinogen concentrations
(two studies, 441 patients, MD = 0.13, 95% CI = 0.02 to 0.24, P = 0.69,
I²= 0%) were observed in the delirious group. Due to high
heterogeneity in albumin levels (P < 0.00001, I²= 80%), we
conducted a subgroup and sensitivity analysis, and confirmed that the
association of albumin levels was not influenced by surgery type, design
or delirium evaluation instruments. <br/>Conclusion(s): Preoperative
albumin, fibrinogen and AFR levels were associated with POD, potentially
aiding in identifying high-risk patients and playing a key role in
preventing POD.<br/>Copyright &#xa9; 2024 E-Century Publishing
Corporation. All rights reserved.

<93>
Accession Number
2030849460
Title
A Comparative Study of Cardioprotective Effect of Three Anesthetic Agents
by Measuring Serum Level of Troponin-T after Coronary Artery Bypass
Grafting.
Source
Journal of Cardiovascular Disease Research. 15(2) (pp 1318-1322), 2024.
Date of Publication: 2024.
Author
Chhabra V.; Makwana D.; Pandey V.
Institution
(Chhabra) Department of Cardiac Anesthesia, Mahatma Gandhi Hospital,
Sitapura, India
(Makwana) Department of Medicine, Dr Laxminarayan Pandey Government
Medical College and Hospital, M.P, Ratlam, India
(Pandey) Department of Pathology, Rajmata Smt. Devendra Kumari Singhdeo
Government Medical College, Chhattisgarh, Ambikapur, India
Publisher
EManuscript Technologies
Abstract
Background: Coronary artery bypass grafting (CABG) surgery is a common
procedure for revascularization in patients with coronary artery disease.
Anesthetic agents used during CABG can impact perioperative myocardial
injury. Troponin-T (TnT) is a sensitive biomarker for myocardial injury.
This study aims to compare the cardioprotective effects of three
anesthetic agents by measuring serum levels of TnT after CABG surgery.
<br/>Material(s) and Method(s): A prospective comparative study was
conducted on 150 patients undergoing elective CABG surgery. Patients were
divided into three groups based on the anesthetic agent used: Group A
(propofol), Group B (sevoflurane), and Group C (isoflurane). Serum TnT
levels were measured at baseline (preoperatively) and at 6, 12, and 24
hours postoperatively. Demographic data, surgical details, and
perioperative variables were recorded. Statistical analysis was performed
using ANOVA and post-hoc Tukey's test. <br/>Result(s): The mean baseline
serum TnT levels were comparable among the three groups (p > 0.05). At 6,
12, and 24 hours postoperatively, Group A showed significantly lower serum
TnT levels compared to Group B and Group C (p < 0.05). The mean TnT levels
at 24 hours postoperatively were 0.12 ng/mL in Group A, 0.18 ng/mL in
Group B, and 0.20 ng/mL in Group C. <br/>Conclusion(s): Propofol-based
anesthesia demonstrated superior cardioprotective effects compared to
sevoflurane and isoflurane in patients undergoing CABG surgery, as
evidenced by lower serum TnT levels postoperatively. Further studies are
warranted to elucidate the underlying mechanisms of this cardioprotection
and its clinical implications.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

<94>
Accession Number
2030898886
Title
Anticoagulation for mechanical aortic valves: An international survey of
current practice patterns and perceptions.
Source
Thrombosis Update. 14 (no pagination), 2024. Article Number: 100164. Date
of Publication: March 2024.
Author
Gupta S.; McEwen C.C.; Hou W.; Crowther M.; Siegal D.; Eikelboom J.;
Whitlock R.P.; Belley-Cote E.P.
Institution
(Gupta) Division of Cardiac Surgery, University of Ottawa Heart Institute,
University of Ottawa, Ottawa, ON, Canada
(McEwen, Whitlock) Division of Cardiac Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
(Hou) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Crowther, Eikelboom) Division of Hematology and Thromboembolism,
Department of Medicine, Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Crowther) Pathology and Molecular Medicine, Faculty of Health Sciences,
McMaster University, Hamilton, ON, Canada
(Siegal) Division of Hematology, Department of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Siegal) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Canada
(Eikelboom, Whitlock, Belley-Cote) Population Health Research Institute,
Hamilton, ON, Canada
(Belley-Cote) Division of Cardiology, Department of Medicine, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Introduction: For patients with mechanical aortic valves, guideline
recommended INR targets range from 2.0 to 3.5, depending on thromboembolic
risk factors. Supporting data is largely historical and of low quality. We
aimed to characterize clinicians' practices around INR targets for these
patients and perceptions of evidence supporting these recommendations.
<br/>Method(s): A 33-question web-based survey was sent to 75
cardiologists, cardiac surgeons, and thrombosis specialists globally. We
inquired about anticoagulation practices for patients with mechanical
aortic valves, perceptions of guideline recommendations, and interest in
participating in a randomized controlled trial comparing lower and higher
INR targets in these patients. <br/>Result(s): Of 55 respondents (73%
response rate), 78% worked in academic hospitals. In patients with
mechanical aortic valve and no additional thromboembolic risk factors, 80%
targeted an INR of 2.5. Among patients with additional thromboembolic risk
factors, 48% targeted an INR of 2.5, while 44% targeted an INR of 3.0.
Additionally, 57% of respondents believed that evidence for the guidelines
was up to date, and 53% believed that it applied to bi-leaflet valves.
However, 57% of respondents said that the evidence was not high quality.
Lastly, 66% of respondents would accept a higher thromboembolic risk to
reduce risk of major bleeding; 86% were willing to randomize patients with
mechanical aortic valve to a target INR of 2.0 if they had no
thromboembolic risk factors. <br/>Conclusion(s): Clinicians target
different INRs for patients with mechanical aortic valves; their
perception of the evidence and guidelines varies. Of respondents, 86%
would randomize patients to lower INR targets.<br/>Copyright &#xa9; 2024
The Authors

<95>
Accession Number
2030840049
Title
Concomitant tricuspid valve repair for mild-moderate tricuspid
regurgitation patients undergoing mitral valve surgery? A meta-analysis
and meta-regression.
Source
Journal of Cardiovascular Surgery. 64(4) (pp 657-667), 2023. Date of
Publication: December 2023.
Author
Awad A.K.; Sayed A.; Elbadawy M.A.; Ahmed A.; Ming Wang T.K.; Elgharably
H.
Institution
(Awad, Sayed, Elbadawy) Faculty of Medicine, Ain-shams University, Cairo,
Egypt
(Ahmed) CUNY School of Medicine, New York, NY, United States
(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
Publisher
Edizioni Minerva Medica
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 re-interventions, 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.<br/>Copyright &#xa9; 2023 EDIZIONI MINERVA MEDICA.

<96>
Accession Number
2030821951
Title
Novel Polygenic Risk Score and Established Clinical Risk Factors for Risk
Estimation of Aortic Stenosis.
Source
JAMA Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Small A.M.; Melloni G.E.M.; Kamanu F.K.; Bergmark B.A.; Bonaca M.P.;
O'Donoghue M.L.; Giugliano R.P.; Scirica B.M.; Bhatt D.; Antman E.M.; Raz
I.; Wiviott S.D.; Truong B.; Wilson P.W.F.; Cho K.; O'Donnell C.J.;
Braunwald E.; Lubitz S.A.; Ellinor P.; Peloso G.M.; Ruff C.T.; Sabatine
M.S.; Natarajan P.; Marston N.A.
Institution
(Small, Bergmark, O'Donoghue, Giugliano, Scirica, Antman, Wiviott,
O'Donnell, Braunwald, Lubitz, Ruff, Sabatine, Marston) Cardiovascular
Medicine Division, Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Small, O'Donnell) Department of Cardiology, Boston Veterans Affairs
Healthcare System, West Roxbury, MA, United States
(Melloni, Kamanu, Bergmark, O'Donoghue, Giugliano, Scirica, Antman,
Wiviott, Braunwald, Ruff, Sabatine, Marston) TIMI Study Group, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Bonaca) Department of Medicine, Cardiology and Vascular Medicine,
University of Colorado School of Medicine, Aurora, United States
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Raz) Department of Endocrinology and Metabolism, Hadassah Hebrew
University Hospital, Jerusalem, Israel
(Truong, Lubitz, Ellinor, Natarajan) Cardiovascular Disease Initiative,
The Broad Institute of MIT and Harvard, Cambridge, MA, United States
(Wilson) Atlanta Veterans Affairs Medical Center, Decatur, Georgia
(Wilson) Division of Cardiology, Department of Medicine, Emory University
School of Medicine, Atlanta, GA, United States
(Cho, Peloso) Veterans Affairs Healthcare System, Boston, MA, United
States
(Cho) Division of Aging, Mass General Brigham, Department of Medicine,
Harvard Medical School, Boston, MA, United States
(Lubitz, Ellinor, Natarajan) Cardiovascular Research Center, Massachusetts
General Hospital, Boston, United States
(Ellinor, Natarajan) Division of Cardiology, Department of Medicine,
Massachusetts General Hospital, Boston, United States
(Peloso) Department of Biostatistics, Boston University School of Public
Health, Boston, MA, United States
(Natarajan) Center for Genomic Medicine, Massachusetts General Hospital,
Boston, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Polygenic risk scores (PRSs) have proven to be as strong as or
stronger than established clinical risk factors for many cardiovascular
phenotypes. Whether this is true for aortic stenosis remains unknown.
OBJECTIVE To develop a novel aortic stenosis PRS and compare its aortic
stenosis risk estimation to established clinical risk factors. DESIGN,
SETTING, AND PARTICIPANTS Thiswas a longitudinal cohort study using data
from the Million Veteran Program (MVP; 2011-2020), UK Biobank (2006-2010),
and 6 Thrombolysis in Myocardial Infarction (TIMI) trials, including
DECLARE-TIMI 58 (2013-2018), FOURIER (TIMI 59; 2013-2017), PEGASUS-TIMI 54
(2010-2014), SAVOR-TIMI 53 (2010-2013), SOLID-TIMI 52 (2009-2014), and
ENGAGE AF-TIMI 58 (2008-2013), which were a mix of population-based and
randomized clinical trials. Individuals from UK Biobank and the MVP
meeting a previously validated case/control definition for aortic stenosis
were included. All individuals from TIMI trials were included unless they
had a documented preexisting aortic valve replacement. Analysis took place
from January 2022 to December 2023. EXPOSURES PRS for aortic stenosis
(developed using data from MVP and validated in UK Biobank) and other
previously validated cardiovascular PRSs, defined either as a continuous
variable or as low (bottom 20%), intermediate, and high (top 20%), and
clinical risk factors. MAIN OUTCOMES Aortic stenosis (defined using
International Classification of Diseases or Current Procedural Terminology
codes in UK Biobank and MVP or safety event data in the TIMI trials).
RESULTS The median (IQR) age in MVP was 67 (57-73) years, and 135 140 of
147 104 participants (92%) were male. The median (IQR) age in the TIMI
trials was 66 (54-78) years, and 45 524 of 59 866 participants (71%) were
male. The best aortic stenosis PRS incorporated 5 170 041
single-nucleotide variants and was associated with aortic stenosis in both
the MVP testing sample (odds ratio, 1.41; 95%CI, 1.37-1.45 per 1 SD PRS; P
= 4.6 x 10^-116) and TIMI trials (hazard ratio, 1.44; 95%CI,
1.27-1.62 per 1 SD PRS; P = 3.2 x 10^-9). Among genetic and
clinical risk factors, the aortic stenosis PRS performed comparably to
most risk factors besides age, and within a given age range, the
combination of clinical and genetic risk factors was additive, providing a
3- to 4-fold increased gradient of risk of aortic stenosis. However, the
addition of the aortic stenosis PRS to a model including clinical risk
factors only improved risk discrimination of aortic stenosis by 0.01 to
0.02 (C index in MVP: 0.78 with clinical risk factors, 0.79 with risk
factors and aortic stenosis PRS; C index in TIMI: 0.71 with clinical risk
factors, 0.73 with risk factors and aortic stenosis PRS). CONCLUSIONS This
study developed and validated 1 of the first aortic stenosis PRSs. While
aortic stenosis genetic risk was independent from clinical risk factors
and performed comparably to all other risk factors besides age, genetic
risk resulted in only a small improvement in overall aortic stenosis risk
discrimination beyond age and clinical risk factors. This work sets the
stage for further development of an aortic stenosis PRS. <br/>Copyright
&#xa9; 2024 American Medical Association. All rights reserved.

<97>
Accession Number
2028326352
Title
Effect of Intermittent Thoracic Paravertebral Block on Postoperative
Nausea and Vomiting Following Thoracoscopic Radical Resection of the Lung
Cancer: A Prospective Randomized Trial.
Source
Journal of Pain Research. 17 (pp 931-939), 2024. Date of Publication:
2024.
Author
Ma T.; Yu Y.; Cao H.; Wang H.; Wang M.
Institution
(Ma) Anesthesia Department, The First Affiliated Hospital of Zhejiang
Chinese Medical University (Zhejiang Provincial Hospital of Chinese
Medicine), Zhejiang, Hangzhou 310000, China
(Yu, Wang, Wang) Anesthesia Department, Taizhou Hospital of Zhejiang
Province Affiliated to Wenzhou Medical University, Zhejiang, Taizhou
317000, China
(Cao) Obstetrical Department, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: To explore the benefits of ultrasound-guided intermittent
thoracic paravertebral block (TPVB) combined with intravenous analgesia
(PCIA) in alleviating postoperative nausea and vomiting (PONV) during
video-assisted thoracic surgery (VATS). <br/>Patients and Methods: 120
patients with lung carcinoma undergoing VATS were included and divided
into three groups: group S (single TPVB+PCIA), group I (intermittent
TPVB+PCIA), and group P (PCIA). The patients' NRS scores, postoperative
hydro-morphone hydrochloride consumption, and intramuscular injection of
bucinnazine hydrochloride were recorded. The incidence of PONV and
complications were documented. <br/>Result(s): Compared with the group P,
both group I and group S had significantly lower static NRS scores from
1-48 hours after the operation (P <0.05), and the dynamic NRS score of
group I at the 1-48 hours after the operation were significantly decreased
(P <0.05). Compared with the group P, the proportion of patients with PONV
in group I was significantly lower (P <0.05), while there was no
significant difference in group S. Moreover, the hospitalization period of
patients in group I was significantly reduced compared with the other two
groups (P <0.01), and the patient satisfaction was significantly increased
compared with the group P (P <0.05). <br/>Conclusion(s): Intermittent TPVB
combined with PCIA can reduce the postoperative pain and the occurrence of
PONV.<br/>Copyright &#xa9; 2024 Ma et al.

