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<1>
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.

<2>
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.

<3>
Accession Number
2031416242
Title
Incidence, management and prognosis of new-onset sarcoidosis post covid-19
infection.
Source
Sarcoidosis Vasculitis and Diffuse Lung Diseases. 41(1) (no pagination),
2024. Article Number: e2024004. Date of Publication: 26 Mar 2024.
Author
Vij O.; Dey M.; Morrison K.; Kouranloo K.
Institution
(Vij) Guy's Hospital, London, United Kingdom
(Dey) Institute of Life Course and Medical Sciences, University of
Liverpool, Liverpool, United Kingdom
(Dey) Centre for Rheumatic Diseases, King's College London, London, United
Kingdom
(Morrison) BMA House -British Medical Association, London, United Kingdom
(Kouranloo) School of Medicine, University of Liverpool, Merseyside,
United Kingdom
(Kouranloo) Department of Rheumatology, East Surrey Hospital, Redhill,
United Kingdom
Publisher
Mattioli 1885
Abstract
Background and aim: SARS-CoV-2 infection has been linked to
hyperinflammation in multiple organs with a potential mechanistic link
with resulting autoimmunity. There have been reports of many inflammatory
complications following COVID-19, including sarcoidosis. A literature
review on new-onset sarcoidosis following COVID-19 is lacking. We
evaluated potential associations between COVID-19 and development of
new-onset sarcoidosis. <br/>Method(s): Articles discussing biopsy-proven
sarcoidosis after confirmed COVID-19 infection, published 1956 until April
2023, were included. All article types were deemed eligible except opinion
and review articles. <br/>Result(s): A pooled total of 15 patients with
new-onset diagnosis of sarcoidosis after COVID-19 infection were included,
45.5% female, mean age 46.1 years (standard deviation 14.7) at onset of
sarcoidosis. Patients were from: Europe (n=11); North America (n=2); South
America (n=1); Asia (n=1). The mean time between COVID-19 infection and
diagnosis of sarcoidosis was 56.3 days, although this ranged from 10 to
140 days. Organ systems predominantly affected by sarcoidosis were:
pulmonary (n=11); cutaneous (n=3); cardiac (n=2); ocular (n=1); systemic
(n=1) (with overlapping features in certain patients). Sarcoidosis was
treated as follows: glucocorticoids (n=8); azathioprine (n=1); cardiac
re-synchronisation therapy (n=1); heart transplant (n=1). All patients
were reported to have survived, with one requiring intensive care
admission. <br/>Conclusion(s): Our result suggests there is a potential
link between COVID-19 and new-onset sarcoidosis. The potential mechanism
for this is through cytokine mediated immune modulation in COVID-19
infection. Obtaining a tissue sample remains key in confirming the
diagnosis of sarcoidosis and this may be delayed during active COVID-19
infection.<br/>Copyright &#xa9; Mattioli 1885.

<4>
Accession Number
2031335657
Title
Randomized comparison of oblique and perpendicular stabilizers for
minimally invasive repair of pectus excavatum.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 38(3) (no
pagination), 2024. Article Number: ivae040. Date of Publication: 01 Mar
2024.
Author
Tedde M.L.; De Carvalho R.L.C.; De Campos J.R.M.; Da Silva D.A.G.; Okumura
E.M.; Guilherme G.F.; Marchesi A.C.; Petrizzo P.; Maior B.S.S.;
Pego-Fernandes P.M.
Institution
(Tedde, De Carvalho, De Campos, Da Silva, Okumura, Guilherme, Marchesi,
Petrizzo, Maior, Pego-Fernandes) Divisao Cirurgia Toracica, Instituto do
Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, SP, Sao Paulo, Brazil
(Tedde) Thoracic Surgery Division, Hospital Infantil Sabara, Sao Paulo,
Brazil
Publisher
Oxford University Press
Abstract
OBJECTIVES: Bar dislocation is one of the most feared complications of the
minimally invasive repair of pectus excavatum. <br/>METHOD(S): Prospective
randomized parallel-group clinical trial intending to assess whether
oblique stabilizers can reduce bar displacement in comparison with regular
stabilizers used in minimally invasive repair of pectus excavatum.
Additionally, we evaluated pain, quality of life and other postoperative
complications. Participants were randomly assigned to surgery with
perpendicular (n = 16) or oblique stabilizers (n = 14) between October
2017 and September 2018 and followed for 3 years. Bar displacements were
evaluated with the bar displacement index. Pain scores were evaluated
through visual analogue scale and quality of life through the Pectus
Excavatum Evaluation Questionnaire. <br/>RESULT(S): Control group average
displacement index was 17.7 (+/-26.7) and intervention group average
displacement index was 8.2 (+/- 10.9). There was 1 reoperation in each
group that required correction with 2 bars. Bar displacement was similar
among groups (P = 0.12). No other complications were recorded. There was
no statistically significant difference on pain score. There was a
significant difference between pre- and postoperative composite scores of
the participants' body image domain and psycho-social aspects in both
groups. The difference between the pre- and postoperative participants'
perception of physical difficulties was greater and statistically
significant in the intervention group. <br/>CONCLUSION(S): There was no
statistical difference in the use of perpendicular or oblique stabilizers,
but the availability of different models of stabilizers during the study
suggested that this can be advantageous. The trial is registered at
ClinicalTrials.gov, number NCT03087734.<br/>Copyright # The Author(s)
2024.

<5>
[Use Link to view the full text]
Accession Number
2031208276
Title
Iatrogenic aortic dissection in patients undergoing coronary artery bypass
grafting surgery: A systemic review of published literatures.
Source
Medicine (United States). 103(12) (pp E37472), 2024. Date of Publication:
22 Mar 2024.
Author
Yuan X.; Sun Y.; Chen H.; Lan Q.; Wu W.; Yao Y.
Institution
(Yuan, Lan, Wu) Department of Anesthesiology, Xichang People's Hospital,
Xichang, China
(Yuan, Sun, Yao) Department of Anesthesiology, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Fuwai
Hospital, Peking Union Medical College, Beijing, China
(Sun) Department of Anesthesiology, Baoji High-Tech Hospital, Shaanxi,
China
(Chen) Department of Laboratory, Xichang People's Hospital, Xichang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Iatrogenic aortic dissection (IAD) is a rare but highly lethal
complication that may occur following coronary artery bypass grafting
(CABG) surgery. Aortic dissection (AD) is often asymptomatic, making early
detection difficult. We aimed to optimize preoperative evaluation
strategies of CABG surgery for minimizing the incidence of IAD and assess
early recognition and management of IAD for improving outcomes.
<br/>Method(s): Electronic databases were searched to identify all case
reports of patients undergoing CABG surgery who developed IAD. Clinical
characteristics, operative information, perioperative management, and
patient outcomes were compiled and analyzed. <br/>Result(s): Nineteen case
reports involving 27 patients aged 50 to 81 were included. Patients were
from Europe (n = 23) and Asia (n = 4), mostly men (n = 25). The aorta was
described as normal, abnormal, and unmentioned (n = 8, 5, and 14,
respectively). Sixteen patients had a bypass with more than 3 grafts. Most
patients (n = 25) experienced type A dissection. There were intraoperative
(n = 12) and postoperative (n = 15) cases. Surgery (n = 19) was the most
common treatment, with 9 patients selecting deep hypothermic circulatory
arrest. Eighteen patients were restored to health, while 9 patients died
(3 died before treatment). <br/>Conclusion(s): Our study focused on
patients with IAD and developed a recommended management protocol for
patients undergoing CABG surgery.<br/>Copyright &#xa9; 2024 Lippincott
Williams and Wilkins. All rights reserved.

<6>
Accession Number
2031082475
Title
Secondary stroke prevention in people with atrial fibrillation: treatments
and trials.
Source
The Lancet Neurology. 23(4) (pp 404-417), 2024. Date of Publication: April
2024.
Author
Seiffge D.J.; Cancelloni V.; Raber L.; Paciaroni M.; Metzner A.; Kirchhof
P.; Fischer U.; Werring D.J.; Shoamanesh A.; Caso V.
Institution
(Seiffge, Fischer) Department of Neurology, Inselspital University
Hospital Bern and University of Bern, Switzerland
(Raber) Department of Cardiology, Inselspital University Hospital Bern and
University of Bern, Switzerland
(Cancelloni, Paciaroni, Caso) Stroke Unit, Santa Maria della Misericordia
Hospital, University of Perugia, Perugia, Italy
(Metzner, Kirchhof) Department of Cardiology, University Heart and
Vascular Center Hamburg, University Center Hamburg Eppendorf, Hamburg,
Germany
(Metzner, Kirchhof) German Center for Cardiovascular Research, partner
site Hamburg, Kiel, and Lubeck, Germany
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Fischer) Department of Neurology, University Hospital Basel, Switzerland
(Werring) Stroke Research Centre, UCL Queen Square Institute of Neurology,
London, United Kingdom
(Shoamanesh) Division of Neurology, Department of Medicine, Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Ltd
Abstract
Atrial fibrillation is one of the most common cardiac arrhythmias and is a
major cause of ischaemic stroke. Recent findings indicate the importance
of atrial fibrillation burden (device-detected, subclinical, or paroxysmal
and persistent or permanent) and whether atrial fibrillation was known
before stroke onset or diagnosed after stroke for the risk of recurrence.
Secondary prevention in patients with atrial fibrillation and stroke aims
to reduce the risk of recurrent ischaemic stroke. Findings from randomised
controlled trials assessing the optimal timing to introduce direct oral
anticoagulant therapy after a stroke show that early start (ie, within 48
h for minor to moderate strokes and within 4-5 days for large strokes)
seems safe and could reduce the risk of early recurrence. Other promising
developments regarding early rhythm control, left atrial appendage
occlusion, and novel factor XI inhibitor oral anticoagulants suggest that
these therapies have the potential to further reduce the risk of stroke.
Secondary prevention strategies in patients with atrial fibrillation who
have a stroke despite oral anticoagulation therapy is an unmet medical
need. Research advances suggest a heterogeneous spectrum of causes, and
ongoing trials are investigating new approaches for secondary prevention
in this vulnerable patient group. In patients with atrial fibrillation and
a history of intracerebral haemorrhage, the latest data from randomised
controlled trials on stroke prevention shows that oral anticoagulation
reduces the risk of ischaemic stroke but more data are needed to define
the safety profile.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<7>
Accession Number
2031019171
Title
Saffron therapy for the ongoing treatment of age-related macular
degeneration.
Source
BMJ Open Ophthalmology. 9(1) (no pagination), 2024. Article Number:
e001399. Date of Publication: 13 Mar 2024.
Author
Broadhead G.K.; Grigg J.; McCluskey P.J.; Hong T.; Schlub T.E.; Chu E.;
Chang A.A.
Institution
(Broadhead, Grigg, McCluskey, Chang) The University of Sydney, Save Sight
Institute, Sydney, NSW, Australia
(Broadhead, Hong, Chu, Chang) Sydney Retina Clinic, Sydney, NSW, Australia
(Broadhead, Hong, Chu, Chang) Cureos, Sydney, NSW, Australia
(Schlub) The University of Sydney School of Public Health, Sydney, NSW,
Australia
Publisher
BMJ Publishing Group
Abstract
Objective To assess the long-term efficacy and safety of oral saffron, a
natural antioxidant, in treating mild/moderate age-related macular
degeneration (AMD). Methods and analysis Open-label, extension trial of 93
adults (>50 years) with mild/moderate AMD and vision >20/70 Snellen
equivalent in at least 1 eye. Exclusion criteria included confounding
visual lesions or significant gastrointestinal disease impairing
absorption. Participants were given oral saffron supplementation (20
mg/day) for 12 months. Those already consuming Age-Related Eye Diseases
Study (AREDS) supplements or equivalent maintained these. Primary outcomes
included changes in multifocal electroretinogram (mfERG) response density
and latency, and changes in best-corrected visual acuity (BCVA). Secondary
outcomes included safety outcomes, changes in mfERG and BCVA among
participants on AREDS supplements and changes in microperimetry. Results
At 12 months, mean mfERG response density was significantly higher in
rings 1, 2 and overall (p<0.001 for all) but not in rings 3-6, and there
was no difference in response between those taking AREDS supplements and
those not (p>0.05). Mean mfERG latency was not significantly different in
any of rings 1-6 or overall (p>0.05 for all), again with no difference
between those taking AREDS supplements or not (p>0.05). Mean BCVA was 1.6
letters worse (p<0.05) with no difference between those on AREDS
supplements or not, and this may have been related to cataract
progression. No saffron-related serious adverse events were detected.
Conclusion Saffron supplementation modestly improved mfERG responses in
participants with AMD, including those using AREDS supplements. Given the
chronic nature of AMD, longer-term supplementation may produce greater
benefits.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2024.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<8>
Accession Number
2029052130
Title
Advancements in Human Embryonic Stem Cell Research: Clinical Applications
and Ethical Issues.
Source
Tissue Engineering and Regenerative Medicine. 21(3) (pp 379-394), 2024.
Date of Publication: April 2024.
Author
Park S.J.; Kim Y.Y.; Han J.Y.; Kim S.W.; Kim H.; Ku S.-Y.
Institution
(Park, Kim, Han, Kim, Kim, Ku) Department of Obstetrics and Gynecology,
Seoul National University Hospital, Seoul, South Korea
(Kim, Ku) Department of Obstetrics and Gynecology, Seoul National
University College of Medicine, 101 Daehak-Ro Jongno-Gu, Seoul 03080,
South Korea
(Kim, Kim, Ku) Institute of Reproductive Medicine and Population, Medical
Research Center, Seoul National University, Seoul, South Korea
Publisher
Korean Tissue Engineering and Regenerative Medicine Society
Abstract
Background: The development and use of human embryonic stem cells (hESCs)
in regenerative medicine have been revolutionary, offering significant
advancements in treating various diseases. These pluripotent cells,
derived from early human embryos, are central to modern biomedical
research. However, their application is mired in ethical and regulatory
complexities related to the use of human embryos. <br/>Method(s): This
review utilized key databases such as ClinicalTrials.gov, EU Clinical
Trials Register, PubMed, and Google Scholar to gather recent clinical
trials and studies involving hESCs. The focus was on their clinical
application in regenerative medicine, emphasizing clinical trials and
research directly involving hESCs. <br/>Result(s): Preclinical studies and
clinical trials in various areas like ophthalmology, neurology,
endocrinology, and reproductive medicine have demonstrated the versatility
of hESCs in regenerative medicine. These studies underscore the potential
of hESCs in treating a wide array of conditions. However, the field faces
ethical and regulatory challenges, with significant variations in policies
and perspectives across different countries. <br/>Conclusion(s): The
potential of hESCs in regenerative medicine is immense, offering new
avenues for treating previously incurable diseases. However, navigating
the ethical, legal, and regulatory landscapes is crucial for the continued
advancement and responsible application of hESC research in the medical
field. Considering both scientific potential and ethical implications, a
balanced approach is essential for successfully integrating hESCs into
clinical practice.<br/>Copyright &#xa9; The Author(s) 2024.

<9>
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.

<10>
Accession Number
2031383219
Title
Pulmonary Vein Isolation With or Without Left Atrial Appendage Ligation in
Atrial Fibrillation: The aMAZE Randomized Clinical Trial.
Source
JAMA. 331(13) (pp 1099-1108), 2024. Date of Publication: 02 Apr 2024.
Author
Lakkireddy D.R.; Wilber D.J.; Mittal S.; Tschopp D.; Ellis C.R.; Rasekh
A.; Hounshell T.; Evonich R.; Chandhok S.; Berger R.D.; Horton R.; Hoskins
M.H.; Calkins H.; Yakubov S.J.; Simons P.; Saville B.R.; Lee R.J.
Institution
(Lakkireddy) Kansas City Heart Rhythm Institute, University of
Missouri-Columbia, Overland Park Regional Medical Center, 12200W106th St,
Overland Park, KS 66215, United States
(Wilber) Loyola University Chicago Stritch School of Medicine, Maywood,
IL, United States
(Mittal) Valley Health System, Ridgewood, NJ, United States
(Tschopp, Horton) Texas Cardiac Arrhythmia Research, Austin, United States
(Ellis) Vanderbilt University Heart-EP, Nashville, TN, United States
(Rasekh) Baylor College of Medicine, Houston, TX, United States
(Hounshell) MercyOne Iowa Heart Center, West Des Moines, United States
(Evonich) UP Health System-Marquette, Marquette, MI, United States
(Chandhok) Bryn Mawr Medical Specialists Association, Bryn Mawr, PA,
United States
(Berger, Calkins) Johns Hopkins University, Baltimore, MD, United States
(Hoskins) New Mexico Heart Institute, Albuquerque, United States
(Yakubov) OhioHealth Heart and Vascular, Columbus, United States
(Simons, Lee) AtriCure Inc, Mason, OH, United States
(Saville) Berry Consultants LLC, Austin, TX, United States
(Lee) University of California, San Francisco, United States
Publisher
American Medical Association
Abstract
Importance: Left atrial appendage elimination may improve catheter
ablation outcomes for atrial fibrillation. <br/>Objective(s): To assess
the safety and effectiveness of percutaneous left atrial appendage
ligation adjunctive to catheter pulmonary vein isolation for nonparoxysmal
atrial fibrillation. <br/>Design, Setting, and Participant(s): This
multicenter, prospective, open-label, randomized clinical trial evaluated
the safety and effectiveness of percutaneous left atrial appendage
ligation adjunctive to planned pulmonary vein isolation for nonparoxysmal
atrial fibrillation present for less than 3 years. Eligible patients were
randomized in a 2:1 ratio to undergo left atrial appendage ligation and
pulmonary vein isolation or pulmonary vein isolation alone. Use of a 2:1
randomization ratio was intended to provide more device experience and
safety data. Patients were enrolled from October 2015 to December 2019 at
53 US sites, with the final follow-up visit on April 21, 2021.
<br/>Intervention(s): Left atrial appendage ligation plus pulmonary vein
isolation compared with pulmonary vein isolation alone. <br/>Main Outcomes
and Measures: A bayesian adaptive analysis was used for primary end
points. Primary effectiveness was freedom from documented atrial
arrythmias of greater than 30 seconds duration 12 months after undergoing
pulmonary vein isolation. Rhythm was assessed by Holter monitoring at 6
and 12 months after pulmonary vein isolation, symptomatic event
monitoring, or any electrocardiographic tracing obtained through 12 months
after pulmonary vein isolation. Primary safety was a composite of
predefined serious adverse events compared with a prespecified 10%
performance goal 30 days after the procedure. Left atrial appendage
closure was evaluated through 12 months after pulmonary vein isolation.
<br/>Result(s): Overall, 404 patients were randomized to undergo left
atrial appendage ligation plus pulmonary vein isolation and 206 were
randomized to undergo pulmonary vein isolation alone. Primary
effectiveness was 64.3% with left atrial appendage ligation and pulmonary
vein isolation and 59.9% with pulmonary vein isolation only (difference,
4.3% [bayesian 95% credible interval, -4.2% to 13.2%]; posterior
superiority probability, 0.835), which did not meet the statistical
criterion to establish superiority (0.977). Primary safety was met, with a
30-day serious adverse event rate of 3.4% (bayesian 95% credible interval,
2.0% to 5.0%; posterior probability, 1.0) which was less than the
prespecified threshold of 10%. At 12 months after pulmonary vein
isolation, complete left atrial appendage closure (0 mm residual
communication) was observed in 84% of patients and less than or equal to 5
mm residual communication was observed in 99% of patients.
<br/>Conclusions and Relevance: Percutaneous left atrial appendage
ligation adjunctive to pulmonary vein isolation did not meet prespecified
efficacy criteria for freedom from atrial arrhythmias at 12 months
compared with pulmonary vein isolation alone for patients with
nonparoxysmal atrial fibrillation, but met prespecified safety criteria
and demonstrated high rates of closure at 12 months. Trial Registration:
ClinicalTrials.gov Identifier: NCT02513797.<br/>Copyright &#xa9; 2024
American Medical Association. All rights reserved.

<11>
Accession Number
2030850946
Title
Transversus Thoracic Muscle Plane Block For Postoperative Pain in
Pediatric Cardiac Surgery: A Systematic Review And Meta-Analysis of
Randomized And Observational Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(5) (pp 1228-1238),
2024. Date of Publication: May 2024.
Author
Cui Y.-Y.; Xu Z.-Q.; Hou H.-J.; Zhang J.; Xue J.-J.
Institution
(Cui) First School of Clinical Medicine, Gansu University of Chinese
Medicine, Chengguan District, Lanzhou, China
(Xu, Hou, Zhang, Xue) Department of Anesthesiology, Gansu Province
Hospital of Traditional Chinese Medicine, Lanzhou, China
(Xu, Hou, Zhang, Xue) Gansu Clinical Research Center of Integrative
Anesthesiology, Lanzhou, China
(Xue) Evidence-based Medicine Center, School of Basic Medical Science,
Lanzhou University, Gansu, Lanzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: Pediatric patients undergoing cardiac surgery usually
experience significant surgical pain. Additionally, the effect of poor
surgical analgesia creates a pain continuum that extends to the
postoperative period. Transversus thoracic muscle plane block (TTMPB) is a
novel plane block technique that can provide analgesia to the anterior
chest wall. The analgesic role of TTMPB in pediatric cardiac surgery is
still uncertain. A meta-analysis was conducted to determine the analgesic
efficacy of this procedure. Design and Setting: Systematic review and
meta-analysis. PubMed, Embase, Web of Science, CENTRAL, WanFang Data, and
the China National Knowledge Infrastructure were searched to November
2023, and the Grading of Recommendations Assessment, Development, and
Evaluation approach was followed to evaluate the certainty of evidence.
<br/>Participant(s): Eligible studies enrolled pediatric patients from 2
months to 12 years old scheduled to undergo cardiac surgery, and
randomized them to receive a TTMPB or no block/sham block.
<br/>Measurements and Main Results: Six studies that enrolled 601
pediatric patients were included. Low-certainty evidence from randomized
trials showed that, compared with no block or sham block, TTMPB in
pediatric patients undergoing cardiac surgery may reduce postoperative
modified objective pain score at 12 hours (weighted mean difference [WMD]
-2.20, 95% CI -2.73 to -1.68) and 24 hours (WMD -1.76, 95% CI -2.09 to
-1.42), intraoperative opioid consumption (WMD -3.83, 95% CI -5.90 to
-1.76 mug/kg), postoperative opioid consumption (WMD -2.51, 95% CI -2.84
to -2.18 mug/kg), length of intensive care unit (ICU) stay (WMD -5.56, 95%
CI -8.30 to -2.83 hours), and extubation time (WMD -2.13, 95% CI -4.21 to
-0.05 hours). Retrospective studies provided very low certainty that the
results were consistent with the randomized trials. <br/>Conclusion(s):
Very low- to low-certainty evidence showed that TTMPB in pediatric
patients undergoing cardiac surgery may reduce postoperative pain, opioid
consumption, ICU length of stay, and extubation time.<br/>Copyright &#xa9;
2024 Elsevier Inc.

<12>
Accession Number
2030766326
Title
Meta-analysis in cardiovascular surgery: A valuable statistical tool.
Source
Cirugia Cardiovascular. 31(2) (pp 45-46), 2024. Date of Publication: 01
Mar 2024.
Author
Urso S.; Dayan V.
Institution
(Urso) Servicio de Cirugia Cardiaca, Hospital Universitario Dr. Negrin,
Las Palmas de Gran Canaria, Spain
(Dayan) Centro Cardiovascular Universitario Hospital de Clinicas. Coronary
artery bypass grafting is superior to percutaneous coronary intervention
for all women subgroups, Montevideo, Uruguay
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)

<13>
Accession Number
2029244284
Title
Prognostic significance of echocardiographic deformation imaging in adult
congenital heart disease.
Source
European Journal of Clinical Investigation. (no pagination), 2024. Date
of Publication: 2024.
Author
van Rosendael P.J.; Taha K.; Guglielmo M.; Teske A.J.; van der Harst P.;
Sieswerda G.; Cramer M.J.; van der Zwaan H.B.
Institution
(van Rosendael, Taha, Guglielmo, Teske, van der Harst, Sieswerda, Cramer,
van der Zwaan) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Guglielmo) Department of Cardiology, Haga Teaching Hospital, The Hague,
Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Due to medical and surgical advancements, the population of
adult patients with congenital heart disease (ACHD) is growing. Despite
successful therapy, ACHD patients face structural sequalae, placing them
at increased risk for heart failure and arrhythmias. Left and right
ventricular function are important predictors for adverse clinical
outcomes. In acquired heart disease it has been shown that
echocardiographic deformation imaging is of superior prognostic value as
compared to conventional parameters as ejection fraction. However, in
adult congenital heart disease, the clinical significance of deformation
imaging has not been systematically assessed and remains unclear.
<br/>Method(s): According to the Preferred Reporting Items for Systematic
Reviews checklist, this systematic review included studies that reported
on the prognostic value of echocardiographic left and/or right ventricular
strain by 2-dimensional speckle tracking for hard clinical end-points
(death, heart failure hospitalization, arrhythmias) in the most frequent
forms of adult congenital heart disease. <br/>Result(s): In total, 19
contemporary studies were included. Current data shows that left
ventricular and right ventricular global longitudinal strain (GLS) predict
heart failure, transplantation, ventricular arrhythmias and mortality in
patients with Ebstein's disease and tetralogy of Fallot, and that GLS of
the systemic right ventricle predicts heart failure and mortality in
patients post atrial switch operation or with a congenitally corrected
transposition of the great arteries. <br/>Conclusion(s): Deformation
imaging can potentially impact the clinical decision making in ACHD
patients. Further studies are needed to establish disease-specific
reference strain values and ranges of impaired strain that would indicate
the need for medical or structural intervention.<br/>Copyright &#xa9; 2024
The Authors. European Journal of Clinical Investigation published by John
Wiley & Sons Ltd on behalf of Stichting European Society for Clinical
Investigation Journal Foundation.

