EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 107

Results Generated From:
Embase <1980 to 2024 Week 10>
Embase Weekly Updates (updates since 2024-03-01)

<1>
Accession Number
2030647303
Title
Gamification-augmented home-based exercise for peripheral artery disease:
Rationale and design of the GAMEPAD Study.
Source
American Heart Journal. 270 (pp 95-102), 2024. Date of Publication: April
2024.
Author
Fanaroff A.C.; Coratti S.; Farraday D.; Norton L.; Rareshide C.; Zhu J.;
Levin M.G.; Damrauer S.M.; Giri J.S.; Chokshi N.P.; Jackson B.M.; Patel
M.S.
Institution
(Fanaroff, Zhu, Levin, Giri, Chokshi) Department of Medicine, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, United
States
(Fanaroff, Damrauer) Penn Cardiovascular Outcomes, Quality, and Evaluative
Research Center, University of Pennsylvania, Philadelphia, PA, United
States
(Fanaroff, Coratti, Farraday, Norton, Rareshide, Zhu, Giri) Penn Center
for Health Incentives and Behavioral Economics, University of
Pennsylvania, Philadelphia, PA, United States
(Fanaroff, Damrauer, Giri, Chokshi) Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, PA, United States
(Fanaroff, Chokshi) Penn Center for Digital Cardiology, University of
Pennsylvania, Philadelphia, PA, United States
(Norton, Zhu) Department of Medical Ethics and Health Policy, University
of Pennsylvania, Philadelphia, PA, United States
(Levin, Damrauer, Giri) Corporal Michael J. Crescenz VA Medical Center,
Philadelphia, United States
(Damrauer) Division of Vascular Surgery, University of Pennsylvania,
Philadelphia, PA, United States
(Jackson) Division of Vascular Surgery, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Patel) Ascension Health, St. Louis, MO, United States
Publisher
Elsevier Inc.
Abstract
Background: Supervised exercise therapy improves walking performance,
functional capacity, and quality of life in patients with peripheral
artery disease (PAD). However, few patients with PAD are enrolled in
supervised exercise programs, and there are a number of logistical and
financial barriers to their participation. A home-based walking
intervention is likely to be more accessible to patients with PAD, but no
fully home-based walking program has demonstrated efficacy. Concepts from
behavioral economics have been used to design scalable interventions that
increase daily physical activity in patients with atherosclerotic vascular
disease, but whether a similar program would be effective in patients with
PAD is uncertain. Study Design and Objectives: GAMEPAD (NCT04536012) is a
pragmatic, virtual, randomized controlled trial designed to evaluate the
effectiveness of a gamification strategy informed by concepts from
behavioral economics to increase daily physical activity in patients with
PAD who are seen in cardiology and vascular surgery clinics affiliated
with the University of Pennsylvania Health System. Patients are contacted
by email or text message, and complete enrollment and informed consent on
the Penn Way to Health online platform. A GAMEPAD substudy will evaluate
the effectiveness of opt-in versus opt-out framing when approaching
patients for study participation. Patients are then provided with a
wearable fitness tracker, establish a baseline daily step count, set a
goal to increase daily step count by 33%-50%, and are randomized 1:1 to
the gamification or control arms. Interventions continue for 16 weeks,
including a 4-week period during which goal step count is gradually
increased in the gamification arm, with follow-up for an additional 8
weeks to evaluate the durability of behavior change. The trial has met its
enrollment goal of 102 participants, with a primary endpoint of change
from baseline in daily steps over the 16-week intervention period. Key
secondary endpoints include change from baseline in daily steps over the
8-week postintervention follow-up period and changes in patient-reported
measures of PAD symptoms and quality of life over the intervention and
follow-up periods. Conclusion(s): GAMEPAD is a virtual, pragmatic
randomized clinical trial of a novel, fully home-based walking
intervention informed by concepts from behavioral economics to increase
physical activity and PAD-specific quality of life in patients with PAD.
Its results will have important implications for the application of
behavioral economic concepts to scalable home-based strategies to promote
physical activity in patients with PAD and other disease processes where
physical activity is limited by exertional symptoms. Clinical trial
registration: clinicaltrials.gov; NCT04536012. Copyright © 2024
Elsevier Inc.

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

<3>
[Use Link to view the full text]
Accession Number
2030606116
Title
Transcatheter or Surgical Aortic Valve Replacement in Patients with Severe
Aortic Stenosis and Small Aortic Annulus: A Randomized Clinical Trial.
Source
Circulation. 149(9) (pp 644-655), 2024. Date of Publication: 27 Feb 2024.
Author
Rodes-Cabau J.; Ribeiro H.B.; Mohammadi S.; Serra V.; Al-Atassi T.;
Iniguez A.; Vilalta V.; Nombela-Franco L.; Saez De Ibarra Sanchez J.I.;
Auffret V.; Forcillo J.; Conradi L.; Urena M.; Moris C.; Munoz-Garcia A.;
Paradis J.-M.; Dumont E.; Kalavrouziotis D.; Maria Pomerantzeff P.; Rosa
V.E.E.; Pezzute Lopes M.; Sureda C.; Diaz V.A.J.; Giuliani C.; Avvedimento
M.; Pelletier-Beaumont E.; Pibarot P.
Institution
(Rodes-Cabau, Mohammadi, Paradis, Dumont, Kalavrouziotis, Giuliani,
Avvedimento, Pelletier-Beaumont, Pibarot) Cardiology Department, Quebec
Heart and Lung Institute, Laval University, Quebec City, Canada
(Ribeiro, Maria Pomerantzeff, Rosa, Pezzute Lopes) Interventional
Cardiology Department, Heart Institute (InCor), Hospital das Clinicas
HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo,
Brazil
(Serra, Sureda) Cardiology Department, Vall d'Hebron University Hospital,
Barcelona, Spain
(Al-Atassi) Division of Cardiac Surgery, University of Ottawa Heart
Institute, ON, Canada
(Iniguez, Diaz) Cardiology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Spain
(Al-Atassi) Cardiovascular Research Group, Galicia sur Health Research
Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
(Vilalta) Department of Interventional Cardiology, Germans Trias i Pujol
University Hospital, Badalona, Spain
(Nombela-Franco) Interventional Cardiology Department, Cardiovascular
Institute, IdISSC, Hospital Clinico San Carlos, Madrid, Spain
(Saez De Ibarra Sanchez) Department of Cardiac Surgery, University
Hospital de Son Espases, Mallorca, Spain
(Auffret) Department of Cardiology, Rennes University Hospital, Rennes,
France
(Forcillo) Department of Cardiac Surgery, Centre Hospitalier Universitaire
de Montreal, Montreal, Canada
(Conradi) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Urena) Department of Cardiology, Hospital Bichat Claude-Bernard, Paris,
France
(Moris) Department of Cardiology, University Hospital Central de Asturias,
Oviedo, Spain
(Munoz-Garcia) Cardiology Department, University Hospital Virgen de la
Victoria, Centro de Investigacion Biomedica en Red Enfermedades
Cardiovasculares, (CIBERCV), Malaga, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The optimal treatment in patients with severe aortic stenosis
and small aortic annulus (SAA) remains to be determined. This study aimed
to compare the hemodynamic and clinical outcomes between transcatheter
aortic valve replacement (TAVR) and surgical aortic valve replacement
(SAVR) in patients with a SAA. METHOD(S): This prospective
multicenter international randomized trial was performed in 15 university
hospitals. Participants were 151 patients with severe aortic stenosis and
SAA (mean diameter <23 mm) randomized (1:1) to TAVR (n=77) versus SAVR
(n=74). The primary outcome was impaired valve hemodynamics (ie, severe
prosthesis patient mismatch or moderate-severe aortic regurgitation) at 60
days as evaluated by Doppler echocardiography and analyzed in a central
echocardiography core laboratory. Clinical events were secondary outcomes.
 RESULT(S): The mean age of the participants was 75.5+/-5.1 years,
with 140 (93%) women, a median Society of Thoracic Surgeons predicted risk
of mortality of 2.50% (interquartile range, 1.67%-3.28%), and a median
annulus diameter of 21.1 mm (interquartile range, 20.4-22.0 mm). There
were no differences between groups in the rate of severe prosthesis
patient mismatch (TAVR, 4 [5.6%]; SAVR, 7 [10.3%]; P=0.30) and
moderate-severe aortic regurgitation (none in both groups). No differences
were found between groups in mortality rate (TAVR, 1 [1.3%]; SAVR, 1
[1.4%]; P=1.00) and stroke (TAVR, 0; SAVR, 2 [2.7%]; P=0.24) at 30 days.
After a median follow-up of 2 (interquartile range, 1-4) years, there were
no differences between groups in mortality rate (TAVR, 7 [9.1%]; SAVR, 6
[8.1%]; P=0.89), stroke (TAVR, 3 [3.9%]; SAVR, 3 [4.1%]; P=0.95), and
cardiac hospitalization (TAVR, 15 [19.5%]; SAVR, 15 [20.3%]; P=0.80).
 CONCLUSION(S): In patients with severe aortic stenosis and SAA (women
in the majority), there was no evidence of superiority of contemporary
TAVR versus SAVR in valve hemodynamic results. After a median follow-up of
2 years, there were no differences in clinical outcomes between groups.
These findings suggest that the 2 therapies represent a valid alternative
for treating patients with severe aortic stenosis and SAA, and treatment
selection should likely be individualized according to baseline
characteristics, additional anatomical risk factors, and patient
preference. However, the results of this study should be interpreted with
caution because of the limited sample size leading to an underpowered
study, and need to be confirmed in future larger studies. REGISTRATION:
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT03383445. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<4>
Accession Number
2020443606
Title
The effect of Del Nido versus custodiol cardioplegia on clinical outcomes
and troponin-I changes among pediatrics with tetralogy of fallot
undergoing cardiopulmonary bypass.
Source
Perfusion (United Kingdom). 39(2) (pp 317-323), 2024. Date of Publication:
March 2024.
Author
Gholampour Dehaki M.; Gorjipour F.; Mahdavi M.; Kachoueian N.; Heidarynia
S.
Institution
(Gholampour Dehaki, Gorjipour, Mahdavi, Heidarynia) Iran University of
Medical Sciences, Rajaie Cardiovascular Medical and Research Center,
Tehran, Iran, Islamic Republic of
(Gorjipour, Heidarynia) Iranian Scientific Society of Extracorporeal
Technology, Iran University of Medical Sciences, Rajaie Cardiovascular
Medical and Research Center, Tehran, Iran, Islamic Republic of
(Gorjipour) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Gorjipour) Qashqaei Biotechnology Laboratories, Tehran, Iran, Islamic
Republic of
(Kachoueian) Imam Hossein Educational Hospital, Shahid Beheshti University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Background: Myocardial protection during operations with cardiopulmonary
bypass (CPB) and aortic cross clamping is vital. For this purpose, Del
Nido (DN) and Custodiol cardioplegia (CC) solutions are used for
single-dose cardioplegia in cardiac surgical procedures with CPB. Present
study aimed to compare the effects of DN and CC on peri-operative clinical
outcomes in pediatrics with Tetralogy of Fallot (TF) undergoing
cardiopulmonary bypass. Method(s): Present randomized clinical trial
was performed in two trial groups with parallel design. One group received
DN and another group received CC. We assessed circulatory Troponin-I
(cTnI) and coronary sinus lactate level as primary outcomes. Secondary
outcomes were ventilation time, electrolytes levels, pump time,
cross-clamp time and other clinical parameters. Result(s): Duration
of CPB and cross-clamp were the same in both groups. There were no
significant differences in hemodynamic parameters, left ventricular
ejection fraction after the surgery and discharge time between the two
trial groups. Ventilation time (8.5 vs. 18; p = 0.001), ICU stay,
Troponin-I in ICU admission and Coronary sinus lactate level (p = 0.001)
were significantly higher among patients of Custodiol group compared to
other trial group. Electrolytes Na, Cl and K levels, during CPB, were
significantly less in Custodiol group. Conclusion(s): When used for
inducing cardiac arrest during CPB, DN solution offers better maintenance
of the electrolyte balance during CPB, and is associated with less
circulatory cTnI and coronary sinus lactate level compared with the
CC. Copyright © The Author(s) 2022.

<5>
Accession Number
643639657
Title
Transapical Off-Pump Mitral Valve Repair With Neochord Implantation: A
Systematic Review.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 269), 2023. Date of Publication: 2023.
Author
Ahmed A.
Institution
(Ahmed) Ain Shams University, Cairo, Egypt
Publisher
Galenos Publishing House
Abstract
Introduction: Mitral valve repair (MVr) is the gold standard for the
treatment of degenerative mitral valve regurgitation (MR). The recently
introduced NeoChord DS1000 has gained increasing recognition as a
feasible, potentially safe, and effective procedure with minor
complications and promising outcomes. This study aims to conduct a
systematic review of the published literature that discusses the technical
feasibility and outcome of transapical off-pump MVr with NeoChord DS1000
device implantation in the treatment of degenerative MR. Method(s):
This review was performed according to the PRISMA statement. Databases
searched in this review included Pubmed, Web of Science, Scopus, and
Cochrane databases for systematic reviews. All English articles on humans
reporting isolated MVr using NeoChord DS1000 device were included provided
that basic preoperative data, operative specifications, and postoperative
mortality and morbidity were reported. Result(s): This review
included six studies comprised 249 patients who had NeoChord mitral
procedure. Almost all patients included had severe MR (243/249, 97.6%).
Operative success was achieved in 241 out of the 249 patients (96.8%). No
intraoperative mortality was reported. Intraoperative arrhythmia was
reported in six patients (2.4%) and significant bleeding was reported in
eight patients (3.2%). Conclusion(s): Awaiting more evidence,
NeoChord mitral procedure appears to be a promising procedure that can be
considered in selected cases.

<6>
Accession Number
643639546
Title
Minimizing The Need For Intraoperative Blood Transfusion In Three
Different Ways Comparatively In Coronary By-Pass Surgery Patients Using
Pre-Op Acetylsalicylic Acid.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 48-50), 2023. Date of Publication: 2023.
Author
Yurtman V.; Bayezid O.
Institution
(Yurtman, Bayezid) AntalyaTurkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE The decrease in platelet counts and aggregation abilities after
cardiopulmonary bypass is an important cause of postoperative bleeding. On
the other hand, aspirin, which is routinely used in coronary artery
disease, increases hemorrhagic diathesis by affecting platelet functions
even one week after the last dose is taken. In this study, it was planned
to compare the effects of desmopressin acetate and autologous blood
transfusion in coronary bypass operations performed under the influence of
aspirin in patients with the same demographic data, individually and
together with normal patients, and to evaluate prospectively in terms of
bleeding and transfusion need in the early postoperative period. METHODS
Three different types of peri-op intervention were planned in order to
reduce the blood transfusion need of these groups as much as possible by
prospectively following up 120 coronary artery graft patients who were
operated while under the influence of ASA. According to Magovern
transfusion risk scoring, 120 patients from three different risk groups
(40 patients from each group) were planned to be evaluated. It was planned
to divide these 40-person groups equally into four(3 study + 1 control)
groups. Magovern Transfusion Risk Scoring System Emergency 4 Cardiogenic
shock 3 Priority 3 Body mass index<24 2 Left ventricular EF<30% 2 Age>74 2
Woman 2 Red cell mass<1500mL 2 Diabetes 1 Peripheral vascular disease 1
Creatinine >1.8mg/dL 1 Albumin<4gr/dL 1 Reoperation 1 Low risk group <2
points Intermediate risk group 2-6 points High risk group >6 points
Treatment was planned in accordance with the following algorithm for the
patients in three different risk groups, which were divided into four,
together with the control group. Prospective Study Algorithm Group I
:Transfusion score group I: <2 points Gruop II :Transfusion score group
II: 2-6 points GroupIII :Transfusion score group III: >6 points Group A:
Desmopressin administered group Group B: Autologous blood transfusion
group Group C: Desmopressin + Autologous blood transfusion group Group D:
Control group Patients were continued to be included in the study until
the required number of patients was reached. In this way, 172 patients
were included in the study. Thus, a total of 120 patients were randomly
determined for 3 different risk groups. RESULTS Age and gender
distributions of the patients who were operated on in all groups were
similar. There was no statistically significant difference between pre-op
PT and aPTT values. In addition, there was no significant difference
between the groups in terms of discontinuing the use of acetylsalicylic
acid on a daily basis. There was no statistically significant difference
between pre-op, post-op 6th hour, post-op 24th hour, post-op 1st month and
post-op 6th month values in all groups within the same period. It was
observed that the long-term recovery process and therefore the morbidity
were the same in all three blood preservation methods compared to each
other and to the control group. No statistically significant difference
was found in the first three groups (A, B, C) in which blood preservation
techniques were applied compared to the control group in terms of urine
follow-up and total urine output. There was a statistically significant
difference in the use of RBC and TDP in the first three groups(A, B, C) in
which blood preservation techniques were applied compared to the control
group. Significant difference in P value was found for Group D(P =
<0.001). There was a statistically significant difference in the first
three groups (A, B, C) in which blood preservation techniques were applied
compared to the control group in terms of surgical bleeding in the
intensive care unit. Significant difference in P value was found for Group
D(P = <0.001). CONCLUSIONS Non-surgical bleeding complication with
extracorporeal circulation; It may be due to heparin, platelets and
fibrinolysis. Insufficiency of coagulation factors is rarely encountered
as a cause of bleeding during and after open heart surgery. Today, the use
of homologous blood products is becoming increasingly limited due to both
side effects and availability. For this reason, alternative and blood
preservation methods should be developed in order to reduce the use of
blood and to perform bloodless surgery if necessary. .

<7>
Accession Number
643639531
Title
Current perspectives on venous grafts in cardiac surgery: Focus on
long-term patency.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 43), 2023. Date of Publication: 2023.
Author
Kaleda V.; Molochkov A.
Institution
(Kaleda, Molochkov) Central Clinical Hospital, Kazakhstan
Publisher
Galenos Publishing House
Abstract
Background: Despite the increasing evidence of the superiority of arterial
grafts in coronary artery bypass grafting surgery (CABG), venous grafts
are still the most popular ones: about 95% of CABG cases utilize at least
one venous graft. Hence, techniques to improve vein graft patency are
extremely important. Method(s): We present a review of the literature
on various current approaches to improve early and late results of venous
grafting in cardiac surgery. Result(s): Among the methods used to
improve the results of venous grafting there are medical therapy, vein
preservation solutions, arteriovenous composites, endoscopic vein
harvesting, no-touch vein harvesting, and others. Conclusion(s):
There is vast room for approaches to improve the results of venous
grafting, with the most effective, probably, a combination of several
techniques. Endoscopic no-touch vein harvesting is one of the most
demanding techniques. However, its' main limitation is the absence of
dedicated instrumentation.

<8>
Accession Number
643639525
Title
Perioperative Use Of Levosimendan In Patients With Severe Left Ventricular
Dysfunction Undergoing Cardiac Surgery: A Systematic Review And
Metaanalysis.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 316-317), 2023. Date of Publication: 2023.
Author
Ahmed A.
Institution
(Ahmed) Ain Shams University, Cairo, Egypt
Publisher
Galenos Publishing House
Abstract
Background: Levosimendan is a calcium-sensitizing ionodilator. However,
the current level of clinical evidence is insufficient to determine the
clinical value of levosimendan in patients with severe left ventricular
dysfunction subjected to cardiac surgery. The aim of this meta-analysis to
provide an update of the current clinical evidence regarding the clinical
value of perioperative levosimendan use in adult patients with severe
cardiac dysfunction subjected to cardiac surgery. Method(s): This
meta-analysis was performed according to PRISMA statement. Databases
searched included Pubmed, Web of Science, Scopus and Cochrane databases
for systematic reviews. Search keywords were extracted from initially
retrieved articles and comprised "levosimendan" and "cardiac surgery"
using the Boolean search operator AND. The reported outcomes included
early mortality, development of atrial fibrillation, acute kidney injury
and/or renal replacement therapy, postoperative myocardial infarction,
hypotension and low cardiac output syndrome. Aim of the work: The aim of
this meta-analysis to provide an update of the current clinical evidence
regarding the clinical value of perioperative levosimendan use in adult
patients with severe cardiac dysfunction subjected to cardiac surgery.
 Result(s): The present meta-analysis showed significant association
between levosimendan use and significant reduction of perioperative low
cardiac output syndrome [OR (95% CI): 0.60 (0.44-0.82), p=0.001], renal
injury and/or renal replacement therapy [OR (95% CI): 0.51 (0.30-0.86),
p=0.01]. Also, levosimendan use was associated with a marginal trend
towards lower mortality [OR (95% CI): 0.64 (0.39-1.03), p=0.07].
 Conclusion(s): Levosimendan use is associated with reduction of
perioperative low cardiac output syndrome and renal injury and/or renal
replacement therapy.

<9>
Accession Number
643639520
Title
Management of Coronary Artery Bypass Graft Operation in a Patient with
Romatoid Arthritis.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 40), 2023. Date of Publication: 2023.
Author
Ozer S.F.; Altinbas O.; Isik M.
Institution
(Ozer) Karaman Training and Research Hospital, Turkey
(Altinbas) Gaziantep University, Turkey
(Isik) Konya Necmettin Erbakan University, Turkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE: Romatoid arthritis is a kind of inflammatory disease
characterized by systemic and joint manifestations. Females are affected
more than males. Its association with coronary artery disease is well
established in the literature. In this study we aimed to report the
management of a patient with romatoid arthritis underwent coronary artery
bypass graft operation (CABG). METHOD(S): A 55 year old woman was
evaluated with the complaint of chest pain. She was diagnosed with
romatoid arthritis for ten years and her medication includes sulfasalazine
and a non steroid antiinflammatory drug (NSAID). Coronary angiography
revealed 90%< stenosis in LAD, Cx and RCA. There was no additional cardiac
pathology and ejection fraction was 55%. CABG was decided. NSAID was
stopped and sulfasalazine was continued before operation. RESULT(S):
CABG was performed with the anastomosis of LIMA-LAD, Ao-Cx andAo-RCA. The
patient was extubated on the operation day and stayed 2 days in intensive
care unit. Sulfasalazine was admitted as soon as the patient's oral intake
started. She was discharged on postoperative 5th day without any
complication. CONCLUSION(S): Management of the chronic inflammatory
diseases requires attention not only in terms of medication but also
probable accompanied disorders. Rheumatid arthritis affects many organs
and systems. Cardiovascular system is one of the systems involved in
rheumatoid arthritis. A meta-analysis of 14 studies involving 41,490
patients with RA revealed that the risk of CVD increases by 48% and the
risk of myocardial infarction increases by 68%. Inflammatory mediators
produced by the synovium destroy the vascular endothelial cells and alter
lipid distribution and insulin resistance. Blood pressure also affected by
these mediators. Progression of atherosclerosis occurs as the result of
these processes. Therefore it is important to keep on mind that patients
with romatoid arthritis may be a candidate for coronary artery disease and
routine follow up is vital. One of the medications given in rheumatoid
arthritis is sulfasalazine and it must be continued until operation time
and started as soon as possible in early postoperative period due to its
cardioprotective effects.

<10>
Accession Number
643639405
Title
Assessment of Gender Diversity among Authors in the Journal of Turkish
Thoracic and Cardiovascular Surgery Publications.
Source
E Journal of Cardiovascular Medicine. Conference: 19th International
Congress of Update in Cardiology and Cardiovascular Surgery. Istanbul
Turkey. 11(1) (pp 282-283), 2023. Date of Publication: 2023.
Author
Ozsoy A.; Karademir B.C.; Adademir T.
Institution
(Ozsoy, Karademir) Yeditepe University, Faculty of Medicine, Istanbul,
Turkey
(Karademir, Adademir) University of Health Sciences, Kosuyolu Heart and
Research Hospital, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
Background: The number of female cardiovascular surgeons has been steadily
increasing over the years in Turkey. The number of female members in the
Turkish Society of Cardiovascular Surgery was 57 (6.95% of the total
number of surgeons) in 2010 and increased to 321 (13.97%) in 2022. It is
unknown whether the contribution of female cardiovascular surgeons to the
scientific literature has paralleled this increase. The aim of our study
is to elucidate the proportion of female physician contributions in the
publications of the Turkish Journal of Thoracic and Cardiovascular
Surgery. Method(s): Between 2010 and 2022, a comprehensive review was
conducted on the original articles, reviews, and case reports published in
the Turkish Journal of Thoracic and Cardiovascular Surgery, focusing
specifically on the field of cardiovascular surgery. The analysis involved
determining the total number of authors, differentiating between female
and male authors, and documenting whether female authors held positions as
either the first or last author. In cases where gender identification
based on names was inconclusive (unisex names), gender verification was
performed by accessing the official websites of the authors' affiliated
institutions. Authors who were not cardiovascular surgeons, publications
in the field of thoracic surgery, and articles submitted from sources
outside of Turkey were excluded from the study. Result(s): A total of
1,112 publications from the Turkish Journal of Thoracic and Cardiovascular
Surgery were included in the study, encompassing 4,393 authors. Among
these authors, 6.65% (n=292) were female. Female authors were identified
as the first author in 65 articles (5.85%) and as the last author in 48
articles (4.31%). The summary of female surgeon representation within the
Turkish Society of Cardiovascular Surgery, including overall contributions
and proportions of first and last authorship among women, is presented in
Table 1. Conclusion(s): Despite the increasing number of female
surgeons, it is observed that the contribution of female surgeons in
publications remains relatively stable and lags behind the overall
proportion. The reasons for the relatively low contribution of female
authors to scientific literature should be examined, and authors should be
encouraged to contribute more to the field of science.

<11>
Accession Number
2030773691
Title
Comparative analysis of machine learning vs. traditional modeling
approaches for predicting in-hospital mortality after cardiac surgery:
temporal and spatial external validation based on a nationwide cardiac
surgery registry.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 10(2) (pp
121-131), 2024. Date of Publication: 01 Mar 2024.
Author
Zeng J.; Zhang D.; Lin S.; Su X.; Wang P.; Zhao Y.; Zheng Z.
Institution
(Zeng, Zhang, Lin, Su, Wang, Zhao, Zheng) National Clinical Research
Center of Cardiovascular Diseases, Fuwai Hospital, National Center for
Cardiovascular Diseases, 167 Beilishi Road, Xicheng, Beijing 100037, China
(Zeng, Zhang, Lin, Su, Wang, Zhao, Zheng) State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, 167 Beilishi Road, Xicheng, Beijing 100037, China
(Zeng, Zhang, Lin, Su, Wang, Zheng) Chinese Academy of Medical Sciences,
Peking Union Medical College, 9 Dongdansantiao, Dongcheng, Beijing 100730,
China
(Zhang) Department of Cardiac Surgery, Fujian Children's Hospital (Fujian
Branch of Shanghai Children's Medical Center), College of Clinical
Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical
University, 966 Hengyu Road, Fuzhou, Jinan 350014, China
(Lin, Zheng) Department of Cardiovascular Surgery, Fuwai Hospital,
National Center for Cardiovascular Diseases, 167 Beilishi Road, Xicheng,
Beijing 100037, China
(Zheng) Key Laboratory of Coronary Heart Disease Risk Prediction and
Precision Therapy, Chinese Academy of Medical Sciences, Peking Union
Medical College, 167 Beilishi Road, Xicheng, Beijing 100037, China
Publisher
Oxford University Press
Abstract
Aims Preoperative risk assessment is crucial for cardiac surgery. Although
previous studies suggested machine learning (ML) may improve in-hospital
mortality predictions after cardiac surgery compared to traditional
modeling approaches, the validity is doubted due to lacking external
validation, limited sample sizes, and inadequate modeling considerations.
We aimed to assess predictive performance between ML and traditional
modelling approaches, while addressing these major limitations. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Methods and Adult cardiac surgery cases (n = 168 565) between 2013 and
2018 in the Chinese Cardiac Surgery Registry were results used to develop,
validate, and compare various ML vs. logistic regression (LR) models. The
dataset was split for temporal (2013-2017 for training, 2018 for testing)
and spatial (geographically-stratified random selection of 83 centers for
training, 22 for testing) experiments, respectively. Model performances
were evaluated in testing sets for discrimination and calibration. The
overall in-hospital mortality was 1.9%. In the temporal testing set (n =
32 184), the best-performing ML model demonstrated a similar area under
the receiver operating characteristic curve (AUC) of 0.797 (95% CI
0.779-0.815) to the LR model (AUC 0.791 [95% CI 0.775-0.808]; P = 0.12).
In the spatial experiment (n = 28 323), the best ML model showed a
statistically better but modest performance improvement (AUC 0.732 [95% CI
0.710-0.754]) than LR (AUC 0.713 [95% CI 0.691-0.737]; P = 0.002). Varying
feature selection methods had relatively smaller effects on ML models.
Most ML and LR models were significantly miscalibrated. . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusion
ML provided only marginal improvements over traditional modelling
approaches in predicting cardiac surgery mortality with routine
preoperative variables, which calls for more judicious use of ML in
practice. Copyright © The Author(s) 2023.

<12>
Accession Number
2030773120
Title
Effects of opioid-free anaesthesia compared with balanced general
anaesthesia on nausea and vomiting after video-assisted thoracoscopic
surgery: a single-centre randomised controlled trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e079544. Date of
Publication: 01 Mar 2024.
Author
Bao R.; Zhang W.-S.; Zha Y.-F.; Zhao Z.-Z.; Huang J.; Li J.-L.; Wang T.;
Guo Y.; Bian J.-J.; Wang J.-F.
Institution
(Bao, Zhang, Zha, Zhao, Huang, Li, Wang, Guo, Bian, Wang) Department of
Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai,
China
(Zha) Department of Anesthesiology, Huashan Hospital, Fudan University,
Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Objectives Opioid-free anaesthesia (OFA) has emerged as a promising
approach for mitigating the adverse effects associated with opioids. The
objective of this study was to evaluate the impact of OFA on postoperative
nausea and vomiting (PONV) following video-assisted thoracic surgery.
Design Single-centre randomised controlled trial. Setting Tertiary
hospital in Shanghai, China. Participants Patients undergoing
video-assisted thoracic surgery were recruited from September 2021 to June
2022. Intervention Patients were randomly allocated to OFA or traditional
general anaesthesia with a 1:1 allocation ratio. Primary and secondary
outcome measures The primary outcome measure was the incidence of PONV
within 48 hours post-surgery, and the secondary outcomes included PONV
severity, postoperative pain, haemodynamic changes during anaesthesia, and
length of stay (LOS) in the recovery ward and hospital. Results A total of
86 and 88 patients were included in the OFA and control groups,
respectively. Two patients were excluded because of severe adverse events
including extreme bradycardia and epilepsy-like convulsion. The incidence
and severity of PONV did not significantly differ between the two groups
(29 patients (33.0%) in the control group and 22 patients (25.6%) in the
OFA group; relative risk 0.78, 95% CI 0.49 to 1.23; p=0.285). Notably, the
OFA approach used was associated with an increase in heart rate (89+/-17
vs 77+/-15 beats/min, t-test: p<0.001; U test: p<0.001) and diastolic
blood pressure (87+/-17 vs 80+/-13 mm Hg, t-test: p=0.003; U test:
p=0.004) after trachea intubation. Conversely, the control group exhibited
more median hypotensive events per patient (mean 0.5+/-0.8 vs 1.0+/-2.0,
t-test: p=0.02; median 0 (0-4) vs 0 (0-15), U test: p=0.02) during
surgery. Postoperative pain scores, and LOS in the recovery ward and
hospital did not significantly differ between the two groups. Conclusions
Our study findings suggest that the implementation of OFA does not
effectively reduce the incidence of PONV following thoracic surgery when
compared with traditional total intravenous anaesthesia. The opioid-free
strategy used in our study may be associated with severe adverse
cardiovascular events. Trial registration number ChiCTR2100050738.
 Copyright © The Author(s) 2024.

<13>
Accession Number
2030747073
Title
Transcarotid versus trans-axillary/subclavian transcatheter aortic valve
replacement (TAVR): A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102488. Date of Publication: May 2024.
Author
Dawadi S.; Oli P.R.; Shrestha D.B.; Shtembari J.; Pant K.; Shrestha B.;
Mattumpuram J.; Katz D.H.
Institution
(Dawadi) Department of Internal Medicine, Nepalese Army Institute of
Health Sciences, Kathmandu 44600, Nepal
(Oli) Department of Internal Medicine, Province Hospital, Birendranagar,
Karnali Province, Surkhet 21700, Nepal
(Shrestha, Shtembari) Department of Internal Medicine, Mount Sinai
Hospital, Chicago, IL 60608, United States
(Pant) Department of Internal Medicine, Division of Cardiovascular
Medicine, University of Illinois College of Medicine, OSF Healthcare,
Peoria, IL 61614, United States
(Shrestha, Katz) Division of Cardiology, Department of Internal Medicine,
Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY 13326, United States
(Mattumpuram) Division of Cardiology, Department of Internal Medicine,
University of Louisville School of Medicine, 550 S Jackson St, Louisville,
KY 40202, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) is the treatment
of choice in patients with severe aortic stenosis. Transcarotid (TCa) or
Trans-axillary/subclavian (TAx/Sc) are safer and less invasive non-femoral
approaches, where transfemoral access is difficult or impossible to
obtain. Method(s): This meta-analysis was performed based on PRISMA
guidelines after registering in PROSPERO (CRD42023482842). This
meta-analysis was performed to compare the safety of the transcarotid and
trans-axillary/subclavian approach for TAVR including studies from
inception to October 2023. Result(s): Seven studies with a total of
6227 patients were included in the analysis (TCa: 2566; TAx/Sc: 3661).
Transcarotid TAVR approach had a favorable trend for composite of stroke
and all-cause mortality (OR 0.79, CI 0.60-1.04), all-cause mortality,
stroke, major vascular complication, and new requirement of permanent
pacemaker though those were statistically insignificant. On sub-analysis
of the results of the studies based on the territory (USA vs French),
composite outcome of all cause mortality, stroke and major bleeding (OR
0.54, CI 0.54-0.81), composite of stroke and all cause mortality (OR 0.64,
CI 0.50-0.81), and stroke/TIA (OR 0.53, CI 0.39-0.73) showed lower odds of
occurrence among patient managed with TCa approach in the American cohort.
 Conclusion(s): Overall, transcarotid approach had favorable though
statistically insignificant odds for composite (stroke and all-cause
mortality) and individual outcomes (stroke, all-cause mortality, etc.).
There are significant variations in observed outcomes based on study's
geographic location. Large prospective randomized clinical trials
comparing the two approaches with representative samples are necessary to
guide the clinicians in choosing among these approaches. Copyright
© 2024 Elsevier Inc.

<14>
Accession Number
2028829660
Title
Efficacy of propofol-supplemented cardioplegia on biomarkers of organ
injury in patients having cardiac surgery using cardiopulmonary bypass: a
statistical analysis plan for the ProMPT-2 randomised controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 153. Date of
Publication: December 2024.
Author
Smartt H.; Angelini G.D.; Gibbison B.; Rogers C.A.
Institution
(Smartt, Rogers) Bristol Trials Centre, Bristol Medical School, University
of Bristol, Bristol, United Kingdom
(Angelini) National Institute for Health Research Bristol Biomedical
Research Centre, University Hospitals Bristol and Weston NHS Foundation
Trust and University of Bristol, Bristol, United Kingdom
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Gibbison) Department of Anaesthesia, University Hospitals Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: The ProMPT-2 trial (Propofol for Myocardial Protection Trial
#2) aims to compare the safety and efficacy of low- and high-dose propofol
supplementation of the cardioplegia solution during adult cardiac surgery
versus sham supplementation. This update presents the statistical analysis
plan, detailing how the trial data will be analysed and presented.
Outlined analyses are in line with the Consolidated Standards of Reporting
Trials and the statistical analysis plan has been written prior to
database lock and the final analysis of trial data to avoid reporting bias
(following recommendations from the International Conference on
Harmonisation of Good Clinical Practice). Methods/design: ProMPT-2 is a
multi-centre, blinded, parallel three-group randomised controlled trial
aiming to recruit 240 participants from UK cardiac surgery centres to
either sham cardioplegia supplementation, low dose (6 microg/ml) or high
dose (12 microg/ml) propofol cardioplegia supplementation. The primary
outcome is cardiac-specific troponin T levels (a biomarker of cardiac
injury) measured during the first 48 h following surgery. The statistical
analysis plan describes the planned analyses of the trial primary and
secondary outcomes in detail, including approaches to deal with missing
data, multiple testing, violation of model assumptions, withdrawals from
the trial, non-adherence with the treatment and other protocol deviations.
It also outlines the planned sensitivity analyses and exploratory analyses
to be performed. Discussion(s): This manuscript prospectively
describes, prior to the completion of data collection and database lock,
the analyses to be undertaken for the ProMPT-2 trial to reduce risk of
reporting and data-driven analyses. Trial registration: ISRCTN
ISRCTN15255199. Registered on 26 March 2019. Copyright © The
Author(s) 2024.