<98>
Accession Number
2028928005
Title
Effects of short-term preoperative intranasal dexmedetomidine plus
conventional treatment on delirium following cardiac surgery in patients
with sleep disorders.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 17.
Date of Publication: December 2024.
Author
Fang J.; Yang J.; Zhai M.; Zhang Q.; Zhang M.; Xie Y.
Institution
(Fang, Yang, Zhai, Zhang, Xie) Department of Anaesthesiology, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Anhui, Hefei 230001, China
(Zhang) Department of Cardiovascular Surgery, The First Affiliated
Hospital of USTC, Division of Life Sciences and Medicine, University of
Science and Technology of China, Anhui, Hefei 230001, China
Publisher
BioMed Central Ltd
Abstract
Study objectives: To assess whether preoperative dexmedetomidine (DEX)
nasal drips combined with conventional treatment could mitigate the
occurrence of postoperative delirium (POD). <br/>Design(s): A prospective
randomised controlled study. <br/>Setting(s): The cardiac surgery
intensive care unit (CSICU) and patient hospitalisation ward at a
university hospital. <br/>Participant(s): A total of 100 patients (aged
>=60 years) undergoing cardiac surgery at a university hospital between 7
January 2022, and 30 November 2022 met the eligibility criteria and were
included in the study. <br/>Intervention(s): Patients with sleep disorders
(Pittsburgh Sleep Quality Index >=8) were divided into two groups: Group A
(the placebo group, n=50), receiving a short-term preoperative placebo
combined with conventional treatment and Group B (the DEX group, n=50),
receiving short-term preoperative DEX combined with conventional
treatment. Measurements and results: The Confusion Assessment Method for
the ICU (CAM-ICU) was used for POD assessment in the CSICU, while the CAM
was employed to assess delirium in the patient ward. Group B demonstrated
a reduced incidence of POD compared to Group A (12% vs. 30%, odds ratio:
0.318, 95% confidence interval: 0.112-0.905, p=0.027). <br/>Conclusion(s):
The combined treatment involving DEX demonstrated a decreased incidence of
POD in elderly individuals with sleep disorders undergoing cardiac surgery
compared to the placebo combination treatment. Trial registration: URL:
www.chictr.org.cn with registration number ChiCTR 2100043968, registered
on 06/03/2021.<br/>Copyright &#xa9; The Author(s) 2024.

<99>
Accession Number
2028910355
Title
The efficacy of different types of cerebral embolic protection device
during transcatheter aortic valve implantation: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1205943. Date of Publication: 2024.
Author
Wang C.; Han J.; Lu L.; Qiu J.; Fu Y.; Zheng J.
Institution
(Wang, Lu, Qiu, Fu, Zheng) Department of Cardiovascular Surgery, Sun
Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
(Wang, Han) Department of Thoracic and Cardiac Surgery, The Eighth
Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
Publisher
Frontiers Media SA
Abstract
Aims: Perioperative stroke remains a devastating complication after
transcatheter aortic valve implantation (TAVI), and using a cerebral
embolic protection device (CEPD) during TAVI may reduce the occurrence of
stroke according to some studies. Therefore, we conducted this
meta-analysis to determine whether CEPD should be routinely used during
TAVI. <br/>Methods and Results: The inclusion criteria for this study were
randomized controlled trials (RCTs) that examined the outcome of stroke
with or without CEPD during TAVI, with a minimum follow-up period of 30
days. The primary endpoint was the occurrence of stroke (including both
cerebrovascular accidents and death due to cerebrovascular accidents). The
risk of stroke was lower in the CEPD group: RR 0.68, 95% CI 0.49-0.96, p =
0.03, I²= 0%. A subgroup analysis was conducted according to
the type of CEPD. The risk of stroke was lower in the I&LCCA (filter cover
the innominate and the left common carotid arteries) type CEPD group: RR
0.66, 95% CI 0.49-0.96, p = 0.03, I²= 36%. However, there was
no statistically significant difference in the risk of stroke in the TMCA
[filter cover the three major cerebral arteries (innominate, left common
carotid, and subclavian arteries)] type CEPD group: RR 0.81, 95% CI
0.36-1.80, p = 0.60, I²= 0%. <br/>Conclusion(s): In this
meta-analysis, the I&LCCA-type CEPD can reduce the risk of stroke within
30 days following TAVI, but the TMCA type cannot.<br/>Copyright 2024 Wang,
Han, Lu, Qiu, Fu and Zheng.

<100>
Accession Number
2028891312
Title
The role of perioperative sedative anesthetics in preventing postoperative
delirium: a systematic review and network-meta analysis including 6679
patients.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
147. Date of Publication: December 2024.
Author
Huang J.-X.; Zhang S.-S.; Wang S.-X.; Xi D.-S.; Luo F.-R.; Liu C.-J.; Li
H.
Institution
(Huang, Zhang, Wang, Xi, Luo, Li) Department of Anesthesiology, Second
Affiliated Hospital of Army Medical University, Chongqing, China
(Liu) Department of General Medicine, Affiliated Anqing First People's
Hospital of Anhui Medical University, Anqing, China
Publisher
BioMed Central Ltd
Abstract
Objective: Postoperative delirium is a common and debilitating
complication that significantly affects patients and their families. The
purpose of this study is to investigate whether there is an effective
sedative that can prevent postoperative delirium while also examining the
safety of using sedatives during the perioperative period. <br/>Method(s):
The net-meta analysis was used to compare the incidence of postoperative
delirium among four sedatives: sevoflurane, propofol, dexmedetomidine, and
midazolam. Interventions were ranked according to their surface under the
cumulative ranking curve (SUCRA). <br/>Result(s): A total of 41 RCT
studies involving 6679 patients were analyzed. Dexmedetomidine can
effectively reduce the incidence of postoperative delirium than propofol
(OR 0.47 95% CI 0.25-0.90), midazolam (OR 0.42 95% CI 0.17-1.00), normal
saline (OR 0.42 95% CI 0.33-0.54) and sevoflurane (OR 0.39 95% CI
0.18-0.82). The saline group showed a significantly lower incidence of
bradycardia compared to the group receiving dexmedetomidine (OR 0.55 95%
CI 0.37-0.80). In cardiac surgery, midazolam (OR 3.34 95%CI 2.04-5.48) and
normal saline (OR 2.27 95%CI 1.17-4.39) had a higher rate of postoperative
delirium than dexmedetomidine, while in non-cardiac surgery, normal saline
(OR 1.98 95%CI 1.44-2.71) was more susceptible to postoperative delirium
than dexmedetomidine. <br/>Conclusion(s): Our analysis suggests that
dexmedetomidine is an effective sedative in preventing postoperative
delirium whether in cardiac surgery or non-cardiac surgery. The preventive
effect of dexmedetomidine on postoperative delirium becomes more apparent
with longer surgical and extubation times. However, it should be
administered with caution as it was found to be associated with
bradycardia.<br/>Copyright &#xa9; The Author(s) 2024.

<101>
Accession Number
2030789611
Title
Pain management after cardiac surgery via median sternotomy.
Source
European Journal of Anaesthesiology. 40(10) (pp 758-768), 2023. Date of
Publication: 01 Oct 2023.
Author
Maessen T.; Korir N.; Kennes J.; Wu C.; Van de Velde M.; Joshi G.P.;
Pogatzki-Zahn E.; Dewinter G.; Kehlet H.; Bonnet M.P.; Rawal N.; Volk T.;
Lavand'homme P.; Beloeil H.; Raeder J.; Sauter A.; Albrecht E.; Lobo D.;
Freys S.
Institution
(Maesen, Pogatzki-Zahn) The Department of Anaesthesiology, Intensive Care,
and Pain Medicine, University Hospital Munster, Munster, Germany
(Korir, Van de Velde, Kennes) The Department of Cardiovascular Sciences,
Section Anaesthesiology, KU Leuven, University Hospital Leuven, Leuven,
Belgium
(Joshi) The Department of Anesthesiology and Pain Management, University
of Texas Southwestern Medical Centre, Dallas, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Pain after cardiac surgery via median sternotomy can be
difficult to treat, and if inadequately managed can lead to respiratory
complications, prolonged hospital stays and chronic pain. OBJECTIVES To
evaluate available literature and develop recommendations for optimal pain
management after cardiac surgery via median sternotomy. DESIGN A
systematic review using PROcedure-SPECific Pain Management (PROSPECT)
methodology. ELIGIBILITY CRITERIA Randomised controlled trials and
systematic reviews published in the English language until November 2020
assessing postoperative pain after cardiac surgery via median sternotomy
using analgesic, anaesthetic or surgical interventions. DATA SOURCES
PubMed, Embase and Cochrane Databases. RESULTS Of 319 eligible studies,
209 randomised controlled trials and three systematic reviews were
included in the final analysis. Pre-operative, intra-operative and
postoperative interventions that reduced postoperative pain included
paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous
magnesium, intravenous dexmedetomidine and parasternal block/infiltration.
CONCLUSIONS The analgesic regimen for cardiac surgery via sternotomy
should include paracetamol and NSAIDs, unless contraindicated,
administered intra-operatively and continued postoperatively.
Intra-operative magnesium and dexmedetomidine infusions may be considered
as adjuncts particularly when basic analgesics are not administered. It is
not clear if combining dexmedetomidine and magnesium would provide
superior pain relief compared with either drug alone. Parasternal
block/surgical site infiltration is also recommended. However, no basic
analgesics were used in the studies assessing these interventions. Opioids
should be reserved for rescue analgesia. Other interventions, including
cyclo-oxygenase-2 specific inhibitors, are not recommended because there
was insufficient, inconsistent or no evidence to support their use and/or
due to safety concerns.<br/>Copyright &#xa9; 2023 European Society of
Anaesthesiology and Intensive Care.

<102>
Accession Number
2028818515
Title
The role of beta-adrenergic receptors in the regulation of cardiac
tolerance to ischemia/reperfusion. Why do beta-adrenergic receptor
agonists and antagonists protect the heart?.
Source
Fundamental and Clinical Pharmacology. (no pagination), 2024. Date of
Publication: 2024.
Author
Maslov L.N.; Naryzhnaya N.V.; Voronkov N.S.; Kurbatov B.K.; Derkachev
I.A.; Ryabov V.V.; Vyshlov E.V.; Kolpakov V.V.; Tomilova E.A.;
Sapozhenkova E.V.; Singh N.; Fu F.; Pei J.
Institution
(Maslov, Naryzhnaya, Voronkov, Kurbatov, Derkachev, Ryabov, Vyshlov)
Cardiology Research Institute, Tomsk National Research Medical Centre,
Russian Academy of Sciences, Tomsk, Russian Federation
(Kolpakov, Tomilova, Sapozhenkova) Tyumen State Medical University,
Tyumen, Russian Federation
(Singh) Department of Pharmaceutical Sciences and Drug Research, Punjabi
University, Patiala, India
(Fu, Pei) Department of Physiology and Pathophysiology, National Key
Discipline of Cell Biology, School of Basic Medicine, Fourth Military
Medical University, Xi'an, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Catecholamines and beta-adrenergic receptors (beta-ARs) play
an important role in the regulation of cardiac tolerance to the impact of
ischemia and reperfusion. This systematic review analyzed the molecular
mechanisms of the cardioprotective activity of beta-AR ligands.
<br/>Method(s): We performed an electronic search of topical articles
using PubMed databases from 1966 to 2023. We cited original in vitro and
in vivo studies and review articles that documented the cardioprotective
properties of beta-AR agonists and antagonists. <br/>Result(s): The
infarct-reducing effect of beta-AR antagonists did not depend on a
decrease in the heart rate. The target for beta-blockers is not only
cardiomyocytes but also neutrophils. beta1-blockers (metoprolol,
propranolol, timolol) and the selective beta2-AR agonist arformoterol have
an infarct-reducing effect in coronary artery occlusion (CAO) in animals.
Antagonists of beta1- and beta2-AR (metoprolol, propranolol, nadolol,
carvedilol, bisoprolol, esmolol) are able to prevent reperfusion cardiac
injury. All beta-AR ligands that reduced infarct size are the selective or
nonselective beta1-blockers. It was hypothesized that beta1-AR blocking
promotes an increase in cardiac tolerance to I/R. The activation of
beta1-AR, beta2-AR, and beta3-AR can increase cardiac tolerance to I/R.
The cardioprotective effect of beta-AR agonists is mediated via the
activation of kinases and reactive oxygen species production.
<br/>Conclusion(s): It is unclear why beta-blockers with the similar
receptor selectivity have the infarct-sparing effect while other
beta-blockers with the same selectivity do not affect infarct size. What
is the molecular mechanism of the infarct-reducing effect of beta-blockers
in reperfusion? Why did in early studies beta-blockers decrease the
mortality rate in patients with acute myocardial infarction (AMI) and
without reperfusion and in more recent studies beta-blockers had no effect
on the mortality rate in patients with AMI and reperfusion? The creation
of more effective beta-AR ligands depends on the answers to these
questions.<br/>Copyright &#xa9; 2024 Societe Francaise de Pharmacologie et
de Therapeutique. Published by John Wiley & Sons Ltd.

