EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2031051452
Title
Adherence to the Enhanced Recovery After Surgery in Cardiac Surgery
Patients: A Randomized Clinical Trial.
Source
Heart Surgery Forum. 27(3) (pp E222-E229), 2024. Date of Publication:
2024.
Author
Hosseini S.; Shariatpanahi Z.V.; Maleki M.; Noohi F.; Totonchi Z.
Institution
(Hosseini, Shariatpanahi) Department of Clinical Nutrition and Dietetics,
Faculty of Nutrition and Food Technology, Shahid Beheshti University of
Medical Sciences, Tehran 1981619573, Iran, Islamic Republic of
(Hosseini) Heart Valve Disease Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran
1995614331, Iran, Islamic Republic of
(Maleki, Noohi) Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran 1995614331, Iran, Islamic Republic of
(Totonchi) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran 1995614331, Iran, Islamic Republic
of
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Improving patients' outcomes using enhanced recovery after
surgery (ERAS) during the surgical period has significant economic savings
and increases organizational productivity. We evaluated the effects of
ERAS protocol on outcomes including high sensitive-C-reactive protein
(hs-CRP), hospitalization, intensive care unit (ICU) stay, feeding
tolerance and pain score of cardiac surgical patients. <br/>Method(s): A
total of 260 patients were randomly assigned to the ERAS and control
groups according to stratified block randomization. Fasting time in the
ERAS group reduced from the conventional 12 h to 6 h with light meals.
Also, on the day of the operation, 2 hours before the surgery, they
received 250 mL of oral carbohydrate solution containing 25 g glucose. The
control group received conventional standard care. Serum hs-CRP was
measured before and after the operation. <br/>Result(s): Out of 260
participants, 107 patients received protocolized care (ERAS group), and
103 patients received conventional standard care. Recommendations to
follow the ERAS resulted in a significant reduction in hs-CRP relative to
the control group (p = 0.001). Complaints about thirst, hunger, anxiety,
and pain were significantly less in the intervention group than the
control group (All p-values = 0.001). In addition, the length of
hospitalization, ICU stay, ventilation time, and first mobility were
significantly shorter in the ERAS group (All p-values = 0.001). Besides,
the first postoperative meal started earlier in the intervention group
than the control group (p = 0.001). <br/>Conclusion(s): ERAS approach can
lead to improvement in postoperative inflammation, thirst, hunger,
anxiety, pain, duration of hospitalization, duration of ICU stay, first
mobility, and ventilation time.<br/>Copyright &#xa9; 2024 Forum Multimedia
Publishing, LLC.

<2>
Accession Number
2030359262
Title
Utility of Fractional Flow Reserve Computed Tomography for Coronary Artery
Disease: A Re-Analysis With Prediction Interval.
Source
American Journal of Cardiology. 215 (pp 104-105), 2024. Date of
Publication: 15 Mar 2024.
Author
Chen I.-W.; Kao C.-L.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Liouying, Taiwan (Republic of China)
(Kao) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung City, Taiwan (Republic of China)
(Hung) Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
(Republic of China)
Publisher
Elsevier Inc.

<3>
Accession Number
2030338144
Title
Significance of abnormal stress electrocardiography with normal cardiac
imaging during stress testing-a meta-analysis.
Source
Journal of Electrocardiology. 83 (pp 64-70), 2024. Date of Publication: 01
Mar 2024.
Author
Mansour M.; Alqaisi O.; Gautam N.; Vallurupalli S.
Institution
(Mansour, Alqaisi, Gautam, Vallurupalli) Department of Medicine, Division
of Cardiology, University of Arkansas for Medical Sciences, Little Rock,
AR, United States
Publisher
Elsevier B.V.
Abstract
Background and aims: Diagnostic testing for coronary artery disease
frequently involves functional stress testing where imaging is often
coupled with electrocardiogram (ECG) analysis. While decision-making is
straightforward when both functional testing and ECG are either positive
or negative, interpretation is challenging and prognostic importance
uncertain with positive ECG and negative imaging since imaging is
considered more sensitive. Prior studies have demonstrated mixed results.
We sought to perform a meta-analysis of published studies to determine the
significance of this particular type of discordant stress test result.
<br/>Methods and Results: PubMed, Cochrane, and Google Scholar were
searched to identify studies reporting results of functional imaging
(pharmacological exercise echocardiography or SPECT) and ECG analysis,
along with the major adverse cardiovascular events (MACE) at patient
follow-up. Studies were stratified based on functional imaging modality
used. Primary outcome was a composite of all-cause death or myocardial
infarction, and secondary outcome was the need for coronary
revascularization. Random effects model was used to calculate risk ratios
(RR), and heterogeneity among studies was assessed using the Higgins
I² value. Nine studies with a total of 23,715 patients were
included. Primary end point was more common with discordant results with
exercise stress echocardiography (RR 1.33, 95% confidence intervals
[1.08-1.63]) or pharmacological SPECT (RR 6.53 95% CI [2.31-18.48]).
<br/>Conclusion(s): Patients in the discordant exercise stress
echocardiography and pharmacological SPECT groups were more likely to
suffer the primary end point than those with a normal stress test.
Discordant results should be interpreted carefully in the clinical
context, given their prognostic impact based on the stress modality
used.<br/>Copyright &#xa9; 2024

<4>
Accession Number
2028809583
Title
Effectiveness and safety of injectable PCSK9 inhibitors in dyslipidaemias'
treatment and cardiovascular disease prevention: An overview of 86
systematic reviews and a network metaanalysis.
Source
Clinica e Investigacion en Arteriosclerosis. 36(2) (pp 86-100), 2024. Date
of Publication: 01 Mar 2024.
Author
Pamporis K.; Karakasis P.; Simantiris S.; Sagris M.; Bougioukas K.I.;
Fragakis N.; Tousoulis D.
Institution
(Pamporis, Simantiris, Sagris, Tousoulis) 1st Cardiology Clinic, National
and Kapodistrian University of Athens, School of Medicine, Hippokration
General Hospital, Athens, Greece
(Pamporis, Karakasis, Bougioukas) Department of Hygiene, Social-Preventive
Medicine & Medical Statistics, School of Medicine, Faculty of Health
Sciences, Aristotle University of Thessaloniki, University Campus,
Thessaloniki 54124, Greece
(Karakasis, Fragakis) Second Department of Cardiology, Hippokration
General Hospital, Aristotle University of Thessaloniki, Greece
Publisher
Sociedad Espanola de Arteriosclerosis
Abstract
Objective: Multiple systematic reviews (SR) have been performed on the
effects of proprotein convertase subtilisin/kexin type 9 inhibitors
(PCSK9i), often providing conflicting findings. This overview and network
meta-analysis (NMA) aimed to summarize SR findings on the efficacy and
safety of PCSK9i and provide an updated NMA. <br/>Material(s) and
Method(s): MEDLINE (Pubmed), Scopus, Cochrane, Epistemonikos and Google
Scholar were searched from inception to September 21, 2023 for SRs of
randomized controlled trials (RCTs) and from January 1, 2020 to September
21, 2023 for additional RCTs. Double-independent study selection, data
extraction and quality assessment were performed. Qualitative analysis was
performed for SRs and a frequentist random-effects model NMA was performed
for RCTs. <br/>Result(s): Totally, 86 SRs and 76 RCTs were included.
Alirocumab (77/86 [90%]) and evolocumab (73/86 [85%]) were mostly
analyzed. Associations from SRs (35/42 [83%]) and the updated NMA
indicated PCSK9i benefit on major adverse cardiovascular events (MACEs).
Reductions were also noted for cerebrovascular events (47/66 [71%]),
coronary revascularization (29/33 [88%]) and myocardial infarction (41/63
[65%]). Alirocumab was associated with reductions on all-cause mortality
(RR = 0.82, 95%CI [0.72,0.94]). Data on any CV event reduction were
conflicting (7/16 [44%]). Inclisiran appeared effective only on MACEs (RR
= 0.76, 95%CI [0.61,0.94]). No reductions in heart failure were observed
(0/16). No increases were identified between PCSK9i and any (0/35) or
serious adverse events (0/52). However, PCSK9i were associated with
injection-site reactions (20/28 [71%]). <br/>Conclusion(s): PCSK9i
appeared to be effective in CV outcomes and their clinical application was
generally safe.<br/>Copyright &#xa9; 2023 Sociedad Espanola de
Arteriosclerosis

<5>
Accession Number
2027936697
Title
Hyponatremia Associated with Pregabalin.
Source
Medical Forum Monthly. 34(7) (pp 112-115), 2023. Date of Publication: July
2023.
Author
Cheema S.U.R.; Tauseef A.; Fatima M.; Iqbal M.D.; Rehman R.; Cheema S.S.
Institution
(Cheema, Rehman) Department of Nephrology, Jinnah hospital & Allama Iqbal
Medical College, Lahore, Pakistan
(Tauseef, Fatima, Iqbal, Cheema) Department of Nephrology, CMH Lahore
Medical College & IOD, Pakistan
Publisher
Medical Academic Foundation
Abstract
Objective: To assess if hyponatremia is associated with pregabalin.
Pregabalin, an analog of the neurotransmitter gamma-aminobutyric acid,
possesses analgesic, anticonvulsant, and anxiolytic properties. <br/>Study
Design: A prospective randomized interventional trial study Place and
Duration of Study: This study was conducted at the Jinnah Hospital
dialysis center from 01^st January 2021 to 31^st
December 2021. <br/>Material(s) and Method(s): All the patients with
hyponatremia & taking pregabalin were included in the study. Although
hyponatremia (when serum sodium level below 135 mmol/L) is the most common
abnormality of electrolytes observed in hospitalized patients, it is
typically associated with certain drugs such as diuretics,
antidepressants, and antiepileptic medications. Notably, hyponatremia as a
side effect of pregabalin has not been reported due to its relatively
recent introduction. However, we present a few clinical scenarios where it
is highly probable that hyponatremia was associated with pregabalin.
<br/>Result(s): Out of 60 patients with hyponatremia, ten were found to be
taking pregabalin. Three out of 10 (30%) cases of hyponatremia were found
to be associated with pregabalin. These case scenarios are discussed in
detail in the main body of this study. <br/>Conclusion(s): While
hyponatremia is an infrequent occurrence, it is a potential side effect of
pregabalin. Therefore, caution should be exercised when prescribing
pregabalin to patients who are at a higher risk of developing
hyponatremia.<br/>Copyright &#xa9; 2023, Medical Academic Foundation. All
rights reserved.

<6>
Accession Number
2030712769
Title
Preoperative assessment of cardiac risk in noncardiac surgery: Six
reasonable and pragmatic rules for 2024.
Source
Anesthesie et Reanimation. 10(2) (pp 49-54), 2024. Date of Publication:
March 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)

<7>
Accession Number
2029025221
Title
Effect of oxygen delivery during cardiopulmonary bypass on postoperative
neurological outcomes in patients undergoing cardiac surgery: A scoping
review of the literature.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Elsebaie A.; Shakeel A.; Zhang S.; Alarie M.; El Tahan M.; El-Diasty M.
Institution
(Elsebaie) Faculty of Health Sciences, Queen's University, Kingston, ON,
Canada
(Shakeel) School of Medicine, Queen's University, Kingston, ON, Canada
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
(Alarie) Kingston Health Sciences Centre, Kingston, ON, Canada
(El Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
(El-Diasty) University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
SAGE Publications Ltd
Abstract
Background: Reduced oxygen delivery (DO<inf>2</inf>) during
cardiopulmonary bypass (CPB) was proposed as a risk factor for the
development of postoperative neurological complications (PONCs), including
cerebrovascular accidents (CVA), delirium, and postoperative cognitive
dysfunction (POCD). We aimed to review the current evidence on the
association between intraoperative DO<inf>2</inf> and the incidence of
PONCs. <br/>Method(s): MEDLINE, Embase, the Cochrane Library, and Web of
Science were electronically searched to identify comparative studies from
inception until July 2023 that reported the association between
intraoperative DO<inf>2</inf> levels and the incidence of PONCs (as
defined by the scales and diagnostic tools utilized by the studies'
authors) in adults patients undergoing cardiac surgery using CPB.
<br/>Result(s): Of the 2513 papers identified, 10 studies, including
21,875 participants, were included. Of these, three studies reported on
delirium, two on POCD, and five on CVA. Eight studies reported reduced
intraoperative DO<inf>2</inf> in patients who developed delirium and CVA.
There was a lack of consensus on the cut-off of DO<inf>2</inf> levels or
the correlation between the period below these threshold values and the
development of PONC. <br/>Conclusion(s): Limited data suggest that
maintaining intraoperative DO<inf>2</inf> above the critical threshold
levels and ensuring adequate intraoperative cerebral perfusion may play a
role in minimizing the incidence of neurological events in adult patients
undergoing cardiac surgery on cardiopulmonary bypass.<br/>Copyright &#xa9;
The Author(s) 2024.

<8>
Accession Number
2029021195
Title
Systematic Review of Literature Citing the ISCHEMIA Trial.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
King D.J.; Eskander C.; Ricci J.; Gittess D.; Patel R.; Bourne M.; Budweg
J.; Winchester D.E.
Institution
(King, Eskander, Gittess, Patel, Bourne) Department of Medicine,
University of Florida, Gainesville, FL, United States
(Ricci) College of Medicine, University of Florida, Gainesville, FL,
United States
(Budweg, Winchester) Division of Cardiovascular Medicine, University of
Florida, Gainesville, FL, United States
Publisher
Springer
Abstract
Purpose of Review: Optimal therapy for patients with chronic coronary
artery disease (CCD) has long been a topic under investigation and a
subject of debate. Seeking to clarify appropriate management, the
International Study of Comparative Health Effectiveness with Medical and
Invasive Approaches (ISCHEMIA) trial compared medical management versus
coronary angiography for patients with stable ischemic heart disease. Its
reception in the medical community has been met with both acclaim and
criticism. In light of such disparate views of this trial, a systematic
review of the literature citing the ISCHEMIA trial was performed. Recent
Findings: All articles citing the ISCHEMIA trial on PubMed as of July 21,
2023, were compiled and underwent qualitative analysis. A total of 430
articles were evaluated; 109 (25.3%) did not offer substantial commentary
on ISCHEMIA and cite it as background evidence for further study. Of the
commentary articles, the majority (224, 52.1%) gave balanced, honest
appraisals of the ISCHEMIA trial. A total of 46 (10.7%) strongly praised
the trial while another 39 (9.1%) were strongly critical of the results.
<br/>Summary: Almost three-quarters of the literature citing the ISCHEMIA
trial was commentary in nature, with roughly equal distribution across the
spectrum of praise and criticism. Despite being one of the largest studies
on CCD and coronary revascularization ever conducted, the impact of
ISCHEMIA on the cardiology community appears to be mixed.<br/>Copyright
&#xa9; This is a U.S. Government work and not under copyright protection
in the US; foreign copyright protection may apply 2024.

<9>
Accession Number
2029010686
Title
Antithrombotic strategies for preventing graft failure in coronary artery
bypass graft.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2024. Date of
Publication: 2024.
Author
Mauro M.S.; Finocchiaro S.; Calderone D.; Rochira C.; Agnello F.; Scalia
L.; Capodanno D.
Institution
(Mauro, Finocchiaro, Calderone, Rochira, Agnello, Scalia, Capodanno)
Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G.
Rodolico-San Marco", University of Catania, Via Santa Sofia, 78, Catania,
Italy
Publisher
Springer
Abstract
Coronary artery bypass graft (CABG) procedures face challenges related to
graft failure, driven by factors such as acute thrombosis, neointimal
hyperplasia, and atherosclerotic plaque formation. Despite extensive
efforts over four decades, the optimal antithrombotic strategy to prevent
graft occlusion while minimizing bleeding risks remains uncertain, relying
heavily on expert opinions rather than definitive guidelines. To address
this uncertainty, we conducted a review of randomized clinical trials and
meta-analyses of antithrombotic therapy for patients with CABG. These
studies examined various antithrombotic regimens in CABG such as single
antiplatelet therapy (aspirin or P2Y<inf>12</inf> inhibitors), dual
antiplatelet therapy, and anticoagulation therapy. We evaluated outcomes
including the patency of grafts, major adverse cardiovascular events, and
bleeding complications and also explored future perspectives to enhance
long-term outcomes for CABG patients. Early studies established aspirin as
a key component of antithrombotic pharmacotherapy after CABG. Subsequent
randomized controlled trials focused on adding a P2Y<inf>12</inf>
inhibitor (such as clopidogrel, ticagrelor, or prasugrel) to aspirin,
yielding mixed results. This article aims to inform clinical
decision-making and guide the selection of antithrombotic strategies after
CABG.<br/>Copyright &#xa9; The Author(s) 2024.

<10>
Accession Number
2028997078
Title
Mean Arterial Pressure (MAP) Trial: study protocol for a multicentre,
randomized, controlled trial to compare three different strategies of mean
arterial pressure management during cardiopulmonary bypass.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 191. Date of
Publication: December 2024.
Author
Francica A.; Mazzeo G.; Galeone A.; Linardi D.; San Biagio L.; Luciani
G.B.; Onorati F.
Institution
(Francica, Mazzeo, Galeone, Linardi, San Biagio, Luciani, Onorati)
Division of Cardiac Surgery, Department of Surgery, Dentistry, Paediatrics
and Gynaecology, University of Verona, Piazzale Stefani 1, Verona 37126,
Italy
Publisher
BioMed Central Ltd
Abstract
Background: One of the main goals of cardiopulmonary bypass (CPB) is
targeting an adequate mean arterial pressure (MAP) during heart surgery,
in order to maintain appropriate perfusion pressures in all end-organs. As
inheritance of early studies, a value of 50-60 mmHg has been historically
accepted as the "gold standard" MAP. However, in the last decades, the CPB
management has remarkably changed, thanks to the evolution of technology
and the availability of new biomaterials. Therefore, as highlighted by the
latest European Guidelines, the current management of CPB can no longer
refer to those pioneering studies. To date, only few single-centre studies
have compared different strategies of MAP management during CPB, but with
contradictory findings and without achieving a real consensus. Therefore,
what should be the ideal strategy of MAP management during CPB is still on
debate. This trial is the first multicentre, randomized, controlled study
which compares three different strategies of MAP management during the
CPB. <br/>Method(s): We described herein the methodology of a multicentre,
randomized, controlled trial comparing three different approaches to MAP
management during CPB in patients undergoing elective cardiac surgery: the
historically accepted "standard MAP" (50-60 mmHg), the "high MAP" (70-80
mmHg) and the "patient-tailored MAP" (comparable to the patient's
preoperative MAP). It is the aim of the study to find the most suitable
management in order to obtain the most adequate perfusion of end-organs
during cardiac surgery. For this purpose, the primary endpoint will be the
peak of serum lactate (Lmax) released during CPB, as index of tissue
hypoxia. The secondary outcomes will include all the intraoperative
parameters of tissue oxygenation and major postoperative complications
related to organ malperfusion. <br/>Discussion(s): This trial will assess
the best strategy to target the MAP during CPB, thus further improving the
outcomes of cardiac surgery. Trial registration: mailto:NCT05740397
(retrospectively registered; 22/02/2023).<br/>Copyright &#xa9; The
Author(s) 2024.

<11>
Accession Number
2028991774
Title
Effect of preoperative vitamin D on postoperative atrial fibrillation
incidence after coronary artery bypass grafting.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2024. Date
of Publication: 2024.
Author
Alirezaei T.; Ansari Aval Z.; Karamian A.; Hayati A.
Institution
(Alirezaei) Cardiology Department of Shohaday-e-Tajrish Hospital, Shahid
Behesti University of Medical Science, Tehran, Iran, Islamic Republic of
(Ansari Aval) Cardiovascular Research Center, Shahid Beheshti University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Karamian) School of Medicine, Lorestan University of Medical Sciences,
Khorramabad, Iran, Islamic Republic of
(Hayati) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
Background: Post-operative atrial fibrillation (POAF) is associated with
adverse long-term cardiovascular events. <br/>Objective(s): This study
investigated the effects of a high-dose vitamin D administered
preoperatively on the postoperative atrial fibrillation (POAF) incidence
in patients with vitamin D deficiency following coronary artery bypass
grafting (CABG) surgery. <br/>Method(s): This randomized controlled
clinical trial was conducted on 246 CABG patients with vitamin D
deficiency. All patients were randomly divided into intervention and
control groups including 123 cases for each group. In the intervention
group, from 3 days before surgery, they received a daily dose of 150,000
units of vitamin D orally (50,000 units of Vit D tablet three times a day)
and the patients in the control group received placebo tablets before
surgery. All patients in the intervention group were assessed continuously
for the occurrence of POAF during the recovery period. <br/>Result(s): In
terms of gender, age, and BMI there were no significant differences
between intervention and control groups. Our findings showed that the use
of vitamin D supplements did not cause a significant change in the
duration of intubation and hospitalization. The ratio of POAF following
CABG surgery in the control and treatment groups was 26% and 11.4%,
respectively (odds ratio = 0.36; 95% CI = 0.18-0.72; P = 0.003).
<br/>Conclusion(s): Our findings revealed that high-dose vitamin D
supplementation before CABG surgery significantly reduced the incidence of
POAF. Further multicenter randomized trials with larger sample sizes are
certainly warranted to confirm our results.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery 2024.

<12>
Accession Number
2020657805
Title
Outcomes of coronary artery bypass grafting with coronary endarterectomy:
A systematic review and meta-analysis of recent studies.
Source
Perfusion (United Kingdom). 39(3) (pp 489-498), 2024. Date of Publication:
April 2024.
Author
Zhang W.; Wu H.
Institution
(Zhang, Wu) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of this systematic review and meta-analysis was to
evaluate the short-term and long-term outcomes of coronary artery bypass
grafting (CABG) with coronary endarterectomy (CE) versus isolated CABG.
<br/>Method(s): Studies evaluating outcomes of CABG with CE (CE-CABG) were
searched from 1 January 2000 to 30 September 2022, on PubMed, Embase, and
Cochrane databases. The primary outcome was 30 -days mortality. Secondary
outcomes were postoperative myocardial infraction, low output syndrome,
cardiac arrhythmia, renal dysfunction, and 5 years survival.
<br/>Result(s): A total of 12 observational studies including 114,319
patients assessing CE-CABG (n = 35,174) versus isolated CABG (n = 79,145)
were included. Compared to isolated CABG alone, CE-CABG was significantly
associated with increased incidences of 30-days mortality (RR, 1.87; 95%
CI, 1.73-2.07; p < 0.01), postoperative myocardial infraction (RR, 1.61;
95% CI, 1.26-2.05; p < 0.01), low output syndrome (RR, 1.54; 95% CI,
1.17-2.02; p < 0.01), and renal dysfunction (RR, 1.56; 95% CI, 1.44-1.69;
p < 0.01). However, there was no difference in either rate of cardiac
arrhythmia (RR, 1.06; 95% CI, 0.97-1.15; p = 0.20) or 5 years survival
(RR, 1.05; 95% CI, 0.95-1.16; p = 0.34) between the CE-CABG group and the
control group. Subgroup analysis on CE technique showed that CE-CABG was
also associated with 30 days mortality in patients undergoing closed CE
(RR, 1.49; 95% CI, 1.09-2.03), whereas this association between CE and 30
days mortality was not observed in patients undergoing open CE (RR, 1.76;
95% CI, 0.58-5.32). <br/>Conclusion(s): Despite poor short-term outcomes,
CE-CABG appeared to offer satisfactory long-term survival in patients with
diffuse coronary artery disease.<br/>Copyright &#xa9; The Author(s) 2022.

<13>
Accession Number
628825341
Title
Review of available evidence supporting different transfusion thresholds
in different patient groups with anemia.
Source
Annals of the New York Academy of Sciences. 1450(1) (pp 221-238), 2019.
Date of Publication: August 2019.
Author
Chai K.L.; Cole-Sinclair M.
Institution
(Chai, Cole-Sinclair) Department of Haematology, St Vincent's Hospital,
Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
In patients with anemia, transfusion of red blood cells (RBCs) can save
lives and improve quality of life. The choice to transfuse should be
cautiously made owing to risks of transfusion, economic costs, and
limitations on the blood supply. Until the 1980s, the decision for RBC
transfusion was guided by Hb threshold, with the aim of maintaining the
patient's blood Hb level over 100 grams per liter. Since then, multiple
randomized controlled trials and key systematic reviews have provided
evidence-based guidelines as to appropriate transfusion thresholds in a
number of clinical settings. Here, we aimed to address the outcome of
defining different anemia criteria in specific clinical populations
exclusively on the basis of the need for RBC transfusion based on Hb
concentration. We focused on the patient populations, where there were the
most available data on differing transfusion thresholds, which looked at
transfusing to a higher or liberal transfusion threshold in comparison
with a lower or restrictive transfusion threshold. These included patients
in intensive care with or without septic shock, hip fracture surgery,
cardiovascular surgery, and upper gastrointestinal bleeding, the pediatric
population, and also those with malaria, by reviewing key randomized
controlled trials and systematic reviews. Twenty-four randomized
controlled studies and 12 systematic reviews have been included, and these
are discussed below.<br/>Copyright &#xa9; 2019 New York Academy of
Sciences.

<14>
Accession Number
2028423624
Title
Efficacy of Respiratory Muscle Training in the Immediate Postoperative
Period of Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(1) (no pagination), 2024.
Article Number: e20220165. Date of Publication: 2024.
Author
Aquino T.N.; Prado J.P.; Crisafulli E.; Clini E.M.; Galdino G.
Institution
(Aquino, Prado, Galdino) Instituto de Ciencias da Motricidade,
Universidade Federal de Alfenas, Minas Gerais, Alfenas, Brazil
(Aquino) Department of Rehabilitation and Cardiology, Hospital Santa
Lucia, Minas Gerais, Pocos de Caldas, Brazil
(Crisafulli) Department of Medicine and Surgery, Respiratory Disease and
Lung Function Unit, University of Parma, Parma, Italy
(Clini) Department of Medical and Surgical Sciences, University of Modena
and Reggio Emilia and University Hospital of Modena Policlinico, Modena,
Italy
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: This study aimed to evaluate the efficacy of respiratory
muscle training during the immediate postoperative period of cardiac
surgery on respiratory muscle strength, pulmonary function, functional
capacity, and length of hospital stay. <br/>Method(s): This is a
systematic review and meta-analysis. A comprehensive search on PubMed,
Excerpta Medica Database (or Embase), Cumulative Index of Nursing and
Allied Health Literature (or CINAHL), Latin American and Caribbean Health
Sciences Literature (or LILACS), Scientific Electronic Library Online (or
SciELO), Physiotherapy Evidence Database (or PEDro), and Cochrane Central
Register of Controlled Trials databases was performed. A combination of
free-text words and indexed terms referring to cardiac surgery, coronary
artery bypass grafting, respiratory muscle training, and clinical trials
was used. A total of 792 studies were identified; after careful selection,
six studies were evaluated. <br/>Result(s): The studies found significant
improvement after inspiratory muscle training (IMT) (n = 165, 95%
confidence interval [CI] 9.68, 21.99) and expiratory muscle training (EMT)
(n = 135, 95% CI 8.59, 27.07) of maximal inspiratory pressure and maximal
expiratory pressure, respectively. Also, IMT increased significantly (95%
CI 19.59, 349.82, n = 85) the tidal volume. However, no differences were
found in the peak expiratory flow, functional capacity, and length of
hospital stay after EMT and IMT. <br/>Conclusion(s): IMT and EMT
demonstrated efficacy in improving respiratory muscle strength during the
immediate postoperative period of cardiac surgery. There was no evidence
indicating the efficacy of IMT for pulmonary function and length of
hospital stay and the efficacy of EMT for functional
capacity.<br/>Copyright &#xa9; 2024, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<15>
Accession Number
643763477
Title
A Review of High-Intensity Interval Training in Heart Transplant
Recipients: CURRENT KNOWLEDGE AND FUTURE PERSPECTIVES.
Source
Journal of cardiopulmonary rehabilitation and prevention. (no
pagination), 2024. Date of Publication: 15 Mar 2024.
Author
Nytroen K.; Rolid K.
Institution
(Nytroen) Oslo University Hospital, Rikshospitalet, Norway (Drs Nytroen
and Rolid); The Norwegian Health Archives, Tynset, Norway (Dr Nytroen);
and The Research Council of Norway, Oslo, Norway (Dr Rolid)
Abstract
OBJECTIVE: This review reports how exercise-based rehabilitation
strategies have developed over the past decades, and it specifically
focuses on the effectiveness, safety, and implementation of high-intensity
interval training (HIIT). It provides an overview of the historical
progression, main research findings, and considerations surrounding HIIT
as the preferred exercise modality for recipients of heart transplant
(HTx). REVIEW METHODS: The review includes a timeline of studies spanning
from 1976-2023. The 2017 Cochrane systematic review on exercise-based
cardiac rehabilitation in recipients of HTx serves as the main knowledge
base (>=2015). Additionally, literature searches in PubMed/Medline and
ClinicalTrials.gov have been performed, and all reviews and studies
reporting the effects of moderate- to high-intensity exercise in
recipients of HTx, published in 2015 or later have been screened. SUMMARY:
High-intensity interval training has gained prominence as an effective
exercise intervention for recipients of HTx, demonstrated by an
accumulation of performed studies in the past decade, although
implementation in clinical practice remains limited. Early restrictions on
HIIT in HTx recipients lacked evidence-based support, and recent research
challenges these previous restrictions. High-intensity interval training
results in greater improvements and benefits compared with
moderate-intensity continuous training in the majority of studies. While
HIIT is now regarded as generally suitable on a group level, individual
assessment is still advised. The impact of HIIT involves reinnervation and
central and peripheral adaptations to exercise, with variations in
recipent responses, especially between de novo and maintenance recipients,
and also between younger and older recipients. Long-term effects and
mechanisms behind the HIIT effect warrant further investigation, as well
as a focus on optimized HIIT protocols and exercise
benefits.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All rights
reserved.

<16>
[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.

<17>
Accession Number
2030655515
Title
Systematic review and meta-analysis of diagnostic test accuracy of
ST-segment elevation for acute coronary occlusion.
Source
International Journal of Cardiology. 402 (no pagination), 2024. Article
Number: 131889. Date of Publication: 01 May 2024.
Author
de Alencar Neto J.N.; Scheffer M.K.; Correia B.P.; Franchini K.G.;
Felicioni S.P.; De Marchi M.F.N.
Institution
(de Alencar Neto, Scheffer, Correia, Franchini, Felicioni, De Marchi)
Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Objective: To evaluate the diagnostic sensitivity and specificity of
ST-segment elevation on a 12-lead ECG in detecting ACO across any coronary
artery, challenging the current STEMI-NSTEMI paradigm. <br/>Method(s):
Studies from MEDLINE and Scopus (2012-2023) comparing ECG findings with
coronary angiograms were systematically reviewed and analyzed following
PRISMA-DTA guidelines. QUADAS-2 assessed the risk of bias. Study
selection: Studies included focused on AMI patients and provided data
enabling the construction of contingency tables for sensitivity and
specificity calculation, excluding those with non-ACS conditions, outdated
STEMI criteria, or a specific focus on bundle branch blocks or other
complex diagnoses. Data were extracted systematically and pooled test
accuracy estimates were computed using MetaDTA software, employing
bivariate analyses for within- and between-study variation. The primary
outcomes measured were the sensitivity and specificity of ST-segment
elevation in detecting ACO. <br/>Result(s): Three studies with 23,704
participants were included. The pooled sensitivity of ST-segment elevation
for detecting ACO was 43.6% (95% CI: 34.7%-52.9%), indicating that over
half of ACO cases may not exhibit ST-segment elevation. The specificity
was 96.5% (95% CI: 91.2%-98.7%). Additional analysis using the OMI-NOMI
strategy showed improved sensitivity (78.1%, 95% CI: 62.7%-88.3%) while
maintaining similar specificity (94.4%, 95% CI: 88.6%-97.3%).
<br/>Conclusion(s): The findings reveal a significant diagnostic gap in
the current STEMI-NSTEMI paradigm, with over half of ACO cases potentially
lacking ST-segment elevation. The OMI-NOMI strategy could offer an
improved diagnostic approach. The high heterogeneity and limited number of
studies necessitate cautious interpretation and further research in
diverse settings.<br/>Copyright &#xa9; 2024 Elsevier B.V.