<15>
Accession Number
2028810040
Title
Effect of topical application of autologous platelet gel on sternal wound
infection after cardiac surgery: A meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14761. Date of Publication: March 2024.
Author
Li Y.; Wu Z.
Institution
(Li, Wu) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Following heart operation, a severe life-threatening complication has been
identified by investigators who have recently discovered that local
application of platelet-rich plasma (PRP) can lower the rate of wound
infection in heart surgery. Nevertheless, due to the low quality of these
trials, we have tried to perform high-quality meta-analyses to prove the
efficacy of PRP in heart surgery for post-operative wound infections. In
this study, five randomised controlled trials (RCTs) were chosen from
three databases, and there were 1005 studies to analyse the data. Among
181 cases, PRP was applied to the surgical site, and 205 in the control
group. Both the CI and the OR or the average difference (MD) were computed
with either a fixed or random-effect model. A meta-analysis of the data
was carried out with RevMan 5.3. The results showed that there were no
statistically significant differences in the incidence of post-operative
surgical site infection (SSI) in control group compared to those treated
with PRP gel (OR, 0.97; 95% CI, 0.38, 2.47; p = 0.95); In the heart
operation, the local application of PRP gel decreased the rate of drainage
after operation (MD, -217.82; 95% CI, -335.38, -100.26; p = 0.0003); The
operation time of the PRP gel was not significantly different from that of
the control group (MD, 12.65; 95% CI, -2.95, 28.24; p = 0.11). Contrary to
earlier research, the application of autoplatelet gel in heart surgery did
not seem to decrease operative site infections after the operation, but it
did decrease the amount of postoperative drainage. Nevertheless, because
of the limited number of RCTs in this meta-analysis, caution should be
exercised in their treatment. More high-quality randomised, large-sample
trials are required to further confirm the findings. Copyright ©
2024 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<16>
Accession Number
2030786037
Title
Initial results from a randomized trial in video-assisted versus open
thoracic surgery.
Source
Journal of Thoracic Disease. 11 (pp S1317-S1319), 2019. Date of
Publication: 28 May 2019.
Author
Eklund A.; Sartipy U.
Institution
(Eklund, Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Eklund, Sartipy) Heart and Vascular Theme, Karolinska University
Hospital, Stockholm, Sweden
Publisher
AME Publishing Company

<17>
Accession Number
2028725914
Title
Comparison of different porcine models simulating myocardial cold ischemia
of pediatric donor hearts.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Stukov Y.; Bleiweis M.S.; Wilson L.; Peek G.J.; March K.; Richards E.M.;
Staples E.D.; Jacobs J.P.
Institution
(Stukov, Bleiweis, Peek, Staples, Jacobs) Congenital Heart Center,
Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics,
University of Florida, Gainesville, FL, United States
(Stukov, Bleiweis, Peek, March, Richards, Staples, Jacobs) UF Center for
Regenerative Medicine, Department of Medicine, Division of Cardiovascular
Medicine, University of Florida, Gainesville, FL, United States
(Wilson) Congenital Heart Center, Division of Pediatric Cardiology,
Department of Pediatrics, University of Florida, Gainesville, FL, United
States
(March, Staples) Malcom Randall VA Medical Center, Gainesville, FL, United
States
(Richards) Department of Physiology and Aging, University of Florida,
Gainesville, FL, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Our team previously identified a stem cell-derived
cardioprotective additive that can be added to standard cardioplegia to
extend myocardial viability during prolonged myocardial cold ischemic time
(CIT) in rodent models. The purpose of this study was to utilize a porcine
model to compare in-vivo versus ex-vivo porcine simulation of CIT that
accompanies cardiac transplantation in humans, in order to determine an
optimal method for translation of our studies to larger animals.
 Method(s): Eight 39-55 kg Yorkshire X pigs were randomly assigned to
either in-vivo or ex-vivo simulation. After administration of general
anesthesia and endotracheal intubation, baseline measurement of left
ventricular performance was obtained via transesophageal echocardiography
(TEE). After midline sternotomy and heparin administration, the aorta was
cross-clamped and two liters of HTK-Custodiol were introduced via the
aortic root. The in-vivo method utilized cold ischemic heart storage in
the chest cavity while supporting the experimental animal with
cardiopulmonary bypass (CPB). The ex-vivo method involved standard cardiac
procurement, cold ischemic storage outside of the body, and subsequent
cardiac reperfusion utilizing cardiac reanimation in a Langendorff heart
perfusion mode. After CIT, measurements of post-ischemic left ventricular
performance were obtained via echocardiography. Results are presented as:
Mean +/- Standard Deviation (Median, Minimum-Maximum). Result(s):
Weight (kilograms) was similar in the in-vivo group and the ex-vivo group:
44 +/- 1.8 (44, 42-46) versus 44 +/- 5.1 (43.5, 39-51), respectively. Cold
ischemic time (minutes) was longer in the ex-vivo group: 360 +/- 0 (360,
360-360) versus 141 +/- 26.7 (149, 102-163). Temperature (degrees Celsius)
was colder in the ex-vivo group: 8 +/- 0 (8, 8-8) versus 16.5 +/- 4.2 (16,
12-16). In the in-vivo group, baseline ejection fraction and ejection
fraction after CIT were: 48.25% +/- 14.95% (48.5%, 33%-63%) and 41.25% +/-
22.32% (41.5%, 20%-62%), respectively. In the ex-vivo group, baseline
ejection fraction and ejection fraction after CIT were: 56.4% +/- 5.9%
(57%, 50%-67%) and 60.4% +/- 7.7% (61.5%, 51.9%-67%), respectively.
 Conclusion(s): The ex-vivo technique is suitable to evaluate
cardioplegia additives that may substantially extend myocardial tolerance
to cold ischemia. Copyright © The Author(s) 2024.

<18>
Accession Number
643636763
Title
Dexmedetomidine mitigates acute kidney injury after coronary artery bypass
grafting: a prospective clinical trial.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2024.
Date of Publication: 27 Feb 2024.
Author
Zhang C.; Zhang Y.; Liu D.; Mei M.; Song N.; Zhuang Q.; Jiang Y.; Guo Y.;
Liu G.; Li X.; Ren L.
Institution
(Zhang, Zhang, Liu, Mei, Song, Zhuang, Liu) Department of Anesthesiology,
First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
(Jiang) Department of Cardiac Surgery, First Affiliated Hospital of Bengbu
Medical College, Bengbu, Anhui, China
(Guo) Department of Urology, First Affiliated Hospital of Bengbu Medical
College, Bengbu, Anhui, China
(Li) Department of Anesthesiology, First Affiliated Hospital of Bengbu
Medical College, Bengbu, Anhui, China
(Ren) School of Laboratory Medicine, Bengbu Medical College, Bengbu,
Anhui, China
Abstract
INTRODUCTION AND OBJECTIVES: To evaluate the impact of dexmedetomidine
impact on cardiac surgery-associated (CSA) acute renal failure, kidney
function, and metabolic and oxidative stress in patients undergoing
coronary artery bypass grafting with heart-lung machine support.
 METHOD(S): A randomized double-masked trial with 238 participants
(50-75 years) undergoing coronary artery bypass grafting was conducted
from January 2021 to December 2022. The participants were divided into Dex
(n = 119) and normal saline (NS) groups (n = 119). Dex was administered at
0.5 mcg/kg over 10 minutes, then 0.4 mcg/kg/h until the end of surgery;
the NS group received equivalent saline. Blood and urine were sampled at
various time points pre- and postsurgery. The primary outcome measure was
the incidence of CSA-acute kidney injury (AKI), defined as the occurrence
of AKI within 96 hours after surgery. RESULT(S): The incidence of
CSA-AKI was significantly lower in the Dex group than in the NS group
(18.26% vs 32.46%; P = .014). Substantial increases were found in
estimated glomerular filtration rate value at T4-T6 (P < .05) and urine
volume 24 hours after surgery (P < .01). Marked decreases were found in
serum creatinine level, blood glucose level at T1-T2 (P < .01), blood urea
nitrogen level at T3-T6 (P < .01), free fatty acid level at T2-T3 (P <
.01), and lactate level at T3-T4 (P < .01). CONCLUSION(S): Dex
reduces CSA-AKI, potentially by regulating metabolic disorders and
reducing oxidative stress. Copyright © 2024 Sociedad Espanola de
Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

<19>
Accession Number
643636545
Title
The role of beta-adrenergic receptors in the regulation of cardiac
tolerance to ischemia/reperfusion. Why do beta-adrenergic receptor
agonists and antagonists protect the heart?.
Source
Fundamental & clinical pharmacology. (no pagination), 2024. Date of
Publication: 29 Feb 2024.
Author
Maslov L.N.; Naryzhnaya N.V.; Voronkov N.S.; Kurbatov B.K.; Derkachev
I.A.; Ryabov V.V.; Vyshlov E.V.; Kolpakov V.V.; Tomilova E.A.;
Sapozhenkova E.V.; Singh N.; Fu F.; Pei J.
Institution
(Maslov, Naryzhnaya, Voronkov, Kurbatov, Derkachev, Ryabov, Vyshlov)
Cardiology Research Institute, Tomsk National Research Medical Centre,
Russian Academy of Sciences, Tomsk, Russian Federation
(Kolpakov, Tomilova, Sapozhenkova) Tyumen State Medical University,
Tyumen, Russian Federation
(Singh) Department of Pharmaceutical Sciences and Drug Research, Punjabi
University, Patiala, India
(Fu, Pei) Department of Physiology and Pathophysiology, National Key
Discipline of Cell Biology, School of Basic Medicine, Fourth Military
Medical University, Xi'an, China
Abstract
BACKGROUND: Catecholamines and beta-adrenergic receptors (beta-ARs) play
an important role in the regulation of cardiac tolerance to the impact of
ischemia and reperfusion. This systematic review analyzed the molecular
mechanisms of the cardioprotective activity of beta-AR ligands.
 METHOD(S): We performed an electronic search of topical articles
using PubMed databases from 1966 to 2023. We cited original in vitro and
in vivo studies and review articles that documented the cardioprotective
properties of beta-AR agonists and antagonists. RESULT(S): The
infarct-reducing effect of beta-AR antagonists did not depend on a
decrease in the heart rate. The target for beta-blockers is not only
cardiomyocytes but also neutrophils. beta1-blockers (metoprolol,
propranolol, timolol) and the selective beta2-AR agonist arformoterol have
an infarct-reducing effect in coronary artery occlusion (CAO) in animals.
Antagonists of beta1- and beta2-AR (metoprolol, propranolol, nadolol,
carvedilol, bisoprolol, esmolol) are able to prevent reperfusion cardiac
injury. All beta-AR ligands that reduced infarct size are the selective or
nonselective beta1-blockers. It was hypothesized that beta1-AR blocking
promotes an increase in cardiac tolerance to I/R. The activation of
beta1-AR, beta2-AR, and beta3-AR can increase cardiac tolerance to I/R.
The cardioprotective effect of beta-AR agonists is mediated via the
activation of kinases and reactive oxygen species production.
 CONCLUSION(S): It is unclear why beta-blockers with the similar
receptor selectivity have the infarct-sparing effect while other
beta-blockers with the same selectivity do not affect infarct size. What
is the molecular mechanism of the infarct-reducing effect of beta-blockers
in reperfusion? Why did in early studies beta-blockers decrease the
mortality rate in patients with acute myocardial infarction (AMI) and
without reperfusion and in more recent studies beta-blockers had no effect
on the mortality rate in patients with AMI and reperfusion? The creation
of more effective beta-AR ligands depends on the answers to these
questions. Copyright © 2024 Societe Francaise de Pharmacologie et
de Therapeutique. Published by John Wiley & Sons Ltd.

<20>
Accession Number
643636323
Title
Enhanced recovery protocols after surgery: A systematic review and
meta-analysis of randomized trials in cardiac surgery.
Source
World journal of surgery. (no pagination), 2024. Date of Publication: 29
Feb 2024.
Author
Spadaccio C.; Salsano A.; Pisani A.; Nenna A.; Nappi F.; Osho A.;
D'Alessandro D.; Sundt T.M.; Crestanello J.; Engelman D.; Rose D.
Institution
(Spadaccio, Crestanello) Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Spadaccio, Osho, D'Alessandro, Sundt) Cardiac Surgery, Massachusetts
General Hospital (MGH) - Harvard Medical School, Boston, MA, United States
(Salsano) Cardiac Surgery, DISC Department, University of Genoa, Genoa,
Italy
(Pisani) Cardiac Surgery, Hopital Bichat - Claude-Bernard, Paris, France
(Nenna) Cardiovascular Surgery, Universita Campus Bio-Medico di Roma,
Rome, Italy
(Nappi) Cardiac Surgery, Centre Cardiologique du Nord de Saint Denis,
Paris, France
(Engelman) Division of Cardiac Surgery, Baystate Medical Center,
Springfield, MA, United States
(Rose) Cardiothoracic Surgery, Lancashire Cardiac Center - Blackpool
Victoria Hospital, Blackpool, United Kingdom
Abstract
BACKGROUND: Previous meta-analyses combining randomized and observational
evidence in cardiac surgery have shown positive impact of enhanced
recovery protocols after surgery (ERAS) on postoperative outcomes.
However, definitive data based on randomized studies are missing, and the
entirety of the ERAS measures and pathway, as recently systematized in
guidelines and consensus statements, have not been captured in the
published studies. The available literature actually focuses on
"ERAS-like" protocols or only limited number of ERAS measures. This study
aims at analyzing all randomized studies applying ERAS-like protocols in
cardiac surgery for perioperative outcomes. METHOD(S): A
meta-analysis of randomized controlled trials (RCTs) comparing ERAS-like
with standard protocols of perioperative care was performed (PROSPERO
registration CRD42021283765). PRISMA guidelines were used for abstracting
and assessing data. RESULT(S): Thirteen single center RCTs (N = 1704,
850 in ERAS-like protocol and 854 in the standard care group) were
selected. The most common procedures were surgical revascularization
(66.3%) and valvular surgery (24.9%). No difference was found in the
incidence of inhospital mortality between the ERAS and standard treatment
group (risk ratio [RR] 0.61 [0.31; 1.20], p = 0.15). ERAS was associated
with reduced intensive care unit (standardized mean difference [SMD]
-0.57, p < 0.01) and hospital stay (SMD -0.23, p < 0.01) and reduced rates
of overall complications when compared to the standard protocol (RR 0.60,
p < 0.01) driven by the reduction in stroke (RR 0.29 [0.13; 0.62], p <
0.01). A significant heterogeneity in terms of the elements of the ERAS
protocol included in the studies was observed. CONCLUSION(S):
ERAS-like protocols have no impact on short-term survival after cardiac
surgery but allows for a faster hospital discharge while potentially
reducing surgical complications. However, this study highlights a
significant nonadherence and heterogeneity to the entirety of ERAS
protocols warranting further RCTs in this field including a greater number
of elements of the framework. Copyright © 2024 International
Society of Surgery/Societe Internationale de Chirurgie (ISS/SIC).

<21>
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. 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. 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.
 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). 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. Copyright © 2024 American College of Cardiology
Foundation

<22>
[Use Link to view the full text]
Accession Number
2030721890
Title
Electroconvulsive Therapy in Heart Transplant Patients: To Avoid or
Embrace?.
Source
Journal of ECT. 40(1) (pp 6-9), 2024. Date of Publication: 01 Mar 2024.
Author
Ketcham E.; Glass O.M.; Hermida A.P.
Institution
(Ketcham) Department of Psychiatry, Dartmouth Hitchcock Medical Center,
Lebanon, NH, United States
(Glass) Northeast Georgia Physicians Group, Gainesville, United States
(Hermida) Department of Psychiatry and Behavioral Sciences, Emory
University, Augusta, GA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Patients with heart disease are at an increased risk of depression.
Electroconvulsive therapy (ECT) is a highly effective treatment for severe
depressive episodes. However, ECT may increase the risk for adverse
outcomes in certain patients because of changes in blood pressure and
heart rate secondary to an initial parasympathetic surge followed by a
sympathetic surge and peripheral catecholamine release. In post-cardiac
transplant patients, these acute hemodynamic changes on a denervated heart
may bring clinical challenges. The available data on ECT in heart
transplant patients are limited. The authors of this article present a
summary of the available literature relating to ECT in heart transplant
patients. The authors performed a literature search of 6 online databases
yielding 6 English-language case reports of ECT in cardiac transplant
patients. All patients experienced changes in hemodynamic variables during
and immediately after ECT, ranging from moderate decrease in blood
pressure to extreme hypertension. The cases did not report any serious
cardiac complications during the course of ECT. In the 5 patients whose
psychiatric responses to treatment were detailed, all had improvement in
their depressive symptoms. Electroconvulsive therapy may be considered for
severe cases of depression in patients with a history of cardiac
transplant, but the potential benefit of ECT needs to be weighed against
risks. In the limited number of cases reported in the literature, ECT
seems to have been relatively safe and effective. Copyright ©
Wolters Kluwer Health, Inc. All rights reserved.

<23>
Accession Number
2030698961
Title
High flow nasal oxygen vs. conventional oxygen therapy over respiratory
oxygenation index after esophagectomy: an observational study.
Source
Journal of Thoracic Disease. 16(2) (pp 997-1008), 2024. Date of
Publication: 29 Feb 2024.
Author
Deana C.; Vecchiato M.; Bellocchio F.; Tullio A.; Martino A.; Ziccarelli
A.; Patruno V.; Pascolo M.; Bassi F.; Pontoni M.; Raimondi P.; Cereser L.;
Vetrugno L.; Petri R.; Uzzau A.
Institution
(Deana, Bassi) Anesthesia and Intensive Care Department, Health Integrated
Agency of Friuli Centrale, Udine, Italy
(Vecchiato, Martino, Ziccarelli, Pascolo, Petri, Uzzau) Department of
Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy
(Bellocchio, Uzzau) Department of Medical Area, University of Udine,
Udine, Italy
(Tullio) Hygiene and Clinical Epidemiology Unit, Health Integrated Agency
of Friuli Centrale, Udine, Italy
(Patruno, Pontoni, Raimondi) Pulmonology Unit, Cardiothoracic Department,
Health Integrated Agency of Friuli Centrale, Udine, Italy
(Cereser) Institute of Radiology, Department of Medicine, University of
Udine, Udine, Italy
(Vetrugno) Department of Anesthesiology, Critical Care Medicine and
Emergency, SS. Annunziata Hospital, Chieti, Italy
(Vetrugno) Department of Medical, Oral and Biotechnological Sciences,
University of Chieti-Pescara, Chieti, Italy
Publisher
AME Publishing Company
Abstract
Background: Postoperative pulmonary complications after esophagectomy
still represent a matter of concern. High flow nasal cannula (HFNC) early
after major abdominal and thoracic surgery has demonstrated some
advantages over conventional oxygen therapy. Data about respiratory effect
of HFNC after esophagectomy is scarce. The primary aim of this study is to
investigate if the early use of HFNC after esophagectomy could enhance
patients' postoperative respiratory oxygenation (ROX) index and,
ultimately, reduce postoperative pneumonia. Method(s): In this single
center retrospective study all patients undergoing to esophagectomy for
cancer from May 2020 to November 2022 were evaluated. Historical cohort
(HC) received postoperative oxygen supplementation with Venturi mask or
nasal goggles, and a cohort was put under HFNC (HFNC cohort). ROX index,
blood gas analysis, radiological atelectasis score (RAS), post-operative
complications' data and information on hospital stay have been collected
and analyzed. Result(s): Seventy-one patients were included for the
final statistical analysis, 31 in the HFNC and 40 in the HC cohort. Mean
age was 64+/-10 years and body mass index (BMI) was 26 [24-29]
kg/m2. ROX index was higher in the HFNC patients than in the
HC, 20.8 [16.7-25.9] vs. 14.9 [10.8-18.2] (P<0.0001). In the HFNC cohort
patients, pH was higher, 7.42 [7.40-7.44] vs. 7.39 [7.37-7.43] than HC,
while PaCO<inf>2</inf> was lower in HFNC cohort compared with HC, 39
[36-41] vs. 42 [39-45] mmHg, respectively (P=0.01). RAS was similar
between the two cohorts of patients, 1.5+/-0.98 vs. 1.4+/-1.04 in the HFNC
and the HC cohort, respectively (P=0.611). Lower acute respiratory failure
(ARF) rate was recorded among HFNC than HC cohort, 0% vs. 13%
respectively, P=0.06. No difference in pneumonia frequency between two
cohorts was shown. Conclusion(s): HFNC improved the ROX index after
esophagectomy through significant respiratory rate reduction. This tool
should be considered for early respiratory support after extubation in
this category of patients, not only as a rescue therapy for ARF, but also
to optimize early postoperative respiratory function. Whether this will
improve patients' outcomes requires further large randomized controlled
trials. Copyright © Journal of Thoracic Disease. All rights
reserved.

<24>
Accession Number
2030765997
Title
Perioperative hemadsorption therapy in infective endocarditis: systematic
review and meta-analysis.
Source
Cirugia Cardiovascular. (no pagination), 2024. Date of Publication: 2024.
Author
Martin Gutierrez E.; Castillo Pardo L.; Maiorano P.; Oujo Gonzalez B.;
Laguna Nunez G.; Martinez Comendador J.M.; Gualis Cardona J.; Castano Ruiz
M.
Institution
(Martin Gutierrez, Castillo Pardo, Maiorano, Oujo Gonzalez, Gualis
Cardona, Castano Ruiz) Servicio de Cirugia cardiaca, Hospital
Universitario de Leon, Leon, Spain
(Laguna Nunez) Servicio de Cirugia cardiovascular, Hospital Universitario
Virgen de las Nieves, Granada, Spain
(Martinez Comendador) Servicio de Cirugia cardiaca, Complexo Hospitalario
Universitario A Coruna, A Coruna, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Infective endocarditis (IE) is a systemic disease with multiorgan
involvement. It is a severe disease, which frequently requires surgical
treatment, despite which mortality rates can be high due to complications
related to an uncontrolled systemic inflammatory response and/or sepsis.
Hemadsorption systems such as Cytosorb allow the removal of
proinflammatory cytokines and endotoxins to improve the prognosis of these
patients. We performed a systematic review in Pubmed and Cochrane to
identify controlled comparative studies of the perioperative use of
Cytosorb in patients undergoing cardiac surgery for IE. A meta-analysis
was performed comparing different clinical outcomes. 9 studies were
finally included in the meta-analysis. The use of hemadsorption therapy
did not reduce mortality in the early postoperative period (RR = 0.75; p =
0.05). Both, the duration of mechanical ventilation (mean difference =
-6.91 hours; p = 0.01) and the duration of support with vasopressor drugs
(mean difference = -34.47 hours; p = 0.03) were significantly shorter in
the case of patients treated with hemadsorption. However, postoperative
stays, the incidence of postoperative renal failure or the need for
surgical revision due to bleeding did not show differences between groups.
To conclude, the use of the Cytosorb hemadsorption filter in cardiac
surgery for IE allowed better control of postoperative inflammatory
activity, with lower requirements for vasopressor support and duration of
mechanical ventilation, but without impact on perioperative mortality or
other related complications. Copyright © 2024 Sociedad Espanola
de Cirugia Cardiovascular y Endovascular

<25>
Accession Number
2030658798
Title
Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2
Diabetes.
Source
JAMA. 331(8) (pp 654-664), 2024. Date of Publication: 27 Feb 2024.
Author
Courcoulas A.P.; Patti M.E.; Hu B.; Arterburn D.E.; Simonson D.C.; Gourash
W.F.; Jakicic J.M.; Vernon A.H.; Beck G.J.; Schauer P.R.; Kashyap S.R.;
Aminian A.; Cummings D.E.; Kirwan J.P.
Institution
(Courcoulas, Gourash) Department of Surgery, University of Pittsburgh,
Pittsburgh, PA, United States
(Patti) Research Division, Joslin Diabetes Center, and Harvard Medical
School, Boston, MA, United States
(Hu, Beck) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Arterburn) Kaiser Permanente Washington Health Research Institute,
Seattle, United States
(Simonson) Division of Endocrinology, Diabetes and Hypertension, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Jakicic) Department of Internal Medicine, Division of Physical Activity
and Weight Management, University of Kansas Medical Center, Kansas City,
United States
(Vernon) Division of General and GI Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Schauer) Metamor Institute, Pennington Biomedical Research Center, Baton
Rouge, LA, United States
(Kashyap) Weill Cornell Medicine-New York Presbyterian, Department of
Medicine, Division of Endocrinology, Diabetes and Metabolism, New York,
NY, United States
(Aminian) Bariatric and Metabolic Institute, Department of General
Surgery, Cleveland Clinic, Cleveland, OH, United States
(Cummings) Department of Medicine, University of Washington, VA Puget
Sound Health Care System, Seattle, United States
(Kirwan) Pennington Biomedical Research Center, Baton Rouge, LA, United
States
Publisher
American Medical Association
Abstract
Importance: Randomized clinical trials of bariatric surgery have been
limited in size, type of surgical procedure, and follow-up duration.
 Objective(s): To determine long-Term glycemic control and safety of
bariatric surgery compared with medical/lifestyle management of type 2
diabetes. Design, Setting, and Participant(s): ARMMS-T2D (Alliance of
Randomized Trials of Medicine vs Metabolic Surgery in Type 2 Diabetes) is
a pooled analysis from 4 US single-center randomized trials conducted
between May 2007 and August 2013, with observational follow-up through
July 2022. Intervention(s): Participants were originally randomized
to undergo either medical/lifestyle management or 1 of the following 3
bariatric surgical procedures: Roux-en-Y gastric bypass, sleeve
gastrectomy, or adjustable gastric banding. Main Outcome and Measures: The
primary outcome was change in hemoglobin A<inf>1c</inf>(HbA<inf>1c</inf>)
from baseline to 7 years for all participants. Data are reported for up to
12 years. Result(s): A total of 262 of 305 eligible participants
(86%) enrolled in long-Term follow-up for this pooled analysis. The mean
(SD) age of participants was 49.9 (8.3) years, mean (SD) body mass index
was 36.4 (3.5), 68.3% were women, 31% were Black, and 67.2% were White.
During follow-up, 25% of participants randomized to undergo
medical/lifestyle management underwent bariatric surgery. The median
follow-up was 11 years. At 7 years, HbA<inf>1c</inf>decreased by 0.2% (95%
CI,-0.5% to 0.2%), from a baseline of 8.2%, in the medical/lifestyle group
and by 1.6% (95% CI,-1.8% to-1.3%), from a baseline of 8.7%, in the
bariatric surgery group. The between-group difference was-1.4% (95%
CI,-1.8% to-1.0%; P <.001) at 7 years and-1.1% (95% CI,-1.7% to-0.5%; P
=.002) at 12 years. Fewer antidiabetes medications were used in the
bariatric surgery group. Diabetes remission was greater after bariatric
surgery (6.2% in the medical/lifestyle group vs 18.2% in the bariatric
surgery group; P =.02) at 7 years and at 12 years (0.0% in the
medical/lifestyle group vs 12.7% in the bariatric surgery group; P <.001).
There were 4 deaths (2.2%), 2 in each group, and no differences in major
cardiovascular adverse events. Anemia, fractures, and gastrointestinal
adverse events were more common after bariatric surgery. Conclusion and
Relevance: After 7 to 12 years of follow-up, individuals originally
randomized to undergo bariatric surgery compared with medical/lifestyle
intervention had superior glycemic control with less diabetes medication
use and higher rates of diabetes remission. Trial Registration:
ClinicalTrials.gov Identifier: NCT02328599. Copyright © 2024
American Medical Association. All rights reserved.

<26>
Accession Number
2028810496
Title
Prevention of post-operative delirium using an overnight infusion of
dexmedetomidine in patients undergoing cardiac surgery: a pragmatic,
randomized, double-blind, placebo-controlled trial.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 64. Date of
Publication: December 2024.
Author
Huet O.; Gargadennec T.; Oilleau J.-F.; Rozec B.; Nesseler N.; Bougle A.;
Kerforne T.; Lasocki S.; Eljezi V.; Dessertaine G.; Amour J.; Chapalain
X.; Le Gac G.; Djavidi N.; Rineau E.; Eddi D.; Novak E.; Consigny M.;
Ashenoune K.; Roquilly A.; Seguin P.; Dayot-Fitzellier C.; Remerand F.;
Laffon M.
Institution
(Huet, Gargadennec, Oilleau, Chapalain) Department of Anaesthesia,
Intensive Care Medicine and Peri-Operative Medicine, Hopital de la cavale
Blanche, CHRU de Brest, Brest, France
(Rozec) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, Hopital Laennec, University Hospital Centre
Nantes, Nantes, France
(Nesseler, Seguin) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, University Hospital of Rennes, Rennes, France
(Bougle) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, Institut de Cardiologie, Hopital La
Pitie-Salpetriere, Paris, France
(Kerforne, Dayot-Fitzellier) Department of Anaesthesia, Intensive Care
Medicine and Peri-Operative Medicine CHU de POITIERS, Poitiers, France
(Lasocki) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, CHU de ANGERS, I, Angers, France
(Eljezi) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, Hopital Gabriel Montpied, CHU de Clermont
Ferrand, Clermont Ferrand, France
(Dessertaine) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, Grenoble Alpes University Hospital, Grenoble,
France
(Amour) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, Hopital Prive Jacques Cartier, Massy, France
(Le Gac) INSERM, Univ Rennes, CHU Rennes, Department of Anesthesia and
Critical Care, CLCC Eugene Marquis, COSS [(Chemistry Oncogenesis Stress
Signaling)] - UMR_S 1242, Rennes 35000, France
(Djavidi) Sorbonne Universite, GRC 29, Assistance Publique - Hopitaux de
Paris, DMU DREAM, Departement d'Anesthesie Et Reanimation, Institut de
Cardiologie, Hopital La Pitie-Salpetriere, Paris, France
(Rineau) Service d'anesthesie-Reanimation Et Medecine Perioperatoire CHU
de ANGERS, Angers, France
(Eddi, Novak, Consigny) Direction de La Recherche Clinique Et de
L'innovation, CHRU de Brest, Brest, France
(Ashenoune, Roquilly) Department of Anaesthesia, Intensive Care Medicine
and Peri-Operative Medicine, University Hospital Centre Nantes, Nantes,
France
(Remerand, Laffon) Department of Anaesthesia, Intensive Care Medicine and
Peri-Operative Medicine, CHU de Tours, Tours, France
Publisher
BioMed Central Ltd
Abstract
Background: After cardiac surgery, post-operative delirium (PoD) is
acknowledged to have a significant negative impact on patient outcome. To
date, there is no valuable and specific treatment for PoD. Critically ill
patients often suffer from poor sleep condition. There is an association
between delirium and sleep quality after cardiac surgery. This study aimed
to establish whether promoting sleep using an overnight infusion of
dexmedetomidine reduces the incidence of delirium after cardiac surgery.
 Method(s): Randomized, pragmatic, multicentre, double-blind, placebo
controlled trial from January 2019 to July 2021. All adult patients aged
65 years or older requiring elective cardiac surgery were randomly
assigned 1:1 either to the dexmedetomidine group or the placebo group on
the day of surgery. Dexmedetomidine or matched placebo infusion was
started the night after surgery from 8 pm to 8 am and administered every
night while the patient remained in ICU, or for a maximum of 7 days.
Primary outcome was the occurrence of postoperative delirium (PoD) within
the 7 days after surgery. Result(s): A total of 348 patients provided
informed consent, of whom 333 were randomized: 331 patients underwent
surgery and were analysed (165 assigned to dexmedetomidine and 166
assigned to placebo). The incidence of PoD was not significantly different
between the two groups (12.6% vs. 12.4%, p = 0.97). Patients treated with
dexmedetomidine had significantly more hypotensive events (7.3% vs 0.6%; p
< 0.01). At 3 months, functional outcomes (Short-form 36, Cognitive
failure questionnaire, PCL-5) were comparable between the two groups.
 Conclusion(s): In patients recovering from an elective cardiac
surgery, an overnight infusion of dexmedetomidine did not decrease
postoperative delirium. Trial registration This trial was registered on
ClinicalTrials.gov (number: NCT03477344; date: 26th March
2018). Copyright © The Author(s) 2024.

<27>
Accession Number
2028782814
Title
Meta-analysis of clinical efficacy of thoracoscopy and robotic surgery in
the treatment of mediastinal tumors.
Source
World Journal of Surgical Oncology. 22(1) (no pagination), 2024. Article
Number: 70. Date of Publication: December 2024.
Author
Dang J.; Sun S.; Wu Z.; Shan Y.; Zhang H.
Institution
(Dang, Sun, Wu, Shan, Zhang) Wuwei Liangzhou Hospital, Gansu, China
Publisher
BioMed Central Ltd
Abstract
Objective: Comparing the clinical efficacy of thoracoscopy and robotic
surgery in the treatment of mediastinal tumors using meta-analysis.
 Method(s): Computer retrieval of PubMed, Embase, The Cochrane
Library, and Web of Science databases for literature comparing the
clinical effects of video-assisted thoracic surgery (VATS) and
robot-assisted thoracic surgery (RATS) in treating mediastinal tumors,
with the retrieval time limit from the establishment of the database to
September 2023. Two evaluators independently screened the literature,
extracted data, and assessed the risk of bias. Meta-analysis was performed
using RevMan 5.4. Result(s): A total of 19 articles were included,
with a total of 3517 patients. The results of the Meta-analysis showed
that the RATS group had less intraoperative bleeding [MD = - 5.20, 95%CI
(- 9.28, - 1.12), P = 0.01], lower rate of conversion to thoracotomy [OR =
0.41, 95%CI (0.23, 0.72), P = 0.002], lower rate of total postoperative
complications [OR = 0.57, 95%CI (0.34, 0.95), P = 0.03], shorter
postoperative drainage time [MD = - 0.72, 95%CI (- 1.13, - 0.32), P =
0.0004], and shorter postoperative hospital stay [MD = - 0.90, 95%CI (-
1.16, - 0.65), P < 0.001], in comparison with the VATS group. There was an
insignificant difference between the two groups in terms of tumor size [MD
= - 0.02, 95%CI (- 0.33, 0.30), P = 0.91] and operation time [MD = 0.17,
95%CI (- 7.61, 7.94), P = 0.97]. However, in regards to hospitalization
costs [MD = 2634.75, 95%CI (991.62, 4277.88), P = 0.002], the RATS group
was more expensive than the VATS group. Conclusion(s): Robot-assisted
mediastinal tumor resection surgery has more advantages in terms of
intraoperative bleeding, conversion to thoracotomy rate, total
postoperative complication rate, postoperative drainage time, and
postoperative hospital stay, in comparison with thoracoscopic-assisted
mediastinal tumor resection surgery. There is an insignificant difference
in tumor size and operation time between the two surgeries. However,
robot-assisted mediastinal tumor resection surgery increases
hospitalization costs. Copyright © The Author(s) 2024.