<103>
Accession Number
643668301
Title
Surgical prevalence and outcomes in ischemic colitis: A systematic review
and meta-analysis.
Source
World journal of surgery. (no pagination), 2024. Date of Publication: 05
Mar 2024.
Author
Qian W.; Bruinsma J.; Mac Curtain B.; Ibraheem M.; Temperley H.C.; Ng Z.Q.
Institution
(Qian, Bruinsma, Mac Curtain, Ibraheem) Department of Surgery, St John of
God Subiaco Hospital, Subiaco, WA, Australia
(Temperley) Department of Surgery, Royal College of Surgeons in Ireland,
Dublin, Ireland
(Ng) Department of General Surgery, Royal Perth Hospital, Perth, WA,
Australia
Abstract
BACKGROUND/AIM: This study reviews the literature to examine the
proportion of patients requiring surgical management in ischemic colitis
(IC) and identify surgical outcomes. <br/>METHOD(S): A systematic review
of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was
conducted in accordance with the latest Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) statement. English language
studies and adult patients were included. Studies with fewer than 10
patients, and IC post aortic or cardiac surgery was excluded. We present
our systematic review and meta-analysis with pooled proportions of right
sided IC distribution and prevalence of surgical treatment.
<br/>RESULT(S): 23 studies with a total of 12,844 patients were included
in the systematic review, with 19 studies and 12,420 patients included in
the meta-analysis. Four studies were excluded from the meta-analysis due
to only including specific cohorts of patients-two with cocaine induced
colitis, one with phlebosclerotic colitis, and one with IC associated with
acute myocardial infarction. The pooled proportion of right sided IC
distribution was 15% (CI 14%-17%, p < 0.001), whilst the pooled proportion
of surgical management of IC was 15% (CI 13%-16% p < 0.001).
<br/>CONCLUSION(S): Prevalence of surgical management of IC is rare. Right
sided IC is associated with higher mortality and higher rates of surgical
management. Reporting of surgical outcomes is scant.<br/>Copyright &#xa9;
2024 International Society of Surgery/Societe Internationale de Chirurgie
(ISS/SIC).

<104>
Accession Number
643667100
Title
Micronutrients as therapy in critical illness.
Source
Current opinion in critical care. (no pagination), 2024. Date of
Publication: 08 Jan 2024.
Author
Stoppe C.; Dresen E.; de Man A.
Institution
(Stoppe, Dresen) Department of Anaesthesiology, Intensive Care, Emergency,
Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
(Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine,
German Heart Center Charite Berlin, Berlin, Germany
(de Man) Department of Intensive Care, Amsterdam UMC, location Vrije
Universiteit, Amsterdam, The Netherlands; Amsterdam Cardiovascular
Sciences, Amsterdam, The Netherlands
Abstract
PURPOSE OF REVIEW: Recent large-scale randomized controlled trials (RCTs)
challenged current beliefs about the potential role of micronutrients to
attenuate the inflammatory response and improve clinical outcomes of
critically ill patients. The purpose of this narrative review is to
provide an overview and critical discussion about most recent clinical
trials, which evaluated the clinical significance of a vitamin C, vitamin
D, or selenium administration in critically ill patients. RECENT FINDINGS:
None of the most recent large-scale RCTs could demonstrate any clinical
benefits for a micronutrient administration in ICU patients, whereas a
recent RCT indicated harmful effects, if high dose vitamin C was
administered in septic patients. Following meta-analyses could not confirm
harmful effects for high dose vitamin C in general critically ill patients
and indicated benefits in subgroup of general ICU patients with higher
mortality risk. For vitamin D, the most recent large-scale RCT could not
demonstrate clinical benefits for critically ill patients, whereas another
large-scale RCT is still ongoing. The aggregated and meta-analyzed
evidence highlighted a potential role for intravenous vitamin D
administration, which encourages further research. In high-risk cardiac
surgery patients, a perioperative application of high-dose selenium was
unable to improve patients' outcome. The observed increase of selenium
levels in the patients' blood did not translate into an increase of
antioxidative or anti-inflammatory enzymes, which illuminates the urgent
need for more research to identify potential confounding factors. SUMMARY:
Current data received from most recent large-scale RCTs could not
demonstrate clinically meaningful effects of an intervention with either
vitamin C, vitamin D, or selenium in critically ill patients. More
attention is needed to carefully identify potential confounding factors
and to better evaluate the role of timing, duration, and combined
strategies.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<105>
Accession Number
643665546
Title
The protocol of enhanced recovery after cardiac surgery in adult patients:
a stepped wedge cluster randomized trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 02
Mar 2024.
Author
Dou D.; Yuan S.; Jia Y.; Wang Y.; Li Y.; Wang H.; Ding J.; Wu X.; Bie D.;
Liu Q.; An R.; Yan H.; Yan F.
Institution
(Dou, Yuan, Jia, Li, Wang, Ding, Wu, Bie, Liu, An, Yan, Yan) Department of
Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai
Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of
Medical Sciences & Peking Union Medical College, Beijing 100037, China
(Wang) Department of Medical Research & Biometrics Centre, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking
Union Medical College, Beijing 100037, China
Abstract
BACKGROUND: The Enhanced Recovery After Cardiac Surgery is a bundle of
measurements from preoperative to postoperative phases to improve
patients' recovery. <br/>METHOD(S): This study is a multicenter, stepwise
design, cluster randomized controlled trial. 3600 patients presenting
during control and intervention periods are eligible if they are aged from
18 to 80 years old awaiting elective cardiac surgery with cardiopulmonary
bypass (CPB). 5 centers are randomly assigned to staggered start dates for
one-way crossover from the control phase to the intervention phase. In the
intervention periods, patients will receive ERAS strategy including
preoperative, intraoperative and postoperative approaches. During the
control phase, patients receive usual care. The primary outcome consists
of major adverse cardiac and cerebrovascular events (MACCEs),
postoperative pulmonary complications (PPCs), and acute kidney injury
(AKI). DISCUSSION: This study aims to compare the application of ERAS
management protocol and traditional management protocol in adult cardiac
surgery under extracorporeal circulation.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.

<106>
Accession Number
643664753
Title
Reducing length of stay after transfemoral transcatheter aortic valve
implantation: the FAST-TAVI II trial.
Source
European heart journal. (no pagination), 2024. Date of Publication: 04
Mar 2024.
Author
Durand E.; Beziau-Gasnier D.; Michel M.; Iung B.; Tchetche D.; Bonnet G.;
Lhermusier T.; Gilard M.; Souteyrand G.; Bouleti C.; Ohlmann P.; Lefevre
T.; Beygui F.; Chassaing S.; Chevreul K.; Eltchaninoff H.
Institution
(Durand, Beziau-Gasnier, Eltchaninoff) Univ Rouen Normandie, Inserm U1096,
CHU Rouen, Department of Cardiology, Rouen F-76000, France
(Michel, Chevreul) ParisFrance
(Michel, Chevreul) Inserm, ECEVE, Paris, France
(Michel, Chevreul) Clinical Epidemiology Unit, Robert Debre Hospital,
Assistance Publique-Hopitaux de Paris, Paris, France
(Iung) Cardiology Department, Bichat-Claude-Bernard Hospital Cardiology
Service, Paris, France
(Tchetche) Clinique Pasteur, Toulouse, France
(Bonnet) Unite medico-chirurgicale des valvulopathies, CHU de Bordeaux,
Pessac 33600, France
(Lhermusier) Pole Cardiovasculaire et Metabolique, CHU de Toulouse,
Toulouse, France
(Gilard) Department of Cardiology, CHRU Brest, Brest 29200, France
(Souteyrand) CHU de Clermont-Ferrand, Clermont-Ferrand, France
(Bouleti) Clinical Investigation Center (INSERM 1204), Cardiology
Department, ACTION and FACT study groups, University of Poitiers, Poitiers
Hospital, France
(Ohlmann) Universite de Strasbourg, Pole d'Activite Medico-Chirurgicale
Cardio-Vasculaire, Nouvel Hopital Civil, Centre Hospitalier Universitaire,
Strasbourg, France
(Lefevre) Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques
Cartier, Ramsay Generale de sante, Massy, France
(Beygui) Service de Cardiologie, ACTION Study Group, Centre Hospitalier
Universitaire (CHU) de Caen Normandie, Normandie Univ, GIP Cyceron, Caen,
France
(Chassaing) Cardiology Department, Tours, France
Abstract
BACKGROUND AND AIMS: The length of stay (LOS) after transcatheter aortic
valve implantation (TAVI) remains extremely variable whereas early
discharge has been shown to be feasible and safe. The study objective was
to evaluate the efficacy and safety of an intervention aimed at reducing
LOS after transfemoral TAVI. <br/>METHOD(S): FAST-TAVI II is a
prospective, multicentre, cluster, randomized, controlled study including
patients with severe symptomatic aortic stenosis, who had transfemoral
TAVI. The intervention consisted in a dedicated training programme to
implement 10 quality of care measures to reduce LOS with an implementation
phase of eight weeks. The primary endpoint was the proportion of patients
discharged early within 3 days. Secondary endpoints included: LOS, 30-day
mortality and 30-day incidence of readmission for cardiovascular events.
<br/>RESULT(S): During the study period, 969 patients were enrolled in the
intervention group and 860 patients in the control group. Mean age was
81.9 +/- 6.6 years and mean EuroSCORE II was 4.4 +/- 4.5%. Early discharge
was achieved in 563 (58.1%) patients in the intervention group vs. 364
(42.3%) patients in the control group (P < .0001). Median LOS was
significantly reduced in the intervention group compared to the control
group [3 (IQR: 3) vs. 4 days (IQR: 3), P < .0001]. Thirty-day mortality
was low and similar in the two groups (0.5% vs. 0.9%, P = .30), as were
30-day readmissions (4.6% vs. 2.8%, P = .28). <br/>CONCLUSION(S): The
intervention was simple and fast to implement, and was effective and safe
to reduce LOS and increase the proportion of patients discharged early
after TAVI (NCT04503655).<br/>Copyright &#xa9; The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<107>
Accession Number
643654201
Title
Systematic review and meta-analysis of randomized and nonrandomized
studies on fractional flow reserve-guided revascularization.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2024.
Date of Publication: 01 Mar 2024.
Author
Mangiacapra F.; Paolucci L.; Johnson N.P.; Viscusi M.M.; Ussia G.P.;
Grigioni F.; Bruyne B.; Barbato E.
Institution
(Mangiacapra, Paolucci, Ussia, Grigioni) Research Unit of Cardiovascular
Science, Department of Medicine and Surgery, Universita Campus Bio-Medico
di Roma, Rome, Italy; Fondazione Policlinico Universitario Campus
Bio-Medico, Rome, Italy
(Johnson) Division of Cardiology, Department of Medicine, Weatherhead PET
Center, McGovern Medical School at UTHealth and Memorial Hermann Hospital,
Houston, TX, United States
(Viscusi) Research Unit of Cardiovascular Science, Department of Medicine
and Surgery, Universita Campus Bio-Medico di Roma, Rome, Italy; Fondazione
Policlinico Universitario Campus Bio-Medico, Rome, Italy; Cardiovascular
Center, OLV Clinic, Aalst, Belgium
(Bruyne) Cardiovascular Center, OLV Clinic, Aalst, Belgium
(Barbato) Cardiovascular Center, OLV Clinic, Aalst, Belgium; Department of
Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
Abstract
INTRODUCTION AND OBJECTIVES: Several studies have investigated the
effectiveness of fractional flow reserve (FFR) guidance in improving
clinical outcomes after myocardial revascularization, yielding conflicting
results. The aim of this study was to compare clinical outcomes in
patients with coronary artery disease following FFR-guided or
angiography-guided revascularization. <br/>METHOD(S): Both randomized
controlled trials (RCTs) and nonrandomized intervention studies were
included. Coprimary endpoints were all-cause death, myocardial infarction,
and major adverse cardiovascular events (MACE). The study is registered
with PROSPERO (CRD42022344765). <br/>RESULT(S): A total of 30 studies
enrolling 393588 patients were included. FFR-guided revascularization was
associated with significantly lower rates of all-cause death (OR, 0.63;
95%CI, 0.53-0.73), myocardial infarction (OR, 0.70; 95%CI, 0.59-0.84), and
MACE (OR, 0.77; 95%CI, 0.70-0.85). When only RCTs were considered, no
significant difference between the 2 strategies was observed for any
endpoints. However, the use of FFR was associated with reduced rates of
revascularizations and treated lesions. Metaregression suggested that the
higher the rate of revascularized patients the lower the benefit of FFR
guidance on MACE reduction compared with angiography guidance (P = .012).
Similarly, higher rates of patients with acute coronary syndromes were
associated with a lower benefit of FFR-guided revascularization (P =
.039). <br/>CONCLUSION(S): FFR-guided revascularization was associated
with lower rates of all-cause death, myocardial infarction and MACE
compared with angiographic guidance, with RCTs and nonrandomized
intervention studies yielding conflicting data. The benefits of
FFR-guidance seem to be less evident in studies with high
revascularization rates and with a high prevalence of patients with acute
coronary syndrome.<br/>Copyright &#xa9; 2024. Published by Elsevier
Espana, S.L.U.

