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<1>
Accession Number
2031227223
Title
Foetomaternal Outcomes in Pregnant Women with Corrected vs Non corrected
Heart Disease: A Cross-sectional Analysis at a Tertiary Care Institute of
Eastern India.
Source
Journal of Clinical and Diagnostic Research. 18(3) (pp QC01-QC04), 2024.
Date of Publication: 01 Mar 2024.
Author
Debbarma K.; Bandyopadhyay S.; Roychoudhury B.; Mondal S.; Singh N.; Roy
R.
Institution
(Debbarma, Bandyopadhyay, Roychoudhury) Department of Obstetrics and
Gynaecology, IPGME&R and SSKM Hospital, West Bengal, Kolkata, India
(Mondal) Department of Cardiology, IPGME&R and SSKM Hospital, West Bengal,
Kolkata, India
(Singh, Roy) Department of Obstetrics and Gynaecology, ESI-PGIMSR and ESIC
MC, Joka, West Bengal, Kolkata, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Cardiac disease in pregnancy remains a major concern,
particularly in developing countries like India. Pregnancy in women with
heart disease increases the risk of maternal and foetal complications.
Approximately 1% to 4% of pregnant women have concomitant cardiac disease.
<br/>Aim(s): To examine the foetomaternal outcomes of pregnant women in
the corrected vs. non corrected heart disease groups. <br/>Material(s) and
Method(s): This was a cross-sectional study conducted in the Department of
Obstetrics and Gynaecology at IPGME&R, Kolkata, West Bengal, India, from
February 2020 to July 2021. A total of 50 pregnant women were included in
the present study, with 25 in the corrected heart disease group and 25 in
the non corrected heart disease group. Foetomaternal outcomes, including
intrapartum complications, maternal intensive care unit admission, mode of
delivery, and foetal complications, were observed. Comparative analyses
were conducted using the Student's t-test and Chi-square test. The
p-values <0.05 was considered statistically significant. <br/>Result(s):
Data from the present study showed that out of a total of 50 pregnant
women with heart disease, the majority (60%) were young (<=25 years).
Approximately 48% of women were in their second pregnancy. The most common
cardiac lesion in the corrected group was closure of Atrial Septal Defect
(ASD) in 8 (16%) cases, while in the non corrected group, the most common
was mitral regurgitation in 11 (22%) cases. In the corrected heart disease
group, 15 (30%) had a caesarean section and 10 (20%) delivered vaginally,
whereas in the non corrected group, 17 (34%) had a caesarean section and 8
(16%) delivered vaginally. Adverse cardiac events occurred in 2 (4%) of
the corrected group, whereas 11 (22%) were observed in the non corrected
group (p-value=0.0088, significant). Preterm birth and low birth weight
babies were more common in the non corrected heart disease group
(p-value=0.0449, significant). <br/>Conclusion(s): The study concludes
that most women with cardiac disease are young. Compared to the Corrected
Group of Heart Disease (CGHD), the non corrected group of pregnant women
are more likely to experience severe cardiac complications and require
admission to the intensive care unit. The foetomaternal outcome is better
in the corrected group. Successful management of pregnant women with heart
disease requires a comprehensive multidisciplinary approach to optimise
foetomaternal outcomes.<br/>Copyright &#xa9; 2024 JCDR Research and
Publications Pvt Ltd. All rights reserved.

<2>
Accession Number
2030994894
Title
Transfemoral transcatheter aortic valve replacement with
VitaFlow^TM valve for pure native aortic regurgitation in
patients with high surgical risk: Rationale and design of a prospective,
multicenter, and randomized SEASON-AR trial.
Source
American Heart Journal. 271 (pp 76-83), 2024. Date of Publication: May
2024.
Author
Zhang J.; Kong X.-Q.; Gao X.-F.; Chen J.; Chen X.; Li B.; Shao Y.-B.; Wang
Y.; Jiang H.; Zhu J.-C.; Zhang J.-J.; Chen S.-L.
Institution
(Zhang, Kong, Gao, Zhu, Zhang, Chen) Department of Cardiology, Nanjing
First Hospital, Nanjing Medical University, Nanjing, China
(Chen, Jiang) Department of Cardiology, Renmin Hospital of Wuhan
University, Wuhan University, Wuhan, China
(Chen, Wang) Department of Cardiology, Xiamen Cardiovascular Hospital,
Xiamen University, Xiamen, China
(Li) Department of Cardiology, Zibo Central Hospital, Zibo, China
(Shao) Department of Cardiology, Qingdao Municipal Hospital, Qingdao,
China
Publisher
Elsevier Inc.
Abstract
Background: Previous studies primarily demonstrated that transfemoral
transcatheter aortic valve replacement (TAVR) with self-expanding valve
appeared to be a safe and feasible treatment for patients with pure native
aortic regurgitation (AR). However, the routine application of
transfemoral TAVR for pure AR patients lacks support from randomized
trials. Trial design: SEASON-AR trial is a prospective, multicenter,
randomized, controlled, parallel-group, open-label trial, involving at
least 20 sites in China, aiming to enroll 210 patients with pure native
severe AR and high surgical risk. All enrolled patients are randomly
assigned in a 1:1 fashion to undergo transfemoral TAVR with
VitaFlow^TM valve and receive guideline-directed medical therapy
(GDMT) or to receive GDMT alone. The primary endpoint is the rate of major
adverse cardiac events (MACE) at 12 months after the procedure, defined by
the composite of all-cause mortality, disabling stroke, and
rehospitalization for heart failure. The major secondary endpoints
encompass various measures, including procedure-related complications,
device success, 6-minute walk distance, and the occurrence of each
individual component of the primary endpoint. After hospital discharge,
follow-up was conducted through clinical visits or telephone contact at 1,
6, and 12 months. The follow-up will continue annually until 5 years after
the index procedure to assess the long-term outcomes. <br/>Conclusion(s):
SEASON-AR trial is the first study designed to investigate the clinical
efficacy and safety of transfemoral TAVR with a self-expanding valve in
patients with pure native severe AR with inoperable or high-risk, as
compared to medical treatment only.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<3>
Accession Number
2030917213
Title
Paclitaxel-Coated Balloon vs Uncoated Balloon for Coronary In-Stent
Restenosis: The AGENT IDE Randomized Clinical Trial.
Source
JAMA. 331(12) (pp 1015-1024), 2024. Date of Publication: 26 Mar 2024.
Author
Yeh R.W.; Shlofmitz R.; Moses J.; Bachinsky W.; Dohad S.; Rudick S.;
Stoler R.; Jefferson B.K.; Nicholson W.; Altman J.; Bateman C.;
Krishnaswamy A.; Grantham J.A.; Zidar F.J.; Marso S.P.; Tremmel J.A.;
Grines C.; Ahmed M.I.; Latib A.; Tehrani B.; Abbott J.D.; Batchelor W.;
Underwood P.; Allocco D.J.; Kirtane A.J.
Institution
(Yeh) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Shlofmitz) St Francis Hospital, Roslyn, NY, United States
(Moses, Kirtane) Columbia University, Irving Medical Center,
NewYork-Presbyterian Hospital, Cardiovascular Research Foundation, New
York, United States
(Bachinsky) University of Pittsburgh Medical Center, Harrisburg, PA,
United States
(Dohad) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Rudick) Lindner Center for Research and Education at Christ Hospital,
Cincinnati, OH, United States
(Stoler) Baylor Scott and White Heart and Vascular Hospital, Dallas, TX,
United States
(Jefferson) HCA Tristar Centennial Medical Center, Nashville, TN, United
States
(Nicholson) Emory University Hospital, Atlanta, GA, United States
(Altman) St Anthony Hospital, Denver, CO, United States
(Bateman) South Denver Cardiology, Littleton, CO, United States
(Krishnaswamy) Cleveland Clinic Foundation, Cleveland, OH, United States
(Grantham) St Luke's Hospital of Kansas City, Kansas City, MO, United
States
(Zidar) Austin Heart, Austin, TX, United States
(Marso) Overland Park Regional Medical Center, Overland Park, KS, United
States
(Tremmel) Stanford University Medical Center, Stanford, CA, United States
(Grines) Northside Hospital Cardiovascular Institute, Atlanta, GA, United
States
(Ahmed) University of Alabama at Birmingham, United States
(Latib) Montefiore Medical Center, Albert Einstein College of Medicine,
Bronx, NY, United States
(Tehrani, Batchelor) The Inova Schar Heart and Vascular Institute, Falls
Church, VA, United States
(Abbott) Lifespan Cardiovascular Institute, Rhode Island Hospital,
Providence, United States
(Underwood, Allocco) Boston Scientific Corp, Marlborough, MA, United
States
Publisher
American Medical Association
Abstract
Importance: Drug-coated balloons offer a potentially beneficial treatment
strategy for the management of coronary in-stent restenosis. However, none
have been previously evaluated or approved for use in coronary circulation
in the United States. <br/>Objective(s): To evaluate whether a
paclitaxel-coated balloon is superior to an uncoated balloon in patients
with in-stent restenosis undergoing percutaneous coronary intervention.
<br/>Design, Setting, and Participant(s): AGENT IDE, a multicenter
randomized clinical trial, enrolled 600 patients with in-stent restenosis
(lesion length <26 mm and reference vessel diameter >2.0 mm to <=4.0 mm)
at 40 centers across the United States between May 2021 and August 2022.
One-year clinical follow-up was completed on October 2, 2023.
<br/>Intervention(s): Participants were randomized in a 2:1 allocation to
undergo treatment with a paclitaxel-coated (n = 406) or an uncoated (n =
194) balloon. <br/>Main Outcomes and Measures: The primary end point of
1-year target lesion failure - defined as the composite of ischemia-driven
target lesion revascularization, target vessel-related myocardial
infarction, or cardiac death - was tested for superiority. <br/>Result(s):
Among 600 randomized patients (mean age, 68 years; 157 females [26.2%]; 42
Black [7%], 35 Hispanic [6%] individuals), 574 (95.7%) completed 1-year
follow-up. The primary end point at 1 year occurred in 17.9% in the
paclitaxel-coated balloon group vs 28.6% in the uncoated balloon group,
meeting the criteria for superiority (hazard ratio [HR], 0.59 [95% CI,
0.42-0.84]; 2-sided P =.003). Target lesion revascularization (13.0% vs
24.7%; HR, 0.50 [95% CI, 0.34-0.74]; P =.001) and target vessel-related
myocardial infarction (5.8% vs 11.1%; HR, 0.51 [95% CI, 0.28-0.92]; P
=.02) occurred less frequently among patients treated with
paclitaxel-coated balloon. The rate of cardiac death was 2.9% vs 1.6% (HR,
1.75 [95% CI, 0.49-6.28]; P =.38) in the coated vs uncoated balloon
groups, respectively. <br/>Conclusions and Relevance: Among patients
undergoing coronary angioplasty for in-stent restenosis, a
paclitaxel-coated balloon was superior to an uncoated balloon with respect
to the composite end point of target lesion failure. Paclitaxel-coated
balloons are an effective treatment option for patients with coronary
in-stent restenosis. Trial Registration: ClinicalTrials.gov Identifier:
NCT04647253.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<4>
Accession Number
2030789611
Title
Pain management after cardiac surgery via median sternotomy.
Source
European Journal of Anaesthesiology. 40(10) (pp 758-768), 2023. Date of
Publication: 01 Oct 2023.
Author
Maessen T.; Korir N.; Kennes J.; Wu C.; Van de Velde M.; Joshi G.P.;
Pogatzki-Zahn E.; Dewinter G.; Kehlet H.; Bonnet M.P.; Rawal N.; Volk T.;
Lavand'homme P.; Beloeil H.; Raeder J.; Sauter A.; Albrecht E.; Lobo D.;
Freys S.
Institution
(Maesen, Pogatzki-Zahn) The Department of Anaesthesiology, Intensive Care,
and Pain Medicine, University Hospital Munster, Munster, Germany
(Korir, Van de Velde, Kennes) The Department of Cardiovascular Sciences,
Section Anaesthesiology, KU Leuven, University Hospital Leuven, Leuven,
Belgium
(Joshi) The Department of Anesthesiology and Pain Management, University
of Texas Southwestern Medical Centre, Dallas, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Pain after cardiac surgery via median sternotomy can be
difficult to treat, and if inadequately managed can lead to respiratory
complications, prolonged hospital stays and chronic pain. OBJECTIVES To
evaluate available literature and develop recommendations for optimal pain
management after cardiac surgery via median sternotomy. DESIGN A
systematic review using PROcedure-SPECific Pain Management (PROSPECT)
methodology. ELIGIBILITY CRITERIA Randomised controlled trials and
systematic reviews published in the English language until November 2020
assessing postoperative pain after cardiac surgery via median sternotomy
using analgesic, anaesthetic or surgical interventions. DATA SOURCES
PubMed, Embase and Cochrane Databases. RESULTS Of 319 eligible studies,
209 randomised controlled trials and three systematic reviews were
included in the final analysis. Pre-operative, intra-operative and
postoperative interventions that reduced postoperative pain included
paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous
magnesium, intravenous dexmedetomidine and parasternal block/infiltration.
CONCLUSIONS The analgesic regimen for cardiac surgery via sternotomy
should include paracetamol and NSAIDs, unless contraindicated,
administered intra-operatively and continued postoperatively.
Intra-operative magnesium and dexmedetomidine infusions may be considered
as adjuncts particularly when basic analgesics are not administered. It is
not clear if combining dexmedetomidine and magnesium would provide
superior pain relief compared with either drug alone. Parasternal
block/surgical site infiltration is also recommended. However, no basic
analgesics were used in the studies assessing these interventions. Opioids
should be reserved for rescue analgesia. Other interventions, including
cyclo-oxygenase-2 specific inhibitors, are not recommended because there
was insufficient, inconsistent or no evidence to support their use and/or
due to safety concerns.<br/>Copyright &#xa9; 2023 European Society of
Anaesthesiology and Intensive Care.

<5>
Accession Number
2030325800
Title
Utility of native T1 mapping and myocardial extracellular volume fraction
in patients with nonischemic dilated cardiomyopathy: A systematic review
and meta-analysis.
Source
IJC Heart and Vasculature. 51 (no pagination), 2024. Article Number:
101339. Date of Publication: April 2024.
Author
Tao M.; Dhaliwal S.; Ghosalkar D.; Sheng S.; Dianati-Maleki N.; Tam E.;
Rahman T.; Mann N.; Kort S.
Institution
(Tao, Dhaliwal, Ghosalkar, Sheng, Dianati-Maleki, Tam, Rahman, Mann, Kort)
Department of Medicine, Division of Cardiology, Stony Brook University
Hospital, Stony Brook, NY 11794, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Cardiac magnetic resonance imaging (CMR) based T1 mapping and
extracellular volume fraction (ECV) are powerful tools for identifying
myocardial fibrosis. This systematic review and meta-analysis aims to
characterize the utility of native T1 mapping and ECV in patients with
non-ischemic cardiomyopathy (NICM) and to clarify the prognostic
significance of elevated values. <br/>Method(s): A literature search was
conducted for studies reporting on use of CMR-based native T1 mapping and
ECV measurement in NICM patients and their association with major adverse
cardiac events (MACE), ventricular arrhythmias (VAs), and left ventricular
reverse remodeling (LVRR). Databases searched included: Ovid MEDLINE,
EMBASE, Web of Science, and Google Scholar. The search was not restricted
to time or publication status. <br/>Result(s): Native T1 and ECV were
significantly higher in NICM patients compared to controls (MD 78.80, 95 %
CI 50.00, 107.59; p < 0.01; MD 5.86, 95 % CI 4.55, 7.16; p < 0.01). NICM
patients who experienced MACE had higher native T1 and ECV (MD 52.87, 95 %
CI 26.59, 79.15; p < 0.01; MD 6.03, 95 % CI 3.79, 8.26; p < 0.01). There
was a non-statistically significant trend toward higher native T1 time in
NICM patients who experienced VAs. NICM patients who were poor treatment
responders had higher baseline native T1 and ECV (MD 40.58, 95 % CI 12.90,
68.25; p < 0.01; MD 3.29, 95 % CI 2.25, 4.33; p < 0.01).
<br/>Conclusion(s): CMR-based native T1 and ECV quantification may be
useful tools for risk stratification of patients with NICM. They may
provide additional diagnostic utility in combination with LGE, which
poorly characterizes fibrosis in patients with diffuse myocardial
involvement.<br/>Copyright &#xa9; 2024 The Author(s)

<6>
Accession Number
2029199669
Title
Effect of ultrasound-guided lung recruitment to reduce pulmonary
atelectasis after non-cardiac surgery under general anesthesia: a
systematic review and meta-analysis of randomized controlled trials.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 23.
Date of Publication: December 2024.
Author
Liao B.; Liao W.; Yin S.; Liu S.; Wu X.
Institution
(Liao, Liao, Liu, Wu) Department of Anesthesiology, Peking University
Shenzhen Hospital, No. 1120, Lianhua Street, Guangdong, Shenzhen 518000,
China
(Yin) Department of Anesthesiology, Shenzhen Hospital, Southern Medical
University, No. 1333, Xinhu Street, Guangdong, Shenzhen 518000, China
Publisher
BioMed Central Ltd
Abstract
Background: At present, the application of bedside lung ultrasound is
increasing gradually, but there is no relevant expert consensus or
guidance for its evaluation in the field of perioperative anesthesia.
Through this meta-analysis, we tried to determine the impact of
ultrasound-guided lung recruitment maneuvers (LRM) on perioperative
patients. <br/>Method(s): We searched PubMed, Cochrane Library database,
Embase, and Clinical Trials gov for the randomized controlled trials
(RCTs) published up to December 31, 2022. The primary outcome was the
incidence of postoperative atelectasis. Secondary outcomes included lung
ultrasound score (LUS) and LUS of each part. A total of 443 patients were
examined in nine randomized controlled trials. <br/>Result(s): The
incidence of atelectasis after surgery in patients with ultrasound-guided
LRM was less (RR 0.31; 95% CI 0.25-0.40; p < 0.05). The LUS (WMD - 6.24;
95% CI - 6.90-5.59; p < 0.05) and the LUS of each part (LUS in front lung
region (WMD - 2.00; 95% CI - 2.49 to - 1.51; p < 0.05); LUS in lateral
lung region (WMD - 2.50; 95% CI - 3.20 to - 1.80; p < 0.05); LUS in
posterior lung region (WMD - 3.24; 95% CI - 4.23 to - 2.24; p < 0.05)) in
patients with ultrasound-guided LRM were lower. <br/>Conclusion(s):
Ultrasound-guided lung recruitment maneuvers have been shown to be a
promising approach for improving perioperative lung ventilation by
increasing aeration while mitigating the development of atelectasis. In
comparison to non-ultrasound-guided methods, this technique has exhibited
superior effects.<br/>Copyright &#xa9; The Author(s) 2024.

<7>
Accession Number
2029148213
Title
Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer:
A Systematic Review and Meta-Analysis.
Source
Cancers. 16(6) (no pagination), 2024. Article Number: 1200. Date of
Publication: March 2024.
Author
Kopatsaris S.; Apostolopoulou A.; Tsakiridis I.; Tranidou A.; Zachomitros
F.; Papanikolaou E.; Daponte A.; Kalogiannidis I.; Dagklis T.
Institution
(Kopatsaris, Tsakiridis, Tranidou, Zachomitros, Papanikolaou,
Kalogiannidis, Dagklis) Third Department of Obstetrics and Gynecology,
School of Medicine, Faculty of Health Sciences, Aristotle University of
Thessaloniki, Thessaloniki 54124, Greece
(Apostolopoulou) Laboratory of Hygiene, Social & Preventive Medicine and
Medical Statistics, School of Medicine, Faculty of Health Sciences,
Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
(Daponte) Department of Obstetrics and Gynecology, School of Medicine,
Faculty of Health Sciences, University of Thessaly, Larisa 41110, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The early and accurate diagnosis of endometrial cancer is of paramount
importance for the survival of these patients. The aim of this study was
to systematically appraise the available data regarding the accuracy of
frozen section biopsy in diagnosing endometrial cancer. A thorough
literature search was performed in PubMed/Medline, Scopus and the Cochrane
Central Register of Controlled Trials databases from inception up to
January 2023, with the use of specific, relevant key terms. A quality
evaluation for each study was performed with the QUADAS-2 tool, whereas a
bivariate random-effect model was performed to generate a summary
receiver-operated curve. Heterogeneity was evaluated with Cochrane Q and
Higgins' I2 statistics. Subgroup analyses were performed for studies
focused on atypical hyperplasia and those focused on endometrial cancer.
The search yielded 47 studies, involving 7790 patients with endometrial
cancer. Among them, only 11 could be included in the quantitative
analysis. QUADAS-2 evaluation resulted in rather high quality among the
included studies. Quantitative synthesis resulted in a pooled sensitivity
of 0.863 and pooled specificity of 0.916. The AUC was 0.948, the Q
statistic was 10.488 (10 df, p = 0.399) and Higgins' I²
(4.655%) reported no significant heterogeneity. Subgroup analyses based on
the diagnosis revealed a pooled sensitivity 0.886, specificity 0.862 and
AUC 0.934 for endometrial cancer versus a sensitivity of 0.816,
specificity of 0.962 and AUC 0.939 for atypical hyperplasia. Frozen
section appears as a valid and reliable diagnostic tool for endometrial
cancer. Its reliability seems to be even higher for the diagnosis of
atypical hyperplasia. Therefore, this method may be considered in clinical
practice and in settings with appropriate resources.<br/>Copyright &#xa9;
2024 by the authors.

<8>
Accession Number
2029134616
Title
Accuracy of Intraoperative Neuromonitoring in the Diagnosis of
Intraoperative Neurological Decline in the Setting of Spinal Surgery-A
Systematic Review and Meta-Analysis.
Source
Global Spine Journal. 14(3_suppl) (pp 105S-149S), 2024. Date of
Publication: March 2024.
Author
Alvi M.A.; Kwon B.K.; Hejrati N.; Tetreault L.A.; Evaniew N.; Skelly A.C.;
Fehlings M.G.
Institution
(Alvi, Fehlings) Institute of Medical Science, University of Toronto,
Toronto, ON, Canada
(Kwon) International Collaboration on Repair Discoveries (ICORD),
University of British Columbia, Vancouver, BC, Canada
(Kwon) Department of Orthopaedics, University of British Columbia,
Vancouver, BC, Canada
(Hejrati, Fehlings) Division of Neurosurgery, Krembil Neuroscience Centre,
Toronto Western Hospital, University Health Network, Toronto, ON, Canada
(Tetreault) Department of Neurology, NYU Langone Medical Center, New York,
NY, United States
(Evaniew) McCaig Institute for Bone and Joint Health, Department of
Surgery, Orthopaedic Surgery, Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
(Skelly) Aggregate Analytics, Inc., Fircrest, WA, United States
(Fehlings) Division of Neurosurgery and Spine Program, Department of
Surgery, University of Toronto, Toronto, ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Study Design: Systematic review and meta-analysis. <br/>Objective(s): In
an effort to prevent intraoperative neurological injury during spine
surgery, the use of intraoperative neurophysiological monitoring (IONM)
has increased significantly in recent years. Using IONM, spinal cord
function can be evaluated intraoperatively by recording signals from
specific nerve roots, motor tracts, and sensory tracts. We performed a
systematic review and meta-analysis of diagnostic test accuracy (DTA)
studies to evaluate the efficacy of IONM among patients undergoing spine
surgery for any indication. <br/>Method(s): The current systematic review
and meta-analysis was performed using the Preferred Reporting Items for a
Systematic Review and Meta-analysis statement for Diagnostic Test Accuracy
Studies (PRISMA-DTA) and was registered on PROSPERO. A comprehensive
search was performed using MEDLINE, EMBASE and SCOPUS for all studies
assessing the diagnostic accuracy of neuromonitoring, including
somatosensory evoked potential (SSEP), motor evoked potential (MEP) and
electromyography (EMG), either on their own or in combination
(multimodal). Studies were included if they reported raw numbers for True
Positives (TP), False Negatives (FN), False Positives (FP) and True
Negative (TN) either in a 2 x 2 contingency table or in text, and if they
used postoperative neurologic exam as a reference standard. Pooled
sensitivity and specificity were calculated to evaluate the overall
efficacy of each modality type using a bivariate model adapted by Reitsma
et al, for all spine surgeries and for individual disease groups and
regions of spine. The risk of bias (ROB) of included studies was assessed
using the quality assessment tool for diagnostic accuracy studies
(QUADAS-2). <br/>Result(s): A total of 163 studies were included; 52 of
these studies with 16,310 patients reported data for SSEP, 68 studies with
71,144 patients reported data for MEP, 16 studies with 7888 patients
reported data for EMG and 69 studies with 17,968 patients reported data
for multimodal monitoring. The overall sensitivity, specificity, DOR and
AUC for SSEP were 71.4% (95% CI 54.8-83.7), 97.1% (95% CI 95.3-98.3), 41.9
(95% CI 24.1-73.1) and.899, respectively; for MEP, these were 90.2% (95%
CI 86.2-93.1), 96% (95% CI 94.3-97.2), 103.25 (95% CI 69.98-152.34)
and.927; for EMG, these were 48.3% (95% CI 31.4-65.6), 92.9% (95% CI
84.4-96.9), 11.2 (95% CI 4.84-25.97) and.773; for multimodal, these were
found to be 83.5% (95% CI 81-85.7), 93.8% (95% CI 90.6-95.9), 60 (95% CI
35.6-101.3) and.895, respectively. Using the QUADAS-2 ROB analysis, of the
52 studies reporting on SSEP, 13 (25%) were high-risk, 10 (19.2%) had some
concerns and 29 (55.8%) were low-risk; for MEP, 8 (11.7%) were high-risk,
21 had some concerns and 39 (57.3%) were low-risk; for EMG, 4 (25%) were
high-risk, 3 (18.75%) had some concerns and 9 (56.25%) were low-risk; for
multimodal, 14 (20.3%) were high-risk, 13 (18.8%) had some concerns and 42
(60.7%) were low-risk. <br/>Conclusion(s): These results indicate that all
neuromonitoring modalities have diagnostic utility in successfully
detecting impending or incident intraoperative neurologic injuries among
patients undergoing spine surgery for any condition, although it is clear
that the accuracy of each modality differs. PROSPERO Registration Number:
CRD42023384158.<br/>Copyright &#xa9; The Author(s) 2023.

<9>
Accession Number
2028577596
Title
Sex Differences in Revascularization, Treatment Goals, and Outcomes of
Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial.
Source
Journal of the American Heart Association. 13(5) (no pagination), 2024.
Article Number: e029850. Date of Publication: 2024.
Author
Reynolds H.R.; Cyr D.D.; Merz C.N.B.; Shaw L.J.; Chaitman B.R.; Boden
W.E.; Alexander K.P.; Rosenberg Y.D.; Bangalore S.; Stone G.W.; Held C.;
Spertus J.; Goetschalckx K.; Bockeria O.; Newman J.D.; Berger J.S.;
Elghamaz A.; Lopes R.D.; Min J.K.; Berman D.S.; Picard M.H.; Kwong R.Y.;
Harrington R.A.; Thomas B.; O'brien S.M.; Maron D.J.; Hochman J.S.
Institution
(Reynolds, Bangalore, Newman, Berger, Hochman) NYU Grossman School of
Medicine, New York, NY, United States
(Cyr, Alexander, Lopes, O'brien) Duke Clinical Research Institute, Durham,
NC, United States
(Merz) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States
(Shaw, Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular
Research Foundation, New York, NY, United States
(Chaitman) St. Louis University School of Medicine, St. Louis, MO, United
States
(Boden) VA New England Healthcare System, Bedford, MA, United States
(Rosenberg) National Heart, Lung, and Blood Institute, Bethesda, MD,
United States
(Held) Dept of Medical Sciences, Cardiology, Uppsala University and
Uppsala Clinical Research Center, Uppsala, Sweden
(Spertus) Saint Luke's Mid America Heart Institute/University of
Missouri-Kansas City (UMKC), Kansas City, MO, United States
(Goetschalckx) Department of Cardiovascular Diseases, UZ Leuven, Leuven,
Belgium
(Bockeria) National Research Center for Cardiovascular Surgery, Moscow,
Russian Federation
(Elghamaz) Northwick Park Hospital-Royal Brompton Hospital, London, United
Kingdom
(Min) Cleerly Inc., New York, NY, United States
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Picard) Massachusetts General Hospital and Harvard Medical School,
Boston, MA, United States
(Kwong) Brigham and Women's Hospital, Boston, MA, United States
(Harrington, Maron) Department of Medicine, Stanford University School of
Medicine, Stanford, CA, United States
(Thomas) Hospital Cruz Vermelha Portuguesa, Lisbon, Portugal
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Women with chronic coronary disease are generally older than
men and have more comorbidities but less atherosclerosis. We explored sex
differences in revascularization, guideline-directed medical therapy, and
outcomes among patients with chronic coronary disease with ischemia on
stress testing, with and without invasive management. METHODS AND RESULTS:
The ISCHEMIA (International Study of Comparative Health Effectiveness with
Medical and Invasive Approaches) trial randomized patients with moderate
or severe ischemia to invasive management with angiography,
revascularization, and guideline-directed medical therapy, or initial
conservative management with guideline-directed medical therapy alone. We
evaluated the primary outcome (cardiovascular death, myocardial
infarction, or hospitalization for unstable angina, heart failure, or
resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%)
women and 4011 (77.4%) men. Invasive group catheterization rates were
similar, with less revascularization among women (73.4% of
invasive-assigned women revascularized versus 81.2% of invasive-assigned
men; P<0.001). Women had less coronary artery disease: multi-vessel in
60.0% of invasive-assigned women and 74.8% of invasive-assigned men, and
no >=50% stenosis in 12.3% versus 4.5% (P<0.001). In the conservative
group, 4-year catheterization rates were 26.3% of women versus 25.6% of
men (P=0.72). Guideline-directed medical therapy use was lower among women
with fewer risk factor goals attained. There were no sex differences in
the primary outcome (adjusted hazard ratio [HR] for women versus men, 0.93
[95% CI, 0.77-1.13]; P=0.47) or the major secondary outcome of
cardiovascular death/myocardial infarction (adjusted HR, 0.93 [95% CI,
0.76-1.14]; P=0.49), with no significant sex-by-treatment-group
interactions. <br/>CONCLUSION(S): Women had less extensive coronary artery
disease and, therefore, lower revascularization rates in the invasive
group. Despite lower risk factor goal attainment, women with chronic
coronary disease experienced similar risk-adjusted outcomes to men in the
ISCHEMIA trial. REGISTRATION: URL: http://wwwclinicaltrials.gov. Unique
identifier: NCT01471522.<br/>Copyright &#xa9; 2024 The Authors. Published
on behalf of the American Heart Association, Inc., by Wiley.

<10>
Accession Number
2028577184
Title
Evaluation of Vasodilatory Effect of Nitroglycerin in Cardioplegia
Solution on Patients Undergoing Coronary Artery Bypass Graft Surgery.
Source
ARYA Atherosclerosis. 19(3) (pp 87-94), 2023. Date of Publication: May
2023.
Author
Hosseini A.; Shahzamani M.; Amiri F.
Institution
(Hosseini, Shahzamani) Department of Surgery, Chamran Cardiovascular and
Medical Research Hospital, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Amiri) Department of Surgery, School of Medicine, Isfahan University of
Medical Sciences, Isfahan, Iran, Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
INTRODUCTION: This study aimed to evaluate the vasodilatory effect of
nitroglycerin (NTG) in cardioplegia solution on changes in troponin I and
creatine phosphokinase-MB (CPK-MB) levels during coronary artery bypass
graft (CABG) surgery. <br/>METHOD(S): A randomized controlled double-blind
clinical trial was performed on 44 patients who were candidates for CABG
surgery. These patients were divided into two groups. In the first group
(NTG group), 3 mg/kg NTG was added to the cardioplegia solution, while 10
cc placebo (distilled water) was added to the cardioplegia solution in the
second group (control group). Troponin I and CPK-MB levels were then
assessed before and after the surgery. <br/>RESULT(S): In this study,
72.7% and 27.3% of patients in the NTG group and 68.2% and 31.8% of
patients in the control group were male and female, respectively. In
addition, 9.1% within the age range of 40-50 years, 27.3% within the age
range of 50-60 years, and 63.6% within the age range of more than 60 years
were present in the NTG group. Moreover, 18.2% within the age range of
40-50 years, 36.4% within the age range of 50-60 years, and 45.5% within
the age range of more than 60 years were present in the control group.
Although the mean cardiopulmonary bypass (CPB) and cross-clamp time was
insignificantly higher in the NTG group compared to the control group. In
addition, troponin I and CPK-MB levels after surgery in the NTG group with
the mean of 2090.68 +/- 1856.07 and 97.27 +/- 38.17 were significantly
lower than those of the control group with the mean of 2697.02 +/- 5586.56
and 137.95 +/- 227.99, respectively (P-value <0.05). <br/>CONCLUSION(S):
According to the results of this study, although troponin I and CPK-MB
levels increased significantly after CABG surgery, this increase was
significantly lower in the intervention group compared to the control
group following the administration of NTG.<br/>Copyright &#xa9; 2023,
Isfahan University of Medical Sciences(IUMS). All rights reserved.