<18>
Accession Number
2030575371
Title
An overview of reviews and synthesis across 440 studies examines the
importance of hospital readmission predictors across various patient
populations.
Source
Journal of Clinical Epidemiology. 167 (no pagination), 2024. Article
Number: 111245. Date of Publication: March 2024.
Author
Koch J.J.; Beeler P.E.; Marak M.C.; Hug B.; Havranek M.M.
Institution
(Koch, Havranek) Competence Center for Health Data Science, Faculty of
Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3,
Lucerne 6002, Switzerland
(Beeler) Center for Primary and Community Care, Faculty of Health Sciences
and Medicine, University of Lucerne, Frohburgstrasse 3, Lucerne 6002,
Switzerland
(Marak) Currently an Independent Researcher, Previously at Texas A&M
University, 400 Bizzell St, College Station, TX 77843, United States
(Hug) Faculty of Health Sciences and Medicine, University of Lucerne,
Frohburgstrasse 3, Lucerne 6002, Switzerland
(Hug) Cantonal Hospital Lucerne, Department of Internal Medicine,
Spitalstrasse, Lucerne 6000, Switzerland
Publisher
Elsevier Inc.
Abstract
Objectives: The scientific literature contains an abundance of prediction
models for hospital readmissions. However, no review has yet synthesized
their predictors across various patient populations. Therefore, our aim
was to examine predictors of hospital readmissions across 13 patient
populations. Study Design and Setting: An overview of systematic reviews
was combined with a meta-analytical approach. Two thousand five hundred
four different predictors were categorized using common ontologies to pool
and examine their odds ratios and frequencies of use in prediction models
across and within different patient populations. <br/>Result(s):
Twenty-eight systematic reviews with 440 primary studies were included.
Numerous predictors related to prior use of healthcare services (odds
ratio; 95% confidence interval: 1.64; 1.42-1.89), diagnoses (1.41;
1.31-1.51), health status (1.35; 1.20-1.52), medications (1.28;
1.13-1.44), administrative information about the index hospitalization
(1.23; 1.14-1.33), clinical procedures (1.20; 1.07-1.35), laboratory
results (1.18; 1.11-1.25), demographic information (1.10; 1.06-1.14), and
socioeconomic status (1.07; 1.02-1.11) were analyzed. Diagnoses were
frequently used (in 37.38%) and displayed large effect sizes across all
populations. Prior use of healthcare services showed the largest effect
sizes but were seldomly used (in 2.57%), whereas demographic information
(in 13.18%) was frequently used but displayed small effect sizes.
<br/>Conclusion(s): Diagnoses and patients' prior use of healthcare
services showed large effects both across and within different
populations. These results can serve as a foundation for future prediction
modeling.<br/>Copyright &#xa9; 2023 The Authors

<19>
Accession Number
2030265717
Title
Exercise Training for Patients With Peripheral Arterial Occlusive Disease.
Source
Deutsches Arzteblatt International. 120(51-52) (pp 879-885), 2023. Date of
Publication: 27 Dec 2023.
Author
Ingwersen M.; Kunstmann I.; Oswald C.; Best N.; Weisser B.; Teichgraber U.
Institution
(Ingwersen, Kunstmann, Oswald, Teichgraber) Institute of Diagnostic and
Interventional Radiology, Jena University Hospital, Jena, Germany
(Best) Institute of Physical and Rehabilitation Medicine, Sophien and
Hufeland Hospital Weimar, Academic Teaching Hospital, University of Jena,
Jena, Germany
(Weisser) Institute of Sports Science, Department of Sports Medicine, Kiel
University, Kiel, Germany
Publisher
Deutscher Arzte-Verlag GmbH
Abstract
Background: One-third of all persons with peripheral arterial occlusive
disease (PAOD) suffer from intermittent claudication. Exercise training
under appropriate supervision is recommended in the pertinent guidelines,
but physicians order it too rarely, and so-called vascular exercise groups
are not available everywhere. This situation needs improvement in view of
the importance of walking ability and cardiorespiratory fitness for
patients' quality of life and long-term disease outcome. <br/>Method(s):
We review the scientific evidence on exercise training and on ways to
lower barriers to the ordering of exercise training and to patient
participation, on the basis of pertinent articles retrieved by a search of
PubMed and in specialized sports science journals. <br/>Result(s): 10
meta-analyses, 12 randomized controlled trials (RCTs), and 7 cohort
studies were considered for this review. Large-scale cohort studies have
shown that exercise is associated with a lower risk of death (relative
risk 0.65-0.78 after 12 months of exercise training, compared to an
inactive lifestyle). Exercise training also improves the maximal walking
distance by a mean of 136 m (training at home) or 180-310 m (supervised
training). An additional improvement by a mean of 282 m can be expected
from a combination of exercise training and endovascular
revascularization. Further behavior-modifying interventions, such as
goal-setting, planning, and feedback, increase both the maximum walking
distance and the weekly duration of exercise. <br/>Conclusion(s): Exercise
improves walking ability and lowers mortality. To attract patients with
intermittent claudication to exercise training, a broad assortment of
analog, digital and telemetric tools and a dense network of vascular
exercise groups should be made available, along with regular contact
between physicians and patients.<br/>Copyright &#xa9; 2023 Deutscher
Arzte-Verlag GmbH. All rights reserved.

<20>
Accession Number
2030142666
Title
Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A
Trial Sequential Analysis.
Source
American Journal of Cardiology. 215 (pp 101-102), 2024. Date of
Publication: 15 Mar 2024.
Author
Chen I.-W.; Weng H.-L.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Liouying,
Tainan city, Taiwan (Republic of China)
(Weng) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung City, Taiwan (Republic of China)
(Hung) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
Publisher
Elsevier Inc.

<21>
Accession Number
2029173019
Title
Very early invasive strategy in higher risk non-ST-elevation acute
coronary syndrome: the RAPID NSTEMI trial.
Source
Heart. 110(7) (pp 500-507), 2023. Date of Publication: 16 Dec 2023.
Author
Kite T.A.; Ladwiniec A.; Greenwood J.P.; Gale C.P.; Anantharam B.; More
R.; Hetherington S.L.; Khan S.Q.; O'Kane P.; Rakhit R.; Chase A.; Barber
S.; Waheed G.; Berry C.; Flather M.; McCann G.P.; Curzen N.; Banning A.P.;
Gershlick A.H.
Institution
(Kite, Ladwiniec, McCann, Gershlick) Department of Cardiovascular
Sciences, The NIHR Leicester Biomedical Research Centre, Glenfield
Hospital, University of Leicester, University Hospitals of Leicester NHS
Trust, Leicester, United Kingdom
(Greenwood, Gale) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, The Department of Cardiology Leeds Teaching
Hospitals NHS Trust, Leeds, United Kingdom
(Anantharam) Portsmouth Hospitals University NHS Trust, Portsmouth, United
Kingdom
(More) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Hetherington) Department of Cardiology, Kettering General Hospital NHS
Foundation Trust, Kettering, United Kingdom
(Khan) Department of Cardiology, Queen Elizabeth Hospital, University
Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(O'Kane) The Royal Bournemouth Hospital, University Hospitals Dorset NHS
Foundation Trust, Bournemouth, United Kingdom
(Rakhit) Department of Cardiology, Royal Free Hospital, Institute of
Cardiovascular Sciences, University College London, London, United Kingdom
(Chase) Department of Cardiology, Morriston Hospital, Swansea, United
Kingdom
(Barber, Waheed) Leicester Clinical Trials Unit, University of Leicester,
Leicester, United Kingdom
(Berry) School of Cardiovascular and Metabolic Health, British Heart
Foundation Glasgow Cardiovascular Research Centre, Golden Jubilee National
Hospital, University of Glasgow, Glasgow, United Kingdom
(Flather) Norwich Medical School, University of East Anglia, Norwich,
United Kingdom
(Curzen) Faculty of Medicine, University of Southampton, University
Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
(Banning) Department of Cardiology, John Radcliffe Hospital, Oxford
University Hospitals NHS Trust, Oxford, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective To investigate whether a very early invasive strategy
(IS)+/-revascularisation improves clinical outcomes compared with standard
care IS in higher risk patients with non-ST-elevation acute coronary
syndrome (NSTE-ACS). Methods Multicentre, randomised, controlled,
pragmatic strategy trial of higher risk patients with NSTE-ACS, defined by
Global Registry of Acute Coronary Events 2.0 score of >=118, or >=90 with
at least one additional high-risk feature. Participants were randomly
assigned to very early IS+/-revascularisation (<90 min from randomisation)
or standard care IS+/-revascularisation (<72 hours). The primary outcome
was a composite of all-cause mortality, new myocardial infarction or
hospitalisation for heart failure at 12 months. results The trial was
discontinued early by the funder due to slow recruitment during the
COVID-19 pandemic. 425 patients were randomised, of whom 413 underwent an
IS: 204 to very early IS (median time from randomisation: 1.5 hours (IQR:
0.9-2.0)) and 209 to standard care IS (median: 44.0 hours (IQR:
22.9-72.6)). At 12 months, there was no significant difference in the
primary outcome between the early IS (5.9%) and standard IS (6.7%) groups
(OR 0.93, 95% CI 0.42 to 2.09; p=0.86). The incidence of stroke and major
bleeding was similar. The length of hospital stay was reduced with a very
early IS (3.9 days (SD 6.5) vs 6.3 days (SD 7.6), p<0.01). Conclusions A
strategy of very early IS did not improve clinical outcomes compared with
a standard care IS in higher risk patients with NSTE-ACS. However, the
primary outcome rate was low and the trial was underpowered to detect such
a difference.<br/>Copyright &#xa9; Author(s)(or their employer(s)) 2024.

<22>
Accession Number
2028924755
Title
Diaphragm thickness modifications and associated factors during VA-ECMO
for a cardiogenic shock: a cohort study.
Source
Annals of Intensive Care. 14(1) (no pagination), 2024. Article Number: 38.
Date of Publication: December 2024.
Author
Moury P.-H.; Behouche A.; Bailly S.; Durand Z.; Dessertaine G.; Pollet A.;
Jaber S.; Verges S.; Albaladejo P.
Institution
(Moury, Behouche, Durand, Dessertaine, Pollet, Albaladejo) Pole
Anesthesie-Reanimation, Grenoble Alpes University, Grenoble, France
(Moury, Bailly, Verges) Univ. Grenoble Alpes, Inserm, Grenoble Alpes
University Hospital, HP2 Laboratory, Grenoble, France
(Jaber) Intensive Care Unit, Anaesthesiology and Critical Care Department
B, Saint Eloi Teaching Hospital, Universite Montpellier 1, Centre
Hospitalier Universitaire Montpellier, Montpellier, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The incidence, causes and impact of diaphragm thickness
evolution in veno-arterial extracorporeal membrane oxygenation (VA-ECMO)
for cardiogenic shock are unknown. Our study investigates its evolution
during the first week of VA-ECMO and its relationship with sweep gas flow
settings. <br/>Method(s): We conducted a prospective monocentric
observational study in a 12-bed ICU in France, enrolling patients on the
day of the VA-ECMO implantation. The diaphragm thickness and the diaphragm
thickening fraction (as index of contractile activity, dTF; dTF < 20%
defined a low contractile activity) were daily measured for one week using
ultrasound. Factors associated with diaphragm thickness evolution
(categorized as increased, stable, or atrophic based on > 10% modification
from baseline to the last measurement), early extubation role (< day4),
and patients outcome at 60 days were investigated. Changes in diaphragm
thickness, the primary endpoint, was analysed using a mixed-effect linear
model (MLM). <br/>Result(s): Of the 29 included patients, seven (23%)
presented diaphragm atrophy, 18 remained stable (60%) and 4 exhibited an
increase (17%). None of the 13 early-extubated patients experienced
diaphragm atrophy, while 7 (46%) presented a decrease when extubated later
(p-value = 0.008). Diaphragm thickness changes were not associated with
the dTF (p-value = 0.13) but with sweep gas flow (Beta = - 3; Confidence
Interval at 95% (CI) [- 4.8; - 1.2]. p-value = 0.001) and pH (Beta = - 2;
CI [- 2.9; - 1]. p-value < 0.001) in MLM. The dTF remained low (< 20%) in
20 patients (69%) at the study's end and was associated with sweep gas
flow evolution in MLM (Beta = - 2.8; 95% CI [- 5.2; - 0.5], p-value =
0.017). Odds ratio of death at 60 days in case of diaphragm atrophy by day
7 was 8.50 ([1.4-74], p = 0.029). <br/>Conclusion(s): In our study,
diaphragm thickness evolution was frequent and not associated with the
diaphragm thickening fraction. Diaphragm was preserved from atrophy in
case of early extubation with ongoing VA-ECMO assistance. Metabolic
disorders resulting from organ failures and sweep gas flow were linked
with diaphragm thickness evolution. Preserved diaphragm thickness in
VA-ECMO survivors emphasizes the importance of diaphragm-protective
strategies, including meticulous sweep gas flow titration.<br/>Copyright
&#xa9; The Author(s) 2024.

<23>
Accession Number
2028232560
Title
Impact of S<inf>pO2</inf> Targets and Pulse Oximeter Brand on Oxygen Flow
Requirements and Oxygenation.
Source
Respiratory Care. 69(1) (pp 110-113), 2024. Date of Publication: 01 Jan
2024.
Author
Lellouche F.; Bouchard P.-A.; Branson R.D.
Institution
(Lellouche, Bouchard) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec, QC,
Canada
(Branson) Department of Surgery, Division of Trauma & Critical Care,
University Cincinnati, Cincinnati, OH, United States
Publisher
American Association for Respiratory Care

<24>
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.

<25>
Accession Number
2027734631
Title
Expert Opinion on the Utility of Telemedicine in Obesity Care:
Recommendations on a Hybrid Multidisciplinary Integrated Care Follow-Up
Algorithm.
Source
Current Obesity Reports. 13(1) (pp 167-182), 2024. Date of Publication:
March 2024.
Author
Bayram F.; Sonmez A.; Kiyici S.; Akbas F.; Yetgin M.K.; Yazici D.; Cingi
A.; Sargin M.; Unal S.; Iseri C.; Mahmutoglu F.S.; Yumuk V.D.
Institution
(Bayram) Department of Endocrinology and Metabolism, Erciyes University
Faculty of Medicine, Kayseri, Turkey
(Sonmez) Department of Endocrinology and Metabolism, Ankara Guven
Hospital, Ankara, Turkey
(Kiyici) Department of Endocrinology and Metabolism, University of Health
Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Akbas) Department of Internal Medicine, Istanbul Training and Research
Hospital, Istanbul, Turkey
(Yetgin) Department of Coaching Education, Sport Health Sciences, Marmara
University Faculty of Sports Science, Istanbul, Turkey
(Yazici) Department of Endocrinology and Metabolism, Koc University
Faculty of Medicine, Istanbul, Turkey
(Cingi) Department of General Surgery, Marmara University Faculty of
Medicine, Istanbul, Turkey
(Sargin) Department of Family Medicine, Istanbul Medeniyet University
Faculty of Medicine, Istanbul, Turkey
(Unal) Private Clinical Psychology Office, Istanbul, Turkey
(Iseri) Department of Internal Medicine, Nutrition Science, Istanbul
University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
(Mahmutoglu) Department of Criminal Law and Criminal Procedure Law,
Turkish-German University Faculty of Law, Istanbul, Turkey
(Yumuk) Department of Endocrinology and Metabolism, Istanbul
University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
Publisher
Springer
Abstract
Purpose of Review: The proposed expert opinion was prepared by a panel of
obesity and law specialists from Turkey to review the utility of
telemedicine in obesity care and to provide a guidance document with
recommendations on a hybrid multidisciplinary integrated care follow-up
algorithm and the legislation governing telemedicine practice to assist
obesity specialists in practicing the telemedicine. Recent Findings: The
efficacy and feasibility of telemedicine interventions in supporting
obesity management programs even during pandemics confirm that obesity is
a particularly well-suited field for telemedicine, emphasizing the strong
likelihood of continued utilization of telemedicine in obesity management,
beyond the pandemic period. <br/>Summary: Telemedicine has great potential
to address several barriers to ongoing weight-management care, such as
challenges of access to specialized care, cost, and time limitations as
well as patient adherence to treatment. However, telemedicine practice
should complement rather than replace the in-person visits which are
unique in building rapport and offering social support. Accordingly, the
participating experts recommend the use of a hybrid integrated care model
in the management of obesity, with the use of telemedicine, as an adjunct
to in-person visits, to enable the provision of suggested intensive
obesity management via frequent visits by a multidisciplinary team of
obesity specialists. Further research addressing the utility of
telemedicine in terms of optimal modality and duration for successful
long-term obesity management outcomes is necessary to develop specific
guidelines on telemedicine practice. In addition, the legislation
governing the norms and protocols on confidentiality, privacy, access, and
liability needs to be improved.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2023.

<26>
Accession Number
2031019077
Title
Comparison of ultrasound-guided subtransverse process interligamentary
plane block with paravertebral block for postoperative analgesia in
thoracic surgery: Protocol for a randomised non-inferiority trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e082135. Date of
Publication: 13 Mar 2024.
Author
Wu W.; Wang D.; Liu Y.; Zhu T.; He W.; Shi H.
Institution
(Wu, Wang, Liu, Shi) Department of Anesthesiology, Shanghai Pulmonary
Hospital, School of Medicine, Tongji University, Shanghai, China
(Zhu) School of Medicine, Tongji University, Shanghai, China
(He) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School
of Medicine, Tongji University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction The subtransverse process interligamentary (STIL) plane block
is an emerging interfascial plane block that has garnered attention for
its potential to provide effective postoperative analgesia for breast and
thoracic surgeries. However, a direct comparative assessment between the
STIL plane block and the paravertebral block is currently lacking.
Consequently, our study aims to assess the analgesic efficacy of the STIL
block in comparison to paravertebral block for patients undergoing
video-assisted thoracoscopic surgery (VATS). Methods and analysis This
study is a randomised, parallel-controlled, double-blind, non-inferiority
trial, with the goal of enrolling 114 participants scheduled for uniportal
VATS at Shanghai Pulmonary Hospital. Participants will be randomly
assigned in a 1:1 ratio through block randomisation to receive either the
STIL plane block (n=57) or the paravertebral block (n=57). The primary
outcome of the study is the area under the curve of Numerical Rating
Scale(NRS) scores recorded over a 48-hour period following the surgical
procedure. Secondary outcomes encompass the evaluation of Quality of
Recovery-40, cumulative sufentanil consumption, serum inflammatory
factors, rescue medication usage, the incidence of adverse events and the
patient satisfaction scores. Ethics and dissemination This study has
received approval from the Medical Ethics Committee of Shanghai Pulmonary
Hospital (approval no. L22-329). Written informed consent will be obtained
from all participants. The findings will be submitted for publication in
peer-reviewed journals. Trial registration number ChiCTR2200066909.
<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.

<27>
Accession Number
2031019070
Title
High-flow nasal oxygenation versus face mask oxygenation for
preoxygenation in patients undergoing double-lumen endobronchial
intubation: Protocol of a randomised controlled trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e080422. Date of
Publication: 14 Mar 2024.
Author
He R.; Fang Y.; Jiang Y.; Yao D.; Li Z.; Zheng W.; Liu Z.; Luo N.
Institution
(He, Fang, Jiang, Liu, Luo) Department of Anesthesiology, Shenzhen Second
People's Hospital, The First Affiliated Hospital of Shenzhen University,
Guangdong, Shenzhen, China
(Yao) Department of Thoracic Surgery, Shenzhen Second People's Hospital,
The First Affiliated Hospital of Shenzhen University, Guangdong, Shenzhen,
China
(Li) Department of Anesthesiology, Second People' S Hospital of Futian
District, Shenzhen, China
(Zheng) School of Public Health, Zhejiang Chinese Medical University,
Zhejiang, Hangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction With the growing emphasis on swift recovery, minimally
invasive thoracic surgery has advanced significantly. Video-assisted
thoracoscopic surgery (VATS) has seen rapid development, and the
double-lumen tube (DLT) remains the most dependable method for tracheal
intubation in VATS. However, hypoxaemia during DLT intubation poses a
threat to the perioperative safety of thoracic surgery patients. Recently,
transnasal high-flow nasal oxygen (HFNO) has shown promise in anaesthesia,
particularly in handling short-duration hypoxic airway emergencies. Yet,
its application in the perioperative period for patients undergoing
pulmonary surgery with compromised cardiopulmonary function lacks
evidence, and there are limited reliable clinical data. Methods and
analysis A prospective, randomised, controlled, single-blind design will
be employed in this study. 112 patients aged 18-60 years undergoing
elective VATS-assisted pulmonary surgery will be enrolled and randomly
divided into two groups: the nasal high-flow oxygen group (H group) and
the traditional mask transnasal oxygen group (M group) in a 1:1 ratio.
HFNO will be used during DLT intubation for the prevention of asphyxia in
group H, while conventional intubation procedures will be followed by
group M. Comparison will be made between the two groups in terms of
minimum oxygen saturation during intubation, hypoxaemia incidence during
intubation, perioperative complications and postoperative hospital days.
Ethics and dissemination Approval for this study has been granted by the
local ethics committee at Shenzhen Second People's Hospital. The trial
results will be disseminated through peer-reviewed journals and scientific
conferences. Trial registration number NCT05666908. <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.

<28>
Accession Number
2030423047
Title
Clinical Outcomes of Erector Spinae Plane Block for Midline Sternotomy in
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 964-973),
2024. Date of Publication: April 2024.
Author
Greene J.J.; Chao S.; Tsui B.C.H.
Institution
(Greene, Chao, Tsui) Department of Anesthesiology, Perioperative and Pain
Medicine, Stanford University School of Medicine, Stanford, CA, United
States
(Greene) University of California - San Francisco School of Medicine,
University of California - San Francisco, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the benefit of single-shot erector spinae plane
block (ESPB) on pain at postoperative hours 4 and 12, duration of
mechanical ventilation, hospital length of stay, intensive care unit (ICU)
length of stay, cumulative postoperative opioid usage, and incidence of
postoperative nausea and vomiting (PONV) after cardiac surgery via
sternotomy Design: A systematic review and meta-analysis of randomized
controlled trials and prospective clinical trials. <br/>Setting(s):
Studies were identified through the search of PubMed and EMBASE on July
19, 2023. <br/>Participant(s): Adults and children undergoing cardiac
surgery via sternotomy. <br/>Intervention(s): Single-shot ESPB versus
standard-of-care analgesia. <br/>Measurements and Main Results: A
systematic review and meta-analysis of 10 studies (N = 695 patients). The
single-shot ESPB arm exhibited statistically significant reductions in
pain score at postoperative hour 4 (standardized mean difference [SMD]
-2.95, 95% CI -5.86 to -0.04, p = 0.0466), duration of mechanical
ventilation (SMD -1.23, 95% CI -2.21 to -0.24, p = 0.0145), cumulative
postoperative opioid usage (SMD -1.48, 95% CI -2.46 to -0.49, p = 0.0033),
and PONV incidence (risk ratio 0.4358, 95% CI 0.2105-0.9021, p = 0.0252).
The single-shot ESPB arm did not exhibit a statistically significant
reduction in pain score at postoperative hour 12, length of hospital stay,
and length of ICU stay. <br/>Conclusion(s): Single-shot ESPB improves
near-term clinical outcomes in patients undergoing cardiac surgery via
sternotomy. More randomized controlled trials are needed to validate these
findings.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<29>
Accession Number
2029997706
Title
Effect of Retrograde Autologous Priming on Coagulation Assessed by
Rotation Thromboelastometry in Patients Undergoing Valvular Cardiac
Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 939-945),
2024. Date of Publication: April 2024.
Author
Ko S.H.; Nan Z.; Soh S.; Shim J.-K.; Lee H.W.; Kwak Y.L.; Song J.W.
Institution
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Department of Anesthesiology and
Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Anesthesia and Pain Research
Institute, Yonsei University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of retrograde autologous priming
(RAP) on coagulation function using rotation thromboelastometry (ROTEM) in
patients undergoing valvular cardiac surgery. <br/>Design(s): A
prospective, randomized, patient- and outcome assessor-blinded study.
<br/>Setting(s): At a single-center university hospital.
<br/>Participant(s): Patients aged 20 years or older undergoing valvular
cardiac surgery. <br/>Intervention(s): A total of 104 patients were
allocated to the RAP or control group (1:1 ratio). In the RAP group, the
prime was displaced into the collection bag before bypass initiation.
ROTEM was performed at the induction of anesthesia, at the beginning of
rewarming, and after the reversal of heparinization. Allogeneic plasma
products and platelet concentrates were transfused according to
ROTEM-based algorithms. <br/>Measurements and Main Results: An average
volume of 635 +/- 114 mL was removed using RAP (from the 1,600 mL initial
prime volume). The hematocrit 10 minutes after cardiopulmonary bypass
(CPB) was 24.7 +/- 3.5% in the control group, and 26.1 +/- 4.1% in the RAP
group (p = 0.330). ROTEM, including EXTEM, INTEM, and FIBTEM, showed
prolonged clotting time and decreased maximal clot firmness after CPB in
both groups without intergroup differences. The number of patients who
received intraoperative erythrocytes (27% v 25%, control versus RAP, p =
0.823), fresh frozen plasma (14% v 8%, control versus RAP, p = 0.339),
cryoprecipitate (21% v 12%, control versus RAP, p = 0.185), or platelet
concentrate transfusion (19% v 12%, control versus RAP, p = 0.277) did not
differ between the groups. <br/>Conclusion(s): Cardiopulmonary bypass
induced impaired coagulation function on ROTEM. However, RAP did not
improve coagulation function when compared with conventional priming in
patients undergoing valvular cardiac surgery.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<30>
Accession Number
2020841745
Title
Cardiopulmonary bypass parameters improve the prediction of 30-day
mortality following cardiac surgery.
Source
Perfusion (United Kingdom). 39(3) (pp 479-488), 2024. Date of Publication:
April 2024.
Author
Newland R.F.; Baker R.A.
Institution
(Newland, Baker) Cardiothoracic Surgery, Division of Surgery &
Perioperative Medicine, Flinders Medical Centre & Cardiothoracic Surgery,
Department of Surgery, College of Medicine and Public Health, Flinders
University, Bedford Park, SA, Australia
Publisher
SAGE Publications Ltd
Abstract
Currently 30-day mortality is commonly used as a quality indicator for
cardiac surgery; however, prediction models have not included the role of
cardiopulmonary bypass (CPB). We hypothesized that reproducing currently
utilised prediction model methods of 30-day mortality using the Australian
and New Zealand Collaborative Perfusion Registry (ANZCPR) would identify
relevant CPB predictors. Nine centers in Australia and New Zealand
collected data using the ANZCPR between 2011-2020. CPB parameter selection
was determined by evaluating association with 30-day mortality. Data were
divided into model creation (n = 15,073) and validation sets (n = 15,072).
Bootstrap sampling and automated variable selection methods were used to
develop candidate models. The final model was selected using prediction
mean square error and Bayesian Information Criteria. The average receiver
operating characteristic (ROC), p-value for Hosmer-Lemeshow chi-squared
test and MSE were obtained from multifold validation. In total, 30,145
patients were included, of which 735 (2.4%) died within 30 day of surgery.
The area under the ROC curve for the model including CPB parameters was
significantly greater than preoperative risk factors only (0.829 vs 0.783,
p < 0.001). CPB parameters included in the predictive model were CPB time,
red blood cell transfusion, mean arterial pressure <50 mmHg, minimum
oxygen delivery, cardiac index <1.6 L/min/m². CPB parameters
improve the prediction of 30-day mortality. Randomised trials designed to
evaluate modifiable CPB parameters will determine their impact on
mortality.<br/>Copyright &#xa9; The Author(s) 2022.

<31>
Accession Number
643752172
Title
The effectiveness of a web-based information-knowledge-attitude-practice
continuous intervention on the psychological status, medical compliance,
and quality of life of patients after coronary artery bypass grafting
surgery: a parallel randomized clinical trial.
Source
Journal of cardiothoracic surgery. 19(1) (pp 125), 2024. Date of
Publication: 13 Mar 2024.
Author
Li J.; Deng Y.; Jiang Y.
Institution
(Li, Jiang) Department of Emergency Medicine, Shengjing Hospital of China
Medical University, No.36 Sanhao Street ,Heping DistrictLiaoning Province,
Shenyang 110004, China
(Deng) Department of Intensive Care Medicine, Shengjing Hospital of China
Medical University, No.36 Sanhao Street ,Heping DistrictLiaoning Province,
Shenyang 110004, China
Abstract
BACKGROUND: Coronary artery disease (CAD) patients who have undergone
coronary artery bypass grafting (CABG) often experience a severe
psychological burden for a long period of time, which can adversely affect
their post-operative prognosis. Therefore, this study aimed to evaluate
the effect of a web-based Information-Knowledge-Attitude-Practice (WIKAP)
continuous intervention on the psychological status, medical compliance,
and quality of life (QoL) in patients with CAD after CABG surgery.
<br/>METHOD(S): A parallel randomized clinical trial enrolled 174 CAD
patients who underwent CABG at our hospital between January 2018 and
December 2019. The participants were randomly divided into the Control and
WIKAP group and received intervention for 12 months. The scores for
anxiety, depression, medical compliance, and QoL were assessed on the
first day (M0), 3rd month (M3), 6th month (M6), 9th month (M9) and 12th
month (M12) after discharge. Furthermore, the occurrence of major adverse
cardiac and cerebrovascular events (MACCE) was analyzed using the
Kaplan-Meier curve and Cox proportional regression models for an
additional 24-month follow-up period without any intervention.
<br/>RESULT(S): After the 12-month intervention, the scores of anxiety and
depression were significantly reduced in the WIKAP group at M9 and M12
compared to those in the Control group (all P<0.05). Additionally, the
scores of medical compliance in the WIKAP group were remarkably elevated
at M6, M9, and M12 compared with those scores in the Control group (all
P<0.05). Furthermore, the QoL scores were lower in the WIKAP group at M6,
M9, and M12 compared to the Control group (all P<0.05). However, the
MACCE-free survival showed no significant difference between the two
groups (P>0.05). Cox proportional regression analysis also showed that the
nursing intervention (Control vs. WKIAP) was not associated with the
incidence of MACCE. <br/>CONCLUSION(S): WIKAP nursing intervention
effectively improved the psychological health, medical compliance, and QoL
in CAD patients who underwent CABG operation, but it did not prolong
MACCE-free survival. TRAIL REGISTRATION: The study is registered in
isrctn.org: ISRCTN13653455.<br/>Copyright &#xa9; 2024. The Author(s).