<28>
Accession Number
2027991674
Title
Safety, feasibility, tolerability, and clinical effects of repeated
psilocybin dosing combined with non-directive support in the treatment of
obsessive-compulsive disorder: protocol for a randomized,
waitlist-controlled trial with blinded ratings.
Source
Frontiers in Psychiatry. 14 (no pagination), 2023. Article Number:
1278823. Date of Publication: 2023.
Author
Ching T.H.W.; Amoroso L.; Bohner C.; D'Amico E.; Eilbott J.; Entezar T.;
Fitzpatrick M.; Fram G.; Grazioplene R.; Hokanson J.; Kichuk S.A.; Martins
B.; Patel P.; Schaer H.; Shnayder S.; Witherow C.; Pittenger C.; Kelmendi
B.
Institution
(Ching, Amoroso, Bohner, D'Amico, Eilbott, Entezar, Fitzpatrick, Fram,
Grazioplene, Hokanson, Kichuk, Martins, Patel, Schaer, Shnayder, Witherow,
Pittenger, Kelmendi) Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, United States
(Pittenger) Department of Psychology, Yale University, New Haven, CT,
United States
(Pittenger) Center for Brain and Mind Health, Yale University School of
Medicine, New Haven, CT, United States
(Pittenger) Child Study Center, Yale University School of Medicine, New
Haven, CT, United States
Publisher
Frontiers Media SA
Abstract
Background: To date, few randomized controlled trials of psilocybin with
non-directive support exist for obsessive-compulsive disorder (OCD).
Results and participant feedback from an interim analysis of an ongoing
single-dose trial (NCT03356483) converged on the possibility of
administering a higher fixed dose and/or more doses of psilocybin in
future trials for presumably greater benefits. Objective(s): This
trial aims to evaluate the safety, feasibility, tolerability, and clinical
effects of two doses of psilocybin paired with non-directive support in
the treatment of OCD. This trial also seeks to examine whether two doses
of psilocybin lead to greater OCD symptom reduction than a single dose,
and to elucidate psychological mechanisms underlying the effects of
psilocybin on OCD. Design(s): A randomized (1:1), waitlist-controlled
design with blinded ratings will be used to examine the effects of two
doses of oral psilocybin paired with non-directive support vs. waitlist
control on OCD symptoms. An adaptive dose selection strategy will be
implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods
and analysis: This single-site trial will enroll 30 adult participants
with treatment-refractory OCD. Aside from safety, feasibility, and
tolerability metrics, primary outcomes include OCD symptoms assessed on
the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A
blinded independent rater will assess primary outcomes at baseline and the
primary endpoint at the end of the second dosing week. Participants will
be followed up to 12 months post-second dosing. Participants randomized to
waitlist will be rescreened after 7 weeks post-randomization, and begin
their delayed treatment phase thereafter if still eligible. Ethics:
Written informed consent will be obtained from participants. The
institutional review board has approved this trial (protocol v. 1.7; HIC
#2000032623). Discussion(s): This study seeks to advance our ability
to treat refractory OCD, and catalyze future research seeking to optimize
the process of psilocybin treatment for OCD through understanding relevant
psychological mechanisms. Clinical trial registration: ClinicalTrials.gov,
identifier NCT05370911. Copyright © 2024 Ching, Amoroso, Bohner,
D'Amico, Eilbott, Entezar, Fitzpatrick, Fram, Grazioplene, Hokanson,
Kichuk, Martins, Patel, Schaer, Shnayder, Witherow, Pittenger and
Kelmendi.

<29>
Accession Number
2030698912
Title
An Updated Meta-Analysis of Treatment in Patients with Heart Failure
Complicated Ventricular Functional Mitral Regurgitation.
Source
Reviews in Cardiovascular Medicine. 25(2) (no pagination), 2024. Date of
Publication: 2024.
Author
Sasmita B.R.; Luo S.; Huang B.
Institution
(Sasmita, Luo, Huang) Department of Cardiology, The First Affiliated
Hospital of Chongqing Medical University, Chongqing 400016, China
Publisher
IMR Press Limited
Abstract
Backgrounds: Ventricular functional mitral regurgitation (FMR) is a common
morbidity in patients with heart failure (HF). In addition to
guideline-directed medical therapy, mitral valve (MV) repair or
replacement has become an option for such patients. However, the impact of
different treatments on cardiac remodeling, function, and clinical
outcomes remains unclear. Method(s): We systematically searched
PubMed, EMBASE, Medline, Clinical Trials.gov, and the Cochrane Central
Register of Controlled Trials with search terms related to mitral
regurgitation, mitral valve repair, surgical mitral valve replacement,
mitral annuloplasty device, and MitraClip. The outcomes were left
ventricular ejection fraction (LVEF), left ventricular (LV) remodeling,
all-cause mortality, cardiovascular death, and HF hospitalization.
Sensitivity analysis was performed by removing high-bias risk studies. The
analysis was done by Review Manager 5.4 Analyzer and MedCalc Statistical
Software version 19.2.6. Result(s): This meta-analysis included 10
studies with a total of 2533 patients (567 with transcatheter MitraClip,
823 with surgical MV repair, 651 with surgical MV replacement, and 492
with medical therapy). Our meta-analysis revealed that surgical MV repair
had significant improvement in LVEF compared to the surgical MV
replacement (mean differences (MD) 2.32, [95% CI 0.39, 4.25]), while
transcatheter MitraClip treatment was associated with LVEF reduction (MD
-4.82, [95% CI -7.29, -2.34]). In terms of LV remodeling, transcatheter
MitraClip treatment was associated with improvement in left ventricular
end-diastolic volume (MD -10.36, [95% CI -18.74, -1.99]). Furthermore,
compared to surgical MV replacement, surgical MV repair was not associated
with a reduction of all-cause mortality (risk ratio (RR) 0.83, [95% CI
0.61, 1.13]) and cardiovascular death (RR 0.95, [95% CI 0.56, 1.62]),
while transcatheter MitraClip was associated with reduced risk of
all-cause mortality (RR 0.87, [95% CI 0.78, 0.98]). Conclusion(s):
Surgical MV repair was associated with significant improvement in LVEF but
had no significant effect on all-cause mortality compared to surgical MV
replacement. Transcatheter MitraClip was associated with better long-term
survival than the non-MitraClip group, thus, transcatheter MitraClip could
be considered an alternative treatment in patients with HF-complicated
ventricular FMR. Copyright: © 2024 The Author(s). Published by
IMR Press. This is an open access article under the CC BY 4.0 license.

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

<31>
Accession Number
2030632207
Title
Training simulator efficacy in developing thoracic and general surgical
skills in a residency programme: a pilot study.
Source
European Journal of Cardio-thoracic Surgery. 65(2) (no pagination), 2024.
Article Number: ezae044. Date of Publication: 01 Feb 2024.
Author
Grossi S.; Cattoni M.; Filipponi L.; Marzorati A.; Rotolo N.; Carcano G.;
Imperatori A.
Institution
(Grossi, Cattoni, Filipponi, Rotolo, Imperatori) Center for Thoracic
Surgery, Department of Medicine and Surgery (DMC), University of Insubria,
Varese, Italy
(Marzorati, Carcano) General, Emergency and Transplant Surgery, Department
of Medicine and Innovation Technology (DiMIT), University of Insubria,
Varese, Italy
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Virtual training simulators have been introduced in several
surgical disciplines to improve residents' abilities. Through the use of
the LapSimVR virtual training simulator (Surgical Science, Goteborg,
Sweden), this study aims to plan an effective learning path in minimally
invasive thoracic and general surgery. METHOD(S): All thoracic and
general surgery trainees in their 1st and 2nd year of residency at the
University of Insubria were enrolled and randomized into 2 groups:
residents undergoing an intensive twice-a-week virtual training programme
(group A: n 8) and those undergoing a once-weekly non-intensive virtual
training programme (group B: n 9). The virtual training programme was
divided into 4 modules, each of 12weeks. In the 1st module, trainees
repeated grasping, cutting, clip application, lifting and grasping, and
fine dissection exercises during each training session. Seal-and-cut
exercise was performed as the initial and final test. Data on surgical
manoeuvres (time and on mistakes) were collected; intra- and inter-group
comparisons were planned. RESULT(S): No significant differences were
observed between groups A and B at the 1st session, confirming that the 2
groups had similar skills at the beginning. After 12weeks, both groups
showed improvements, but comparing data between initial and final test,
only Group A registered a significant reduction in total time (P-value
0.0015), left (P-value 0.0017) and right (P-value 0.0186) instrument path
lengths, and in left (P-value 0.0010) and right (P-value 0.0073)
instrument angular path lengths, demonstrating that group A acquired
greater precision in surgical manoeuvres. CONCLUSION(S): Virtual
simulator training programme performed at least twice a week was effective
for implementing basic surgical skills required for the trainee's
professional growth. Additional virtual training modules focused on more
complex exercises are planned to confirm these preliminary
results. Copyright © The Author(s) 2024.

<32>
[Use Link to view the full text]
Accession Number
2030606118
Title
Cognitive Effects of Body Temperature during Hypothermic Circulatory
Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes
after Aortic Arch Surgery.
Source
Circulation. 149(9) (pp 658-668), 2024. Date of Publication: 27 Feb 2024.
Author
Hughes G.C.; Chen E.P.; Browndyke J.N.; Szeto W.Y.; Dimaio J.M.; Brinkman
W.T.; Gaca J.G.; Blumenthal J.A.; Karhausen J.A.; Bisanar T.; James M.L.;
Yanez D.; Li Y.-J.; Mathew J.P.
Institution
(Hughes, Chen, Gaca) Department of Surgery, Division of Thoracic and
Cardiovascular Surgery, Duke University Medical Center, Durham, NC, United
States
(Browndyke, Blumenthal) Department of Psychiatry and Behavioral Sciences,
Division of Behavioral Medicine and Neurosciences, Duke University Medical
Center, Durham, NC, United States
(Szeto) Department of Surgery, Division of Cardiovascular Surgery,
University of Pennsylvania, Philadelphia, United States
(Dimaio, Brinkman) The Heart Hospital, Baylor Scott and White, Plano, TX,
United States
(Karhausen, Bisanar, James, Mathew) Department of Anesthesiology, Duke
University School of Medicine, Durham, NC, United States
(James) Department of Neurology, Duke University School of Medicine,
Durham, NC, United States
(Yanez, Li) Department of Biostatistics and Bioinformatics, Duke
University School of Medicine, Durham, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Deep hypothermia has been the standard for hypothermic
circulatory arrest (HCA) during aortic arch surgery. However, centers
worldwide have shifted toward lesser hypothermia with antegrade cerebral
perfusion. This has been supported by retrospective data, but there has
yet to be a multicenter, prospective randomized study comparing deep
versus moderate hypothermia during HCA. METHOD(S): This was a
randomized single-blind trial (GOT ICE [Cognitive Effects of Body
Temperature During Hypothermic Circulatory Arrest]) of patients undergoing
arch surgery with HCA plus antegrade cerebral perfusion at 4 US referral
aortic centers (August 2016-December 2021). Patients were randomized to 1
of 3 hypothermia groups: DP, deep (<=20.0 degreeC); LM, low-moderate
(20.1-24.0 degreeC); and HM, high-moderate (24.1-28.0 degreeC). The
primary outcome was composite global cognitive change score between
baseline and 4 weeks postoperatively. Analysis followed the
intention-To-Treat principle to evaluate if: (1) LM noninferior to DP on
global cognitive change score; (2) DP superior to HM. The secondary
outcomes were domain-specific cognitive change scores, neuroimaging
findings, quality of life, and adverse events. RESULT(S): A total of
308 patients consented; 282 met inclusion and were randomized. A total of
273 completed surgery, and 251 completed the 4-week follow-up (DP, 85
[34%]; LM, 80 [34%]; HM, 86 [34%]). Mean global cognitive change score
from baseline to 4 weeks in the LM group was noninferior to the DP group;
likewise, no significant difference was observed between DP and HM.
Noninferiority of LM versus DP, and lack of difference between DP and HM,
remained for domain-specific cognitive change scores, except structured
verbal memory, with noninferiority of LM versus DP not established and
structured verbal memory better preserved in DP versus HM (P = 0.036).
There were no significant differences in structural or functional magnetic
resonance imaging brain imaging between groups postoperatively. Regardless
of temperature, patients who underwent HCA demonstrated significant
reductions in cerebral gray matter volume, cortical thickness, and
regional brain functional connectivity. Thirty-day in-hospital mortality,
major morbidity, and quality of life were not different between groups.
 CONCLUSION(S): This randomized multicenter study evaluating arch
surgery HCA temperature strategies found low-moderate hypothermia
noninferior to traditional deep hypothermia on global cognitive change 4
weeks after surgery, although in secondary analysis, structured verbal
memory was better preserved in the deep group. The verbal memory
differences in the low-and high-moderate groups and structural and
functional connectivity reductions from baseline merit further
investigation and suggest opportunities to further optimize brain
perfusion during HCA. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT02834065. Copyright © 2024 Lippincott
Williams and Wilkins. All rights reserved.

<33>
Accession Number
2030603913
Title
Mechanisms of rosuvastatin-related acute kidney injury following cardiac
surgery: the STICS trial.
Source
European Heart Journal. 45(8) (pp 629-631), 2024. Date of Publication: 21
Feb 2024.
Author
Wijesurendra R.S.; Sardell R.; Jayaram R.; Samuel N.; Chen Z.; Staplin N.;
Collins R.; Zheng Z.; Haynes R.; Hill M.; Emberson J.; Casadei B.
Institution
(Wijesurendra, Jayaram, Casadei) Division of Cardiovascular Medicine, BHF
Centre of Research Excellence, University of Oxford, United Kingdom
(Wijesurendra, Sardell, Samuel, Chen, Staplin, Collins, Haynes, Hill,
Emberson) Clinical Trial Service Unit, Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Staplin, Haynes, Hill, Emberson) Medical Research Council Population
Health Research Unit, Nuffield Department of Population Health, University
of Oxford, Oxford, United Kingdom
(Zheng) Department of Cardiovascular Surgery, State Key Laboratory of
Cardiovascular Disease, National Clinical Research Center of
Cardiovascular Diseases, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
Oxford University Press

<34>
Accession Number
2030592903
Title
Merits of simulation-based education: A systematic review and
meta-analysis.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 90 (pp 227-239),
2024. Date of Publication: March 2024.
Author
Foppiani J.; Stanek K.; Alvarez A.H.; Weidman A.; Valentine L.; Oh I.J.;
Albakri K.; Choudry U.; Rogers-Vizena C.R.; Lin S.J.
Institution
(Foppiani, Alvarez, Weidman, Valentine, Lin) Department of Plastic and
Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA,
United States
(Stanek, Rogers-Vizena) Department of Plastic and Oral Surgery, Boston
Children's Hospital, Boston, MA, United States
(Oh) Georgetown University School of Medicine, Washington, DC, United
States
(Albakri) Faculty of Medicine, The Hashemite University, Zarqa, Jordan
(Choudry) Department of Plastic and Reconstructive Surgery, University of
Minnesota, Minneapolis, MN, United States
(Rogers-Vizena, Lin) Department of Surgery, Harvard Medical School,
Boston, MA, United States
Publisher
Churchill Livingstone
Abstract
Background: The drive to improve surgical proficiency through advanced
simulation-based training has gained momentum. This meta-analysis
systematically evaluated evidence regarding the impact of plastic
surgery-related simulation on the performance of residents.
 Method(s): A systematic search of PubMed, Web of Science, and
Cochrane Library and review of articles was performed following the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
protocol. An inverse-variance random-effects model was used to combine
study estimates to account for between-study variability. Objective
structured assessment of technical skills (OSATS) scores and subjective
confidence scores were used to assess the impact of the simulation with
positive changes from the baseline indicating better outcomes.
 Result(s): Eighteen studies pooling 367 trainees who participated in
various simulations were included. Completion of simulation training was
associated with significant improvement in subjective confidence scores
with a mean increase of 1.44 units (95% CI: 0.93 to 1.94, P < 0.001), and
in OSATS scores, with a mean increase of 1.24 units (95% CI: 0.87 to 1.62,
P < 0.001), both on a 1-5 scale. Participants reported high satisfaction
scores (mean = 4.76 units, 95% CI = 4.61 to 4.91, P = 0.006), also on a
1-5 scale. Conclusion(s): Participation in surgical simulation
markedly improved objective and subjective scoring metrics for surgical
trainees. Several simulation devices are available for honing surgical
skills, with the potential for advancements. The evidence demonstrates the
effectiveness of simulations; thus, incorporating simulation into training
curricula should be a priority in the field of plastic
surgery. Copyright © 2024

<35>
Accession Number
2030586769
Title
Efficacy of avoiding chest drains after video-assisted thoracoscopic
surgery wedge resection: protocol for a randomised controlled trial.
Source
BMJ Open. 14(2) (no pagination), 2024. Article Number: e080573. Date of
Publication: 20 Feb 2024.
Author
Holbek B.L.; Huang L.; Christensen T.D.; Bendixen M.; Hansen H.J.; Kehlet
H.; Petersen R.H.
Institution
(Holbek, Huang, Hansen, Petersen) Department of Cardiothoracic Surgery,
Copenhagen University Hospital Rigshospitalet, Kobenhavn, Denmark
(Christensen, Bendixen) Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Aarhus, Denmark
(Christensen, Bendixen) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
(Kehlet) Section for Surgical Pathophysiology, Copenhagen University
Hospital Rigshospitalet, Kobenhavn, Denmark
(Petersen) Institute for Clinical Medicine, Faculty of Health and Medical
Sciences, Copenhagen University, Kobenhavn, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction The use of routine postoperative chest drains after
video-assisted thoracoscopic surgery (VATS) of the lung is a practice
based on tradition with the aim of draining fluid and air. However, new
evidence suggests that chest drains can be avoided in selected cases. With
this randomised controlled trial, we wish to establish the efficacy and
safety of avoiding postoperative chest drains compared with routine
postoperative chest drains. Methods and analysis This is a two-centre
randomised controlled trial without allocation concealment, but where
randomisation occurs after the end of procedure leaving operative
personnel blinded during surgery. The sample size is calculated to show a
difference in pain measurements using the Numeric Rating Scale under
different circumstances and at different time points to show superiority
of the intervention. The trial is pragmatic by design to reflect the daily
clinical scenario and with the aim of increasing the external validity of
the results. Ethics and dissemination Approval by the local ethics
committees has been obtained for both sites. The study was registered with
ClinicalTrials.gov (NCT05358158) prior to inclusion. The results of the
trial will be disseminated by publication in an international journal and
presentation at major international thoracic surgical meetings. Article
summary This is a randomised controlled trial estimating the effects of
avoiding a chest drain after VATS wedge resection of the lung on pain,
total morphine use, quality of life and complications. Copyright
© 2024 BMJ Publishing Group. All rights reserved.

<36>
[Use Link to view the full text]
Accession Number
2030570220
Title
Safety and Efficacy of Ticagrelor Monotherapy in Patients with Acute
Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An
Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized
Trials.
Source
Circulation. 149(8) (pp 574-584), 2024. Date of Publication: 20 Feb 2024.
Author
Baber U.; Jang Y.; Oliva A.; Cao D.; Vogel B.; Dangas G.; Sartori S.;
Spirito A.; Smith K.F.; Branca M.; Collier T.; Pocock S.; Valgimigli M.;
Kim B.-K.; Hong M.-K.; Mehran R.
Institution
(Baber) Cardiovascular Disease Section, Department of Medicine, University
of Oklahoma, Health Sciences Center, Oklahoma City, United States
(Jang) Bundang CHA Medical Center, CHA University, School of Medicine,
Seongnam, South Korea
(Oliva, Cao, Vogel, Dangas, Sartori, Spirito, Smith, Mehran) The Zena and
Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Oliva, Cao) Department of Biomedical Sciences, Humanitas University, MI,
Pieve Emanuele, Italy
(Branca) CTU Bern, University of Bern, Switzerland
(Collier, Pocock) Department of Medical Statistics, London School of
Hygiene and Tropical Medicine, United Kingdom
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale
(EOC), Lugano, Switzerland
(Valgimigli) Department of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Kim, Hong) Severance Cardiovascular Hospital, Yonsei University, College
of Medicine, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Dual antiplatelet therapy with a potent P2Y12inhibitor coupled
with aspirin for 1 year is the recommended treatment for patients with
acute coronary syndrome (ACS) undergoing percutaneous coronary
intervention (PCI). As an alternative, monotherapy with a P2Y12inhibitor
after a short period of dual antiplatelet therapy has emerged as a
bleeding reduction strategy. METHOD(S): We pooled individual patient
data from randomized trials that included patients with ACS undergoing PCI
treated with an initial 3-month course of dual antiplatelet therapy
followed by ticagrelor monotherapy versus continued ticagrelor plus
aspirin. Patients sustaining a major ischemic or bleeding event in the
first 3 months after PCI were excluded from analysis. The primary outcome
was Bleeding Academic Research Consortium type 3 or 5 bleeding occurring
between 3 and 12 months after index PCI. The key secondary end point was
the composite of death, myocardial infarction, or stroke. Hazard ratios
and 95% CIs were generated using Cox regression with a one-stage approach
in the intention-to-treat population. RESULT(S): The pooled cohort
(n=7529) had a mean age of 62.8 years, 23.2% were female, and 55%
presented with biomarker-positive ACS. Between 3 and 12 months, ticagrelor
monotherapy significantly reduced Bleeding Academic Research Consortium 3
or 5 bleeding compared with ticagrelor plus aspirin (0.8% versus 2.1%;
hazard ratio, 0.37 [95% CI, 0.24-0.56]; P<0.001). Rates of all-cause
death, myocardial infarction, or stroke were not significantly different
between groups (2.4% versus 2.7%; hazard ratio, 0.91 [95% CI, 0.68-1.21];
P=0.515). Findings were unchanged among patients presenting with
biomarker-positive ACS. CONCLUSION(S): Among patients with ACS
undergoing PCI who have completed a 3-month course of dual antiplatelet
therapy, discontinuation of aspirin followed by ticagrelor monotherapy
significantly reduced major bleeding without incremental ischemic risk
compared with ticagrelor plus aspirin. REGISTRATION: URL:
https://www.crd.york.ac.uk/prospero; Unique identifier:
CRD42023449646. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<37>
Accession Number
2028285085
Title
Literature Review of Handheld Articulating Instruments in Minimally
Invasive Surgery.
Source
Journal of Laparoendoscopic and Advanced Surgical Techniques. 34(1) (pp
47-54), 2024. Date of Publication: 01 Jan 2024.
Author
Mao R.; Gao L.; Gang W.; Wen L.
Institution
(Mao, Gao, Wen) Department of Medical Equipment, Sichuan Provincial
People's Hospital, School of Medicine, University of Electronic Science
and Technology of China, Chengdu, China
(Mao) School of Biological Science and Medical Engineering, Beihang
University, Beijing, China
(Gang) Hepatobiliary and Pancreatic Surgery Department, Sichuan Provincial
People's Hospital, Chengdu, China
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Minimally invasive surgery (MIS) using handheld articulating
instruments (HAIs) has emerged as an innovative approach, offering
enhanced dexterity and accessibility compared with conventional straight
tools. There has been a significant surge in market interest surrounding
HAIs. However, the question about the potential benefits of these devices
for surgeons and patients in clinical applications remains unclear.
 Method(s): We thoroughly searched relevant literature about the HAIs
with clinical applications. This article reviews the feasibility, safety,
outcomes, ergonomics, and learning curve associated with utilizing HAIs,
including notable commercial products FlexDex, ArtiSential, and HandX.
This study also investigates the comparisons of the use of HAIs with
traditional laparoscopy and the da Vinci robotic system in terms of
surgical outcomes and operational efficiency. Result(s): Early
clinical studies demonstrate the applicability of HAIs across
gastrointestinal, urologic, cardiothoracic, and general surgery, with
promising results and few complications reported. Comparisons with
conventional laparoscopy reveal no significant differences in surgical
outcomes. However, HAIs present a more prolonged learning curve than
robotic surgery for novice users. Combining three-dimensional
visualization techniques facilitate performance. Further research with
larger sample sizes is warranted to establish definitive superiority in
surgical efficiency and characterize optimal training methodology.
 Conclusion(s): Overall, the maneuverability and lower cost of HAIs
present new possibilities in MIS, potentially expanding accessibility for
smaller health care organizations and benefiting more
patients. Copyright © Mary Ann Liebert, Inc.

<38>
Accession Number
2027727399
Title
Non-calcified plaque in asymptomatic patients with zero coronary artery
calcium score: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Computed Tomography. 18(1) (pp 43-49), 2024.
Date of Publication: 01 Jan 2024.
Author
Sama C.; Abdelhaleem A.; Velu D.; Ditah Chobufo M.; Fongwen N.T.; Budoff
M.J.; Roberts M.; Balla S.; Mills J.D.; Njim T.N.; Greathouse M.; Zeb I.;
Hamirani Y.S.
Institution
(Sama, Roberts) Department of Medicine, Section of Internal Medicine, West
Virginia University School of Medicine, WV, United States
(Abdelhaleem, Velu, Ditah Chobufo, Balla, Mills, Greathouse, Zeb,
Hamirani) Department of Medicine, Division of Cardiovascular Diseases,
West Virginia University School of Medicine, WV, United States
(Fongwen) London School of Hygiene and Tropical Medicine & Africa Centres
for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
(Budoff) Division of Cardiology, Harbor-UCLA Medical Center and the
Lundquist Institute for Biomedical Innovation, Torrance, CA, United States
(Njim) Department of International Public Health, Liverpool School of
Tropical Medicine, Liverpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: There is growing interest in understanding the coronary
atherosclerotic burden in asymptomatic patients with zero coronary artery
calcium score (CACS). In this population, we aimed to investigate the
prevalence and severity of non-calcified coronary plaques (NCP) as
detected by coronary CT angiography (CCTA), and to analyze the associated
clinical predictors. Method(s): This was a systematic review with
meta-analysis of studies indexed in PubMed/Medline and Web of Science from
inception of the database to March 31st, 2023. Using the random-effects
model, separate Forest and Galbraith plots were generated for each effect
size assessed. Heterogeneity was assessed using the I2
statistics whilst Funnel plots and Egger's test were used to assess for
publication bias. Result(s): From a total of 14 studies comprising
37808 patients, we approximated the pooled summary estimates for the
overall prevalence of NCP to be 10% (95%CI: 6%-13%). Similarly, the pooled
prevalence of obstructive NCP was estimated at 1.1% (95%CI: 0.7%-1.5%)
from a total of 10 studies involving 21531 patients. Hypertension [OR:
1.46 (95%CI:1.31-1.62)] and diabetes mellitus [OR: 1.69 (95%CI:
1.41-1.97)] were significantly associated with developing any NCP, with
male gender being the strongest predictor [OR: 3.22 (95%CI: 2.17-4.27)].
 Conclusion(s): There is a low burden of NCP among asymptomatic
subjects with zero CACS. In a subset of this population who have clinical
predictors of NCP, the addition of CCTA has a potential to provide a
better insight about occult coronary atherosclerosis, however, a
risk-benefit approach must be factored in prior to CCTA use given the low
prevalence of NCP. Copyright © 2023

<39>
Accession Number
2027253007
Title
Management of Bilateral Vocal Fold Paralysis: A Systematic Review.
Source
Otolaryngology - Head and Neck Surgery (United States). 170(3) (pp
724-735), 2024. Date of Publication: March 2024.
Author
Lechien J.R.; Hans S.; Mau T.
Institution
(Lechien) Department of Otolaryngology, Elsan Hospital, Paris, France
(Lechien, Hans) Department of Otolaryngology-Head & Neck Surgery, Foch
Hospital, School of Medicine, UFR Simone Veil, Universite Versailles
Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
(Lechien) Division of Laryngology and Bronchoesophagology, Department of
Otolaryngology Head Neck Surgery, EpiCURA Hospital, UMONS Research
Institute for Health Sciences and Technology, Faculty of Medicine,
University of Mons (UMons), Mons, Belgium
(Lechien) Department of Otolaryngology-Head & Neck Surgery, CHU
Saint-Pierre (CHU de Bruxelles), Brussels, Belgium
(Mau) Department of Otolaryngology-Head and Neck Surgery, Clinical Center
for Voice Care, University of Texas Southwestern Medical Center, Dallas,
TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: To review the current literature about epidemiology, etiologies
and surgical management of bilateral vocal fold paralysis (BVFP).
 Data Sources: PubMED, Scopus, and Cochrane Library. Review Methods: A
systematic review of the literature on epidemiology, etiologies, and
management of adult patients with BVFP was conducted through preferred
reporting items for systematic reviews and meta-analyses statements by 2
investigators. Result(s): Of the 360 identified papers, 245 were
screened, and of these 55 were considered for review. The majority (76.6%)
of BVFP cases are iatrogenic. BVFP requires immediate tracheotomy in 36.2%
of cases. Laterofixation of the vocal fold was described in 9 studies and
is a cost-effective alternative procedure to tracheotomy while awaiting
potential recovery. Unilateral and bilateral posterior transverse
cordotomy outcomes were reported in 9 and 7 studies, respectively. Both
approaches are associated with a 95.1% decannulation rate, adequate airway
volume, but voice quality worsening. Unilateral/bilateral partial
arytenoidectomy data were described in 4 studies, which reported lower
decannulation rate (83%) and better voice quality outcome than cordotomy.
Revision rates and complications vary across studies, with complications
mainly involving edema, granuloma, fibrosis, and scarring. Selective
posterior cricoarytenoid reinnervation is being performed by more surgeons
and should be a promising addition to the BVFP surgical armamentarium.
 Conclusion(s): Depending on techniques, the management of BVFP may be
associated with several degrees of airway improvements while worsened or
unchanged voice quality. The heterogeneity between studies, the lack of
large-cohort controlled randomized studies and the confusion with
posterior glottic stenosis limit the draw of clear conclusion about the
superiority of some techniques over others. Copyright © 2023
American Academy of Otolaryngology-Head and Neck Surgery Foundation.

<40>
Accession Number
2026731126
Title
Effect of 5% albumin on endothelial glycocalyx degradation during off-pump
coronary artery bypass.
Source
Canadian Journal of Anesthesia. 71(2) (pp 244-253), 2024. Date of
Publication: February 2024.
Author
Nan Z.; Soh S.; Shim J.-K.; Kim H.B.; Yang Y.S.; Kwak Y.L.; Song J.W.
Institution
(Nan, Soh, Shim, Yang, Kwak) Department of Anesthesiology and Pain
Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Nan, Soh, Shim, Kwak) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Song) Department of Anesthesiology and Pain Medicine, Anesthesia and Pain
Research Institute, Yonsei Cardiovascular Hospital, Yonsei University
College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
Publisher
Springer
Abstract
Purpose: The integrity of the endothelial glycocalyx (EG), a critical
player in vascular homeostasis, reportedly influences the outcomes of
critically ill patients. We investigated the effect of 5% albumin, which
preserved EG integrity in preclinical studies, vs balanced crystalloid
solution on EG degradation in patients undergoing off-pump coronary
surgery. Method(s): Patients were randomized to receive either 5%
albumin (N = 51) or balanced crystalloid solution (Plasma-Lyte [Baxter
Incorporated, Seoul, Republic of Korea]; N = 53) for intravenous volume
replacement during surgery (double-blinded). The primary outcome was
plasma syndecan-1 concentration, a marker of EG degradation, measured
after anesthetic induction (baseline), completion of grafting, and sternal
closure. Secondary outcomes were atrial natriuretic peptide (ANP), tumour
necrosis factor (TNF)-alpha, soluble thrombomodulin, and perioperative
fluid balance. Result(s): The mean (standard deviation) fluid
requirements were 833 (270) mL and 1,323 (492) mL in the albumin and
Plasma-Lyte group, respectively (mean difference, -489 mL; 95% confidence
interval [CI], -643 to -335; P < 0.001). Plasma syndecan-1 concentration
increased after completion of grafting (median difference, 116
ng.mL-1; 95% CI, 67 to 184; P < 0.001) and sternal closure
(median difference, 57 ng.mL-1; 95% CI, 36 to 80; P < 0.001)
compared with those at baseline, without any intergroup differences.
Atrial natriuretic peptide, TNF-alpha, and soluble thrombomodulin
concentrations were similar between the two groups. The amount of chest
tube drainage was greater in the albumin group than that in the
Plasma-Lyte group (median difference, 190 mL; 95% CI, 18 to 276; P =
0.03). Conclusion(s): Off-pump coronary surgery was associated with
significant EG degradation. Yet, intraoperative fluid therapy with 5%
albumin could not ameliorate EG degradation when compared with balanced
crystalloid solution. Trial registration: ClinicalTrials.gov
(NCT03699462); first posted 9 October 2018. Copyright © Canadian
Anesthesiologists' Society 2023.

<41>
Accession Number
2026567233
Title
Outcomes of left-sided heart valve surgery after heart transplantation: a
systematic review.
Source
Heart Failure Reviews. 29(1) (pp 227-234), 2024. Date of Publication:
January 2024.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Modine T.; Labrousse L.; Pernot M.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Modine, Labrousse, Pernot)
Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Av. Magellan,
Pessac 33604, France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Louvain, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Springer
Abstract
As the survival after heart transplantation (HTx) is steadily improving,
an increasing number of patients with late cardiac pathologies such as
valvular disease is expected to rise. Nevertheless, no guidelines for
indication of redo cardiac surgery after HTx exists. The aim of the
present systematic review is to describe the results reported in the
literature of surgical management of severe aortic and/or mitral valve
disease. A systematic review was conducted including studies reporting on
adult patients with severe mitral or aortic valve pathology needing
surgery after their previous HTx. Exclusion criteria consisted in surgery
with no left heart valve surgery, concomitant valve surgery during heart
transplant, transcatheter interventions, and heterotopic HTx. A total of
35 papers met our inclusion criteria out of 2755 potentially eligible
studies with 44 mitral valve surgery patients and 20 aortic valve surgery
patients. In the entire population, the mean time from HTx to
reintervention was 6.19 +/- 5.22 years. After a mean follow-up of 2.78 +/-
3.54 years and 1.53 +/- 2.26 years from reintervention, 65.6% mitral and
86.7% aortic patients were reported as alive, respectively. As guidelines
on cardiac surgery after HTx are currently lacking, left-sided valvular
cardiac reinterventions can be considered a possible therapeutic approach
in carefully selected patients. These interventions may not only improve
the patient's functional status and survival, but may ultimately reduce
the need for re-transplantation due to the chronic shortage of donor
hearts. However, the support of more robust data is
warranted. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2023.

<42>
Accession Number
2026433032
Title
Effect of acupressure on pain among older female patients undergoing
extracorporeal shock wave lithotripsy: A randomized controlled clinical
trial.
Source
Explore. 20(2) (pp 233-238), 2024. Date of Publication: 01 Mar 2024.
Author
Ziaei Azarkhavarani F.; Rejeh N.; Valiani M.; Kazemi R.
Institution
(Ziaei Azarkhavarani) Department of Nursing, Faculty of Nursing &
Midwifery, Shahed University, Tehran, Iran, Islamic Republic of
(Rejeh) Elderly Care Research Center, Department of Nursing, Faculty of
Nursing & Midwifery, Shahed University, Tehran, Iran, Islamic Republic of
(Valiani) Nursing and Midwifery Care Research Center, Faculty of Nursing,
Isfahan University of Medical sciences, Isfahan, Iran, Islamic Republic of
(Kazemi) Department of Urology, School of Medicine, Al-Zahra Hospital,
Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background and aim: Urinary stones are highly prevalent among older
people. Extracorporeal lithotripsy is one of the commonly used treatment
methods, but it causes pain. Acupressure is a non-pharmacological
therapeutic method that is effective in relieving pain among patients with
various health conditions. This study aimed to investigate the effect of
acupressure on pain among female older people undergoing extracorporeal
lithotripsy. Method(s): This randomized controlled clinical trial was
conducted on 66 older female patients undergoing extracorporeal
lithotripsy. They were enrolled in the study through convenient sampling
and were assigned to the intervention and control groups through the block
randomization method. The intervention group underwent acupressure for 16
min which was repeated twice with an interval of 20 min, but the control
group received only touch without any pressure for the same period. The
McGill Pain Questionnaire and Visual Analogue Scale were completed 60 min
before the intervention and immediately after lithotripsy.
 Finding(s): Before the intervention, no statistically significant
difference in the quality and intensity of pain between the two groups was
observed (p > 0.05). However, after acupressure, the mean scores of
quality and intensity of pain decreased significantly (p < 0.001) in the
intervention group compared with the control group. Conclusion(s):
Acupressure as a complementary and alternative medicine can reduce pain
and suffering among older people undergoing extracorporeal lithotripsy. It
can be included in the routine therapeutic measures for relieving pain and
suffering during noninvasive methods for older people and reducing their
need for medication use and avoiding related pharmacological side
effects. Copyright © 2023

<43>
Accession Number
2026184192
Title
Outcomes of tricuspid valve prostheses after heart transplantation: a
systematic review.
Source
Heart Failure Reviews. 29(1) (pp 219-226), 2024. Date of Publication:
January 2024.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Modine T.; Labrousse L.; Pernot M.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Modine, Labrousse, Pernot)
Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Av. Magellan,
Pessac 33604, France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Louvain, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Springer
Abstract
Tricuspid regurgitation (TR) is the most common valvular pathology after
heart transplantation (HTx) and endomyocardial biopsy (EMB) remains
responsible for the majority of cases due to the high probability of
structural valve damage. The aim of the present review was to describe the
results of surgical management of severe tricuspid regurgitation through
tricuspid valve replacement (TVR) after a previous HTx. A systematic
review was conducted by searching Pubmed, ScienceDirect, SciELO, DOAJ, and
Cochrane databases until June 2023 for publications reporting patients
undergoing TVR surgery after a previous HTx. If no right heart valve
surgery was undertaken, or a heterotopic heart transplant was performed,
or if the concomitant procedure was performed during the transplant
itself, the paper was excluded. Twenty articles met our inclusion criteria
out of 1532 potentially eligible studies, with a total of 300 patients.
Mean age was 55.1 +/- 9.6 years, and 85.1% were male. The mean number of
EMB per patient was 31.1 +/- 5.5 with a mean time between HTx and TVR of
7.64 +/- 3.31 years. Bioprostheses were used in 83.3% of cases and 75.0%
of patients with a bioprosthesis were reported as alive at last follow-up.
Tricuspid valve repair is a valuable option, but these patients will be
susceptible to recurrent TR after EMB. TVR with a bioprosthesis may
provide the optimal solution for this subset of patients, as EMB is not
feasible with a mechanical valve. Copyright © The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2023.