<14>
Accession Number
643856609
Title
Conservative Versus Surgical Therapy in Patients With Infective
Endocarditis and Surgical Indication-Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 13(7) (pp e033404), 2024. Date
of Publication: 02 Apr 2024.
Author
Caldonazo T.; Hagel S.; Doenst T.; Kirov H.; Sa M.P.; Jacquemyn X.;
Tasoudis P.; Franz M.; Diab M.
Institution
(Caldonazo, Doenst, Kirov, Diab) Department of Cardiothoracic Surgery
Friedrich-Schiller-University Jena Jena Germany, Germany
(Hagel) Institute for Infectious Diseases and Infection Control,
Friedrich-Schiller-University Jena Jena Germany, Germany
(Sa) Department of Cardiothoracic Surgery University of Pittsburgh
Pittsburgh PA USA
(Sa) UPMC Heart and Vascular Institute, University of Pittsburgh Medical
Center Pittsburgh PA USA
(Jacquemyn) Department of Cardiovascular Sciences KU Leuven Leuven
Belgium, Belgium
(Tasoudis) Division of Cardiothoracic Surgery University of North Carolina
Chapel Hill NC USA
(Franz) Division of Cardiology, Department of Internal Medicine
Friedrich-Schiller-University Jena Jena Germany, Germany
(Diab) Department of Cardiothoracic Surgery Cardiovascular Center
Rotenburg Rotenburg an der Fulda Germany, Germany
Abstract
BACKGROUND: Infective endocarditis represents a life-threatening disease
with high mortality rates. A fraction of patients receives exclusively
conservative antibiotic treatment due to their comorbidities and high
operative risk, despite fulfilling criteria for surgical therapy. The aim
of the present study is to compare outcomes in patients with infective
endocarditis and indication for surgical therapy in those who underwent or
did not undergo valve surgery. METHODS AND RESULTS: Three databases were
systematically assessed. A pooled analysis of Kaplan-Meier-derived
reconstructed time-to-event data from studies with longer follow-up
comparing conservative and surgical treatment was performed. A landmark
analysis to further elucidate the effect of surgical intervention on
mortality was carried out. Four studies with 3003 patients and median
follow-up time of 7.6months were included. Overall, patients with an
indication for surgery who were surgically treated had a significantly
lower risk of mortality compared with patients who received conservative
treatment (hazard ratio [HR], 0.27 [95% CI, 0.24-0.31], P<0.001). The
survival analysis in the first year showed superior survival for patients
who underwent surgery when compared with those who did not at 1month
(87.6% versus 57.6%; HR, 0.31 [95% CI, 0.26-0.37], P<0.01), at 6 months
(74.7% versus 34.6%) and at 12months (73.3% versus 32.7%).
<br/>CONCLUSION(S): Based on the findings of this study-level
meta-analysis, patients with infective endocarditis and formal indication
for surgical intervention who underwent surgery are associated with a
lower risk of short- and long-term mortality when compared with
conservative treatment.

<15>
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. 13(7) (pp e033176), 2024. Date
of Publication: 02 Apr 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.

<16>
Accession Number
2031522114
Title
Percutaneous left atrial appendage closure with the Watchman device: a
systematic review.
Source
Postepy w Kardiologii Interwencyjnej. 20(1) (pp 18-29), 2024. Date of
Publication: 2024.
Author
Maksym J.; Grabowski M.; Mazurek T.
Institution
(Maksym, Grabowski, Mazurek) First Chair and Department of Cardiology,
Medical University of Warsaw, Warsaw, Poland
Publisher
Termedia Publishing House Ltd.
Abstract
Atrial fibrillation (AF) is the most commonly observed arrhythmia in the
world and its prevalence increases with age. The main and most severe
complication of AF is ischemic stroke. Oral anticoagulation (OAC) therapy
is the standard of care for stroke prevention in the high risk population.
Initiation of this treatment is associated with a substantial risk of
bleeding complications. Moreover, there is a group of patients who cannot
tolerate OAC. In patients with AF the left atrial appendage (LAA) is the
main source of thrombus formation. Percutaneous left atrial appendage
closure (LAAC) has become an important non-pharmacological intervention
for stroke prevention in patients with non-valvular AF. The procedure aims
to reduce the risk of thromboembolism without increasing the risk of
bleeding. Over the last few years, the safety and long-term efficacy of
the procedure in specific populations have increased and more patients are
being treated. The Watchman device is the most studied device in this
field. Randomized controlled trials demonstrated non-inferiority of
percutaneous left atrial appendage closure using the WATCHMAN 2.5 device
to OAC (Boston Scientific, Marlborough, MA, USA). The new generation
device, WATCHMAN FLX, was introduced and its use was associated with fewer
safety events and a higher success rate of effective appendage closure.
Nevertheless, several unsolved problems remain, including device-related
thrombosis, the post-LAAC antithrombotic regimen, and peri-device leakage.
This review will focus on LAAC with the Watchman device for stroke
prevention in AF patients. Current status, available literature, clinical
safety and efficacy will be summarized.<br/>Copyright &#xa9; 2024 Termedia
Publishing House Ltd.. All rights reserved.

<17>
Accession Number
2031483740
Title
Ischaemic heart disease in patients with cancer.
Source
European Heart Journal. 45(14) (pp 1209-1223), 2024. Date of Publication:
07 Apr 2024.
Author
Ameri P.; Canepa M.; Lopez-Fernandez T.; Nohria A.; Bertero E.; Vergallo
R.; Lombardi M.; Lyon A.R.; Porto I.
Institution
(Ameri, Canepa, Vergallo, Porto) Cardiovascular Disease Unit, IRCCS
Ospedale Policlinico San Martino, Genova, Italy
(Ameri, Canepa, Bertero, Vergallo, Lombardi, Porto) Department of Internal
Medicine, University of Genova, Viale Benedetto XV, 6, Genova 16132, Italy
(Bertero) Comprehensive Heart Failure Center (CHFC), University Clinic
Wurzburg, Wurzburg, Germany
(Lombardi) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Universita Cattolica Sacro Cuore, Roma,
Italy
(Nohria) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Lyon) Cardio-Oncology Service, Royal Brompton Hospital, London, United
Kingdom
(Lopez-Fernandez) Cardiology Department, La Paz University Hospital,
IdiPAZ Research Institute, Madrid, Spain
(Lopez-Fernandez) Cardiology Department, Quiron Pozuelo University
Hospital, Madrid, Spain
Publisher
Oxford University Press
Abstract
Cardiologists are encountering a growing number of cancer patients with
ischaemic heart disease (IHD). Several factors account for the
interrelationship between these two conditions, in addition to improving
survival rates in the cancer population. Established cardiovascular (CV)
risk factors, such as hypercholesterolaemia and obesity, predispose to
both IHD and cancer, through specific mechanisms and via low-grade,
systemic inflammation. This latter is also fuelled by clonal
haematopoiesis of indeterminate potential. Furthermore, experimental work
indicates that IHD and cancer can promote one another, and the CV or
metabolic toxicity of anticancer therapies can lead to IHD. The
connections between IHD and cancer are reinforced by social determinants
of health, non-medical factors that modify health outcomes and comprise
individual and societal domains, including economic stability, educational
and healthcare access and quality, neighbourhood and built environment,
and social and community context. Management of IHD in cancer patients is
often challenging, due to atypical presentation, increased bleeding and
ischaemic risk, and worse outcomes as compared to patients without cancer.
The decision to proceed with coronary revascularization and the choice of
antithrombotic therapy can be difficult, particularly in patients with
chronic coronary syndromes, necessitating multidisciplinary discussion
that considers both general guidelines and specific features on a case by
case basis. Randomized controlled trial evidence in cancer patients is
very limited and there is urgent need for more data to inform clinical
practice. Therefore, coexistence of IHD and cancer raises important
scientific and practical questions that call for collaborative efforts
from the cardio-oncology, cardiology, and oncology
communities.<br/>Copyright &#xa9; 2024 Oxford University Press. All rights
reserved.

<18>
Accession Number
2029348616
Title
Comparison of Thoracoscopy-Guided Thoracic Paravertebral Block and
Ultrasound-Guided Thoracic Paravertebral Block in Postoperative Analgesia
of Thoracoscopic Lung Cancer Radical Surgery: A Randomized Controlled
Trial.
Source
Pain and Therapy. (no pagination), 2024. Date of Publication: 2024.
Author
Xu X.; Xie Y.-X.; Zhang M.; Du J.-H.; He J.-X.; Hu L.-H.
Institution
(Xu, Xie, Zhang, Du, Hu) Department of Anesthesiology, The Affiliated
Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo
315040, China
(He) Department of Thoracic Surgery, The Affiliated Lihuili Hospital of
Ningbo University, No. 57 Xingning road, Ningbo 315040, China
Publisher
Adis
Abstract
Introduction: Ultrasound-guided thoracic paravertebral block (UTPB) is
widely used for postoperative analgesia in thoracic surgery. However, it
has many disadvantages. Thoracoscopy-guided thoracic paravertebral block
(TTPB) is a new technique for thoracic paravertebral block (TPB). In this
study, we compared the use of TTPB and UTPB for pain management after
thoracoscopic radical surgery for lung cancer. <br/>Method(s): In total,
80 patients were randomly divided 1:1 into the UTPB group and the TTPB
group. The surgical time of TPB, the success rate of the first puncture,
block segment range, visual analog scale (VAS) scores at 2, 6, 12, 24, and
48 h post operation, and the incidence of postoperative adverse reactions
were compared between the two groups. <br/>Result(s): The surgical time of
TPB was significantly shorter in the TTPB group than in the UTPB group
(2.2 +/- 0.3 vs. 5.7 +/- 1.7 min, t = - 12.411, P < 0.001). The success
rate of the first puncture and the sensory block segment were
significantly higher in the TTPB group than in the UTPB group (100% vs.
76.9%, chi² = 8.309, P < 0.001; 6.5 +/- 1.2 vs. 5.1 +/- 1.3
levels, t = - 5.306, P < 0.001, respectively). The VAS scores were
significantly higher during rest and coughing at 48 h post operation than
at 2, 6, 12, and 24 h post operation in the TTPB group. The VAS scores
were significantly lower during rest and coughing at 12 and 24 h post
operation in the TTPB group than in the UTPB group (rest: 2.5 +/- 0.4 vs.
3.4 +/- 0.6, t = 7.325, P < 0.001; 2.5 +/- 0.5 vs. 3.5 +/- 0.6, t = 7.885,
P < 0.001; coughing: 3.4 +/- 0.6 vs. 4.2 +/- 0.7, t = 5.057, P < 0.001;
3.4 +/- 0.6 vs. 4.2 +/- 0.8, t = 4.625, P < 0.001, respectively). No
significant difference was observed in terms of postoperative adverse
reactions between the two groups. <br/>Conclusion(s): Compared with UTPB,
TTPB shows advantages, such as simpler and more convenient surgery,
shorter surgical time, a higher success rate of the first puncture, wider
block segments, and superior analgesic effect. TTPB can effectively reduce
postoperative pain due to thoracoscopic lung cancer radical surgery. Trial
Registration: https://www.chictr.org.cn, identifier ChiCTR2300072005,
prospectively registered on 31/05/2023.<br/>Copyright &#xa9; The Author(s)
2024.

<19>
Accession Number
2007551380
Title
Dexmedetomidine improves early postoperative neurocognitive disorder in
elderly male patients undergoing thoracoscopic lobectomy.
Source
Experimental and Therapeutic Medicine. 20(4) (pp 3867-3876), 2020. Date of
Publication: October 2020.
Author
Shi H.; Du X.; Wu F.; Hu Y.; Xv Z.; Mi W.
Institution
(Shi, Xv, Mi) Anesthesia and Operation Center, Chinese PLA General
Hospital, Beijing 100853, China
(Shi, Du, Wu, Hu) Department of Anesthesiology, Affiliated Hospital of
Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, China
Publisher
Spandidos Publications
Abstract
Perioperative neurocognitive disorder (PND) is a common complication
following thoracic surgery that frequently occurs in patients >=65 years.
PND includes postoperative cognitive dysfunction (POCD) and postoperative
delirium (POD). To investigate whether intravenous dexmedetomidine (DEX)
is able to improve neurocognitive function in elderly male patients
following thoracoscopic lobectomy, a randomized, double-blinded,
placebo-controlled trial was performed at the Affiliated Hospital of Inner
Mongolia Medical University (Hohhot, China). Patients aged >=65 years were
enrolled and were subjected to thoracic surgery under general anesthesia.
A computer-generated randomization sequence was used to randomly assign
patients (at a 1:1 ratio) to receive either intravenous DEX (0.5 microg/kg
per h, from induction until chest closure) or placebo (intravenous normal
saline).TheprimaryendpointwastheresultoftheMini-Mental State Examination
(MMSE). The secondary endpoints were the results of the Montreal Cognitive
Assessment (MoCA) and those obtained with the Confusion Assessment Method
(CAM), as well as the incidence of POCD and POD during the first 7
postoperative days. Other observational indexes included sleep quality at
night, self-anxiety scale prior to the operation and 7 days following the
operation and the visual analogue scale (VAS) score at rest and during
movement on the first and third day following the operation. Furthermore,
at 6 h following surgery, the MMSE score in the DEX group was
significantly higher than that in the saline group. At 6 h and on the
first day postoperatively, the MoCA score in the DEX group was
significantly higher than that in the saline group. The incidence of POCD
and POD in the DEX group was 13.2 and 7.5%, respectively, while that in
the saline group was 35.8 and 11.3%, respectively. There was a significant
difference in the incidence of POCD between the two groups (P<0.01). In
the DEX group, mean sleep quality was increased, whereas the mean VAS was
decreased compared with the corresponding values in the saline group. In
conclusion, elderly male patients who underwent thoracoscopic lobectomy
under continuous infusion of DEX (0.5 microg/kg/h) exhibited a reduced
incidence of POCD during the first 7 postoperative days as compared with
the placebo group. Furthermore, DEX improved the subjective sleep quality
in the first postoperative night, reduced anxiety and alleviated
postoperative pain. In addition, it increased the incidence of
bradycardia. The present study was registered in the Chinese Clinical
Trial Registry (www.chictr.org.cn; registration no.
ChiCTR-IPR-17010958).<br/>Copyright &#xa9; This work is licensed under a
Creative Commons Attribution 4.0 International (CC BY 4.0) License

<20>
Accession Number
2031446364
Title
A Study of Safety and Effectiveness of Evicel Fibrin Sealant as an
Adjunctive Hemostat in Pediatric Surgery.
Source
European Journal of Pediatric Surgery. (no pagination), 2023. Date of
Publication: 2023.
Author
Kenny S.; Gabra H.; Hall N.J.; Flageole H.; Illie B.; Barnett E.;
Kocharian R.; Sharif K.
Institution
(Kenny) Department of Paediatric Surgery, Alder Hey Children's Hospital,
Merseyside, Liverpool, United Kingdom
(Gabra) Department of Children's Surgery, Great North Children's Hospital,
Newcastle Upon Tyne, United Kingdom
(Hall) Department of Neonatal and Paediatric Surgery, Southampton
Children's Hospital, Southampton, United Kingdom
(Flageole) United Kingdom of Great Britain and Northern Ireland, United
Kingdom
(Illie, Kocharian) Department of Pediatric Surgery, McMaster Children's
Hospital, Hamilton, ON, Canada
(Barnett) Department of Scientific Affairs, Ethicon Inc, Raritan, NJ,
United States
(Sharif) Department of Scientific Affairs, Ethicon UK, Livingston, United
Kingdom
Publisher
Georg Thieme Verlag
Abstract
Introduction Data on the use of fibrin sealants to control intraoperative
bleeding in children are scarce. Evicel Fibrin Sealant (Ethicon Inc.,
Raritan, New Jersey, United States) was found safe and effective in
clinical trials of adults undergoing various surgery types. We evaluated
the safety and efficacy of Evicel versus Surgicel Absorbable Hemostat
(Ethicon Inc.) as adjunctive topical hemostats for mild/moderate
raw-surface bleeding in pediatric surgery. Methods A phase III randomized
clinical trial was designed as required by the European Medicines Agency's
Evicel Pediatric Investigation Plan: 40 pediatric subjects undergoing
abdominal, retroperitoneal, pelvic, or thoracic surgery were randomized to
Evicel or Surgicel, to treat intraoperative mild-to-moderate bleeding.
Descriptive analyses included time-to-hemostasis and rates of treatment
success (4, 7, 10 minutes), intraoperative treatment failure, rebleeding,
and thromboembolic events. Results Forty of 130 screened subjects aged 0.9
to 17 years were randomized 1:1 to Evicel or Surgicel. Surgeries were
predominantly open abdominal procedures. The median bleeding area was 4.0
cm ²for Evicel and 1.0 cm ²for Surgicel. The median
time-to-hemostasis was 4.0 minutes for both groups. The 4-, 7-, and
10-minute treatment success rates were 80.0% versus 65.0%, 100.0% versus
80.0%, and 95.0% versus 90.0%, whereas treatment failure rates were 5.0%
versus 25.0%, for Evicel and Surgicel, respectively. No deaths or
thrombotic events occurred. Re-bleeding occurred in 5.0% of Evicel and
10.0% of Surgicel subjects. Conclusions In accordance with adult clinical
trials, this randomized study supports the safety and efficacy of Evicel
for controlling mild-to-moderate surgical bleeding in a broad range of
pediatric surgical procedures.<br/>Copyright &#xa9; 2023 Georg Thieme
Verlag. All rights reserved.

<21>
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.

<22>
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

<23>
Accession Number
2028179844
Title
A systematic review of neurological airway respiratory cardiovascular
other-surgical severity (NARCO-SS) score as a pediatric perioperative
scoring system.
Source
Paediatric Anaesthesia. 34(5) (pp 396-404), 2024. Date of Publication: May
2024.
Author
Udupa A.N.; Majmudar A.A.; Tran L.
Institution
(Udupa) Queen Elizabeth Hospital, Central Adelaide Local Health Network,
Adelaide, SA, Australia
(Udupa, Majmudar, Tran) Faculty of Health and Medical Sciences, University
of Adelaide, Adelaide, SA, Australia
(Majmudar, Tran) Royal Adelaide Hospital, Central Adelaide Local Health
Network, Adelaide, SA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Objective: To systematically identify and synthesize the available
evidence of the neurological airway respiratory cardiovascular
other-surgical severity (NARCO-SS) score as compared to other pediatric
specific perioperative scoring systems. <br/>Design(s): This systematic
review was conducted in accordance with the Preferred Reporting Items for
Systematic Review and Meta-analysis (PRISMA) statement. All studies in all
languages comparing NARCO-SS with pediatric perioperative scoring systems
against outcomes were included. Records were screened and data were
extracted by three independent reviewers into standardized pilot-tested
extraction templates. <br/>Data Sources: Electronic searches were
performed in MEDLINE, Embase, Scopus, and CINAHL (from inception to
February 2023). Review Methods: The references were uploaded to a
validated software for systematic reviews (Rayyan) and screened against
the inclusion criteria. Full text of included studies were reviewed and
the available data were tabulated. We conducted Risk of Bias analysis on
the included studies using the Prediction model Risk Of Bias ASsessment
Tool (PROBAST). <br/>Result(s): A meta-analysis could not be performed due
to differences in outcome definitions across the included studies.
Correlations between NARCO-SS scores, ASA-PS scores and the predefined
outcomes of each study were presented as a narrative synthesis. The
included studies were determined to have a high risk of bias using the
PROBAST. <br/>Conclusion(s): This review has identified a need for
high-quality studies assessing NARCO-SS before recommendations for
clinical practice can be made. Addressing its limitations and enhancing
the NARCO-SS through targeted refinements of its individual descriptive
categories could potentially lead to improvement in its overall predictive
accuracy and facilitate wider adoption into clinical
practice.<br/>Copyright &#xa9; 2024 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<24>
Accession Number
2028055517
Title
Dexmedetomidine and magnesium sulfate in preventing junctional ectopic
tachycardia after pediatric cardiac surgery.
Source
Paediatric Anaesthesia. 34(5) (pp 459-466), 2024. Date of Publication: May
2024.
Author
Hassan P.F.; ElHaddad A.M.
Institution
(Hassan, El Haddad) Intensive Care, and Pain Management, Kasr Al Aini
Hospital, Cairo University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Background: Junctional ectopic tachycardia (JET) is a serious
tachyarrhythmia following pediatric cardiac surgery. It isn't easy to
treat and better to be prevented. This study aimed to examine the
prophylactic effects of dexmedetomidine, MgSO<inf>4</inf>, or their
combination in reducing JET following pediatric open cardiac surgery.
<br/>Method(s): Hundred and twenty children under 5 years, weighing more
than 5 kg, who were scheduled for corrective acyanotic cardiac surgeries
were randomized into three groups. Group MD
(Dexmedetomidine-MgSO<inf>4</inf> group): received dexmedetomidine 0.5
mug/kg IV over 20 min after induction, then infusion 0.5 mug/kg/h for 72
h, and 50 mg/kg bolus of MgSO<inf>4</inf> with aortic cross-clamp release,
then continued administration for 72 h postoperatively at a dose of 30
mg/kg/day. Group D (the dexmedetomidine group) received the same
dexmedetomidine as the MD group in addition to normal saline instead of
MgSO<inf>4</inf>. Group C (control group): received normal saline instead
of dexmedetomidine and MgSO<inf>4</inf>. The primary outcome was the
detection of JET incidence; the secondary outcomes were hemodynamic
parameters, ionized Mg, vasoactive-inotropic score, extubation time, PCCU
and hospital stay, and perioperative complications. <br/>Result(s): The
incidence of JET was significantly reduced in Group MD and Group D (p
=.007) compared to Group C. Ionized Mg was significantly higher in Group
MD than in Groups D and C during rewarming and in the ICU (p <.001).
Better hemodynamic profile in Group MD compared to Group D and Group C
throughout surgery and in the ICU, the predictive indexes were
significantly better in Group MD than in Groups D and C (p <.001).
Including the extubation time, PCCU, and hospital stay.
<br/>Conclusion(s): Dexmedetomidine alone or combined with
MgSO<inf>4</inf> had a therapeutic role in the prevention of JET in
children after congenital heart surgery.<br/>Copyright &#xa9; 2024 John
Wiley & Sons Ltd.

<25>
Accession Number
2030140192
Title
A rare diagnosis: Dressler's pericarditis.
Source
American Journal of the Medical Sciences. Conference: The American Journal
of the Medical Sciences Annual Meeting. InterContinental Hotel, New
Orleans United States. 367(Supplement 1) (pp S94), 2024. Date of
Publication: February 2024.
Author
Malik H.; Pirzadah H.; Malik A.; Livitz M.; Engel L.S.; Sanne S.; Ziada
M.E.
Institution
(Malik, Pirzadah, Malik, Livitz, Engel, Sanne, Ziada) LSU Health Sciences
Center - New Orleans, New Orleans, LA, United States
Publisher
Elsevier B.V.
Abstract
Case Report: Introduction: Dressler's Syndrome (DS) is a rare pericarditis
that develops following an insult to the heart or pericardium. Although
the exact cause is unknown, DS is hypothesized to be a primary
immunedriven pathology in response to an initial injury to mesothelial
pericardial cells and blood in the pericardial space. The incidence of DS
is less than 5% in developed countries, with an onset frequently
associated with a latency period of two to fourteen days before the
prodromal period. It is primarily seen in patients following an acute
myocardial infarction or cardiac surgery. Case: A 70-year-old man
presented to the emergency department in cardiogenic shock. An ECG was
consistent with an inferolateral ST elevation myocardial infarction
(STEMI) and a bedside echocardiogram showed fluid in the pericardium. An
emergent angiogram confirmed a late-presenting STEMI without the need for
stenting a lesion at that time. A pericardial drain was placed after 400
mL of fluid was removed during the pericardiocentesis. A cardiac Magnetic
Resonance Imaging showed no evidence of pseudoaneurysm, aneurysm, or
ventricular free wall rupture. Given the timing of the STEMI, presenting
symptoms, and an elevated ESR/CRP, the decision was made to start
colchicine and high-dose aspirin (ASA) therapy. <br/>Discussion(s): In our
case, the patient had multiple risk factors for the development of DS. The
timing from the MI, blood present in the pericardium, and
pericardiocentesis with drain placement increased the likelihood of the
diagnosis. The mainstay of treatment is a combination of colchicine and
ASA therapy. Recurrence of DS is between 10-15% and therapy duration is
variable. DS is a rare condition but should be taken into consideration in
all patients who develop persistent fever and pleural thoracic pain. Early
recognition and treatment are important to avoid late complications of the
disease. The mainstays of treatment are anti-inflammatory nonsteroidal
anti-inflammatory drugs (NSAIDs) and the adjunct use of colchicine,
however treatment in a patient in whom NSAIDs are contraindicated can be
difficult. Currently there are no randomized controlled trials addressing
specific treatment approaches for DS. The decision was made to monitor
inflammatory marker levels as an outpatient to determine the final
duration of treatment. Further research is needed to examine the roles of
biologics and glucocorticoids in the treatment of DS.<br/>Copyright &#xa9;
2024 Elsevier Inc. All rights reserved.

