EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
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

<2>
Accession Number
2031106937
Title
Multimodal Opioid-Free Anesthesia Versus Opioid-Based Anesthesia for
Patients Undergoing Cardiac Valve Surgeries: A Randomized Controlled
Trial.
Source
Bali Journal of Anesthesiology. 8(1) (pp 33-39), 2024. Date of
Publication: 01 Jan 2024.
Author
Elgendy M.; El-Ashmawi H.; Said A.; Mortada A.; Soliman D.
Institution
(Elgendy, El-Ashmawi, Said, Mortada, Soliman) Department of Anesthesia,
Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo
University, Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Opioid-based anesthesia (OA) is the cornerstone of cardiac
anesthesia. <br/>Objective(s): The aim of this study was to assess safety
and efficacy of multimodal opioid-free anesthesia (OFA) regimen as an
alternative to the conventional OA regimen in adult patients undergoing
cardiac valve surgeries. <br/>Material(s) and Method(s): A total of 60
patients were randomly assigned to two groups: group F (received OFA) and
group O (received OA). Group F received oral pregabalin plus intravenous
(IV) infusion of ketorolac, acetaminophen, dexmedetomidine, and lidocaine
preoperatively. Lidocaine and dexmedetomidine were continuously infused
throughout the procedure. In group O, patients received placebo in the
form of oral pills plus IV infusion of normal saline preoperatively. After
anesthesia induction, group F received a bolus dose of ketamine, whereas
group O received fentanyl. The study outcomes were extubation time,
arterial blood pressure (systolic, diastolic, and mean), heart rate (HR),
visual analog scale (VAS), length of intensive care unit (ICU) stay,
postoperative morphine consumption, and postoperative complications.
<br/>Result(s): Extubation time was significantly shorter in the group F
[4.5 (3-6) vs. 10 (8-12), P < 0.001]. The VAS over 24 h was also lower in
group F [2 (0-3) vs. 3 (3-3.5), P < 0.001]. Furthermore, OFA was
associated with significantly lower postoperative morphine intake, shorter
stays in the ICU, and lower intraoperative HR and mean arterial pressure.
<br/>Conclusion(s): In valve surgeries, a multimodal OFA regimen might be
a good substitute for the standard opioid-based regimen. In addition, OFA
can have the added benefit of a more rapid recovery and a shorter ICU
stay, making it more feasible to be considered in patients with a history
of previous opioid addiction or Parkinsonian patients.<br/>Copyright
&#xa9; 2024 Bali Journal of Anesthesiology <br/> Published by Wolters
Kluwer - Medknow.

<3>
Accession Number
2031106936
Title
A Randomized Controlled Study of the Effect of Perioperative Pregabalin in
Acute and Chronic Pain in Postoperative Patients of Off-Pump Coronary
Artery Bypass Grafting.
Source
Bali Journal of Anesthesiology. 8(1) (pp 26-32), 2024. Date of
Publication: 01 Jan 2024.
Author
Singh G.; Patel R.; Arora V.; Pandya H.
Institution
(Singh, Patel, Arora, Pandya) Department of Cardiac Anaesthesia, U. N.
Mehta Institute of Cardiology and Research Center, Asarwa, Gujarat,
Ahmadabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: This study evaluates the efficacy of perioperative pregabalin
in reducing acute and chronic postoperative pain and opioid consumption in
patients undergoing off-pump coronary artery bypass grafting (OPCABG).
<br/>Material(s) and Method(s): A total of 150 patients, aged 30-70 years
underwent elective OPCABG and were randomized into two groups of 75.
Patients in Group P received 150 mg of pregabalin 2 h before induction of
anesthesia and were given pregabalin 75 mg every 12 h for two
postoperative days. Patients in Group C received a placebo at similar time
intervals. Recorded outcome variables were the Visual Analog Scale (VAS)
at rest and during deep breathing from the postoperative period until 3
months after hospital discharge. The time to extubation, hemodynamic
parameters, and episodes of breakthrough pain till 48 h were also noted.
<br/>Result(s): VAS during rest and on deep breathing were significantly
less in group P compared with group C from extubation up to 48 h
postoperative. The difference in VAS at rest between both the groups was
also significant at 1 month (0.32 +/- 0.46 vs. 0.56 +/- 0.49, P = 0.003)
but was insignificant at 3 months (0.10 +/- 0.31 vs. 0.13 +/- 0.34, P =
0.618). The sedation score was comparable in both groups.
<br/>Conclusion(s): Perioperative pregabalin reduces the pain scores at
rest and on deep breathing in patients undergoing elective OPCABG up to 72
h postsurgery. Furthermore, the significance was still showing at 1-month
postsurgery but diminished at 3-month postsurgery.<br/>Copyright &#xa9;
2024 Bali Journal of Anesthesiology <br/> Published by Wolters Kluwer -
Medknow.

<4>
Accession Number
2029061292
Title
The Diaphragmatic Initiated Ventilatory Assist (DIVA) trial: study
protocol for a randomized controlled trial comparing rates of extubation
failure in extremely premature infants undergoing extubation to
non-invasive neurally adjusted ventilatory assist versus non-synchronized
nasal intermittent positive pressure ventilation.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 201. Date of
Publication: December 2024.
Author
Matlock D.N.; Ratcliffe S.J.; Courtney S.E.; Kirpalani H.; Firestone K.;
Stein H.; Dysart K.; Warren K.; Goldstein M.R.; Lund K.C.; Natarajan A.;
Demissie E.; Foglia E.E.
Institution
(Matlock) University of Arkansas for Medical Sciences, 4301 W. Markham
St., Slot 512-5B, Little Rock, AR 72205, United States
(Matlock, Courtney) University of Arkansas for Medical Sciences, Little
Rock, AR, United States
(Ratcliffe) University of Virginia, Charlottesville, VA, United States
(Kirpalani, Foglia) University of Pennsylvania Perelman School of
Medicine, Philadelphia, PA, United States
(Kirpalani) McMaster University, Hamilton, ON, Canada
(Firestone) Akron Children's Hospital, Akron, OH, United States
(Stein) Ebeid Children's Hospital, Toledo, OH, United States
(Dysart) Nemours Children's Health Wilmington, Philadelphia, PA, United
States
(Warren, Foglia) The Children's Hospital of Philadelphia, Philadelphia,
PA, United States
(Goldstein) Loma Linda University School of Medicine, Loma Linda, CA,
United States
(Lund) University of Utah, Salt Lake City, UT, United States
(Natarajan, Demissie) National Heart, Lung and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
Publisher
BioMed Central Ltd
Abstract
Background: Invasive mechanical ventilation contributes to
bronchopulmonary dysplasia (BPD), the most common complication of
prematurity and the leading respiratory cause of childhood morbidity.
Non-invasive ventilation (NIV) may limit invasive ventilation exposure and
can be either synchronized or non-synchronized (NS). Pooled data suggest
synchronized forms may be superior. Non-invasive neurally adjusted
ventilatory assist (NIV-NAVA) delivers NIV synchronized to the neural
signal for breathing, which is detected with a specialized catheter. The
DIVA (Diaphragmatic Initiated Ventilatory Assist) trial aims to determine
in infants born 24^0/7-27^6/7 weeks' gestation
undergoing extubation whether NIV-NAVA compared to non-synchronized nasal
intermittent positive pressure ventilation (NS-NIPPV) reduces the
incidence of extubation failure within 5 days of extubation.
<br/>Method(s): This is a prospective, unblinded, pragmatic, multicenter
phase III randomized clinical trial. Inclusion criteria are preterm
infants 24-27^6/7 weeks gestational age who were intubated
within the first 7 days of life for at least 12 h and are undergoing
extubation in the first 28 postnatal days. All sites will enter an initial
run-in phase, where all infants are allocated to NIV-NAVA, and an
independent technical committee assesses site performance. Subsequently,
all enrolled infants are randomized to NIV-NAVA or NS-NIPPV at extubation.
The primary outcome is extubation failure within 5 days of extubation,
defined as any of the following: (1) rise in FiO<inf>2</inf> at least 20%
from pre-extubation for > 2 h, (2) pH <= 7.20 or pCO<inf>2</inf> >= 70
mmHg; (3) > 1 apnea requiring positive pressure ventilation (PPV) or >= 6
apneas requiring stimulation within 6 h; (4) emergent intubation for
cardiovascular instability or surgery. Our sample size of 478 provides 90%
power to detect a 15% absolute reduction in the primary outcome. Enrolled
infants will be followed for safety and secondary outcomes through 36
weeks' postmenstrual age, discharge, death, or transfer.
<br/>Discussion(s): The DIVA trial is the first large multicenter trial
designed to assess the impact of NIV-NAVA on relevant clinical outcomes
for preterm infants. The DIVA trial design incorporates input from
clinical NAVA experts and includes innovative features, such as a run-in
phase, to ensure consistent technical performance across sites. Trial
registration: www.ClinicalTrials.gov, trial identifier NCT05446272,
registered July 6, 2022.<br/>Copyright &#xa9; The Author(s) 2024.

<5>
Accession Number
2028979816
Title
Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with
severe calcification: A multicenter systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 103(5) (pp 710-721),
2024. Date of Publication: 01 Apr 2024.
Author
Sagris M.; Ktenopoulos N.; Dimitriadis K.; Papanikolaou A.; Tzoumas A.;
Terentes-Printzios D.; Synetos A.; Soulaidopoulos S.; Lichtenberg M.;
Korosoglou G.; Honton B.; Tousoulis D.; Tsioufis C.; Toutouzas K.
Institution
(Sagris, Ktenopoulos, Dimitriadis, Papanikolaou, Terentes-Printzios,
Synetos, Soulaidopoulos, Tousoulis, Tsioufis, Toutouzas) School of
Medicine, "Hippokration" General Hospital, National and Kapodistrian
University of Athens, Athens, Greece
(Tzoumas) Department of Internal Medicine, University of Cincinnati
Medical Center, Cincinnati, OH, United States
(Lichtenberg) Department of Cardiology, Vascular Medicine and Pneumology,
GRN Hospital, Weinheim, Germany
(Korosoglou) Vascular Center Arnsberg, Arnsberg, Germany
(Honton) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
Publisher
John Wiley and Sons Inc
Abstract
Background: With heavily calcified coronary and peripheral artery lesions,
lesion preparation is crucial before stent placement to avoid
underexpansion, associated with stent thrombosis or restenosis and patency
failure in the long-term. Intravascular lithotripsy (IVL) technology
disrupts superficial and deep calcium by using localized pulsative sonic
pressure waves, making it to a promising tool for patients with severe
calcification in coronary bed. <br/>Aim(s): The aim of the study is to
systematically review and summarize available data regarding the safety
and efficacy of IVL for lesion preparation in severely calcified coronary
arteries before stenting. <br/>Method(s): This study was conducted
according to the PRISMA guidelines. We systematically searched PubMed,
SCOPUS, and Cochrane databases from their inception to February 23, 2023,
for studies assessing the characteristics and outcomes of patients
undergoing IVL before stent implantation. The diameter of the vessel lumen
before and after IVL, as well as stent implantation, were analyzed. The
occurrence of major adverse cardiovascular events (MACE) was assessed
using a random-effects model. <br/>Result(s): This meta-analysis comprised
38 studies including 2977 patients with heavily calcified coronary
lesions. The mean age was 72.2 +/- 9.1 years, with an overall IVL clinical
success of 93% (95% confidence interval [CI]: 91%-95%, I² = 0%)
and procedural success rate of 97% (95% CI: 95%-98%, I² =
73.7%), while the in-hospital and 30-days incidence of MACE, myocardial
infarction (MI), and death were 8% (95% CI: 6%-11%, I² =
84.5%), 5% (95% CI: 2%-8%, I² = 85.6%), and 2% (95% CI: 1%-3%,
I² = 69.3%), respectively. There was a significant increase in
the vessel diameter (standardized mean difference [SMD]: 2.47, 95% CI:
1.77-3.17, I² = 96%) and a decrease in diameter stenosis (SMD:
-3.44, 95% CI: -4.36 to -2.52, I² = 97.5%) immediately after
IVL application, while it was observed further reduction in diameter
stenosis (SMD: -6.57, 95% CI: -7.43 to -5.72, I² = 95.8%) and
increase in the vessel diameter (SMD: 4.37, 95% CI: 3.63-5.12,
I² = 96.7%) and the calculated lumen area (SMD: 3.23, 95% CI:
2.10-4.37, I² = 98%), after stent implantation. The mean acute
luminal gain following IVL and stent implantation was estimated to be 1.27
+/- 0.6 and 1.94 +/- 1.1 mm, respectively. Periprocedural complications
were rare, with just a few cases of perforations, dissection, or no-reflow
phenomena recorded. <br/>Conclusion(s): IVL seems to be a safe and
effective strategy for lesion preparation in severely calcified lesions
before stent implantation in coronary arteries. Future prospective studies
are now warranted to compare IVL to other lesion preparation
strategies.<br/>Copyright &#xa9; 2024 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<6>
Accession Number
2028806345
Title
Allopurinol and cardiovascular outcomes in patients with ischaemic heart
disease: the ALL-HEART RCT and economic evaluation.
Source
Health Technology Assessment. 28(18) (no pagination), 2024. Date of
Publication: March 2024.
Author
Mackenzie I.S.; Hawkey C.J.; Ford I.; Greenlaw N.; Pigazzani F.; Rogers
A.; Struthers A.D.; Begg A.G.; Wei L.; Avery A.J.; Taggar J.S.; Walker A.;
Duce S.L.; Barr R.J.; Dumbleton J.S.; Rooke E.D.; Townend J.N.; Ritchie
L.D.; Macdonald T.M.
Institution
(Mackenzie, Pigazzani, Rogers, Struthers, Begg, Duce, Barr, Rooke,
Macdonald) MEMO Research, Division of Molecular and Clinical Medicine,
University of Dundee, Dundee, United Kingdom
(Hawkey, Dumbleton) Nottingham Digestive Diseases Centre, University of
Nottingham, Nottingham, United Kingdom
(Ford, Greenlaw) The Robertson Centre for Biostatistics, University of
Glasgow, Glasgow, United Kingdom
(Wei) School of Pharmacy, University College London, London, United
Kingdom
(Avery, Taggar) Centre for Academic Primary Care, School of Medicine,
University of Nottingham, Nottingham, United Kingdom
(Walker) Salus Alba, Glasgow, United Kingdom
(Townend) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Ritchie) Academic Primary Care, University of Aberdeen, Aberdeen, United
Kingdom
Publisher
NIHR Journals Library
Abstract
Background: Allopurinol is a xanthine oxidase inhibitor that lowers serum
uric acid and is used to prevent acute gout flares in patients with gout.
Observational and small interventional studies have suggested beneficial
cardiovascular effects of allopurinol. <br/>Objective(s): To determine
whether allopurinol improves major cardiovascular outcomes in patients
with ischaemic heart disease. <br/>Design(s): Prospective, randomised,
open-label, blinded endpoint multicentre clinical trial. <br/>Setting(s):
Four hundred and twenty-four UK primary care practices.
<br/>Participant(s): Aged 60 years and over with ischaemic heart disease
but no gout. <br/>Intervention(s): Participants were randomised (1: 1)
using a central web-based randomisation system to receive allopurinol up
to 600 mg daily that was added to usual care or to continue usual care.
<br/>Main Outcome Measure(s): The primary outcome was the composite of
non-fatal myocardial infarction, non-fatal stroke or cardiovascular death.
Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke,
cardiovascular death, all-cause mortality, hospitalisation for heart
failure, hospitalisation for acute coronary syndrome, coronary
revascularisation, hospitalisation for acute coronary syndrome or coronary
revascularisation, all cardiovascular hospitalisations, quality of life
and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a
Cox proportional hazards model was assessed for superiority in a modified
intention-to-treat analysis. <br/>Result(s): From 7 February 2014 to 2
October 2017, 5937 participants were enrolled and randomised to the
allopurinol arm (n = 2979) or the usual care arm (n = 2958). A total of
5721 randomised participants (2853 allopurinol; 2868 usual care) were
included in the modified intention-to-treat analysis population (mean age
72.0 years; 75.5% male). There was no difference between the allopurinol
and usual care arms in the primary endpoint, 314 (11.0%) participants in
the allopurinol arm (2.47 events per 100 patient-years) and 325 (11.3%) in
the usual care arm (2.37 events per 100 patient-years), hazard ratio 1.04
(95% confidence interval 0.89 to 1.21); p = 0.65. Two hundred and
eighty-eight (10.1%) participants in the allopurinol arm and 303 (10.6%)
participants in the usual care arm died, hazard ratio 1.02 (95% confidence
interval 0.87 to 1.20); p = 0.77. The pre-specified health economic
analysis plan was to perform a 'within trial' cost-utility analysis if
there was no statistically significant difference in the primary endpoint,
so NHS costs and quality-adjusted life-years were estimated over a 5-year
period. The difference in costs between treatment arms was +115 higher for
allopurinol (95% confidence interval 17 to 210) with no difference in
quality-adjusted life-years (95% confidence interval -0.061 to +0.060). We
conclude that there is no evidence that allopurinol used in line with the
study protocol is cost-effective. <br/>Limitation(s): The results may not
be generalisable to younger populations, other ethnic groups or patients
with more acute ischaemic heart disease. One thousand six hundred and
thirty-seven participants (57.4%) in the allopurinol arm withdrew from
randomised treatment, but an on-treatment analysis gave similar results to
the main analysis. <br/>Conclusion(s): The ALL-HEART study showed that
treatment with allopurinol 600 mg daily did not improve cardiovascular
outcomes compared to usual care in patients with ischaemic heart disease.
We conclude that allopurinol should not be recommended for the secondary
prevention of cardiovascular events in patients with ischaemic heart
disease but no gout.<br/>Copyright &#xa9; 2024 Mackenzie et al.

<7>
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

<8>
Accession Number
2029352246
Title
Single versus dual antiplatelet therapy following percutaneous left atrial
appendage closure-A systematic review and meta-analysis.
Source
European Journal of Clinical Investigation. (no pagination), 2024. Date
of Publication: 2024.
Author
Continisio S.; Montonati C.; Angelini F.; Bocchino P.P.; Carbonaro C.;
Giacobbe F.; Dusi V.; DeFilippo O.; Ielasi A.; Giannino G.; Boldi E.;
Fabris T.; D'Ascenzo F.; DeFerrari G.M.; Tarantini G.
Institution
(Continisio, Boldi) Division of Cardiology, Clinica S. Rocco di
Franciacorta, Brescia, Italy
(Montonati, Ielasi) Division of Cardiology, IRCCS Hospital
Galeazzi-Sant'Ambrogio, Milan, Italy
(Angelini, Bocchino, Dusi, De Filippo, D'Ascenzo, De Ferrari) Division of
Cardiology, Cardiovascular and Thoracic Department, 'Citta della Salute e
della Scienza' Hospital, Turin, Italy
(Carbonaro, Giacobbe, Dusi, Giannino, D'Ascenzo, De Ferrari) Department of
Medical Sciences, University of Turin, Turin, Italy
(Fabris, Tarantini) Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua Medical School, Padua, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: In the last few years, percutaneous LAA occlusion (LAAO) has
become a plausible alternative in atrial fibrillation (AF) patients with
contraindications to anticoagulation therapy. Nevertheless, the optimal
antiplatelet strategy following percutaneous LAAO remains to be defined.
<br/>Method(s): Studies comparing single antiplatelet therapy (SAPT)
versus dual antiplatelet therapy (DAPT) following LAAO were systematically
searched and screened. The outcomes of interest were ischemic stroke,
device-related thrombus (DRT) and major bleeding. A random-effect
meta-analysis was performed comparing outcomes in both groups. The
moderator effect of baseline characteristics on outcomes was evaluated by
univariate meta-regression analyses. <br/>Result(s): Sixteen observational
studies with 3255 patients treated with antiplatelet therapy (SAPT, n =
1033; DAPT, n = 2222) after LAAO were included. Mean age was 74.5 +/- 8.3
years, mean CHA<inf>2</inf>DS<inf>2</inf>-VASc and HAS-BLED scores were
4.3 +/- 1.5 and 3.2 +/- 1.0, respectively. At a weighted mean follow-up of
12.7 months, the occurrence of stroke (RR 1.33; 95% CI 0.64-2.77; p =.44),
DRT (RR 1.52; 95% CI 0.90-2.58; p =.12), and the composite of stroke and
DRT (RR 1.26; 95% CI 0.67-2.37; p =.47) did not differ significantly
between SAPT and DAPT groups. The rate of major bleedings was also not
different between groups (RR 1.41; 95% CI 0.64-3.12; p =.39).
<br/>Conclusion(s): Among AF patients at high bleeding risk undergoing
percutaneous LAAO, a post-procedural minimalistic antiplatelet strategy
with SAPT did not significantly differ from DAPT regimens regarding the
rate of stroke, DRT and major bleeding.<br/>Copyright &#xa9; 2024
Stichting European Society for Clinical Investigation Journal Foundation.
Published by John Wiley & Sons Ltd.

<9>
Accession Number
2028055114
Title
Clinical impact of cerebral protection during transcatheter aortic valve
implantation.
Source
European Journal of Clinical Investigation. 54(5) (no pagination), 2024.
Article Number: e14166. Date of Publication: May 2024.
Author
Boccuto F.; Carabetta N.; Cacia M.A.; Kanagala S.G.; Panuccio G.; Torella
D.; DeRosa S.
Institution
(Boccuto, Carabetta, Cacia, Panuccio, De Rosa) Department of Medical and
Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
(Kanagala) Department of Internal Medicine, Metropolitan Hospital Center,
New York, NY, United States
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Embolization of debris can complicate transcatheter aortic
valve implantation (TAVI) causing stroke. Cerebral embolism protection
(CEP) devices can divert or trap debris. <br/>Purpose(s): To evaluate the
efficacy of CEP during TAVI vs the standard procedure. <br/>Data Sources:
PubMed, SCOPUS and DOAJ 1/01/2014-04/12/2023. Study Selection: Randomized
and observational studies comparing CEP versus standard TAVI, according to
PRISMA. <br/>Primary Outcome: stroke. <br/>Secondary Outcomes: death,
bleeding, vascular access complications, acute kidney injury and infarct
area. <br/>Data Extraction: Two investigators independently assessed study
quality and extracted data. <br/>Data Synthesis: Twenty-six articles were
included (540.247 patients). The primary endpoint was significantly lower
(RR = 0.800 95%CI:0.682-0.940; p = 0.007) with CEP. Similarly, death rates
were significantly lower with CEP (RR = 0.610 95%CI:0.482-0.771; p <
0.001). No difference was found for bleeding (RR = 1.053
95%CI:0.793-1.398; p = 0.721), vascular complications (RR = 0.937
95%CI:0.820-1.070; p = 0.334) or AKI (RR = 0.982 95%CI:0.754-1.279; p =
0.891). <br/>Conclusion(s): Use of CEP during TAVI is associated with
improved outcomes. Future studies will identify patients who benefit most
from CEP.<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.

<10>
Accession Number
2025519691
Title
The incidence of surgical site infections in China.
Source
Journal of Hospital Infection. 146 (pp 206-223), 2024. Date of
Publication: April 2024.
Author
Lin J.; Peng Y.; Guo L.; Tao S.; Li S.; Huang W.; Yang X.; Qiao F.; Zong
Z.
Institution
(Lin, Zong) Center of Infectious Diseases, West China Hospital, Sichuan
University, Chengdu, China
(Lin, Peng, Guo, Tao, Li, Huang, Qiao) Department of Infectious Control,
West China Hospital, Sichuan University, Chengdu, China
(Yang) Southern Central Hospital of Yunnan Province, Honghe, China
(Zong) Center for Pathogen Research, West China Hospital, Sichuan
University, Chengdu, China
Publisher
W.B. Saunders Ltd
Abstract
Surgical site infections (SSIs) are a common type of healthcare-associated
infection. We performed a literature review to demonstrate the incidence
of SSIs in mainland China based on studies since 2010. We included 231
eligible studies with >=30 postoperative patients, comprising 14 providing
overall SSI data regardless of surgical sites and 217 reporting SSIs for a
specific site. We found that the overall SSI incidence was 2.91% (median;
interquartile range: 1.05%, 4.57%) or 3.18% (pooled; 95% confidence
interval: 1.85%, 4.51%) and the SSI incidence varied remarkably according
to the surgical site between the lowest (median, 1.00%; pooled, 1.69%) in
thyroid surgeries and the highest (median, 14.89%; pooled, 12.54%) in
colorectal procedures. We uncovered that Enterobacterales and
staphylococci were the most common types of micro-organisms associated
with SSIs after various abdominal surgeries and cardiac or neurological
procedures, respectively. We identified two, nine, and five studies
addressing the impact of SSIs on mortality, the length of stay (LOS) in
hospital, and additional healthcare-related economic burden, respectively,
all of which demonstrated increased mortality, prolonged LOS, and elevated
medical costs associated with SSIs among affected patients. Our findings
illustrate that SSIs remain a relatively common, serious threat to patient
safety in China, requiring more action. To tackle SSIs, we propose to
establish a nationwide network for SSI surveillance using unified criteria
with the aid of informatic techniques and to tailor and implement
countermeasures based on local data and observation. We highlight that the
impact of SSIs in China warrants further study.<br/>Copyright &#xa9; 2023
The Healthcare Infection Society

<11>
Accession Number
643986883
Title
Efficacy and safety of tranexamic acid in patients undergoing thoracic
surgery: a systematic review and PRIMSA-compliant meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 195), 2024. Date of
Publication: 09 Apr 2024.
Author
Gao B.; Liu Y.; Yao Y.-T.
Institution
(Gao, Liu) Department of Anesthesiology, Huzhou Central Hospital,
Affiliated Central Hospital of Huzhou University, No. 1558, Sanhuan North
Road, Huzhou 313000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing
100037, China
Abstract
OBJECTIVES: Perioperative bleeding poses a significant issue during
thoracic surgery. Tranexamic acid (TXA) is one of the most commonly used
antifibrinolytic agents for surgical patients. The purpose of the current
study was designed to investigate the efficacy and safety of TXA in
patients undergoing thoracic surgery. <br/>METHOD(S): An extensive search
of PubMed, Web of Science (WOS), Cochrane Library (trials), Embase, OVID,
China National Knowledge Infrastructure (CNKI), Wanfang, and VIP
electronic databases was performed to identify studies published between
the inception of these databases and March 2023. The primary outcomes
included perioperative blood loss and blood transfusions. Secondary
outcomes of interest included the length of stay (LOS) in hospital and the
incidence of thromboembolic events. Weighted mean differences (WMDs) or
odds ratios (OR) with 95% confidence intervals (CI) were used to determine
treatment effects for continuous and dichotomous variables, respectively.
<br/>RESULT(S): Five qualified studies including 307 thoracic surgical
patients were included in the current study. Among them, 65 patients were
randomly allocated to the group receiving TXA administration (the TXA
group); the other 142 patients were assigned to the group not receiving
TXA administration (the control group). TXA significantly reduced the
quantity of hemorrhage in the postoperative period (postoperative 12h: WMD
= -81.90 ml; 95% CI: -139.55 to -24.26; P = 0.005; postoperative 24h: WMD
= -97.44 ml; 95% CI: -121.44 to -73.44; P< 0.00001); The intraoperative
blood transfusion volume (WMD = -0.54 units; 95% CI: -1.06 to -0.03; P =
0.04); LOS in hospital (WMD = -0.6 days; 95% CI: -1.04 to -0.16; P =
0.008); And there was no postoperative thromboembolic event reported in
the included studies. <br/>CONCLUSION(S): The present study demonstrated
that TXA significantly decreased blood loss within 12 and 24 hours
postoperatively. A qualitative review did not identify elevated risks of
safety outcomes such as thromboembolic events. It also suggested that TXA
administration was associated with shorter LOS in hospital as compared to
control. To validate this further, additional well-planned and adequately
powered randomized studies are necessary.<br/>Copyright &#xa9; 2024. The
Author(s).

<12>
Accession Number
643061582
Title
Association of Mechanical Energy and Power with Postoperative Pulmonary
Complications in Lung Resection Surgery: A Post Hoc Analysis of Randomized
Clinical Trial Data.
Source
Anesthesiology. 140(5) (pp 920-934), 2024. Date of Publication: 01 May
2024.
Author
Yoon S.; Nam J.-S.; Blank R.S.; Ahn H.J.; Park M.; Kim H.; Kim H.J.; Choi
H.; Kang H.-U.; Lee D.-K.; Ahn J.
Institution
(Yoon) Department of Anesthesiology and Pain Medicine, Seoul National
University Hospital, University of Seoul National College of Medicine,
Seoul, South Korea
(Nam, Kang, Lee) Department of Anesthesiology and Pain Medicine, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Blank) Department of Anesthesiology, University of Virginia Health
System, Charlottesville, VA, United States
(Ahn, Park) Department of Anesthesiology and Pain Medicine, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Guro Hospital, Korea University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Anesthesia and Pain
Research Institute, Yonsei University College of Medicine, Seoul, South
Korea
(Choi) Department of Anesthesiology and Pain Medicine, Seoul St. Mary's
Hospital, College of Medicine, Catholic University of Korea, Seoul, South
Korea
(Ahn) Biomedical Statistics Center, Data Science Research Institute,
Research Institute for Future Medicine, Samsung Medical Center, Seoul,
South Korea
Abstract
BACKGROUND: Mechanical power (MP), the rate of mechanical energy (ME)
delivery, is a recently introduced unifying ventilator parameter
consisting of tidal volume, airway pressures, and respiratory rates, which
predicts pulmonary complications in several clinical contexts. However, ME
has not been previously studied in the perioperative context, and neither
parameter has been studied in the context of thoracic surgery utilizing
one-lung ventilation. <br/>METHOD(S): The relationships between ME
variables and postoperative pulmonary complications were evaluated in this
post hoc analysis of data from a multicenter randomized clinical trial of
lung resection surgery conducted between 2020 and 2021 (n = 1,170).
Time-weighted average MP and ME (the area under the MP time curve) were
obtained for individual patients. The primary analysis was the association
of time-weighted average MP and ME with pulmonary complications within 7
postoperative days. Multivariable logistic regression was performed to
examine the relationships between energy variables and the primary
outcome. <br/>RESULT(S): In 1,055 patients analyzed, pulmonary
complications occurred in 41% (431 of 1,055). The median (interquartile
ranges) ME and time-weighted average MP in patients who developed
postoperative pulmonary complications versus those who did not were 1,146
(811 to 1,530) J versus 924 (730 to 1,240) J (P < 0.001), and 6.9 (5.5 to
8.7) J/min versus 6.7 (5.2 to 8.5) J/min (P = 0.091), respectively. ME was
independently associated with postoperative pulmonary complications
(ORadjusted, 1.44 [95% CI, 1.16 to 1.80]; P = 0.001). However, the
association between time-weighted average MP and postoperative pulmonary
complications was time-dependent, and time-weighted average MP was
significantly associated with postoperative pulmonary complications in
cases utilizing longer periods of mechanical ventilation (210min or
greater; ORadjusted, 1.46 [95% CI, 1.11 to 1.93]; P = 0.007).
Normalization of ME and time-weighted average MP either to predicted body
weight or to respiratory system compliance did not alter these
associations. <br/>CONCLUSION(S): ME and, in cases requiring longer
periods of mechanical ventilation, MP were independently associated with
postoperative pulmonary complications in thoracic surgery.<br/>Copyright
&#xa9; 2023 American Society of Anesthesiologists. All Rights Reserved.

<13>
Accession Number
2031659016
Title
Impact of cancer in patients with aortic stenosis undergoing transcatheter
aortic valve replacement: A systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 52 (no pagination), 2024. Article Number:
101410. Date of Publication: June 2024.
Author
Osawa T.; Tajiri K.; Hoshi T.; Ieda M.; Ishizu T.
Institution
(Osawa, Hoshi, Ieda, Ishizu) Department of Cardiology, Institute of
Medicine, University of Tsukuba, Japan
(Osawa) Department of Cardiology, Tsukuba Medical Center Hospital, Japan
(Osawa, Tajiri) Department of Cardiology, National Cancer Center Hospital
East, Japan
(Tajiri) Tsukuba Life Science Innovation Program (T-LSI), School of
Integrative and Global Majors (SIGMA), University of Tsukuba, Japan
(Ieda) Department of Cardiology, Keio University School of Medicine, Japan
Publisher
Elsevier Ireland Ltd
Abstract
Background: Owing to the minimally invasive nature of transcatheter aortic
valve replacement (TAVR), TAVR seems to be preferred in patients with
cancer; however, related research on the clinical efficacy and safety of
TAVR in patients with cancer and severe aortic stenosis is limited, and
conclusions are controversial. This study aimed to evaluate the clinical
outcomes of patients with cancer who underwent TAVR. Method and results:
We conducted a systematic review and meta-analysis to investigate the
clinical outcomes in patients with and without cancer who underwent TAVR.
We systematically reviewed and analyzed 15 studies (195,658 patients)
published in PubMed and Cochrane Library databases between January 2022
and January 2023. The primary outcomes were short-term (in-hospital or
30-day) and long-term (>=12 months) mortality. The prevalence of current
or previous cancer in the patients undergoing TAVR was 19.8 % (38,695
patients). Patients with cancer had a lower risk of short-term mortality
(odds ratio [OR] 0.69, 95 % confidence interval [CI] 0.61-0.77, P < 0.001)
but a higher risk of long-term mortality (OR 1.54, 95 % CI 1.35-1.76, P <
0.001) than those without cancer. Patients with cancer had a lower
incidence of postprocedural stroke and acute kidney injury but a higher
incidence of pacemaker implantation than patients without cancer.
<br/>Conclusion(s): Patients with cancer undergoing TAVR have a good
short-term prognosis and acceptable perioperative complications compared
with patients without cancer. However, the long-term outcomes are
contingent on cancer survival.<br/>Copyright &#xa9; 2024 The Author(s)

<14>
Accession Number
2031653169
Title
Perioperative adverse cardiac events in maxillofacial surgery: A
systematic review and meta-analysis.
Source
Indian Journal of Anaesthesia. 68(5) (pp 426-438), 2024. Date of
Publication: May 2024.
Author
Chohan M.; Liu W.; Chowdhury T.
Institution
(Chohan) Department of Health Science, Queen's University, Kingston, ON,
Canada
(Liu) Michael G. DeGroote School of Medicine, McMaster, Hamilton, ON,
Canada
(Chowdhury) Department of Anaesthesiology and Pain Medicine, Toronto
Western Hospital, Toronto, ON, Canada
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Maxillofacial surgeries, including procedures to the
face, oral cavity, jaw, and head and neck, are common in adults . However,
they impose a risk of adverse cardiac events (ACEs). While ACEs are well
understood for other non-cardiac surgeries, there is a paucity of data
about maxillofacial surgeries. This systematic review and meta-analysis
report the incidence and presentation of perioperative ACEs during
maxillofacial surgery. <br/>Method(s): We included primary studies that
reported on perioperative ACEs in adults. To standardise reporting, ACEs
were categorised as 1. heart rate and rhythm disturbances, 2. blood
pressure disturbances, 3. ischaemic heart disease and 4. heart failure and
other complications. The primary outcome was ACE presentation and
incidence during the perioperative period. Secondary outcomes included the
surgical outcome according to the Clavien-Dindo classification and
trigeminocardiac reflex involvement. STATA version 17.0 and MetaProp were
used to delineate proportion as effect size with a 95% confidence interval
(CI). <br/>Result(s): Twelve studies (34,227 patients) were included. The
incidence of perioperative ACEs was 2.58% (95% CI 1.70, 3.45, I2 = 96.17%,
P = 0.001). Heart rate and rhythm disturbances resulted in the greatest
incidence at 3.84% among the four categories. Most commonly, these ACEs
resulted in intensive care unit admission (i.e. Clavien-Dindo score of 4).
<br/>Conclusion(s): Despite an incidence of 2.58%, ACEs can
disproportionately impact surgical outcomes. Future research should
include large-scale prospective studies that may provide a better
understanding of the contributory factors and long-term effects of ACEs in
patients during maxillofacial surgery.<br/>Copyright &#xa9; 2024 Indian
Journal of Anaesthesia.

<15>
Accession Number
2031674650
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:
2024.
Author
Stolz L.; Doldi P.M.; Sannino A.; Hausleiter J.; Grayburn P.A.
Institution
(Stolz, Doldi, Hausleiter) Medizinische Klinik und Poliklinik I, Klinikum
der Universitat Munchen, Munich, Germany
(Sannino, Grayburn) Division of Cardiology, Department of Internal
Medicine, Baylor Scott and White The Heart Hospital, Plano, TX, United
States
(Sannino) Department of Advanced Biomedical Sciences, Division of
Cardiology, Federico II University, Naples, Italy
(Hausleiter) German Center for Cardiovascular Research (DZHK), Partner
Site Munich Heart Alliance, Munich, Germany
Publisher
Elsevier Inc.
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

<16>
Accession Number
2031648066
Title
A multi-centre randomised control trial of directly observed therapy to
promote medication adherence in paediatric heart transplant recipients.
Source
Cardiology in the Young. (no pagination), 2024. Date of Publication:
2024.
Author
Killian M.O.; Mayewski S.; Gupta D.
Institution
(Killian, Mayewski) College of Social Work, Florida State University,
Tallahassee, FL, United States
(Killian) College of Medicine, Florida State University, Tallahassee, FL,
United States
(Gupta) Pediatrics, Congenital Heart Center, University of Florida,
Gainesville, FL, United States
Publisher
Cambridge University Press
Abstract
Medication non-adherence remains a significant challenge for adolescent
heart transplant recipients. Building on the success of a pilot
intervention study, herein we describe the protocol for a follow-up
randomised control trial using mobile video directly observed therapy,
featuring several innovations, to promote medication adherence in a
multi-centre sample of adolescent heart transplant patients.
<br/>Copyright &#xa9; The Author(s), 2024. Published by Cambridge
University Press.