<44>
Accession Number
2019875753
Title
Mitral valve surgery assisted by virtual and augmented reality: Cardiac
surgery at the front of innovation.
Source
Perfusion (United Kingdom). 39(2) (pp 244-255), 2024. Date of Publication:
March 2024.
Author
Nanchahal S.; Arjomandi Rad A.; Naruka V.; Chacko J.; Liu G.; Afoke J.;
Miller G.; Malawana J.; Punjabi P.
Institution
(Nanchahal, Arjomandi Rad) Department of Medicine, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Naruka, Chacko, Liu, Afoke, Punjabi) Department of Cardiothoracic
Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital,
London, United Kingdom
(Miller, Malawana) Research Unit, The Healthcare Leadership Academy,
London, United Kingdom
(Punjabi) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: Given the variety in mitral valve (MV) pathology and
associated surgical techniques, extended reality (XR) holds great
potential to assist MV surgeons. This review aims to systematically
evaluate the currently available evidence investigating the use of XR and
associated technologies in MV surgery. Method(s): A systematic
database search was conducted of original articles and case reports that
explored the use of XR and MV surgery in EMBASE, MEDLINE, Cochrane
database and Google Scholar, from inception to February 2022.
 Result(s): Our search yielded 171 articles, of which 15 studies were
included in this review, featuring 328 patients. Two main areas of
application were identified: (i) pre-operative planning and (ii)
predicting post-operative outcomes. The articles reporting outcomes
relating to pre-operative planning were further categorised as exploring
themes relevant to (i) mitral annular assessment; (ii) training; (iii)
evaluation of surgical technique; (iv) surgical approach or plan and (v)
selecting ring size or type. Preoperatively, XR has been shown to evaluate
mitral annular pathology more accurately than echocardiography, informing
the surgeon about the optimal surgical technique, approach and plan for a
particular patient's MV pathology. Furthermore, XR could simulate and aid
ring size/type selection for MV annuloplasty, creating a personalized
surgical plan. Additionally, XR could estimate the postoperative MV
biomechanical and physiological characteristics, predicting and
pre-empting post-operative complications. Conclusion(s): XR
demonstrated promising applications for assisting MV surgery, enhancing
outcomes and patient-centred care, nevertheless, there remain the need for
randomized studies to ascertain its feasibility, safety, and validity in
clinical practice. Copyright © The Author(s) 2022.

<45>
Accession Number
2030290396
Title
Respect Versus Resect Approaches for Mitral Valve Repair-A Meta-Analysis
of Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. 215 (pp 91), 2024. Date of Publication: 15
Mar 2024.
Author
Rafael A.E.; Meyer D.M.
Institution
(Rafael, Meyer) Cardiovascular and Thoracic Surgery, Baylor University
Medical Center at Dallas, Dallas, TX, United States
Publisher
Elsevier Inc.

<46>
Accession Number
2028877656
Title
Individualised, perioperative open-lung ventilation strategy during
one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled
clinical trial.
Source
The Lancet Respiratory Medicine. 12(3) (pp 195-206), 2024. Date of
Publication: March 2024.
Author
Ferrando C.; Carraminana A.; Pineiro P.; Mirabella L.; Spadaro S.; Librero
J.; Ramasco F.; Scaramuzzo G.; Cervantes O.; Garutti I.; Parera A.;
Argilaga M.; Herranz G.; Unzueta C.; Vives M.; Regi K.; Costa-Reverte M.;
Sonsoles Leal M.; Nieves-Alonso J.; Garcia E.; Rodriguez-Perez A.; Farina
R.; Cabrera S.; Guerra E.; Gallego-Ligorit L.; Herrero-Izquierdo A.;
Valles-Torres J.; Ramos S.; Lopez-Herrera D.; De La Matta M.; Gokhan S.;
Kucur E.; Mugarra A.; Soro M.; Garcia L.; Aguirre P.; Salazar C.J.; Ramos
M.C.; Morocho D.R.; Trespalacios R.; Lamanna A.; Pia Cantatore L.;
Laforgia D.; Bellas S.; Lopez C.; Navarro-Ripoll R.; Vallverdu J.; Jacas
A.; Belda F.J.; Tusman G.; Suarez-Sipmann F.; Villar J.; Leal M.S.; Sastre
J.A.; Jimena-Salazar C.; Ezequiel-Fernandez F.; Cantatore L.P.; Laforogia
D.; Yepes-Temino M.J.; Martinez S.; Azparren G.; Bausili M.; Torres S.;
Diaz M.; Ricart A.; Gasco I.; Parramon F.; Sanz-Iturbe M.;
Garcia-Ballester S.; Mendez-Arias E.; Cabadas R.; Grosso L.; Becerra A.;
Hussein Z.; Sanjuan-Villarreal T.A.; Puertolas M.; Izquierdo-Villarroya
B.; Almajano R.; Romero B.; Colomina L.; Quesada N.; Latorre J.A.; Franco
J.A.; Laval A.; Garcia-Tirado J.; Embun R.; Bueno C.; Jaren P.;
Martinez-Serrano R.; Garcia-Latasa B.; Baquedano S.; Motilva B.; Hernando
B.; Herrero M.; Oliver-Fornies P.; Recuero J.L.; Carbo-Espinosa F.; Lucas
A.; Munoz-Gonzalez N.; Lafuente N.; Acosta-Martinez J.; Ragazzi R.; Volta
C.A.; Maniscalco P.; Arribas M.P.; de Celis M.I.; Pascual M.J.; Martinez
P.; Martinez O.; Reparaz J.R.; Dominguez D.; Fernandez M.; Sanchez V.;
Perez-Lozana B.; Martin E.; Fernandez D.; Gonzalez A.; Pico J.; El-Hefny
D.A.; Armengol L.; Comino O.; Rovira I.; Arguis M.J.; Matute P.; Carretero
M.J.; Ibanez C.; Perdomo J.; Ruiz C.; Gonzalez N.; Gonzalez M.; Bolado A.;
Trabanco S.; Largo A.; Maestro A.; Pascual A.; Reyes A.I.; Bartolome M.J.;
Williams M.M.; del Olmo P.; Cimadevilla B.; Pardo S.; Sancho L.; Lascorz
L.; Carbonell J.A.; Hurtado L.; Florea R.; Martinez-Castro S.; Monleon B.;
Perez S.; Jurado A.; Barcena E.; Segura N.; Cuervo J.; Belmonte L.; Pardo
P.; Utrera E.; Serralta F.; Parra M.J.; Arocas B.; Gutierrez A.;
Cruz-Pardos P.; de la Gala-Garcia F.; Sanchez-Pedrosa G.; Duque-Gonzalez
P.; De La Fuente-Tornero E.; Puig-Ramos A.; Garcia-Hernandez S.;
Martinez-Gascuena D.; Calvo-Garcia C.A.; Reyes-Fierro A.; Novoa-Lago E.;
Anaya-Camacho R.; Monteserin-Matesanz C.; Martinez-Merino N.;
Arnalich-Montiel A.; Pizarro-Calderon A.G.; Ruiz-Ortega A.; Benito-Saz P.;
Rodriguez A.E.; Garcia-Bunger B.; Garcia-Ramos S.; Lopez-Gil E.;
Power-Esteban M.; Ramos-Fernandes R.; Sevilla-Bayon R.; Solchaga-Sanchez
I.; Tullo L.; Gambetti G.; Carrideo A.; Morelli A.; Aiello D.; Spiga S.
Institution
(Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain
(Ferrando) CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos
III, Madrid, Spain
(Carraminana, Navarro-Ripoll, Vallverdu, Jacas) Department of
Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona,
Spain
(Pineiro, Garutti, Ramos, Martinez) Department of Anesthesiology and
Critical Care, Hospital Universitario Gregorio Maranon, Madrid, Spain
(Mirabella, Lamanna, Pia Cantatore, Laforgia) Department of Medical and
Surgical Sciences, Universita Degli Studi di Foggia, Foggia, Italy
(Spadaro, Scaramuzzo) Department of Anesthesiology and Critical Care,
Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
(Librero) UPNA, REDISSEC Red de Investigacion en Servicios de Salud,
Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
(Ramasco, Nieves-Alonso, Garcia) Department of Anesthesiology and Critical
Care, Hospital Universitario de La Princesa, Madrid, Spain
(Cervantes) Department of Anesthesiology and Critical Care, Hospital
Universitario Germans Trias i Pujol, Barcelona, Spain
(Parera, Argilaga, Herranz, Unzueta) Department of Anesthesiology and
Critical Care, Hospital Universitario Santa Creu i Sant Pau, Barcelona,
Spain
(Vives, Regi) Department of Anesthesiology and Critical Care, Hospital
Universitario Josep Trueta, Girona, Spain
(Costa-Reverte) Department of Anesthesiology and Critical Care, Hospital
Universitario de Bellvitge, Barcelona, Spain
(Sonsoles Leal) Hospital Rivera Povisa, Vigo, Spain
(Rodriguez-Perez, Farina, Cabrera, Guerra) Department of Anesthesiology
and Critical Care, Hospital Universitario de Gran Canaria Dr Negrin, Gran
Canarias, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Department of
Anesthesiology and Critical Care, Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Gallego-Ligorit, Herrero-Izquierdo, Valles-Torres) Instituto de
Investigacion Sanitaria Aragon IIS Aragon, Zaragoza, Spain
(Lopez-Herrera, De La Matta) Department of Anesthesiology and Critical
Care, Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Gokhan, Kucur) Department of Anesthesiology and Critical Care, Bakirkoy
Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
(Gokhan) Outcomes Research Consortium, Cleveland, OH, United States
(Mugarra, Soro, Garcia, Belda) Department of Anesthesiology and Critical
Care, Hospital Universitario Clinico de Valencia, Valencia, Spain
(Sastre) Department of Anesthesiology and Critical Care, Hospital
Universitario de Salamanca, Salamanca, Spain
(Aguirre) Department of Anesthesiology and Critical Care, Hospital Alvaro
Cunqueiro, Vigo, Spain
(Salazar, Ramos) Department of Anesthesiology and Critical Care, Hospital
Universitario Ntra Sra de Candelaria, Santa Cruz de Tenerife, Spain
(Morocho) Department of Anesthesiology, Hospital Eugenio Espejo, Quito,
Ecuador
(Trespalacios, Ezequiel-Fernandez) Department of Anesthesiology and
Critical Care, Hospital Universitario Central de Asturias, Oviedo, Spain
(Bellas) Department of Anesthesiology and Critical Care, Hospital
Universitario Fundacion Jimenez Diaz, Madrid, Spain
(Lopez) Department of Anesthesiology and Critical Care, Hospital
Universitario Marques de Valdecilla, Santander, Spain
(Yepes-Temino) Department of Anesthesiology and Critical Care, Clinica
Universidad de Navarra, Pamplona, Spain
(Tusman) Department of Anesthesiology, Hospital Privado de Comunidad,
Buenos Aires, Mar de Plata, Argentina
(Suarez-Sipmann) CIBER de Enfermedades Respiratorias CIBERES, Instituto de
Salud Carlos III, Madrid, Spain
(Suarez-Sipmann) Hedenstierna Laboratory, Department of Surgical Sciences,
Uppsala University, Uppsala, Sweden
(Villar) CIBER de Enfermedades Respiratorias, Madrid, Spain
(Villar) Hospital Universitario Dr Negrin, Las Palmas de Gran Canaria,
Spain
(Villar) Li Ka Shing Knowledge Institute for Medical Science, St Michael's
Hospital, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: It is uncertain whether individualisation of the perioperative
open-lung approach (OLA) to ventilation reduces postoperative pulmonary
complications in patients undergoing lung resection. We compared a
perioperative individualised OLA (iOLA) ventilation strategy with standard
lung-protective ventilation in patients undergoing thoracic surgery with
one-lung ventilation. Method(s): This multicentre, randomised
controlled trial enrolled patients scheduled for open or video-assisted
thoracic surgery using one-lung ventilation in 25 participating hospitals
in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age
>=18 years) were randomly assigned to receive iOLA or standard
lung-protective ventilation. Eligible patients (stratified by centre) were
randomly assigned online by local principal investigators, with an
allocation ratio of 1:1. Treatment with iOLA included an alveolar
recruitment manoeuvre to 40 cm H<inf>2</inf>O of end-inspiratory pressure
followed by individualised positive end-expiratory pressure (PEEP)
titrated to best respiratory system compliance, and individualised
postoperative respiratory support with high-flow oxygen therapy.
Participants allocated to standard lung-protective ventilation received
combined intraoperative 4 cm H<inf>2</inf>O of PEEP and postoperative
conventional oxygen therapy. The primary outcome was a composite of severe
postoperative pulmonary complications within the first 7 postoperative
days, including atelectasis requiring bronchoscopy, severe respiratory
failure, contralateral pneumothorax, early extubation failure (rescue with
continuous positive airway pressure, non-invasive ventilation, invasive
mechanical ventilation, or reintubation), acute respiratory distress
syndrome, pulmonary infection, bronchopleural fistula, and pleural
empyema. Due to trial setting, data obtained in the operating and
postoperative rooms for routine monitoring were not blinded. At 24 h, data
were acquired by an investigator blinded to group allocation. All analyses
were performed on an intention-to-treat basis. This trial is registered
with ClinicalTrials.gov, NCT03182062, and is complete. Finding(s):
Between Sept 11, 2018, and June 14, 2022, we enrolled 1380 patients, of
whom 1308 eligible patients (670 [434 male, 233 female, and three with
missing data] assigned to iOLA and 638 [395 male, 237 female, and six with
missing data] to standard lung-protective ventilation) were included in
the final analysis. The proportion of patients with the composite outcome
of severe postoperative pulmonary complications within the first 7
postoperative days was lower in the iOLA group compared with the standard
lung-protective ventilation group (40 [6%] vs 97 [15%], relative risk 0.39
[95% CI 0.28 to 0.56]), with an absolute risk difference of -9.23 (95% CI
-12.55 to -5.92). Recruitment manoeuvre-related adverse events were
reported in five patients. Interpretation(s): Among patients
subjected to lung resection under one-lung ventilation, iOLA was
associated with a reduced risk of severe postoperative pulmonary
complications when compared with conventional lung-protective ventilation.
 Funding(s): Instituto de Salud Carlos III and the European Regional
Development Funds. Copyright © 2024 Elsevier Ltd

<47>
Accession Number
2028803162
Title
Effect of levosimendan on ventricular remodelling in patients with left
ventricular systolic dysfunction: a meta-analysis.
Source
ESC Heart Failure. (no pagination), 2024. Date of Publication: 2024.
Author
Wang X.; Zhao X.-Z.; Wang X.-W.; Cao L.-Y.; Lu B.; Wang Z.-H.; Zhang W.;
Ti Y.; Zhong M.
Institution
(Wang, Wang, Cao, Lu, Zhang, Ti, Zhong) National Key Laboratory for
Innovation and Transformation of Luobing Theory, The Key Laboratory of
Cardiovascular Remodeling and Function Research, Chinese Ministry of
Education, Chinese National Health Commission and Chinese Academy of
Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong
University, China
(Zhao) Department of Cardiology, People's Hospital of Lixia District of
Jinan, Shandong, Jinan, China
(Wang) Department of Geriatric Medicine, Shandong Key Laboratory of
Cardiovascular Proteomics, Qilu Hospital, Cheeloo College of Medicine,
Shandong University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
Heart failure is the final stage of several cardiovascular diseases, and
the key to effectively treating heart failure is to reverse or delay
ventricular remodelling. Levosimendan is a novel inotropic and vasodilator
agent used in heart failure, whereas the impact of levosimendan on
ventricular remodelling is still unclear. This study aims to investigate
the impact of levosimendan on ventricular remodelling in patients with
left ventricular systolic dysfunction. Electronic databases were searched
to identify eligible studies. A total of 66 randomized controlled trials
involving 7968 patients were included. Meta-analysis results showed that
levosimendan increased left ventricular ejection fraction [mean difference
(MD) = 3.62, 95% confidence interval (CI) (2.88, 4.35), P < 0.00001] and
stroke volume [MD = 6.59, 95% CI (3.22, 9.96), P = 0.0001] and
significantly reduced left ventricular end-systolic volume [standard mean
difference (SMD) = -0.52, 95% CI (-0.67, -0.37), P < 0.00001], left
ventricular end-diastolic volume index [SMD = -1.24, 95% CI (-1.61,
-0.86), P < 0.00001], and left ventricular end-systolic volume index [SMD
= -1.06, 95% CI (-1.43, -0.70), P < 0.00001]. In terms of biomarkers,
levosimendan significantly reduced the level of brain natriuretic peptide
[SMD = -1.08, 95% CI (-1.60, -0.56), P < 0.0001], N-terminal pro-brain
natriuretic peptide [SMD = -0.99, 95% CI (-1.41, -0.56), P < 0.00001], and
interleukin-6 [SMD = -0.61, 95% CI (-0.86, -0.35), P < 0.00001].
Meanwhile, levosimendan may increase the incidence of hypotension [risk
ratio (RR) = 1.24, 95% CI (1.12, 1.39), P < 0.0001], hypokalaemia [RR =
1.57, 95% CI (1.08, 2.28), P = 0.02], headache [RR = 1.89, 95% CI (1.50,
2.39), P < 0.00001], atrial fibrillation [RR = 1.31, 95% CI (1.12, 1.52),
P = 0.0005], and premature ventricular complexes [RR = 1.86, 95% CI (1.27,
2.72), P = 0.001]. In addition, levosimendan reduced all-cause mortality
[RR = 0.83, 95% CI (0.74, 0.94), P = 0.002]. In conclusion, our study
found that levosimendan might reverse ventricular remodelling when applied
in patients with left ventricular systolic dysfunction, especially in
patients undergoing cardiac surgery, decompensated heart failure, and
septic shock. Copyright © 2024 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<48>
Accession Number
2020509523
Title
Should moderate ischemic mitral regurgitation be corrected during coronary
artery bypass grafting? a systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 39(2) (pp 373-381), 2024. Date of Publication:
March 2024.
Author
Wu H.; Zhang W.
Institution
(Wu, Zhang) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ischemic mitral regurgitation (IMR) is associated with
increased risks of mortality and heart failure. However, the optimal
management of moderate IMR remains controversial. We conducted a
meta-analysis to appraise whether moderate IMR should be corrected during
coronary artery bypass grafting (CABG). Method(s): We searched
PubMed, Embase, and Cochrane databases from its inception up to 15 October
2022 for studies that assessed CABG alone versus CABG with mitral valve
(MV) surgery in patients with moderate IMR. The primary outcome was
perioperative mortality. Result(s): Four randomized controlled trials
and three observational studies with propensity-matched data including
1209 patients assessing CABG alone (n = 598) versus CABG with MV surgery
(n = 611) were included. Compared to CABG alone, the addition of MV
surgery did not significantly increase perioperative mortality (RR, 1.01;
95% CI, 0.52-1.96; p = 0.98) and stroke (RR, 2.14; 95% CI, 0.97-4.72; p =
0.06), whereas a longer cardiopulmonary bypass duration (MD, 54.91; 95%
CI, 42.13-67.68; p < 0.01) and an increased incidence of renal failure
were observed in the combined-procedure group. At follow-up, the addition
of MV surgery was significantly associated with reduced rates of residual
MR (RR, 0.26; 95% CI, 0.13-0.51; p < 0.01) and NYHA class III-IV (RR,
0.54; 95% CI, 0.37-0.78; p < 0.01). However, there was no difference in
either mid-term mortality (RR, 1.05; 95% CI, 0.65-1.70; p = 0.82) or late
mortality (RR, 91; 95% CI, 0.49-1.71; p = 0.78) between the CABG alone
group and the combined-procedure group. Conclusion(s): In patients
with moderate IMR, the addition of MV surgery to CABG did not increase
perioperative mortality. Despite the reduced rates of moderate MR and NYHA
class III-IV at follow-up, the addition of MV surgery did not translate in
a reduction in mid-term or late mortality. Copyright © The
Author(s) 2022.

<49>
Accession Number
2020215914
Title
Preoperative ultrasound-guided bilateral thoracic erector spinae plane
block within an enhanced recovery program is associated with decreased
intraoperative lactate levels in cardiac surgery.
Source
Perfusion (United Kingdom). 39(2) (pp 324-333), 2024. Date of Publication:
March 2024.
Author
Demir A.Z.; Ozgok A.; Balci E.; Karaca O.G.; Simsek E.; Gunaydin S.
Institution
(Demir, Ozgok, Balci) Anesthesiology Department, The University of Health
Sciences, Ankara City Hospital, Ankara, Turkey
(Karaca, Simsek, Gunaydin) Cardiovascular Surgery Department, The
University of Health Sciences, Ankara City Hospital, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Introduction: In the perioperative period, regional analgesia techniques
may play an increasingly important role in "Enhanced Recovery After
Surgery (ERAS)" programs, as they can facilitate recovery. We hypothesized
that Erector Spinae Plane (ESP) block could improve regional perfusion,
thereby limiting blood lactate increase. Therefore, we aimed to evaluate
the effect of ESP block on intraoperative blood lactate levels in patients
scheduled for elective on-pump cardiac surgery with ERAS protocol.
 Method(s): A total of 68 adult patients scheduled for on-pump cardiac
surgery were included. All patients were randomized to the ESP group and
the non-ESP group. Blood lactate analyses were performed at intraoperative
five-time points. C-Reactive protein (CRP) values were also measured.
 Result(s): Blood lactate values were significantly lower in the ESP
group than in the Non-ESP group, at the end of CPB [1.78 (1.23-2.78) mmol
L-1 to 2.63 (1.70-3.12) mmol L-1] and during the
sternal closure period [1.78 (1.27-2.42) mmol L-1 to 2.40
(2.14-2.80) mmol L-1] (p = 0.039, p = 0.009). In addition, CRP
values were significantly lower in the ESP group in the postoperative
period [0.048 (0.036-0.105) g L-1 to 0.090 (0.049-0.154) g
L-1] (p = 0.035). Conclusion(s): This study showed that
preoperative bilateral single-shot ESP block significantly reduces
intraoperative final blood lactate and postoperative CRP values. We
consider that these results are related to the attenuation of
intraoperative hypoperfusion and the alleviation of surgery-related
postoperative inflammation. ERAS programs aim to achieve the rapid
recovery of patients, a decrease in inflammation, and high-quality
analgesia with less opioid consumption. Therefore, our results also prove
that it is easier to reach the primary goals of ERAS programs with the
application of ESP block in cardiac surgery. Copyright © The
Author(s) 2022.

<50>
Accession Number
643396992
Title
The effects of video double-lumen tubes on intubation complications in
patients undergoing thoracic surgery: A randomised controlled study.
Source
European journal of anaesthesiology. 41(4) (pp 305-313), 2024. Date of
Publication: 01 Apr 2024.
Author
Shui W.; Hu W.; Ma W.; Han Y.; Hao I.Y.; Sun Y.; Deng Z.; Gao Y.; Heng L.;
Zhu S.
Institution
(Shui) From the Jiangsu Province Key laboratory of Anaesthesiology, Xuzhou
Medical University (WS, WH, YS, ZD, SZ), Department of Anaesthesiology,
Xuzhou Cancer Hospital, Xuzhou (WM, YH, SZ, LH, SZ), California State
University, Los Angeles, USA (IYH) and Jiangsu University, Zhenjiang,
Jiangsu, China (YG)
Abstract
BACKGROUND: Tracheal injuries, vocal cord injuries, sore throat and
hoarseness are common complications of double-lumen tube (DLT) intubation.
 OBJECTIVE(S): This study aimed to evaluate the effects of 'video
double-lumen tubes' (VDLTs) on intubation complications in patients
undergoing thoracic surgery. DESIGN: A randomised controlled study.
SETTINGT: Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June
2023. PATIENTS: One hundred eighty-two patients undergoing elective
thoracic surgery with one-lung ventilation were randomised into two
groups: 90 in the DLT group and 92 in the VDLT group. INTERVENTION: VDLT
was selected for intubation in the VDLT group, and DLT was selected for
intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to
record tracheal and vocal cord injuries. MAIN OUTCOME MEASURES: The
primary outcomes were the incidence of moderate-to-severe tracheal injury
and the incidence of vocal cord injury. The secondary outcomes included
the incidence and severity of postoperative 24 and 48 h sore throat and
hoarseness. RESULT(S): The incidence of moderate-to-severe tracheal
injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT
group ( P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The
incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the
DLT and VDLT groups, respectively ( P = 0.449). The incidence of
postoperative 24 h sore throat and hoarseness was significantly higher in
the VDLT group than in the DLT group (for sore throat: P = 0.032,
relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P = 0.018,
relative risk 1.48, 95% CI, 1.06 to 2.06). CONCLUSION(S): There was
no statistically significant difference in the incidence of
moderate-to-severe tracheal injury and vocal cord injury between DLTs and
VDLTs. While improving the first-attempt success rate, intubation with
VDLT increased the incidence of postoperative 24 h sore throat and
hoarseness. TRIAL REGISTRATION: Chinese Clinical Trial Registry
identifier: ChiCTR2300067348. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc. on behalf of the European Society
of Anaesthesiology.

<51>
Accession Number
642138076
Title
Oesophagopleural fistula after pneumonectomy: A systematic review and case
series.
Source
Annals of the Royal College of Surgeons of England. 106(3) (pp 226-236),
2024. Date of Publication: 01 Mar 2024.
Author
Phelan L.; Layton G.R.; Lee E.H.; Halle-Smith J.; Bishay E.; Griffiths
E.A.
Institution
(Phelan, Halle-Smith, Bishay, Griffiths) University Hospitals Birmingham
NHS Foundation Trust, United Kingdom
(Layton) University Hospitals of Leicester NHS Trust, United Kingdom
(Lee) University of Birmingham Medical School, United Kingdom
(Griffiths) Institute of Cancer and Genomic Sciences, College of Medical
and Dental Sciences, University of Birmingham, United Kingdom
Abstract
INTRODUCTION: There is a paucity of data on the optimal management of
oesophagopleural fistula (OPF) following pneumonectomy. The current
published literature is limited to case reports and small case series.
Although rare, OPF can have a significant impact on both the morbidity and
mortality of patients. METHOD(S): Two cases of OPF managed at our
institution were reported. A systematic review was then conducted in line
with Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidance concerning OPF following pneumonectomy. Demographic, operative
and management data were analysed. FINDINGS: Systematic review-identified
data pertaining to 59 patients from 31 papers was collated. Median patient
age was 59.5 years with pneumonectomy performed typically for malignancy
(68%) or tuberculosis (19%). Median time from pneumonectomy to a diagnosis
of OPF was 12.5 months. Twenty-five per cent of the patients had a
synchronous bronchopleural fistula. Management of OPF in this setting is
heterogenous. Conservative management was often reserved for asymptomatic
or unfit patients. The remainder underwent endoscopic or surgical
correction of the fistulae or a combination of the two with varying
outcomes. Median follow-up was 18 months. All-cause mortality was 31%
(18/59) with a median duration from pneumonectomy to death of 35 days
(range 1-1,095). CONCLUSION(S): Major heterogeneity of management for
this rare complication hinders the introduction of standardised guidance
of post-pneumonectomy OPF. Surgical and endoscopic intervention is
feasible and can be successful in specialist centres. Adopting an
multidisciplinary team approach involving both oesophagogastric and
thoracic surgery teams and the introduction of a registry database of
postoperative complications are likely to yield optimal outcomes.

<52>
Accession Number
643609325
Title
6USING VIRTUAL REALITY TO SIMULATE AN OPERATING ROOM: SATISFACTION AND
RESULTS FROM THE FIRST PILOT STUDY FOR NURSES.
Source
British Journal of Surgery. Conference: 27th Congress of the Spanish
Society for Surgical Research. Madrid Spain. 111(Supplement 1) (no
pagination), 2024. Date of Publication: February 2024.
Author
Zabaleta Jimenez J.; Blasco A.; Fernandez-Monge A.; Lizarbe J.A.; Mainer
M.; Esnal T.; Baez J.; Aldazabal J.
Institution
(Zabaleta Jimenez, Blasco, Fernandez-Monge, Lizarbe, Mainer) Hospita
Universitario Donostia, Spain
(Esnal) Kauka, Spain
(Baez, Aldazabal) Tecnun-Universidad de Navarra, Spain
Publisher
Oxford University Press
Abstract
Introduction: Virtual reality (VR) provides a firsthand active learning
experience through varying degrees of immersion. The aim of this pilot
study is to evaluate the use of VR as a potential tool for training
operating room nurses to perform thoracic surgery procedures.
 Method(s): This is an open parallel-group randomized clinical trial.
One group will receive basic training followed by an assessment module.
The experimental group will receive the same basic training, followed by
thoracic surgery training, and then an assessment module. Result(s):
Fifty-five nurses participated in the study (50 females), with a mean age
of 41.6 years. The average score obtained by each participant in the
evaluation mode was 477 points. The experimental group (513 points)
achieved an overall higher score than the control group (445 points;
p=0.04). Regarding age, women in the second quartile of age among the
participants (35-41 years) achieved significantly better results than the
rest (p=0.04). When evaluating results based on the practice moment,
exercises performed in the last 10 minutes yielded better results than
those performed in the first 10 minutes (1064 points versus 554 points; p
<0.001). The most frequent adverse effect reported was blurred vision. The
overall satisfaction rating with the experience was 8.5 out of 10.
 Conclusion(s): Virtual reality is a useful tool for training
operating room nurses.

<53>
Accession Number
643609436
Title
Treatment of skin tumors in organ transplant recipients.
Source
Polish Archives of Internal Medicine. Conference: 1st Scientific and
Training Conference Nephrooncology. Gdansk Poland. 129(Supplement 2) (pp
45-47), 2019. Date of Publication: 2019.
Author
Imko Walczuk B.; Kadylak D.; Slizien A.D.
Institution
(Imko Walczuk, Kadylak) Dermatology and Sexually Transmitted Diseases
Outpatient Clinic, Copernicus Medical Centre, Gdansk, Poland
(Imko Walczuk) Department of Physiotherapy and Health Sciences, School of
Management, Gdansk, Poland
(Slizien) Department of Nephrology,Transplantology and Internal Diseases,
Medical University of Gdansk, Gdansk, Poland
(Imko Walczuk) Independent Public Healthcare Centre, Dermatology and
Venereology Clinic, ul. Nowe Ogrody 1 6, Gdansk 80 803, Poland
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
Introduction Patients after organ transplantations are particularly prone
to developing skin tumors. The most common de novo tumors in organ
transplant recipients (OTRs) are skin tumors; in 95% of cases, it is
nonmelanoma skin cancer (NMSC), mostly squamous cell carcinoma (SCC) and
basal cell carcinoma (BCC).1 Other, less frequent tumors are melanoma,
Kaposi sarcoma, Merkel cell carcinoma, sebaceous carcinoma, and anogenital
cancer. In the general population, BCC is more prevalent than SCC. In
patients after transplantation, however, this ratio is reversed and SCC is
more frequent: the risk of developing BCC and SCC in OTRs is 10 and 65-
fold greater, respectively. SCC in OTRs usually develops much faster, is
often multifocal, has a tendency to invasive growth, and in 8% of cases
metastasizes to regional lymph nodes.1 Approximately 70% of SCC cases
develop from actinic keratosis (AK). AK is a premalignant condition,
characterized by the presence of red-yellow hyperkeratotic lesions,
stemming from areas of the skin that were damaged by UV radiation. It
usually occurs in 40% of OTRs within 5 years after the transplantation.
The most important risk factors of skin cancer in OTRs are Fitzpatrick
skin type, cumulated sun exposure, certain types of immunosuppression, as
well as longer duration and intensity of immunosuppression. Other risk
factors involve age at transplantation, history of skin cancer prior to
transplantation, biological treatment, type of transplanted organ (with
the highest risk in heart transplant recipients, followed by lung, kidney,
and liver transplant recipients). Some additional risk factors are human
papillomavirus (HPV) infection, history of leukemia or lymphoma before or
after transplantation, and voriconazole treatment. Patients with AK,
warts, and papillomas have a higher incidence of SCC compared with those
who do not present with the aboveconditions. 1 Treatment Destructive
therapy of skin cancers involves, for example, cryotherapy, laser
ablation, electrocoagulation, curettage, radiotherapy, and surgical
treatment. The most common method is cryotherapy because of its wide
accessibility, low cost, and effectiveness. It also does not require local
anesthesia. It is commonly used in the therapy of AK, superficial NMSC,
and flat, sebaceous, and viral warts. It should only be used to remove
solitary lesions. There is no evidence that curettage, electrocoagulation,
or laser ablation is a more effective method than cryotherapy.2 In OTRs,
considering the recurrent and multifocal character of skin lesions in this
population, it is recommended to treat the field cancerization, which is
basically the removal of visible and subclinical lesions within the field
of UV-damaged skin. This method allows not only a removal of the existing
lesions but also a prevention of new ones. The most common therapeutic
methods in skin tumors include the use of 5-fluorouracil (5-FU),
imiquimod, diclofenac sodium, ingenol mebutate, and photodynamic therapy
(PDT) (TABLE 1).2 Photodynamic therapy is based on a phototoxic reaction,
which is achieved by a mutual influence of photosensitive substance and
light with appropriate wavelength. The most common photosensitive
compounds are 5-aminolevulinic acid and methyl aminolevulinate. It is
proved to be an effective and safe method of AK and NMSC treatment in
OTRs. Cyclic PDT may be beneficial in the prophylaxis of AK and SCC in
patients with a high risk of developing NMSC; however, further randomized
studies with a broader spectrum are necessary.3 However, the use of PDT is
limited due to its being a painful and expensive method. The cytotoxic
agent 5-FU acts by disrupting DNA replication and RNA synthesis, leading
to cellular death. It is used topically as a 5% cream. Indications include
AK, solitary or multiple forms of BBC that are hard to access surgically,
and Bowen disease. The most common adverse effects are pain, itching,
erythema, burning sensation, exfoliation, depigmentation, and secondary
infections. There are multiple treatment regimens, but 5-FU is frequently
administered twice a day over the course of 4 weeks. Less frequent doses
may reduce the adverse effects and increase drug tolerance. Better
treatment outcomes are achieved with a combination of 5-FU and tretinoin.3
Imiquimod is used in the form of a 5% cream. Its clinical effectiveness
was proved in treating genital warts, AK, and superficial BCC. Its action
is due to stimulation of immune response, enabling antiviral,
antiproliferative, and anticancer response. The safety and efficacy of
topical imiquimod were observed while treating AK in OTRs. The overall
clearance ratio in patients treated with imiquimod was calculated at 62%
compared with 0% in the placebo group.3 Adverse effects were most commonly
itching, burning sensation, severe erythema, exfoliation, and scab
formation. Diclofenac is a nonsteroidal anti-inflammatory drug, applied as
3% gel dispersed in hyaluronic acid. The mechanism of action in AK
treatment is unknown but may be linked to cyclooxygenase- 2 inhibition,
which inhibits prostaglandin E2 synthesis. Local reactions to diclofenac
gel formulation are smaller and appear later than after 5-FU or imiquimod
administration. Urlich et al4 investigated the safety and effectiveness of
3% diclofenac gel in OTRs. Thirty- two patients who underwent organ
transplantation were administered 3% diclofenac gel (n = 24) or placebo (n
= 8). It was distributed on the skin area of 50 cm2 with -3 AK lesions
twice a day over the course of 16 weeks. In the group treated with
diclofenac, complete regression of AK was obtained in 41% of patients
compared with 0% in the placebo group. Adverse reactions in most patients
involved a mild erythema and mild- to-moderate swelling of treated areas.
Neither a tendency to a deterioration of transplanted organ function nor
organ rejection was observed. In 55% of patients with prior regression of
AK, 9.3 months was the average time after which a secondary lesion
occurred. No patient developed invasive SCC within 24 months of follow-up.
This study suggests that 3% diclofenac gel is not only an efficient and
well- tolerated drug in OTRs, but it may also prevent an invasive SCC in
high-risk patients.4 Ingenol mebutate is a relatively new drug with a
double mechanism of action. It directly contributes to cellular death by
its destructive action on the mitochondrial membrane, and also via
inducing an infiltration of inflammatory cells (lymphocytes, neutrophils,
and inflammatory cytokines). Ingenol mebutate is available in 2
concentrations, 0.015% (face and scalp) and 0.05% (limbs and trunk). Its
advantage is the short period of treatment, which is usually 2 to 3 days.2
Research on its safety and effectiveness in OTRs is currently ongoing.
Systemic immunomodulating therapy Discontinuation of immunosuppression
might be a reasonable approach in patients who are at highrisk of SCC
metastases or develop more than 5 to 10 high-risk SCCs per year. It might
be achieved via reducing the dose or changing the treatment regimen. Many
factors, such as age, serum drug concentrations, HLA matching, history of
graft rejection, allograft source, prior transplantation and time after
transplantation, should be considered when tapering immunosuppressive
treatment.3 Sirolimus is a nonnephrotoxic immunosuppressive agent with
anticancer and antiangiogenic properties. Similarly to everolimus, it is a
mammalian target of rapamycin inhibitor. In a 2014 systematic review and
meta-analysis, sirolimus was linked to a 40% reduction in malignancy risk
and 56% lower risk of NMSC. It was the most beneficial in patients who
switched to sirolimus from immunosuppression based on calcineurin.
However, it was also connected with an increased risk of death in
comparison with the control group, so it seems reasonable to consider
whether it should be administered to the majority of patients after kidney
transplantation. The authors stressed that further research is necessary
to determine whether switching to sirolimus could be beneficial for OTRs
at high risk for cancer.5 In a study on rodents (Mastomys coucha), Vinzon
et al6 aimed to determine the effectiveness of HPV vaccination (HPV caused
skin infections) and whether it would reduce the number of skin tumor
cases. One group of rodents were supplemented with cyclosporine A.