<26>
Accession Number
2030140134
Title
Mechanical valve bacterial endocarditis masquerading as acute ischemic
stroke.
Source
American Journal of the Medical Sciences. Conference: The American Journal
of the Medical Sciences Annual Meeting. InterContinental Hotel, New
Orleans United States. 367(Supplement 1) (pp S69), 2024. Date of
Publication: February 2024.
Author
Pennington J.; Burroughs-Ray D.
Institution
(Pennington, Burroughs-Ray) University of Tennessee Medical Science
Center, Memphis, TN, United States
Publisher
Elsevier B.V.
Abstract
Case Report: Patients with prosthetic valves undergoing dental procedures
are recommended to receive prophylactic antibiotics to prevent bacteremia.
In this case, a 73- year-old male with history notable for prosthetic
mitral valve replacement on warfarin, coronary artery disease status post
coronary artery bypass surgery, and atrial fibrillation status post
ablation, presented with twelve hours of dysarthria, left facial droop,
and abdominal pain. Computed tomography (CT) head and CT angiography head
and neck showed multiple remote bilateral cerebral infarcts. CT abdomen
and pelvis, to assess his abdominal pain, revealed small peripheral
splenic lesions suggestive of acute infarcts. Despite his supratherapeutic
international normalized ratio of 4.0, a cardioembolic origin was
suspected due to small multifocal areas of acute infarction in the
bilateral cerebral hemispheres and left cerebellar hemispheres on magnetic
resonance imaging (MRI) brain. The patient was admitted and empiric
intravenous antibiotics were initiated. Due to concern for endocarditis,
transthoracic echocardiogram was obtained and did not show evidence of
valvular vegetation, thrombus or patent foramen ovale. Subsequent
transesophageal echocardiography (TEE) revealed a 7 mmx 8 mm vegetation on
the lateral atrial aspect of the sewing ring of his prosthetic mitral
valve. Blood culture grew Streptococcus constellatus on day two of
admission. Additional history revealed that the patient had a temporary
crowning one week before his presentation and received oral clindamycin
instead of amoxicillin for endocarditis prophylaxis because of a
penicillin allergy. Cardiothoracic surgery was consulted for mechanical
valve replacement but given a perioperative cardiac catheterization
revealing multivessel coronary artery disease, medical treatment was
pursued over surgical treatment. After negative blood cultures, the
patient was discharged home with eight weeks of IV vancomycin therapy.
Over the next five weeks, the patient returned with new neurological
deficits and was found to have acute cerebral infarcts. Repeat TEE
revealed a larger vegetation on the mitral valve ring. After another
failed attempt at medical management with vancomycin and ceftriaxone, the
patient was able to receive a mitral valve replacement. This case
demonstrates an unusual presentation of infective endocarditis with acute
strokes and highlights the importance of antibiotic prophylaxis choice. A
systematic review by Lafaurie GI in 2019 found that amoxicillin reduced
risk of bacteremia by 59% compared to 11% by clindamycin and 49% by
azithromycin. Penicillin allergies should be investigated to determine the
presence of true allergy and antibiotics such as azithromycin should be
considered as an alternative.<br/>Copyright &#xa9; 2024 Elsevier Inc. All
rights reserved.

<27>
Accession Number
643894392
Title
Literature Review of Hormone Therapy (HT) Containing Estradiol or
Progesterone vs HT Containing Other Estrogens or Progestogens.
Source
Menopause. Conference: 2021 Annual Meeting of the North American Menopause
Society. Washington, DC United States. 28(12) (pp 1449-1450), 2021. Date
of Publication: 2021.
Author
Graham S.; Archer D.F.; Simon J.A.; Ohleth K.; Bernick B.A.; Mirkin S.
Institution
(Ohleth) Precise Publications, Pluckemin, NJ, United States
(Graham, Bernick, Mirkin) TherapeuticsMD, Boca Raton, FL, United States
(Archer) Clinical Research Center, Eastern Virginia Medical School,
Norfolk, VA, United States
(Simon) School of Medicine, George Washington University, Intim Medicine,
Washington, DC, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: Risks for endometrial cancer, venous thromboembolism (VTE),
cardiovascular diseases, stroke, breast cancer, cognition decline, and
menopausal symptoms may differ between hormone therapy (HT) formulations.
This systematic review aimed to determine reported differences in these
risks with HT containing estradiol (E2) versus other estrogens and
progesterone (P4) versus other progestogens. <br/>Design(s): PubMed and
EMBASE were searched from inception through February 2021 for
English-language publications examining safety risks and outcomes on bone
health, vasomotor symptoms (VMS), and quality of life in postmenopausal
women taking different HT formulations. Keywords included endometrium,
endometrial, cardiovascular, coronary, venous thromboembolism (VTE),
thrombosis, myocardial infarction, coronary artery bypass graft, stroke,
coagulation, lipids, hypertension, blood pressure, mortality, breast,
cognition, bone, hot flush, vasomotor symptoms, quality of life (QOL),
weight, metabolic, and sleep, in conjunction with (E2 and menopause) or
(P4 and menopause). <br/>Result(s): Seventy-one comparative studies of
various designs were identified, including prospective, randomized trials;
prospective, observational/ interventional trials; retrospective or
cross-sectional, observational studies; and systematic
review/meta-analyses (26 comparing estrogens and 47 comparing
progestogens). Although an increased endometrial cancer risk with P4-based
HT was suggested in two observational studies,1,2 data from
randomized-controlled studies support that P4 offers similar endometrial
protection as progestins when used at an adequate dose.3,4 Large,
observational studies found that similar or lower risks of breast cancer
and cardiovascular diseases with E2 versus CEE5-11 or P4 versus
progestins.12-21 E2 tends to provide better protection against declines in
cognition and bone health versus CEE,22-24 while P4 was similar to
progestins for these outcomes in general.22,25-28 Comparable effects
between HT on VMS control were reported.4,29-31 P4- versus progestin-based
HT led to similar or better improvements on QOL and sleep.31-35
<br/>Conclusion(s): Evidence suggests a differential effect of HT
containing E2 or P4 versus those containing CEE or progestins, supporting
a better safety profile with HT containing E2 and/or P4. 1. Allen NE. Am J
Epidemiol 2010;172:1394-1403. 2. Fournier A. Am J Epidemiol
2014;180:508-517. 3. Writing Group for the PEPI Trial JAMA.
1996;275:370-375. 4. Pelissier C. Maturitas 2001;40:85-94. 5. Sweetland S.
J Thromb Haemost 2012;10:2277-2286. 6. Shufelt CL. Menopause
2014;21:260-266. 7. Bakken K. Int J Cancer 2011;128:144-156. 8. Shufelt C.
Menopause 2018. 9. Brusselaers N. Ann Oncol 2018;29:1771-1776. 10. Tsai
WC. Sci Rep 2016;6:24132. 11. Vinogradova Y. BMJ 2019;364:k4810. 12.
Canonico M. Stroke 2016;47:1734-1741. 13. Canonico M. Arterioscler Thromb
Vasc Biol 2010;30:340-345. 14. Fournier A. Int J Cancer 2005;114:448-454.
15. Fournier A. Breast Cancer Res Treat 2008;107:103-111. 16. Fournier A.
J Clin Oncol 2008;26:1260-1268. 17. Fournier A. J Clin Oncol
2009;27:5138-5143. 18. Canonico M. Circulation 2007;115:840- 845. 19.
Espie M. Gynecol Endocrinol 2007;23:391-397. 20. Olie V. Menopause
2011;18:488-493. 21. Cordina-Duverger E. PLoS One 2013;8:e78016. 22.
Wroolie TE. Am J Geriatr Psychiatry 2011;19:792-802. 23. Wroolie TE. Am J
Geriatr Psychiatry 2015;23:1117-1126. 24. Zhu L. Menopause
2016;23:461-470. 25. Sherwin BB. Fertil Steril 2011;96:399-403. 26.
Writing Group for the Pepi Trial. JAMA 1996;276:1389- 1396. 27. Zhu SY.
Gynecol Endocrinol 2019;35:165-169. 28. Zuo H. Med Sci Monit
2019;25:819-826. 29. Utian WH. Menopause 2005;12:708-715. 30. Greendale
GA. Obstet Gynecol 1998;92:982-988. 31. Gambacciani M. Maturitas
2005;50:91-97. 32. Fitzpatrick LA. J Womens Health Gend Based Med
2000;9:381-387. 33. Ryan N. Clin Ther 2001;23:1099-1115. 34. Gao L.
Climacteric 2018;21:69-74. 35. Leeangkoonsathian E. Gynecol Endocrinol
2017;33:933-936.

<28>
Accession Number
2031493530
Title
Outcomes of mitral valve transcatheter edge-to-edge repair for patients
with hemodynamic instability: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Yokoyama H.; Kokawa T.; Shigekiyo S.; Seno A.; Izumi T.; Ogura R.; Mahara
K.; Hosokawa S.
Institution
(Yokoyama, Kokawa, Shigekiyo, Seno, Izumi, Ogura, Mahara, Hosokawa)
Tokushima Red Cross Hospital, Tokushima, Japan
Publisher
Elsevier Inc.
Abstract
Background: The outcomes after mitral valve transcatheter edge-to-edge
repair (M-TEER) for the patients with severe mitral regurgitation (MR) in
hemodynamically unstable conditions, such as cardiogenic shock, still
remain unclear. We aimed to integrate previous publications regarding
M-TEER indicated for life-threatening conditions and indirectly
particularly compared the short-term outcomes thereof, with that of other
treatments. <br/>Method(s): We systematically searched the PubMed,
Cochrane, and MEDLINE databases for studies from inception to June 2023,
regarding M-TEER in patients with hemodynamic instability and severe MR.
The primary outcomes analyzed included the in-hospital and 30-day
mortality rates, and peri-procedural complications. <br/>Result(s): Of the
initial 820 publications, we conducted a meta-analysis of a total of 25
studies. The relative risk of moderate-to-severe or severe MR was 0.13 (95
% confidence interval [CI]: 0.10-0.18, I² = 45.2 %). The pooled
in-hospital and 30-day mortality rates were 11.8 % (95 % CI: 8.7-15.9,
I² = 96.4 %) and 14.1 % (95 % CI: 10.9-18.3, I² =
35.5 %), respectively. The 30-day mortality rate was statistically
significantly correlated with the residual moderate-to-severe or severe
MR, as per the meta-regression analysis (coefficient beta = 3.48 [95 % CI:
0.99-5.97], p = 0.006). Regarding peri-procedural complications, the
pooled rates of a stroke or transient ischemic attack, life-threatening or
major bleeding, acute kidney injury, and peri-procedural mitral valve
surgery were 2.3 % (95 % CI: 1.9-2.6), 7.6 % (95 % CI: 6.8-8.5), 32.9 %
(95 % CI: 31.6-34.3), and 1.0 % (95 % CI: 0.8-1.3), respectively.
<br/>Conclusion(s): This meta-analysis demonstrates that the relatively
higher rates of procedural complications were observed, nevertheless,
M-TEER can potentially provide favorable short-term outcomes even in
hemodynamically unstable patients. PROSPERO registration number:
CRD42023468946.<br/>Copyright &#xa9; 2024

<29>
Accession Number
2031489671
Title
Outcomes of Vasopressin-Receptor Agonists Versus Norepinephrine in Adults
With Perioperative Hypotension: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Heybati K.; Xie G.; Ellythy L.; Poudel K.; Deng J.; Zhou F.; Chelf C.J.;
Ripoll J.G.; Ramakrishna H.
Institution
(Heybati, Xie, Ellythy, Poudel) Mayo Clinic Alix School of Medicine, Mayo
Clinic, Rochester, MN, United States
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Chelf) Mayo Clinic Libraries, Rochester, MN, United States
(Ripoll, Ramakrishna) Department of Anesthesiology and Perioperative
Medicine, Mayo Clinic, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Consensus statements recommend the use of norepinephrine and/or
vasopressin for hypotension in cardiac surgery. However, there is a
paucity of data among other surgical subgroups and vasopressin analogs.
Therefore, the authors conducted a systematic review of randomized
controlled trials (RCTs) to compare vasopressin-receptor agonists with
norepinephrine for hypotension among those undergoing surgery with general
anesthesia. This review was registered prospectively (CRD42022316328).
Literature searches were conducted by a medical librarian to November 28,
2023, across MEDLINE, EMBASE, CENTRAL, and Web of Science. The authors
included RCTs enrolling adults (>=18 years of age) undergoing any surgery
under general anesthesia who developed perioperative hypotension and
comparing vasopressin receptor agonists with norepinephrine. The risk of
bias was assessed by the Cochrane risk of bias tool for randomized trials
(RoB-2). Thirteen (N = 719) RCTs were included, of which 8 (n = 585)
enrolled patients undergoing cardiac surgery. Five trials compared
norepinephrine with vasopressin, 4 trials with terlipressin, 1 trial with
ornipressin, and the other 3 trials used vasopressin as adjuvant therapy.
There was no significant difference in all-cause mortality. Among patients
with vasoplegic shock after cardiac surgery, vasopressin was associated
with significantly lower intensive care unit (N = 385; 2 trials; mean
100.8 v 175.2 hours, p < 0.005; median 120 [IQR 96-168] v 144 [96-216]
hours, p = 0.007) and hospital lengths of stay, as well as fewer cases of
acute kidney injury and atrial fibrillation compared with norepinephrine.
One trial also found that terlipressin was associated with a significantly
lower incidence of acute kidney injury versus norepinephrine overall.
Vasopressin and norepinephrine restored mean arterial blood pressure with
no significant differences; however, the use of vasopressin with
norepinephrine was associated with significantly higher mean arterial
blood pressure versus norepinephrine alone. Further high-quality trials
are needed to determine pooled treatment effects, especially among
noncardiac surgical patients and those treated with vasopressin
analogs.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<30>
Accession Number
2031489647
Title
Differences in excess mortality by recipient sex after heart transplant:
An individual patient data meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2024. Date of
Publication: 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, Foster) Research Institute of the McGill University Health
Centre, Montreal, QC, Canada
(Foster) Department of Epidemiology, Biostatistics, and Occupational
Health, McGill University, Montreal, QC, Canada
(Susal, Dohler) Institute of Immunology, Heidelberg University Hospital,
Heidelberg, Germany
(Susal) Transplant Immunology Research Center of Excellence, Koc
University, Istanbul, Turkey
(Melk) Children's Hospital, Hannover Medical School, Hannover, Germany
(Sapir-Pichhadze) Department of Medicine, Division of Nephrology, McGill
University, Montreal, 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, Brisbane,
Australia
(Francis) Department of Nephrology, Queensland Children's Hospital,
Brisbane, QLD, Australia
(Pilmore) Department of Renal Medicine, Auckland City Hospital, Auckland,
New Zealand
(Grinspan) Recanati/Miller Transplantation Institute, Icahn School of
Medicine at Mount Sinai, New York, New York, United States
(Foster) Department of Pediatrics, Division of Nephrology, McGill
University Faculty of Medicine, Montreal, QC, Canada
Publisher
Elsevier Inc.
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 vs 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 2-stage individual patient data meta-analysis,
to compare the excess risk of mortality in female vs 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 The Authors

<31>
Accession Number
2031488994
Title
Hemodynamic management of cardiogenic shock in the intensive care unit.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2024. Date of
Publication: 2024.
Author
Lim H.S.; Gonzalez-Costello J.; Belohlavek J.; Zweck E.; Blumer V.;
Schrage B.; Hanff T.C.
Institution
(Lim) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Lim) University Hospitals Birmingham NHS Foundation Trust, Birmingham,
United Kingdom
(Gonzalez-Costello) Advanced Heart Failure and Heart Transplant Unit,
Department of Cardiology, Hospital Universitari de Bellvitge,
BIOHEART-Cardiovascular Diseases Research Group, Bellvitge Biomedical
Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
(Gonzalez-Costello) Department of Clinical Sciences, School of Medicine,
Universitat de Barcelona, Barcelona, Spain
(Gonzalez-Costello) Ciber Cardiovascular (CIBERCV), Instituto Salud Carlos
III, Madrid, Spain
(Belohlavek) 2nd Department of Medicine-Department of Cardiovascular
Medicine, First Faculty of Medicine, Charles University in Prague and
General University Hospital, Prague, Czechia
(Belohlavek) Institute of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
(Zweck) Department of Cardiology, Pulmonology and Vascular Medicine,
University Hospital Duesseldorf, Duesseldorf, Germany
(Blumer) Inova Schar Heart and Vascular Institute, Inova Fairfax Medical
Campus, Falls Church, VA, United States
(Schrage) University Heart and Vascular Centre Hamburg, German Centre for
Cardiovascular Research, Partner Site Hamburg/Kiel/Lubeck, Hamburg,
Germany
(Hanff) Division of Cardiovascular Medicine, University of Utah School of
Medicine, Salt Lake City, Utah, United States
Publisher
Elsevier Inc.
Abstract
Hemodynamic derangements are defining features of cardiogenic shock.
Randomized clinical trials have examined the efficacy of various
therapeutic interventions, from percutaneous coronary intervention to
inotropes and mechanical circulatory support (MCS). However, hemodynamic
management in cardiogenic shock has not been well-studied. This
State-of-the-Art review will provide a framework for hemodynamic
management in cardiogenic shock, including a description of the 4
therapeutic phases from initial 'Rescue' to 'Optimization',
'Stabilization' and 'de-Escalation or Exit therapy' (R-O-S-E), phenotyping
and phenotype-guided tailoring of pharmacological and MCS support, to
achieve hemodynamic and therapeutic goals. Finally, the premises that form
the basis for clinical management and the hypotheses for randomized
controlled trials will be discussed, with a view to the future direction
of cardiogenic shock.<br/>Copyright &#xa9; 2024 The Authors

<32>
Accession Number
2031474972
Title
Comparative effects of variable versus conventional volume-controlled
one-lung ventilation on gas exchange and respiratory system mechanics in
thoracic surgery patients: A randomized controlled clinical trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111444. Date of Publication: August 2024.
Author
Wittenstein J.; Huhle R.; Mutschke A.-K.; Piorko S.; Kramer T.; Dorfinger
L.; Tempel F.; Jager M.; Schweigert M.; Mauer R.; Koch T.; Richter T.;
Scharffenberg M.; Gama de Abreu M.
Institution
(Wittenstein, Huhle, Mutschke, Piorko, Kramer, Dorfinger, Tempel, Jager,
Koch, Richter, Scharffenberg, Gama de Abreu) Department of Anesthesiology
and Intensive Care Medicine, Pulmonary Engineering Group, University
Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology,
Dresden, Germany
(Schweigert) Department of Thoracic Surgery, University Hospital
Schleswig-Holstein, Luebeck, Germany
(Mauer) Faculty of Medicine Carl Gustav Carus, Institute for Medical
Informatics and Biometry (IMB), Technische Universitat, Dresden, Germany
(Gama de Abreu) Department of Intensive Care and Resuscitation,
Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
(Gama de Abreu) Department of Cardiothoracic Anesthesia, Anesthesiology
Institute, Cleveland Clinic, Cleveland, OH, United States
(Gama de Abreu) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Mechanical ventilation with variable tidal volumes (V-VCV) has
the potential to improve lung function during general anesthesia. We
tested the hypothesis that V-VCV compared to conventional
volume-controlled ventilation (C-VCV) would improve intraoperative
arterial oxygenation and respiratory system mechanics in patients
undergoing thoracic surgery under one-lung ventilation (OLV).
<br/>Method(s): Patients were randomized to V-VCV (n = 39) or C-VCV (n =
39). During OLV tidal volume of 5 mL/kg predicted body weight (PBW) was
used. Both groups were ventilated with a positive end-expiratory pressure
(PEEP) of 5 cm H<inf>2</inf>O, inspiration to expiration ratio (I:E) of
1:1 (during OLV) and 1:2 during two-lung ventilation, the respiratory rate
(RR) titrated to arterial pH, inspiratory peak-pressure <= 40 cm
H<inf>2</inf>O and an inspiratory oxygen fraction of 1.0. <br/>Result(s):
Seventy-five out of 78 Patients completed the trial and were analyzed
(dropouts were excluded). The partial pressure of arterial oxygen
(PaO<inf>2</inf>) 20 min after the start of OLV did not differ among
groups (V-VCV: 25.8 +/- 14.6 kPa vs C-VCV: 27.2 +/- 15.3 kPa; mean
difference [95% CI]: 1.3 [-8.2, 5.5], P = 0.700). Furthermore,
intraoperative gas exchange, intraoperative adverse events, need for
rescue maneuvers due to desaturation and hypercapnia, incidence of
postoperative pulmonary and extra-pulmonary complications, and hospital
free days at day 30 after surgery did not differ between groups.
<br/>Conclusion(s): In thoracic surgery patients under OLV, V-VCV did not
improve oxygenation or respiratory system mechanics compared to C-VCV.
Ethical Committee: EK 420092019. Trial registration: at the German
Clinical Trials Register: DRKS00022202 (16.06.2020).<br/>Copyright &#xa9;
2024 Elsevier Inc.

<33>
Accession Number
2031472744
Title
One-lung ventilation with fixed and variable tidal volumes on oxygenation
and pulmonary outcomes: A randomized trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111465. Date of Publication: August 2024.
Author
Szamos K.; Balla B.; Paloczi B.; Enyedi A.; Sessler D.I.; Fulesdi B.; Vegh
T.
Institution
(Szamos, Balla, Paloczi, Fulesdi, Vegh) University of Debrecen, Department
of Anesthesiology and Intensive Care, Debrecen, Hungary
(Enyedi) University of Debrecen, Institute of Surgery, Department of
Thoracic Surgery, Debrecen, Hungary
(Sessler, Fulesdi, Vegh) Outcomes Research Consortium, Cleveland, OH,
United States
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
Publisher
Elsevier Inc.
Abstract
Objective: Test the hypothesis that one-lung ventilation with variable
tidal volume improves intraoperative oxygenation and reduces postoperative
pulmonary complications after lung resection. <br/>Background(s): Constant
tidal volume and respiratory rate ventilation can lead to atelectasis.
Animal and human ARDS studies indicate that oxygenation improves with
variable tidal volumes. Since one-lung ventilation shares characteristics
with ARDS, we tested the hypothesis that one-lung ventilation with
variable tidal volume improves intraoperative oxygenation and reduces
postoperative pulmonary complications after lung resection.
<br/>Design(s): Randomized trial. <br/>Setting(s): Operating rooms and a
post-anesthesia care unit. <br/>Patient(s): Adults having elective open or
video-assisted thoracoscopic lung resection surgery with general
anesthesia were randomly assigned to intraoperative ventilation with fixed
(n = 70) or with variable (n = 70) tidal volumes. <br/>Intervention(s):
Patients assigned to fixed ventilation had a tidal volume of 6 ml/kgPBW,
whereas those assigned to variable ventilation had tidal volumes ranging
from 6 ml/kg PBW +/- 33% which varied randomly at 5-min intervals.
Measurements: The primary outcome was intraoperative oxygenation;
secondary outcomes were postoperative pulmonary complications, mortality
within 90 days of surgery, heart rate, and SpO<inf>2</inf>/FiO<inf>2</inf>
ratio. <br/>Result(s): Data from 128 patients were analyzed with 65
assigned to fixed-tidal volume ventilation and 63 to variable-tidal volume
ventilation. The time-weighted average PaO<inf>2</inf> during one-lung
ventilation was 176 (86) mmHg in patients ventilated with fixed-tidal
volume and 147 (72) mmHg in the patients ventilated with variable-tidal
volume, a difference that was statistically significant (p < 0.01) but
less than our pre-defined clinically meaningful threshold of 50 mmHg. At
least one composite complication occurred in 11 (17%) of patients
ventilated with variable-tidal volume and in 17 (26%) of patients assigned
to fixed-tidal volume ventilation, with a relative risk of 0.67 (95% CI
0.34-1.31, p = 0.24). Atelectasis in the ventilated lung was less common
with variable-tidal volumes (4.7%) than fixed-tidal volumes (20%) in the
initial three postoperative days, with a relative risk of 0.24 (95% CI
0.01-0.8, p = 0.02), but there were no significant late postoperative
differences. No other secondary outcomes were both statistically
significant and clinically meaningful. <br/>Conclusion(s): One-lung
ventilation with variable tidal volume does not meaningfully improve
intraoperative oxygenation, and does not reduce postoperative pulmonary
complications.<br/>Copyright &#xa9; 2024 The Authors