<108>
Accession Number
2030751780
Title
Flurbiprofen in the subglottic space to prevent postoperative sore throat
after cardiac surgery: A randomized double-blind study.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111418. Date of Publication: August 2024.
Author
Calabrese M.; Arlotta G.; Antoniucci M.E.; Montini L.; Giannarelli D.;
Taccheri T.; Corsi F.; De Paulis S.; Scapigliati A.; Bevilacqua F.; Vargas
J.; Corrado M.; Pavone N.; Bruno P.; Massetti M.; Cavaliere F.
Institution
(Calabrese, Arlotta, Antoniucci, Taccheri, Corsi, De Paulis, Scapigliati,
Bevilacqua, Vargas, Corrado, Cavaliere) Department of Cardiovascular
Sciences, Intensive Care Unit, Fondazione Policlinico Universitario "A.
Gemelli" IRCCS, Rome, Italy
(Montini) Department of Intensive Care Medicine and Anesthesiology,
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic
University of the Sacred Heart, Rome, Italy
(Giannarelli) Facility Epidemiology and Biostatistics, Fondazione
Policlinico Universitario "A. Gemelli", Rome, Italy
(Pavone, Bruno, Massetti) Department of Cardiovascular Sciences, Cardiac
Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS,
Rome, Italy
Publisher
Elsevier Inc.
Abstract
Study objective: Postoperative sore throat (POST) and hoarseness are
common complications of tracheal intubation. This study aims to evaluate
the efficacy of flurbiprofen administered through the subglottic port of
tracheal tubes to prevent POST after cardiac surgery. <br/>Design(s):
Single-center, prospective, randomized, double-blind, placebo-controlled
trial. <br/>Setting(s): Tertiary Care Referral University Hospital
(Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome).
<br/>Patient(s): Included 71 patients undergoing for elective cardiac
surgery. Inclusion criteria were (a) age between 50 and 75 years, (b) NYHA
class I or II, (c) surgery for myocardial revascularization or valve
repair or replacement under cardiopulmonary bypass. <br/>Intervention(s):
Patients were double blind randomized to receive flurbiprofen or saline in
the subglottic port of the endotracheal tube (groups F and P). The
solution was injected ten minutes after tracheal tube placement, ten
minutes after ICU admission and ten minutes before tracheal tube removal.
Measurements: The primary outcome was to assess the effect of topical
flurbiprofen administered through the subglottic port of the tracheal tube
to prevent post-operative sore throat (POST). The secondary outcomes were
the presence of hoarseness safety and patient's subjective satisfaction
with their recovery. We did not report any exploratory outcomes. <br/>Main
Result(s): We analyzed 68 patients, 34 patients in each group. In group F,
two patients complained of POST and hoarseness (5.9%), while all controls
did. The two groups significantly differed in the severity scores (VAS and
TPS for sore throat and HOAR for hoarseness) at all time points. In group
P, patients reported mild to moderate symptoms that significantly improved
or disappeared 36 h after tracheal tube removal. According to the
multivariable model, hoarseness affected women less than men, in the
control group (p = 0.002). None of the patients in either group reported
any adverse effects. <br/>Conclusion(s): Repeated administration of
flurbiprofen through the subglottic port of tracheal tubes reduced the
incidence of sore throat and hoarseness after cardiac surgery without
evidence of complications.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<109>
Accession Number
355113031
Title
The Thrombin Receptor Antagonist for Clinical Event Reduction in Acute
Coronary Syndrome (TRA*CER) trial: study design and rationale.
Source
American Heart Journal. 158(3) (pp 334.e4), 2009. Date of Publication:
September 2009.
Author
Harrington R.A.; Van De Werf F.; Armstrong P.W.; Aylward P.; Veltri E.;
Mahaffey K.W.; Moliterno D.J.; Strony J.; Wallentin L.; White H.D.; Diaz
R.; Huber K.; Nicolau J.C.; Prieto J.C.; Isaza D.; Widimsky P.; Grande P.;
Nieminen M.; Montalescot G.; Bode C.; Wong L.; Ofner P.; Lewis B.S.;
Ambrosio G.; Valgimigli M.; Ogawa H.; Yamaguchi J.-I.; Jukema J.W.; Cornel
J.H.; Nordrehaug J.E.; Ruzyllo W.; Providencia L.; Tan H.-C.; Dalby A.;
Park S.-J.; Betriu A.; Cequier A.; Held C.; Pfisterer M.; Chen M.F.;
Timurkaynak T.; Storey R.F.; Chen E.; Hudson M.P.; Lincoff A.M.; Morrow
D.A.; Tricoci P.; Whellan D.; Verheugt F.; Frye R.L.; Hochman J.; Steg
P.G.; Bailey K.R.
Institution
(Harrington, Mahaffey, Tricoci) Duke Clinical Research Institute, Durham,
NC, United States
(Van De Werf) Department of Cardiology, University of Leuven, Belgium
(Armstrong) Division of Cardiology, University of Alberta, Edmonton,
Canada
(Aylward) Department of Cardiovascular Medicine, Flinders Medical Centre,
Bedford Park, Australia
(Veltri, Strony, Chen) Schering-Plough Research Institute, Kenilworth, NJ,
United States
(Moliterno) Gill Heart Institute, Division of Cardiovascular Medicine,
University of Kentucky, Lexington, KY, United States
(Wallentin, Held) Uppsala Clinical Research Center, Uppsala, Sweden
(White) Green Lane Cardiovascular Service, Auckland, New Zealand
(Diaz) Instituto Cardiovascular de Rosario, Rosario, Argentina
(Huber) Wilhelminenspital der Stadt Wien, Vienna, Austria
(Nicolau) Heart Institute (InCor), University of Sao Paulo Medical School,
Brazil
(Prieto) Hospital Jose Joaquin Aguirre, Santiago, Chile
(Isaza) Fundacion Clinica Shaio, Bogota, Colombia
(Widimsky) Cardiocenter, University Hospital Vinohrady, Prague, Czechia
(Grande) Heart Center, University Hospital of Copenhagen, Copenhagen,
Denmark
(Nieminen) Division of Cardiology, Helsinki University Central Hospital,
Helsinki, Finland
(Montalescot) Department of Cardiology, Centre Hospitalier Universitaire
Pitie-Salpetriere, Paris, France
(Bode) Universitat Klinikum Freiburg, Freiburg, Germany
(Wong) Division of Neurology, Chinese University of Hong Kong, Hong Kong
(Ofner, Ruzyllo) National Institute of Cardiology, Budapest, Hungary
(Lewis) Department of Cardiovascular Medicine, The Heart Hospital at Lady
Davis Carmel Medical Center, Haifa, Israel
(Ambrosio) Division of Cardiology, University of Perugia School of
Medicine, Perugia, Italy
(Valgimigli) Cattedra di Cardiologia, Azienda Ospedaliera Universitaria di
Ferrara, Ferrara, Italy
(Ogawa) Department of Cardiovascular Medicine, Graduate School of Medical
Sciences, Kumamoto University, Kumamoto, Japan
(Yamaguchi) Department of Cardiology, The Heart Institute of Japan, Tokyo
Women's Medical University, Tokyo, Japan
(Jukema) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Cornel) Department of Cardiology, Medisch Centrum Alkmaar, Alkmaar,
Netherlands
(Nordrehaug) University of Bergen, Bergen, Norway
(Providencia) Division of Cardiology, Hospitais da Universidade de
Coimbra, Coimbra, Portugal
(Tan) Cardiology Department, National University Hospital, Singapore
(Dalby) University of Witwatersrand, Johannesburg, South Africa
(Park) Asan Medical Center, Seoul, South Korea
(Betriu) Hospital Clinic, University of Barcelona, Barcelona, Spain
(Cequier) Division of Cardiology, Hospital de Bellvitge, University of
Barcelona, Barcelona, Spain
(Pfisterer) Department of Cardiology, University Hospital Basel, Basel,
Switzerland
(Chen) National Taiwan University College of Medicine, Taipei, Taiwan
(Republic of China)
(Timurkaynak) Department of Cardiology, Gazi University Hospital, Ankara,
Turkey
(Storey) Cardiovascular Research Unit, University of Sheffield, United
Kingdom
(Hudson) Henry Ford Heart and Vascular Institute, Detroit, MI, United
States
(Lincoff) Cleveland Clinic Coordinating Center for Clinical Research,
Cleveland, OH, United States
(Morrow) TIMI Study Group, Boston, MA, United States
(Whellan) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
(Verheugt) University Medical Ctr St. Radboud, Nijmegen, Netherlands
(Frye, Bailey) Mayo Clinic, Rochester, MN, United States
(Hochman) New York University School of Medicine, New York, NY, United
States
(Steg) Hopital Bichat-CI. Bernard, Paris Cedex, France
Publisher
Mosby Inc.
Abstract
Background: The protease-activated receptor 1 (PAR-1), the main platelet
receptor for thrombin, represents a novel target for treatment of arterial
thrombosis, and SCH 530348 is an orally active, selective, competitive
PAR-1 antagonist. We designed TRA*CER to evaluate the efficacy and safety
of SCH 530348 compared with placebo in addition to standard of care in
patients with non-ST-segment elevation (NSTE) acute coronary syndromes
(ACS) and high-risk features. Trial design: TRA*CER is a prospective,
randomized, double-blind, multicenter, phase III trial with an original
estimated sample size of 10,000 subjects. Our primary objective is to
demonstrate that SCH 530348 in addition to standard of care will reduce
the incidence of the composite of cardiovascular death, myocardial
infarction (MI), stroke, recurrent ischemia with rehospitalization, and
urgent coronary revascularization compared with standard of care alone.
Our key secondary objective is to determine whether SCH 530348 will reduce
the composite of cardiovascular death, MI, or stroke compared with
standard of care alone. Secondary objectives related to safety are the
composite of moderate and severe GUSTO bleeding and clinically significant
TIMI bleeding. The trial will continue until a predetermined minimum
number of centrally adjudicated primary and key secondary end point events
have occurred and all subjects have participated in the study for at least
1 year. The TRA*CER trial is part of the large phase III SCH 530348
development program that includes a concomitant evaluation in secondary
prevention. <br/>Conclusion(s): TRA*CER will define efficacy and safety of
the novel platelet PAR-1 inhibitor SCH 530348 in the treatment of
high-risk patients with NSTE ACS in the setting of current treatment
strategies.<br/>Copyright &#xa9; 2009 Mosby, Inc. All rights reserved.

<110>
Accession Number
2030000051
Title
Percutaneous Coronary Revascularization Strategies for Small Vessel
Disease: Is an Old Solution Still in Its Prime?.
Source
American Journal of Cardiology. 215 (pp 76-77), 2024. Date of Publication:
15 Mar 2024.
Author
Mrad S.; Tanguay J.-F.
Institution
(Mrad, Tanguay) Interventional Cardiology Division, Medicine Department -
Montreal Heart Institute, Universite de Montreal, Montreal, Canada
Publisher
Elsevier Inc.

<111>
Accession Number
2029586078
Title
Effectiveness of general anaesthesia with remimazolam tosilate on
intraoperative haemodynamics and postoperative recovery: Study protocol
for a randomised, positive-controlled, pragmatic clinical trial (GARTH
trial).
Source
BMJ Open. 14(1) (no pagination), 2024. Article Number: e073024. Date of
Publication: 04 Jan 2024.
Author
Lu C.; Kang Y.; Luo Q.; Zhong F.; Cai Y.; Zhang G.; Guo Z.; Zhang S.; Ma
J.; Shu H.
Institution
(Lu, Kang, Luo, Cai, Zhang, Guo, Zhang, Ma, Shu) Department of
Anesthesiology, Guangdong Provincial People's Hospital, Southern Medical
University, Guangzhou, China
(Lu) Department of Anesthesiology, Shenzhen Traditional Chinese Medicine
Hospital, The Fourth Clinical Medical College of Guangzhou University of
Chinese Medicine, Shenzhen, China
(Zhong) Global Health Research Center, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Guo, Shu) Guangdong Cardiovascular Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Zhang) Department of Anesthesiology, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Shu) School of Medicine, South China University of Technology, Guangzhou,
China
Publisher
BMJ Publishing Group
Abstract
Introduction It is encouraged to estimate the effectiveness of components
within the enhanced recovery after surgery (ERAS) protocol through
patient-reported outcomes, alongside doctor-reported outcomes and length
of hospital stay. At present, studies on the contributions of optimal
anaesthetic drugs within the ERAS protocol to patient-reported and
doctor-reported outcomes are limited. Therefore, this study aims to
pragmatically evaluate the effectiveness and safety of general anaesthesia
(GA) with remimazolam tosilate within the ERAS protocol on intraoperative
haemodynamics and postoperative recovery in adults undergoing elective
surgeries, compared with propofol. Methods and analysis This study is a
single-centre, randomised, blinded, positive-controlled, pragmatic
clinical trial. A total of 900 patients, aged >=18 years old, scheduled
for an elective surgical procedure under GA will be included. Patients
will be randomised in a 1:1 ratio to the remimazolam group (the GA with
remimazolam tosilate within the ERAS protocol group) or propofol group
(the GA with propofol within the ERAS protocol group), stratified by
general surgery, thoracic surgery and other surgeries (including
urological surgery and otolaryngology surgery). The primary outcomes
include the 24-hour postoperative quality of recovery-40 score and the
rate of intraoperative hypotension. Secondary endpoints include the rate
of sedative hypotension requiring treatment, the haemodynamic profiles,
the 72-hour postoperative quality of recovery-40 score, the functional
anaesthetic capability, adverse events and complications, quality of life
within 3 months as well as economic health outcomes. Ethics and
dissemination This study protocol has been approved by the ethics
committee of Guangdong Provincial People's Hospital (KY-H-2022-005-03-08).
Dissemination plans will be presented at scientific meetings and in
scientific publications. Trial registration number
ChiCTR2200062520.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<112>
Accession Number
2028899698
Title
Femoral Arterial Calcification and Plug- vs. Suture-Based Closure Device
Strategies Post-Transcatheter Aortic Valve Implantation: Insights From
CHOICE-CLOSURE.
Source
Structural Heart. 8(2) (no pagination), 2024. Article Number: 100236. Date
of Publication: March 2024.
Author
Fitzgerald S.; Dumpies O.; Shibata M.; Hartung P.; Obradovic D.;
Boekstegers P.; Vorpahl M.; Rotta detto Loria J.; Kiefer P.; Desch S.;
Thiele H.; Abdel-Wahab M.
Institution
(Fitzgerald, Dumpies, Shibata, Hartung, Obradovic, Rotta detto Loria,
Desch, Thiele, Abdel-Wahab) Department of Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(Boekstegers) Department of Cardiology, Helios Clinic Siegburg, Siegburg,
Germany
(Boekstegers, Vorpahl) Witten Herdecke University, Witten, Germany
(Vorpahl) Department of Cardiology, Helios University Hospital Wuppertal,
Wuppertal, Germany
(Kiefer) Department of Cardiac Surgery, Heart Center Leipzig at University
of Leipzig, Leipzig, Germany
Publisher
Cardiovascular Research Foundation
Abstract
Background: The location and severity of vascular calcification may
influence closure device success in transfemoral transcatheter aortic
valve implantation. The aim of this study was to analyze effects of
vascular access-site calcification on vascular and bleeding outcomes
post-transcatheter aortic valve implantation. <br/>Method(s): The
Randomized Comparison of CatHeter-based Strategies fOr Interventional
ACcess SitE CLOSURE during Transfemoral Transcatheter Aortic Valve
Implantation (CHOICE-CLOSURE) trial assigned 516 patients to access site
closure using a pure plug-based technique (MANTA, Teleflex) or a primary
suture-based technique (ProGlide, Abbott Vascular). The principal finding
of the overall study was that access-site or access-related complications
were more common after the plug-based strategy compared to percutaneous
closure with a suture-based strategy. In this predefined subgroup
analysis, the overall cohort was split into patients with and without
anterior calcification at the access site and divided by degree of
calcification severity using the classification system developed in the
MANTA vs. suture-based vascular closure after transcatHeter aortic valve
replacement (MASH) trial. Differences in bleeding and vascular
complications were compared. The primary endpoint consisted of
access-site- or access-related major and minor vascular complications.
<br/>Result(s): There were more access-site-related major and minor
vascular complications for patients with anterior wall vascular
calcification and MASH severe calcification. No significant interaction
with choice of closure technique in terms of access-site-related major and
minor vascular complications was observed (odds ratio 1.70, 95% CI
0.77-3.78, p = 0.19 for the primary endpoint in plug- vs. suture-based
strategy in patients with anterior calcification, odds ratio 1.78, 95% CI
0.56-5.65, p = 0.33 for primary endpoint in plug- vs. suture-based
strategy with MASH severe calcification, p<inf>int</inf> = 0.97 for
anterior calcification, p<inf>int</inf> = 0.95 for MASH severe
calcification). <br/>Conclusion(s): The total number of vascular
complications was found to be greater in the presence of anterior and MASH
severe calcification. Overall, the presence of anterior or severe
calcification does not significantly modify the efficacy of the
suture-based strategy compared to the plug-based strategy.<br/>Copyright
&#xa9; 2023 The Authors