<11>
Accession Number
2027973008
Title
Effects of Interventions Based on Patient Expectations on Coronary Surgery
Outcomes: A Randomized Clinical Trial.
Source
Journal of Tehran University Heart Center. 18(4) (pp 269-277), 2023. Date
of Publication: 2023.
Author
Noruzi Larki K.; Mohammadi T.; Zakerimoghadam M.; Sayadi L.
Institution
(Noruzi Larki, Zakerimoghadam) School of Nursing and Midwifery, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mohammadi) Departments of Biostatistics, School of Public Health, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Sayadi) Nursing and Midwifery Care Research Center, School of Nursing and
Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Tehran Heart Center
Abstract
Background: Coronary surgery can have various outcomes, such as fear of
death, cardiac anxiety, and pain disability. This study aimed to evaluate
the effects of interventions based on patient expectations on different
outcomes of coronary surgery, including expectations, cardiac anxiety, and
pain-induced disability. <br/>Method(s): This randomized clinical trial
evaluated 60 coronary surgery candidates. Patients meeting the inclusion
criteria were randomly assigned to control and intervention groups. The
patients were contacted 1 to 2 weeks before coronary surgery to complete
the Cardiac Surgery Patient Expectations Questionnaire (C-SPEQ). Based on
the analysis of expectations, the intervention group underwent
interventions to optimize expectations, whereas the control group received
only routine care. The Cardiac Anxiety Questionnaire (CAQ) and the Pain
Disability Index (PDI) were completed on the day of hospitalization. Three
months later, the participants recompleted all 3 questionnaires. The data
were analyzed with descriptive and analytical statistics in SPSS 16.0.
<br/>Result(s): There were no significant differences between the control
and intervention groups in baseline variables, pain-induced disability
(P=0.353), and cardiac anxiety (P=0.479). After the intervention, no
significant differences were observed between the groups concerning
expectations (P=0.554) and pain-induced disability (P=0.557) when the
confounding variables were adjusted. Nevertheless, cardiac anxiety
decreased significantly (P=0.027). <br/>Conclusion(s): Our interventions
improved expectations and mitigated anxiety among coronary surgery
patients. Actualization and optimization of patient expectations should be
considered in the care of coronary surgery candidates.<br/>Copyright
&#xa9; 2023 Tehran University of Medical Sciences.

<12>
Accession Number
2031273437
Title
Palliative care in the cardiovascular intensive care unit: A systematic
review of current literature.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Belur A.D.; Mehta A.; Bansal M.; Wieruszewski P.M.; Kataria R.; Saad M.;
Clancy A.; Levine D.J.; Sodha N.R.; Burtt D.M.; Rachu G.S.; Abbott J.D.;
Vallabhajosyula S.
Institution
(Belur) Division of Cardiovascular Medicine, Department of Medicine,
University of Louisville School of Medicine, Louisville, KY, United States
(Mehta) Department of Medicine, University of Connecticut School of
Medicine, Farmington, CT, United States
(Bansal) Department of Medicine, East Carolina University Brody School of
Medicine, Greenville, NC, United States
(Wieruszewski) Departments of Pharmacy and Anesthesiology, Mayo Clinic,
Rochester, MN, United States
(Kataria, Saad, Levine, Burtt, Abbott, Vallabhajosyula) Division of
Cardiology, Department of Medicine, Warren Alpert Medical School of Brown
University, Providence, RI, United States
(Kataria, Saad, Levine, Sodha, Burtt, Abbott, Vallabhajosyula) Lifespan
Cardiovascular Institute, Providence, RI, United States
(Clancy) Department of Pharmacy, Lifespan Health System, Providence, RI,
United States
(Sodha) Division of Cardiothoracic Surgery, Department of Surgery, Warren
Alpert Medical School of Brown University, Providence, RI, United States
(Rachu) Division of Geriatrics and Palliative Medicine, Department of
Medicine, Warren Alpert Medical School of Brown University, Providence,
RI, United States
Publisher
Elsevier Inc.
Abstract
Background: There has been an evolution in the disease severity and
complexity of patients presenting to the cardiac intensive care unit
(CICU). There are limited data evaluating the role of palliative care in
contemporary CICU practice. <br/>Method(s): PubMed Central, CINAHL,
EMBASE, Medline, Cochrane Library, Scopus, and Web of Science databases
were evaluated for studies on palliative care in adults (>=18 years)
admitted with acute cardiovascular conditions - acute myocardial
infarction, cardiogenic shock, cardiac arrest, advanced heart failure,
post-cardiac surgery, spontaneous coronary artery dissection, Takotsubo
cardiomyopathy, and pulmonary embolism - admitted to the CICU, coronary
care unit or cardiovascular intensive care unit from 1/1/2000 to 8/8/2022.
The primary outcome of interest was the utilization of palliative care
services. Secondary outcomes of included studies were also addressed.
Meta-analysis was not performed due to heterogeneity. <br/>Result(s): Of
5711 citations, 30 studies were included. All studies were published in
the last seven years and 90 % originated in the United States.
Twenty-seven studies (90 %) were retrospective analyses, with a majority
from the National Inpatient Sample database. Heart failure was the most
frequent diagnosis (47 %), and in-hospital mortality was reported in 67 %
of studies. There was heterogeneity in the timing, frequency, and
background of the care team that determined palliative care consultation.
In two randomized trials, there appeared to be improvement in quality of
life without an impact on mortality. <br/>Conclusion(s): Despite the
growing recognition of the role of palliative care, there are limited data
on palliative care consultation in the CICU.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<13>
Accession Number
2024220676
Title
A randomised controlled trial of prehabilitation in patients undergoing
elective cardiac surgery.
Source
Anaesthesia. 78(9) (pp 1120-1128), 2023. Date of Publication: September
2023.
Author
Akowuah E.F.; Wagnild J.M.; Bardgett M.; Prichard J.G.; Mathias A.;
Harrison S.L.; Ogundimu E.O.; Hancock H.C.; Maier R.H.; Wilkinson C.;
Kasim A.; Witharana P.; Trevis J.; Neave C.; Sarginson L.; Honeyman B.;
Walker Y.; Lewis S.; Holden A.; Ainsworth K.; Wanless F.; Hauxwell T.;
Metson L.
Institution
(Akowuah, Maier) Academic Cardiovascular Unit, South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
(Akowuah) Translational and Clinical Research Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Wagnild) Department of Anthropology, Durham University, Durham, United
Kingdom
(Bardgett, Prichard, Mathias, Hancock) Newcastle Clinical Trials Unit,
Newcastle University, Newcastle Upon Tyne, United Kingdom
(Harrison) Centre for Rehabilitation, School of Health and Life Sciences,
Teesside University, Middlesborough, United Kingdom
(Ogundimu) Durham Biostatistics Unit, Department of Mathematical Sciences,
Durham University, Durham, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
The feasibility, safety and efficacy of prehabilitation in adult patients
awaiting elective cardiac surgery are unknown. A total of 180 participants
undergoing elective cardiac surgery were allocated randomly to receive
either standard pre-operative care or prehabilitation, consisting of
pre-operative exercise and inspiratory muscle training. The primary
outcome was change in six-minute walk test distance from baseline to
pre-operative assessment. Secondary outcomes included change in
inspiratory muscle strength (maximal inspiratory pressure); sarcopenia
(handgrip strength); quality of life and compliance. Safety outcomes were
pre-specified surgical and pulmonary complications and adverse events. All
outcomes were assessed at baseline; at pre-operative assessment; and 6 and
12 weeks following surgery. Mean (SD) age was 64.7 (10.2) years; 33/180
(18%) were women. In total, 65/91 (71.4%) participants who were allocated
to prehabilitation attended at least four of eight supervised in-hospital
exercise classes; participants aged > 50 years were more likely than
younger participants to attend (odds ratio (95%CI) of 4.6 (1.0-25.1)).
Six-minute walk test was not significantly different between groups (mean
difference (95%CI) -7.8 m (-30.6-15.0), p = 0.503) in the
intention-to-treat analysis. Subgroup analyses based on tests for
interaction indicated improvements in six-minute walk test distance were
larger amongst sarcopenic patients in the prehabilitation group (p =
0.004). Change in maximal inspiratory pressure from baseline to all
time-points was significantly greater in the prehabilitation group, with
the greatest mean difference (95%CI) observed 12 weeks after surgery (10.6
cmH<inf>2</inf>O (4.6-16.6) cmH<inf>2</inf>O, p < 0.001). There were no
differences in handgrip strength or quality of life up to 12 weeks after
surgery. There was no significant difference in postoperative mortality
(one death in each group), surgical or pulmonary complications. Of 71
pre-operative adverse events, six (8.5%) were related to prehabilitation.
The combination of exercise and inspiratory muscle training in a
prehabilitation intervention before cardiac surgery was not superior to
standard care in improving functional exercise capacity measured by
six-minute walk test distance pre-operatively. Future trials should target
patients living with sarcopenia and include inspiratory muscle strength
training.<br/>Copyright &#xa9; 2023 The Authors. Anaesthesia published by
John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<14>
Accession Number
2031150300
Title
Integration of MRI for detection and surgical planning of advanced
endometriosis.
Source
American Journal of Obstetrics and Gynecology. Conference: Society of
Gynecologic Surgeons 50th Annual Scientific Meeting. Orlando United
States. 230(4 Supplement) (pp S1282), 2024. Date of Publication: April
2024.
Author
Gallant T.; King C.; Luna Russo M.; Clay J.; Hansen J.
Institution
(Gallant, King, Luna Russo, Clay, Hansen) Cleveland Clinic, United States
Publisher
Elsevier Inc.
Abstract
Introduction: While physical examination, laboratory tests, and imaging
have been used in the work-up of endometriosis, diagnostic laparoscopy
with histopathology has long been used as the gold standard for
endometriosis diagnosis. This method, however, has diagnostic limitations
given variability of the appearance of lesions. Surgery also comes with
potential patient complications and a high cost to the healthcare system.
(Byrne, et al. 2018). A recent systematic review and meta-analysis
revealed that ultrasound and MRI may be highly useful alternatives to
laparoscopy for diagnosis of deep infiltrating endometriosis (Zhang et al.
2020). At our institution, we have employed an endometriosis specific MRI
protocol to aid in diagnosing deeply infiltrating endometriosis. This
protocol allows for optimal surgical case preparation. We are able to
appropriately and preoperatively consult our surgical colleagues, such as
colorectal surgery, cardio thoracic surgery, and urology as needed. We are
also able to better individualize patient counseling and expectations.
<br/>Objective(s): This video aims to describe our institution's
endometriosis-specific MRI protocol and illustrate how it enhances
surgical planning for deep infiltrating endometriosis. This protocol
facilitates collaboration with other surgical specialties, optimizes
patient counseling, and improves the identification of often-overlooked
lesions. <br/>Method(s): Our institution utilizes an
endometriosis-specific MRI protocol, employing a small field of view, IV
and vaginal contrast, and unique angles to detect challenging lesions.
Detailed reports categorize lesions in anterior, middle, posterior, and
extra-pelvic sections. Rectal lesions are further described in terms of
length, circumferential extent, muscular wall invasion, and distance to
the anal verge. Surgical video footage demonstrates how this protocol aids
in patient preparation. <br/>Result(s): This video shows how
implementation of the endometriosis specific MRI protocol has allowed us
to better prepare for surgery. We discuss the collaboration with other
surgical specialties, preoperative patient counseling, and identifying
lesions that may have been missed. <br/>Conclusion(s): This video
underscores the importance of implementing an endometriosis-specific MRI
protocol for the detection and characterization of deeply infiltrating
endometriosis. The protocol's unique features and detailed reporting allow
for precise lesion recognition and optimal patient management. Disclosure:
No.<br/>Copyright &#xa9; 2023

<15>
Accession Number
2031397526
Title
Cognitive impairment as a risk factor for postoperative delirium in
cardiac surgery based on the Mini Mental State Examination, in people over
60 years of age: A systematic review.
Source
Psiquiatria Biologica. 31(2) (no pagination), 2024. Article Number:
100463. Date of Publication: 01 Apr 2024.
Author
Ujaldon-Martinez R.; Devi-Bastida J.
Institution
(Ujaldon-Martinez, Devi-Bastida) Departamento de Psicologia Clinica y de
la Salud, Universidad Autonoma de Barcelona, Barcelona, Spain
(Devi-Bastida) Institut de Salut Mental, Hospital del Mar - Centre Dr.
Emili Mira, Barcelona, Spain
Publisher
Sociedad Espanola de Psiquiatria Biologica (SEPB)
Abstract
Introduction: Delirium is a neurocognitive disorder whose prevalence
increases with age. Its incidence after cardiac surgery ranges between 11%
and 52%. There are a large number of studies on the risk factors that
affect the appearance of postoperative delirium in cardiac surgery,
although most of them are oriented to physiological factors, often
ignoring the possible relevance of neuropsychological aspects, such as
cognitive impairment. The objective of this work was to analyze the
influence of cognitive impairment as an independent risk factor
(predictor) in the appearance of postoperative delirium based on the Mini
Mental State Examination (MMSE), after cardiac surgery. Development: A
search was carried out in the databases PubMed, PsycInfo, Scopus and Web
of Science. The search was limited to articles published between 2001 and
2022. 384 articles were obtained. Those that were repeated and not related
to the topic were eliminated, leaving a total of 8 articles that met the
selection criteria. This systematic review was carried out in accordance
with the criteria of the PRISMA 2020 statement. <br/>Conclusion(s): A
statistically significant correlation was observed between the measure of
cognitive impairment, the MMSE, and the different measures of
postoperative delirium, in the majority of studies, so it can be concluded
that possibly a mild degree of cognitive impairment may be a sufficient
condition for the probability of appearance of postoperative delirium in
cardiac surgeries in patients over 60 years of age. Therefore, assessment
of cognitive impairment using MMSE before cardiac surgery could be useful
to predict the development of postoperative delirium in people over 60
years of age.<br/>Copyright &#xa9; 2024

<16>
Accession Number
2031365989
Title
Cardiovascular outcomes 50 years after antenatal exposure to
betamethasone: Follow-up of a randomised double-blind, placebo-controlled
trial.
Source
PLoS Medicine. 21(4) (no pagination), 2024. Article Number: e1004378. Date
of Publication: April 2024.
Author
Walters A.G.B.; Gamble G.D.; Crowther C.A.; Dalziel S.R.; Eagleton C.L.;
McKinlay C.J.D.; Milne B.J.; Harding J.E.
Institution
(Walters, Gamble, Crowther, Eagleton, Harding) Liggins Institute,
University of Auckland, Auckland, New Zealand
(Dalziel, McKinlay) Department of Paediatrics, Child and Youth Health,
University of Auckland, Auckland, New Zealand
(Dalziel) Department of Surgery, University of Auckland, Auckland, New
Zealand
(Milne) Centre of Methods and Policy Application in Social Sciences,
University of Auckland, Auckland, New Zealand
Publisher
Public Library of Science
Abstract
Background Antenatal corticosteroids for women at risk of preterm birth
reduce neonatal morbidity and mortality, but there is limited evidence
regarding their effects on long-term health. This study assessed
cardiovascular outcomes at 50 years after antenatal exposure to
corticosteroids. Methods and findings We assessed the adult offspring of
women who participated in the first randomised, double-blind,
placebo-controlled trial of antenatal betamethasone for the prevention of
neonatal respiratory distress syndrome (RDS) (1969 to 1974). The first 717
mothers received 2 intramuscular injections of 12 mg betamethasone or
placebo 24 h apart and the subsequent 398 received 2 injections of 24 mg
betamethasone or equivalent volume of placebo. Follow-up included a health
questionnaire and consent to access administrative data sources. The
co-primary outcomes were the prevalence of cardiovascular risk factors
(any of hypertension, hyperlipidaemia, diabetes mellitus, gestational
diabetes mellitus, or prediabetes) and age at first major adverse
cardiovascular event (MACE) (cardiovascular death, myocardial infarction,
coronary revascularisation, stroke, admission for peripheral vascular
disease, and admission for heart failure). Analyses were adjusted for
gestational age at entry, sex, and clustering. Of 1,218 infants born to
1,115 mothers, we followed up 424 (46% of survivors; 212 [50%] female) at
mean (standard deviation) age 49.3 (1.0) years. There were no differences
between those exposed to betamethasone or placebo for cardiovascular risk
factors (159/229 [69.4%] versus 131/195 [67.2%]; adjusted relative risk
1.02, 95% confidence interval [CI] [0.89, 1.18;]; p = 0.735) or age at
first MACE (adjusted hazard ratio 0.58, 95% CI [0.23, 1.49]; p = 0.261).
There were also no differences in the components of these composite
outcomes or in any of the other secondary outcomes. Key limitations were
follow-up rate and lack of in-person assessments. Conclusions There is no
evidence that antenatal corticosteroids increase the prevalence of
cardiovascular risk factors or incidence of cardiovascular events up to 50
years of age. Established benefits of antenatal corticosteroids are not
outweighed by an increase in adult cardiovascular disease.<br/>Copyright:
&#xa9; 2024 Walters et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<17>
Accession Number
2029258351
Title
Sedation versus general anesthesia on all-cause mortality in patients
undergoing percutaneous procedures: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 126. Date
of Publication: December 2024.
Author
Su X.; Zhao Z.; Zhang W.; Tian Y.; Wang X.; Yuan X.; Tian S.
Institution
(Su) The First College for Clinical Medicine, Shanxi Medical University,
No. 56 Xinjian South Road, Shanxi, Taiyuan, China
(Zhao, Tian) College of Anesthesia, Shanxi Medical University, No. 56
Xinjian South Road, Shanxi, Taiyuan, China
(Zhang, Wang, Yuan) Department of Anesthesiology, First Hospital of Shanxi
Medical University, No. 85 Jiefang South Road, Shanxi, Taiyuan, China
(Tian) John Muir College, University of California San Diego, 8775 Costa
Verde Blvd, San Diego, CA, United States
(Tian) Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to
Cancer Hospital, Chinese Academy of Medical Sciences No. 3, Workers' New
Village, Xinghualing District, Shanxi, Taiyuan, China
Publisher
BioMed Central Ltd
Abstract
Background: The comparison between sedation and general anesthesia (GA) in
terms of all-cause mortality remains a subject of ongoing debate. The
primary objective of our study was to investigate the impact of GA and
sedation on all-cause mortality in order to provide clarity on this
controversial topic. <br/>Method(s): A systematic review and meta-analysis
were conducted, incorporating cohort studies and RCTs about postoperative
all-cause mortality. Comprehensive searches were performed in the PubMed,
EMBASE, and Cochrane Library databases, with the search period extending
until February 28, 2023. Two independent reviewers extracted the relevant
information, including the number of deaths, survivals, and risk effect
values at various time points following surgery, and these data were
subsequently pooled and analyzed using a random effects model.
<br/>Result(s): A total of 58 studies were included in the analysis, with
a majority focusing on endovascular surgery. The findings of our analysis
indicated that, overall, and in most subgroup analyses, sedation exhibited
superiority over GA in terms of in-hospital and 30-day mortality. However,
no significant difference was observed in subgroup analyses specific to
cerebrovascular surgery. About 90-day mortality, the majority of studies
centered around cerebrovascular surgery. Although the overall pooled
results showed a difference between sedation and GA, no distinction was
observed between the pooled ORs and the subgroup analyses based on RCTs
and matched cohort studies. For one-year all-cause mortality, all included
studies focused on cardiac and macrovascular surgery. No difference was
found between the HRs and the results derived from RCTs and matched cohort
studies. <br/>Conclusion(s): The results suggested a potential superiority
of sedation over GA, particularly in the context of cardiac and
macrovascular surgery, mitigating the risk of in-hospital and 30-day
death. However, for the longer postoperative periods, this difference
remains uncertain. Trial registration: PROSPERO CRD42023399151; registered
24 February 2023.<br/>Copyright &#xa9; The Author(s) 2024.

<18>
Accession Number
2029171584
Title
The impact of long-term antihypertensive treatment on wound healing after
major non-cardiac surgery in patients with cardiovascular diseases: A
meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14858. Date of Publication: April 2024.
Author
Liu Y.; Ma C.; Tang X.; Liu S.; Jin Y.
Institution
(Liu, Ma, Tang, Liu, Jin) Department of General Practice, Zhongnan
Hospital of Wuhan University, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
Hypertension is a prevalent condition that poses significant challenges in
the perioperative management of patients undergoing major non-cardiac
surgery, particularly concerning wound healing and scar formation. This
meta-analysis assesses the impact of long-term antihypertensive treatment
on postoperative wound healing, examining data from seven studies
involving patients who received such treatments compared to untreated
controls. Our findings reveal that long-term antihypertensive therapy is
associated with significantly improved wound healing outcomes, as
indicated by lower REEDA scores (I² = 96%, SMD = -25.71, 95%
CI: [-33.71, -17.70], p < 0.01) 1 week post-surgery and reduced scar
formation, demonstrated by lower Manchester Scar Scale scores
(I² = 93%, SMD = -37.29, 95% CI: [-44.93, -29.64], p < 0.01) 2
months post-surgery. These results underscore the potential benefits of
antihypertensive treatment in enhancing surgical recovery and offer
insights into optimising perioperative care for hypertensive
patients.<br/>Copyright &#xa9; 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<19>
Accession Number
643856533
Title
Impact of Prosthesis-Patient Mismatch After Surgical Aortic Valve
Replacement: Systematic Review and Meta-Analysis of Reconstructed
Time-to-Event Data of 122989 Patients With 592952 Patient-Years.
Source
Journal of the American Heart Association. (pp e033176), 2024. Date of
Publication: 27 Mar 2024.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Chu D.; Serna-Gallegos D.; Ebels
T.; Clavel M.-A.; Pibarot P.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery
University of Pittsburgh PA USA
(Sa, Chu, Serna-Gallegos, Sultan) University of Pittsburgh Medical Center
UPMC Heart and Vascular Institute Pittsburgh PA USA
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences KU Leuven
Leuven Belgium, Belgium
(Ebels) Department of Cardiothoracic Surgery, University Medical Center
Groningen University of Groningen The Netherlands, Netherlands
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec Quebec City Quebec Canada, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine Universite
Laval Quebec City Quebec Canada, Canada
Abstract
BACKGROUND: It remains controversial whether prosthesis-patient mismatch
(PPM) impacts long-term outcomes after surgical aortic valve replacement.
We aimed to evaluate the association of PPM with mortality,
rehospitalizations, and aortic valve reinterventions. METHODS AND RESULTS:
We performed a systematic review with meta-analysis of reconstructed
time-to-event data of studies published by March 2023 (according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Sixty-five studies met our eligibility criteria and included 122989
patients (any PPM: 68 332 patients, 55.6%). At 25years of follow-up, the
survival rates were 11.8% and 20.6% in patients with and without any PPM,
respectively (hazard ratio [HR], 1.16 [95% CI, 1.13-1.18], P<0.001). At
20years of follow-up, the survival rates were 19.5%, 12.1%, and 8.8% in
patients with no, moderate, and severe PPM, respectively (moderate versus
no PPM: HR, 1.09 [95% CI, 1.06-1.11], P<0.001; severe versus no PPM: HR,
1.29 [95% CI, 1.24-1.35], P<0.001). PPM was associated with higher risk of
cardiac death, heart failure-related hospitalizations, and aortic valve
reinterventions over time (P<0.001). Statistically significant
associations between PPM and worse survival were observed regardless of
valve type (bioprosthetic versus mechanical valves), contemporary PPM
definitions unadjusted and adjusted for body mass index, and PPM
quantification method (in vitro, in vivo, Doppler echocardiography). Our
meta-regression analysis revealed that populations with more women tend to
have higher HRs for all-cause death associated with PPM.
<br/>CONCLUSION(S): The results of the present study suggest that any
degree of PPM is associated with poorer long-term outcomes following
surgical aortic valve replacement and provide support for implementation
of preventive strategies to avoid PPM after surgical aortic valve
replacement.

<20>
[Use Link to view the full text]
Accession Number
2031202973
Title
Evaluation of Proximal Femoral Bone Mineral Density in Cementless Total
Hip Arthroplasty: A 3-Arm Prospective Randomized Controlled Trial.
Source
Journal of Bone and Joint Surgery. 106(6) (pp 508-516), 2024. Date of
Publication: 20 Mar 2024.
Author
Hooper G.; Thompson D.; Frampton C.; Lash N.; Sharr J.; Fulker D.;
Gilchrist N.
Institution
(Hooper, Thompson, Gilchrist) Cgm Research Trust, South Island,
Christchurch, New Zealand
(Hooper, Lash, Sharr) Department of Orthopaedic Surgery and
Musculoskeletal Medicine, University of Otago, South Island, Christchurch,
New Zealand
(Frampton) Department of Medicine, University of Otago, South Island,
Christchurch, New Zealand
(Fulker) Stryker Australia, St Leonards, Sydney, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Femoral stem design affects periprosthetic bone mineral density
(BMD), which may impact long-term survival of cementless implants in total
hip arthroplasty (THA). The aim of this study was to examine proximal
femoral BMD in 3 morphologically different uncemented femoral stem designs
to investigate whether any particular design resulted in better
preservation of BMD. <br/>Method(s):A total of 119 patients were
randomized to receive a proximally coated collarless dual-taper wedge
stem, a proximally coated collarless anatomic stem, or a fully coated
collarless triple-taper stem. All surgeries were performed via the
posterior approach, with mobilization on the day of surgery. Dual x-ray
absorptiometry scans (Lunar iDXA, GE Healthcare) assessed BMD across the 7
Gruen zones preoperatively and at 6 weeks and 2 years postoperatively; if
available, the native contralateral femur was also assessed as a control.
Patient-reported outcomes of pain, function, and health were also assessed
at these follow-ups. <br/>Result(s):Averaged across all stems, BMD
increased in zones 1 (2.5%), 2 (17.1%), 3 (13.0%), 5 (10%), and 6 (17.9%)
at 2 years. Greater preservation of BMD was measured on the lateral cortex
(zone 2) for both the dual-taper wedge and anatomic stems (p = 0.019). The
dual-taper wedge stem also demonstrated preservation of BMD in the medial
calcar (zone 7), while the anatomic and triple-taper stems declined in
this region; however, the difference did not reach significance (p =
0.059). Averaged across all stems, BMD decreased in the mid-diaphysis
region, distal to the stem tip (zone 4). All stems performed similarly at
the time of final follow-up with respect to the patient-reported outcomes.
<br/>Conclusion(s):This study demonstrated maintenance of femoral BMD
after use of 3 different cementless femoral stem designs, with all
achieving excellent improvements in patient-reported outcomes. The stems
designed to load the proximal metaphyseal region resulted in higher BMD in
that region. No significant stress-shielding was observed; however, longer
follow-up is required to elucidate the impact of this finding on implant
survivorship. COPYRIGHT<br/>Copyright &#xa9; 2023 BY THE JOURNAL OF BONE
AND JOINT SURGERY, INCORPORATED.

<21>
Accession Number
2030955963
Title
Hybrid Coronary Revascularization: Has Everything Clearly Described?.
Source
American Journal of Cardiology. 218 (pp 1), 2024. Date of Publication: 01
May 2024.
Author
Babayigit E.; Gorenek B.
Institution
(Babayigit, Gorenek) Cardiology Department, Eskisehir Osmangazi
University, Health, Practice and Research Hospital, Eskisehir, Turkey
Publisher
Elsevier Inc.

<22>
Accession Number
2030940099
Title
Mortality in patients admitted to hospital with heart failure in China: a
nationwide Cardiovascular Association Database-Heart Failure Centre
Registry cohort study.
Source
The Lancet Global Health. 12(4) (pp e611-e622), 2024. Date of Publication:
April 2024.
Author
Wang H.; Li Y.; Chai K.; Long Z.; Yang Z.; Du M.; Wang S.; Zhan S.; Liu
Y.; Wan Y.; Wang F.; Yin P.; Li W.; Liao Y.; Dong Y.; Li X.; Zhou J.; Yiu
K.-H.; Zhou M.; Huo Y.; Yang J.
Institution
(Wang, Li, Chai, Yang, Du, Liu, Wan, Wang, Yang) Department of Cardiology,
Beijing Hospital, National Centre of Gerontology, Institute of Geriatric
Medicine, Chinese Academy of Medical Sciences, Beijing, China
(Long, Yin, Zhou) National Centre for Chronic and Noncommunicable Disease
Control and Prevention, Chinese Centre for Disease Control and Prevention,
Beijing, China
(Wang, Zhan) Department of Epidemiology and Biostatistics, School of
Public Health, Peking University, Beijing, China
(Li) The First Affiliated Hospital of Harbin Medical University, Harbin,
China
(Liao) Union Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
(Dong) The First Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
(Li) The First Affiliated Hospital of Nanjing Medical University, Nanjing,
China
(Zhou) Department of Cardiology, Shanghai Institute of Cardiovascular
Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
(Yiu) Cardiology Division, The University of Hong Kong, Queen Mary
Hospital, Hong Kong Special Administrative Region, Hong Kong
(Huo) Department of Cardiology, Peking University First Hospital, Beijing,
China
Publisher
Elsevier Ltd
Abstract
Background: China has the largest burden of heart failure worldwide.
However, large-scale studies on heart failure mortality are scarce. We
aimed to investigate mortality and identify risk factors for mortality
among patients with heart failure in China. <br/>Method(s): This
prospective cohort study used data from the China Cardiovascular
Association (CCA) Database-Heart Failure Centre Registry, which were
linked to the National Mortality Registration Information Management
System by the Chinese Centre for Disease Control and Prevention. We
included patients enrolled from Jan 1, 2017, to Dec 31, 2021, across 572
CCA Database-Heart Failure Centre certified hospitals in 31 provinces of
mainland China. Eligible patients were aged 18 years or older (younger
than 100 years) with a principal discharge diagnosis of heart failure
based on Chinese heart failure guidelines. All-cause mortality at 30 days,
1 year, and 3 years for patients with heart failure were calculated and
the causes of death were recorded. Multivariable analysis was used to
analyse factors associated with all-cause mortality and cardiovascular
mortality. This study was registered with the Chinese Clinical Trial
Registry, ChiCTR2200066305. <br/>Finding(s): Of the 327 477 patients in
the registry, 230 637 eligible adults with heart failure were included in
our analyses. Participant mean age was 69.3 years (SD 13.2), 94 693
(41.1%) participants were female, and 135 944 (58.9%) were male. The
median follow-up time was 531 days (IQR 251-883). Post-discharge all-cause
mortality of patients with heart failure at 30 days was 2.4% (95% CI
2.3-2.5), at 1 year was 13.7% (13.5-13.9), and at 3 years was 28.2%
(27.7-28.6). Cardiovascular death accounted for 32 906 (71.5%) of 46 006
all-cause deaths. Patients with heart failure with reduced ejection
fraction had the highest all-cause mortality. A lower guideline adherence
score was independently associated with the increase of all-cause and
cardiovascular mortality. <br/>Interpretation(s): In China, mortality for
patients with heart failure is still high, especially in patients with
reduced ejection fraction. Our findings suggest that guideline-directed
medical therapy needs to be improved. <br/>Funding(s): National High Level
Hospital Clinical Research Funding, the Capital's Funds for Health
Improvement and Research, and the Chinese Academy of Medical Sciences
Innovation Fund for Medical Sciences. Translation: For the Chinese
translation of the abstract see Supplementary Materials
section.<br/>Copyright &#xa9; 2024 The Author(s). Published by Elsevier
Ltd. This is an Open Access article under the CC BY 4.0 license

<23>
Accession Number
2030702832
Title
Postoperative atrial fibrillation (POAF) after cardiac surgery: clinical
practice review.
Source
Journal of Thoracic Disease. 16(2) (pp 1503-1520), 2024. Date of
Publication: February 2024.
Author
Suero O.R.; Ali A.K.; Barron L.R.; Segar M.W.; Moon M.R.; Chatterjee S.
Institution
(Suero) Divisions of Cardiovascular Anesthesia & Critical Care Medicine,
Department of Anesthesiology, Baylor College of Medicine, Houston, TX,
United States
(Ali, Barron, Moon, Chatterjee) Division of Cardiothoracic Surgery,
Michael E. DeBakey Department of Surgery, Baylor College of Medicine,
Houston, TX, United States
(Barron, Moon, Chatterjee) Department of Cardiovascular Surgery, The Texas
Heart Institute, Houston, TX, United States
(Segar) Department of Cardiology, The Texas Heart Institute, Houston, TX,
United States
(Chatterjee) Division of General Surgery, Michael E. DeBakey Department of
Surgery, Baylor College of Medicine, Houston, TX, United States
Publisher
AME Publishing Company
Abstract
Postoperative atrial fibrillation (POAF) after cardiac surgery is
associated with elevated morbidity and mortality. Although current
prediction models have limited efficacy, several perioperative
interventions can reduce patients' risk of POAF. These begin with
preoperative medications, including beta-blockers and amiodarone.
Moreover, patients should be screened for preexisting atrial fibrillation
(AF) so that concomitant surgical ablation and left atrial appendage
occlusion can be performed in appropriate candidates. Intraoperative
interventions such as posterior pericardiectomy can reduce mediastinal
fluid accumulation, which is a trigger for POAF. Furthermore, many
preventive strategies for POAF are implemented in the immediate
postoperative period. Initiating beta-blockers, amiodarone, or both is
reasonable for most patients. Overdrive atrial pacing, colchicine, and
steroids have been used by some, although the evidence base is less
robust. For patients with POAF, rate-control and rhythm-control strategies
have comparable outcomes. Decision-making regarding anticoagulation should
recognize that the stroke risk associated with POAF appears to be lower
than that for general nonvalvular AF. The evidence that oral
anticoagulation reduces stroke risk is less clear for POAF patients than
for patients with general nonvalvular AF. Given that POAF tends to be
shorter-lived and is associated with greater bleeding risks in the
perioperative period, decisions regarding anticoagulation should be
individualized. Finally, wearable technology and machine learning
algorithms for better predicting and managing POAF appear to be coming
soon. These technologies and a comprehensive clinical program could
meaningfully reduce the incidence of this common
complication.<br/>Copyright &#xa9; Journal of Thoracic Disease. All rights
reserved.