<32>
[Use Link to view the full text]
Accession Number
643086024
Title
Pulmonary vagus nerve transection for chronic cough after video-assisted
lobectomy: a randomized controlled trial.
Source
International journal of surgery (London, England). 110(3) (pp 1556-1563),
2024. Date of Publication: 01 Mar 2024.
Author
Zhang Q.; Ge Y.; Sun T.; Feng S.; Zhang C.; Hong T.; Liu X.; Han Y.; Cao
J.-L.; Zhang H.
Institution
(Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou
Medical University
(Zhang) Department of Anesthesiology, Yancheng Third People's Hospital,
Yancheng, Jiangsu, China
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Thoracic Surgery Laboratory,
Xuzhou Medical University
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Department of Thoracic Surgery,
Affiliated Hospital of Xuzhou Medical University
(Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan
University, Shanghai, China
(Cao) Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical
University, Jiangsu, China
Abstract
BACKGROUND: Chronic cough is common after lobectomy. Vagus nerves are part
of the cough reflex. Accordingly, transection of the pulmonary branches of
vagus nerve may prevent chronic cough. And there are no clear
recommendations on the management of the pulmonary branches of vagus in
any thoracic surgery guidelines. <br/>METHOD(S): This is a single-center,
randomized controlled trial. Adult patients undergoing elective
video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized
at a 1:1 ratio to undergo a sham procedure (control group) or transection
of the pulmonary branches of the vagus nerve that innervate the bronchial
stump plus the caudal-most large pulmonary branch of the vagus nerve. The
primary outcome was the rate of chronic cough, as assessed at 3 months
after surgery in the intent-to-treat population. <br/>RESULT(S): Between 1
February 2020 and 1 August 2020, 116 patients (59.6+/-10.1 years of age;
45 men) were randomized (58 in each group). All patients received
designated intervention. The rate of chronic cough at 3 months was 19.0%
(11/58) in the vagotomy group versus 41.4% (24/58) in the control group
(OR=0.332, 95% CI: 0.143-0.767; P =0.009). In the 108 patients with 2-year
assessment, the rate of persistent cough was 12.7% (7/55) in the control
and 1.9% (1/53) in the vagotomy group ( P =0.032). The two groups did not
differ in postoperative complications and key measures of pulmonary
function, for example, maximal voluntary ventilation, diffusing capacity
of the lungs for carbon monoxide, and forced expiratory volume.
<br/>CONCLUSION(S): Transecting the pulmonary branches of vagus nerve that
innervate the bronchial stump plus the caudal-most large pulmonary branch
decreased the rate of chronic cough without affecting pulmonary function
in patients undergoing video-assisted lobectomy and
lymphadenectomy.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<33>
Accession Number
640027615
Title
Effects of high-intensity inspiratory muscle training on systemic
inflammatory response in cardiac surgery - A randomized clinical trial.
Source
Physiotherapy theory and practice. 40(4) (pp 778-788), 2024. Date of
Publication: 01 Apr 2024.
Author
Furon Y.; Dang Van S.; Blanchard S.; Saulnier P.; Baufreton C.
Institution
(Furon) Department of Physical and Rehabilitation Medicine, University
Hospital of Angers, Angers, France
(Dang Van, Baufreton) Department of Cardiac Surgery, University Hospital
of Angers, Angers, France
(Blanchard) Laboratory of Immunology and Allergology, University Hospital
of Angers, Angers, France
(Saulnier) Research Department Unit, University Hospital of Angers,
Angers, France
Abstract
PURPOSE: Preoperative inspiratory muscle training reduces the incidence of
postoperative pulmonary complications after cardiac surgery, but training
protocols vary widely in terms of intensity. Currently, the mechanisms
underlying the effectiveness of this practice are not known. The purpose
of the present study is to determine whether preoperative high-intensity
inspiratory muscle training (HI-IMT) modulates the perioperative systemic
inflammatory response in cardiac surgery patients. <br/>METHOD(S):
Participants awaiting surgical aortic valve replacement were randomized to
3 to 6 weeks preoperative home-based HI-IMT or same duration low-intensity
inspiratory muscle training (LI-IMT). The primary outcome was the
preoperative value of the soluble tumor necrosis factor receptor 1
(sTNFR1). Secondary outcomes assessed perioperative evolution of the
cytokines: sTNFR1, Tumor necrosis factor-alpha, Interleukin (IL)-6, IL-8,
IL10, IL1beta, and their combined z-score; reflecting post-training and
postoperative inflammatory response. Perioperative pulmonary function and
postoperative clinical outcomes were collected. <br/>RESULT(S): Between
February 2018 and March 30, 2019 patients were randomized, to HI-IMT or
LI-IMT. There were no differences between the groups in terms of baseline
characteristics. The median (IQR) training duration was 34 (28-44) days.
After training, the median (IQR) predicted maximal inspiratory pressure
was higher in the HI-IMT vs LI-IMT group (119 (96-142%) vs 97 (81-107%); p
= .04) Levels of the sTNFR1 cytokine increased during training in the
HI-IMT group, pre vs post training (Median (IQR) 1073 (920; 1219) vs 1172
(965; 1368) ng/L; p = .03). The 24-h postoperative global inflammatory
score was lower in the HI-IMT than in the LI-IMT group (Median (IQR),
-0.37 (-0.62, 0.03) vs -0.10 (-0.17, 0.49), p = .04). Global inflammatory
scores were not different at other time points. There were no significant
differences between the groups in post-operative pulmonary function and
postoperative clinical outcome. <br/>CONCLUSION(S): High intensity
inspiratory muscle training shows immunomodulatory properties. These
properties could explain why preoperative inspiratory muscle training can
lead to lung protection after cardiac surgery.

<34>
Accession Number
2031053935
Title
Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in
the Operating Room: A Cluster Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
Ruetzler K.; Bustamante S.; Schmidt M.T.; Almonacid-Cardenas F.; Duncan
A.; Bauer A.; Turan A.; Skubas N.J.; Sessler D.I.
Institution
(Ruetzler, Schmidt, Almonacid-Cardenas, Duncan, Turan, Sessler) Outcomes
Research Consortium, Department of Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Ruetzler, Turan) Division of Multi-Specialty Anesthesiology, Department
of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Bustamante, Duncan, Bauer, Skubas) Division of Cardiothoracic
Anesthesiology, Department of Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
Publisher
American Medical Association
Abstract
Importance: Endotracheal tubes are typically inserted in the operating
room using direct laryngoscopy. Video laryngoscopy has been reported to
improve airway visualization; however, whether improved visualization
reduces intubation attempts in surgical patients is unclear.
<br/>Objective(s): To determine whether the number of intubation attempts
per surgical procedure is lower when initial laryngoscopy is performed
using video laryngoscopy or direct laryngoscopy. <br/>Design, Setting, and
Participant(s): Cluster randomized multiple crossover clinical trial
conducted at a single US academic hospital. Patients were adults aged 18
years or older having elective or emergent cardiac, thoracic, or vascular
surgical procedures who required single-lumen endotracheal intubation for
general anesthesia. Patients were enrolled from March 30, 2021, to
December 31, 2022. Data analysis was based on intention to treat.
<br/>Intervention(s): Two sets of 11 operating rooms were randomized on a
1-week basis to perform hyperangulated video laryngoscopy or direct
laryngoscopy for the initial intubation attempt. <br/>Main Outcomes and
Measures: The primary outcome was the number of operating room intubation
attempts per surgical procedure. Secondary outcomes were intubation
failure, defined as the responsible clinician switching to an alternative
laryngoscopy device for any reason at any time, or by more than 3
intubation attempts, and a composite of airway and dental injuries.
<br/>Result(s): Among 8429 surgical procedures in 7736 patients, the
median patient age was 66 (IQR, 56-73) years, 35% (2950) were women, and
85% (7135) had elective surgical procedures. More than 1 intubation
attempt was required in 77 of 4413 surgical procedures (1.7%) randomized
to receive video laryngoscopy vs 306 of 4016 surgical procedures (7.6%)
randomized to receive direct laryngoscopy, with an estimated proportional
odds ratio for the number of intubation attempts of 0.20 (95% CI,
0.14-0.28; P <.001). Intubation failure occurred in 12 of 4413 surgical
procedures (0.27%) using video laryngoscopy vs 161 of 4016 surgical
procedures (4.0%) using direct laryngoscopy (relative risk, 0.06; 95% CI,
0.03-0.14; P <.001) with an unadjusted absolute risk difference of -3.7%
(95% CI, -4.4% to -3.2%). Airway and dental injuries did not differ
significantly between video laryngoscopy (41 injuries [0.93%]) vs direct
laryngoscopy (42 injuries [1.1%]). Conclusion and Relevance: In this study
among adults having surgical procedures who required single-lumen
endotracheal intubation for general anesthesia, hyperangulated video
laryngoscopy decreased the number of attempts needed to achieve
endotracheal intubation compared with direct laryngoscopy at a single
academic medical center in the US. Results suggest that video laryngoscopy
may be a preferable approach for intubating patients undergoing surgical
procedures. Trial Registration: ClinicalTrials.gov Identifier:
NCT04701762.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<35>
Accession Number
2031045878
Title
Mitral Regurgitation "Proportionality" in Functional Mitral Regurgitation
and Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair: A
Systematic Review and Meta-Analysis.
Source
Structural Heart. (no pagination), 2024. Article Number: 100284. Date of
Publication: 2024.
Author
Moonen A.; Cao J.; Celermajer D.S.; Ng M.K.C.
Institution
(Moonen, Cao, Celermajer, Ng) Faculty of Medicine, University of Sydney,
Sydney, NSW, Australia
(Cao) Department of Cardiology, St Vincent's Hospital, Sydney, NSW,
Australia
(Celermajer, Ng) Department of Cardiology, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
(Celermajer, Ng) Heart Research Institute, Sydney, NSW, Australia
Publisher
Cardiovascular Research Foundation
Abstract
Background: Certain patients with functional mitral regurgitation survive
longer with fewer heart failure hospitalizations after undergoing
transcatheter edge-to-edge repair (TEER); however, clinical markers
identifying who will benefit have not been established. The
'proportionality' of mitral regurgitation (MR) severity compared to left
ventricular size has been hypothesized to predict clinical outcome.
<br/>Method(s): We sought to combine existing studies to compare outcomes
between 'proportionate' MR and 'disproportionate' MR in patients
undergoing TEER. PubMed and Medline were searched from January 2018 until
May 2023. Data was extracted and synthesized by 2 independent authors
using random effects models with risk ratios (RRs) for binary outcomes.
The primary outcome was a combined endpoint of all-cause mortality or
heart failure hospitalization (ACM/HFH). Other outcomes of interest
included ACM and residual >2+ MR after TEER. <br/>Result(s): Six trials
with a total of 1594 patients (mean age 71 years, 66% male) were included,
which assessed MR proportionality using either a ratio of estimated
regurgitant orifice area to left ventricular end-diastolic volume
(EROA:LVEDV) or regurgitant fraction. Seven hundred and five (mean age 70
years, 75% male) were classified as proportionate MR, and 889 (mean age 72
years, 60% male) had disproportionate MR. There was no significant
association between MR proportionality (by EROA:LVEDV) and ACM (RR 0.79,
95% confidence interval [CI] 0.44-1.42). Proportionality did not
significantly associate with ACM/HFH, though there were divergent effect
signals when proportionality was measured by EROA:LVEDV (RR 0.80, 95% CI
0.45-1.44) or regurgitant fraction (RR 1.48, 95% CI 0.53-4.11).
Disproportionate MR showed a greater association with residual MR > 2+
post-TEER that did not meet statistical significance (RR 1.86, 95% CI
0.77-4.49). <br/>Conclusion(s): In patients undergoing TEER for functional
mitral regurgitation, MR proportionality was not significantly associated
with ACM/HFH, all-cause mortality, or residual MR.<br/>Copyright &#xa9;
2024

<36>
Accession Number
643760557
Title
Impact of subclinical hypothyroidism on outcomes after coronary artery
bypass grafting: a systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2024. Date of
Publication: 14 Mar 2024.
Author
Larik M.O.; Shahid A.R.; Shiraz M.I.; Urooj M.
Institution
(Larik) Department of Medicine, Dow International Medical College,
Karachi, Pakistan
(Shahid, Shiraz, Urooj) Department of Medicine, Dow International Medical
College, Karachi, Pakistan
Abstract
INTRODUCTION: Coronary artery bypass grafting (CABG) is a surgical
procedure that restores blood flow to heart muscle by bypassing the
blocked or narrowed coronary arteries. On the other hand, subclinical
hypothyroidism (SCH) is characterized by an elevated serum concentration
of thyroid stimulating hormone with normal levels of serum free thyroxine.
With limited research into the impact of SCH on postoperative CABG
outcomes, this systematic review and meta-analysis was performed. EVIDENCE
ACQUISITION: An electronic search of PubMed, Cochrane Library, and Scopus
was performed from inception to April 2023. After the inclusion of five
studies, a total of 2,786 patients were pooled in this quantitative
synthesis. EVIDENCE SYNTHESIS: It was observed that SCH significantly
increased cardiovascular mortality (OR: 2.80; 95% CI: 1.37, 5.72;
P=0.005), and all-cause mortality (OR: 2.62; 95% CI: 1.80, 3.80;
P<0.00001). However, no significant differences were observed for
secondary outcomes, including major adverse cardiac events, incidence of
postoperative stroke, and incidence of postoperative myocardial
infarction. <br/>CONCLUSION(S): To the best of our knowledge, this is the
first meta-analysis conducted that evaluates the impact of SCH on outcomes
after CABG. The preoperative assessment of thyroid function may be
considered prior to cardiovascular procedures, particularly within CABG.
However, future comprehensive studies, with individual participant-level
data, are necessary in order to arrive at a valid conclusion and
recommendation.

<37>
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.

<38>
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.

<39>
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.

<40>
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.

<41>
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.

<42>
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

<43>
Accession Number
2030583084
Title
Prognostic Value of Qualitative and Quantitative Stress CMR in Patients
With Known or Suspected CAD.
Source
JACC: Cardiovascular Imaging. 17(3) (pp 248-265), 2024. Date of
Publication: March 2024.
Author
Yarahmadi P.; Forouzannia S.M.; Forouzannia S.A.; Malik S.B.; Yousefifard
M.; Nguyen P.K.
Institution
(Yarahmadi, Nguyen) Department of Medicine, Division of Cardiovascular
Medicine, Stanford University, Stanford, CA, United States
(Yarahmadi, Nguyen) Stanford Cardiovascular Institute, Stanford, CA,
United States
(Forouzannia) Department of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Forouzannia) Department of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Malik) Department of Radiology, Division of Cardiovascular Imaging,
Stanford University, Stanford, CA, United States
(Yousefifard) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background: Recent studies suggest that quantitative cardiac magnetic
resonance (CMR) may have more accuracy than qualitative CMR in coronary
artery disease (CAD) diagnosis. However, the prognostic value of
quantitative and qualitative CMR has not been compared systematically.
<br/>Objective(s): The objective was to conduct a systematic review and
meta-analysis assessing the utility of qualitative and quantitative stress
CMR in the prognosis of patients with known or suspected CAD.
<br/>Method(s): A comprehensive search was performed through Embase,
Scopus, Web of Science, and Medline. Studies that used qualitative
vasodilator CMR or quantitative CMR assessments to compare the prognosis
of patients with positive and negative CMR results were extracted. A
meta-analysis was then performed to assess: 1) major adverse
cardiovascular events (MACE) including cardiac death, nonfatal myocardial
infarction (MI), unstable angina, and coronary revascularization; and 2)
cardiac hard events defined as the composite of cardiac death and nonfatal
MI. <br/>Result(s): Forty-one studies with 38,030 patients were included
in this systematic review. MACE occurred significantly more in patients
with positive qualitative (HR: 3.86; 95% CI: 3.28-4.54) and quantitative
(HR: 4.60; 95% CI: 1.60-13.21) CMR assessments. There was no significant
difference between qualitative and quantitative CMR assessments in
predicting MACE (P = 0.75). In studies with qualitative CMR assessment,
cardiac hard events (OR: 7.21; 95% CI: 4.99-10.41), cardiac death (OR:
5.63; 95% CI: 2.46-12.92), nonfatal MI (OR: 7.46; 95% CI: 3.49-15.96),
coronary revascularization (OR: 6.34; 95% CI: 3.42-1.75), and all-cause
mortality (HR: 1.66; 95% CI: 1.12-2.47) were higher in patients with
positive CMR. <br/>Conclusion(s): The presence of myocardial ischemia on
CMR is associated with worse clinical outcomes in patients with known or
suspected CAD. Both qualitative and quantitative stress CMR assessments
are helpful tools for predicting clinical outcomes.<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<44>
Accession Number
2030096896
Title
Preoperative Ocular Symptoms Predict Acute Glaucoma After Carotid
Revascularization: An Analysis of Combined Single-Center Data and a
Systematic Review.
Source
World Neurosurgery. 183 (pp e576-e586), 2024. Date of Publication: March
2024.
Author
Fujimoto M.; Shimizu K.; Ogata H.; Yamashita H.; Yoshida S.; Akiyama Y.;
Tani S.
Institution
(Fujimoto, Shimizu, Ogata, Yamashita, Yoshida, Akiyama, Tani) Department
of Neurosurgery and Stroke Center, Tenri Hospital, Tenri, Japan
Publisher
Elsevier Inc.
Abstract
Background: Acute glaucoma is a potential complication of carotid
revascularization procedures such as endarterectomy or stenting. Although
preoperative ocular hypoperfusion may predispose patients to postoperative
glaucoma, the details of this complication have not been clarified.
<br/>Method(s): We retrospectively reviewed the medical records of
consecutive patients who underwent carotid revascularization at our
institution from January 2019 to December 2022. These patients were
divided into glaucoma and nonglaucoma groups. Given the rarity of the
event, a systematic literature review was performed to additionally
include data from patients who developed acute glaucoma after carotid
revascularization. Multivariate logistic regression was performed to
identify the risk factors for acute glaucoma. <br/>Result(s): Thirty-five
cases, including 2 from our institution, were included in the glaucoma
group, and 130 were included in the nonglaucoma group. Most cases (79%)
occurred within five days postoperatively. Multivariate analysis revealed
that preoperative ocular symptoms were significantly associated with the
development of postoperative glaucoma (odds ratio, 361.06; 95% confidence
interval, 34.09-3824.27; P < 0.001). Preoperative neovascularization at
the iris or anterior chamber angle, indicating severe ocular
hypoperfusion, was found in 84% of patients with glaucoma. Permanent
visual loss occurred in 41% of patients. The incidence of postoperative
glaucoma at our institution was 1.5% (2/132). The positive predictive
value of preoperative ocular symptoms for postoperative glaucoma was 0.25
(95% confidence interval, 0.18-0.32). <br/>Conclusion(s): This study was
the first to clarify the risk factors and characteristics of acute
glaucoma after carotid revascularization.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<45>
Accession Number
2029883001
Title
The provision and impact of rehabilitation provided by physiotherapists in
children and young people with congenital heart disease following cardiac
surgery: a scoping review.
Source
Physiotherapy (United Kingdom). 122 (pp 47-56), 2024. Date of Publication:
March 2024.
Author
Clarke S.L.; Milburn N.C.; Menzies J.C.; Drury N.E.
Institution
(Clarke, Milburn) Department of Physiotherapy, Birmingham Women's and
Children's Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4
6NH, United Kingdom
(Menzies) Paediatric Intensive Care, Birmingham Women's and Children's
Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, United
Kingdom
(Drury) Department of Paediatric Cardiac Surgery, Birmingham Children's
Hospital, Steel House Lane, Birmingham B4 6NH, United Kingdom
(Drury) Institute of Cardiovascular Sciences, University of Birmingham,
Edgbaston, Birmingham B15 2TT, United Kingdom
Publisher
Elsevier Ltd
Abstract
Introduction: Children with congenital heart disease (CHD) are at risk of
delayed motor development with increased risk for those requiring cardiac
surgical intervention. We conducted a scoping review to identify the
provision and impact of physiotherapy-delivered rehabilitation in children
and young people with CHD following cardiac surgery. <br/>Method(s):
CINAHL, EMBASE, PUBMED, AHMED, EMCARE, Cochrane Database of Systematic
Reviews, NHS Evidence databases were searched (2000-2022). Included
studies were published in full, in English and reported the use of
physiotherapy in CHD (participants 0-18years) post-surgical procedure.
Articles were screened by title and abstract and through full-text review
with results structured in accordance with the PAGER framework and PRISMA-
ScR checklist. <br/>Result(s): Seven full text peer reviewed papers
published 2014-2021 were identified from 5747 papers screened. Included
papers were predominantly non-randomised cohort studies with a sample size
of between one and 247. Study participants ranged from eight days to 16
years, with a variety of congenital heart defects and surgical procedures.
The provision of physiotherapy varied with a range of rehabilitation
formats and physiotherapeutic interventions utilised. Physiotherapy
provision appeared to have a positive impact on functional/ developmental
outcomes and muscle strength. <br/>Discussion(s): Assessing the impact and
provision of physiotherapy in CHD post-surgical intervention is
challenging based on the published literature, due to small sample sizes,
lack of control groups, heterogeneous demographics and variable
intervention and formats delivered. Further research is required to
identify the optimum format of physiotherapy provision and establish the
potential impact of physiotherapy delivered rehabilitation on motor
function and development. Contribution of the paper: * In this study we
highlight that the role of physiotherapy in the rehabilitation of children
with CHD is an emerging area of research which needs further exploration.
To the authors knowledge there are currently no published articles that
have fully explored and reviewed the literature surrounding this topic. *
Children with CHD are at increased risk of motor developmental delay and
loss of motor function, thus requiring a period of rehabilitation by a
physiotherapist. Currently, clinical practice is widely based on anecdotal
evidence and local service provision. * The articles included in this
review suggest that physiotherapeutic intervention can be helpful.
However, due to the heterogeneous methodologies employed it is not
possible to use the current published literature to generate universal
guidelines that can be transferred into clinical practice. Key themes
highlighted in the literature were the need for clarification regarding
what format is optimal and the impact physiotherapeutic interventions have
on outcomes.<br/>Copyright &#xa9; 2023 Chartered Society of Physiotherapy

<46>
Accession Number
2028915899
Title
Efficacy and safety of Wuhu oral liquid in treating acute soft tissue
injuries: a multicenter, randomized, double-blind, double-dummy,
parallel-controlled trial.
Source
Frontiers in Pharmacology. 15 (no pagination), 2024. Article Number:
1335182. Date of Publication: 2024.
Author
Zhu W.-H.; Shen Y.; Xiao Y.; Shi Q.; Fan Z.-X.; Feng Y.-Q.; Wan H.-B.; Qu
B.; Zhao J.; Zhang W.-Q.; Xu G.-H.; Wu X.-Q.; Tang D.-Z.
Institution
(Zhu, Shen, Xiao, Shi, Fan, Feng, Wan, Wu, Tang) Longhua Hospital,
Shanghai University of Traditional Chinese Medicine, Shanghai, China
(Zhu, Shen, Shi, Tang) Institute of Spine, Shanghai University of
Traditional Chinese Medicine, Shanghai, China
(Zhu, Shen, Xiao, Shi, Wu, Tang) Shanghai University of Traditional
Chinese Medicine, Shanghai, China
(Shi, Tang) Key Laboratory of Theory and Therapy of Muscles and Bones,
Ministry of Education, Shanghai, China
(Qu) The First Affiliated Hospital of Chengdu Medical College, Chengdu,
China
(Zhao) Xi'an Hospital of Traditional Chinese Medicine, Xi'an, China
(Zhang, Xu) Huadong Hospital Affiliated to Fudan University, Shanghai,
China
Publisher
Frontiers Media SA
Abstract
Background: Wuhu Oral Liquid (WHOL) is a modified preparation derived from
the famous Wuhu Powder, which has a long history of use in treating
traumatic injuries. This preparation has anti-inflammatory and analgesic
properties and accelerates recovery following acute soft tissue injuries.
<br/>Aim(s): To evaluate the efficacy and safety of WHOL in treating acute
soft tissue injury associated with qi stagnation and blood stasis syndrome
and to provide a basis for applying for the protection of varieties of
Chinese medicine for WHOL. <br/>Method(s): This study was a randomized,
controlled, double-blind, multicenter clinical trial in which Fufang Shang
Tong Capsule (FFSTC) was selected as the control drug. A total of 480
subjects with acute soft tissue injury associated with qi stagnation and
blood stasis syndrome were randomly divided into a test and control group
in a 3:1 ratio. The duration of drug treatment was 10 days. The primary
outcome was Visual Analogue Scale (VAS) score for pain (including pain at
rest and pain on activity). Secondary outcomes included the disappearance
time of the pain at rest and on activity; the curative effect of TCM
syndrome and improvement in the individual symptoms of TCM (swelling,
ecchymosis, and dysfunction); and changes in C-reactive protein (CRP) and
interleukin-6 (IL-6) levels. Safety was assessed using vital signs,
laboratory examinations, electrocardiograms, and physical examinations.
<br/>Result(s): Patient compliance was satisfactory in both groups (all
between 80% and 120%). After 4 days of treatment, the WHOL group was
superior to the FFSTC group in decreasing the VAS scores for pain at rest
(-1.88 +/- 1.13 vs. -1.60 +/- 0.93, p < 0.05) and on activity (-2.16 +/-
1.18 vs. -1.80 +/- 1.07, p < 0.05). After 7 days of treatment, the WHOL
group was superior to the FFSTC group in decreasing the VAS scores for
pain on activity (-3.87 +/- 1.60 vs. -3.35 +/- 1.30, p < 0.01) and
improving swelling (cure rate: 60.4% vs. 46.2%, p < 0.05; obvious
effective rate: 60.7% vs. 47.0%, p < 0.05). After 10 days of treatment,
the WHOL group was superior to the FFSTC group in decreasing the levels of
CRP (-0.13 +/- 2.85 vs. 0.25 +/- 2.09, p < 0.05) and improving the TCM
syndrome (cure rate: 44.1% vs. 30.8%, p < 0.05) and swelling (cure rate:
75.6% vs. 67.5%, p < 0.01; obvious effective rate: 75.6% vs. 68.4%, p <
0.05; effective rate: 77.0% vs. 71.8%, p < 0.05). The disappearance time
of pain at rest was 8 days in both groups and 9 days on activity in both
groups. In addition, there was no statistical difference between the
incidence of adverse events (4.5% vs. 2.6%, p > 0.05) and adverse
reactions (0.3% vs. 0%, p > 0.05) between the WHOL group and the FFSTC
group. No serious adverse events occurred in either group, and no subjects
were withdrawn because of adverse events. <br/>Conclusion(s): WHOL
relieves the symptoms caused by acute soft tissue injury associated with
qi stagnation and blood stasis syndrome more rapidly than FFSTC, and it is
effective and safe in the treatment of acute soft tissue injury. Future
studies still need a larger sample size to verify its efficacy and safety.
Clinical Trial Registration:
https://www.chictr.org.cn/showproj.html?proj=149531, Identifier
ChiCTR2200056411.<br/>Copyright &#xa9; 2024 Zhu, Shen, Xiao, Shi, Fan,
Feng, Wan, Qu, Zhao, Zhang, Xu, Wu and Tang.

<47>
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.

<48>
Accession Number
2027967646
Title
Non-pharmacological Methods in the Management of Postoperative Sore Throat
in Patients Undergoing Endotracheal Intubation: A Systematic Review.
Source
Bezmialem Science. 12(1) (pp 137-144), 2024. Date of Publication: January
2024.
Author
Ozsoy H.; Yesilyaprak T.
Institution
(Ozsoy) Burdur Mehmet Akif Ersoy University, Golhisar Vocational School of
Health Services, First and Emergency Aid Program, Burdur, Turkey
(Yesilyaprak) Pamukkale University, Denizli Vocational School of Health
Services, Anaesthesia Program, Denizli, Turkey
Publisher
Galenos Publishing House
Abstract
The aim of this study was to determine and compare non-pharmacologic
methods for the management of postoperative sore throat in adult patients
undergoing endotracheal intubation. This study used a systematic review of
clinical trials. Articles published between 2010 and 2022 in PubMed,
Scopus, Web of Science, MEDLINE, EBSCOHost databases were included. The
review was organized according to Cochrane Collaboration guidelines and
reported using Preferred Reporting Items for Systematic Reviewsand
Meta-Analyses. A total of 857 articles were retrieved in the initial
search. After reviewing the articles according to the inclusion and
exclusion criteria, a final set of seven articles was evaluated. It was
observed that ASA I-II patients in whom elective surgery was planned were
mostly included in the studies. It was determined that cold vapor, ice
cube, licorice gargle, luo han guo (Monk fruit) herbal tea and tube
warming were used as non-pharmacological methods. Interventions were
performed preoperatively in five of the studies and postoperatively in
two. Numeric pain scale was frequently used to assess sore throat.
Patients' sore throat was most commonly evaluated in the second, fourth
and 24^th hours after extubation. Cold vapor, licorice gargle,
luo han guo herbal tea and tube warming were found to be effective in
reducing sore throat. Several reliable non-pharmacological methods are
available for managing a sore throat in patients undergoing endotracheal
intubation. However, more research is needed to determine the most
effective non-pharmacological approach.<br/>Copyright &#xa9; 2024 by
Bezmialem Vakif University published by Galenos Publishing House.

<49>
Accession Number
2025575080
Title
Real-time ultrasound guidance versus fluoroscopic guidance in thoracic
epidural catheter placement: a single-center, non-inferiority, randomized,
active-controlled trial.
Source
Regional Anesthesia and Pain Medicine. 49(3) (pp 168-173), 2023. Date of
Publication: 23 Jun 2023.
Author
Kwon H.-J.; Lee J.-B.; Lee K.; Shin J.Y.; Jeong S.-M.; Lee J.-H.; Kim
D.-H.
Institution
(Kwon, Lee, Shin, Jeong, Lee, Kim) Department of Anesthesiology and Pain
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Lee) Department of Clinical Epidemiology and Biostatistics, University of
Ulsan College of Medicine, Seoul, South Korea
Publisher
BMJ Publishing Group
Abstract
Introduction Fluoroscopy can improve the success rate of thoracic epidural
catheter placement (TECP). Real-time ultrasound (US)-guided TECP was
recently introduced and showed a high first-pass success rate. We tested
whether real-time US-guided TECP results in a non-inferior first-pass
success rate compared with that of fluoroscopy-guided TECP. Methods In
this single-center, non-inferiority, randomized trial, the primary outcome
was the comparison of the first-pass success rate of TECP between
real-time US guidance (US group) and fluoroscopic guidance (fluoroscopy
group). Secondary outcomes included time to identifying epidural space,
procedure time, total number of needle passes, number of skin punctures,
final success, and cross-over success. Results We randomly assigned 132
patients to the allocated groups. The difference in the first-pass success
rate between the groups did not exceed the non-inferiority margin of 15%
(US group: 66.7% vs fluoroscopy group: 68.2%; difference -1.5%, 95% exact
CI: -14.9% to 11.9%). The difference in the final success rate also did
not differ between the groups (98.5% vs 100.0%; difference -1.5%, 95%
exact CI: -4.0% to 1.0%). The time to identifying epidural space (45.6
(34-62) vs 59.0 (42-77) s, p=0.004) and procedure time (39.5 (28-78) vs
112.5 (93-166) s, p<0.001) were significantly shorter in the US group.
Conclusions Real-time US guidance provided a non-inferior success rate and
shorter time spent on preparation and procedure compared with fluoroscopic
guidance in TECP.<br/>Copyright &#xa9; American Society of Regional
Anesthesia & Pain Medicine 2024. No commercial re-use.