<113>
Accession Number
2028877656
Title
Individualised, perioperative open-lung ventilation strategy during
one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled
clinical trial.
Source
The Lancet Respiratory Medicine. 12(3) (pp 195-206), 2024. Date of
Publication: March 2024.
Author
Ferrando C.; Carraminana A.; Pineiro P.; Mirabella L.; Spadaro S.; Librero
J.; Ramasco F.; Scaramuzzo G.; Cervantes O.; Garutti I.; Parera A.;
Argilaga M.; Herranz G.; Unzueta C.; Vives M.; Regi K.; Costa-Reverte M.;
Sonsoles Leal M.; Nieves-Alonso J.; Garcia E.; Rodriguez-Perez A.; Farina
R.; Cabrera S.; Guerra E.; Gallego-Ligorit L.; Herrero-Izquierdo A.;
Valles-Torres J.; Ramos S.; Lopez-Herrera D.; De La Matta M.; Gokhan S.;
Kucur E.; Mugarra A.; Soro M.; Garcia L.; Aguirre P.; Salazar C.J.; Ramos
M.C.; Morocho D.R.; Trespalacios R.; Lamanna A.; Pia Cantatore L.;
Laforgia D.; Bellas S.; Lopez C.; Navarro-Ripoll R.; Vallverdu J.; Jacas
A.; Belda F.J.; Tusman G.; Suarez-Sipmann F.; Villar J.; Leal M.S.; Sastre
J.A.; Jimena-Salazar C.; Ezequiel-Fernandez F.; Cantatore L.P.; Laforogia
D.; Yepes-Temino M.J.; Martinez S.; Azparren G.; Bausili M.; Torres S.;
Diaz M.; Ricart A.; Gasco I.; Parramon F.; Sanz-Iturbe M.;
Garcia-Ballester S.; Mendez-Arias E.; Cabadas R.; Grosso L.; Becerra A.;
Hussein Z.; Sanjuan-Villarreal T.A.; Puertolas M.; Izquierdo-Villarroya
B.; Almajano R.; Romero B.; Colomina L.; Quesada N.; Latorre J.A.; Franco
J.A.; Laval A.; Garcia-Tirado J.; Embun R.; Bueno C.; Jaren P.;
Martinez-Serrano R.; Garcia-Latasa B.; Baquedano S.; Motilva B.; Hernando
B.; Herrero M.; Oliver-Fornies P.; Recuero J.L.; Carbo-Espinosa F.; Lucas
A.; Munoz-Gonzalez N.; Lafuente N.; Acosta-Martinez J.; Ragazzi R.; Volta
C.A.; Maniscalco P.; Arribas M.P.; de Celis M.I.; Pascual M.J.; Martinez
P.; Martinez O.; Reparaz J.R.; Dominguez D.; Fernandez M.; Sanchez V.;
Perez-Lozana B.; Martin E.; Fernandez D.; Gonzalez A.; Pico J.; El-Hefny
D.A.; Armengol L.; Comino O.; Rovira I.; Arguis M.J.; Matute P.; Carretero
M.J.; Ibanez C.; Perdomo J.; Ruiz C.; Gonzalez N.; Gonzalez M.; Bolado A.;
Trabanco S.; Largo A.; Maestro A.; Pascual A.; Reyes A.I.; Bartolome M.J.;
Williams M.M.; del Olmo P.; Cimadevilla B.; Pardo S.; Sancho L.; Lascorz
L.; Carbonell J.A.; Hurtado L.; Florea R.; Martinez-Castro S.; Monleon B.;
Perez S.; Jurado A.; Barcena E.; Segura N.; Cuervo J.; Belmonte L.; Pardo
P.; Utrera E.; Serralta F.; Parra M.J.; Arocas B.; Gutierrez A.;
Cruz-Pardos P.; de la Gala-Garcia F.; Sanchez-Pedrosa G.; Duque-Gonzalez
P.; De La Fuente-Tornero E.; Puig-Ramos A.; Garcia-Hernandez S.;
Martinez-Gascuena D.; Calvo-Garcia C.A.; Reyes-Fierro A.; Novoa-Lago E.;
Anaya-Camacho R.; Monteserin-Matesanz C.; Martinez-Merino N.;
Arnalich-Montiel A.; Pizarro-Calderon A.G.; Ruiz-Ortega A.; Benito-Saz P.;
Rodriguez A.E.; Garcia-Bunger B.; Garcia-Ramos S.; Lopez-Gil E.;
Power-Esteban M.; Ramos-Fernandes R.; Sevilla-Bayon R.; Solchaga-Sanchez
I.; Tullo L.; Gambetti G.; Carrideo A.; Morelli A.; Aiello D.; Spiga S.
Institution
(Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain
(Ferrando) CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos
III, Madrid, Spain
(Carraminana, Navarro-Ripoll, Vallverdu, Jacas) Department of
Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona,
Spain
(Pineiro, Garutti, Ramos, Martinez) Department of Anesthesiology and
Critical Care, Hospital Universitario Gregorio Maranon, Madrid, Spain
(Mirabella, Lamanna, Pia Cantatore, Laforgia) Department of Medical and
Surgical Sciences, Universita Degli Studi di Foggia, Foggia, Italy
(Spadaro, Scaramuzzo) Department of Anesthesiology and Critical Care,
Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
(Librero) UPNA, REDISSEC Red de Investigacion en Servicios de Salud,
Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
(Ramasco, Nieves-Alonso, Garcia) Department of Anesthesiology and Critical
Care, Hospital Universitario de La Princesa, Madrid, Spain
(Cervantes) Department of Anesthesiology and Critical Care, Hospital
Universitario Germans Trias i Pujol, Barcelona, Spain
(Parera, Argilaga, Herranz, Unzueta) Department of Anesthesiology and
Critical Care, Hospital Universitario Santa Creu i Sant Pau, Barcelona,
Spain
(Vives, Regi) Department of Anesthesiology and Critical Care, Hospital
Universitario Josep Trueta, Girona, Spain
(Costa-Reverte) Department of Anesthesiology and Critical Care, Hospital
Universitario de Bellvitge, Barcelona, Spain
(Sonsoles Leal) Hospital Rivera Povisa, Vigo, Spain
(Rodriguez-Perez, Farina, Cabrera, Guerra) Department of Anesthesiology
and Critical Care, Hospital Universitario de Gran Canaria Dr Negrin, Gran
Canarias, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Department of
Anesthesiology and Critical Care, Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Instituto de
Investigacion Sanitaria Aragon IIS Aragon, Zaragoza, Spain
(Lopez-Herrera, De La Matta) Department of Anesthesiology and Critical
Care, Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Gokhan, Kucur) Department of Anesthesiology and Critical Care, Bakirkoy
Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
(Gokhan) Outcomes Research Consortium, Cleveland, OH, United States
(Mugarra, Soro, Garcia, Belda) Department of Anesthesiology and Critical
Care, Hospital Universitario Clinico de Valencia, Valencia, Spain
(Sastre) Department of Anesthesiology and Critical Care, Hospital
Universitario de Salamanca, Salamanca, Spain
(Aguirre) Department of Anesthesiology and Critical Care, Hospital Alvaro
Cunqueiro, Vigo, Spain
(Salazar, Ramos) Department of Anesthesiology and Critical Care, Hospital
Universitario Ntra Sra de Candelaria, Santa Cruz de Tenerife, Spain
(Morocho) Department of Anesthesiology, Hospital Eugenio Espejo, Quito,
Ecuador
(Trespalacios, Ezequiel-Fernandez) Department of Anesthesiology and
Critical Care, Hospital Universitario Central de Asturias, Oviedo, Spain
(Bellas) Department of Anesthesiology and Critical Care, Hospital
Universitario Fundacion Jimenez Diaz, Madrid, Spain
(Lopez) Department of Anesthesiology and Critical Care, Hospital
Universitario Marques de Valdecilla, Santander, Spain
(Yepes-Temino) Department of Anesthesiology and Critical Care, Clinica
Universidad de Navarra, Pamplona, Spain
(Tusman) Department of Anesthesiology, Hospital Privado de Comunidad,
Buenos Aires, Mar de Plata, Argentina
(Suarez-Sipmann) CIBER de Enfermedades Respiratorias CIBERES, Instituto de
Salud Carlos III, Madrid, Spain
(Suarez-Sipmann) Hedenstierna Laboratory, Department of Surgical Sciences,
Uppsala University, Uppsala, Sweden
(Villar) CIBER de Enfermedades Respiratorias, Madrid, Spain
(Villar) Hospital Universitario Dr Negrin, Las Palmas de Gran Canaria,
Spain
(Villar) Li Ka Shing Knowledge Institute for Medical Science, St Michael's
Hospital, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: It is uncertain whether individualisation of the perioperative
open-lung approach (OLA) to ventilation reduces postoperative pulmonary
complications in patients undergoing lung resection. We compared a
perioperative individualised OLA (iOLA) ventilation strategy with standard
lung-protective ventilation in patients undergoing thoracic surgery with
one-lung ventilation. <br/>Method(s): This multicentre, randomised
controlled trial enrolled patients scheduled for open or video-assisted
thoracic surgery using one-lung ventilation in 25 participating hospitals
in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age
>=18 years) were randomly assigned to receive iOLA or standard
lung-protective ventilation. Eligible patients (stratified by centre) were
randomly assigned online by local principal investigators, with an
allocation ratio of 1:1. Treatment with iOLA included an alveolar
recruitment manoeuvre to 40 cm H<inf>2</inf>O of end-inspiratory pressure
followed by individualised positive end-expiratory pressure (PEEP)
titrated to best respiratory system compliance, and individualised
postoperative respiratory support with high-flow oxygen therapy.
Participants allocated to standard lung-protective ventilation received
combined intraoperative 4 cm H<inf>2</inf>O of PEEP and postoperative
conventional oxygen therapy. The primary outcome was a composite of severe
postoperative pulmonary complications within the first 7 postoperative
days, including atelectasis requiring bronchoscopy, severe respiratory
failure, contralateral pneumothorax, early extubation failure (rescue with
continuous positive airway pressure, non-invasive ventilation, invasive
mechanical ventilation, or reintubation), acute respiratory distress
syndrome, pulmonary infection, bronchopleural fistula, and pleural
empyema. Due to trial setting, data obtained in the operating and
postoperative rooms for routine monitoring were not blinded. At 24 h, data
were acquired by an investigator blinded to group allocation. All analyses
were performed on an intention-to-treat basis. This trial is registered
with ClinicalTrials.gov, NCT03182062, and is complete. <br/>Finding(s):
Between Sept 11, 2018, and June 14, 2022, we enrolled 1380 patients, of
whom 1308 eligible patients (670 [434 male, 233 female, and three with
missing data] assigned to iOLA and 638 [395 male, 237 female, and six with
missing data] to standard lung-protective ventilation) were included in
the final analysis. The proportion of patients with the composite outcome
of severe postoperative pulmonary complications within the first 7
postoperative days was lower in the iOLA group compared with the standard
lung-protective ventilation group (40 [6%] vs 97 [15%], relative risk 0.39
[95% CI 0.28 to 0.56]), with an absolute risk difference of -9.23 (95% CI
-12.55 to -5.92). Recruitment manoeuvre-related adverse events were
reported in five patients. <br/>Interpretation(s): Among patients
subjected to lung resection under one-lung ventilation, iOLA was
associated with a reduced risk of severe postoperative pulmonary
complications when compared with conventional lung-protective ventilation.
<br/>Funding(s): Instituto de Salud Carlos III and the European Regional
Development Funds.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<114>
Accession Number
2028854129
Title
Educational challenges and opportunities for the future generation of
surgeons: a scoping review.
Source
Langenbeck's Archives of Surgery. 409(1) (no pagination), 2024. Article
Number: 82. Date of Publication: December 2024.
Author
Poljo A.; Sortino R.; Daume D.; Probst P.; Billeter A.T.; Muller-Stich
B.P.; Klasen J.M.
Institution
(Poljo, Sortino, Billeter, Muller-Stich, Klasen) Department of Visceral
Surgery, Clarunis - University Digestive Healthcare Center Basel,
University Hospital Basel and St. Clara Hospital, Basel, Switzerland
(Daume) Department of Surgery, Lucerne Cantonal Hospital, Spitalstrasse,
Lucerne 6000, Switzerland
(Probst) Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld
8501, Switzerland
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Surgery offers exciting opportunities but comes with demanding
challenges that require attention from both surgical program
administrators and aspiring surgeons. The hashtag
#NoTrainingTodayNoSurgeonsTomorrow on X (previously Twitter) underscores
the importance of ongoing training. Our scoping review identifies
educational challenges and opportunities for the next generation of
surgeons, analyzing existing studies and filling gaps in the literature.
<br/>Method(s): Following the PRISMA guidelines, MEDLINE/PubMed was
searched in February 2022, using the MeSH terms "surgeons/education," for
articles in English or German on general, abdominal, thoracic, vascular,
and hand surgery and traumatology targeting medical students, surgical
residents, future surgeons, and fellows. <br/>Result(s): The initial
search yielded 1448 results. After a step-by-step evaluation process, 32
publications remained for complete review. Three main topics emerged:
surgical innovations and training (n = 7), surgical culture and
environment (n = 19), and mentoring (n = 6). The articles focusing on
surgical innovations and training mainly described the incorporation of
structured surgical training methods and program initiatives. Articles on
surgical culture examined residents' burnout, well-being, and gender
issues. Challenges faced by women, including implicit bias and sexual
harassment, were highlighted. Regarding mentoring, mentees' needs,
training challenges, and the qualities expected of both mentors and
mentees were addressed. <br/>Conclusion(s): At a time of COVID-19-driven
surgical innovations, the educational and working environment of the new
generation of surgeons is changing. Robotic technology and other
innovations require future surgeons to acquire additional technological
and digital expertise. With regard to the cultural aspects of training,
surgery needs to adapt curricula to meet the demands of the new generation
of surgeons, but even more it has to transform its culture.<br/>Copyright
&#xa9; The Author(s), under exclusive licence to Springer-Verlag GmbH
Germany, part of Springer Nature 2024.