<24>
[Use Link to view the full text]
Accession Number
2030264351
Title
One-Year Outcomes After Amulet or Watchman Device for Percutaneous Left
Atrial Appendage Closure: A Prespecified Analysis of the SWISS-APERO
Randomized Clinical Trial.
Source
Circulation. 149(6) (pp 484-486), 2024. Date of Publication: 06 Feb 2024.
Author
Galea R.; Meneveau N.; De Marco F.; Aminian A.; Heg D.; Chalkou K.; Grani
C.; Anselme F.; Franzone A.; Vranckx P.; Fischer U.; Bedogni F.; Raber L.;
Valgimigli M.
Institution
(Galea, Grani, Raber, Valgimigli) Department of Cardiology, Bern
University Hospital, Department of Clinical Research, Switzerland
(Heg, Chalkou, Fischer) Department of Neurology, Bern University Hospital,
Department of Clinical Research, Switzerland
(Meneveau) CTU Bern, University of Bern, Switzerland, Besancon University
Hospital, University of Burgundy Franche-Comte, Besancon, France
(De Marco) Department of Cardiology, Monzino Cardiology Center, Milan,
Italy
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Belgium
(Anselme) Department of Cardiology, University Hospital of Rouen, France
(Franzone) Department of Advanced Biomedical Sciences, University Federico
II University, Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Belgium
(Bedogni) Department of Cardiology, IRCCS Policlinico San Donato, San
Donato Milanese, Milan, Italy
(Valgimigli) Cardiocentro Ticino Institute, Universita della Svizzera
Italiana (USI), Lugano, Switzerland
Publisher
Lippincott Williams and Wilkins

<25>
Accession Number
2029133219
Title
Efficacy of ultrasound-guided pecto-intercostal fascial block and
transversus thoracis muscle plane block for postoperative analgesia in
cardiac surgery in adult patients: A randomized study.
Source
Egyptian Journal of Anaesthesia. 40(1) (pp 201-208), 2024. Date of
Publication: 2024.
Author
Eloraby A.N.; El Mourad M.B.; Elatafy E.E.; Marouf H.M.; Ibrahim M.A.
Institution
(Eloraby, El Mourad, Marouf, Ibrahim) Anesthesiology, Surgical Intensive
Care and Pain Medicine Department, Faculty of Medicine, Tanta, Egypt
(Elatafy) Cardiothoracic Surgery Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Insufficient management of postoperative pain is a notable
issue encountered by individuals after open-heart operations. The study
aimed to evaluate the effect of ultrasound-guided pecto-intercostal
fascial block (PIFB) and transversus thoracis muscle plane (TTB) on the
analgesic efficacy in adult patients undergoing open-heart operations and
the duration of mechanical ventilation (MV). <br/>Method(s): A randomized
double-blind controlled trial was conducted on a cohort of 90 adult
patients with elective open-heart surgery, namely valve replacement, with
midline sternotomy. Patients were divided into three groups of similar
size. The first group (control group) received conventional systemic
analgesia alone, while the second group received bilateral TTB and the
third group received bilateral PIFB, using ultra-sound guided technique.
<br/>Result(s): A significant reduction in NRS (Numeric Rating Scale)
values was observed in both the TTB group and the PIFB group as compared
to the control group at zero, three and 6-hour postoperative. The PIFB and
TTB group exhibited an important delay in the initiation of first rescue
analgesia, as well as a reduction in the overall intake of fentanyl for
rescue purposes during a twenty-four-hour period. Additionally, the TTB
group and the PIFB group demonstrated considerably shorter durations of
mechanical ventilation as compared to the control group.
<br/>Conclusion(s): The utilization of ultrasound TTB and PIFB
demonstrated efficacy in providing postoperative analgesia compared to the
control group. This was evidenced by the less requirement for additional
analgesic medication, reducing postoperative pain scores and a shorter
duration of mechanical ventilation.<br/>Copyright &#xa9; 2024 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<26>
Accession Number
2029132820
Title
Amino acids to prevent cardiac surgery-associated acute kidney injury: a
randomized controlled trial.
Source
JA Clinical Reports. 10(1) (no pagination), 2024. Article Number: 19. Date
of Publication: December 2024.
Author
Kazawa M.; Kabata D.; Yoshida H.; Minami K.; Maeda T.; Yoshitani K.;
Matsuda H.; Shintani A.
Institution
(Kazawa, Minami) Department of Critical Care Medicine, National Cerebral
and Cardiovascular Center, 6-1, Kishibe-Shinmachi, Osaka, Suita, Japan
(Kazawa, Kabata, Yoshida, Shintani) Department of Medical Statistics,
Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
(Matsuda) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Maeda, Yoshitani) Department of Anesthesiology, National Cerebral and
Cardiovascular Center, Osaka, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: This study aimed to examine the preventive effect of amino
acids on postoperative acute kidney injury (AKI). <br/>Method(s): This was
single-center, patient- and assessor-blinded, randomized controlled trial.
Patients who underwent aortic surgery with cardiopulmonary bypass were
included. The intervention group received 60 g/day of amino acids for up
to 3 days. The control group received standard care. The primary outcome
was the incidence of AKI. We assessed the effect of amino acids on AKI
using a Cox proportional hazards regression model. <br/>Result(s):
Sixty-six patients were randomly assigned to the control or intervention
group. One patient in the control group withdrew consent after
randomization. The incidence of AKI was 10 patients (30.3%) in the
intervention group versus 18 patients (56.2%) in the control group
(adjusted hazard ratio, 0.44; 95% confidence interval, 0.20-0.95; P =
0.04). <br/>Conclusion(s): This trial demonstrated a significant reduction
in AKI incidence with amino acid supplementation. Trial registration:
jRCT, jRCTs051210154. Registered 31 December 2021,
https://jrct.niph.go.jp/re/reports/detail/69916.<br/>Copyright &#xa9; The
Author(s) 2024.

<27>
Accession Number
2028796133
Title
Cardiac Output Changes during Renal Replacement Therapy: A Scoping Review.
Source
Blood Purification. 53(3) (pp 151-161), 2024. Date of Publication: 01 Mar
2024.
Author
Spano S.; Maeda A.; Lam J.; Chaba A.; See E.; Mount P.; Nichols-Boyd M.;
Bellomo R.
Institution
(Spano, Maeda, Chaba, See, Bellomo) Department of Intensive Care, Austin
Hospital, Heidelberg, VIC, Australia
(Spano) Department of Anesthesiology and Intensive Care Units, IRCCS
Humanitas Research Hospital, Milan, Italy
(Lam, Mount) Department of Nephrology, Austin Hospital, Heidelberg, VIC,
Australia
(See) Department of Nephrology, The Royal Melbourne Hospital, Parkville,
VIC, Australia
(See, Bellomo) Department of Critical Care, School of Medicine, University
of Melbourne, Parkville, VIC, Australia
(See, Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Parkville, VIC, Australia
(See, Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(Mount) Department of Medicine, Melbourne Medical School, University of
Melbourne, Parkville, VIC, Australia
(Nichols-Boyd) Austin Health Sciences Library, Austin Health, Heidelberg,
VIC, Australia
(Bellomo) Data Analytics Research and Evaluation, Austin Hospital,
Melbourne, VIC, Australia
Publisher
S. Karger AG
Abstract
Introduction: Renal replacement therapy (RRT) is associated with
hypotension. However, its impact on cardiac output (CO) is less
understood. We aimed to describe current knowledge of CO monitoring and
changes during RRT. <br/>Method(s): We searched MEDLINE, Embase, and
Cochrane from January 1, 2000, to January 31, 2023, using Covidence for
studies of intermittent hemodialysis (IHD) and continuous RRT (CRRT) with
at least three CO measurements during treatment. Two independent reviewers
screened citations, and a third resolved disagreements. The findings did
not allow meta-analysis and are presented descriptively. <br/>Result(s):
We screened 3,285 articles and included 48 (37 during IHD, nine during
CRRT, and two during both). Non-invasive devices (electrical conductivity
techniques and finger cuff pulse contour) were the most common CO
measurement techniques (21 studies). The median baseline cardiac index in
IHD studies was 3 L/min/m² (95% CI, 2.7-3.39). Among the 88
patient cohorts studied, a decrease in CO occurred in 63 (72%). In 16
cohorts, the decrease was severe (>25%). Changes in blood pressure (BP)
were not concordant in extent or direction with changes in CO. The
decrease in CO correlated weakly with ultrafiltration rate (r = -0.3, p =
0.05) and strongly with changes in systemic vascular resistance (SVR) (r =
-0.6, p < 0.001). <br/>Conclusion(s): There are limited data on CO changes
during RRT. However, a decrease in CO appeared common and was marked in 1
of 5 patient cohorts. Such decreases often occurred without BP changes and
were associated with increased SVR. &#xa9; 2023 S. Karger AG,
Basel<br/>Copyright &#xa9; 2024 S. Karger AG. All rights reserved.

<28>
Accession Number
2028506957
Title
Effect of Aggressive Warming versus Routine Thermal Management on the
Incidence of Perioperative Hypothermia in Patients Undergoing Thyroid
Surgery: A Prospective, Randomized, Double-Blind Controlled Trial.
Source
Therapeutics and Clinical Risk Management. 20 (pp 207-216), 2024. Date of
Publication: 2024.
Author
Bai Y.; Zhang Y.; Du Y.; Liu M.; Zhu J.; Wang G.
Institution
(Zhang, Bai, Zhang, Du, Liu, Zhu, Wang) Department of Anesthesiology,
Beijing Tongren Hospital, Capital Medical University, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Despite the implementation of various insulation measures, the
incidence of hypothermia during thyroid surgery remains high. This
randomized controlled study aimed to evaluate the effects of aggressive
thermal management combined with resistive heating mattresses to prevent
perioperative hypothermia in patients undergoing thyroid surgery.
<br/>Patients and Methods: 142 consecutive patients scheduled for elective
thyroid surgery were enrolled in the study. They were randomly and equally
allocated to the aggressive warming or routine care groups (n = 71). The
patients' body temperature was monitored before the induction of
anesthesia until they returned to the ward. The primary outcome was the
incidence of perioperative hypothermia. Secondary outcomes included
postoperative complications, such as mortality, cardiovascular
complications, wound infection, shivering, postoperative nausea and
vomiting (PONV), visual analog scale (VAS) pain scores, fever, headache
and hospital length of stay (LOS). <br/>Result(s): In our study, the
results showed that a significantly higher rate of hypothermia was
observed in the routine care group compared with the aggressive warming
group. The incidence of perioperative hypothermia was 19.72% (14/71) in
the aggressive warming group and 35.21% (25/71) in the routine care group
(P < 0.05). The incidence of shivering in the aggressive warming group
(1.41%) was significantly lower than that in the routine care group
(11.27%) (P < 0.05), and a one-day reduction in hospital length of stay
was observed in the aggressive warming group (P < 0.05). There was no
significant difference in mortality or other postoperative complications,
such as cardiovascular complications, wound infection, PONV, pain, fever
or headache, between the two groups (P > 0.05). <br/>Conclusion(s): Our
results suggest that aggressive thermal management combined with resistive
heating mattresses provided improved perioperative body temperature and
reduced the incidence of perioperative hypothermia and shivering compared
to routine thermal management.<br/>Copyright &#xa9; 2024 Zhang et al.

<29>
Accession Number
2027946313
Title
Pre-emptive treatment of heart failure exacerbations in patients managed
with the HeartLogicTM algorithm.
Source
ESC Heart Failure. 11(2) (pp 1228-1235), 2024. Date of Publication: April
2024.
Author
Garcia R.; Gras D.; Mansourati J.; Defaye P.; Bisson A.; Boveda S.;
Gandjbakhch E.; Gras M.; Gueffet J.-P.; Himbert C.; Jacon P.; Khattar P.;
Lequeux B.; Li A.; Mansourati V.; Minois D.; Marijon E.; Pierre B.; Probst
V.; Degand B.
Institution
(Garcia, Gras, Lequeux, Degand) Department of Cardiology, University
Hospital of Poitiers, Poitiers, France
(Garcia) Centre d'investigation clinique 1402, University Hospital of
Poitiers, Poitiers, France
(Gras, Gueffet) Department of Cardiology, Hopital prive du Confluent,
Nantes, France
(Mansourati, Mansourati) Department of Cardiology, University Hospital of
Brest, Brest, France
(Defaye, Jacon) Department of Cardiology, University Hospital Grenoble
Alpes, Grenoble, France
(Bisson, Pierre) Department of Cardiology, University Hospital of Tours,
Chambray-les-Tours, France
(Bisson) Department of Cardiology, University Hospital of Orleans,
Orleans, France
(Boveda) Department of Cardiology, Clinique Pasteur, Toulouse, France
(Boveda) Universiteit Ziekenhuis, Vrije Universiteit Brussel (VUB), Jette,
Belgium
(Gandjbakhch, Himbert) Department of Cardiology, Hopital la Pitie
Salpetriere, Paris, France
(Khattar) Department of Cardiology, Hospital of Lorient, Lorient, France
(Li) Department of Cardiology, St. George's University of London, Cranmer
Terrace, London, United Kingdom
(Minois, Probst) Department of Cardiology, University Hospital of Nantes,
Nantes Cedex 1, France
(Marijon) Department of Cardiology, Hopital Europeen Georges Pomipdou,
Paris, France
(Marijon) Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
Publisher
John Wiley and Sons Inc
Abstract
Aims: Heart failure (HF) is a chronic disease affecting 64 million people
worldwide and places a severe burden on society because of its mortality,
numerous re-hospitalizations and associated costs. HeartLogicTM is an
algorithm programmed into implanted devices incorporating several
biometric parameters which aims to predict HF episodes. It provides an
index which can be monitored remotely, allowing pre-emptive treatment of
congestion to prevent acute decompensation. We aim to assess the impact
and security of pre-emptive HF management, guided by the HeartLogicTM
index. <br/>Methods and Results: The HeartLogicTM France Cohort Study is
an investigator-initiated, prospective, multi-centre, non-randomized
study. Three hundred ten patients with a history of HF (left ventricular
ejection fraction <=40%; or at least one episode of clinical HF with
elevated NT-proBNP >=450 ng/L) and implanted with a cardioverter
defibrillator enabling HeartLogicTM index calculation will be included
across 10 French centres. The HeartLogicTM index will be monitored
remotely for 12 months and in the event of a HeartLogicTM index >=16, the
local investigator will contact the patient for assessment and adjust HF
treatment as necessary. The primary endpoint is unscheduled
hospitalization for HF. Secondary endpoints are all-cause mortality,
cardiovascular death, HF-related death, unscheduled hospitalizations for
ventricular or atrial arrhythmia and HeartLogicTM index evolution over
time. Blood samples will be collected for biobanking, and quality of life
will be assessed. Finally, the safety of a HeartLogicTM-triggered strategy
for initiating or increasing diuretic therapy will be assessed. A blind
and independent committee will adjudicate the events. <br/>Conclusion(s):
The HeartLogicTM France Cohort Study will provide robust real-world data
in a cohort of HF patients managed with the HeartLogicTM algorithm
allowing pre-emptive treatment of heart failure
exacerbations.<br/>Copyright &#xa9; 2024 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<30>
Accession Number
639575603
Title
Fascia Iliaca Block Reduces Remifentanil Requirement in Conscious Sedation
for Transcatheter Aortic Valve Implantation- A Randomized Clinical Trial.
Source
Circulation journal : official journal of the Japanese Circulation
Society. 88(4) (pp 475-482), 2024. Date of Publication: 25 Mar 2024.
Author
Kinoshita H.; Yamamoto M.; Adachi Y.; Yamaguchi R.; Takemura A.
Institution
(Kinoshita) Department of Dental Anesthesiology, Institute of Biomedical
Sciences, Tokushima University Graduate School
(Kinoshita) Department of Anesthesiology and Intensive Care, Hamamatsu
Medical University
(Kinoshita) Department of Anesthesiology, Toyohashi Heart Center
(Yamamoto, Adachi, Yamaguchi, Takemura) Department of Cardiology,
Toyohashi Heart Center
Abstract
BACKGROUND: Whether nerve block improves the quality of conscious sedation
(CS) in patients undergoing transcatheter aortic valve implantation (TAVI)
is unclear. This study investigated whether fascia iliaca block (FIB)
reduced the remifentanil requirement and relieved pain in CS for
TAVI.Methods and Results: This prospective study randomized 72 patients
scheduled for elective TAVI under CS into 2 groups, with (FIB) and without
(control) FIB (n=36 in each group). The sedation targeted a Bispectral
Index <90 with a Richmond Agitation-Sedation Scale of -2 to -1.
Dexmedetomidine (0.7 microg/kg, i.v.) combined with remifentanil (0.03
microg/kg/min, i.v.) and propofol (0.3 mg/kg/h, i.v.) was used to commence
sedation. FIB using 30 mL of 0.185% ropivacaine was implemented 2 min
before TAVI. Patient sedation was maintained with dexmedetomidine (0.4
microg/kg/h, i.v.) supplemented with remifentanil (0-0.02 microg/kg/min,
i.v.). Remifentanil (20 microg, i.v.) was used as a rescue dose for
intraprocedural pain. Compared with the control group, FIB reduced the
both the total (median [interquartile range] 83.0 [65.0-98.0] vs. 34.5
[26.0/45.8)] microg; P<0.001) and continuous (25.3 [20.9/31.5] vs. 9.5
[6.8/12.5] ng/kg/min; P<0.001) doses of remifentanil administered.
<br/>CONCLUSION(S): FIB reduced the remifentanil requirement and relieved
pain in patients undergoing TAVI with CS. Therefore, FIB improved the
quality of CS in TAVI.

<31>
Accession Number
2031368365
Title
Ultrasonographic comparison of the diaphragm function in critically ill
patients with volume and pressure modes.
Source
Journal of Critical Care. Conference: International Conference on Complex
Acute Illness (ICCAI) 2023. Augsburg Germany. 81 (no pagination), 2024.
Article Number: 154621. Date of Publication: June 2024.
Author
Jahromi G.S.; Tabatabaei S.M.; Zand F.; Nikandish R.; Masjedi M.; Boldaji
V.N.
Institution
(Jahromi) Trauma Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Tabatabaei) Zahedan University of Medical Sciences, Zahedan, Iran,
Islamic Republic of
(Zand, Nikandish, Masjedi, Boldaji) Anesthesiology and Critical Care
Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
Publisher
W.B. Saunders
Abstract
Mechanical ventilation and the effect of respiratory muscle unloading on
the diaphragm causes atrophy of the diaphragmatic muscle. Aim of the
present study was to evaluate the ultra sonographic indices of diaphragm
contractile activity (respiratory excursion and thickening) during
mechanical ventilation with Bilevel Positive Airway Pressure (BiPAP) and
Synchronized intermittent mandatory ventilation (SIMV), widely used modes
in critically ill patients [1]. <br/>Patients and Methods: Eligible
patients admitted to the ICU who met criteria equally divided in 2 groups;
1) BiPAP (n = 20) and 2) SIMV (n = 20). Cases of thoracic/gastric/
esophageal surgery, patients with the history of neuromuscular disorders,
and who weaned from mechanical ventilation during the first 48 h after
ultra sonographic recording were excluded. The right hemidiaphragm was
evaluated by B- and M-mode ultrasonography to record diaphragmatic
excursion (DE) and thickening fraction (DTF) [2]. <br/>Result(s): In the
BiPAP group, DTF values in the first, third and seventh days were 39 +/-
9%, 27.8 +/- 7.4% and 22 +/- 6.5% and diaphragmatic excursion (DE) were 2
+/- 0.31 cm, 1.35 +/- 0.19 cm and 1.13 +/- 0.14 cm respectively. First,
third and seventh days DTF values in the SIMV group, were 32 +/- 5.1%, 25
+/- 4.2% and 21.5 +/- 4.47%; and DE were 1.9 +/- 0.32 cm, 1.38 +/- 0.26 cm
and 0.95 +/- 0.23 cm respectively. The DTF and DE values reduced
significantly during the time in both groups (P value <0.001) but there is
no significant difference between two groups of the study. Diaphragmatic
dysfunction (DD) defined as DTF <= 20%, or DE <= 1.5 cm, was seen in 10%
of BiPAP and 15% of SIMV groups. <br/>Conclusion(s): The DE and DTF values
decreased significantly in both study groups. However, there were no
significant difference between groups in this regard. References:
1-Supinski G, Dhr S, Callahan L. Diaphragm Dysfunction in Critical
Illness. Chest 2018;153:1040-1051 2-Zambon M, Greco M, Bocchino S, et al.
Assessment of diaphragmatic dysfunction in the Critically ill patient with
Ultrasound: a systematic review. Intensive Care Medicine
2017;43:29-38<br/>Copyright &#xa9; 2024

<32>
Accession Number
2031363750
Title
Elective ICU booking for postoperative patients and actual utilization.
Source
Journal of Critical Care. Conference: International Conference on Complex
Acute Illness (ICCAI) 2023. Augsburg Germany. 81 (no pagination), 2024.
Article Number: 154629. Date of Publication: June 2024.
Author
Ghaffar W.; Wasim V.; Ghaffar M.B.A.; Tamraiz M.A.; Sohaib M.; Khan M.F.;
Latif A.; Shamim M.F.; Pervaiz A.
Institution
(Ghaffar, Wasim, Tamraiz, Sohaib, Khan, Latif, Shamim) Department of
Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan
(Ghaffar, Pervaiz) Department of Surgery, Aga Khan University Hospital,
Karachi, Pakistan
Publisher
W.B. Saunders
Abstract
The planned postoperative utilization of the intensive care unit decreases
perioperative mortality. However, the preoperative request for ICU
admission is made subjectively. Some high-risk elective procedures can get
delayed or cancelled due to the unavailability of the ICU bed. The
American College of surgeons national surgical quality improvement (ACS
NSQIP) risk calculator estimates the likelihood of postoperative
complications. Thus, the increased probability of postoperative
complications can guide the physician to book ICU in advance to avoid
unplanned ICU admission. The primary objective was to determine the number
of preoperative ICU requests generated and their utilization
postoperatively after an elective surgical procedure. The secondary
objective was to evaluate the characteristics of these patients using the
ACS NSQIP risk calculator and its effectiveness as a predictive tool for
postoperative ICU admission. <br/>Patients and Methods: This was a
retrospective study. All patients undergoing elective non-cardiothoracic
surgical procedures from January 2019 to December 2022 were included. The
emergency/ urgent cases and patients with incomplete medical record were
excluded. <br/>Result(s): During the period, 940 requests were generated
for postoperative ICU admission, however, only 24% (225 patients) ensued
in ICU. As shown in Fig. 1, the majority of ICU requests were generated by
neurosurgery (39.7%) followed by obstetrics (14.1%). Both of these
specialties were accounted for least effective utilization of ICU. Most
optimum utilization was ensued by the general surgery. One possible reason
is the usage of the ACS NSQIP calculator is part of their practice for
high-risk procedures. Cardiology consult was generated in most for
anticipated high risk of major adverse cardiac events. However, as per the
NSQIP calculator, 54.6% of patients had a below-average risk of cardiac
complications, depicting that for majority of patients, ICU booking was
overutilized. <br/>Conclusion(s): The number of postoperative ICU bookings
was higher in comparison to the actual utilization. The ACS NSQIP
calculator should be considered before request generation for
postoperative ICU, especially in patients with a high risk of cardiac
complications. References: Bainbridge D, Martin J, Arango M, Cheng D,
Evidence-based Peri-operative Clinical Outcomes Research (EPiCOR) Group.
Perioperative and anaesthetic-related mortality in developed and
developing countries: a systematic review and meta-analysis. The Lancet.
2012 Sep 22;380(9847):1075-81.<br/>Copyright &#xa9; 2024

<33>
[Use Link to view the full text]
Accession Number
643848450
Title
USEFULNESS OF PATIENT-SPECIFIC NEAR-INFRARED SPECTROSCOPY-BASED ALGORITHMS
FOR THE INTRAOPERATIVE MANAGEMENT DURING CARDIAC SURGERY.
Source
Journal of Cardiovascular Medicine. Conference: 19th Meeting of the
Societa Italiana di Chirurgia Cardiaca. Rome Italy. 19(Supplement 2) (pp
e77), 2018. Date of Publication: December 2018.
Author
Serraino G.F.; Jiritano F.; Garrasi C.; Musolino G.; Di Virgilio A.; Malta
E.; Mastroroberto P.
Institution
(Serraino, Jiritano, Garrasi, Musolino, Di Virgilio, Malta, Mastroroberto)
Cardiac Surigery Unit, Magna Graecia University, Catanzaro, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background After a systematic review showing poor and conflicting results
about the clinical effectiveness of near-infrared spectroscopy(NIRS)-based
patient-specific goal-directed algorithms for the prevention of organ
failure, sepsis and death in cardiac surgery patients, the proposal of
this study was to evaluate if a NIRS-based specific algorithm could
improve the intraoperative management, achieving an optimisation of
cerebral oxygenation during cardiopulmonary bypass (CPB) combined with a
restrictive blood red cell transfusion threshold. Methods 168 patients
were randomized into two groups: the NIRS-based algorithm Group, that
included a restrictive red cell transfusion threshold (haematocrit 18%),
and the control group, that had not a based algorithm. The primary outcome
for the trial was cognitive function measured up to 3 months post-surgery.
Secondary outcomes, including kidney and myocardial injury markers,
adverse clinical events, blood transfusion and cost-effectiveness were
compared between groups. Results Of the 168 patients, 136 with complete
follow-up data for the primary end point formed the analysis cohort. There
was no difference between the groups with respect to neurocognitive
impairment and for the secondary outcomes. Conversely, a subgroup analysis
showed that in aortic arch surgery, for NIRS-based algorithm patients
cognitive testing scores were higher in the verbal fluency domain (p <
0.01), whereas transfusion rates are similar in both groups (p > 0.05).
Conclusions Near-infrared spectroscopy-based algorithms for the management
of CPB do not show clinical advantages except for aortic arch surgery
patients.

<34>
[Use Link to view the full text]
Accession Number
643848445
Title
SAFETY AND EFFICACY OF BIATRIAL VS LEFT ATRIAL APPROACHES IN PATIENTS
UNDERGOING CONCOMITANT ATRIAL FIBRILLATION ABLATION DURING CARDIAC
SURGERY: A META-ANALYSIS.
Source
Journal of Cardiovascular Medicine. Conference: 19th Meeting of the
Societa Italiana di Chirurgia Cardiaca. Rome Italy. 19(Supplement 2) (pp
e77), 2018. Date of Publication: December 2018.
Author
Cappabianca G.; Corazzari C.; Tutino C.; Musazzi A.; Ferrarese S.; Beghi
C.
Institution
(Cappabianca, Corazzari, Tutino, Musazzi, Ferrarese, Beghi) Cardiac
Surgery Research Centre, Insubria University, Circolo Hospital, Varese,
Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background the latest STS guidelines recommend concomitant AF ablation not
only during mitral surgery (Class I, Level A) but also during other
cardiac surgery procedures (Class I, Level B) for patients with atrial
fibrillation (AF). Nevertheless, it is still unclear if limiting the
lesion set to the left atrium (LA) yields similar safety and efficacy
compared to a biatrial (BA) approach. Methods Pubmed, Scopus and WOS were
searched from their inception to April 2018: 23 studies comparing BA vs.
LA approaches for concomitant AF ablation (3, randomized, 5
propensity-adjusted, and 15 observational) including 6216 patients, were
identified. Of these, 9 studies (1236 patients) focused on mitral surgery
as main procedure. Results Freedom from AF was significantly higher in the
BA group at 6 months (OR 1.38, CI 1.08-1.76, p = 0.01) and one year (OR
1.53, CI 1.05-2.23, p = 0.03), but also permanent pacemaker (PPM) implants
(OR 1.62, CI 1.17 - 2.24, p = 0.004) and reopening for bleeding (OR 1.83,
CI 1.01 - 3.31, p = 0.05) were higher in the BA group. In the mitral
surgery subgroup, BA approach was superior in terms of one year freedom
from AF but no significant differences were found regarding PPM implants
and postoperative bleeding. Conclusions BA AF ablation seems more
effective than LA approach achieving sinus rhythm at one year; on the
other hand a LA approach may be preferable in patients with higher risk of
bleeding (i.e. dual antiplatelet, complex surgery) and in procedures with
a substantial risk of AV block.

<35>
[Use Link to view the full text]
Accession Number
643848367
Title
SYSTEMATIC REVIEW OF THE PREDICTIVE ACCURACY OF POINT OF CARE TESTS OF
COAGULOPATHY IN CARDIAC SURGERY.
Source
Journal of Cardiovascular Medicine. Conference: 19th Meeting of the
Societa Italiana di Chirurgia Cardiaca. Rome Italy. 19(Supplement 2) (pp
e30), 2018. Date of Publication: December 2018.
Author
Corazzari C.; Monaghan A.; Tutino C.; Murphy G.; Beghi C.
Institution
(Corazzari, Tutino, Beghi) Medicina e Chirurgia, Varese, Italy
(Monaghan, Murphy) Cardiovascular Science, Leicester, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background Coagulopathic haemorrhage is a common and serious complication
of cardiac surgery. Timely diagnosis and treatment of coagulopathy is
considered an important determinant of outcome. The aims of the review
were to quantify and compare the predictive accuracy of POC tests in
clinical use. Methods Observational studies and randomized controlled
trials that report measures of predictive accuracy for POC tests that are,
or have been used clinically for the diagnosis and treatment of
coagulopathic haemorrhage. Results 56 studies recruiting a total of 9123
participants, met the inclusion criteria for the qualitative analysis and
15 studies were included for quantitative analysis. We have shown that the
existing evidence is of insufficient quality to determine the predictive
accuracy of point of care diagnostic tests. The point estimates of the
Summary AUCROC analyses and the analysis of sensitivity and specificity
estimates from individual studies suggested that: Viscoelastic tests had
low sensitivity and high specificity, Platelet Function Tests had low
sensitivity and moderate specificity, and combined Viscoelastic and
Platelet Function tests had high sensitivity and low specificity. However
there was great uncertainty around all of these estimates and the 95%
margins of uncertainty included values less 0.5 in every analysis.
Calculated diagnostic odd ratios also indicated poor predictive accuracy
for all of the groups. Conclusions Coagulopathic haemorrhage remains a
common and severe complication of cardiac surgery. A systematic review of
available evidence did not demonstrate predictive accuracy for
point-of-care tests in clinical use for the diagnosis of coagulopathy in
cardiac surgery.

<36>
[Use Link to view the full text]
Accession Number
643848219
Title
MIDTERM RESULTS OF RANDOMIZED TRIAL OF TRICUSPID ANNULOPLASTY FOR LESS
THAN SEVERE FUNCTIONAL TRICUSPID REGURGITATION AT THE TIME OF MITRAL VALVE
SURGERY.
Source
Journal of Cardiovascular Medicine. Conference: 19th Meeting of the
Societa Italiana di Chirurgia Cardiaca. Rome Italy. 19(Supplement 2) (pp
e4), 2018. Date of Publication: December 2018.
Author
Pettinari M.; Lazam S.; De Kerchove L.; Pasquet A.; Gerber B.;
Vanoverschelde J.; El-Khoury G.
Institution
(Pettinari) Ziekenhuis Oost Limburg, Genk, Belgium
(Lazam, De Kerchove, Pasquet, Gerber, Vanoverschelde, El-Khoury) Cliniques
Universitaires Saint-Luc, Brussel, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives The optimal management of functional tricuspid regurgitation
(FTR) in the setting of mitral valve operations remains controversial. A
prospective randomized trial was performed to evaluate the worth of
repairing moderate FTR during mitral valve operations. Methods A single
center randomized study was design to allocate patients with less than
severe FTR undergoing mitral valve surgery to be prophylactically treated
with(TVP+) or without(TVP-) tricuspid valve annuloplasty. Primary outcome
was the recurrence of more than mild tricuspid regurgitation (TR)(Vena
contracta >4 mm) and secondary outcome was VO2 max, right ventricle(RV)
dimension and function measured by cardiac magnetic resonance(CMR).
Results Of the 103 consecutive patients enrolled, 51 (49.5%) were
allocated in the TVP- group and 52 (50.5%) in the TVP+ group. At a median
follow up was 3.1 years, TR > mild was observed in 13.7% (7/51) of
patients in the TVP- and in 1.9% (1/52) of patients in the TVP- group (p =
0.05). VO2max (TVP- = 20.1+/-7.6 vs TVP+ = 19 +/-7.8 ml/kg/min, p = 0.09)
was similar. CMR confirms no difference in RV end-diastolic (TVP- =
157.05+/-33.40 vs TVP+ = 149.5+/-33.6 ml, p = 0.58), end-systolic volume
(TVP- = 76.3+/-23.2 vs TVP+ = 70.9+/-21.7 ml, p = 0.55) and RV Ejection
Fraction (TVP- = 51.97+/-8.33 vs TVP+ = 53.26+/-4.56%, p = 0.5).
Conclusion This single-center prospective randomized trial demonstrated
that tricuspid annuloplasty at the time of mitral surgery reduce the
incidence of moderate or severe FTR. Nevertheless, the functional
capacity, the right ventricle function/dimension remain similar. The
influence of the tricuspid annulus dimension has still to be validated and
this sub-analysis is still in progress.