<17>
Accession Number
2029423760
Title
Prominent crista terminalis mimicking a right atrial mass: a systematic
literature review and meta-analysis.
Source
Acta Radiologica. (no pagination), 2024. Date of Publication: 2024.
Author
Matusik P.S.; Mikrut K.; Bryll A.; Podolec M.; Popiela T.J.; Matusik P.T.
Institution
(Matusik, Bryll, Popiela) Department of Diagnostic Imaging, University
Hospital, Krakow, Poland
(Matusik, Popiela) Chair of Radiology, Jagiellonian University Medical
College, Krakow, Poland
(Mikrut) Department of Cardiology, The Ohio State University Wexner
Medical Center, Columbus, OH, United States
(Bryll) Jagiellonian University Medical College, Krakow, Poland
(Podolec) Department of Coronary Artery Disease and Heart Failure, St John
Paul II Hospital, Krakow, Poland
(Podolec) Center for Innovative Medical Education, Jagiellonian University
Medical College, Krakow, Poland
(Matusik) Department of Electrocardiology, Institute of Cardiology,
Faculty of Medicine, Jagiellonian University Medical College, Krakow,
Poland
(Matusik) Department of Electrocardiology, St John Paul II Hospital,
Krakow, Poland
Publisher
SAGE Publications Inc.
Abstract
The crista terminalis is an anatomical structure localized on the
posterolateral wall of the right atrium (RA). We performed a systematic
review of the literature and meta-analysis concerning cases of unusual
prominent crista terminalis mimicking RA mass. Moreover, we described the
differential diagnosis of cardiac masses with the use of echocardiography,
computed tomography, and cardiac magnetic resonance (CMR). We also
emphasize the potential importance of this structure in
electrophysiological procedures, including its role in exaggerated
arrhythmias. Prominent crista terminalis may be a potential obstacle
during invasive cardiac procedures or catheter ablation target. In
analyzed cases, the crista terminalis was often erroneously interpreted as
pathologic and at first confused with a thrombus or tumor during
transthoracic echocardiography examination. The correct final diagnoses
were mostly made with used transesophageal echocardiography or CMR. The
most important imaging findings suggestive of prominent crista terminalis
rather than tumor were a similar echogenicity/intensity with adjacent
myocardium, the location on posterolateral wall of the RA, the phasic
change in size, and no enhancement after contrast injection. We describe
up to date and detailed imaging features for the differential diagnostics
of selected intracardiac masses using various imaging techniques,
including multimodality cardiac imaging. Familiarity with the anatomy and
the imaging findings of the prominent crista terminalis will reduce
misdiagnosis and avoid additional tests and unwarranted clinical
interventions, while in patients considered for invasive cardiac
procedures it might increase their efficacy and safety.<br/>Copyright
&#xa9; The Foundation Acta Radiologica 2024.

<18>
Accession Number
643985385
Title
The Effect of Individualized Nutrition Training of Children with
Congenital Heart Disease (CHD) on Their Growth and Development A
Randomized Controlled Trial.
Source
Current problems in cardiology. (pp 102567), 2024. Date of Publication:
08 Apr 2024.
Author
Yuruk E.; Cetinkaya S.
Institution
(Yuruk) Cukurova University, Health Sciences Institute, Child Health and
Diseases Nursing, Adana, Turkey
(Cetinkaya) Cukurova University, Faculty of Health Sciences, Department of
Nursing, Child Health and Diseases Nursing, Adana, Turkey
Abstract
OBJECTIVE: This study investigated the effectiveness of individualized
nutrition training for mothers of children who underwent congenital heart
disease (CHD) surgery on their children's growth and development.
<br/>METHOD(S): The researchers conducted a randomized controlled trial at
Cukurova University Medical Faculty Balcali Hospital in Adana, Turkey,
between January 20th, 2021, and June 30th, 2021. They recruited 42
children with CHD and their families. Researchers used a personal
information form, growth parameter measurements, and the Ankara
Developmental Screening Inventory to assess the children. Participants
were randomly divided into three groups. Control group, received standard
care. Experimental group 1 (orally fed), received family-centered care and
individualized nutrition training focused on age-appropriate food content,
preparation methods, and meeting children's caloric needs. Experimental
group 2 (orally and nutritionally fed), received the same interventions as
group 1. The training programs for the experimental groups included
information on strengthening breast milk and additional nutritional
nutrition support. The training programs for the experimental groups
likely addressed feeding challenges specific to children with CHD.
<br/>RESULT(S): The study found a statistically significant difference in
weight gain between the first and third follow-ups within the training
group (children who received individualized nutrition education). This
suggests that the training may have positively impacted weight gain.
Additionally, the children in the training groups who were breastfed for
longer than 12 months had better growth parameters and developmental
scores compared to those with shorter breastfeeding durations.
<br/>CONCLUSION(S): This study suggests that individualized nutrition
training for mothers of children with CHD surgery may support their
children's growth and development, particularly when combined with
prolonged breastfeeding.<br/>Copyright &#xa9; 2024. Published by Elsevier
Inc.

<19>
Accession Number
2031568089
Title
Isolated tricuspid valve surgery for functional tricuspid regurgitation.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Kaneyuki D.; Jordan A.M.; Rosen J.L.; MacMillan T.R.; Morris R.;
Tchantchaleishvili V.
Institution
(Kaneyuki, Jordan, Rosen, MacMillan, Morris, Tchantchaleishvili) Division
of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia,
United States
Publisher
Georg Thieme Verlag
Abstract
Background: Severe tricuspid regurgitation (TR) adversely affects
long-term survival; however, isolated tricuspid valve (TV) surgery has
been rarely performed due to high operative mortality. In addition, the
previous literature included heterogeneous TR etiologies. Therefore, we
aimed to elucidate early and long-term outcomes of isolated TV surgery for
functional TR. <br/>Method(s): An electronic search was performed to
identify all relevant studies. Baseline characteristics, perioperative
variables, and clinical outcomes were extracted and pooled for
meta-analysis. <br/>Result(s): This meta-analysis included seven studies.
Pooled analyses showed that 68% (35, 89) of patients had preoperative
atrial fibrillation or flutter, and 58% (11, 94) had a history of
left-sided valve surgery. Seventy-three percent (65, 80) of patients had
at least one physical exam finding of right-sided heart failure, and 57%
(44, 69) were in New York Heart Association class III or IV. TV
replacement was more common than repair. In TV replacement, bioprosthetic
valve (39%, 13, 74) was more common than mechanical prosthesis (22%, 18,
26). The early mortality rate was 7%. Twenty percent of patients required
a permanent pacemaker postoperatively. The overall 1- and 5-year survival
rates were 84.5% and 69.1%, respectively. <br/>Conclusion(s): More than
half of the patients who underwent isolated TV surgery for functional TR
had undergone left-sided valve surgery and had significant heart failure
symptoms at the time of surgery. Further studies on the surgical
indication for concomitant TV surgery at the time of left-sided valve
surgery and the appropriate timing of surgery for isolated functional TR
are needed to improve survival.<br/>Copyright &#xa9; 2023 Georg Thieme
Verlag. All rights reserved.

<20>
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.

<21>
Accession Number
2029343611
Title
Volatile versus propofol sedation after cardiac valve surgery: a
single-center prospective randomized controlled trial.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 111. Date of
Publication: December 2024.
Author
Flinspach A.N.; Raimann F.J.; Kaiser P.; Pfaff M.; Zacharowski K.; Neef
V.; Adam E.H.
Institution
(Flinspach, Raimann, Pfaff, Zacharowski, Neef, Adam) Department of
Anaesthesiology, Intensive Care Medicine and Pain Therapy, University
Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7,
Frankfurt am Main 60590, Germany
(Kaiser) Department of Cardiothoracic Surgery, University Hospital
Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Optimal intensive care of patients undergoing valve surgery is
a complex balancing act between sedation for monitoring and timely
postoperative awakening. It remains unclear, if these requirements can be
fulfilled by volatile sedations in intensive care medicine in an efficient
manner. Therefore, this study aimed to assess the time to extubation and
secondary the workload required. <br/>Method(s): We conducted a
prospective randomized single-center trial at a tertiary university
hospital to evaluate the postoperative management of open valve surgery
patients. The study was randomized with regard to the use of volatile
sedation compared to propofol sedation. Sedation was discontinued 60 min
after admission for critical postoperative monitoring. <br/>Result(s): We
observed a significantly earlier extubation (91 +/- 39 min vs. 167 +/- 77
min; p < 0.001), eye-opening (86 +/- 28 min vs. 151 +/- 71 min; p < 0.001)
and command compliance (93 +/- 38 min vs. 164 +/- 75 min; p < 0.001) using
volatile sedation, which in turn was associated with a significantly
increased workload of a median of 9:56 min (+/- 4:16 min) set-up time. We
did not observe any differences in complications. Cardiopulmonary bypass
time did not differ between the groups 101 (IQR 81; 113) versus 112 (IQR
79; 136) minutes p = 0.36. <br/>Conclusion(s): Using volatile sedation is
associated with few minutes additional workload in assembling and enables
a significantly accelerated evaluation of vulnerable patient groups.
Volatile sedation has considerable advantages and emerges as a safe
sedation technique in our vulnerable study population. Trial registration:
Clinical trials registration (NCT04958668) was completed on 1 July
2021.<br/>Copyright &#xa9; The Author(s) 2024.

<22>
[Use Link to view the full text]
Accession Number
2002842879
Title
Safety of a restrictive versus liberal approach to red blood cell
transfusion on the outcome of aki in patients undergoing cardiac surgery:
A randomized clinical trial.
Source
Journal of the American Society of Nephrology. 30(7) (pp 1294-1304), 2019.
Date of Publication: 2019.
Author
Garg A.X.; Badner N.; Bagshaw S.M.; Cuerden M.S.; Fergusson D.A.; Gregory
A.J.; Hall J.; Hare G.M.T.; Khanykin B.; McGuinness S.; Parikh C.R.;
Roshanov P.S.; Shehata N.; Sontrop J.M.; Syed S.; Tagarakis G.I.; Thorpe
K.E.; Verma S.; Wald R.; Whitlock R.P.; Mazer C.D.
Institution
(Garg, Cuerden, Sontrop) Division of Nephrology, Department of Medicine,
London Health Sciences Centre and Western University, Westminster Tower,
800 Commissioner's Road East, ELL-215, London, ON N6A 4G5, Canada
(Badner) Department of Anesthesia and Clinical Pharmacology, University of
British Columbia, Kelowna, BC, Canada
(Bagshaw) Department of Critical Care Medicine, University of Alberta,
Edmonton, AB, Canada
(Fergusson) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Gregory) Department of Anesthesiology, Perioperative and Pain Medicine,
University of Calgary, Calgary, AB, Canada
(Hall, Hare, Thorpe, Verma, Wald, Mazer) Li Ka Shing Knowledge Institute,
St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Khanykin) Cardiothoracic Anesthesiology Department, Copenhagen University
Hospital, Copenhagen, Denmark
(McGuinness) Cardiothoracic and Vascular Intensive Care and High
Dependency Unit, Auckland City Hospital, Auckland, New Zealand
(Parikh) Division of Nephrology, Department of Medicine, Johns Hopkins
School of Medicine, Baltimore, MD, United States
(Roshanov, Syed, Whitlock) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Shehata) Department of Medicine, Mount Sinai Hospital, University of
Toronto, Toronto, ON, Canada
(Tagarakis) Department of Cardiothoracic Surgery, Aristotle University
Hospital of Thessaloniki, Thessaloniki, Greece
Publisher
American Society of Nephrology
Abstract
Background: Safely reducing red blood cell transfusions can prevent
transfusion-related adverse effects, conserve the blood supply, and reduce
health care costs. Both anemia and red blood cell transfusion are
independently associated with AKI, but observational data are insufficient
to determine whether a restrictive approach to transfusion can be used
without increasing AKI risk. <br/>Method(s): In a prespecified kidney
substudy of a randomized noninferiority trial, we compared a restrictive
threshold for red blood cell transfusion (transfuse if hemoglobin<7.5
g/dl, intraoperatively and postoperatively) with a liberal threshold
(transfuse if hemoglobin<9.5 g/dl in the operating roomor intensive care
unit, or if hemoglobin<8.5 g/dl on the nonintensive care ward). We studied
4531 patients undergoing cardiac surgery with cardiopulmonary bypass who
had a moderate-to-high risk of perioperative death. The substudy's primary
outcome was AKI, defined as a postoperative increase in serum creatinine
of >=0.3 mg/dl within 48 hours of surgery, or >=50% within 7 days of
surgery. <br/>Result(s): Patients in the restrictive-threshold group
received significantly fewer transfusions than patients in the
liberal-threshold group (1.8 versus 2.9 on average, or 38% fewer
transfusions in the restrictedthreshold group compared with the
liberal-threshold group; P<0.001). AKI occurred in 27.7% of patients in
the restrictive-threshold group (624 of 2251) and in 27.9% of patients in
the liberal-threshold group (636 of 2280). Similarly, among patients with
preoperative CKD, AKI occurred in 33.6% of patients in the
restrictive-threshold group (258 of 767) and in 32.5% of patients in the
liberal-threshold group (252 of 775). <br/>Conclusion(s): Among patients
undergoing cardiac surgery, a restrictive transfusion approach resulted in
fewer red blood cell transfusions without increasing the risk of
AKI.<br/>Copyright &#xa9; 2019 by the American Society of Nephrology.

<23>
[Use Link to view the full text]
Accession Number
620563926
Title
Perioperative THR-184 and AKI after Cardiac Surgery.
Source
Journal of the American Society of Nephrology. 29(2) (pp 670-679), 2018.
Date of Publication: February 2018.
Author
Himmelfarb J.; Chertow G.M.; McCullough P.A.; Mesana T.; Shaw A.D.; Sundt
T.M.; Brown C.; Cortville D.; Dagenais F.; De Varennes B.; Fontes M.;
Rossert J.; Tardif J.-C.
Institution
(Himmelfarb) Department of Medicine, Kidney Research Institute, University
of Washington, Seattle, WA, United States
(Chertow) School of Medicine, Stanford University, Stanford, CA, United
States
(McCullough) Department of Medicine, Baylor University, Medical Center,
Dallas, TX, United States
(Mesana) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Shaw) Department of Anesthesiology, Vanderbilt University, Medical
Center, Nashville, TN, United States
(Sundt) Department of Surgery, Massachusetts General Hospital, Boston, MA,
United States
(Brown) Department of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, NB, Canada
(Cortville) Department of Cardiology, Cardiac and Vascular Research
Center, McLaren Northern Michigan, Petoskey, MI, United States
(Dagenais) Department of Cardiac Surgery, Institut Universitaire de
Cardiologie et de Pneumologie, Quebec City, QC, Canada
(De Varennes) Department of Surgery, McGill University Health Centre,
Montreal, QC, Canada
(Fontes) Department of Anesthesiology, Yale University, School of
Medicine, New Haven, CT, United States
(Rossert) Thrasos Therapeutics, Inc., Boston, MA, United States
(Tardif) Department of Medicine, Montreal Heart Institute, Montreal, QC,
Canada
Publisher
American Society of Nephrology
Abstract
AKI after cardiac surgery is associated with mortality, prolonged hospital
length of stay, use of dialysis, and subsequent CKD. We evaluated the
effects of THR-184, a bone morphogenetic protein-7 agonist, in patients at
high risk for AKI after cardiac surgery. We conducted a randomized,
double-blind, placebo-controlled, multidose comparison of the safety and
efficacy of perioperative THR-184 using a two-stage seamless adaptive
design in 452 patients between 18 and 85 years of age who were scheduled
for nonemergent cardiac surgery requiring cardiopulmonary bypass and had
recognized risk factors for AKI. The primary efficacy end point was the
proportion of patients who developed AKI according to Kidney Disease
Improving Global Outcomes (KDIGO) criteria. The proportion of patients who
developed AKI within 7 days of surgery was similar in THR-184 treatment
groups and placebo groups (range, 74%-79%; P=0.43). Prespecified secondary
end point analysis did not show significant differences in the severity of
AKI stage (P=0.53) or the total duration of AKI (P=0.44). A composite of
death, dialysis, or sustained impaired renal function by day 30 after
surgery did not differ between groups (range, 11%-20%; P=0.46).
Safety-related outcomes were similar across all treatment groups. In
conclusion, compared with placebo, administration of perioperative THR-184
through a range of dose exposures failed to reduce the incidence,
severity, or duration of AKI after cardiac surgery in high-risk
patients.<br/>Copyright &#xa9; 2018 by the American Society of Nephrology

<24>
[Use Link to view the full text]
Accession Number
620142123
Title
Allogeneic mesenchymal stem cells for treatment of AKI after cardiac
surgery.
Source
Journal of the American Society of Nephrology. 29(1) (pp 260-267), 2017.
Date of Publication: January 2018.
Author
Swaminathan M.; Stafford-Smith M.; Chertow G.M.; Warnock D.G.; Paragamian
V.; Brenner R.M.; Lellouche F.; Fox-Robichaud A.; Atta M.G.; Melby S.;
Mehta R.L.; Wald R.; Verma S.; Mazer C.D.; Lombard F.W.; Schroder J.;
Kurtzberg J.; Bisnar T.; Conte J.; Dodd-O J.; Rabb H.; Katz N.; Shah A.;
Huyette-Arrizza E.; Bellot C.; Kramer R.; Tolson B.; Solomon R.; Brooks
C.; Mora-Mangano C.; Wong J.; Kashani K.; Naka Y.; Umanath K.; Yee J.;
Kilic A.; Lecker S.; Frendl G.; MacKensen B.; Simon M.; Dagenais F.;
Ferland M.-C.; Bouchard P.-A.; Whitlock R.; Ainsworth C.; McDonald E.;
Curley G.; Yagnik S.; Crescini C.; Ferland A.; Maier K.; Denault A.; Ly
H.; Bainbridge D.; Bentall T.; Legare J.-F.; Grocott H.
Institution
(Swaminathan, Stafford-Smith) Division of Cardiothoracic Anesthesiology,
Department of Anesthesiology, Duke University School of Medicine, Durham,
NC, United States
(Chertow) Department of Medicine (Nephrology), Stanford University,
Stanford, CA, United States
(Warnock) Division of Nephrology, Department of Medicine, Birmingham, AB,
United States
(Paragamian, Brenner) Division of Cardiothoracic Surgery, Department of
Surgery, University of Alabama at Birmingham, Birmingham, AB, United
States
(Lellouche) AlloCure Inc., Burlington, MA, United States
(Fox-Robichaud) Department of Anesthesiology and Critical Care Medicine,
Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval
University, Quebec City, QC, Canada
(Atta) Division of Critical Care, Department of Medicine and Thrombosis,
Atherosclerosis Research Institute, McMaster University and Hamilton
Health Sciences, Hamilton, ON, Canada
(Melby) Division of Nephrology, Department of Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Mehta) Division of Nephrology, Department of Medicine, University of
California, San Diego, CA, United States
(Wald) Division of Nephrology, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Canada
(Verma) Department of Surgery, Division of Cardiac Surgery, Keenan
Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute of
St. Michael's Hospital, Canada
(Mazer) Department of Anesthesia, Keenan Research Centre for Biomedical
Science, Li Ka Shing Knowledge Institute of St. Michael's Hospital,
University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON
M5B 1W8, Canada
(Lombard, Schroder, Kurtzberg, Bisnar) Duke University, United States
(Conte, Dodd-O, Rabb, Katz, Shah, Huyette-Arrizza) Johns Hopkins
University, United States
(Bellot) University of Alabama, Birmingham, United States
(Kramer, Tolson) Maine Medical Center, United States
(Solomon) Fletcher Allen Health Care, United States
(Brooks) University of Virginia, United States
(Mora-Mangano, Wong) Stanford University, United States
(Kashani) Mayo Clinic, United States
(Naka) Columbia University, United States
(Umanath, Yee) Henry Ford Hospital, United States
(Kilic) Ohio State University, United States
(Lecker) Beth Israel Deaconess, Medical Center, United States
(Frendl) Brigham and Women's Hospital, United States
(MacKensen) University of Washington, United States
(Simon, Dagenais, Ferland, Bouchard) Institut Universitaire de Cardiologie
et de Pneumologie, Quebec, Canada
(Whitlock, Ainsworth, McDonald) McMaster-Hamilton General Hospital,
Thrombosis and Atherosclerosis Research Institute, Canada
(Curley, Yagnik, Crescini) St. Michael's Hospital, Canada
(Ferland, Maier) Libin Cardiovascular Institute of Alberta Foothills
Hospital, Canada
(Denault, Ly) Montreal Heart Institute, Canada
(Bainbridge, Bentall) London Health Sciences Centre, University Hospital,
Canada
(Legare) Capital District Health Authority, Queen Elizabeth II Health
Sciences Centre, Canada
(Grocott) St. Boniface Hospital, University of Manitoba, Canada
Publisher
American Society of Nephrology
Abstract
AKI after cardiac surgery remains strongly associated with mortality and
lacks effective treatment or prevention. Preclinical studies suggest that
cell-based interventions may influence functional recovery. We conducted a
phase 2, randomized, double-blind, placebo-controlled trial in 27 centers
across North America to determine the safety and efficacy of allogeneic
human mesenchymal stem cells (MSCs) in reducing the time to recovery from
AKI after cardiac surgery. We randomized 156 adult subjects undergoing
cardiac surgery with evidence of early AKI to receive intra-aortic MSCs
(AC607; n=67) or placebo (n=68). The primary outcome was the time to
recovery of kidney function defined as return of postintervention
creatinine level to baseline. The median time to recovery of kidney
function was 15 days with AC607 and 12 days with placebo (25th, 75th
percentile range, 10-29 versus 6-21, respectively; hazard ratio, 0.81; 95%
confidence interval, 0.53 to 1.24; P=0.32). We did not detect a
significant difference between groups in 30-day all-cause mortality (16.7%
with AC607; 11.8% with placebo) or dialysis (10.6% with AC607; 7.4% with
placebo). At follow-up, 12 patients who received AC607 and six patients
who received placebo had died. Rates of other adverse events did not
differ between groups. In these patients with AKI after cardiac surgery,
administration of allogeneic MSCs did not decrease the time to recovery of
kidney function. Our results contrast with those in preclinical studies
and provide important information regarding the potential effects of MSCs
in this setting.<br/>Copyright &#xa9; 2018 by the American Society of
Nephrology.

<25>
[Use Link to view the full text]
Accession Number
619051493
Title
Urinary matrix metalloproteinase-7 predicts severe AKI and poor outcomes
after cardiac surgery.
Source
Journal of the American Society of Nephrology. 28(11) (pp 3373-3382),
2017. Date of Publication: November 2017.
Author
Yang X.; Chen C.; Teng S.; Fu X.; Zha Y.; Liu H.; Wang L.; Tian J.; Zhang
X.; Liu Y.; Nie J.; Hou F.F.
Institution
(Yang, Teng, Fu, Tian, Liu, Nie, Hou) National Clinical Research Center
for Kidney Disease, Southern Medical University, Nanfang Hospital, 1838
North Guangzhou Avenue, Guangzhou 510515, China
(Chen) Department of Critical Care Medicine, Guangdong Cardiovascular
Institute, Guangdong Academy of Medical Sciences, Guangdong General
Hospital, Guangzhou, China
(Zha, Zhang) Department of Nephrology, Guiyang Medical University, Guizhou
Provincial People's Hospital, Guiyang, China
(Liu) Division of Nephrology, Institute of Nephrology, Guangdong Medical
College, Zhanjiang, China
(Wang) Division of Nephrology, Sichuan Provincial People's Hospital,
Chengdu, China
Publisher
American Society of Nephrology
Abstract
Urinary matrix metalloproteinase-7 (uMMP-7) levels consistently reflect
the activity of intrarenal Wnt/b-catenin, which is activated in AKImodels.
To test the hypothesis that uMMP-7 is a predictor for severe AKI in
patients after cardiac surgery, we performed a prospective, multicenter,
two-stage cohort study in 721 patients undergoing cardiac surgery. In
stage 1,we enrolled 323 children from three academic medical centers. In
stage 2, we enrolled 398 adults at six centers. We analyzed levels of
uMMP-7 and other injury biomarkers during the perioperative period.
SevereAKI was defined asKidneyDisease ImprovingGlobalOutcomesstage2or3.
uMMP-7 levelpeaked within 6 hours after surgery in patients who
subsequently developed severe AKI. After multivariate adjustment, the
highest quintile of postoperative uMMP-7 level, compared with the lowest
quintile, associated with 17-fold (in adults) and 36-fold (in children)
higher odds of severe AKI. ElevateduMMP-7 level associatedwith increased
risk of composite events (severe AKI, acute dialysis, and in-hospital
death) and longer stay in the intensive care unit and hospital. For
predicting severe AKI, uMMP-7 had an area under the receiver operating
characteristic curve of 0.81 (in children) and 0.76 (in adults),
outperforming urinary IL-18, angiotensinogen, neutrophil
gelatinase-associated lipocalin, albumin-to-creatinine ratio, and tissue
inhibitor of metalloproteinase-2zIGF-binding protein-7 and the clinical
model. uMMP-7 significantly improved risk reclassification over the
clinicalmodel alone, as measured by net reclassification improvement and
integrated discrimination improvement. In conclusion, uMMP-7 is a
promising predictor for severe AKI and poor in-hospital outcomes in
patients after cardiac surgery.<br/>Copyright &#xa9; 2017 by the American
Society of Nephrology.

<26>
[Use Link to view the full text]
Accession Number
617032362
Title
Evaluation of short-term changes in serum creatinine level as a meaningful
end point in randomized clinical trials.
Source
Journal of the American Society of Nephrology. 27(8) (pp 2529-2542), 2016.
Date of Publication: 2016.
Author
Coca S.G.; Zabetian A.; Ferket B.S.; Zhou J.; Testani J.M.; Garg A.X.;
Parikh C.R.
Institution
(Coca) Division of Nephrology, Icahn School of Medicine at Mount Sinai,
One Gustave L. Levy Place, New York, NY 10029, United States
(Zabetian, Testani, Parikh) Program of Applied Translational Research,
Department of Internal Medicine, Yale University School of Medicine, New
Haven, CT, United States
(Ferket, Zhou) Institute for Healthcare Delivery Science, Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Garg) Division of Nephrology, Department of Medicine, Western University,
London, ON, Canada
Publisher
American Society of Nephrology
Abstract
Observational studies have shown that acute change in kidney function
(specifically, AKI) is a strong risk factor for poor outcomes. Thus, the
outcome of acute change in serum creatinine level, regardless of
underlying biology or etiology, is frequently used in clinical trials as
both efficacy and safety end points.We performed ameta-analysis of
clinical trials to quantify the relationship between positive or negative
short-term effects of interventions on change in serum creatinine level
and more meaningful clinical outcomes. After a thorough literature
search,we included 14 randomized trials of interventions that altered risk
for an acute increase in serum creatinine level and had reported
between-group differences in CKD and/or mortality rate 3 months after
randomization. Seven trials assessed interventions that, compared with
placebo, increased risk of acute elevation in serum creatinine level
(pooled relative risk, 1.52; 95% confidence interval, 1.22 to 1.89), and
seven trials assessed interventions that, compared with placebo, reduced
risk of acute elevation in serumcreatinine level (pooled relative risk,
0.57; 95%confidence interval, 0.44 to 0.74). However, pooled risks for CKD
andmortality associated with interventions did not differ fromthose with
placebo in either group. In conclusion, several interventions that affect
risk of acute, mild to moderate, often temporary elevation in serum
creatinine level in placebo-controlled randomized trials showed no
appreciable effect on CKD or mortalitymonths later, raising questions
about the value of using small to moderate changes in serum creatinine
level as end points in clinical trials.<br/>Copyright &#xa9; 2016 by the
American Society of Nephrology.

<27>
Accession Number
608484196
Title
Intraoperative high-dose dexamethasone and severe AKI after cardiac
surgery.
Source
Journal of the American Society of Nephrology. 26(12) (pp 2947-2951),
2015. Date of Publication: December 2015.
Author
Jacob K.A.; Leaf D.E.; Dieleman J.M.; Van Dijk D.; Nierich A.P.; Rosseel
P.M.; Van Der Maaten J.M.; Hofland J.; Diephuis J.C.; De Lange F.; Boer
C.; Kluin J.; Waikar S.S.
Institution
(Jacob, Dieleman, Van Dijk) Department of Anesthesiology and Intensive
Care Medicine, University Medical Center Utrecht, Intensive Care and
Emergency Medicine, Mail Stop F.06.149, PO Box 85500, Utrecht 3508 GA,
Netherlands
(Jacob, Kluin) Department of Cardiothoracic Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Leaf, Waikar) Division of Renal Medicine, Harvard Medical School, Brigham
and Women's Hospital, Boston, MA, United States
(Nierich) Department of Anesthesiology, Isala Klinieken, Zwolle,
Netherlands
(Rosseel) Department of Anesthesiology, Amphia Ziekenhuis, Breda,
Netherlands
(Van Der Maaten) Department of Anesthesiology, University Medical Center,
Groningen, Netherlands
(Hofland) Department of Anesthesiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Diephuis) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(De Lange) Department of Cardiac Anesthesiology, Medical Center
Leeuwarden, Leeuwarden, Netherlands
(Boer) Department of Anesthesiology, Vrije Universiteit University Medical
Center, Amsterdam, Netherlands
Publisher
American Society of Nephrology
Abstract
Administration of prophylactic glucocorticoids has been suggested as a
strategy to reduce postoperative AKI and other adverse events after
cardiac surgery requiring cardiopulmonary bypass. In this post hoc
analysis of a large placebo-controlled randomized trial of dexamethasone
in 4465 adult patients undergoing cardiac surgery, we examined severe AKI,
defined as use of RRT, as a primary outcome. Secondary outcomes were
doubling of serum creatinine level or AKI-RRT, as well as AKI-RRT or
in-hospital mortality (RRT/death). The primary outcome occurred in ten
patients (0.4%) in the dexamethasone group and in 23 patients (1.0%) in
the placebo group (relative risk, 0.44; 95% confidence interval, 0.19 to
0.96). In stratified analyses, the strongest signal for potential benefit
of dexamethasone was in patients with an eGFR,15 ml/min per 1.73 m2. In
conclusion, comparedwith placebo, intraoperative dexamethasone appeared to
reduce the incidence of severe AKI after cardiac surgery in those with
advanced CKD.<br/>Copyright &#xa9; 2015 by the American Society of
Nephrology.

<28>
Accession Number
2031579577
Title
Biomaterials for direct cardiac repair-A rapid scoping review 2012-2022.
Source
Acta Biomaterialia. (no pagination), 2024. Date of Publication: 2024.
Author
Sedlakova V.; Mourcos S.; Pupkaite J.; Lunn Y.; Visintini S.; Guzman-Soto
I.; Ruel M.; Suuronen E.; Alarcon E.I.
Institution
(Sedlakova) Department of Histology and Embryology, Faculty of Medicine,
Masaryk University, Kamenice 753/5, Brno 625 00, Czechia
(Mourcos, Pupkaite, Lunn, Guzman-Soto, Ruel, Suuronen, Alarcon) BEaTS
Research, Division of Cardiac Surgery, University of Ottawa Heart
Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Mourcos, Lunn, Ruel, Suuronen, Alarcon) Division of Cardiac Surgery,
University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y
4W7, Canada
(Mourcos) Department of Biomedical Science, Faculty of Science, University
of Ottawa, 150 Louis-Pasteur Private, Ottawa, ON K1N 9A7, Canada
(Lunn, Alarcon) Department of Biochemistry, Microbiology, Immunology,
Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H
8M5, Canada
(Visintini) Berkman Library, University of Ottawa Heart Institute, 40
Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Suuronen) Department of Cellular and Molecular Medicine, Faculty of
Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
Publisher
Acta Materialia Inc
Abstract
A plethora of biomaterials for heart repair are being tested worldwide for
potential clinical application. These therapeutics aim to enhance the
quality of life of patients with heart disease using various methods to
improve cardiac function. Despite the myriad of therapeutics tested, only
a minority of these studied biomaterials have entered clinical trials.
This rapid scoping review aims to analyze literature available from 2012
to 2022 with a focus on clinical trials using biomaterials for direct
cardiac repair, i.e., where the intended function of the biomaterial is to
enhance the repair of the endocardium, myocardium, epicardium or
pericardium. This review included neither biomaterials related to stents
and valve repair nor biomaterials serving as vehicles for the delivery of
drugs. Surprisingly, the literature search revealed that only 8 different
biomaterials mentioned in 23 different studies out of 7038 documents
(journal articles, conference abstracts or clinical trial entries) have
been tested in clinical trials since 2012. All of these, intended to treat
various forms of ischaemic heart disease (heart failure, myocardial
infarction), were of natural origin and most used direct injections as
their delivery method. This review thus reveals notable gaps between
groups of biomaterials tested pre-clinically and clinically. Statement of
significance: Rapid scoping review of clinical application of biomaterials
for cardiac repair. 7038 documents screened; 23 studies mention 8
different biomaterials only. Biomaterials for repair of endocardium,
myocardium, epicardium or pericardium. Only 8 different biomaterials
entered clinical trials in the past 10 years. All of the clinically
translated biomaterials were of natural origin.<br/>Copyright &#xa9; 2024
The Author(s)

<29>
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

<30>
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.

<31>
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

<32>
Accession Number
2030800007
Title
Effects of interval training on haemodynamic variables after coronary
artery bypass graft: A meta-analysis.
Source
Journal of the Pakistan Medical Association. 74(4) (pp 528-533), 2024.
Date of Publication: March 2024.
Author
Zehra F.; Aslam S.; Saeed M.
Institution
(Zehra) Jinnah University for Women, Karachi, Pakistan
(Aslam, Saeed) Department of Physical Therapy, Jinnah University for
Women, Karachi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Objective:To assess the combined impact of interval training programme on
haemodynamic variables, specifically blood pressure and heart rate, in
patients having undergone coronary artery bypass graft surgery.
<br/>Method(s):The meta-analysis was conducted from October to December
2022, and comprised search on PubMed, MEDLINE, Web of Science, PeDro,
EMBASE, Science Direct, Cochrane Central Register of Controlled Clinical
Trials, Google Scholar and Scopus electronic databases by two researchers
independently for literature published between 2009 and 2020 related to
the effects of interval training on coronary artery bypass graft patients.
Meta-analysis was then performed to analyse the effects of an interval
training on systolic blood pressure, diastolic blood pressure, and heart
rate. The meta-analysis was performed in line with the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis guidelines. <br/>Result(s):
Of the 122 studies initially located, 7 were related to the effects of
different forms of interval trainings and their impact on systolic and
diastolic blood pressure of the patients, and 5 studies analysing the
effects of interval trainings on heart rate. Interval training showed mild
improvement in decreasing SBP compared to control groups. Standardized
mean difference suggested an effect size of -0.226 in random effect model
(I2=52.01; p=0.064). Similarly, a small effect size of 0.136 (I2=39.19%,
p=0.14) was observed for diastolic blood pressure. Also, there was a small
effect size of 0.155 (I2= 28.08, p=0.23) observed for heart rate.
<br/>Conclusion(s): Interval training programmes, including high-intensity
interval training, low-volume interval training, and aerobic interval
training, had a small effect on systolic blood pressure, whereas
continuous training protocols had a similarly small effect size on
diastolic blood pressure and heart rate.<br/>Copyright &#xa9; 2024
Pakistan Medical Association. All rights reserved.

<33>
[Use Link to view the full text]
Accession Number
2002545985
Title
Safety of a restrictive versus liberal approach to red blood cell
transfusion on the outcome of AKI in patients undergoing cardiac surgery:
A randomized clinical trial.
Source
Journal of the American Society of Nephrology. 30(7) (pp 1294-1304), 2019.
Date of Publication: July 2019.
Author
Garg A.X.; Badner N.; Bagshaw S.M.; Cuerden M.S.; Fergusson D.A.; Gregory
A.J.; Hall J.; Hare G.M.T.; Khanykin B.; McGuinness S.; Parikh C.R.;
Roshanov P.S.; Shehata N.; Sontrop J.M.; Syed S.; Tagarakis G.I.; Thorpe
K.E.; Verma S.; Wald R.; Whitlock R.P.; Mazer C.D.
Institution
(Garg, Cuerden, Sontrop) Division of Nephrology, Department of Medicine,
London Health Sciences Centre and Western University, London, ON, Canada
(Badner) Department of Anesthesia & Clinical Pharmacology, University of
British Columbia, Kelowna, BC, Canada
(Bagshaw) Department of Critical Care Medicine, University of Alberta,
Edmonton, AB, Canada
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Gregory) Department of Anesthesiology, Perioperative and Pain Medicine,
University of Calgary, Calgary, AB, Canada
(Hall, Hare, Thorpe, Verma, Wald, Mazer) Li Ka Shing Knowledge Institute,
St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Khanykin) Cardiothoracic Anesthesiology Department, Copenhagen University
Hospital, Copenhagen, Denmark
(McGuinness) Cardiothoracic and Vascular Intensive Care and High
Dependency Unit, Auckland City Hospital, Auckland, New Zealand
(Parikh) Division of Nephrology, Department of Medicine, Johns Hopkins
School of Medicine, Baltimore, MD, United States
(Roshanov, Syed, Whitlock) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Shehata) Department of Medicine, Mount Sinai Hospital, University of
Toronto, Toronto, ON, Canada
(Tagarakis) Department of Cardiothoracic Surgery, Aristotle University
Hospital of Thessaloniki, Thessaloniki, Greece
Publisher
American Society of Nephrology
Abstract
Background Safely reducing red blood cell transfusions can prevent
transfusion-related adverse effects, conserve the blood supply, and reduce
health care costs. Both anemia and red blood cell transfusion are
independently associated with AKI, but observational data are insufficient
to determine whether a restrictive approach to transfusion can be used
without increasing AKI risk. Methods In a prespecified kidney substudy of
a randomized noninferiority trial, we compared a restrictive threshold for
red blood cell transfusion (transfuse if hemoglobin<7.5 g/dl,
intraoperatively and postop-eratively) with a liberal threshold (transfuse
if hemoglobin<9.5 g/dl in the operating room or intensive care unit, or if
hemoglobin<8.5 g/dl on the nonintensive care ward). We studied 4531
patients undergoing cardiac surgery with cardiopulmonary bypass who had a
moderate-to-high risk of perioperative death. The substudy's primary
outcome was AKI, defined as a postoperative increase in serum creatinine
of >=0.3 mg/dl within 48 hours of surgery, or >=50% within 7 days of
surgery. Results Patients in the restrictive-threshold group received
significantly fewer transfusions than patients in the liberal-threshold
group (1.8 versus 2.9 on average, or 38% fewer transfusions in the
restricted-threshold group compared with the liberal-threshold group;
P<0.001). AKI occurred in 27.7% of patients in the restrictive-threshold
group (624 of 2251) and in 27.9% of patients in the liberal-threshold
group (636 of 2280). Similarly, among patients with preoperative CKD, AKI
occurred in 33.6% of patients in the restrictive-threshold group (258 of
767) and in 32.5% of patients in the liberal-threshold group (252 of 775).
Conclusions Among patients undergoing cardiac surgery, a restrictive
transfusion approach resulted in fewer red blood cell transfusions without
increasing the risk of AKI.<br/>Copyright &#xa9; 2019 by the American
Society of Nephrology.