<34>
Accession Number
2031386473
Title
Evaluating Various Modes of Ventilation during Cardiopulmonary Bypass and
its Postoperative effect on Pulmonary Dysfunction.
Source
Journal of Cardiovascular Disease Research. 15(3) (pp 1547-1552), 2024.
Date of Publication: 2024.
Author
Gupta S.; Hashmi N.A.; Dev S.; Singh D.P.
Institution
(Gupta) Department of Cardiac Anaesthesia, Mahatma Gandhi Medical College,
Jaipur, India
(Hashmi) Department of General Medicine, People's College of Medical
Sciences and Research Centre, M.P, Bhopal, India
(Dev) Department of Oral and Maxillofacial Surgery, PDM Dental College and
Research Institute, Bahadurgarh, India
(Singh) Department of Dentistry, Government Medical College, Chittorgarh,
India
Publisher
EManuscript Technologies
Abstract
Background: Cardiopulmonary bypass (CPB) is a crucial component of cardiac
surgery, yet it often leads to postoperative pulmonary dysfunction (PPD).
Various modes of ventilation during CPB have been employed, but their
comparative effects on PPD remain unclear. <br/>Material(s) and Method(s):
This study aimed to compare different modes of ventilation-namely,
conventional ventilation (CV) and protective ventilation (PV)-during CPB
and assess their impact on PPD. A total of 100 patients undergoing cardiac
surgery were randomly assigned to either the CV group or the PV group.
Demographic data, intraoperative variables, and postoperative outcomes
were recorded. PPD was assessed through pulmonary function tests (PFTs)
postoperatively. <br/>Result(s): In the CV group, PPD was observed in 45%
of patients, with a mean reduction in forced vital capacity (FVC) of 25%
and forced expiratory volume in one second (FEV1) of 30%. Contrastingly,
in the PV group, PPD occurred in only 20% of patients, with a mean
reduction in FVC of 15% and FEV1 of 20%. The incidence of pneumonia was
also significantly lower in the PV group (p < 0.05). <br/>Conclusion(s):
Protective ventilation during CPB appears to mitigate the incidence and
severity of postoperative pulmonary dysfunction compared to conventional
ventilation. Employing protective ventilation strategies may contribute to
improved postoperative outcomes and reduced pulmonary complications
following cardiac surgery.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

<35>
Accession Number
2031487898
Title
Pericardiotomy and atrial fibrillation after isolated coronary artery
bypass grafting: A systematic review and meta-analysis of 16 randomised
controlled trials.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
San T.M.M.; Han K.P.P.; Ismail M.; Thu L.M.; Thet M.S.
Institution
(San) Department of Surgery, Pyin Oo Lwin General Hospital, University of
Medicine Mandalay, Myanmar
(Han) Department of Medicine, Mandalay General Hospital, Mandalay, Myanmar
(Ismail) Department of Neurosurgery, Khalifa Gul Nawaz Hospital, Medical
Teaching Institution, Bannu, Pakistan
(Thu) Department of Trauma & Orthopaedic, Colchester General Hospital,
Colchester, United Kingdom
(Thet) Department of Surgery and Cancer, Imperial College London, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) and pericardial effusion are notable
complications following coronary artery bypass grafting (CABG),
contributing to increased morbidity and healthcare costs. Posterior
pericardiotomy has been proposed to mitigate these complications. This
systematic review and meta-analysis aim to evaluate the efficacy of
posterior pericardiotomy in reducing postoperative AF and pericardial
effusion in isolated CABG patients. <br/>Material(s) and Method(s): A
comprehensive literature search, adhering to PRISMA guidelines, was
conducted across PubMed, MEDLINE via Ovid, Embase, Scopus, the Central
Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov up to
December 2023. Only randomised controlled trials (RCTs) comparing
prophylactic posterior pericardiotomy to control treatments in adult CABG
patients were included. The primary outcomes assessed were the incidences
of postoperative AF and pericardial effusion. <br/>Result(s): The
meta-analysis incorporated 16 RCTs with a total of 2414 patients. The
findings demonstrated a significant reduction in the incidence of
postoperative AF (Odds Ratio = 0.34, 95 % CI: 0.25-0.48, P < 0.00001) and
pericardial effusion (Odd Ratio = 0.24, 95 % CI: 0.15-0.38, P < 0.0001) in
the group undergoing posterior pericardiotomy. However, the analysis
revealed substantial heterogeneity and publication bias in the included
studies. <br/>Conclusion(s): The posterior pericardiotomy is effective in
reducing the incidences of AF and pericardial effusion in patients
undergoing isolated CABG. Despite the positive outcomes, the presence of
heterogeneity and publication bias warrants a cautious interpretation of
the results and underscores the need for further multicentre RCTs in this
area.<br/>Copyright &#xa9; 2024 The Authors

<36>
Accession Number
2029291230
Title
Telesimulation Training for Endoscopic Mitral Valve Surgery: An Air-Pilot
Training Concept for Distance Training.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2024. Date of Publication: 2024.
Author
Cheheili Sobbi S.; Imran Hamid U.; Arjomandi Rad A.; Fillet M.; Maesen J.;
Sardari Nia P.
Institution
(Cheheili Sobbi, Imran Hamid, Arjomandi Rad, Maesen, Sardari Nia)
Department of Cardiothoracic Surgery, Heart and Vascular Centre,
Maastricht University Medical Centre, Netherlands
(Fillet, Maesen) Maastricht University, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of this study was to validate and assess the
feasibility and impact of telesimulation training on surgical skills using
a portable mitral valve telesimulator. <br/>Method(s): A telesimulation
course composed of 3 online modules was designed based on backwards
chaining, preassessment and postassessment, performance feedback, hands-on
training on a telesimulator, and the theoretical content. A fully
3-dimensional-printed and transportable telesimulator was developed and
sent out to the participants with instruments that were needed. Feedback
about the platform was obtained from participants to validate its value as
a training tool. Theoretical and technical assessments were carried out
before and after the course. Technical assessments were based on the
accuracy and time taken to place sutures at the anterior and posterior
mitral annulus. <br/>Result(s): In total, 11 practicing cardiac surgeons
from Oceania, Asia, Europe, and North America completed the course.
Theoretical preassessment and postassessment showed that participants
scored significantly higher on postassessment (mean 87.5% vs 68.1%, P <
0.004). The participant evaluation scores of the simulator as a tool for
endoscopic mitral valve surgery was 4 to 5 out of 5. There was a
significant improvement in the speed (median 14.5 vs 39.5 s, P < 0.005)
and the accuracy to place sutures in the mitral valve annulus following
course completion (P < 0.001). <br/>Conclusion(s): Here we validated the
educational value of a novel telesimulation platform and validated the
feasibility to teach participants at a distance the knowledge and skills
for endoscopic mitral valve surgery. Future studies will be required to
validate the improvement in skills during surgery.<br/>Copyright &#xa9;
The Author(s) 2024.

<37>
Accession Number
2029135412
Title
Transcatheter valve-in-valve interventions after aortic root replacement:
A systematic review.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2024.
Date of Publication: 2024.
Author
Baudo M.; Cuko B.; Ternacle J.; Sicouri S.; Torregrossa G.; Pernot M.;
Busuttil O.; Beurton A.; Alaux A.; Ouattara A.; Lafitte S.; Bonnet G.;
Leroux L.; De Vincentiis C.; Labrousse L.; Ramlawi B.; Modine T.
Institution
(Baudo, Torregrossa, Ramlawi) Department of Cardiac Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Baudo, Sicouri, Torregrossa, Ramlawi) Department of Cardiac Surgery
Research, Lankenau Institute for Medical Research, Main Line Health,
Wynnewood, PA, United States
(Cuko, Ternacle, Pernot, Busuttil, Lafitte, Bonnet, Leroux, Labrousse,
Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac,
France
(Beurton, Alaux, Ouattara) Department of Cardiovascular Anesthesia and
Critical Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University
Hospital, Pessac, France
(Bonnet) Cardiovascular Research Foundation, New York, NY, United States
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Structural valve deterioration after aortic root replacement (ARR) surgery
may be treated by transcatheter valve-in-valve (ViV-TAVI) intervention.
However, several technical challenges and outcomes are not well described.
The aim of the present review was to analyze the outcomes of ViV-TAVI in
deteriorated ARR. This review included studies reporting any form of
transcatheter valvular intervention in patients with a previous ARR. All
forms of ARR were considered, as long as the entire root was replaced.
Pubmed, ScienceDirect, SciELO, DOAJ, and Cochrane library databases were
searched until September 2023. Overall, 86 patients were included from 31
articles that met our inclusion criteria out of 741 potentially eligible
studies. In the entire population, the mean time from ARR to
reintervention was 11.0 years (range: 0.33-22). The most frequently
performed techniques/grafts for ARR was homograft (67.4%) and the main
indication for intervention was aortic regurgitation (69.7%). Twenty-three
articles reported no postoperative complications. Six (7.0%) patients
required permanent pacemaker implantation (PPI) after the ViV-TAVI
procedure, and 4 (4.7%) patients had a second ViV-TAVI implant. There were
three device migrations (3.5%) and 1 stroke (1.2%). Patients with previous
ARR present a high surgical risk. ViV-TAVI can be considered in selected
patients, despite unique technical challenges that need to be carefully
addressed according to the characteristics of the previous surgery and on
computed tomography analysis.<br/>Copyright &#xa9; 2024 Wiley Periodicals
LLC.

<38>
Accession Number
2029133455
Title
High-sensitive troponinT, interleukin-8, and interleukin-6 link with
post-surgery risk in infant heart surgery.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2024. Date of
Publication: 2024.
Author
Thorlacius E.M.; Keski-Nisula J.; Vistnes M.; Ojala T.; Molin M.;
Synnergren M.; Romlin B.S.; Ricksten S.-E.; Wahlander H.; Castellheim A.G.
Institution
(Thorlacius, Romlin, Ricksten, Castellheim) Department of Anesthesiology
and Intensive Care medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Thorlacius, Romlin, Ricksten, Wahlander, Castellheim) Region Vastra
Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
(Keski-Nisula) Department of Anesthesia and Intensive Care, Children's
Hospital, Helsinki University Hospital, Helsinki University, Helsinki,
Finland
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital and
Institute for Experimental Medical Research, Oslo University Hospital and
University of Oslo, Oslo, Norway
(Ojala) Department of Pediatric Cardiology, Children's Hospital, Helsinki
University Hospital, Helsinki University, Helsinki, Finland
(Molin) Statistical Consultation Group, Gothenburg, Sweden
(Synnergren) Department of Pediatric Thoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: This study focuses on biomarkers in infants after open heart
surgery, and examines the association of high-sensitive troponin T
(hs-cTnT), interleukin-6 (IL-6), and interleukin-8 (IL-8) with
postoperative acute kidney injury (AKI), ventilatory support time and need
of vasoactive drugs. <br/>Method(s): Secondary exploratory study from a
double-blinded clinical randomized trial (Mile-1) on 70 infants undergoing
open heart surgery with cardiopulmonary bypass (CPB). In this sub-study,
the entire study population was examined without considering the study
drugs. The biomarkers' peak concentration (highest concentration at 2 or 6
h post-CPB) were used for statistical analyses. <br/>Result(s): Peak IL-8,
hs-cTnT, and IL-6 occurred at 2 h post-CPB for 96%, 79%, and 63% of the
patients, respectively. The odds ratio of developing AKI2-3 for IL-6 > 293
pg/mL was 23.4 (95% CI 5.3;104.0), for IL-8 > 100 pg/mL it was 11.5
(3.0;44.2), and for hs-cTnT >5597 pg/mL it was 6.1 (1.5; 24.5). In more
than two third of the patients with the highest peak concentrations of
IL-8, IL-6, and hs-cTnT, there was a need for ventilatory support for >24
h and use of vasoactive drugs at 24 h post-CPB, while in less than one
third of the patients with the lowest peak concentrations of IL-8 and
hs-cTnT such requirements were observed. <br/>Conclusion(s): The peak
biomarker concentrations and CPB-time strongly predicted AKI2-3, with IL-6
and IL-8 emerging as strongest predictors. Furthermore, our findings
suggest that measuring hs-cTnT and IL-8 just 2 h post-CPB-weaning may
assist in identifying infants suitable for early extubation and highlight
those at risk of prolonged ventilation.<br/>Copyright &#xa9; 2024 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<39>
Accession Number
643906559
Title
What are the main oral manifestations in heart transplant patients? A
scoping review.
Source
Special care in dentistry : official publication of the American
Association of Hospital Dentists, the Academy of Dentistry for the
Handicapped, and the American Society for Geriatric Dentistry. (no
pagination), 2024. Date of Publication: 31 Mar 2024.
Author
Pimentel M.C.D.S.; Fernandes M.M.; Vogel J.O.; Freire C.H.; Pereira C.M.;
Andrade B.A.B.; Rech B.O.; Tenorio J.R.
Institution
(Pimentel, Vogel, Freire, Pereira, Andrade, Tenorio) Department of Oral
Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio
de Janeiro, Rio de Janeiro, Brazil
(Fernandes, Rech) School of Dentistry, Universidade do Sul de Santa
Catarina, Palhoca, Brazil
Abstract
OBJECTIVE: The purpose of this scoping review is to evaluate the oral
manifestations (OM) of heart transplant (HT) patients undergoing
immunosuppressive therapy (IT). MATERIAL AND METHODS: A literature search
was performed using keywords and MeSH terms related to OM and HT in the
Medline/PubMed, Web of Science, Cochrane Library, Scopus, LILACS/BBO
databases and in gray literature without language or date restrictions
until June 2023. Studies that evaluated HT individuals who used any IT and
who reported the occurrence of OM were considered eligible. The results
from the search were imported to EndNote Web, and duplicates were removed
followed by title/abstract and full-text analysis. <br/>RESULT(S): A total
of 402 nonduplicated studies were found and 13 fulfilled the criteria and
were included in the present review: 10 cross-sectional, 2 cohorts, and 1
clinical trial. The most reported OM were periodontal diseases, including
drug-induced gingival enlargement (DIGE), gingival bleeding, gingivitis,
and periodontitis. Reported in a minority of studies are oral cancer,
opportunistic infections (oral hairy leukoplakia and erythematous
candidiasis), enamel defects, and burning mouth. <br/>CONCLUSION(S):
Considering the methodological heterogeneity of the studies analyzed, DIGE
is the most commonly observed oral manifestation in HT
individuals.<br/>Copyright &#xa9; 2024 Special Care Dentistry Association
and Wiley Periodicals LLC.

<40>
Accession Number
643905402
Title
Inhaled nitric oxide and postoperative outcomes in cardiac surgery during
cardiopulmonary bypass: A systematic review and meta-analysis.
Source
Nitric oxide : biology and chemistry. (no pagination), 2024. Date of
Publication: 29 Mar 2024.
Author
Yan Y.; Kamenshchikov N.; Zheng Z.; Lei C.
Institution
(Yan) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, The Fourth Military Medical University, Xi'an, 710032, China;
Department of Anesthesiology, China-Japan Friendship Hospital, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing,
100029, China
(Kamenshchikov) Laboratory of Critical Care Medicine, Department of
Anesthesiology and Intensive Care, Cardiology Research Institute, Tomsk
National Research Medical Center, Russian Academy of Sciences, 111a
Kievskaya St., Tomsk 634012, Russian Federation
(Zheng, Lei) Department of Anesthesiology and Perioperative Medicine,
Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
Abstract
Cardiac surgeries under cardiopulmonary bypass (CPB) are complex
procedures with high incidences of complications, morbidity and mortality.
The inhaled nitric oxide (iNO) has been frequently used as an important
composite of perioperative management during cardiac surgery under CPB. We
conducted a meta-analysis of published randomized clinical trials (RCTs)
to assess the effects of iNO on reducing postoperative complications,
including the duration of postoperative mechanical ventilation, length of
intensive care unit (ICU) stay, length of hospital stay, mortality,
hemodynamic improvement (the composite right ventricular failure, low
cardiac output syndrome, pulmonary arterial pressure, and vasoactive
inotropic score) and myocardial injury biomarker (postoperative troponin I
levels). Subgroup analyses were performed to assess the effect of
modification and interaction. These included iNO dosage, the timing and
duration of iNO therapy, different populations (children and adults), and
comparators (other vasodilators and placebo or standard care). A
comprehensive search for iNO and cardiac surgery was performed on online
databases. Twenty-seven studies were included after removing the
duplicates and irrelevant articles. The results suggested that iNO could
reduce the duration of mechanical ventilation, but had no significance on
the ICU stay, hospital stay, and mortality. This may be attributed to the
small sample size of the most included studies and heterogeneity in
timing, dosage and duration of iNO administration. Well-designed,
large-scale, multicenter clinical trials are needed to further explore the
effect of iNO in improving postoperative prognosis in cardiovascular
surgical patients.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<41>
[Use Link to view the full text]
Accession Number
2031265262
Title
Risk Factors for Early Fungal Disease in Solid Organ Transplant
Recipients: A Systematic Review and Meta-analysis.
Source
Transplantation. 108(4) (pp 970-984), 2024. Date of Publication: 01 Apr
2024.
Author
Pennington K.M.; Martin M.J.; Murad M.H.; Sanborn D.; Saddoughi S.A.;
Gerberi D.; Peters S.G.; Razonable R.R.; Kennedy C.C.
Institution
(Pennington, Martin, Sanborn, Peters, Kennedy) Division of Pulmonary and
Critical Care Medicine, Mayo Clinic, Rochester, MN, United States
(Pennington, Peters, Razonable, Kennedy) William J. von Liebig Center for
Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN,
United States
(Murad, Kennedy) Robert D. and Patricia E. Kern Center for the Science of
Health Care Delivery, Mayo Clinic, Rochester, MN, United States
(Saddoughi) Division of Thoracic Surgery, Mayo Clinic, Rochester, MN,
United States
(Gerberi) Department of Library Services, Mayo Clinic, Rochester, MN,
United States
(Razonable) Division of Public Health, Infectious Diseases and
Occupational Medicine, Mayo Clinic, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background. Invasive fungal infections are associated with high morbidity
in solid organ transplant recipients. Risk factor modification may help
with preventative efforts. The objective of this study was to identify
risk factors for the development of fungal infections within the first
year following solid organ transplant. Methods. We searched for eligible
articles through February 3, 2023. Studies published after January 1,
2001, that pertained to risk factors for development of invasive fungal
infections in solid organ transplant were reviewed for inclusion. Of 3087
articles screened, 58 were included. Meta-analysis was conducted using a
random-effects model to evaluate individual risk factors for the primary
outcome of any invasive fungal infections and invasive candidiasis or
invasive aspergillosis (when possible) within 1 y posttransplant. Results.
We found 3 variables with a high certainty of evidence and strong
associations (relative effect estimate >= 2) to any early invasive fungal
infections across all solid organ transplant groups: reoperation (odds
ratio [OR], 2.92; confidence interval [CI], 1.79-4.75), posttransplant
renal replacement therapy (OR, 2.91; CI, 1.87-4.51), and cytomegalovirus
disease (OR, 2.97; CI, 1.78-4.94). Both posttransplant renal replacement
therapy (OR, 3.36; CI, 1.78-6.34) and posttransplant cytomegalovirus
disease (OR, 2.81; CI, 1.47-5.36) increased the odds of early
posttransplant invasive aspergillosis. No individual variables could be
pooled across groups for invasive candidiasis. Conclusions. Several common
risk factors exist for the development of any invasive fungal infections
in solid organ transplant recipients. Additional risk factors for invasive
candidiasis and aspergillosis may be unique to the pathogen, transplanted
organ, or both.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<42>
Accession Number
2031227350
Title
In adults aged >=80 y with NSTE-ACS, an invasive vs. conservative strategy
improved outcomes at a median 5.3 y.
Source
Annals of Internal Medicine. 177(3) (pp JC27), 2024. Date of Publication:
01 Mar 2024.
Author
Yonis H.; Granger C.B.
Institution
(Yonis, Granger) Duke Clinical Research Institute, Durham, NC, United
States
Publisher
American College of Physicians

<43>
Accession Number
2030956243
Title
P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy after Deployment
of a Drug-Eluting Stent: The SHARE Randomized Clinical Trial.
Source
JAMA Network Open. 7(3) (pp E240877), 2024. Date of Publication: 07 Mar
2024.
Author
Min P.-K.; Kang T.S.; Cho Y.-H.; Cheong S.-S.; Kim B.-K.; Kwon S.W.; Park
W.J.; Lee J.-H.; Kim W.; Lee W.-S.; Yoon Y.W.; Lee B.K.; Kwon H.M.; Hong
B.-K.
Institution
(Min, Yoon, Lee, Kwon, Hong) Cardiology Division, Department of Internal
Medicine, Gangnam Severance Hospital, Yonsei University, College of
Medicine, Seoul, South Korea
(Kang) Division of Cardiology, Dankook University Hospital, Cheonan, South
Korea
(Cho) Division of Cardiology, Myongji Hospital, Hanyang University,
College of Medicine, Goyang, South Korea
(Cheong) Department of Cardiology, Gangneung Asan Hospital, University of
Ulsan, College of Medicine, Gangneung, South Korea
(Kim) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University, College of Medicine, Seoul, South Korea
(Kwon) Division of Cardiology, Inha University Hospital, Incheon, South
Korea
(Park) Division of Cardiology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Lee) Division of Cardiology, Yeungnam University Medical Center, Daegu,
South Korea
(Kim) Eulji University, School of Medicine, Daejeon, South Korea
(Lee) Heart Research Institute, Chung-Ang University Hospital, Seoul,
South Korea
Publisher
American Medical Association
Abstract
Importance: P2Y12 inhibitor monotherapy after dual antiplatelet therapy
(DAPT; a P2Y12 inhibitor plus aspirin) for a brief duration has recently
emerged as an attractive alternative for patients undergoing percutaneous
coronary intervention (PCI) with a drug-eluting stent. <br/>Objective(s):
To investigate whether P2Y12 inhibitor monotherapy after 3 months of DAPT
was noninferior to 12 months of DAPT following PCI with a drug-eluting
stent. <br/>Design, Setting, and Participant(s): The Short-Term Dual
Antiplatelet Therapy After Deployment of Bioabsorbable Polymer
Everolimus-Eluting Stent (SHARE) open-label, noninferiority randomized
clinical trial was conducted from December 15, 2017, through December 14,
2020. Final 1-year clinical follow-up was completed in January 2022. This
study was a multicenter trial that was conducted at 20 hospitals in South
Korea. Patients who underwent successful PCI with bioabsorbable polymer
everolimus-eluting stents were enrolled. <br/>Intervention(s): Patients
were randomly assigned to receive P2Y12 inhibitor monotherapy after 3
months of DAPT (n = 694) or 12 months of DAPT (n = 693). <br/>Main
Outcomes and Measures: The primary outcome was a net adverse clinical
event, a composite of major bleeding (based on Bleeding Academic Research
Consortium type 3 or type 5 bleeding) and major adverse cardiac and
cerebrovascular events (cardiac death, myocardial infarction, stent
thrombosis, stroke, or ischemia-driven target lesion revascularization)
between 3 and 12 months after the index PCI. The major secondary outcomes
were major adverse cardiac and cerebrovascular events and major bleeding.
The noninferiority margin was 3.0%. <br/>Result(s): Of the total 1452
eligible patients, 65 patients were excluded before the 3-month follow-up,
and 1387 patients (mean [SD] age, 63.0 [10.7] years; 1055 men [76.1%])
were assigned to P2Y12 inhibitor monotherapy (n = 694) or DAPT (n = 693).
Between 3 and 12 months of follow-up, the primary outcome (using
Kaplan-Meier estimates) occurred in 9 patients (1.7%) in the P2Y12
inhibitor monotherapy group and in 16 patients (2.6%) in the DAPT group
(absolute difference, -0.93 [1-sided 95% CI, -2.64 to 0.77] percentage
points; P <.001 for noninferiority). For the major secondary outcomes
(using Kaplan-Meier estimates), major adverse cardiac and cerebrovascular
events occurred in 8 patients (1.5%) in the P2Y12 inhibitor monotherapy
group and in 12 patients (2.0%) in the DAPT group (absolute difference,
-0.49 [95% CI, -2.07 to 1.09] percentage points; P =.54). Major bleeding
occurred in 1 patient (0.2%) in the P2Y12 inhibitor monotherapy group and
in 5 patients (0.8%) in the DAPT group (absolute difference, -0.60 [95%
CI, -1.33 to 0.12] percentage points; P =.10). <br/>Conclusions and
Relevance: In patients with coronary artery disease undergoing PCI with
the latest generation of drug-eluting stents, P2Y12 inhibitor monotherapy
after 3-month DAPT was not inferior to 12-month DAPT for net adverse
clinical events. Considering the study population and lower-than-expected
event rates, further research is required in other populations. Trial
Registration: ClinicalTrials.gov Identifier: NCT03447379.<br/>Copyright
&#xa9; 2024 American Medical Association. All rights reserved.

<44>
Accession Number
2030943378
Title
Estimated prevalence of frailty and prefrailty in patients undergoing
coronary artery or valvular surgeries/procedures: A systematic review and
proportional meta-analysis.
Source
Ageing Research Reviews. 96 (no pagination), 2024. Article Number: 102266.
Date of Publication: April 2024.
Author
Wong C.W.Y.; Li P.W.C.; Yu D.S.F.; Ho B.M.H.; Chan B.S.
Institution
(Wong, Li, Yu, Ho, Chan) School of Nursing, Li Ka Shing Faculty of
Medicine, The University of Hong Kong, Hong Kong
Publisher
Elsevier Ireland Ltd
Abstract
Background: The aging population has led to an increasing number of older
patients undergoing cardiac surgeries/procedures. Frailty and prefrailty
have emerged as important prognostic indicators among these patients. This
proportional meta-analysis estimated the prevalence of frailty and
prefrailty among patients undergoing cardiac surgery. <br/>Method(s): We
searched seven electronic databases for observational studies that used
validated measure(s) of frailty and reported prevalence data on frailty
and/or prefrailty in older patients undergoing coronary artery or valvular
surgeries or transcatheter procedures. Meta-analyses were performed using
a random-effects model. <br/>Result(s): One hundred and one articles
involving 626,863 patients were included. The pooled prevalence rates of
frailty and prefrailty were 28% (95% confidence interval [CI]: 23%-33%)
and 40% (95% CI: 31%-50%), respectively, for patients scheduled for
open-heart surgeries and 40% (95% CI: 36%-45%) and 43% (95% CI: 34%-53%),
respectively, for patients undergoing transcatheter procedures. Frailty
measured using a multidimensional approach identified a higher proportion
of frail patients when compared with measures solely focused on physical
frailty. Older age, female sex, and lower body mass index and hemoglobin
concentrations were significantly associated with higher frailty
prevalence. Moreover, countries with higher gross domestic product spent
on healthcare exhibited a higher frailty prevalence. <br/>Conclusion(s):
Frailty represents a considerable health challenge among patients
undergoing cardiac surgeries/procedures. Routine screening for frailty
should be considered during perioperative care planning.<br/>Copyright
&#xa9; 2024 Elsevier B.V.