<37>
Accession Number
2029244903
Title
The effect of glycopyrrolate vs. atropine in combination with neostigmine
on cardiovascular system for reversal of residual neuromuscular blockade
in the elderly: a randomized controlled trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 123. Date
of Publication: December 2024.
Author
Wang Y.; Ren L.; Li Y.; Zhou Y.; Yang J.
Institution
(Wang, Ren, Li, Zhou, Yang) Department of Anesthesiology, Pain and
Perioperative Medicine, The First Affiliated Hospital of Zhengzhou
University, No.1 East Jianshe Road, Zhengzhou 450052, China
Publisher
BioMed Central Ltd
Abstract
Background: Glycopyrrolate-neostigmine (G/N) for reversing neuromuscular
blockade (NMB) causes fewer changes in heart rate (HR) than
atropine-neostigmine (A/N). This advantage may be especially beneficial
for elderly patients. Therefore, this study aimed to compare the
cardiovascular effects of G/N and A/N for the reversal of NMB in elderly
patients. <br/>Method(s): Elderly patients aged 65-80 years who were
scheduled for elective non-cardiac surgery under general anesthesia were
randomly assigned to the glycopyrrolate group (group G) or the atropine
group (group A). Following the last administration of muscle relaxants for
more than 30 min, group G received 4 ug/kg glycopyrrolate and 20 ug/kg
neostigmine, while group A received 10 ug/kg atropine and 20 ug/kg
neostigmine. HR, mean arterial pressure (MAP), and ST segment in lead II
(ST-II) were measured 1 min before administration and 1-15 min after
administration. <br/>Result(s): HR was significantly lower in group G
compared to group A at 2-8 min after administration (P < 0.05). MAP was
significantly lower in group G compared to group A at 1-4 min after
administration (P < 0.05). ST-II was significantly depressed in group A
compared to group G at 2, 3, 4, 5, 6, 7, 8, 9, 11, 13, 14, and 15 min
after administration (P < 0.05). <br/>Conclusion(s): In comparison to A/N,
G/N for reversing residual NMB in the elderly has a more stable HR, MAP,
and ST-II within 15 min after administration.<br/>Copyright &#xa9; The
Author(s) 2024.

<38>
Accession Number
2031327781
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Cardiology Clinics. (no pagination), 2024. Date of Publication: 2024.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
W.B. Saunders

<39>
Accession Number
643852485
Title
Stroke prevention strategies for cardiac surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
ANZ journal of surgery. (no pagination), 2024. Date of Publication: 26
Mar 2024.
Author
Fong K.Y.; Yeo S.; Luo H.; Kofidis T.; Teoh K.L.K.; Kang G.S.
Institution
(Fong, Yeo) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Luo, Kofidis, Teoh, Kang) Department of Cardiac, Thoracic and Vascular
Surgery, National University Heart Centre, Singapore
Abstract
BACKGROUND: Stroke is a much-feared complication of cardiac surgery, but
existing literature on preventive strategies is fragmented. Hence, a
systematic review and meta-analysis of stroke prevention strategies for
cardiac surgery was conducted. <br/>METHOD(S): An electronic literature
search was conducted to retrieve randomized controlled trials (RCTs)
investigating perioperative interventions for cardiac surgery, with stroke
as an outcome. Random-effects meta-analyses were conducted to generate
risk ratios (RRs), 95% confidence intervals (95% CI), and forest plots.
Descriptive analysis and synthesis of literature was conducted for
interventions not amenable to meta-analysis, focusing on risks of stroke,
myocardial infarction and study-defined major adverse cardiovascular
events (MACE). <br/>RESULT(S): Fifty-six RCTs (61894 patients) were
retrieved. Many included trials were underpowered to detect differences in
stroke risk. Among pharmacological therapies, only preoperative amiodarone
was shown to reduce stroke risk in one trial. Concomitant left atrial
appendage closure (LAAC) significantly reduced stroke risk (RR=0.55, 95%
CI=0.36-0.84, P=0.006) in patients with preoperative atrial fibrillation,
and there was no difference in on-pump versus off-pump coronary artery
bypass grafting (CABG) (RR=0.94, 95% CI=0.64-1.37, P=0.735). Much
controversy exists in literature on the timing of carotid endarterectomy
relative to CABG in patients with severe carotid stenosis. The use of
preoperative remote ischemic preconditioning was not found to reduce rates
of stroke or MACE. <br/>CONCLUSION(S): This review presents a
comprehensive synthesis of existing interventions for stroke prevention in
cardiac surgery, and identifies gaps in research which may benefit from
future, large-scale RCTs. LAAC should be considered to reduce stroke
incidence in patients with preoperative atrial fibrillation.<br/>Copyright
&#xa9; 2024 Royal Australasian College of Surgeons.

<40>
Accession Number
2031195706
Title
Effects of esketamine on postoperative negative emotions and early
cognitive disorders in patients undergoing non-cardiac thoracic surgery: A
randomized controlled trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111447. Date of Publication: August 2024.
Author
Luo T.; Deng Z.; Ren Q.; Mu F.; Zhang Y.; Wang H.
Institution
(Luo, Deng, Ren, Mu, Zhang, Wang) Department of Anesthesiology, Affiliated
Hospital of Zunyi Medical University, Zunyi 563100, China
(Luo, Wang) Guizhou Key Laboratory of Anesthesia and Organ Protection,
Zunyi 563100, China
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate whether a single dosage of esketamine
injection in the anesthesia period could improve postoperative negative
emotions and early cognitive function in patients undergoing non-cardiac
thoracic surgery. <br/>Design(s): A prospective single center double
blinded randomized placebo-controlled trial. <br/>Setting(s):
Perioperative period; operating room, post anesthesia care unit and
hospital ward. <br/>Patient(s): 129 adult patients that underwent elective
non-cardiac thoracic surgery under general anesthesia.
<br/>Intervention(s): During the operation, pharmacologic prevention of
postoperative negative emotion and early cognitive disorder with 0.2 mg/kg
(Low esketamine group) and 0.5 mg/kg esketamine (High esketamine group)
vs. placebo. Measurements: Emotion and early cognitive performance were
assessed on the day before surgery (POD-1), postoperative day 1 (POD1) and
day 3 (POD3) using HADS-A, HADS-D, Pain Visual Analogue Scale (VAS),
Confusion Assessment Method (CAM), Mini-Mental State Examination (MMSE),
and serum biomarkers (S100beta, BDNF, IL-6, acetylcholine, and
norepinephrine). <br/>Main Result(s): The high esketamine group showed
significantly lower HADS-A and HADS-D scores than control group on POD1
and POD3. No significant differences were observed between the low
esketamine group and the control group. The esketamine-treated groups
showed lower pain VAS scores than the control group at 2 h and on the
first day after operation. There were no significant differences among the
three groups in CAM and MMSE scores. However, the high esketamine group
had lower S100beta and IL-6 levels, and higher BDNF levels
postoperatively, while serum acetylcholine and norepinephrine were not
significantly different. <br/>Conclusion(s): A single intraoperative
injection of 0.5 mg/kg esketamine can alleviate postoperative anxiety,
depression, and pain to some extent. Although cognitive function
behavioral evaluation did not show obvious benefits, it can also reduce
the production of pro-inflammatory and brain injury-related factors while
promoting the generation of brain-derived neurotrophic factor.
Registration Trial registry: http://www.chictr.org.cn/; Identifier:
ChiCTR2100047067.<br/>Copyright &#xa9; 2024 The Authors

<41>
Accession Number
2031220195
Title
One-month DAPT with ticagrelor and aspirin for patients undergoing
coronary artery bypass grafting: rationale and design of the randomised,
multicentre, double-blind, placebo-controlled ODIN trial.
Source
EuroIntervention. 20(5) (pp e322-e328), 2024. Date of Publication: March
2024.
Author
Sandner S.; Gaudino M.; Redfors B.; Angiolillo D.J.; Ben-Yehuda O.; Bhatt
D.L.; Fremes S.E.; Lamy A.; Marano R.; Mehran R.; Pocock S.; Rao S.V.;
Spertus J.A.; Weinsaft J.W.; Wells G.; Ruel M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Ben-Yehuda) University of California San Diego, San Diego, CA, United
States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, University of Toronto, Toronto, ON, Canada
(Lamy) Division of Cardiac Surgery, Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Marano) Department of Radiological and Hematological Sciences, Section of
Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Rao) New York University Langone Health System, New York, NY, United
States
(Spertus) University of Missouri-Kansas City's Healthcare Institute for
Innovations in Quality, Kansas City, MO, United States
(Spertus) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Weinsaft) Department of Medicine, Greenberg Cardiology Division, Weill
Cornell Medical College, New York, NY, United States
(Wells) Heart Institute, School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Europa Group
Abstract
The optimal antiplatelet strategy after coronary artery bypass graft
(CABG) surgery in patients with chronic coronary syndromes (CCS) is
unclear. Adding the P2Y<inf>12</inf> inhibitor, ticagrelor, to low-dose
aspirin for 1 year is associated with a reduction in graft failure,
particularly saphenous vein grafts, at the expense of an increased risk of
clinically important bleeding. As the risk of thrombotic graft failure and
ischaemic events is highest early after CABG surgery, a better
risk-to-benefit profile may be attained with short-term dual antiplatelet
therapy followed by single antiplatelet therapy. The One Month Dual
Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft
Patients (ODIN) trial is a prospective, randomised, double-blind,
placebo-controlled, international, multicentre study of 700 subjects that
will evaluate the effect of short-term dual antiplatelet therapy with
ticagrelor plus low-dose aspirin after CABG in patients with CCS. Patients
will be randomised 1:1 to ticagrelor 90 mg twice daily or matching
placebo, in addition to aspirin 75-150 mg once daily for 1 month; after
the first month, antiplatelet therapy will be continued with aspirin
alone. The primary endpoint is a hierarchical composite of all-cause
death, stroke, myocardial infarction, revascularisation and graft failure
at 1 year. The key secondary endpoint is a hierarchical composite of
all-cause death, stroke, myocardial infarction, Bleeding Academic Research
Consortium (BARC) type 3 bleeding, revascularisation and graft failure at
1 year (net clinical benefit). ODIN will report whether the addition of
ticagrelor to low-dose aspirin for 1 month after CABG reduces ischaemic
events and provides a net clinical benefit in patients with CCS.
(ClinicalTrials.gov: NCT05997693).<br/>Copyright &#xa9; Europa Digital &
Publishing 2024. All rights reserved.

<42>
Accession Number
2031002220
Title
Looking Forward Vericiguat in Heart Failure - A Systematic Review.
Source
European Journal of Cardiovascular Medicine. 14(1) (pp 267-272), 2024.
Date of Publication: January 2024.
Author
Dave P.; Sawant A.; Kothari A.; Gaikwad R.
Institution
(Dave, Kothari, Gaikwad) Department of Medicine, MIMER Medical College,
Talegaon Dabhade, Pune, India
(Sawant) Department of Pharmacology, MIMER Medical College, Talegaon
Dabhade, Pune, India
Publisher
Healthcare Bulletin
Abstract
Background: Despite recent advances in heart failure (HF) management,
mortality and morbidity remain high in patients with heart failure with
reduced and preserved ejection fraction. HF is characterized by
endothelial dysfunction, inflammation, and increased oxidative stress that
results due to a reduction in the activity of the nitric oxide-soluble
guanylate cyclase-cyclic guanosine monophosphate (NOsGC-cGMP) signaling
pathway. All these factors contribute to direct damage at the myocardial,
vascular, and renal levels. At a fundamental level, it is known that this
cardioprotective pathway of NO-sGC-cGMP is impaired in heart failure
patients. <br/>Material(s) and Method(s): Vericiguat is a soluble
guanylate cyclase stimulator approved by various global regulatory bodies
in January 2021 and recommended in recently updated clinical practice
guidelines to reduce morbidity and mortality in patients with worsening
chronic heart failure (HF) with reduced ejection fraction (HFrEF). It is a
novel, orally used, small molecule, and direct stimulator of the soluble
guanylate cyclase. It restores the deficiency in this signaling pathway,
through stimulation and activation of sGC, aiming to increase cGMP levels,
with a reduction in HF-related oxidative stress and endothelial
dysfunction. For the present systematic review a Boolean search was
carried out in Pubmed, Google Scholar and Embase. <br/>Conclusion(s):
Overall, four main clinical trials have been carried out for vericiguat
namely the SOCRATES-REDUCED, SOCRATES - PRESERVED, VICTORIA, and VITALITY.
Vericiguat resulted in reduced CV death and HF hospitalization in patients
with HFrEF and a recent episode of cardiac decompensation.<br/>Copyright
&#xa9; 2024 Healthcare Bulletin. All rights reserved.

<43>
Accession Number
2030939830
Title
Complete Coronary Revascularization and Outcomes in Patients Who Underwent
Coronary Artery Bypass Grafting: Insights from The REGROUP Trial.
Source
American Journal of Cardiology. 217 (pp 127-135), 2024. Date of
Publication: 15 Apr 2024.
Author
Belyayev L.; Stock E.M.; Hattler B.; Bakaeen F.G.; Kinlay S.; Quin J.A.;
Haime M.; Biswas K.; Zenati M.A.
Institution
(Belyayev, Zenati) Division of Thoracic and Cardiac Surgery, Brigham and
Women's Hospital, Boston, Massachusetts, United States
(Stock, Biswas) Cooperative Studies Program Coordinating Center, Office of
Research and Development, US Department of Veterans Affairs, Perry Point,
Maryland, United States
(Hattler) Division of Cardiology, Eastern Colorado Veterans Affairs
Healthcare System and University of Colorado, Aurora, Colorado, United
States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United States
(Kinlay) Divisions of Cardiology, Veterans Affairs Boston Healthcare
System, and Harvard Medical School, Boston, Massachusetts, United States
(Quin, Haime, Zenati) Cardiac Surgery, Veterans Affairs Boston Healthcare
System, and Harvard Medical School, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
There is growing evidence in support of coronary complete
revascularization (CR). Nonetheless, there is no universally accepted
definition of CR in patients who undergo coronary bypass grafting surgery
(CABG). We sought to investigate the outcomes of CR, defined as surgical
revascularization of any territory supplied by a suitable coronary artery
with >=50% stenosis. We performed a preplanned subanalysis in the
Randomized Trial of Endoscopic or Open Saphenous Vein Graft Harvesting
(REGROUP) clinical trial cohort. Of 1,147 patients who underwent CABG, 810
(70.6%) received CR. The primary outcome was a composite of major adverse
cardiac events (MACEs), including death from any cause, nonfatal
myocardial infarction, or repeat revascularization over a median 4.7 years
of follow-up. MACE occurred in 175 patients (21.6%) in the CR group and 86
patients (25.5%) in the incomplete revascularization (IR) group (hazard
ratio [HR] 0.87, 95% confidence interval [CI] 0.67 to 1.13, p = 0.29). A
total of 97 patients (12.0%) in the CR group and 48 patients (14.2%) in
the IR group died (HR 0.93, 95% CI 0.65 to 1.32, p = 0.67); nonfatal
myocardial infarction occurred in 49 patients (6.0%) in the CR group and
30 patients (8.9%) in the IR group (HR 0.76, 95% CI 0.48 to 1.2, p =
0.24), and repeat revascularization occurred in 62 patients (7.7%) in the
CR group and 39 patients (11.6%) in the IR group (HR 0.64; 95% CI 0.42 to
0.95, p = 0.027). In conclusion, in patients with a great burden of
co-morbidities who underwent CABG in the REGROUP trial over a median
follow-up period of a median 4.7 years, CR was associated with similar
MACE rates but a reduced risk of repeat revascularization. Longer-term
follow-up is warranted.<br/>Copyright &#xa9; 2024

<44>
Accession Number
2030890849
Title
COVID-19 and Mortality in the Global Surgical Population: A Systematic
Review and Meta-Analysis.
Source
Journal of Surgical Research. 297 (pp 88-100), 2024. Date of Publication:
May 2024.
Author
Obidike P.; Chang A.; Calisi O.; Lee J.J.; Ssentongo P.; Ssentongo A.E.;
Oh J.S.
Institution
(Obidike) Department of General Surgery, University of Virginia,
Charlottesville, VA, United States
(Obidike, Chang, Calisi, Lee) Penn State College of Medicine and Milton S.
Hershey Medical Center, Hershey, Pennsylvania, United States
(Ssentongo) Department of Medicine, Penn State College of Medicine and
Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
(Ssentongo, Ssentongo) Department of Public Health Sciences, Penn State
College of Medicine and Milton S. Hershey Medical Center, Hershey,
Pennsylvania, United States
(Ssentongo, Oh) Division of Trauma Surgery, Department of Surgery, Penn
State College of Medicine and Milton S. Hershey Medical Center, Hershey,
Pennsylvania, United States
Publisher
Academic Press Inc.
Abstract
Introduction: To date, no systematic review or meta-analysis has
comprehensively estimated the risk of mortality by surgery type on an
international scale. We aim to delineate the risk of mortality in patients
with COVID-19 who undergo surgery. <br/>Method(s): PubMed (MEDLINE),
Scopus, OVID, the World Health Organization Global Literature on
Coronavirus Disease, and Corona-Central databases were searched from
December 2019 through January 2022. Studies providing data on mortality in
patients undergoing surgery were included. The Preferred Reporting Items
for Systematic Reviews and Meta-analyses guidelines for abstracting data
were followed and performed independently by two reviewers. The main
outcome was mortality in patients with COVID-19. <br/>Result(s): Of a
total of 4023 studies identified, 46 studies with 80,015 patients met our
inclusion criteria. The mean age was 67 y; 57% were male. Surgery types
included general (14.9%), orthopedic (23.4%), vascular (6.4%), thoracic
(10.6%), and urologic (8.5%). Patients undergoing surgery with COVID-19
elicited a nine-fold increased risk of mortality (relative risk [RR] 8.99,
95% confidence interval [CI] 4.96-16.32) over those without COVID-19. In
low-income and middle-income countries (RR: 16.04, 95% CI: 4.59-56.12),
the mortality risk was twice as high compared to high-income countries
(RR: 7.50, 95% CI: 4.30-13.09). <br/>Conclusion(s): Mortality risk in
surgical patients with COVID-19 compared to those without is increased
almost 10-fold. The risk was highest in low-income and middle-income
countries compared to high-income countries, suggesting a disproportionate
effect of the pandemic on resource-constrained regions.<br/>Copyright
&#xa9; 2024 Elsevier Inc.

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

<46>
Accession Number
2030287812
Title
Comparison of Multiple Injection Costotransverse Block and Erector Spinae
Plane Block for Post-Sternotomy Pain Relief in Pediatric Patients
Undergoing Cardiac Surgery: A Prospective Randomized Comparative Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 974-981),
2024. Date of Publication: April 2024.
Author
Somani S.; Makhija N.; Chauhan S.; Bhoi D.; Das S.; Bandi S.G.; Rajashekar
P.; Bisoi A.K.
Institution
(Somani, Makhija, Chauhan, Das) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
(Bhoi) Department of Anaesthesiology, Pain Medicine and Critical Care, All
India Institute of Medical Sciences, New Delhi, India
(Bandi, Rajashekar, Bisoi) Department of Cardiothoracic and Vascular
Surgery, All India Institute of Medical Sciences, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: The aim of this study was to evaluate the efficacy of
ultrasound-guided multiple injection costotransverse block (MICB) and
compare it with erector spinae plane block (ESPB) for poststernotomy pain
relief in pediatric cardiac surgical patients. <br/>Design(s): A
prospective, randomized, double-blind, comparative study. <br/>Setting(s):
At a single institution tertiary referral cardiac center.
<br/>Participant(s): A total of 90 children with acyanotic congenital
heart disease requiring surgery via sternotomy. <br/>Intervention(s):
Children were allocated randomly to 1 of the 3 following groups: ESPB
(group 1), MICB (group 2), or Control (group 3). Participants in groups 1
and 2 received 4 mg/kg of 0.2% ropivacaine for bilateral ultrasound-guided
block after induction of anesthesia. Postoperatively, intravenous
paracetamol was used for multimodal analgesia, and fentanyl/tramadol was
used for rescue analgesia. <br/>Measurements and Main Results: The
modified objective pain score (MOPS) was evaluated at 0, 1, 2, 4, 6, 8,
10, and 12 hours postextubation. After all exclusions, 84 patients were
analyzed. The MOPS score was found to be significantly lower in ESPB and
MICB groups compared to the control group until 10 hours postextubation (p
< 0.05), with no statistically significant difference at the 12th hour (p
= 0.2198). The total intraoperative fentanyl consumption (p = 0.0005),
need for fentanyl supplementation on incision (p < 0.0001), and need for
rescue opioid requirement in the postoperative period (p = 0.034) were
significantly lower in both the ESPB and MICB groups than the control
group. There were no statistically significant differences in both primary
and secondary outcomes between the ESPB and MICB groups.
<br/>Conclusion(s): Ultrasound-guided MICB was effective and comparable to
ESPB for post-sternotomy pain management in pediatric cardiac surgical
patients.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<47>
Accession Number
2028951004
Title
A Narrative Review on Robotic Surgery as Treatment for Renal Cell
Carcinoma with Inferior Vena Cava Thrombus.
Source
Journal of Clinical Medicine. 13(5) (no pagination), 2024. Article Number:
1308. Date of Publication: March 2024.
Author
Shah M.S.; Wang K.R.; Shah Y.B.; Ragam R.; Simhal R.K.; Ghodoussipour S.;
Djaladat H.; Mark J.R.; Lallas C.D.; Chandrasekar T.
Institution
(Shah, Wang, Shah, Ragam, Mark, Lallas) Department of Urology, Sidney
Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
19107, United States
(Simhal) Department of Urology, Oschner Health, New Orleans, LA 70121,
United States
(Ghodoussipour) Division of Urologic Oncology, Rutgers Cancer Institute of
New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
08901, United States
(Djaladat) Institute of Urology, Keck School of Medicine, University of
Southern California, Los Angeles, CA 90007, United States
(Chandrasekar) Department of Urology, University of California, Davis,
Sacramento, CA 92868, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Renal cell carcinoma (RCC) is a common diagnosis, of which a notable
portion of patients present with an extension into the venous circulation
causing an inferior vena cava (IVC) tumor thrombus. Venous extension has
significant implications for staging and subsequent treatment planning,
with recommendations for more aggressive surgical removal, although
associated surgical morbidity and mortality is relatively increased. The
methods for surgical removal of RCC with IVC thrombus remain complex,
particularly surrounding the use of robot-assisted surgery. Robot
assistance for radical nephrectomy in this context is recently emerging.
Thrombus level has important implications for surgical technique and
prognosis. Other preoperative considerations may include location,
laterality, size, and wall invasion. The urology literature on treatment
of such tumors is largely limited to case series and institutional studies
that describe the feasibility of various surgical options for these
complex tumors. Further understanding of the outcomes and patient-specific
risk factors would shed increased light on the optimal treatment for such
cases. This narrative review provides a thorough overview on the
previously reported use of robot-assisted nephrectomy in RCC with IVC
thrombus to inform further studies which may optimize outcomes and guide
shared decision-making.<br/>Copyright &#xa9; 2024 by the authors.

<48>
Accession Number
2028519612
Title
Differences in the Incidence of Hypotension and Hypertension between Sexes
during Non-Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(3) (no pagination), 2024. Article Number:
666. Date of Publication: February 2024.
Author
Bos E.M.E.; Tol J.T.M.; de Boer F.C.; Schenk J.; Hermanns H.; Eberl S.;
Veelo D.P.
Institution
(Bos, Tol, de Boer, Schenk, Hermanns, Eberl, Veelo) Department of
Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9,
Amsterdam 1105 AZ, Netherlands
(Schenk) Department of Intensive Care, Amsterdam UMC, University of
Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
(Schenk) Department of Epidemiology and Data Science, Amsterdam UMC,
University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Major determinants of blood pressure (BP) include sex and age.
In youth, females have lower BP than males, yet in advanced age, more
pronounced BP increases result in higher average BPs in females over 65.
This hypothesis-generating study explored whether age-related BP
divergence impacts the incidence of sex-specific intraoperative
hypotension (IOH) or hypertension. <br/>Method(s): We systematically
searched PubMed and Embase databases for studies reporting intraoperative
BP in males and females in non-cardiac surgery. We analyzed between-sex
differences in the incidence of IOH and intraoperative hypertension
(primary endpoint). <br/>Result(s): Among 793 identified studies, 14 were
included in this meta-analysis, comprising 1,110,636 patients (56%
female). While sex was not associated with IOH overall (females: OR 1.10,
95%CI [0.98-1.23], I² = 99%), a subset of studies with an
average age >=65 years showed increased exposure to IOH in females (OR
1.17, 95%CI [1.01-1.35], I² = 94%). One study reported
sex-specific differences in intraoperative hypertension, with a higher
incidence in females (31% vs. 28%). <br/>Conclusion(s): While sex-specific
reporting on intraoperative BP was limited, IOH did not differ between
sexes. However, an exploratory subgroup analysis offers the hypothesis
that females of advanced age may face an increased risk of IOH, warranting
further investigation.<br/>Copyright &#xa9; 2024 by the authors.

<49>
Accession Number
2031226539
Title
Prospective Randomized Pilot Trial on the Effects of Mild Hypercapnia on
Cerebral Oxygen Saturation in Patients Undergoing Off-Pump Coronary Artery
Bypass Grafting.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Bhandari C.; Gandhi H.; Panwar A.; Haranal M.; Pandya H.
Institution
(Bhandari, Gandhi, Panwar) Department of Cardiac Anesthesia, U. N. Mehta
Institute of Cardiology and Research Center (affiliated with B. J. Medical
College), New Civil Hospital Campus, Ahmedabad, Asarwa, India
(Haranal) Department CVTS, U. N. Mehta Institute of Cardiology and
Research Center (affiliated with B. J. Medical College), New Civil
Hospital Campus, Ahmedabad, Asarwa, India
(Pandya) Department of Research, U. N. Mehta Institute of Cardiology and
Research Center (affiliated with B. J. Medical College), New Civil
Hospital Campus, Ahmedabad, Asarwa, India
Publisher
W.B. Saunders
Abstract
Objective and Design: A single-center prospective randomized controlled
study was conducted to assess the effect of targeted mild hypercapnia
(TMH) on cerebral oxygen saturation (rSO<inf>2</inf>) in patients
undergoing off-pump coronary artery bypass grafting (CABG). Setting and
Participants: A prospective randomized controlled study involving 100
patients undergoing off-pump CABG at U. N. Mehta Hospital, Ahmedabad,
Gujarat, India. <br/>Intervention(s): Patients were randomized to either
the TMH (PaCO<inf>2</inf> 45-55 mmHg) or the targeted normocapnia (TN;
PaCO<inf>2</inf> 35-45 mmHg) group, containing 50 patients in each group.
Measurements: Monitoring of rSO<inf>2</inf>, heart rate, mean arterial
pressure (MAP), PaCO<inf>2</inf>, and peripheral oxygen saturation was
done at baseline, after induction, after left internal mammary artery
harvesting, at each grafting (distal and proximal), after protamine, and
after shifting to the intensive care unit. The standardized
minimental-state examination (SMMSE) was performed preoperatively and at
8, 12, and 24 hours postextubation. Data were analyzed using an
independent sample t test. <br/>Result(s): The TMH group had higher MAP
during grafting (p < 0.001) and higher rSO<inf>2</inf> on both sides
during distal and proximal grafting (p < 0.001) and after protamine (p <
0.05), as compared to the TN group. Compared to preoperative values, SMMSE
scores in the TN group were significantly lower at 12 and 24 hours
postextubation (p < 0.001). <br/>Conclusion(s): TMH during grafting
increased the cerebral blood flow and rSO<inf>2</inf> when hemodynamic
instability was very common. It has a protective role on the brain and
helps maintain cognition postoperatively.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<50>
Accession Number
2027953782
Title
Outcomes of transcatheter aortic valve replacement in patients with mitral
annular calcification and concomitant mitral valve dysfunction: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 61 (pp 99-109), 2024. Date of
Publication: April 2024.
Author
Ahmad S.; Yousaf A.; Ghumman G.M.; Dvalishvili M.; Ahsan M.J.; Dilibe A.;
Reis H.L.; Qavi A.H.; Szerlip M.; Goldsweig A.M.
Institution
(Ahmad, Goldsweig) Division of Cardiovascular Medicine, University of
Nebraska Medical Center, Omaha, NE, United States
(Yousaf) Department of Medicine, McLaren Flint-Michigan State University,
Flint, MI, United States
(Ghumman) Department of Cardiology, St. Vincent Mercy Medical Center,
Toledo, OH, United States
(Ahmad, Dvalishvili, Dilibe) Department of Medicine, East Carolina
University, Greenville, NC, United States
(Ahsan) Department of Cardiology, Iowa Heart Center, Des Moines, IA,
United States
(Reis) William E Laupus Health Sciences Library, East Carolina University,
Greenville, NC, United States
(Qavi) Division of Cardiovascular Medicine, East Carolina Heart Institute,
Greenville, NC, United States
(Szerlip) Department of Cardiology, Baylor Scott and White, The Heart
Hospital Plano, Plano, TX, United States
(Goldsweig) Department of Cardiology, Baystate Medical Center/UMass Chan
Medical School, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Calcific aortic stenosis is the principal indication for
transcatheter aortic valve replacement (TAVR). Comorbid mitral annular
calcification (MAC) is often present in patients undergoing TAVR. Limited
data exist on the impact of MAC on TAVR outcomes. We conducted a
systematic review and meta-analysis to explore the effects of MAC and
concomitant mitral valve dysfunction (MVD) on TAVR outcomes.
<br/>Method(s): A comprehensive literature review was conducted using
PubMed, Embase, Google Scholar, ClinicalTrials.gov, Scopus, and OVID for
studies until March 20, 2023. Using the random-effects Mantel-Haenszel
method, we calculated pooled risk ratios (RRs) and their corresponding 95
% confidence intervals (CIs) for all dichotomous variables.
<br/>Result(s): Six studies comprising 5822 patients (2541 with MAC
[severe MAC (>4 mm thickness) 583; non-severe MAC 1958; 400 with MVD; and
1071 without MVD], 3281 without MAC) met inclusion criteria. At 30 days
and 1 year, no significant differences were observed between the overall
MAC and no MAC groups in terms of mortality, stroke, and permanent
pacemaker implantation. However, MAC with MVD was associated with a higher
risk of all-cause mortality compared to MAC without MVD at 30 days (RR =
3.43, 95 % CI 2.04-5.76, P < 0.00001) and at 1 year (RR = 2.44, 95 % CI
1.85-3.20, P < 0.00001). Moreover, the risk of cardiovascular mortality
was higher in patients with MAC and MVD compared to those with MAC alone
(RR = 2.77, 95 % CI 1.89-4.06, P < 0.00001). Additionally, patients with
severe MAC had a higher risk of major bleeding at 30 days compared to the
non-severe MAC group (RR = 1.33, 95 % CI 1.04-1.69, P = 0.02).
<br/>Conclusion(s): TAVR appears to be safe in patients with non-severe
MAC, but severe MAC is associated with a higher risk of major bleeding and
concomitant MVD increases the mortality risk in patients undergoing
TAVR.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<51>
Accession Number
2029240758
Title
Novel role of cardiovascular MRI to contextualise tuberculous pericardial
inflammation and oedema as predictors of constrictive pericarditis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1329767. Date of Publication: 2024.
Author
Giliomee L.J.; Doubell A.F.; Robbertse P.S.; John T.J.; Herbst P.G.
Institution
(Giliomee, Doubell, Robbertse, Herbst) Division of Cardiology, Department
of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch
University and Tygerberg Hospital, Bellville, South Africa
(John) Heart Unit, Mediclinic Panorama, Cape Town, South Africa
Publisher
Frontiers Media SA
Abstract
Tuberculosis (TB) and human immunodeficiency virus/acquired
immunodeficiency syndrome have reached epidemic proportions, particularly
affecting vulnerable populations in low- and middle-income countries of
sub-Saharan Africa. TB pericarditis is the commonest cardiac manifestation
of TB and is the leading cause of constrictive pericarditis, a reversible
(by surgical pericardiectomy) cause of diastolic heart failure in endemic
areas. Unpacking the complex mechanisms underpinning constrictive
haemodynamics in TB pericarditis has proven challenging, leaving various
basic and clinical research questions unanswered. Subsequently, risk
stratification strategies for constrictive outcomes have remained
unsatisfactory. Unique pericardial tissue characteristics, as identified
on cardiovascular magnetic resonance imaging, enable us to stage and
quantify pericardial inflammation and may assist in identifying patients
at higher risk of tissue remodelling and pericardial constriction, as well
as predict the degree of disease reversibility, tailor medical therapy,
and determine the ideal timing for surgical pericardiectomy.<br/>Copyright
2024 Giliomee, Doubell, Robbertse, John and Herbst.

<52>
Accession Number
2029215132
Title
Right Ventricular Dysfunction before and after Cardiac Surgery: Prognostic
Implications.
Source
Journal of Clinical Medicine. 13(6) (no pagination), 2024. Article Number:
1609. Date of Publication: March 2024.
Author
Merlo A.; Cirelli C.; Vizzardi E.; Fiorendi L.; Roncali F.; Marino M.;
Merlo M.; Senni M.; Sciatti E.
Institution
(Merlo, Cirelli, Senni) School of Medicine and Surgery, University of
Milan-Bicocca, Milan 20126, Italy
(Vizzardi) Section of Cardiovascular Disease, Department of Medical and
Surgical Specialties, Radiological Sciences and Public Health, University
of Brescia, Brescia 25133, Italy
(Fiorendi, Roncali, Marino, Senni, Sciatti) Cardiology 1 Unit, ASST Papa
Giovanni XXIII, Bergamo 24121, Italy
(Merlo) Cardiac Surgery Unit, ASST Papa Giovanni XXIII, Bergamo 24121,
Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Right ventricular dysfunction is a prognostic factor for morbidity and
mortality across a broad spectrum of cardiovascular diseases. While the
role of the right ventricle in surgical patients has emerged, the
prognostic impact of right ventricular dysfunction remains unclear in a
large cardiac surgery population. We reviewed the existing literature
about the role of right ventricular dysfunction in adults undergoing
different kinds of cardiac surgery either present before or developed
after surgery itself. Pre- and post-operative right ventricular
dysfunction has demonstrated substantial prognostic implications. However,
there remains a lack of consensus regarding its definition and diagnostic
criteria. The available literature is limited to small-sized studies,
underscoring the need for studies with larger populations.<br/>Copyright
&#xa9; 2024 by the authors.