<34>
Accession Number
643668301
Title
Surgical prevalence and outcomes in ischemic colitis: A systematic review
and meta-analysis.
Source
World journal of surgery. 48(4) (pp 943-953), 2024. Date of Publication:
01 Apr 2024.
Author
Qian W.; Bruinsma J.; Mac Curtain B.; Ibraheem M.; Temperley H.C.; Ng Z.Q.
Institution
(Qian, Bruinsma, Mac Curtain, Ibraheem) Department of Surgery, St John of
God Subiaco Hospital, Subiaco, WA, Australia
(Temperley) Department of Surgery, Royal College of Surgeons in Ireland,
Dublin, Ireland
(Ng) Department of General Surgery, Royal Perth Hospital, Perth, WA,
Australia
Abstract
BACKGROUND/AIM: This study reviews the literature to examine the
proportion of patients requiring surgical management in ischemic colitis
(IC) and identify surgical outcomes. <br/>METHOD(S): A systematic review
of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was
conducted in accordance with the latest Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) statement. English language
studies and adult patients were included. Studies with fewer than 10
patients, and IC post aortic or cardiac surgery was excluded. We present
our systematic review and meta-analysis with pooled proportions of right
sided IC distribution and prevalence of surgical treatment.
<br/>RESULT(S): 23 studies with a total of 12,844 patients were included
in the systematic review, with 19 studies and 12,420 patients included in
the meta-analysis. Four studies were excluded from the meta-analysis due
to only including specific cohorts of patients-two with cocaine induced
colitis, one with phlebosclerotic colitis, and one with IC associated with
acute myocardial infarction. The pooled proportion of right sided IC
distribution was 15% (CI 14%-17%, p < 0.001), whilst the pooled proportion
of surgical management of IC was 15% (CI 13%-16% p < 0.001).
<br/>CONCLUSION(S): Prevalence of surgical management of IC is rare. Right
sided IC is associated with higher mortality and higher rates of surgical
management. Reporting of surgical outcomes is scant.<br/>Copyright &#xa9;
2024 International Society of Surgery/Societe Internationale de Chirurgie
(ISS/SIC).

<35>
Accession Number
2031646004
Title
Prognostic Value of Cardiovascular Magnetic Resonance in Aortic
Regurgitation: A Network Meta-analysis.
Source
Journal of Cardiovascular Magnetic Resonance. Conference: CMR 2024 Global
CMR Conference. QEII Centre, London United Kingdom. 26(Supplement 1) (no
pagination), 2024. Article Number: 100753. Date of Publication: Spring
2024.
Author
Georgiopoulos G.; Stankowski K.; Maio S.D.; Figliozzi S.; Masci P.G.
Institution
(Georgiopoulos) University of Athens
(Stankowski, Figliozzi) Humanitas Research Institute
(Maio, Masci) King's College London
Publisher
Elsevier B.V.
Abstract
Background: Cardiovascular magnetic resonance (CMR) has gained increasing
attention to study patients with aortic regurgitation (AR) given its
unparalleled ability to quantify the regurgitation volume (RegVol), left
ventricular (LV) volumes, and function as well as myocardial fibrosis by
late-gadolinium-enhancement (LGE). However, clinical evidence supporting
CMR in this context is still limited. Therefore, we conducted a large
network meta-analysis to investigate the prognostic impact of CMR-derived
parameters. <br/>Method(s): PubMed, Embase and Cochrane library were
searched for studies published from 1980 to June 2023. Original papers
enrolling patients with native chronic AR assessed by CMR, including
phase-contrast velocity-encoded imaging for RegVol quantification, and
clinical follow-up were included. The endpoint was a composite of
all-cause death, heart failure hospitalization, aortic valve replacement,
new-onset symptoms related to AR, NYHA class progression, and left
ventricular ejection fraction (LV-EF) <50%. A pairwise meta-analysis was
performed to obtain the pooled estimate separately for the association
between baseline variables and the study endpoint. A random-effects
network meta-analysis was subsequently used to assess the prognostic value
of outcome associates comparatively. <br/>Result(s): A total of 8 studies
with 1,579 patients with AR were included. Both RegVol and regurgitation
fraction (Reg%) as continuous variables were associated with a higher
incidence of the study endpoint (pooled-HR=1.04 [95%CI:1.03-1.06] 1.02
[95%CI:1.01-1.02], respectively). The presence of LGE was associated with
an almost two-fold increased risk of the developing the study endpoint
(pooled-HR=1.86 [95%CI: 1.20-2.89]). Increased LV end-diastolic and
end-systolic volumes (pooled-HR=1.02 [95%CI:1.018-1.024] and
pooled-HR=1.020 [95%CI:1.016-1.025], respectively) and decreased LV-EF
(pooled-HR 0.98 [95%:CI 0.96-0.99]) were also associated with the study
endpoint. No association was found between bicuspid anatomy and clinical
outcome. Network meta-analysis disclosed that LGE presence (P-score 0.884)
and Reg% (P-score 0.727) were the most and second most relevant predictor,
respectively, for the study endpoint. <br/>Conclusion(s): This network
meta-analysis supports the role of multi-parametric CMR for risk
stratification in patients with chronic native AR underpinning the
clinical relevance of myocardial fibrosis by LGE and Reg%. [Formula
presented] [Formula presented] Author Disclosure: G Georgiopoulos: Nothing
to disclose; K Stankowski: N/A; S Di Maio: N/A; S Figliozzi: N/A; P Masci:
N/A<br/>Copyright &#xa9; 2024

<36>
[Use Link to view the full text]
Accession Number
2031587859
Title
Aortic Valve Replacement: Is Minimally Invasive Really Better? A
Contemporary Systematic Review and Meta-Analysis.
Source
Cardiology in Review. 32(3) (pp 217-242), 2024. Date of Publication: 01
May 2024.
Author
El-Andari R.; Fialka N.M.; Shan S.; White A.; Manikala V.K.; Wang S.
Institution
(El-Andari, Shan, White, Manikala, Wang) The Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Fialka) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
In recent years, minimally invasive cardiac surgery has increased in
prevalence. There has been significant debate regarding the optimal
approach to isolated aortic valve replacement between conventional midline
sternotomy and minimally invasive approaches. We performed a systematic
review of the contemporary literature comparing minimally invasive to full
sternotomy aortic valve replacement. PubMed and Embase were systematically
searched for articles published from 2010-2021. A total of 1215 studies
were screened and 45 studies (148,606 patients total) met the inclusion
criteria. This study found rates of in-hospital mortality were higher with
full sternotomy than ministernotomy (P = 0.02). 30-day mortality was
higher with full sternotomy compared to right anterior thoracotomy (P =
0.006). Renal complications were more common with full sternotomy versus
ministernotomy (P < 0.00001) and right anterior thoracotomy (P < 0.0001).
Rates of wound infections were greater with full sternotomy than
ministernotomy (P = 0.02) and right anterior thoracotomy (P < 0.00001).
Intensive care unit length of stay (P = 0.0001) and hospital length of
stay (P < 0.0001) were shorter with ministernotomy compared to full
sternotomy. This review found that minimally invasive approaches to
isolated aortic valve replacement result in reduced early mortality and
select measures of postoperative morbidity; however, long-term mortality
is not significantly different based on surgical approach. An analysis of
mortality alone is not sufficient for the selection of the optimal
approach to isolated aortic valve replacement. Surgeon experience,
individual patient characteristics, and preference require thorough
consideration, and additional studies investigating quality of life
measures will be imperative in identifying the optimal approach to
isolated aortic valve replacement. <br/>Copyright &#xa9; 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<37>
Accession Number
2031669279
Title
Inhaled nitric oxide and postoperative outcomes in cardiac surgery with
cardiopulmonary bypass: A systematic review and meta-analysis.
Source
Nitric Oxide - Biology and Chemistry. 146 (pp 64-74), 2024. Date of
Publication: 01 May 2024.
Author
Yan Y.; Kamenshchikov N.; Zheng Z.; Lei C.
Institution
(Yan, Zheng, Lei) Department of Anesthesiology and Perioperative Medicine,
Xijing Hospital, The Fourth Military Medical University, Xi'an 710032,
China
(Yan) 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
Publisher
Academic Press Inc.
Abstract
Cardiac surgeries under cardiopulmonary bypass (CPB) are complex
procedures with high incidence 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 in
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 Elsevier Inc.

<38>
Accession Number
2031653427
Title
Epidural Catheterization in Cardiac Surgery: A Systematic Review and Risk
Assessment of Epidural Hematoma.
Source
Annals of Cardiac Anaesthesia. 27(2) (pp 111-120), 2024. Date of
Publication: 2024.
Author
Laferriere-Langlois P.; Jeffries S.; Harutyunyan R.; Hemmerling T.M.
Institution
(Laferriere-Langlois) Department of Anaesthesiology and Pain Medicine,
Maisonneuve-Rosemont Hospital, CIUSSS de l'Est de L'Ile de Montreal,
Montreal, QC, Canada
(Jeffries, Harutyunyan, Hemmerling) Department of Experimental Surgery,
McGill University Health Centre, Montreal, Canada
(Jeffries, Harutyunyan, Hemmerling) Intelligent Technology Anaesthesia
Group (ITAG) Laboratory, McGill University, Montreal, Canada
Publisher
Wolters Kluwer Medknow Publications
Abstract
The potential benefits of epidural anesthesia on mortality, atrial
fibrillation, and pulmonary complications must be weighed against the risk
of epidural hematoma associated with intraoperative heparinization. This
study aims to provide an updated assessment of the clinical risks of
epidural anesthesia in cardiac surgery, focusing on the occurrence of
epidural hematomas and subsequent paralysis. A systematic search of
Embase, Medline, Ovid Central, Web of Science, and PubMed was conducted to
identify relevant publications between 1966 and 2022. Two independent
reviewers assessed the eligibility of the retrieved manuscripts. Studies
reporting adult patients undergoing cardiac surgery with epidural
catheterization were included. The incidence of hematomas was calculated
by dividing the number of hematomas by the total number of patients in the
included studies. Risk calculations utilized various denominators based on
the rigor of trial designs, and the risks of hematoma and paralysis were
compared to other commonly encountered risks. The analysis included a
total of 33,089 patients who underwent cardiac surgery with epidural
catheterization. No epidural hematomas were reported across all published
RCTs, prospective, and retrospective trials. Four case reports associated
epidural hematoma with epidural catheterization and perioperative
heparinization. The risks of epidural hematoma and subsequent paralysis
were estimated at 1:7643 (95% CI 1:3860 to 380,916) and 1:10,190 (95% CI
1:4781 to 0:1), respectively. The risk of hematoma is similar to the
non-obstetric population (1:5405; 95% CI 1:4784 to 6134). The risk of
hematoma in cardiac surgery patients receiving epidural anesthesia is
therefore similar to that observed in some other surgical non-obstetric
populations commonly exposed to epidural catheterization.<br/>Copyright
&#xa9; 2024 Annals of Cardiac Anaesthesia.

<39>
Accession Number
2031653423
Title
Incidence and Risk Factors for Postoperative Visual Loss after Cardiac
Surgical Procedures: A Systematic Review.
Source
Annals of Cardiac Anaesthesia. 27(2) (pp 101-110), 2024. Date of
Publication: 2024.
Author
Gupta B.; Singla D.; Gupta A.; Mahaseth R.
Institution
(Gupta, Singla, Mahaseth) Departments of Anaesthesiology, AIIMS,
Uttarakhand, Rishikesh, India
(Gupta) CTVS, AIIMS, Uttarakhand, Rishikesh, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Postoperative visual loss (POVL) is an infrequent yet consequential
complication that can follow cardiac surgical interventions. This
systematic review aims to provide a comprehensive analysis of the
incidence of POVL after cardiac surgery and to delineate the associated
risk factors. A comprehensive search was conducted in major medical
databases for relevant studies published up to September 2022. Eligible
studies reporting on the incidence of POVL and identifying risk factors in
patients undergoing cardiac surgery were included. Data extraction was
performed independently by two reviewers. The pooled incidence rates and
the identified risk factors were synthesized qualitatively. POVL after
cardiac surgery has an overall incidence of 0.015%, that is, 15 cases per
100,000 cardiac surgical procedures. Risk factors for POVL include patient
characteristics (advanced age, diabetes, hypertension, and preexisting
ocular conditions), procedural factors (prolonged surgery duration,
cardiopulmonary bypass time, and aortic cross-clamping), anesthetic
considerations (hypotension, blood pressure fluctuations, and specific
techniques), and postoperative complications (stroke, hypotension, and
systemic hypoperfusion). Ischemic optic neuropathy (ION) is an uncommon
complication, associated with factors like prolonged cardiopulmonary
bypass, low hematocrit levels, excessive body weight gain, specific
medications, hypothermia, anemia, raised intraocular pressure, and
micro-embolization. Diabetic patients with severe postoperative anemia are
at increased risk for anterior ischemic optic neuropathy (AION). Posterior
ischemic optic neuropathy (PION) can occur with factors like hypertension,
postoperative edema, prolonged mechanical ventilation, micro-embolization,
inflammation, hemodilution, and hypothermia. While the overall incidence
of POVL postcardiac surgery remains modest, its potential impact is
substantial, necessitating meticulous consideration of modifiable risk
factors. Notably, prolonged surgical duration, intraoperative hypotension,
anemia, and reduced hematocrit levels remain salient contributors.
Vigilance is indispensable to promptly detect this infrequent yet visually
debilitating phenomenon in the context of postcardiac surgical
care.<br/>Copyright &#xa9; 2024 Annals of Cardiac Anaesthesia.

<40>
Accession Number
2029413021
Title
Rationale and Design of the IMPROVE Trial: A Multicenter, Randomized,
Controlled, Open-label, Blinded-endpoint Trial Assessing the Efficacy of
Remote Ischemic Conditioning in Patients Undergoing Off-Pump Coronary
Artery Bypass Grafting.
Source
Advances in Therapy. (no pagination), 2024. Date of Publication: 2024.
Author
Yan Y.; Zhao C.; Niu J.; Yan P.; Li J.; Wang D.; Li G.
Institution
(Yan, Zhao, Niu, Yan, Li, Wang) Department of Cardiovascular Surgery, The
First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
(Li) Department of Cardiovascular Surgery, People's Hospital of Qinghai
Province, Xining, China
(Wang) Department of Clinical Sciences, Liverpool School of Tropical
Medicine, Pembroke Place, Liverpool, United Kingdom
(Wang) Department of Neurology, Guangdong Key Laboratory of Age-Related
Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical
University, Zhanjiang, China
(Li) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Xi'an Jiaotong University, Xi'an, China
Publisher
Adis
Abstract
Introduction: Despite the appearance of off-pump coronary artery bypass
grafting (CABG), ischemia-reperfusion injury (IRI) in the perioperative
period still arouses concerns of clinicians. Remote ischemic conditioning
(RIC) is the process of repeated ischemia and reperfusion in the
peripheral vessels, which is proven to reduce IRI in vital organs.
However, the effect of RIC in patients undergoing off-pump CABG is still
unclear. <br/>Method(s): This IMPROVE trial is a national, multicenter,
randomized, controlled, open-label, blinded-endpoint clinical trial
designed to assess whether RIC intervention can improve short-term
prognosis of patients undergoing off-pump CABG. It plans to enroll 648
patients who will be randomly assigned into a RIC group or control group.
Patients in the RIC group will receive four cycles of 5 min of
pressurization (about 200 mmHg) and 5 min of rest in the 3 days before and
7 days after the surgery. Planned Outcomes: The primary outcome is the
occurrence of major adverse cardiovascular and cerebrovascular events
(MACCE) within the 3-month follow-up. MACCE is defined as all-cause death,
myocardial infarction, stroke, and coronary revascularization surgery.
Clinical Trial Registration: NCT06141525
(ClinicalTrials.gov).<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Healthcare Ltd., part of Springer Nature 2024.

<41>
Accession Number
2029397282
Title
Remimazolam to prevent hemodynamic instability during catheter ablation
under general anesthesia: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Yim S.; Choi C.I.; Park I.; Koo B.W.; Oh A.Y.; Song I.-A.
Institution
(Yim, Park, Koo, Oh, Song) Department of Anesthesiology and Pain Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Choi) Department of Anesthesiology and Pain Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Choi) Department of Anesthesiology and Pain Medicine, Yongin Severance
Hospital, Yongin, South Korea
(Koo, Oh, Song) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
Springer
Abstract
Purpose: Maintaining hemodynamic stability during cardiac ablation under
general anesthesia is challenging. Remimazolam, a novel ultrashort-acting
benzodiazepine, is characterized by maintaining comparatively stable blood
pressure and does not influence the cardiac conduction system, which
renders it a reasonable choice for general anesthesia for cardiac
ablation. We aimed to evaluate whether remimazolam is associated with a
decreased incidence of intraoperative hypotension compared with
desflurane. <br/>Method(s): In this single-centre, parallel-group,
prospective, single-blind, randomized clinical trial, we randomized
patients (1:1) into a remimazolam group (remimazolam-based total
intravenous anesthesia) or desflurane group (propofol-induced and
desflurane-maintained inhalational anesthesia) during cardiac ablation
procedures for arrhythmia. The primary outcome was the incidence of
intraoperative hypotensive events, defined as mean arterial pressure of <
60 mm Hg at any period. <br/>Result(s): Overall, we enrolled 96 patients
between 2 August 2022 and 19 May 2023 (47 and 49 patients in the
remimazolam and desflurane groups, respectively). The remimazolam group
showed a significantly lower incidence of hypotensive events (14/47, 30%)
than the desflurane group (29/49, 59%; relative risk [RR], 0.5; 95%
confidence interval [CI], 0.31 to 0.83; P = 0.004). Remimazolam was
associated with a lower requirement for bolus or continuous vasopressor
infusion than desflurane was (23/47, 49% vs 43/49, 88%; RR, 0.56; 95% CI,
0.41 to 0.76; P < 0.001). No between-group differences existed in the
incidence of perioperative complications such as nausea, vomiting, oxygen
desaturation, delayed emergence, or pain. <br/>Conclusion(s): Remimazolam
was a viable option for general anesthesia for cardiac ablation.
Remimazolam-based total intravenous anesthesia was associated with
significantly fewer hypotensive events and vasopressor requirements than
desflurane-based inhalational anesthesia was, without significantly more
complications. Study registration: ClinicalTrials.gov (NCT05486377); first
submitted 1 August 2022.<br/>Copyright &#xa9; Canadian Anesthesiologists'
Society 2024.

<42>
Accession Number
643975816
Title
Remote Acute Assessment of Cardiac Patients Post-Acute Coronary Syndrome
(TELE-ACS): A Randomized Controlled Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2024.
Date of Publication: 28 Mar 2024.
Author
Alshahrani N.S.; Hartley A.; Howard J.; Hajhosseiny R.; Khawaja S.;
Seligman H.; Akbari T.; Alharbi B.A.; Bassett P.; Al-Lamee R.; Francis D.;
Kaura A.; Kelshiker M.A.; Peters N.S.; Khamis R.
Institution
(Alshahrani, Alharbi) National Heart and Lung Institute, Imperial College
London, UK; King Khalid University, Abha, Saudi Arabia
(Hartley, Howard, Hajhosseiny, Al-Lamee, Francis, Kaura, Kelshiker,
Peters, Khamis) National Heart and Lung Institute, Imperial College
London, UK; Imperial College Healthcare NHS Trust, London, UK
(Khawaja, Seligman, Akbari) Imperial College Healthcare NHS Trust, London,
United Kingdom
(Bassett) Statsconsultancy Ltd., Amersham, Buckinghamshire, UK
Abstract
BACKGROUND: Telemedicine programmes can provide remote diagnostic
information to aid clinical decision that could optimize care and reduce
unplanned re-admissions post ACS. <br/>OBJECTIVE(S): TELE-ACS is a
randomized controlled trial which aims to compare a telemedicine-based
approach versus standard care in patients following ACS. <br/>METHOD(S):
Patients were suitable for inclusion with at least one cardiovascular risk
factor and presenting with ACS and were randomized (1:1) prior to
discharge. The primary outcome was time to first readmission at 6-months.
Secondary outcomes included emergency department (ED) visits, major
adverse cardiovascular events and patient reported symptoms. The primary
analysis was performed according to intention to treat. The trial was
registered on ClinicalTrial.gov (NCT05015634). <br/>RESULT(S): 337
patients were randomized from January 2022 to April 2023, with a 3.6%
drop-out rate. The mean age was 58.1 years. There was a reduced rate of
readmission over 6-months (hazard ratio [HR] 0.24; 95% confidence interval
[CI] 0.13 to 0.44; p < 0.001) and ED attendance (HR 0.59; 95% CI 0.59; 95%
CI 0.40 to 0.89) in the telemedicine arm, and fewer unplanned coronary
revascularizations (3% in telemedicine arm versus 9% in standard therapy
arm). The occurrence of chest pain (9% versus 24%), breathlessness (21%
versus 39%) and dizziness (6% versus 18%) at 6-months was lower in the
telemedicine group. <br/>CONCLUSION(S): The TELE-ACS study has shown that
a telemedicine-based approach for the management of patients following ACS
was associated with a reduction in hospital readmission, ED visits,
unplanned coronary revascularization and patient reported
symptoms.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<43>
Accession Number
643974356
Title
Outcomes of Heart Transplantation From Donation After Circulatory Death:
An Up-to-Date Systematic Meta-analysis.
Source
Transplantation. (no pagination), 2024. Date of Publication: 05 Apr 2024.
Author
Zong J.; Ye W.; Yu J.; Zhang X.; Cui J.; Chen Z.; Li Y.; Wang S.; Ran S.;
Niu Y.; Luo Z.; Li X.; Zhao J.; Hao Y.; Xia J.; Wu J.
Institution
(Zong, Ye, Yu, Zhang, Cui, Chen, Li, Wang, Ran, Niu, Luo, Li, Zhao, Hao,
Xia, Wu) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
Hubei, China
(Zong, Ye, Chen, Xia, Wu) Center for Translational Medicine, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, Hubei, China
(Yu, Zhang, Cui, Li, Wang, Ran, Niu, Luo, Li, Zhao, Hao, Xia, Wu) Hubei
Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
Hubei, China
(Xia, Wu) Key Laboratory of Organ Transplantation, Ministry of Education,
Chinese Academy of Medical Sciences, Wuhan, Hubei, China
(Xia, Wu) NHC Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Wuhan, Hubei, China
(Xia, Wu) Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Wuhan, Hubei, China
(Xia, Wu) Institute of Translational Medicine, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, Hubei, China
Abstract
BACKGROUND: Donation after circulatory death (DCD) heart transplantation
(HTx) significantly expands the donor pool and reduces waitlist mortality.
However, high-level evidence-based data on its safety and effectiveness
are lacking. This meta-analysis aimed to compare the outcomes between DCD
and donation after brain death (DBD) HTxs. <br/>METHOD(S): Databases,
including MEDLINE, Embase, CINAHL, and the Cochrane Central Register of
Controlled Trials, were systematically searched for randomized controlled
trials and observational studies reporting the outcomes of DCD and DBD
HTxs published from 2014 onward. The data were pooled using random-effects
models. Risk ratios (RRs) with 95% confidence intervals (CIs) were used as
the summary measures for categorical outcomes and mean differences were
used for continuous outcomes. <br/>RESULT(S): Twelve eligible studies were
included in the meta-analysis. DCD HTx was associated with lower 1-y
mortality rate (DCD 8.13% versus DBD 10.24%; RR = 0.75; 95% CI, 0.59-0.96;
P = 0.02) and 5-y mortality rate (DCD 14.61% versus DBD 20.57%; RR = 0.72;
95% CI, 0.54-0.97; P = 0.03) compared with DBD HTx. <br/>CONCLUSION(S):
Using the current DCD criteria, HTx emerges as a promising alternative to
DBD transplantation. The safety and feasibility of DCD hearts deserve
further exploration and investigation.<br/>Copyright &#xa9; 2024 Wolters
Kluwer Health, Inc. All rights reserved.

<44>
Accession Number
643973556
Title
Topical Versus Intravenous Tranexamic Acid in Patients Undergoing Cardiac
Surgery: The DEPOSITION Randomized Controlled Trial.
Source
Circulation. (no pagination), 2024. Date of Publication: 08 Apr 2024.
Author
Lamy A.; Sirota D.A.; Jacques F.; Poostizadeh A.; Noiseux N.; Efremov S.;
Demers P.; Akselrod B.; Wang C.Y.; Arora R.C.; Branny P.; McGuinness S.P.;
Brown C.D.; Jeanmart H.; Zhao Q.; Zhang H.; Belley-Cote E.P.; Whitlock
R.P.; Browne A.; Copland I.; Vincent J.; Khatun R.; Balasubramanian K.;
Bangdiwala S.I.; McGillion M.H.; Fox-Robichaud A.E.; Spence J.; Yusuf S.;
Devereaux P.J.
Institution
(Lamy, Whitlock) Population Health Research Institute, Hamilton, Canada;
Department of Surgery, McMaster University, Hamilton, Canada
(Sirota) E. Meshalkin National Medical Research Center, Novosibirsk,
Russian Federation
(Jacques) Institut Universitaire de cardiologie et de pneumologie de
Quebec, Universite Laval, IUCPQ, Quebec City, Canada
(Poostizadeh) Kelowna General Hospital, Kelowna, Canada
(Noiseux) Centre de Recherche du Centre Hospitalier de l'Universite de
Montreal (CRCHUM), Montreal, Canada
(Efremov) Saint Petersburg State University Hospital, Saint Petersburg,
Russian Federation
(Demers) Montreal Heart Institute, Montreal, Canada
(Akselrod) Petrovsky National Centre of Surgery, Moscow, Russian
Federation
(Wang) Department of Anaesthesiology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
(Arora) Division of Cardiac Surgery, Harrington Heart and Vascular
Institute, University of Hospitals, Cleveland, OH; Department of Surgery,
Case Western Reserve University, Cleveland, OH
(Branny) Head of Cardiac Surgery Department, Hospital Agel Trinec-Podlesi,
Trinec, Czechia
(McGuinness) Auckland City Hospital, Auckland, New Zealand
(Brown) New Brunswick Heart Centre, Saint John, New Brunswick
(Jeanmart) CIUSSS-NIM Hopital du Sacre-Coeur de Montreal, Montreal, Canada
(Zhao) Rujin Hospital, Shanghai, China; Shanghai Jiao Tong University
School of Medicine, Shanghai, China
(Zhang) Beijing Anzhen Hospital, Beijing, China
(Belley-Cote, Yusuf) Population Health Research Institute, Hamilton,
Canada; Department of Medicine, McMaster University, Hamilton, Canada
(Browne) Hamilton Health Sciences, General Hospital, Hamilton, Canada
(Copland, Vincent, Balasubramanian) Population Health Research Institute,
Hamilton, Canada
(Khatun) Population Health Research Institute, Canada
(Bangdiwala) Population Health Research Institute, Hamilton, Canada;
Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, Canada
(McGillion) Population Health Research Institute, Hamilton, Canada; School
of Nursing, McMaster University, Hamilton, Canada
(Fox-Robichaud) Dept of Medicine and Thrombosis and Atherosclerosis
Research Institute, McMaster University, Hamilton, Bermuda
(Spence) Population Health Research Institute, Hamilton, Canada;
Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, Canada; Department of Anesthesia, McMaster
University, Hamilton, Canada
(Devereaux) Population Health Research Institute, Hamilton, Canada;
Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, Canada; Department of Medicine, McMaster University,
Hamilton, Canada
Abstract
BACKGROUND: Although intravenous tranexamic acid is used in cardiac
surgery to reduce bleeding and transfusion, topical tranexamic acid
results in lower plasma concentrations compared to intravenous tranexamic
acid, which may lower the risk of seizures. We aimed to determine whether
topical tranexamic acid reduces the risk of in-hospital seizure without
increasing the risk of transfusion among cardiac surgery patients.
<br/>METHOD(S): We conducted a multicenter, double dummy, blinded,
randomized controlled trial of patients recruited by convenience sampling
in academic hospitals undergoing cardiac surgery with cardiopulmonary
bypass. Between September 17, 2019, and November 28, 2023, a total of 3242
patients from 16 hospitals in 6 countries were randomly assigned (1:1
ratio) to receive either intravenous tranexamic acid (control) through
surgery or topical tranexamic acid (treatment) at the end of surgery. The
primary outcome was seizure, and the secondary outcome was red blood cell
transfusion. After the last planned interim analysis-when 75% of
anticipated participants had completed follow up-the Data and Safety
Monitoring Board recommended to terminate the trial, and upon unblinding,
the Operations Committee stopped the trial for safety. <br/>RESULT(S):
Among 3242 randomized patients (mean age, 66.0 years; 77.7% male),
in-hospital seizure occurred in 4 of 1624 patients (0.2%) in the topical
group and in 11 of 1628 patients (0.7%) in the intravenous group (absolute
risk difference, -0.5%; 95% CI, -0.9 to 0.03; P = .07). Red blood cell
transfusion occurred in 570 patients (35.1%) in the topical group and in
433 (26.8%) in the intravenous group (absolute risk difference, 8.3%; 95%
CI, 5.2 to 11.5; P = .007). The absolute risk difference in transfusion of
>=4 units of red blood cells in the topical group compared to the
intravenous group was 8.2% (95% CI, 3.4 to 12.9). <br/>CONCLUSION(S):
Among patients having cardiac surgery, topical administration of
tranexamic acid resulted in an 8.3% absolute increase in transfusion
without reducing the incidence of seizure, compared to intravenous
tranexamic acid.

<45>
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

<46>
Accession Number
2029262411
Title
The association of atherogenic index of plasma with cardiovascular
outcomes in patients with coronary artery disease: A systematic review and
meta-analysis.
Source
Cardiovascular Diabetology. 23(1) (no pagination), 2024. Article Number:
119. Date of Publication: December 2024.
Author
Rabiee Rad M.; Ghasempour Dabaghi G.; Darouei B.; Amani-Beni R.
Institution
(Rabiee Rad, Ghasempour Dabaghi) Interventional Cardiology Research
Center, Cardiovascular Research Institute, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Darouei, Amani-Beni) School of Medicine, Isfahan University of Medical
Science, Isfahan, Iran, Islamic Republic of
(Ghasempour Dabaghi) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Atherogenic index of plasma (AIP) represents a novel marker in
the current era of cardiovascular diseases. In this meta-analysis, we
aimed to evaluate the association of AIP with cardiovascular prognosis in
patients with coronary artery disease (CAD). <br/>Method(s): PubMed,
Scopus, and Web of Science databases were searched from inception through
2024. The primary outcome was major cardiovascular events (MACE). The
secondary outcomes included all-causes death, cardiovascular death,
myocardial infarction (MI), stroke, revascularization, and no-reflow
phenomenon. AIP was determined by taking the logarithm of the ratio of
triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C). The
data analysis was represented using the risk ratio (RR) along with a 95%
confidence interval (CI). <br/>Result(s): Sixteen studies with a total
number of 20,833 patients met the eligible criteria. The pooled-analysis
showed a significant increased risk of MACE in the highest AIP group
compared with the lowest AIP group (RR = 1.63; 95% CI, 1.44-1.85; P <
0.001). A similar result was observed when AIP was regarded as a
continuous variable (RR = 1.54; 95% CI, 1.30-1.83; P < 0.001). Besides,
elevated AIP was associated with increased risk of cardiovascular death
(RR = 1.79; 95% CI, 1.09-2.78; P = 0.02), MI (RR = 2.21; 95% CI,
1.55-3.13; P < 0.001), revascularization (RR = 1.62; 95% CI, 1.34-1.97; P
< 0.001), no-reflow phenomenon (RR = 3.12 95% CI, 1.09-8.96; P = 0.034),
and stent thrombosis (RR = 13.46; 95%CI, 1.39-129.02; P = 0.025). However,
AIP was not significantly associated with the risk of all-causes death and
stroke among patients with CAD. <br/>Conclusion(s): The results of this
study demonstrated that increased AIP is an independent prognostic factors
in patients with CAD. Further research is warranted to elucidate the
potential development of targeted interventions to modify AIP levels and
improve patient outcomes.<br/>Copyright &#xa9; The Author(s) 2024.

<47>
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.