<50>
Accession Number
2031046249
Title
Effect of Seated Cervical Spinal Manipulation on Autonomic Nervous System
Activity as Measured by Heart Rate Variability and Plasma Norepinephrine
Levels: A randomized Pre- and Poststudy.
Source
Journal of Manipulative and Physiological Therapeutics. (no pagination),
2024. Date of Publication: 2024.
Author
Budgell B.S.; Injeyan H.S.; Teodorczyk-Injeyan J.
Institution
(Budgell) Canadian Memorial Chiropractic College, Toronto, ON, Canada
(Injeyan, Teodorczyk-Injeyan) Department of Research and Innovation,
Canadian Memorial Chiropractic College, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to determine whether seated
cervical manipulation produced changes in autonomic nervous system
activity, as measured by heart rate variability and plasma norepinephrine
levels. <br/>Method(s): Ninety-five healthy young adults (ages 20-48
years) were recruited into a single-blinded physiological study, with 47
randomized to a seated cervical manipulation and 44 randomized to a sham
procedure. Heart rate variability in the frequency domain, and plasma
norepinephrine levels were measured prior to, immediately following, and 5
minutes following the intervention. <br/>Result(s): Electrocardiograms
were obtained from 39 subjects in the sham group and 43 subjects in the
manipulation group. No statistically significant changes were found in
measures of heart rate variability in the frequency domain in either the
manipulation or sham groups. Blood samples were obtained from 22 subjects
in the sham group and 27 subjects in the manipulation group. Plasma
norepinephrine levels, as measured by spectrophotometry, declined in both
groups from pre- to immediately postintervention, and they remained at
decreased levels 5 minutes after the interventions. There were no
statistically significant differences between groups in pre- or
postintervention norepinephrine levels. <br/>Conclusion(s): Measures of
heart rate variability and plasma norepinephrine levels did not show that
seated cervical manipulation produced short-term changes in autonomic
nervous system activity compared to a sham procedure in healthy young
adults.<br/>Copyright &#xa9; 2024

<51>
Accession Number
2030972726
Title
Impact of maintaining serum potassium concentration >= 3.6mEq/L versus >=
4.5mEq/L for 120 hours after isolated coronary artery bypass graft surgery
on incidence of new onset atrial fibrillation: Protocol for a randomized
non-inferiority trial.
Source
PLoS ONE. 19(3 March) (no pagination), 2024. Article Number: e0296525.
Date of Publication: March 2024.
Author
Campbell N.G.; Allen E.; Evans R.; Jamal Z.; Opondo C.; Sanders J.;
Sturgess J.; Montgomery H.E.; Elbourne D.; O'Brien B.
Institution
(Campbell) Faculty of Biology, Division of Cardiovascular Sciences, School
of Medical Sciences, Medicine and Health, University of Manchester,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Campbell) Manchester Heart Institute, Manchester University Foundation
NHS Trust, Manchester, United Kingdom
(Allen, Evans, Jamal, Opondo, Sturgess, Elbourne) Clinical Trials Unit,
London School of Hygiene and Tropical Medicine, London, United Kingdom
(Sanders) William Harvey Research Institute, Queen Mary University of
London, London, United Kingdom
(Montgomery) Division of Medicine and Institute for Sport, Exercise and
Health, University College London, London, United Kingdom
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St Bartholomew's Hospital,
Barts Health NHS Trust, London, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland, OH, United States
Publisher
Public Library of Science
Abstract
Background Atrial Fibrillation After Cardiac Surgery (AFACS) occurs in
about one in three patients following Coronary Artery Bypass Grafting
(CABG). It is associated with increased short- and long-term morbidity,
mortality and costs. To reduce AFACS incidence, efforts are often made to
maintain serum potassium in the high-normal range (>= 4.5mEq/L). However,
there is no evidence that this strategy is efficacious. Furthermore, the
approach is costly, often unpleasant for patients, and risks causing harm.
We describe the protocol of a planned randomized non-inferiority trial to
investigate the impact of intervening to maintain serum potassium >= 3.6
mEq/L vs >= 4.5 mEq/L on incidence of new-onset AFACS after isolated
elective CABG. Methods Patients undergoing isolated CABG at sites in the
UK and Germany will be recruited, randomized 1:1 and stratified by site to
protocols maintaining serum potassium at either >= 3.6 mEq/L or >= 4.5
mEq/L. Participants will not be blind to treatment allocation. The primary
endpoint is AFACS, defined as an episode of atrial fibrillation, flutter
or tachycardia lasting >= 30 seconds until hour 120 after surgery, which
is both clinically detected and electrocardiographically confirmed.
Assuming a 35% incidence of AFACS in the 'tight control group', and
allowing for a 10% loss to follow-up, 1684 participants are required to
provide 90% certainty that the upper limit of a one-sided 97.5% confidence
interval (CI) will exclude a > 10% difference in favour of tight potassium
control. Secondary endpoints include mortality, use of hospital resources
and incidence of dysrhythmias not meeting the primary endpoint (detected
using continuous heart rhythm monitoring). Discussion The Tight K Trial
will assess whether a protocol to maintain serum potassium >= 3.6 mEq/L is
non inferior to maintaining serum potassium >= 4.5 mEq/L in preventing
new-onset AFACS after isolated CABG.<br/>Copyright &#xa9; 2024 Campbell et
al.

<52>
Accession Number
2030749857
Title
Incidence, Predictors, and Impact of Hospital Readmission After
Revascularization for Left Main Coronary Disease.
Source
Journal of the American College of Cardiology. 83(11) (pp 1073-1081),
2024. Date of Publication: 19 Mar 2024.
Author
Kosmidou I.; Shahim B.; Dressler O.; Redfors B.; Morice M.-C.; Puskas
J.D.; Kandzari D.E.; Karmpaliotis D.; Brown W.M.; Lembo N.J.; Banning
A.P.; Kappetein A.P.; Serruys P.W.; Sabik J.F.; Stone G.W.
Institution
(Kosmidou, Lembo) Memorial Sloan Kettering Cancer Center, New York and
Weill Cornell College of Medicine, New York, NY, United States
(Kosmidou, Shahim, Dressler, Redfors, Lembo) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Morice) Hopital prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Puskas) Mount Sinai Heart at Mount Sinai Saint Luke's, New York, NY,
United States
(Kandzari, Brown) Piedmont Heart Institute, Atlanta, GA, United States
(Karmpaliotis) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Serruys) Department of Cardiology, NUIG, National University of Ireland,
Galway, Ireland
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The frequency of and relationship between hospital
readmissions and outcomes after revascularization for left main coronary
artery disease (LMCAD) are unknown. <br/>Objective(s): The purpose of this
study was to study the incidence, predictors, and clinical impact of
readmissions following percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) for LMCAD. <br/>Method(s): In the
EXCEL (XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of
Left Main Revascularization) trial, 1,905 patients with LMCAD were
randomized to PCI vs CABG. The cumulative incidence of readmissions was
analyzed with multivariable Anderson-Gill and joint frailty models to
account for recurrent events and the competing risk of death. The impact
of readmission on subsequent mortality within 5-year follow-up was
determined in a time-adjusted Cox proportional hazards model.
<br/>Result(s): Within 5 years, 1,868 readmissions occurred in 851 of
1,882 (45.2%) hospital survivors (2.2 +/- 1.9 per patient with
readmission[s], range 1-16), approximately one-half for cardiovascular
causes and one-half for noncardiovascular causes (927 [49.6%] and 941
[50.4%], respectively). One or more readmissions occurred in 463 of 942
(48.6%) PCI patients vs 388 of 940 (41.8%) CABG patients (P = 0.003).
After multivariable adjustment, PCI remained an independent predictor of
readmission (adjusted HR: 1.22; 95% CI: 1.10-1.35; P < 0.0001), along with
female sex, comorbidities, and the extent of CAD. Readmission was
independently associated with subsequent all-cause death, with interaction
testing indicating a higher risk after PCI than CABG (adjusted HR: 5.72;
95% CI: 3.42-9.55 vs adjusted HR: 2.72; 95% CI: 1.64-4.88, respectively;
P<inf>int</inf> = 0.03). <br/>Conclusion(s): In the EXCEL trial,
readmissions during 5-year follow-up after revascularization for LMCAD
were common and more frequent after PCI than CABG. Readmissions were
associated with an increased risk of all-cause death, more so after PCI
than with CABG.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<53>
Accession Number
2030287812
Title
Comparison of Multiple Injection Costotransverse Block and Erector Spinae
Plane Block for Post-Sternotomy Pain Relief in Pediatric Patients
Undergoing Cardiac Surgery: A Prospective Randomized Comparative Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 974-981),
2024. Date of Publication: April 2024.
Author
Somani S.; Makhija N.; Chauhan S.; Bhoi D.; Das S.; Bandi S.G.; Rajashekar
P.; Bisoi A.K.
Institution
(Somani, Makhija, Chauhan, Das) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
(Bhoi) Department of Anaesthesiology, Pain Medicine and Critical Care, All
India Institute of Medical Sciences, New Delhi, India
(Bandi, Rajashekar, Bisoi) Department of Cardiothoracic and Vascular
Surgery, All India Institute of Medical Sciences, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: The aim of this study was to evaluate the efficacy of
ultrasound-guided multiple injection costotransverse block (MICB) and
compare it with erector spinae plane block (ESPB) for poststernotomy pain
relief in pediatric cardiac surgical patients. <br/>Design(s): A
prospective, randomized, double-blind, comparative study. <br/>Setting(s):
At a single institution tertiary referral cardiac center.
<br/>Participant(s): A total of 90 children with acyanotic congenital
heart disease requiring surgery via sternotomy. <br/>Intervention(s):
Children were allocated randomly to 1 of the 3 following groups: ESPB
(group 1), MICB (group 2), or Control (group 3). Participants in groups 1
and 2 received 4 mg/kg of 0.2% ropivacaine for bilateral ultrasound-guided
block after induction of anesthesia. Postoperatively, intravenous
paracetamol was used for multimodal analgesia, and fentanyl/tramadol was
used for rescue analgesia. <br/>Measurements and Main Results: The
modified objective pain score (MOPS) was evaluated at 0, 1, 2, 4, 6, 8,
10, and 12 hours postextubation. After all exclusions, 84 patients were
analyzed. The MOPS score was found to be significantly lower in ESPB and
MICB groups compared to the control group until 10 hours postextubation (p
< 0.05), with no statistically significant difference at the 12th hour (p
= 0.2198). The total intraoperative fentanyl consumption (p = 0.0005),
need for fentanyl supplementation on incision (p < 0.0001), and need for
rescue opioid requirement in the postoperative period (p = 0.034) were
significantly lower in both the ESPB and MICB groups than the control
group. There were no statistically significant differences in both primary
and secondary outcomes between the ESPB and MICB groups.
<br/>Conclusion(s): Ultrasound-guided MICB was effective and comparable to
ESPB for post-sternotomy pain management in pediatric cardiac surgical
patients.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<54>
Accession Number
2030255900
Title
Race and Ethnicity in Cardiac Surgery: A Missed Opportunity?.
Source
Annals of Thoracic Surgery. 117(4) (pp 714-722), 2024. Date of
Publication: April 2024.
Author
Elfaki L.A.; Nwakoby A.; Keshishi M.; Vervoort D.; Yanagawa B.; Fremes
S.E.
Institution
(Elfaki, Nwakoby, Keshishi, Yanagawa) Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Vervoort, Yanagawa) Division of Cardiac Surgery, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Vervoort, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Vervoort, Fremes) Division of Cardiac Surgery, Sunnybrook Health Sciences
Centre, University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patients' race and/or ethnicity are increasingly being
associated with differential surgical access and outcomes in cardiac
surgery. However, deriving evidence-based conclusions that can inform
surgical care has been difficult because of poor diversity in study
populations and conflicting research methodology and findings. Using a
fictional patient example, this review identifies areas of concern in
research engagement, methodology, and analyses, as well as potential steps
to improve race and ethnicity considerations in cardiac surgical research.
<br/>Method(s): A narrative literature review was performed using the
PubMed/MEDLINE and Google Scholar databases, with a combination of cardiac
surgery, race, ethnicity, and disparities keywords. <br/>Result(s): Less
than half of the published cardiac surgery randomized control trials
report the race and/or ethnicity of research participants. Racial and/or
ethnic minorities make up <20% of most study populations and are
significantly underrepresented relative to their proportions of the
general population. Further, race and/or ethnicity of research
participants is variably categorized based on ancestry, geographic
regions, cultural similarities, or minority status. There is growing
consideration of analyzing interrelated and confounding variables, such as
socioeconomic status, geographic location, or hospital quality, to better
elucidate racial and/or ethnic disparities; however, intersectionality
considerations remain limited in cardiac surgery research.
<br/>Conclusion(s): Racial and/or ethnic disparities are increasingly
being reported in research engagement, cardiac pathologies, and surgical
outcomes. To promote equitable surgical care, tangible efforts are needed
to recruit racially and/or ethnically minoritized patients to research
studies, be transparent and consistent in their groupings, and elucidate
the impact of their intersectional social identities.<br/>Copyright &#xa9;
2024 The Society of Thoracic Surgeons

<55>
Accession Number
2028980675
Title
Right ventricular outflow tract obstruction in twin-to-twin transfusion
syndrome undergoing laser surgery: A systematic review and meta-analysis.
Source
Acta Obstetricia et Gynecologica Scandinavica. (no pagination), 2024.
Date of Publication: 2024.
Author
Mustafa H.J.; Jawwad M.; IqbalMansoor A.; Pagani G.; D'Antonio F.; Khalil
A.
Institution
(Mustafa) Division of Maternal-Fetal Medicine, Indiana University School
of Medicine, Indianapolis, IN, United States
(Mustafa) The Fetal Center at Riley Children's and Indiana University
Health, Indianapolis, IN, United States
(Jawwad, Iqbal Mansoor) Department of Medicine and Surgery, Dow University
of Health and Sciences, Karachi, Pakistan
(Pagani) Maternal Fetal Medicine Unit, Department of Obstetrics and
Gynecology, ASST-Papa Giovanni XXIII, Bergamo, Italy
(D'Antonio) Center for Fetal Care and High-Risk Pregnancy, Department of
Obstetrics and Gynecology, University Hospital of Chieti, Chieti, Italy
(Khalil) Fetal Medicine Unit, St George's Hospital, St George's University
of London, London, United Kingdom
(Khalil) Vascular Biology Research Centre, Molecular and Clinical Sciences
Research Institute, St George's University of London, London, United
Kingdom
(Khalil) Twins Trust Centre for Research and Clinical Excellence, St
George's University of London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: We aimed to investigate the incidence, prenatal factors and
outcomes of twin-to-twin transfusion (TTTS) with right ventricular outflow
tract obstruction (RVOTO). <br/>Material(s) and Method(s): A systematic
search was conducted to identify relevant studies published until February
2023 in English using the databases PubMed, Scopus and Web of Science.
Studies reporting on pregnancies with TTTS and RVOTO were included. The
random-effect model pooled the mean differences or odds ratios (OR) and
the corresponding 95% confidence intervals. Heterogeneity was assessed
using the I² value. <br/>Result(s): A total of 17 studies
encompassing 4332 TTTS pregnancies, of which 225 cases had RVOTO, were
included. Incidence of RVOTO at time of TTTS diagnosis was 6%. In all,
134/197 (68%) had functional pulmonary stenosis and 62/197 (32%) had
functional pulmonary atresia. Of these, 27% resolved following laser and
55% persisted after birth. Of those persisting, 27% required cardiac valve
procedures. Prenatal associations were TTTS stage III (53% vs 39% in
no-RVOTO), stage IV TTTS (28% in RVOTO vs 12% in no-RVOTO) and ductus
venosus reversed a-wave (60% in RVOTO vs 19% in no-RVOTO). Gestational age
at laser and gestational age at delivery were comparable between groups.
Survival outcomes were also comparable between groups, including fetal
demise of 26%, neonatal death of 12% and 6-month survival of 82% in RVOTO
group. Findings were similar when subgroup analysis was done for studies
including head-to-head analysis. <br/>Conclusion(s): RVOT occurs in about
6% of the recipient twins with TTTS, especially in stages III and IV and
those with reversed ductus venosus a-wave. The findings from this
systematic review support the need for a thorough cardiac assessment of
pregnancies complicated by TTTS, both before and after laser, to maximize
perinatal outcome, and the importance of early diagnosis of TTTS and
timely management.<br/>Copyright &#xa9; 2024 The Authors. Acta Obstetricia
et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf
of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

<56>
Accession Number
2028958271
Title
Cerebral Embolic Protection Devices for Transcatheter Aortic Valve
Replacement: Review of the Literature and Future Perspectives.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Ng S.; Cunningham T.; Vavalle J.P.
Institution
(Ng, Vavalle) Division of Cardiology, University of North Carolina at
Chapel Hill, 160 Dental Circle, Chapel Hill, NC 27599-7075, United States
(Cunningham) Campbell University School of Osteopathic Medicine,
Lillington, NC, United States
(Vavalle) Structural Heart Disease Program, University of North Carolina
at Chapel Hill, 160 Dental Circle, Chapel Hill, NC 27599-7075, United
States
(Vavalle) School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC 27599-7075, United States
Publisher
Springer
Abstract
Purpose of Review: Transcatheter aortic valve replacement (TAVR) has been
a revolutionary therapy in the treatment of aortic valve stenosis. The
risk of stroke associated with TAVR has decreased significantly since its
introduction; however, it remains a devastating complication when it does
occur. Recent Findings: Many of the strokes associated with TAVR occur
peri-procedurally and are thought to be due to embolic debris entering the
cerebrovascular circulation. A number of different cerebral embolic
protection devices (CEPD) have been developed and are in various stages of
testing and use. <br/>Summary: The results from clinical trials evaluating
the role for CEPD to reduce the risk of stroke have been mixed. As a
result, their uptake has been very heterogeneous. This review provides a
summary of the diverse CEPD devices available for use and outlines the
clinical evidence available to date.<br/>Copyright &#xa9; The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<57>
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.

<58>
Accession Number
2031047913
Title
Effect of Adding Early Bedside Cycling to Inpatient Cardiac Rehabilitation
on Physical Function and Length of Stay After Heart Valve Surgery: A
Randomized Controlled Trial.
Source
Archives of Physical Medicine and Rehabilitation. (no pagination), 2024.
Date of Publication: 2024.
Author
Ahmad A.M.; Abusarea S.A.; Fouad B.Z.; Guirguis S.A.; Shafie W.A.
Institution
(Ahmad, Abusarea, Guirguis) Department of Physical Therapy for
Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy,
Cairo University, Giza, Egypt
(Fouad) Department of Cardiology, National Heart Institute, Giza, Egypt
(Shafie) Intensive Care Unit, National Heart Institute, Giza, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To assess whether adding bedside cycling to inpatient cardiac
rehabilitation (CR) early after heart valve surgery could lead to better
physical function and shorter length of hospital stays. <br/>Design(s):
This is a single-centered, randomized, controlled, parallel-group
intervention study. <br/>Setting(s): This study was conducted at the
National Heart Institute from December 2022 to June 2023.
<br/>Participant(s): Thirty-one patients following heart valve surgery
completed this study after being randomized into 2 groups: an intervention
group (n<inf>1</inf>=16) and an active control group (n<inf>2</inf>=15).
Eligibility criteria were heart valve surgery with median sternotomy,
clinical stability, and age from 20 to 40 years. <br/>Intervention(s): The
intervention group received early bedside cycling for the lower limbs,
using a mini bike, in addition to an inpatient CR program, and the control
group received the inpatient CR program alone. <br/>Main Outcome
Measure(s): The primary outcome was the physical functional capacity
assessed by the 6-minute walk distance (6MWD). The secondary outcomes were
the Barthel Index (BI), the forced vital capacity (FVC), the length of
intensive care unit (ICU) stay, the total length of hospital stay, and the
physical component summary (PCS) of the 12-item Short Form (SF-12) Health
Survey. <br/>Result(s): Compared with the control group, the intervention
group showed significantly greater 6MWD (P<.001), BI score (P<.001), and
FVC (P=.006) at hospital discharge, and shorter ICU stay (P=.002) and
total hospital stay (P=.015). At 1-month follow-up, the intervention group
showed a non-significantly higher PCS mean score than the control group
(P=.057). <br/>Conclusion(s): Adding early bedside cycling to a usual
inpatient CR program after heart valve surgery could induce significantly
greater short-term physical functional capacity as assessed by the 6MWD,
better activities of daily living as evaluated by the BI, higher pulmonary
function as measured by the FVC, and shorter lengths of ICU and total
hospital stays than the usual inpatient CR program alone.<br/>Copyright
&#xa9; 2024 American Congress of Rehabilitation Medicine

<59>
Accession Number
2028963456
Title
A New Frontier for Drug-Coated Balloons: Treatment of "De Novo" Stenosis
in Large Vessel Coronary Artery Disease.
Source
Journal of Clinical Medicine. 13(5) (no pagination), 2024. Article Number:
1320. Date of Publication: March 2024.
Author
Sciahbasi A.; Mazza T.M.; Pidone C.; Samperi S.; Cittadini E.; Granatelli
A.
Institution
(Sciahbasi, Mazza, Pidone, Samperi, Cittadini, Granatelli) Interventional
Cardiology, Sandro Pertini Hospital-ASL RM2, Rome 00157, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Drug-coated balloons (DCB) are a well-established option for
treating in-stent restenosis endorsed by European Guidelines on myocardial
revascularization. However, in recent years, a strategy of "leaving
nothing behind" with DCB in de novo coronary stenosis has emerged as an
appealing approach. <br/>Method(s): We performed a systematic review to
evaluate the current literature on the use of drug-coated balloons in the
treatment of de novo stenosis in large vessel disease. <br/>Result(s):
Observational studies, as well as randomized studies, demonstrated the
safety of DCB percutaneous coronary interventions (PCI) in large vessel
disease. The rate of major adverse cardiac events is even lower compared
to drug-eluting stents in stable coronary artery disease.
<br/>Conclusion(s): DCB PCI is feasible in large vessel disease, and
future large, randomized studies are ongoing to confirm these
results.<br/>Copyright &#xa9; 2024 by the authors.

<60>
Accession Number
2028963446
Title
Mechanical Circulatory Support Systems in Fulminant Myocarditis: Recent
Advances and Outlook.
Source
Journal of Clinical Medicine. 13(5) (no pagination), 2024. Article Number:
1197. Date of Publication: March 2024.
Author
Lenz M.; Krychtiuk K.A.; Zilberszac R.; Heinz G.; Riebandt J.; Speidl W.S.
Institution
(Lenz, Krychtiuk, Zilberszac, Heinz, Speidl) Department of Internal
Medicine II, Division of Cardiology, Medical University of Vienna, Vienna
1090, Austria
(Lenz, Speidl) Ludwig Boltzmann Institute for Cardiovascular Research,
Waehringer Guertel 18-20, Vienna 1090, Austria
(Riebandt) Department of Cardiac Surgery, Medical University of Vienna,
Vienna 1090, Austria
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Fulminant myocarditis (FM) constitutes a severe and
life-threatening form of acute cardiac injury associated with cardiogenic
shock. The condition is characterised by rapidly progressing myocardial
inflammation, leading to significant impairment of cardiac function. Due
to the acute and severe nature of the disease, affected patients require
urgent medical attention to mitigate adverse outcomes. Besides
symptom-oriented treatment in specialised intensive care units (ICUs), the
necessity for temporary mechanical cardiac support (MCS) may arise.
Numerous patients depend on these treatment methods as a bridge to
recovery or heart transplantation, while, in certain situations, permanent
MCS systems can also be utilised as a long-term treatment option.
<br/>Method(s): This review consolidates the existing evidence concerning
the currently available MCS options. Notably, data on venoarterial
extracorporeal membrane oxygenation (VA-ECMO), microaxial flow pump, and
ventricular assist device (VAD) implantation are highlighted within the
landscape of FM. <br/>Result(s): Indications for the use of MCS,
strategies for ventricular unloading, and suggested weaning approaches are
assessed and systematically reviewed. <br/>Conclusion(s): Besides general
recommendations, emphasis is put on the differences in underlying
pathomechanisms in FM. Focusing on specific aetiologies, such as
lymphocytic-, giant cell-, eosinophilic-, and COVID-19-associated
myocarditis, this review delineates the indications and efficacy of MCS
strategies in this context.<br/>Copyright &#xa9; 2024 by the authors.

<61>
Accession Number
2028394601
Title
Cardiovascular Symptoms, Dysautonomia, and Quality of Life in Adult and
Pediatric Patients with Hypermobile Ehlers-Danlos Syndrome: A Brief
Review.
Source
Current Cardiology Reviews. 20(1) (no pagination), 2024. Article Number:
e240124226070. Date of Publication: 2024.
Author
Hertel A.; Black W.R.; Walton L.M.; Martin J.R.; Jones J.T.
Institution
(Hertel) School of MedicineUniversity of Kansas Medical Center, Kansas
City, KS, United States
(Black, Walton, Jones) Department of PediatricsUniversity of Kansas School
of Medicine, Kansas City, KS, United States
(Black) Center for Children's Healthy Lifestyles and NutritionChildren's
Mercy Kansas City, Kansas City, MO, United States
(Black) Center for Biobehavioral HealthAbigail Wexner Research Institute
at Nationwide Children's HospitalThe Ohio State University, Columbus,
United States
(Walton, Martin, Jones) Department of PediatricsChildren's Mercy Kansas
City, Kansas City, MO, United States
(Walton, Jones) Department of PediatricsUniversity of MissouriKansas City
School of Medicine, Kansas City, MO, United States
Publisher
Bentham Science Publishers
Abstract
Background: Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective
tissue disorder characterized by joint hypermobility and other systemic
manifestations, such as cardiovascular symptoms, musculoskeletal pain, and
joint instability. Cardiovascular symptoms, such as lightheadedness and
palpitations, and types of dysautonomia, including postural orthostatic
tachycardia syndrome (POTS), are frequently reported in adults with hEDS
and have been shown to negatively impact quality of life (QoL).
<br/>Objective(s): This brief review will be an overview of co-occurring
symptoms in POTS and hEDS to inform potential cardiovascular screening
procedures. <br/>Result(s): While many patients with hEDS report
cardiovascular symptoms, few have structural abnormalities, suggesting
that dysautonomia is likely responsible for these symptoms. One validated
screening measure for dysautonomia symptom burden is the Composite
Autonomic Symptom Scale (COMPASS-31). Studies have found that adults with
POTS, hEDS, and both POTS and hEDS have higher COMPASS-31 scores than the
general population, suggesting a high symptom burden due to dysautonomia,
which leads to impaired QoL. <br/>Conclusion(s): While studies have
examined cardiovascular symptoms and the impact of dysautonomia in adults
with and without hEDS, there is scant literature on dysautonomia in
pediatric patients with hEDS. Therefore, more studies on cardiovascular
symptoms and dysautonomia, as they relate to the quality of life in
pediatric patients with hEDS, are needed. This brief review summarizes the
current literature on dysautonomia and cardiovascular symptoms in
pediatric and adult populations with hEDS.<br/>Copyright &#xa9; 2024
Bentham Science Publishers.