<53>
Accession Number
2029134664
Title
Optimization of cardiopulmonary bypass prime fluid to preserve
microcirculatory perfusion during on-pump coronary artery bypass graft
surgery: PRIME study protocol for a double-blind randomized trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 219. Date of
Publication: December 2024.
Author
Beukers A.M.; Bulte C.S.E.; Bosch R.J.; Eberl S.; van den Brom C.E.; Loer
S.A.; Vonk A.B.A.
Institution
(Beukers, Bulte, van den Brom, Loer) Department of Anaesthesiology,
Amsterdam UMC, VU University Amsterdam, Boelelaan 1117, Amsterdam,
Netherlands
(Beukers, Bulte, van den Brom) Amsterdam Cardiovascular Sciences,
Amsterdam UMC, Amsterdam, Netherlands
(Bosch, Vonk) Department of Cardiothoracic Surgery, Amsterdam UMC,
University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
(Eberl) Department of Anesthesiology, Amsterdam UMC, University of
Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
(van den Brom) Laboratory for Experimental Intensive Care and
Anesthesiology (LEICA), Amsterdam, UMC, University of Amsterdam,
Amsterdam, Netherlands
(van den Brom) Department of Intensive Care Medicine, Amsterdam UMC,
University of Amsterdam, Amsterdam, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Acute microcirculatory perfusion disturbances and organ edema
are important factors leading to organ dysfunction during cardiac surgery
with cardiopulmonary bypass (CPB). Priming of the CPB system with
crystalloid or colloid fluids, which inevitably leads to hemodilution,
could contribute to this effect. However, there is yet no optimal
evidence-based strategy for this type of priming. Hence, we will
investigate different priming strategies to reduce hemodilution and
preserve microcirculatory perfusion. <br/>Method(s): The PRIME study is a
single-center double-blind randomized trial. Patients undergoing elective
coronary artery bypass graft surgery with CPB will be randomized into
three groups of prime fluid strategy: (1) gelofusine with crystalloid, (2)
albumin with crystalloid, or (3) crystalloid and retrograde autologous
priming. We aim to include 30 patients, 10 patients in each arm. The
primary outcome is the change in microcirculatory perfusion. Secondary
outcomes include colloid oncotic pressure; albumin; hematocrit;
electrolytes; fluid balance and requirements; transfusion rates; and
endothelial-, glycocalyx-, inflammatory- and renal injury markers.
Sublingual microcirculatory perfusion will be measured using non-invasive
sidestream dark field video microscopy. Microcirculatory and blood
measurements will be performed at five consecutive time points during
surgery up to 24 h after admission to the intensive care unit.
<br/>Discussion(s): PRIME is the first study to assess the effect of
different prime fluid strategies on microcirculatory perfusion in cardiac
surgery with CPB. If the results suggest that a specific crystalloid or
colloid prime fluid strategy better preserves microcirculatory perfusion
during on-pump cardiac surgery, the current study may help to find the
optimal pump priming in cardiac surgery. Trial registration:
ClinicalTrials.gov NCT05647057. Registered on 04/25/2023.
ClinicalTrials.gov PRS: Record Summary NCT05647057, all items can be found
in the protocol.<br/>Copyright &#xa9; The Author(s) 2024.

<54>
Accession Number
2031325058
Title
Heel skin microclimate control: Secondary analysis of a self-controlled
randomized clinical trial.
Source
Journal of Tissue Viability. (no pagination), 2024. Date of Publication:
2024.
Author
Eberhardt T.D.; Lima S.B.D.; Pozzebon B.R.; Santos K.P.D.; Silveira
L.B.D.; Soares R.S.D.A.; Alves P.J.
Institution
(Eberhardt) University of Passo Fundo, RS, Brazil
(Lima, Santos, Silveira) University Federal of Santa Maria, RS, Brazil
(Pozzebon) Hospital Santa Cruz, RS, Santa Cruz do Sul, Brazil
(Soares) Polytechnic College of University Federal of Santa Maria, RS,
Brazil
(Alves) Portuguese Catholic University, Porto, Portugal
Publisher
Tissue Viability Society
Abstract
Objective: this study was undertaken to evaluate the efficacy of
multilayer polyurethane foam with silicone (MPF) compared to transparent
polyurethane film (TPF) dressings in the control of heel skin microclimate
(temperature and moisture) of hospitalized patients undergoing elective
surgeries. <br/>Method(s): the study took of a secondary analysis of a
randomized self-controlled trial, involving patients undergoing elective
surgical procedure of cardiac and gastrointestinal specialties in a
university hospital in southern Brazil, from March 2019 to February 2020.
Patients served as their own control, with their heels randomly allocated
to either TPF (control) or MPF (intervention). Skin temperature was
measured using a digital infrared thermometer; and moisture determined
through capacitance, at the beginning and end of surgery. The study was
registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5.
<br/>Result(s): significant difference in the microclimate variables were
observed when the groups (intervention and control) and the timepoint of
measurement (beginning and end of surgery) were compared. When assessing
temperature, an increase (+3.3 degreeC) was observed with TPF and a
decrease (-7.4 degreeC) was recorded with MPF. Regarding skin moisture, an
increase in moisture (+14.6 AU) was recorded with TPF and a slight
decrease (-0.3 AU) with MPF. <br/>Conclusion(s): The findings of this
study suggest that MPF is more effective than TPF in controlling skin
microclimate (temperature and moisture) in heels skin of hospitalized
patients undergoing elective surgeries. However, this control should be
better investigated in other studies.<br/>Copyright &#xa9; 2024 Tissue
Viability Society / Society of Tissue Viability

<55>
Accession Number
2029232716
Title
Year in Review 2023: Noteworthy Literature in Cardiothoracic
Transplantation.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2024. Date of Publication: 2024.
Author
Saleem F.; Liang H.; Martin A.K.
Institution
(Saleem, Liang, Martin) Division of Cardiovascular and Thoracic
Anesthesiology, Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Jacksonville, FL, United States
Publisher
SAGE Publications Inc.
Abstract
This review highlights key studies examining perioperative management of
cardiothoracic transplantation published in 2023. Articles were manually
screened after searching Scopus, PubMed, and Google Scholar databases for
manuscripts related to cardiothoracic transplantation, which yielded 343
papers with 15 qualitatively selected as the most salient for readers.
Overarching themes include differences in outcomes across the various
etiologies of end-stage lung disease, novel developments to expand the
donor pool, and multi-organ transplantation.<br/>Copyright &#xa9; The
Author(s) 2024.

<56>
Accession Number
643846513
Title
Differences in excess mortality by recipient sex after heart transplant:
An Individual Patient Data Meta-Analysis.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2024. Date of Publication: 22 Mar 2024.
Author
Vinson A.J.; Zhang X.; Dahhou M.; Susal C.; Dohler B.; Melk A.;
Sapir-Pichhadze R.; Cardinal H.; Wong G.; Francis A.; Pilmore H.; Grinspan
L.T.; Foster B.J.
Institution
(Vinson) Department of Medicine, Nephrology Division, Dalhousie
University, Halifax, NS, Canada
(Zhang, Dahhou) Research Institute of the McGill University Health Centre,
Montreal, QC, Canada
(Susal) Institute of Immunology, Heidelberg University Hospital,
Heidelberg, Germany; Transplant Immunology Research Center of Excellence,
Koc University, Istanbul, Turkey
(Dohler) Institute of Immunology, Heidelberg University Hospital,
Heidelberg, Germany
(Melk) Children's Hospital, Hannover Medical School, Hannover, Germany
(Sapir-Pichhadze) Department of Medicine, Division of Nephrology, McGill
University, QC, Canada
(Cardinal) Department of Medicine, Division of Nephrology, Centre
Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
(Wong) School of Public Health, University of Sydney, Sydney, NSW,
Australia
(Francis) School of Clinical Medicine, University of Queensland,
Australia; Department of Nephrology, Queensland Children's Hospital,
Brisbane, Australia
(Pilmore) Department of Renal Medicine, Auckland City Hospital
(Grinspan) Recanati/Miller Transplantation Institute, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
(Foster) Research Institute of the McGill University Health Centre,
Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and
Occupational Health, McGill University, Montreal, QC, Canada; Department
of Pediatrics, Division of Nephrology, McGill University Faculty of
Medicine, QC, Canada
Abstract
BACKGROUND: Identification of differences in mortality risk between female
and male heart transplant recipients may prompt sex-specific management
strategies. Because worldwide, males of all ages have higher absolute
mortality rates than females, we aimed to compare the excess risk of
mortality (risk above the general population) in female versus male heart
transplant recipients. <br/>METHOD(S): We used relative survival models
conducted separately in SRTR and CTS cohorts from 1988-2019, and
subsequently combined using two-stage individual patient data
meta-analysis, to compare the excess risk of mortality in female versus
male first heart transplant recipients, accounting for the modifying
effects of donor sex and recipient current age. <br/>RESULT(S): We
analyzed 108,918 patients. When the donor was male, female recipients 0-12
years (Relative excess risk (RER) 1.13, 95% CI 1.00-1.26), 13-44 years
(RER 1.17, 95% CI 1.10-1.25), and >=45 years (RER 1.14, 95% CI 1.02-1.27)
showed higher excess mortality risks than male recipients of the same age.
When the donor was female, only female recipients 13-44 years showed
higher excess risks of mortality than males (RER 1.09, 95% CI 1.00-1.20),
though not significantly (p= 0.05). <br/>CONCLUSION(S): In the setting of
a male donor, female recipients of all ages had significantly higher
excess mortality than males. When the donor was female, female recipients
of reproductive age had higher excess risks of mortality than male
recipients of the same age, though this was not statistically significant.
Further investigation is required to determine the reasons underlying
these differences.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<57>
Accession Number
643845373
Title
10-Year Mortality of Off-Pump Versus On-Pump Coronary Artery Bypass
Grafting: An Updated Systematic Review, Meta-Analysis, and
Meta-Regression.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 22 Mar 2024.
Author
Comanici M.; Bulut H.I.; Raja S.G.
Institution
(Comanici, Bulut, Raja) Department of Cardiac Surgery, Harefield Hospital,
United Kingdo, London, United Kingdom
Abstract
The longstanding debate on off-pump coronary artery bypass grafting
(OPCAB) versus on-pump coronary artery bypass grafting (ONCAB) has
primarily focused on short- and mid-term outcomes, with limited attention
to long-term survival. This study aims to address this gap by providing an
updated analysis of 10-year mortality rates following OPCAB versus ONCAB.
We have conducted a systematic review and meta-analysis, incorporating 22
studies comprising 69,449 patients. The primary endpoint was all-cause
mortality at 10 years. Meta-regression analysis explored sources of
heterogeneity. The meta-analysis revealed no significant difference in
long-term all-cause mortality between OPCAB and ONCAB (Hazard Ratio [HR]
1.000; 95% Confidence Interval [CI] 0.92-1.08; p=0.95). While substantial
heterogeneity existed across studies, meta-regression identified older age
as a significant factor favouring OPCAB. However, patient characteristics
like gender, comorbidities, and graft numbers did not significantly
influence the choice of surgical technique. In conclusion, this study
challenges historical concerns regarding OPCAB's quality of
revascularization and long-term survival demonstrating comparable outcomes
to ONCAB in well-selected patients when performed by experienced surgeons.
The results emphasize the importance of surgeon proficiency and advocate
for recognizing surgical revascularization as a
subspecialty.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<58>
Accession Number
643844411
Title
Systematic Dental Screening Before Transcatheter Aortic Valve Replacement:
A Call to Action!.
Source
Cardiology in review. (no pagination), 2024. Date of Publication: 23 Mar
2024.
Author
Amoroso G.; Mellema E.C.
Institution
(Amoroso) From the OLVG Amsterdam, Amsterdam the Netherlands
(Mellema) MKA Kennemer & Meer, Haarlem the Netherlands
Abstract
Transcatheter aortic valve implantation (TAVR) offers an alternative to
surgical aortic valve replacement for high-risk patients. Despite its
benefits, concerns arise from its association with prosthetic valve
endocarditis (PVE), a severe complication. Recent studies indicate a
potential higher incidence of PVE in TAVR recipients, especially within
the first year postimplantation. A significant proportion of these cases
trace back to oral-pharyngeal bacteria. However, no consensus exists on
dental screening for TAVR, unlike the standard procedure for surgical
aortic valve replacement. Dental screenings could reduce PVE risks and aid
in patient recovery. This article underscores the importance of dental
screenings, calling for more research to establish its efficacy and
systematic application for TAVRI candidates. Collaborative efforts between
oral and maxillofacial surgeons and cardiologists are crucial for optimal
patient outcomes.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<59>
Accession Number
2031347062
Title
The Influence of Audiovisual Distraction on Pain Reduction During
Transcatheter Aortic Valve Implantation Under Monitored Anesthesia Care: A
Prospective Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Pitts L.; Hellner N.; Kofler M.; Ryschka M.; Unbehaun A.; O'Brien B.;
Kempfert J.; Hommel M.
Institution
(Pitts, Kofler, Unbehaun, Kempfert) Department of Cardiothoracic and
Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Pitts, Hellner, Kofler, Ryschka, Unbehaun, O'Brien, Kempfert, Hommel)
Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Hellner, Ryschka, O'Brien, Hommel) Department of Cardiac Anesthesiology
and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin,
Germany
(Kofler, O'Brien, Kempfert) German Center for Cardiovascular Research,
Berlin, Germany
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of an audiovisual distraction system
on the dose of remifentanil for perioperative sedation during
transcatheter aortic valve implantation under monitored anesthesia care.
<br/>Design(s): Single-center prospective randomized nonblinded study.
<br/>Setting(s): Tertiary referral academic hospital. <br/>Participant(s):
Ninety patients who underwent transfemoral transcatheter aortic valve
implantation between July 2019 and July 2021. <br/>Intervention(s):
Patients were randomized to use either a novel audiovisual distraction
system during the intervention (n = 45) or standard care without an
audiovisual distraction system (n = 45). <br/>Measurements and Main
Results: Standardized questionnaires were given to each patient at
admission and before and after the intervention to assess their levels of
anxiety. Primary endpoints were the average and peak infusion rates of
remifentanil. All patients were considered for the final analysis
according to an intention-to-treat design. No relevant differences in pre-
and postinterventional anxiety status were observed between the groups.
Similarly, there were no significant differences in reported pain scores
(p = 0.364). The average infusion rate (p = 0.028) and peak infusion rate
(p = 0.025) of remifentanil were lower in the group with an audiovisual
distraction system. <br/>Conclusion(s): Audiovisual distraction is a
useful adjunct to reduce the dose of remifentanil under monitored
anesthesia care during transcatheter aortic valve implantation. Larger
studies are needed to evaluate potential positive effects on patient
satisfaction, incidence of delirium, and possible economic
benefits.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<60>
Accession Number
2029092294
Title
Preoperative routine measurement of NT-proBNP predicts postoperative
morbidity after non-cardiac surgery with intermediate or high surgical
risk: an observational study.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 113. Date
of Publication: December 2024.
Author
Schmidt G.; Frieling N.; Schneck E.; Habicher M.; Koch C.; Rubarth K.;
Balzer F.; Assmus B.; Sander M.
Institution
(Schmidt, Frieling, Schneck, Habicher, Koch, Sander) Department of
Anaesthesiology, Operative Intensive Care Medicine and Pain Therapy,
Justus Liebig University Giessen, Rudolf-Buchheim-Strasse 7, Giessen
35392, Germany
(Rubarth, Balzer) Institute of Medical Informatics, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin
and Humboldt- Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Asmus) Department of Cardiology and Angiology, Justus Liebig University
of Giessen, Klinikstrasse 33, Giessen 35392, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Chronic heart failure (HF) is a common clinical condition
associated with adverse outcomes in elderly patients undergoing
non-cardiac surgery. This study aimed to estimate a clinically applicable
NT-proBNP cut-off that predicts postoperative 30-day morbidity in a
non-cardiac surgical cohort. <br/>Method(s): One hundred ninety-nine
consecutive patients older than 65 years undergoing elective non-cardiac
surgery with intermediate or high surgical risk were analysed.
Preoperative NT-proBNP was measured, and clinical events were assessed up
to postoperative day 30. The primary endpoint was the composite morbidity
endpoint (CME) consisting of rehospitalisation, acute decompensated heart
failure (ADHF), acute kidney injury (AKI), and infection at postoperative
day 30. Secondary endpoints included perioperative fluid balance and
incidence, duration, and severity of perioperative hypotension.
<br/>Result(s): NT-proBNP of 443 pg/ml had the highest accuracy in
predicting the composite endpoint; a clinical cut-off of 450 pg/ml was
implemented to compare clinical endpoints. Although 35.2% of patients had
NT-proBNP above the threshold, only 10.6% had a known history of HF. The
primary endpoint was the composite morbidity endpoint (CME) consisting of
rehospitalisation, acute decompensated heart failure (ADHF), acute kidney
injury (AKI), and infection. Event rates were significantly increased in
patients with NT-proBNP > 450 pg/ml (70.7% vs. 32.4%, p < 0.001), which
was due to the incidence of cardiac rehospitalisation (4.4% vs. 0%, p =
0.018), ADHF (20.1% vs. 4.0%, p < 0.001), AKI (39.8% vs. 8.3%, p < 0.001),
and infection (46.3% vs. 24.4%, p < 0.01). Perioperative fluid balance and
perioperative hypotension were comparable between groups. Preoperative
NT-proBNP > 450 pg/ml was an independent predictor of the CME in a
multivariable Cox regression model (hazard ratio 2.92 [1.72-4.94]).
<br/>Conclusion(s): Patients with NT-proBNP > 450 pg/ml exhibited
profoundly increased postoperative morbidity. Further studies should focus
on interdisciplinary approaches to improve outcomes through integrated
interventions in the perioperative period. Trial registration: German
Clinical Trials Register: DRKS00027871, 17/01/2022<br/>Copyright &#xa9;
The Author(s) 2024.

<61>
Accession Number
2031187894
Title
Sex-Specific Disparities in Clinical Outcomes After Transcatheter Aortic
Valve Replacement Among Different Racial Populations.
Source
JACC: Asia. 4(4) (pp 292-302), 2024. Date of Publication: April 2024.
Author
Kim M.; Kang D.-Y.; Ahn J.-M.; Kim J.B.; Yeung A.C.; Nishi T.; Fearon
W.F.; Cantey E.P.; Flaherty J.D.; Davidson C.J.; Malaisrie S.C.; Kim H.J.;
Lee J.; Park J.; Kim H.; Cho S.; Choi Y.; Park S.-J.; Park D.-W.
Institution
(Kim, Kang, Ahn, Lee, Park, Kim, Cho, Choi, Park, Park) Division of
Cardiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Kim, Yeung, Nishi, Fearon) Department of Medicine/Division of
Cardiovascular Medicine, Stanford University School of Medicine, Stanford,
CA, United States
(Cantey, Flaherty, Davidson, Malaisrie) Bluhm Cardiovascular Institute
Northwestern University Feinberg School of Medicine, Division of
Cardiology and Cardiac Surgery, Departments of Medicine and Surgery,
Chicago, IL, United States
(Kim) Department of Clinical Epidemiology and Biostatistics, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Sex-related disparities in clinical outcomes following
transcatheter aortic valve replacement (TAVR) and the impact of sex on
clinical outcomes after TAVR among different racial groups are
undetermined. <br/>Objective(s): This study assessed whether sex-specific
differences in baseline clinical and anatomical characteristics affect
clinical outcomes after TAVR and investigated the impact of sex on
clinical outcomes among different racial groups. <br/>Method(s): The
TP-TAVR (Trans-Pacific TAVR) registry is a multinational cohort study of
patients with severe aortic stenosis who underwent TAVR at 2 major centers
in the United States and 1 major center in South Korea. The primary
outcome was a composite of death from any cause, stroke, or
rehospitalization after 1 year. <br/>Result(s): The incidence of the
primary composite outcome was not significantly different between sexes
(27.9% in men vs 28% in women; adjusted HR: 0.97; 95% CI: 0.79-1.20). This
pattern was consistent in Asian (23.5% vs 23.3%; adjusted HR: 0.99; 95%
CI: 0.69-1.41) and non-Asian (30.8% vs 31.6%; adjusted HR: 0.95; 95% CI:
0.72-1.24) cohorts, without a significant interaction between sex and
racial group (P for interaction = 0.74). The adjusted risk for all-cause
mortality was similar between sexes, regardless of racial group. However,
the adjusted risk of stroke was significantly lower in male patients than
in female patients, which was more prominent in the non-Asian cohort.
<br/>Conclusion(s): Despite significantly different baseline and
procedural characteristics, there were no sex-specific differences in the
adjusted 1-year rates of primary composite outcomes and all-cause
mortality, regardless of different racial groups. (Transpacific TAVR
registry [TP-TAVR]; NCT03826264)<br/>Copyright &#xa9; 2024 The Authors

<62>
Accession Number
2031135889
Title
Bartonella quintana Endocarditis: A Systematic Review of Individual Cases.
Source
Clinical Infectious Diseases. 78(3) (pp 554-561), 2024. Date of
Publication: 15 Mar 2024.
Author
Boodman C.; Gupta N.; Nelson C.A.; van Griensven J.
Institution
(Boodman) Division of Infectious Diseases, Department of Internal
Medicine, University of Manitoba, Winnipeg, MB, Canada
(Boodman, van Griensven) Unit of HIV and Neglected Tropical Diseases,
Institute of Tropical Medicine, Antwerp, Belgium
(Gupta) Department of Infectious Disease, Kasturba Medical College,
Manipal Academy of Higher Education, Manipal, India
(Nelson) Division of Vector-Borne Diseases, Centers for Disease Control
and Prevention, Fort Collins, CO, United States
Publisher
Oxford University Press
Abstract
Background. Bartonella quintana is a louse-borne bacterium that remains a
neglected cause of endocarditis in low-resource settings. Our
understanding of risk factors, clinical manifestations, and treatment of
B. quintana endocarditis are biased by older studies from high-income
countries. Methods. We searched Pubmed Central, Medline, Scopus, Embase,
EBSCO (CABI) Global Health, Web of Science and international trial
registers for articles published before March 2023 with terms related to
Bartonella quintana endocarditis. We included articles containing
case-level information on B. quintana endocarditis and extracted data
related to patient demographics, clinical features, diagnostic testing,
treatment, and outcome. Results. A total of 975 records were identified,
of which 569 duplicates were removed prior to screening. In total, 84
articles were eligible for inclusion, describing a total of 167 cases.
Infections were acquired in 40 different countries; 62 cases (37.1%) were
acquired in low- and middle-income countries (LMICs). Disproportionately
more female and pediatric patients were from LMICs. More patients
presented with heart failure (n = 70/167 [41.9%]) than fever (n = 65/167
[38.9%]). Mean time from symptom onset to presentation was 5.1 months.
Also, 25.7% of cases (n = 43/167) were associated with embolization, most
commonly to the spleen and brain; 65.5% of antimicrobial regimens included
doxycycline. The vast majority of cases underwent valve replacement
surgery (n = 154/167, [98.0%]). Overall case fatality rate was 9.6% (n =
16/167). Conclusions. B. quintana endocarditis has a global distribution,
and long delays between symptom onset and presentation frequently occur.
Improved clinician education and diagnostic capacity are needed to screen
at-risk populations and identify infection before endocarditis
develops.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of Infectious Diseases Society of America. All
rights reserved.

<63>
Accession Number
2030998525
Title
Dapagliflozin in Patients With a Failing Systemic Right Ventricle: Results
From the DAPA-SERVE Trial.
Source
JACC: Heart Failure. 12(4) (pp 789-791), 2024. Date of Publication: April
2024.
Author
Fusco F.; Scognamiglio G.; Abbate M.; Merola A.; Grimaldi N.; Ciriello
G.D.; Sarubbi B.
Institution
(Fusco, Scognamiglio, Abbate, Merola, Grimaldi, Ciriello, Sarubbi) Monaldi
Hospital, Naples, Italy
Publisher
Elsevier Inc.

<64>
[Use Link to view the full text]
Accession Number
2030843318
Title
Patient-Level Pooled Analysis of Endovascular Ultrasound Renal Denervation
or a Sham Procedure 6 Months After Medication Escalation: The RADIANCE
Clinical Trial Program.
Source
Circulation. 149(10) (pp 747-759), 2024. Date of Publication: 05 Mar 2024.
Author
Azizi M.; Sharp A.S.P.; Fisher N.D.L.; Weber M.A.; Lobo M.D.; Daemen J.;
Lurz P.; Mahfoud F.; Schmieder R.E.; Basile J.; Bloch M.J.; Saxena M.;
Wang Y.; Sanghvi K.; Jenkins J.S.; Devireddy C.; Rader F.; Gosse P.;
Claude L.; Augustin D.A.; McClure C.K.; Kirtane A.J.
Institution
(Azizi) Universite Paris Cite, France
(Azizi) AP-HP, Hopital Europeen Georges- Pompidou, Hypertension Department
and DMU CARTE, Paris, France
(Azizi) INSERM, Paris, France
(Sharp) University Hospital of Wales, Cardiff University, Cardiff, United
Kingdom
(Fisher) The Brigham and Women's Hospital, Boston, MA, United States
(Weber, Saxena) Division of Cardiovascular Medicine, State University of
New York, Downstate Medical Center, New York, United States
(Lobo) Barts NIHR Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London, United Kingdom
(Daemen) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Lurz) Zentrum fur Kardiologie, Universitatsmedizin Mainz, Germany
(Mahfoud) Klinik fur Innere Medizin III, Saarland University Hospital,
Saar, Homburg, Germany
(Mahfoud) Institute for Medical Engineering and Science, Massachusetts
Institute of Technology, Cambridge, MA, United States
(Schmieder) Nephrology and Hypertension, University Hospital Erlangen,
Friedrich Alexander University, Erlangen, Germany
(Basile) Division of Cardiovascular Medicine, Medical University of South
Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, United
States
(Bloch) Department of Medicine, University of Nevada School of Medicine
and Vascular Care, Renown Institute of Heart and Vascular Health, Reno,
United States
(Wang) Minneapolis Heart Institute, Abbott Northwestern Hospital, MN,
United States
(Sanghvi) Deborah Heart & Lung Center, Brown Mills, NJ, United States
(Jenkins) Ochsner Medical Center, New Orleans, LA, United States
(Devireddy) Division of Cardiology, Department of Medicine, Emory
University School of Medicine, Atlanta, GA, United States
(Rader) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
(Gosse) Hopital Saint-Andre-CHU, Bordeaux, France
(Claude, Augustin) Recor Medical, Inc., Palo Alto, CA, United States
(McClure) NAMSA, Minneapolis, MN, United States
(Kirtane) Columbia University Irving Medical Center, New York-
Presbyterian Hospital and the Cardiovascular Research Foundation, New
York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The randomized, sham-controlled RADIANCE-HTN (A Study of the
Recor Medical Paradise System in Clinical Hypertension) SOLO, RADIANCE-HTN
TRIO, and RADIANCE II (A Study of the Recor Medical Paradise System in
Stage II Hypertension) trials independently met their primary end point of
a greater reduction in daytime ambulatory systolic blood pressure (SBP) 2
months after ultrasound renal denervation (uRDN) in patients with
hypertension. To characterize the longer-term effectiveness and safety of
uRDN versus sham at 6 months, after the blinded addition of
antihypertensive treatments (AHTs), we pooled individual patient data
across these 3 similarly designed trials. <br/>METHOD(S): Patients with
mild to moderate hypertension who were not on AHT or with hypertension
resistant to a standardized combination triple AHT were randomized to uRDN
(n=293) versus sham (n=213); they were to remain off of added AHT
throughout 2 months of follow-up unless specified blood pressure (BP)
criteria were exceeded. In each trial, if monthly home BP was >=135/85 mm
Hg from 2 to 5 months, standardized AHT was sequentially added to target
home BP <135/85 mm Hg under blinding to initial treatment assignment.
Six-month outcomes included baseline- and AHT-adjusted change in daytime
ambulatory, home, and office SBP; change in AHT; and safety. Linear mixed
regression models using all BP measurements and change in AHT from
baseline through 6 months were used. <br/>RESULT(S): Patients (70% men)
were 54.1+/-9.3 years of age with a baseline daytime
ambulatory/home/office SBP of 150.5+/-9.8/151.0+/-12.4/155.5+/-14.4 mm Hg,
respectively. From 2 to 6 months, BP decreased in both groups with AHT
titration, but fewer uRDN patients were prescribed AHT (P=0.004), and
fewer additional AHT were prescribed to uRDN patients versus sham patients
(P=0.001). Whereas the unadjusted between-group difference in daytime
ambulatory SBP was similar at 6 months, the baseline and
medication-adjusted between-group difference at 6 months was -3.0 mm Hg
(95% CI, -5.7, -0.2; P=0.033), in favor of uRDN+AHT. For home and office
SBP, the adjusted between-group differences in favor of uRDN+AHT over 6
months were -5.4 mm Hg (.6.8, -4.0; P<0.001) and -5.2 mm Hg (.7.1, -3.3;
P<0.001), respectively. There was no heterogeneity between trials. Safety
outcomes were few and did not differ between groups. <br/>CONCLUSION(S):
This individual patient-data analysis of 506 patients included in the
RADIANCE trials demonstrates the maintenance of BP-lowering efficacy of
uRDN versus sham at 6 months, with fewer added AHTs.<br/>Copyright &#xa9;
2024 Lippincott Williams and Wilkins. All rights reserved.

<65>
[Use Link to view the full text]
Accession Number
2030843316
Title
Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve
Replacement Among Patients With Atrial Fibrillation.
Source
Circulation. 149(10) (pp 734-743), 2024. Date of Publication: 05 Mar 2024.
Author
Kapadia S.R.; Krishnaswamy A.; Whisenant B.; Potluri S.; Iyer V.; Aragon
J.; Gideon P.; Strote J.; Leonardi R.; Agarwal H.; Larrain G.; Sanchez C.;
Panaich S.S.; Harvey J.; Vahl T.; Menon V.; Wolski K.; Wang Q.; Leon M.B.
Institution
(Kapadia, Krishnaswamy, Menon, Wolski, Wang) Cleveland Clinic, Cleveland,
OH, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Potluri) Baylor Scott and White The Heart Hospital, Plano, TX, United
States
(Iyer) University of Buffalo, NY, United States
(Aragon) Santa Barbara Cottage Hospital, CA, United States
(Gideon) Banner University Medical Center, Phoenix, AZ, United States
(Strote) Medical Center of the Rockies, Loveland, CO, United States
(Leonardi) Lexington Medical Heart and Vascular Center, West Columbia, SC,
United States
(Agarwal) CHI Health Research Center, Omaha, NE, United States
(Larrain) Aspirus Research Institute, Wausau, WI, United States
(Sanchez) Ohio Health Research Institute, Columbus, OH, United States
(Panaich) University of Iowa Hospitals & Clinics, Iowa City, IA, United
States
(Harvey) WellSpan York Hospital, York, PA, United States
(Vahl, Leon) Columbia University Medical Center, New York, NY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Atrial fibrillation (AF) is common in patients undergoing
transcatheter aortic valve replacement (TAVR) and is associated with
increased risk of bleeding and stroke. While left atrial appendage
occlusion (LAAO) is approved as an alternative to anticoagulants for
stroke prevention in patients with AF, placement of these devices in
patients with severe aortic stenosis, or when performed at the same time
as TAVR, has not been extensively studied. <br/>METHOD(S): WATCH-TAVR
(WATCHMAN for Patients with AF Undergoing TAVR) was a multicenter,
randomized trial evaluating the safety and effectiveness of concomitant
TAVR and LAAO with WATCHMAN in AF patients. Patients were randomized 1:1
to TAVR + LAAO or TAVR + medical therapy. WATCHMAN patients received
anticoagulation for 45 days followed by dual antiplatelet therapy until 6
months. Anticoagulation was per treating physician preference for patients
randomized to TAVR + medical therapy. The primary noninferiority end point
was all-cause mortality, stroke, and major bleeding at 2 years between the
2 strategies. <br/>RESULT(S): The study enrolled 349 patients (177 TAVR +
LAAO and 172 TAVR + medical therapy) between December 2017 and November
2020 at 34 US centers. The mean age of patients was 81 years, and the mean
scores for CHA2DS2-VASc and HAS-BLED (Hypertension, Abnormal renal/liver
function, Stroke, Bleeding history or predisposition, Labile INR, Elderly,
Drugs/alcohol concomitantly) were 4.9 and 3.0, respectively. At baseline,
85.4% of patients were taking anticoagulants and 71.3% patients were on
antiplatelet therapy. The cohorts were well-balanced for baseline
characteristics. The incremental LAAO procedure time was 38 minutes, and
the median contrast volume used for combined procedures was 119 mL versus
70 mL with TAVR alone. At the 24-month follow-up, 82.5% compared with
50.8% of patients were on any antiplatelet therapy, and 13.9% compared
with 66.7% of patients were on any anticoagulation therapy in TAVR + LAAO
compared with TAVR + medical therapy group, respectively. For the
composite primary end point, TAVR + LAAO was noninferior to TAVR + medical
therapy (22.7 versus 27.3 events per 100 patient-years for TAVR + LAAO and
TAVR + medical therapy, respectively; hazard ratio, 0.86 [95% CI,
0.60-1.22]; P<inf>noninferiority</inf><0.001). <br/>CONCLUSION(S):
Concomitant WATCHMAN LAAO and TAVR is noninferior to TAVR with medical
therapy in severe aortic stenosis patients with AF. The increased
complexity and risks of the combined procedure should be considered when
concomitant LAAO is viewed as an alternative to medical therapy for
patients with AF undergoing TAVR.<br/>Copyright &#xa9; 2023 American Heart
Association, Inc.