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

<49>
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

<50>
[Use Link to view the full text]
Accession Number
2031265332
Title
Intravascular ultrasound-guided percutaneous coronary intervention for
patients with unprotected left main coronary artery lesions.
Source
Coronary Artery Disease. 35(3) (pp 171-178), 2024. Date of Publication: 01
May 2024.
Author
Bendary A.; Elsaed A.; Tabl M.A.; Ahmed Elrabat K.; Zarif B.
Institution
(Bendary, Tabl, Ahmed Elrabat) Cardiology Department, Faculty of Medicine,
Benha University, Benha, Egypt
(Elsaed, Zarif) National Heart Institute, Cairo, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Background In percutaneous coronary intervention (PCI) procedures for
patients with unprotected left main coronary artery (ULMCA) lesions,
intravascular ultrasonography (IVUS) guidance has shown potential for
enhancing clinical outcomes. However, studies confirming its superiority
to conventional angiographic-guided PCI remain few. This study aimed to
assess if IVUS-guided PCI for patients with unprotected LMCA stenosis
improves clinical outcomes compared to angiographic-guided PCI. Methods
This randomized clinical study enrolled 181 patients with ULMCA lesions
scheduled for drug-eluting stent implantation. Patients were split into 90
in the IVUS-guided group and 91 in the conventional group. Procedural
characteristics, clinical outcomes, and the incidence of major adverse
cardiovascular event (MACE) were evaluated for all patients. The risk
reduction associated with IVUS-guided PCI was evaluated using a
multivariate Cox regression analysis. Results Patients who underwent IVUS
demonstrated significantly higher pre-dilatation before stenting (88.9%
vs. 72.5%, P = 0.005), post-dilatation balloon diameter (4.46 +/- 0.48 vs.
4.21 +/- 0.49, P < 0.001), stent diameter (3.9 +/- 0.4 vs. 3.7 +/- 0.3, P
= 0.002), and pressure for post dilatation (18 +/- 3 vs. 16 +/- 2, P =
0.001). Regarding 12-month outcomes, patients who underwent IVUS
demonstrated significantly lower MACE (3.3% vs. 18.7%, P < 0.001) than
those who underwent the conventional method. Multivariate Cox regression
analysis revealed that IVUS was related to 84.4% risk reduction of 1-year
MACE (HR = 0.156, 95% CI = 0.044-0.556, P = 0.004). Conclusion Compared to
angiographic-guided PCI, IVUS-guided PCI resulted in improved clinical
results and a markedly reduced risk of MACE in patients with ULMCA
lesions.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<51>
Accession Number
2031018321
Title
Implantation of a double allogeneic human engineered tissue graft on
damaged heart: insights from the PERISCOPE phase I clinical trial.
Source
eBioMedicine. 102 (no pagination), 2024. Article Number: 105060. Date of
Publication: April 2024.
Author
Bayes-Genis A.; Gastelurrutia P.; Monguio-Tortajada M.; Camara M.L.;
Prat-Vidal C.; Cediel G.; Rodriguez-Gomez L.; Teis A.; Revuelta-Lopez E.;
Ferrer-Curriu G.; Roura S.; Galvez-Monton C.; Bisbal F.; Vives J.;
Vilarrodona A.; Munoz-Guijosa C.; Querol S.
Institution
(Bayes-Genis, Gastelurrutia, Monguio-Tortajada, Camara, Cediel, Teis,
Revuelta-Lopez, Roura, Galvez-Monton, Bisbal, Munoz-Guijosa) Heart
Institute and Heart Failure Unit (iCor), Germans Trias i Pujol University
Hospital (HUGTiP), Badalona, Spain
(Bayes-Genis, Gastelurrutia, Cediel, Revuelta-Lopez, Ferrer-Curriu, Roura,
Galvez-Monton, Bisbal, Munoz-Guijosa) CIBER Cardiovascular, Instituto de
Salud Carlos III, Madrid, Spain
(Bayes-Genis, Vives) Department of Medicine, Autonomous University of
Barcelona, Barcelona, Spain
(Bayes-Genis, Gastelurrutia, Monguio-Tortajada, Revuelta-Lopez, Roura,
Galvez-Monton) ICREC Research Program, Germans Trias i Pujol Health
Science Research Institute (IGTP), Spain
(Prat-Vidal, Rodriguez-Gomez, Vives, Querol) Cell Therapy Service, Banc de
Sang i Teixits (BST), Barcelona, Spain
(Roura) Faculty of Medicine, University of Vic-Central University of
Catalonia (UVic-UCC), Victoria, Spain
(Vives) Vall d'Hebron Institute of Research (VHIR), Autonomous University
of Barcelona, Barcelona, Spain
(Vilarrodona) Barcelona Tissue Bank (BTB), Banc de Sang i Teixits (BST),
Barcelona, Spain
Publisher
Elsevier B.V.
Abstract
Background: In preclinical studies, the use of double allogeneic grafts
has shown promising results in promoting tissue revascularization,
reducing infarct size, preventing adverse remodelling and fibrosis, and
ultimately enhancing cardiac function. Building upon these findings, the
safety of PeriCord, an engineered tissue graft consisting of a
decellularised pericardial matrix and umbilical cord Wharton's jelly
mesenchymal stromal cells, was evaluated in the PERISCOPE Phase I clinical
trial (NCT03798353), marking its first application in human subjects.
<br/>Method(s): This was a double-blind, single-centre trial that enrolled
patients with non-acute myocardial infarction eligible for surgical
revascularization. Seven patients were implanted with PeriCord while five
served as controls. <br/>Finding(s): Patients who received PeriCord showed
no adverse effects during post-operative phase and one-year follow-up. No
significant changes in secondary outcomes, such as quality of life or
cardiac function, were found in patients who received PeriCord. However,
PeriCord did modulate the kinetics of circulating monocytes involved in
post-infarction myocardial repair towards non-classical
inflammation-resolving macrophages, as well as levels of monocyte
chemoattractants and the prognostic marker Meteorin-like in plasma
following treatment. <br/>Interpretation(s): In summary, the PeriCord
graft has exhibited a safe profile and notable immunomodulatory
properties. Nevertheless, further research is required to fully unlock its
potential as a platform for managing inflammatory-related pathologies.
<br/>Funding(s): This work was supported in part by grants fromMICINN
(SAF2017-84324-C2-1-R);Instituto de Salud Carlos III (ICI19/00039 and Red
RICORS-TERAV RD21/0017/0022, and CIBER Cardiovascular CB16/11/00403) as a
part of the Plan Nacional de I + D + I, and co-funded by
ISCIII-Subdireccion General de Evaluacion y elFondo Europeo de Desarrollo
Regional (FEDER) andAGAUR (2021-SGR-01437).<br/>Copyright &#xa9; 2024 The
Author(s)

<52>
Accession Number
2030968508
Title
Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and
Anemia.
Source
New England Journal of Medicine. 389(26) (pp 2446-2456), 2023. Date of
Publication: 28 Dec 2023.
Author
Carson J.L.; Brooks M.M.; Hebert P.C.; Goodman S.G.; Bertolet M.; Glynn
S.A.; Chaitman B.R.; Simon T.; Lopes R.D.; Goldsweig A.M.; Defilippis
A.P.; Abbott J.D.; Potter B.J.; Carrier F.M.; Rao S.V.; Cooper H.A.;
Ghafghazi S.; Fergusson D.A.; Kostis W.J.; Noveck H.; Kim S.; Tessalee M.;
Ducrocq G.; De Barros E Silva P.G.M.; Triulzi D.J.; Alsweiler C.; Menegus
M.A.; Neary J.D.; Uhl L.; Strom J.B.; Fordyce C.B.; Ferrari E.; Silvain
J.; Wood F.O.; Daneault B.; Polonsky T.S.; Senaratne M.; Puymirat E.;
Bouleti C.; Lattuca B.; White H.D.; Kelsey S.F.; Steg P.G.; Alexander J.H.
Institution
(Carson, Potter, Fordyce, Alexander) Department of Medicine, Rutgers
Robert Wood Johnson Medical School, New Brunswick, NJ, United States
(Brooks) the Departments of Epidemiology and Biostatistics, School of
Public Health, University of Pittsburgh, United States
(Hebert) the Department of Pathology, Division of Transfusion Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, United States
(Goodman) the Bruyere Research Institute, University of Ottawa, Canada
(Bertolet) the Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Ottawa, Canada
(Glynn) St. Michael s Hospital, University of Toronto, Toronto, Canada
(Chaitman) Canadian VIGOUR Centre, University of Alberta, Canada
(Simon, Lopes) the Department of Medicine, Grey Nuns Hospital, Edmonton,
Canada
(Goldsweig) CHUM Research Centre, the Departments of Anesthesiology and
Medicine, Division of Critical Care, Centre Hospitalier de l Universite de
Montreal, Innovation and Evaluation Hub, Centre de Recherche du CHUM,
Canada
(Defilippis) the Department of Anesthesiology and Pain Medicine,
Universite de Montreal, Montreal, Canada
(Abbott, Carrier) the Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Rao) the Division of Cardiology and Centre for Cardiovascular Innovation,
Vancouver General Hospital and University of British Columbia, Vancouver,
Canada
(Cooper) Centre Hospitalier Universitaire (CHU) de Sherbrooke, Universite
de Sherbrooke, Sherbrooke, QC, Canada
(Ghafghazi) the National Heart, Lung, Blood Institute, Bethesda, MD,
United States
(Fergusson) St. Louis University School of Medicine, St. Louis, United
States
(Kostis) FACT (French Alliance for Cardiovascular Trials), Service de
Pharmacologie, Plateforme de Recherche Clinique de l Est Parisien,
Assistance Publique Hopitaux de Paris, Hopital Saint Antoine, Sorbonne
Universite, Universite Paris-Cite, INSERM Unite 1148 and AP-HP, Hopital
Bichat, Sorbonne Universite, France
(Noveck) INSERM UMRS1166, Hopital Pitie Salpetriere AP-HP, AP-HP, Hopital
Europeen Georges Pompidou, Department of Cardiology, Universite de Paris,
Paris, France
(Kim) Hopital Pasteur, Service de Cardiologie, CHU Nice, Nice, France
(Tessalee) University Hospital of Poitiers, Clinical Investigation Center
(INSERM 1204), Cardiology Department, Poitiers, France
(De Barros E Silva) Nimes University Hospital, Montpelier University,
ACTION Group, Nimes, France
(Ducrocq, Triulzi) Duke Clinical Research Institute, Duke University,
Durham, United States
(Alsweiler) the Department of Medicine, WakeMed Health and Hospitals,
Winston-Salem, NC, United States
(Menegus) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Neary) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Uhl) the Department of Medicine, Baystate Medical Center, Springfield,
United States
(Strom, Daneault) the Department of Pathology and Richard A. and Susan F.
Smith Center for Outcomes Research in Cardiology, Israel
(Ferrari, Wood, Polonsky) Deaconess Medical Center, Harvard Medical
School, Boston, MA, United States
(Silvain, Senaratne) the University of Nebraska Medical Center, Omaha,
United States
(Puymirat) the Department of Medicine, Vanderbilt University Medical
Center, Nashville, United States
(Bouleti) Lifespan Cardiovascular Institute and the Department of
Medicine, Division of Cardiology, Alpert Medical School of Brown
University, Providence, RI, United States
(Lattuca) the Department of Medicine, NYU Langone Health System, the
Department of Medicine, Montefiore Medical Center, New York, United States
(White) the Department of Cardiology, Westchester Medical Center,
Valhalla, NY, United States
(Kelsey) the Department of Medicine, University of Louisville, Louisville,
KY, United States
(Steg) UChicago AdventHealth Heart and Vascular (M.T.) and the Department
of Medicine, University of Chicago Medicine, Chicago, United States
(Alexander) Green Lane Coordinating Center, Auckland, New Zealand
Publisher
Massachussetts Medical Society
Abstract
Abstract Background A strategy of administering a transfusion only when
the hemoglobin level falls below 7 or 8 g per deciliter has been widely
adopted. However, patients with acute myocardial infarction may benefit
from a higher hemoglobin level. Methods In this phase 3, interventional
trial, we randomly assigned patients with myocardial infarction and a
hemoglobin level of less than 10 g per deciliter to a restrictive
transfusion strategy (hemoglobin cutoff for transfusion, 7 or 8 g per
deciliter) or a liberal transfusion strategy (hemoglobin cutoff, <10 g per
deciliter). The primary outcome was a composite of myocardial infarction
or death at 30 days. Results A total of 3504 patients were included in the
primary analysis. The mean (+/-SD) number of red-cell units that were
transfused was 0.7+/-1.6 in the restrictive-strategy group and 2.5+/-2.3
in the liberal-strategy group. The mean hemoglobin level was 1.3 to 1.6 g
per deciliter lower in the restrictive-strategy group than in the
liberal-strategy group on days 1 to 3 after randomization. A
primary-outcome event occurred in 295 of 1749 patients (16.9%) in the
restrictive-strategy group and in 255 of 1755 patients (14.5%) in the
liberal-strategy group (risk ratio modeled with multiple imputation for
incomplete follow-up, 1.15; 95% confidence interval [CI], 0.99 to 1.34;
P=0.07). Death occurred in 9.9% of the patients with the restrictive
strategyand in 8.3% of the patients with the liberal strategy (risk ratio,
1.19; 95% CI, 0.96 to 1.47); myocardial infarction occurred in 8.5% and
7.2% of the patients, respectively (risk ratio, 1.19; 95% CI, 0.94 to
1.49). Conclusions In patients with acute myocardial infarction and
anemia, a liberal transfusion strategy did not significantly reduce the
risk of recurrent myocardial infarction or death at 30 days. However,
potential harms of a restrictive transfusion strategy cannot be excluded.
(Funded by the National Heart, Lung, and Blood Institute and others; MINT
ClinicalTrials.gov number, NCT02981407.)<br/>Copyright &#xa9; 2023
Massachusetts Medical Society.

<53>
Accession Number
2029974767
Title
Variation in the definition of 'failure to rescue' from postoperative
complications: a systematic review and recommendations for outcome
reporting.
Source
Surgery (United States). 175(4) (pp 1103-1110), 2024. Date of Publication:
April 2024.
Author
Wells C.I.; Bhat S.; Xu W.; Varghese C.; Keane C.; Baraza W.; O'Grady G.;
Harmston C.; Bissett I.P.
Institution
(Wells, Bhat, Xu, Varghese, Keane, Baraza, O'Grady, Harmston, Bissett)
Department of Surgery, The University of Auckland, Auckland, New Zealand
(Varghese) Department of General Surgery, Te Whatu Ora Counties Manukau,
Auckland, New Zealand
(Bhat) Department of Surgery, Te Whatu Ora MidCentral, Palmerston North,
New Zealand
(Wells, Baraza, O'Grady, Bissett) Department of Surgery, Te Whatu Ora Te
Toka Tumai, Auckland, New Zealand
(Xu, Keane, Harmston) Department of Surgery, Te Whatu Ora Te Tai Tokerau,
Whangarei, New Zealand
Publisher
Elsevier Inc.
Abstract
Background: Failure to rescue is the rate of death amongst patients with
postoperative complications and has been proposed as a perioperative
quality indicator. However, variation in its definition has limited
comparisons between studies. We systematically reviewed all surgical
literature reporting failure to rescue rates and examined variations in
the definition of the 'numerator,' 'denominator,' and timing of failure to
rescue measurement. <br/>Method(s): Databases were searched from inception
to 31 December 2022. All studies reporting postoperative failure to rescue
rates as a primary or secondary outcome were included. We examined the
complications included in the failure to rescue denominator, the
percentage of deaths captured by the failure to rescue numerator, and the
timing of measurement for complications and mortality. <br/>Result(s): A
total of 359 studies, including 212,048,069 patients, were analyzed. The
complications included in the failure to rescue denominator were reported
in 295 studies (82%), with 131 different complications used. The median
number of included complications per study was 10 (interquartile range
8-15). Studies that included a higher number of complications in the
failure-to-rescue denominator reported lower failure-to-rescue rates.
Death was included as a complication in the failure to rescue the
denominator in 65 studies (18%). The median percentage of deaths captured
by the failure to rescue calculation when deaths were not included in the
denominator was 79%. Complications (52%) and mortality (40%) were mostly
measured in-hospital, followed by 30-days after surgery.
<br/>Conclusion(s): Failure to rescue is an important concept in the study
of postoperative outcomes, although its definition is highly variable and
poorly reported. Researchers should be aware of the advantages and
disadvantages of different approaches to defining failure to
rescue.<br/>Copyright &#xa9; 2024 The Authors

<54>
Accession Number
2029312473
Title
Associations of sleep disorders with all-cause MCI/dementia and different
types of dementia - clinical evidence, potential pathomechanisms and
treatment options: A narrative review.
Source
Frontiers in Neuroscience. 18 (no pagination), 2024. Article Number:
1372326. Date of Publication: 2024.
Author
Mayer G.; Frohnhofen H.; Jokisch M.; Hermann D.M.; Gronewold J.
Institution
(Mayer) Department of Neurology, Philipps-Universitat Marburg, Marburg,
Germany
(Frohnhofen) Department of Orthopedics and Trauma Surgery, University
Hospital Dusseldorf, Heinrich Heine University, Dusseldorf, Germany
(Frohnhofen) Department of Medicine, Faculty of Health, University
Witten-Herdecke, Witten, Geriatrics, Germany
(Jokisch, Hermann, Gronewold) Department of Neurology and Center for
Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital
Essen, University Duisburg-Essen, Essen, Germany
Publisher
Frontiers Media SA
Abstract
Due to worldwide demographic change, the number of older persons in the
population is increasing. Aging is accompanied by changes of sleep
structure, deposition of beta-amyloid (As) and tau proteins and vascular
changes and can turn into mild cognitive impairment (MCI) as well as
dementia. Sleep disorders are discussed both as a risk factor for and as a
consequence of MCI/dementia. Cross-sectional and longitudinal
population-based as well as case-control studies revealed sleep disorders,
especially sleep-disorderded breathing (SDB) and excessive or insufficient
sleep durations, as risk factors for all-cause MCI/dementia. Regarding
different dementia types, SDB was especially associated with vascular
dementia while insomnia/insufficient sleep was related to an increased
risk of Alzheimer's disease (AD). Scarce and still inconsistent evidence
suggests that therapy of sleep disorders, especially continuous positive
airway pressure (CPAP) in SDB, can improve cognition in patients with
sleep disorders with and without comorbid dementia and delay onset of
MCI/dementia in patients with sleep disorders without previous cognitive
impairment. Regarding potential pathomechanisms via which sleep disorders
lead to MCI/dementia, disturbed sleep, chronic sleep deficit and SDB can
impair glymphatic clearance of beta-amyloid (As) and tau which lead to
amyloid deposition and tau aggregation resulting in changes of brain
structures responsible for cognition. Orexins are discussed to modulate
sleep and As pathology. Their diurnal fluctuation is suppressed by sleep
fragmentation and the expression suppressed at the point of hippocampal
atrophy, contributing to the progression of dementia. Additionally, sleep
disorders can lead to an increased vascular risk profile and vascular
changes such as inflammation, endothelial dysfunction and atherosclerosis
which can foster neurodegenerative pathology. There is ample evidence
indicating that changes of sleep structure in aging persons can lead to
dementia and also evidence that therapy of sleep disorder can improve
cognition. Therefore, sleep disorders should be identified and treated
early.<br/>Copyright &#xa9; 2024 Mayer, Frohnhofen, Jokisch, Hermann and
Gronewold.

<55>
Accession Number
2029067318
Title
Ferroptosis mechanisms and regulations in cardiovascular diseases in the
past, present, and future.
Source
Cell Biology and Toxicology. 40(1) (no pagination), 2024. Article Number:
17. Date of Publication: December 2024.
Author
Fang W.; Xie S.; Deng W.
Institution
(Fang, Xie, Deng) Department of Cardiology, Renmin Hospital of Wuhan
University, Jiefang Road 238, Wuhan 430060, China
(Fang, Xie, Deng) Hubei Key Laboratory of Metabolic and Chronic Diseases,
Wuhan 430060, China
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiovascular diseases (CVDs) are the main diseases that endanger human
health, and their risk factors contribute to high morbidity and a high
rate of hospitalization. Cell death is the most important pathophysiology
in CVDs. As one of the cell death mechanisms, ferroptosis is a new form of
regulated cell death (RCD) that broadly participates in CVDs (such as
myocardial infarction, heart transplantation, atherosclerosis, heart
failure, ischaemia/reperfusion (I/R) injury, atrial fibrillation,
cardiomyopathy (radiation-induced cardiomyopathy, diabetes cardiomyopathy,
sepsis-induced cardiac injury, doxorubicin-induced cardiac injury, iron
overload cardiomyopathy, and hypertrophic cardiomyopathy), and pulmonary
arterial hypertension), involving in iron regulation, metabolic mechanism
and lipid peroxidation. This article reviews recent research on the
mechanism and regulation of ferroptosis and its relationship with the
occurrence and treatment of CVDs, aiming to provide new ideas and
treatment targets for the clinical diagnosis and treatment of CVDs by
clarifying the latest progress in CVDs research. Graphical Abstract: * The
identification, development history and characterization of ferroptosis. *
The role of different subcellular organelles and organelle-specific
regulators in ferroptosis. * The mechanism of ferroptosis includes iron
metabolism, amino acid metabolism, and lipid metabolism. * The role of
ferroptosis in different cardiovascular cells and cardiovascular diseases.
* The treatment efficacy and pathological mechanism involved in
ferroptosis and cardiovascular diseases. (Figure
presented.).<br/>Copyright &#xa9; The Author(s) 2024.

<56>
Accession Number
2028339032
Title
Safety of bempedoic acid in patients at high cardiovascular risk and with
statin intolerance.
Source
Journal of Clinical Lipidology. 18(1) (pp e59-e69), 2024. Date of
Publication: 01 Jan 2024.
Author
Bays H.E.; Bloedon L.T.; Lin G.; Powell H.A.; Louie M.J.; Nicholls S.J.;
Lincoff A.M.; Nissen S.E.
Institution
(Bays) Louisville Metabolic and Atherosclerosis Research Center, Illinois
Avenue, (Dr Bays), 3288, Louisville, KY 40213, United States
(Bloedon, Lin, Powell, Louie) Esperion Therapeutics, Inc., 3891 Ranchero
Drive, Suite 150, (Dr Bloedon, Lin, Powell and Louie), Ann Arobor, MI
48108, United States
(Nicholls) Victorian Heart Institute, Monash University, 631 Blackburn Rd,
(Dr Nicholls), Clayton VIC 3168, Australia
(Lincoff, Nissen) Cleveland Clinic, 9500 Euclid Avenue, Rm JB-820, (Dr
Lincoff and Nissen), Cleveland, OH 44195, United States
Publisher
Elsevier Ltd
Abstract
Background: Bempedoic acid is an oral adenosine triphosphate citrate lyase
(ACL) inhibitor that lowers low-density lipoprotein cholesterol (LDL-C)
blood levels. The Cholesterol Lowering via Bempedoic acid, an
ACL-Inhibiting Regimen (CLEAR) Outcomes study demonstrated that bempedoic
acid reduced cardiovascular (CV) risk in patients at high risk for CV
events who were unwilling or unable to take guideline-recommended doses of
statins. <br/>Objective(s): To describe detailed safety information from
CLEAR Outcomes, including events in the United States (US) prescribing
information based on previous phase 3 hyperlipidemia studies.
<br/>Method(s): CLEAR Outcomes was a double-blind trial conducted in
13,970 patients randomized to oral bempedoic acid 180 mg daily or placebo
and followed for a median of 3.4 years. <br/>Result(s): In patients who
received at least one dose (7,001 bempedoic acid, 6,964 placebo),
treatment emergent adverse events (AE) occurred in 86.3 % and 85 % of
patients, respectively. COVID-19 was the most frequently reported AE in
both groups. Changes in serum creatinine, blood urea nitrogen, hemoglobin,
aminotransaminases, and uric acid were consistent with the known safety
profile of bempedoic acid. Gout or gouty arthritis occurred in 3.2 % of
bempedoic acid and 2.2 % of placebo patients. AE associated with
tendinopathies, including tendon rupture, occurred in 2 % of patients in
both treatment groups. Cholelithiasis occurred in 2.2 % of bempedoic acid
and 1.2 % of placebo patients; AE related to gallbladder disease were
similar between treatment groups. <br/>Conclusion(s): Bempedoic acid was
well-tolerated compared with placebo. Safety data from the long-term CLEAR
Outcomes study reinforce the positive benefit-risk profile of bempedoic
acid.<br/>Copyright &#xa9; 2023

<57>
Accession Number
2027717051
Title
Optimizing Safety and Success: The Advantages of Bloodless Cardiac
Surgery. A Systematic Review and Meta-Analysis of Outcomes in Jehovah's
Witnesses.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102078. Date of Publication: January 2024.
Author
Gemelli M.; Italiano E.G.; Geatti V.; Addonizio M.; Cao I.; Dimagli A.;
Dokollari A.; Tarzia V.; Gallo M.; Ferrari E.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Italiano, Geatti, Addonizio, Cao, Tarzia, Gerosa) Cardiac
Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua, Padua, Italy
(Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Dokollari) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Gallo, Slaughter) Department of Cardiothoracic Surgery, University of
Louisville, Louisville, KY, United States
(Ferrari) Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale, Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
Transfusions are extremely frequent after cardiac surgery, and they have a
considerable economic burden and impact on outcomes. Optimal patient blood
management could play a fundamental role in reducing the rate of
transfusion and Jehovah's Witnesses (JW) represent the ideal surrogate
study population. This meta-analysis compares outcomes of JWs and non-JWs'
patients undergoing cardiac surgery, assessing the safety of a bloodless
cardiac surgery. A scoping review was conducted using a search strategy
for studies assessing outcomes of JW undergoing cardiac surgery. The
primary outcome was perioperative mortality, and a random-effects
meta-analysis was performed. Ten studies were included in our
meta-analysis, involving 780 JW patients refusing any type of transfusion
("JW") and 1182 patients accepting transfusion if needed ("non-JW"). 86%
of non-JW patients received at least 1 transfusion. There was no
significant difference in terms of perioperative mortality (OR 0.91; 95%
CI 0.55-1.52; p = 0.72). The volume blood loss was significantly less in
the JW (p = 0.001), while the rate of reoperation for bleeding was also
lower, but not statistically significative, in the JW (p = 0.16). Both
preoperative and postoperative hemoglobin and hematocrit were
significantly higher in the JW. Therefore, we concluded that bloodless
cardiac surgery is safe and early outcomes are similar between JW and
non-JW patients: optimal patient blood management is fundamental in
guarantying these results. Further studies are needed to assess if a
limitation of transfusion could have a positive long-term impact on
outcomes.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<58>
Accession Number
2029312023
Title
Preoperative localization for pulmonary nodules: a meta-analysis of coil
and liquid materials.
Source
Minimally Invasive Therapy and Allied Technologies. (no pagination),
2024. Date of Publication: 2024.
Author
Sun Z.-H.; Cheng H.; Su J.; Sun Q.-L.
Institution
(Sun, Cheng, Su) Geriatrics Department, Second Affiliated Hospital of
Shandong University of Traditional Chinese Medicine, Jinan, China
(Sun) Tumor Minimally Invasive Department, Second Affiliated Hospital of
Shandong University of Traditional Chinese Medicine, Jinan, China
Publisher
Taylor and Francis Ltd.
Abstract
Purpose: This study was designed to conduct pooled comparisons of the
relative clinical efficacy and safety of computed tomography (CT)-guided
localization for pulmonary nodules (PNs) using either coil- or liquid
material-based approaches. <br/>Material(s) and Method(s): Relevant
articles published as of July 2023 were identified in the Web of Science,
PubMed, and Wanfang databases, and pooled analyses of relevant endpoints
were then conducted. <br/>Result(s): Six articles that enrolled 287
patients (341 PNs) and 247 patients (301 PNs) that had respectively
undergone CT-guided localization procedures using coil- and liquid
material-based approaches prior to video-assisted thoracic surgery (VATS)
were included in this meta-analysis. The liquid material group exhibited a
significantly higher pooled successful localization rate as compared to
the coil group (p = 0.01), together with significantly lower pooled total
complication rates (p = 0.0008) and pneumothorax rates (p = 0.01). Both
groups exhibited similar rates of pulmonary hemorrhage (p = 0.44) and
successful wedge resection (p = 0.26). Liquid-based localization was also
associated with significant reductions in pooled localization and VATS
procedure durations (p = 0.004 and 0.007). <br/>Conclusion(s): These data
are consistent with CT-guided localization procedures performed using
liquid materials being safer and more efficacious than coil-based
localization in patients with PNs prior to VATS resection.<br/>Copyright
&#xa9; 2024 Society of Medical Innovation and Technology.

<59>
Accession Number
2028951476
Title
Identification of Preoperative Risk Factors for the Development of Cardiac
Allograft Vasculopathy: A Systematic Review.
Source
Current Surgery Reports. 12(5) (pp 104-110), 2024. Date of Publication:
May 2024.
Author
Roberts W.S.; Pirovic A.; Ionescu A.; Ryan M.; Schaffer S.; Nguyen H.
Institution
(Roberts, Pirovic, Ionescu, Ryan, Schaffer) Osteopathic Medicine, Nova
Southeastern University Dr. Kiran C. Patel College of Osteopathic
Medicine, 3400 Gulf to Bay Blvd, Clearwater, FL 33759, United States
(Nguyen) Foundational Sciences, Nova Southeastern University Dr. Kiran C.
Patel College of Osteopathic Medicine, Clearwater, United States
Publisher
Springer
Abstract
Purpose of Review: The purpose of this systematic review was to analyze
the current literature and identify all known preoperative risk factors
associated with an increased incidence of cardiac allograft vasculopathy.
Recent Findings: A total of 7 independent preoperative risk factors for
cardiac allograft vasculopathy were identified, namely T. gondii
seropositivity (HR 4.39, 1.26-15.62, p < 0.02), elevated body mass index
(HR 1.116, 1.015-1.23, p < 0.02), 2-1 haptoglobin phenotype (HR 2.73,
1.03-7.19, p < 0.01), elevated low-density lipoproteins (OR 2.14,
1.02-4.46, p < 0.04), single-nucleotide polymorphism -201 matching (HR
11.9, 4.3-32.9, p < 0.01), stroke cause of death (HR 1.47, 1.04-2.09, p <
0.03), and pre-transplant hemodynamic instability (HR 1.79, 1.15-2.77, p <
0.01). <br/>Summary: Cardiac allograft vasculopathy is the leading cause
of death in patients who survive more than a few years following
transplantation and is likely the limiting factor in expanding the average
life expectancy post-transplant. The development of therapeutics targeting
the multifactorial etiology of this vasculopathy would undoubtedly provide
hope for patients whose time is currently limited.<br/>Copyright &#xa9;
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<60>
Accession Number
639841610
Title
Oral hygiene prior to cardiac surgery to prevent infections: Randomized
clinical trial.
Source
International journal of dental hygiene. 22(2) (pp 384-393), 2024. Date of
Publication: 01 May 2024.
Author
Nunez M.D.R.R.; Engel F.D.; Cardoso M.; Castro R.G.; Montoya J.A.G.; de
Mello A.L.S.F.
Institution
(Nunez, Engel, Cardoso, Castro, de Mello) Federal University of Santa
Catarina, Florianopolis, Brazil
(Montoya) Universidad de Granada, Granada, Spain
Abstract
CONTEXT: It is not clear if an oral hygiene protocol to control biofilm
applied before cardiac surgery can reduce infection rates.
<br/>OBJECTIVE(S): We aim to verify the effectiveness of an oral hygiene
protocol in reducing postoperative infections when compared to usual
practices, in patients admitted to a cardiology unit, prior to cardiac
surgery. DESIGN, SETTING AND PARTICIPANTS: Randomized, blind, controlled
clinical trial, with 107 participants who expected to undergo cardiac
surgery, randomized into two groups: Experimental Group (EG) standardized
oral hygiene protocol (54) and Control Group (CG), usual practices
performed in patients admitted (53). INTERVENTION: a standardized oral
hygiene protocol, 1day before surgery: professional prophylaxis with a
portable ultrasound device, tooth brushing and flossing plus a 0.12%
chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When
applicable, removable prostheses cleaning. PRIMARY OUTCOME: the presence
of infection. <br/>RESULT(S): The occurrence of postoperative infection
was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical
difference was found between protocols (p = 0.518). The length of stayed
from surgery to discharge presented a statistical difference (p = 0.047;
RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was
almost five times higher in those participants who stayed 11 or more days.
<br/>CONCLUSION(S): The standardized oral hygiene protocol with mechanical
and chemical cleaning, 1day before cardiac surgery, was not more effective
than the usual practices performed regarding the reduction of
postoperative infections. Other interventions regarding oral hygiene
procedures before cardiac surgery must be studied to contribute to the
reduction of adverse post-surgical events. CLINICAL TRIAL REGISTRATION:
Site Ensaclinicos.gov.br number U1111-1214-2862. DESCRIPTORS: Healthcare
Associated Infections, Cardiovascular Diseases, Periodontal Diseases,
Dental Biofilm, Cardiovascular Surgery.<br/>Copyright &#xa9; 2022 John
Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<61>
Accession Number
2031644075
Title
Right Ventricular Function and Myocardial Deformation in Patients with
Pulmonary Regurgitation with versus Without Tetralogy of Fallot.
Source
Journal of Cardiovascular Magnetic Resonance. Conference: CMR 2024 Global
CMR Conference. QEII Centre, London United Kingdom. 26(Supplement 1) (no
pagination), 2024. Article Number: 100367. Date of Publication: Spring
2024.
Author
Inage A.; Mizuno N.; Kishiki K.; Matsuda J.
Institution
(Inage) Japanese Red Cross Medical Center
(Mizuno, Kishiki, Matsuda) Sakakibara Heart Institute
Publisher
Elsevier B.V.
Abstract
Background: Right ventricular (RV) dilation due to pulmonary valvular
regurgitation (PR) is common after interventions for tetralogy of Fallot
(TOF) and pulmonary atresia with intact ventricular septum (PA/IVS). It is
not well recognized whether PR and RV dilation have similar effects on RV
function in these patients compared to patients of repaired TOF. The
objective of this study was to compare RV function and myocardial
deformation in TOF versus PA/IVS patients. <br/>Method(s): Ten PA/IVS
after interventions (PA/IVS group) and 10 repaired TOF patients (TOF
group) with significant PR and RV dilation were retrospectively
randomized. Clinical characteristics, RV function and myocardial
deformation by cardiovascular MRI and ECG were compared between groups.
<br/>Result(s): Global RV function (RVEF: 45.3+/-7.1% versus 45.1+/-10.3%,
p>0.05) was preserved between groups. RV end-diastolic volume (RVEDV)
correlated negatively with RVEF in both groups (PA/IVS: r=-0.37, TOF:
r=-0.41). QRS duration was wider in TOF group, and in both groups
negatively correlated with RVEF (PA/IVS: r=-0.73, TOF: r=-0.64). In
contrast to global function, RV longitudinal strain was lower in TOF group
compared to PA/IVS group (-19.1+/-4.3 versus -24.2+/-5.4, p<0.01).
<br/>Conclusion(s): Significant tricuspid regurgitation and repair are
more commonly observed among patients with PA/IVS compared with TOF
patients. Global RV function is similarly preserved in PA/IVS and TOF
groups with severely dilated RV. The significant decreased RV longitudinal
function and worsening dyssynchrony may be prognostic factors and optimal
timing of pulmonary valve replacement in the TOF group. Author Disclosure:
A Inage: Nothing to disclose; N Mizuno: N/A; k Kishiki: N/A; J Matsuda:
N/A<br/>Copyright &#xa9; 2024

<62>
Accession Number
2031581731
Title
The Association Between Body Mass Index, Exercise Capacity, and
Health-Related Quality of Life in Heart Transplant Recipients.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre Prague. Prague
Congress Centre, Prague Czechia. 43(4 Supplement) (pp S504-S505), 2024.
Date of Publication: April 2024.
Author
Broch K.; Holmen S.; Rolid K.; Englund K.; Ostby C.M.; Gude E.; Andreassen
A.K.; Gullestad L.
Institution
(Broch, Holmen, Ostby, Gude, Andreassen, Gullestad) Oslo University
Hospital, Oslo, Norway
(Rolid) The Research Council of Norway, Oslo, Norway
(Englund) Akershus University Hospital, Lorenskog, Norway
Publisher
Elsevier Inc.
Abstract
Purpose: Rapid weight gain is common after heart transplantation and
associated with increased risk of allograft vasculopathy, major adverse
cardiovascular events, and rejections. Physical capacity and quality of
life are reduced in heart transplant recipients versus the general
population. We aimed to assess the association between overweight or
obesity, defined as a body mass index (BMI) >= 27 kg/m², and
exercise capacity and quality of life in contemporary heart transplant
recipients. <br/>Method(s): This study is based on baseline data from the
randomised controlled IronIC trial, which randomized 102 heart transplant
recipients with iron deficiency to ferric derisomaltose or placebo. We
performed cardiopulmonary exercise testing in all participants at
baseline. To assess quality of life, we used the SF-36v2 questionnaire,
which can be converted to 2 sum scores: the physical component summary
(PCS) and the mental component summary (MCS). <br/>Result(s): 46/102
patients (45 %) had a BMI >= 27 kg/m². Their characteristics,
compared with those of patients with a BMI < 27 kg/m², are
presented in the Table. Peak oxygen consumption was 6.6 ml/kg/min (95 % CI
4.3 - 8.8 ml/kg/min) higher in patients with a BMI < 27 kg/m²
(p < 0.001: Figure). The PCS, but not the MSC, was clinically and
statistically significantly lower in the overweight group versus the group
with a BMI < 27 kg/m²: 48.3 +/- 8.1 vs 43.8 +/- 11.1 for a
between-group difference of 4.7 (95 % CI 0.6 - 8.7); p = 0.02.
<br/>Conclusion(s): Almost half of our heart transplant recipients in
long-term follow-up had a BMI >= 27 kg/m². These patients had
lower exercise capacity and lower quality of life. [Formula presented]
Table Population characteristics [Formula presented]<br/>Copyright &#xa9;
2024

<63>
Accession Number
2031581414
Title
The Effect of Everolimus vs Calcineurin Inhibitors on Quality of Life 11
Years After Heart Transplantation: The Results of a Randomized Controlled
Trial (Schedule Trial).
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre Prague. Prague
Congress Centre, Prague Czechia. 43(4 Supplement) (pp S88-S89), 2024. Date
of Publication: April 2024.
Author
Grov I.; Relbo Authen A.; Bergh N.; Rolid K.; Gustafsson F.; Eiskjaer H.;
Radegran G.; Gude E.; Arora S.; Andreassen A.; Halden T.; Broch K.;
Gullestad L.
Institution
(Grov, Relbo Authen, Gude, Arora, Andreassen, Broch) Department of
Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
(Bergh) Sahlgrenska University Hospital, Gothenburg, Sweden
(Rolid) The Research Council of Norway, Oslo, Norway
(Gustafsson) Department of Cardiology, Copenhagen University Hospital,
Copenhagen, Denmark
(Eiskjaer) Aarhus University Hospital, Aarhus, Denmark
(Radegran) The Section for Heart Failure and Valvular Disease, Skane
University Hospital and Lund University, Lund, Sweden
(Halden) Novartis Norge AS, Oslo, Norway
(Gullestad) K.GJebsen Cardiac Research Centre and Center for Heart Failure
Research, Faculty of Medicine, University of Oslo, Oslo, Norway
Publisher
Elsevier Inc.
Abstract
Purpose: Long-term complications of calcineurin inhibitors (CNI) in heart
transplantation (HTx) has increased the interest in everolimus (EVR)-based
regimens allowing for CNI withdrawal. We compared quality of Life (QoL) in
a CNI-based regimen versus a CNI-free, EVR-based regimen during long-term
treatment in The Scandinavian heart transplant everolimus de novo study
with early CNI avoidance (SCHEDULE trial). <br/>Method(s): In the SCHEDULE
trial, 115 patients (mean age 51+/-13 years, 27 % women) were randomly
assigned within 5 days of HTx to low-dose EVR and reduced dose CNI
followed by cyclosporine withdrawal in week 7-11 (EVR group; n=56), or
standard cyclosporine dosage (CNI group; n=59). The primary efficacy
endpoint was renal function measured by glomerular filtration rate (mGFR)
at 12 and 36 months. Secondary objectives were rejections, serious adverse
events (SAE) and QoL, assessed by EQ-5D, 21 -item Beck Depression
Inventory (BDI), Short Form 36 version 2 (SF-36v2) questionnaire. The
SF-36 scores can be converted to 2 norm-based sum scores: the physical
component summary (PCS) and the mental component summary (MCS).
<br/>Result(s): 78 patients attended follow-up visits at a median of 11
years after HTx. In the EVR group, 35/4 (88%) still received everolimus,
while in the CNI group, 33/38 (87%) still received CNI. In the ITT
population, from baseline (pre-HTx) to 11 years post-HTx, QoL measured by
EQ-5D index/100 mm visual analog score increased from 47.0+/-24.8 to
74.2+/-20.9 for EVE (p<0.01) and from 40.9+/-22.5 to 70.9+/-10.3 for CNI
(p<0.01). There was no significant difference between the groups
(intra-group comparison p=0.99). Mean BDI decreased significantly from
12+/-11 to 7+/-9 (EVR; p<0.01) and 13+/-9 to 7+/-6 (CNI, P<0.01) but there
was no significant difference between the groups (intra-group comparison
p=0.95). The mean SF-36 PCS increased significantly from 31.8+/-10.0 to
44.1+/-11.5 (P<0.01) with EVE and from 32.5+/-8.6 to 44.3+/-10.8 (p<0.01)
with CNI, and the MCS from 45.6+/-11.5 to 52.7+/-13.0 (EVE; p=0.04) and
38.2+/-12.5 to 48.7+/-12.8 (CNI, P<0.01). There was no significant
difference between the groups for PCS or MCS (p=0.43 and p=0.86,
respectively). <br/>Conclusion(s): Both groups demonstrated a similar
long-term improvement in QoL. There was no significant difference in
long-term QoL between the two regimens.<br/>Copyright &#xa9; 2024