<54>
Accession Number
2028252244
Title
Effect of Gut Microbiota on Metabolic and Inflammatory Biomarkers in
Cardiovascular Surgery: A Systematic Review and Meta-Analysis.
Source
Razavi International Journal of Medicine. 12(1) (pp 10-16), 2024. Article
Number: e1310. Date of Publication: February 2024.
Author
Valaei M.; Sadeghi H.; Ghasemi R.; Hajipour F.; Yaghubi M.
Institution
(Valaei) Department of Gastroenterology and Hepatology, Imam Reza
Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Sadeghi) Department of Anesthesiology, Razavi Hospital, Mashhad, Iran,
Islamic Republic of
(Ghasemi) Department of Cardiology, 9 Dey Educational Hospital, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Hajipour) Department of Extra-Corporeal Circulation (ECC), Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Mashhad, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: The gastrointestinal microbiota is pivotal in cardiovascular
surgery outcomes. Objective(s): This systematic review and
meta-analysis aimed to synthesize current evidence regarding the impact of
gut microbiota on postoperative metabolomic markers and patient recovery.
 Method(s): Following PRISMA guidelines, a comprehensive query was
conducted on MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's
CENTRAL databases. Studies involving patients undergoing cardiovascular
surgery and reporting on gut microbiota were included. Data extraction
focused on study characteristics and metabolomic outcomes. The
Newcastle-Ottawa Scale (NOS) assessed the risk of bias. Result(s):
Six studies met the inclusion criteria, involving 530 patients.
Meta-analysis revealed that a beneficial gut microbiota profile is
associated with less increase in LDL cholesterol (Mean Difference: 14.4
mg/dL, SE: 0.816), a smaller decrease in HDL cholesterol (Mean
Difference:-4.9 mg/dL, SE: 0.437), a lower rise in triglycerides (Mean
Difference: 11.2 mg/dL, SE: 0.552), and a reduced elevation in c-reactive
protein (CRP) levels (Mean Difference: 2.4 mg/L, SE: 0.291) post-surgery.
The overall risk of bias ranged from moderate to low across studies.
 Conclusion(s): As evidenced by the obtained results, gut microbiota
composition significantly affected lipid metabolism and inflammatory
responses post-cardiovascular surgery. A favorable microbiota profile may
provide a protective effect against postoperative complications. These
insights underline the potential for microbiota-modulating interventions
in enhancing cardiovascular surgery outcomes. Copyright © 2024,
Razavi International Journal of Medicine.

<55>
Accession Number
2028652449
Title
Use of high-flow nasal cannula versus other noninvasive ventilation
techniques or conventional oxygen therapy for respiratory support
following pediatric cardiac surgery: A systematic review and
meta-analysis.
Source
Paediatric Anaesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Elmitwalli I.; Abdelhady E.; Kalsotra S.; Gehred A.; Tobias J.; Olbrecht
V.A.
Institution
(Elmitwalli, Kalsotra, Tobias, Olbrecht) Department of Anesthesiology and
Pain Medicine, Nationwide Children's Hospital, Columbus, OH, United States
(Abdelhady) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Gehred) Grant Morrow III Library, Nationwide Children's Hospital and The
Ohio State University, Columbus, OH, United States
(Tobias, Olbrecht) Department of Anesthesiology and Pain Medicine, The
Ohio State University College of Medicine, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Noninvasive respiratory support may be provided to decrease
the risk of postextubation failure following surgery. Despite these
efforts, approximately 3%-27% of infants and children still experience
respiratory failure after tracheal extubation following cardiac surgery.
This systematic review evaluates studies comparing the efficacy of
high-flow nasal cannula to conventional oxygen therapy such as nasal
cannula and other noninvasive ventilation techniques in preventing
postextubation failure in this patient population. Method(s): A
systematic and comprehensive search was conducted in major databases
including MEDLINE, EMBASE, Web of Science, and Central. The search
encompassed articles focusing on the prophylactic use of high-flow nasal
cannula following tracheal extubation in pediatric patients undergoing
cardiac surgery for congenital heart disease. The inclusion criteria for
this review consisted of randomized clinical trials as well as
observational, cohort, and case-control studies. Result(s): A total
of 1295 studies were screened and 12 studies met the inclusion criteria.
These 12 studies included a total of 1565 children, classified into three
groups: seven studies compared high-flow nasal cannula to noninvasive
ventilation techniques, four studies compared high-flow nasal cannula to
conventional oxygen therapy, and one observational single-arm study
explored the use of high-flow nasal cannula with no control group. There
was no significant difference in the incidence of tracheal reintubation
between high-flow nasal cannula and conventional oxygen therapy (risk
ratio [RR] = 0.67, 95% confidence interval [CI]: 0.24-1.90, p =.46).
However, there was a lower incidence of tracheal reintubation in patients
who were extubated to high-flow nasal cannula versus those extubated to
noninvasive ventilation techniques (RR = 0.45, 95% CI: 0.32-0.63, p <.01).
The high-flow nasal cannula group also demonstrated a lower mortality rate
compared to the noninvasive ventilation techniques group (RR = 0.31, 95%
CI: 0.16-0.61, p <.01) as well as a shorter postoperative length of stay
(mean difference = -8.76 days, 95% CI: -13.08 to -4.45, p <.01) and
shorter intensive care length of stay (mean difference = -4.63 days, 95%
CI: -9.16 to -0.11, p =.04). Conclusion(s): High-flow nasal cannula
is more effective in reducing the rate of postextubation failure compared
to other forms of noninvasive ventilation techniques following surgery for
congenital heart disease in pediatric-aged patients. high-flow nasal
cannula is also associated with lower mortality rates and shorter length
of stay. However, when comparing high-flow nasal cannula to conventional
oxygen therapy, the findings were inconclusive primarily due to a limited
number of scientific studies available on this specific comparison. Future
study is needed to further define the benefit of high-flow nasal cannula
compared to conventional oxygen therapy and various types of noninvasive
ventilation techniques. Copyright © 2024 John Wiley & Sons Ltd.

<56>
Accession Number
643624911
Title
Assessing the impact of risk-based data monitoring on outcomes for a
paediatric multicentre randomised controlled trial.
Source
Clinical trials (London, England). (pp 17407745231222019), 2024. Date of
Publication: 29 Feb 2024.
Author
Le Marsney R.; Johnson K.; Chumbes Flores J.; Coetzer S.; Darvas J.;
Delzoppo C.; Jolly A.; Masterson K.; Sherring C.; Thomson H.; Ergetu E.;
Gilholm P.; Gibbons K.S.
Institution
(Le Marsney, Johnson, Ergetu, Gilholm, Gibbons) Children's Intensive Care
Research Program, Child Health Research Centre, University of Queensland,
South Brisbane, Australia
(Johnson) Paediatric Intensive Care Unit, Queensland Children's Hospital,
Children's Health Queensland, Brisbane, Australia
(Chumbes Flores, Jolly, Thomson) Paediatric Intensive Care Unit, Perth
Children's Hospital, Perth, WA, Australia
(Coetzer, Sherring) Paediatric Intensive Care Unit, Starship Child Health,
Auckland, New Zealand
(Darvas) Paediatric Intensive Care Unit, Children's Hospital at Westmead,
NSW, Sydney, Australia
(Delzoppo, Masterson) Paediatric Intensive Care Unit, Royal Children's
Hospital Melbourne, Melbourne, VIC, Australia
(Delzoppo, Masterson) Murdoch Children's Research Institute, Melbourne,
VIC, Australia
Abstract
BACKGROUND/AIMS: Regulatory guidelines recommend that sponsors develop a
risk-based approach to monitoring clinical trials. However, there is a
lack of evidence to guide the effective implementation of monitoring
activities encompassed in this approach. The aim of this study was to
assess the efficiency and impact of the risk-based monitoring approach
used for a multicentre randomised controlled trial comparing treatments in
paediatric patients undergoing cardiac bypass surgery. METHOD(S):
This is a secondary analysis of data from a randomised controlled trial
that implemented targeted source data verification as part of the
risk-based monitoring approach. Monitoring duration and source to database
error rates were calculated across the monitored trial dataset. The
monitored and unmonitored trial dataset, and simulated trial datasets with
differing degrees of source data verification and cohort sizes were
compared for their effect on trial outcomes. RESULT(S): In total,
106,749 critical data points across 1,282 participants were verified from
source data either remotely or on-site during the trial. The total time
spent monitoring was 365 hours, with a median (interquartile range) of 10
(7, 16) minutes per participant. An overall source to database error rate
of 3.1% was found, and this did not differ between treatment groups. A low
rate of error was found for all outcomes undergoing 100% source data
verification, with the exception of two secondary outcomes with error
rates >10%. Minimal variation in trial outcomes were found between the
unmonitored and monitored datasets. Reduced degrees of source data
verification and reduced cohort sizes assessed using simulated trial
datasets had minimal impact on trial outcomes. CONCLUSION(S):
Targeted source data verification of data critical to trial outcomes,
which carried with it a substantial time investment, did not have an
impact on study outcomes in this trial. This evaluation of the
cost-effectiveness of targeted source data verification contributes to the
evidence-base regarding the context where reduced emphasis should be
placed on source data verification as the foremost monitoring activity.

<57>
Accession Number
643622962
Title
Effectiveness of Peer-Based and Conventional Video Education in Reducing
Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting
Patients: A Randomized Controlled Trial.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2024. Date of
Publication: 26 Feb 2024.
Author
Pedramrazi S.; Mohammadabadi A.; Rooddehghan Z.; Haghani S.
Institution
(Pedramrazi) Faculty of Nursing and Midwifery, Department of Nursing and
Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Mohammadabadi, Rooddehghan, Haghani) Nursing Care Research Center,
Department of Nursing and Midwifery, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Abstract
PURPOSE: Depression and anxiety are common comorbidities in patients
undergoing coronary artery bypass grafting (CABG), with potential adverse
effects on surgical outcomes. Effective interventions to reduce depression
and anxiety in these patients are therefore warranted. This study
investigated the effectiveness of peer-based video education compared to
conventional video education in reducing perioperative depression and
anxiety in CABG patients. DESIGN: A three-arm, parallel, randomized,
controlled trial design was employed. METHOD(S): A total of 114
participants were randomly assigned to 1 of 3 groups (n = 38 per group):
standard education (control), conventional video education, and peer-based
video education. State anxiety levels were measured using the Spielberger
State Anxiety Questionnaire at 1 day before surgery (baseline), 1 hour
before surgery, and 4 weeks after surgery. Depression levels were measured
using the Beck Depression Inventory Short-Form at baseline and 4 weeks
after surgery. Statistical analyses, including chi2, Fisher's exact test,
one-way analysis of variance, and repeated-measures analysis of variance,
were applied to analyze the collected data. FINDINGS: Both peer-based and
conventional video education groups demonstrated lower preoperative
anxiety levels compared to the control group. However, only the peer-based
video education group exhibited a statistically significant difference (P
< .05). Four weeks after surgery, anxiety and depression levels decreased
in all participants compared to baseline, with no statistically
significant differences among the three groups. CONCLUSION(S): Our
findings suggest that peer-based video education is more effective in
controlling preoperative anxiety in patients undergoing CABG than
conventional video education and standard education. Moreover, video-based
education, whether conventional or peer-based, appears to be as effective
as standard education in reducing anxiety and depression 4 weeks after
CABG surgery. Further research is warranted to investigate the influence
of content and presentation methods on patient outcomes and explore the
potential long-term benefits of video-based education in promoting patient
care. Copyright © 2024 The American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<58>
Accession Number
643622860
Title
Novel Polygenic Risk Score and Established Clinical Risk Factors for Risk
Estimation of Aortic Stenosis.
Source
JAMA cardiology. (no pagination), 2024. Date of Publication: 28 Feb 2024.
Author
Small A.M.; Melloni G.E.M.; Kamanu F.K.; Bergmark B.A.; Bonaca M.P.;
O'Donoghue M.L.; Giugliano R.P.; Scirica B.M.; Bhatt D.; Antman E.M.; Raz
I.; Wiviott S.D.; Truong B.; Wilson P.W.F.; Cho K.; O'Donnell C.J.;
Braunwald E.; Lubitz S.A.; Ellinor P.; Peloso G.M.; Ruff C.T.; Sabatine
M.S.; Natarajan P.; Marston N.A.
Institution
(Small, Bergmark, O'Donoghue, Giugliano, Scirica, Antman, Wiviott,
O'Donnell, Braunwald, Lubitz, Ruff, Sabatine, Marston) Cardiovascular
Medicine Division, Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Small, O'Donnell) Department of Cardiology, Boston Veterans Affairs
Healthcare System, West Roxbury, MA, United States
(Melloni, Kamanu, Bergmark, O'Donoghue, Giugliano, Scirica, Antman,
Wiviott, Braunwald, Ruff, Sabatine, Marston) TIMI Study Group, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Bonaca) Department of Medicine, Cardiology and Vascular Medicine,
University of Colorado School of Medicine, Aurora, United States
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, NY, United States
(Raz) Department of Endocrinology and Metabolism, Hadassah Hebrew
University Hospital, Jerusalem, Israel
(Truong, Lubitz, Ellinor, Natarajan) Cardiovascular Disease Initiative,
Broad Institute of MIT and Harvard, Cambridge, MA, United States
(Wilson) Atlanta Veterans Affairs Medical Center, Decatur, Georgia
(Wilson) Division of Cardiology, Department of Medicine, Emory University
School of Medicine, Atlanta, Georgia
(Cho, Peloso) Veterans Affairs Healthcare System, Boston, MA, United
States
(Cho) Division of Aging, Mass General Brigham and Department of Medicine,
Harvard Medical School, Boston, MA, United States
(Lubitz, Ellinor, Natarajan) Cardiovascular Research Center, Massachusetts
General Hospital, Boston, United States
(Ellinor, Natarajan) Division of Cardiology, Department of Medicine,
Massachusetts General Hospital, Boston, United States
(Peloso) Department of Biostatistics, Boston University School of Public
Health, Boston, MA, United States
(Natarajan) Center for Genomic Medicine, Massachusetts General Hospital,
Boston, United States
Abstract
Importance: Polygenic risk scores (PRSs) have proven to be as strong as or
stronger than established clinical risk factors for many cardiovascular
phenotypes. Whether this is true for aortic stenosis remains unknown.
 Objective(s): To develop a novel aortic stenosis PRS and compare its
aortic stenosis risk estimation to established clinical risk factors.
 Design, Setting, and Participant(s): This was a longitudinal cohort
study using data from the Million Veteran Program (MVP; 2011-2020), UK
Biobank (2006-2010), and 6 Thrombolysis in Myocardial Infarction (TIMI)
trials, including DECLARE-TIMI 58 (2013-2018), FOURIER (TIMI 59;
2013-2017), PEGASUS-TIMI 54 (2010-2014), SAVOR-TIMI 53 (2010-2013),
SOLID-TIMI 52 (2009-2014), and ENGAGE AF-TIMI 58 (2008-2013), which were a
mix of population-based and randomized clinical trials. Individuals from
UK Biobank and the MVP meeting a previously validated case/control
definition for aortic stenosis were included. All individuals from TIMI
trials were included unless they had a documented preexisting aortic valve
replacement. Analysis took place from January 2022 to December 2023.
Exposures: PRS for aortic stenosis (developed using data from MVP and
validated in UK Biobank) and other previously validated cardiovascular
PRSs, defined either as a continuous variable or as low (bottom 20%),
intermediate, and high (top 20%), and clinical risk factors. Main
Outcomes: Aortic stenosis (defined using International Classification of
Diseases or Current Procedural Terminology codes in UK Biobank and MVP or
safety event data in the TIMI trials). Result(s): The median (IQR)
age in MVP was 67 (57-73) years, and 135140 of 147104 participants (92%)
were male. The median (IQR) age in the TIMI trials was 66 (54-78) years,
and 45524 of 59866 participants (71%) were male. The best aortic stenosis
PRS incorporated 5170041 single-nucleotide variants and was associated
with aortic stenosis in both the MVP testing sample (odds ratio, 1.41; 95%
CI, 1.37-1.45 per 1 SD PRS; P=4.6x10-116) and TIMI trials (hazard ratio,
1.44; 95% CI, 1.27-1.62 per 1 SD PRS; P=3.2x10-9). Among genetic and
clinical risk factors, the aortic stenosis PRS performed comparably to
most risk factors besides age, and within a given age range, the
combination of clinical and genetic risk factors was additive, providing a
3- to 4-fold increased gradient of risk of aortic stenosis. However, the
addition of the aortic stenosis PRS to a model including clinical risk
factors only improved risk discrimination of aortic stenosis by 0.01 to
0.02 (C index in MVP: 0.78 with clinical risk factors, 0.79 with risk
factors and aortic stenosis PRS; C index in TIMI: 0.71 with clinical risk
factors, 0.73 with risk factors and aortic stenosis PRS).
 Conclusion(s): This study developed and validated 1 of the first
aortic stenosis PRSs. While aortic stenosis genetic risk was independent
from clinical risk factors and performed comparably to all other risk
factors besides age, genetic risk resulted in only a small improvement in
overall aortic stenosis risk discrimination beyond age and clinical risk
factors. This work sets the stage for further development of an aortic
stenosis PRS.

<59>
Accession Number
643622632
Title
Development and validation of the ASGARD risk score for safe monitoring in
asymptomatic nonsevere aortic stenosis.
Source
European journal of preventive cardiology. (no pagination), 2024. Date of
Publication: 28 Feb 2024.
Author
Hadziselimovic E.; Greve A.M.; Sajadieh A.; Olsen M.H.; Nienaber C.A.; Ray
S.G.; Rossebo A.B.; Wachtell K.; Dominguez H.; Valeur N.; Carstensen H.G.;
Nielsen O.W.
Institution
(Hadziselimovic, Sajadieh, Dominguez, Valeur, Carstensen, Nielsen)
Department of Cardiology, Bispebjerg University Hospital, Copenhagen,
Denmark
(Greve) Department of Clinical Biochemistry 3011, Rigshospitalet,
Copenhagen, Denmark
(Sajadieh, Dominguez, Nielsen) Faculty of Health and Medical Sciences,
University of Copenhagen, Denmark
(Olsen) Department of Internal Medicine 1, Holbaek Hospital, Denmark
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Denmark
(Olsen) Department of Clinical Medicine, University of Copenhagen, Denmark
(Nienaber) Royal Brompton and Harefield NHS Foundation Trust, Imperial
College, United Kingdom of Great Britain & Northern Ireland, London,
United Kingdom
(Ray) Manchester University Hospitals, United Kingdom of Great Britain &
Northern Ireland, Manchester, Jamaica
(Rossebo) Department of Cardiology, Oslo University Hospital, Ulleval,
Norway
(Wachtell) Division of Cardiology, Weill Cornell Medicine, NY, United
States
Abstract
AIMS: Current guidelines recommend serial echocardiography at minimum 1-2
year intervals for monitoring patients with nonsevere aortic valve
stenosis (AS), which is costly and often clinically inconsequential.We
aimed to develop and test whether the biomarker-based ASGARD risk score
(Aortic Valve Stenosis Guarded by Amplified Risk Determination) can guide
the timing of echocardiograms in asymptomatic patients with nonsevere AS.
 METHOD(S): The development cohort comprised 1,093 of 1,589 (69%)
asymptomatic patients with mild-to-moderate AS who remained event-free one
year after inclusion into the SEAS trial. Cox regression landmark analyses
with a 2-year follow-up identified the model (ASGARD) with the lowest
Akaike information criterion for association to AS-related composite
outcome (heart failure hospitalization, aortic valve replacement, or
cardiovascular death). Fine-Gray analyses provided cumulative event rates
by ASGARD score quartiles. The ASGARD score was internally validated in
the remaining 496 patients (31%) from the SEAS-cohort and externally in 71
asymptomatic outpatients with nonsevere AS from six Copenhagen hospitals.
 RESULT(S): The ASGARD score comprises updated measurements of heart
rate and age- and sex-adjusted N-terminal pro-brain natriuretic peptide
upon transaortic maximal velocity (Vmax) from the previous year. The
ASGARD score had high predictive accuracy across all cohorts (external
validation: area under the curve: 0.74 [95% CI, 0.62-0.86]), and similar
to an updated Vmax measurement. An ASGARD score <=50% was associated with
AS-related event rates <=5% for a minimum of 15 months.
 CONCLUSION(S): The ASGARD score could provide a personalized and safe
surveillance alternative to routinely planned echocardiograms, so
physicians can prioritize echocardiograms for high-risk
patients. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<60>
Accession Number
643618967
Title
Transfemoral transcatheter aortic valve replacement with
VitaFlowTM 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. (no pagination), 2024. Date of Publication: 25
Feb 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) 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
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Chen) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
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 VitaFlowTM
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. 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. Copyright © 2024. Published by Elsevier Inc.

<61>
Accession Number
643614166
Title
Remote ischemic conditioning reduces postoperative bleeding in adult
cardiac surgical patients: a systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2024. Date of
Publication: 27 Feb 2024.
Author
Chen L.-L.; Yao Y.-T.
Institution
(Chen) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen, Guangdong, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Abstract
INTRODUCTION: The current study was designed to systemically investigate
the impact of RIC on intra- and postoperative bleeding and transfusion in
patients undergoing cardiac surgery. EVIDENCE ACQUISITION: We included all
randomized controlled trials (RCTs) comparing RIC with control on intra-
and postoperative blood loss and blood transfusion. The inclusion criteria
were as follows: 1) adult patients undergoing cardiac surgery; 2) RCT; 3)
perioperative administration of RIC compared to control; 4) outcomes of
interest reported. Exclusion criteria included: 1) case reports, reviews,
or abstracts; 2) animal or cell studies; 3) duplicate publications; 4)
studies lacking information about outcomes of interest. EVIDENCE
SYNTHESIS: Databases search yielded 24 RCTs including 3530 patients, 1765
patients were allocated into RIC group and 1765 into control group. The
current study suggested that RIC administration was associated with
reduced postoperative blood loss (WMD=-57.89; 95% CI: -89.89 to -25.89;
P=0.0004). RIC did not affect the incidence of intraoperative blood loss
(WMD=-4.02; 95% CI: -14.09 to 6.05; P=0.43), the volume of intra- and
postoperative transfusion of RBC (WMD=-15.66; 95% CI: -39.35 to 8.03;
P=0.20), the re-exploration for bleeding (WMD=-0.01; 95% CI: -0.03 to
0.01; P=0.21). CONCLUSION(S): RIC might reduce postoperative blood
loss in adult cardiac surgical patients and reduced intraoperative RBC
transfusion in patients undergoing coronary artery bypass grafting.
However, RIC did not influence intraoperative bleeding, the volume of
re-exploration for bleeding or blood transfusion postoperatively.

<62>
Accession Number
2030751780
Title
Flurbiprofen in the subglottic space to prevent postoperative sore throat
after cardiac surgery: A randomized double-blind study.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111418. Date of Publication: August 2024.
Author
Calabrese M.; Arlotta G.; Antoniucci M.E.; Montini L.; Giannarelli D.;
Taccheri T.; Corsi F.; De Paulis S.; Scapigliati A.; Bevilacqua F.; Vargas
J.; Corrado M.; Pavone N.; Bruno P.; Massetti M.; Cavaliere F.
Institution
(Calabrese, Arlotta, Antoniucci, Taccheri, Corsi, De Paulis, Scapigliati,
Bevilacqua, Vargas, Corrado, Cavaliere) Department of Cardiovascular
Sciences, Intensive Care Unit, Fondazione Policlinico Universitario "A.
Gemelli" IRCCS, Rome, Italy
(Montini) Department of Intensive Care Medicine and Anesthesiology,
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic
University of the Sacred Heart, Rome, Italy
(Giannarelli) Facility Epidemiology and Biostatistics, Fondazione
Policlinico Universitario "A. Gemelli", Rome, Italy
(Pavone, Bruno, Massetti) Department of Cardiovascular Sciences, Cardiac
Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS,
Rome, Italy
Publisher
Elsevier Inc.
Abstract
Study objective: Postoperative sore throat (POST) and hoarseness are
common complications of tracheal intubation. This study aims to evaluate
the efficacy of flurbiprofen administered through the subglottic port of
tracheal tubes to prevent POST after cardiac surgery. Design(s):
Single-center, prospective, randomized, double-blind, placebo-controlled
trial. Setting(s): Tertiary Care Referral University Hospital
(Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome).
 Patient(s): Included 71 patients undergoing for elective cardiac
surgery. Inclusion criteria were (a) age between 50 and 75 years, (b) NYHA
class I or II, (c) surgery for myocardial revascularization or valve
repair or replacement under cardiopulmonary bypass. Intervention(s):
Patients were double blind randomized to receive flurbiprofen or saline in
the subglottic port of the endotracheal tube (groups F and P). The
solution was injected ten minutes after tracheal tube placement, ten
minutes after ICU admission and ten minutes before tracheal tube removal.
Measurements: The primary outcome was to assess the effect of topical
flurbiprofen administered through the subglottic port of the tracheal tube
to prevent post-operative sore throat (POST). The secondary outcomes were
the presence of hoarseness safety and patient's subjective satisfaction
with their recovery. We did not report any exploratory outcomes. Main
Result(s): We analyzed 68 patients, 34 patients in each group. In group F,
two patients complained of POST and hoarseness (5.9%), while all controls
did. The two groups significantly differed in the severity scores (VAS and
TPS for sore throat and HOAR for hoarseness) at all time points. In group
P, patients reported mild to moderate symptoms that significantly improved
or disappeared 36 h after tracheal tube removal. According to the
multivariable model, hoarseness affected women less than men, in the
control group (p = 0.002). None of the patients in either group reported
any adverse effects. Conclusion(s): Repeated administration of
flurbiprofen through the subglottic port of tracheal tubes reduced the
incidence of sore throat and hoarseness after cardiac surgery without
evidence of complications. Copyright © 2024 Elsevier Inc.

<63>
Accession Number
2004057772
Title
Ramucirumab plus erlotinib in patients with untreated, EGFR-mutated,
advanced non-small-cell lung cancer (RELAY): a randomised, double-blind,
placebo-controlled, phase 3 trial.
Source
The Lancet Oncology. 20(12) (pp 1655-1669), 2019. Date of Publication:
December 2019.
Author
Nakagawa K.; Garon E.B.; Seto T.; Nishio M.; Ponce Aix S.; Paz-Ares L.;
Chiu C.-H.; Park K.; Novello S.; Nadal E.; Imamura F.; Yoh K.; Shih J.-Y.;
Au K.H.; Moro-Sibilot D.; Enatsu S.; Zimmermann A.; Frimodt-Moller B.;
Visseren-Grul C.; Reck M.; Chu Q.; Cortot A.; Pujol J.-L.; Fabre E.;
Lamour C.; Bischoff H.; Kollmeier J.; Kimmich M.; Engel-Riedel W.;
Hammerschmidt S.; Schutte W.; Syrigos K.; Ho J.C.M.; Au K.-H.; Ardizzoni
A.; Pasello G.; Gregorc V.; Del Conte A.; Galetta D.; Takahashi T.;
Kumagai T.; Hotta K.; Goto Y.; Hosomi Y.; Sakai H.; Takiguchi Y.; Kim
Y.H.; Kurata T.; Yamaguchi H.; Daga H.; Okamoto I.; Satouchi M.; Ikeda S.;
Kasahara K.; Atagi S.; Azuma K.; Aoe K.; Horio Y.; Yamamoto N.; Tanaka H.;
Watanabe S.; Nogami N.; Ozaki T.; Koyama R.; Hirashima T.; Kaneda H.;
Tomii K.; Fujita Y.; Seike M.; Nishimura N.; Kato T.; Ichiki M.; Saka H.;
Hirano K.; Nakahara Y.; Sugawara S.; Kim S.-W.; Min Y.J.; Lee H.W.; Kang
J.-H.; An H.J.; Lee K.H.; Kim J.-S.; Lee G.-W.; Lee S.Y.; Alexandru A.;
Udrea A.A.; Juan-Vidal O.; Gil-Bazo I.; Ponce-Aix S.; Rubio-Viqueira B.;
Alonso Garcia M.; Felip Font E.; Fuentes Pradera J.; Coves Sarto J.; Lin
M.-C.; Su W.-C.; Hsia T.-C.; Chang G.-C.; Wei Y.-F.; Su J.; Cicin I.;
Goksel T.; Harputluoglu H.; Ozyilkan O.; Henning I.; Popat S.; Hatcher O.;
Mileham K.; Acoba J.; Garon E.; Jung G.; Raj M.; Martin W.; Dakhil S.
Institution
(Nakagawa) Department of Medical Oncology, Kindai University Faculty of
Medicine, Osaka, Japan
(Garon) David Geffen School of Medicine at University of California Los
Angeles, Translational Research in Oncology US Network, Los Angeles, CA,
United States
(Seto) National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
(Nishio) Department of Thoracic Medical Oncology, The Cancer Institute
Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
(Ponce Aix, Paz-Ares) Hospital Universitario 12 de Octubre, H12O-CNIO Lung
Cancer Clinical Research Unit, Universidad Complutense and Ciberonc,
Madrid, Spain
(Chiu) Department of Chest Medicine, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Park) Samsung Medical Center, Division of Hematology and Oncology,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Novello) Department of Oncology, University of Turin, Azienda
ospedaliero-universitaria San Luigi, Orbassano, Italy
(Nadal) Department of Medical Oncology, Catalan Institute of Oncology, and
Clinical Research in Solid Tumors group, Oncobell, l'Institut
d'Investigacio Biomedica de Bellvitge, L'Hospitalet, Barcelona, Spain
(Imamura) Osaka International Cancer Institute, Osaka, Japan
(Yoh) National Cancer Center Hospital East, Kashiwa, Japan
(Shih) Department of Internal Medicine, National Taiwan University
Hospital, Taipei, Taiwan (Republic of China)
(Au) Queen Elizabeth Hospital, Kowloon, Hong Kong
(Moro-Sibilot) Grenoble University Hospital, Grenoble, France
(Enatsu) Eli Lilly Japan KK Kobe, Kobe, Japan
(Zimmermann) Eli Lilly and Company, Indianapolis, IN, United States
(Frimodt-Moller) Eli Lilly and Company, Copenhagen, Denmark
(Visseren-Grul) Lilly Oncology, Utrecht, Netherlands
(Reck) LungenClinic, Airway Research Center North, German Center for Lung
Research, Grosshansdorf, Germany
Publisher
Elsevier Ltd
Abstract
Background: Dual blockade of the EGFR and VEGF pathways in EGFR-mutated
metastatic non-small-cell lung cancer (NSCLC) is supported by preclinical
and clinical data, yet the approach is not widely implemented. RELAY
assessed erlotinib, an EGFR tyrosine kinase inhibitor (TKI) standard of
care, plus ramucirumab, a human IgG1 VEGFR2 antagonist, or placebo in
patients with untreated EGFR-mutated metastatic NSCLC. Method(s):
This is a worldwide, double-blind, phase 3 trial done in 100 hospitals,
clinics, and medical centres in 13 countries. Eligible patients were aged
18 years or older (20 years or older in Japan and Taiwan) at the time of
study entry, had stage IV NSCLC, with an EGFR exon 19 deletion (ex19del)
or exon 21 substitution (Leu858Arg) mutation, an Eastern Cooperative
Oncology Group performance status of 0 or 1, and no CNS metastases. We
randomly assigned eligible patients in a 1:1 ratio to receive oral
erlotinib (150 mg/day) plus either intravenous ramucirumab (10 mg/kg) or
matching placebo once every 2 weeks. Randomisation was done by an
interactive web response system with a computer-generated sequence and
stratified by sex, geographical region, EGFR mutation type, and EGFR
testing method. The primary endpoint was investigator-assessed
progression-free survival in the intention-to-treat population. Safety was
assessed in all patients who received at least one dose of study
treatment. This trial is registered at ClinicalTrials.gov, NCT02411448,
and is ongoing for long-term survival follow-up. Finding(s): Between
Jan 28, 2016, and Feb 1, 2018, 449 eligible patients were enrolled and
randomly assigned to treatment with ramucirumab plus erlotinib (n=224) or
placebo plus erlotinib (n=225). Median duration of follow-up was 20.7
months (IQR 15.8-27.2). At the time of primary analysis, progression-free
survival was significantly longer in the ramucirumab plus erlotinib group
(19.4 months [95% CI 15.4-21.6]) than in the placebo plus erlotinib group
(12.4 months [11.0-13.5]), with a stratified hazard ratio of 0.59 (95% CI
0.46-0.76; p<0.0001). Grade 3-4 treatment-emergent adverse events were
reported in 159 (72%) of 221 patients in the ramucirumab plus erlotinib
group versus 121 (54%) of 225 in the placebo plus erlotinib group. The
most common grade 3-4 treatment-emergent adverse events in the ramucirumab
plus erlotinib group were hypertension (52 [24%]; grade 3 only) and
dermatitis acneiform (33 [15%]), and in the placebo plus erlotinib group
were dermatitis acneiform (20 [9%]) and increased alanine aminotransferase
(17 [8%]). Treatment-emergent serious adverse events were reported in 65
(29%) of 221 patients in the ramucirumab plus erlotinib group and 47 (21%)
of 225 in the placebo plus erlotinib group. The most common serious
adverse events of any grade in the ramucirumab plus erlotinib group were
pneumonia (seven [3%]) and cellulitis and pneumothorax (four [2%], each);
the most common in the placebo plus erlotinib group were pyrexia (four
[2%]) and pneumothorax (three [1%]). One on-study treatment-related death
due to an adverse event occurred (haemothorax after a thoracic drainage
procedure for a pleural empyema) in the ramucirumab plus erlotinib group.
 Interpretation(s): Ramucirumab plus erlotinib demonstrated superior
progression-free survival compared with placebo plus erlotinib in patients
with untreated EGFR-mutated metastatic NSCLC. Safety was consistent with
the safety profiles of the individual compounds in advanced lung cancer.
The RELAY regimen is a viable new treatment option for the initial
treatment of EGFR-mutated metastatic NSCLC. Funding(s): Eli
Lilly. Copyright © 2019 Elsevier Ltd

<64>
Accession Number
629427427
Title
Comparison of the sustainability of mitral annular dynamics between two
semi-rigid annuloplasty devices.
Source
European Journal of Cardio-thoracic Surgery. 56(2) (pp 360-368), 2019.
Date of Publication: 01 Aug 2019.
Author
Bouchez S.; Timmermans F.; Philipsen T.; Francois K.; Bove T.
Institution
(Bouchez) Department of Cardiac Anesthesiology, University Hospital of
Gent, Gent, Belgium
(Timmermans) Department of Cardiology, University Hospital of Gent, Gent,
Belgium
(Philipsen, Francois, Bove) Department of Cardiac Surgery, University
Hospital of Gent, Corneel Heymanslaan 10, Gent 9000, Belgium
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The choice of annuloplasty device is fundamental at the time
of mitral valve repair, the goal being to optimally restore the
physiological 3-dimensional (3D) structure and dynamics of the mitral
annulus (MA). This study evaluated MA dynamics after annuloplasty with 2
different semi-rigid devices. Method(s): Thirty-three patients
eligible for mitral valve repair were selected for annuloplasty with the
Physio II ring (Edwards Lifesciences, Irving, CA, USA) (n = 17) or the
Memo 3D ring (LivaNova, Saluggia, Italy) (n = 16). MA dynamics were
assessed with transoesophageal 3D echocardiography intraoperatively and 1
year after repair. Result(s): The postoperative changes in the
anteroposterior diameter {3.7% [standard deviation (SD) 2.7] vs 1.9% [SD
1.3]; P = 0.013} and in the annular height [27.7% (SD 8.7) vs 18.0% (SD
13.9); P = 0.003] were significantly larger with the Memo 3D ring during
the cardiac cycle. The restoration of the saddle shape at baseline was
superior with the Physio II ring, defined by a larger systolic annular
height-to-commissural width ratio [15.1% (SD 2.3) vs 7.1% (SD 2.4); P <
0.001]. These observations of MA dynamics were sustained after 1 year,
shown by a greater anteroposterior extension [5.1% (SD 1.0) vs 1.7% (SD
1.6); P = 0.002] and change in annular height-to-commissural width ratio
[15.7% (SD 12.7) vs 3.1% (SD 3.0); P = 0.020] for the Memo 3D ring. There
were no significant differences in mitral valve function between the 2
devices. Conclusion(s): The MA dynamics after annuloplasty with the
Physio II and Memo 3D rings demonstrated a better systolic 3D restoration
of the saddle shape with the Physio II ring, whereas the saddle-shaped
geometry improved significantly with the Memo 3D ring, as a dynamic
phenomenon. The Memo 3D ring also showed increased anteroposterior annular
mobility and folding dynamics throughout the cardiac cycle. Moreover, the
observed differences in MA dynamics between both devices appeared to be
sustainable 1 year after ring implantation. Copyright © 2019 The
Author(s). All rights reserved.