<66>
Accession Number
2030795880
Title
Comparative Study of Rigid Ring with Prosthetic Fashioned Bands for
Tricuspid Annuloplasty.
Source
European Journal of Cardiovascular Medicine. 14(1) (pp 239-244), 2024.
Date of Publication: January 2024.
Author
Varadaraju R.; Ramesh H.C.; Bhagyashree J.; Cherukamudi A.
Institution
(Varadaraju, Ramesh, Bhagyashree, Cherukamudi) Dept of CTVS, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Bengaluru, India
Publisher
Healthcare Bulletin
Abstract
Background: Tricuspid valve repair for moderate to severe functional
tricuspid regurgitation is effectively performed as a concomitant
procedure during mitral valve surgery. Although various studies have shown
that three dimensional rigid rings are gold standard for tricuspid valve
annuloplasty, fashioned prosthetic bands are also used. Our study is aimed
to compare the results of using a rigid ring versus prosthetic fashioned
band (teflon strip) for functional tricuspid regurgitation in patients
undergoing mitral valve surgery. <br/>Method(s): A single-centre
randomized study was designed to allocate patients with functional
tricuspid regurgitation undergoing mitral valve surgery to be treated with
either a rigid ring or a prosthetic fashioned band (PTFE). A prospective
randomized study was done for a period of three years between January 2018
to December 2021 at Sri Jayadeva Institute of Cardiovascular Sciences and
Research, Bengaluru. 188 patients were enrolled in this study. Inclusion
criteria: all patients with moderate or more TR secondary to severe mitral
regurgitation or stenosis. Exclusion criteria: Patients with mild TR, with
no annular dilatation or severe pulmonary hypertension; patients with
organic TR, patients with concomitant coronary artery disease and those
with isolated TR. The primary outcome was freedom from progression of TR
by more than 2 grades at 12-months followup in both the groups.
<br/>Result(s): The data of 188 adult patients with moderate or more
functional tricuspid regurgitation secondary to mitral stenosis or
regurgitation receiving tricuspid valve repair using either rigid rings or
prosthetic fashioned bands (Teflon) and mitral valve surgery. Patients
were classified into two matched groups: rigid ring group (group A)
consisting of 96 cases and prosthetic teflon band group (group B)
consisting of 92 cases. In-hospital mortality was similar among both the
groups. Rigid ring and Teflon strip annuloplasty improved postoperative
tricuspid regurgitation grades, systolic pulmonary artery pressure and
TAPSE (tricuspid annular plane systolic excursion) as compared to baseline
values. <br/>Conclusion(s): Tricuspid valve repair with rigid rings or
fashioned flexible bands must be used for moderate or more secondary TR
while addressing the mitral valve to prevent further progression of TR
grades and eventual right ventricular dysfunction. Our study showed that
both rigid rings and flexible bands offer good long-term outcomes in terms
of preventing progression of TR, preventing right ventricular dysfunction
and providing freedom from re-operations.<br/>Copyright &#xa9; 2024
Healthcare Bulletin. All rights reserved.

<67>
Accession Number
2030423047
Title
Clinical Outcomes of Erector Spinae Plane Block for Midline Sternotomy in
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 964-973),
2024. Date of Publication: April 2024.
Author
Greene J.J.; Chao S.; Tsui B.C.H.
Institution
(Greene, Chao, Tsui) Department of Anesthesiology, Perioperative and Pain
Medicine, Stanford University School of Medicine, Stanford, CA, United
States
(Greene) University of California - San Francisco School of Medicine,
University of California - San Francisco, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the benefit of single-shot erector spinae plane
block (ESPB) on pain at postoperative hours 4 and 12, duration of
mechanical ventilation, hospital length of stay, intensive care unit (ICU)
length of stay, cumulative postoperative opioid usage, and incidence of
postoperative nausea and vomiting (PONV) after cardiac surgery via
sternotomy Design: A systematic review and meta-analysis of randomized
controlled trials and prospective clinical trials. <br/>Setting(s):
Studies were identified through the search of PubMed and EMBASE on July
19, 2023. <br/>Participant(s): Adults and children undergoing cardiac
surgery via sternotomy. <br/>Intervention(s): Single-shot ESPB versus
standard-of-care analgesia. <br/>Measurements and Main Results: A
systematic review and meta-analysis of 10 studies (N = 695 patients). The
single-shot ESPB arm exhibited statistically significant reductions in
pain score at postoperative hour 4 (standardized mean difference [SMD]
-2.95, 95% CI -5.86 to -0.04, p = 0.0466), duration of mechanical
ventilation (SMD -1.23, 95% CI -2.21 to -0.24, p = 0.0145), cumulative
postoperative opioid usage (SMD -1.48, 95% CI -2.46 to -0.49, p = 0.0033),
and PONV incidence (risk ratio 0.4358, 95% CI 0.2105-0.9021, p = 0.0252).
The single-shot ESPB arm did not exhibit a statistically significant
reduction in pain score at postoperative hour 12, length of hospital stay,
and length of ICU stay. <br/>Conclusion(s): Single-shot ESPB improves
near-term clinical outcomes in patients undergoing cardiac surgery via
sternotomy. More randomized controlled trials are needed to validate these
findings.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<68>
[Use Link to view the full text]
Accession Number
2030224465
Title
Goal-directed Perioperative Albumin Substitution Versus Standard of Care
to Reduce Postoperative Complications: A Randomized Clinical Trial
(SuperAdd Trial).
Source
Annals of Surgery. 279(3) (pp 402-409), 2024. Date of Publication: 01 Mar
2024.
Author
Schaller S.J.; Fuest K.; Ulm B.; Schmid S.; Bubb C.A.B.; Eckstein H.-H.;
Von Eisenhart-Rothe R.; Friess H.; Kirchhoff C.; Luppa P.; Blobner M.;
Jungwirth B.
Institution
(Schaller, Fuest, Ulm, Schmid, Bubb, Blobner, Jungwirth) Department of
Anesthesiology and Intensive Care Medicine, Technical University of
Munich, School of Medicine, Munich, Germany
(Schaller) Dept. of Anesthesiology and Intensive Care Medicine (CVK, CCM),
Charite - Universitatsmedizin Berlin, Berlin, Germany
(Fuest) Department of Anesthesiology and Intensive Care Medicine,
University of Ulm, Faculty of Medicine, Ulm, Germany
(Eckstein) Department of Vascular Surgery, Technical University of Munich,
School of Medicine, Munich, Germany
(Von Eisenhart-Rothe) Department of Orthopaedics, Technical University of
Munich, School of Medicine, Munich, Germany
(Friess) Department of Surgery, Technical University of Munich, School of
Medicine, Munich, Germany
(Kirchhoff) Department of Traumatology, Technical University of Munich,
School of Medicine, Munich, Germany
(Luppa) Technical University of Munich, School of Medicine, Institute of
Clinical Chemistry and Pathobiochemistry, Munich, Germany
Publisher
Wolters Kluwer Health
Abstract
Objective: To investigate whether goal-directed albumin substitution
during surgery and postanesthesia care to maintain a serum albumin
concentration >30 g/L can reduce postoperative complications.
<br/>Background(s): Hypoalbuminemia is associated with numerous
postoperative complications. Since albumin has important physiological
functions, substitution of patients with hypoalbuminemia is worth
considering. <br/>Method(s): We conducted a single-center, randomized,
controlled, outcome assessor-blinded clinical trial in adult patients,
American Society of Anesthesiologists physical status classification 3 to
4 or undergoing high-risk surgery. Patients, whose serum albumin
concentration dropped <30 g/L were randomly assigned to goal-directed
albumin substitution maintaining serum concentration >30 g/L or to
standard care until discharge from the postanesthesia intermediate care
unit. Standard of care allowed albumin substitution in hemodynamic
instable patients with serum concentration <20 g/L, only. Primary outcome
was the incidence of postoperative complications >=2 according to the
Clavien-Dindo Classification in at least 1 of 9 domains (pulmonary,
infectious, cardiovascular, neurological, renal, gastrointestinal, wound,
pain, and hematological) until postoperative day 15. <br/>Result(s): Of
2509 included patients, 600 (23.9%) developed serum albumin concentrations
<30 g/L. Human albumin 60 g (40-80 g) was substituted to 299 (99.7%)
patients in the intervention group and to 54 (18.0%) in the standard care
group. At least 1 postoperative complication classified as Clavien-Dindo
Classification >=2 occurred in 254 of 300 patients (84.7%) in the
intervention group and in 262 of 300 (87.3%) in the standard treatment
group (risk difference -2.7%, 95% CI, -8.3% to 2.9%). <br/>Conclusion(s):
Maintaining serum albumin concentration of >30 g/L perioperatively cannot
generally be recommended in high-risk noncardiac surgery
patients.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health. All rights
reserved.

<69>
Accession Number
2029079023
Title
Application of three-dimensional technology in video-assisted
thoracoscopic surgery sublobectomy.
Source
Frontiers in Oncology. 14 (no pagination), 2024. Article Number: 1280075.
Date of Publication: 2024.
Author
Zhang X.; Yang D.; Li L.; Wang J.; Liang S.; Li P.; Han Z.; Wang X.; Zhang
K.
Institution
(Zhang, Yang) Clinical Medical College of Hebei University, Affiliated
Hospital of Hebei University, Baoding, China
(Zhang, Yang, Zhang) Thoracic Surgery Department, Affiliated Hospital of
Hebei University Cardiothoracic Surgical Department, Affiliated Hospital
of Hebei University, Baoding, China
(Li) Surgical Department, Affiliated Hospital of Hebei University,
Baoding, China
(Li, Liang, Li, Han, Wang, Zhang) Basic Research Key Laboratory of General
Surgery for Digital Medicine, Baoding, China
(Li, Wang, Liang, Li, Han, Wang, Zhang) Institute of Life Science and
Green Development, Hebei University, Baoding, China
(Li, Zhang) 3D Image and 3D Printing Center, Affiliated Hospital of Hebei
University, Baoding, China
(Wang) Imaging Department of Hebei University Affiliated Hospital,
Baoding, China
Publisher
Frontiers Media SA
Abstract
Background: Due to the widespread use of imaging techniques, the detection
rate of early-stage lung cancer has increased. Video-assisted
thoracoscopic surgery (VATS) sublobectomy has emerged as a prominent
alternative to lobectomy, offering advantages like reduced resection
range, better preservation of lung function, and enhanced postoperative
quality of life. However, sublobectomy is more intricate than lobectomy,
necessitating a higher level of surgical proficiency and anatomical
understanding. <br/>Method(s): Three electronic databases were searched to
capture relevant studies from January 2016 to March 2023, which related to
the application of three-dimensional(3D) technology in VATS sublobectomy.
<br/>Result(s): Currently, clinical departments such as orthopedics,
hepatobiliary surgery, and urology have started using 3D technology. This
technology is expected to be widely used in thoracic surgery in future.
Now 3D technology assists in preoperative planning, intraoperative
navigation and doctor-patient communication. <br/>Conclusion(s): 3D
technologies, instrumental in locating pulmonary nodules and identifying
variations in target lung segmental vessels and bronchi, play pivotal
roles in VATS sublobectomy, especially in preoperative planning,
intraoperative navigation, and doctor-patient communication. The
limitations of 3D technology in clinical application are analyzed, and the
future direction of existing 3D technology development is
prospected.<br/>Copyright &#xa9; 2024 Zhang, Yang, Li, Wang, Liang, Li,
Han, Wang and Zhang.

<70>
Accession Number
2028880025
Title
Thoraflex Hybrid Prosthesis (THP): the profile.
Source
Expert Review of Medical Devices. 21(3) (pp 165-177), 2024. Date of
Publication: 2024.
Author
Jubouri M.; Kayali F.; Agbobu T.; Tahhan O.; Moothathamby T.; Abdulwahab
E.R.; Velayudhan B.; Mohammed I.; Bashir M.
Institution
(Jubouri, Agbobu) Hull York Medical School, University of York, York,
United Kingdom
(Kayali) University Hospitals Sussex NHS Foundation Trust, Sussex, United
Kingdom
(Tahhan) Aston Medical School, Aston University, Birmingham, United
Kingdom
(Moothathamby) Barts and The London School of Medicine and Dentistry,
Queen Mary University of London, London, United Kingdom
(Abdulwahab) University Hospitals Birmingham NHS Foundation Trust,
Birmingham, United Kingdom
(Velayudhan, Mohammed) Institute of Cardiac and Aortic Disorders (ICAD),
SRM Institutes for Medical Science (SIMS Hospital), Tamil Nadu, Chennai,
India
(Bashir) Neurovascular Research Laboratory, Faculty of Life Sciences and
Education, University of South Wales, Pontypridd, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: With the incidence of thoracic aortic disease on the rise,
total arch replacement (TAR) with frozen elephant trunk (FET) remains the
gold-standard management strategy due to optimal results. Several FET
devices exist commercially on the global market. However, the mainstay and
most commonly used and reported device is the Thoraflex Hybrid Prosthesis
(THP), with several recent reports suggesting its superiority. Areas
covered: This review aims to collate and summarize the evidence in the
literature on the clinical outcomes of TAR with FET using THP, with a
focus on mortality, neurological complications, endoleak, distal
stent-induced new entry (dSINE), aortic remodeling, coagulopathy, and
graft kinking. In addition, the design features of THP is discussed, and
an overview of market competitors is also highlighted. Expert opinion: THP
consistently demonstrates its effectiveness in treating complex thoracic
aortic pathology through favorable clinical outcomes, which can be
attributed to its unique and innovative design. Rates of early mortality
ranged 0.6-14.2%, neurological complications 0-25%, endoleak 0-8.4% and
dSINE 0-14.5%, with minimal incidence of graft kinking and coagulopathy.
Aortic remodeling is favorable and comparable to competitors. All this
evidence solidifies THP as the leading FET device, particularly when
combined with appropriate patient selection and surgical
planning.<br/>Copyright &#xa9; 2024 Informa UK Limited, trading as Taylor
& Francis Group.

<71>
Accession Number
2027668315
Title
Utility of dexmedetomidine on surgical site wound pain undergoing
thoracoscopic surgery: A meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14629. Date of Publication: April 2024.
Author
Li M.; Zhang K.; Lu H.; Liang Y.; Zhang Y.; Feng G.
Institution
(Li, Lu, Liang, Zhang, Feng) Department of Pharmacy, Gaozhou People's
Hospital, Guangdong, Gaozhou, China
(Zhang) Department of Cardiovascular Surgery, Gaozhou People's Hospital,
Guangdong, Gaozhou, China
Publisher
John Wiley and Sons Inc
Abstract
We conducted this study aimed to evaluate the analgesic effect of
dexmedetomidine in thoracoscopic surgery on postoperative wound pain, and
to provide a reference for clinical use of the drug. We searched PubMed,
Embase, Cochrane Library, Web of Science, Wanfang, Chinese Biomedical
Literature Database and China National Knowledge Infrastructure databases,
and supplemented with manual searching. We searched from database
inception to October 2023, to collect the randomised controlled trials
(RCTs) on dexmedetomidine application in thoracoscopic surgery. Two
researchers screened all the literature according to the inclusion and
exclusion criteria and the literature included in the study was evaluated
for quality, extracted information and required data. Stata 17.0 software
was employed for data analysis and the outcomes were 2 6, 12, 24 and 48 h
postoperative wound visual analog scores (VAS). Twenty-four RCTs totalling
2246 patients undergoing thoracoscopic surgery were finally included. The
analysis revealed dexmedetomidine applied to thoracoscopic surgery
significantly reduced the postoperative wound VAS scores at 2 h (SMD:
-0.96, 95% CI: -1.57 to -0.36, p = 0.002), 6 h (SMD: -0.98, 95% CI: -1.27
to -0.69, p < 0.001), 12 h (SMD: -1.19, 95% CI: -1.44 to -0.94, p <
0.001), 24 h (SMD: -0.91, 95% CI: -1.16 to -0.66, p < 0.001) and 48 h
(SMD: -0.75, 95% CI: -1.02 to -0.48, p < 0.001). Our results suggest
dexmedetomidine applied to thoracoscopic surgery can significantly reduce
postoperative wound pain, which is worthy of clinical
application.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<72>
Accession Number
2027251621
Title
Impact of preoperative chemotherapy on cutaneous wound healing in lung
cancer patients: A meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14518. Date of Publication: April 2024.
Author
Zhao J.; Cui H.; Qu M.; Xu Z.; Zhang Y.; Ma C.
Institution
(Zhao, Qu, Xu, Zhang, Ma) Department of Cardiothoracic Surgery,
Heilongjiang Provincial Hospital, Harbin, China
(Cui) Department of Respiratory Medicine, Heilongjiang Provincial
Hospital, Harbin, China
Publisher
John Wiley and Sons Inc
Abstract
As part of their treatment, lung cancer patients frequently endure
thoracic oncological surgery, with preoperative chemotherapeutic
interventions being the common approach. However, the potential impact of
these chemotherapeutic regimens on cutaneous wound healing outcomes
following surgery remains the topic of considerable clinical interest.
This meta-analysis sought to evaluate comprehensively the effect of
preoperative chemotherapeutic regimens on cutaneous wound healing in lung
cancer patients following thoracic oncological surgery. Extensive
literature searches were conducted using the leading databases PubMed,
Embase, Cochrane Library and Scopus. Eight studies out of 1342 identified
satisfied the inclusion criteria. Consideration was given to both
randomized controlled trials (RCTs) and observational studies. Data
pertaining to study characteristics, patient demographics,
chemotherapeutic regimens and wound healing outcomes were extracted with
great attention to detail. The examination of these varied studies
provided insights into the fluctuations in rates of recovery following
treatment, incidences of wound infections and frequencies of surgical
complications. The research studies provided odds ratios for recovery that
varied significantly in magnitude from 0.95 to 0.38, with regard to the
probability of wound infection. Furthermore, a range of odds ratios for
complications were disclosed, with certain odds ratios displaying narrow
confidence intervals. The complexity of the effect of preoperative
chemotherapy on wound closure subsequent to thoracic oncologic surgery is
highlighted by our findings. The results underscore the need for
individualized treatment strategies for lung cancer patients undergoing
surgical procedures that strike a balance between patient safety and
optimal clinical outcomes.<br/>Copyright &#xa9; 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<73>
Accession Number
2027197590
Title
Use of intraoperative haemoadsorption in patients undergoing heart
transplantation: a proof-of-concept randomized trial.
Source
ESC Heart Failure. 11(2) (pp 772-782), 2024. Date of Publication: April
2024.
Author
Nemeth E.; Soltesz A.; Kovacs E.; Szakal-Toth Z.; Tamaska E.; Katona H.;
Racz K.; Csikos G.; Berzsenyi V.; Fabry S.; Ulakcsai Z.; Tamas C.; Nagy
B.; Varga M.; Merkely B.
Institution
(Nemeth, Soltesz, Kovacs, Szakal-Toth, Tamaska, Katona, Racz, Csikos,
Berzsenyi, Fabry, Ulakcsai, Tamas, Merkely) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Nemeth, Soltesz, Kovacs, Tamaska, Katona, Racz, Csikos, Berzsenyi, Fabry,
Ulakcsai) Department of Anaesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Nagy) Department of Pathology and Experimental Cancer Research,
Semmelweis University, Budapest, Hungary
(Varga) Department of Laboratory Medicine, Semmelweis University,
Budapest, Hungary
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this trial was to compare the clinical effects of
intraoperative haemoadsorption versus standard care in patients undergoing
orthotopic heart transplantation (OHT). <br/>Methods and Results: In a
randomized, controlled trial, OHT recipients were randomized to receive
intraoperative haemoadsorption or standard care. Outcomes were
vasoactive-inotropic score (VIS), frequency of vasoplegic syndrome (VS) in
the first 24 h; post-operative change in procalcitonin (PCT) and
C-reactive protein (CRP) levels; intraoperative change in mycophenolic
acid (MPA) concentration; frequency of post-operative organ dysfunction,
major complications, adverse immunological events and length of
in-hospital stay and 1-year survival. Sixty patients were randomized
(haemoadsorption group N = 30, control group N = 25 plus 5 exclusions).
Patients in the haemoadsorption group had a lower median VIS and rate of
VS (VIS: 27.2 [14.6-47.7] vs. 41.9 [22.4-63.2], P = 0.046, and VS: 20.0%
vs. 48.0%, P = 0.028, respectively), a 6.4-fold decrease in the odds of
early VS (OR: 0.156, CI: 0.029-0.830, P = 0.029), lower PCT levels,
shorter median mechanical ventilation (MV: 25 [19-68.8] hours vs. 65
[23-287] hours, P = 0.025, respectively) and intensive care unit stay (ICU
stay: 8.5 [8.0-10.3] days vs. 12 [8.5-18.0] days, P = 0.022, respectively)
than patients in the control group. Patients in the haemoadsorption versus
control group experienced lower rates of acute kidney injury (AKI: 36.7%
vs. 76.0%, P = 0.004, respectively), renal replacement therapy (RRT: 0%
vs. 16.0%, P = 0.037, respectively) and lower median per cent change in
bilirubin level (PCB: 2.5 [-24.6 to 71.1] % vs. 72.1 [11.2-191.4] %, P =
0.009, respectively) during the post-operative period. MPA concentrations
measured at pre-defined time points were comparable in the haemoadsorption
compared to control groups (MPA pre-cardiopulmonary bypass: 2.4
[1.15-3.60] mug/mL vs. 1.6 [1.20-3.20] mug/mL, P = 0.780, and MPA 120 min
after cardiopulmonary bypass start: 1.1 [0.58-2.32] mug/mL vs. 0.9
[0.45-2.10] mug/mL, P = 0.786). The rates of cardiac allograft rejection,
30-day mortality and 1-year survival were similar between the groups.
<br/>Conclusion(s): Intraoperative haemoadsorption was associated with
better haemodynamic stability, mitigated PCT response, lower rates of
post-operative AKI and RRT, more stable hepatic bilirubin excretion, and
shorter durations of MV and ICU stay. Intraoperative haemoadsorption did
not show any relevant adsorption effect on MPA. There was no increase in
the frequency of early cardiac allograft rejection related to
intraoperative haemoadsorption use.<br/>Copyright &#xa9; 2023 The Authors.
ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<74>
Accession Number
2027177875
Title
Correlates of malnutrition in patients with heart failure: the role of
social support.
Source
ESC Heart Failure. 11(2) (pp 719-726), 2024. Date of Publication: April
2024.
Author
Sharifi M.H.; Afshari M.; Vardanjani H.M.; Nikmanesh A.; Nikoo M.H.
Institution
(Sharifi) Research Center for Traditional Medicine and History of
Medicine, Non-Communicable Diseases Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Afshari) Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Vardanjani) MPH Department, School of Medicine, Research Center for
Traditional Medicine and History of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Nikmanesh) Fasa University of Medical Sciences, Fasa, Iran, Islamic
Republic of
(Nikoo) Non-Communicable Disease Research Centre, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Aims: Heart failure (HF) is a major public health challenge. Malnutrition
has a significant effect on HF prognosis. Understanding the impact of
social and clinical factors on the risk of malnutrition is necessary
because it may aid in improving the health status of HF patients.
<br/>Methods and Results: Three hundred twenty patients with HF who were
hospitalized in a heart centre in Shiraz, Iran, from March to November
2022 were studied. Two validated questionnaires were used to evaluate
malnutrition and social support: (1) Mini-Nutritional Assessment Short
Form and (2) Medical Outcomes Study Social Support Survey. The
participants were then divided into three groups: those with normal
nutritional status (scores 12-14), those at risk of malnutrition (scores
7-11), and those who were malnourished (scores 0-6). The potential
correlates of malnutrition (including socio-demographic, clinical,
comorbidities, and laboratory factors) were included in the study. Then,
ordinal logistic regression was used to investigate the correlates of
malnutrition. The mean age of the participants was 64.2 +/- 11.2 years,
and more than half were male and married. Normal nutritional status was
seen in 110 (34.4%) participants, 151 (47.2%) were at risk of
malnutrition, and 58 (18.1%) were malnourished. The mean social support
score of the participants was 61.65 +/- 12.91. According to the adjusted
odds ratios (95% confidence intervals) obtained from multivariate
analysis, increased risk of malnutrition was associated with having a
lower social support score [0.95 (0.93-0.97), P-value <= 0.001], lower
body mass index [0.91 (0.86-0.97), P-value = 0.004], higher New York Heart
Association classification [1.26 (1.02-1.56), P-value = 0.03], longer
duration of disease [1.006 (1.001-1.01), P-value = 0.006], and lower serum
albumin level [0.25 (0.08-0.75), P-value = 0.01]. <br/>Conclusion(s):
Besides the clinical conditions affecting the risk of malnutrition in
patients with HF, social support may play an important role. Including
this factor in HF guidelines and developing educational programmes may
help improve HF patients' health.<br/>Copyright &#xa9; 2023 The Authors.
ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<75>
Accession Number
2027173493
Title
Risk factors associated with surgical site infections in patients
undergoing cardiothoracic surgery: A systematic review and meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14573. Date of Publication: April 2024.
Author
Zhang Y.; Tan S.; Chen S.; Fan X.
Institution
(Zhang, Tan, Fan) Department of Cardiovascular Surgery, Guangdong
Provincial Hospital of Chinese Medicine, Guangdong Province, Guangzhou,
China
(Chen) Department of Cardiology, Shengjing Hospital of China Medical
University, Liaoning Province, Shenyang, China
Publisher
John Wiley and Sons Inc
Abstract
Surgical site infections (SSIs) following cardiothoracic surgery can pose
significant challenges to patient recovery and outcome. This systematic
review and meta-analysis aim to identify and quantify the risk factors
associated with SSIs in patients undergoing cardiothoracic surgery. A
comprehensive literature search adhering to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines and based on the
PICO paradigm was conducted across four databases: PubMed, Embase, Web of
Science and the Cochrane Library, without any temporal restrictions. The
meta-analysis incorporated studies detailing the risk factors for
post-operative sternal infections, especially those reporting odds ratios
(OR) or relative risks with 95% confidence intervals (CI). Quality
assessment of the studies was done using the Newcastle-Ottawa Scale.
Statistical analysis was executed using the chi-square tests for
inter-study heterogeneity, with further analyses depending on
I² values. Sensitivity analyses were performed, and potential
publication bias was also assessed. An initial dataset of 2442 articles
was refined to 21 articles after thorough evaluations based on inclusion
and exclusion criteria. Patients with diabetes mellitus have an OR of 1.80
(95% CI: 1.40-2.20) for the incidence of SSIs, while obese patients
demonstrate an OR of 1.63 (95% CI: 1.40-1.87). Individuals who undergo
intraoperative blood transfusion present an OR of 1.13 (95% CI:
1.07-1.18), and smokers manifest an OR of 1.32 (95% CI: 1.03-1.60). These
findings unequivocally indicate a pronounced association between these
factors and an elevated risk of SSIs post-operatively. This meta-analysis
confirms that diabetes, obesity, intraoperative transfusion and smoking
heighten the risk of SSIs post-cardiac surgery. Clinicians should be alert
to these factors to optimise patient outcomes.<br/>Copyright &#xa9; 2023
The Authors. International Wound Journal published by Medicalhelplines.com
Inc and John Wiley & Sons Ltd.

<76>
Accession Number
2026625324
Title
The long-term incidence of chronic post-surgical pain after coronary
artery bypass surgery - A prospective observational study.
Source
European Journal of Pain (United Kingdom). 28(4) (pp 599-607), 2024. Date
of Publication: April 2024.
Author
Charlton E.; Atkins K.J.; Evered L.; Silbert B.; Scott D.A.
Institution
(Charlton, Atkins, Evered, Silbert, Scott) Department of Anaesthesia and
Acute Pain Medicine, St Vincent's Hospital Melbourne, Fitzroy, VIC,
Australia
(Charlton) Melbourne Medical School, The University of Melbourne,
Melbourne, VIC, Australia
(Atkins, Evered, Silbert, Scott) Department of Critical Care, Melbourne
Medical School, University of Melbourne, Melbourne, VIC, Australia
(Atkins, Evered) Department of Anesthesiology, Weill Cornell Medicine, New
York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Chronic post-surgical pain (CPSP) represents a significant
issue for many patients following surgery; however, the long-term
incidence and impact have not been well described following cardiac
surgery. Our aim was to characterize CPSP at least 5 years following
coronary artery bypass grafting (CABG) surgery. <br/>Method(s): This
prospective observational study investigated a cohort of patients from a
larger trial investigating cognitive outcomes following CABG surgery, with
89 of 148 eligible patients (60.1%) assessed for CPSP at a mean (standard
deviation [SD]) of 6.8 [1.2] years. Questionnaires interrogated pain
presence, intensity, location, neuropathic characteristics, Geriatric
Depression Scale scores (GDS) and instrumental activities of daily living
(IADL). <br/>Result(s): CPSP was described in 21/89 (23.6%), with 10
rating it as moderate to severe. Six of the CPSP patients (29%) met
criteria for neuropathic pain (6.7% overall). The highest rate of CPSP was
associated with the leg surgical site (chest 12/89 [13.5%], arm 8/68
[11.8%] and leg (saphenous vein graft-SVG) 11/37 [29.7%]; chi²
= 6.523, p = 0.038). IADL scores were significantly lower for patients
with CPSP (mean [SD]: 36.7 [1.6] vs. no CPSP 40.6 [0.6]; p = 0.006).
Patients had GDS scores consistent with moderate depression (GDS >8) in
3/21 (14.3%) with CPSP, versus 3/68 (4.4%) non-CPSP patients
(chi² = 3.20, p = 0.073). <br/>Conclusion(s): This study
identified a CPSP incidence of 23.6% at a mean of 6.8 years after CABG
surgery, with the highest pain proportion at SVG harvest sites. CPSP was
associated with neuropathic pain symptoms and had a significant impact on
IADLs. This emphasizes the need for long-term follow-up of CABG patients.
<br/>Significance: This study highlights the impact of CPSP 7 years
following cardiac surgery and highlights the effect of surgical site,
neuropathic pain and the importance of including pain assessment and
management in the long-term follow-up of cardiac surgical patients.
Strategies to address and prevent chronic pain following cardiac surgery
should be further explored.<br/>Copyright &#xa9; 2023 European Pain
Federation - EFIC .

<77>
Accession Number
2026470209
Title
Preoperative anemia and anemia treatment in cardiac surgery: a systematic
review and meta-analysis.
Source
Canadian Journal of Anesthesia. 71(1) (pp 127-142), 2024. Date of
Publication: January 2024.
Author
Lau M.P.X.L.; Low C.J.W.; Ling R.R.; Liu N.S.H.; Tan C.S.; Ti L.K.;
Kofidis T.; MacLaren G.; Ramanathan K.
Institution
(Lau, Low, Ling, Liu, Tan, Ti, Kofidis, MacLaren, Ramanathan) Yong Loo Lin
School of Medicine, National University of Singapore, National University
Health System, Singapore, Singapore
(Tan) Saw Swee Hock School of Public Health, National University of
Singapore, National University Health System, Singapore, Singapore
(Ti) Department of Anaesthesia, National University Hospital, National
University Health System, Singapore, Singapore
(Kofidis) Department of Cardiac, Thoracic, and Vascular Surgery, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(MacLaren, Ramanathan) Cardiothoracic Intensive Care Unit, National
University Heart Centre, National University Hospital, National University
Health System, Singapore, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Level 9, 1E Kent Ridge Road,
Singapore 119228, Singapore
Publisher
Springer
Abstract
Purpose: We aimed to conduct a systematic review and meta-analysis to
assess the effects of anemia and anemia severity on patient outcomes in
cardiac surgery and determine whether preoperative treatments confer
postoperative benefit. Source: We searched four international databases
for observational and randomized studies published until 1 October 2022.
Study quality was assessed via Newcastle-Ottawa scores and the Cochrane
Risk-of-Bias 2 tool and certainty of evidence was rated with the Grading
of Recommendations, Assessment, Development and Evaluations approach. We
conducted random-effects meta-analyses for our primary outcome of
mortality, for secondary outcomes including length of stay (LOS) in the
hospital and intensive care unit, and for postsurgical complications. As
part of a secondary analysis, we analyzed short-term preoperative anemia
treatments and conducted trial sequential analysis of randomized trials to
assess the efficacy of these treatment programs. Principal findings: We
included 35 studies (159,025 patients) in our primary meta-analysis.
Preoperative anemia was associated with increased mortality (odds ratio
[OR], 2.5; 95% confidence interval [CI], 2.2 to 2.9; P < 0.001, high
certainty). Study-level meta-regression revealed lower hemoglobin levels
and studies with lower proportions of male patients to be associated with
increased risk of mortality. Preoperative anemia was also associated with
an increase in LOS and postsurgical complications. Our secondary analysis
(seven studies, 1,012 patients) revealed short-term preoperative anemia
treatments did not significantly reduce mortality (OR, 1.1; 95% CI, 0.65
to 1.9; P = 0.69). Trial sequential analysis suggested that there was
insufficient evidence to conclude if treatment programs yield any benefit
or harm. <br/>Conclusion(s): Preoperative anemia is associated with
mortality and morbidity after cardiac surgery. More research is warranted
to test the efficacy of current anemia treatment programs. Study
registration: PROSPERO (CRD42022319431); first submitted 17 April
2023.<br/>Copyright &#xa9; Canadian Anesthesiologists' Society 2023.