<62>
Accession Number
2030994893
Title
Strategy to optimize PeriproCeduraL AnticOagulation in structural
transseptal interventions: Design and rationale of the STOP CLOT trial.
Source
American Heart Journal. 271 (pp 68-75), 2024. Date of Publication: May
2024.
Author
Pregowski J.; Pracon R.; Mioduszewska A.; Skowronski J.; Sondergaard L.;
Mintz G.S.; Capodanno D.; Kim S.-W.; De Baker O.; Wacinski P.; Wojakowski
W.; Rdzanek A.; Grygier M.; Chmielecki M.; Franco L.N.; Stoklosa P.; Firek
B.; Marczak M.; Milosz B.; Chmielak Z.; Demkow M.; Witkowski A.
Institution
(Pregowski, Pracon, Mioduszewska, Skowronski, Stoklosa, Firek, Marczak,
Milosz, Chmielak, Demkow, Witkowski) National Institute of Cardiology,
Warsaw, Poland
(Sondergaard) Abbott, Santa Clara, CA, United States
(Mintz) Cardiovascular Research Foundation, New York, NY, United States
(Capodanno) Policlinico "G. Rodolico-San Marco", University of Catania,
Catania, Italy
(Kim) Chung-Ang University Hospital, Seoul, South Korea
(De Baker) Rigshospitalet - Copenhagen University Hospital, Copenhagen,
Denmark
(Wacinski) Samodzielny Publiczny Szpital Kliniczny 4 w Lublinie, Lublin,
Poland
(Wojakowski) Gornoslaskie Centrum Medyczne im prof. L. Gieca Slaskiego
Uniwersytetu Medycznego, Katowice, Poland
(Rdzanek) Uniwersyteckie Centrum Medyczne Warszawskiego Uniwersytetu
Medycznego, Warsaw, Poland
(Grygier) Uniwersytecki Szpital Kliniczny w Poznaniu, Poznan, Poland
(Chmielecki) Kliniczne Centrum Kardiologii, Uniwersyteckie, Centrum
Kliniczne, Gdanski, Poland
(Franco) Hospital Clinico San Carlos, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Both transcatheter edge-to-edge repair (TEER) of mitral
regurgitation or left atrial appendage closure (LAAC) require
periprocedural anticoagulation with unfractionated heparin (UFH) that is
administered either before or immediately after transseptal puncture
(TSP). The optimal timing of UFH administration (before or after TSP) is
unknown. The Strategy To Optimize PeriproCeduraL AnticOagulation in
Structural Transseptal Interventions trial (STOP CLOT Trial) was designed
to determine if early anticoagulation is effective in reducing ischemic
complications without increasing the risk of periprocedural bleeding.
<br/>Method(s): The STOP CLOT trial is a multicenter, prospective,
double-blind, placebo-controlled, randomized trial. A total of 410
patients scheduled for TEER or LAAC will be randomized 1:1 either early
UFH administration (iv. bolus of 100 units/kg UFH or placebo, given after
obtaining femoral vein access and at least 5 minutes prior to the start of
the TSP) or late UFH administration (iv. bolus of 100 units/kg UFH or
placebo given immediately after TSP). Prespecified preliminary statistical
analysis will be performed after complete follow-up of the first 196
randomized subjects. To ensure blinding, a study nurse responsible for
randomization and UFH/placebo preparation is not involved in the care of
the patients enrolled into the study. The primary study endpoint is a
composite of (1) major adverse cardiac and cerebrovascular events (death,
stroke, TIA, myocardial infarction, or peripheral embolization) within 30
days post-procedure, (2) intraprocedural fresh thrombus formation in the
right or left atrium as assessed with periprocedural transesophageal
echocardiography, or (3) occurrence of new ischemic lesions (diameter >=4
mm) on brain magnetic resonance imaging performed 2 to 5 days after the
procedure. The safety endpoint is the occurrence of moderate or severe
bleeding complications during the index hospitalization.
<br/>Conclusion(s): Protocols of periprocedural anticoagulation
administration during structural interventions have never been tested in a
randomized clinical trial. The Stop Clot trial may help reach consensus on
the optimal timing of initiation of periprocedural anticoagulation.
Clinical trials registration number: The study protocol is registered at
ClinicalTrials.gov, identifier NCT05305612.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<63>
Accession Number
643752253
Title
Effectiveness and safety of enhanced postoperative care units for
non-cardiac, non-neurological surgery: a systematic review protocol.
Source
JBI evidence synthesis. (no pagination), 2024. Date of Publication: 14
Mar 2024.
Author
Tran L.; Stern C.; Harford P.; Ludbrook G.; Whitehorn A.
Institution
(Tran, Stern, Harford, Whitehorn) JBI, Faculty of Health and Medical
Sciences, School of Public Health, University of Adelaide, SA, Australia
(Tran, Ludbrook) Department of Anaesthesia, Royal Adelaide Hospital,
Central Adelaide Local Health Network, Adelaide, SA, Australia
(Tran, Harford, Ludbrook) Royal Adelaide Hospital, Central Adelaide Local
Health Network, Adelaide, SA, Australia
(Ludbrook) Discipline of Acute Care Medicine, University of Adelaide,
Adelaide, SA, Australia
Abstract
OBJECTIVE: The proposed systematic review will evaluate the evidence on
the effectiveness and safety of enhanced post-operative care (EPC) units
on patient and health service outcomes in adult patients following
non-cardiac, non-neurological surgery. INTRODUCTION: The increase in
surgical procedures globally has placed a significant economic and
societal burden on health care systems. Recognizing this challenge, EPC
units have emerged as a model of care, bridging the gap between
traditional, ward-level care and intensive care. EPC offers benefits such
as higher staff-to-patient ratios, close patient monitoring (eg, invasive
monitoring), and access to critical interventions (eg, vasopressor
support). However, there is a lack of well-established guidelines and
empirical evidence regarding the safety and effectiveness of EPC units for
adult patients following surgery. INCLUSION CRITERIA: This review will
include studies involving adult patients (>= 18 years) undergoing any
elective or emergency non-cardiac, non-neurological surgery, who have been
admitted to an EPC unit. Experimental, quasi-experimental, and
observational study designs will be eligible. <br/>METHOD(S): This review
will follow the JBI methodology for systematic reviews of effectiveness.
The search strategy will identify published and unpublished studies from
the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), and Scopus, as well
as gray literature sources, from 2010 to the present. Two independent
reviewers will screen studies, extract data, and critically appraise
selected studies using standardized JBI assessment tools. Where feasible,
a statistical meta-analysis will be performed to combine study findings.
The certainty of evidence will be assessed using the Grading of
Recommendations, Assessment, Development and Evaluation (GRADE)
methodology. REVIEW REGISTRATION NUMBER: PROSPERO
CRD42023455269.<br/>Copyright &#xa9; 2024 JBI.

<64>
Accession Number
643748070
Title
Effectiveness of non-pharmacological interventions in improving sleep
quality after cardiac surgery: A systematic review and meta-analysis.
Source
Journal of clinical nursing. (no pagination), 2024. Date of Publication:
13 Mar 2024.
Author
Soh P.Q.P.; Wong W.H.T.; Roy T.; Tam W.W.S.
Institution
(Soh, Wong, Roy, Tam) Alice Lee Centre for Nursing Studies, Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Soh) Tan Tock Seng Hospital, Singapore
(Wong) Singapore General Hospital, Singapore
Abstract
BACKGROUND: Sleep disturbance is highly prevalent among post-operative
cardiac patients, with negative impacts on surgical recovery and
rehabilitation. Post-operative pain and anxiety commonly seen in cardiac
surgery patients are associated with poor sleep. Sleep medications
commonly used are not ideal with prolonged usage, and non-pharmacological
interventions can be good alternatives or complements. AIM: To examine
effectiveness of non-pharmacological interventions in post-operative
cardiac settings on sleep quality, pain intensity and anxiety. DESIGN:
Systematic review and meta-analysis. <br/>METHOD(S): PubMed, CENTRAL,
Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were
searched on 12 October 2022. Randomised controlled trials of
non-pharmacological interventions examining sleep quality for adult
post-operative cardiac patients were included. Included studies were
appraised using Cochrane Risk of Bias tool version 1. Meta-analysis was
conducted using RevMan version 5.4.1, and heterogeneity was assessed using
I2 statistics and Cochran Q's test. <br/>RESULT(S): Eighteen studies
involving 1701 participants were identified. Coronary artery bypass graft
was most common. Non-pharmacological interventions varied in types and
duration. All intervention groups were compared to usual care, placebo, no
interventions or active comparators. Statistically significant improvement
in sleep quality (SMD = -.91, 95% CI = -1.17 to -.65) was found among
intervention groups that explored cognitive behavioural therapy,
relaxation techniques, exercise, massage, acupressure, aromatherapy,
music, eye mask and earplugs. Pain intensity was reduced (SMD = -.63, 95%
CI = -1.05 to -.20) with cognitive behavioural therapy, relaxation
techniques, massage, music and eye mask. Anxiety was improved (SMD = -.21,
95% CI = -.38 to -.04) with exercise and music. <br/>CONCLUSION(S): The
overall use of non-pharmacological interventions can optimise sleep after
cardiac surgery. Further research with greater methodological rigour is
needed to investigate different intervention-related characteristics while
considering potential confounders. RELEVANCE TO CLINICAL PRACTICE:
Post-operative cardiac settings can consider incorporating
non-pharmacological interventions. Patients and healthcare providers can
be better informed about the use of such interventions to improve sleep.
REGISTRATION: PROSPERO CRD42022384991.<br/>Copyright &#xa9; 2024 The
Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

<65>
Accession Number
643733562
Title
Half-dose direct oral anticoagulation versus warfarin for atrial
fibrillation following cardiac surgery.
Source
The Journal of cardiovascular surgery. (no pagination), 2024. Date of
Publication: 12 Mar 2024.
Author
Hashim S.W.; Collazo S.; Greco A.; Mather J.F.; McKay R.G.
Institution
(Hashim, Collazo) Hartford HealthCare Heart and Vascular Institute,
Hartford Hospital, Hartford, CT, United States
(Greco) Salve Regina University, Newport, RI, United States
(Mather) Clinical Research Center, Hartford Hospital, Hartford, CT, United
States
(McKay) Hartford HealthCare Heart and Vascular Institute, Hartford
Hospital, Hartford, CT, United States
Abstract
BACKGROUND: Optimal anticoagulation strategies have not been defined for
patients with atrial fibrillation following cardiac surgery.
<br/>METHOD(S): From a total cohort of 228 patients with pre-existing or
new onset atrial fibrillation following coronary artery bypass grafting
and/or valve surgery, we compared in-hospital and 30-day outcomes in 119
patients treated with low-dose aspirin and a half-dose direct oral
anticoagulant (DOAC) versus 109 treated with low-dose aspirin and
warfarin. <br/>RESULT(S): DOAC patients were older (73.1+/-7.0 vs.
68.7+/-11.4 years, P<0.001) and had a lower incidence of preoperative
atrial fibrillation (37 [31.1%] vs. 69 [63.3%], P<0.001). Otherwise, the
two cohorts were well matched for baseline demographics, cardiovascular
risk factors, comorbidities, prior cardiac history and STS Risk Score. In
comparison to Warfarin patients, DOAC patients had a shorter length of
post-surgical stay (6 [5-8] vs. 7 [5-10] days, P=0.037). The two cohorts,
however, had a similar incidence of stroke, transient ischemic attack,
reoperation for bleeding and postoperative blood bank product usage.
Follow-up 30-day outcomes did not differ between the two groups with
respect to mortality (0 [0.0%] vs. 0 [0.0%], P=1.000) and hospital
readmission (16 [13.4%] vs. 14 [12.8%], P=0.893), although two DOAC
patients required drainage of sanguineous pericardial effusions.
<br/>CONCLUSION(S): In comparison to warfarin, half-dose DOAC
anticoagulation in patients with atrial fibrillation following cardiac
surgery is associated with a shorter postoperative length of stay, without
a significant increase in stroke/transient ischemic attack, reoperation
for bleeding or postoperative blood product transfusion. Follow-up
echocardiography in anticoagulated patients is recommended to rule out
significant sanguineous pericardial effusions in the early postoperative
period following hospital discharge.

<66>
Accession Number
643732746
Title
N-Acetylcysteine To Reduce Mortality For Patients Requiring Cardiac
Catheterization or Cardiac Surgery: A Systematic Review And Meta-Analysis.
Source
Journal of cardiovascular pharmacology. (no pagination), 2024. Date of
Publication: 06 Mar 2024.
Author
Gakuba C.; Dumitrascu A.-D.; Marson P.-E.; Legallois D.; Hanouz J.-L.;
Vivien D.; Martinez De Lizarrondo S.; Gauberti M.; Cerasuolo D.
Institution
(Gakuba, Dumitrascu, Marson, Hanouz) CHU de Caen Normandie, Service
d'Anesthesie Reanimation, Caen 14000, France
(Gakuba, Hanouz, Vivien, Martinez De Lizarrondo, Gauberti) Normandie Univ,
UNICAEN, INSERM, PhIND << Physiopathology and imaging of Neurological
Disorders >>, Institut Blood and Brain @ Caen-Normandie, Caen 14000,
France
(Legallois) . CHU de Caen Normandie, Service de Cardiologie, EA4650
(SEILIRM), FHU REMOD-VHF, 14000 Caen, France
(Vivien) CHU de Caen Normandie, Departement de Recherche Clinique, Caen
14000, France
(Gauberti) CHU de Caen Normandie, Service de Radiologie diagnostique et
interventionnelle, Caen 14000, France
(Cerasuolo) Centre hospitalier universitaire de Caen, Unite de sante
publique, Caen, France
(Cerasuolo) Normandie Univ, UNICAEN, INSERM U1086, Caen, France
Abstract
Multimers of von Willebrand factor (VWF) play a critical role in various
processes inducing morbidity and mortality in cardiovascular risk
patients. With the ability to reduce VWF multimers, N-acetylcysteine (NAC)
could reduce mortality in patients undergoing coronary catheterization or
cardiac surgery. However, its impact in perioperative period has never
been studied so far in regard of its potential cardiovascular benefits.
Then, four databases were searched for randomized controlled trials that
compared in-hospital mortality between an experimental group, with NAC,
and a control group without NAC, in patients undergoing coronary
catheterization or cardiac surgery. The primary efficacy outcome was
in-hospital mortality. Secondary outcomes were the occurrence of
thrombotic events, major cardiovascular events, myocardial infarction, and
contrast induced nephropathy. The safety outcome was occurrence of
hemorrhagic events. Nineteen studies totaling 3718 patients were included.
Pooled analysis demonstrated a reduction of in-hospital mortality
associated with NAC: Odds Ratio (OR), 0.60; 95% CI, 0.39-0.92; P=0.02. The
occurrence of secondary outcomes was not significantly reduced with NAC
except for contrast-induced nephropathy. No difference was reported for
hemorrhagic events. Subgroup analyses revealed a life-saving effect of NAC
in a dose-dependent manner with reduction of in-hospital mortality for the
NAC high-dose group, but not for the NAC standard-dose (<3500 mg) group.
In conclusion, without being able to conclude on the nature of the
mechanism involved, our review suggests a benefit of NAC in cardiovascular
risk patients in perioperative period in terms of mortality and supports
prospective confirmatory studies.<br/>Copyright &#xa9; 2024 Wolters Kluwer
Health, Inc. All rights reserved.

<67>
Accession Number
2030849451
Title
Comparative Study Evaluating Effects of Intravenous Sedation by
Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative
Outcomes in Cardiac Surgery.
Source
Journal of Cardiovascular Disease Research. 15(1) (pp 3252-3256), 2024.
Date of Publication: 2024.
Author
Chhabra V.; Makwana D.; Pandey V.
Institution
(Chhabra) Department of Cardiac Anesthesia, Mahatma Gandhi Hospital,
Sitapur, 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: In cardiac surgery, the choice of intravenous sedatives plays
a crucial role in maintaining hemodynamic stability and ensuring favorable
postoperative outcomes. Dexmedetomidine and propofol are commonly used
agents, each with distinct pharmacological properties. This study aims to
compare the effects of intravenous sedation by dexmedetomidine and
propofol on patient hemodynamics and postoperative outcomes in cardiac
surgery. <br/>Material(s) and Method(s): A prospective comparative study
was conducted on 100 patients undergoing cardiac surgery, randomly
assigned to receive either dexmedetomidine (n=50) or propofol (n=50) for
intravenous sedation. Hemodynamic parameters including heart rate, mean
arterial pressure, and cardiac output were monitored intraoperatively.
Postoperative outcomes such as time to extubation, length of intensive
care unit stay, and incidence of adverse events were recorded. Statistical
analysis was performed using appropriate tests to compare the two groups.
<br/>Result(s): Intraoperatively, patients sedated with dexmedetomidine
exhibited a statistically significant decrease in heart rate (p < 0.05)
compared to the propofol group. Mean arterial pressure remained stable in
both groups throughout the procedure. Additionally, patients in the
dexmedetomidine group had a significantly lower incidence of postoperative
delirium compared to those in the propofol group (p < 0.01). Time to
extubation was comparable between the two groups, with no significant
difference observed. However, patients sedated with dexmedetomidine
experienced a shorter duration of intensive care unit stay compared to the
propofol group (p < 0.05). <br/>Conclusion(s): Intravenous sedation with
dexmedetomidine in cardiac surgery appears to offer superior hemodynamic
stability compared to propofol, as evidenced by decreased heart rate
without compromising mean arterial pressure. Furthermore, dexmedetomidine
is associated with a lower incidence of postoperative delirium and may
contribute to shorter intensive care unit stays compared to propofol.
These findings suggest that dexmedetomidine may be a preferable sedative
agent in cardiac surgery settings.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

<68>
Accession Number
2030394053
Title
Disparities in COVID-19 mortality amongst the immunosuppressed: A
systematic review and meta-analysis for enhanced disease surveillance.
Source
Journal of Infection. 88(3) (no pagination), 2024. Article Number: 106110.
Date of Publication: March 2024.
Author
Leston M.; Elson W.; Ordonez-Mena J.M.; Kar D.; Whitaker H.; Joy M.;
Roberts N.; Hobbs F.D.R.; de Lusignan S.
Institution
(Leston, Elson, Ordonez-Mena, Kar, Joy, Hobbs, de Lusignan) Nuffield
Department of Primary Care Health Sciences, University of Oxford, Oxford
OX2 6GG, United Kingdom
(Whitaker) Immunisation and Vaccine Preventable Diseases Division, UK
Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, United
Kingdom
(Roberts) Bodleian Health Care Libraries, University of Oxford, Old Campus
Road, Old Campus Research Building, Headington, Oxford OX3 7DQ, United
Kingdom
Publisher
W.B. Saunders Ltd
Abstract
Background: Effective disease surveillance, including that for COVID-19,
is compromised without a standardised method for categorising the
immunosuppressed as a clinical risk group. <br/>Method(s): We conducted a
systematic review and meta-analysis to evaluate whether excess
COVID-associated mortality compared to the immunocompetent could
meaningfully subdivide the immunosuppressed. Our study adhered to UK
Immunisation against infectious disease (Green Book) criteria for defining
and categorising immunosuppression. Using OVID (EMBASE, MEDLINE,
Transplant Library, and Global Health), PubMed, and Google Scholar, we
examined relevant literature between the entirety of 2020 and 2022. We
selected for cohort studies that provided mortality data for
immunosuppressed subgroups and immunocompetent comparators. Meta-analyses,
grey literature and any original works that failed to provide comparator
data or reported all-cause or paediatric outcomes were excluded. Odds
Ratios (OR) and 95% confidence intervals (CI) of COVID-19 mortality were
meta-analysed by immunosuppressed category and subcategory. Subgroup
analyses differentiated estimates by effect measure, country income, study
setting, level of adjustment, use of matching and publication year. Study
screening, extraction and bias assessment were performed blinded and
independently by two researchers; conflicts were resolved with the
oversight of a third researcher. PROSPERO registration number is
CRD42022360755. <br/>Finding(s): We identified 99 unique studies,
incorporating data from 1,542,097 and 56,248,181 unique immunosuppressed
and immunocompetent patients with COVID-19 infection, respectively.
Compared to immunocompetent people (pooled OR, 95%CI), solid organ
transplants (2.12, 1.50-2.99) and malignancy (2.02, 1.69-2.42) patients
had a very high risk of COVID-19 mortality. Patients with rheumatological
conditions (1.28, 1.13-1.45) and HIV (1.20, 1.05-1.36) had just slightly
higher risks than the immunocompetent baseline. Case type, setting income
and mortality data matching and adjustment were significant modifiers of
excess immunosuppressed mortality for some immunosuppressed subgroups.
<br/>Interpretation(s): Excess COVID-associated mortality among the
immunosuppressed compared to the immunocompetent was seen to vary
significantly across subgroups. This novel means of subdivision has
prospective benefit for targeting patient triage, shielding and
vaccination policies during periods of high disease
transmission.<br/>Copyright &#xa9; 2024 The Authors

<69>
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.

<70>
Accession Number
2030257085
Title
Systematic Review and Case of Thrombectomy for Pediatric Stroke Due to
Myxoma Embolism.
Source
World Neurosurgery. 183 (pp e761-e771), 2024. Date of Publication: March
2024.
Author
Bandlamuri S.; Custozzo A.; Silva J.; Bandlamuri S.K.; Qian J.; Paul A.R.
Institution
(Bandlamuri, Custozzo, Silva, Paul) Department of Neurosurgery, Albany
Medical Center, Albany, NY, United States
(Bandlamuri) Department of Computer Science, University of Arizona,
Tucson, AZ, United States
(Qian) Department of Pathology and Laboratory Medicine, Albany Medical
Center, Albany, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Stroke presentation secondary to a cardiac myxoma
thromboembolism is rare in the pediatric population. Because of such
rarity, the reported cases in the literature are primarily case reports.
Additionally, general pediatric stroke management lacks evidence-based
guidelines because of its low incidence and lack of clinical trials. In
pediatric strokes identified from a cardiac myxoma, the incidence favors
boys with the classical presentation of unilateral weakness and aphasia.
We present a pediatric patient who presented with strokelike symptoms
secondary to an intracranial embolus from a previously undiagnosed cardiac
myxoma. <br/>Method(s): We performed a systematic review by searching
PubMed, Google Scholar, Web of Science, and Embase databases for cases of
pediatric myxoma causing stroke (n = 2431) and identified 19 reported uses
of surgical management in treating pediatric patients who present with
stroke symptoms secondary to a cardiac myxoma thromboembolism.
<br/>Result(s): The most common imaging modality was magnetic resonance
imaging in 42% of cases, computed tomography in 36.8%, followed by
computed tomography angiography in 31.6% of cases. Of these 19 children
treated with procedures, 36.8% of pediatric patients aged between 4 and 14
years underwent neurosurgery (n = 7). <br/>Conclusion(s): We describe an
urgent mechanical thrombectomy and share preoperative and postoperative
images and pathology slides confirming a stroke from myxoma origin. We
provide added insight in the safe use of mechanical thrombectomy as
treatment for pediatric strokes secondary to a
thromboembolism.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<71>
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.

<72>
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.

<73>
Accession Number
2028157238
Title
Intracardiac echocardiography guided electrified J-wire trans-septal
puncture: A prospective randomized controlled trial.
Source
PACE - Pacing and Clinical Electrophysiology. 47(3) (pp 448-454), 2024.
Date of Publication: March 2024.
Author
Cheng H.; Bangash A.B.; Tao Y.; Jiang R.; Liu Q.; Cheng C.; Fu G.; Jiang
C.
Institution
(Cheng, Bangash, Tao, Jiang, Liu, Fu, Jiang) Department of Cardiology, Sir
Run Run Shaw Hospital, School of Medicine, Zhejiang University, Key
Laboratory of Cardiovascular Intervention and Regenerative Medicine of
Zhejiang Province, Zhejiang, Hangzhou, China
(Cheng) Department of Cardiology, The Second Hospital of Anhui Medical
University, Anhui, HeFei, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Application of electrocautery to a J-wire is used to perform
transseptal puncture (TSP), but with limited evidence supporting safety
and efficacy. We conducted a prospective randomized controlled trial to
evaluate the safety and efficacy of this technique. <br/>Method(s): Two
hundred consecutive patients were randomized in a 1:1 fashion to either
the ICE-guided electrified J-wire TSP group or a conventional
Brockenbrough (BRK) needle TSP group. The TSP was performed with a 0.032
guidewire under 20 W, "coag" mode and was compared to TSP using the BRK
needle. The primary safety endpoints were complications related to TSP.
The primary efficacy endpoints included the TSP success rate, the total
TSP time, and the total procedure time. <br/>Result(s): All patients
complete the procedure safely. The electrified J-wire TSP group had a
significantly shorter TSP time than BRK needle TSP group. The total
procedure time, number of TSP attempts required to achieve successful LA
access, width of the intra-atrial shunt at the end of ablation were
similar between the two groups. The incidence of new cerebral infarction
detected by MRI were similar between the two groups (3/32 patients in the
J-wire TSP group and 2/26 patients in conventional BRK TSP group, p =.82).
And no difference in the incidence of residual intra-atrial shunt (4.3%
vs. 6%, p =.654) during the 3-month's follow up. <br/>Conclusion(s): Using
an electrified J-wire for TSP under the guidance of ICE appears to be as
safe as and more efficient than conventional BRK needle TSP, which may be
especially useful in the era of non-fluoroscopy AF ablation.<br/>Copyright
&#xa9; 2024 Wiley Periodicals LLC.

<74>
Accession Number
643460392
Title
Systematic review on timing of perioperative pharmacological
thromboprophylaxis initiation and its effect on venous thromboembolism and
bleeding outcomes.
Source
Canadian Urological Association Journal. Conference: 75th Annual Meeting
Of Canadian Urological Association, CUA 2020. Virtual. 14(6 Supplement 2)
(pp S107), 2020. Date of Publication: June 2020.
Author
McAlpine K.; Breau R.H.; Carrier M.; Fergusson D.; Cagiannos I.; Morash
C.G.; Lavallee L.T.
Institution
(McAlpine, Breau, Cagiannos, Morash, Lavallee) Division of Urology, Ottawa
Hospital, Ottawa, ON, Canada
(Breau, Carrier, Fergusson, Cagiannos, Morash, Lavallee) Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Carrier) Department of Medicine, Ottawa Hospital, Ottawa, ON, Canada
Publisher
Canadian Urological Association
Abstract
Introduction: Venous thromboembolism (VTE) and bleeding are important
complications of urological surgery. Thromboprophylaxis guidelines for
urologists are conflicting on timing of the initial dose of perioperative
thromboprophylaxis and are largely based on non-urological literature. We
sought to systematically assess the literature on the effect of the timing
of the initial dose of perioperative thromboprophylaxis on VTE and
bleeding outcomes. <br/>Method(s): EMBASE, MEDLINE, and CENTRAL databases
were search on July 10, 2019 for randomized controlled trials (RCT) that
evaluated VTE and/or bleeding outcomes between groups receiving the
initial dose of thromboprophylaxis at different times perioperatively.
Trials were limited to those that used the same medication between groups
to ensure comparability. Prespecified subgroup analyses of abdominopelvic
surgery (e.g., urological) and orthopedic surgery RCTs were planned.
<br/>Result(s): The initial search resulted in 3067 entries. After manual
review, 21 RCTs including 16 962 randomized patients met full inclusion
criteria. Nine RCTs assessed abdominopelvic surgery, nine assessed
orthopedic surgery, and three assessed other surgeries (e.g., thoracic).
Only three RCTs showed a statistically significant difference between
study groups in VTE (one RCT) or bleeding outcomes (two RCTs). These RCTs
showed increased bleeding and decreased VTE rates with earlier initiation
of thromboprophylaxis. Bleeding outcomes were reported with high
variability with only three RCTs using established definitions for major
and minor bleeding. Most studies were underpowered to detect a difference
between study groups. Variability in the timing and medications between
studies did not allow for a meta-analysis of outcomes. <br/>Conclusion(s):
This systematic review confirms limited high-quality evidence is available
on the optimal timing of the initial dose of perioperative
thromboprophylaxis to prevent VTEs and bleeding. RCTs in urological
patients are necessary to guide best practice.

<75>
Accession Number
643432176
Title
Efficacy and safety of pharmacological prophylaxis for venous
thromboembolism in patients undergoing non-cardiac surgery: A network
meta-analysis.
Source
Canadian Urological Association Journal. Conference: 74th Annual Meeting
of Canadian Urological Association, CUA 2019. Quebec City, QC Canada. 13(6
Supplement 5) (pp S136), 2019. Date of Publication: 2019.
Author
Marcucci M.; Etxeandia I.; Agarwal A.; Gupta S.; Germini F.; Yang S.;
Ventresca M.; Tang S.; Tikkinen K.A.O.; Guyatt G.H.; Violette P.D.
Institution
(Marcucci, Etxeandia, Gupta, Germini, Yang, Ventresca, Guyatt, Violette)
Health Research Methods Evidence and Impact, McMaster University,
Hamilton, ON, Canada
(Agarwal) University of Toronto, Toronto, ON, Canada
(Tang) Epidemiology, School of Public Health, Nanjing Medical University,
Nanjing, China
(Tikkinen) Urology and Public Health, University of Helsinki, Helsinki,
Finland
(Violette) Division of Urology, Division of Urology, London, ON, Canada
Publisher
Canadian Urological Association
Abstract
Introduction: Low-dose low molecular weight heparin (LMWH) and direct oral
anticoagulants (DOAC) may be reasonable alternatives for postoperative
thromboprophylaxis in urology. We, therefore, performed a systematic
review and network meta-analysis (NMA) of randomized controlled trials
(RCTs) of these agents. <br/>Method(s): We searched Medline, Embase, and
Central Cochrane library up to August 2018 to identify RCTs evaluating
LMWH or DOAC in head-tohead comparisons or compared with placebo or no
treatment in patients undergoing non-cardiac surgery. Outcomes included
symptomatic pulmonary embolism (PE), symptomatic venous thromboembolism
(VTE), and major bleeding. We used the Cochrane Collaboration risk of bias
tool, and GRADE assessments of quality are pending. <br/>Result(s): We
included 72 RCTs (62 792 patients) of which 56 involved orthopedic
surgery, nine general, four thoracic, two gynecologic, and one urologic
surgery, typically comparing LMWH to DOAC (32%) or placebo (36%). Studies
reported 99 (0.24%) symptomatic PEs in 40 791 patients, 191 (0.66%)
symptomatic VTEs in 29 085 patients, and 345 (0.86%) major bleedings in 39
921 patients. The majority of studies were generally low risk of bias
(Fig. 1). Compared to LMWH, DOACs may reduce symptomatic VTE (odds ratio
[OR] 0.49; 0.30-0.80; p=0.005) without increase in major bleeding (OR
1.13; 0.81- 1.57; p=0.469). LMWH did not reduce symptomatic VTE (OR 0.54;
0.20,1.45; p=0.219) but did increase major bleeding (OR 1.79; 1.00, 3.23;
p=0.049). Both DOACs and LMWH increased major bleeding relative to placebo
(Table 1). <br/>Conclusion(s): DOACs may be more effective than LMWH at
reducing symptomatic VTE. Difference in efficacy between LMWH and DOAC in
reducing symptomatic PE could not be demonstrated likely due to low event
rates. Our NMA emphasizes the need for an RCT to directly evaluate the
efficacy of pharmacological thromboprophylaxis in urological surgery.

<76>
[Use Link to view the full text]
Accession Number
2030955278
Title
Micronutrients as therapy in critical illness.
Source
Current Opinion in Critical Care. 30(2) (pp 178-185), 2024. Date of
Publication: 01 Apr 2024.
Author
Stoppe C.; Dresen E.; De Man A.
Institution
(Stoppe, Dresen) University Hospital Wuerzburg, Department of
Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Wurzburg,
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, Netherlands
(De Man) Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewRecent 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
findingsNone 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 the 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.SummaryCurrent 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 Lippincott Williams and Wilkins. All
rights reserved.