<65>
Accession Number
626935299
Title
There may be a role for addition of rivaroxaban to aspirin in patients
with stable coronary artery disease.
Source
BMJ Evidence-Based Medicine. 24(2) (pp 78-79), 2019. Date of Publication:
April 2019.
Author
Banerjee A.
Institution
(Banerjee) Farr Institute of Health Informatics, University College
London, London WC1E 6BT, United Kingdom
Publisher
BMJ Publishing Group

<66>
Accession Number
2030650502
Title
Relationship between Prediction of Platelet-Lymphocyte Ratio and Atrial
Fibrillation in Perioperative Patients: A Systematic Review and
Meta-Analysis.
Source
Heart Surgery Forum. 27(2) (pp E180-E187), 2024. Date of Publication:
2024.
Author
Gan J.; Han Y.; Yu L.; Huang Y.; Ye B.
Institution
(Ye) Hospital Infection and Control Department, Shenzhen Qianhai SheKou
Free Trade Zone Hospital, Guangdong, Shenzhen 518067, China
(Gan) Medical Department, Shenzhen Qianhai SheKou Free Trade Zone
Hospital, Guangdong, Shenzhen 518067, China
(Han, Yu) The Intensive Care Unit, Shenzhen Qianhai SheKou Free Trade Zone
Hospital, Guangdong, Shenzhen 518067, China
(Huang) Nurse of The Intensive Care Unit, Shenzhen Qianhai SheKou Free
Trade Zone Hospital, Guangdong, Shenzhen 518067, China
(Ye) Infectious Disease Prevention and Control Department, Shenzhen
Longgang District Centers for Disease Control and Prevention, Guangdong,
Shenzhen 518172, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The platelet-to-lymphocyte ratio (PLR) could be a convenient
method to predict atrial fibrillation (AF) likelihood and, in turn, to
determine the patients' postoperative trajectory. This study aimed to
evaluate the prognostic effect of pre-intervention PLR in predicting the
occurrence of AF after surgery. Method(s): PubMed, Embase, and the
Cochrane library were searched for available papers published up to
October 2023. The primary outcome was the odds ratio (OR) of numerical PLR
in the model predicting AF occurrence. The random-effects model was used
in all analyses. Result(s): Six studies were included. There were
1197 patients with AF and 1998 patients without AF. The combined analysis
of all six studies showed that PLR was associated with AF after surgery
(OR = 1.01, 95% confidence interval (CI): 1.00-1.01, p = 0.000
I2 = 43.4%, p<inf>heterogeneity</inf> = 0.116). Three studies
examined PLR before coronary artery bypass graft (CABG), and the
meta-analysis showed that PLR was associated with AF after CABG (OR =
1.01, 95% CI: 1.00-1.02, p = 0.002 I2 = 0.0%,
p<inf>heterogeneity</inf> = 0.894). The sensitivity analysis showed that
the results were not robust. There was no obvious publication bias.
 Conclusion(s): Pre-intervention PLR was significantly associated with
post-intervention AF in patients who underwent CABG or other surgeries.
Elevated PLR is a risk factor for postoperative atrial
fibrillation. Copyright © 2024 Forum Multimedia Publishing, LLC.

<67>
Accession Number
2030576552
Title
YouTube as a Source of Patient and Trainee Education in Vascular Surgery:
A Systematic Review.
Source
EJVES Vascular Forum. 61 (pp 62-76), 2024. Date of Publication: January
2024.
Author
Javidan A.; Vignarajah M.; Nelms M.W.; Zhou F.; Lee Y.; Naji F.; Kayssi A.
Institution
(Javidan, Kayssi) Division of Vascular Surgery, Department of Surgery,
University of Toronto, Toronto, ON, Canada
(Javidan) Institute of Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
(Vignarajah) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Nelms) Temerty Faculty of Medicine, University of Toronto, Toronto,
Canada
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Lee) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Lee) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Naji) Division of Vascular Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
Elsevier Ltd
Abstract
Objective: Due to its video based approach, YouTube has become a widely
accessed educational resource for patients and trainees. This systematic
review characterised and evaluated the peer reviewed literature
investigating YouTube as a source of patient or trainee education in
vascular surgery. Data sources: A comprehensive literature search was
conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception until
19 January 2023. All primary studies and conference abstracts evaluating
YouTube as a source of vascular surgery education were included. Review
methods: Video educational quality was analysed across several factors,
including pathology, video audience, and length. Result(s): Overall,
24 studies were identified examining 3 221 videos with 123.1 hours of
content and 37.1 million views. Studies primarily examined YouTube videos
on diabetic foot care (7/24, 29%), peripheral arterial disease (3/24,
13%), carotid artery stenosis (3/24, 13%), varicose veins (3/24, 13%), and
abdominal aortic aneurysm (2/24, 8%). Video educational quality was
analysed using standardised assessment tools, author generated scoring
systems, or global author reported assessment of quality. Six studies
assessed videos for trainee education, while 18 studies evaluated videos
for patient education. Among the 20 studies which reported on the overall
quality of educational content, 10/20 studies deemed it poor, and 10/20
studies considered it fair, with 53% of studies noting poor educational
quality for videos intended for patients and 40% of studies noting poor
educational quality in videos intended for trainees. Poor quality videos
had more views than fair quality videos (mean 27 348, 95% CI 15 154-39 543
views vs. 11 372, 95% CI 3 115-19 629 views, p = .030).
 Conclusion(s): The overall educational quality of YouTube videos for
vascular surgery patient and trainee education is suboptimal. There is
significant heterogeneity in the quality assessment tools used in their
evaluation. A standardised approach to online education with a consistent
quality assessment tool is required to better support online patient and
trainee education in vascular surgery. Copyright © 2024 The
Authors

<68>
[Use Link to view the full text]
Accession Number
2030570221
Title
An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting:
STOPDAPT-3 Randomized Trial.
Source
Circulation. 149(8) (pp 585-600), 2024. Date of Publication: 20 Feb 2024.
Author
Natsuaki M.; Watanabe H.; Morimoto T.; Yamamoto K.; Obayashi Y.; Nishikawa
R.; Ando K.; Domei T.; Suwa S.; Ogita M.; Isawa T.; Takenaka H.; Yamamoto
T.; Ishikawa T.; Hisauchi I.; Wakabayashi K.; Onishi Y.; Hibi K.; Kawai
K.; Yoshida R.; Suzuki H.; Nakazawa G.; Kusuyama T.; Morishima I.; Ono K.;
Kimura T.
Institution
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Japan
(Watanabe, Takenaka, Yamamoto, Kimura) Division of Cardiology, Hirakata
Kohsai Hospital, Hirakata, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Nishinomiya, Japan
(Yamamoto, Ando, Domei) Department of Cardiology, Kokura Memorial
Hospital, Kitakyusyu, Japan
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Graduate
School of Medicine, Kyoto University, Japan
(Suwa, Ogita) Department of Cardiology, Juntendo University, Shizuoka
Hospital, Izunokuni, Japan
(Isawa) Department of Cardiology, Sendai Kousei Hospital, Japan
(Ishikawa, Hisauchi) Department of Cardiology, Dokkyo Medical University,
Saitama Medical Center, Koshigaya, Japan
(Wakabayashi) Department of Cardiology, Showa University, Koto Toyosu
Hospital, Tokyo, Japan
(Onishi) Department of Cardiology, Hiratsuka Kyosai Hospital, Japan
(Hibi) Division of Cardiology, Yokohama City University, Medical Center,
Japan
(Kawai) Division of Cardiology, Chikamori Hospital, Kochi, Japan
(Yoshida) Division of Cardiology, Japanese Red Cross Aichi Medical Center,
Nagoya Daini Hospital, Nagoya, Japan
(Suzuki) Division of Cardiology, Showa University, Fujigaoka Hospital,
Yokohama, Japan
(Nakazawa) Department of Cardiology, Kindai University, Faculty of
Medicine, Osakasayama, Japan
(Kusuyama) Division of Cardiology, Tsukazaki Hospital, Himeji, Japan
(Morishima) Department of Cardiology, Ogaki Municipal Hospital, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Bleeding rates on dual antiplatelet therapy (DAPT) within 1
month after percutaneous coronary intervention (PCI) remain high in
clinical practice, particularly in patients with acute coronary syndrome
or high bleeding risk. Aspirin-free strategy might result in lower
bleeding early after PCI without increasing cardiovascular events, but its
efficacy and safety have not yet been proven in randomized trials.
 METHOD(S): We randomly assigned 6002 patients with acute coronary
syndrome or high bleeding risk just before PCI either to prasugrel (3.75
mg/day) monotherapy or to DAPT with aspirin (81-100 mg/day) and prasugrel
(3.75 mg/day) after loading of 20 mg of prasugrel in both groups. The
coprimary end points were major bleeding (Bleeding Academic Research
Consortium 3 or 5) for superiority and cardiovascular events (a composite
of cardiovascular death, myocardial infarction, definite stent thrombosis,
or ischemic stroke) for noninferiority with a relative 50% margin.
 RESULT(S): The full analysis set population consisted of 5966
patients (no-aspirin group, 2984 patients; DAPT group, 2982 patients; age,
71.6+/-11.7 years; men, 76.6%; acute coronary syndrome, 75.0%). Within 7
days before randomization, aspirin alone, aspirin with P2Y12 inhibitor,
oral anticoagulants, and intravenous heparin infusion were given in 21.3%,
6.4%, 8.9%, and 24.5%, respectively. Adherence to the protocol-specified
antiplatelet therapy was 88% in both groups at 1 month. At 1 month, the
no-aspirin group was not superior to the DAPT group for the coprimary
bleeding end point (4.47% and 4.71%; hazard ratio, 0.95 [95% CI,
0.75-1.20]; P<inf>superiority</inf>=0.66). The no-aspirin group was
noninferior to the DAPT group for the coprimary cardiovascular end point
(4.12% and 3.69%; hazard ratio, 1.12 [95% CI, 0.87-1.45]; P<inf>non</inf>
<inf>inferiority</inf>=0.01). There was no difference in net adverse
clinical outcomes and each component of coprimary cardiovascular end
point. There was an excess of any unplanned coronary revascularization
(1.05% and 0.57%; hazard ratio, 1.83 [95%CI, 1.01-3.30]) and subacute
definite or probable stent thrombosis (0.58% and 0.17%; hazard ratio, 3.40
[95% CI, 1.26-9.23]) in the no-aspirin group compared with the DAPT group.
 CONCLUSION(S): The aspirin-free strategy using low-dose prasugrel
compared with the DAPT strategy failed to attest superiority for major
bleeding within 1 month after PCI but was noninferior for cardiovascular
events within 1 month after PCI. However, the aspirin-free strategy was
associated with a signal suggesting an excess of coronary events.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04609111. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<69>
Accession Number
2030523951
Title
Analgaesic Effect of Erector Spinae Plane Block in Coronary Surgery: A
Randomised Controlled Trial.
Source
Journal of the College of Physicians and Surgeons Pakistan. 34(2) (pp
129-134), 2024. Date of Publication: February 2024.
Author
Disikirik A.; Bilgi M.; Turkoglu M.; Ucaroglu E.R.
Institution
(Disikirik, Bilgi, Turkoglu) Department of Anaesthesiology and
Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey
(Ucaroglu) Department of Cardiovascular Surgery, Abant Izzet Baysal
University Medical School, Bolu, Turkey
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To investigate the effect of preemptive erector spinae plane
(ESP) block application on postoperative pain scores and opioid demand in
off-pump coronary artery bypass graft (CABG) surgery. Study Design:
Randomised-controlled trial. Place and Duration of the Study: Department
of Anaesthesiology and Reanimation, Abant Izzet Baysal University (AIBU)
Medical School, Bolu, Turkiye, from November 2020 to April 2021.
Methodology: Fifty patients between the ages of 50 and 75 years, received
CABG surgery. These participants who were at risk of the American Society
of Anesthesiologists (ASA) III were randomly divided into two groups: ESP
(Group E) and Control (Group C). Intervention in Group E was performed
bilaterally at the T5 level before the operation. In the study, the
primary outcome was postoperative opioid demand while the secondary
outcomes consisted of intraoperative opioid demand, visual analogue scale
scores, and the duration of hospital stay. Result(s): Tramadol demand
was significantly decreased in Group E at 0-1, 1-12, 12-24, and 0-48 hours
(p <0.05). Intraoperative fentanyl demand for Group E was also
statistically significantly decreased (p= 0.001). In Group E, the visual
analogue scale scores at 30 minutes, 1st, 2nd,
4th, 8th, 12th hour, and 16th
hour after postoperative extubation were observed to be significantly
lower than those of Group C (p <0.05). Conclusion(s): Preemptive ESP
block application in CABG surgery patients reduced postoperative tramadol
demand, intraoperative fentanyl demand, and postoperative pain
scores. Copyright © 2024 College of Physicians and Surgeons
Pakistan. All rights reserved.

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

<71>
Accession Number
2028657765
Title
The role of dexmedetomidine administered via intravenous infusion as
adjunctive therapy to mitigate postoperative delirium and postoperative
cognitive dysfunction in elderly patients undergoing regional anesthesia:
a meta-analysis of randomized controlled trials.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 73. Date
of Publication: December 2024.
Author
Wang D.; He X.; Li Z.; Tao H.; Bi C.
Institution
(Wang, Li, Tao, Bi) Department of Anesthesiology, Dalian Municipal Central
Hospital Affiliated to Dalian University of Technology, Dalian, Liaoning,
China
(Wang, He, Li) Dalian Medical University, Dalian, China
Publisher
BioMed Central Ltd
Abstract
Study objective: This meta-analysis aimed to assess whether continuous
intravenous administration of DEX during surgery can be part of the
measures to prevent the onset of postoperative delirium and postoperative
cognitive dysfunction in elderly individuals following regional
anesthesia. Method(s): We searched the databases of PubMed, Embase,
the Cochrane Library and China National Knowledge Infrastructure (by June
1, 2023) for all available randomized controlled trials assessing whether
intravenous application of dexmedetomidine can help with postoperative
delirium and postoperative cognitive dysfunction in the elderly with
regional anesthesia. Subsequently, we carried out statistical analysis and
graphing using Review Manager software (RevMan version 5.4.1) and STATA
software (Version 12.0). Main Result(s): Within the scope of this
meta-analysis, a total of 18 randomized controlled trials were included.
Among them, 10 trials aimed to assess the incidence of postoperative
delirium as the primary outcome, while the primary focus of the other 8
trials was on the incidence of postoperative cognitive dysfunction. The
collective evidence from these 10 studies consistently supports a positive
relationship between the intravenous administration of dexmedetomidine and
a decreased risk of postoperative delirium (RR: 0.48; 95%CI: 0.37 to 0.63,
p < 0.00001, I2 = 0%). The 8 literature articles and
experiments evaluating postoperative cognitive dysfunction showed that
continuous intravenous infusion of dexmedetomidine during the entire
surgical procedure exhibited a positive preventive effect on cognitive
dysfunction among the elderly population with no obvious heterogeneity
(RR: 0.35; 95%CI: 0.25 to 0.49,p < 0.00001, I2 = 0%).
 Conclusion(s): Administering dexmedetomidine intravenously during
surgery can potentially play a significant role in preventing
postoperative delirium and postoperative cognitive dysfunction in patients
older than 60 years with regional anesthesia according to this
meta-analysis. Copyright © The Author(s) 2024.

<72>
Accession Number
2028102940
Title
Acceptability of a Text Message-Based Mobile Health Intervention to
Promote Physical Activity in Cardiac Rehabilitation Enrollees: A
Qualitative Substudy of Participant Perspectives.
Source
Journal of the American Heart Association. 13(2) (no pagination), 2024.
Article Number: e030807. Date of Publication: 2024.
Author
Atluri N.; Mishra S.R.; Anderson T.; Stevens R.; Edwards A.; Luff E.;
Nallamothu B.K.; Golbus J.R.
Institution
(Atluri) Department of Internal Medicine, University of Michigan, Ann
Arbor, MI, United States
(Mishra, Anderson, Stevens, Luff, Nallamothu, Golbus) Division of
Cardiovascular Medicine, Department of Internal Medicine, University of
Michigan, Ann Arbor, MI, United States
(Edwards) Department of Pharmacy, University of Michigan, Ann Arbor, MI,
United States
(Nallamothu) Michigan Integrated Center for Health Analytics and Medical
Prediction (MiCHAMP), University of Michigan, Ann Arbor, MI, United States
(Nallamothu, Golbus) The Center for Clinical Management and Research, Ann
Arbor VA Medical Center, Ann Arbor, MI, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Mobile health (mHealth) interventions have the potential to
deliver longitudinal support to users outside of epi-sodic clinical
encounters. We performed a qualitative substudy to assess the
acceptability of a text message-based mHealth intervention designed to
increase and sustain physical activity in cardiac rehabilitation
enrollees. METHODS AND RESULTS: Semistructured interviews were conducted
with intervention arm participants of a randomized controlled trial
delivered to low-and moderate-risk cardiac rehabilitation enrollees.
Interviews explored participants' interaction with the mobile application,
reflections on tailored text messages, integration with cardiac
rehabilitation, and opportunities for improvement. Transcripts were
thematically analyzed using an iteratively developed codebook. Sample size
consisted of 17 participants with mean age of 65.7 (SD 8.2) years; 29%
were women, 29% had low functional capacity, and 12% were non-White. Four
themes emerged from interviews: engagement, health impact,
personalization, and future directions. Participants engaged meaningfully
with the mHealth intervention, finding it beneficial in promoting
increased physical activity. However, participants desired greater
personalization to their individual health goals, fitness levels, and
real-time environment. Generally, those with lower functional capacity and
less experience with exercise were more likely to view the intervention
positively. Finally, participants identified future directions for the
intervention including better incorporation of exercise physiologists and
social support systems. CONCLUSION(S): Cardiac rehabilitation
enrollees viewed a text message-based mHealth intervention favorably,
suggesting the potentially high usefulness of mHealth technologies in this
population. Addressing participant-identified needs on increased user
customization and inclusion of clinical and social support is crucial to
enhancing the effectiveness of future mHealth interventions. Copyright
© 2024 The Authors.

<73>
Accession Number
2026729530
Title
Impact of diabetic versus non-diabetic patients undergoing coronary artery
bypass graft surgery on postoperative wound complications: A
meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14495. Date of Publication: March 2024.
Author
He L.; Liu M.; He Y.; Guo A.
Institution
(He) Operating Room, Xiang'an Hospital, Xiamen University, Xiamen, China
(Liu) Department of Endocrinology Hospital of Xiamen University, School of
Medicine, Xiamen University, Xiamen, China
(He) Department of Rheumatology and Immunology, Run Run Shaw Hospital of
the School of Medicine of Zhejiang University, Hangzhou, China
(Guo) Department of Cardiac Surgery, Xiangan Hospital Affiliated to Xiamen
University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
The effect of diabetes mellitus (DM) on the incidence of postoperative
wound complications in patients with coronary artery bypass grafting
(CABG) is still unclear. Thus, we performed a meta-analysis of CABG in DM
patients to evaluate existing data from both prospective and historical
cohorts. The objective of this trial was to assess the relevance and
extent of the effect of diabetes on the outcome of previous CABG
procedures. Data sources like Embase and Pubmed were found throughout the
research, and the language was limited to English through manual search.
The searches were performed up to August 2023. The data were extracted
from the study of the inclusion/exclusion criteria, the features of the
population, the statistical approach and the clinical results. A
qualitative evaluation of the qualifying studies has been carried out. Out
of the 1874 studies identified, 21 cohort studies were chosen for
analysis. Meta-analyses were performed in 258 454 patients (71 351
diabetic and 187 103 non-diabetic). Twenty-one studies on deep sternal
wound infections in CABG patients showed a lower rate of deep sternal
wound infections in non-diabetes group compared with those with diabetes
(OR, 2.13; 95% CI: 1.97, 2.31, p < 0.00001). And 16 studies of superficial
wound infections in patients undergoing CABG were found to be associated
with a lower rate of superficial injury (OR, 1.93; 95% CI: 1.53, 2.43, p <
0.00001) compared with those with diabetes; In five trials, perfusion time
during CABG (MD, 2.31; 95% CI: -0.16, 4.79, p = 0.07) was observed, and
there were no significant differences between diabetes and non-diabetes.
Currently, there is a higher risk for CABG in diabetes than in
non-diabetes patients with sternal infections and superficial injuries.
Future randomized trials will concentrate on the treatment of such
perioperatively related complications, which will lower the risk of
postoperative wound infection in diabetes. Copyright © 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<74>
Accession Number
2026401087
Title
Risk factors for sternal wound infection after open-heart operations: A
systematic review and meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14457. Date of Publication: March 2024.
Author
Chen D.; Zhang J.; Wang Y.; Jiang W.; Xu Y.; Xiong C.; Feng Z.; Han Y.;
Chen Y.
Institution
(Chen, Wang, Jiang, Xu, Xiong, Han, Chen) Department of Plastic and
Reconstructive Surgery, The First Medical Centre of Chinese PLA General
Hospital, Beijing, China
(Zhang) Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army
Medical University, Chongqing, China
(Feng) Department of Cardiovascular Surgery, The First Medical Centre of
Chinese PLA General Hospital, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
We aimed to quantitatively and systematically elucidate the rationality of
the examined variables as independent risk factors for sternal wound
infection. We searched databases to screen studies, ascertained the
variables to be analysed, extracted the data and applied meta-analysis to
each qualified variable. Odds ratios and mean differences were considered
to be the effect sizes for binary and continuous variables, respectively.
A random-effects model was used for these procedures. The source of
heterogeneity was evaluated using a meta-regression. Publication bias was
tested by funnel plot and Egger's test, the significant results of which
were then calculated using trim and fill analysis. We used a sensitivity
analysis and bubble chart to describe their robustness. After screening
all variables in the eligible literature, we excluded 55 because only one
or no research found them significant after multivariate analysis, leaving
33 variables for synthesis. Two binary variables (age over 65 years, NYHA
class >2) and a continuous variable (preoperative stay) were not
significant after the meta-analysis. The most robust independent risk
factors in our study were diabetes mellitus, obesity, use of bilateral
internal thoracic arteries, chronic obstructive pulmonary disease,
prolonged surgery time, prolonged ventilation and critical preoperative
state, followed by congestive heart failure, atrial fibrillation, renal
insufficiency, stroke, peripheral vascular disease and use of an
intra-aortic balloon pump. Relatively low-risk factors were
emergent/urgent surgery, smoking, myocardial infarction, combined surgery
and coronary artery bypass grafting. Sternal wound infection after
open-heart surgery is a multifactorial disease. The detected risk factors
significantly affected the wound healing process, but some were different
in strength. Anything that affects wound healing and antibacterial
ability, such as lack of oxygen, local haemodynamic disorders,
malnutrition condition and compromised immune system will increase the
risk, and this reminds us of comprehensive treatment during the
perioperative period. Copyright © 2023 The Authors. International
Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons
Ltd.

<75>
Accession Number
2028899698
Title
Femoral Arterial Calcification and Plug- vs. Suture-Based Closure Device
Strategies Post-Transcatheter Aortic Valve Implantation: Insights From
CHOICE-CLOSURE.
Source
Structural Heart. 8(2) (no pagination), 2024. Article Number: 100236. Date
of Publication: March 2024.
Author
Fitzgerald S.; Dumpies O.; Shibata M.; Hartung P.; Obradovic D.;
Boekstegers P.; Vorpahl M.; Rotta detto Loria J.; Kiefer P.; Desch S.;
Thiele H.; Abdel-Wahab M.
Institution
(Fitzgerald, Dumpies, Shibata, Hartung, Obradovic, Rotta detto Loria,
Desch, Thiele, Abdel-Wahab) Department of Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(Boekstegers) Department of Cardiology, Helios Clinic Siegburg, Siegburg,
Germany
(Boekstegers, Vorpahl) Witten Herdecke University, Witten, Germany
(Vorpahl) Department of Cardiology, Helios University Hospital Wuppertal,
Wuppertal, Germany
(Kiefer) Department of Cardiac Surgery, Heart Center Leipzig at University
of Leipzig, Leipzig, Germany
Publisher
Cardiovascular Research Foundation
Abstract
Background: The location and severity of vascular calcification may
influence closure device success in transfemoral transcatheter aortic
valve implantation. The aim of this study was to analyze effects of
vascular access-site calcification on vascular and bleeding outcomes
post-transcatheter aortic valve implantation. Method(s): The
Randomized Comparison of CatHeter-based Strategies fOr Interventional
ACcess SitE CLOSURE during Transfemoral Transcatheter Aortic Valve
Implantation (CHOICE-CLOSURE) trial assigned 516 patients to access site
closure using a pure plug-based technique (MANTA, Teleflex) or a primary
suture-based technique (ProGlide, Abbott Vascular). The principal finding
of the overall study was that access-site or access-related complications
were more common after the plug-based strategy compared to percutaneous
closure with a suture-based strategy. In this predefined subgroup
analysis, the overall cohort was split into patients with and without
anterior calcification at the access site and divided by degree of
calcification severity using the classification system developed in the
MANTA vs. suture-based vascular closure after transcatHeter aortic valve
replacement (MASH) trial. Differences in bleeding and vascular
complications were compared. The primary endpoint consisted of
access-site- or access-related major and minor vascular complications.
 Result(s): There were more access-site-related major and minor
vascular complications for patients with anterior wall vascular
calcification and MASH severe calcification. No significant interaction
with choice of closure technique in terms of access-site-related major and
minor vascular complications was observed (odds ratio 1.70, 95% CI
0.77-3.78, p = 0.19 for the primary endpoint in plug- vs. suture-based
strategy in patients with anterior calcification, odds ratio 1.78, 95% CI
0.56-5.65, p = 0.33 for primary endpoint in plug- vs. suture-based
strategy with MASH severe calcification, p<inf>int</inf> = 0.97 for
anterior calcification, p<inf>int</inf> = 0.95 for MASH severe
calcification). Conclusion(s): The total number of vascular
complications was found to be greater in the presence of anterior and MASH
severe calcification. Overall, the presence of anterior or severe
calcification does not significantly modify the efficacy of the
suture-based strategy compared to the plug-based strategy. Copyright
© 2023 The Authors

<76>
Accession Number
2030485243
Title
800.06 Transcarotid vs. Transaxillary/Subclavian Transcatheter Aortic
Valve Replacement (TAVR): A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S66-S67), 2024. Date of Publication: 26 Feb 2024.
Author
Shrestha D.B.; Dawadi S.; Oli P.; Shtembari J.; Pant K.; Mattumpuram J.
Institution
(Shrestha, Shtembari) Mount Sinai Hospital, Chicago, IL
(Dawadi) Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
(Oli) Province Hospital, Birendranagar, Nepal
(Pant) OSF UIC Peoria, Peoria, IL, United States
(Mattumpuram) University of Louisville School of Medicine, Louisville, KY
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) is the treatment
of choice in patients with severe Aortic stenosis. Trans-femoral access
has been the choice for the procedure and has been widely adopted. In
certain populations of patients where transfemoral access is difficult or
not possible to obtain, non-femoral access is used. Trans-carotid (TCa) or
Trans axillary/ subclavian (TAx/Sc) are safer and less invasive than other
non-femoral approaches. This meta-analysis aimed to compare the safety of
the trans-carotid and trans-axillary/subclavian approach for TAVR.
 METHOD(S): A comprehensive and systematic search was performed on
PubMed, Medline, Scopus, and Embase to identify studies comparing TCa vs
TAx/ Sc access for TAVR from inception to October 2023. Data analysis was
done using Revman Web. Odds Ratio (OR) with a 95% confidence interval used
for effect measure. RESULT(S): Seven studies with a total of 6227
patients were included in the analysis. (TCa: 2566; TAx/ Sc: 3661).
Transcarotid TAVR was associated with lower odds of composite stroke and
all-cause mortality (OR 0.76 CI 0.63- 0.92) (Fig.). TAx/ Sc approach had a
favorable trend for all-cause mortality (OR 0.84, CI 0.64- 1.08) (Fig.),
stroke and /or TIA (OR 0.85 CI 0.50-1.43) (Fig.), major vascular
complication (0.73 CI 0.50- 1.06) and new requirement of permanent
pacemaker (OR 0.87 CI 0.74-1.01) however, it didn't reach statistical
significance. CONCLUSION(S): Transcarotid TAVR had lower odds of
composite stroke and all-cause mortality. Although the trend favors the
trans-carotid approach, there was no statistical difference between the
two groups for individual outcomes (stroke, all-cause mortality, etc.).
Large prospective randomized clinical trials comparing the two approaches
are necessary to guide the clinicians for the approaches. [Formula
presented] Copyright © 2024

<77>
Accession Number
2030458716
Title
100.03 Routine Invasive Versus Conservative Management of Non-ST Elevation
Acute Coronary Syndromes in Patients With Previous Coronary Artery Bypass
Grafting: A Systematic Review and Meta-Analysis of Randomised Clinical
Trials.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S4-S5), 2024. Date of Publication: 26 Feb 2024.
Author
Kelham M.; Vyas R.; Rameseshan R.; Rathod K.; de Winter R.J.; de Winter
R.W.; Bendz B.; Thiele H.; Hirlekar G.; Morici N.; Myat A.; Michalis L.;
Sanchis J.; Kunadian V.; Berry C.; Mathur A.; Jones D.
Institution
(Kelham, Vyas, Rameseshan, Rathod, Jones) St Bartholomew's, London, United
Kingdom
(de Winter, de Winter) Amsterdam UMC, Amsterdam, Netherlands
(Bendz) Oslo University Hospital and Institute of Clinical Medicine, Oslo,
Norway
(Thiele) Heart Center Leipzig, Leipzig, Germany
(Hirlekar) Sahlgrenska University Hospital, Gothenburg, Sweden
(Morici) IRCCS S. Maria Nascente, Milan, Italy
(Myat) Medical Director Medpace UK, London, United Kingdom
(Michalis) University of Ioannina and University Hospital of Ioannina,
Ioannina, Greece
(Sanchis) University Clinic Hospital of Valencia, Valencia, Spain
(Kunadian) Faculty of Medical Sciences, Newcastle University, Newcastle,
United Kingdom
(Berry) British Heart Foundation Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Mathur) Centre for Cardiovascular Medicine and Devices, Faculty of
Medicine & Dentistry, Queen Mary University of London, London, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: A routine invasive strategy is recommended in the management
of higher risk patients with non-ST elevation acute coronary syndromes
(NSTE-ACS). However, patients with previous coronary artery bypass graft
surgery (CABG) were excluded from key trials that informed these
guidelines. Thus, the benefit of a routine invasive strategy is less
certain in this specific subgroup. Method(s): A systematic review and
meta-analysis of randomized controlled trials (RCT) was conducted.
Eligible studies were RCTs of routine invasive versus a conservative or
selective invasive strategy in patients presenting with NSTE-ACS that
included patients with previous CABG. Summary data was collected from the
authors of each trial if not previously published. Outcomes assessed were
all-cause mortality, cardiac mortality, myocardial infarction and cardiac
related hospitalization. Using a random-effects model, risk ratios with
95% confidence intervals were calculated. Result(s): Summary data was
obtained from eleven RCTs, including previously unpublished subgroup
outcomes of nine trials, comprising 897 patients with previous CABG (477
routine invasive, 420 conservative/selective invasive). A routine invasive
strategy did not reduce all-cause mortality (RR 1.12, 95% CI 0.97-1.29),
cardiac mortality (RR 1.05, 95% CI 0.70-1.58), myocardial infarction (RR
0.90, 95% CI 0.65-1.23) or cardiac related hospitalization (RR 1.05, 95%
CI 0.78-1.40). Conclusion(s): This is the first meta-analysis
assessing the effect of a routine invasive strategy in patients with prior
CABG who present with NSTE-ACS. The results confirm the
under-representation of this patient group in RCTs of invasive management
in NSTE-ACS and suggest there is no benefit to a routine invasive strategy
compared to a conservative approach with regard to major adverse cardiac
events. These findings should be validated in an adequately powered RCT.
Prospero registration: CRD42022332048 Copyright © 2024

<78>
Accession Number
2030458313
Title
300.13 Jetstream Atherectomy With Paclitaxel-Coated Balloons: Three-Year
Outcome of the Prospective Randomized JET-RANGER Study.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S36), 2024. Date of Publication: 26 Feb 2024.
Author
Shammas N.W.; Shammas G.A.; Christensen L.; Jones-Miller S.
Institution
(Shammas, Shammas, Christensen, Jones-Miller) Midwest Cardiovascular
Research Foundation, Davenport, IA, United States
Publisher
Elsevier Inc.
Abstract
Background: The JET-RANGER study (NCT03206762) was a multicenter (11 US
centers) randomized trial, core lab adjudicated, designed to demonstrate
the superiority of Jetstream + Paclitaxel coated balloon (JET+PCB) versus
angioplasty (PTA) + PCB in treating femoropopliteal (FP) arterial disease.
The 1-year and 2-year data have already been presented. The 3-year data is
being presented in this report. This study was stopped early during the
COVID pandemic and the FDA warning on paclitaxel. Method(s): The
JET-RANGER Trial initially had 47 patients with 48 lesions (31 JET arm and
16 PTA Arm; randomized 2:1). There were 43 patients who completed the
1-year follow-up. At 3-year follow-up the JET arm had 20 patients and the
PTA arm 14 patients. Kaplan Meier Survival analysis was performed to
estimate the freedom from TLR. Bailout stenting was not considered a TLR
in this analysis. Comparison of survival curves was done by Wilcoxon.
Major and minor amputation, all-cause mortality, target vessel
revascularization (TVR), bypass surgery and stent thrombosis were also
measured at the 3-year follow up. Statistical significance was determined
by a p-value < 0.05. Result(s): The probability of freedom from TLR
was numerically higher but statistically not significant in the JET+PCB vs
PTA+PCB at 3 years when bailout stenting was not considered a TLR (88.0%
vs 67.8%, p=0.1380), but was significantly higher in the JET+PCB arm vs
PTA+PCB arm when bailout stenting was considered as a TLR (88.1 vs 23.4%,
p<0.0001 respectively). There was also no significant difference in the
change of ABI between the PTA + PCB and JET + PCB from baseline and 3-year
(p-value=0.310). There was a significant mean difference between 3-year
and baseline Walking Impairment Questionnaire (WIQ) (23.1 +/- 26.3,
p-value = 0.0110) in the PTA + PCB arm but not the JET + PCB arm (4.9 +/-
22.5, p=0.3640). There was also no statistical difference between the JET
+ PCB and PTA + PCB arms for Rutherford Category (RCC) improvement by one
or more category (p-value= 1.000). There were no minor or major
amputations for either arm throughout the 3-year follow up. A total of 5
JET+PCB patients died, none related to device or procedure (2 cardiac
arrest, 2 cancers, 1 myocardial infarction). Conclusion(s): JET + PCB
had similar freedom from TLR to PTA + PCB when bailout stenting was not
considered a TLR, and no significant improvement in ABI and RCC at 3-year
follow-up when compared to PTA + PCB. No statistical difference in
amputation or mortality was seen between the 2 arms. Copyright ©
2024