<78>
Accession Number
2026445986
Title
Cardiovascular anomalies in patients with Tessier syndrome: a systematic
review.
Source
European Journal of Pediatrics. 183(1) (pp 73-82), 2024. Date of
Publication: January 2024.
Author
Nazari S.; Vaezi A.; Mossavarali S.; Ghanavati K.; Shafiee A.
Institution
(Nazari) Pediatric Congenital Hematologic Disorders Research Center,
Research Institute for Children Health, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Vaezi, Mossavarali) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ghanavati) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Cardiac Primary Prevention Research Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Department of Cardiovascular Research, Tehran Heart Center,
North Kargar Ave., Tehran 1411713138, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Tessier clefts are skeletal and soft tissue abnormalities of a neonate's
facial structures. They could be classified as syndromic and non-syndromic
clefts, which can be attributed to disruptions in fetal development and
genetic mutations, respectively. Reported cases of these clefts typically
document the presence of additional abnormalities associated with these
clefts. In this systematic review, we analyzed reports of Tessier clefts
accompanied by cardiovascular anomalies, as one of the commonly
encountered anomalies. We systematically searched PubMed (MEDLINE),
Scopus, Web of Science, Science Direct, and Google Scholar. We selected
and included case reports, case series, and case reviews on patients with
Tessier cleft and cardiovascular anomalies. The critical appraisal of the
included studies was performed by two independent investigators using the
Consensus-based Clinical Case Reporting Guideline Development (CARE)
checklist. Overall, 20 reports (18 case reports and 2 case series) were
eligible for inclusion in this review. Tessier clefts 3 and 30 were the
most commonly observed. In addition, the most prevalent cardiovascular
anomalies consisted of the ventricular septal defect (VSD), double-outlet
right ventricle, and atrial septal defect (ASD). Most of the patients
received cosmetic and cardiovascular surgeries. However, some were not
proper candidates for cardiovascular surgery because of their unstable
condition and therefore did not survive. <br/>Conclusion(s): Regardless of
the focus placed on the cleft and subsequent plastic surgery procedures in
these cases, it is important to prioritize other abnormalities that may be
associated with mortality. A complete cardiovascular system and associated
disorders assessment should be performed before facial cosmetic surgeries.
(Table presented.)<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023.

<79>
Accession Number
2029091732
Title
Use of cardiac contractility modulation combined with left bundle branch
pacing CRT-P in a female with a 22-year history of non-ischemic dilated
cardiomyopathy: A case report.
Source
Echocardiography. 41(3) (no pagination), 2024. Article Number: e15762.
Date of Publication: March 2024.
Author
Fang L.; Ma Y.; Wu Y.; Ge Y.; Liang X.; Tang R.
Institution
(Fang) Department of Laboratory Medicine, The First Affiliated Hospital of
Xiamen University, Xiamen, China
(Fang, Ma, Wu, Ge, Tang) The School of Clinical Medicine, Fujian Medical
University, Xiamen, China
(Fang) Xiamen Key Laboratory of Genetic Testing, Xiamen, China
(Fang) School of Public Health, Xiamen University, Xiamen, China
(Ma, Tang) Department of Cardiology, The First Affiliated Hospital of
Xiamen University, Xiamen, China
(Wu, Ge) Department of Medical Ultrasound, The First Affiliated Hospital
of Xiamen University, Xiamen, China
(Liang) Center of Clinical Laboratory, Zhongshan Hospital, School of
Medicine, Xiamen University, Xiamen, China
(Liang) Institute of Infectious Disease, School of Medicine, Xiamen
University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Cardiac contractility modulation (CCM) is a novel device-based therapy
used to treat patients with heart failure with reduced ejection fraction
(HFrEF). In both randomized clinical trials and real-life studies, CCM has
been shown to improve exercise tolerance and quality of life, reverse left
ventricular remodeling, and reduce hospitalization in patients with HFrEF.
In this case report, we describe for the first time the use of CCM
combined with left bundle branch pacing (LBBP) cardiac resynchronization
therapy pacemaker (CRT-P) implantation therapy in a female with a 22-year
history of non-ischemic dilated cardiomyopathy. With the optimal medical
therapy and cardiac resynchronization therapy (CRT) strategies, the
patient's quality of life initially recovered to some extent, but began to
deteriorate in the past year. Additionally, heart transplantation was not
considered due to economic reasons and late stage systolic heart failure.
This is the first case of CCM implantation in Fujian Province and the
first report of a combined CCM and left bundle branch pacing CRT-P
implantation strategy in a patient with non-ischemic etiology dilated
cardiomyopathy in China.<br/>Copyright &#xa9; 2024 Wiley Periodicals LLC.

<80>
Accession Number
2027608398
Title
Inhaled iloprost in off-pump coronary artery bypass surgery: a randomized
controlled trial.
Source
Canadian Journal of Anesthesia. 71(4) (pp 479-489), 2024. Date of
Publication: April 2024.
Author
Ko S.H.; Shim J.-K.; Song J.-W.; Soh S.; Kwak Y.-L.
Institution
(Ko, Shim, Song, Soh, Kwak) Department of Anesthesiology and Pain
Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro,
Seodaemun-gu, Seoul 03722, South Korea
(Ko, Shim, Song, Soh, Kwak) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
Publisher
Springer
Abstract
Purpose: Mechanical cardiac constraint during off-pump coronary artery
bypass surgery (OPCAB) causes right ventricle (RV) compression and
increased pulmonary artery pressure (PAP), which may further compromise RV
dysfunction. We aimed to assess the effect of inhaled iloprost, a potent
selective pulmonary vasodilator, on the cardiac index (CI) during
mechanical constraint. The secondary aim was to determine the resultant
changes in the hemodynamic and respiratory parameters. <br/>Method(s): A
total of 100 adult patients with three-vessel coronary artery disease who
had known risk factors for hemodynamic instability (congestive heart
failure, mean PAP >= 25 mm Hg, RV systolic pressure >= 50 mm Hg on
preoperative echocardiography, left ventricular ejection fraction < 50%,
myocardial infarction within one month of surgery, redo surgery, and left
main disease) were enrolled in a randomized controlled trial. The patients
were randomly allocated to the control or iloprost groups at a 1:1 ratio,
in which saline and iloprost (20 mug) were inhaled for 15 min after
internal mammary artery harvesting, respectively. Cardiac index was
measured by pulmonary artery catheterization. <br/>Result(s): There were
no significant intergroup differences in CI during grafting (P = 0.36).
The mean PAP had a significant group-time interaction (P = 0.04) and was
significantly lower in the iloprost group at circumflex grafting (mean
[standard deviation], 26 [3] mm Hg vs 24 [3] mm Hg; P = 0.01). The
remaining hemodynamic parameters were similar between the groups.
<br/>Conclusion(s): Inhaled iloprost showed a neutral effect on
hemodynamic parameters, including the CI and pulmonary vascular resistance
index, during OPCAB. Trial registration: ClinicalTrials.gov (NCT04598191);
first submitted 12 October 2020.<br/>Copyright &#xa9; Canadian
Anesthesiologists' Society 2023.

<81>
Accession Number
643836734
Title
CABG versus PCI in Heart Failure with Reduced Ejection Fraction Patients:
A Systematic Review & Meta-analysis Stratified by Left Ventricular
Ejection Fraction.
Source
British Journal of Surgery. Conference: Annual Scientific Meeting of the
Surgical Research Society. Cambridge United Kingdom. 111(Supplement 2) (pp
ii26), 2024. Date of Publication: March 2024.
Author
Jubouri M.; Surkhi A.; Al-Tawil M.; Mohammed I.; Williams I.; Bailey D.;
Bashir M.; Awad W.
Institution
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Surkhi, Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem,
Palestine
(Mohammed) Institute of Cardiac and Aortic Disorders (ICAD), SRM
Institutes for Medical Science (SIMS Hospital), Chennai, India
(Williams) Department of Vascular Surgery, University Hospital of Wales,
Cardiff, United Kingdom
(Bailey) Neurovascular Research Laboratory, Faculty of Life Sciences and
Education, University of South Wales, Pontypridd, United Kingdom
(Bashir) Vascular and Endovascular Surgery, Velindre University NHS Trust,
Health Education and Improvement Wales (HEIW), Cardiff, United Kingdom
(Awad) Department of Cardiothoracic Surgery, Barts Heart Centre, St
Bartholomew's Hospital, London, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Comparing coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) in patients with heart failure
with reduced ejection fraction (HFrEF) remains controversial within the
literature. The current meta-analysis aimed to compare CABG and PCI in
HFrEF patients regarding mortality and long-term survival, repeat
revascularization, new postoperative myocardial infarction (MI) and
stroke, stratified by the degree of LVEF reduction. <br/>Method(s): In a
systematic review, a comprehensive literature search was conducted on
multiple electronic databases using strict search terms. Twenty studies
met the set inclusion/exclusion criteria. Meta-analysis of extracted data
was conducted using the R-studio and STATA software. Furthermore, the
aforementioned study endpoints were stratified by the degree of left
ventricular ejection fraction (LVEF) reduction into severe (<35%),
moderate (<40%) and mild (<50%). <br/>Result(s): Data from 25,031 HFrEF
patients was analysed, out of which 12,957 (52%) underwent CABG and 12,074
(48%) received PCI. Long-term survival was significantly higher in the
severe (<35%) and mildly (<50%) reduced LVEF groups, with no significant
different found in the moderately (<40%) reduced LVEF cohort. However, all
3 groups significantly favoured CABG in terms of need for
revascularization, but no difference in stroke incidence was found. As for
postoperative MI, this followed the same trend as survival. No evidence of
significant heterogeneity or publication bias was found.
<br/>Conclusion(s): CABG yields more favourable results than PCI in HFrEF
patients. Further stratifying the clinical outcomes measured by the degree
of LVEF reduction sheds light on the importance of risk stratification of
patients to optimise results.

<82>
Accession Number
2031228009
Title
EFFICACY OF ICOSAPENT ETHYL FOR REDUCING CARDIOVASCULAR OUTCOMES BY
BASELINE LOW DENSITY LIPOPROTEIN CHOLESTEROL LEVEL.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 1683), 2024. Date of Publication: 02
Apr 2024.
Author
Aggarwal R.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Dunbar R.L.; Ketchum S.; Tardif J.C.; Mason R.P.; Ballantyne C.M.
Institution
(Aggarwal, Bhatt, Steg, Miller, Brinton, Jacobson, Dunbar, Ketchum,
Tardif, Mason, Ballantyne) the REDUCE-IT Investigators, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background We performed a post hoc analysis of REDUCE-IT data to determine
if icosapent ethyl reduces cardiovascular (CV) outcomes among high CV risk
patients irrespective of baseline low-density lipoprotein cholesterol
(LDL-C). Methods This double-blind trial included statin-treated patients
>=45 years with CV disease or >=50 years with diabetes and >=1 CV risk
factor, having triglycerides (TGs) 135-499 mg/dL and LDL-C 41-100 mg/dL.
Patients were randomized to icosapent ethyl (4g/d) or placebo and for this
analysis, stratified by LDL-C <55 vs >=55 mg/dL. The primary outcome was a
composite of CV death, nonfatal myocardial infarction, nonfatal stroke,
coronary revascularization, or unstable angina. Differences were assessed
with Cox proportional-hazard models. Results Among 8179 patients, 1058
(12.9%) had LDL-C <55 mg/dL. The primary outcome rate among patients with
LDL-C <55 mg/dL was 16.2% in the icosapent ethyl group and 22.8% in the
placebo group (number needed to treat (NNT): 15, Hazard Ratio (HR): 0.66,
95% CI: 0.50, 0.87, P=0.003). Findings were consistent in the LDL-C >=55
mg/dL stratum, with 17.4% in the icosapent ethyl group and 21.9% in the
placebo group (NNT: 22, HR: 0.76, 95% CI: 0.69, 0.85, P<0.0001). No
significant interaction by baseline LDL-C was observed (P = 0.40). Similar
findings were observed across secondary outcomes (Figure). Conclusion
Among adults with increased CV risk and elevated TGs, icosapent ethyl
reduced the rate of CV outcomes irrespective of baseline LDL-C. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<83>
Accession Number
2031172761
Title
LEFT ATRIAL APPENDAGE CLOSURE DEVICE VERSUS MEDICAL THERAPY FOR TREATMENT
OF ATRIAL FIBRILLATION.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 240), 2024. Date of Publication: 02
Apr 2024.
Author
Fu D.; Moras E.C.; Aronow W.S.
Institution
(Fu, Moras, Aronow) Mount Sinai, New York City, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Despite the emergence of oral anticoagulants, numerous patients
find it challenging or are unwilling to use it for various reasons. Left
atrial appendage closure (LAAC) has emerged as an alternative to long-term
oral anticoagulation for stroke prophylaxis in patients with nonvalvular
atrial fibrillation. However current data remains controversial regarding
it's safety and efficacy. Methods We performed a systematic search of the
standard databases to identify all studies comparing LAAC to medical
therapy up to September 2023. A random-effects model was used to calculate
risk ratios (RR) and 95% confidence interval (CI) for the outcomes.
Results From 8 Studies (3 randomized controlled trials, 5 observational) a
total of 6302 patients (3235 LAAC, 3067 medical therapy) were included in
the final analysis. LAAC was associated with a reduced risk of all-cause
mortality (RR 0.64; 95% CI 0.51-0.81; p< 0.005) and major bleeding (RR
0.69; 95% CI, 0.57-0.84; p < 0.001). There were no significant differences
in terms of stroke from all causes (RR 0.98; 95% CI, 0.79-1.21; p < 0.83)
or cardiovascular death (CVD; RR 0.72; 95% CI, 0.51-1.02; p < 0.07).
Conclusion Findings from our meta-analysis indicates that the use of LAAC
device shows evidence of reduced long-term risk of death, possibly
attributed to lower rates of major bleeding. Rates of stroke and CVD were
comparable in the two groups. Additional extensive clinical trials are
required to further confirm the validity of these findings. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<84>
Accession Number
2031172633
Title
COMPARISON OF 30-DAY MORTALITY, STROKE, MAJOR BLEEDING, AND NEW PACEMAKER
IMPLANTATION AMONG PATIENTS UNDERSTAND DIFFERENT AORTIC VALVE-IN-VALVE
STRATEGIES: A META-ANALYSIS OF OBSERVATIONAL STUDIES.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 1113), 2024. Date of Publication: 02
Apr 2024.
Author
Nafee T.; Arasteh A.; Wakil C.; Sharma A.; Das D.; Atallah I.; Ghosh S.;
Mirza J.; Chitturu N.; Shrivastava S.; Rojulpote C.; Jain P.; Khan A.A.;
Ahmad A.; Towers A.A.; Gokul K.; Maniar H.; Mehanni M.; Lin C.-J.; Harjai
K.J.; Verma D.
Institution
(Nafee, Arasteh, Wakil, Sharma, Das, Atallah, Ghosh, Mirza, Chitturu,
Shrivastava, Rojulpote, Jain, Khan, Ahmad, Towers, Gokul, Maniar, Mehanni,
Lin, Harjai, Verma) Saint Louis University, St. Louis, MO, United States
Publisher
Elsevier Inc.
Abstract
Background The optimal native aortic valve replacement strategy in
patients expected to outlive their valve and to require valve-in-valve
intervention remains unclear. We performed a meta-analysis of
observational studies to evaluate short-term outcomes of different
valve-invalve strategies. Methods We underwent search of Medline
databases. Observational studies that enrolled patients who underwent
TAVR-in-TAVR or TAVR-in-SAVR were included. Those that did not report
30-day outcomes or included patients that underwent bailout TAVR were
excluded. Pooled analyses of incidence of 30-day mortality, stroke, major
bleeding, and pacemaker requirement was performed. Unadjusted comparison
of incidence rate ratios (IRR) between the groups was performed. Results
Our search yielded 60 observational studies that enrolled approximately
18,000 patients who underwent valve-in-valve intervention. Compared to
TAV-in-SAVR, TAVR-in-TAVR was associated with increased risk of 30-day
mortality (IRR 1.55, CI 1.27-1.89, p<0.001) and major bleeding (IRR=1.21,
CI 1.06-1.37, p=0.003) but a decreased risk of stroke (IRR=0.53, CI
0.39-0.70, p<0.001) and new pacemaker implantation (IRR=0.72, CI
0.59-0.88, p<0.001). Conclusion TAVR-in-TAVR was associated with increased
30-day mortality and major bleeding but a reduced risk of stroke and new
pacemaker implantation, compared to TAVR-in-SAVR. Adequately powered
randomized trials are required to define the optimal strategy in this
patient population. [Formula presented]<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<85>
Accession Number
2031171317
Title
CEREBROVASCULAR ACCIDENTS AND MORTALITY FOLLOWING LEFT ATRIAL APPENDAGE
OCCLUSION IN PATIENTS WITH MODERATE AND SEVERE CHRONIC RENAL IMPAIRMENT: A
COMPREHENSIVE META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 1142), 2024. Date of Publication: 02
Apr 2024.
Author
Gupta R.; Ghaseminejad-Raeini A.; Esmaeili S.; Shirinezhad A.; Sood A.;
Aronow W.S.; Patel N.C.
Institution
(Gupta, Ghaseminejad-Raeini, Esmaeili, Shirinezhad, Sood, Aronow, Patel)
Lehigh Valley Health Network, Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Background This study aims to assess mortality and cerebrovascular events
post LAAO in patients with different stages of chronic renal disease.
Methods We conducted a systematic review following PRISMA guidelines. We
searched PubMed, Scopus, and Web of Science for relevant citations. Two
independent reviewers screened and extracted data. Eligible studies
compared post-LAAO mortality and stroke between CKD and non-CKD patients,
with a meta-analysis planned to assess outcomes in ESRD. Statistical
analyses were performed using R software. Results In total, 13 studies
involving 56,041 patients were analyzed. Post-LAAO, patients with CKD had
a higher mortality rate (OR=2.46 [2.00-3.03], I2=0%). However, there was
no significant difference in stroke/TIA incidence between the groups
(OR=0.80 [0.57-1.12], I2=30%). ESRD was associated with significantly
higher odds of mortality (OR=3.19 [1.22-8.38], I2=82%) and stroke/TIA
(OR=4.17 [2.97-5.85], I2=0%) following LAAO. No publication bias was
detected based on Egger's regression test. Conclusion Our study suggests
that LAAO may have similar efficacy in individuals with or without CKD.
However, the mortality rate is higher, especially in patients with
end-stage renal disease (ESRD). This underscores the need for
well-designed clinical trials to compare treatment strategies, such as
novel anticoagulants and LAAO, for managing atrial fibrillation in severe
CKD. [Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<86>
Accession Number
2031170983
Title
CRITICAL INSIGHTS INTO INFECTIVE ENDOCARDITIS: IMPLICATIONS FOR
DIALYSIS-DEPENDENT PATIENTS WITH CHRONIC KIDNEY DISEASE. A SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 2192), 2024. Date of Publication: 02
Apr 2024.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Akinyemi T.; Lali M.; Iglesias J.
Institution
(Ang, Chia, Jaiswal, Akinyemi, Lali, Iglesias) Rutgers Health/Community
Medical Center, Toms River, NJ, United States
(Ang, Chia, Jaiswal, Akinyemi, Lali, Iglesias) Texas Tech University
Health Science Center, TX, United States
Publisher
Elsevier Inc.
Abstract
Background The risk of developing infective endocarditis is significantly
increased among patients undergoing chronic hemodialysis, but data
comparing dialysis and non-dialysis patients are limited. This study aimed
to systematically compare the clinical and microbiological profiles,
surgical intervention rates and clinical outcomes between patients
undergoing chronic hemodialysis compared to non-dialysis patients. Methods
A comprehensive search was conducted to identify relevant studies across
major electronic databases including PubMed, Embase and Cochrane Library
from their inception to September 2023. Outcomes of interest include
in-hospital mortality and long-term all-cause mortality as well as and
in-hospital complications such as stroke and acute heart failure. The
outcomes were pooled using the DerSimonian-and-Laird random-effects model,
and the results were expressed as odds ratio (OR) with their corresponding
95% confidence intervals (CI). Results Eleven studies with 267,153 (46,152
dialysis, 221,001 non-dialysis) patients were included in the study. Age
was similar (median 59.8 vs. 60.9 years), but there was a higher
proportion of females in the dialysis group (47% vs. 40%). Staphylococcus
aureus was the most frequently identified organism in blood cultures, with
a notably higher incidence among dialysis patients (42% vs. 30%). Cardiac
surgery was less common among dialysis patients (8% vs. 12%, p=0.001).
Dialysis patients had a higher risk of in-hospital mortality (OR 1.49,
95%CI: 1.18-1.89, p<0.001), stroke (OR 1.07, 95%CI: 1.04-1.11, p<0.001)
and long-term all-cause mortality (OR 2.61, 95%CI: 2.18-3.19, p<0.001)
compared to non-dialysis patients. The risk of acute heart failure was
comparable between both groups of patients (OR 0.98, 95%CI: 0.71-1.37,
p=0.91). Conclusion Patients undergoing dialysis for chronic kidney
disease face an elevated risk of adverse outcomes when diagnosed with IE,
including increased mortality rates and a higher likelihood of stroke.
These findings emphasize the need of developing tailored management
approaches for this at-risk patient population.<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<87>
Accession Number
2031170976
Title
THE PROMISING ROLE OF SLEEVE GASTRECTOMY IN QUALIFYING MORBIDLY OBESE
HEART FAILURE PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE FOR HEART
TRANSPLANTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 300), 2024. Date of Publication: 02
Apr 2024.
Author
Asadi M.S.; Shoar S.; Hicks A.J.; Nascimbene A.; De Armas I.A.S.; Kumar S.
Institution
(Asadi, Shoar, Hicks, Nascimbene, De Armas, Kumar) University of Maryland
Medical Center, Baltimore, MD, United States
(Asadi, Shoar, Hicks, Nascimbene, De Armas, Kumar) Memorial Hermann Texas
Medical Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background In advanced heart failure patients, left ventricular assist
device (LVAD) can serve as bridge to heart transplantation (HTX) or
destination therapy. Due to strenuous requirements, obese LVAD patients
with BMI >35 need to achieve weight loss before being considered for HTX
listing. The current study aims to evaluate the efficacy and safety of
sleeve gastrectomy (SG) in patients with LVAD and severe obesity. Methods
We conducted a systematic literature review to identify relevant articles
investigating the impact of SG on obese patients with LVAD. A
meta-analysis was performed to pool the prevalence of LVAD patients who
were listed for and later received HTX following SG. Results A total of 14
studies with 309 patients were included in this study. Body mass index
(BMI) significantly reduced with a mean difference of -10.53 after SG.
Furthermore, 68% of patients were listed for heart transplant and 31%
received a heart transplant. The rate of 30-day readmission after SG was
12%. The most common complication after SG was gastrointestinal bleeding
reported in 17.77% of cases. The rate of 30-day and 1-year mortality after
SG was 0%. Conclusion These findings strongly suggest that sleeve
gastrectomy should be considered as a viable therapeutic option for LVAD
patients with significant obesity. Moreover, this data demonstrated that
SG is efficacious procedure in patients supported by left ventricular
assist devices in need of significant weight loss for potential transplant
candidacy. [Formula presented]<br/>Copyright &#xa9; 2024 American College
of Cardiology Foundation

<88>
Accession Number
2031169166
Title
EFFECT OF BEMPEDOIC ACID ON CARDIOVASCULAR OUTCOMES: AN UPDATED
META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC.24. Atlanta
United States. 83(13 Supplement) (pp 1808), 2024. Date of Publication: 02
Apr 2024.
Author
Almas T.; Cheema H.A.; Sohail A.; Zahid I.; Naveed A.; Ehsan M.; Shahid
A.; Ahmad A.; Rehman W.; Titus A.; Alsufyani R.; Dani S.S.
Institution
(Almas, Cheema, Sohail, Zahid, Naveed, Ehsan, Shahid, Ahmad, Rehman,
Titus, Alsufyani, Dani) University Hospitals Cleveland Medical Center,
Cleveland, OH, United States
(Almas, Cheema, Sohail, Zahid, Naveed, Ehsan, Shahid, Ahmad, Rehman,
Titus, Alsufyani, Dani) Tufts University School of Medicine, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Background Bempedoic acid (BA) is a novel low-density lipoprotein
cholesterol (LDL-C) lowering agent that has promising potential. However,
its effect on cardiovascular outcomes is uncertain due to underpowered
trials. We aimed to conduct this meta-analysis to investigate the efficacy
and safety of BA for reducing cardiovascular morbidity and mortality.
Methods We searched PubMed, Embase, the Cochrane Library, and
ClinicalTrials.gov from inception to August 2023 for all randomized
controlled trials (RCTs) reporting the effect of BA on at least one
relevant cardiovascular outcome. Data were pooled using RevMan 5.4 under a
random-effects model Results Seven RCTs with 18,035 patients were included
in our review. Our meta-analysis demonstrated that the incidence of major
adverse cardiac events (MACE) was significantly lower among patients who
used BA as compared to placebo (RR 0.87, 95% CI: 0.800.94;
I²=0%). BA did not reduce the risk of cardiovascular mortality
(RR 1.05, 95% CI: 0.89-1.24; I²=0%). The use of BA was
significantly associated with reductions in non-fatal myocardial
infarction (MI), coronary revascularization, and hospitalization for
unstable angina. However, there was no significant difference in the risk
of non-fatal stroke, all-cause mortality, and new-onset or worsening
diabetes mellitus between the two groups. BA was not associated with an
increased incidence of overall adverse events (AEs), serious AEs, or
muscle-related adverse events but was associated with elevated hepatic
enzymes, an increased risk of gout, and an increased incidence of
worsening renal function. BA had no effect on the risk of neurocognitive
disorders. Conclusion BA reduced the risk of MACE, MI, coronary
revascularization, and hospitalization for unstable angina but did not
affect cardiac mortality and all-cause mortality. While BA did not
increase overall AEs and serious AEs, it increased the risk of liver
dysfunction, gout, and renal dysfunction. Overall, BA is a promising
lipid-modifying therapy as an add-on or alternative to statins in
statin-intolerant patients.<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<89>
Accession Number
2029196830
Title
The Influence of High-Dose Parenteral Vitamin C on the Incidence and
Severity of Postoperative Pulmonary Complications in Cardiac Surgery with
Extracorporeal Circulation: A Randomized Controlled Trial.
Source
Nutrients. 16(6) (no pagination), 2024. Article Number: 761. Date of
Publication: March 2024.
Author
Karadzic Kocica M.; Ristic A.; Soldatovic I.; Lazovic D.; Cumic J.; Grujic
M.; Karan R.; Terzic D.; Palibrk I.; Kocica M.; Markovic D.
Institution
(Karadzic Kocica, Cumic, Karan, Markovic) Department of Anesthesiology,
Reanimatology and Intensive Care, Clinic for Cardiac Surgery, University
Clinical Centre of Serbia, Belgrade 11000, Serbia
(Karadzic Kocica, Ristic, Soldatovic, Lazovic, Cumic, Grujic, Karan,
Terzic, Palibrk, Markovic) School of Data Science, Fudan University,
Shanghai 200433, China
(Ristic) Clinic for Cardiology, University Clinical Centre of Serbia,
Belgrade 11000, Serbia
(Soldatovic) Department of Medical Statistics and Informatics, Medical
Faculty, University of Belgrade, Belgrade 11000, Serbia
(Lazovic, Grujic, Terzic, Kocica) Clinic for Cardiac Surgery, University
Clinical Centre of Serbia, Belgrade 11000, Serbia
(Palibrk) Department of Anesthesiology, Reanimatology and Intensive Care,
Clinic for Abdominal Surgery, University Clinical Centre of Serbia,
Belgrade 11000, Serbia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac surgery (CS) with extracorporeal circulation (ECC), induces
intense oxidative stress (OS) and systemic inflammatory response (SIR),
which may seriously affect postoperative lung function. We aimed to test
if high parenteral (200 mg/kg/24 h) daily doses of Vitamin C (VitC), given
within 48 h after the beginning of the operation, may reduce the incidence
and severity of postoperative pulmonary complications (PPCs) in CS
patients. This single-center, prospective, randomized, single-blinded,
interventional trial included 150 patients, assigned to control Group A (n
= 75) and interventional Group B (n = 75). Group B intraoperatively
received one-fourth (i.e., 50 mg/kg) of the planned daily Vit C dose,
divided into three equal parts and diluted in 10 mL of normal saline,
while Group A received an equal volume of normal saline at the same time
frames (i.e., the induction of anesthesia, aortic cross-clamp release, and
sternal closure). After 6 h from the first intraoperative dose, the
following regimen was applied: Group B: 50 mg/kg, 30 min i.v. infusion of
VitC in 50 mL of normal saline, every 6 h, for the next 48 h, and Group A:
30 min i.v. infusion of an equal volume of normal saline every 6 h, for
the next 48 h. Modified Kroenke's score was used to determine the
incidence and severity of PPCs. The overall incidence of PPCs was 36.7%
and was significantly lower in Group B (13.3% vs. 60.0%, p < 0.001). The
PPCs severity score was also significantly lower in Group B (1 vs. 3, p <
0.001). In addition, patients from Group B had significantly less damaged
lungs, better postoperative renal function, shorter ICU stays, fewer ICU
re-admissions, and lower hospital mortality. No VitC-related adverse
effects were recorded. High parenteral daily VitC doses given within 48 h
after the beginning of CS are safe and effective in reducing the incidence
and severity of PPCs. A multicenter RCT is needed to confirm these
results.<br/>Copyright &#xa9; 2024 by the authors.

<90>
Accession Number
2029152726
Title
The Extents of Coronary Heart Disease and the Severity of Newly Developed
Dry Eye Disease: A Nationwide Cohort Study.
Source
Diagnostics. 14(6) (no pagination), 2024. Article Number: 586. Date of
Publication: March 2024.
Author
Lee C.-Y.; Yang S.-F.; Huang J.-Y.; Chang C.-K.
Institution
(Lee, Yang) Institute of Medicine, Chung Shan Medical University, Taichung
402, Taiwan (Republic of China)
(Lee, Chang) Nobel Eye Institute, Taipei 115, Taiwan (Republic of China)
(Lee) Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung
412, Taiwan (Republic of China)
(Yang, Huang) Department of Medical Research, Chung Shan Medical
University Hospital, Taichung 402, Taiwan (Republic of China)
(Chang) Department of Optometry, Da-Yeh University, Chunghua 515, Taiwan
(Republic of China)
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This study aimed to evaluate the potential association between coronary
heart disease (CHD) severity and the subsequent dry eye disease (DED) with
a different severity through the use of the National Health Insurance
Research Database (NHIRD) of Taiwan. A retrospective cohort study was
conducted. The CHD population was further divided into a severe CHD that
had received coronary artery bypass graft (CABG) surgery group and a mild
CHD that had received medicine group, then matched with a 1:2 ratio, and
29,852 and 14,926 CHD patients were put into the severe CHD and mild CHD
groups, respectively. The primary outcomes were the development of DED and
severe DED after CHD diagnosis. The Cox proportional hazards regression
was used to produce the adjusted hazard ratio (aHR) and 95% confidence
interval (CI) of DED and severe DED between groups. There were 3440 and
1276 DED cases in the mild CHD and severe CHD groups, respectively. And
another 37 and 48 severe CHD events were observed in the mild and severe
CHD groups, respectively. The incidence of severe DED in the severe CHD
group was significantly higher compared to the mild CHD group (aHR: 5.454,
95% CI: 1.551-7.180, p = 0.0001). The cumulative probabilities of DED and
severe DED were significantly higher in the severe CHD group than the mild
CHD group (both p < 0.0001). In the subgroup analysis, the correlation
between severe CHD and DED was higher in the patients aged older than 70
years (p < 0.0001). In conclusion, severe CHD is associated with a higher
incidence of severe DED with a higher cumulative incidence.<br/>Copyright
&#xa9; 2024 by the authors.

<91>
Accession Number
2031276463
Title
Perioperative intravenous lidocaine in thoracoscopic surgery for improved
postoperative pain control: a randomized, placebo-controlled,
double-blind, superiority trial.
Source
Journal of Thoracic Disease. 16(3) (pp 1923-1932), 2024. Date of
Publication: 29 Mar 2024.
Author
Hojski A.; Bolliger D.; Mallaev M.; Dackam S.; Tsvetkov N.; Wiese M.;
Schneider T.; Lampart A.; Lardinois D.
Institution
(Hojski, Mallaev, Dackam, Tsvetkov, Wiese, Lardinois) Department of
Thoracic Surgery, University Hospital Basel, Basel, Switzerland
(Bolliger, Schneider, Lampart) Department of Anesthesiology, University
Hospital Basel, Basel, Switzerland
(Bolliger) Department of Clinical Research, University of Basel, Basel,
Switzerland
Publisher
AME Publishing Company
Abstract
Background: Pain, including associated pain management, remains a burden
on patients after thoracic surgery. Our objective was to investigate
whether perioperative intravenous administration of lidocaine reduces
postoperative morphine consumption and pain intensity after video-assisted
thoracoscopic surgery (VATS). <br/>Method(s): In this double-blind,
placebo-controlled superiority trial, patients undergoing VATS with a
planned duration of <=90 minutes were randomized within an
intention-to-treat setting. Patients received either intravenous lidocaine
or placebo as a bolus of 1.5 mg/kg 30 minutes before incision, followed by
a continuous infusion of 3.0 mg/kg/hour until 2 hours after skin closure.
Pain and morphine consumption were evaluated when resting and when
coughing 1, 2, 4, 8, 16, 24, and 48 hours after skin closure and in a
follow-up 14, 90, and 180 days postoperatively. <br/>Result(s):
Twenty-eight patients were included in the lidocaine group, 24 in the
placebo group. Patients' characteristics and preoperative pain scores were
similar in both groups. When coughing, patients of the lidocaine group had
less pain within 24 hours after skin closure than the placebo group
(4.60+/-1.64 vs. 5.52+/-1.65; P=0.02). Morphine consumption was not
statistically significantly lower in lidocaine group (18.22+/-12.87 vs.
21.26+/-9.39 mg; P=0.26). There were no significant differences between
groups in secondary outcomes. <br/>Conclusion(s): Our results suggest that
perioperative intravenous lidocaine administration reduces pain scores
after VATS. The beneficial clinical effects are limited. Nevertheless,
intravenous lidocaine may be helpful as part of a multimodal analgesia
protocol or with patients in whom the use of other analgesics is
contraindicated.<br/>Copyright &#xa9; Journal of Thoracic Disease.