<77>
Accession Number
2030994894
Title
Transfemoral transcatheter aortic valve replacement with
VitaFlow^TM valve for pure native aortic regurgitation in
patients with high surgical risk: Rationale and design of a prospective,
multicenter, and randomized SEASON-AR trial.
Source
American Heart Journal. 271 (pp 76-83), 2024. Date of Publication: May
2024.
Author
Zhang J.; Kong X.-Q.; Gao X.-F.; Chen J.; Chen X.; Li B.; Shao Y.-B.; Wang
Y.; Jiang H.; Zhu J.-C.; Zhang J.-J.; Chen S.-L.
Institution
(Zhang, Kong, Gao, Zhu, Zhang, Chen) Department of Cardiology, Nanjing
First Hospital, Nanjing Medical University, Nanjing, China
(Chen, Jiang) Department of Cardiology, Renmin Hospital of Wuhan
University, Wuhan University, Wuhan, China
(Chen, Wang) Department of Cardiology, Xiamen Cardiovascular Hospital,
Xiamen University, Xiamen, China
(Li) Department of Cardiology, Zibo Central Hospital, Zibo, China
(Shao) Department of Cardiology, Qingdao Municipal Hospital, Qingdao,
China
Publisher
Elsevier Inc.
Abstract
Background: Previous studies primarily demonstrated that transfemoral
transcatheter aortic valve replacement (TAVR) with self-expanding valve
appeared to be a safe and feasible treatment for patients with pure native
aortic regurgitation (AR). However, the routine application of
transfemoral TAVR for pure AR patients lacks support from randomized
trials. Trial design: SEASON-AR trial is a prospective, multicenter,
randomized, controlled, parallel-group, open-label trial, involving at
least 20 sites in China, aiming to enroll 210 patients with pure native
severe AR and high surgical risk. All enrolled patients are randomly
assigned in a 1:1 fashion to undergo transfemoral TAVR with
VitaFlow^TM valve and receive guideline-directed medical therapy
(GDMT) or to receive GDMT alone. The primary endpoint is the rate of major
adverse cardiac events (MACE) at 12 months after the procedure, defined by
the composite of all-cause mortality, disabling stroke, and
rehospitalization for heart failure. The major secondary endpoints
encompass various measures, including procedure-related complications,
device success, 6-minute walk distance, and the occurrence of each
individual component of the primary endpoint. After hospital discharge,
follow-up was conducted through clinical visits or telephone contact at 1,
6, and 12 months. The follow-up will continue annually until 5 years after
the index procedure to assess the long-term outcomes. <br/>Conclusion(s):
SEASON-AR trial is the first study designed to investigate the clinical
efficacy and safety of transfemoral TAVR with a self-expanding valve in
patients with pure native severe AR with inoperable or high-risk, as
compared to medical treatment only.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<78>
Accession Number
2028517853
Title
A Contemporary Review of the Use of Extracorporeal CytoSorb
Hemoadsorption Therapy in Patients with Infective Endocarditis.
Source
Journal of Clinical Medicine. 13(3) (no pagination), 2024. Article Number:
763. Date of Publication: February 2024.
Author
Gong A.; Li Y.; Yang M.; Wang S.; Su B.
Institution
(Gong, Li, Wang, Su) Department of Nephrology, Kidney Research Institute,
Frontiers Science Center for Disease-Related Molecular Network, West China
Hospital, Sichuan University, Chengdu 610041, China
(Gong, Li, Wang, Su) West China School of Medicine, Sichuan University,
Chengdu 610041, China
(Yang) General Practice Ward/International Medical Center Ward, General
Practice Medical Center, West China Hospital, Sichuan University, Chengdu
610041, China
(Yang) Department of Nephrology, The First People's Hospital of Shuangliu
District, Chengdu 610200, China
(Su) Med+ Biomaterial Institute of West China Hospital/West China School
of Medicine, Sichuan University, Chengdu 610041, China
(Su) Med-X Center for Materials, Sichuan University, Chengdu 610041, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Infective endocarditis (IE) is a rare but severe disease with high
morbidity and mortality. Cardiac surgery plays a major role in the
contemporary clinical management of IE patients. During cardiac surgery,
cardiopulmonary bypass significantly contributes to an increased risk of
organ dysfunction and mortality by inducing an acute inflammatory
response, vascular endothelial cell injury, impairment of the coagulation
cascade, and ischemia-reperfusion injury. During the past decade, the use
of extracorporeal hemoadsorption therapy with the CytoSorb
hemoadsorber (CytoSorbents Europe GmbH, Berlin, Germany) has been proposed
as an adjuvant therapy to mediate inflammatory responses in IE patients
undergoing cardiac surgery with cardiopulmonary bypass. However, there is
currently no systematic evaluation of the effect of CytoSorb
hemoadsorption on clinical outcomes such as hemodynamics, organ
dysfunction, and mortality in patients with IE. Therefore, in this review,
we exclusively discuss contemporary findings concerning the rationale,
clinical evidence, and future perspectives for CytoSorb
hemoadsorption therapy in IE patients.<br/>Copyright &#xa9; 2024 by the
authors.

<79>
Accession Number
2028516409
Title
Perioperative myocardial injury and infarction after noncardiac surgery: a
review of pathophysiology, diagnosis, and management.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1323425. Date of Publication: 2024.
Author
Kashlan B.; Kinno M.; Syed M.
Institution
(Kashlan) Department of Internal Medicine, Loyola University Medical
Center, Maywood, IL, United States
(Kinno, Syed) Department of Cardiology, Loyola University Medical Center,
Maywood, IL, United States
Publisher
Frontiers Media SA
Abstract
Perioperative myocardial injury is a relatively common complication after
noncardiac surgery associated with significant morbidity and mortality. It
is frequently driven by physiologic factors such as hypotension,
tachycardia, and anemia. Diagnosis of perioperative myocardial injury
after noncardiac surgery is based on elevated cardiac troponin levels,
greater than the 99th percentile of the assay's upper reference limit
within 30 days of surgery. Perioperative myocardial injury is further
classified into non-ischemic and ischemic based on the underlying
pathophysiology. Ischemic injury, also called myocardial injury after
non-cardiac surgery (MINS), is further classified into perioperative
myocardial infarction or myocardial injury without infarction. Classifying
perioperative myocardial injury further is particularly important for
clinical management and prognosis. MINS-with or without infarction-is
independently and strongly associated with short- and long-term mortality.
Compared to nonoperative myocardial infarction, perioperative myocardial
infarction carries an increased risk of adverse outcomes including
all-cause mortality. Preventative measures include a thorough preoperative
risk assessment, risk factor optimization, and avoidance of intraoperative
mismatch of myocardial oxygen supply and demand. Surveillance of patients
at higher risk of cardiovascular complications is warranted and can lead
to early recognition, closer monitoring, and appropriate management. This
review will provide a framework for understanding perioperative myocardial
injury and highlight the contemporary literature addressing its diagnosis
and management.<br/>Copyright 2024 Kashlan, Kinno and Syed.

<80>
Accession Number
2030237077
Title
Statin treatment after surgical aortic valve replacement for aortic
stenosis is associated with better long-term outcome.
Source
European Journal of Cardio-thoracic Surgery. 65(2) (no pagination), 2024.
Article Number: ezae007. Date of Publication: 01 Feb 2024.
Author
Pan E.; Nielsen S.J.; Landenhed-Smith M.; Torngren C.; Bjorklund E.;
Hansson E.C.; Jeppsson A.; Martinsson A.
Institution
(Pan) University of Turku, Turku, Finland
(Pan) Department of Surgery, Central Finland Hospital Nova, Jyvaskyla,
Finland
(Nielsen, Landenhed-Smith, Torngren, Bjorklund, Hansson, Jeppsson,
Martinsson) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Nielsen, Landenhed-Smith, Torngren, Hansson, Jeppsson) Department of
Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg,
Sweden
(Martinsson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Bjorklund) Department of Medicine, Southern Alvborg Hospital, Boras,
Sweden
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to evaluate the association between
statin use after surgical aortic valve replacement for aortic stenosis and
long-term risk for major adverse cardiovascular events (MACEs) in a large
population-based, nationwide cohort. <br/>METHOD(S): All patients who
underwent isolated surgical aortic valve replacement due to aortic
stenosis in Sweden 2006-2020 and survived 6 months after discharge were
included. Individual patient data from 5 nationwide registries were
merged. Primary outcome is MACE (defined as all-cause mortality,
myocardial infarction or stroke). Multivariable Cox regression model
adjusted for age, sex, comorbidities, valve type, operation year and
secondary prevention medications is used to evaluate the association
between time-updated dispense of statins and long-term outcome in the
entire study population and in subgroups based on age, sex and
comorbidities. <br/>RESULT(S): A total of 11 894 patients were included.
Statins were dispensed to 49.8% (5918/11894) of patients at baseline, and
51.0% (874/1713) after 10 years. At baseline, 3.6% of patients were
dispensed low dose, 69.4% medium dose and 27.0% high-dose statins. After
adjustments, ongoing statin treatment was associated with a reduced risk
for MACE [adjusted hazard ratio 0.77 (95% confidence interval 0.71-0.83).
P < 0.001], mainly driven by a reduction in all-cause mortality [adjusted
hazard ratio, 0.70 (0.64-0.76)], P < 0.001. The results were consistent in
all subgroups. <br/>CONCLUSION(S): The results suggest that statin therapy
might be beneficial for patients undergoing surgical aortic valve
replacement for aortic stenosis. Randomized controlled trials are
warranted to establish causality between statin treatment and improved
outcome. <br/>Copyright &#xa9; 2024 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<81>
Accession Number
2028957286
Title
Valve Type and Operative Risks in Surgical Explantation of Transcatheter
Aortic Valves: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(5) (no pagination), 2024. Article Number:
1262. Date of Publication: March 2024.
Author
Abbasciano R.G.; Magouliotis D.E.; Koulouroudias M.; Spiliopoulos K.;
Xanthopoulos A.; Kourliouros A.; Casula R.; Athanasiou T.; Viviano A.
Institution
(Abbasciano, Casula, Viviano) Department of Cardiothoracic Surgery,
Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
(Abbasciano, Athanasiou) Department of Surgery & Cancer, Imperial College,
London SW7 2BX, United Kingdom
(Magouliotis) Unit of Quality Improvement, Department of Cardiothoracic
Surgery, University of Thessaly, Biopolis, Larissa 41 110, Greece
(Koulouroudias) Department of Cardiac Surgery, Nottingham University
Hospitals NHS Trust, Nottingham NG7 2UH, United Kingdom
(Spiliopoulos) Department of Cardiothoracic Surgery, University of
Thessaly, Biopolis, Larissa 41 110, Greece
(Xanthopoulos) Department of Cardiology, University Hospital of Larissa,
Larissa 413 34, Greece
(Kourliouros) Department of Cardiothoracic Surgery, John Radcliffe
Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3
9DU, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Indication to perform surgical explantation of TAVR is becoming
increasingly more frequent, due to the higher number of transcatheter
procedures performed in patients with longer life expectancy. We proposed
to perform a systematic review and meta-analysis with metaregression to
identify potential factors that can determine an increase in the high
mortality and morbidity that characterize these surgical procedures.
MEDLINE and Embase were searched for relevant studies. Twelve studies were
eligible according to our inclusion criteria. TAVR explantation was
confirmed as a procedure with high 30-day mortality (0.17; 95% CI,
0.14-0.21) and morbidity (stroke incidence 5%; 95% CI, 0.04-0.07; kidney
injury incidence 16%; 95% CI, 0.11-0.24). The type of transcatheter valve
implanted during the index procedure did not influence the outcomes after
surgical explantation. The role of these high-risk operations is growing,
and it will likely expand in the coming years. Specific tools for risk
stratification are required.<br/>Copyright &#xa9; 2024 by the authors.

<82>
Accession Number
2028017897
Title
Comparison of Intrathecal Dexmedetomidine with Buprenorphine as an
Adjuvant to Hyperbaric Bupivacaine in Infraumbilical Surgeries.
Source
International Journal of Pharmaceutical and Clinical Research. 16(1) (pp
1098-1104), 2024. Date of Publication: 2024.
Author
Das B.; Das A.
Institution
(Das, Das) Department of Anaesthesiology and critical care, Silchar
medical college and hospital, Assam, Silchar 788014, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background and aims: Emerging regional anesthesia trend uses less local
anaesthetic, segmental blocks, supplemented with opioids, alpha2 agonists
for prolonged analgesia and minimizes spinal anaesthesia drawbacks.
Current study evaluated effects of dexmedetomidine (5mug) and
buprenorphine (75mug), with intrathecal hyperbaric bupivacaine (0.5%) for
sensorimotor block and analgesia. <br/>Method(s): This prospective,
randomized controlled, single-blinded study conducted in the Department of
Anaesthesiology, Silchar Medical College, Assam after obtaining ethical
committee clearance. Informed written consent obtained from 120 ASA I/II
patients, aged18-60years, for infraumbilical surgery. Exclusions:
coagulopathy, cardiac issues, pregnancy, obese (>30 BMI), spinal
deformities. Randomly divided (3 groups, n=40 each) via sealed envelopes.
Group BC received 3ml (15mg) of 0.5% Bupivacaine heavy + 0.5ml of normal
saline (control). Group BD received 3ml (15mg)of 0.5% Bupivacaine heavy+
dexmedetomidine(5mug)in 0.5ml NS. Group BB received 3ml (15mg) of 0.5%
Bupivacaine heavy+ 0.5ml of buprenorphine (75mug). Parameters assessed:
onset and duration of sensorimotor block, analgesia duration,
haemodynamics, sedation and side effects. Data analyzed with relevant
statistics. <br/>Result(s): Onset of sensory and motor blockades showed no
statistical difference. However, Group BD exhibited considerably longer
sensory (438.88+/-31.27min) and motor (447.9+/-34.23min) blocks compared
to Group BC (204.7+/-28.63min; 307.98+/-16.11min) and Group BB
(279.88+/-16.58min; 305.2+/-11.1min) (p<0.0001). Group BD also displayed
prolonged post-operative analgesic request time (459.13+/-37.11min),
surpassing other groups (p<0.0001). Although Group BC had the highest
sympathomimetic need (65%), Group BD demonstrated superior hemodynamic
stability (p<0.022) despite transient bradycardia in fewer subjects.
<br/>Conclusion(s): Dexmedetomidine (5mug) as an intrathecal adjuvant with
0.5% hyperbaric bupivacaine prolong the sensory and motor blockade
duration. It increases the time to rescue analgesia, minimizes side
effects, and provides sedation compared to other groups.<br/>Copyright
&#xa9; 2024, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

<83>
Accession Number
643443869
Title
Periprocedural Myocardial Infarction and Injury.
Source
European heart journal. Acute cardiovascular care. (no pagination), 2024.
Date of Publication: 07 Feb 2024.
Author
Spagnolo M.; Occhipinti G.; Laudani C.; Greco A.; Capodanno D.
Institution
(Spagnolo, Occhipinti, Laudani, Greco, Capodanno) Division of Cardiology,
A.O.U. Policlinico "G. Rodolico - San Marco", University of Catania,
Catania, Italy
Abstract
Periprocedural myocardial infarction (PMI) and injury, pertinent to both
cardiac and non-cardiac procedures, have gained increasing recognition in
clinical practice. Over time, diverse definitions for diagnosing PMI have
been developed and validated among patient populations undergoing coronary
revascularization. However, this variety in definitions presents
considerable challenges in clinical settings and complicates both the
design and interpretation of clinical trials. The necessity to accurately
diagnose PMI has spurred significant interest in establishing universally
accepted and prognostically meaningful thresholds for cardiac biomarkers
elevation and supportive ancillary criteria. In fact, elevations in
cardiac biomarkers in line with the 4th Universal Definition of Myocardial
Infarction, have been extensively confirmed to be associated with
increased mortality and cardiovascular events. In the context of
non-coronary cardiac procedures, such as Transcatheter Aortic Valve
Implantation, there is a growing acknowledgment of both the high incidence
rates and the adverse impact of PMI on patient outcomes. Similarly,
emerging research underscores the significance of PMI and injury in
non-cardiac surgery, highlighting the urgent need for effective prevention
and risk management strategies in this domain.<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.

<84>
Accession Number
643443727
Title
Postcardiac Injury Syndrome After Cardiac Surgery: An Evidence-Based
Review.
Source
Cardiology in review. (no pagination), 2024. Date of Publication: 07 Feb
2024.
Author
Tahir M.H.; Sohail S.; Shahid D.; Hussain I.; Malik J.; Iqra S.; Faraz M.
Institution
(Tahir) From the Department of Cardiovascular Medicine, Cardiovascular
Analytics Group, Islamabad, Pakistan
Abstract
Postcardiac injury syndrome (PCIS) serves as a comprehensive term
encompassing a spectrum of conditions, namely postpericardiotomy syndrome,
postmyocardial infarction (MI) related pericarditis (Dressler syndrome),
and post-traumatic pericarditis stemming from procedures like percutaneous
coronary intervention or cardiac implantable electronic device placement.
These conditions collectively give rise to PCIS, triggered by cardiac
injury affecting pericardial or pleural mesothelial cells, leading to
subsequent inflammation syndromes spanning from uncomplicated pericarditis
to substantial pleural effusion. A thorough literature search conducted on
MEDLINE/PubMed utilizing search terms including "postacute cardiac injury
syndrome," "postcardiac injury syndrome," "postcardiotomy syndrome,"
"postpericardiotomy syndrome," and "post-MI pericarditis" was instrumental
in collating pertinent studies. To encapsulate the amassed evidence,
relevant full-text materials were meticulously selected and amalgamated
narratively. The pathophysiology of PCIS is proposed to manifest through
an autoimmune-mediated process, particularly in predisposed individuals.
This process involves the development of anti-actin and antimyosin
antibodies after a cascade of cardiac injuries in diverse forms. Treatment
strategies aimed at preventing recurrent PCIS episodes have shown
efficacy, with colchicine and nonsteroidal anti-inflammatory drugs,
including ibuprofen, demonstrating positive outcomes. Conversely,
corticosteroids have exhibited no discernible benefit concerning prognosis
or recurrence rates for this ailment. In summary, PCIS serves as a
unifying term encompassing a spectrum of cardiac injury-related syndromes.
A comprehensive review of relevant literature underscores the
autoimmune-mediated pathophysiology in susceptible individuals. The
therapeutic landscape involves the proficient use of colchicine and
Nonsteroidal anti-inflammatory drugs to deter recurrent PCIS episodes,
while corticosteroids do not appear to contribute to improved prognosis or
reduced recurrence rates. This nuanced understanding contributes to an
enhanced comprehension of PCIS and its multifaceted clinical
manifestations, potentially refining its diagnosis and
management.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<85>
Accession Number
643443423
Title
Ischaemic heart disease in patients with cancer.
Source
European heart journal. (no pagination), 2024. Date of Publication: 07
Feb 2024.
Author
Ameri P.; Bertero E.; Lombardi M.; Porto I.; Canepa M.; Nohria A.;
Vergallo R.; Lyon A.R.; Lopez-Fernandez T.
Institution
(Ameri, Porto, Canepa, Vergallo) Cardiovascular Disease Unit, IRCCS
Ospedale Policlinico San Martino, Genova, Italy
(Ameri, Bertero, Lombardi, Porto, Canepa, Vergallo) Department of Internal
Medicine, University of Genova, Viale Benedetto XV, Genova 16132, Italy
(Bertero) Comprehensive Heart Failure Center (CHFC), University Clinic
Wurzburg, Wurzburg, Germany
(Lombardi) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Universita Cattolica Sacro Cuore, Roma,
Italy
(Nohria) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Lyon) Cardio-Oncology Service, Royal Brompton Hospital, London, United
Kingdom
(Lopez-Fernandez) Cardiology Department, La Paz University Hospital,
IdiPAZ Research Institute, Madrid, Spain
(Lopez-Fernandez) Cardiology Department, Quiron Pozuelo University
Hospital, Madrid, Spain
Abstract
Cardiologists are encountering a growing number of cancer patients with
ischaemic heart disease (IHD). Several factors account for the
interrelationship between these two conditions, in addition to improving
survival rates in the cancer population. Established cardiovascular (CV)
risk factors, such as hypercholesterolaemia and obesity, predispose to
both IHD and cancer, through specific mechanisms and via low-grade,
systemic inflammation. This latter is also fuelled by clonal
haematopoiesis of indeterminate potential. Furthermore, experimental work
indicates that IHD and cancer can promote one another, and the CV or
metabolic toxicity of anticancer therapies can lead to IHD. The
connections between IHD and cancer are reinforced by social determinants
of health, non-medical factors that modify health outcomes and comprise
individual and societal domains, including economic stability, educational
and healthcare access and quality, neighbourhood and built environment,
and social and community context. Management of IHD in cancer patients is
often challenging, due to atypical presentation, increased bleeding and
ischaemic risk, and worse outcomes as compared to patients without cancer.
The decision to proceed with coronary revascularization and the choice of
antithrombotic therapy can be difficult, particularly in patients with
chronic coronary syndromes, necessitating multidisciplinary discussion
that considers both general guidelines and specific features on a case by
case basis. Randomized controlled trial evidence in cancer patients is
very limited and there is urgent need for more data to inform clinical
practice. Therefore, coexistence of IHD and cancer raises important
scientific and practical questions that call for collaborative efforts
from the cardio-oncology, cardiology, and oncology
communities.<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.

<86>
Accession Number
643435284
Title
Efficacy of Single-Bolus Administration of Remimazolam During Induction of
Anesthesia in Patients Undergoing Cardiac Surgery: A Prospective,
Single-Center, Randomized Controlled Study.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 05
Feb 2024.
Author
Lee S.-H.; Nam J.-S.; Choi D.-K.; Chin J.-H.; Choi I.-C.; Kim K.
Institution
(Lee) From the Department of Anesthesiology and Pain Medicine, Dongsan
Medical Center, Keimyung University School of Medicine, Daegu, South Korea
(Nam, Choi, Chin, Choi, Kim) Department of Anesthesiology and Pain
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
Abstract
BACKGROUND: Remimazolam is a recently marketed ultrashort-acting
benzodiazepine. This drug is considered safe and effective during general
anesthesia; however, limited information is available about its effects on
patients undergoing cardiac surgery. Therefore, the present study was
conducted to evaluate the efficacy and hemodynamic stability of a bolus
administration of remimazolam during anesthesia induction in patients
undergoing cardiac surgery. <br/>METHOD(S): Patients undergoing elective
cardiac surgery were randomly assigned to any 1 of the following 3 groups:
anesthesia induction with a continuous infusion of remimazolam 6 mg/kg/h
(continuous group), a single-bolus injection of remimazolam 0.1 mg/kg
(bolus 0.1 group), or a single-bolus injection of remimazolam 0.2 mg/kg
(bolus 0.2 group). Time to loss of responsiveness, defined as modified
Observer's Assessment of Alertness/Sedation Scale <3, and changes in
hemodynamic status during anesthetic induction were measured.
<br/>RESULT(S): Times to loss of responsiveness were 137 +/- 20, 71 +/-
35, and 48 +/- 9 seconds in the continuous, bolus 0.1, and bolus 0.2
groups, respectively. The greatest mean difference was observed between
the continuous and bolus 0.2 groups (89.0, 95% confidence interval [CI],
79.1-98.9), followed by the continuous and bolus 0.1 groups (65.8, 95% CI,
46.9-84.7), and lastly between the bolus 0.2 and bolus 0.1 groups (23.2,
95% CI, 6.6-39.8). No significant differences were found in terms of
arterial blood pressures and heart rates of the patients.
<br/>CONCLUSION(S): A single-bolus injection of remimazolam provided
efficient anesthetic induction in patients undergoing cardiac surgery. A
0.2 mg/kg bolus injection of remimazolam resulted in the shortest time to
loss of responsiveness among the 3 groups, without significantly altering
the hemodynamic parameters. Therefore, this dosing can be considered a
favorable anesthetic induction method for patients undergoing cardiac
surgery.<br/>Copyright &#xa9; 2024 International Anesthesia Research
Society.

<87>
Accession Number
2030252517
Title
Aortic patient-prosthesis mismatch - does it matter? A review for
cardiologists and cardiac surgeons.
Source
Romanian Journal of Cardiology / Revista Romana de Cardiologie. (no
pagination), 2024. Date of Publication: 2024.
Author
Visan A.C.; Zlibut A.; Ionescu A.; Stoica S.C.
Institution
(Visan) Department of Cardiothoracic Surgery, James Cook University
Hospital, South Tees NHS Foundation Trust, Middlesbrough, United Kingdom
(Zlibut) Department of Cardiology, Emergency Clinical Hospital, Bucharest,
Romania
(Ionescu) Department of Cardiology, Morriston Cardiac Centre, Swansea Bay
University Health Board, Swansea, United Kingdom
(Stoica) Department of Adult and Paediatric Cardiac Surgery, Bristol Heart
Institute, University Hospitals Bristol NHS Foundation Trust, Bristol,
United Kingdom
Publisher
Sciendo
Abstract
Patient-prosthesis mismatch (PPM) is the situation in which the area of an
artificial valve is smaller than that of a healthy native valve it
replaces. By this definition, all artificial valves demonstrate PPM, but
large observational studies and several meta-analyses suggest that it is
present in 30-50% of patients after surgical aortic valve replacement
(SAVR). PPM has an impact on outcomes only when the indexed aortic valve
area (AVAi) is <=0.85cm2/m2 (moderate PPM) or 0.65cm2/m2 (severe PPM),
particularly in patients with reduced LVEF. In transcatheter aortic valve
replacement, the prevalence of PPM may be as low as 0.1%, and its impact
on hard outcomes is not clear. We present a review of the relevant
literature together with a framework for the differential diagnosis of
increased pressure gradient and reduced area in prosthetic aortic valves
and different strategies to reduce the risk of PPM with
SAVR.<br/>Copyright &#xa9; 2024 MediaMed Publicis. All rights reserved.

<88>
Accession Number
2027972163
Title
Expert Consensus on Nutritional Support for Children with Congenital Heart
Disease (2023 Edition).
Source
Congenital Heart Disease. 18(6) (pp 571-593), 2023. Date of Publication:
2023.
Author
Mo X.; Cai W.; Xu Z.; Wang Y.; Yan W.; Li S.; Dong N.; Chen X.; Liu J.;
Shu Q.; Chen J.; Xing Q.; An Q.; Wang X.; He Y.; Su J.; Fan T.; Ming T.;
Tang W.; Hong L.; Zheng J.; Ye M.; Sun G.; Ding Y.; Tao L.; Yang Y.; Wu
Z.; Cao H.; Wang Q.; Yang K.; Zhang L.; Wen P.; Cui Y.; Zhai B.; Zou Y.;
Tang Q.; Wu C.; Feng Z.; Liu C.; Mi Y.; Zhang R.; Lin K.; Li X.; Pi M.;
Fan X.; Shi S.; Huang P.; Pan Z.; Qi J.; Chen R.; Tao S.; Shu Y.; Zhang
H.; Jiang L.; Da M.; Patel N.; Hu L.
Institution
(Mo, Qi, Shu, Jiang, Da, Patel, Hu) Department of Cardiothoracic Surgery,
Children's Hospital of Nanjing Medical University, Nanjing 210008, China
(Cai) Department of Pediatric Surgery and Nutrition, Xinhua Hospital,
School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
(Xu, Liu, Zhang, Zheng) Department of Cardiothoracic Surgery, Shanghai
Children's Medical Center, School of Medicine, Shanghai Jiao Tong
University, Shanghai 200127, China
(Wang, Yan) Division of Pediatric Gastroenterology and Nutrition, Xinhua
Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai
200092, China
(Li, Yang) Pediatric Cardiac Surgery Center, Fuwai Hospital, National
Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular
Disease, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing 100037, China
(Dong) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan
430022, China
(Chen) Cardiovascular Center, Guangzhou Women and Children's Medical
Center, Guangzhou Medical University, Guangzhou 510623, China
(Shu, Fan) Department of Cardiac Surgery, Children's Hospital, Zhejiang
University School of Medicine, National Clinical Research Center for Child
Health, Hangzhou 310052, China
(Chen) Department of Cardiovascular Surgery, Guangdong Cardiovascular
Institute, Guangdong Provincial People's Hospital, Guangdong Academy of
Medical Sciences, Southern Medical University, Guangzhou 519041, China
(Zhang) Heart Center and Shanghai Institue of Pediatric Congenital Heart
Disease, Shanghai Children's Medical Center, National Children's Medical
Center, School of Medicine, Shanghai Jiao Tong University, Shanghai
200127, China
(Xing, Chen) Heart Center, Qingdao Women and Children's Hospital, Qingdao
266034, China
(An, Lin) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu 610041, China
(Li) Department of Cardiac Surgery, Beijing Children's Hospital, Capital
Medical University, National Center for Children's Health, Beijing 100045,
China
(Wang) Department of Pediatric Intensive Care Unit, Fuwai Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing
100037, China
(He) Department of ICU in Pediatric Cardiology, Beijing Anzhen Hospital,
Capital Medical University, Beijing 100029, China
(Su, Wang) Department of Pediatric Cardiac Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
(Fan) Department of Cardiovascular Surgery, Central China Fuwai Hospital
of Zhengzhou University, Zhengzhou 451460, China
(Ming, Zou) Pediatric Heart Disease Treatment Center of Jiangxi Province,
Jiangxi Provincial Children's Hospital, Nanchang 330006, China
(Tang) Department of Pediatric Surgery, Children's Hospital of Nanjing
Medical University, Nanjing 210008, China
(Hong) Department of Clinical Nutrition, Shanghai Children's Medical
Center, School of Medicine, Shanghai Jiao Tong University, Shanghai
200127, China
(Ye, Mi, Zhang) Department of Cardiothoracic Surgery, Children's Hospital
of Fudan University, Shanghai 201102, China
(Sun) Department of Cardiovascular Surgery, Xijing Hospital, Fourth
Military Medical University, Xi'an 710032, China
(Ding) Department of Pediatric Cardiology, The University of Hong
Kong-Shenzhen Hospital, Shenzhen 518038, China
(Tao) Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan
430056, China
(Yang, Wu) Department of Cardiovascular Surgery, The Second Xiangya
Hospital of Central South University, Changsha 410011, China
(Cao) Department of Cardiac Surgery, Fujian Children's Hospital (Fujian
Branch of Shanghai Children's Medical Center), College of Clinical
Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical
University, Fuzhou 350001, China
(Zhang) Department of Pediatric Surgery, Chengdu Women's and Children's
Central Hospital, School of Medicine, University of Electronic Science and
Technology of China, Chengdu 611731, China
(Wen) Heart Center, Dalian Municipal Women and Children's Medical Center
(Group), Dalian 116699, China
(Cui) Cardiac Intensive Care Unit, The Heart Center, Guangzhou Women and
Children's Medical Center, Guangzhou Medical University, Guangzhou 510623,
China
(Zhai) Department of Cardiothoracic Surgery, Children's Hospital
Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou
Children's Hospital, Zhengzhou 451161, China
(Tang) Department of Clinical Nutrition, Xinhua Hospital, School of
Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
(Wu, Pan) Department of Cardiothoracic Surgery, Children's Hospital of
Chongqing Medical University, Chongqing 400014, China
(Feng) Department of Cardiac Surgery, Qilu Children's Hospital of Shandong
University, Jinan 250022, China
(Liu) Department of Cardiology, Children's Hospital of Shanxi, Women
Health Center of Shanxi, Taiyuan 030025, China
(Zhang) Department of Pediatric Cardiothoracic Surgery, Shanghai
Children's Hospital, School of Medicine, Shanghai Jiao Tong University,
Shanghai 200062, China
(Li) Department of Cardiothoracic Surgery, Children's Hospital of Soochow
University, Suzhou 215002, China
(Pi) Department of Cardiothoracic Surgery, Wuhan Children's Hospital
(Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College,
Huazhong University of Science and Technology, Wuhan 430019, China
(Shi) Department of Cardiac Intensive Care Unit, Children's Hospital,
Zhejiang University School of Medicine, National Clinical Research Center
for Child Health, Hangzhou 310052, China
(Huang) Department of Cardiothoracic Surgery, Hunan Children's Hospital,
Changsha 410007, China
(Qi) Department of Cardiothoracic Surgery, Harbin Children's Hospital,
Harbin Medical University, Harbin 150010, China
(Chen) Department of Cardiothoracic Surgery, Hainan Women and Children's
Medical Center, Haikou 571103, China
(Tao) Department of Cardiac Surgery, Children's Hospital in Hebei
Province, Shijiazhuang 050200, China
Publisher
Tech Science Press
Abstract
The second edition of the expert consensus on pediatric nutrition was
formed based on a global update of pediatric nutrition guidelines or
consensus worldwide, the management of congenital heart disease, and the
results of multi-center clinical nutrition research for congenital heart
disease following the first Chinese consensus edition of 2016. The
consensus was also shaped by the results of three discussion sessions and
two questionnaires conducted by the 13-member collaboration group. This
process was informed by both clinical guidelines and expert consensus. The
quality of literature, both in English and Chinese, and the level of
recommendations were evaluated using the Grading of Recommendations
Assessment, Development, and Evaluations (GRADE) system.<br/>Copyright
&#xa9; 2023, Tech Science Press. All rights reserved.

<89>
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.

<90>
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

<91>
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.