<45>
Accession Number
2030918885
Title
Home-based mobile-guided exercise-based cardiac rehabilitation among
patients undergoing transcatheter aortic valve replacement (REHAB-TAVR):
protocol for a randomised clinical trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e080042. Date of
Publication: 07 Mar 2024.
Author
Shen Z.; Mi S.; Huang C.; Zhou D.; Pan W.; Xu X.; Lin Y.; Zhang Y.
Institution
(Shen, Huang, Xu, Lin, Zhang) Department of Nursing, Zhongshan Hospital,
Fudan University, Shanghai, China
(Mi, Zhou, Pan) Department of Cardiology, Zhongshan Hospital, Fudan
University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Transcatheter aortic valve replacement (TAVR) is a standard
treatment for aortic stenosis, particularly in older adults. Reduced
exercise capacity and frailty significantly impact outcomes in TAVR
patients, yet current management lacks strategies to address these issues.
This study aims to assess the effectiveness of home-based mobile-guided
exercise-based cardiac rehabilitation in TAVR patients, led by a
multidisciplinary team with clear progression milestones. Methods and
analysis The study involves 90 patients aged 60-89 in a single centre who
will be randomised to a 3-month novel multidomain exercise intervention or
routine care. Outcome assessors will be blinded towards group allocation.
The primary outcome is the 6-min walk distance at month 3. The secondary
outcomes include the 6-min walk distance at month 6, physical function
measured by total Short Physical Performance Battery score and exercise
adherence measured by the Exercise Adherence Rating Scale at months 3 and
6. Additional outcome measures, including rehospitalisations, death,
handgrip strength, frailty (Fried Criteria and Essential Toolset),
cognitive function (Mini-Mental State Examination), quality of life
(EuroQol 5-Dimension 5-Level), nutritional status (Mini-Nutritional
Assessment), anxiety (General Anxiety Disorder-7), depression (Geriatric
Depression Scale), sleep (Pittsburgh Sleep Quality Index), functional
capacity (Duke Activity Status Index), clinical indices (body mass index,
symptoms, signs, left ventricular ejection fraction (LVEF), N-Terminal
Pro-Brain Natriuretic Peptide, etc) and social support (Lubben Social
Network Scale-6), along with comprehensive cost analysis, enhance the
study's significance. The study's findings hold crucial implications for
crafting an effective exercise-focused cardiac rehabilitation strategy for
TAVR patients. Community implementation not only deepens understanding but
also fosters the potential integration of exercise-based cardiac
rehabilitation into self-care, promising enhanced patient adherence and
overall cardiovascular health management. Ethics and dissemination Ethical
approval was obtained from the Zhongshan Hospital, Fudan University Ethics
Committee (B2022-062R). Results will be disseminated to local stakeholders
and the research community through publications and
conferences.<br/>Copyright &#xa9; 2024 BMJ Publishing Group. All rights
reserved.

<46>
Accession Number
2030370202
Title
Coronary artery lesions in Takayasu arteritis.
Source
Reumatologia. 61(6) (pp 460-472), 2023. Date of Publication: 2023.
Author
Dzhus M.; Mostbauer H.
Institution
(Dzhus, Mostbauer) Department of Internal Medicine No. 2, O. Bohomolets
National Medical University, Kyiv, Ukraine
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Takayasu arteritis (TAK) is a granulomatous inflammation of
vessels of large diameter, mainly affecting the aorta and its proximal
branches, which is more common in young women. The incidence of coronary
artery disease in TAK is unknown and not sufficiently studied.
<br/>Material(s) and Method(s): A literature review was performed for the
period 2003 to 2023 using a search of the PubMed and Scopus scientific
databases. We used the following key words to search the academic journal
databases: "Takayasu arteritis", "coronary angiography", "myocardial
revascularization", "coronary artery disease", "angina pectoris", and
"myocardial infarction". <br/>Result(s): The analysis of studies showed
that coronary artery lesions (CAL) in TAK are not uncommon, being
identified particularly in children and young individuals. Pathology of
the coronary arteries increases the morbidity and mortality of TAK
patients. In TAK, the ostia and proximal segments of the coronary arteries
are more frequently affected, presenting as stenosis or occlusion with the
development of stable coronary artery disease, unstable coronary artery
disease, acute myocardial infarction, and sudden death. The diagnosis of
TAK and coronary artery pathology is often complicated due to nonspecific
manifestations and frequently the absence of symptoms. The treatment of
patients with TAK with CAL is challenging and requires both
pharmacological therapy and interventional or surgical methods of
myocardial revascularization. <br/>Conclusion(s): Takayasu arteritis is a
more prevalent cause of CAL development, especially in young patients,
than previously believed, and cardiovascular death due to CAL is not rare.
Early diagnosis of TAK with CAL, particularly occlusion or hemodynamically
significant stenosis, and the prompt initiation of appropriate treatment
prevent dangerous complications, reduce mortality, and improve
prognosis.<br/>Copyright &#xa9; 2023 Termedia Publishing House Ltd.. All
rights reserved.

<47>
Accession Number
2030175873
Title
Cost-Effectiveness of Fractional FlowReserve-Guided Treatment for Acute
Myocardial Infarction and Multivessel Disease A Prespecified Analysis of
the FRAME-AMI Randomized Clinical Trial.
Source
JAMA Network Open. 7(1) (pp E2352427), 2024. Date of Publication: 25 Jan
2024.
Author
Hong D.; Lee S.H.; Lee J.; Lee H.; Shin D.; Kim H.K.; Park K.H.; Choo
E.H.; Kim C.J.; Kim M.C.; Hong Y.J.; Jeong M.H.; Ahn S.G.; Doh J.-H.; Lee
S.Y.; Park S.D.; Lee H.-J.; Kang M.G.; Koh J.-S.; Cho Y.-K.; Nam C.-W.;
Choi K.H.; Park T.K.; Yang J.H.; Song Y.B.; Choi S.-H.; Gwon H.-C.;
Guallar E.; Cho J.; Hahn J.-Y.; Kang D.; Lee J.M.
Institution
(Hong, Lee, Lee, Lee, Park, Hong, Lee, Park, Lee, Choi, Park, Yang, Song,
Choi, Gwon, Hahn, Lee) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Hong, Lee, Lee, Lee, Kim, Kim, Kim, Hong, Jeong, Lee, Lee, Lee) Chonnam
National University Hospital, Gwangju, South Korea
(Lee, Lee, Lee, Lee, Lee, Kang, Cho, Cho, Kang, Lee) Center for Clinical
Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul,
South Korea
(Lee, Lee, Lee, Lee, Lee, Kang, Cho, Cho, Kang, Lee) Department of
Clinical Research Design and Evaluation, Samsung Advanced Institute for
Health Sciences and Technology, Sungkyunkwan University, Seoul, South
Korea
(Lee, Lee, Lee, Lee, Lee, Lee) College of Pharmacy, Ajou University,
Suwon, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Duke
University Medical Center, Durham, NC, United States
(Kim, Park, Kim, Kim, Park, Park) Chosun University Hospital, University
of Chosun College of Medicine, Gwangju, South Korea
(Choo) Seoul St Mary's Hospital, The Catholic University of Korea, Seoul,
South Korea
(Kim, Kim, Kim) Uijeongbu St Mary's Hospital, The Catholic University of
Korea, Seoul, South Korea
(Ahn) Yonsei UniversityWonju College of Medicine, Wonju Severance
Christian Hospital, Wonju, South Korea
(Doh) Department of Medicine, Inje University Ilsan Paik Hospital, Goyang,
South Korea
(Lee, Lee, Lee, Lee, Lee, Lee) Chung-Ang University College of Medicine,
Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
(Park, Park, Park) Inha University Hospital, Incheon, South Korea
(Lee, Lee, Lee, Lee, Lee, Lee) Sejong General Hospital, Bucheon, South
Korea
(Kang, Koh, Kang) Gyeongsang National University School of Medicine,
Gyeongsang National University Hospital, Jinju, South Korea
(Cho, Nam, Cho) Keimyung University Dongsan Medical Center, Daegu, South
Korea
(Guallar) Department of Epidemiology and Medicine, Welch Center for
Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical
Institutions, Baltimore, MD, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Complete revascularization by non-infarct-related artery (IRA)
percutaneous coronary intervention (PCI) in patients with acutemyocardial
infarction is standard practice to improve patient prognosis. However, it
is unclear whether a fractional flow reserve (FFR)-guided or
angiography-guided treatment strategy for non-IRA PCI would be more
cost-effective. OBJECTIVE To evaluate the cost-effectiveness of FFR-guided
compared with angiography-guided PCI in patients with acutemyocardial
infarction and multivessel disease. DESIGN, SETTING, AND PARTICIPANTS In
this prespecified cost-effectiveness analysis of the FRAME-AMI randomized
clinical trial, patients were randomly allocated to either FFR-guided or
angiography-guided PCI for non-IRA lesions between August 19, 2016, and
December 24, 2020. Patients were aged 19 years or older, had ST-segment
elevationmyocardial infarction (STEMI) or non-STEMI and underwent
successful primary or urgent PCI, and had at least 1 non-IRA lesion
(diameter stenosis > 50% in a major epicardial coronary artery or major
side branch with a vessel diameter of >=2.0 mm). Data analysis was
performed on August 27, 2023. INTERVENTION Fractional flow reserve-guided
vs angiography-guided PCI for non-IRA lesions. MAIN OUTCOMES AND MEASURES
The model simulated death, myocardial infarction, and repeat
revascularization. Future medical costs and benefits were discounted by
4.5%per year. The main outcomes were quality-adjusted life-years (QALYs),
direct medical costs, incremental costeffectiveness ratio (ICER), and
incremental net monetary benefit (INB) of FFR-guided PCI compared with
angiography-guided PCI. State-transition Markov models were applied to the
Korean, US, and European health care systems using medical cost (presented
in US dollars), utilities data, and transition probabilities from
meta-analysis of previous trials. RESULTS The FRAME-AMI trial randomized
562 patients, with a mean (SD) age of 63.3 (11.4) years. Most patients
were men (474 [84.3%]). Fractional flow reserve-guided PCI increased QALYs
by 0.06 compared with angiography-guided PCI. The total cumulative cost
per patient was estimated as $1208 less for FFR-guided compared with
angiography-guided PCI. The ICER was -$19 484 and the INB was $3378,
indicating that FFR-guided PCI was more cost-effective for patients with
acute myocardial infarction and multivessel disease. Probabilistic
sensitivity analysis showed consistent results and the likelihood
iteration of cost-effectiveness in FFR-guided PCI was 97%. When transition
probabilities from the pairwise meta-analysis of the FLOWER-MI and
FRAME-AMI trials were used, FFR-guided PCI was more cost-effective than
angiography-guided PCI in the Korean, US, and European health care
systems, with an INB of $3910, $8557, and $2210, respectively. In
probabilistic sensitivity analysis, the likelihood iteration of
cost-effectiveness with FFR-guided PCIwas 85%, 82%, and 31% for the
Korean, US, and European health care systems, respectively. CONCLUSIONS
AND RELEVANCE This cost-effectiveness analysis suggests that FFR-guided
PCI for non-IRA lesions saved medical costs and increased quality of life
better than angiography-guided PCI for patients with acute myocardial
infarction and multivessel disease. Fractional flow reserve- guided PCI
should be considered in determining the treatment strategy for non-IRA
stenoses in these patients.<br/>Copyright &#xa9; 2024 American Medical
Association. All rights reserved.

<48>
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.

<49>
Accession Number
2029218545
Title
Radial artery pseudoaneurysm a rare complication after coronary
angiography: A case report and systematic review of the reported cases.
Source
Clinical Case Reports. 12(4) (no pagination), 2024. Article Number: e8725.
Date of Publication: April 2024.
Author
Alqahtani N.G.
Institution
(Alqahtani) Department of Internal Medicine, Cardiology Section, College
of Medicine, King Khalid University, Abha, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
This is a case of 83 years old male who had radial artery pseudoaneurysm
after cardiac catheterization. The diagnosis was through Doppler
ultrasound and the patient was treated with thrombin injection and
reported good outcomes. The literature also included 41 cases of
pseudoaneurysm after catheterization. The mean age of patients was 68.5
years with a male prevalence of 49%. Onset of pseudoaneurysm ranged from 0
days (directly after the catheterization) to 150 days with a median of 5
days. The treatment of patients was mainly surgical (19 cases) followed by
compression (either manual or TR band) (12 cases), thrombin injection
(four cases), compression then surgery (three cases), compression then
thrombin injection (one case), percutaneous endovascular repair using a
covered stent (one case) and not reported in one case. All cases recovered
well.<br/>Copyright &#xa9; 2024 The Authors. Clinical Case Reports
published by John Wiley & Sons Ltd.

<50>
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.

<51>
Accession Number
2028523941
Title
Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic
Surgery and the Predictors of Moderate-to-Severe Pain-Secondary Data
Analysis.
Source
Journal of Clinical Medicine. 13(3) (no pagination), 2024. Article Number:
844. Date of Publication: February 2024.
Author
Tomaszek L.; Fenikowski D.; Ciez-Piekarczyk N.; Medrzycka-Dabrowska W.
Institution
(Tomaszek, Fenikowski, Ciez-Piekarczyk) Department of Thoracic Surgery,
Institute of Tuberculosis and Lung Diseases, Rabka-Zdroj Branch,
Rabka-Zdroj 34-700, Poland
(Tomaszek) Department of Specialist Nursing, Faculty of Medicine and
Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow
30-705, Poland
(Ciez-Piekarczyk) Medical Institute, Academy of Applied Sciences in Nowy
Targ, Nowy Targ 34-400, Poland
(Medrzycka-Dabrowska) Department of Anaesthesiology and Intensive Care
Nursing, Medical University of Gdansk, Gdans, 7 Debinki Street, Gdansk
80-211, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Pain management among children following thoracic surgery is
an area of significant practice variability. Understanding the risk
factors of moderate-to-severe pain intensity will allow for adequate pain
relief. The aim of the study was to assess the maximum intensity of pain
at rest in pediatric patients within 24 h of thoracic surgery and to
investigate the prevalence and predictors of moderate-to-severe pain.
Methods and findings: This is a prospective cohort study of patients in
observational and randomized controlled trials following thoracic surgery.
A secondary analysis of data was conducted using data collected from 446
patients aged 7-18 years undergoing thoracic surgery. The primary endpoint
was maximum pain intensity (Numerical Rating Scale; NRS; range: 0-10) and
the secondary endpoint was the prevalence and predictors of
moderate-to-severe pain (NRS > 2/10). The median maximum pain in the
cohort was 3 [0; 4]. During the immediate postoperative period, 54% of
patients reported a maximum NRS > 2/10. The infusion of morphine by an
intravenous route (vs. epidural route) was a protective factor against
moderate-to-severe pain. Taking into account the findings related to the
type of epidural analgesia (vs. intravenous morphine), it was found that
only the administration of 0.25% bupivacaine combined with morphine or
fentanyl was a protective factor against moderate-to-severe postoperative
pain. Patients aged 14-18 years (vs. aged 7-13 years) had an increased
risk of reporting pain as moderate-to-severe. <br/>Conclusion(s): The
route of analgesic administration, type of multimodal analgesia, and
patients' age predict moderate-to-severe pain in pediatric patients after
thoracic surgery.<br/>Copyright &#xa9; 2024 by the authors.

<52>
Accession Number
2023336557
Title
Effects of levosimendan on the outcome of veno-arterial extracorporeal
membrane oxygenation: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. 113(4) (pp 509-521), 2024. Date of
Publication: April 2024.
Author
Liu Y.; Zhang L.; Yao Y.; Qin W.; Li Y.; Xue W.; Li P.; Chen Y.; Chen X.;
Guo H.
Institution
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Guo) Department of Critical
Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong
University, 107 Wenhua Xi Road, Shandong, Jinan 250012, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Emergency and Critical Care Medicine of Shandong Province,
Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Cardiovascular Remodeling and Function Research, Chinese
Ministry of Education and Chinese Ministry of Health, Qilu Hospital,
Cheeloo College of Medicine, Shandong University, Shandong, Jinan, China
(Chen) Department of Emergency Medicine and Chest Pain Center, Qilu
Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: For patients with severe cardiopulmonary failure, such as
cardiogenic shock, veno-arterial extracorporeal membrane oxygenation
(VA-ECMO) is primarily utilized to preserve their life by providing
continuous extracorporeal respiration and circulation. However, because of
the complexity of patients' underlying diseases and serious complications,
successful weaning from ECMO is often difficult. At present, there have
been limited studies on ECMO weaning strategies, so the principal purpose
of this meta-analysis is to examine how levosimendan contributes to the
weaning of extracorporeal membrane oxygenation. <br/>Method(s): The
Cochrane Library, Embase, Web of Science, and PubMed were browsed for all
potentially related research about clinical benefits of levosimendan in
weaning patients receiving VA-ECMO and included 15 of them. The main
outcome is success of weaning from extracorporeal membrane oxygenation,
with the secondary outcomes of 1-month mortality (28 or 30 days), ECMO
duration, hospital or intensive care unit (ICU) length of stay, and use of
vasoactive drugs. <br/>Result(s): 1772 patients altogether from 15
publications were incorporated in our meta-analysis. We used fixed and
random-effect models to combine odds ratio (OR) and 95% confidence
interval (CI) for dichotomous outcomes and standardized mean difference
(SMD) for continuous outcomes. The weaning success rate in the
levosimendan group was considerably higher in contrast to the comparison
(OR = 2.78, 95% CI 1.80-4.30; P < 0.00001; I² = 65%), and
subgroup analysis showed that there was less heterogeneity in patients
after cardiac surgery (OR = 2.06, 95% CI, 1.35-3.12; P = 0.0007;
I² = 17%). In addition, the effect of levosimendan on improving
weaning success rate was statistically significant only at 0.2 mcg/kg/min
(OR = 2.45, 95% CI, 1.11-5.40; P = 0.03; I² = 38%). At the same
time, the 28-day or 30-day proportion of deaths in the sample receiving
levosimendan also decreased (OR = 0.47, 95% CI, 0.28-0.79; P = 0.004;
I² = 73%), and the difference was statistically significant. In
terms of secondary outcomes, we found that individuals undergoing
levosimendan treatment had a longer duration of VA-ECMO support.
<br/>Conclusion(s): In patients receiving VA-ECMO, levosimendan treatment
considerably raised the weaning success rate and helped lower mortality.
Since most of the evidence comes from retrospective studies, more
randomized multicenter trials are required to verify the conclusion.
Graphical abstract: (Figure presented.).<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023.

<53>
Accession Number
2020319841
Title
Complete transcatheter versus surgical approach to aortic stenosis with
coronary artery disease: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(4) (pp 1305-1313.e9),
2024. Date of Publication: April 2024.
Author
Sakurai Y.; Yokoyama Y.; Fukuhara S.; Takagi H.; Kuno T.
Institution
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, WVa, United States
(Yokoyama) Department of Surgery, St Luke's University Health Network, Pa,
United States
(Fukuhara) Department of Cardiothoracic Surgery, University of Michigan,
Ann Arbor, Mich, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: This meta-analysis aimed to evaluate outcomes of transcatheter
aortic valve replacement (TAVR) with percutaneous coronary intervention
(PCI) versus surgical aortic valve replacement (SAVR) with coronary artery
bypass grafting (CABG). <br/>Method(s): The MEDLINE, EMBASE, and Cochrane
Library databases were searched through November 2021 to identify studies
comparing TAVR + PCI and SAVR + CABG for severe aortic stenosis with
concurrent coronary artery disease. Outcomes of interest were all-cause
mortality, repeat coronary intervention, rehospitalization, myocardial
infarction, and stroke during follow-up, and 30-day periprocedural
outcomes. <br/>Result(s): Two randomized controlled trials and 6
observational studies including a total of 104,220 patients (TAVR + PCI, n
= 5004; SAVR + CABG, n = 99,216) were included. The weighted mean
follow-up period was 30.2 months. TAVR + PCI was associated with greater
all-cause mortality and coronary reintervention during follow-up period
(hazard ratio, 1.35; 95% confidence interval [CI], 1.11-1.65; P = .003,
hazard ratio, 4.14; 95% CI, 1.74-9.86; P = .001, respectively), 30-day
permanent pacemaker implantation rate (odds ratio [OR], 3.79; 95% CI,
1.61-8.95; P = .002), and periprocedural vascular complications (OR, 6.97;
95% CI, 1.85-26.30; P = .004). In contrast, TAVR + PCI was associated with
a lower rate of 30-day acute kidney injury (OR, 0.32; 95% CI, 0.20-0.50; P
= .0001). Rehospitalization, myocardial infarction, stroke during
follow-up, and other periprocedural outcomes including 30-day mortality
were similar in both groups. <br/>Conclusion(s): In patients with severe
aortic stenosis and coronary artery disease, TAVR + PCI was associated
with greater all-cause mortality at follow-up compared with SAVR + CABG.
Heart Team approach to assess TAVR candidacy remains
imperative.<br/>Copyright &#xa9; 2022 The American Association for
Thoracic Surgery

<54>
Accession Number
2031428423
Title
Perioperative hyperoxia- impact on myocardial biomarkers, strain and
outcome in high-risk patients undergoing non-cardiac surgery: Protocol for
a prospective randomized controlled trial.
Source
Contemporary Clinical Trials. 140 (no pagination), 2024. Article Number:
107512. Date of Publication: May 2024.
Author
Friess J.O.; Stiffler S.; Mikasi J.; Erdoes G.; Nagler M.; Grani C.; Weiss
S.; Fischer K.; Guensch D.P.
Institution
(Friess, Stiffler, Mikasi, Erdoes, Fischer, Guensch) Department of
Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Nagler) Institute of Clinical Chemistry, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Grani) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Weiss) Department of Vascular Surgery, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Supplemental oxygen is used during every general anesthesia.
However, for the maintenance phase of a general anesthesia, in most cases
the longest part of anesthesia, only scarce evidence of dosing
supplemental oxygen exists. Oxygen is a well-known coronary
vasoconstrictor and thus may contribute to cardiovascular complications
especially in vulnerable high-risk patients with coronary artery disease
undergoing major non-cardiac surgery. Myocardial biomarkers are early
indicators of myocardial injury. Oxygen supply demand mismatches due to
coronary artery disease aggravated by hyperoxia might be displayed by
changes from the biomarker's baseline-values. This study is designed to
detect changes in myocardial biomarkers levels associated with
perioperative hyperoxia. <br/>Method(s): This prospective randomized
controlled interventional trial investigates the impact of maintaining
perioperative high oxygen supplementation in high-risk patients undergoing
non-cardiac vascular surgery on cardiac biomarkers, myocardial strain and
outcome in 110 patients. Patients are allocated to be supplemented with
either 0.3 (normal) or 0.8 (high) fraction of inspired oxygen
(FiO<inf>2</inf>) perioperatively. Included is a short crossover phase
during which transesophageal echocardiography is used to evaluate
myocardial function at FiO<inf>2</inf> 0.3 and 0.8 by strain analysis in
each patient. Patients will be followed up for complications at 30 days
and 1 year. <br/>Conclusion(s): The trial is designed to evaluate
perioperative changes from baseline myocardial biomarkers associated with
perioperative FiO<inf>2</inf>. Furthermore, exploration and correlation of
changes in biomarkers, acute early changes in myocardial function and
clinical outcomes induced by different FiO<inf>2</inf> may be
possible.<br/>Copyright &#xa9; 2024 The Authors