<115>
Accession Number
2028659428
Title
Factors Contributing to Surgical Site Infections: A Comprehensive
Systematic Review of Etiology and Risk Factors.
Source
Clinics and Practice. 14(1) (pp 52-68), 2024. Date of Publication:
February 2024.
Author
Bucataru A.; Balasoiu M.; Ghenea A.E.; Zlatian O.M.; Vulcanescu D.D.;
Horhat F.G.; Bagiu I.C.; Sorop V.B.; Sorop M.I.; Oprisoni A.; Boeriu E.;
Mogoanta S.S.
Institution
(Bucataru) Doctoral School Department, University of Medicine and Pharmacy
of Craiova, Craiova 200349, Romania
(Bucataru) Infectious Disease Department, Victor Babes University Hospital
Craiova, Craiova 200515, Romania
(Balasoiu, Ghenea, Zlatian) Department of
Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of
Craiova, Craiova 200349, Romania
(Vulcanescu, Horhat, Bagiu) Department of Microbiology, "Victor Babes"
University of Medicine and Pharmacy, Eftimie Murgu Square 2, Timisoara
300041, Romania
(Vulcanescu, Horhat, Bagiu) Multidisciplinary Research Center on
Antimicrobial Resistance (MULTI-REZ), Microbiology Department, "Victor
Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2,
Timisoara 300041, Romania
(Sorop) Department of Obstetrics and Gynecology, "Victor Babes" University
of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, Timisoara 300041,
Romania
(Sorop) Doctoral School, "Victor Babes" University of Medicine and
Pharmacy, Timisoara 300041, Romania
(Oprisoni, Boeriu) Department of Pediatrics, Discipline of Pediatric
Oncology and Hematology, "Victor Babes" University of Medicine and
Pharmacy, Eftimie Murgu Square, No. 2, Timisoara 300041, Romania
(Mogoanta) Third General Surgery Department, Clinical Emergency County
Hospital, Craiova 200642, Romania
(Mogoanta) Department of General Surgery, Faculty of Dental Medicine,
University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Surgical site infections persist as a substantial concern within the realm
of hospital-acquired infections. This enduring issue is further compounded
by the mounting challenge of antibiotic resistance, a surge in surgical
interventions, and the presence of comorbidities among patients. Thus, a
comprehensive exploration of all discernible risk factors, as well as
proactive preventive and prophylactic strategies, becomes imperative.
Moreover, the prevalence of multidrug-resistant microorganisms has reached
alarming proportions. Consequently, there is an acute need to investigate
and scrutinize all potential therapeutic interventions to counter this
burgeoning threat. Consequently, the primary objective of this review is
to meticulously assess the origins and risk elements intertwined with
surgical site infections across a diverse spectrum of surgical procedures.
As the medical landscape continues to evolve, this critical analysis seeks
to provide a nuanced understanding of the multi-faceted factors
contributing to surgical site infections, with the overarching aim of
facilitating more effective management and mitigation strategies. By
exploring these dimensions comprehensively, we endeavor to enhance patient
safety and the quality of surgical care in this era of evolving healthcare
challenges.<br/>Copyright &#xa9; 2023 by the authors.

<116>
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.
<br/>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. <br/>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.
<br/>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.)<br/>Copyright &#xa9; The Author(s) 2024.

<117>
Accession Number
2027822932
Title
The CINCH-FMR postmarket registry: Real-world long-term outcomes with
percutaneous mitral valve repair with the Carillon Mitral Contour System.
Source
Cardiovascular Revascularization Medicine. 60 (pp 35-40), 2024. Date of
Publication: March 2024.
Author
Yildiz M.; Haude M.; Sievert H.; Fichtlscherer S.; Lehmann R.; Klein N.;
Witte K.; Degen H.; Pfeiffer D.; Goldberg S.L.
Institution
(Yildiz) Hospital zum Heiligen Geist, Fritzlar, Germany
(Haude, Degen) Lukaskrankenhaus GmbH, Neuss, Germany
(Sievert) CVC Rhein- Main, Frankfurt, Germany
(Fichtlscherer, Lehmann) Universitatsklinik Frankfurt, Frankfurt, Germany
(Lehmann) UMM Universitatsklinik Mannheim, Mannheim, Germany
(Klein, Pfeiffer) Universitatsklinik Leipzig AoR, Leipzig, Germany
(Klein) Leipzig Klinikum St. Georg, Leipzig, Germany
(Witte) Universitatsklinik Aachen AoR, Aachen, Germany
(Goldberg) Private practice, Monterey, CA, United States
(Goldberg) Cardiac Dimensions, Kirkland, WA, United States
Publisher
Elsevier Inc.
Abstract
Background: The Carillon Mitral Contour System has been studied in 4
prospective controlled studies in the treatment of functional mitral
regurgitation (FMR) where it has been found to reduce mitral
regurgitation, reduce left ventricular and atrial volumes, and be
associated with improvements in clinical parameters. <br/>Aim(s): The
CINCH post-market registry is designed to evaluate immediate, mid-term and
long-term outcomes from a post-approval study of the Carillon device
evaluated in real-world practice. <br/>Method(s): The CINCH post-market
registry is a single-arm study of percutaneous mitral annuloplasty with
the Carillon device in patients with functional (secondary) mitral
regurgitation and symptomatic congestive heart failure when utilized in
real-world conditions. Patient selection, echocardiographic hemodynamic
measurements, and patient follow-up requirements were performed per
standard of care at each institution. <br/>Result(s): A total of 101
patients treated with the Carillon device at 13 sites in Germany were
enrolled in the CINCH registry. The mean age was 75 +/- 9 years, 57 % were
male, and patient presentation included primarily NYHA class III (69 %)
with MR grade 3 (68 %). Over 5 years of follow-up, all-cause mortality was
40.1 %, the incidence of HFH was 53.9 %, and the composite outcome of HFH
or death was 66.4 %. At each follow-up interval through 5 years,
statistically significant reductions in NYHA class (p < 0.05) and MR grade
(p < 0.01) were reported. <br/>Conclusion(s): In this "real world"
registry of the Carillon Mitral Contour System, procedural safety and
medium-term follow-up outcomes is similar to the outcomes seen in the
prospective, controlled clinical trials, despite being used in populations
of patients that extend outside of those studied in the trials. The use of
this therapy in patients with atrial functional mitral regurgitation, and
heart failure with preserved ejection fraction, was notable, since these
types of patients were excluded from the prospective, controlled trials.
This supports possible additional patient populations who might benefit
from this type of mechanical therapy. The safety profile of this therapy
in this registry and in the earlier trials may support a potential role in
earlier forms of secondary mitral regurgitation.<br/>Copyright &#xa9; 2023

<118>
Accession Number
636467151
Title
Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery A
Systematic Review and Meta-analysis.
Source
JAMA Network Open. 4(11) (pp E2133394), 2021. Date of Publication: 15 Nov
2021.
Author
Guerra-Londono C.E.; Privorotskiy A.; Cozowicz C.; Hicklen R.S.;
Memtsoudis S.G.; Mariano E.R.; Cata J.P.
Institution
(Guerra-Londono, Cata) Department of Anesthesiology and Perioperative
Medicine, MD Anderson Cancer Center, University of Texas, Houston, United
States
(Privorotskiy) Eastern Virginia Medical School, Norfolk, United States
(Cozowicz) Department of Anesthesiology, Perioperative Medicine and
Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
(Hicklen) Research Medical Library, MD Anderson Cancer Center, University
of Texas, Houston, United States
(Memtsoudis) Department of Anesthesia, Hospital for Special Surgery, New
York, NY, United States
(Mariano) Department of Anesthesia, School of Medicine, Stanford
University, Stanford, CA, United States
(Cata) Anesthesiology and Surgical Oncology Research Group, Houston, TX,
United States
Publisher
American Medical Association
Abstract
IMPORTANCE The use of intercostal nerve block (ICNB) analgesia with local
anesthesia is common in thoracic surgery. However, the benefits and safety
of ICNB among adult patients undergoing surgery is unknown. OBJECTIVE To
evaluate the analgesic benefits and safety of ICNB among adults undergoing
thoracic surgery. DATA SOURCES A systematic search was performed in Ovid
MEDLINE, Ovid Embase, Scopus, and the Cochrane Library databases using
terms for ICNB and thoracic surgery (including thoracic surgery,
thoracoscopy, thoracotomy, nerve block, intercostal nerves). The search
and results were not limited by date, with the last search conducted on
July 24, 2020. STUDY SELECTION Selected studies were experimental or
observational and included adult patients undergoing cardiothoracic
surgery in which ICNB was administered with local anesthesia via single
injection, continuous infusion, or a combination of both techniques in at
least 1 group of patients. For comparison with ICNB, studies that examined
systemic analgesia and different forms of regional analgesia (such as
thoracic epidural analgesia [TEA], paravertebral block [PVB], and other
techniques) were included. These criteria were applied independently by 2
authors, and discrepancies were resolved by consensus. A total of 694
records were selected for screening. DATA EXTRACTION AND SYNTHESIS This
study followed the Preferred Reporting Items for Systematic Reviews and
Meta-analyses (PRISMA) reporting guideline. Data including patient
characteristics, type of surgery, intervention analgesia, comparison
analgesia, and primary and secondary outcomes were extracted independently
by 3 authors. Synthesis was performed using a fixed-effects model. MAIN
OUTCOMES AND MEASURES The coprimary outcomes were postoperative pain
intensity (measured as the worst static or dynamic pain using a validated
10-point scale, with 0 indicating no pain and 10 indicating severe pain)
and opioid consumption (measured in morphine milligram equivalents [MMEs])
at prespecified intervals (0-6 hours, 7-24 hours, 25-48 hours, 49-72
hours, and >72 hours). Clinically relevant analgesiawas defined as a
1-point or greater difference in pain intensity score at any interval.
Secondary outcomes included 30-day postoperative complications and
pulmonary function. RESULTS Of 694 records screened, 608 were excluded
based on prespecified exclusion criteria. The remaining 86 full-text
articles were assessed for eligibility, and 20 of those articles were
excluded. All of the 66 remaining studies (5184 patients; mean [SD] age,
53.9 [10.2] years; approximately 59% men and 41% women) were included in
the qualitative analysis, and 59 studies (3325 patients) that provided
data for at least 1 outcome were included in the quantitative
metaanalysis. Experimental studies had a high risk of bias in multiple
domains, including allocation concealment, blinding of participants and
personnel, and blinding of outcome assessors. Marked differences (eg,
crossover studies, timing of the intervention [intraoperative vs
postoperative], blinding, and type of control group) were observed in the
design and implementation of studies. The use of ICNB vs systemic
analgesia was associated with lower static pain (0-6 hours after surgery:
mean score difference, -1.40 points [95%CI, -1.46 to -1.33 points]; 7-24
hours after surgery: mean score difference, -1.27 points [95%CI, -1.40 to
-1.13 points]) and lower dynamic pain (0-6 hours after surgery: mean score
difference, -1.66 points [95%CI, -1.90 to -1.41 points]; 7-24 hours after
surgery: mean score difference, -1.43 points [95%CI, -1.70 to -1.17
points]). Intercostal nerve block analgesia was noninferior to TEA (mean
score difference in worst dynamic panic at 7-24 hours after surgery: 0.79
points; 95%CI, 0.28-1.29 points) and marginally inferior to PVB (mean
score difference in worst dynamic pain at 7-24 hours after surgery: 1.29
points; 95%CI, 1.16 to 1.41 points). The largest opioidsparing effect of
ICNB vs systemic analgesia occurred at 48 hours after surgery (mean
difference, -10.97 MMEs; 95%CI, -12.92 to -9.02 MMEs). The use of ICNB was
associated with higher MME values compared with TEA (eg, 48 hours after
surgery: mean difference, 48.31 MMEs; 95%CI, 36.11- 60.52 MMEs) and PVB
(eg, 48 hours after surgery: mean difference, 3.87MMEs; 95%CI, 2.59-5.15
MMEs). CONCLUSIONS AND RELEVANCE In this study, single-injection ICNB was
associated with a reduction in pain during the first 24 hours after
thoracic surgery and was clinically noninferior to TEA or PVB. Intercostal
nerve block analgesia had opioid-sparing effects; however, TEA and PVB
were associated with larger decreases in postoperative MMEs, suggesting
that ICNB may be most beneficial for cases in which TEA and PVB are not
indicated. <br/>Copyright &#xa9; 2021 Guerra-Londono CE et al.