<64>
Accession Number
2031581306
Title
Dapagliflozin for Graft Dysfunction After Pediatric Heart Transplant.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre Prague. Prague
Congress Centre, Prague Czechia. 43(4 Supplement) (pp S617-S618), 2024.
Date of Publication: April 2024.
Author
Profita E.L.; Barkoff L.; Lee J.; Hollander S.; Gonzales S.; Wujcik K.;
Almond C.
Institution
(Profita, Hollander, Almond) Department of Pediatrics, Stanford
University, Palo Alto, CA, United States
(Barkoff, Lee, Wujcik) Lucile Packard Children's Hospital Stanford, Palo
Alto, CA, United States
(Gonzales) Stanford University School of Medicine, Palo Alto, CA, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: Dapagliflozin is an SGLT-2 inhibitor that is approved for the
management of heart failure (HF) in adults. There is emerging data on the
use of dapagliflozin in pediatric HF, but little is known about its
effects after heart transplant (HT) or in management of graft dysfunction.
We sought to describe our center's experience with dapagliflozin in
pediatric HT recipients with graft dysfunction. <br/>Method(s): All HT
recipients at a single pediatric center prescribed dapagliflozin between
2022 and 2023 were identified using a hospital pharmacy database. Graft
dysfunction was classified as systolic if EF<50% and diastolic if EF>=50%.
Patients were considered to have elevated hemodynamics if right atrial
(RA) pressure >= 10 mmHg and pulmonary capillary wedge pressure (PCWp) >=
15 mmHg. Medication tolerability, side effects and outcomes were analyzed.
<br/>Result(s): There were 12 pediatric HT patients started on
dapagliflozin for graft dysfunction, 3 with systolic and 9 with diastolic
(7 with elevated hemodynamics). Dapagliflozin was initiated at a median
age of 19.3 years (IQR 15, 21), weight 77.5 kg (42, 88) and 23 mo (1.8,
47) post- HT, and duration of 184 days (83, 293). At time of last
follow-up, 5 (42%) had discontinued medication (2 died, 2 improvement, 1
medication side effect). AKI was noted in 2 patients. There was no
difference in ejection fraction or NT-proBNP (LVEF Pre 58% vs Post 61%, p
= 0.95, NT-proBNP Pre 3140 vs Post 2359, p =0.917). In 6 patients with
elevated hemodynamics with repeat data available, RA and PCWp improved
with use of dapagliflozin (RA 16.5 to 7.5, p = 0.027, PCWp 22.5 to 12.5, p
= 0.027). <br/>Conclusion(s): Dapagliflozin appears to be well tolerated
in children with heart transplant graft dysfunction, with most common
concern being AKI. This small cohort suggests it may be useful in patients
with elevated hemodynamics. While the safety profile appears acceptable in
our study, a randomized clinical trial would afford the field with the
best opportunity to understand the comparative safety and efficacy of
SGLT-2 inhibitors in children. [Formula presented]<br/>Copyright &#xa9;
2024

<65>
Accession Number
2031581176
Title
Impact of Concomitant Surgical Procedures in a Randomized Controlled Trial
of Aspirin Removal in Left Ventricular Assist Device Patients - An
Analysis from The ARIES Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre Prague. Prague
Congress Centre, Prague Czechia. 43(4 Supplement) (pp S60-S61), 2024. Date
of Publication: April 2024.
Author
Pagani F.; Mehra M.R.
Institution
(Pagani) University of Michigan, Ann Arbor, MI, United States
(Mehra) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: ARIES is an international, placebo-controlled, study of aspirin
(100mg daily) in patients implanted with the HM3 LVAD to demonstrate that
elimination of aspirin from the antithrombotic regimen preserves safety
and efficacy and reduces residual risk of non-surgical bleeding
complications. The primary endpoint results of the ARIES HM3 Trial will be
presented in November 2023. In this analysis, we seek to analyze the
impact of concomitant procedures (stratified by valvular and non-valvular
surgery) on hemocompatibility related outcomes within the study. Methods
and Analysis Plan: Advanced HF patients implanted with the HM3 LVAD were
randomized 1:1 to an antithrombotic regimen of VKA (INR: 2.0-3.0) with
either aspirin or placebo. We shall assess the impact of a) valvular
procedures (mitral, aortic and tricuspid) or b) non-valvular surgery (PFO
or LAA closure) and their interaction with aspirin use on the composite
primary end point of survival free of a major non-surgical (>14-days
post-implant) hemocompatibility related adverse event (including stroke,
pump thrombosis, major bleeding, or arterial peripheral thromboembolism)
at 12-months, and the principal secondary endpoint of cumulative
non-surgical bleeding events and on overall survival. Population: The
intent-to-treat population included 628 patients implanted with the HM3
LVAD (314 received either placebo or aspirin in each arm) of whom 296
patients and 293 respectively were in the modified intent to treat
population which informs the primary analysis. A diverse geographic
enrollment is ensured with patients from the United States, Canada, United
Kingdom, Austria, Czech Republic, Italy, France, Kazakhstan, and
Australia. Results for this analysis will be available by MAR-20-2024.
Endpoints and Outcomes: The ARIES HM3 trial will establish the impact of
aspirin in patients who undergo concomitant surgical procedures supported
with a fully magnetically levitated LVAD. These data will inform practice
with antithrombotic regimens among those LVAD patients undergoing
additional surgical procedures. Funding Statement: The ARIES HM3 Trial
(ClinicalTrials.gov: NCT04069156) is funded by Abbott (Abbott Park,
IL).<br/>Copyright &#xa9; 2024

<66>
Accession Number
2031580767
Title
Non-HLA Antibodies in Transplantation: A Multi-Center Collaborative
Towards Developing a Strategy for Testing.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre Prague. Prague
Congress Centre, Prague Czechia. 43(4 Supplement) (pp S625), 2024. Date of
Publication: April 2024.
Author
Iler C.; Backowski J.; Bastardi H.; Boyle C.; Buesking C.; Daneman S.; Ha
L.; Huston A.; Sinicropi N.; White R.; Deshpande S.
Institution
(Iler, Deshpande) Advanced Cardiac Therapies and Heart Transplant,
Children's National Hospital, Washington, DC, United States
(Backowski, Buesking) Heart Transplant, St. Louis Children's Hospital, St.
Louis, MO, United States
(Bastardi) Advanced Cardiac Therapies and Heart Transplant, Children's
Hospital of Boston, Boston, MA, United States
(Boyle, Ha, White) Pediatric Heart Failure and Transplant, Children's
Hospital of Philadelphia, Philadelphia, PA, United States
(Daneman) Pediatric Heart Transplant, Children's Medical Center of Dallas,
Dallas, TX, United States
(Huston) Pediatric Heart and Lung Transplant, UPMC Children's Hospital of
Pittsburgh, Pittsburgh, PA, United States
(Sinicropi) Pediatric Heart Failure and Heart Transplant, C.S. Mott
Children's Hospital, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Non-HLA antibodies (NHAb) are increasingly being investigated for
their potential role in graft complications. Consensus on which NHAb to
test and with what frequency varies between centers. This multi-center
collaboration aims to develop a sample testing strategy to aid centers who
wish to incorporate NHAb testing into practice. <br/>Method(s): Seven
pediatric heart transplant centers in the United States participated in a
literature review of currently tested NHAb for solid organ transplants
using specific search terms within PubMed. Through a pragmatic approach, a
consensus strategy for testing was proposed. <br/>Result(s): Current
literature supports that presence of NHAb is linked with antibody mediated
rejection, coronary artery vasculopathy, and graft dysfunction after heart
transplantation in adults. Use of ventricular assist devices
pre-transplant, injury from the transplant surgery, de novo donor specific
antibody, and acute rejection are all suggested triggers for development
of NHAb. Up to 123 NHAb have been identified in solid organ transplant
recipients. Angiotensin II Type 1 Receptor Antibodies (AT1R) have the most
evidence for contributing to post-transplant complications. Other NHAb
with evidence of negative outcomes in post heart transplant recipients are
Endothelin A Receptor (ETAR), Major Histocompatibility Complex class
I-related chain A (MICA), and Vimentin. The literature review did not
yield recommendations for testing indications, frequency, or application
in clinical practice. Therefore, a sample testing schedule was developed
using consensus building (Figure 1). <br/>Conclusion(s): There is
increasing evidence that NHAb may play an important role in development of
graft dysfunction and warrants continued research. Adopting a testing
schedule, such as the one presented in Figure 1, may allow continued and
systematic collection of important clinical data to further our
understanding of the role of NHAb in transplantation. [Formula
presented]<br/>Copyright &#xa9; 2024

<67>
Accession Number
643965538
Title
PCI as a Primary Choice in the Treatment of Left Main Stenosis.
Source
Cardiology (Switzerland). Conference: 25th Nordic-Baltic Congress of
Cardiology 2015. Tallinn Estonia. 31(Supplement 1) (pp 11), 2015. Date of
Publication: June 2015.
Author
Kervinen K.
Institution
(Kervinen) Consulting Cardiologist, Oulu University Hospital, Finland
Publisher
S. Karger AG
Abstract
In the first decade of the present millennium, CABG was still regarded as
the standard treatment for left main (LM) stenosis. The ESC year 2008
guidelines on PCI stated that 'Stenting for unprotected LM disease should
only be considered in the absence of other revascularization options'.
This recommendation was largely based on data using the treatment methods
of the 1970's and 1980's comparing CABG and medical therapy. The recent
data, based on the present treatment standards, such as drug eluting
stents and usage of statins suggest that PCI provides at least equivalent
or even superior results to CABG in most LM lesions. This is based on
several randomised studies and metaanalyses. In the SYNTAX trial, the
5-year results for 705 patients showed no overall difference between PCI
and CABG in death (7.3% PCI vs. 8.4% CABG) or MI (6.9% vs. 4.1%) but a
higher incidence of stroke with CABG (1.2% vs. 4%). The need for repeat
revascularization (mainly PCI) was 20% for the PCI group vs. 12% for CABG.
In patients with SYNTAX score 32 or less, the incidence of death and MI
tended to be less after PCI. In the patients with SYNTAX score over 32,
these endpoints tended to be met less often after CABG. The meta-analysis
by Capodanno et al. (2011) consisted of 1611 patients from four randomised
studies with one year follow-up. The analysis showed that there was no
significant difference in death or MI between PCI and CABG, but there were
less strokes (OR 0.15 in favour of PCI) and more need for repeat
revascularization (OR 2.25) in the PCI patients. Based on the present
data, PCI is the treatment of choice in most patients with LM stenosis:
isolated LM, LM + 1-2 vessels and LM + 2-3 vessels when the SYNTAX score
remains 32 or less.

<68>
[Use Link to view the full text]
Accession Number
2031588006
Title
Sugammadex shortens operation time and improves operation turnover
efficacy in video-assisted thoracoscopic surgery.
Source
Journal of the Chinese Medical Association. 87(4) (pp 448-452), 2024. Date
of Publication: 01 Apr 2024.
Author
Lin Y.-T.; Ting C.-K.; Hsu H.-S.
Institution
(Lin, Ting, Hsu) Institute of Emergency and Critical Care Medicine, School
of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
(Republic of China)
(Lin) Nursing Department, Taipei Veterans General Hospital, Taipei, Taiwan
(Republic of China)
(Ting) Department of Anesthesiology, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Ting) Department of Anesthesiology, School of Medicine, National Yang
Ming Chiao Tung University, Taipei, Taiwan (Republic of China)
(Hsu) Division of Thoracic Surgery, Department of Surgery, Taipei Veterans
General Hospital, Taipei, Taiwan (Republic of China)
Publisher
Wolters Kluwer Health
Abstract
Background: This study compared sugammadex and neostigmine as agents for
routine neuromuscular blockade reversal in video-assisted thoracoscopic
surgery (VATS) to determine the optimal choice that achieves a shorter
operation time and improved turnover efficiency while enhancing
postoperative outcomes and ensuring patient safety during thoracic
surgery. <br/>Method(s): This prospective study, conducted from July 2022
to March 2023, compared the effect of sugammadex and neostigmine on
operation time and turnover efficiency in VATS, involving 60 participants
randomly assigned to either group, with the primary objective of
identifying the optimal anesthesia reversal choice for improved outcomes
and patient safety during thoracic surgery. <br/>Result(s): In the study,
the sugammadex group showed a significantly shorter total operation room
occupancy time (130 +/- 7 vs 157 +/- 7 minutes; p = 0.009) than the
neostigmine group. Patients in the neostigmine group had higher mean pulse
rates when leaving the operation room (85 +/- 3 vs 73 +/- 3 beats/min; p =
0.002) and 120 minutes later in the postanesthesia care unit (76 +/- 2 vs
68 +/- 2; p = 0.016). <br/>Conclusion(s): This study's findings suggest
that sugammadex may enhance total operating room occupancy time, operation
turnover efficacy, and respiratory recovery outcomes in VATS, potentially
improving patient care and anesthesia management.<br/>Copyright &#xa9;
2024 Wolters Kluwer Health. All rights reserved.

<69>
Accession Number
2031585100
Title
Skeletal muscle relaxants as adjunctive pain control following
cardiothoracic surgery: a systematic review protocol.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e079685. 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, 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
Publisher
BMJ Publishing Group
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
1 week 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.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2024.

<70>
Accession Number
643961625
Title
Pro- and Anti-inflammatory Biomarkers Responses after Aerobic Training in
Heart Transplant Recipients: A Systematic Review and Meta-analysis.
Source
Current cardiology reviews. (no pagination), 2024. Date of Publication:
02 Apr 2024.
Author
Franzoni L.T.; da Motta S.B.; Carvalho G.; Costa R.R.; Ahner M.M.; Saffi
M.A.L.; Pereira A.A.; Pereira A.H.; da Silveira A.D.; Stein R.
Institution
(Franzoni, da Motta, Carvalho, Saffi, da Silveira, Stein) Programa de
Pos-graduacao em Ciencias da Saude: Cardiologia e Ciencias
Cardiovasculares da Universidade Federal do Rio Grande do Sul - Porto
Alegre/Brazil
(Franzoni, da Motta, Carvalho, Costa, Saffi, da Silveira, Stein) Grupo de
Pesquisa em Cardiologia do Exercicio do Hospital de Clinicas de Porto
Alegre - Porto Alegre/Brazil
(Costa) Universidade de Brasilia - UnB - Brasilia/DF/Brazil, Brazil
(Ahner, Pereira) Universidade Federal do Rio Grande do Sul
(Pereira, Stein) Faculdade de Medicina da Universidade Federal do Rio
Grande do Sul - Porto Alegre/Brazil
(Pereira) Universidade Federal do Rio Grande do Sul Ambulatorio de
Cirurgia Vascular Porto Alegre Brazil
Abstract
BACKGROUND: Physical exercise (PE) may improve plasma concentration of
interleukin- 6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and
adiponectin (adpN) in heart transplant (HT) patients. However, no
consistent data is available on this population. AIM: Thus, we aimed to
conduct a systematic review and meta-analysis on the effects of PE over
these pro- and anti-inflammatory biomarkers in HT patients.
<br/>METHOD(S): Following the guidelines established by the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020
statement, we conducted a systematic literature search in the PubMed,
Cochrane, and Scopus databases. Outcomes included IL-6, TNF-alpha, and
adpN. Effect size (ES) was calculated using the standardized mean
difference with a 95% confidence interval (CI). <br/>RESULT(S): The PE
group (aerobic modality) was associated with reduced IL-6 compared to the
control group (ES: -0.53; 95% CI: -0.99 to -0.06 pg/mL; P = 0.026).
However, the PE group did not show a significant effect on TNF-alpha and
adpN levels (ES: -0.33; 95% CI: -0.79 to 0.13; P = 0.16 and ES: -0.20; 95%
CI: -0.70 to 0.30 pg/mL; P = 0.444, respectively). <br/>CONCLUSION(S): PE
is associated with IL-6 reductions, although TNF alpha and adpN did not
change after this intervention in HT patients. Therefore, PE is an
effective intervention to downregulate IL-6 in post-HT
patients.<br/>Copyright&#xa9; Bentham Science Publishers; For any queries,
please email at epub@benthamscience.net.

<71>
Accession Number
2031636435
Title
Effectiveness of Cardiac Rehabilitation With mHealth Through Smartphone
Functionalities: A Systematic Review Protocol.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Paiva M.C.; Castro A.A.M.; Carvalho P.F.; Sales W.B.; Oliveira I.C.S.;
Mourao M.N.; Maciel A.C.C.; Souza G.F.
Institution
(Paiva, Carvalho, Sales, Oliveira, Maciel, Souza) Department of
Physiotherapy, Federal University of Rio Grande do Norte, Rio Grande do
Norte, Natal, Brazil
(Castro, Mourao) Department of Physiotherapy, Federal University of Pampa,
Rio Grande do Sul, Uruguaiana, Brazil
Publisher
Elsevier Inc.
Abstract
Cardiovascular diseases are the leading cause of mortality worldwide,
requiring support to manage symptoms and improve prognosis. Home-based
cardiac rehabilitation is a realistic resource for this purpose, but it
requires patients' self-management skills in order to change behaviours.
Smartphones are considered mHealth technology (mobile technological
resources in healthcare) and have the potential to provide modalities for
delivery of cardiac rehabilitation. This systematic review aims to examine
these modalities and identify those that are most effective for improving
exercise capacity, quality of life, and patient compliance. Randomized
controlled trials (1994 to 2022) performed with adults with coronary
artery disease (post-myocardial infarction, angina, post-coronary artery
bypass graft surgery) or heart failure eligible for home-based cardiac
rehabilitation (mHealth) will be selected. Studies published in English,
Spanish, or Portuguese that compare rehabilitation-specific mobile apps or
smartphone-based features with conventional cardiac rehabilitation will be
included. Searches will be conducted in MEDLINE, CENTRAL, EMBASE, LILACS,
PEDro, grey literature, and ongoing or recently completed studies. Data
and risk of bias will be assessed, and if appropriate, a meta-analysis
will be carried out.<br/>Copyright &#xa9; 2023 The Authors

<72>
Accession Number
2029341759
Title
Laparoscopic assisted versus ultrasound guided transversus abdominis plane
block in laparoscopic bariatric surgery: a randomized controlled trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 133. Date
of Publication: December 2024.
Author
Algyar M.F.; Abdelsamee K.S.
Institution
(Algyar) Anesthesiology, Surgical Intensive Care and Pain Medicine
Department, Faculty of Medicine, Kafr ElSheikh University, Kafr ElSheikh
33516, Egypt
(Abdelsamee) Surgery Department, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Transversus abdominis plane block (TAPB) guided by laparoscopy
and ultrasound showed promise in enhancing the multimodal analgesic
approach following several abdominal procedures. This study aimed to
compare the efficacy and safety between Laparoscopic (LAP) TAP block
(LTAP) and ultrasound-guided TAP block (UTAP) block in patients undergoing
LAP bariatric surgery. <br/>Patients and Methods: This non-inferiority
randomized controlled single-blind study was conducted on 120 patients
with obesity scheduled for LAP bariatric surgeries. Patients were
allocated into two equal groups: LTAP and UTAP, administered with 20 mL of
0.25% bupivacaine on each side. <br/>Result(s): There was no statistically
significant difference in the total morphine consumption, Visual Analogue
Scale (VAS) score at all times of measurements, and time to the first
rescue analgesia (p >.05) between both groups. The duration of anesthesia
and duration of block performance were significantly shorter in the LTAP
group than in the UTAP group (p <.001). Both groups had comparable
post-operative heart rate, mean arterial pressure, adverse effects, and
patient satisfaction. <br/>Conclusion(s): In LAP bariatric surgery, the
analgesic effect of LTAP is non-inferior to UTAP, as evidenced by
comparable time to first rescue analgesia and total morphine consumption
with similar safety blocking through the low incidence of post-operative
complications and patient satisfaction. Trial registration: The study was
registered in Pan African Clinical Trials Registry (PACTR) (ID:
PACTR202206871825386) on June 29, 2022.<br/>Copyright &#xa9; The Author(s)
2024.

<73>
Accession Number
2029291286
Title
Efficacy and Safety of Long-Term Dual Antiplatelet Therapy: A Systematic
Review and Meta-Analysis.
Source
Clinical and Applied Thrombosis/Hemostasis. 30 (no pagination), 2024. Date
of Publication: January-December 2024.
Author
Zhang X.; Zhou D.; Song S.; Huang X.; Ding Y.; Meng R.
Institution
(Zhang, Zhou, Huang, Meng) Department of Neurology, Xuanwu Hospital,
Capital Medical University, Beijing, China
(Zhang, Zhou, Huang, Meng) Advanced Center of Stroke, Beijing Institute
for Brain Disorders, Beijing, China
(Zhang, Zhou, Huang, Meng) National Center for Neurological Disorders,
Xuanwu Hospital, Capital Medical University, Beijing, China
(Song) Division of Neurocritical Care and Emergency Neurology, Center for
Genomic Medicine, Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
(Ding) Department of Neurosurgery, Wayne State University School of
Medicine, Detroit, MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12
inhibitor is a standard therapy in patients with ischemic vascular
diseases (IVD) including coronary artery, cerebrovascular and peripheral
arterial diseases, although the optimal duration of this treatment is
still debated. Previous meta-analyses reported conflicting results about
the effects of long-term and short-term as well as non-DAPT use in various
clinical settings. Herein, we conducted a comprehensive meta-analysis to
assess the efficacy and safety of different durations of DAPT.
<br/>Method(s): We reviewed relevant articles and references from
database, which were published prior to April 2023. Data from prospective
studies were processed using RevMan5.0 software, provided by Cochrane
Collaboration and transformed using relevant formulas. The inclusion
criteria involved randomization to long-term versus short-term or no DAPT;
the endpoints included at least one of total or cardiovascular (CV)
mortalities, IVD recurrence, and bleeding. <br/>Result(s): A total of 34
randomized studies involving 141 455 patients were finally included. In
comparison with no or short-term DAPT, long-term DAPT reduced MI and
stroke, but did not reduce the total and CV mortalities. Meanwhile,
bleeding events were increased, even though intracranial and fatal
bleedings were not affected. Besides, the reduction of MI and stroke
recurrence showed no statistical significance between long-term and
short-term DAPT groups. <br/>Conclusion(s): Long-term DAPT may not reduce
the mortality of IVD besides increasing bleeding events, although reduced
the incidences of MI and stroke early recurrence to a certain extent and
did not increase the risk of fatal intracranial bleeding.<br/>Copyright
&#xa9; The Author(s) 2024.

<74>
Accession Number
2028266720
Title
Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing
Cardiac Surgery: Systematic Review with Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(2) (no pagination), 2024.
Article Number: e20230076. Date of Publication: 2024.
Author
Li J.-P.; Li Y.; Li B.; Bian C.-H.; Zhao F.
Institution
(Li) Medical Oncology, Zibo Municipal Hospital, Shandong, Zibo, China
(Li, Bian, Zhao) Department of Blood Transfusion, Zibo Municipal Hospital,
Shandong, Zibo, China
(Li) Thoracic and Cardiovascular Surgery, Zibo Municipal Hospital,
Shandong, Zibo, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: The purpose of present study was to comprehensively explore the
efficacy and safety of prothrombin complex concentrate (PCC) to treat
massive bleeding in patients undergoing cardiac surgery. <br/>Method(s):
PubMed, Embase, and Cochrane Library databases were searched for studies
investigating PCC administration during cardiac surgery published before
September 10, 2022. Mean difference (MD) with 95% confidence interval (CI)
was applied to analyze continuous data, and dichotomous data were analyzed
as risk ratio (RR) with 95% CI. <br/>Result(s): Twelve studies were
included in the meta-analysis. Compared with other non-PCC treatment
regimens, PCC was not associated with elevated mortality (RR=1.18, 95%
CI=0.86-1.60, P=0.30, I²=0%), shorter hospital stay (MD=-2.17
days; 95% CI=-5.62-1.28, P=0.22, I²=91%), reduced total
thoracic drainage (MD=-67.94 ml, 95% CI=-239.52-103.65, P=0.44,
I²=91%), thromboembolic events (RR=1.10, 95% CI=0.74-1.65,
P=0.63, I²=39%), increase in atrial fibrillation events
(RR=0.73, 95% CI=0.52-1.05, P=0.24, I²=29%), and myocardial
infarction (RR=1.10, 95% CI=0.80-1.51, P=0.57, I²=81%).
However, PCC use was associated with reduced intensive care unit length of
stay (MD=-0.81 days, 95% CI=-1.48--0.13, P=0.02, I²=0%),
bleeding (MD=-248.67 ml, 95% CI=-465.36--31.97, P=0.02,
I²=84%), and intra-aortic balloon pump/extracorporeal membrane
oxygenation (RR=0.65, 95% CI=0.42-0.996, P=0.05, I²=0%) when
compared with non-PCC treatment regimens. <br/>Conclusion(s): The use of
PCC in cardiac surgery did not correlate with mortality, length of
hospital stay, thoracic drainage, atrial fibrillation, myocardial
infarction, and thromboembolic events. However, PCC significantly improved
postoperative intensive care unit length of stay, bleeding, and
intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in
patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2024, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<75>
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.

<76>
Accession Number
2031580507
Title
Comparative efficacy and safety of mitral valve repair versus mitral valve
replacement in Rheumatic heart disease: A high-value care systematic
review and meta-analysis.
Source
Current Problems in Cardiology. 49(6) (no pagination), 2024. Article
Number: 102530. Date of Publication: June 2024.
Author
Yasmin F.; Jawed S.; Najeeb H.; Moeed A.; Atif A.R.; Umar M.; Asghar M.S.;
Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT 06511, United
States
(Jawed, Najeeb, Moeed, Atif) Dow Medical College, Karachi 74200, Pakistan
(Umar) IU Health Ball Memorial Hospital, Muncie, IN 47303, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, DMC Heart
Hospital, Detroit, MI 48201, United States
Publisher
Elsevier Inc.
Abstract
Rheumatic Heart Disease (RHD) remains a leading cause of cardiovascular
death (CVD) globally. Mitral Valve repair (MVP) and mitral valve
replacement (MVR) are the two most commonly and successfully used
techniques to treat the disease. MVP is associated with reduced
post-operative complications compared to MVR; however, it carries the risk
of valvular fibrosis and scarring. Given the lack of recommendations,
inconsistent findings, and paucity of pathophysiological evidence at
present, we aimed to conduct a meta-analysis and systematically review the
available literature to determine the efficacy and safety of MVP compared
to MVR in improving clinical outcomes among patients with RHD. A
comprehensive literature search was conducted on MEDLINE (PubMed),
Cochrane Central and Scopus from inception till September 2023. The
primary objective was early mortality defined as any cause-related death
occurring 30 days following surgery. Secondary outcomes included long-term
survival defined as the time duration between hospital discharge and
all-cause death. Infectious endocarditis, thromboembolic events (including
stroke, brain infarction, peripheral embolism, valve thrombosis, and
transient ischemic attack), and haemorrhagic events (any serious bleeding
event that required hospitalisation, resulted in death, resulted in
permanent injury, or required blood transfusion) were all considered as
post- operative complications. Additionally aggregated Kaplan-Meier curves
were reconstructed for long term survival, freedom from reoperation, and
freedom from valve-related adverse events by merging the reconstructed
individual patient data (IPD) from each individual study. A significant
decrease in early mortality with MV repair strategy versus MV replacement
[RR 0.63; P = 0.003) irrespective of mechanical or bioprosthetic valves
was noted. The results reported significantly higher long-term survival in
patients undergoing MVP versus MVR (HR 0.53; P = 0.0009). Reconstructed
Kaplan-Meier curves showed that the long term survival rates at 4, 8, and
12 years were 88.6, 82.0, 74.6 %, in the MVR group and 91.7, 86.8, 81.0 %,
in the MVP group, respectively. MVP showed statistically significant
reduction in early mortality, adverse vascular events, and better
long-term survival outcomes compared to the MVR strategy in this
analysis.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<77>
Accession Number
2031580208
Title
Minimally invasive versus conventional sternotomy for aortic valve
replacement: A systematic review and meta-analysis.
Source
Clinical Medicine, Journal of the Royal College of Physicians of London.
23(Supplement 6) (pp 58-59), 2023. Date of Publication: November 2023.
Author
Mohamed A.; Negida A.; Shaboub A.
Institution
(Mohamed, Shaboub) Ain Shams University, Cairo, Egypt
(Negida) Harvard Medical School, Cambridge, United States
Publisher
Elsevier B.V.

<78>
Accession Number
2031498563
Title
Has the time come for a systematic top-down approach in Crohn's disease?.
Source
The Lancet Gastroenterology and Hepatology. 9(5) (pp 394-395), 2024. Date
of Publication: May 2024.
Author
Fumery M.; Buisson A.
Institution
(Fumery) Department of Gastroenterology, CHU Amiens and PeriTox, UMR-I 01
INERIS, Picardie Jules. Verne University, Amiens, France
(Buisson) Universite Clermont Auvergne, 3iHP, CHU Clermont-Ferrand,
Service d'Hepato-Gastroenterologie, Inserm U1071, M2iSH, USC-INRA 2018,
Clermont-Ferrand, France
Publisher
Elsevier Ltd

<79>
Accession Number
2031416110
Title
Effect of smoking cessation interventions on abstinence and tuberculosis
treatment outcomes among newly diagnosed patients: a randomized controlled
trial.
Source
Microbiology Spectrum. 12(4) (no pagination), 2024. Date of Publication:
April 2024.
Author
Khan M.T.; Zaheer S.; Amar W.; Shafique K.
Institution
(Khan, Zaheer, Shafique) School of Public Health, Dow University of Health
Sciences, Karachi, Pakistan
(Amar) Dr. A. Q. Khan Institute of Behavioral Sciences, Karachi, Pakistan
Publisher
American Society for Microbiology
Abstract
The study evaluates the effectiveness of smoking cessation interventions
[Behavioral Change Communication (BCC) and Behavioral Change Communication
plus bupropion (BCC+)] compared to conventional Directly Observed Therapy
Short Course (DOT) treatment in improving pulmonary tuberculosis treatment
outcomes and abstinence among newly diagnosed pulmonary tuberculosis (PTB)
patients, highlighting the scarcity of robust experimental studies. The
current randomized controlled trial, conducted at Ojha Institute of Chest
Diseases between October 2017 and June 2019, randomized 292 patients who
were current smokers with newly diagnosed pulmonary tuberculosis into
three arms: control (n = 97), BCC (n = 97), and BCC+ (n = 98) arms. The
outcomes of the interventions were compared in terms of favorable
treatment outcomes and abstinence achieved at the end of 6 months.
Baseline characteristics were compared between groups. Cox regression
quantified the effect size of interventions for both outcome variables and
reported as (crude and adjusted) hazard ratios with 95% confidence
intervals (CI). No statistically significant difference was observed in
baseline characteristics in each arm. Both BCC+ and BCC showed a
statistically significant effect in achieving favorable PTB outcomes at 6
months (aHR 2.37, 95% CI 1.52-3.70 and aHR 2.34, 95% CI 1.51-3.60), as
well as for abstinence from smoking at 6 months (BCC+: aHR 4.03, 95% CI
2.18-7.44 and BCC: aHR 3.87, 95% CI 2.12-7.05) compared to the control
arm. Both BCC and BCC+ aided by pharmacologic agents such as bupropion
when incorporated with conventional DOTs were found to be significantly
effective in attaining favorable tuberculosis treatment outcomes as well
as in attaining smoking abstinence at the end of the 6-month
treatment.<br/>Copyright &#xa9; 2024 American Society for Microbiology.
All rights reserved.

<80>
Accession Number
2031397526
Title
Cognitive impairment as a risk factor for postoperative delirium in
cardiac surgery based on the Mini Mental State Examination, in people over
60 years of age: A systematic review.
Source
Psiquiatria Biologica. 31(2) (no pagination), 2024. Article Number:
100463. Date of Publication: 01 Apr 2024.
Author
Ujaldon-Martinez R.; Devi-Bastida J.
Institution
(Ujaldon-Martinez, Devi-Bastida) Departamento de Psicologia Clinica y de
la Salud, Universidad Autonoma de Barcelona, Barcelona, Spain
(Devi-Bastida) Institut de Salut Mental, Hospital del Mar - Centre Dr.
Emili Mira, Barcelona, Spain
Publisher
Sociedad Espanola de Psiquiatria Biologica (SEPB)
Abstract
Introduction: Delirium is a neurocognitive disorder whose prevalence
increases with age. Its incidence after cardiac surgery ranges between 11%
and 52%. There are a large number of studies on the risk factors that
affect the appearance of postoperative delirium in cardiac surgery,
although most of them are oriented to physiological factors, often
ignoring the possible relevance of neuropsychological aspects, such as
cognitive impairment. The objective of this work was to analyze the
influence of cognitive impairment as an independent risk factor
(predictor) in the appearance of postoperative delirium based on the Mini
Mental State Examination (MMSE), after cardiac surgery. Development: A
search was carried out in the databases PubMed, PsycInfo, Scopus and Web
of Science. The search was limited to articles published between 2001 and
2022. 384 articles were obtained. Those that were repeated and not related
to the topic were eliminated, leaving a total of 8 articles that met the
selection criteria. This systematic review was carried out in accordance
with the criteria of the PRISMA 2020 statement. <br/>Conclusion(s): A
statistically significant correlation was observed between the measure of
cognitive impairment, the MMSE, and the different measures of
postoperative delirium, in the majority of studies, so it can be concluded
that possibly a mild degree of cognitive impairment may be a sufficient
condition for the probability of appearance of postoperative delirium in
cardiac surgeries in patients over 60 years of age. Therefore, assessment
of cognitive impairment using MMSE before cardiac surgery could be useful
to predict the development of postoperative delirium in people over 60
years of age.<br/>Copyright &#xa9; 2024

<81>
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.

<82>
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

<83>
Accession Number
2031093429
Title
The BLISTER Score: A Novel, Externally Validated Tool for Predicting
Cardiac Implantable Electronic Device Infections, and Its Cost-Utility
Implications for Antimicrobial Envelope Use.
Source
Circulation: Arrhythmia and Electrophysiology. 17(3) (pp E012446), 2024.
Date of Publication: 01 Mar 2024.
Author
Maclean E.; Mahtani K.; Honarbakhsh S.; Butcher C.; Ahluwalia N.; Dennis
A.S.C.; Creta A.; Finlay M.; Elliott M.; Mehta V.; Wijesuriya N.; Shaikh
O.; Zaw Y.; Ogbedeh C.; Gautam V.; Lambiase P.D.; Schilling R.J.; Earley
M.J.; Moore P.; Muthumala A.; Sporton S.C.E.; Hunter R.J.; Rinaldi C.A.;
Behar J.; Martin C.; Monkhouse C.; Chow A.
Institution
(Maclean, Mahtani, Honarbakhsh, Butcher, Ahluwalia, Dennis, Creta, Finlay,
Lambiase, Schilling, Earley, Moore, Muthumala, Sporton, Hunter, Monkhouse,
Chow) Department of Cardiac Electrophysiology, Barts Heart Centre, St.
Bartholomew's Hospital, London, United Kingdom
(Maclean, Honarbakhsh, Ahluwalia, Hunter, Chow) William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Elliott, Mehta, Wijesuriya, Rinaldi, Behar) Department of Cardiac
Electrophysiology, St. Thomas' Hospital, London, United Kingdom
(Shaikh, Zaw, Ogbedeh, Gautam, Martin) Department of Cardiac
Electrophysiology, Royal Papworth Hospital, Cambridge, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Antimicrobial envelopes reduce the incidence of cardiac
implantable electronic device infections, but their cost restricts routine
use in the United Kingdom. Risk scoring could help to identify which
patients would most benefit from this technology. <br/>METHOD(S): A novel
risk score (BLISTER [Blood results, Long procedure time, Immunosuppressed,
Sixty years old (or younger), Type of procedure, Early re-intervention,
Repeat procedure]) was derived from multivariate analysis of factors
associated with cardiac implantable electronic device infection.
Diagnostic utility was assessed against the existing PADIT score (Prior
procedure, Age, Depressed renal function, Immunocompromised, Type of
procedure) in both standard and high-risk external validation cohorts, and
cost-utility models examined different BLISTER and PADIT score thresholds
for TYRX (Medtronic; Minneapolis, MN) antimicrobial envelope allocation.
<br/>RESULT(S): In a derivation cohort (n=7383), cardiac implantable
electronic device infection occurred in 59 individuals within 12 months of
a procedure (event rate, 0.8%). In addition to the PADIT score
constituents, lead extraction (hazard ratio, 3.3 [95% CI, 1.9-6.1];
P<0.0001), C-reactive protein >50 mg/L (hazard ratio, 3.0 [95% CI,
1.4-6.4]; P=0.005), reintervention within 2 years (hazard ratio, 10.1 [95%
CI, 5.6-17.9]; P<0.0001), and top-quartile procedure duration (hazard
ratio, 2.6 [95% CI, 1.6-4.1]; P=0.001) were independent predictors of
infection. The BLISTER score demonstrated superior discriminative
performance versus PADIT in the standard risk (n=2854, event rate: 0.8%,
area under the curve, 0.82 versus 0.71; P=0.001) and high-risk validation
cohorts (n=1961, event rate: 2.0%, area under the curve, 0.77 versus 0.69;
P=0.001), and in all patients (n=12 198, event rate: 1%, area under the
curve, 0.8 versus 0.75, P=0.002). In decision-analytic modeling, the
optimum scenario assigned antimicrobial envelopes to patients with BLISTER
scores >=6 (10.8%), delivering a significant reduction in infections
(relative risk reduction, 30%; P=0.036) within the National Institute for
Health and Care Excellence cost-utility thresholds (incremental
cost-effectiveness ratio, 18 446). <br/>CONCLUSION(S): The BLISTER score
(https://qxmd.com/calculate/calculator_876/the-blister-score-for-cied-infe
ction) was a valid predictor of cardiac implantable electronic device
infection, and could facilitate cost-effective antimicrobial envelope
allocation to high-risk patients.<br/>Copyright &#xa9; 2024 Lippincott
Williams and Wilkins. All rights reserved.