<92>
Accession Number
2031270785
Title
Efficacy of bilateral catheter superficial parasternal intercostal plane
blocks using programmed intermittent bolus for opioid-sparing
postoperative analgesia in cardiac surgery with sternotomy: A randomized,
double-blind, placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111430. Date of Publication: August 2024.
Author
Li Q.; Liao Y.; Wang X.; Zhan M.; Xiao L.; Chen Y.
Institution
(Li, Liao, Wang, Xiao, Chen) Department of Anesthesiology, The First
Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
(Zhan) Department of Anesthesiology, Guangdong Provincial People's
Hospital, Guangzhou, China
Publisher
Elsevier Inc.
Abstract
Study objective: This study investigated whether catheter superficial
parasternal intercostal plane (SPIP) blocks, using a programmed
intermittent bolus (PIB) with ropivacaine, could reduce opioid consumption
while delivering enhanced analgesia for a period exceeding 48 h following
cardiac surgery involving sternotomy. <br/>Design(s): A double-blind,
prospective, randomized, placebo-controlled trial. <br/>Setting(s):
University-affiliated tertiary care hospital. <br/>Patient(s): 60 patients
aged 18 or older, scheduled for cardiac surgery via sternotomy.
<br/>Intervention(s): The patients were randomly assigned in a 1:1 ratio
to either the ropivacaine or saline group. After surgery, patients
received bilateral SPIP blocks for 48 h with 0.4% ropivacaine (20 mL per
side) for induction, followed by bilateral SPIP catheters using PIB with
0.2% ropivacaine (8 mL/side, interspersed with a 2-h interval) or 0.9%
normal saline following the same administration schedule. All patients
were administered patient-controlled analgesia with hydromorphone.
Measurements: The primary outcome was the cumulative morphine equivalent
consumption during the initial 48 h after the surgery. Secondary outcomes
included postoperative pain assessment using the Numeric Rating Scale
(NRS) at rest and during coughing at designated intervals for three days
post-extubation. Furthermore, recovery indicators and ropivacaine plasma
levels were diligently documented. <br/>Main Result(s): Cumulative
morphine consumption within 48 h in ropivacaine group decreased
significantly compared to saline group (25.34 +/- 31.1 mg vs 76.28 +/-
77.2 mg, respectively; 95% CI, -81.9 to -20.0, P = 0.002). The ropivacaine
group also reported lower NRS scores at all recorded time points (P <
0.05) and a lower incidence of nausea and vomiting than the saline group
(3/29 vs 12/29, respectively; P = 0.007). Additionally, the ropivacaine
group showed significant improvements in ambulation (P = 0.018),
respiratory exercises (P = 0.006), and self-reported analgesia
satisfaction compared to the saline group (P = 0.016). <br/>Conclusion(s):
Bilateral catheter SPIP blocks using PIB with ropivacaine reduced opioid
consumption over 48 h, concurrently delivering superior postoperative
analgesia in adult cardiac surgery with sternotomy.<br/>Copyright &#xa9;
2024 The Authors

<93>
Accession Number
2031290129
Title
Fewer severe infections with tranexamic acid in patients with hematologic
malignancies.
Source
Research and Practice in Thrombosis and Haemostasis. 8(2) (no pagination),
2024. Article Number: 102358. Date of Publication: February 2024.
Author
Poston J.N.; Brown S.P.; Ilich A.; Ginsburg A.S.; Herren H.; El Kassar N.;
Jensen C.E.; Triulzi D.J.; Key N.S.; May S.; Gernsheimer T.B.
Institution
(Poston, Gernsheimer) Division of Hematology, University of Washington
School of Medicine and Fred Hutchinson Cancer Center, Seattle, WA, United
States
(Poston) Division of Hematology/Oncology, Department of Medicine,
University of Washington School of Medicine, Seattle, WA, United States
(Poston) Fred Hutchinson Cancer Center, Seattle, WA, United States
(Poston) Department of Pathology & Laboratory Medicine, Larner College of
Medicine at the University of Vermont, Burlington, VT, United States
(Brown, Ginsburg, Herren, May) Department of Biostatistics, University of
Washington, Seattle, WA, United States
(Ilich, Jensen, Key) Department of Medicine, Division of Hematology and
Blood Research Center, University of North Carolina at Chapel Hill, Chapel
Hill, NC, United States
(El Kassar) Division of Blood Diseases and Resources, National Institutes
of Health, National Heart, Lung and Blood Institute, Bethesda, MD, United
States
(Triulzi) Department of Pathology, Division of Transfusion Medicine,
University of Pittsburgh, Pittsburgh, PA, United States
Publisher
Elsevier B.V.
Abstract
Background: Tranexamic acid (TXA) is an antifibrinolytic agent that
reduces bleeding in a multitude of clinical settings from postpartum
hemorrhage to trauma. TXA may have clinical effects unrelated to bleeding;
plasminogen, the target of TXA, alters immune responses, and TXA appears
to decrease the risk of infection in patients undergoing cardiac surgery,
as well as joint arthroplasty. <br/>Objective(s): To address whether TXA
alters rates of infection and inflammatory outcomes in patients with
hematologic malignancies. <br/>Method(s): We performed a post hoc analysis
of outcomes of patients randomized to receive either TXA or placebo in the
double-blinded, multicenter American Trial to Evaluate Tranexamic Acid
Therapy in Thrombocytopenia (Clinicaltrials.gov identifier: NCT02578901).
<br/>Result(s): TXA did not change the overall rate of infections, but the
rate of severe infections (Common Toxicology Criteria for Adverse Events
grade 3+) was lower in patients who received TXA compared with the placebo
group. Patients who experienced grade 3+ infections had higher rates of
World Health Organization grade 2+ bleeding and red blood cell transfusion
requirements than patients who did not experience a grade 3+ infection,
irrespective of treatment group. TXA did not impact other inflammatory
outcomes such as mucositis, rash, or graft vs host disease.
<br/>Conclusion(s): Patients with hematologic malignancies who received
TXA had less severe infections than those who received placebo with no
difference in overall rate of infection or other inflammatory outcomes.
Further investigation is needed on the impact of TXA on infections in this
population.<br/>Copyright &#xa9; 2024 The Author(s)

<94>
Accession Number
2031228336
Title
Evaluation of the efficacy and safety of robot-assisted and video assisted
thoracic surgery for early non-small cell lung cancer: A meta-analysis.
Source
Technology and Health Care. 32(2) (pp 511-523), 2024. Date of Publication:
14 Mar 2024.
Author
Wang P.; Fu Y.-H.; Qi H.-F.; He P.; Wang H.-F.; Li C.; Liu X.-C.
Institution
(Wang, Qi, He, Wang, Li, Liu) Department of Cardiothoracic Surgery, The
82nd Group Military Hospital of PLA, Hebei, Baoding, China
(Fu) Department of Rheumatology and Immunology, Baoding Children's
Hospital, Hebei, Baoding, China
Publisher
IOS Press BV
Abstract
BACKGROUND: Radical resection of lung cancer and chemotherapy are the main
methods for the treatment of early lung cancer, but surgical treatment is
still the key and preferred method. <br/>OBJECTIVE(S): To evaluate the
efficacy and safety of robotic-assisted thoracic surgery (RATS) and video
assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC).
<br/>METHOD(S): The clinical cohort studies on the comparison of the
effects of RATS and VATS in the treatment of NSCLC published in Web of
Science, PubMed, The National Library of Medicine (NLM), China National
Knowledge Infrastructure (CNKI) and Wanfang database from January 1, 2015
to December 31, 2022 were searched. Two researchers independently screened
the literature, extracted the data, such as operation time, intraoperative
conversion rate, intraoperative blood loss, number of lymph nodes
dissected, and evaluated the quality of the included literature based on
the Newcastle-Ottawa Scale (NOS). RevMan 5.3 software was used for Meat
analysis. <br/>RESULT(S): A total of 18 articles and 21,802 subjects were
included. The results of the meta-analysis showed that the intraoperative
blood loss of RATS was significantly less than that of VAS, and the
difference was statistically significant [MD =-38.43 (95% CI: -57.71,
-19.15, P< 0.001)]. Compared with VATS, the number of lymph nodes
dissected in RATS was significantly higher [MD = 2.61 (95% CI: 0.47, 4.76,
P= 0.02)]. The rate of conversion to thoracotomy in RATS was lower, and
the difference was statistically significant [OR = 0.59 (95% CI: 0.50,
0.70, P< 0.001)]. There was no significant difference between RATS and
VATS in operation time [MD =-9.34 (95% CI: -28.72, 10.04, P= 0.34)],
postoperative thoracic drainage time [MD =-0.08 (95% CI: -0.42, 0.26, P=
0.64)], postoperative hospital stay [MD =-0.05 (95% CI: -0.19, 0.08, P=
0.42)], postoperative mortality [OR = 0.88 (95% CI: 0.56, 1.36, P= 0.56)]
and postoperative complications [OR = 1.03 (95% CI: 0.93, 1.13, P= 0.57)].
<br/>CONCLUSION(S): Compared with VATS, the number of lymph nodes
dissected in RATS was significantly more, and the removal of lesions and
lymph nodes was more thorough and accurate. More flexible and precise
operation avoids the injury of important blood vessels during operation,
effectively reduces the amount of blood loss during operation, shortens
the indwelling time of thoracic drainage tube, and is conducive to
postoperative rehabilitation of patients.<br/>Copyright &#xa9; 2024 - The
authors. Published by IOS Press.

<95>
Accession Number
2028436180
Title
Comparison of Ondansetron and Metoclopramide in Prevention of Nausea and
Vomiting after Coronary Artery Bypass Graft Surgery.
Source
GMJ Medicine. 1(3) (pp 97-100), 2022. Date of Publication: Summer 2022.
Author
Mohammadipour A.H.; Sadeghi S.
Institution
(Mohammadipour, Sadeghi) Tuberculosis and Lung Disease Research Center,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
Publisher
Afarand Scholarly Publishing Institute
Abstract
Aims: The aim of this study was to determine the effect of ondansetron and
metoclopramide on the prevention of PONV in high-risk patients. The reason
for choosing these two drugs is that ondansetron is a drug that is widely
used in the world today as a first-line drug in the prevention and
treatment of PONV, and metoclopramide is a drug that is cheap and
available as a common anti-emetic drug by surgeons PONV control is
prescribed in Iran. <br/>Material(s) and Method(s): A total of 126
patients who were candidates for coronary artery bypass graft surgery
during 2018 and 2019 were evaluated in this study. Intraoperative
injection of metoclopramide or ondansetron was compared between all
patients and the severity of postoperative nausea and vomiting was
compared. <br/>Finding(s): The rate of nausea in patients was about 67.5%
with an average of 158.5 seconds of nausea in these patients each day and
there was no significant difference between the two drug groups in terms
of these two variables (p=0.342; p=0.900). The average rate of vomiting in
patients was 19.8%, of which 52% had vomiting once and 48% had vomited
more than once. There was a significant difference in the presence of
vomiting in the two drug groups (p=0.044). <br/>Conclusion(s):
Metoclopramide and Ondansetron have the similar effects on nausea and
vomiting after coronary artery bypass graft surgery.<br/>Copyright &#xa9;
2022, the Authors <br/> Publishing Rights, ASPI.

<96>
Accession Number
643841475
Title
Post-operative Pain Control: A Comparison between Bupivacaine and Tramadol
Local Wound Infiltration in Children Undergoing Herniotomy and
Orchidopexy.
Source
African journal of paediatric surgery : AJPS. (no pagination), 2024. Date
of Publication: 14 Mar 2024.
Author
Aisien E.; Chibuzom C.N.; Osifo D.O.; Evbuomwan I.
Institution
(Aisien, Osifo, Evbuomwan) Department of Surgery, University of Benin
Teaching Hospital, Benin City, Nigeria
(Chibuzom) Department of Surgery, Nnamdi Azikiwe University Teaching
Hospital, Nnewi, Anambra State, Nigeria
Abstract
INTRODUCTION: Post-operative pain control improves patient's satisfaction
and affects the period of admission. Local wound infiltration following
hernia surgery using xylocaine or bupivacaine has been a common practice.
The use of tramadol for such infiltration is relatively new and has not
been studied in our environment. This study compared the efficacy of
post-operative pain control between Bupivacaine and Tramadol wound
infiltration in children who underwent herniotomy and orchidopexy.
<br/>PATIENTS AND METHODS: This was a prospective randomised study
involving 104 patients. A simple random method was used to allocate the
study group into two equal groups (A, n = 52 and B, n = 52) using sealed
envelopes with contents labelled A or B. Pre- and post-operative
respiratory rate, heart rate, and C-reactive protein (CRP) were all
recorded. Time to first and subsequent analgesia was determined using
face, legs, activity, cry, consolability (FLACC) pain score.
<br/>RESULT(S): Fifteen patients in Group A and 18 patients in Group B
received each two doses of supplemental analgesia within the first 24 h,
(P = 0.527). Time to first analgesia was significantly different between
the two groups, (6.93 +/- 0.80 h and 6.11 +/- 1.08 h, P = 0.020). The mean
FLACC pain score at the time of first analgesia in hours was 4.93 +/- 0.59
and 4.72 +/- 0.67 for Group A and B, respectively, P = 0.350. The changes
in CRP were not different in the two groups, (P = 0.665). Four patients in
Group A, but none in Group B had an episode each of post-operative
vomiting. <br/>CONCLUSION(S): Tramadol showed comparable efficacy with
bupivacaine in post-operative pain control by wound infiltration in
children who had unilateral herniotomy or orchidopexy. Tramadol, however,
achieves a longer duration of action before rescue analgesic is required.
Caution is necessary to avoid post-operative vomiting.<br/>Copyright
&#xa9; 2024 Copyright: &#xa9; 2024 African Journal of Paediatric Surgery.

<97>
Accession Number
643839893
Title
Comparative Efficacy and Safety of Mitral Valve Repair Versus Mitral Valve
Replacement in Improving Clinical Outcomes in Patients with Rhematic Heart
Disease: A High-Value Care Systematic Review and Meta-Analysis.
Source
Current problems in cardiology. (pp 102530), 2024. Date of Publication:
20 Mar 2024.
Author
Yasmin F.; Moeed A.; Najeeb H.; Umar M.; Jawed S.; Atif A.R.; Asghar M.S.;
Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven CT 06511, United
States
(Moeed, Najeeb, Jawed, Atif) Dow Medical College, Karachi 74200, Pakistan
(Umar) IU Health Ball Memorial Hospital, Muncie, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, DMC Heart
Hospital, Detroit, United States
Abstract
Rheumatic Heart Disease (RHD) remains a leading cause of cardiovascular
death (CVD) globally. Mitral Valve repair (MVP) and mitral valve
replacement (MVR) are the two most commonly and successfully used
techniques to treat the disease. MVP is associated with reduced
post-operative complications compared to MVR; however, it carries the risk
of valvular fibrosis and scarring. Given the lack of recommendations,
inconsistent findings, and paucity of pathophysiological evidence at
present, we aimed to conduct a meta-analysis and systematically review the
available literature to determine the efficacy and safety of MVP compared
to MVR in improving clinical outcomes among patients with RHD. A
comprehensive literature search of PubMed, Cochrane Central, Google
Scholar was conducted from its inception up until September 2023. The
primary objective was early mortality defined as any cause-related death
occurring 30 days following surgery. Secondary outcomes included long-term
survival was referred to as the period of time between discharge and death
from any cause. Infectious endocarditis, thromboembolic events (including
stroke, brain infarction, peripheral embolism, valve thrombosis, and
transient ischemic attack), and haemorrhagic events (any serious bleeding
event that required hospitalisation, resulted in death, resulted in
permanent injury, or required blood transfusion) were all considered as
post- operative complications. Additionally aggregated Kaplan-Meier curves
were reconstructed for long term survival, freedom from reoperation, and
freedom from valve-related adverse events by merging the reconstructed
individual patient data (IPD) from each individual study. A significant
decrease in early mortality with MV repair strategy versus MV replacement
[RR 0.63; P=0.003) irrespective of mechanical or bioprosthetic valves was
noted. The results reported significantly higher long-term survival in
patients undergoing MVP versus MVR (HR 0.53; P=0.0009). Reconstructed
Kaplan-Meier curves showed that the long term survival rates at 4, 8, and
12 years were 88.6, 82.0, 74.6%, in the MVR group and 91.7, 86.8, 81.0%,
in the MVP group, respectively. MVP proved to be statistically significant
in reducing early mortality, adverse vascular events, and better long-term
survival outcomes compared to the MVR strategy in this
analysis.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<98>
Accession Number
643839075
Title
The Impact of Prone Ventilation on Hypoxemia Following Extracorporeal
Cardiac Surgery: A Meta Analysis.
Source
Alternative therapies in health and medicine. (no pagination), 2024. Date
of Publication: 22 Mar 2024.
Author
Li J.; Yu Q.; Jian Z.; Li T.; Jiang X.; Li E.
Abstract
Objective: To systematically assess the impact of prone position
ventilation on hypoxemia in patients following extracorporeal cardiac
surgery and to establish a reference for further clinical investigation
into effective post-surgery mechanical ventilation positions.
<br/>Method(s): A meta-analysis was conducted through extensive database
searches, focusing on randomized controlled trials of cardiopulmonary
bypass in hypoxic patients meeting specific inclusion and exclusion
criteria. A total of 8 papers involving 442 patients were finally included
in this study. <br/>Result(s): The meta-analysis revealed that the
oxygenation index was significantly higher in the prone position
ventilation group compared to the supine position ventilation group
[MD=51.24, 95% CI (46.14, 56.35), P < .001]. The partial pressure of
oxygen in prone patients was also significantly higher than in supine
patients [MD=-2.96, 95% CI (1.78, 4.14), P < .001]. Regarding oxygen
saturation, blood oxygen saturation in the prone position group surpassed
that in the supine position group, showing a statistically significant
difference [MD=4.81, 95% CI (3.83, 5.79), P < .001]. Additionally,
patients ventilated in the prone position exhibited a shorter duration of
mechanical ventilation compared to those in the supine position, with a
statistically significant difference [MD=-57.31, 95% CI (-66.57, -48.06),
P < .001]. <br/>Conclusion(s): In the absence of significant hemodynamic
changes, prone position ventilation significantly enhances the oxygenation
index and reduces the duration of mechanical ventilation in patients
undergoing extracorporeal circulation surgery. However, the observed
heterogeneity across studies may be attributed to variations in breathing
styles, respiratory techniques, and physiological parameters among
different patient groups.

<99>
Accession Number
2031193614
Title
Midterm Survival of Low-Risk Patients Treated With Transcatheter Versus
Surgical Aortic Valve Replacement: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 12(21) (no pagination), 2023.
Article Number: e030012. Date of Publication: 07 Nov 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Serna-Gallegos D.; Chu D.; Clavel
M.-A.; Pibarot P.; Sultan I.
Institution
(Sa, Serna-Gallegos, Chu) Department of Cardiothoracic Surgery, University
of Pittsburgh, PA, United States
(Sa, Serna-Gallegos, Chu) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Clavel, Pibarot, Sultan) Centre de Recherche de l'Institut Universitaire
de Cardiologie et de Pneumologie de Quebec, Quebec City, QC, Canada
(Clavel, Pibarot, Sultan) Department of Medicine, Faculty of Medicine,
Universite Laval, Quebec City, QC, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: We performed a meta-analysis of reconstructed time-to-event
data from randomized controlled trials (RCTs) and propensity-score matched
(PSM) studies comparing transcatheter versus surgical aortic valve
replacement (TAVR versus SAVR) to evaluate midterm outcomes in patients
considered low risk for SAVR. METHODS AND RESULTS: Study-level
meta-analysis of reconstructed time-to-event data from Kaplan- Meier
curves of RCTs and PSM studies published by December 31, 2022 was
conducted. Eight studies (3 RCTs, 5 PSM studies) met our eligibility
criteria and included 5444 patients; 2639 patients underwent TAVR, and
2805 patients underwent SAVR. TAVR showed a higher risk of all-cause
mortality at 8 years of follow-up (hazard ratio [HR] 1.22, [95% CI,
1.03-1.43], P=0.018). Up to 2 years of follow-up, TAVR was not inferior to
SAVR (HR, 1.08 [95% CI, 0.89-1.31], P=0.448); however, we observed a
statistically significant difference after 2 years with higher mortality
with TAVR (HR, 1.51 [95% CI, 1.14-2.00]; P=0.004). This difference was
driven by PSM studies; our sensitivity analysis showed a statistically
significant difference between TAVR and SAVR when we included only PSM
studies (HR, 1.41 [95% CI, 1.16-1.72], P=0.001) but no statistically
significant difference when we included only RCTs (HR, 0.89 [95% CI,
0.69-1.16], P=0.398). <br/>CONCLUSION(S): In comparison with TAVR, SAVR
appeared to be associated with improved survival beyond 2 years in
low-risk patients. However, the survival benefit of SAVR was observed only
in PSM studies and not in RCTs. The addition of data from ongoing RCTs as
well as longer follow-up in previous RCTs will help to confirm if there is
a difference in mid-and long-term survival between TAVR versus SAVR in the
low-risk population.<br/>Copyright &#xa9; 2023 The Authors.

<100>
Accession Number
2030766755
Title
Life After Chronic Total Occlusion Percutaneous Coronary Intervention.
Source
American Journal of Cardiology. 216 (pp 91-92), 2024. Date of Publication:
01 Apr 2024.
Author
Rempakos A.; Brilakis E.S.
Institution
(Rempakos, Brilakis) XXX, Minneapolis Heart Institute and Minneapolis
Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN,
United States
Publisher
Elsevier Inc.

<101>
Accession Number
2029076323
Title
Overcoming barriers for left atrial appendage thrombus: a systematic
review of left atrial appendage closure.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
175. Date of Publication: December 2024.
Author
Zhang Z.; Zhou J.; Lin Q.; Wang C.; Huang Y.; Dai Y.; Zuo W.; Liu N.; Xiao
Y.; Liu Q.
Institution
(Zhang, Zhou, Lin, Huang, Liu, Xiao, Liu) Department of Cardiovascular
Medicine, The Second Xiangya Hospital, Central South University, 139
Renmin Road, Furong District, Hunan Province, Changsha 410011, China
(Wang) Department of Metabolic Endocrinology, The Second Xiangya Hospital,
Central South University, Hunan Province, Changsha 410011, China
(Dai) Department of Pharmacology, Wuhan University TaiKang Medical School
(School of Basic Medical Sciences), Hubei Province, Wuhan 430071, China
(Zuo) Department of Hematology, The Second Xiangya Hospital, Central South
University, Hunan Province, Changsha 410011, China
Publisher
BioMed Central Ltd
Abstract
Background: Approximately 90% of intracardial thrombi originate from the
left atrial appendage in non-valvular atrial fibrillation patients. Even
with anticoagulant therapy, left atrial appendage thrombus (LAAT) still
occurs in 8% of patients. While left atrial appendage closure (LAAC) could
be a promising alternative, the current consensus considers LAAT a
contraindication to LAAC. However, the feasibility and safety of LAAC in
patients with LAAT have yet to be determined. <br/>Method(s): This
systematic review synthesizes published data to explore the feasibility
and safety of LAAC for patients with LAAT. <br/>Result(s): This study
included a total of 136 patients with LAATs who underwent successful LAAC.
The Amulet Amplatzer device was the most frequently utilized device
(48.5%). Among these patients, 77 (56.6%) had absolute contraindications
to anticoagulation therapy. Cerebral protection devices were utilized by
47 patients (34.6%). Transesophageal echocardiography (TEE) is the primary
imaging technique used during the procedure. Warfarin and novel oral
anticoagulants were the main anticoagulant medications used prior to the
procedure, while dual antiplatelet therapy was primarily used
post-procedure. During a mean follow-up period of 13.2 +/- 11.5 months,
there was 1 case of fatality, 1 case of stroke, 3 major bleeding events, 3
instances of device-related thrombus, and 8 cases of peri-device leakage.
<br/>Conclusion(s): This review highlights the preliminary effectiveness
and safety of the LAAC procedure in patients with persistent LAAT. Future
large-scale RCTs with varied LAAT characteristics and LAAC device types
are essential for evidence-based decision-making in clinical
practice.<br/>Copyright &#xa9; The Author(s) 2024.

<102>
Accession Number
2028928005
Title
Effects of short-term preoperative intranasal dexmedetomidine plus
conventional treatment on delirium following cardiac surgery in patients
with sleep disorders.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 17.
Date of Publication: December 2024.
Author
Fang J.; Yang J.; Zhai M.; Zhang Q.; Zhang M.; Xie Y.
Institution
(Fang, Yang, Zhai, Zhang, Xie) Department of Anaesthesiology, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Anhui, Hefei 230001, China
(Zhang) Department of Cardiovascular Surgery, The First Affiliated
Hospital of USTC, Division of Life Sciences and Medicine, University of
Science and Technology of China, Anhui, Hefei 230001, China
Publisher
BioMed Central Ltd
Abstract
Study objectives: To assess whether preoperative dexmedetomidine (DEX)
nasal drips combined with conventional treatment could mitigate the
occurrence of postoperative delirium (POD). <br/>Design(s): A prospective
randomised controlled study. <br/>Setting(s): The cardiac surgery
intensive care unit (CSICU) and patient hospitalisation ward at a
university hospital. <br/>Participant(s): A total of 100 patients (aged
>=60 years) undergoing cardiac surgery at a university hospital between 7
January 2022, and 30 November 2022 met the eligibility criteria and were
included in the study. <br/>Intervention(s): Patients with sleep disorders
(Pittsburgh Sleep Quality Index >=8) were divided into two groups: Group A
(the placebo group, n=50), receiving a short-term preoperative placebo
combined with conventional treatment and Group B (the DEX group, n=50),
receiving short-term preoperative DEX combined with conventional
treatment. Measurements and results: The Confusion Assessment Method for
the ICU (CAM-ICU) was used for POD assessment in the CSICU, while the CAM
was employed to assess delirium in the patient ward. Group B demonstrated
a reduced incidence of POD compared to Group A (12% vs. 30%, odds ratio:
0.318, 95% confidence interval: 0.112-0.905, p=0.027). <br/>Conclusion(s):
The combined treatment involving DEX demonstrated a decreased incidence of
POD in elderly individuals with sleep disorders undergoing cardiac surgery
compared to the placebo combination treatment. Trial registration: URL:
www.chictr.org.cn with registration number ChiCTR 2100043968, registered
on 06/03/2021.<br/>Copyright &#xa9; The Author(s) 2024.

<103>
Accession Number
2028326352
Title
Effect of Intermittent Thoracic Paravertebral Block on Postoperative
Nausea and Vomiting Following Thoracoscopic Radical Resection of the Lung
Cancer: A Prospective Randomized Trial.
Source
Journal of Pain Research. 17 (pp 931-939), 2024. Date of Publication:
2024.
Author
Ma T.; Yu Y.; Cao H.; Wang H.; Wang M.
Institution
(Ma) Anesthesia Department, The First Affiliated Hospital of Zhejiang
Chinese Medical University (Zhejiang Provincial Hospital of Chinese
Medicine), Zhejiang, Hangzhou 310000, China
(Yu, Wang, Wang) Anesthesia Department, Taizhou Hospital of Zhejiang
Province Affiliated to Wenzhou Medical University, Zhejiang, Taizhou
317000, China
(Cao) Obstetrical Department, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: To explore the benefits of ultrasound-guided intermittent
thoracic paravertebral block (TPVB) combined with intravenous analgesia
(PCIA) in alleviating postoperative nausea and vomiting (PONV) during
video-assisted thoracic surgery (VATS). <br/>Patients and Methods: 120
patients with lung carcinoma undergoing VATS were included and divided
into three groups: group S (single TPVB+PCIA), group I (intermittent
TPVB+PCIA), and group P (PCIA). The patients' NRS scores, postoperative
hydro-morphone hydrochloride consumption, and intramuscular injection of
bucinnazine hydrochloride were recorded. The incidence of PONV and
complications were documented. <br/>Result(s): Compared with the group P,
both group I and group S had significantly lower static NRS scores from
1-48 hours after the operation (P <0.05), and the dynamic NRS score of
group I at the 1-48 hours after the operation were significantly decreased
(P <0.05). Compared with the group P, the proportion of patients with PONV
in group I was significantly lower (P <0.05), while there was no
significant difference in group S. Moreover, the hospitalization period of
patients in group I was significantly reduced compared with the other two
groups (P <0.01), and the patient satisfaction was significantly increased
compared with the group P (P <0.05). <br/>Conclusion(s): Intermittent TPVB
combined with PCIA can reduce the postoperative pain and the occurrence of
PONV.<br/>Copyright &#xa9; 2024 Ma et al.

<104>
Accession Number
2031226595
Title
TAVI versus surgical aortic valve replacement. Where are the limits?.
Source
Cirugia Cardiovascular. (no pagination), 2024. Date of Publication: 2024.
Author
Pinon M.
Institution
(Pinon) CAS Aortico, CAS Mitral y Tricuspide, Cirugia Cardiaca, Hospital
Alvaro Cunqueiro, Pontevedra, Vigo, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Transcatheter aortic valve implantation (TAVI) has experienced an increase
in the number of procedures of 50% with its expansion to low risk, over
the numbers obtained with high and intermediate risks. Recently, updates
have been made public in the follow-up of the main randomized clinical
studies (RCTs) in this group of patients. Although the results of these
studies have served as a basis for recommending TAVI in elderly patients
with intermediate or high risks, there are still several aspects that need
to be clarified before expanding, in an indiscriminate or unselected
manner to low-risk young patients. This review's aim is to analyze the
results available in the published evidence, as well as the most
significant variables that can affect their consistency, both in early and
long term; for consideration in individualized patient-centered decision
making.<br/>Copyright &#xa9; 2024 Sociedad Espanola de Cirugia
Cardiovascular y Endovascular

<105>
Accession Number
2031105425
Title
Efficacy and safety of Tongxin formula after stent implantation for acute
coronary syndrome: A multicenter, double-blind, placebo-controlled
randomized trial.
Source
Explore. (no pagination), 2024. Date of Publication: 2024.
Author
Zhu W.; Wang S.; Zhang L.; Xie F.-Q.; Cheng J.; Li X.-K.; Chen W.; Yan
S.-Y.; Feng Q.-M.
Institution
(Zhu, Wang, Zhang, Xie, Cheng, Feng) Department of Cardiology, Shanghai
Municipal Hospital of Traditional Chinese Medicine, Shanghai University of
Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District,
Shanghai 200071, China
(Li) Department of Cardiology, Tenth People's Hospital, Tongji University,
Shanghai 200072, China
(Chen) Department of Cardiology, Changzheng Hospital, Second Military
Medical University, Shanghai 200003, China
(Yan) Institute of Science, Technology and Humanities, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
Publisher
Elsevier Inc.
Abstract
Objective: The aim of this study is to comprehensively evaluate both the
efficacy and safety profile of integrating the Tongxin formula with
optimal medical therapy (OMT) for patients experiencing acute coronary
syndromes subsequent to coronary stenting, over the course of one year.
<br/>Method(s): We enrolled 150 patients diagnosed with acute coronary
syndromes who had received stent placement within one month and exhibited
a TCM syndrome characterized by Qi deficiency and blood stasis. This group
comprised patients with unstable angina, non-ST-segment elevation
myocardial infarction, and ST-segment elevation myocardial infarction. The
participants were divided equally, allocating 75 to the Tongxin formula
group and 75 to a placebo-controlled group. After undergoing percutaneous
coronary intervention (PCI) surgery, both groups received conventional
Western medical care, including dual antiplatelet therapy and
lipid-lowering medications. The placebo-controlled group received a
placebo, while the Tongxin formula group were administered Tongxin formula
granules orally. Both study cohorts were monitored for a duration of 6
months. The primary endpoints included the occurrence of major adverse
cardiovascular events and the rate of lumen diameter reduction
post-treatment in both groups, with the Seattle Angina Scale serving as a
secondary assessment tool. Safety evaluations encompassed the measurement
of liver and kidney function, coagulation parameters, and other relevant
indicators. <br/>Result(s): The rate of adverse cardiovascular events in
the placebo-controlled group was 42.46 % within a year of surgery, whereas
it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the
Tongxin formula group to the placebo-controlled group, there was a
decrease in the frequency of unstable angina and readmission due to
cardiovascular events (P < 0.05). Coronary angiography performed 6 months
after surgery revealed that the Tongxin formula group had considerably
less lumen loss than the placebo-controlled group in a number of segments,
including the entire segment, within the stent, at the proximal end, and
at the distal end (P < 0.05). Six months after surgery, the Seattle angina
score was higher in the Tongxin formula group than in the
placebo-controlled group (P < 0.05). There were no significant changes in
indicators such as liver and renal function as well as coagulation indexes
in both groups within the first 12 months after surgery (P > 0.05).
<br/>Conclusion(s): Tongxin formula has been shown to lower the occurrence
of major adverse cardiovascular events, minimize narrowing of blood vessel
lumen, enhance clinical symptoms, and enhance the quality of life of
patients following PCI surgery, all while maintaining a good safety
profile.<br/>Copyright &#xa9; 2024