<119>
Accession Number
2030702844
Title
Cardiac related pleural effusions: a narrative review.
Source
Journal of Thoracic Disease. 16(2) (pp 1674-1686), 2024. Date of
Publication: February 2024.
Author
Wijayaratne T.; Yousuf A.; Panchal R.
Institution
(Wijayaratne, Yousuf, Panchal) Department of Respiratory Medicine,
Glenfield Hospital, University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
Publisher
AME Publishing Company
Abstract
Background and Objective: Pleural effusions (PEs) are commonly seen in
various pathologies and have a significant impact on patient health and
quality of life. Unlike for malignant PEs, non-malignant PEs (NMPEs) do
not have well-established guidelines. Much of the evidence base in this
field is from a handful of randomised controlled trials (RCTs) and the
majority are from retrospective cohort analyses and cases series. Cardiac
related PEs fall within the entity of NMPEs and the aim of this narrative
review is to gather the existing evidence in the field of congestive heart
failure (CHF), pericarditis and post-cardiac injury syndrome (PCIS). This
narrative review investigates the pathophysiology, diagnostic criteria and
treatment options for the various cause of cardiac related PEs.
<br/>Method(s): This narrative review is based on a comprehensive
literature search analysing RCTs, prospective and retrospective cohort
analyses and published case series. Key Content and Findings: CHF related
PEs have a substantial mortality rate and carry a worse prognosis if the
PEs are bilateral and transudative in nature. Light's criteria have often
shown to misclassify transudative effusions in CHF (pseudo-exudates) and
hence measuring serum-pleural albumin gradient is an invaluable tool to
accurately identify transudates. Elevated serum and pleural N-terminal
pro-B type natriuretic peptide (NT-proBNP) has shown increasing evidence
of correctly identifying PEs secondary to CHF. However, they should be
considered with the pre-test probability of CHF. Therapeutic thoracentesis
and indwelling pleural catheter (IPC) placement may be necessary if
medical management has failed. PEs can also occur secondary to
pericarditis and are often small, bilateral and exudative. PCIS also
results in PEs and are commonly seen in post-coronary artery bypass graft
(CABG) surgery. Both entities need management of the underlying cause
first, but in cases where PEs are refractory, individualised pleural
interventions may be necessary. <br/>Conclusion(s): This comprehensive
narrative review provides valuable insights into the aetiology, diagnosis
and management of PEs secondary to CHF, pericarditis and PCIS. The aim is
to enhance the clinicians' knowledge of this complex and controversial
topic to improve patient care of cardiac-related PEs. Ongoing trials in
this field will be able to provide valuable insights.<br/>Copyright &#xa9;
Journal of Thoracic Disease. All rights reserved.

<120>
Accession Number
2030702833
Title
Tackling complex thoracic surgical operations with robotic solutions: a
narrative review.
Source
Journal of Thoracic Disease. 16(2) (pp 1521-1536), 2024. Date of
Publication: February 2024.
Author
Odeh A.M.; Wyant K.; Freeman R.K.; Abdelsattar Z.M.
Institution
(Odeh, Wyant, Freeman, Abdelsattar) Stritch School of Medicine, Loyola
University Chicago, Chicago, IL, United States
(Odeh, Wyant, Freeman, Abdelsattar) Department of Thoracic &
Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL,
United States
(Abdelsattar) US Department of Veterans Affairs, Edward Hines Jr. VA
Hospital, Hines, IL, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: The adoption of robotic surgery for general
thoracic surgery has rapidly progressed over the last two decades from its
application in basic operations to complex pathologies. As such, the
purpose of this narrative review is to highlight the collective experience
of tackling complex thoracic surgical operations with minimally invasive
robotic solutions. <br/>Method(s): Electronic searches of PubMed were
conducted for each subtopic, using specific keywords and inclusion
criteria. Once identified, the articles were screened through the
abstract, introduction, results and conclusion for relevancy, and included
based on a standard narrative review inclusion criteria. Key Content and
Findings: The role of the robotic approach has increased in thoracic
outlet syndrome, chest wall resection, tracheobronchomalacia, airway and
sleeve lung surgery, lobectomy after neoadjuvant therapy, complex
segmentectomy, giant paraesophageal hernia repair, esophagectomy and
esophageal enucleation, mediastinal masses and thymectomy and lung
transplantation. Robotic surgery has several advantages when compared to
video-assisted and open thoracoscopic surgery. These include better pain
control and aesthetic outcome, improved handling of complex anatomy,
enhanced access to lymph nodes, and faster recovery rates. Although it is
associated with longer operative time, robotic surgery has comparable
morbidity rates. <br/>Conclusion(s): The robotic approach to complex
thoracic problems is safe, effective, and associated with improved patient
outcomes. To encourage wider adoption of robotic technology, increased
training and expanded research efforts are essential, alongside improved
worldwide access to this technology.<br/>Copyright &#xa9; Journal of
Thoracic Disease. All rights reserved.

<121>
Accession Number
2030702832
Title
Postoperative atrial fibrillation (POAF) after cardiac surgery: clinical
practice review.
Source
Journal of Thoracic Disease. 16(2) (pp 1503-1520), 2024. Date of
Publication: February 2024.
Author
Suero O.R.; Ali A.K.; Barron L.R.; Segar M.W.; Moon M.R.; Chatterjee S.
Institution
(Suero) Divisions of Cardiovascular Anesthesia & Critical Care Medicine,
Department of Anesthesiology, Baylor College of Medicine, Houston, TX,
United States
(Ali, Barron, Moon, Chatterjee) Division of Cardiothoracic Surgery,
Michael E. DeBakey Department of Surgery, Baylor College of Medicine,
Houston, TX, United States
(Barron, Moon, Chatterjee) Department of Cardiovascular Surgery, The Texas
Heart Institute, Houston, TX, United States
(Segar) Department of Cardiology, The Texas Heart Institute, Houston, TX,
United States
(Chatterjee) Division of General Surgery, Michael E. DeBakey Department of
Surgery, Baylor College of Medicine, Houston, TX, United States
Publisher
AME Publishing Company
Abstract
Postoperative atrial fibrillation (POAF) after cardiac surgery is
associated with elevated morbidity and mortality. Although current
prediction models have limited efficacy, several perioperative
interventions can reduce patients' risk of POAF. These begin with
preoperative medications, including beta-blockers and amiodarone.
Moreover, patients should be screened for preexisting atrial fibrillation
(AF) so that concomitant surgical ablation and left atrial appendage
occlusion can be performed in appropriate candidates. Intraoperative
interventions such as posterior pericardiectomy can reduce mediastinal
fluid accumulation, which is a trigger for POAF. Furthermore, many
preventive strategies for POAF are implemented in the immediate
postoperative period. Initiating beta-blockers, amiodarone, or both is
reasonable for most patients. Overdrive atrial pacing, colchicine, and
steroids have been used by some, although the evidence base is less
robust. For patients with POAF, rate-control and rhythm-control strategies
have comparable outcomes. Decision-making regarding anticoagulation should
recognize that the stroke risk associated with POAF appears to be lower
than that for general nonvalvular AF. The evidence that oral
anticoagulation reduces stroke risk is less clear for POAF patients than
for patients with general nonvalvular AF. Given that POAF tends to be
shorter-lived and is associated with greater bleeding risks in the
perioperative period, decisions regarding anticoagulation should be
individualized. Finally, wearable technology and machine learning
algorithms for better predicting and managing POAF appear to be coming
soon. These technologies and a comprehensive clinical program could
meaningfully reduce the incidence of this common
complication.<br/>Copyright &#xa9; Journal of Thoracic Disease. All rights
reserved.

<122>
Accession Number
2030702790
Title
Cerebral protection in acute type A aortic dissection surgery: a
systematic review and meta-analysis.
Source
Journal of Thoracic Disease. 16(2) (pp 1289-1312), 2024. Date of
Publication: February 2024.
Author
Rahimi M.; Sahrai H.; Norouzi A.; Taban-Sadeghi M.; Khalili A.;
Hamzehzadeh S.; Khoei R.A.A.; Hosseinifard H.; Sulague R.M.; Kpodonu J.
Institution
(Rahimi, Taban-Sadeghi, Khalili) Cardiovascular Research Center, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Sahrai, Norouzi, Hamzehzadeh) Student Research Committee, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Khoei) Research Center for Evidence-Based Medicine, Iranian EBM Center, A
Joanna Briggs Institute Center of Excellence, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Hosseinifard) Department of Biostatistics, School of Public Health,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Sulague) Graduate School of Arts and Sciences, Georgetown University,
Washington, DC, United States
(Kpodonu) Division of Cardiac Surgery, Beth Israel Deaconess Medical
Center, Boston, MA, United States
Publisher
AME Publishing Company
Abstract
Background: Acute type A aortic dissection (ATAAD) still challenges
physicians and warrants emergent surgical management. Two main methods to
reduce cerebrovascular events in ATAAD surgeries are antegrade cerebral
perfusion (ACP) and retrograde cerebral perfusion (RCP). We conducted a
systematic review and meta-analysis to compare the outcomes of ACP and RCP
methods during the ATAAD surgery. <br/>Method(s): In this study, we
searched the databases until March 29^th, 2023. Studies that
reported the data for comparison of different types of brain perfusion
protection during aortic surgery in patients with ATAAD were included.
<br/>Result(s): Twenty-six studies met the eligibility criteria. All
studies had a low risk of bias as they were evaluated by the Joanna Briggs
Institute (JBI) critical appraisal tool. Eventually, we included 26
studies in the current meta-analysis, and a total of 13,039 patients were
evaluated. The calculated risk ratio (RR) for permanent neurologic
dysfunction (PND) in ACP and RCP comparison was RR =1.23, 95% confidence
interval (CI): (0.84, 1.80) (P value =0.2662), and in unilateral ACP
(uACP) and bilateral ACP (bACP) was RR =1.2786, 95% CI: (0.7931, 2.0615)
(P value =0.3132). When comparing the ACP-RCP and uACP-bACP groups,
significant differences were found between ACP-RCP the groups in terms of
circulatory arrest time (P value =0.0017 and P value =0.1995,
respectively), cardiopulmonary bypass time (P value =0.5312 and P value
=0.7460, respectively), intensive care unit (ICU)-stay time (P value
=0.2654 and P value =0.0099), cross-clamp time (P value =0.6228 and P
value =0.2625), and operative mortality (P value =0.9368 and P value
=0.2398, respectively), and when comparing the u-ACP and b-ACP groups for
transient neurologic deficit (TND), an RR of 1.32, 95% CI: (1.05, 1.67) (P
value =0.0199). The results showed high heterogeneity and no publication
bias. <br/>Conclusion(s): This study demonstrated that the ACP and RCP are
both safe and acceptable techniques to use in emergent settings. The uACP
technique is equivalent to bACP in terms of PND and mortality, however,
uACP is preferred over bACP in terms of TND.<br/>Copyright &#xa9; Journal
of Thoracic Disease. All rights reserved.

<123>
Accession Number
2028266801
Title
Effect of Buteyko Breathing Technique as an Adjunct to Routine
Physiotherapy on Pulmonary Functions in Patients Undergoing Off-pump
Coronary Artery Bypass Surgery: A Randomized Controlled Trial.
Source
Indian Journal of Critical Care Medicine. 28(3) (pp 280-285), 2024. Date
of Publication: March 2024.
Author
Mavkar S.S.; Shukla M.P.
Institution
(Mavkar) Department of Cardiovascular and Respiratory Physiotherapy, MGM
Institute of Physiotherapy, Chhatrapati Sambhaji Nagar, Maharashtra, India
(Shukla) Department of Physiotherapy, MGM Institute of Physiotherapy,
Chhatrapati Sambhaji Nagar, Maharashtra, India
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Background: Coronary artery disease (CAD) poses a substantial and
increasing public health concern in India, particularly among individuals
aged 20 and above. The postoperative phase following coronary artery
bypass graft (CABG) surgery presents potential complications, notably
impacting the pulmonary system. Emerging evidence suggests that the
Buteyko breathing technique not only improves lung function but also
positively influences the psychological well-being of CABG patients. This
study seeks to assess the impact of the Buteyko breathing technique on
pulmonary functions in individuals who have undergone off-pump CABG.
<br/>Material(s) and Method(s): In this randomized controlled trial,
patients undergoing off-pump CABG were allocated to either the Buteyko
breathing technique group (n = 35) or the control group (n = 35). The
intervention group received supervised Buteyko breathing technique
sessions twice daily for 15 minutes, concurrently with cardiac
rehabilitation from postoperative day (POD-2 to POD-7). The control group
underwent phase I cardiac rehabilitation. Outcome measures, including
pulmonary function test (PFT), chest expansion, and breath-holding tests
were evaluated at baseline (POD-2) and conclusion (POD-7). <br/>Result(s):
Statistical analyses were conducted with a significance level set at p <
0.05. Both the control and intervention groups exhibited statistically
significant improvements in pulmonary function, chest expansion at three
levels, and breath-holding time (p = 0.0001). However, the Buteyko
breathing group demonstrated a more significant improvement compared with
the control group. <br/>Conclusion(s): The integration of the Buteyko
breathing technique into conventional physiotherapy proves to be a
beneficial strategy, leading to improvements in pulmonary function,
breath-holding duration, and chest expansion for individuals who underwent
off-pump CABG surgery.<br/>Copyright &#xa9; The Author(s). 2024.

<124>
[Use Link to view the full text]
Accession Number
2030774060
Title
The effects of video double-lumen tubes on intubation complications in
patients undergoing thoracic surgery: A randomised controlled study.
Source
European Journal of Anaesthesiology. 41(4) (pp 305-313), 2024. Date of
Publication: 01 Apr 2024.
Author
Shui W.; Hu W.; Ma W.; Han Y.; Hao I.Y.; Sun Y.; Deng Z.; Gao Y.; Heng L.;
Zhu S.
Institution
(Shui, Hu, Zhu, Sun, Deng, Zhu) The Jiangsu Province Key laboratory of
Anaesthesiology, Xuzhou Medical University, China
(Ma, Han, Zhu, Heng, Zhu) Department of Anaesthesiology, Xuzhou Cancer
Hospital, Xuzhou, China
(Hao) California State University, Los Angeles, CA, United States
(Gao) Jiangsu University, Jiangsu, Zhenjiang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background Tracheal injuries, vocal cord injuries, sore throat and
hoarseness are common complications of double-lumen tube (DLT) intubation.
OBJECTIVE This study aimed to evaluate the effects of 'video double-lumen
tubes' (VDLTs) on intubation complications in patients undergoing thoracic
surgery. DESIGNA randomised controlled study. SETTING TXuzhou Cancer
Hospital, Xuzhou, China, from January 2023 to June 2023.PATIENTS One
hundred eighty-two patients undergoing elective thoracic surgery with
one-lung ventilation were randomised into two groups: 90 in the DLT group
and 92 in the VDLT group. INTERVENTION VDLT was selected for intubation in
the VDLT group, and DLT was selected for intubation in the DLT group. A
fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord
injuries. MAIN OUTCOME MEASURES The primary outcomes were the incidence of
moderate-to-severe tracheal injury and the incidence of vocal cord injury.
The secondary outcomes included the incidence and severity of
postoperative 24 and 48 h sore throat and hoarseness, RESULTS The
incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the
DLT group, and 45/92 (48.9%) in the VDLT group (P = 0.077; relative risk
1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90
(34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively (P =
0.449). The incidence of postoperative 24 h sore throat and hoarseness was
significantly higher in the VDLT group than in the DLT group (for sore
throat: P = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for
hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06).
CONCLUSION There was no statistically significant difference in the
incidence of moderate-to-severe tracheal injury and vocal cord injury
between DLTs and VDLTs. While improving the first-attempt success rate,
intubation with VDLT increased the incidence of postoperative 24 h sore
throat and hoarseness. <br/>Copyright &#xa9;2024 The Author.