<84>
Accession Number
2030972726
Title
Impact of maintaining serum potassium concentration >= 3.6mEq/L versus >=
4.5mEq/L for 120 hours after isolated coronary artery bypass graft surgery
on incidence of new onset atrial fibrillation: Protocol for a randomized
non-inferiority trial.
Source
PLoS ONE. 19(3 March) (no pagination), 2024. Article Number: e0296525.
Date of Publication: March 2024.
Author
Campbell N.G.; Allen E.; Evans R.; Jamal Z.; Opondo C.; Sanders J.;
Sturgess J.; Montgomery H.E.; Elbourne D.; O'Brien B.
Institution
(Campbell) Faculty of Biology, Division of Cardiovascular Sciences, School
of Medical Sciences, Medicine and Health, University of Manchester,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Campbell) Manchester Heart Institute, Manchester University Foundation
NHS Trust, Manchester, United Kingdom
(Allen, Evans, Jamal, Opondo, Sturgess, Elbourne) Clinical Trials Unit,
London School of Hygiene and Tropical Medicine, London, United Kingdom
(Sanders) William Harvey Research Institute, Queen Mary University of
London, London, United Kingdom
(Montgomery) Division of Medicine and Institute for Sport, Exercise and
Health, University College London, London, United Kingdom
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St Bartholomew's Hospital,
Barts Health NHS Trust, London, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland, OH, United States
Publisher
Public Library of Science
Abstract
Background Atrial Fibrillation After Cardiac Surgery (AFACS) occurs in
about one in three patients following Coronary Artery Bypass Grafting
(CABG). It is associated with increased short- and long-term morbidity,
mortality and costs. To reduce AFACS incidence, efforts are often made to
maintain serum potassium in the high-normal range (>= 4.5mEq/L). However,
there is no evidence that this strategy is efficacious. Furthermore, the
approach is costly, often unpleasant for patients, and risks causing harm.
We describe the protocol of a planned randomized non-inferiority trial to
investigate the impact of intervening to maintain serum potassium >= 3.6
mEq/L vs >= 4.5 mEq/L on incidence of new-onset AFACS after isolated
elective CABG. Methods Patients undergoing isolated CABG at sites in the
UK and Germany will be recruited, randomized 1:1 and stratified by site to
protocols maintaining serum potassium at either >= 3.6 mEq/L or >= 4.5
mEq/L. Participants will not be blind to treatment allocation. The primary
endpoint is AFACS, defined as an episode of atrial fibrillation, flutter
or tachycardia lasting >= 30 seconds until hour 120 after surgery, which
is both clinically detected and electrocardiographically confirmed.
Assuming a 35% incidence of AFACS in the 'tight control group', and
allowing for a 10% loss to follow-up, 1684 participants are required to
provide 90% certainty that the upper limit of a one-sided 97.5% confidence
interval (CI) will exclude a > 10% difference in favour of tight potassium
control. Secondary endpoints include mortality, use of hospital resources
and incidence of dysrhythmias not meeting the primary endpoint (detected
using continuous heart rhythm monitoring). Discussion The Tight K Trial
will assess whether a protocol to maintain serum potassium >= 3.6 mEq/L is
non inferior to maintaining serum potassium >= 4.5 mEq/L in preventing
new-onset AFACS after isolated CABG.<br/>Copyright &#xa9; 2024 Campbell et
al.

<85>
Accession Number
2030937072
Title
Sympathicotomy for isolated facial blushing: long-term follow-up of a
randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 65(3) (no pagination), 2024.
Article Number: ezad414. Date of Publication: 01 Mar 2024.
Author
Dittberner F.A.; Jorgensen O.D.; Pilegaard H.K.; Ladegaard L.; Licht P.B.
Institution
(Dittberner, Jorgensen, Pilegaard, Ladegaard, Licht) Department of
Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark
(Dittberner, Jorgensen, Pilegaard, Ladegaard, Licht) Department of
Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Denmark
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Thoracoscopic sympathicotomy may be an effective treatment for
disabling facial blushing in selected patients. Short- and mid-term
results are good but very long-term results are scarce in the medical
literature and there is no knowledge which extent of sympathicotomy is
better long-term for isolated facial blushing. <br/>METHOD(S): We
previously randomized 100 patients between a rib-oriented R2 or R2-R3
sympathicotomy for isolated facial blushing, and reported local effects,
side effects and quality of life after 12 months. In the present study, we
sent identical questionnaires to all patients after a median of 16 years
(interquartile range 15-17 years). <br/>RESULT(S): The response rate was
66%. Overall, 82% reported excellent or satisfactory results on facial
blushing, with significant better local effect after R2 sympathicotomy
compared with R2-R3 sympathicotomy. Patients who underwent R2
sympathicotomy were also significantly more satisfied with the operation.
We found no significant difference between R2 and R2-R3 sympathicotomy in
quality of life or rates of compensatory sweating (77%) and recurrence of
blushing (41%) which was milder than preoperatively in most patients.
<br/>CONCLUSION(S): R2 sympathicotomy should be the preferred approach for
isolated facial blushing because of better local effect and higher
satisfaction rates. Although this was a very long-term follow-up of the
only randomized trial of its kind the response rate was limited leaving a
risk of undetected bias.<br/>Copyright # The Author(s) 2023.

<86>
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.

<87>
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

<88>
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

<89>
Accession Number
2028957286
Title
Valve Type and Operative Risks in Surgical Explantation of Transcatheter
Aortic Valves: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(5) (no pagination), 2024. Article Number:
1262. Date of Publication: March 2024.
Author
Abbasciano R.G.; Magouliotis D.E.; Koulouroudias M.; Spiliopoulos K.;
Xanthopoulos A.; Kourliouros A.; Casula R.; Athanasiou T.; Viviano A.
Institution
(Abbasciano, Casula, Viviano) Department of Cardiothoracic Surgery,
Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
(Abbasciano, Athanasiou) Department of Surgery & Cancer, Imperial College,
London SW7 2BX, United Kingdom
(Magouliotis) Unit of Quality Improvement, Department of Cardiothoracic
Surgery, University of Thessaly, Biopolis, Larissa 41 110, Greece
(Koulouroudias) Department of Cardiac Surgery, Nottingham University
Hospitals NHS Trust, Nottingham NG7 2UH, United Kingdom
(Spiliopoulos) Department of Cardiothoracic Surgery, University of
Thessaly, Biopolis, Larissa 41 110, Greece
(Xanthopoulos) Department of Cardiology, University Hospital of Larissa,
Larissa 413 34, Greece
(Kourliouros) Department of Cardiothoracic Surgery, John Radcliffe
Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3
9DU, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Indication to perform surgical explantation of TAVR is becoming
increasingly more frequent, due to the higher number of transcatheter
procedures performed in patients with longer life expectancy. We proposed
to perform a systematic review and meta-analysis with metaregression to
identify potential factors that can determine an increase in the high
mortality and morbidity that characterize these surgical procedures.
MEDLINE and Embase were searched for relevant studies. Twelve studies were
eligible according to our inclusion criteria. TAVR explantation was
confirmed as a procedure with high 30-day mortality (0.17; 95% CI,
0.14-0.21) and morbidity (stroke incidence 5%; 95% CI, 0.04-0.07; kidney
injury incidence 16%; 95% CI, 0.11-0.24). The type of transcatheter valve
implanted during the index procedure did not influence the outcomes after
surgical explantation. The role of these high-risk operations is growing,
and it will likely expand in the coming years. Specific tools for risk
stratification are required.<br/>Copyright &#xa9; 2024 by the authors.

<90>
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.

<91>
Accession Number
2028017897
Title
Comparison of Intrathecal Dexmedetomidine with Buprenorphine as an
Adjuvant to Hyperbaric Bupivacaine in Infraumbilical Surgeries.
Source
International Journal of Pharmaceutical and Clinical Research. 16(1) (pp
1098-1104), 2024. Date of Publication: 2024.
Author
Das B.; Das A.
Institution
(Das, Das) Department of Anaesthesiology and critical care, Silchar
medical college and hospital, Assam, Silchar 788014, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background and aims: Emerging regional anesthesia trend uses less local
anaesthetic, segmental blocks, supplemented with opioids, alpha2 agonists
for prolonged analgesia and minimizes spinal anaesthesia drawbacks.
Current study evaluated effects of dexmedetomidine (5mug) and
buprenorphine (75mug), with intrathecal hyperbaric bupivacaine (0.5%) for
sensorimotor block and analgesia. <br/>Method(s): This prospective,
randomized controlled, single-blinded study conducted in the Department of
Anaesthesiology, Silchar Medical College, Assam after obtaining ethical
committee clearance. Informed written consent obtained from 120 ASA I/II
patients, aged18-60years, for infraumbilical surgery. Exclusions:
coagulopathy, cardiac issues, pregnancy, obese (>30 BMI), spinal
deformities. Randomly divided (3 groups, n=40 each) via sealed envelopes.
Group BC received 3ml (15mg) of 0.5% Bupivacaine heavy + 0.5ml of normal
saline (control). Group BD received 3ml (15mg)of 0.5% Bupivacaine heavy+
dexmedetomidine(5mug)in 0.5ml NS. Group BB received 3ml (15mg) of 0.5%
Bupivacaine heavy+ 0.5ml of buprenorphine (75mug). Parameters assessed:
onset and duration of sensorimotor block, analgesia duration,
haemodynamics, sedation and side effects. Data analyzed with relevant
statistics. <br/>Result(s): Onset of sensory and motor blockades showed no
statistical difference. However, Group BD exhibited considerably longer
sensory (438.88+/-31.27min) and motor (447.9+/-34.23min) blocks compared
to Group BC (204.7+/-28.63min; 307.98+/-16.11min) and Group BB
(279.88+/-16.58min; 305.2+/-11.1min) (p<0.0001). Group BD also displayed
prolonged post-operative analgesic request time (459.13+/-37.11min),
surpassing other groups (p<0.0001). Although Group BC had the highest
sympathomimetic need (65%), Group BD demonstrated superior hemodynamic
stability (p<0.022) despite transient bradycardia in fewer subjects.
<br/>Conclusion(s): Dexmedetomidine (5mug) as an intrathecal adjuvant with
0.5% hyperbaric bupivacaine prolong the sensory and motor blockade
duration. It increases the time to rescue analgesia, minimizes side
effects, and provides sedation compared to other groups.<br/>Copyright
&#xa9; 2024, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

<92>
Accession Number
2025900299
Title
Custodiol versus blood cardioplegia in pediatric cardiac surgery: a
randomized controlled trial.
Source
European Journal of Medical Research. 28(1) (no pagination), 2023. Article
Number: 404. Date of Publication: December 2023.
Author
Elmahrouk A.F.; Shihata M.S.; AL-Radi O.O.; Arafat A.A.; Altowaity M.;
Alshaikh B.A.; Galal M.N.; Bogis A.A.; Al Omar H.Y.; Assiri W.J.; Jamjoom
A.A.
Institution
(Elmahrouk, Shihata, AL-Radi, Altowaity, Bogis, Jamjoom) Cardiothoracic
Surgery Department, King Faisal Specialist Hospital and Research Centre,
MBC J-16, P.O. Box: 40047, Jeddah 21499, Saudi Arabia
(Elmahrouk, Arafat) Cardiothoracic Surgery Department, Tanta University,
Tanta, Egypt
(AL-Radi) Department of Surgery, Cardiac Surgery Section, King Abdulaziz
University, Jeddah, Saudi Arabia
(Alshaikh) Cardiac Surgery Department, King Fahad Armed Forces Hospital,
Jeddah, Saudi Arabia
(Galal) Pediatric Cardiac Surgery Department, King Fahad Armed Forces
Hospital, Jeddah, Saudi Arabia
(Al Omar) Research Centre, King Faisal Specialist Hospital and Research
Centre, Jeddah, Saudi Arabia
(Assiri) Department of Nursing, King Faisal Specialist Hospital and
Research Centre, Jeddah, Saudi Arabia
Publisher
BioMed Central Ltd
Abstract
Background: Blood-based cardioplegia is the standard myocardial protection
strategy in pediatric cardiac surgery. Custadiol
(histidine-tryptophan-ketoglutarate), an alternative, may have some
advantages but is potentially less effective at myocardial protection.
This study aimed to test whether custadiol is not inferior to blood-based
cardioplegia in pediatric cardiac surgery. <br/>Method(s): The study was
designed as a randomized controlled trial with a blinded outcome
assessment. All pediatric patients undergoing cardiac surgery with
cardiopulmonary bypass and cardioplegia, including neonates, were
eligible. Emergency surgery was excluded. The primary outcome was a
composite of death within 30 days, an ICU stay longer than 5 days, or
arrhythmia requiring intervention. Secondary endpoints included total
hospital stay, inotropic score, cardiac troponin levels, ventricular
function, and extended survival postdischarge. The sample size was
determined a priori for a noninferiority design with an expected primary
outcome of 40% and a clinical significance difference of 20%.
<br/>Result(s): Between January 2018 and January 2021, 226 patients,
divided into the Custodiol cardioplegia (CC) group (n = 107) and the blood
cardioplegia (BC) group (n = 119), completed the study protocol. There was
no difference in the composite endpoint between the CC and BC groups, 65
(60.75%) vs. 71 (59.66%), respectively (P = 0.87). The total length of
stay in the hospital was 14 (Q2-Q3: 10-19) days in the CC group vs. 13
(10-21) days in the BC group (P = 0.85). The inotropic score was not
significantly different between the CC and BC groups, 5 (2.6-7.45) vs. 5
(2.6-7.5), respectively (P = 0.82). The cardiac troponin level and
ventricular function did not differ significantly between the two groups
(P = 0.34 and P = 0.85, respectively). The median duration of follow-up
was 32.75 (Q2-Q3: 18.73-41.53) months, and there was no difference in
survival between the two groups (log-rank P = 0.55). <br/>Conclusion(s):
Custodial cardioplegia is not inferior to blood cardioplegia for
myocardial protection in pediatric patients. Trial registration The trial
was registered in Clinicaltrials.gov, and the ClinicalTrials.gov
Identifier number is NCT03082716 Date: 17/03/2017<br/>Copyright &#xa9;
2023, BioMed Central Ltd., part of Springer Nature.

<93>
Accession Number
2031563051
Title
The progress of percutaneous left atrial appendage occlusion: A
bibliometric analysis from 1994 to 2022.
Source
Medicine (United States). 103(14) (pp E37742), 2024. Date of Publication:
01 Apr 2024.
Author
Zhai H.; Kang L.; Li Y.; Zhao X.; Chu Q.; Li R.
Institution
(Zhai, Kang, Li) The First Clinical Medical College, Guangzhou University
of Chinese Medicine, Guangzhou, China
(Zhao, Chu, Li) Department of Cardiovascular Disease, The First Affiliated
Hospital of Guangzhou, University of Chinese Medicine, Guangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Atrial fibrillation is the most common cardiac arrhythmia,
affecting 32 million individuals worldwide. Although atrial fibrillation
has been studied for decades, a comprehensive analysis using bibliometrics
has not been performed for atrial fibrillation-left atrial appendage
occlusion (LAAO). Therefore, we analyzed the scientific outputs of global
LAAO research and explored the current research status and hotpots from
1994 to 2022. <br/>Method(s): We searched the Web of Science core
collection for publications related to LAAO that were published between
1994 and 2022. We then performed bibliometric analysis and visualization
using Microsoft Excel 2021, Bibliometric (https://bibliometric.com),
VOSviewer (version 1.6.19), CiteSpace (version 6.2. R2), and the
Bibliometrix 4.0.0 Package (https://www.bibliometrix.org) based on the R
language were used to perform the bibliometric analysis, trend and
emerging foci of LAAO in the past 29 years, including author, country,
institution, journal distribution, article citations, and keywords. In
total, we identified 1285 eligible publications in the field of LAAO, with
an increasing trend in the annual number of publications. <br/>Result(s):
The United States is the country with the most published articles in this
field, while the United Kingdom is the country with the most cited
literature. Mayo Clinic, from the United States, has the most publications
in this area and Horst Sievert from Germany had the highest number of
individual publications. The analysis of keywords showed that
fibrillation, stroke, safety, oral anticoagulants, and watchman were the
main hotpots and frontier directions of LAAO. Surgical treatment of
nonvalvular atrial fibrillation, upgrading of related surgical
instruments, and anticoagulation regimen after surgical treatment are the
major research frontiers. <br/>Conclusion(s): We show that the research of
percutaneous LAAO has been increasing rapidly over the last decade. Our
aim was to overview past studies in the field of LAAO, to grasp the frame
of LAAO research, and identify new perspectives for future
research.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<94>
Accession Number
2031481655
Title
Protocol for a randomised controlled trial: optimisation of perioperative
analgesia protocol for uniportal video-assisted thoracoscopic surgery.
Source
BMJ Open. 14(4) (no pagination), 2024. Article Number: e079434. Date of
Publication: 02 Apr 2024.
Author
Wang L.F.; Feng H.X.; Shi Y.H.; Li Y.; Zheng M.T.; Bu T.; Zhang Z.R.
Institution
(Wang, Li, Zheng) Anesthesiology, China-Japan Friendship Hospital,
Beijing, China
(Feng, Shi) Department of Thoracic Surgery, China-Japan Friendship
Hospital, Beijing, China
(Li, Zhang) China-Japan Friendship Hospital, Beijing, China
(Bu) Department of Anesthesiology, Peking University First Hospital,
Xicheng District, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative pain after thoracic surgery impairs patients'
quality of life and increases the incidence of respiratory complications.
Optimised analgesia strategies include minimally invasive incisions,
regional analgesia and early chest tube removal. However, little is known
about the optimal analgesic regimen for uniportal video-assisted
thoracoscopic surgery (uVATS). Methods and analysis We will conduct a
single-centre, prospective, single-blind, randomised trial. The effects of
postoperative analgesia will be tested using thoracic paravertebral block
(PVB) in combination with patient-controlled intravenous analgesia
(PVB+PCIA), erector spinae plane block (ESPB) in combination with
patient-controlled intravenous analgesia (ESPB+PCIA) or PCIA alone; 102
patients undergoing uVATS will be enrolled in this study. Patients will be
randomly assigned to the PVB group (30 mL of 0.33% ropivacaine with
dexamethasone), ESPB group (40 mL of 0.25% ropivacaine with dexamethasone)
or control groups. PCIA with sufentanil will be administered to all
patients after surgery. The primary outcome will be total opioid
consumption after surgery. Secondary outcomes include postoperative pain
score; postoperative chronic pain at rest and during coughing; sensations
of touch and pain in the chest wall, non-opioid analgesic consumption;
length of stay; ambulation time, the total cost of hospitalisation and
long-term postoperative analgesia. Adverse reactions to analgesics and
adverse events related to the regional blocks will also be recorded. The
statisticians will be blinded to the group allocation. Comparison of the
continuous data among the three groups will be performed using a one-way
analysis of variance to assess differences among the means. Ethics and
dissemination The results will be published in patient education courses,
academic conferences and peer-reviewed journals. Trial registration number
NCT06016777. <br/>Copyright &#xa9; 2024 BMJ Publishing Group. All rights
reserved.

<95>
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

<96>
Accession Number
2030098029
Title
The American Association for Thoracic Surgery (AATS) 2023 Expert Consensus
Document: Recommendation for the care of children with trisomy 13 or
trisomy 18 and a congenital heart defect.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1519-1532),
2024. Date of Publication: May 2024.
Author
St Louis J.D.; Bhat A.; Carey J.C.; Lin A.E.; Mann P.C.; Smith L.M.;
Wilfond B.S.; Kosiv K.A.; Sorabella R.A.; Alsoufi B.
Institution
(St Louis, Mann) Department of Surgery, Children's Hospital of Georgia,
Augusta University, Augusta, Ga, United States
(Bhat, Wilfond) Department of Pediatrics, Seattle Children's Hospital and
University of Washington, Seattle, Wash, United States
(Carey) Department of Pediatrics, University of Utah Health and Primary
Children's Hospital, Salt Lake City, Utah, United States
(Lin) Department of Pediatrics, Mass General Hospital for Children,
Boston, Mass, United States
(Smith) Department of Pediatrics, Oregon Health and Science University,
Portland, Ore, United States
(Kosiv) Department of Pediatrics, Yale University School of Medicine, New
Haven, Conn, United States
(Sorabella) Department of Surgery, University of Alabama at Birmingham,
Birmingham, Ala, United States
(Alsoufi) Department of Surgery, University of Louisville and Norton
Children's Hospital, Louisville, Ky, United States
Publisher
Elsevier Inc.
Abstract
Objectives: Recommendations for surgical repair of a congenital heart
defect in children with trisomy 13 or trisomy 18 remain controversial, are
subject to biases, and are largely unsupported with limited empirical
data. This has created significant distrust and uncertainty among parents
and could potentially lead to suboptimal care for patients. A working
group, representing several clinical specialties involved with the care of
these children, developed recommendations to assist in the decision-making
process for congenital heart defect care in this population. The goal of
these recommendations is to provide families and their health care teams
with a framework for clinical decision making based on the literature and
expert opinions. <br/>Method(s): This project was performed under the
auspices of the AATS Congenital Heart Surgery Evidence-Based Medicine
Taskforce. A Patient/Population, Intervention, Comparison/Control, Outcome
process was used to generate preliminary statements and recommendations to
address various aspects related to cardiac surgery in children with
trisomy 13 or trisomy 18. Delphi methodology was then used iteratively to
generate consensus among the group using a structured communication
process. <br/>Result(s): Nine recommendations were developed from a set of
initial statements that arose from the Patient/Population, Intervention,
Comparison/Control, Outcome process methodology following the groups'
review of more than 500 articles. These recommendations were adjudicated
by this group of experts using a modified Delphi process in a reproducible
fashion and make up the current publication. The Class (strength) of
recommendations was usually Class IIa (moderate benefit), and the overall
level (quality) of evidence was level C-limited data. <br/>Conclusion(s):
This is the first set of recommendations collated by an expert
multidisciplinary group to address specific issues around indications for
surgical intervention in children with trisomy 13 or trisomy 18 with
congenital heart defect. Based on our analysis of recent data, we
recommend that decisions should not be based solely on the presence of
trisomy but, instead, should be made on a case-by-case basis, considering
both the severity of the baby's heart disease as well as the presence of
other anomalies. These recommendations offer a framework to assist parents
and clinicians in surgical decision making for children who have trisomy
13 or trisomy 18 with congenital heart defect.<br/>Copyright &#xa9; 2023
The American Association for Thoracic Surgery

<97>
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.

<98>
Accession Number
2028931541
Title
Sex differences in the outcomes after transcatheter aortic valve
replacement with newer generation devices: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 103(5) (pp 808-814),
2024. Date of Publication: 01 Apr 2024.
Author
El Sherbini A.H.; Servito M.; Zidan A.; Elsherif S.; Ko G.; Elgendy I.Y.;
Ya'Qoub L.
Institution
(El Sherbini, Zidan, Ko) Department of Internal Medicine Faculty of Health
Sciences, Queen's University, Kingston, ON, Canada
(Servito) Division of Cardiac Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Elsherif) Department of Internal Medicine Faculty of Health Sciences,
McMaster University, Hamilton, ON, Canada
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Ya'Qoub) Division of Cardiovascular Medicine, University of California
San Francisco, San Francisco, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a reasonable
therapeutic approach among patients with symptomatic severe aortic
stenosis irrespective of surgical risk. Data regarding sex-specific
differences in the outcomes with newer generation valves are limited.
<br/>Method(s): Electronic databases were searched for studies assessing
sex differences in the outcomes of patients undergoing TAVR with newer
generation valves (SAPIEN 3 or Evolut). Random effects model was
constructed for summary estimates. <br/>Result(s): Four observational
studies with 4522 patients (44.8% women) were included in the
meta-analysis. Women were older and had a lower prevalence of coronary
artery disease and mean EuroScore. Women had a higher incidence of
short-term mortality (up to 30 days) (risk ratio [RR]: 1.60, 95%
confidence interval [CI]: 1.14-2.25), but no difference in 1-year
mortality (RR: 0.92, 95% CI: 0.72-1.17). There was no significant
difference in the incidence of major bleeding (RR: 1.16, 95% CI:
0.86-1.57), permanent pacemaker (PPM) (RR: 0.80, 95% CI: 0.62-1.04), or
disabling stroke (RR: 1.16, 95% CI: 0.54-2.45). <br/>Conclusion(s): In
this meta-analysis, we found that women undergoing TAVR with
newer-generation devices were older but had a lower prevalence of
comorbidities. Women had a higher incidence of short-term mortality but no
difference in the 1-year mortality, bleeding, PPM, or stroke compared with
men. Future studies are required to confirm these findings.<br/>Copyright
&#xa9; 2024 Wiley Periodicals LLC.

<99>
Accession Number
2022693536
Title
Anatomic, stage-based repair of secondary mitral valve disease.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1733-1744),
2024. Date of Publication: May 2024.
Author
Drake D.H.; Zhang P.; Zimmerman K.G.; Morrow C.D.; Sidebotham D.A.
Institution
(Drake) Department of Cardiac Surgery, University of Michigan Medical
School, Ann Arbor, Mich, United States
(Drake) Department of Surgery, Munson Medical Center, Traverse City, Mich,
United States
(Zhang) Department of Surgery, University of Michigan Medical School, Ann
Arbor, Mich, United States
(Zimmerman) Department of Cardiology, Henry Ford Health System, Detroit,
Mich, United States
(Morrow) Health Systems, Management & Policy, Colorado School of Public
Health, Aurora, Colo, United States
(Sidebotham) Department of Cardiothoracic Anaesthesia and Cardiothoracic
Intensive Care, Auckland City Hospital, Auckland, New Zealand
Publisher
Elsevier Inc.
Abstract
Objective: Intervention for repair of secondary mitral valve disease is
frequently associated with recurrent regurgitation. We sought to determine
if there was sufficient evidence to support inclusion of anatomic indices
of leaflet dysfunction in the management of secondary mitral valve
disease. <br/>Method(s): We performed a systematic review and
meta-analysis of published reports comparing anatomic indices of leaflet
dysfunction with the complexity of valve repair and the outcome from
intervention. Patients were stratified by the severity of leaflet
dysfunction. A secondary analysis was performed comparing outcomes when
procedural complexity was optimally matched to severity of leaflet
dysfunction and when intervention was not matched to dysfunction.
<br/>Result(s): We identified 6864 publications, of which 65 met inclusion
criteria. An association between the severity of leaflet dysfunction and
the procedural complexity was highly predictive of satisfactory freedom
from recurrent regurgitation. Patients were categorized into 4 groups
based on stratification of leaflet dysfunction. Satisfactory results were
achieved in 93.7% of patients in whom repair complexity was appropriately
matched to severity of leaflet dysfunction and in 68.8% in whom repair was
not matched to dysfunction (odds ratio, 0.148; 95% confidence interval,
0.119-0.184; P < .0001). <br/>Conclusion(s): For patients with secondary
mitral valve disease, satisfactory outcome from valve repair improves when
procedural complexity is matched to anatomic indices of leaflet
dysfunction. Anatomic indices of leaflet dysfunction should be considered
when planning interventions for secondary mitral regurgitation. Routine
inclusion of anatomic indices in trial design and reporting should
facilitate comparison of results and strengthen guidelines. There are
sufficient data to support anatomic staging of secondary mitral valve
disease.<br/>Copyright &#xa9; 2023 The American Association for Thoracic
Surgery

<100>
Accession Number
2021703568
Title
Intimal hyperplasia, saphenous vein graft disease, and clinical outcomes:
Insights from the CTSN VEST randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1782-1792.e5),
2024. Date of Publication: May 2024.
Author
Goldstein D.J.; Chang H.L.; Mack M.J.; Voisine P.; Gammie J.S.; Marks
M.E.; Iribarne A.; Vengrenyuk Y.; Raymond S.; Taylor B.S.; Dagenais F.;
Ailawadi G.; Chu M.W.A.; DiMaio J.M.; Narula J.; Moquete E.G.; O'Sullivan
K.; Williams J.B.; Crestanello J.A.; Scavo V.; Puskas J.D.; Acker M.A.;
Gillinov M.; Gelijns A.C.; O'Gara P.T.; Moskowitz A.J.; Alexander J.H.;
Bagiella E.
Institution
(Goldstein) Department of Cardiovascular and Thoracic Surgery, Montefiore
Medical Center, Bronx, NY, United States
(Chang, Marks, Raymond, Moquete, O'Sullivan, Gelijns, Moskowitz, Bagiella)
Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Mack, DiMaio) Cardiothoracic Surgery, Baylor Scott & White Health, Plano,
Tex, United States
(Voisine, Dagenais) Department of Surgery, Institut de Cardiologie et
Pneumologie de Quebec, Quebec City, Quebec, Canada
(Gammie) Johns Hopkins Heart and Vascular Institute, Johns Hopkins Health
System, Baltimore, Md, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
NH, Lebanon
(Vengrenyuk) Division of Cardiology, Mount Sinai Hospital and Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Taylor) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, Md, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Narula) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Williams) Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh,
NC, United States
(Crestanello) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minn, United States
(Scavo) Cardiovascular and Thoracic Surgery, Lutheran Medical Group, Fort
Wayne, Ind, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY, United States
(Acker) Division of Cardiovascular Surgery, University of Pennsylvania,
Hospital of the University of Pennsylvania, Philadelphia, Pa, United
States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
Mass, United States
(Alexander) Division of Cardiology, Department of Medicine, Duke
University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Diffuse intimal hyperplasia and graft irregularity adversely
affect the long-term patency of saphenous vein grafts (SVGs) and clinical
outcomes of patients undergoing coronary artery bypass grafting (CABG).
The VEST trial evaluated the efficacy of external graft support in
limiting the development of intimal hyperplasia (IH) at 1 year
postsurgery. In the present secondary analysis, we explored the
associations between graft disease and IH and clinical events. We also
examined risk factors for early graft occlusion. <br/>Method(s): VEST is a
within-patient randomized, multicenter trial that enrolled 224 patients
with multivessel coronary disease undergoing CABG surgery, of whom 203
were evaluated by 1 year postsurgery. Intimal hyperplasia, lumen
uniformity, graft stenosis, and graft perfusion were measured by
intravascular ultrasound and angiography. Major cardiac and
cerebrovascular events (MACCE; including death, myocardial infarction,
stroke, and revascularization) were recorded over a median follow-up of 3
years. <br/>Result(s): Worse lumen uniformity, greater stenosis, and worse
graft perfusion were associated with higher IH values and an increased
incidence of clinical events. Consistent with previous findings, we
identified endoscopic vein harvesting, female sex, and transit time flow
measurement of pulsatility index and flow as risk factors for SVG
occlusion during the first year postsurgery. <br/>Conclusion(s): In this
secondary analysis of the VEST trial, we observed an association between
intimal hyperplasia area and clinical measures of SVG disease at 1 year
postsurgery. More severe SVG disease and larger areas of IH were
associated with a higher incidence of 3-year MACCE. Ongoing follow-up to 5
years will further elucidate the impact of SVG disease on long-term
clinical outcomes of CABG.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<101>
Accession Number
2031557745
Title
Peripheral Versus Central Cannulation of VA-ECMO for Primary Graft
Dysfunction After Heart Transplantation: A Systematic Review and
Metanalysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S367-S368), 2024. Date of Publication: April 2024.
Author
Rodenas Alesina E.; Olivella A.; Orchanian-Cheff A.; Foroutan F.; Alba A.;
Moayedi Y.; Rao V.; Billia F.; Ross H.; Aleksova N.
Institution
(Rodenas Alesina, Olivella) Vall d'Hebron University Hospital, Barcelona,
Spain, Spain
(Orchanian-Cheff, Billia) University Health Network, Toronto, ON, Canada,
Canada
(Foroutan) Ted Rogers Centre for Heart Research, Toronto, ON, Canada,
Canada
(Alba, Rao, Ross) Toronto General Hospital, Toronto, ON, Canada, Canada
(Moayedi) UHN, Toronto, ON, Canada, Canada
(Aleksova) University Health Network, Women's College Hospital, Toronto,
ON, Canada, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Primary graft dysfunction (PGD) is a major cause of death in the
postoperative period after heart transplantation (HT). The optimal
configuration of veno-arterial extracorporeal membrane oxygenation
(VA-ECMO) in this setting is debated. We conducted a systematic review and
metanalysis to determine whether a peripheral or central configuration was
associated with improved outcomes. <br/>Method(s): Embase, Medline and
Cochrane were queried for studies including adult (>= 18 years old) HT
recipients who required VA-ECMO for PGD during index admission for HT and
reported on the use of central or peripheral cannulation and short-term
outcomes, defined as death at 30 days or hospital discharge, or 1-year
mortality. We combined previously individual patient data and aggregate
study data and performed a meta-analysis on the association between ECMO
configuration and mortality using random effects models. We used the
ROBINS-I tool to assess risk of bias and GRADE framework to assess
certainty on evidence. <br/>Result(s): Overall, we included 17 studies
comprising 935 patients from 34 centres. The pooled short-term mortality
was 33% (95%CI 23-44%, I2=90%) and 1-year mortality was 47% (95%CI 37-57%,
I2=85%). With low certainty, peripheral cannulation was not associated
with decreased short-term mortality (OR=0.72, 95%CI 0.42-1.24,
I²=52.9%), but was associated with reduced 1-year mortality
(OR=0.59, 95%CI 0.37-0.94; I²=31.8%). Compared to central
cannulation, peripheral cannulation was associated with less major
bleeding (OR=0.57, 95%CI 0.34-0.94), more limb ischemia (OR=2.52, 95%CI
1.13-5.59) and infection (OR=1.87, 95%CI 1.10-3.19), and a similar need
for dialysis (OR=0.75, 95%CI 0.51-1.11). <br/>Conclusion(s): With low
certainty, when compared to central VA-ECMO, peripheral cannulation is
associated with lower risk of 1-year mortality and major bleeding, despite
higher risk of infection and limb ischemia, and may be preferred for PGD
after HT. [Formula presented]<br/>Copyright &#xa9; 2024

<102>
Accession Number
2031555772
Title
Durable versus Temporary Left-Ventricular Assist Devices versus
Extracorporeal Membrane Oxygenation for Bridging to Orthotopic Heart
Transplantation: A Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S595), 2024. Date of Publication: April 2024.
Author
Saemann L.; Maier S.; Kohl M.; Simm A.; Szabo G.
Institution
(Saemann, Simm, Szabo) Department of Cardiac Surgery, University Hospital
Halle, Halle (Saale), Germany, Germany
(Maier) Department of Cardiac Surgery, University Hospital Freiburg,
Freiburg im Breisgau, Germany, Germany
(Kohl) Faculty Medical and Life Sciences, Furtwangen University of Applied
Sciences, Villingen-Schwenningen, Germany, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Patients listed for orthotopic heart transplantation (OHTX) are
increasingly bridged to transplantation with circulatory support devices.
However, the survival after OTHX might depend on the type of circulatory
support. Thus, we compared the outcome of patients after OHTX who were
bridged with a durable left-ventricular assist device (d-LVAD) to those
who were bridged with a temporary LVAD (t-LVAD) device to those who were
bridged with venoarterial extracorporeal membrane oxygenation (VA-ECMO).
<br/>Method(s): We searched Medline via Pub Med, Web of Science, and the
Cochrane Library from the beginning to September 21^st, 2023. As
support devices, we included d-LVAD and t-LVAD that provide comparable
flow rates and VA-ECMO for bridging adult patients to OHTX. 497 records
were screened. Of those, we included 1 prospective trial and 3 registry
studies. One registry study reported two separate cohorts for the
respective LVAD. The R package metafor was used for the analyses. The
statistical comparison was performed by applying a meta-regression using a
mixed-effects model. The primary endpoint was the 1-year survival after
OHTX. <br/>Result(s): 1678 patients were included. 1150 patients were
bridged with d-LVAD, 394 with t-LVAD, and 134 with VA-ECMO. The 1-year
survival probability was significantly (p<0.0001) higher in t-LVAD (0.929;
95%CI: 0.897 to 0.961) compared to VA-ECMO (0.716; 95%CI: 0.640 to 0.793).
In d-LVAD (0.868; 95%CI: 0.770 to 0.965), the 1-year survival probability
was also significantly (p=0.0023) higher compared to VA-ECMO. The 1-year
survival probability in d-LVAD compared to t-LVAD was not significantly
(p=0.2315) different. <br/>Conclusion(s): The type of circulatory support
has a significant impact on the 1-year survival after OHTX. Both d-LVAD
and t-LVAD seem to result in a superior 1-year survival compared to
VA-ECMO. However, d-LVAD and t-LVAD appear to have a comparable 1-year
survival probability. [Formula presented]<br/>Copyright &#xa9; 2024

<103>
Accession Number
2031555613
Title
Let Us Shock You! Multidisciplinary Team Approach to Cardiogenic Shock
Improves Patient Outcomes and Reduces Complications.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S603-S604), 2024. Date of Publication: April 2024.
Author
Hajj J.; Kilic A.; Houston B.; Carnicelli A.; Witer L.; McMurray J.D.;
Bunting L.; Dodson K.; Summer M.; Yourshaw J.
Institution
(Hajj, Bunting, Dodson) Medical University of South Carolina, Charleston,
SC
(Kilic, Witer) Cardiothoracic Surgery, Medical University of South
Carolina, Charleston, SC
(Houston, Carnicelli) Cardiology, Medical University of South Carolina,
Charleston, SC
(McMurray) Critical Care Anesthesia, Medical University of South Carolina,
Charleston, SC
(Summer) Heart & Vascular Quality/Safety, Medical University of South
Carolina, Charleston, SC
(Yourshaw) Cardiology, Med Univ of South Carolina, Charleston, SC
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiogenic shock (CS) patients experience high mortality,
complication rates, and require resource-intensive care. Modes of care
delivery with proven benefit for these patients have become increasingly
complex and reliant on temporary mechanical circulatory support (tMCS)
devices. Our team felt it was critical to develop a quality scorecard to
demonstrate meaningful improvements in survival to tMCS explant and
discharge by enacting protocol-driven, physician-led, nurse coordinated
care for CS patients [1]. <br/>Method(s): A cardiogenic shock leadership
team was formed at MUSC in August of 2022 which included cardiothoracic
surgery, interventional cardiology, advanced heart failure, critical care,
quality data analyst, and cardiogenic shock RN. Adverse event definitions
were established by the group and an outcome scorecard was developed for
tracking patient events and outcomes within our organization who presented
in cardiogenic shock. <br/>Result(s): After protocol development, ICU
nurse training, regular quality review, and implementation of daily rounds
by the cardiogenic shock RN, we saw a significant reduction in adverse
events within our cardiogenic shock patient cohort. These included major
bleeds, neurologic events, device related complications, and
thromboembolisms. <br/>Conclusion(s): Despite advancements in tMCS devices
and guidelines in the identification and management of cardiogenic shock
patients, in-hospital mortality for cardiogenic shock is still reported at
27-51% [2, 3]. Multidisciplinary management and regular quality review of
this patient population leads to reduction in complications and adverse
events. [Formula presented]<br/>Copyright &#xa9; 2024