<92>
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.

<93>
Accession Number
631587875
Title
Cerebrovascular events after transcatheter mitral valve interventions: a
systematic review and meta-analysis.
Source
Heart. 106(22) (pp 1759-1768), 2020. Date of Publication: 17 Apr 2020.
Author
Chateauneuf G.; Nazif T.M.; Beaupre F.; Kodali S.; Rodes-Cabau J.; Paradis
J.-M.
Institution
(Chateauneuf, Beaupre, Rodes-Cabau, Paradis) Quebec Heart and Lung
Institute, Quebec, QC, Canada
(Nazif, Kodali) Columbia University Medical Center, NewYork-Presbyterian
Hospital and the Cardiovascular Research Foundation, New York, NY, United
States
Publisher
BMJ Publishing Group
Abstract
Objective Current guidelines support the use of transcatheter mitral valve
interventions to treat some selected high-risk patients with significant
mitral valvulopathy. As with any other interventional cardiac procedure,
concerns have been raised about cerebrovascular event. The aim of this
systematic review and meta-analysis was to determine the incidence of
cerebrovascular events following (1) transcatheter mitral valve
edge-to-edge repair with mitral valve clip and (2) transcatheter mitral
valve replacement (TMVR). Methods We conducted a systematic review of
studies reporting the cerebrovascular adverse events after transcatheter
mitral valve edge-to-edge repair and TMVR procedures. The primary endpoint
was the incidence of cerebrovascular events as defined by the Mitral Valve
Academic Research Consortium. An event that occurred within 30 days or
during index hospitalisation was defined as periprocedural; otherwise it
was defined as non-periprocedural. This study was designed in accordance
with the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. Aggregated study-level data were pooled using a
random effect model. The quality of each study was appraised with the
Hawker checklist, a method of systematically reviewing research from
different paradigms. Results Sixty studies totalling 28 155 patients
undergoing edge-to-edge repair with mitral valve clip were included in the
analysis. Periprocedural stroke and non-periprocedural stroke rates were
0.9% (95% CI 0.6 to 1.1) and 2.4% (95% CI 1.6 to 3.2), respectively. For
TMVR procedures, 26 studies including 1910 patients were analysed. The
estimated periprocedural stroke incidence was 1% (95% CI 0.5 to 1.8)
compared with 7% (95% CI 0.8 to 18.5) for non-periprocedural stroke.
Conclusions Transcatheter mitral valve interventions are associated with
low rates of cerebrovascular events. The exact mechanisms of these
complications are still poorly understood given the relative paucity of
good quality data. <br/>Copyright &#xa9; Author(s) (or their employer(s))
2019. No commercial re-use. See rights and permissions. Published by BMJ.

<94>
Accession Number
2027989820
Title
FIVE-YEAR BIOPROSTHETIC VALVE DYSFUNCTION AFTER SURGERY OR SELF-EXPANDING
TRANSCATHETER AORTIC VALVE IMPLANTATION.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Montreal Canada. 47(7 Supplement) (pp S19-S20), 2023. Date of
Publication: November 2023.
Author
Radhakrishnan S.; Yakubov S.; Van Mieghem N.; Oh J.; Dedrick A.; Reardon
M.
Institution
(Radhakrishnan, Yakubov, Van Mieghem, Oh, Dedrick, Reardon) TorontoOntario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: Bioprosthetic valve dysfunction (BVD) after aortic valve
replacement includes structural valve deterioration (SVD), non-structural
valve dysfunction (NSVD) (prosthesis-patient mismatch [PPM], paravalvular
regurgitation [PVR]), clinical valve thrombosis, and infectious
endocarditis. Our prior work from the CoreValve US High Risk and SURTAVI
randomized clinical trials (RCTs) demonstrated a significantly lower
5-year incidence of SVD in TAVI vs surgery.1 Here, we evaluate 5-year
valve performance and durability by incidence of overall BVD. METHODS AND
RESULTS: Five-year BVD data from the CoreValve Pivotal and SURTAVI trials
were recently presented at CRT 2023 as a late breaker. A total of 1128
TAVI and 971 surgery patients from the CoreValve US High Risk and SURTAVI
RCTs were retrospectively analyzed. BVD was defined as: 1) SVD; mean
gradient increase >=10 mmHg from discharge/30-day to last echo AND >=20
mmHg at last echo, OR new onset/increase of >= moderate intraprosthetic
aortic regurgitation, 2) NSVD; severe PPM (VARC-3) at 30-day/discharge, OR
severe PVR through 5 years, 3) clinical valve thrombosis, OR 4) infectious
endocarditis. The cumulative incidence rates of BVD, SVD, NSVD and severe
PVR were estimated using interval censoring analysis and treating death as
a competing risk. The cumulative incidence rates of thrombosis and
endocarditis were estimated using proportional sub-distribution hazard
regression for right-censored data. Severe PPM rate was estimated as a
proportion. BVD was found in 80 TAVI and 130 surgery randomized patients
through 5 years. The cumulative incidence rate of BVD was significantly
lower following TAVI than surgery (7.8% vs 14.2%; hazard ratio [HR], 0.50;
95% confidence interval [CI], 0.38-0.66; p< 0.001). SVD and NSVD were
significantly lower after TAVI vs surgery, whereas no significant
differences were found in the incidence of valve thrombosis or
endocarditis (Table). <br/>CONCLUSION(S): Five-year valve performance
assessed by BVD was significantly better after self-expanding,
supra-annular TAVI vs surgery, with three times lower severe PPM. These
findings may have implications for shared decision-making in lower risk
patients with severe aortic stenosis, where durability should be a key
consideration for initial valve selection. REFERENCES 1. O'Hair D, Yakubov
SJ, Grubb KJ, et al. (2022). Structural Valve Deterioration After
Self-Expanding Transcatheter or Surgical Aortic Valve Implantation in
Patients at Intermediate or High Risk. JAMA Cardiol,. 2. Yakubov SJ, Van
Mieghem NM, Oh JK, et al (2023). Five-Year Incidence of Bioprosthetic
Valve Dysfunction in Patients Randomized to Surgery or TAVR: Insights From
the CoreValve US Pivotal and SURTAVI Trials. Late breaker presentation,
CRT 2023, February 25-28, 2023. Washington, USA. [Formula
presented]<br/>Copyright &#xa9; 2023

<95>
Accession Number
2027981595
Title
A RANDOMIZED, MULTI-CENTER, PHASE 2 TRIAL OF RBT-1 VERSUS PLACEBO
EVALUATING CYTOPROTECTIVE BIOMARKERS AND POSTOPERATIVE OUTCOMES IN
PATIENTS UNDERGOING CARDIAC SURGERY ON CARDIOPULMONARY BYPASS.
Source
Canadian Journal of Diabetes. Conference: Canadian Cardiovascular Congress
2023. Montreal Canada. 47(7 Supplement) (pp S140), 2023. Date of
Publication: November 2023.
Author
Lamy A.; Jessen M.; Marzouk M.; Ruiz S.; Singh B.
Institution
(Lamy, Jessen, Marzouk, Ruiz, Singh) Burlington, Ontario
Publisher
Elsevier B.V.
Abstract
BACKGROUND: Among patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB), postoperative complications are common and significantly
impact long-term outcomes. We conducted a Phase 2 clinical trial of RBT-1,
a pharmacologic preconditioning drug, to assess cytoprotective biomarkers
and clinical outcomes. We are reporting our final results. METHODS AND
RESULTS: This randomized, blinded, placebo-controlled trial enrolled 152
patients in US, Canada, and Australia who were scheduled to undergo CABG
and/or valve surgery on CPB. Eligible patients were randomized to receive
one intravenous dose of RBT-1 (low or high dose) or placebo 24 to 48 hours
before surgery. The primary endpoint was a cytoprotective preconditioning
response, measured by a composite of biomarkers representing antioxidant,
anti-inflammatory, and iron scavenging pathways (i.e., heme oxygenase-1,
interleukin-10, and ferritin). Key secondary/exploratory endpoints
included ventilator, ICU, and hospital days; readmission rates, and
incidence of AKI and major adverse kidney events (MAKE). <br/>Result(s):
Baseline characteristics were: mean age 65 years, heart failure rate of
15%, Stage 3 or 4 CKD at 25%, and 23% of patients underwent combined
CABG/valve surgery. Both low and high doses of RBT-1 significantly
increased the biomarker response by >160% (p < 0.0001), meeting our
primary endpoint. RBT-1 yielded a significant reduction in ICU days
(p=0.0101) and 30-day cardiopulmonary readmission rates (p=0.0391). RBT-1
yielded a meaningful reduction in hospital days, atrial fibrillation, and
MAKE at Day 30 (MAKE30). RBT-1 was well tolerated with only transient
photosensitivity (19.8% incidence) as the primary adverse event and more
commonly seen in the high dose group. A post-hoc hierarchical composite
(win ratio) of clinical outcomes (in rank-order of death, AKI requiring
dialysis, ICU days, cardiopulmonary readmission, atrial fibrillation, and
hospital days) achieved a statistically significant win ratio of 1.63
(p=0.0161), suggesting RBT-1 improved clinical outcomes post-cardiac
surgery. <br/>CONCLUSION(S): RBT-1 is a novel preconditioning drug used
safely in the setting of CABG/valve surgery requiring CPB. Treatment with
RBT-1 resulted in favorable changes in cytoprotective biomarkers and
suggested benefits on multiple clinical outcomes of relevance. Based on
these findings, FDA has granted Fast Track designation to advance clinical
development of RBT-1 to reduce the risk of postoperative complications in
patients undergoing cardiac surgery. [Formula presented]<br/>Copyright
&#xa9; 2023

<96>
Accession Number
2027720685
Title
POSTOPERATIVE CHANGES IN SERUM LIPID LEVELS AFTER PROPOFOL 1% VS 2%
INFUSION FOR MAINTENANCE OF ANAESTHESIA IN PATIENTS UNDERGOING CARDIAC
SURGERY WITH CARDIOPULMONARY BYPASS.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 17), 2023.
Date of Publication: October 2023.
Author
Tewari P.; Farzana N.
Institution
(Tewari) Sanjay Gandhi Postgraduate Institute of medical sciences -
Department of Anaesthesiology, Lucknow, India
(Farzana) Medanta Hospital- Department of Anaesthesiology, Lucknow, India
Publisher
W.B. Saunders
Abstract
Introduction: Dyslipidemia is a known risk factor for cardiovascular
events. 1% Propofol, a commonly used anaesthetic drug, a lipid emulsion
had shown hypertriglyceridemia on long-term sedation as well as
maintenance of anaesthesia.(1) The formulation 2% propofol with half the
lipid load has reduced its occurrence. However, data related to cardiac
surgery on cardiopulmonary bypass (CPB) is scarce. This study compared
propofol 1% [Group 1] versus 2% [Group 2] infusion used for BIS guided
maintenance of anaesthesia in patients undergoing cardiac surgery on
cardiopulmonary bypass and the effect on serum triglycerides in
postoperative period in cardiac ICU. <br/>Method(s): After institutional
ethics committee clearance and informed consent, 70 patients were
randomized into two Groups as per formulation of propofol used as
maintenance of anaesthesia in this prospective, randomized, double-blind,
study. Rest of intraoperative management was similar to all patients
including heparinization dose and CPB management. Inclusion criteria were,
male or female adult patients between 18 and 65 years age, NYHA grade 1 or
2 with single valvular heart disease without having arrhythmia or on lipid
controlling drugs. Serum triglycerides were measured just before induction
(Baseline sample 1) in OR and at 2-hours after cessation of propofol
infusion (Sample 2) and after extubation (Sample 3) in postoperative
period in ICU. The primary outcome was to compare the effect on serum
triglycerides in both the groups. The data was presented as mean with SD
or as median and analysed with appropriate statistical methods using
statistical package (SPSS-23, IBM, Chicago, USA). <br/>Result(s): 57
patients' complete data, Gr. 1(n=27) and Gr.2(n=30) was analysed. Serum
triglycerides decreased in all but significantly in Gr. 1 [Baseline
110.70+/-55.4 mg/dl to 95.4+/-42.3 mg/dl, p=0.05] as compared to Gr. 2
[Baseline 102.1+/-50.0 mg/dl to 90.0+/-45.5 mg/dl, p=0.059. There was no
significant correlation of levels of serum triglycerides with either of
volume of the propofol infused (Pearson correlation=-0.069, p=0.609) or
amount of propofol infused (Pearson correlation=-0.053, p=0.693). Effect
of gender was, the decrease in females was more and significant
(107.9+/-50.0 to 90.0+/-45.5, p= 0.015) as compared to males. The sample 3
was taken at the time of extubation that ranged from 210 to 1200 minutes
in ICU after cessation of propofol infusion. This data had non-normal
distribution and hence comparing the median value of triglyceride levels
showed significant reduction from baseline in both Gr.1 (median reduction
98 to 77mg/dl p=.001), and Gr.2 (median reduction 89 to 71 mg/dl p=.008).
When the entire study group was analysed (n=57), the sample 3 (median=74
mg/dl) was significantly lower than sample 1(median=95 mg/dl p= 0.00) and
sample 2(median=82 mg/dl p= 0.28). <br/>Discussion(s): Serum triglyceride
levels had significantly decreased in patients undergoing surgery on
cardiac bypass irrespective of the formulation 1% LCT or 2% MCT of
propofol used as maintenance of Anaesthesia. Heparin induced release of
lipoprotein lipase primarily acts on VLDL and may decrease triglyceride
levels. Haemodilution on CPB can be the other factor affecting it. The
reduction was seen more in females as compared to males and may be due to
accelerated clearance.<br/>Copyright &#xa9; 2023

<97>
Accession Number
2027720680
Title
Inspired Oxygen Concentration of 80% Worsens Left Ventricular Global
Circumferential Strain in Anaesthetised Patients with Coronary Artery
Disease.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 52), 2023.
Date of Publication: October 2023.
Author
LAEDERACH T.; FISCHER K.; FRIESS J.-O.; LEVIS A.; HIRSCHI T.; GERBER D.;
ERDOES G.; TERBECK S.; EBERLE B.; GUENSCH D.P.
Institution
(LAEDERACH, FISCHER, FRIESS, LEVIS, HIRSCHI, GERBER, ERDOES, TERBECK,
EBERLE, GUENSCH) Department of Anaesthesiology and Pain Medicine,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
Publisher
W.B. Saunders
Abstract
Introduction: Although oxygen is the most widely used drug in medicine,
clinical practice and formal recommendations regarding oxygen
administration during general anaesthesia (GA) remain inconsistent. Oxygen
has potent vasoconstrictive properties which may also act on coronary
vasculature. In patients with coronary artery disease (CAD), a population
at increased risk for perioperative cardiac complications, hyperoxic
vasoconstriction may potentially trigger myocardial ischaemia. One of the
most sensitive and earliest markers of myocardial ischaemia is myocardial
systolic dysfunction, which can be assessed by myocardial deformation
analysis from transoesophageal echocardiography (TOE) cine loops, also
known as strain. While strain has been traditionally mainly investigated
in longitudinal orientation, more recent data also appreciate the role of
circumferential strain analysis in short-axis images. We investigated
whether global circumferential strain (GCS) analysis detects any effects
on systolic function when marked hyperoxia is induced by use of FIO2=0.8
in anaesthetised CAD patients. <br/>Method(s): For this randomized,
controlled crossover clinical trial, 106 CAD patients scheduled for
elective coronary artery bypass graft surgery were prospectively
recruited. After induction of general anaesthesia and prior to surgical
incision, FIO2 was first titrated to either a normoxaemic (FIO2=0.3, SpO2
95-98%) or a hyperoxic state (FIO2=0.8). Thereafter, three left
ventricular short axis cine loops (basal, mid-ventricular, apical) were
acquired with TOE. The opposite FIO2 level was then targeted and a second
set of TOE images loops in the identical views was acquired.
Subendocardial GCS of the left ventricle was quantified by a blinded
reader and compared between FIO2 levels (figures 1 and 2). Independently,
the burden of CAD was calculated by counting the number of myocardial
segments (AHA 16-segment model) perfused by vessels with angiographically
defined stenoses. <br/>Result(s): Patients were aged 66 (44-81) years, 87%
male. The majority (59%) had 3-vessel disease, with 33% presenting with
2-vessel disease and 8% with single-vessel disease. Overall, GCS
significantly worsened from -26.0+/-6.9% at normoxaemia to -25.5+/-7.2% at
hyperoxia (p=0.042, n=98). Regression analysis indicated that patients
with better GCS at normoxaemia (r=-0.312, p=0.002), and those with fewer
myocardial segments subtended to coronary stenoses (r=-0.246, p=0.015)
showed poorer GCS at hyperoxia. <br/>Discussion(s): LV systolic function
of anaesthetised CAD patients as assessed by GCS analysis was, in general,
better when inspired oxygen concentration was titrated to 30%.
Nevertheless, patients with more myocardium at ischaemic risk and/or worse
strain at normoxaemia showed better GCS at hyperoxic conditions.
Consequently, for support of their LV function under GA, patients with CAD
may benefit from individualized FIO2 titration based on the known amount
of myocardium at risk and on their normoxaemic GCS.<br/>Copyright &#xa9;
2023

<98>
Accession Number
2027720679
Title
PECS II BLOCK AS PART OF MULTIMODAL ANALGESIA FOR MINIMALLY INVASIVE
CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS - A TRIPLE-BLINDED,
RANDOMIZED, CONTROLLED TRIAL.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 5-6),
2023. Date of Publication: October 2023.
Author
GASTEIGER L.; HOERNER E.; NAEGELE F.; BONNARDS N.; SEISL A.; MAIR P.;
FIALA A.; STUNDNER O.
Institution
(GASTEIGER, HOERNER, SEISL, MAIR, FIALA, STUNDNER) Departement of
Anaesthesiology & Intensive Care, Medical University Innsbruck, Innsbruck,
Austria
(NAEGELE, BONNARDS) Departement of Cardiac Surgery, Medical University
Innsbruck, Innsbruck, Austria
Publisher
W.B. Saunders
Abstract
Introduction: Minimally-invasive, on-bypass cardiac surgery (MIC) through
a unilateral mini-thoracotomy is increasingly popular but associated with
high levels of postoperative pain, opioid consumption and
opioid-associated side effects. Enhanced Recovery After Surgery (ERAS)
protocols as multimodal, multidisciplinary perioperative care approaches
are aimed to improveme clinical outcomes and cost savings.1 Opioid-sparing
pain management by additional regional analgesia is a cornerstone of ERAS,
but the evidence for its usage in cardiac surgery is scarce.2 The PECS II
block a interfascial plane block, provides good analgesia to the
hemithorax, by depositing involves depositing local anesthetics between
(1) pectoralis major and pectoralis minor muscles and (2) pectoralis minor
and serratus anterior muscles, at the levels of the third rib.3 This study
aimed to elucidate whether adding a PECS II block to conventional
multimodal analgesia improves opioid consumption, pain, and quality of
recovery, and could therefore be part of an ERAS. <br/>Method(s): After
approval by the ethics committee, patients scheduled for MIC were
randomized between ultrasound-guided, preoperative unilateral PECS II
block with ropivacaine 0.5% vs. placebo (saline). Patients, practitioners
and data collectors were blinded to the intervention drug; a standardized
multimodal analgesic protocol was applied to all patients. Numerical
rating scores (NRS), analgesic consumption and the Overall Benefit of
Analgesia Score (OBAS) were collected at different time points up to 24
hours postoperatively, and compared between groups. <br/>Result(s): 57
patients were included (ropivacaine n=28, vs. placebo n=29). Block
performance (after central venous access) took 5+/-2.5 minutes. Patients
in the ropivacaine group had significantly lower morphine milligram
equivalents (MME) during the first 24 hours after extubation (median
(interquartile range): 4.2 (2.1-7.6) vs 8.3 (4.2-15.7) mg, p=0.016). NRS
at extubation was lower in the ropivacaine group (0.0 (0.0-2.0) vs 1.5
(0.3-3.0), p=0.041). Non-opioid analgesic consumption was similar. The
OBAS was, by trend, improved in the ropivacaine group (4.0 (3.0-6.0) vs.
7.0 (3.0-9.0), p=0.082). (Table 1) Discussion: The addition of PECS II
block to conventional, opioid-based multimodal analgesia protocols is a
simple, yet effective measure to optimize opioid consumption, pain relief
and side effect profile in patients undergoing minimal invasive cardiac
surgery.<br/>Copyright &#xa9; 2023

<99>
Accession Number
2027720673
Title
Comparison of the effectiveness of bilateral parasternal plane block as an
adjunct for postoperative pain management in patients undergoing median
sternotomy for cardiac surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 17), 2023.
Date of Publication: October 2023.
Author
SZALAY-FRANK T.; LORINCZ J.; ZAVORSZKY L.; LEX D.; LUKACS F.; PETER A.;
CSOMOS A.
Institution
(SZALAY-FRANK, LORINCZ, ZAVORSZKY, LEX, LUKACS, PETER, CSOMOS) Medical
Centre, Hungarian Defence Forces, Dept. of Anaesthesiology and Intensive
Therapy, Budapest, Hungary
Publisher
W.B. Saunders
Abstract
Introduction: Cardiac surgery is associated with significant pain and high
intra- and postoperative opioid use. Ineffective pain management and the
side effects of opioids can lead to increased perioperative complications
and prolonged hospital stay. As part of a multimodal pain management,
parasternal plane block has been shown to effectively reduce postoperative
pain intensity and opioid requirements without complications in small
randomized controlled trials [1]. <br/>Method(s): We conducted a
prospective, randomized, single-center study in elective cardiac surgery
patients undergoing sternotomy who were expected to be extubated within 6
hours. Patients were randomly assigned to receive either parasternal plane
block (PPB) or standard care. Postoperative pain management was
standardized in both groups (regular analgesics and morphine PCA). In
addition to demographic and historical data, pain intensity at rest and
during coughing was assessed using visual analogue scale (VAS) and
behavioral pain scale (BPS). Opioid consumption and the use of rescue
analgesics were recorded at 1, 3, 6, 12, and 24 hours after the block. The
primary endpoint was the opioid requirement in the first 24 hours,
calculated as mg/kg body weight morphine equivalents. Secondary endpoints
included mean and maximum VAS and BPS scores in the first 24 hours,
average patient satisfaction, and the number of complications associated
with PPB. <br/>Result(s): At the time of abstract submission, 33 patients
were enrolled in the study. While there were no significant differences at
the interim analysis of the initial small sample size, we observed a trend
towards lower rest and movement pain scores in the PPB group, and patient
satisfaction was higher compared to the control group. Rescue analgesic
administration was required more frequently in the control group. No
complications were observed in either group. Our results may change as the
number of cases increases. <br/>Discussion(s): Parasternal plane block
might be a promising method to increase the effectiveness of multimodal
pain management and improve the postoperative comfort of patients
undergoing cardiac surgery.<br/>Copyright &#xa9; 2023

<100>
Accession Number
2027720670
Title
Role of positive chronotropic medications in management of symptomatic
bradyarrythmias after cardiac surgery to avoid permanent pacemaker
implantation. The road between Scylla and Charybdis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 21), 2023.
Date of Publication: October 2023.
Author
HASSAN M.; RADAKOVIC D.; KELLER D.; MADRAHIMOV N.; HAMOUDA K.; LEYH R.;
BENING C.
Institution
(HASSAN, RADAKOVIC, KELLER, MADRAHIMOV, HAMOUDA, LEYH, BENING)
Cardiothoracic surgery, Wurzburg University, Wurzburg, Germany
Publisher
W.B. Saunders
Abstract
Introduction: * Bradyarrythmias requiring pacemaker implantation are
occasional complications after Cardiac surgery. * Currently, bradycardia
treatment is limited to permanent pacemaker (PM) implantation. No
consensus exists as to its optimal medication regimen. However,
Intravenous s-stimulators (Dobutamine) are effective in the short term but
are harmful over the long term because of their side effects, which
include cardiotoxicity and arrhythmia, specially in the vulnerable phase
direct after cardiac surgery. * Implantation of a permanent PM is the
first-line treatment for these patients. Although the efficacy and safety
of permanent PM have been established, implantation and generator
replacement are sometimes accompanied by complications such as infection
or bleeding. * Only few studies have previously dealt with this concern,
and in our study, we investigated the effectiveness of dobutamine to
increase heart rate and thus to avoid pacemaker implantation Methods: * We
performed a retrospective review of 2382 patients undergoing cardiac
surgery between the years 2012 and 2020. * Patients were 72,54 +/- 17,26
years old, 75% male, 25% female. * We included the patients diagnosed with
symptomatic bradyarrythmias (after excluding patients with prior PM
implantation), of whom 908 patients received Dobutamine (Dobutamine group)
and 1288 patients did not receive any positive chronotropic medications
(control group). Propensity score matching analysis was used and the
groups were matched in a 1:1 ratio. * The primary endpoint was the PM
implantation rate in the initial postoperative hospital stay (7days+/-3).
* The secondary endpoint was the incidence rate of postoperative atrial
fibrillation and ventricular tachycardia. <br/>Result(s): Of 2196
patients, the PM implantation rate was lower in the control group than the
dobutamine group (30,1 % vs. 42 %, respectively; p = 0.001). In the
subgroup analysis of symptomatic patients, the administration of
Dobutamine was associated with higher incidence rate of postoperative
ventricular tachycardia than in the control group (22,5 % vs. 11,5 %,
respectively; p = 0.001). Moreover, the administration of dobutamine
wasnot associated with higher incidence rate of postoperative atrial
fibrillation than in the control group (41,9 % vs. 43,8 %, respectively; p
= 0.28). <br/>Discussion(s): Dobutamine was not effective for the
treatment of symptomatic bradyarrythmias to avoid PM implantation. The
administration of dobutamine was associated with higher incidence rate of
postoperative ventricular tachycardia than in the control group. Further
large-scale randomized controlled studies are needed to elucidate the role
of the Intravenous sstimulators (Dobutamine) in the management of
postoperative bradyarrhythmias after cardiac surgery<br/>Copyright &#xa9;
2023

<101>
Accession Number
2027720660
Title
ADENOSINE IN WARM BLOOD CARDIOPLEGIA: A RANDOMIZED, DOUBLE-BLINDED,
PLACEBO-CONTROLLED TRIAL.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 52-53),
2023. Date of Publication: October 2023.
Author
SCOHY T.; ENGELHART J.; BENTALA M.; ENGST E.; VAN 'T VEER N.; RETTIG T.;
GERRITSE E.; GERRITSE B.
Institution
(SCOHY, BENTALA, ENGST, VAN 'T VEER, RETTIG, GERRITSE) Amphia Hospital,
Breda, Netherlands
(ENGELHART) Treant Hospital, Emmen, Netherlands
(GERRITSE) Rhadboud University:Institute for Computing and Information
Sciences, Nijmegen, Netherlands
Publisher
W.B. Saunders
Abstract
Introduction: Myocardial protection with cardioplegia is a major issue in
cardiac surgery since inadequate cardiac protection increases the risk of
postoperative cardiac dysfunction. Whether adenosine as an adjunct to
intermittent warm blood cardioplegia has an added value remains unclear
(1, 2). Therefore we investigated if the addition of adenosine to standard
intermittent warm blood cardioplegia reduced post-operative myocardial
injury in patients scheduled for minimal invasive mitral valve surgery
with endo-aortic clamping. <br/>Method(s): from Feb 2016 - July 2019,
ninety-four patients scheduled for minimal-invasive mitral valve surgery
are were included in this randomized, double-blinded, placebo-controlled
trial, at the Amphia Hospital (Breda, the Netherlands). The primary end
point is 6-hour Cardiac troponin T (cTnT) release. Secondary cardiac end
point is 18-hour postoperative Area Under the Curve (AUC) release of cTnT.
Routine blood samples: pre-operatively (T0); post-operatively, at arrival
at ICU (T1), 6 hours after arrival at ICU (T2), and 18 hours after arrival
at ICU (T3). All patients received through an endo aortic balloon (EAB) a
0.4mg adenosine bolus just before inflating the EAB. After inflation of
the EAB, antegrade warm blood cardioplegia is induced via bolus and
maintained via intermittent application of the 20:1 ratio of oxygenated
blood and hyperkalemic cardioplegic solution. One group received
adenosine-enriched cardioplegic solution (A group), and the second group
received cardioplegic solution (P group), cardioplegia is repeated every
20 minutes in both groups. <br/>Result(s): The median 6-hour cTnT release
was 0.26ng/L (IQR 0.22) in the A-group and 0.28 ng/L (IQR 0.28) in the
P-group (P=0.48) There was also no significant difference in the18 hour
postoperative AUC of cTnT (Adenosine Median 3.61 and IQR 4.35; Placebo
Median 4.38 and IQR 2.10), P=0.34. Post-operative atrial fibrillation
occurred in 13% in the A-group and 10% in the P-group. <br/>Discussion(s):
Adenosine as an added adjunct to intermittent antegrade warm blood
cardioplegia in minimal invasive mitral valve surge did not attenuate
postoperative myocardial injury.<br/>Copyright &#xa9; 2023

<102>
Accession Number
2027720631
Title
HEPARIN REVERSAL WITH TWO PROTAMINE-HEPARIN RATIOS AFTER CARDIOPULMONARY
BYPASS. A RANDOMIZED CONTROLLED PILOT FEASIBILITY STUDY.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 8-9),
2023. Date of Publication: October 2023.
Author
SAMARA E.; KARAKOSTA A.; ATHANASOPOULOU E.; OIKONOMOU D.; SIMINELAKIS S.;
TAHAN M.R.E.; TZIMAS P.
Institution
(SAMARA, KARAKOSTA, TZIMAS) University of Ioannina, Faculty of Medicine,
Department of Anesthesia and Postoperative Intensive Care, Ioannina,
Greece
(ATHANASOPOULOU, OIKONOMOU) University Hospital of Ioannina, Department of
Anesthesia and Postoperative Intensive Care, Ioannina, Greece
(SIMINELAKIS) University of Ioannina, Faculty of Medicine, Department of
Cardiothoracic Surgery, Ioannina, Greece
(TAHAN) Imam Abdulrahman Bin Faisal University, College of Medicine,
Anesthesiology Department, Dammam, Saudi Arabia
(TAHAN) Mansoura University, College of Medicine, Department of
Anaesthesia and Surgical Intensive Care, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Introduction: Protamine use for heparin reversal following cardiac surgery
may be associated with adverse events, while protamine excess may have an
additional anticoagulant effect.1 There is no consensus on the appropriate
protamine: heparin ratio despite the trend towards using a lower reversal
ratio than 1:1.2 The present pilot study aimed to compare the feasibility
of using two low ratios (0.6:1 vs. 0.8:1) of total calculated heparin dose
regarding the Activated Clotting Time (ACT), viscoelastic assays
(Clot-Pro), and clinical hemorrhage for the planned randomized controlled
study. <br/>Method(s): Following ethical approval, 27 patients undergoing
elective cardiac surgery with cardiopulmonary bypass were randomized to
receive an initial protamine dose in a ratio of 0.6:1 (11 patients) or
0.8:1 (16 patients) of the total calculated heparin dose used. ACT value
and Clot Pro tests were recorded before surgery and after administering
the initial and subsequent reversal doses. Subsequent 25mg boluses of
protamine were administrated in case of ongoing clinical hemorrhage or
identified heparin excess measured with plasma heparin concentration.
Cumulative 24-hour blood loss, packed red blood cells (PRBCs), platelets
(PLT), fresh frozen plasma (FFP), prothrombin concentrate complex (PCC),
and fibrinogen administrated, guided by the Clot Pro results, were
recorded. <br/>Result(s): Compared with the 0.8:1 ratio, patients in the
0.6:1 ratio group received less protamine and less PLT units
intraoperatively (Table 1). The two groups were similar regarding the need
for additional protamine (0% vs. 38%, p=0.07), heparin excess without
clinical bleeding detected with Clot Pro (18% vs. 44%, p=0.33),
intraoperative and 24 postoperative hours in the transfused PRBCs, FFP,
fibrinogen, and PPC (Table 1), postoperative ACT. One patient of the 06:1
group required re-operation for postoperative bleeding.
<br/>Discussion(s): Heparin reversal with a protamine: heparin ratio of
0.6:1 is feasible compared with a 0.8:1 ratio. Larger studies are needed
to examine the efficacy and safety of the 0.6:1 ratio and the sensitivity
and specificity of Clot Pro 's compared with ACT.<br/>Copyright &#xa9;
2023