<79>
Accession Number
2030456962
Title
800.07 Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Implantation in Patients with Small Aortic Annuli: A Meta-Analysis of 6984
Patients.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S67), 2024. Date of Publication: 26 Feb 2024.
Author
Yassin M.; Elkasaby M.; Altobaishat O.; Rashed M.; Omar I.; Mansour M.;
Khalefa B.B.; Bani-Salameh A.; Hasan M.; Al Hennawi H.; Abdelaziz A.
Institution
(Yassin) Faculty of Medicine, Helwan University, Cairo, Egypt
(Elkasaby, Rashed, Hasan, Abdelaziz) Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
(Altobaishat, Bani-Salameh) Faculty of Medicine, Jordan University of
Science and Technology, Irbid, Jordan
(Omar) Faculty of Pharmacy, South Valley University, Qena, Egypt
(Mansour) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Al Hennawi) Jefferson Abington Hospital, Abington, PA
Publisher
Elsevier Inc.
Abstract
Background: Limited data is available on the impact of different types of
valves on patients with small aortic annuli (SAA) undergoing transcatheter
aortic valve implantation (TAVI) for aortic stenosis (AS). We aim to
compare self-expandable (SEV) and balloon-expandable valves (BEV) in AS
for patients with SAA undergoing TAVI. Method(s): PubMed, Scopus,
Cochrane CENTRAL, Embase, and Web of Science were searched from inception
until August 2, 2023. We included studies that compared SEV to BEV in
patients with SAA undergoing TAVI. We used Review Manager software for
statistical analysis. We used the risk ratio (RR) and their corresponding
95% confidence intervals (CI) to compare dichotomous outcomes and the mean
difference and its 95% CI for continuous outcomes. Result(s): We
included twenty studies comprising 3800 patients for SEV and 3184 patients
for BEV. Patients who received SEV had a significantly lower risk of
moderate to severe patient prosthesis mismatch (PPM) (RR = 0.51, 95% CI
[0.45, 0.58], p<0.0001) (I2 = 0%, p=0.65) (Figure. 1), and
long-term stroke (RR = 2.15, 95% CI [1.09, 4.27], p=0.03) (I2 =
0%, p=0.76). On the other hand, BEV was associated with a lower risk of
permanent pacemaker implantation (PPI) (RR = 1.61, 95% CI [1.25, 2.08],
p=0.0002) (I2 = 2%, p=0.43). There were no differences in these
outcomes in the short term: all-cause mortality (p=0.57), cardiovascular
mortality (p=0.57), stroke (0.05), and myocardial infarction (MI) (p=
0.76). Also, long-term all-cause mortality, MI, and PPI were not
significant with these values (p=0.46), (p=0.34), and (p=0.09),
respectively. Conclusion(s): Patients with SAA who underwent TTVI
with SEV reported a lower risk of moderate to severe PPM and long-term
stroke. BEV was associated with decreased PPI. [Formula
presented] Copyright © 2024

<80>
Accession Number
2030456947
Title
800.44 Comparative Acute Thrombogenicity of the CLAAS Foam Implant and
Watchman FLX in an In Vitro Blood Loop Model.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S74), 2024. Date of Publication: 26 Feb 2024.
Author
Gray W.A.; Devellian C.; Baker L.; Levine A.; Kaplan A.V.
Institution
(Gray) Lankenau Heart Institute, Wynnewood, PA, United States
(Devellian, Levine) Conformal Medical, Inc., Nashua, NH
(Baker) Insight Medical Consulting, Northboro, MA
(Kaplan) Dartmouth-Hitchcock Medical Center, NH, Lebanon
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) is emerging as an
important stroke prevention strategy for patients with atrial
fibrillation. However, device-related thrombus (DRT) has been reported in
approximately 2-4% of patients and is associated with cerebral vascular
events. The Conformal CLAAS device (Conformal Medical, Inc., Nashua, NH)
is composed of a foam cup with an embedded nitinol skeleton covered by an
ePTFE (fluoropolymer) cover. The WATCHMAN FLXTM (Boston Scientific Corp.,
Marlboro, MA) is composed of a nitinol frame covered by a polyethylene
terephthalate (PET) cover. In this study, we evaluated the relative
thrombogenicity of the CLAAS Device by comparing it to the Watchman FLX in
an acute radiolabeled in vitro blood loop model. Method(s): CLAAS (27
mm, Regular Size) (n=3) and Watchman FLX (27mm) (n=3) devices were
inserted into the wall of a 25.4 mm inner diameter loop system which
recirculated heparinized bovine blood admixed with radiolabeled platelets
for 90 or 120 minutes. After run completion, samples were gently rinsed
and evaluated qualitatively. Result(s): Evaluation of the blood loop
exposed surface of the comparator device showed complete coverage with
adherent clot on all devices. The blood loop exposed surface of the CLAAS
device was incompletely covered with adherent clot which was thinner.
Compared to the comparator device, platelet deposition on the CLAAS
devices was lower by approximately 44%. Conclusion(s): In this model,
the CLAAS device appeared to have less thrombus formation when compared to
a commercially available LAA Closure Device. Data from an ongoing large
randomized clinical trial will be needed to understand the impact of these
findings. [Formula presented] Copyright © 2024

<81>
Accession Number
2030456942
Title
800.54 Outcomes of Transcatheter Mitral Valve Replacement with Sapien
Transcatheter Heart Valve for Degenerated Bioprostheses and Failed
Annuloplasty Rings: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S76-S77), 2024. Date of Publication: 26 Feb 2024.
Author
Aoun J.; Agrawal A.; Khan S.; Akbar U.A.; Zhu Z.; Kleiman N.S.; Reardon
M.J.; Lone A.N.; Laird R.; Arshad H.; Atkins M.; Faza N.; Little S.H.;
Goel; S.
Institution
(Aoun, Agrawal, Khan, Akbar, Zhu, Kleiman, Reardon, Lone, Laird, Arshad,
Atkins, Faza, Little, Goel;) Houston Methodist, DeBakey Heart & Vascular
Center, Houston, TX
Publisher
Elsevier Inc.
Abstract
Introduction: Transcatheter mitral valve replacement (TMVR) with Sapien
transcatheter heart valve (THV) is currently the mainstay of therapy for
patients with degenerative bioprosthetic valves and failed surgical mitral
valve repairs who are unsuitable for surgical interventions.
 Purpose(s): We aimed to compare the outcomes of these procedures.
 Method(s): We searched electronic databases (OVID Medline, Embase,
SCOPUS, web of Science and Cochrane, between 2015 and 2022). We focused on
all-cause mortality, stroke, acute kidney injury (AKI), infective
endocarditis (IE), major bleeding, permanent pacemaker (PPM), and residual
mitral regurgitation (MR) after intervention. We performed random-effects
meta-analysis and estimated percentages with 95% confidence intervals for
valve in ring (ViR), and valve in valve (ViV). We estimated p-interaction
(p-int) across the interventions. Outcomes were assessed at 30 days and 1
year. Result(s): Of 30 studies (n =5,233), at 30 days, compared with
ViR, ViV showed no significant differences for all-cause mortality (6.2%
vs. 7.2%), stroke (2.4% vs.3.4%), AKI (8.2% vs. 13.0%), IE (4.7% vs.
0.5%), major bleeding (7.9% vs. 7.0%), and PPM (2.8% vs. 6.3%). There were
similar rates of residual MR<=1+ and MR<=2+, however residual MR >=3+ were
lower in ViV than ViR (0.8% vs. 12.5%) (p<0.01). At 1-year, compared with
ViR, ViV had lower proportion of all-cause mortality (10.4% vs. 22.5%) and
AKI (ViV: 1.4%; ViR: 13.3%), but no significant differences for stroke
(4.4% vs. 3.3%), IE (0.5% vs. 0.5%), major bleeding (3.3% vs. 6.7%), and
PPM (2.8% vs. 0.5%). There were similar rates of residual MR<=1+ and
MR<=2+, however residual MR>=3+ were lower in ViV (3.3% vs. 18.5%) than
ViR (p<0.01). Conclusion(s): In this meta-analysis, we have
demonstrated that TMVR with Sapien valve for degenerative bioprostheses
and failed annuloplasty rings result in favorable short-term survival
rates at 30 days and 1-year Copyright © 2024

<82>
Accession Number
2030456874
Title
800.22 Transcatheter vs. Surgical Valve Replacement in Severe Aortic
Stenosis with Small Annulus: A Meta-Analytical Review of Two-Year
Outcomes.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S72), 2024. Date of Publication: 26 Feb 2024.
Author
Ellauzi R.; Kumar A.; Ismayl M.; Hamza I.; Hamza T.; Anavekar N.
Institution
(Ellauzi) Henry Ford Hospital, Detroit, MI, United States
(Kumar) Cleveland Clinic, Akron, OH
(Ismayl, Anavekar) Mayo Clinic, Rochester, MN
(Hamza) The University of Texas Medical Branch, Galveston, TX
(Hamza) Houston Methodist Hospital, Houston, TX
Publisher
Elsevier Inc.
Abstract
Background: The optimal approach for severe aortic stenosis (AS) patients
with small aortic annulus (SAA) remains uncertain when comparing
transcatheter (TAVR) and surgical aortic valve replacement (SAVR).
 Method(s): We conducted a pooled analysis of data from observational
studies and randomized controlled trials that compared TAVR and SAVR in
patients with severe aortic stenosis and small aortic annulus. The key
endpoints evaluated were all-cause mortality, stroke, and myocardial
infarction over a 2-year follow-up period. We used inverse variance method
with Paule-Mandel estimator for tau2 and Hartung-Knapp adjustment for
random effects model accounting for small study effect and heterogeneity
in the current analysis. All analysis was carried out using R version
4.0.3. Result(s): The meta-analysis incorporated data from three
studies, evaluating a total of 279 TAVR and 231 SAVR patients with severe
aortic stenosis and small aortic annulus. The analysis demonstrated no
significant difference in all-cause mortality at 2 years follow-up, with a
pooled risk ratio of 0.82 (95% CI [0.56; 1.21]), and no heterogeneity
(I2 = 0%) [Figure, PANEL A]. The risk of stroke was comparable
between TAVR and SAVR, with a risk ratio of 1.34 (95% CI [0.06; 28.44])
and moderate heterogeneity (I2 = 59%) [Figure, PANEL B].
Myocardial infarction was also comparable between TAVR and SAVR, yielding
a risk ratio of 0.66 (95% CI [0.10; 4.15]) with no detected heterogeneity
(I2 = 0%) [Figure, PANEL C]. Conclusion(s): In patients
with severe aortic stenosis and small aortic annulus, TAVR and SAVR
reported comparable results in all-cause mortality, stroke, and myocardial
infarction at 2 years. Selection of valve replacement therapy should be
individualized, considering these findings. [Formula
presented] Copyright © 2024

<83>
Accession Number
2030456866
Title
100.86 Role of LA Strain Assessed by Speckle-Tracking Echocardiography in
Predicting POAF After Coronary Artery Bypass Grafting: A Systematic Review
and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S27), 2024. Date of Publication: 26 Feb 2024.
Author
Bulaeva N.; Berdibekov B.; Mrikaev D.; Golukhova E.
Institution
(Bulaeva, Berdibekov, Mrikaev, Golukhova) Bakulev Scientific Center for
Cardiovascular Surgery, Moscow, Russian Federation
Publisher
Elsevier Inc.
Abstract
Background: The current study aimed to conduct a systematic review and
meta-analysis with the objective of evaluating left atrial (LA) strain
using speckle-tracking echocardiography for predicting new onset
postoperative atrial fibrillation (POAF) in patients undergoing coronary
artery bypass grafting (CABG). Material(s) and Method(s): We searched
PubMed, Google Scholar for studies that investigated the prognostic value
of LA strain using speckle-tracking echocardiography as predictors of POAF
in patients undergoing CABG. To determine the weighted mean difference of
LA strain, was performed a pooled analysis of mean values of global LA
strain, LA reservoir strain (PALS - peak atrial longitudinal atrial
strain), conduit (LACS - left atrial conduit strain) and contraction
(LACtS - left atrial contractile strain). Odds ratios (OR) were extracted
from multivariate models reporting on the association of PALS and POAF and
described as pooled estimates with 95% confidence intervals (CI).
 Result(s): 12 studies were retrieved from 404 publications for this
systematic review and meta-analysis. In total, 1093 patients, mean age
60,5 years were included in the analysis. Meta-analysis showed the showed
that patients with POAF had lower global LA strain than patients without
POAF (weighted mean difference - 5.03%; 95% CI: -6.89 to -3.16; p <0.001).
In addition, patients with POAF had lower values of LA strain in the
reservoir phase (PALS), conduit (LACS) and contraction (LACtS), these
weighted mean difference were - 9.90% (95% CI: - 12.95 to - 6.85; p
<0.001), - 4.17% (95% CI: -6.05 to -2.29; p<0.001) and - 6.17% (95% CI: -
12.01 to - 0.33; p=0.04), respectively (Figure 1). Moreover, pooled
analysis of OR showed that PALS was an independent predictor of POAF after
CABG (OR: 0.88 per 1% increase of PALS; 95% CI: 0.82-0.94; p<0.0001).
 Conclusion(s): LA strain assessed using speckle-tracking
echocardiography provides important additional information for predicting
new-onset POAF in patients undergoing isolated CABG. Copyright ©
2024

<84>
Accession Number
2030456788
Title
800.5 Trends in Outcomes of Multi-transcatheter Strategy for the Treatment
of Combined Aortic Stenosis and Mitral Regurgitation.
Source
JACC: Cardiovascular Interventions. Conference: CRT 2024, Cardiovascular
Research Technologies. Washington Hilton, Washington, DC United States.
17(4 Supplement) (pp S75), 2024. Date of Publication: 26 Feb 2024.
Author
Lupu L.; Ben-Dor I.; Haberman D.; Chitturi K.; Chaturvedi A.; Abusnina W.;
Merdler I.; Reddy P.; Rogers T.; Satler L.; Waksman R.
Institution
(Lupu, Ben-Dor, Haberman, Chitturi, Chaturvedi, Abusnina, Merdler, Reddy,
Rogers, Satler, Waksman) MedStar Washington Hospital Center, Washington,
DC
Publisher
Elsevier Inc.
Abstract
Background: Significant progress has been achieved in transcatheter
treatments for aortic stenosis (AS) and mitral regurgitation (MR).
However, data on multi-valve disease treated with the transcatheter
approach is limited. The study aim was to report on the outcome of a
multi-transcatheter strategy for treating combined AS and MR disease.
 Method(s): We conducted a systematic review of the PubMed database to
identify studies on interventions for combined AS and MR. We focused on
short-term periprocedural mortality, including both staged and
same-admission procedures. To ensure contemporary relevance, we limited
our inclusion to studies published in the past ten years. Result(s):
We identified six studies meeting the inclusion criteria, including 1,483
patients who underwent transcatheter aortic valve replacement (TAVR) and
mitral transcutaneous edge-to-edge repair (M-TEER) or transcatheter mitral
valve replacement (TMVR) from 2017 to 2023. During the past 6 years,
In-hospital mortality decreased from 7.5% to 0.8% for staged TAVR and
M-TEER and from 10.8% to 6.5% for same-admission TAVR and M-TEER.
Same-admission TAVR and M-TEER patients had a higher rate of non-elective
admissions, heart failure, and cardiogenic shock, suggesting a higher-risk
population. Overall, TAVR+TMVR mortality has trended downward from 16.67%
to 13.13%. Conclusion(s): Our findings suggest the feasibility and
safety of a multi-transcatheter approach to address combined severe AS and
severe MR. With the observed trend of decreasing in-hospital mortality,
this strategy should be considered for patients with multivalve disease.
[Formula presented] Copyright © 2024

<85>
Accession Number
2029557557
Title
The Use Of Ecpella In Cardiogenic Shock, An Umbrella Meta-Analysis.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2023. Cleveland United States. 30(1) (pp
257-258), 2024. Date of Publication: January 2024.
Author
Iskander B.; Yarrarapu S.; Desai A.; Patel U.; Khalife W.
Institution
(Iskander) University Hospitals/ Case Western Reserve University,
Cleveland, OH
(Yarrarapu) Department of Internal Medicine, Monmouth Medical
Center/RWJBH, Long Branch, Long Branch, NJ, United States
(Desai) Department of Internal Medicine, University of California
Riverside School of Medicine, Riverside, CA
(Patel) Icahn School of Medicine at Mount Sinai, New York, OH, Newyork,
United Kingdom
(Khalife) The University of Texas Medical Branch Health, Friendswood, TX,
United States
Publisher
Elsevier B.V.
Abstract
Background: Veno-arterial Extra-corporeal membrane oxygenation (VA-ECMO)
is used in the treatment of severe cardiogenic shock. Impella can be used
to unload the left ventricle and improve hemodynamics when used with
VA-ECMO. Our study aims to evaluate the difference between the use of
VA-ECMO alone vs. VA-ECMO with Impella. Method(s): Using PRISMA
guidelines, we conducted an umbrella meta-analysis study on the previously
published meta-analysis articles. All studies comparing VA-ECMO to VA-ECMO
with Impella were identified using MeSH keywords. Relative risks were
extracted and converted to log relative risk using RevMan 5.4. We used a
random effects model with generic inverse variance to calculate the
relative risks. The risk of bias was assessed using the Newcastle Ottawa
scale. A p<0.05 was considered significant. A heterogeneity (I2) of more
than 50 was considered high. Result(s): 104 studies were screened and
3 meta-analyses were selected. Our analysis showed that the ECPella group
compared to the VA-ECMO group had Lower mortality (pooled RR 0.88, 95% CI
0.81, 0.95, p<0.00001) (Figure 1). ECPella group had a higher risk of
major bleeding (1.60, 1.32, 1.94, p<0.00001), hemolysis (1.85, 1.56-2.20,
p<0.00001), and need for renal replacement therapy (1.49, 1.27-1.76,
p<0.00001) (Figures 2-4). There was no significant difference between the
two groups in bridging to left ventricular assist device or heart
transplant (1.15, 0.36-3.68, p<0.00001) (Figure 5). Conclusion(s):
VA-ECMO with Impella showed less mortality risk and higher risk for
significant bleeding, hemolysis, and need for renal replacement therapy
than patients who received VA-ECMO. VA-ECMO and Impella did not increase
the likelihood of bridging to an LVAD or heart transplant. More studies
are needed to investigate if using ECPella raises the possibility of
bridging to heart transplantation or a left ventricular assist
device. Copyright © 2023

<86>
Accession Number
2028807416
Title
Patient-centered evaluation of an expectation-focused intervention for
patients undergoing heart valve surgery: a qualitative study.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1338964. Date of Publication: 2024.
Author
Clifford C.; Girdauskas E.; Klotz S.G.R.; Kurz S.; Lowe B.; Kohlmann S.
Institution
(Clifford, Kurz, Lowe, Kohlmann) Department of Psychosomatic Medicine and
Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany
(Girdauskas) Department of Cardiothoracic Surgery, University Medical
Center Augsburg, Augsburg, Germany
(Klotz) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
Publisher
Frontiers Media SA
Abstract
Objective: Randomized controlled trials demonstrate the effectiveness of
expectation-focused interventions in improving recovery outcomes following
cardiac surgery. For dissemination in routine health care, it is important
to capture the perspective of affected individuals. This qualitative study
explores the perceived benefits and intervention-specific needs of
patients who received expectation-focused intervention in the context of
heart valve surgery. In addition, it explores potential barriers and
adverse effects. Method(s): As part of an Enhanced Recovery After
Surgery (ERAS) program within a multicentered randomized controlled trial,
patients undergoing minimally invasive heart valve surgery received an
intervention focused on their expectations. Six weeks after the
intervention, semi-structured interviews were conducted with 18 patients
to assess its feasibility, acceptance, barriers, benefits, and side
effects. The transcribed interviews were analyzed using qualitative
content analysis. Result(s): The results indicate that both the
intervention and the role of the patient and psychologist are key aspects
in evaluating the expectation-focused intervention. Five key themes
emerged from the patients' perspective: personal needs, expectations and
emotions, relationship, communication, and individuality. Patients valued
the preparation for surgery and recovery and the space for emotions.
Establishing a trustful relationship and addressing stigmatization were
identified as primary challenges within the intervention.
 Conclusion(s): Overall, patients experienced the expectation-focused
intervention as helpful and no adverse effects were reported. Perceived
benefits included enhanced personal control throughout the surgery and
recovery, while the potential barrier of stigmatization towards a
psychologist may complicate establishing a trustful relationship.
Addressing personal needs, as a relevant topic to the patients, could be
achieved through additional research to identify the specific needs of
different patient subgroups. Enhancing the expectation-focused
intervention could involve the implementation of a modular concept to
address individual needs better. Copyright 2024 Clifford, Girdauskas,
Klotz, Kurz, Lowe and Kohlmann.

<87>
Accession Number
2028769577
Title
The future of artificial intelligence in thoracic surgery for non-small
cell lung cancer treatment a narrative review.
Source
Frontiers in Oncology. 14 (no pagination), 2024. Article Number: 1347464.
Date of Publication: 2024.
Author
Abbaker N.; Minervini F.; Guttadauro A.; Solli P.; Cioffi U.; Scarci M.
Institution
(Abbaker, Scarci) Division of Thoracic Surgery, Imperial College NHS
Healthcare Trust and National Heart and Lung Institute, London, United
Kingdom
(Minervini) Division of Thoracic Surgery, Luzerner Kantonsspital, Lucern,
Switzerland
(Guttadauro) Division of Surgery, Universita Milano-Bicocca and Istituti
Clinici Zucchi, Monza, Italy
(Solli) Division of Thoracic Surgery, Policlinico S. Orsola-Malpighi,
Bologna, Italy
(Cioffi) Department of Surgery, University of Milan, Milan, Italy
Publisher
Frontiers Media SA
Abstract
Objectives: To present a comprehensive review of the current state of
artificial intelligence (AI) applications in lung cancer management,
spanning the preoperative, intraoperative, and postoperative phases.
 Method(s): A review of the literature was conducted using PubMed,
EMBASE and Cochrane, including relevant studies between 2002 and 2023 to
identify the latest research on artificial intelligence and lung cancer.
 Conclusion(s): While AI holds promise in managing lung cancer,
challenges exist. In the preoperative phase, AI can improve diagnostics
and predict biomarkers, particularly in cases with limited biopsy
materials. During surgery, AI provides real-time guidance.
Postoperatively, AI assists in pathology assessment and predictive
modeling. Challenges include interpretability issues, training limitations
affecting model use and AI's ineffectiveness beyond classification.
Overfitting and global generalization, along with high computational costs
and ethical frameworks, pose hurdles. Addressing these challenges requires
a careful approach, considering ethical, technical, and regulatory
factors. Rigorous analysis, external validation, and a robust regulatory
framework are crucial for responsible AI implementation in lung surgery,
reflecting the evolving synergy between human expertise and
technology. Copyright © 2024 Abbaker, Minervini, Guttadauro,
Solli, Cioffi and Scarci.

<88>
Accession Number
2030627365
Title
The effect of reflexology on pain, anxiety, fatigue, and sleep in patients
undergoing coronary artery bypass graft surgery: A randomized controlled
trial.
Source
European Journal of Integrative Medicine. 66 (no pagination), 2024.
Article Number: 102342. Date of Publication: February 2024.
Author
Gunes K.; Gezginci E.; Tok M.
Institution
(Gunes) Department of Cardiovascular Surgery, Uludag University Health
Application and Research Center, Bursa, Turkey
(Gezginci) Department of Surgical Nursing, Hamidiye Faculty of Nursing,
University of Health Sciences Turkey, Istanbul, Turkey
(Tok) Department of Cardiovascular Surgery, Uludag University Faculty of
Medicine, Bursa, Turkey
Publisher
Elsevier GmbH
Abstract
Introduction: Reflexology is a non-pharmacological method that helps
normalization of bodily functions by applying pressure to the reflex
points on the hands, feet and ears, which correspond to all the organs and
glands in the body. This study aimed to evaluate the effect of reflexology
on pain, anxiety, fatigue, and sleep in patients undergoing cardiovascular
surgery. Method(s): This open-label, randomized parallel-group
controlled trial was conducted between September 2020 to May 2021 in a
university hospital in Turkey. Seventy eligible patients who underwent
cardiovascular surgery were randomized into reflexology group (n = 35) or
control group (n = 35). While foot reflexology was applied to the
reflexology group for 40 min in the first three days after surgery, no
intervention was applied to control group. The primary outcome was pain
severity, assessed using the Visual Analog Scale, in the first three
postoperative days. The other outcomes were anxiety level assessed using
the State-Trait Anxiety Inventory, fatigue level assessed using the Visual
Analog Scale in the first three postoperative days, and sleep quality
assessed using the Richards-Campbell Sleep Questionnaire in the first four
postoperative days. Result(s): After applying reflexology on the
first, second, and third postoperative days, pain scores (d=-2.736, 95%
Cl=-3.388 to -2.084) (d=-7.954, 95% Cl=-9.352 to -6.555) (d=-7.528, 95%
Cl=-8.860 to -6.196), anxiety scores (d=-3.462, 95% Cl=-4.202 to -1.721)
(d=-6.077, 95% Cl=-7.187 to -4.967) (d=-6.537, 95% Cl=-7.717 to -5.357),
and fatigue scores (d=-2.490, 95% Cl=-3.115 to -1.866) (d=-6.245, 95%
Cl=-7.380 to -5.109) (d=-8.223, 95% Cl=-9.675 to -6.791, respectively)
were statistically significantly lower in reflexology group compared to
control group. On the second, third, and fourth postoperative days, sleep
scores in reflexology group were statistically significantly higher than
control group (d = 3.230, 95% Cl=2.519 to 3.941) (d = 4.280, 95% Cl=3.431
to 5.130) (d = 6.106, 95% Cl=4.992 to 7.221, respectively). During the
study period, no adverse events were noted in either groups.
 Conclusion(s): This study showed that applying foot reflexology to
patients undergoing cardiovascular surgery reduced pain, anxiety, and
fatigue and improved sleep quality. Further studies on reflexology
practice are recommended to be conducted with larger sample sizes and
different groups. Trial registration Clinical: Trials.gov
NCT04473287. Copyright © 2024 Elsevier GmbH

<89>
Accession Number
643589903
Title
Mortality and Heart Transplantation After Hybrid Palliation of Hypoplastic
Left Heart Syndrome: A Systematic Review and Meta-Analysis.
Source
World journal for pediatric & congenital heart surgery. (pp
21501351231224323), 2024. Date of Publication: 25 Feb 2024.
Author
Jacquemyn X.; Singh T.P.; Gossett J.G.; Averin K.; Kutty S.; Zuhlke L.J.;
Abdullahi L.H.; Kulkarni A.
Institution
(Jacquemyn, Kutty) Helen B. Taussig Heart Center, Department of
Pediatrics, Johns Hopkins Hospital, Baltimore, MD, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Singh) Department of Cardiology, Boston Children's Hospital, Boston, MA,
United States
(Gossett, Averin, Kulkarni) Cohen Children's Heart Center, Donald and
Barbara Zucker School of Medicine at Hofstra/ Northwell, New Hyde Park,
NY, United States
(Zuhlke) President's Office, South African Medical Research Council, Cape
Town, South Africa
(Zuhlke) Division of Paediatric Cardiology, Department of Paediatrics,
Institute of Child Health, Faculty of Health Sciences, University of Cape
Town, Cape Town, South Africa
(Abdullahi) Save the Children International (SCI), Kenya
Abstract
BACKGROUND: Newborns with hypoplastic left heart syndrome (HLHS) who are
considered at increased risk for death following Norwood/Sano surgery
often undergo hybrid palliation (HP) as initial surgery. We aimed to
compile the HP experience in HLHS and its variants and assess the rates
of, and risk factors for, death and heart transplantation. METHOD(S):
CINAHL, CINAHL PLUS, PubMed/MEDLINE, and SCOPUS were systematically
searched for HP outcome studies of death or heart transplantation in HLHS
between 1998 and 2022. Pooled incidence was estimated, and potential risk
factors were identified using random-effects meta-analysis and
reconstructed time-to-event data from Kaplan-Meier curves. RESULT(S):
Thirty-three publications were included in our review. Overall, of 1,162
patients 417 died and 57 underwent heart transplantation, resulting in a
combined outcome of 40.7%, (474/1,162). There was a trend toward
decreasing mortality risk across the stages of palliation. Pooled
mortality between HP and comprehensive stage 2 palliation was 25%, after
stage 2 up to Fontan palliation was 16%, and 6% post-Fontan. The incidence
of death or heart transplantation was higher in high-risk patients-43%
died and 10% received heart transplantation. CONCLUSION(S): Our
systematic review and meta-analysis found high rates of death or heart
transplantation in HP of HLHS patients between HP and Fontan surgeries.
All patients should be closely followed during the initial interstage
period, which is associated with the highest hazard. Prospective studies
on appropriate patient selection, indications, and / or alternatives, as
well as refining HP strategies for managing newborns with HLHS are needed
to improve outcomes.

<90>
Accession Number
643588152
Title
CPAP may promote an endothelial inflammatory milieu in sleep apnoea after
coronary revascularization.
Source
EBioMedicine. (pp 105015), 2024. Date of Publication: 16 Feb 2024.
Author
Peker Y.; Celik Y.; Behboudi A.; Redline S.; Lyu J.; Wei Y.; Gottlieb
D.J.; Jelic S.
Institution
(Peker) Koc University School of Medicine, Istanbul, Turkey; University of
Gothenburg, Gothenburg, Sweden; Brigham & Women's Hospital, Boston, MA,
USA; University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;
Lund University, Lund, Sweden
(Celik) Koc University School of Medicine, Istanbul, Turkey; Columbia
University Vagelos College of Physicians and Surgeons, New York, NY, USA
(Behboudi) University of Skovde, Sweden
(Redline) Brigham & Women's Hospital, Boston, MA, United States
(Lyu, Wei) Columbia University Vagelos College of Physicians and Surgeons,
New York, NY, USA
(Gottlieb) Brigham & Women's Hospital, Boston, MA, USA; VA Boston
Healthcare System, Boston, MA, USA
(Jelic) Columbia University Vagelos College of Physicians and Surgeons,
New York, NY, USA. Electronic address: sj366@cumc.columbia.edu
Abstract
BACKGROUND: Continuous positive airway pressure (CPAP) has failed to
reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized
trials. CPAP increases angiopoietin-2, a lung distension-responsive
endothelial proinflammatory marker associated with increased
cardiovascular risk. We investigated whether CPAP has unanticipated
proinflammatory effects in patients with OSA and cardiovascular disease.
 METHOD(S): Patients with OSA (apnoea-hypopnea index [AHI] >=15
events/h without excessive sleepiness) in the Randomized Intervention with
CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or
usual care following coronary revascularization. Changes in plasma levels
of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular
endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor
of advanced glycation end-products [sRAGE]) function from baseline to
12-month follow-up were compared across groups and associations with
cardiovascular morbidity and mortality assessed. FINDINGS: Patients with
OSA (n = 189; 84% men; age 66 +/- 8 years, BMI 28 +/- 3.5 kg/m2, AHI 41
+/- 23 events/h) and 91 patients without OSA participated. Angiopoietin-2
remained elevated whereas VEGF-A declined significantly over 12 months in
the CPAP group (n = 91). In contrast, angiopoietin-2 significantly
declined whereas VEGF-A remained elevated in the usual care (n = 98) and
OSA-free groups. The changes in angiopoietin-2 and VEGF-A were
significantly different between CPAP and usual care, whereas Tie-2, sRAGE
and E-selectin were similar. Greater 12-month levels of angiopoietin-2
were associated with greater mortality. Greater CPAP levels were
associated with worse cardiovascular outcomes. INTERPRETATION: Greater
CPAP levels increase proinflammatory, lung distension-responsive
angiopoietin-2 and reduce cardioprotective angiogenic factor VEGF-A
compared to usual care, which may counteract the expected cardiovascular
benefits of treating OSA. FUNDING: National Institutes of Health/National
Heart, Lung, and Blood Institute; Swedish Research Council; Swedish
Heart-Lung Foundation; ResMed Foundation. Copyright © 2024 The
Author(s). Published by Elsevier B.V. All rights reserved.

<91>
Accession Number
2030632178
Title
Erratum: Correlation between second and first primary cancer: systematic
review and meta-analysis of 9 million cancer patients (British Journal of
Surgery (2024) 111:1 (znad377) DOI: 10.1093/bjs/znad377).
Source
British Journal of Surgery. 111(2) (no pagination), 2024. Article Number:
znae044. Date of Publication: 01 Feb 2024.
Author
Anonymous
Publisher
Oxford University Press
Abstract
This is a corrigendum to: Xinyu Wang, Meiyuan Zeng, Xueming Ju, Anqi Lin,
Chaozheng Zhou, Junyi Shen, Zaoqu Liu, Bufu Tang, Quan Cheng, Youyu Wang,
Jian Zhang, Peng Luo, Correlation between second and first primary cancer:
systematic review and meta-analysis of 9 million cancer patients, British
Journal of Surgery, Volume 111, Issue 1, January 2024, znad377,
https://doi.org/10.1093/bjs/znad377 In the originally published version of
this manuscript, authors Xueming Ju and Youyu Wang's affiliations required
correction. Xueming Ju's affiliation, "Department of Utrasound, Sichuan
Provincial People's Hospital, University of Electronic Science and
Technology of China, Chengdu, China", contained a typographical error.
This has been corrected. Youyu Wang's correct affiliation is "Department
of Thoracic Surgery, Sichuan Provincial People's Hospital, University of
Electronic Science and Technology of China, Chengdu, China". This
affiliation has been added to the manuscript. Subsequent affiliations in
the affiliation list have been renumbered accordingly in view of this
change. Copyright © The Author(s) 2024.

<92>
Accession Number
2014428236
Title
Goal-directed fluid therapy versus restrictive fluid therapy: A
cardiomerty study during one-lung ventilation in patients undergoing
thoracic surgery.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 48-57), 2022. Date of
Publication: 2022.
Author
Zidan M.M.O.M.; Osman H.A.; Gafour S.E.; El Tahan D.A.
Institution
(Zidan, Osman, Gafour, El Tahan) Anaesthesia and Surgical Intensive Care,
Alexandria Faculty of Medicine, Alexandria, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Fluid management during thoracic anaesthesia is a challenge
for the anaesthesiologists. The "safe zone" between volume overload
(pulmonary oedema risk) and hypovolemia (renal failure risk) remains to be
narrow and hard to determine. Purpose(s): The aim of the present
study was to assess goal-directed fluid therapy using cardiometry versus
restrictive fluid therapy during one-lung ventilation in patients planned
for having thoracic surgery. Method(s): After receiving the Ethics
Committee approval and taking an informed written consent, a prospective
randomized study was conducted. Fifty adult patients of both genders were
scheduled for thoracic surgery with one lung ventilation. Patients were
randomly categorized using closed envelope technique into two equal groups
(25 patients each). Group I: a number of 25 patients underwent thoracic
surgery and were managed with goal directed fluid therapy using
intraoperative cardiometry. Group II: a number of 25 patients underwent
thoracic surgery and were managed with intraoperative restrictive fluid
therapy. Result(s): There was a significantly increased serum lactate
level, serum creatinine with decreased urine output in restrictive therapy
group (RT) by the end of the surgery, immediately postoperative and 6 h
postoperative (p value of <0.001). The restrictive hypoxic index values
were much higher than the goal directed group values, yet, both were of
normal range and no patient suffered of lung injury. A significant
increase in serum neutrophil gelatinase-associated lipocalin (Ngal) in the
restrictive therapy group compared to the goal directed therapy group. (p
value of <0.001). Conclusion(s): From these results, we concluded
that patients undergoing thoracic surgery are preferably to be maintained
over goal directed therapy protocol using electrical cardiometry. Fluid
restriction is better to be individualized and aided by new technologies
based on beat-to-beat variations. Copyright © 2021 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<93>
[Use Link to view the full text]
Accession Number
2015904085
Title
Impact of renin-angiotensin system inhibitors after revascularization of
patients with left main coronary artery disease.
Source
Coronary Artery Disease. 31(1) (pp 37-44), 2022. Date of Publication: 01
Jan 2022.
Author
Chen S.; Redfors B.; Serruys P.W.; Pieter Kappetein A.; Crowley A.;
Ben-Yehuda O.; Srdanovic I.; Lembo N.J.; Brown W.M.; Sabik J.F.; Stone
G.W.
Institution
(Chen, Redfors, Crowley, Ben-Yehuda, Srdanovic, Lembo, Stone) Clinical
Trials Center, Cardiovascular Research Foundation, New York, NY, United
States
(Chen, Redfors, Ben-Yehuda, Lembo) NewYork-Presbyterian Hospital, Columbia
University Irving Medical Center, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Serruys) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Serruys) Department of Cardiology, Imperial College of London, London,
United Kingdom
(Pieter Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Ben-Yehuda) Division of Cardiology, University of California - San Diego,
San Diego, CA, United States
(Brown) Piedmont Heart Institute, Atlanta, GA, United States
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Sabik) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is a paucity of data regarding the effect of inhibition
of the renin-angiotensin system on outcomes after percutaneous coronary
intervention (PCI) and coronary artery bypass grafting (CABG). We sought
to examine long-term outcomes of patients with left main coronary disease
(LMCAD) randomized to PCI with fluoropolymer-based cobalt-chromium
everolimus-eluting stents or CABG according to treatment at discharge with
angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor
blockers (ARB) in the large-scale, multicenter, randomized EXCEL trial.
 Method(s): EXCEL randomized 1905 patients with LMCAD of low and
intermediate anatomical complexity (visually-assessed SYNTAX score <=32)
to PCI (n = 948) versus CABG (n = 957). Patients were categorized
according to whether they were treated with ACEI/ARB at discharge; their
outcomes from discharge to 5 years were examined using multivariable
logistic regression with an offset for follow-up time. Result(s):
Among 1775 patients discharged alive with known ACEI/ARB treatment status,
896 (50.5%) were treated with one of these agents. Among those treated
with ACEI/ARB, the 5-year rate of all-cause death was similar after PCI or
CABG (10.7% versus 9.8% respectively, adjOR, 0.94; 95% CI, 0.56-1.57) in
contrast to patients not treated with ACEI/ARB (15.0% versus 7.8%,
respectively, adjOR, 2.20; 95% CI, 1.32-3.67) (Pinteraction = 0.02).
Significant interactions between treatment arm (PCI versus CABG) and
ACEI/ARB treatment status were also found for cardiovascular death
(Pinteraction = 0.03), ischemia-driven revascularization (Pinteraction =
0.03), target vessel revascularization (Pinteraction = 0.007) and target
vessel failure (Pinteraction = 0.0009). Conclusion(s): In the EXCEL
trial, the postdischarge rates of death and revascularization after 5
years were similar after PCI and CABG in patients with LMCAD treated with
ACEI/ARB at discharge. In contrast, event rates were higher after PCI
versus CABG in those not so treated. Copyright © 2021 Wolters
Kluwer Health, Inc. All rights reserved.