<104>
Accession Number
2031555474
Title
Randomized Trial to Evaluate the Safety and Efficacy of the Sherpa Pak
Device versus Cold Storage of Donor Hearts in Transplantation: A Pilot
Study.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S155), 2024. Date of Publication: April 2024.
Author
Esmailian F.; Stotland A.; Patel J.; Emerson D.; Mirocha J.; Bowdish M.;
Catarino P.; Megna D.; Gunn T.; Rafiei M.; Babalola O.; Daniels A.;
Kittleson M.; Chang D.; Kransdorf E.; Nikolova A.; Chikwe J.; Kobashigawa
J.
Institution
(Esmailian, Stotland, Patel, Emerson, Bowdish, Catarino, Megna, Gunn,
Rafiei, Babalola, Daniels, Kittleson, Chang, Kransdorf, Nikolova, Chikwe,
Kobashigawa) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA
(Mirocha) Cedars-Sinai Medical Center, Los Angeles, CA
Publisher
Elsevier Inc.
Abstract
Purpose: The standard method of storing donor hearts in preservation fluid
within sequential bags that are then placed on ice and transported in a
cooler does not allow for exact temperature control. The Sherpa Pak
Cardiac Transport System has been developed to provide a safe, consistent
method for cold ischemic storage of donor hearts for transplant. Although
there are registry reports of clinical benefit, the mechanistic benefits
of this device have not been established. Therefore, we performed a
randomized clinical trial (pilot study) to assess short-term clinical
efficacy and impact on cellular viability. <br/>Method(s): 20 patients
undergoing heart transplant were randomized to either the Sherpa Pak
device or routine cold storage preservation. Patients were randomized into
the study only if the donor heart offer occurred from outside the local
area to maximize potential for mechanistic outcome. Endpoints: The primary
endpoint is a composite endpoint including: Absence of severe primary
graft dysfunction, 30-day patient survival, 30-day incidence of ischemic
reperfusion injury on heart biopsies and changes in cell viability
including mitochondria function and quality (at donor heart harvesting,
just prior to donor heart implantation and in the first month post heart
transplant). Specifically, the biopsy samples underwent mass spectrometry
(MS). The MS files were analyzed in DIA-NN 1.8 using the spectral
library-free search with Prosit against the Human Uniprot database.
MetaboAnalyst 5.0 software was used to perform statistical analysis
comparing Sherpa Pak samples to cold storage samples. Unpaired t-test was
used to determine p-values and fold changes in proteins between the two
conditions. PINE pathway analysis indicates that Sherpa Pak samples after
transplant had an expression concomitant with increased fatty acid
metabolism and increased proteins of the mitochondrial intermembrane space
and contractile fiber machinery. Importantly, preliminary IPA analysis
indicates that Sherpa Pak samples have increased cell viability and
autophagy. Final clinical and mechanistic study results will be
reported.<br/>Copyright &#xa9; 2024

<105>
Accession Number
2031554121
Title
Long Term Follow-Up of the Randomized, Prospective Scandinavian Heart
Transplant Everolimus De Novo Study with Early Calcineurin Inhibitors
Avoidance (SCHEDULE) Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S145-S146), 2024. Date of Publication: April 2024.
Author
Bollano E.; Andreassen A.; Eiskjaer H.; Gustafsson F.; Radegran G.; Gude
E.; Halden T.; Gullestad L.; Broch K.; Karason K.; Bartfay S.; Bergh N.
Institution
(Bollano, Karason, Bartfay, Bergh) Sahlgrenska University Hospital,
Gothenburg, Sweden, Sweden
(Andreassen) Oslo University Hosp, Oslo, Norway, Norway
(Eiskjaer) Aarhus University Hospital, Aarhus, Denmark, Denmark
(Gustafsson) Rigshospitalet, Copenhagen, Denmark, Denmark
(Radegran) Skane Univy Hospital, Lund, Sweden, Sweden
(Gude) Oslo Univ Hosp, Oslo, Norway, Norway
(Halden) Novartis, Oslo, Norway, Norway
(Gullestad) Oslo Univ Hospital, Oslo, Norway, Norway
(Broch) Oslo U Hospital, Oslo, Norway, Norway
Publisher
Elsevier Inc.
Abstract
Purpose: Early substitution of calcineurin inhibitor (CNI) with mammalian
target of rapamycin inhibitors has been shown to improve kidney function
and reduce intimal hyperplasia in heart transplant (Htx) recipients but
data on long term outcome of such a regime are still sparse.
<br/>Method(s): In the SCHEDULE trial, 115 de novo Htx recipients were
randomized to a) everolimus with reduced exposure of CNI followed by CNI
withdrawal at week 7-11 posttransplant or b) standard -exposure with CNI.
Both groups received mycophenolate mofetil and corticosteroids. Herein we
report on the 10-12 year long-term follow-up of the study. <br/>Result(s):
A total of 78 patients attended the follow-up visit at a median time of 11
years posttransplant. In the everolimus intention to treat (ITT) group
87.5% (35/40 patients) still received everolimus and in the CNI ITT group
86.8 % (33/38) still received CNI. Estimated GFR (least square mean (95%
CI)) at the 10-12 years visit was 82.7 (74.2 - 91.1) ml/min/1.73m2 and
61.0 (52.3-69.7) ml/min/1.73m2 in the everolimus and CNI group,
respectively (p<0.001). Graft function measured by ejection fraction, ECG,
NT-proBNP and drug safety where comparable between groups. During the
study period there was a total of 28 deaths, but there was no difference
in survival between the everolimus and the CNI group (aHR 0.61 (95% CI
0.29-1.30) p=0.20). For the composite endpoint of death,
retransplantation, myocardial infarction, PCI, dialysis, kidney
transplantation or cancer no between group differences were found (aHR 1.0
(95% CI 0.57-1.77) p=0.99). <br/>Conclusion(s): De novo Htx patients
randomized to everolimus and low dose CNI followed by CNI free therapy
sustained significantly better long-term kidney function than patients
randomized to standard therapy. The graft function at 10-12 years was
similar in both groups and there was no difference in
survival.<br/>Copyright &#xa9; 2024

<106>
Accession Number
2031554076
Title
Multicenter Clinical Trial to Evaluate the Efficacy of a Preventive
Strategy Against Cytomegalovirus Infection in Heart Transplant Patients
Based on the Specific T Cells Response.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S25), 2024. Date of Publication: April 2024.
Author
Garcia-Romero E.; Diez-Lopez C.; Bestard O.; Donoso Trenado V.;
Garcia-Cosio M.; Ortiz-Bautista C.; Hernandez-Perez F.; Couto-Mallon D.;
Gonzalez-Vilchez F.; De la fuente Galan L.; Lopez-Lopez L.; Grande Trillo
A.; Gomez Molina M.; Rosenfeld Vilalta L.; Ibanez Caballero S.; Donadeu
Casassas L.; Sabe N.; Gonzalez-Costello J.
Institution
(Garcia-Romero, Diez-Lopez, Gonzalez-Costello) Department of
CardiologyBioheart Group (IDIBELL)Ciber Cardiovascular Group (CIBER-CV),
Bellvitge University Hospital, Barcelona, Spain, Spain
(Bestard, Donadeu Casassas) Vall d'Hebron University Hospital, Barcelona,
Spain, Spain
(Donoso Trenado) La Fe University Hospital, Valencia, Spain, Spain
(Garcia-Cosio) 12 Octubre University Hospital, Madrid, Spain, Spain
(Ortiz-Bautista) Gregorio Maranon University Hospital, Madrid, Spain,
Spain
(Hernandez-Perez) Puerta de Hierro University Hospital, Madrid, Spain,
Spain
(Couto-Mallon) A Coruna University Hospital Complex, A Coruna, Spain,
Spain
(Gonzalez-Vilchez) Marques de Valdecilla University Hospital, Santander,
Spain, Spain
(De la fuente Galan) Valladolid University Hospital, Valladolid, Spain,
Spain
(Lopez-Lopez) Santa Creu i Sant Pau Hospital, Barcelona, Spain, Spain
(Grande Trillo) Virgen del Rocio University Hospital, Sevilla, Spain,
Spain
(Gomez Molina) Virgen de la Arrixaca University Hospital, Murcia, Spain,
Spain
(Rosenfeld Vilalta, Ibanez Caballero, Sabe) Bellvitge University Hospital,
Barcelona, Spain, Spain
Publisher
Elsevier Inc.
Abstract
Purpose: The prevention of cytomegalovirus (CMV) infection in transplant
patients is currently based exclusively on the presence of antibodies
against CMV of the receptor and the donor. Despite universal prophylaxis
or preemptive therapy, the rate of infection or CMV disease remains high
and has a negative clinical impact. Monitoring CMV-specific cell-mediated
immunity (CMI) in kidney transplantation is useful in predicting CMV risk
infection.This study aims to demonstrate that a preventive strategy
against CMV infection in seropositive heart transplant adult patients,
based on the specific T cell response, measured by IFN-gamma ELISPOT
assay, is effective and safe, compared to universal prophylaxis.
<br/>Method(s): This is a multicenter, randomized, open-label, controlled
phase IV trial, with a non inferiority design. Patients have been randomly
assigned (2:1) to group 1: preventive strategy based on post-transplant
CMI (patients with low CMI will receive valganciclovir for 3 months and
patients with high CMI will be treated with pre-emptive therapy); or group
2: Standard care, universal prophylaxis with valganciclovir for 3 months.
188 patients from 11 Spanish hospitals have been included. Assuming a 40%
cumulative incidence of CMV infection according to the literature and a
non-inferiority margin of 10%, 125 patients have been included in the
experimental group and 63 patients in the control group. The safety and
effectiveness statistical analysis will be based on both per protocol and
per intention to treat analysis. Endpoints: The main study outcome will be
the cumulative incidence of CMV infection during the first year post-heart
transplant in each group. Secondary endpoints examined at one year will
be: CMV disease, late CMV infection, graft vasculopathy, other bacterial
or viral infections, leukopenia, neutropenia and other adverse events
related to prophylaxis, all-cause mortality, CMV infection related
mortality, specific anti CMV IgG antibodies and unspecific gammaglobulin
titers, CMV-specific B memory response, change in CMI against CMV from 10
days to 3 months post-HT, prediction capacity of CMI against CMV at 3
months for late CMV infection, number of spots against CMV antigens, viral
load and cost-effectiveness of both strategies.<br/>Copyright &#xa9; 2024

<107>
Accession Number
2031553625
Title
Re-Evaluating Natriuretic Peptides as Biomarkers of Cardiac Allograft
Vasculopathy.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S98), 2024. Date of Publication: April 2024.
Author
Patel K.; Yadalam A.; Gold M.E.; Patel P.; Waller J.; Gillet A.S.;
Panagopoulos A.; Alkhoder A.; Siddiqui Z.; Khawaja O.; Allaqaband H.; Sakr
S.; Rahbar A.; Haroun Y.; Hashmi H.; Shamim A.; Ejaz K.; Gupta D.; Book
W.; Quyyumi A.A.
Institution
(Patel, Yadalam, Gold, Patel, Waller, Gillet, Panagopoulos, Alkhoder,
Siddiqui, Khawaja, Allaqaband, Sakr, Rahbar, Haroun, Hashmi, Shamim, Ejaz,
Gupta, Book, Quyyumi) Emory University, Atlanta, GA
Publisher
Elsevier Inc.
Abstract
Purpose: Despite initial evidence supporting the use of elevated B-type
natriuretic peptide (BNP) to predict cardiac allograft vasculopathy (CAV),
a recent meta-analysis questioned the diagnostic accuracy of BNP and
N-terminal-pro brain natriuretic peptide (NT-proBNP) in the detection of
CAV following heart transplantation (HTx). To our knowledge, no study has
assessed both BNP and NT-proBNP in the prediction of CAV in HTx.
<br/>Method(s): HTx recipients undergoing coronary angiography for CAV
surveillance had BNP and NT-proBNP levels measured (Abbott Architect,
Abbott Laboratories). CAV was graded as 0, 1, 2 or 3 using the ISHLT
classification. The relationship between BNP/NT-proBNP and CAV was
assessed using Kruskal-Wallis test, as well as Dunn's test with Holm
correction for multiple comparisons. For multivariable analysis, logistic
regression models for presence of CAV by standard deviation (SD) of each
peptide were constructed after adjustment for age, time since transplant,
African American race, hypertension, diabetes, body mass index, total
cholesterol, low-density lipoprotein, and estimated glomerular filtration
rate. <br/>Result(s): 318 HTx patients (median age 58.1 years, median age
at transplant 50.0 years, 21.7% women, 27.3% African American) were
included in the study. Median NT-proBNP and BNP levels were 417.9 pg/mL
(Q1, Q3: 244.9-852.2 pg/mL), and 113.7 pg/mL (Q1, Q3: 68.0-205.0 pg/mL),
giving a ratio of ~4.01:1. CAV grades were: CAV<inf>0</inf> (54%),
CAV<inf>1</inf> (31%), CAV<inf>2</inf> (6%), and CAV<inf>3</inf> (9%).
NT-proBNP and BNP values were highly correlated with Pearson's r=0.80 (p <
0.001). The levels of each peptide varied across CAV grades (p<0.001). To
conduct pairwise comparisons, we adjusted the significance threshold to an
alpha level of 0.025. Peptide levels did not vary between CAV<inf>0</inf>
and CAV<inf>1</inf> (p = 0.207 for NT-proBNP, p = 0.073 for BNP),
CAV<inf>1</inf> and CAV<inf>2</inf> (p = 0.255 for NT-proBNP, p = 0.113
for BNP), nor CAV<inf>2</inf> and CAV<inf>3</inf> (p = 0.033 for
NT-proBNP, p = 0.055 for BNP). In logistic regression analysis, both
peptides were independently associated with the presence of any CAV (OR
12.3, 95% CI 3.13 - 67.75 per SD increase of NT-proBNP; and OR 3.5, 95% CI
1.91 - 7.30 per SD increase of BNP). <br/>Conclusion(s): BNP and NT-proBNP
maintain a strong positive correlation in HTx patients. In the largest
study to date examining natriuretic peptides and CAV, both peptides as
continuous measures were independently associated with the presence of
CAV.<br/>Copyright &#xa9; 2024

<108>
Accession Number
2031553598
Title
Cardiac Vasoplegia Syndrome: An Important Clinical Entity in Need of a
Unified Definition. A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S253), 2024. Date of Publication: April 2024.
Author
Papazisi O.; van der Schoot M.M.; Berendsen R.R.; Arbous S.M.; le Cessie
S.; Dekkers O.M.; Klautz R.J.; Marczin N.; Palmen M.; de Waal E.E.
Institution
(Papazisi, Klautz, Palmen) Department of Cardiothoracic Surgery, Leiden
University Medical Center, Leiden, Netherlands, Netherlands
(van der Schoot, Berendsen) Department of Anesthesiology, Leiden
University Medical Center, Leiden, Netherlands, Netherlands
(Arbous) Department of Intensive Care, Leiden University Medical Center,
Leiden, Netherlands, Netherlands
(le Cessie) Department of Clinical Epidemiology, Department of Biomedical
Data Sciences, Leiden University Medical Center, Leiden, Netherlands,
Netherlands
(Dekkers) Department of Clinical Epidemiology, Leiden University Medical
Center, Leiden, Netherlands, Netherlands
(Marczin) Division of Anesthesia, Pain Medicine and Intensive Care,
Imperial College London, London, United Kingdom, United Kingdom
(de Waal) Department of Anesthesiology, University Medical Center Utrecht,
Utrecht, Netherlands, Netherlands
Publisher
Elsevier Inc.
Abstract
Purpose: Post cardiac surgery vasoplegia syndrome occurs frequently
although a unified definition is lacking. The lack of a unified definition
hampers further research for predictors, outcomes and treatment. We aim to
summarize published vasoplegia definitions and explore differences in
incidences, ICU length of stay (LOS), and 30-day mortality rates related
to vasoplegia. <br/>Method(s): Different databases (PubMed, Embase, Web of
Science, Cochrane Library, Emcare) were searched using relevant MeSH terms
(Vasoplegia, Thoracic Surgery and Thoracic Surgical Procedures). Studies
defining vasoplegia were systematically reviewed by two reviewers and a
third in case of discussion. Studies in cardiac surgery reporting either
on vasoplegia incidence, ICU LOS or 30-day mortality were included for
meta-analysis. Studies were categorized depending on the mean arterial
pressure (MAP) threshold used for the definition (<50, <55, <60, <65, <70
and <80 mmHg, and uncategorized). Random intercept logistic regression
models were used for meta-analysis of incidence and mortality rates.
Random effect meta-analysis was employed for ICU LOS. <br/>Result(s): The
literature search yielded 1711 studies, of which 100 were included for
systematic review. The risk of bias was low according to ROBINS I. No
consensus was found regarding the variables and thresholds used to define
vasoplegia. The reported incidence (60 studies, mean incidence: 20.0%,
[95%CI, 16.1-24.5]) varied largely between studies (2.5%-66.3%) with
substantial heterogeneity: I² 97%, p<0.0001. Meta-regression
models including the MAP-threshold used in studies, did not explain this
heterogeneity. Similarly, the effect of vasoplegia on ICU LOS and 30-day
mortality was very heterogeneous among studies. <br/>Conclusion(s): In
this review, a large heterogeneity in reported vasoplegia incidences was
found. This cannot be explained only by factors such as percentage of
heart failure patients, publication year or MAP threshold. It is probable
that the inherent variations in vasoplegia definitions might have led to
inconsistencies in patient diagnosis. Such inconsistencies could therefore
signify that the so far published results from vasoplegia research are
incomparable. A consensus definition is required to consolidate the scale
of the syndrome and delineate risks, mechanisms and clinical
impact.<br/>Copyright &#xa9; 2024

<109>
Accession Number
2031553592
Title
Non-Ischemic Preservation of the Donor Heart in Heart Transplantation - A
Randomized, Controlled, Multicenter Trial Using The Xvivo Heart Assist
Preservation System for Hypothermic Oxygenated Perfusion (NIHP2019).
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S11), 2024. Date of Publication: April 2024.
Author
Rega F.; Lebreton G.; Para M.; Michel S.; Schramm R.; Begot E.;
Vandendriessche K.; Kamla C.; Gerosa G.; Berman M.; Boeken U.; Clark S.;
Ranasinghe A.; Ius F.; Forteza A.; Hennig F.; Gunter S.; Zuckermann A.;
Knosalla C.; Dellgren G.; Wallinder A.
Institution
(Rega, Vandendriessche) Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium, Belgium
(Lebreton, Begot) Cardiac Surgery Department, Pitie-Salpetriere Hospital,
APHP, Sorbonne University, Paris, France, France
(Para) Department of Cardiovascular Surgery and Transplantation, Bichat
Hospital, universite Paris Cite, Paris, France, France
(Michel, Kamla) Clinic of Cardiac Surgery, Ludwig-Maximilians-University
(LMU) of Munich, Munich, Germany, Germany
(Schramm, Gunter) Clinic for Thoracic- and Cardiovascular Surgery, Heart
and Diabetes Center North Rhine Westfalia, Ruhr-University Bochum, Bad
Oeynhausen, Germany, Germany
(Gerosa) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy, Italy
(Berman) Royal Papworth Hospital NHS Foundation Trust, Cambridge, United
Kingdom, United Kingdom
(Boeken) Department of Cardiac Surgery, Medical Faculty, Heinrich Heine
University, Duesseldorf, Germany, Germany
(Clark) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne,
United Kingdom, United Kingdom
(Ranasinghe) Queen Elizabeth Hospital, University Hospitals Birmingham NHS
Trust, Birmingham, United Kingdom, United Kingdom
(Ius) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hannover Medical School, Hannover, Germany, Germany
(Forteza) Department of Cardiac Surgery, Puerta de Hierro Majadahonda
University Hospital, Madrid, Spain, Spain
(Hennig, Zuckermann) Department of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria, Austria
(Knosalla) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany, Germany
(Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden, Sweden
(Wallinder) XVIVO Perfusion, Gothenburg, Sweden, Sweden
Publisher
Elsevier Inc.
Abstract
Purpose: Cold static storage remains the worldwide gold standard for
preserving donor hearts prior to transplantation. We evaluated if
continuous, hypothermic, oxygenated perfusion of the donor heart with the
XVIVO heart preservation technology, so called non-ischemic heart
preservation (NIHP), is safe and superior compared to ischemic cold static
storage. <br/>Method(s): We performed a randomized, controlled,
multi-center clinical trial, with the intention to enroll 202 eligible
subjects. Allocation was done in a 1:1 ratio. In NIHP the preservation
protocol involved the use of the XVIVO Heart Assist Transport and the
XVIVO Heart Solution by which the donor heart was flushed and subsequently
perfused during ex-vivo preservation. Starting at the donor site the
technology ensures oxygenated, pressure-controlled perfusion of the
resting donor heart through the ascending aorta. The donor hearts in the
control group underwent preservation through ischemic cold static storage
according to standard practices at each participating institution
including the use of the center specific preservation solutions.
Endpoints: The primary endpoint was defined as time-to-first-event of
either cardiac related death, moderate or severe primary graft dysfunction
of the left ventricle or primary graft dysfunction of the right ventricle
(according to Kobashigawa et al., 2014), acute cellular rejection >=2R
(according to Stewart et al., 2005) or graft failure (use of mechanical
circulatory support or re-transplantation) within 30 days after
transplantation. Among the secondary outcome measures were post
transplantation cardiac injury markers, ICU length of stay, adverse events
and echo analysis as well as one year mortality, graft dysfunction and
CAV. Recruitment in the study was initiated in November 2019 and completed
May 2023. A total of 204 patients across 15 sites in 8 European countries
were randomized and transplanted in accordance with the protocol. There
were six cross-overs between the randomization groups. There were no
transplanted patients lost to follow-up. Results of the primary end-point
and selected secondary endpoints will be disclosed.<br/>Copyright &#xa9;
2024

<110>
Accession Number
2031553368
Title
The TEAMMATE Trial: Post-Transplant Outcomes and Social Determinants of
Health.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S61-S62), 2024. Date of Publication: April 2024.
Author
Sleeper L.A.; Singh T.P.; Daly K.P.; Alejos J.C.; Auerbach S.R.; Barkoff
L.; Bock M.J.; Butto A.; Carlo W.F.; Castleberry C.; Chrisant M.;
Deshpande S.; Dreyer W.J.; Feingold B.; Friedland-Little J.; Gonzales S.;
Hollander S.A.; Joong A.; Kindel S.; Klein G.L.; Lal A.K.; Lamour J.;
Lytrivi I.; Peng D.M.; Rossano J.W.; Ryan T.D.; Su J.A.; Sutcliffe D.;
Zangwill S.; Almond C.S.
Institution
(Sleeper) Cardiology, Boston Children's Hosp, Boston, MA
(Singh, Daly, Klein) Boston Children's Hospital, Boston, MA
(Alejos) UCLA Mattel Children's Hosp, Los Angeles, CA
(Auerbach) University of Colorado, Aurora, CO
(Barkoff) Lucile Packard Children's Hospital, Palo Alto, CA
(Bock) Rady Children's Hospital / UC San Diego, San Diego, CA
(Butto) Children's Healthcare of Atlanta, Atlanta, GA
(Carlo) University of Alabama, Birmingham, AL
(Castleberry) Dell Medical School at the University of Texas in Austin,
Austin, TX
(Chrisant) Joe DiMaggio Children's Hospital, Hollywood, FL
(Deshpande) Children's National Hospital, George Washington University,
Washington, DC
(Dreyer) Baylor College of Medicine, Houston, TX
(Feingold) UPMC Children's Hospital of Pittsburgh, Pittsburg, MA
(Friedland-Little) Seattle Children's Hospital, Seattle, WA
(Gonzales, Hollander, Almond) Stanford University, Palo Alto, CA
(Joong) Ann & Robert HLurie Children's Hospital of Chicago, Chigao, IL
(Kindel) Children's Hospital of Wisconsin, Milwaukee, WI
(Lal) University of Utah, Salt Lake City, UT
(Lamour) Mount Sinai Medical Center, New York City, NY
(Lytrivi) Columbia Presbyterian Hospital, New York, New York City, NY
(Peng) University of Michigan, Ann Arbor, MI
(Rossano) The Children's Hospital of Philadelphia, Philadelphia, PA
(Ryan) Cincinnati Children's Hospital Medical Center, Cincinnati, OH
(Su) Children's Hospital Los Angeles, Los Angeles, CA
(Sutcliffe) Children's Mercy Hospital, Kansas City, MO
(Zangwill) Phoenix Children's Hospital, Phoenix, AZ
Publisher
Elsevier Inc.
Abstract
Purpose: TEAMMATE (NCT 03386539) is the first randomized trial of
immunosuppression in pediatric heart transplant (HT) recipients. We report
on the association of social determinants of health (SDOH) to outcomes;
and treatment effects (currently embargoed) according to SDOH.
<br/>Method(s): At 25 U.S. sites, subjects 0-21 years surviving to 6
months after HT were randomized 1:1 to everolimus/low-dose tacrolimus or
standard-dose tacrolimus/mycophenolate mofetil and followed for 30 months.
The primary efficacy outcome was the Major Adverse Transplant Even
(MATE)-3 score reflecting prevalence and severity of coronary, chronic
renal, and acute cellular rejection outcomes. The primary safety endpoint
MATE-6 included MATE-3 +serious infection, post-HT lymphoproliferative
disorder, and antibody-mediated rejection. Secondary endpoints included
quality of life (QOL): Lansky and Karnofsky (L/K) scores and the EQ-5D
(0-100). <br/>Result(s): From 2018-2020, 211 subjects (age 8.2+/-6.3
years, 54% male) were enrolled. Racioethnicity was: 26% Hispanic (H), 40%
non-H white (W), 9% non-H black (B), 6% non-H Asian (A), 19%
other/unknown. Public health insurance varied by racioethnicity (p<0.001):
83% for H; 40% for W, 63% for B and 26% for A. A MATE-6 events occurred in
60% vs. 48% with public vs. private insurance (p=0.07); MATE-3 events
occurred in 46% with public and 31% with private insurance (p=0.02).
MATE-6 score was higher with public insurance (3.0+/-6.2 vs. 1.3+/-27,
p=0.03) as well as MATE-3 (p=0.06). MATE-3 differed by racioethnicity
(Figure; p=0.05). EQ5D score (N=120) was 90.2+/-13.7 and L/K score (N=199)
was 94.4+/-11.7 at 30 months post-randomization. There was no difference
in QOL according to SDOH. Treatment effects according to subgroups defined
by SDOH including Child Opportunity Index will be available at
presentation. <br/>Conclusion(s): In the TEAMMATE Trial, major adverse HT
events were more common in those with public insurance and in Hispanic and
Black participants. Health-related QOL in this cohort was high
irrespective of SDOH. [Formula presented]<br/>Copyright &#xa9; 2024

<111>
Accession Number
2031542499
Title
TCTAP A-015 Clinical Insights: Impact of BMI and Gender on Postoperative
Myocardial Ischemia Following Remote Ischemic Preconditioning in Cardiac
Surgery - A Meta-Regression Analysis.
Source
Journal of the American College of Cardiology. Conference: 29th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Songdo Convensia Convention Center, Incheon South Korea.
83(16 Supplement) (pp S9-S10), 2024. Date of Publication: 23 Apr 2024.
Author
Abbas Al Wssawi A.F.; Gumera A.; Ibrahim A.; Hashim H.T.; Al-shammari
A.S.; Abbas G.M.; Abdeltawwab M.G.; Amim M.; Shamim U.; Alchamaley M.
Institution
(Abbas Al Wssawi, Alchamaley) University of Al-Qadisiyah, Iraq
(Gumera) University of Melbourne, Australia
(Ibrahim) Alexandria University, Egypt
(Hashim) University of Warith Al-Anbiyaa, Iraq
(Al-shammari) Imam Ali General Hospital, Iraq
(Abbas) University of Kufa, Iraq
(Abdeltawwab) Fayoum University, Egypt
(Amim) Fayoum University Hospital, Egypt
(Shamim) The Aga Khan University Hospital, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: In cardiac surgery, patients are vulnerable to the serious
complication of postoperative myocardial ischemia, which can be a
detriment to patient outcomes. Whilst great strides have been made in
minimizing perioperative risks through the development of improved
anesthesia protocols and minimally invasive techniques, the challenge of
postoperative myocardial ischemia continues as a contributor to mortality
and extended hospital stays. Remote Ischemic Preconditioning (RIPC) has
appeared as a promising procedural adjunct via the activation of
endogenous defensive mechanisms to lessen ischemic injury. However, the
efficacy of RIPC has been a recent topic of discussion, and the evidence
for its association with patient-specific characteristics has been
insufficient. The current literature has observed the effectiveness of
RIPC in a varied patient population, without adequate analysis of how
patient characteristics including Body Mass Index (BMI), gender, and
hypertension could influence its effectiveness. This reveals a gap in
applicability, leaving clinicians with uncertainty in patient selection
for RIPC. This study aims to lay the groundwork for tailored approaches in
cardiac care by investigating these factors. <br/>Method(s): The Cochrane
Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE
(including MEDLINE InProcess) (OvidSP), Web of Science, Embase (OvidSP),
and Scopus databases were searched from database inception until August
15th, 2023. We included randomized controlled trials confined to the
English language that studied the effects of RIPC after cardiac surgery.
In accordance with our search strategy, 1065 abstracts were reviewed, and
328 articles were selected for full-text screening after duplicates and
irrelevant topics were removed as per PRISMA standards. A total of 24
studies were included for data extraction. Computations were performed
using the Comprehensive Meta-Analysis Version 4 software. Using Cochrane
tools for systematic reviews, the risk of bias, sensitivity analysis, and
heterogeneity test were performed. [Formula presented] Results: A
meta-analysis of 24 included studies demonstrated a significant reduction
in the odds of postoperative myocardial ischemia with RIPC compared to the
control (OR: 0.811; 95% CI: 0.669 to 0.983; p = 0.033). The reliability of
this result across the included studies is reinforced by the low level of
heterogeneity (I² = 0.143). Meta-regression findings: The
meta-regression analysis showed that there is a significant association
between mean BMI and the incidence of postoperative myocardial ischemia
(Coefficient: 0.1823; 95% CI: 0.0104 to 0.3541; p = 0.0377). There was
also a significant positive association between the percentage of males
and the incidence of postoperative myocardial ischemia (Coefficient:
0.0368; 95% CI: 0.0108 to 0.0628; p = 0.0055). In contrast, hypertension
does not have a significant effect on the incidence of postoperative
myocardial ischemia following RIPC in cardiac surgeries (Coefficient:
0.0045; 95% CI: -0.0211 to 0.0301; p = 0.7307). [Formula presented]
[Formula presented] <br/>Conclusion(s): The study further strengthens the
role of RIPC in reducing the risk of postoperative myocardial ischemia in
cardiac surgeries. Our meta-regression analysis offers evidence that
patient-specific factors significantly affect the risk of postoperative
myocardial ischemia following RIPC. The data highlights a noteworthy
association between mean BMI and gender with postoperative myocardial
ischemia. The findings suggest that all-purpose RIPC protocols may be
flawed, encouraging the development of tailored preconditioning regimens.
This may improve the efficacy of RIPC, thus minimizing the incidence of
myocardial ischemia and related complications. This study also recognizes
gaps in our understanding of the mechanisms of these relationships,
further inspiring future targeted research. The application of these
findings into clinical practice could be an important step toward
improving outcomes in cardiac surgery patients.<br/>Copyright &#xa9; 2024

<112>
Accession Number
2031541567
Title
TCTAP A-021 Re-Evaluating the Role for Revascularisation in Stable
Coronary Disease: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: 29th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Songdo Convensia Convention Center, Incheon South Korea.
83(16 Supplement) (pp S15), 2024. Date of Publication: 23 Apr 2024.
Author
Sultana N.; Nerlekar N.; White A.
Institution
(Sultana, Nerlekar, White) Monash Heart, Victorian Heart Hospital,
Australia
Publisher
Elsevier Inc.
Abstract
Background: Conventional strategies for the management of stable coronary
artery disease (CAD) often favour an initial revascularisation approach.
Whether there is improved mortality and reduction in adverse
cardiovascular outcomes when compared to optimal medical therapy (OMT)
alone remains controversial, given the latter can be underutilised and
sub-optimally administered in clinical settings. This meta-analysis aims
to provide a nuanced perspective on the comparative impacts of routine
revascularisation and OMT on long-term mortality in stable CAD.
<br/>Method(s): A systematic search was conducted using the PUBMED,
MEDLINE and EMBASE databases. Results were limited to randomised
controlled trials (RCT) comparing an initial revascularisation approach
(percutaneous coronary intervention (PCI), coronary artery bypass grafting
(CABG)) to OMT alone. The outcomes of interest were mortality (both
all-cause and cardiac), incidence of myocardial infarction (MI), unplanned
revascularisation, hospitalisation for cardiac reasons and stroke.
Inclusion criteria across all studies comprised of patients with
symptomatic stable angina, or those who demonstrated evidence of ischaemia
on stress testing or had documented disease with at least one stenosis
(above 70%) in a major coronary artery on angiography. Patients with
significantly reduced left ventricular ejection fraction (below 35%) were
excluded from all trials. Random-effects meta-analysis was performed using
the programming language R. Results are reported as odds ratio (OR) with
95% confidence intervals (95% CI). Study heterogeneity is determined by
the I² statistic. [Formula presented] Results: 824 articles
were screened for eligibility, with 33 full-text papers retrieved for
potential inclusion and detailed evaluation. Of this group, 14 RCTs met
criteria for quantitative analysis. Quantitative analysis included 15,081
participants, of whom 7,734 had undergone revascularisation with PCI
(80.2%) or CABG (19.8%). The remaining patients were treated with OMT
(48.8%). Median follow-up ranged between twelve months and five years.
Thirteen of the fourteen trials selected for meta-analysis reported the
incidence of all-cause mortality and MI. The incidence of mortality did
not vary significantly between an approach involving revascularisation
with medical therapy versus medical therapy alone (13 studies, OR, 0.99;
95% CI, 0.87 - 1.12; p = 0.77; I² = 0%). It was a similar case
for MI (OR, 0.94; 95% CI, 0.81 - 1.09; p= 0.35; I² = 10%). Ten
reported the incidence of cardiac death, which demonstrated no significant
difference between either approach also (OR, 0.97; 95% CI, 0.81 - 1.15; p
= 0.87, I² = 0%). The outcomes of unplanned revascularisation
and hospitalisations for cardiac reasons demonstrated benefit of initial
revascularisation (10 studies, OR, 0.75; 95% CI, 0.50 - 1.14; p < 0.01,
I² = 83%), (6 studies, OR, 0.68; 95% CI, 0.39 - 1.20; p < 0.01;
I² = 85%) although with higher heterogeneity. Finally, for the
outcome of stroke, the results were suggestive, but not significant for an
initial conservative strategy of OMT alone (8 studies, OR, 1.48; 95% CI,
0.84 - 2.62, p = 0.17, I² = 33%). [Formula presented]
<br/>Conclusion(s): Compared to OMT alone, an initial revascularisation
strategy demonstrated similar outcomes for all-cause and cardiac
mortality, and MI. However, rates of unplanned revascularisation and
hospitalisation for cardiac reasons were significantly lower among the
initial revascularisation cohort. Incidence of stroke was lower within the
OMT group, although this lacked statistical significance. Further
evaluation of subjective symptoms such as angina and exercise tolerance
would be useful in providing an individualised approach in clinical
settings. Angina questionnaires and scoring systems were not expressed in
a standardised manner across the trials, precluding accurate quantitative
analysis. Extended follow up will be beneficial to observe the impact of
nonfatal events on overall mortality.<br/>Copyright &#xa9; 2024