<103>
Accession Number
2027720599
Title
A randomized comparison between two different CPB oxygenators in order to
improve recovery from delirium and or cognitive decline in the elderly
during cardiac surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 15-16),
2023. Date of Publication: October 2023.
Author
MANTOVANI L.; CIMAGLIA P.; ZANNONI S.; TENTI E.; SANGIORGI D.; SAVINI C.;
TOLIO V.
Institution
(MANTOVANI, CIMAGLIA, ZANNONI, TENTI, SANGIORGI, SAVINI, TOLIO) Maria
Cecilia Hospital - Gruppo Villa Maria Care and Research, Cotignola, Italy
Publisher
W.B. Saunders
Abstract
Introduction: Previous studies reported that the type of oxygenating
system used in extracorporeal circulation is directly involved in
incidence of post-operative delirium and post-operative cognitive
impairment (up to 30%-45% of elderly patients undergoing cardiac surgery)
with a significant impact on quality of life, hospitalizations and short-
and long-term mortality. A multicenter, single blind randomized study was
performed to determine if a new oxygenator, Remowell2, compared with
current gold standard technologies, can reduce delirium and cognitive
dysfunction in older patients undergoing cardiac surgery. <br/>Method(s):
We randomized 175 elderly patients (age 65+) undergoing cardiac surgery
(Coronary Artery Bypass Graft) to two different cardiopulmonary bypass
(CPB) oxygenators (87 Inspire and 88 Remowell2) between september 2019 and
march 2022. Primary aim of the study was to assess incidence of intra
hospital delirium (CAM scale evaluation) and any difference between the
two groups according to structural differences between the construction
technologies of the two types of CPB oxygenators; secondary endpoints were
evaluation of cognitive decline after 6 months (evaluated by
neuropsychiatric tests and MoCa test). We also recorded incidence of AMI
in the first 72 postoperative hours, ARDS during the entire intra hospital
lenght of stay and 1 year incidence of deaths, cardio-vascular related
deaths, cerebral stroke and re-hospitalization. <br/>Result(s): No
statstical difference were observed in baseline characteristics between
the two randomized groups. A statistical trend (p=0.093) was observed in
favour of the Remowell2 (16.0%) group versus Inspire (26.0%) regarding the
incidence of severe postoperative delirium (defined as 4+ positive CAM or
need for delirium therapy), a predictable lower performance was observed
in the delirium group in executing neuropsycological test at discharge and
up to 6 months with a good recovery at one year. Marginal effect plots
showed differences in enolase levels (p=0.049), white blood cells
(p=0.006) and neutrophils (p=0.003) in favour of Remowell2. Plasmatic
levels of pro-inflammatory markers were higher in the severe delirium
group as well as the incidence of deaths (Log-Rank test p=0.022) and
cerebrovascular events (p=0.012) at one year. No statistical difference
between oxygenators was detected for AMI and ARDS events during the
hospital stay. <br/>Discussion(s): Using of novel and better construction
tecnologies in CPB oxygenators devices is probably associated with a
better outcome in the elderly population undergoing cardiac surgery
especially regarding neurocognitive and neurological
outcomes.<br/>Copyright &#xa9; 2023

<104>
Accession Number
2027720594
Title
INVESTIGATING THE PREDICTIVE VALUE OF URINARY BIOMARKERS IN CARDIAC
SURGERY RELATED ACUTE KIDNEY INJURY: SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 38th
EACTAIC Annual Congress. Budapest Hungary. 37(Supplement 1) (pp 22-23),
2023. Date of Publication: October 2023.
Author
KISS N.; PAPP M.; TURAN C.; KOI T.; FEHERVARI P.; MADACH K.; ZUBEK L.;
HEGYI P.; MOLNAR Z.
Institution
(KISS) Semmelweis University, Heart and Vascular Center, Budapest, Hungary
(KISS, PAPP, TURAN, KOI, FEHERVARI, MADACH, ZUBEK, HEGYI, MOLNAR)
Semmelweis University, Centre for Translational Medicine, Budapest,
Hungary
(KISS, TURAN, MADACH, ZUBEK, MOLNAR) Semmelweis University, Department of
Anaesthesiology and Intensive Therapy, Budapest, Hungary
(PAPP) St John's Hospital, Budapest, Hungary
(KOI) Budapest University of Technology and Economics, Department of
Stochastics, Budapest, Hungary
(FEHERVARI) University of Veterinary Medicine, Depertment of
Biostatistics, Budapest, Hungary
Publisher
W.B. Saunders
Abstract
Introduction: Cardiac surgery related acute kidney injury (CS-AKI)
develops in 20-50% of patients undergoing cardiac surgery and is
responsible for increased postoperative morbidity and mortality. Urinary
biomarkers have been investigated to predict and thus prevent acute kidney
injury in several critical condition, but their predictive value remains
unclear in regards to cardiac surgery related postoperative renal failure.
Our aim was to assess the predictive value of urinary biomarkers for
prediction of cardiac surgery related acute kidney injury. <br/>Method(s):
This study was registered in PROSPERO (CRD42022371166). We conducted our
systematic search in 3 databases on 11.11. 2022 (MEDLINE, EMBASE,
COCHRANE) without filters or restrictions. We included both randomised and
non-randomised studies reporting diagnostic accuracy data. Our primary
outcome was the predictive values of individual urinary biomarkers
measured at different time-points to identify patients developing acute
kidney injury as per Kidney Disease Improving Global Outcomes (KDIGO)
criteria and also calculated the performance of combination of urinary
biomarkers. We collected the Area Under the Curve (AUC) values and their
confidence intervals and performed a meta-analysis using random or mixed
effects models. We fitted Summary Receiver Operating Characteristics
(SROC) curves using 2 x 2 contingency tables extracted from the studies
containing the true positive, false positive, false negative, and true
negative values. Risk of bias was assessed by QUADAS-2. <br/>Result(s): We
screened 10763 records and included 92 articles in the analysis.
Predictive value of individual biomarkers was at maximum fair;
TIMP2xIGFBP7 measured in the intraoperative and early postoperative period
AUC 0.73 (95% CI: 0.65-0.81) for prediction of KDIGO stage 2-3 acute
kidney injury; L-FABP measured from 6h till 24h postoperatively AUC 0.75
(95% CI: 0.68-0.81) for prediction of all stages of CS-AKI. There was no
significant difference between the AUC-ROC of urinary biomarkers
(p=0.0655). Combination of urinary biomarker measurements yielded a good
predictive value in identification of both total and only severe cases of
acute kidney injury with AUCs 0.82 (95% CI: 0.75-0.88) and 0.85 (95% CI:
0.79-0.91) respectively. The combination of three biomarkers did not
provide significant predictive value improvement (p=0.625) compared to the
combination of two urinary biomarkers AUC 0.87 (95% CI: 0.78-0.95) vs 0.84
(95% CI: 0.75-0.92) in prediction of severe CS-AKI. <br/>Discussion(s):
Our study shows that biomarkers identified patients developing CS-AKI.
Individual biomarkers performed with fair accuracy, while combination of
two biomarkers improved the accuracy. However, combining more than two
urinary biomarkers did not result in a better predictive value but it
could increase costs unnecessarily.<br/>Copyright &#xa9; 2023

<105>
Accession Number
2030908678
Title
Utilization of a Pharmacy Technician to Improve Immunization Rates for
Pediatric Heart and Kidney Transplant Recipients.
Source
American Journal of Transplantation. Conference: 2022 American Transplant
Congress. Boston United States. 22(Supplement 3) (pp 1073-1074), 2022.
Date of Publication: June 2022.
Author
Brewer A.; Benefield E.; Boehme S.; Jensen B.; Molina K.; Peterson C.;
Heyrend C.
Institution
(Brewer, Benefield, Boehme, Jensen, Heyrend) Primary Children's Hospital,
Salt Lake City, UT, United States
(Molina, Peterson) University of Utah, Salt Lake City, UT, United States
Publisher
Elsevier B.V.
Abstract
Purpose: Transplant recipients are at increased risk of infectious
complications from vaccine-preventable diseases. This study aimed to
evaluate using a pharmacy technician to provide routine childhood
immunizations during kidney transplant or heart transplant clinic to
improve immunization rates. <br/>Method(s): Patients seen in our pediatric
kidney or heart transplant clinics between August 2021 and November 2021
were included. Patient vaccine records were screened by the pharmacy
technician, under transplant pharmacist supervision, prior to clinic
visits to identify needed immunizations. Recommendations were based on the
Advisory Committee on Immunization Practices (ACIP) and the American
Society of Transplantation (AST) guidelines for vaccination of solid organ
transplant candidates and recipients. The pharmacy technician contacted
parents before clinic to discuss in clinic vaccination administration
whenever possible. With verbal consent, the pharmacy technician submitted
a vaccine prescription to the hospital's outpatient pharmacy, acquired the
vaccine from the pharmacy, and administered the vaccine during clinic
under the supervision of an immunization-certified pharmacist. All
vaccines were entered into the Utah State Immunization Information System
Registry. <br/>Result(s): Prior to initiation of this program, vaccines
were rarely administered in clinic. During the 4-month study period, a
total of 168 patients were screened (86 kidney transplant recipients, 82
heart transplant recipients), with 49 (29%) fully vaccinated. A total of
47 patients received vaccines during the study period (22 kidney
transplant recipients, 25 heart transplant recipients) with 89 vaccine
doses administered. The most frequently administered vaccines were
SARS-CoV-2, influenza, and meningococcal (Table 1). No adverse events were
recorded. <br/>Conclusion(s): Utilizing a pharmacy technician certified in
immunization administration increased the number of vaccines administered
to pediatric kidney and heart transplant recipients. Transplant programs
who adopt a pharmacy technician immunization program in the clinic setting
may benefit from close collaboration with an outpatient pharmacy. Vaccines
and Number of Doses Administered Vaccine doses administered Kidney
Transplant Patients (n=22) Heart Transplant Patients (n=25) SARS-CoV-2 17
10 Influenza 9 17 Meningococcal 3 11 Human Papillomavirus 3 8 Pneumococcal
conjugate or polysaccharide 5 4 Polio 0 1 Tetanus-Diphtheria Acellular
Pertussis or Tetanus-Diphtheria Toxoids 0 1 CITATION INFORMATION: Brewer
A., Benefield E., Boehme S., Jensen B., Molina K., Peterson C., Heyrend C.
Utilization of a Pharmacy Technician to Improve Immunization Rates for
Pediatric Heart and Kidney Transplant Recipients AJT, Volume 22,
Supplement 3 DISCLOSURES: A. Brewer: None. E. Benefield: None. S. Boehme:
None. B. Jensen: None. K. Molina: None. C. Heyrend: None. [Figure
presented]<br/>Copyright &#xa9; 2022 American Society of Transplantation &
American Society of Transplant Surgeons. Published by Elsevier Inc. All
rights reserved.

<106>
Accession Number
2030908165
Title
Equity in Access to Deceased Donor Transplant for Candidates on the Heart
Waitlist.
Source
American Journal of Transplantation. Conference: 2022 American Transplant
Congress. Boston United States. 22(Supplement 3) (pp 870), 2022. Date of
Publication: June 2022.
Author
Bradbrook K.; Robinson A.; Goff R.; Stewart D.
Institution
(Bradbrook, Robinson, Goff) Research, United Network for Organ Sharing,
Richmond, VA, United States
(Stewart) United Network for Organ Sharing, Richmond, VA, United States
Publisher
Elsevier B.V.
Abstract
Purpose: Transplantation is often the gold standard therapy for those with
organ failure, but limited supply prevents all patients from accessing
this treatment. The Organ Procurement and Transplantation Network (OTPN)
launched a publicly accessible dashboard which monitors equity in access
to deceased donor (DD) transplantation for lung, liver, and kidney
candidates. Most recently, heart was incorporated into the dashboard.
<br/>Method(s): OPTN data were analyzed using Poisson rate regression
modeling and an access to transplant score (ATS) was created which
summarizes a heart candidate's relative likelihood of receiving a DD
transplant, controlling for intentional policydriven. The model was built
on rolling 6-month cohorts of active heart registrations that waited at
least one day between 1/1/2010 and 6/30/2021. The standard deviation (SD)
in ATS was presented where smaller SDs are favorable and reflect a more
equitable system. <br/>Result(s): The overall SD in ATS has remained
stable over time for heart. After controlling for medical urgency status,
donation service area (DSA), blood type, height and weight were the four
factors most associated with inequity in the recent 6-month period. Blood
type AB candidates had the highest transplant rates and blood type O the
lowest. In addition, taller, less-heavy and younger candidates had better
access. <br/>Conclusion(s): Overall, equity in access to DD heart
transplant has remained relatively stable over the past decade despite
major policy changes in 2018 (6 tiers) and 2020 (removal of DSA). The
equity in access framework provides an additional tool for policy
development and monitoring. Further research is need to investigate
disparities associated with DSA which appear to have declined since 2018.
CITATION INFORMATION: Bradbrook K., Robinson A., Goff R., Stewart D.
Equity in Access to Deceased Donor Transplant for Candidates on the Heart
Waitlist AJT, Volume 22, Supplement 3 DISCLOSURES: K. Bradbrook: None. A.
Robinson: None. [Figure presented]<br/>Copyright &#xa9; 2022 American
Society of Transplantation & American Society of Transplant Surgeons.
Published by Elsevier Inc. All rights reserved.

<107>
Accession Number
2030907786
Title
Unique Treatment of Duodenal Perforation in Middle Aged Female Patient
with Liver Transplant.
Source
American Journal of Transplantation. Conference: 2022 American Transplant
Congress. Boston United States. 22(Supplement 3) (pp 713-714), 2022. Date
of Publication: June 2022.
Author
Elshebiny H.; Syed-Mohammed J.
Institution
(Elshebiny) Wayne State University School of Medicine, Detroit, MI, United
States
(Syed-Mohammed) Henry Ford Health System, Detroit, MI, United States
Publisher
Elsevier B.V.
Abstract
Purpose: We describe a unique method of treatment of duodenal perforation
due to biliary stent using an over the scope clip-OTSC. <br/>Method(s): A
68 year old female with a history of hepatitis B induced cirrhosis, and
hepatic cancer was treated with a liver transplant. Postoperative course
indicated high liver function labs, and endoscope retrograde
echolangiopancreatography-ERCP showed an anastomotic biliary stricture,
and donor-recipient duct mismatch. Sphincterotomy and placement of a stent
treated the stricture. At night, the patient developed gastrointestinal-GI
symptoms and was found to have post-ERCP pancreatitis confirmed by
amylase=520IU/L. She was given IV fluid until the pancreatitis resolved. A
few days later, the patient visited the hospital again with worsening GI
pain, anorexia, and fever. Physical exam showed pain radiating from the
epigastrium to the right upper quadrant, back, and right flank area.
Computerized Topography(CT) scans demonstrated a large abscess collection
extending into the right paracolic gutter, and right perirenal fat with
the biliary stent(BS) extending through the second portion of the duodenum
into this collection, suggesting perforation of the duodenum due to the BS
inserted. After draining the abscess percutaneously, the patient underwent
esophagogastroendoscopy which showed the migration of the BS that resulted
in the perforation of the duodenal wall by the distal end of the stent.
The BS was removed, and the duodenal defect was closed with an OTSC. ERCP
was then performed with placement of a double pigtail BS for treatment of
patient's initial biliary anastomotic stricture. <br/>Result(s): After the
OTSC, the patient's symptoms improved and returned on a regular diet.
However, she later developed multiple cardiac abnormalities including
sinus tachycardia on both Lead II, V1. ECG has also shown dilated left
ventricle, ventricle failure, elevated Troponin I, and elevated pulmonary
artery pressure. Abdomen CT showed contrast within the duodenal cavity
concerning for persistent leak. The duodenal perforation was small,
however the presence of endoscopic over the scope mucosal clip was
identified and was believed to be maintaining a minor patency of the track
from duodenal to retroperitoneal abscess that had been drained for some
months by the biliary pigtail. <br/>Conclusion(s): Omental patch is the
common treatment for post-ERCP pancreatitis and an abdominal lavage, which
is a surgical procedure for treating perforated ulcers. In our case, the
duodenal perforation was closed using an OTSC (non-surgical). In a
retrospective study, it was found that using the OTSC offered a safer
treatment option for patients with non-variceal upper GI bleeding with
cardiovascular comorbidity. Another systematic review shows the OTSC
effectiveness of treatment for defects in the abdomen created by
endoscopic resections and stent fixation. We add to the research the case
of our patient, who did this procedure but developed cardiac symptoms.
CITATION INFORMATION: Elshebiny H., Syed-Mohammed J. Unique Treatment of
Duodenal Perforation in Middle Aged Female Patient with Liver Transplant
AJT, Volume 22, Supplement 3 DISCLOSURES: H. Elshebiny: None. J.
Syed-Mohammed: None.<br/>Copyright &#xa9; 2022 American Society of
Transplantation & American Society of Transplant Surgeons. Published by
Elsevier Inc. All rights reserved.

<108>
Accession Number
2030918885
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) (no pagination), 2024. Article Number: e080042. 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, Lin, Zhang) Department of Nursing, Zhongshan Hospital,
Fudan University, Shanghai, China
(Mi, Zhou, Pan) Department of Cardiology, Zhongshan Hospital, Fudan
University, Shanghai, China
Publisher
BMJ Publishing Group
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.<br/>Copyright &#xa9; 2024 BMJ Publishing Group. All rights
reserved.

<109>
Accession Number
2028382958
Title
Systematic Review and Critical Appraisal of Prediction Models for
Readmission in Coronary Artery Disease Patients: Assessing Current
Efficacy and Future Directions.
Source
Risk Management and Healthcare Policy. 17 (pp 549-557), 2024. Date of
Publication: 2024.
Author
Zhang Y.; Zhu X.; Gao F.; Yang S.
Institution
(Zhang, Zhu, Gao) College of Nursing, Hangzhou Normal University,
Hangzhou, China
(Yang) Department of Nursing, Zhejiang Hospital, Hangzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Coronary artery disease (CAD) patients frequently face
readmissions due to suboptimal disease management. Prediction models are
pivotal for detecting early unplanned readmissions. This review offers a
unified assessment, aiming to lay the groundwork for enhancing prediction
models and informing prevention strategies. <br/>Method(s): A search
through five databases (PubMed, Web of Science, EBSCOhost, Embase, China
National Knowledge Infrastructure) up to September 2023 identified studies
on prediction models for coronary artery disease patient readmissions for
this review. Two independent reviewers used the CHARMS checklist for data
extraction and the PROBAST tool for bias assessment. <br/>Result(s): From
12,457 records, 15 studies were selected, contributing 30 models targeting
various CAD patient groups (AMI, CABG, ACS) from primarily China, the USA,
and Canada. Models utilized varied methods such as logistic regression and
machine learning, with performance predominantly measured by the c-index.
Key predictors included age, gender, and hospital stay duration.
Readmission rates in the studies varied from 4.8% to 45.1%. Despite high
bias risk across models, several showed notable accuracy and calibration.
<br/>Conclusion(s): The study highlights the need for thorough external
validation and the use of the PROBAST tool to reduce bias in models
predicting readmission for CAD patients.<br/>Copyright &#xa9; 2024 Zhang
et al.

<110>
Accession Number
2028523941
Title
Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic
Surgery and the Predictors of Moderate-to-Severe Pain-Secondary Data
Analysis.
Source
Journal of Clinical Medicine. 13(3) (no pagination), 2024. Article Number:
844. Date of Publication: February 2024.
Author
Tomaszek L.; Fenikowski D.; Ciez-Piekarczyk N.; Medrzycka-Dabrowska W.
Institution
(Tomaszek, Fenikowski, Ciez-Piekarczyk) Department of Thoracic Surgery,
Institute of Tuberculosis and Lung Diseases, Rabka-Zdroj Branch,
Rabka-Zdroj 34-700, Poland
(Tomaszek) Department of Specialist Nursing, Faculty of Medicine and
Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow
30-705, Poland
(Ciez-Piekarczyk) Medical Institute, Academy of Applied Sciences in Nowy
Targ, Nowy Targ 34-400, Poland
(Medrzycka-Dabrowska) Department of Anaesthesiology and Intensive Care
Nursing, Medical University of Gdansk, Gdans, 7 Debinki Street, Gdansk
80-211, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Pain management among children following thoracic surgery is
an area of significant practice variability. Understanding the risk
factors of moderate-to-severe pain intensity will allow for adequate pain
relief. The aim of the study was to assess the maximum intensity of pain
at rest in pediatric patients within 24 h of thoracic surgery and to
investigate the prevalence and predictors of moderate-to-severe pain.
Methods and findings: This is a prospective cohort study of patients in
observational and randomized controlled trials following thoracic surgery.
A secondary analysis of data was conducted using data collected from 446
patients aged 7-18 years undergoing thoracic surgery. The primary endpoint
was maximum pain intensity (Numerical Rating Scale; NRS; range: 0-10) and
the secondary endpoint was the prevalence and predictors of
moderate-to-severe pain (NRS > 2/10). The median maximum pain in the
cohort was 3 [0; 4]. During the immediate postoperative period, 54% of
patients reported a maximum NRS > 2/10. The infusion of morphine by an
intravenous route (vs. epidural route) was a protective factor against
moderate-to-severe pain. Taking into account the findings related to the
type of epidural analgesia (vs. intravenous morphine), it was found that
only the administration of 0.25% bupivacaine combined with morphine or
fentanyl was a protective factor against moderate-to-severe postoperative
pain. Patients aged 14-18 years (vs. aged 7-13 years) had an increased
risk of reporting pain as moderate-to-severe. <br/>Conclusion(s): The
route of analgesic administration, type of multimodal analgesia, and
patients' age predict moderate-to-severe pain in pediatric patients after
thoracic surgery.<br/>Copyright &#xa9; 2024 by the authors.

<111>
Accession Number
2028947652
Title
The Surgical Treatment of Infective Endocarditis: A Comprehensive Review.
Source
Diagnostics. 14(5) (no pagination), 2024. Article Number: 464. Date of
Publication: March 2024.
Author
Arjomandi Rad A.; Zubarevich A.; Osswald A.; Vardanyan R.; Magouliotis
D.E.; Ansaripour A.; Kourliouros A.; Sa M.P.; Rassaf T.; Ruhparwar A.;
Sardari Nia P.; Athanasiou T.; Weymann A.
Institution
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford
OX3 9DU, United Kingdom
(Arjomandi Rad, Vardanyan, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London SW7 5NH, United Kingdom
(Arjomandi Rad, Sardari Nia) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, Maastricht 6229 HX, Netherlands
(Zubarevich, Osswald, Ruhparwar, Weymann) Department of Cardiothoracic,
Transplant and Vascular Surgery, Hannover Medical School, Hannover 30625,
Germany
(Magouliotis) Department of Cardiothoracic Surgery, University of
Thessaly, Larissa 38221, Greece
(Ansaripour, Kourliouros) Department of Cardiothoracic Surgery, John
Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
(Sa) Department of Cardiothoracic Surgery, UPMC Heart and Vascular
Institute, University of Pittsburgh, Pittsburgh, PA 15224, United States
(Rassaf) Department of Cardiology, West German Heart and Vascular Center
Essen, University Hospital of Essen, University Duisburg-Essen, Essen
45138, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Infective endocarditis (IE) is a severe cardiac complication with high
mortality rates, especially when surgical intervention is delayed or
absent. This review addresses the expanding role of surgery in managing
IE, focusing on the variation in surgical treatment rates, the impact of
patient demographics, and the effectiveness of different surgical
approaches. Despite varying global data, a notable increase in surgical
interventions for IE is evident, with over 50% of patients undergoing
surgery in tertiary centres. This review synthesizes information from
focused literature searches up to July 2023, covering preoperative to
postoperative considerations and surgical strategies for IE. Key
preoperative concerns include accurate diagnosis, appropriate
antimicrobial treatment, and the timing of surgery, which is particularly
crucial for patients with heart failure or at risk of embolism. Surgical
approaches vary based on valve involvement, with mitral valve repair
showing promising outcomes compared to replacement. Aortic valve surgery,
traditionally favouring replacement, now includes repair as a viable
option. Emerging techniques such as sutureless valves and aortic
homografts are explored, highlighting their potential advantages in
specific IE cases. The review also delves into high-risk groups like
intravenous drug users and the elderly, emphasizing the need for tailored
surgical strategies. With an increasing number of patients presenting with
prosthetic valve endocarditis and device-related IE, the review
underscores the importance of comprehensive management strategies
encompassing surgical and medical interventions. Overall, this review
provides a comprehensive overview of current evidence in the surgical
management of IE, highlighting the necessity of a multidisciplinary
approach and ongoing research to optimize patient outcomes.<br/>Copyright
&#xa9; 2024 by the authors.

<112>
Accession Number
2027973008
Title
Effects of Interventions Based on Patient Expectations on Coronary Surgery
Outcomes: A Randomized Clinical Trial.
Source
Journal of Tehran University Heart Center. 18(4) (pp 269-277), 2023. Date
of Publication: 2023.
Author
Noruzi Larki K.; Mohammadi T.; Zakerimoghadam M.; Sayadi L.
Institution
(Noruzi Larki, Zakerimoghadam) School of Nursing and Midwifery, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mohammadi) Departments of Biostatistics, School of Public Health, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Sayadi) Nursing and Midwifery Care Research Center, School of Nursing and
Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Tehran Heart Center
Abstract
Background: Coronary surgery can have various outcomes, such as fear of
death, cardiac anxiety, and pain disability. This study aimed to evaluate
the effects of interventions based on patient expectations on different
outcomes of coronary surgery, including expectations, cardiac anxiety, and
pain-induced disability. <br/>Method(s): This randomized clinical trial
evaluated 60 coronary surgery candidates. Patients meeting the inclusion
criteria were randomly assigned to control and intervention groups. The
patients were contacted 1 to 2 weeks before coronary surgery to complete
the Cardiac Surgery Patient Expectations Questionnaire (C-SPEQ). Based on
the analysis of expectations, the intervention group underwent
interventions to optimize expectations, whereas the control group received
only routine care. The Cardiac Anxiety Questionnaire (CAQ) and the Pain
Disability Index (PDI) were completed on the day of hospitalization. Three
months later, the participants recompleted all 3 questionnaires. The data
were analyzed with descriptive and analytical statistics in SPSS 16.0.
<br/>Result(s): There were no significant differences between the control
and intervention groups in baseline variables, pain-induced disability
(P=0.353), and cardiac anxiety (P=0.479). After the intervention, no
significant differences were observed between the groups concerning
expectations (P=0.554) and pain-induced disability (P=0.557) when the
confounding variables were adjusted. Nevertheless, cardiac anxiety
decreased significantly (P=0.027). <br/>Conclusion(s): Our interventions
improved expectations and mitigated anxiety among coronary surgery
patients. Actualization and optimization of patient expectations should be
considered in the care of coronary surgery candidates.<br/>Copyright
&#xa9; 2023 Tehran University of Medical Sciences.

<113>
Accession Number
2030766326
Title
Meta-analysis in cardiovascular surgery: A valuable statistical tool.
Source
Cirugia Cardiovascular. (no pagination), 2024. Date of Publication: 2024.
Author
Urso S.; Dayan V.
Institution
(Urso) Servicio de Cirugia Cardiaca, Hospital Universitario Dr. Negrin,
Las Palmas de Gran Canaria, Spain
(Dayan) Centro Cardiovascular Universitario Hospital de Clinicas. Coronary
artery bypass grafting is superior to percutaneous coronary intervention
for all women subgroups, Montevideo, Uruguay
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)

<114>
Accession Number
643713486
Title
Effect of hemoadsorption during cardiac surgery for S. aureus endocarditis
- a REMOVE trial post-hoc analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 09 Mar 2024.
Author
Caldonazo T.; Van den Eynde J.; Doenst T.; Kirov H.; Franz M.; Hagel S.;
Lehmann T.; Diab M.
Institution
(Caldonazo, Doenst, Kirov, Diab) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Franz) Division of Cardiology, Department of Internal Medicine,
Friedrich-Schiller-University Jena, Jena, Germany
(Hagel) Institute for Infectious Diseases and Infection Control,
Friedrich-Schiller-University Jena, Germany
(Lehmann) Institute for Medical Statistics, Friedrich-Schiller-University
Jena, Jena, Germany
(Diab) Department of Cardiac Surgery, Rotenburg an der Fulda, Germany
Abstract
OBJECTIVES: Multi-organ failure is one of the leading causes of mortality
after cardiac surgery for infective endocarditis (IE). Although the
randomized evidence does not support the use of hemoadsorption during
cardiac surgery for IE, observational studies suggest a beneficial effect
in selected patient groups. S. aureus is the most common pathogen, and its
presence is an independent mortality predictor. We aimed to analyze the
effect of hemoadsorption in patients with IE caused by S. aureus.
<br/>METHOD(S): This is a post-hoc analysis of the REMOVE trial that
randomized 288 patients with IE who underwent cardiac surgery with
hemoadsorption using CytoSorb or control. The primary outcome was
DELTASequential Organ Failure Assessment (SOFA), defined as the difference
between the mean total postoperative and baseline SOFA score within
24hours of surgery. <br/>RESULT(S): Among the total of 282 patients
included in the modified intention-to-treat analysis of the REMOVE trial,
73 (25.9%) had S. aureus IE (38 patients in the hemoadsorption group and
35 patients in the control group). The overall DELTASOFA did not differ
between the intervention groups in patients with S. aureus IE (MD= -0.4,
95% CI -2.3 to 1.4, p=0.66) and neither did 30-day mortality (HR=1.32, 95%
CI 0.53 to 3.28, p=0.55). No differences were observed with regard to any
of the other secondary outcomes. <br/>CONCLUSION(S): Based on a post-hoc
analysis from REMOVE trial, the intraoperative use of hemoadsorption in
patients with S. aureus IE was not associated with reduction of
postoperative organ dysfunction, 30-day mortality or other major clinical
end-points.<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.