<125>
Accession Number
2030712769
Title
Preoperative assessment of cardiac risk in noncardiac surgery: Six
reasonable and pragmatic rules for 2024.
Source
Anesthesie et Reanimation. (no pagination), 2024. Date of Publication:
2024.
Author
Fellahi J.-L.; Schweizer R.
Institution
(Fellahi, Schweizer) Hopital universitaire Louis-Pradel, Hospices civils
de Lyon, Service d'anesthesie-reanimation, 59, boulevard Pinel, Lyon cedex
69394, France
(Fellahi) Inserm UMR 1060, universite Claude Bernard Lyon 1, Laboratoire
CarMeN, Lyon, France
Publisher
Elsevier Masson s.r.l.
Abstract
Preoperative cardiac risk evaluation is of paramount importance in
reducing major perioperative cardiac events and mortality after
non-cardiac surgery. If the anesthesiologist plays a pivotal role, the
additional value of the cardiologist is more restricted. Nowadays, the
joint French guidelines published in 2011 are still of interest for
routine practice but the recent recommendations from both the European
Society of Cardiology and the European Society of Anesthesiology and
Intensive Care highlight some important issues that ask crucial questions.
A systematic approach using the six rules described in that review is a
reasonable and pragmatic compromise in 2024 that could help care providers
at the bedside.<br/>Copyright &#xa9; 2024 Societe francaise d'anesthesie
et de reanimation (Sfar)

<126>
Accession Number
2028833073
Title
Assessing the impact of risk-based data monitoring on outcomes for a
paediatric multicentre randomised controlled trial.
Source
Clinical Trials. (no pagination), 2024. Date of Publication: 2024.
Author
Le Marsney R.; Johnson K.; Chumbes Flores J.; Coetzer S.; Darvas J.;
Delzoppo C.; Jolly A.; Masterson K.; Sherring C.; Thomson H.; Ergetu E.;
Gilholm P.; Gibbons K.S.
Institution
(Le Marsney, Johnson, Ergetu, Gilholm, Gibbons) Children's Intensive Care
Research Program, Child Health Research Centre, The University of
Queensland, South Brisbane, QLD, Australia
(Johnson) Paediatric Intensive Care Unit, Queensland Children's Hospital,
Children's Health Queensland, Brisbane, QLD, Australia
(Chumbes Flores, Jolly, Thomson) Paediatric Intensive Care Unit, Perth
Children's Hospital, Perth, WA, Australia
(Coetzer, Sherring) Paediatric Intensive Care Unit, Starship Child Health,
Auckland, New Zealand
(Darvas) Paediatric Intensive Care Unit, The Children's Hospital at
Westmead, Sydney, NSW, Australia
(Delzoppo, Masterson) Paediatric Intensive Care Unit, Royal Children's
Hospital Melbourne, Melbourne, VIC, Australia
(Delzoppo, Masterson) Murdoch Children's Research Institute, Melbourne,
VIC, Australia
Publisher
SAGE Publications Ltd
Abstract
Background/Aims: Regulatory guidelines recommend that sponsors develop a
risk-based approach to monitoring clinical trials. However, there is a
lack of evidence to guide the effective implementation of monitoring
activities encompassed in this approach. The aim of this study was to
assess the efficiency and impact of the risk-based monitoring approach
used for a multicentre randomised controlled trial comparing treatments in
paediatric patients undergoing cardiac bypass surgery. <br/>Method(s):
This is a secondary analysis of data from a randomised controlled trial
that implemented targeted source data verification as part of the
risk-based monitoring approach. Monitoring duration and source to database
error rates were calculated across the monitored trial dataset. The
monitored and unmonitored trial dataset, and simulated trial datasets with
differing degrees of source data verification and cohort sizes were
compared for their effect on trial outcomes. <br/>Result(s): In total,
106,749 critical data points across 1,282 participants were verified from
source data either remotely or on-site during the trial. The total time
spent monitoring was 365 hours, with a median (interquartile range) of 10
(7, 16) minutes per participant. An overall source to database error rate
of 3.1% was found, and this did not differ between treatment groups. A low
rate of error was found for all outcomes undergoing 100% source data
verification, with the exception of two secondary outcomes with error
rates >10%. Minimal variation in trial outcomes were found between the
unmonitored and monitored datasets. Reduced degrees of source data
verification and reduced cohort sizes assessed using simulated trial
datasets had minimal impact on trial outcomes. <br/>Conclusion(s):
Targeted source data verification of data critical to trial outcomes,
which carried with it a substantial time investment, did not have an
impact on study outcomes in this trial. This evaluation of the
cost-effectiveness of targeted source data verification contributes to the
evidence-base regarding the context where reduced emphasis should be
placed on source data verification as the foremost monitoring
activity.<br/>Copyright &#xa9; The Author(s) 2024.

<127>
Accession Number
2028788674
Title
Plasma: indications, controversies, and opportunities.
Source
Postgraduate Medicine. (no pagination), 2024. Date of Publication: 2024.
Author
Benson M.A.; Tolich D.; Callum J.L.; Auron M.
Institution
(Benson) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Tolich) Blood Management, Pathology and Laboratory Medicine Institute,
Cleveland Clinic, Cleveland, OH, United States
(Callum) Department of Laboratory Medicine and Pathobiology, Queens
University, Kingston, ON, Canada
(Auron) Department of Hospital Medicine and Department of Pediatric
Hospital Medicine, Cleveland Clinic, Outcomes Research Consortium,
Cleveland, OH, United States
Publisher
Taylor and Francis Ltd.
Abstract
Plasma is overused as a blood product worldwide; however, data supporting
appropriate use of plasma is scant. Its most common utilization is for
treatment of coagulopathy in actively bleeding patients; it is also used
for coagulation optimization prior to procedures with specific coagulation
profile targets. A baseline literature review in PUBMED and Google Scholar
was done (1 January 2000 to 1 June 2023), utilizing the following search
terms: plasma, fresh frozen plasma, lyophilized plasma, indications,
massive transfusion protocol, liver disease, warfarin reversal,
cardiothoracic surgery, INR < 2. An initial review of the titles and
abstracts excluded all articles that were not focused on transfusional
medicine. Additional references were obtained from citations within the
retrieved articles. This narrative review discusses the main indications
for appropriate plasma use, mainly coagulation factor replacement, major
hemorrhage protocol, coagulopathy in liver disease, bleeding in the
setting of vitamin K antagonists, among others. The correlation between
concentration of coagulation factors and INR, as well as the proper plasma
dosing with its volume being weight-based, is also discussed. A high value
approach to plasma utilization is supported with a review of the clinical
situations where plasma is overutilized or unnecessary. Finally, a
discussion of novel plasma products is presented for enhanced
awareness.<br/>Copyright &#xa9; 2024 Informa UK Limited, trading as Taylor
& Francis Group.

<128>
Accession Number
2028756491
Title
Mortality and Heart Transplantation After Hybrid Palliation of Hypoplastic
Left Heart Syndrome: A Systematic Review and Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2024. Date of Publication: 2024.
Author
Jacquemyn X.; Singh T.P.; Gossett J.G.; Averin K.; Kutty S.; Zuhlke L.J.;
Abdullahi L.H.; Kulkarni A.
Institution
(Jacquemyn, Kutty) Helen B. Taussig Heart Center, Department of
Pediatrics, Johns Hopkins Hospital, Baltimore, MD, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Singh) Department of Cardiology, Boston Children's Hospital, Boston, MA,
United States
(Gossett, Averin, Kulkarni) Cohen Children's Heart Center, Donald and
Barbara Zucker School of Medicine at Hofstra/ Northwell, New Hyde Park,
NY, United States
(Zuhlke) President's Office, South African Medical Research Council, Cape
Town, South Africa
(Zuhlke) Division of Paediatric Cardiology, Department of Paediatrics,
Institute of Child Health, Faculty of Health Sciences, University of Cape
Town, Cape Town, South Africa
(Abdullahi) Save the Children International (SCI), Somalia/Somaliland
Country Office, Nairobi, Kenya
Publisher
SAGE Publications Inc.
Abstract
Background: Newborns with hypoplastic left heart syndrome (HLHS) who are
considered at increased risk for death following Norwood/Sano surgery
often undergo hybrid palliation (HP) as initial surgery. We aimed to
compile the HP experience in HLHS and its variants and assess the rates
of, and risk factors for, death and heart transplantation. <br/>Method(s):
CINAHL, CINAHL PLUS, PubMed/MEDLINE, and SCOPUS were systematically
searched for HP outcome studies of death or heart transplantation in HLHS
between 1998 and 2022. Pooled incidence was estimated, and potential risk
factors were identified using random-effects meta-analysis and
reconstructed time-to-event data from Kaplan-Meier curves. <br/>Result(s):
Thirty-three publications were included in our review. Overall, of 1,162
patients 417 died and 57 underwent heart transplantation, resulting in a
combined outcome of 40.7%, (474/1,162). There was a trend toward
decreasing mortality risk across the stages of palliation. Pooled
mortality between HP and comprehensive stage 2 palliation was 25%, after
stage 2 up to Fontan palliation was 16%, and 6% post-Fontan. The incidence
of death or heart transplantation was higher in high-risk patients-43%
died and 10% received heart transplantation. <br/>Conclusion(s): Our
systematic review and meta-analysis found high rates of death or heart
transplantation in HP of HLHS patients between HP and Fontan surgeries.
All patients should be closely followed during the initial interstage
period, which is associated with the highest hazard. Prospective studies
on appropriate patient selection, indications, and / or alternatives, as
well as refining HP strategies for managing newborns with HLHS are needed
to improve outcomes.<br/>Copyright &#xa9; The Author(s) 2024.

<129>
Accession Number
643643813
Title
Vasoplegic Syndrome during Heart Transplantation: A Systematic Review and
Meta-analysis.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2024. Date of Publication: 28 Feb 2024.
Author
Kumar N.; Fitzsimons M.G.; Iyer M.H.; Essandoh M.; Kumar J.E.; Dalia A.A.;
Osho A.; Sawyer T.R.; Bardia A.
Institution
(Kumar, Fitzsimons, Dalia, Bardia) Department of Anesthesia, Critical
Care, Pain Medicine, Massachusetts General Hospital, Harvard Medical
School, Boston, MA, United States
(Iyer, Essandoh) Department of Anesthesiology, Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Kumar) University of Cincinnati College of Medicine, Cincinnati, OH,
United States
(Osho) Division of Cardiac Surgery, Department of Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Abstract
BACKGROUND: Vasoplegic syndrome (VS) is a common occurrence during heart
transplantation (HT). It currently lacks a uniform definition between
transplant centers, and its pathophysiology and treatment remain
enigmatic. This systematic review summarizes the available published
clinical data regarding VS during HT. <br/>METHOD(S): We searched
databases for all published reports on VS during HT. Data collected
included the incidence of VS in the HT population, patient and
intraoperative characteristics, and postoperative outcomes.
<br/>RESULT(S): 22 publications were included in this review. The
prevalence of VS during HT was 28.72% (95% CI: 27.37%, 30.10%). Factors
associated with VS included male sex, higher body mass index,
hypothyroidism, pre-HT left ventricular assist device or venoarterial
extracorporeal membrane oxygenation (VA-ECMO), pre-HT calcium channel
blocker or amiodarone usage, longer cardiopulmonary bypass time, and
higher blood product transfusion requirement. Patients who developed VS
were more likely to require postoperative VA-ECMO support, renal
replacement therapy, reoperation for bleeding, longer mechanical
ventilation, and a greater 30-day and 1-year mortality.
<br/>CONCLUSION(S): The results of our systematic review are an initial
step for providing clinicians with data that can help identify high-risk
patients and avenues for potential risk mitigation. Establishing
guidelines that officially define VS will aid in the precise diagnosis of
these patients during HT and guide treatment. Future studies of treatment
strategies for refractory VS are needed in this high-risk patient
population.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<130>
Accession Number
643642960
Title
Novel stroke prevention strategies following catheter ablation for atrial
fibrillation.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2024.
Date of Publication: 28 Feb 2024.
Author
Ding W.Y.; Calvert P.; Lip G.Y.H.; Gupta D.
Institution
(Ding, Calvert, Gupta) Liverpool Centre for Cardiovascular Science,
University of Liverpool, Liverpool John Moores University and Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
(Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University and Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom; Danish Centre for Clinical Health
Services Research, Department of Clinical Medicine, Aalborg University,
Aalborg, Denmark
Abstract
Stroke prevention following successful catheter ablation of atrial
fibrillation remains a controversial topic. Oral anticoagulation is
associated with a significant reduction in stroke risk in the general
atrial fibrillation population but may be associated with an increased
risk of major bleeding, and the benefit: risk ratio must be considered.
Improvement in successful catheter ablation and widespread use of cardiac
monitoring devices may allow for novel anticoagulation strategies in a
subset of patients with atrial fibrillation, which may optimize stroke
prevention while minimizing bleeding risk. In this review, we discuss
stroke risk in atrial fibrillation and the effects of successful catheter
ablation on thromboembolic risk. We also explore novel strategies for
stroke prevention following successful catheter ablation.<br/>Copyright
&#xa9; 2024 Sociedad Espanola de Cardiologia. Published by Elsevier
Espana, S.L.U. All rights reserved.