<55>
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

<56>
Accession Number
2031132479
Title
Recurrence of new-onset post-operative AF after cardiac surgery detected
by implantable loop recorders: A systematic review and Meta-analysis.
Source
International Journal of Cardiology. 404 (no pagination), 2024. Article
Number: 131930. Date of Publication: 01 Jun 2024.
Author
Kaur H.; Tao B.; Silverman M.; Healey J.S.; Belley-Cote E.P.; Islam S.;
Whitlock R.P.; Devereaux P.J.; Conen D.; Bidar E.; Kawczynski M.;
Ayala-Paredes F.; Ayala-Valani L.M.; Sandgren E.; El-Chami M.F.; Jorgensen
T.H.; Thyregod H.G.H.; Sabbag A.; McIntyre W.F.
Institution
(Kaur, Silverman) Michael G. DeGroote School of Medicine, Hamilton, ON,
Canada
(Tao) University of British Columbia, BC, Canada
(Healey, Belley-Cote, Islam, Whitlock, Devereaux, Conen, McIntyre)
Population Health Research Institute, ON, Canada
(Bidar, Kawczynski) Maastricht University Medical Centre (MUMC),
Maastricht, Netherlands
(Bidar, Kawczynski) CardioVascular Research Institute Maastricht (CARIM),
Netherlands
(Ayala-Paredes, Ayala-Valani) Sherbrooke University, Quebec, Canada
(Sandgren) Department of Medicine, Halland Hospital Varberg, Varberg,
Sweden
(El-Chami) Department of Medicine, Emory University School of Medicine,
Atlanta, United States
(Jorgensen, Thyregod) Department of Cardiovascular Surgery, Copenhagen
University Hospital, Copenhagen, Denmark
(Sabbag) Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan and
the Faculty of Median, Tel-Aviv University, Israel
Publisher
Elsevier Ireland Ltd
Abstract
Background: Atrial fibrillation (AF) is one of the most common
complications after cardiac surgery. New-onset post-operative AF may
signal an elevated risk of AF and associated outcomes in long-term
follow-up. We aimed to estimate the rate of AF recurrence as detected by
an implantable loop recorder (ILR) in patients experiencing post-operative
AF within 30 days after cardiac surgery. <br/>Method(s): We searched
MEDLINE, Embase and Cochrane CENTRAL to April 2023 for studies of adults
who did not have known AF, experienced new-onset AF within 30 days of
cardiac surgery and received an ILR. We pooled individual participant data
on timing of AF recurrence using a random-effects model with a frailty
model applied to a Cox proportional hazard analysis. <br/>Result(s): From
8671 citations, 8 single-centre prospective cohort studies met eligibility
criteria. Data were available from 185 participants in 7 studies, with a
median follow-up of 1.7 (IQR: 1.3-2.8) years. All included studies were at
a low risk of bias. Pooled AF recurrence rates following 30 post-operative
days were 17.8% (95% CI 11.9%-23.2%) at 3 months, 24.4% (17.7%-30.6%) at 6
months, 30.1% (22.8%-36.7%) at 12 months and 35.3% (27.6%-42.2%) at 18
months. <br/>Conclusion(s): In patients who experience new-onset
post-operative AF after cardiac surgery, AF recurrence lasting at least 30
s occurs in approximately 1 in 3 in the first year after surgery. The
optimal frequency and modality to use for monitoring for AF recurrence in
this population remain uncertain.<br/>Copyright &#xa9; 2024 The Authors

<57>
Accession Number
2030905468
Title
Hemodynamic Monitoring In The Cardiac Surgical Patient: Comparison of
Three Arterial Catheters.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(5) (pp 1115-1126),
2024. Date of Publication: May 2024.
Author
Bui D.; Hayward G.; Chen T.H.; Apruzzese P.; Asher S.; Maslow M.; Gorgone
M.; Hunter C.; Flaherty D.; Kendall M.; Maslow A.
Institution
(Bui, Hayward, Chen, Apruzzese, Asher, Gorgone, Hunter, Flaherty, Kendall,
Maslow) Departments of Anesthesiology, Rhode Island Hospital, Providence,
RI, United States
(Maslow) St. Lawrence University, Canton, NY, United States
Publisher
W.B. Saunders
Abstract
Objective: Systemic systolic (SAP) and mean (MAP) arterial pressure
monitoring is the cornerstone in hemodynamic management of the cardiac
surgical patient, and the radial artery is the most common site of
catheter placement. The present study compared 3 different arterial line
procedures. It is hypothesized that a 20-G 12.7- cm catheter inserted into
the radial artery will be equal to a 20-G 12.7- cm angiocath placed in the
brachial artery, and superior to a 20-G 5.00 cm angiocath placed in the
radial artery. <br/>Design(s): A prospective randomized control study was
performed. <br/>Setting(s): Single academic university hospital.
<br/>Participant(s): Adult patients >=18 years old undergoing nonemergent
cardiac surgery using cardiopulmonary bypass (CPB). <br/>Intervention(s):
After approval by the Rhode Island Hospital institutional review board, a
randomized prospective control study to evaluate 3 different peripheral
intraarterial catheter systems was performed: (1) Radial Short (RS): 20-G
5- cm catheter; (2) Radial Long (RL): 20-G 12- cm catheter; and (3)
Brachial Long (BL): 20-G 12- cm catheter. Measurements and Results:
Gradients between central aortic and peripheral catheters (CA-P) were
compared and analyzed before CPB and 2 and 10 minutes after separation
from CPB. The placement of femoral arterial lines and administration of
vasoactive medications were recorded. After exclusions, 67 BL, 61 RL, and
66 RS patients were compared. Before CPB, CA-P SAP and MAP gradients were
not significant among the 3 groups. Two minutes after CPB, the CA-P SAP
gradient was significant for the RS group (p = 0.005) and insignificant
for BL (p = 0.47) and RL (p = 0.39). Two-group analysis revealed that CA-P
SAP gradients are similar between BL and RL (p = 0.84), both of which were
superior to RS (p = 0.02 and p = 0.04, respectively). At 10 minutes after
CPB, the CA-P SAP gradient for RS remained significant (p = 0.004) and
similar to the gradient at 2 minutes. The CA-P SAP gradients increased
from 2 to 10 minutes for BL (p = 0.13) and RL (p = 0.06). Two minutes
after CPB, the CA-P MAP gradients were significant for the BL (p = 0.003),
RL (p < 0.0001), and RS (p < 0.0001) groups. Two-group analysis revealed
that the CA-P MAP gradients were lower for the BL group compared with the
RL (p = 0.054) and RS (p< 0.05) groups. Ten minutes after CPB, the CA-P
MAP gradients in the RL and RS groups remained significant (p < 0.0001)
and both greater than the BL group (p = 0.002). A femoral arterial line
was placed more frequently in the RS group (8/66 = 12.1%) than in the RL
group (3/61 = 4.9%) and the BL group (2/67 = 3.0%). Vasopressin was
administered significantly more frequently in the RS group.
<br/>Conclusion(s): Regarding CA-P SAP gradients, the RL group performed
equally to the BL group, both being superior to RS. Regarding CA-P MAP
gradients, BL was superior to RL and RS. Clinically, femoral line
placement and vasopressin administration were fewer for the BL and RL
groups when compared with the RS group. This study demonstrated the
benefits of a long (12.7 cm) 20- G angiocath placed in the radial
artery.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<58>
Accession Number
2030765997
Title
Perioperative hemadsorption therapy in infective endocarditis: systematic
review and meta-analysis.
Source
Cirugia Cardiovascular. 31(2) (pp 56-63), 2024. Date of Publication: 01
Mar 2024.
Author
Martin Gutierrez E.; Castillo Pardo L.; Maiorano P.; Oujo Gonzalez B.;
Laguna Nunez G.; Martinez Comendador J.M.; Gualis Cardona J.; Castano Ruiz
M.
Institution
(Martin Gutierrez, Castillo Pardo, Maiorano, Oujo Gonzalez, Gualis
Cardona, Castano Ruiz) Servicio de Cirugia cardiaca, Hospital
Universitario de Leon, Leon, Spain
(Laguna Nunez) Servicio de Cirugia cardiovascular, Hospital Universitario
Virgen de las Nieves, Granada, Spain
(Martinez Comendador) Servicio de Cirugia cardiaca, Complexo Hospitalario
Universitario A Coruna, A Coruna, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Infective endocarditis (IE) is a systemic disease with multiorgan
involvement. It is a severe disease, which frequently requires surgical
treatment, despite which mortality rates can be high due to complications
related to an uncontrolled systemic inflammatory response and/or sepsis.
Hemadsorption systems such as Cytosorb allow the removal of
proinflammatory cytokines and endotoxins to improve the prognosis of these
patients. We performed a systematic review in Pubmed and Cochrane to
identify controlled comparative studies of the perioperative use of
Cytosorb in patients undergoing cardiac surgery for IE. A meta-analysis
was performed comparing different clinical outcomes. 9 studies were
finally included in the meta-analysis. The use of hemadsorption therapy
did not reduce mortality in the early postoperative period (RR = 0.75; p =
0.05). Both, the duration of mechanical ventilation (mean difference =
-6.91 hours; p = 0.01) and the duration of support with vasopressor drugs
(mean difference = -34.47 hours; p = 0.03) were significantly shorter in
the case of patients treated with hemadsorption. However, postoperative
stays, the incidence of postoperative renal failure or the need for
surgical revision due to bleeding did not show differences between groups.
To conclude, the use of the Cytosorb hemadsorption filter in cardiac
surgery for IE allowed better control of postoperative inflammatory
activity, with lower requirements for vasopressor support and duration of
mechanical ventilation, but without impact on perioperative mortality or
other related complications.<br/>Copyright &#xa9; 2024 Sociedad Espanola
de Cirugia Cardiovascular y Endovascular

<59>
Accession Number
2029999878
Title
Impact of Surgical Positioning on the Occurrence of Postoperative
Ipilateral Shoulder Pain After Lung Resection by Video-Assisted
Thoracoscopy: A Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(5) (pp 1190-1197),
2024. Date of Publication: May 2024.
Author
Galvaing G.; Bussieres J.; Simard S.; Couture E.J.; Cournoyer C.; Conti
M.; Lacasse Y.; Laliberte A.S.
Institution
(Galvaing, Conti, Lacasse, Laliberte) Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Multidisciplinary Department of
Pulmonology and Thoracic Surgery, Quebec City, Quebec, Canada
(Galvaing) Jean Perrin Cancer Center, Department of Thoracic and Endocrine
Surgery, Clermont-Ferrand, France
(Bussieres, Couture, Cournoyer) Institut Universitaire de Cardiologie et
de Pneumologie de Quebec, Department of Anesthesiology, Quebec City,
Quebec, Canada
(Simard) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Research Center, Quebec City, Quebec, Canada
Publisher
W.B. Saunders
Abstract
Objective: The aim of this study was to evaluate the impact of the
ipsilateral arm position on ipsilateral shoulder pain after lung cancer
resection by video-assisted thoracic surgery. <br/>Design(s): A
prospective randomized controlled trial. <br/>Setting(s): A single
academic center study. <br/>Participant(s): Patients undergoing
video-assisted thoracic surgery pulmonary resection for cancer at the
Institut Universitaire de Cardiologie et de Pneumologie de Quebec from May
2020 to May 2022 were included. <br/>Intervention(s): Patients randomly
were assigned with a 1:1 ratio to a supported or suspended ipsilateral arm
position. <br/>Measurements and Main Results: Ipsilateral shoulder pain
incidence, pain score, and opioid use were recorded in the postanesthesia
care unit (PACU) on postoperative days 1 and 2. One hundred thirty-three
patients were randomized, 67 in the suspended-arm group and 66 in the
supported-arm group. Of the patients, 31% reported ipsilateral shoulder
pain in the PACU with no difference between groups (19/67 [28.4%] v 22/66
patients (33.3%), p = 0.5767). There was no significant difference between
the pain score in the PACU (3 [0-6] v 4 [0-6], p = 0.9055) at
postoperative day 1 (4 [2-6] v 3 [2-5], p = 0.4113) and at postoperative
day 2 (2 [0-5] v 2 [1-4], p = 0.9508). Ipsilateral shoulder pain score
decreased rapidly on postoperative day 2. There was no statistical
difference in opioid and gabapentinoid use between the groups.
<br/>Conclusion(s): Ipsilateral arm position seems to have no impact on
ipsilateral shoulder pain.<br/>Copyright &#xa9; 2023

<60>
Accession Number
643877282
Title
Skeletal muscle relaxants as adjunctive pain control following
cardiothoracic surgery: a systematic review protocol.
Source
BMJ open. 14(3) (pp e079685), 2024. Date of Publication: 25 Mar 2024.
Author
Kabir S.; Whaley Q.; Fernandez M.; Murphy T.W.
Institution
(Kabir) College of Osteopathic Medicine, Nova Southeastern University
Health Professions Division, Fort Lauderdale, FL, United States
(Whaley, Fernandez) Miami Transplant Institute, Miami, FL, United States
(Murphy) Miami Transplant Institute, Miami, FL, United States
(Murphy) Department of Surgery, Division of Emergency Medicine, University
of Miami School of Medicine, Miami, FL, United States
Abstract
INTRODUCTION: Multimodal pain control following cardiothoracic surgery
remains a focus in international guidelines. We hypothesise that
non-depolarising skeletal muscle relaxants can prove to be a useful
adjunct for this population. METHODS/ANALYSIS: This systematic review will
focus on human adult studies of pain control using muscle relaxants within
1week following cardiac and thoracic surgery available in PubMed, Cochrane
Central, Web of Science and EMBASE. Target studies will have a primary
focus on measured effects on quality of pain control and reduction in
opioid usage. Studies that include non-depolarising skeletal muscle
relaxants given during cardiothoracic surgery or in the week after will be
included. Study selection will be in keeping with Preferred Reporting
Items for Systematic Reviews and Meta-Analyses guidelines. Procedures and
agents used will be analysed together, and a meta-analysis will be
conducted then compared with current therapies recommended in
international practice guidelines. ETHICS AND DISSEMINATION: Formal
ethical approval will not be required as primary data will not be
collected. The results will be disseminated through peer-reviewed
publication, conference presentation and lay press. PROSPERO REGISTRATION
NUMBER: CRD42023397917.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<61>
Accession Number
2030687612
Title
Impact of duration of pre-operative antibiotics on SIRS / urosepsis rates
following PNL for non-staghorn renal stones: A randomized controlled
study.
Source
European Urology. Conference: EAU24 - 39th Annual EAU Congress. Paris
France. 85(Supplement 1) (pp S2059), 2024. Date of Publication: March
2024.
Author
Mete U.; Deshpande R.; Bhadada S.; Taneja N.; Mavuduru R.; Bora G.
Institution
(Mete, Deshpande, Mavuduru, Bora) PGIMER, Dept. of Urology, Chandigarh,
India
(Bhadada) PGIMER, Dept. of Endocrinology, Chandigarh, India
(Taneja) PGIMER, Dept. of Microbiology, Chandigarh, India
Publisher
Elsevier B.V.
Abstract
Introduction & Objectives: SIRS or urosepsis is a known complications
following PNL even amongst patients with preoperative sterile urine and
incidence rate ranges from 0.3-9% in various series. The rate of mortality
following post-PNL sepsis approaches 66 %. Longer duration of preoperative
antibiotics may reduce this incidence as reported in few studies. However
this strategy is debatable as contradictory reports are available. To
address this controversy, we studied the impact of duration of
pre-operative antibiotic (levofloxacin) on SIRS/urosepsis rates in
patients undergoing PNL for non-staghorn renal stones having preoperative
sterile urine culture. <br/>Material(s) and Method(s): Ninety patients
undergoing PNL for non-staghorn renal stones, with a pre-operative sterile
urine culture was randomised into three groups according to the duration
of preoperative antibiotics. All the patients were given injection
levofloxacin at the time of induction of anaesthesia. In addition the
patients in group II had received oral levofloxacin one day prior to
surgery and the patients in group III were given oral levofloxacin for
five days prior to PNL. Post-PNL SIRS/urosepsis was assessed by clinical,
biochemical, and microbiological parameters. Clinical parameters included
post-operative heart rate, respiratory rate, systolic BP, GCS, body
temperature. Laboratory parameters included haemoglobin, TLC, urea,
creatinine, and procalcitonin. For microbiological evidence included urine
culture (intra-operative and post-operative) and stone culture. The
incidence of Post-PNL SIRS/urosepsis across all groups were compared.
<br/>Result(s): Mean increase in TLC was 2812.77 +/- 6528.22 per mm3. The
mean heart rate on post-operative day 1& 2 was 84.43 +/- 16.174 beats/min
& 83.37 +/- 14.408 beats/min respectively. The mean respiratory rate on
post-operative day 1 & 2 was 14.24 +/- 1.478 breaths/min & 14.08 +/- 2.248
breaths/min respectively. The mean systolic blood pressure on
post-operative day 1 & was 119.53 +/- 22.744 mm of Hg, 121.38 +/- 21.806
mm of Hg respectively. The GCS score was 15 for all patients on both
post-operative days. The mean body temperature on postoperative day 1 was
37.091 +/- 0.7876 oC and that on post-operative day 2 was 37.09 +/- 0.676
oC. The mean serum procalcitonin level on postoperative day 2 was 3.6 +/-
21.28 ng/ml.The post operative clinical and biochemical parameters were
not statically different amongst patients across three groups. Overall,
only 1 patient (belonging to Group-I (1/90, 1.11%) qualified as having
developed SIRS. Rest of the patients did not fit into the definition of
SIRS. No patient showed any findings suggestive of sepsis.
<br/>Conclusion(s): Longer duration of pre-operative antibiotics is not
required to prevent the post-operative development of SIRS/urosepsis, in
patients with sterile pre-operative urine culture who underwent PNL for
non-staghorn renal stones.<br/>Copyright &#xa9; 2024 European Association
of Urology. Published by Elsevier B.V. All rights reserved.

<62>
Accession Number
2030140183
Title
Left atrial appendage occlusion device is associated with better survival
than oral anticoagulants in dialysis patients with atrial fibrillation.
Source
American Journal of the Medical Sciences. Conference: The American Journal
of the Medical Sciences Annual Meeting. InterContinental Hotel, New
Orleans United States. 367(Supplement 1) (pp S483), 2024. Date of
Publication: February 2024.
Author
Ong V.; Smith H.; Hunt S.; Phadnis M.; Dhar G.; Jain N.
Institution
(Ong, Jain) University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Smith, Hunt, Phadnis) University of Kansas Medical Center, Kansas City,
KS, United States
(Dhar) Rush University, Chicago, IL, United States
Publisher
Elsevier B.V.
Abstract
Purpose of Study: There is lack of consensus regarding use of oral
anticoagulants in treating atrial fibrillation (AF) of patients with end
stage kidney disease receiving dialysis (ESKD). This study serves to
compare the efficacy of OAC and left atrial appendage occlusion device in
preventing thromboembolic events in ESKD patients. Methods Used: Data from
the US Renal Data System registry was compiled between 01.01.2015 and
31.12.2018 and narrowed down into a final cohort that included 413
individuals treated with the device who were propensity-score matched to
1,652 individuals treated with the anticoagulants. Survival analyses were
performed to compare effectiveness and safety of the two treatments.
Summary of Results: During a median follow up of 2 years, there were 192
(46.5%) deaths in the device arm and 1,130 (68.4%) deaths in the
anticoagulant arm, P < 0.01. Kaplan Meier analysis demonstrated improved
survival in the device arm, log-rank P < 0.01. Compared to the use of oral
anticoagulants, use of the device was associated with better survival in
ESKD patients, unadjusted hazard ratio (HR) 0.51:95% Cl: 0.44, 0.59 and,
this association remained significant even after adjusting for
demographics, concomitant medicines and new strokes, adjusted HR 0.79:95%
CI: 67, 0.93. <br/>Conclusion(s): Use of left atrial appendage occlusion
device may be associated with better survival than oral anticoagulant
therapy in ESKD patients with a diagnosis of atrial fibrillation who
receive therapy. Future randomized controlled trial should investigate
whether this device is superior to oral anticoagulant therapy in this
high-risk patient population.<br/>Copyright &#xa9; 2024 Elsevier Inc. All
rights reserved.

<63>
Accession Number
2030131498
Title
The left atrial appendage: an enigmatic friend or foe and implications of
closure.
Source
American Journal of the Medical Sciences. Conference: The American Journal
of the Medical Sciences Annual Meeting. InterContinental Hotel, New
Orleans United States. 367(Supplement 1) (pp S5), 2024. Date of
Publication: February 2024.
Author
Benson J.; Keesee J.; Smith L.; Navarro J.; Khouzam R.
Institution
(Benson, Keesee, Smith, Khouzam) Grand Strand Medical Center, Myrtle
Beach, SC, United States
(Navarro) Edward Via College of Osteopathic Medicine (VCOM), Spartanburg,
SC, United States
Publisher
Elsevier B.V.
Abstract
Purpose of Study: The left atrial appendage (LAA) is a common nidus of
clot formation in patients with atrial fibrillation (A-fib). Closing the
LAA has been shown to decrease risk of thromboembolic events in patients
who cannot tolerate anticoagulation. The function of the LAA and the
implications of closure are poorly understood. The purpose of our review
is to summarize the functions of the LAA and explore potential risks vs
benefits of closure or excision. Methods Used: This review summarizes
qualitative and quantitative data from primary research, observational
studies, systematic reviews, and meta-analysis describing the function of
the LAA and risks vs benefits associated with LAA closure or excision.
Summary of Results: The structure and physiology of the LAA gives rise to
its unique mechanical and nonmechanical functions. Mechanical functions of
the LAA include increased distensibility allowing it to serve as a
decompression chamber for the LV and filling reservoir when pressures
increase. Similarly, its contractile elements have been found to be
greater than the rest of the left atrium, which can assist with
maintaining LV preload. Important non-mechanical functions include its
role in volume homeostasis. Research has shown that the left atrium has
nearly 40 times the concentration of ANP when compared with rest of the
heart, and the LAA produces 30% of cardiac ANP granules. Despite these
unique features, the LAA has been called "the most lethal human
attachment" for its role as a thromboembolic source for up to 90% of clots
in non-valvular A-fib. Anticoagulation is the mainstay of therapy to
prevent clot formation in A-fib, however bleeding complications and
nonadherence can preclude use. To address this, both surgical and
percutaneous LAA occlusion devices are utilized. While some data has shown
these devices decrease stroke risk and all-cause mortality, there is a
paucity of data describing the negative outcomes associated with LAA
occlusion or surgical removal. It has been suggested that loss of LAA
functions from occlusion or surgical removal can lead to increased
intracardiac pressure and dysregulation of intravascular volume. This
hypothesis is supported in animal models which show a near immediate
decrease in ANP secretion following atrial appendectomy. In patients who
require strict volume regulation, such as those with heart failure,
studies so far have indicated LAA closure or occlusion is safe, however
these studies had important limitations including short follow up time.
<br/>Conclusion(s): The LAA has a unique role in management of pressure
and serves as an important regulator of volume status. Closure of the LAA
reduces thromboembolic events in those with arrhythmias that cannot
tolerate anticoagulation. This benefit needs to be weighed against the
risk of LAA closure which decreases atrial reservoir capacity, diminishes
release of ANP, and potential contributions to dysregulation of volume
homeostasis.<br/>Copyright &#xa9; 2024 Elsevier Inc. All rights reserved.