<94>
Accession Number
634719942
Title
Comparison of 4-Factor Prothrombin Complex Concentrate with Frozen Plasma
for Management of Hemorrhage during and after Cardiac Surgery: A
Randomized Pilot Trial.
Source
JAMA Network Open. 4(4) (no pagination), 2021. Article Number: e213936.
Date of Publication: 02 Apr 2021.
Author
Karkouti K.; Bartoszko J.; Grewal D.; Bingley C.; Armali C.; Carroll J.;
Hucke H.-P.; Kron A.; McCluskey S.A.; Rao V.; Callum J.
Institution
(Karkouti, Bartoszko, Grewal, Bingley, Carroll, McCluskey) Department of
Anesthesia and Pain Management, University Health Network, Sinai Health
System, Women's College Hospital, University of Toronto, Toronto, ON,
Canada
(Karkouti, Bartoszko, McCluskey, Rao) Peter Munk Cardiac Centre and
Toronto General Hospital Research Institute, University Health Network,
Toronto, ON, Canada
(Armali, Kron, Callum) Department of Laboratory Medicine and Molecular
Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Hucke) Department of Biostatistics, Ergomed Cds GmbH, Cologne, Germany
(Rao) Division of Cardiovascular Surgery, Toronto General Hospital,
University Health Network, University of Toronto, Toronto, ON, Canada
(Callum) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Approximately 15% of patients undergoing cardiac surgery
receive frozen plasma (FP) for bleeding. Four-factor prothrombin complex
concentrates (PCCs) have logistical and safety advantages over FP and may
be a suitable alternative. Objective(s): To determine the proportion
of patients who received PCC and then required FP, explore hemostatic
effects and safety, and assess the feasibility of study procedures.
 Design, Setting, and Participant(s): Parallel-group randomized pilot
study conducted at 2 Canadian hospitals. Adult patients requiring
coagulation factor replacement for bleeding during cardiac surgery (from
September 23, 2019, to June 19, 2020; final 28-day follow-up visit, July
17, 2020). Data analysis was initiated on September 15, 2020.
 Intervention(s): Prothrombin complex concentrate (1500 IU for
patients weighing <=60 kg and 2000 IU for patients weighing >60 kg) or FP
(3 U for patients weighing <=60 kg and 4 U for patients weighing >60 kg),
repeated once as needed within 24 hours (FP used for any subsequent doses
in both groups). Patients and outcome assessors were blinded to treatment
allocation. Main Outcomes and Measures: Hemostatic effectiveness
(whether patients received any hemostatic therapies from 60 minutes to 4
and 24 hours after initiation of the intervention, amount of allogeneic
blood components administered within 24 hours after start of surgery, and
avoidance of red cell transfusions within 24 hours after start of
surgery), protocol adherence, and adverse events. The analysis set
comprised all randomized patients who had undergone cardiac surgery,
received at least 1 dose of either treatment, and provided informed
consent after surgery. Result(s): Of 169 screened patients, 131 were
randomized, and 101 were treated (54 with PCC and 47 with FP), provided
consent, and were included in the analysis (median age, 64 years;
interquartile range [IQR], 54-73 years; 28 [28%] were female; 82 [81%]
underwent complex operations). The PCC group received a median 24.9 IU/kg
(IQR, 21.8-27.0 IU/kg) of PCC (2 patients [3.7%; 95% CI, 0.4%-12.7%]
required FP). The FP group received a median 12.5 mL/kg (IQR, 10.0-15.0
mL/kg) of FP (4 patients [8.5%; 95% CI, 2.4%-20.4%] required >2 doses of
FP). Hemostatic therapy was not required at the 4-hour time point for 43
patients (80%) in the PCC group and for 32 patients (68%) in the FP group
(P =.25) nor at the 24-hour time point for 41 patients (76%) in the PCC
group and for 31 patients (66%) patients in the FP group (P =.28). The
median numbers of units for 24-hour cumulative allogeneic transfusions
(red blood cells, platelets, and FP) were 6.0 U (IQR, 4.0-11.0 U) in the
PCC group and 14.0 U (IQR, 8.0-20.0 U) in the FP group (ratio, 0.58; 95%
CI, 0.45-0.77; P <.001). After exclusion of FP administered as part of the
investigational medicinal product, the median numbers of units were 6.0 U
(IQR, 4.0-11.0 U) in the PCC group and 10.0 U (IQR, 6.0-16.0 U) in the FP
group (ratio, 0.80; 95% CI, 0.59-1.08; P =.15). For red blood cells alone,
the median numbers were 1.5 U (IQR, 0.0-4.0 U) in the PCC group and 3.0 U
(IQR, 1.0-5.0 U) in the FP group (ratio, 0.69; 95% CI, 0.47-0.99; P =.05).
During the first 24 hours after start of surgery, 15 patients in the PCC
group (28%) and 8 patients in the FP group (17%) received no red blood
cells (P =.24). Adverse event profiles were similar. Conclusions and
Relevance: This randomized clinical trial found that the study protocols
were feasible. Adequately powered randomized clinical trials are warranted
to determine whether PCC is a suitable substitute for FP for mitigation of
bleeding in cardiac surgery. Trial Registration: ClinicalTrials.gov
Identifier: NCT04114643. Copyright © 2021 American Medical
Association. All rights reserved.

<95>
Accession Number
633939865
Title
Coronary revascularisation in patients with ischaemic cardiomyopathy.
Source
Heart. 107(8) (pp 612-618), 2021. Date of Publication: 01 Apr 2021.
Author
Ryan M.; Morgan H.; Petrie M.C.; Perera D.
Institution
(Ryan, Morgan, Perera) Cardiovascular Division, King's College London,
London, United Kingdom
(Ryan, Morgan, Perera) Cardiology Department, Guy's and St Thomas'
Hospitals Nhs Foundation Trust, London, United Kingdom
(Petrie) University of Glasgow Institute of Cardiovascular and Medical
Sciences, Glasgow, United Kingdom
(Petrie) Cardiology Department, Golden Jubilee National Hospital,
Clydebank, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Heart failure resulting from ischaemic heart disease is associated with a
poor prognosis despite optimal medical treatment. Despite this, patients
with ischaemic cardiomyopathy have been largely excluded from randomised
trials of revascularisation in stable coronary artery disease.
Revascularisation has multiple potential mechanisms of benefit, including
the reversal of myocardial hibernation, suppression of ventricular
arrhythmias and prevention of spontaneous myocardial infarction. Coronary
artery bypass grafting is considered the first-line mode of
revascularisation in these patients; however, evidence from the Surgical
Treatment of Ischaemic Heart Failure (STICH) trial showed a reduction in
mortality, though this only became apparent with extended follow-up due to
an excess of early adverse events in the surgical arm. There is currently
no randomised controlled trial evidence for percutaneous coronary
intervention in patients with ischaemic cardiomyopathy; however, the
REVIVED-BCIS2 trial has recently completed recruitment and will address
this gap in the evidence. Future directions include (1) clinical trials of
revascularisation in patients hospitalised with heart failure, (2)
defining the role of viability and ischaemia testing in heart failure, (3)
studies to enhance the understanding of the mechanistic effects of
revascularisation and (4) generating models to refine pre-and
post-revascularisation risk prediction. Copyright ©

<96>
Accession Number
2015943053
Title
Long-term prognostic value of stress myocardial perfusion echocardiography
in patients with coronary artery disease: a meta-analysis.
Source
European Heart Journal Cardiovascular Imaging. 22(5) (pp 553-562), 2021.
Date of Publication: 01 May 2021.
Author
Qian L.; Xie F.; Xu D.; Porter T.R.
Institution
(Qian, Xu) Department of Geriatrics, First Affiliated Hospital, Nanjing
Medical University, Nanjing, China
(Xie, Porter) Division of Cardiovascular Medicine, University of Nebraska,
Medical Center, Omaha, NE 69198-1165, United States
Publisher
Oxford University Press
Abstract
Aims : To evaluate the prognostic value of myocardial perfusion (MP)
imaging during contrast stress echocardiography (cSE) in patients with
known or suspected coronary artery disease (CAD). Methods and results : A
search in PubMed, Embase databases, and the Cochrane library was conducted
through May 2019. The Cochran Q statistic and the I2 statistic were used
to assess heterogeneity, and the results were analysed by RevMan V5.3 and
Stata V15.1 software. Twelve studies (seven dipyridamole and five
exercise/dobutamine) without evidence of patient overlap (same institution
publishing results over a similar time period) enrolling 5953 subjects
(47% female, 8-80 months of follow-up) were included in the analysis. In
all studies, total adverse cardiovascular events were defined as either
cardiac death, non-fatal myocardial infarction (NFMI), or need for urgent
revascularization. Hazard ratios (HRs) revealed that a MP abnormality
[pooled HR 4.75; 95% confidence interval (CI) 2.47-9.14] was a higher
independent predictor of total events than abnormal wall motion (WM,
pooled HR 2.39; 95% CI 1.58-3.61) and resting left ventricular ejection
fraction (LVEF, pooled HR 1.92; 95% CI 1.44-2.55) with significant
subgroup differences (P = 0.002 compared with abnormal WM and 0.01
compared with abnormal LVEF). Abnormal MP was associated with higher risks
for death [Risk ratio (RR) 5.24; 95% CI 2.91-9.43], NFMI (RR 3.09; 95% CI
1.84-5.21), and need for coronary revascularization (RR 16.44; 95% CI
6.14-43.99). Conclusion : MP analysis during stress echocardiography is an
effective prognostic tool in patients with known or suspected CAD and
provides incremental value over LVEF and WM in predicting clinical
outcomes. Copyright © 2020 Published on behalf of the European
Society of Cardiology.

<97>
Accession Number
643578845
Title
Strategy To Optimize PeriproCeduraL AnticOagulation in Structural
Transseptal Interventions: Design and rationale of the STOP CLOT Trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 22
Feb 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) National Institute of Cardiology, Warsaw, Poland
(Pracon, Mioduszewska, Skowronski, Stoklosa, Firek, Marczak, Milosz,
Chmielak, Demkow, Witkowski) National Institute of Cardiology, Warsaw,
Poland
(Sondergaard) Abbott, Santa Clara, California, USA
(Mintz) Cardiovascular Research Foundation, NY, United States
(Capodanno) 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, Poland
(Franco) Hospital Clinico San Carlos, Madrid, Spain
Abstract
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. 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 100Units/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 100Units/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 2-5 days after the
procedure. The safety endpoint is the occurrence of moderate or severe
bleeding complications during the index hospitalization. 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. Copyright © 2024.
Published by Elsevier Inc.

<98>
Accession Number
643578383
Title
Dexmedetomidine and acute kidney injury after non-cardiac surgery: a
meta-analysis with trial sequential analysis.
Source
Anaesthesia, critical care & pain medicine. (pp 101359), 2024. Date of
Publication: 21 Feb 2024.
Author
Zhuang K.; Yang H.-T.; Long Y.-Q.; Liu H.; Ji F.-H.; Peng K.
Institution
(Zhuang, Yang, Long, Ji, Peng) Department of Anaesthesiology, First
Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China;
Institute of Anaesthesiology, Soochow University, Suzhou, Jiangsu, China
(Liu) Department of Anaesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication after
surgery and is associated with detrimental outcomes. This systematic
review and meta-analysis evaluated perioperative dexmedetomidine on AKI
and renal function after non-cardiac surgery. METHOD(S): PubMed,
Embase, and Cochrane Library databases were searched until August 2023 for
randomised trials comparing dexmedetomidine with normal saline on AKI and
renal function in adults undergoing non-cardiac surgery. The primary
outcome was the incidence of AKI (according to Kidney Disease Improving
Global Outcomes or Acute Kidney Injury Network criteria). Meta-analysis
was performed using a random-effect model. We conducted sensitivity
analysis, trial sequential analysis (TSA), and Grading of Recommendations
Assessment, Development and Evaluation level of evidence. RESULT(S):
Twenty-three trials involving 2440 patients were included. Dexmedetomidine
administration, as compared to normal saline, significantly reduced the
incidence of AKI (7.4% vs. 13.2%; risk ratio=0.57, 95% CI=0.40 to 0.83, P=
0.003, I2=0%; a high level of evidence); TSA and sensitivity analyses
suggested the robustness of this outcome. For the renal function and
inflammation parameters, dexmedetomidine decreased serum creatinine, blood
urea nitrogen, cystatin C, tumour necrosis factor-alpha, and
interleukin-6, and increased urine output and estimated glomerular
filtration rate. Additionally, dexmedetomidine reduced postoperative
nausea and vomiting and length of hospital stay. Dexmedetomidine was
associated with an increased rate of bradycardia, but not hypotension.
 CONCLUSION(S): Dexmedetomidine administration reduced the incidence
of AKI and improved renal function after non-cardiac surgery. Based on a
high level of evidence, dexmedetomidine is recommended as a component of
perioperative renoprotection. REGISTRATION: International Prospective
Register of Systematic Reviews; Registration number:
CRD42022299252. Copyright © 2024. Published by Elsevier Masson
SAS.

<99>
Accession Number
643569134
Title
Transapical Off-Pump Mitral Valve Repair With Neochord Implantation: A
Systematic Review.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Ahmed A.
Institution
(Ahmed) Ain Shams University, Cairo, Egypt
Publisher
Galenos Publishing House
Abstract
Introduction: Mitral valve repair (MVr) is the gold standard for the
treatment of degenerative mitral valve regurgitation (MR). The recently
introduced NeoChord DS1000 has gained increasing recognition as a
feasible, potentially safe, and effective procedure with minor
complications and promising outcomes. This study aims to conduct a
systematic review of the published literature that discusses the technical
feasibility and outcome of transapical off-pump MVr with NeoChord DS1000
device implantation in the treatment of degenerative MR. Method(s):
This review was performed according to the PRISMA statement. Databases
searched in this review included Pubmed, Web of Science, Scopus, and
Cochrane databases for systematic reviews. All English articles on humans
reporting isolated MVr using NeoChord DS1000 device were included provided
that basic preoperative data, operative specifications, and postoperative
mortality and morbidity were reported. Result(s): This review
included six studies comprised 249 patients who had NeoChord mitral
procedure. Almost all patients included had severe MR (243/249, 97.6%).
Operative success was achieved in 241 out of the 249 patients (96.8%). No
intraoperative mortality was reported. Intraoperative arrhythmia was
reported in six patients (2.4%) and significant bleeding was reported in
eight patients (3.2%). Conclusion(s): Awaiting more evidence,
NeoChord mitral procedure appears to be a promising procedure that can be
considered in selected cases.

<100>
Accession Number
643569018
Title
Minimizing The Need For Intraoperative Blood Transfusion In Three
Different Ways Comparatively In Coronary By-Pass Surgery Patients Using
Pre-Op Acetylsalicylic Acid.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Yurtman V.; Bayezid O.
Institution
(Yurtman, Bayezid) AntalyaTurkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE The decrease in platelet counts and aggregation abilities after
cardiopulmonary bypass is an important cause of postoperative bleeding. On
the other hand, aspirin, which is routinely used in coronary artery
disease, increases hemorrhagic diathesis by affecting platelet functions
even one week after the last dose is taken. In this study, it was planned
to compare the effects of desmopressin acetate and autologous blood
transfusion in coronary bypass operations performed under the influence of
aspirin in patients with the same demographic data, individually and
together with normal patients, and to evaluate prospectively in terms of
bleeding and transfusion need in the early postoperative period. METHODS
Three different types of peri-op intervention were planned in order to
reduce the blood transfusion need of these groups as much as possible by
prospectively following up 120 coronary artery graft patients who were
operated while under the influence of ASA. According to Magovern
transfusion risk scoring, 120 patients from three different risk groups
(40 patients from each group) were planned to be evaluated. It was planned
to divide these 40-person groups equally into four(3 study + 1 control)
groups. Magovern Transfusion Risk Scoring System Emergency 4 Cardiogenic
shock 3 Priority 3 Body mass index<24 2 Left ventricular EF<30% 2 Age>74 2
Woman 2 Red cell mass<1500mL 2 Diabetes 1 Peripheral vascular disease 1
Creatinine >1.8mg/dL 1 Albumin<4gr/dL 1 Reoperation 1 Low risk group <2
points Intermediate risk group 2-6 points High risk group >6 points
Treatment was planned in accordance with the following algorithm for the
patients in three different risk groups, which were divided into four,
together with the control group. Prospective Study Algorithm Group I
:Transfusion score group I: <2 points Gruop II :Transfusion score group
II: 2-6 points GroupIII :Transfusion score group III: >6 points Group A:
Desmopressin administered group Group B: Autologous blood transfusion
group Group C: Desmopressin + Autologous blood transfusion group Group D:
Control group Patients were continued to be included in the study until
the required number of patients was reached. In this way, 172 patients
were included in the study. Thus, a total of 120 patients were randomly
determined for 3 different risk groups. RESULTS Age and gender
distributions of the patients who were operated on in all groups were
similar. There was no statistically significant difference between pre-op
PT and aPTT values. In addition, there was no significant difference
between the groups in terms of discontinuing the use of acetylsalicylic
acid on a daily basis. There was no statistically significant difference
between pre-op, post-op 6th hour, post-op 24th hour, post-op 1st month and
post-op 6th month values in all groups within the same period. It was
observed that the long-term recovery process and therefore the morbidity
were the same in all three blood preservation methods compared to each
other and to the control group. No statistically significant difference
was found in the first three groups (A, B, C) in which blood preservation
techniques were applied compared to the control group in terms of urine
follow-up and total urine output. There was a statistically significant
difference in the use of RBC and TDP in the first three groups(A, B, C) in
which blood preservation techniques were applied compared to the control
group. Significant difference in P value was found for Group D(P =
<0.001). There was a statistically significant difference in the first
three groups (A, B, C) in which blood preservation techniques were applied
compared to the control group in terms of surgical bleeding in the
intensive care unit. Significant difference in P value was found for Group
D(P = <0.001). CONCLUSIONS Non-surgical bleeding complication with
extracorporeal circulation; It may be due to heparin, platelets and
fibrinolysis. Insufficiency of coagulation factors is rarely encountered
as a cause of bleeding during and after open heart surgery. Today, the use
of homologous blood products is becoming increasingly limited due to both
side effects and availability. For this reason, alternative and blood
preservation methods should be developed in order to reduce the use of
blood and to perform bloodless surgery if necessary.

<101>
Accession Number
643569005
Title
Current perspectives on venous grafts in cardiac surgery: Focus on
long-term patency.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Kaleda V.
Institution
(Kaleda) Prof. Anatoly Molochkov Central Clinical Hospital, Russian
Federation
Publisher
Galenos Publishing House
Abstract
Background: Despite the increasing evidence of the superiority of arterial
grafts in coronary artery bypass grafting surgery (CABG), venous grafts
are still the most popular ones: about 95% of CABG cases utilize at least
one venous graft. Hence, techniques to improve vein graft patency are
extremely important. Method(s): We present a review of the literature
on various current approaches to improve early and late results of venous
grafting in cardiac surgery. Result(s): Among the methods used to
improve the results of venous grafting there are medical therapy, vein
preservation solutions, arteriovenous composites, endoscopic vein
harvesting, no-touch vein harvesting, and others. Conclusion(s):
There is vast room for approaches to improve the results of venous
grafting, with the most effective, probably, a combination of several
techniques. Endoscopic no-touch vein harvesting is one of the most
demanding techniques. However, its' main limitation is the absence of
dedicated instrumentation.

<102>
Accession Number
643569004
Title
Perioperative Use Of Levosimendan In Patients With Severe Left Ventricular
Dysfunction Undergoing Cardiac Surgery: A Systematic Review And
Metaanalysis.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Ahmed A.
Institution
(Ahmed) Ain Shams University, Cairo, Egypt
Publisher
Galenos Publishing House
Abstract
Background: Levosimendan is a calcium-sensitizing ionodilator. However,
the current level of clinical evidence is insufficient to determine the
clinical value of levosimendan in patients with severe left ventricular
dysfunction subjected to cardiac surgery. The aim of this meta-analysis to
provide an update of the current clinical evidence regarding the clinical
value of perioperative levosimendan use in adult patients with severe
cardiac dysfunction subjected to cardiac surgery. Method(s): This
meta-analysis was performed according to PRISMA statement. Databases
searched included Pubmed, Web of Science, Scopus and Cochrane databases
for systematic reviews. Search keywords were extracted from initially
retrieved articles and comprised "levosimendan" and "cardiac surgery"
using the Boolean search operator AND. The reported outcomes included
early mortality, development of atrial fibrillation, acute kidney injury
and/or renal replacement therapy, postoperative myocardial infarction,
hypotension and low cardiac output syndrome. Aim of the work: The aim of
this meta-analysis to provide an update of the current clinical evidence
regarding the clinical value of perioperative levosimendan use in adult
patients with severe cardiac dysfunction subjected to cardiac surgery.
 Result(s): The present meta-analysis showed significant association
between levosimendan use and significant reduction of perioperative low
cardiac output syndrome [OR (95% CI): 0.60 (0.44-0.82), p=0.001], renal
injury and/or renal replacement therapy [OR (95% CI): 0.51 (0.30-0.86),
p=0.01]. Also, levosimendan use was associated with a marginal trend
towards lower mortality [OR (95% CI): 0.64 (0.39-1.03), p=0.07].
 Conclusion(s): Levosimendan use is associated with reduction of
perioperative low cardiac output syndrome and renal injury and/or renal
replacement therapy.

<103>
Accession Number
643568998
Title
Management of Coronary Artery Bypass Graft Operation in a Patient with
Romatoid Arthritis.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Ozer S.F.; Altinbas O.; Isik M.
Institution
(Ozer) Karaman Training and Research Hospital, Turkey
(Altinbas) Gaziantep University, Turkey
(Isik) Konya Necmettin Erbakan University, Turkey
Publisher
Galenos Publishing House
Abstract
OBJECTIVE: Romatoid arthritis is a kind of inflammatory disease
characterized by systemic and joint manifestations. Females are affected
more than males. Its association with coronary artery disease is well
established in the literature. In this study we aimed to report the
management of a patient with romatoid arthritis underwent coronary artery
bypass graft operation (CABG). METHOD(S): A 55 year old woman was
evaluated with the complaint of chest pain. She was diagnosed with
romatoid arthritis for ten years and her medication includes sulfasalazine
and a non steroid antiinflammatory drug (NSAID). Coronary angiography
revealed 90%< stenosis in LAD, Cx and RCA. There was no additional cardiac
pathology and ejection fraction was 55%. CABG was decided. NSAID was
stopped and sulfasalazine was continued before operation. RESULT(S):
CABG was performed with the anastomosis of LIMA-LAD, Ao-Cx andAo-RCA. The
patient was extubated on the operation day and stayed 2 days in intensive
care unit. Sulfasalazine was admitted as soon as the patient's oral intake
started. She was discharged on postoperative 5th day without any
complication. CONCLUSION(S): Management of the chronic inflammatory
diseases requires attention not only in terms of medication but also
probable accompanied disorders. Rheumatid arthritis affects many organs
and systems. Cardiovascular system is one of the systems involved in
rheumatoid arthritis. A meta-analysis of 14 studies involving 41,490
patients with RA revealed that the risk of CVD increases by 48% and the
risk of myocardial infarction increases by 68%. Inflammatory mediators
produced by the synovium destroy the vascular endothelial cells and alter
lipid distribution and insulin resistance. Blood pressure also affected by
these mediators. Progression of atherosclerosis occurs as the result of
these processes. Therefore it is important to keep on mind that patients
with romatoid arthritis may be a candidate for coronary artery disease and
routine follow up is vital. One of the medications given in rheumatoid
arthritis is sulfasalazine and it must be continued until operation time
and started as soon as possible in early postoperative period due to its
cardioprotective effects.

<104>
Accession Number
643568995
Title
A Rare Cause of Anemia In a Patient With Mechanical Prosthetic Valve:
Ancylostoma Duodenale.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Hasirci S.H.; Karacaglar E.; Tseveldorj N.
Institution
(Hasirci, Karacaglar) Baskent University, Department of Cardiology, Turkey
(Tseveldorj) Baskent University, Department of Gastroenterology, Turkey
Publisher
Galenos Publishing House
Abstract
A 61-year-old male patient with the diagnosis of mechanical prosthetic
aortic valve, mechanical prosthetic mitral valve and tricuspid-plasty in
cardiology follow-up. The patient using warfarin had an INR between 2.5
and 3.5, and the patient had no active complaints. In the patient's
history, he was operated in 2014 due to thrombus in the mitral valve, the
thrombus was cleared, and his left atrial appendage was closed. In April
2023, the patient applied to the Emergency Department with the complaints
of exertional dyspnea and fatigue His Hemoglobin: 6.5 mg/dl so the patient
was given 2 Unit erythrocyte suspension and hospitalized by
Gastroenterology. Warfarin treatment of the patient with INR:3.8 was
discontinued and low molecular weight heparin 2*0.6 cc was started.
Erythematous Gastritis was reported as a result of upper gastrointestinal
endoscopy, and colonoscopy was reported as normal. Hematology evaluated
the patient and as a result of the tests performed, it was reported as
LDH: 661 mg/dl, Haptoglobulin <8 mg/dl, Total Bilirubin: 1.5 mg/dl, Direct
Bilirubin: 0.48 mg/dl PNH: negative. Hemolysis due to prosthetic valve was
considered in the patient and they referred the patient to the Cardiology
Polyclinic. As a result of transesophageal echocardiography, in mitral
position compatible with monoleaflet prosthetic valve (mean gradient: 10.2
mmHg), valvular mild mitral regurjitation, monoleaflet aortic mechanical
valve (mean gradient: 20 mmHg), and no vegetation or thrombus on the
valves were observed (Figure 1A). Although the patient was laboratory
compatible, we did not consider hemolysis in the patient who did not have
a significant increase in valve gradients according to previous
echocardiography and transesophageal echocardiography results. We
reconsidered with gastroenterology and had the patient undergo capsule
endoscopy. Ancylostoma duodenale was observed in the patient and Pyrantel
Pamoat was started (Figure 1B). The patient does not currently have any
active complaints. His Hemoglobin values were around 11 mg/dl in the
follow-up, and he was re-coumadinized (Figure Presented).

<105>
Accession Number
643568923
Title
Assessment of Gender Diversity among Authors in the Journal of Turkish
Thoracic and Cardiovascular Surgery Publications.
Source
E Journal of Cardiovascular Medicine. Conference: 18th International
Congress of Update in Cardiology and Cardiovascular Surgery. Ankara
Turkey. 10(1) (no pagination), 2022. Date of Publication: 2022.
Author
Ozsoy A.; Karademir B.C.; Adademir T.
Institution
(Ozsoy) Yeditepe University, Faculty of Medicine, Istanbul, Turkey
(Karademir, Adademir) University of Health Sciences, Kosuyolu Heart and
Research Hospital, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
Background: The number of female cardiovascular surgeons has been steadily
increasing over the years in Turkey. The number of female members in the
Turkish Society of Cardiovascular Surgery was 57 (6.95% of the total
number of surgeons) in 2010 and increased to 321 (13.97%) in 2022. It is
unknown whether the contribution of female cardiovascular surgeons to the
scientific literature has paralleled this increase. The aim of our study
is to elucidate the proportion of female physician contributions in the
publications of the Turkish Journal of Thoracic and Cardiovascular
Surgery. Method(s): Between 2010 and 2022, a comprehensive review was
conducted on the original articles, reviews, and case reports published in
the Turkish Journal of Thoracic and Cardiovascular Surgery, focusing
specifically on the field of cardiovascular surgery. The analysis involved
determining the total number of authors, differentiating between female
and male authors, and documenting whether female authors held positions as
either the first or last author. In cases where gender identification
based on names was inconclusive (unisex names), gender verification was
performed by accessing the official websites of the authors' affiliated
institutions. Authors who were not cardiovascular surgeons, publications
in the field of thoracic surgery, and articles submitted from sources
outside of Turkey were excluded from the study. Result(s): A total of
1,112 publications from the Turkish Journal of Thoracic and Cardiovascular
Surgery were included in the study, encompassing 4,393 authors. Among
these authors, 6.65% (n=292) were female. Female authors were identified
as the first author in 65 articles (5.85%) and as the last author in 48
articles (4.31%). The summary of female surgeon representation within the
Turkish Society of Cardiovascular Surgery, including overall contributions
and proportions of first and last authorship among women, is presented in
Table 1. Conclusion(s): Despite the increasing number of female
surgeons, it is observed that the contribution of female surgeons in
publications remains relatively stable and lags behind the overall
proportion. The reasons for the relatively low contribution of female
authors to scientific literature should be examined, and authors should be
encouraged to contribute more to the field of science (Figure Presented).

<106>
Accession Number
643569721
Title
A Knowledge Chasm: Preoperative Mental Illness Impact on New Onset
Postoperative Atrial Fibrillation.
Source
Journal of Clinical and Translational Science. Conference: Association for
Clinical and Translational Science, ACTS 2022. Chicago, IL United States.
6(Supplement 1) (pp 48), 2022. Date of Publication: April 2022.
Author
Kolba N.; Shroyer A.L.W.; Bilfinger T.
Institution
(Kolba, Shroyer, Bilfinger) Stony Brook University, School of Medicine,
United States
Publisher
Cambridge University Press
Abstract
OBJECTIVES/GOALS: To date, no reviews have been published combining the
topics of pre-operative mental illness and postoperative atrial
fibrillation (POAF). For adult cardiac surgical procedures, therefore,
this scoping review provides an overview of the published evidence for
this novel topic. METHODS/STUDY POPULATION: A combination of MESH terms
and text words were used to capture all papers analyzing any risk factors
for atrial fibrillation development after any cardiovascular surgery, and
thus, 4,203 search results were initially identified. Papers were manually
screened for relevance, resulting in 69 articles that analyzed risk
factors associated with POAF. As a separate analytical step, all included
publications were used to identify additional citations and Web of Science
PubMed identification number-based (i.e., PMID) specific backwards
citation searches were performed to ensure comprehensive coverage. For
each of the three articles analyzed, moreover, these PMIDs were further
evaluated using individual google scholar searches to assure no other
relevant literature was inadvertently found. RESULTS/ANTICIPATED RESULTS:
For the 69 relevant articles found with multivariable risk models
predicting new onset POAF during this scoping review, a wide variety of
patient risk factors were reported. The statistically significant
predictors reported for new POAF included age (57 papers), hypertension
(22 papers), tobacco use (15 papers), LVEF-related characteristics (14
papers), COPD (13 papers), and patient gender (13 papers). All other
factors were found to be significant 10 times or fewer; importantly, no
multivariable models evaluated mental illness-related factors as
predictors of new onset POAF. Only 3 articles even considered the
potential influence of mental illnesses. DISCUSSION/SIGNIFICANCE: Mentally
ill patients have been documented to have increased incidence of
cardiovascular disease and adverse cardiac outcomes, however, very few
articles evaluated mental illness associations with POAF. This
comprehensive review has demonstrated the urgent need for new research
focused on mental illness impacts.

<107>
Accession Number
643569194
Title
OUTCOMES OF PATIENTS CONFIRMED WITH COVID-19 INCIDENTALLY AFTER CARDIAC
SURGERY.
Source
E Journal of Cardiovascular Medicine. Conference: 17th International
Congress of Update in Cardiology and Cardiovascular Surgery. Virtual. 9(1)
(no pagination), 2021. Date of Publication: 2021.
Author
Dogan O.F.; Abacilar A.F.; Duman U.
Institution
(Dogan) Adiyaman University, School of Medicine, Adiyaman, Turkey
(Abacilar) Izmir Ozel Su hastanesi, Izmir, Turkey
(Duman) Tekirdag Ozel yasam Hastanesi, Tekirdag, Turkey
Publisher
Galenos Publishing House
Abstract
Background: The rate of acute respiratory distress syndrome (ARDS), and
mortality after cardiac surgery in patients confirmed with Covid-19 were
50%, and 38%, respectively. Our aim of this study was to investigate
clinical outcomes of cardiac surgery in patients who diagnosed Covid-19
incidentally in the early postoperative period. Patients and Methods:
We performed 826 open cardiac surgery in 5 tertiary centers. The most of
the surgeries were elective coronary artery by-pass grafting (CABG) (93.8
%). Preoperative RT-PCR test was performed routinely prior to surgery in
all centers. Transcutaneous oxygen saturation, and if we need respiratory
function tests were performed preoperatively. It was also investigated
whether the patients had received covid-19 treatment before diagnosis of
cardiac disease. We questinered whether these patients had family members
confirmed with covid-19. In addition, it was questionered whether patients
had contact with the patient diagnosed with Covid-19 10-14 days before
hospitalization for cardiac disorders. We analysed blood high
sensitive-C-reactive protein (hs-CRP), d-dimer and fibrinogen which play
the main role of activation of procoagulant state after surgeries. We
performed on-pump or off-pump technique in surgery. Result(s): Acute
lung injury related to Covid-19 activation without hemodynamic instability
was observed in 48 out of 826 patients after surgery (5.8 %). Most common
symptoms were dyspnea, tachypnea with a low oxygen saturation. We
performed diagnostic tests include arterial blood gas analyses, laboratory
analyses, chest X-ray, echocardiography, and RT-PCR test. RT-PCR test
results were positive in 29 out of 48 patients (60.4%). We performed
thoracal CT in patients who had normal laboratory tests, echocardiographyc
analyses, and chest X-ray with negative RT-PCR test results, Thoracal
computed tomography (CT) images showed that there was an acute respiratory
distress syndrome (ARDS) with thypical lung involvement by the virus in 19
patients who had negative RT-PCR test results. The median age of patients
was 63.9+/-12.4 years. Euro-Score and Body Mass Index (BMI) in 48 patients
were 6.1+/-1.1, and 29.2+/-4.1kg/m2, respectively. The median
time of extracorporeal circulation (ECC) was 93.2+/-14.6 min. in patients
underwent on-pump surgery (IQR, 68-155). Eleven patients who had ARDS
readmitted to intensive care unit (ICU) (22.9 %). Blood gas analyses
demonstrated that oxygen saturation, FiO2, and PaO2 were significantly
low, and lactate levels were high in readmitted patients than those of the
nonreadmitted patients. Blood lactate levels were mild to moderately
elevated (>=4mmol/L) without metabolic acidosis. Mortality rate was 54.5%
of readmitted patients (6 out of 11 readmitted patients).
 Conclusion(s): Should keep in mind that ARDS related to Covid-19
activation after cardiac surgery may develop if the virus is latent
period. This may be due to negative effects of ECC which may triggered
ARDS itself on immunologic disorders. We need prospective randomized
clinical trial to explain the rate of Covid-19 activation in this unique
group.

EPICORE Embase Updates

Saturday, March 9, 2024

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

No comments:

Post a Comment

Followers

Blog Archive

About Me