<64>
Accession Number
2031490449
Title
Risk factors for interstitial lung disease in patients with non-small cell
lung cancer with epidermal growth factor receptor-tyrosine kinase
inhibitors: A systematic review and meta-analysis.
Source
Respiratory Investigation. 62(3) (pp 481-487), 2024. Date of Publication:
May 2024.
Author
Fukuda Y.; Uchida Y.; Ando K.; Manabe R.; Tanaka A.; Sagara H.
Institution
(Fukuda) Department of Medicine, Division of Respiratory Medicine,
Yamanashi Red Cross Hospital, 6663-1 Funatsu, Fujikawaguchiko-machi,
Yamanashi, Japan
(Fukuda, Uchida, Ando, Manabe, Tanaka, Sagara) Department of Medicine,
Division of Respiratory Medicine and Allergology, Showa University School
of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan
(Ando) Division of Internal Medicine, Showa University Dental Hospital
Medical Clinic, 2-1-1, Kitasenzoku, Ota-ku, Tokyo, Japan
(Ando) Department of Perioperative Medicine, Division of General Medicine,
Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku,
Tokyo, Japan
Publisher
Elsevier B.V.
Abstract
Background: The use of epidermal growth factor receptor-tyrosine kinase
inhibitors (EGFR-TKIs) can potentially result in interstitial lung disease
(ILD), which can substantially impact a patient's quality of life,
subsequently leading to the interruption or discontinuation of EGRF-TKI
treatment. Clinicians, therefore, need to thoroughly assess patients to
determine if they are at risk for ILD. <br/>Method(s): We searched for
observational study in the following databases: MEDLINE via the PubMed,
CENTRAL, and IchushiWeb. The primary outcome was risk factors for the
development of ILD, while the secondary outcome was risk factors for the
severity of ILD. Of the 1602 studies returned, we selected 11 for
meta-analysis, performed using a random-effects model. <br/>Result(s):
Risk factors for developing ILD were sex (odds ratio (OR), 1.87; 95%
confidence interval (CI), 1.08-3.22; I² = 0%; P = 0.02),
smoking history (OR, 2.13; 95% CI, 1.51-3.00; I² = 3 4%; P =
0.0001), and history of ILD (OR = 5.95; 95% CI, 3.34-10.59; I²
= 67%; P = 0.0009). Age, previous thoracic surgery or radiotherapy,
performance status, histological type of lung cancer, and treatment line
were not statistically significant risk factors for ILD. Risk factors
identified in one study were serum albumin level, history of nivolumab
use, radiographic residual lung volume, and history of pulmonary
infection. <br/>Conclusion(s): We identified risk factors for developing
ILD in patients with non-small cell lung cancer treated with
EGFR-TKIs.<br/>Copyright &#xa9; 2024 The Japanese Respiratory Society

<65>
Accession Number
2031474781
Title
High-flow nasal cannula therapy versus conventional oxygen therapy for
adult patients after cardiac surgery: A systemic review and meta-analysis.
Source
Heart and Lung. 66 (pp 47-55), 2024. Date of Publication: 01 Jun 2024.
Author
Liu C.; Lin Q.; Li D.
Institution
(Liu, Lin, Li) Department of Cardiac Surgery, Shengjing Hospital of China
Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning
Province 11004, China
Publisher
Elsevier Inc.
Abstract
Background: Oxygen therapy constitutes a crucial element of post-cardiac
operative care. The study assessed the effectiveness of high-flow nasal
cannula (HFNC) in comparison to conventional oxygen therapy (COT).
<br/>Objective(s): The aim of the study was to assess the effectiveness of
HFNC in comparison to COT for adult patients following cardiac surgery.
<br/>Method(s): We conducted a comprehensive search of Embase, PubMed,
Scopus, Cochrane Library, and Web of Science databases from inception
until April 18, 2023, to identify randomized controlled trials (RCTs) and
crossover studies that compared the efficacy of HFNC with COT in adult
patients following cardiac surgery. <br/>Result(s): The meta-analysis
included nine studies, consisting of eight RCTs and one crossover study.
Compared with COT, HFNC could reduce the need for escalation of
respiratory support (RR 0.67, 95% CI: 0.48 to 0.93, P = 0.02), decrease
arterial partial pressure of carbon dioxide (PaCO<inf>2</inf>) levels (MD
-3.14, 95% CI: -4.90 to -1.39, P<0.001), and increase forced expiratory
volume in 1 second (FEV<inf>1</inf>) levels (MD 0.08, 95% CI: 0.02 to
0.15, P = 0.02). There was no significant difference between the HFNC and
COT groups in terms of mortality, intubation rate, respiratory rate, heart
rate, intensive care unit and hospital length of stay, arterial partial
pressure of oxygen (PaO<inf>2</inf>), forced vital capacity, and
complications of atrial fibrillation and delirium. <br/>Conclusion(s):
Compared with COT, HFNC could decrease the need for escalation of
respiratory support, lower PaCO<inf>2</inf> levels, and elevate
FEV<inf>1</inf> levels in patients following cardiac
surgery.<br/>Copyright &#xa9; 2024

<66>
Accession Number
2031432451
Title
Safety of Biologic and Small Molecule Therapy for Inflammatory Bowel
Disease Among Solid Organ Transplant Recipients: Systematic Review and
Meta-Analysis.
Source
Inflammatory Bowel Diseases. 30(4) (pp 585-593), 2024. Date of
Publication: 01 Apr 2024.
Author
Taneja V.; Anand R.S.; El-Dallal M.; Dong J.; Desai N.; Taneja I.;
Feuerstein J.D.
Institution
(Taneja, Anand, El-Dallal, Dong, Desai, Feuerstein) The Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(El-Dallal) Cambridge Health Alliance, Harvard Medical School, Boston, MA,
United States
(Taneja) Massachusetts General Hospital for Children, Harvard Medical
School, Boston, MA, United States
Publisher
Oxford University Press
Abstract
Background: Patients undergoing organ transplantation are often on
immunosuppressing medications to prevent rejection of the transplant. The
data on use of concomitant immunosuppression for inflammatory bowel
disease (IBD) and organ transplant management are limited. This study
sought to evaluate the safety of biologic and small molecule therapy for
the treatment of IBD among solid organ transplant recipients.
<br/>Method(s): Medline, Embase, and Web of Science databases were
systematically searched for studies reporting on safety outcomes
associated with the use of biologic and small molecule therapy
(infliximab, adalimumab, certolizumab, golimumab, vedolizumab,
ustekinumab, and tofacitinib) in patients with IBD postsolid organ
transplant (eg, liver, kidney, heart, lung, pancreas). The primary outcome
was infectious complications. Secondary outcomes included serious
infections, colectomy, and discontinuation of biologic therapy.
<br/>Result(s): Seven hundred ninety-seven articles were identified for
screening, yielding 16 articles for the meta-analyses with information on
163 patients. Antitumor necrosis factor alpha (Anti-TNFs; infliximab and
adalimumab) were used in 8 studies, vedolizumab in 6 studies, and a
combination of ustekinumab or vedolizumab and anti-TNFs in 2 studies. Two
studies reported outcomes after kidney and cardiac transplant
respectively, whereas the rest of the studies included patients with liver
transplants. The rates of all infections and serious infections were 20.09
per 100 person-years (100-PY; 95% CI, 12.23-32.99 per 100-PY,
I² = 54%) and 17.39 per 100-PY (95% CI, 11.73-25.78 per 100-PY,
I² = 21%), respectively. The rates of colectomy and biologic
medication discontinuation were 12.62 per 100-PY (95% CI, 6.34-25.11 per
100-PY, I² = 34%) and 19.68 per 100-PY (95% CI, 9.97-38.84 per
100-PY, I² = 74%), respectively. No cases of venous
thromboembolism or death attributable to biologic use were reported.
<br/>Conclusion(s): Biologic therapy is overall well tolerated in patients
with solid organ transplant. Long-term studies are needed to better define
the role of specific agents in this patient population.<br/>Copyright
&#xa9; The Author(s) 2023. Published by Oxford University Press on behalf
of Crohn's & Colitis Foundation. All rights reserved.

<67>
Accession Number
2031392786
Title
Device innovation in cardiovascular medicine: a report from the European
Society of Cardiology Cardiovascular Round Table.
Source
European Heart Journal. 45(13) (pp 1104-1115), 2024. Date of Publication:
01 Apr 2024.
Author
Windecker S.; Gilard M.; Achenbach S.; Cribier A.; Delgado V.; Deych N.;
Drossart I.; Eltchaninoff H.; Fraser A.G.; Goncalves A.; Hindricks G.;
Holborow R.; Kappetein A.P.; Kilmartin J.; Kurucova J.; Luscher T.F.;
Mehran R.; O'Connor D.B.; Perkins M.; Samset E.; von Bardeleben R.S.;
Weidinger F.
Institution
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Freiburgstrasse, Bern CH-3010,
Switzerland
(Gilard) Departement de Cardiologie, Hospital La Cavale Blanche, La Cavale
Blanche Hospital Boulevard, Tanguy Prigent, Brest 29200, France
(Achenbach) Department of Cardiology, Friedrich-Alexander-Universitat
Erlangen-Nurnberg (FAU), Erlangen-Nurnberg, Germany
(Cribier) Department of Cardiology, Inserm U1096, Univ Rouen Normandie,
Rouen F-76000, France
(Delgado) Department of Cardiology, University Hospital Germans Trias i
Pujol, Badalona, Spain
(Deych) Regulatory Affairs, Edwards Lifesciences, Nyon, Switzerland
(Drossart) ESC Patient Forum, Sophia Antipolis, France
(Eltchaninoff) Department of Cardiology, University Hospital Charles
Nicolle, Rouen, France
(Fraser) Department of Cardiology, University Hospital of Wales, Cardiff,
United Kingdom
(Goncalves) Precision Diagnostics, Philips, Cambridge, MA, United States
(Goncalves) Department of Surgery and Physiology, Faculty of Medicine,
University of Porto Medical School, Porto, Portugal
(Hindricks) Department of Cardiology, German Heart Center Charite, Berlin,
Germany
(Holborow) Global Compliance, British Standards Institute, Whitchurch,
United Kingdom
(Kappetein) Medtronic Bakken Research Center, Maastricht, Netherlands
(Kilmartin) Regulatory Affairs, Medtronic, Galway, Ireland
(Kurucova) Transcatheter Heart Valve Division, Edwards Lifesciences, Nyon,
Switzerland
(Luscher) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Imperial College, King's College, London, United Kingdom
(Luscher) Center for Molecular Cardiology, University of Zurich, Zurich,
Switzerland
(Mehran) Icahn School of Medicine, Mount Sinai Hospital, New York, NY,
United States
(O'Connor) Health Products Regulatory Authority (HPRA), Dublin, Ireland
(Perkins) GE Healthcare Cardiology Solutions, Harrogate, United Kingdom
(Samset) GE Healthcare Cardiology Solutions, Oslo, Norway
(Samset) Department of Informatics, University of Oslo, Oslo, Norway
(von Bardeleben) Department of Cardiology, Heart Valve Center, University
Medical Center, Mainz, Germany
(Weidinger) Medical Department with Cardiology and Intensive Care
Medicine, Klinik Landstrasse, Vienna, Austria
Publisher
Oxford University Press
Abstract
Research performed in Europe has driven cardiovascular device innovation.
This includes, but is not limited to, percutaneous coronary intervention,
cardiac imaging, transcatheter heart valve implantation, and device
therapy of cardiac arrhythmias and heart failure. An important part of
future medical progress involves the evolution of medical technology and
the ongoing development of artificial intelligence and machine learning.
There is a need to foster an environment conducive to medical technology
development and validation so that Europe can continue to play a major
role in device innovation while providing high standards of safety. This
paper summarizes viewpoints on the topic of device innovation in
cardiovascular medicine at the European Society of Cardiology
Cardiovascular Round Table, a strategic forum for high-level dialogue to
discuss issues related to the future of cardiovascular health in Europe.
Devices are developed and improved through an iterative process throughout
their lifecycle. Early feasibility studies demonstrate proof of concept
and help to optimize the design of a device. If successful, this should
ideally be followed by randomized clinical trials comparing novel devices
vs. accepted standards of care when available and the collection of
post-market real-world evidence through registries. Unfortunately,
standardized procedures for feasibility studies across various device
categories have not yet been implemented in Europe. Cardiovascular imaging
can be used to diagnose and characterize patients for interventions to
improve procedural results and to monitor devices long term after
implantation. Randomized clinical trials often use cardiac imaging-based
inclusion criteria, while less frequently trials randomize patients to
compare the diagnostic or prognostic value of different modalities.
Applications using machine learning are increasingly important, but
specific regulatory standards and pathways remain in development in both
Europe and the USA. Standards are also needed for smart devices and
digital technologies that support device-driven biomonitoring. Changes in
device regulation introduced by the European Union aim to improve clinical
evidence, transparency, and safety, but they may impact the speed of
innovation, access, and availability. Device development programmes
including dialogue on unmet needs and advice on study designs must be
driven by a community of physicians, trialists, patients, regulators,
payers, and industry to ensure that patients have access to innovative
care.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<68>
Accession Number
2031392767
Title
Discontinuation vs. continuation of renin-angiotensin system inhibition
before non-cardiac surgery: the SPACE trial.
Source
European Heart Journal. 45(13) (pp 1146-1155), 2024. Date of Publication:
01 Apr 2024.
Author
Ackland G.L.; Patel A.; Abbott T.E.F.; Begum S.; Dias P.; Crane D.R.;
Somanath S.; Middleditch A.; Cleland S.; del Arroyo A.G.; Brealey D.;
Pearse R.M.
Institution
(Ackland, Patel, Abbott, Begum, Dias, Crane, del Arroyo, Pearse)
Translational Medicine and Therapeutics, William Harvey Research
Institute, Queen Mary University of London, Charterhouse Square, London
EC1M 6BQ, United Kingdom
(Somanath) County Durham and Darlington NHS Foundation Trust, Darlington,
United Kingdom
(Middleditch) University Hospitals Bristol NHS Foundation Trust, United
Kingdom
(Cleland) University Hospitals Plymouth NHS Trust, United Kingdom
(Brealey) Bloomsbury Institute of Intensive Care Medicine, University
College London, London, United Kingdom
(Brealey) UCL Hospitals NHS Foundation Trust, London, United Kingdom
(Brealey) NIHR University College London Hospitals Biomedical Research
Centre, London, United Kingdom
Publisher
Oxford University Press
Abstract
Background and Haemodynamic instability is associated with peri-operative
myocardial injury, particularly in patients receiving renin-angioAims
tensin system (RAS) inhibitors (angiotensin-converting-enzyme
inhibitors/angiotensin II receptor blockers). Whether stopping RAS
inhibitors to minimise hypotension, or continuing RAS inhibitors to avoid
hypertension, reduces peri-operative myocardial injury remains unclear. .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . Methods From 31 July 2017 to 1 October 2021, patients aged >=60
years undergoing elective non-cardiac surgery were randomly assigned to
either discontinue or continue RAS inhibitors prescribed for existing
medical conditions in six UK centres. Renin-angiotensin system inhibitors
were withheld for different durations (2-3 days) before surgery, according
to their pharmacokinetic profile. The primary outcome, masked to
investigators, clinicians, and patients, was myocardial injury [plasma
high-sensitivity troponin-T (hs-TnT) >= 15 ng/L within 48 h after surgery,
or >=5 ng/L increase when pre-operative hs-TnT >=15 ng/L]. Pre-specified
adverse haemodynamic events occurring within 48 h of surgery included
acute hypertension (>180 mmHg) and hypotension requiring vasoactive
therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . Results Two hundred and sixty-two participants were
randomized to continue (n = 132) or stop (n = 130) RAS inhibitors.
Myocardial injury occurred in 58 (48.3%) patients randomized to
discontinue, compared with 50 (41.3%) patients who continued, RAS
inhibitors [odds ratio (for continuing): 0.77; 95% confidence interval
(CI) 0.45-1.31]. Hypertensive adverse events were more frequent when RAS
inhibitors were stopped [16 (12.4%)], compared with 7 (5.3%) who continued
RAS inhibitors [odds ratio (for continuing): 0.4; 95% CI 0.16-1.00].
Hypotension rates were similar when RAS inhibitors were stopped [12
(9.3%)] or continued [11 (8.4%)]. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . Conclusions Discontinuing RAS
inhibitors before non-cardiac surgery did not reduce myocardial injury,
and could increase the risk of clinically significant acute hypertension.
These findings require confirmation in future studies. Structured
Graphical Abstract Key Question Does discontinuing renin-angiotensin II
system inhibitors (RAS inhibitors) before elective non-cardiac surgery
reduce myocardial injury? Key Finding In a randomized controlled trial
enrolling 260 patients preoperative BP was higher when RAS inhibitors were
stopped. A total of 48% patients sustained myocardial injury after
stopping RAS inhibitors, compared with 41% patients who continued therapy.
Hypertensive adverse events were more frequent when RAS inhibitors were
stopped, without affecting hypotension rates. Take Home Message
Discontinuing RAS inhibitors before non-cardiac surgery does not reduce
myocardial injury, and may increase the risk of clinically significant
acute hypertension. Pre-op Surgery Post-op STOP Primary 24h 48h Adverse
outcome events 48% 9% 12% ACE-I and/or Randomize ARB Low High Troponin 41%
8% 5% 24h 48h Pre-op Surgery Post-op CONTINUE In a randomized controlled
trial enrolling 260 patients, did stopping renin-angiotensin system (RAS)
inhibitors [angiotensin-converting-enzyme inhibitors (ACE-I)/angiotensin
II receptor blockers (ARB)] before elective non-cardiac surgery reduce
myocardial injury, taking into account the pharmacokinetic profile of
individual RAS inhibitors? Pre-operative blood pressure was higher when
RAS inhibitors were stopped. Forty-eight per cent of patients sustained
myocardial injury after stopping RAS inhibitors, compared with 41% of
patients who continued therapy. Hypertensive adverse events were more
frequent when RAS inhibitors were stopped, without affecting hypotension
rates. Discontinuing RAS inhibitors before non-cardiac surgery does not
appear to reduce myocardial injury, and could increase the risk of
clinically significant acute hypertension.<br/>Copyright &#xa9; The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<69>
Accession Number
2031382608
Title
Transcatheter or surgical aortic valve implantation: 10-year outcomes of
the NOTION trial.
Source
European Heart Journal. 45(13) (pp 1116-1124), 2024. Date of Publication:
01 Apr 2024.
Author
Horsted Thyregod H.G.; Jorgensen T.H.; Ihlemann N.; Steinbruchel D.A.;
Nissen H.; Kjeldsen B.J.; Petursson P.; De Backer O.; Olsen P.S.;
Sondergaard L.
Institution
(Horsted Thyregod, Steinbruchel, Olsen) Department of Cardiothoracic
Surgery, The Heart Centre, Rigshospitalet, Copenhagen University Hospital,
Blegdamsvej 9, Copenhagen 2100, Denmark
(Jorgensen, De Backer, Sondergaard) Department of Cardiology, The Heart
Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9,
Copenhagen 2100, Denmark
(Ihlemann) Department of Cardiology, Bispebjerg University Hospital,
Bispebjerg Bakke 23, Copenhagen 2400, Denmark
(Nissen) Department of Cardiology, Odense University Hospital, J. B.
Winslows Vej 4, Odense 5000, Denmark
(Kjeldsen) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, J. B. Winslows Vej 4, Odense 5000, Denmark
(Petursson) Department of Cardiology, Sahlgrenska University Hospital, Bla
Straket 5, Gothenburg 413 45, Sweden
Publisher
Oxford University Press
Abstract
Background and Transcatheter aortic valve implantation (TAVI) has become a
viable treatment option for patients with severe aortic valve Aims
stenosis across a broad range of surgical risk. The Nordic Aortic Valve
Intervention (NOTION) trial was the first to randomize patients at lower
surgical risk to TAVI or surgical aortic valve replacement (SAVR). The aim
of the present study was to report clinical and bioprosthesis outcomes
after 10 years. Methods The NOTION trial randomized 280 patients to TAVI
with the self-expanding CoreValve (Medtronic Inc.) bioprosthesis (n = 145)
or SAVR with a bioprosthesis (n = 135). The primary composite outcome was
the risk of all-cause mortality, stroke, or myocardial infarction.
Bioprosthetic valve dysfunction (BVD) was classified as structural valve
deterioration (SVD), non-structural valve dysfunction (NSVD), clinical
valve thrombosis, or endocarditis according to Valve Academic Research
Consortium-3 criteria. Severe SVD was defined as (i) a transprosthetic
gradient of 30 mmHg or more and an increase in transprosthetic gradient of
20 mmHg or more or (ii) severe new intraprosthetic regurgitation.
Bioprosthetic valve failure (BVF) was defined as the composite rate of
death from a valve-related cause or an unexplained death following the
diagnosis of BVD, aortic valve re-intervention, or severe SVD. Results
Baseline characteristics were similar between TAVI and SAVR: age 79.2 +/-
4.9 years and 79.0 +/- 4.7 years (P = .7), male 52.6% and 53.8% (P = .8),
and Society of Thoracic Surgeons score < 4% of 83.4% and 80.0% (P = .5),
respectively. After 10 years, the risk of the composite outcome all-cause
mortality, stroke, or myocardial infarction was 65.5% after TAVI and 65.5%
after SAVR [hazard ratio (HR) 1.0; 95% confidence interval (CI) 0.7-1.3; P
= .9], with no difference for each individual outcome. Severe SVD had
occurred in 1.5% and 10.0% (HR 0.2; 95% CI 0.04-0.7; P = .02) after TAVI
and SAVR, respectively. The cumulative incidence for severe NSVD was 20.5%
and 43.0% (P < .001) and for endocarditis 7.2% and 7.4% (P = 1.0) after
TAVI and SAVR, respectively. No patients had clinical valve thrombosis.
Bioprosthetic valve failure occurred in 9.7% of TAVI and 13.8% of SAVR
patients (HR 0.7; 95% CI 0.4-1.5; P = .4). Conclusions In patients with
severe AS and lower surgical risk randomized to TAVI or SAVR, the risk of
major clinical outcomes was not different 10 years after treatment. The
risk of severe bioprosthesis SVD was lower after TAVR compared with SAVR,
while the risk of BVF was similar.<br/>Copyright &#xa9; 2024 Oxford
University Press. All rights reserved.

<70>
Accession Number
2031335514
Title
Effect of haemoadsorption during cardiac surgery for Staphylococcus aureus
endocarditis: a REMOVE trial post hoc analysis.
Source
European Journal of Cardio-thoracic Surgery. 65(3) (no pagination), 2024.
Article Number: ezae093. Date of Publication: 01 Mar 2024.
Author
Caldonazo T.; Van den Eynde J.; Doenst T.; Kirov H.; Franz M.; Hagel S.;
Lehmann T.; Diab M.
Institution
(Caldonazo, Doenst, Kirov, Diab) Department of Cardiothoracic Surgery,
Jena University Hospital, Jena, Germany
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Franz) Division of Cardiology, Department of Internal Medicine, Jena
University Hospital, Jena, Germany
(Hagel) Institute for Infectious Diseases and Infection Control, Jena
University Hospital, Germany
(Lehmann) Institute for Medical Statistics, Friedrich-Schiller-University
Jena, Jena, Germany
(Diab) Department of Cardiac Surgery, Herz- und Kreislaufzentrum,
Rotenburg an der Fulda, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Multi-organ failure is one of the leading causes of mortality
after cardiac surgery for infective endocarditis (IE). Although the
randomized evidence does not support the use of haemoadsorption during
cardiac surgery for IE, observational studies suggest a beneficial effect
in selected patient groups. Staphylococcus aureus is the most common
pathogen, and its presence is an independent mortality predictor. We aimed
to analyse the effect of haemoadsorption in patients with IE caused by S.
aureus. <br/>METHOD(S): This is a post hoc analysis of the REMOVE trial
that randomized 288 patients with IE who underwent cardiac surgery with
haemoadsorption using CytoSorb or control. The primary outcome
was DSequential Organ Failure Assessment (SOFA), defined as the difference
between the mean total postoperative and baseline SOFA score within 24 h
of surgery. <br/>RESULT(S): Among the total of 282 patients included in
the modified intention-to-treat analysis of the REMOVE trial, 73 (25.9%)
had S. aureus IE (38 patients in the haemoadsorption group and 35 patients
in the control group). The overall DSOFA did not differ between the
intervention groups in patients with S. aureus IE (mead difference 1/4
-0.4, 95% confidence interval -2.3 to 1.4, P 1/4 0.66) and neither did
30-day mortality (hazard ratios 1/4 1.32, 95% confidence interval
0.53-3.28, P 1/4 0.55). No differences were observed with regard to any of
the other secondary outcomes. <br/>CONCLUSION(S): Based on a post hoc
analysis from REMOVE trial, the intraoperative use of haemoadsorption in
patients with S. aureus IE was not associated with reduction of
postoperative organ dysfunction, 30-day mortality or other major clinical
end points.<br/>Copyright &#xa9; The Author(s) 2024.

<71>
Accession Number
2031506123
Title
Transcarotid versus transfemoral transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Munguti C.; Ndunda P.M.; Abukar A.; Jawad M.A.; Vindhyal M.R.; Fanari Z.
Institution
(Munguti) Department of Internal Medicine, University of Kansas School of
Medicine, Wichita, KS, United States
(Munguti, Vindhyal) Department of Internal Medicine, University of Kansas
School of Medicine, Kansas City, KS, United States
(Ndunda) Division of Cardiology, Louisiana State University in Shreveport,
Shreveport, LA, United States
(Abukar, Fanari) Department of Internal Medicine, University of California
San Francisco, San Francisco, CA, United States
(Jawad) Division of Cardiology, Saint Luke's Mid America Heart Institute,
Kansas City, KS, United States
(Fanari) Division of Cardiology, University of California San Francisco,
Fresno, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: In the 2021 Transcatheter Valve Therapy (TVT) registry, 8.9 %
of patients underwent TAVR via access sites other than the femoral artery.
Transthoracic approaches may be contraindicated in some patients and may
be associated with poorer outcomes. Therefore other alternative access
routes are increasingly being performed. We conducted a systematic review
of the literature on transcarotid transcatheter aortic valve replacement
(TC-TAVR) and meta-analysis comparing outcomes of TC-TAVR and other access
routes. <br/>Method(s): We comprehensively searched for controlled
randomized and non-randomized studies from 4 online databases. We
presented data using risk ratios (95 % confidence intervals) and measured
heterogeneity using Higgins' I². <br/>Result(s): Sixteen
observational studies on transcarotid TAVR were included in the analysis;
4 studies compared TC-TAVR vs TF-TAVR. The mean age and STS score for
patients undergoing TC-TAVR were 80 years and 7.6 respectively. For
TF-TAVR patients, mean age and STS score were 81.2 years and 6.5
respectively. There was no difference between patients undergoing TC-TAVR
and TF-TAVR in the following 30-day outcomes: MACE [8.4 % vs 6.7 %; OR
1.32 (95 % CI 0.71-2.46 p = 0.38) I² = 0 %], mortality [5.6 %
vs 4.0 %; OR 0.42 (95 % CI 0.60-3.37, P = 0.42) I² = 0 %] and
stroke [0.7 % vs 2.3 %; OR 0.49 (95 % CI 0.09-2.56, P = 0.40)
I² = 0 %]. There was no difference in 30-day major vascular
complications [0.7 % vs 3 %; OR 0.55 (95 % CI 0.06-5.29, P = 0.61)
I² = 39 %], major bleeding [0.7 % vs 3.8 %; OR 0.39 (95 % CI
0.09-1.67, P = 0.21) I² = 0 %], and moderate or severe aortic
valve regurgitation [8.6 % vs 9.9 %; OR 0.89 (95 % CI 0.48-1.65, P = 0.72)
I² = 0 %]. <br/>Conclusion(s): There are no significant
differences in mortality, stroke MACE and major or life-threatening
bleeding or vascular complications when TC-TAVR is compared to TF-TAVR
approaches.<br/>Copyright &#xa9; 2024 The Authors

<72>
Accession Number
2031490850
Title
The use of extracorporeal photopheresis in solid organ
transplantation-current status and future directions.
Source
American Journal of Transplantation. (no pagination), 2024. Date of
Publication: 2024.
Author
Barten M.J.; Fisher A.J.; Hertig A.
Institution
(Barten) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Fisher) Transplant and Regnerative Medicine Group, Translational and
Clinical Research Institute, Newcastle University, Newcastle upon Tyne,
United Kingdom
(Hertig) Department of Nephrology, University Versailles Saint Quentin,
Foch Hospital, Suresnes, France
Publisher
Elsevier B.V.
Abstract
Prevention and management of allograft rejection urgently require more
effective therapeutic solutions. Current immunosuppressive therapies used
in solid organ transplantation, while effective in reducing the risk of
acute rejection, are associated with substantial adverse effects. There
is, therefore, a need for agents that can provide immunomodulation,
supporting graft tolerance, while minimizing the need for
immunosuppression. Extracorporeal photopheresis (ECP) is an
immunomodulatory therapy currently recommended in international guidelines
as an adjunctive treatment for the prevention and management of organ
rejection in heart and lung transplantations. This article reviews
clinical experience and ongoing research with ECP for organ rejection in
heart and lung transplantations, as well as emerging findings in kidney
and liver transplantation. ECP, due to its immunomodulatory and
immunosuppressive-sparing effects, offers a potential therapeutic option
in these settings, particularly in high-risk patients with comorbidities,
infectious complications, or malignancies.<br/>Copyright &#xa9; 2024 The
Authors

<73>
Accession Number
2029281348
Title
L-carnitine decreases myocardial injury in children undergoing open-heart
surgery: A randomized controlled trial.
Source
European Journal of Pediatrics. (no pagination), 2024. Date of
Publication: 2024.
Author
El Feky W.; El-Afify D.; Abdelhai D.; Elkashlan M.; Fakhreldin A.; El
Amrousy D.
Institution
(El Feky) Cardiothoracic Surgery Department, Faculty of Medicine, Kafr
Elsheikh University, Kafr Elsheikh, Egypt
(El-Afify) Clinical Pharmacy Department, Faculty of Pharmacy, Tanta
University, Tanta, Egypt
(Abdelhai) Clinical Pathology Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Elkashlan) Anesthesia Department, Elmenshawy Hospital, Ministry of
Health, Tanta, Egypt
(Fakhreldin) Pediatric Department, Faculty of Medicine, Aswan University,
Aswan, Egypt
(El Amrousy) Pediatric Department, Faculty of Medicine, Tanta University,
Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Abstract: Myocardial injury in open-heart surgery is related to several
factors including ischemia-reperfusion injury, generation of reactive
oxygen species, increased production of inflammatory mediators, and
enhancement of apoptosis of cardiomyocytes. The aim of this study was to
study the effect of L-carnitine on myocardial injury in children
undergoing open-heart surgery. This clinical trial was performed on 60
children with congenital heart disease (CHD) who underwent open-heart
surgery. They were randomized into two groups: L-carnitine group who
received L-carnitine 50 mg\kg\day once daily for 1 month before cardiac
surgery and control group who received placebo for 1 month before cardiac
surgery. Left ventricular cardiac function was assessed by conventional
echocardiography to measure left ventricular ejection fraction (LVEF) and
two-dimensional speckle tracking echocardiography (2D-STE) to determine
left ventricular global longitudinal strain (2D-LV GLS). Blood samples
were obtained pre-operatively at baseline before the administration of
L-carnitine or placebo and 12 h post-operatively to measure the level of
malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3,
creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had
significantly lower post-operative level of oxidative stress marker (MDA),
apoptosis markers (fas and caspase-3), and myocardial injury markers
(CK-MB and troponin I), but they had significantly higher SOD
post-operative level compared to the control group. In addition,
post-operative LVEF and 2D-LVGLS were significantly lower in the control
group compared to L-carnitine group. <br/>Conclusion(s): L-carnitine can
reduce myocardial injury, improve post-operative left ventricular cardiac
function, and may provide myocardium protection in children with CHD who
underwent open-heart surgery. Trial registration: The clinical trial was
registered at www.pactr.org with registration number PACTR202010570607420
at 29/10/2020 before recruiting the patients. (Table
presented.)<br/>Copyright &#xa9; The Author(s) 2024.

<74>
Accession Number
2029247727
Title
Postoperative Acute Kidney Injury After Transcatheter Aortic Valve
Replacement.
Source
Current Anesthesiology Reports. (no pagination), 2024. Date of
Publication: 2024.
Author
Ayala S.; Ma Z.; Peng K.; Ji F.; Li D.
Institution
(Ayala, Li) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
(Ma, Peng, Ji) The First Affiliated Hospital of Soochow University,
Suzhou, China
Publisher
Springer
Abstract
Purpose of Review: The purpose of this review serves to briefly summarize
the current literature surveying the incidence of posttranscatheter aortic
valve replacement acute kidney injury (TAVR AKI). Furthermore, this review
extends itself to evaluate and potentially address modifiable risk
factors, while acknowledging non-modifiable risk factors in the
perioperative setting. These modifiable risk factors include but are not
limited to access method, perioperative hypotension events, and need for
blood transfusion in the setting of preoperative anemia. Recent Findings:
Recent retrospective studies have highlighted the incidence of post-TAVR
AKI, citing as high as 1 in 6 patients. Despite exclusion of patients with
end-stage renal disease (ESRD) from pivotal TAVR trials, data shows that
over 50% of high-risk patients suffer > 3a chronic kidney disease (CKD)
and about 10% of them suffer > 4 CKD, with the risk of AKI increasing
significantly at each stage of CKD advancement. Meta-analyses have shown
that patients who underwent TAVR via transfemoral (TF) approach compared
to those who had transapical (TA) or transaortic (TaO) approach had
significantly less AKI post-TAVR. Furthermore, in patients who developed
post-TAVR AKI, 55% of them had received packed red blood cell (pRBC)
transfusion, while only 21% of the patients who did not receive pRBCs
develop post-TAVR AKI (p =.002). Post-TAVR AKI has been shown in multiple
studies that it is an independent risk factor for increased short term and
long-term mortality. These findings together highlight both the clinical
significance and continued perioperative vigilance to further improve
clinical outcomes. <br/>Summary: This review aims to summarize recent
literature regarding the association of AKI in the perioperative setting
of TAVR. In addition, it parses the risk factors into both modifiable and
non-modifiable risk factors. Furthermore, it provides some recommendations
including procedure approach, appreciating transfusion implication, and
most importantly, preventing hypotension events in the perioperative
period.<br/>Copyright &#xa9; The Author(s) 2024.

<75>
Accession Number
643879104
Title
A Bayesian meta-analysis of double kissing (DK) crush or provisional
stenting for coronary artery bifurcation lesions.
Source
Indian heart journal. (no pagination), 2024. Date of Publication: 25 Mar
2024.
Author
Kumar A.; Shariff M.; Singal A.; Bhat V.; Stulak J.; Reed G.; Kalra A.
Institution
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, USA; Department of Cardiovascular Medicine, Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
(Shariff, Stulak) Department of General Surgery, Mayo Clinic, Rochester,
MN, USA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
USA
(Singal) Department of Cardiology, Aakash Healthcare, New Delhi, India
(Bhat) Department of Medicine, St. John's Medical College, Bangalore,
India
(Reed) Department of Cardiovascular Medicine, Heart, Vascular and Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
(Kalra) Department of Cardiology, Franciscan Health, Lafayette, IN, United
States
Abstract
OBJECTIVE: Despite the development of dedicated, two-stent strategies,
including the double kissing (DK) crush technique, the ideal technique for
coronary artery bifurcation stenting has not been identified. We aimed to
compare and determine the absolute risk difference (ARD) of the DK crush
technique alone versus provisional stenting approaches for coronary
bifurcation lesions, using the Bayesian technique. <br/>METHOD(S): We
queried PubMed/MEDLINE to identify randomized controlled trials (RCTs)
that compared DK crush technique with provisional stenting for bifurcation
lesions, published till January 2023. We used Bayesian methods to
calculate the ARD and 95% credible interval (CrI). <br/>RESULT(S): We
included three RCTs, with 916 patients, in the final analysis. The ARD of
cardiac death was centered at -0.01 (95% CrI: -0.04 to 0.02; Tau: 0.02,
85% probability of ARD of DK crush vs. provisional stenting <0). ARD for
myocardial infarction was centered at -0.03 (95%CrI: -0.9 to 0.03; Tau:
0.05, 87% probability of ARD of DK crush vs. provisional stenting <0). ARD
for stent thrombosis was centered at 0.00 (95% CrI: -0.04 to 0.03, Tau:
0.03, 51% probability of ARD for DK crush vs. provisional stenting <0).
Finally, ARD for target lesion revascularization was centered at -0.05
(95% CrI: -0.08 to -0.03, Tau: 0.02, 99.97% probability of ARD for DK
crush vs. provisional stenting <0). <br/>CONCLUSION(S): Bayesian analysis
demonstrated a lower probability of cardiac death, myocardial infarction
and target lesion revascularization, with DK crush compared with
provisional stenting techniques, and a minimal probability of difference
in stent thrombosis.<br/>Copyright &#xa9; 2024. Published by Elsevier, a
division of RELX India, Pvt. Ltd.

<76>
Accession Number
643878697
Title
Decision analysis in cardiac surgery: a scoping review and methodological
primer.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 27 Mar 2024.
Author
Vervoort D.; Lee G.S.; Lia H.; Afzal A.M.; Tam D.Y.; Ouzounian M.;
Takkenberg J.J.M.; Wijeysundera H.C.; Fremes S.E.
Institution
(Vervoort, Tam, Wijeysundera, Fremes) Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Vervoort, Tam, Ouzounian, Fremes) Division of Cardiac Surgery, University
of Toronto, Toronto, ON, Canada
(Lee, Lia, Fremes) Temerty Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Afzal) Schulich School of Medicine & Dentistry, University of Western
Ontario, London, ON, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, Toronto, ON, Canada
(Takkenberg) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Wijeysundera, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
Abstract
OBJECTIVES: Randomized controlled trials are the gold standard for
evidence generation in medicine but are limited by their real-world
generalizability, resource needs, shorter follow-up durations, and
inability to be conducted for all clinical questions. Decision analysis
models may simulate trials and observational studies by using existing
data and evidence- and expert-informed assumptions, and extend analyses
over longer time horizons, different study populations, and specific
scenarios, helping to translate population outcomes to patient-specific
clinical and economic outcomes. Here, we present a scoping review and
methodological primer on decision analysis for cardiac surgery research.
<br/>METHOD(S): A scoping review was performed using the PubMed/MEDLINE,
EMBASE, and Web of Science databases for cardiac surgery decision analysis
studies published until December 2021. Articles were summarized
descriptively to quantify trends and ascertain methodological consistency.
<br/>RESULT(S): 184 articles were identified, among which Markov models
(N=92, 50.0%) were the most commonly used models. The most common outcomes
were costs (N=107, 58.2%), quality-adjusted life-years (N=96, 52.2%), and
incremental cost-effectiveness ratios (N=89, 48.4%). Most (N=165, 89.7%)
articles applied sensitivity analyses, most frequently in the form of
deterministic sensitivity analyses (N=128, 69.6%). Reporting of guidelines
to inform the model development and/or reporting was present in 22.3% of
articles. <br/>CONCLUSION(S): Decision analysis methods are increasing but
remain limited and highly variable in cardiac surgery. A methodological
primer is presented and may provide researchers with the foundation to
start with or improve decision analysis, as well as provide readers and
reviewers with the fundamental concepts to review decision analysis
studies.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<77>
Accession Number
2031057773
Title
Mitral Transcatheter Edge-to-Edge Repair in Patients With Atrial
Functional Mitral Regurgitation.
Source
Journal of the American College of Cardiology. 83(13) (pp 1253-1255),
2024. Date of Publication: 02 Apr 2024.
Author
Moras E.; Gandhi K.; Koshy A.N.; Bhatia K.; Krittanawong C.; Dominguez
A.C.; Argulian E.; Stone G.W.
Institution
(Moras, Gandhi) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Koshy) Royal Melbourne Hospital, University of Melbourne, Melbourne,
Australia
(Bhatia, Dominguez, Argulian) Mount Sinai Heart, Mount Sinai Morningside
Hospital, New York, NY, United States
(Krittanawong) NYU Langone Health and NYU School of Medicine, New York,
NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.

<78>
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.

<79>
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.

<80>
Accession Number
2029137386
Title
Triiodothyronine Supplementation for Children Undergoing Cardiopulmonary
Bypass: A Meta-Analysis.
Source
Pediatric Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Radman M.R.; Slee A.E.; Marwali E.M.; Portman M.A.
Institution
(Radman) Division of Cardiac Critical Care, Department of Pediatrics,
Seattle Children's Hospital, University of Washington, 4800 Sand Point Way
NE, RC.2.820, Seattle, WA 98105, United States
(Slee) New Arch Consulting, Issaquah, WA, United States
(Marwali) Division of Pediatric Cardiac Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Portman) Division of Cardiology, Department of Pediatrics, Seattle
Children's Hospital, University of Washington, Seattle, WA, United States
Publisher
Springer
Abstract
Specific pediatric populations have exhibited disparate responses to
triiodothyronine (T3) repletion during and after cardiopulmonary bypass
(CPB). <br/>Objective(s): To determine if T3 supplementation improves
outcomes in children undergoing CPB. We searched randomized controlled
trials (RCT) evaluating T3 supplementation in children aged 0-3 years
undergoing CPB between 1/1/2000 and 1/31/2022. We calculated Hazard ratios
(HR) for time to extubation (TTE), ICU length of stay (LOS), and hospital
LOS. 5 RCTs met inclusion criteria with available patient-level data. Two
were performed in United States (US) and 3 in Indonesia with 767 total
subjects (range 29- 220). Median (IQR) age 4.1 (1.6, 8.0) months; female
43%; RACHS-1 scores: 1-1%; 2-55%; 3-27%; 4-13%; 5-0.1%; 6-3.9%; 54% of
subjects in US vs 46% in Indonesia. Baseline TSH and T3 were lower in
Indonesia (p < 0.001). No significant difference occurred in TTE between
treatment groups overall [HR 1.09 (CI, 0.94-1.26)]. TTE numerically
favored T3-treated patients aged 1-5 months [HR 1.24 (CI, 0.97-1.60)]. TTE
HR for the Indonesian T3 group was 1.31 (CI, 1.04-1.65) vs. 0.95 (CI,
0.78-1.15) in US. The ICU LOS HR for the Indonesian T3 group was 1.19 vs.
0.89 in US (p = 0.046). There was a significant T3 effect on hospital LOS
[HR 1.30 (CI, 1.01-1.67)] in Indonesia but not in US [HR 0.99 (CI,
0.78-1.23)]. T3 supplementation in children undergoing CPB is simple,
inexpensive, and safe, showing benefit in resource-limited settings.
Differences in effects between settings likely relate to depression in
baseline thyroid function often associated with
malnutrition.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2024.

<81>
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.

<82>
Accession Number
643875479
Title
Cabrol procedure and its modifications: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 153), 2024. Date of
Publication: 26 Mar 2024.
Author
Yang S.; Zhang Y.-Y.; Zi Y.-F.; Pu L.; Qian X.; Ren L.; Li Y.-B.; Jin
Z.-H.; Liu J.-F.; Yuan Z.; Li Y.-X.
Institution
(Yang, Zhang, Zi, Pu, Qian, Ren, Li, Jin, Liu, Yuan) Department of
Cardiovascular Surgery, Yan'an Affiliated Hospital of Kunming Medical
University, Kunming, Yunnan, China
(Zhang, Zi, Pu, Qian, Ren, Li, Liu) Key Laboratory of Cardiovascular
Disease of Yunnan Province, Yan'an Affiliated Hospital of Kunming Medical
University, Kunming, Yunnan, China
(Li) Department of Cardiovascular Surgery, Yan'an Affiliated Hospital of
Kunming Medical University, Kunming, Yunnan, China
(Li) Key Laboratory of Cardiovascular Disease of Yunnan Province, Yan'an
Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
Abstract
BACKGROUND: The Cabrol procedure has undergone various modifications and
developments since its invention. However, there is a notable gap in the
literature regarding meta-analyses assessing it. <br/>METHOD(S): A
systematic review and meta-analysis was conducted to evaluate the
effectiveness and long-term outcomes of the Cabrol procedure and its
modifications. Pooling was conducted using random effects model. Outcome
events were reported as linearized occurrence rates (percentage per
patient-year) with 95% confidence intervals. <br/>RESULT(S): A total of 14
studies involving 833 patients (mean age: 50.8 years; 68.0% male) were
included in this meta-analysis. The pooled all-cause early mortality was
9.0% (66 patients), and the combined rate of reoperation due to bleeding
was 4.9% (17 patients). During the average 4.4-year follow-up (3,727.3
patient-years), the annual occurrence rates (linearized) for complications
were as follows: 3.63% (2.79-4.73) for late mortality, 0.64% (0.35-1.16)
for aortic root reoperation, 0.57% (0.25-1.31) for hemorrhage events,
0.66% (0.16-2.74) for thromboembolism, 0.60% (0.29-1.26) for endocarditis,
2.32% (1.04-5.16) for major valve-related adverse events, and 0.58%
(0.34-1.00) for Cabrol-related coronary graft complications.
<br/>CONCLUSION(S): This systematic review provides evidence that the
outcomes of the Cabrol procedure and its modifications are acceptable in
terms of mortality, reoperation, anticoagulation, and valve-related
complications, especially in Cabrol-related coronary graft complications.
Notably, the majority of Cabrol procedures were performed in reoperations
and complex cases. Furthermore, the design and anastomosis of the Dacron
interposition graft for coronary reimplantation, considering natural
anatomy and physiological hemodynamics, may promise future advancements in
this field.<br/>Copyright &#xa9; 2024. The Author(s).

<83>
Accession Number
643863520
Title
Outcomes of patients with suspected heparin-induced thrombocytopenia in a
contemporary cohort of patients.
Source
Swiss Medical Weekly. Conference: Swiss Oncology and Hematology Congress,
SOHC 2023. Basel Switzerland. 153(Supplement 274) (pp 32S), 2023. Date of
Publication: 2023.
Author
Nilius H.; Sinitsa E.; Studt J.D.; Tsakiris D.A.; Greinacher A.; Mendez
A.; Schmidt A.; Wuillemin W.A.; Gerber B.; Kremer Hovinga J.A.; Vishnu P.;
Graf L.; Bakchoul T.; Nagler M.
Institution
(Nilius, Sinitsa, Nagler) Department of Clinical Chemistry, University
Hospital of Bern, Bern, Switzerland
(Nilius) Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
(Studt) Divison of Medical Oncology and Hematology, University Hospital
Zurich, Zurich, Switzerland
(Tsakiris) Diagnostic Haematology, University Hospital Basel, Basel,
Switzerland
(Greinacher) Department of Immunology and Transfusion medicine, University
Hospital Greifswald, Greifswald, Germany
(Mendez) Department of Laboratory Medicine, Cantonal Hospital Aarau,
Aarau, Switzerland
(Schmidt) Clinic of Medical Oncology and Hematology, Triemli City
Hospital, Zurich, Switzerland
(Wuillemin) Division of Hematology and Central Hematology Laboratory,
Cantonal Hospital Lucerne, Lucerne, Switzerland
(Gerber) Clinic of Hematology, Oncology Institute of Southern Switzerland,
Bellinzona, Switzerland
(Kremer Hovinga) Department of Hematology and Central Hematology
Laboratory, University Hospital of Bern, Bern, Switzerland
(Vishnu) Division of Hematology, CHI Franciscan Medical Group, Seattle,
United States
(Graf) Department of Hematology, Cantonal Hospital St. Gallen, St. Gallen,
Switzerland
(Bakchoul) Centre for Clinical Transfusion Medicine, University Hospital
Tubingen, Tubingen, Germany
(Nagler) Medical Faculty, University of Bern, Bern, Switzerland
Publisher
SMW supporting association
Abstract
Introduction: Managing patients with suspected heparin-induced
thrombocytopenia (HIT) remains a major clinical challenge. Knowledge of
the effects of management decisions on clinical outcomes is sparse and
treatment recommendations are often based on low certainty. In a
prospective multicenter cohort study, we studied the treatment and
outcomes of patients with suspected HIT. <br/>Method(s): We included
consecutive patients with suspected HIT and report the outcomes of (a)
patients with HIT, (b) patients without HIT but positive heparin/PF4
antibodies, and (c) patients without HIT. Comprehensive clinical and
laboratory data were collected in detail and the washed-platelet
heparininduced platelet activation test (HIPA) served as the reference
standard test defining HIT. <br/>Result(s): Among 1393 patients included
in 11 study centers (46% female, median age of 67), HIT was confirmed in
119 patients (prevalence 8.5%). The setting was intensive care unit (37%)
and cardiac surgery (32%) in the majority of patients. The predominant
treatment was argatroban (70%), and complete platelet recovery was
observed in 77% of HIT patients. Of the patients with HIT, 23% developed
subsequent venous thromboembolism (TE), 9% arterial TE, and 18% died.
Major bleeding occurred in 13% of HIT patients and did not differ
significantly between drugs. Treatment with argatroban, bivalirudin or
DOAC markedly reduced the risk of subsequent arterial TE. HITnegative
patients with and without H/PF4 antibodies did not differ with regard to
any outcome. <br/>Conclusion(s): Our results indicate that HIT is still a
serious disease with a high risk of major adverse events. In the absence
of randomized controlled trials, our results add further evidence on the
effectiveness of DOAC, argatroban, and bivalirudin treatment. (Figure
Presented).

<84>
Accession Number
2031366556
Title
Cardiac Involvements of Fabry Disease.
Source
West Indian Medical Journal. 71(1) (pp 78-84), 2024. Date of Publication:
2024.
Author
MYuan S.
Institution
(MYuan) Department of Cardiothoracic Surgery, The First Hospital of
Putian, Teaching Hospital, Fujian Medical University, P.R., Putian, China
Publisher
University of the West Indies
Abstract
Fabry disease is a rare, inherited metabolic disorder caused by deficient
activity of a-galactosidase A, which leads to cellular and multiorgan
dysfunction due to progressive intracellular globotriaosylceramide
accumulation, extensive interstitialfibrosis and smooth muscle cell
proliferation, mostly due to accelerated cellular apoptosis and/or
necrosis. Cardiac involvements are frequent in Fabry disease. The patients
may develop hypertrophic cardiomyopathy, arrhythmias, conduction
abnormalities, valvular abnormalities and coronary heart disease. The
diagnosis of Fabry disease is challenging due to the protean
manifestations, which often lead to delayed diagnosis. Enzyme replacement
therapy with the administration - f agalsidases a and - may lead -o -he
-learance of globotriaosylceramides from -he cardiac capillaries and
therefore result in left ventricular structural and functional
improvements. Anticoagulant treatment is necessary for patients with Fabry
disease to prevent ischaemic events. Symptomatic bradycardia and heart
block frequently warrant pacemaker implantation and malignant arrhythmias
may require an implantable cardioverter-defibrillator. Surgical
interventions including valvular operation, myectomy and coronary artery
bypass or coronary angioplasty have been attempted in a limited number of
patients with Fabry disease alongside enzyme replacement therapy. The
early and mid-term follow-up results have been satisfactory. This article
presents a review of the pathogenesis, clinical features, diagnostic
approaches and treatment strategies of the heart involvements of Fabry
disease.<br/>Copyright &#xa9; 2024 University of the West Indies. All
rights reserved.

<85>
Accession Number
643874168
Title
The Evolving Concept of Secondary Mitral Regurgitation Phenotypes: Lessons
From the M-TEER Trials.
Source
JACC. Cardiovascular imaging. (no pagination), 2024. Date of Publication:
18 Mar 2024.
Author
Stolz L.; Doldi P.M.; Sannino A.; Hausleiter J.; Grayburn P.A.
Institution
(Stolz) Medizinische Klinik und Poliklinik I, Klinikum der Universitat
Munchen, Germany. https://twitter.com/stolz_l, Munich, Germany
(Doldi) Medizinische Klinik und Poliklinik I, Klinikum der Universitat
Munchen, Germany. https://twitter.com/DoldiP, Munich, Germany
(Sannino) Division of Cardiology, Department of Internal Medicine, Baylor
Scott and White The Heart Hospital, Plano, Texas, USA; Department of
Advanced Biomedical Sciences, Division of Cardiology, Federico II
University, Naples, Italy. Electronic address:
https://twitter.com/AnnaSannino1985
(Hausleiter) Medizinische Klinik und Poliklinik I, Klinikum der
Universitat Munchen, Munich, Germany; German Center for Cardiovascular
Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
Electronic address: https://twitter.com/j_hausleiter
(Grayburn) Division of Cardiology, Department of Internal Medicine, Baylor
Scott and White The Heart Hospital, Plano, TX, United States
Abstract
Conflicting results from 2 randomized clinical trials of transcatheter
mitral valve edge-to-edge repair in secondary mitral regurgitation (SMR)
have led to the recognition that SMR is a heterogeneous disease entity
presenting with different functional and morphological phenotypes. This
review summarizes the current knowledge on SMR caused primarily by atrial
secondary mitral regurgitation (aSMR) and ventricular SMR pathology.
Although aSMR is generally characterized by severe left atrial enlargement
in the setting of preserved left ventricular anatomy and function,
different patterns of mitral annular distortion cause different phenotypes
of aSMR. In ventricular SMR, the relation of SMR severity to left
ventricular dilation as well as the degree of pulmonary hypertension and
right ventricular dysfunction are important phenotypic characteristics,
which are key for a better understanding of prognosis and treatment
response.<br/>Copyright &#xa9; 2024 The Authors. Published by Elsevier
Inc. All rights reserved.

<86>
Accession Number
2028798656
Title
Landiolol for the prevention of postoperative atrial fibrillation: a trial
sequential analysis.
Source
Canadian Journal of Anesthesia. 71(4) (pp 561-562), 2024. Date of
Publication: April 2024.
Author
Chen I.-W.; Kao C.-L.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Liouying,
Tainan, Taiwan (Republic of China)
(Kao) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung, Taiwan (Republic of China)
(Hung) Department of Anesthesiology, Chi Mei Medical Center, Tainan,
Taiwan (Republic of China)
Publisher
Springer

<87>
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.