<113>
Accession Number
2031541527
Title
TCTAP A-048 Impact of Minimal Invasive Extracorporeal Circulation in
Coronary Artery Bypass Surgery: Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: 29th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Songdo Convensia Convention Center, Incheon South Korea.
83(16 Supplement) (pp S28-S30), 2024. Date of Publication: 23 Apr 2024.
Author
Abbas Al Wssawi A.F.; Gumera A.; Al-Shammari A.S.; Abdelsamad H.; Hashim
H.T.
Institution
(Abbas Al Wssawi) University of Al-Qadisiyah, Iraq
(Gumera) University of Melbourne, Australia
(Al-Shammari) Imam Ali General Hospital, Iraq
(Abdelsamad) Ain Shams University, Egypt
(Hashim) University of Warith Al-Anbiyaa, Iraq
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery disease (CAD) continues to be a leading global
health issue, often treated with coronary artery bypass grafting (CABG),
which implements conventional approaches that have significant drawbacks.
Minimal invasive extracorporeal circulation (MiECC) has emerged as a
promising alternative. However, heterogeneous research has led to clinical
uncertainty. <br/>Objective(s): To evaluate and compare the efficacy and
safety of MiECC with traditional approaches in coronary artery bypass
grafting (CABG). The review aims to address the key question: "Do patients
undergoing CABG with MiECC experience superior outcomes compared to those
using traditional perfusion techniques? [Formula presented] Methods:
Search methods: Articles were searched using medical databases including
PubMed, Medline, Scopus, Embase, Web of Science, and The Cochrane Central
Register Of Controlled Trials (CENTRAL) from the database's inception
until the 18th of August 2023. <br/>Selection Criteria: We included
English-language randomized controlled trials and cohort studies that
looked for adults doing Coronary Artery Bypass Grafting(CABG) surgery and
receiving the Minimally Invasive Extracorporeal Circulation technique.
<br/>Data Collection and Analysis: A total of 1896 abstracts were
screened, followed by full-text for 108 articles checked after duplicates
and not related subjects removal, using PRISMA guidelines. Finally, a
total of 29 studies were included for data extraction in our systematic
review. Data analysis was done using RevMan 5.4 software. The risk of
bias, sensitivity analysis, and heterogeneity test were done using
Cochrane tools for systematic reviews. [Formula presented] Results: Main
results: The primary outcomes for this study were: The duration of
Intensive Care Unit (ICU), hospital stay, Cardiopulmonary Bypass (CPB),
ventilation, and cross-clamp time of MiECC versus the standard method, the
secondary outcomes were the Extracorporeal circuit(ECC), aortic clamp and
operation time, intraoperative blood transfusion, postoperative blood, and
drainage loss, atrial fibrillation incidence, myocardial ischemia, stroke,
total and in-hospital mortality rates of MiECC versus the standard
approach. Regarding the primary outcomes, the overall significant
differences were shown in the ventilation time, MiECC technique was
associated with a reduction in the total hours, Mean difference (MD):
-3.28; 95% confidence interval, -5.7, -0.87; p=0.008; Z=2.67; I2= 92%.
In-hospital stay days were decreased in the MiECC group, MD:-2.17, 95%CI,
(-3.84, -0.5), p=0.01. CPB time was increased in the standard group
compared to the MiECC group, MD: 5.81, 95% CI: 5.81(0.95, 10.66). Overall
cross-clamping time was also decreased but not significantly compared to
the standard group, MD: -0.39; 95% CI, (-2.84, 2.07), P=0.76. The mean
difference reduction in ICU days stays was -0.09 [95% CI, -023, 0.05]; P
=0.22). Regarding the secondary outcomes, there was a significant overall
difference in ECC hours between the two groups, MD: 5.71; 95%CI: (0.02,
11.39), p-value=0.05. Atrial fibrillation complication rate was higher in
the standard group: 0.36; 95%CI: 0.36(0.2, 0.66), p-value=0.05. Myocardial
ischemia complication rate was higher in the standard group, MD: 0.51;
95%CI, (0.27, 0.97), p-=0.04. The stroke complication rate was higher in
the standard group compared to the MiECC group, MD: 0.35; 95%CI:0.16,
0.78), P=0.01. The in-hospital overall mortality rate was higher in the
standard group but did not show significance: 0.61; 95%CI (0.33, 1.13),
p=0.12. Postoperative drainage loss was not significantly different, MD:
-136.71; 95%CI: (-337.17, 63.76), p =0.18. MiECC was linked to an increase
in postoperative blood loss MD: -33.26, 95%CI: (102.1, 35.59), p=0.34.
[Formula presented] [Formula presented] [Formula presented]
<br/>Conclusion(s): The systematic review and meta-analysis confirm that
MiECC in CABG surgeries can be beneficial over standard methods in
multiple outcome measures. However, it is crucial to interpret these
results carefully, as many studies displayed a low risk of bias across
several domains. MiECC may be advantageous in clinical practice,
potentially enhancing patient outcomes and reducing healthcare costs.
However, implementing MiECC should be considered in the context of
individual patient's medical condition and existing guidelines. The review
identifies both potential advantages and gaps in the body of evidence
concerning the use of MiECC in CABG surgeries. The utilization of MiECC
was linked to shorter durations of ICU stay, hospital stay, and mechanical
ventilation time, although the findings exhibited some variability in
sensitivity analyses. The review highlights the need for more
high-quality, effective RCTs with rigorous blinding and allocation
protocols. Future research should investigate the reasons for observed
heterogeneity in results, possibly exploring patient characteristics or
procedural variables that may affect outcomes. A cost-effectiveness
analysis of MiECC compared to standard methods can add another dimension
to this line of research.<br/>Copyright &#xa9; 2024

<114>
Accession Number
2031541051
Title
A Systematic Review of Reporting and Handling of Missing Data in
Observational Studies Using the UNOS Database.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 44th Annual
Meeting and Scientific Sessions Prague Congress Centre. Prague Czechia.
43(4 Supplement) (pp S341), 2024. Date of Publication: April 2024.
Author
Baker W.L.; Moore T.E.; Baron E.; Kittleson M.; Parker W.; Jaiswal A.
Institution
(Baker) UConn School of Pharmacy, Storrs Mansfield, CT
(Moore) University of Connecticut, Storrs Mansfield, CT
(Baron) Servier Pharmaceuticals, Boston, MA
(Kittleson) Cedars-Sinai Heart Institute, Los Angeles, CA
(Parker) University of Chicago Medicine, Chicago, IL
(Jaiswal) Hartford HealthCare, Hartford, CT
Publisher
Elsevier Inc.
Abstract
Purpose: Missing data can undermine a registry's ability to make valid
inferences by reducing study power and introducing bias. We evaluated how
missing data are being reported and addressed in observational studies of
adults undergoing heart transplantation (HT) using the UNOS database.
<br/>Method(s): We conducted a systematic literature search of Medline
from January 1^st 2018 through August 22^nd, 2023 and
included studies that used the UNOS database to evaluate adults (18+
years) who had undergone their first HT. We collected details on the study
population, timeframe used, primary endpoint, details on use of missing
data to establish the cohort, and whether and what methods were used to
handle missing data. Approaches were classified as variable selection (use
amount of missingness to determine if the variable is included in the
analysis), complete case analysis (CCA; excluding patients form an
analysis with any missing information in the outcome or predictor
variable), missing indicator method (creating an additional level of
"unknown" if data missing), single imputation (replace missing value with
either population mean/median/mode), or multiple imputation (repeatedly
replace the missing value with plausible ones across multiple datasets,
then run analysis in each dataset and combine results). <br/>Result(s):
229 studies were included; 43 (18.8%) studies limited their cohorts to
those without missing data for the outcome or key variables and 86 (37.6%)
studies reported missing data handling. Of these, CCA was most used (n=40,
46.5%) followed by multiple imputation (n=20, 23.3%), variable selection
(n=11, 12.8%), a combination of missing indicator method (for binary
variables) and single imputation (for continuous variables; n=6, 7.0%),
and other methods (n=9, 10.5%). Only two studies (0.9%) reported
sensitivity analysis including multiple imputation methods.
<br/>Conclusion(s): Over one-third of all identified UNOS database studies
reported missing data methods, though strategies varied. Although no
singular approach to handling missing data exists, methods are available
that can improve upon the most commonly used approaches that can reduce
bias and increase statistical power. Future best practices should include
explicit reporting of amounts of missing data, clear details on methods,
and sensitivity checks to maximize the credibility of UNOS database
analyses.<br/>Copyright &#xa9; 2024

<115>
Accession Number
2031585206
Title
Perioperative mental health intervention for depression and anxiety
symptoms in older adults study protocol: design and methods for three
linked randomised controlled trials.
Source
BMJ Open. 14(4) (no pagination), 2024. Article Number: e082656. Date of
Publication: 03 Apr 2024.
Author
Holzer K.J.; Bartosiak K.A.; Calfee R.P.; Hammill C.W.; Haroutounian S.;
Kozower B.D.; Cordner T.A.; Lenard E.M.; Freedland K.E.; Tellor Pennington
B.R.; Wolfe R.C.; Miller J.P.; Politi M.C.; Zhang Y.; Yingling M.D.;
Baumann A.A.; Kannampallil T.; Schweiger J.A.; McKinnon S.L.; Avidan M.S.;
Lenze E.J.; Abraham J.
Institution
(Holzer, Haroutounian, Cordner, Tellor Pennington, Kannampallil, McKinnon,
Avidan, Abraham) Department of Anesthesiology, Washington University
School of Medicine in Saint Louis, St Louis, MO, United States
(Bartosiak, Calfee) Department of Orthopaedics, Washington University
School of Medicine in Saint Louis, St Louis, MO, United States
(Hammill, Kozower, Politi, Baumann) Department of Surgery, Washington
University School of Medicine in Saint Louis, St Louis, MO, United States
(Lenard, Freedland, Zhang, Yingling, Schweiger, Lenze) Department of
Psychiatry, Washington University School of Medicine in Saint Louis, St
Louis, MO, United States
(Wolfe) Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO,
United States
(Miller, Kannampallil, Abraham) Institute for Informatics, Data Science
and Biostatistics, Washington University School of Medicine in Saint
Louis, St. Louis, MO, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Preoperative anxiety and depression symptoms among older
surgical patients are associated with poor postoperative outcomes, yet
evidence-based interventions for anxiety and depression have not been
applied within this setting. We present a protocol for randomised
controlled trials (RCTs) in three surgical cohorts: cardiac, oncological
and orthopaedic, investigating whether a perioperative mental health
intervention, with psychological and pharmacological components, reduces
perioperative symptoms of depression and anxiety in older surgical
patients. Methods and analysis Adults >=60 years undergoing cardiac,
orthopaedic or oncological surgery will be enrolled in one of three-linked
type 1 hybrid effectiveness/ implementation RCTs that will be conducted in
tandem with similar methods. In each trial, 100 participants will be
randomised to a remotely delivered perioperative behavioural treatment
incorporating principles of behavioural activation, compassion and care
coordination, and medication optimisation, or enhanced usual care with
mental health-related resources for this population. The primary outcome
is change in depression and anxiety symptoms assessed with the Patient
Health Questionnaire-Anxiety Depression Scale from baseline to 3 months
post surgery. Other outcomes include quality of life, delirium, length of
stay, falls, rehospitalisation, pain and implementation outcomes,
including study and intervention reach, acceptability, feasibility and
appropriateness, and patient experience with the intervention. Ethics and
dissemination The trials have received ethics approval from the Washington
University School of Medicine Institutional Review Board. Informed consent
is required for participation in the trials. The results will be submitted
for publication in peer-reviewed journals, presented at clinical research
conferences and disseminated via the Center for Perioperative Mental
Health website.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024.

<116>
Accession Number
2031552062
Title
Blood bupivacaine concentrations after pecto-serratus and serratus
anterior plane injections of plain and liposomal bupivacaine in
robotically-assisted mitral valve surgery: Sub-study of a randomized
trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111470. Date of Publication: August 2024.
Author
Alfirevic A.; Almonacid-Cardenas F.; Yalcin E.K.; Shah K.; Kelava M.;
Sessler D.I.; Turan A.
Institution
(Alfirevic, Kelava) Division of Cardiothoracic Anesthesiology, Department
of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Almonacid-Cardenas, Shah, Sessler, Turan) Outcomes Research Consortium,
Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, United
States
(Yalcin, Turan) Division of Multi-specialty Anesthesiology, Department of
Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate the timing of peak blood concentrations
and potential toxicity when using a combination of plain and liposomal
bupivacaine for thoracic fascial plane blocks. <br/>Design(s):
Pharmacokinetic analysis. <br/>Setting(s): Operating room.
<br/>Patient(s): Eighteen adult patients undergoing robotically-assisted
mitral valve surgery. <br/>Intervention(s): Ultrasound-guided
pecto-serratus and serratus anterior plane blocks using a mixture of 0.5%
bupivacaine HCl up to 2.5 mg/kg and liposomal bupivacaine up to 266 mg.
Measurements: Arterial plasma bupivacaine concentration. <br/>Main
Result(s): Samples from 13 participants were analyzed. There was
substantial inter-patient variability in plasma concentrations. A
geometric mean maximum bupivacaine concentration was 1492 ng/ml (range 660
to 4650 ng/ml) at median time of 30 min after injection. In 4/13 (31%)
patients, plasma bupivacaine concentrations exceeded our predefined 2000
ng/ml toxic threshold. A second much smaller peak was observed about 32 h
after the injection. No obvious signs of local anesthetic toxicity were
observed. <br/>Conclusion(s): Combined injection of plain and liposomal
bupivacaine for pecto-serratus/serratus anterior plane blocks produced a
biphasic pattern, with the highest arterial plasma concentrations observed
within 30 min. Maximum concentrations exceeded the potential toxic
threshold in nearly a third of patients, but without clinical evidence of
toxicity. Clinicians should not assume that routine combinations of plain
and liposomal bupivacaine for thoracic fascial plane blocks are inherently
safe.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<117>
Accession Number
2031483807
Title
Effects of sevoflurane on left ventricular function by speckle-tracking
echocardiography in coronary bypass patients: A randomized trial.
Source
Journal of Biomedical Research. 38(1) (pp 76-86), 2024. Date of
Publication: 2024.
Author
Gong C.; Zhou X.; Fang Y.; Zhang Y.; Zhu L.; Ding Z.
Institution
(Gong, Zhou, Fang, Zhu, Ding) Department of Anesthesiology and
Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical
University, Jiangsu, Nanjing 210029, China
(Zhang) Department of Cardiology, the First Affiliated Hospital of Nanjing
Medical University, Jiangsu, Nanjing 210029, China
Publisher
Nanjing Medical University and Chungbuk National University Press
Abstract
The present study aimed to dynamically observe the segmental and global
myocardial movements of the left ventricle during coronary artery bypass
grafting by transesophageal speckle-tracking echocardiography, and to
assess the effect of sevoflurane on cardiac function. Sixty-four patients
scheduled for the off-pump coronary artery bypass grafting were randomly
divided into a sevoflurane-based anesthesia (AS) group and a
propofol-based total intravenous anesthesia (AA) group. The AS group
demonstrated a higher absolute value of left ventricular global
longitudinal strain than that of the AA group at both T<inf>1</inf> (after
harvesting all grafts and before coronary anastomosis) and T<inf>2</inf>
(30 min after completing all coronary anastomoses) (P < 0.05). Moreover,
strain improvement in the segment with the highest preoperative strain was
significantly reduced in the AS group, compared with the AA group at both
T<inf>1</inf> and T<inf>2</inf> (P < 0.01). The flow of the left internal
mammary artery-left anterior descending artery graft was superior, and the
postoperative concentration of troponin T decreased rapidly in the AS
group, compared with the AA group (P < 0.05). Compared with total
intravenous anesthesia, sevoflurane resulted in a significantly higher
global longitudinal strain, stroke volume, and cardiac output. Sevoflurane
also led to an amelioration in the condition of the arterial graft.
Furthermore, sevoflurane significantly reduced strain improvement in the
segmental myocardium with a high preoperative strain value. The findings
need to be replicated in larger studies.<br/>Copyright &#xa9; 2024 by
Journal of Biomedical Research.

<118>
Accession Number
2031579767
Title
10-Year Mortality of Off-Pump Versus On-Pump Coronary Artery Bypass
Grafting: An Updated Systematic Review, Meta-Analysis, and
Meta-Regression.
Source
American Journal of Cardiology. 219 (pp 77-84), 2024. Date of Publication:
15 May 2024.
Author
Comanici M.; Bulut H.I.; Raja S.G.
Institution
(Comanici, Bulut, Raja) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
The longstanding debate on off-pump coronary artery bypass grafting
(OPCAB) versus on-pump coronary artery bypass grafting (ONCAB) has
primarily focused on short-term and mid-term outcomes, with limited
attention to long-term survival. This study aims to address this gap by
providing an updated analysis of 10-year mortality rates after OPCAB
versus ONCAB. We have conducted a systematic review and meta-analysis,
incorporating 22 studies comprising 69,449 patients. The primary end point
was all-cause mortality at 10 years. Meta-regression analysis explored
sources of heterogeneity. The meta-analysis revealed no significant
difference in long-term all-cause mortality between OPCAB and ONCAB
(hazard ratio 1.000, 95% confidence interval 0.92 to 1.08, p = 0.95).
Although substantial heterogeneity existed across studies, meta-regression
identified older age as a significant factor favoring OPCAB. However,
patient characteristics like gender, co-morbidities, and graft numbers did
not significantly influence the choice of surgical technique. In
conclusion, this study challenges historical concerns regarding OPCAB's
quality of revascularization and long-term survival demonstrating
comparable outcomes to ONCAB in well-selected patients when performed by
experienced surgeons. The results emphasize the importance of surgeon
proficiency and advocate for recognizing surgical revascularization as a
subspecialty.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<119>
[Use Link to view the full text]
Accession Number
2031563339
Title
Impact of Early Mobilization Within the Intensive Care Unit after Coronary
Artery Bypass Grafting: A Systematic Review.
Source
Cardiopulmonary Physical Therapy Journal. 35(2) (pp 56-70), 2024. Date of
Publication: 01 Apr 2024.
Author
Thomas B.; Morgan S.; Smith J.M.
Institution
(Thomas) School of Physical Therapy and Rehabilitation Sciences,
University of South Florida, Tampa, FL, United States
(Morgan) College of Nursing, University of South Florida, Tampa, FL,
United States
(Smith) Department of Physical Therapy, University of Connecticut, Storrs,
CT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose:Coronary artery bypass grafting (CABG) surgery treats
complications from coronary artery diseases, and its recovery
traditionally consisted of bedrest. Recent research emphasizes the
benefits of early mobilization for hospitalized patients. However, the
functional outcomes and effectiveness of early mobilization for persons
within the intensive care units after CABG has not been investigated thus
far. The objective of this review was to determine the effectiveness of
early mobilization in reducing hospital and intensive care unit length of
stay (LoS) and improving functional outcomes of persons after CABG.
<br/>Method(s):This study was registered with PROSPERO and followed PRISMA
guidelines. PubMed, Embase, CINAHL, and PEDro databases were searched
using MeSH terms. Studies with early mobilization interventions for adults
in the intensive care unit after CABG that recorded outcomes of LoS or
functioning were included. Methodological quality was measured using the
PEDro scale and Oxford Level of Evidence. <br/>Result(s):This systematic
review collectively addressed 2280 participants through 14 studies in 7
countries. The initiation time frames for early mobilization varied, with
the majority beginning within 24 to 48 hours after surgery and
interventions were heterogenous. Early mobility was found to be effective
in reducing atelectasis, improving oxygen saturation, and decreasing time
spent on mechanical ventilation. Among early mobilization participants,
the LoS was reduced in all studies; intensive care unit LoS decreased by
one day or greater in 6 of 14 studies, and hospital LoS decreased by one
day or greater in 5 of 7 studies. <br/>Conclusion(s):Data analysis found
that early mobilization achieved better functional outcomes. It was found
that implementing early mobilization led to decreased intensive care and
hospital lengths of stay, reduced atelectasis and pleural effusion, and
improved functional and respiratory outcomes in persons who underwent CABG
surgery. <br/>Copyright &#xa9; Cardiovascular and Pulmonary Section, APTA.

<120>
[Use Link to view the full text]
Accession Number
2031563129
Title
Nondual Antiplatelet Therapy Versus Dual Antiplatelet Therapy before
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiovascular Pharmacology. 83(4) (pp 297-305), 2024. Date of
Publication: 06 Apr 2024.
Author
Zhang M.; Peng W.; Yin S.; Zhao Y.; Lin Y.
Institution
(Zhang, Peng, Yin, Zhao, Lin) Department of Pharmacy, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Zhang, Yin, Zhao) School of Pharmaceutical Sciences, Capital Medical
University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is an interventional
procedure performed in patients with severe aortic stenosis and often
required perioperative antiplatelet therapy. Most previous studies have
focused on antiplatelet therapy following TAVR. However, few studies have
investigated the prognostic effect of preoperative antiplatelet therapy in
patients undergoing TAVR. This study aimed to compare the efficacy and
safety of nondual antiplatelet therapy (non-DAPT) and DAPT before TAVR. We
performed a systematic search of Embase, PubMed, and Web of Science until
February 2023. Studies were eligible if they compared non-DAPT (single
antiplatelet therapy or no antiplatelet therapy) with DAPT in patients
before TAVR. A total of 5 studies, including 2329 patients, met the
inclusion criteria and were included in the meta-analysis. Preoperative
non-DAPT significantly decreased minor bleeding events compared with
preoperative DAPT [odds ratio 0.58; 95% confidence interval: 0.44-0.76].
There were no significant differences in the incidence of other bleeding
events, transfusions, stroke, myocardial infarction, or all-cause death.
Preoperative single antiplatelet therapy significantly decreased the
incidence of major bleeding compared with DAPT (odds ratio 0.14; 95%
confidence interval: 0.04-0.48). Preoperative non-DAPT significantly
reduced minor bleeding events in patients undergoing TAVR, without
increasing the risk of stroke and myocardial infarction.<br/>Copyright
&#xa9; 2024 Lippincott Williams and Wilkins. All rights reserved.

<121>
Accession Number
2031593875
Title
On the pooling and subgrouping of data from percutaneous coronary
intervention versus coronary artery bypass grafting trials: a call to
circumspection.
Source
European Journal of Cardio-thoracic Surgery. 53(5) (pp 915-918), 2018.
Date of Publication: 01 May 2018.
Author
Freemantle N.; Ruel M.; Gaudino M.F.L.; Pagano D.
Institution
(Freemantle) Comprehensive Clinical Trials Unit, Institute for Clinical
Trials and Methodology, University College London, London, United Kingdom
(Freemantle, Pagano) Quality and Outcomes Research Unit, University
Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
(Ruel) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery

<122>
Accession Number
2031515761
Title
Cell Salvage Using the Autotransfusion Device CATSmart: A Randomized
Controlled Bicentric Trial Evaluating the Quality of Two New Flex Wash
Programs.
Source
Transfusion Medicine and Hemotherapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Arends S.; Thomas M.; Nosch M.; Droll T.; Zwanziger D.; Brenner T.; Haddad
A.
Institution
(Arends, Droll, Brenner, Haddad) Department of Anesthesiology and
Intensive Care Medicine, University Hospital Essen, University
Duisburg-Essen, Essen, Germany
(Thomas, Nosch) Department of Anesthesiology, Intensive Care Medicine, and
Pain Therapy, Marien Hospital Bottrop, Bottrop, Germany
(Zwanziger) Department of Endocrinology, Diabetology und Metabolism,
Clinical Chemistry, Division of Laboratory Research, University Hospital
Essen, University Duisburg-Essen, Essen, Germany
Publisher
S. Karger AG
Abstract
Background: The use of cell salvage and autologous blood transfusion is an
important and widespread method of blood conservation during surgeries
with expected high blood loss. The continuous autotransfusion device
CATSmart (Fresenius Kabi, Germany) contains two new washing programs on
the device called Flex wash 3 and Flex wash 5. To the best of our
knowledge, there are no published clinical data regarding the performance
of the two new washing programs. <br/>Method(s): In total, 69 patients
undergoing cardiac or orthopedic surgery were included in this randomized,
controlled, bicentric trial to validate the red cell separation process
and washout quality of Flex wash 3 compared to Flex wash 5. After washing,
the primary quality target was to determine hematocrit value, recovery
rate, albumin, and total protein elimination rate in the packed red cells
(PRCs). The secondary objective was to assess the elimination of heparin
by measuring the factor anti-Xa activity by a 1- and 2-stage assay in PRC
after washing. <br/>Result(s): In the whole cohort of patients, hematocrit
was 16.00% [9.15%; 21.30%] (median [Q1; Q3]) in the wound blood and 69.90%
[51.10%; 80.90%] in the PRC resulting in a recovery rate of 63.92%
[47.06%; 88.13%]. The albumin elimination rate was 98.77% [97.94%;
99.27%], and the total protein elimination rate was 98.85% [97.76%;
99.42%]. The heparin elimination rate was 99.95% [99.90%; 99.97%] in the
1-stage assay and 99.70% [99.41%; 99.87%] in the 2-stage assay. There was
no difference between Flex wash 3 and Flex wash 5 washing procedure
regarding the recovery rate 63.75% [46.64%; 78.65%] versus 67.89% [47.20%;
92.69%] (p = 0.85), albumin elimination rate 98.74% [97.67%; 99.27%]
versus 98.78% [98.10%; 99.28%] (p = 0.97), protein elimination rate 98.79%
[97.94%; 99.47%] versus 98.92% [97.58%; 99.42%] (p = 0.88), and anti-Xa
elimination rate in the 1-stage assay 99.94% [99.79%; 99.97%] versus
99.95% [99.92%; 99.97%] (p = 0.24) and in 2-stage assay 99.66% [99.20%;
99.86%] versus 99.77% [99.47%; 99.90%] (p = 0.23). <br/>Conclusion(s): The
two new washing procedures, Flex wash 3 and Flex wash 5, enable sufficient
and comparable red cell separation and washout quality of albumin, total
protein, as well as heparin.<br/>Copyright &#xa9; 2024 S. Karger AG. All
rights reserved.

<123>
Accession Number
2031582211
Title
Cost-Effectiveness of Cardiovascular Magnetic Resonance for Rejection
Surveillance After Cardiac Transplantation in the Australian Health Care
System.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Pouliopoulos J.; Anthony C.; Imran M.; Graham R.M.; McCrohon J.; Holloway
C.; Kotlyar E.; Muthiah K.; Keogh A.M.; Hayward C.S.; Macdonald P.S.;
Jabbour A.
Institution
(Pouliopoulos, Imran, Graham, McCrohon, Holloway, Kotlyar, Muthiah, Keogh,
Hayward, Macdonald, Jabbour) Heart and Lung Transplant Unit, St. Vincent's
Hospital, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Victor Chang Cardiac Research
Institute, Sydney, NSW, Australia
(Pouliopoulos, Graham, Keogh, Macdonald, Jabbour) School of Clinical
Medicine, University of New South Wales, Sydney, NSW, Australia
(Anthony, Graham) Alfred Health and Monash University, Melbourne, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Heart transplantation is an effective treatment for end-stage
congestive heart failure, however, achieving the right balance of
immunosuppression to maintain graft function while minimising adverse
effects is challenging. Serial endomyocardial biopsies (EMBs) are
currently the standard for rejection surveillance, despite being invasive.
Replacing EMB-based surveillance with cardiac magnetic resonance
(CMR)-based surveillance for acute cardiac allograft rejection has shown
feasibility. This study aimed to assess the cost-effectiveness of
CMR-based surveillance in the first year after heart transplantation.
<br/>Method(s): A prospective clinical trial was conducted with 40
orthotopic heart transplant (OHT) recipients. Participants were randomly
allocated into two surveillance groups: EMB-based, and CMR-based. The
trial included economic evaluations, comparing the frequency and cost of
surveillance modalities in relation to quality-adjusted life years (QALYs)
within the first year post-transplantation. Sensitivity analysis
encompassed modelled data from observed EMB and CMR arms, integrating two
hypothetical models of expedited CMR-based surveillance. <br/>Result(s):
In the CMR cohort, 238 CMR scans and 15 EMBs were conducted, versus (vs)
235 EMBs in the EMB group. CMR surveillance yielded comparable rejection
rates (CMR 74 vs EMB 94 events, p=0.10) and did not increase
hospitalisation risk (CMR 32 vs EMB 46 events, p=0.031). It significantly
reduced the necessity for invasive EMBs by 94%, lowered costs by an
average of AUD$32,878.61, and enhanced cumulative QALY by 0.588 compared
with EMB. Sensitivity analysis showed that increased surveillance with
expedited CMR Models 1 and 2 were more cost-effective than EMB (all
p<0.01), with CMR Model 1 achieving the greatest cost savings
(AUD$34,091.12+/-AUD$23,271.86 less) and utility increase (+0.62+/-1.49
QALYs, p=0.011), signifying an optimal cost-utility ratio. Model 2 showed
comparable utility to the base CMR model (p=0.900) while offering the
benefit of heightened surveillance frequency during periods of elevated
rejection risk. <br/>Conclusion(s): CMR-based rejection surveillance in
orthotopic heart transplant recipients provides a cost-effective
alternative to EMB-based surveillance. Furthermore, it reduces the need
for invasive procedures, without increased risk of rejection or
hospitalisation for patients, and can be incorporated economically for
expedited surveillance. These findings have important implications for
improving patient care and optimising resource allocation in
post-transplant management.<br/>Copyright &#xa9; 2024 Australian and New
Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac
Society of Australia and New Zealand (CSANZ)

<124>
Accession Number
2031579945
Title
Complications in the TAVI implant. Prevention, resolution and associated
morbimortality.
Source
Cirugia Cardiovascular. (no pagination), 2024. Date of Publication: 2024.
Author
Garrido-Martin P.
Institution
(Garrido-Martin) Hospital Universitario de Canarias, Tenerife, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Introduction: Degenerative aortic stenosis is the most common valvular
pathology in the population over 65 years of age, incidence of 2-7%.
Currently, transcatheter aortic valve implantation is a standard therapy
in these symptomatic patients. This procedure is associated with
relatively high rates of complications, which can be serious. The
objective of this work is to provide an update and detailed description of
the most important complications of the transcatheter aortic valve
procedure in terms of etiology, prevalence, diagnosis, prognosis,
prevention and treatment. <br/>Method(s): Bibliographic review of current
evidence on the most important complications of transcatheter aortic valve
implantation, their prevention and resolution. <br/>Result(s): Rhythm
disorders, vascular complications, prosthetic regurgitation, cardiac
perforation..., are among others some of the possible complications that
appear in 2-10% of cases, and are associated with an increase mortality of
up to 2 or 3 times. <br/>Conclusion(s): Complications of the transcatheter
aortic valve procedure are frequent and often serious, so it is essential
to know the predisposing factors, prevention and treatment strategies.
Careful patient selection, quality infrastructure, training and
accreditation, multidisciplinary collaboration are essential for optimal
prognosis and a decrease in possible complications.<br/>Copyright &#xa9;
2024 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<125>
Accession Number
2029387137
Title
Efficacy of Trimetazidine in the Prevention of Contrast-Induced
Nephropathy in Patients Undergoing Contrast Coronary Intervention: A
Systematic Review and Meta-Analysis (PRISMA).
Source
Journal of Clinical Medicine. 13(7) (no pagination), 2024. Article Number:
2151. Date of Publication: April 2024.
Author
Nair T.; Ray S.; George J.; Pande A.
Institution
(Nair) Department of Cardiology, PRS Hospital, Kerala, Thiruvananthapuram
695002, India
(Ray) Invasive Cardiology, AMRI Hospital, West Bengal, Kolkata 700019,
India
(George) Department of Nephrology, Trivandrum Medical College, Kerala,
Thiruvananthapuram 695011, India
(Pande) Department of Cardiology, Medica Superspeciality Hospital, West
Bengal, Kolkata 700099, India
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: The present systematic review assessed the efficacy of
peri-procedurally administered trimetazidine in the prevention of
contrast-induced nephropathy (CIN) in patients undergoing coronary
interventions with contrast agents. <br/>Method(s): We performed a
systematic literature review of articles published in PubMed and Google
Scholar by 7 December 2023 and included articles from the last 15 years
that evaluated the efficacy of trimetazidine in preventing CIN in cardiac
patients undergoing coronary intervention. <br/>Result(s): After
title/abstract and full-text screening, this systematic review included 9
randomized controlled trials (N = 2158 patients) with two groups:
Trimetazidine (60-70 mg/day 24 to 48 h before and up to 72 h after the
procedure) with hydration and the control group with only hydration. A
total of 234/2158 patients developed CIN (Incidence rate [IR], 10.8%) as
per the CIN definition of the Contrast Media Safety Committee of the
European Society of Urogenital Radiology. The incidence of CIN in the
trimetazidine vs. control group was 6.4% (69/1083) vs. 15.4% (165/1075),
and the odds ratio (95% CI) was 0.3753 (0.279-0.504). <br/>Conclusion(s):
In conclusion, the trimetazidine group had a lower incidence of CIN.
Trimetazidine offers a reno-protective effect and helps in reducing the
CIN incidence in patients undergoing cardiac intervention. Peri-procedure
administration of trimetazidine significantly decreases the risk of CIN in
patients despite comorbidities.<br/>Copyright &#xa9; 2024 by the authors.

<126>
Accession Number
2027777493
Title
Network Meta-Analysis of Initial Antithrombotic Regimens After Left Atrial
Appendage Occlusion.
Source
Journal of the American College of Cardiology. 82(18) (pp 1765-1773),
2023. Date of Publication: 31 Oct 2023.
Author
Carvalho P.E.P.; Gewehr D.M.; Miyawaki I.A.; Nogueira A.; Felix N.; Garot
P.; Darmon A.; Mazzone P.; Preda A.; Nascimento B.R.; Kubrusly L.F.;
Cardoso R.
Institution
(Carvalho) Department of Medicine, Federal University of Minas Gerais,
Belo Horizonte, Brazil
(Gewehr, Kubrusly) Curitiba Heart Institute, Curitiba, Brazil
(Miyawaki) Department of Medicine, Federal University of Parana, Curitiba,
Brazil
(Nogueira) Department of Medicine, Medical and Public Health School of
Bahia, Salvador, Brazil
(Felix) Department of Medicine, Federal University of Campina Grande,
Campina Grande, Brazil
(Garot) Institut Cardiovasculaire Paris Sud, Hopital Jacques Cartier,
Ramsay-Sante, Massy, France
(Darmon) Centre Cardiologique du Nord, Saint-Denis, France
(Mazzone, Preda) Department of Cardiac Electrophysiology and
Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
(Nascimento) Department of Internal Medicine, Federal University of Minas
Gerais, Belo Horizonte, Brazil
(Nascimento) Interventional Cardiology Department, Hospital Madre Teresa,
Belo Horizonte, Brazil
(Cardoso) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal antithrombotic therapy following left atrial
appendage occlusion (LAAO) in patients with nonvalvular atrial
fibrillation (AF) remains uncertain. <br/>Objective(s): In this study, the
authors sought to compare the efficacy and safety of various
antithrombotic strategies after LAAO. <br/>Method(s): We searched the
Medline, Cochrane, EMBASE, LILACS, and ClinicalTrials.gov databases for
studies reporting outcomes after LAAO, stratified by antithrombotic
therapy prescribed at postprocedural discharge. Direct oral anticoagulants
(DOACs), vitamin K antagonists (VKAs), single antiplatelet therapy (SAPT),
dual antiplatelet therapy (DAPT), DOAC plus SAPT, VKA plus SAPT, and no
antithrombotic therapy were analyzed. We performed a frequentist random
effects model network meta-analysis to estimate the OR and 95% CI for each
comparison. P-scores provided a ranking of treatments. <br/>Result(s):
Forty-one studies comprising 12,451 patients with nonvalvular AF were
included. DAPT, DOAC, DOAC plus SAPT, and VKA were significantly superior
to no therapy to prevent device-related thrombosis. DOAC was associated
with lower all-cause mortality than VKA (OR: 0.39; 95% CI: 0.17-0.89; P =
0.03). Compared with SAPT, DAPT was associated with fewer thromboembolic
events (OR: 0.50; 95% CI: 0.29-0.88; P = 0.02), without a difference in
major bleeding. In the analysis of P-scores, DOAC monotherapy was the
strategy most likely to have lower thromboembolic events and major
bleeding. <br/>Conclusion(s): In this network meta-analysis comparing
initial antithrombotic therapies after LAAO, monotherapy with DOAC had the
highest likelihood of lower thromboembolic events and major bleeding. DAPT
was associated with a lower incidence of thromboembolic events compared
with SAPT and may be a preferred option in patients unable to tolerate
anticoagulation.<br/>Copyright &#xa9; 2023 American College of Cardiology
Foundation

<127>
Accession Number
2029393548
Title
Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on
postoperative opioid consumption and pain after video-assisted thoracic
surgery: a double-blind randomized controlled trial.
Source
Surgical Endoscopy. (no pagination), 2024. Date of Publication: 2024.
Author
Lee H.-J.; Choi S.; Yoon S.; Bahk J.-H.
Institution
(Lee, Choi, Yoon, Yoon, Bahk) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu,
Seoul 03080, South Korea
(Lee, Yoon, Bahk) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul
03080, South Korea
Publisher
Springer
Abstract
Background: Video-assisted thoracoscopic surgery (VATS) often induces
significant postoperative pain, potentially leading to chronic pain and
decreased quality of life. This study aimed to evaluate the
acetaminophen/ibuprofen combination effectiveness in reducing analgesic
requirements and pain intensity in patients undergoing VATS. Study design:
This is a double-blinded randomized controlled trial. <br/>Method(s):
Adult patients scheduled for elective VATS for lung resection were
randomized to receive either intravenous acetaminophen and ibuprofen
(intervention group) or 100 mL normal saline (control group). Treatments
were administered post-anesthesia induction and every 6 h for three
cycles. The primary outcome was total analgesic consumption at 24 h
postoperatively. Secondary outcomes were cumulative analgesic consumption
at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality
of recovery at 24 h and 48 h postoperatively; pain intensity at rest and
during coughing; and rescue analgesics use. Chronic postsurgical pain
(CPSP) was assessed through telephone interviews 3 months postoperatively.
<br/>Result(s): The study included 96 participants. The intervention group
showed significantly lower analgesic consumption at 24 h and 48 h
postoperatively (24 h: median difference: - 100 microg equivalent
intravenous fentanyl [95% confidence interval (CI) - 200 to - 5 mug], P =
0.037; 48 h: median difference: - 140 mug [95% CI - 320 to - 20 mug], P =
0.035). Compared to the controls, the intervention group exhibited a
significantly lower quality of recovery 24 h post-surgery, with no
significant difference at 48 h. All pain scores except for coughing at 48
h post-surgery were significantly lower in the intervention group compared
to the controls. No significant differences were observed between the
groups in postoperative nausea and vomiting occurrence, hospital stay
length, and CPSP. <br/>Conclusion(s): Perioperative administration of
acetaminophen/ibuprofen significantly decreased analgesic needs in
patients undergoing VATS, providing an effective postoperative pain
management strategy, and potentially minimizing the need for stronger
analgesics.<br/>Copyright &#xa9; The Author(s) 2024.

<128>
Accession Number
2029291409
Title
Evaluation of the effect of small single intravenous dose of amiodarone on
the prevention of arrhythmias in patients who underwent coronary artery
bypass graft surgery: A randomized controlled trial.
Source
Journal of Arrhythmia. (no pagination), 2024. Date of Publication: 2024.
Author
Azemati S.; Dehghanpisheh L.; Vatankhah P.; Khademi S.; Ghazinour M.;
Eghdami S.
Institution
(Azemati, Dehghanpisheh, Vatankhah, Khademi, Eghdami) Anesthesiology and
Critical Care Research Center, Department of Anesthesiology and Critical
Care, School of Medicine, Shiraz University of Medical Sciences, Shiraz,
Iran, Islamic Republic of
(Ghazinour) Department of Surgery, Section of Cardiac Surgery, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial fibrillation (AF) is the most frequent arrhythmia after
cardiac surgery causing a range of clinical symptoms and treatments that
develop in around one-third of coronary artery bypass surgery patients. We
aimed to evaluate the effect of Amiodarone in preventing arrhythmia in
patients undergoing coronary artery bypass surgery. <br/>Method(s): In
this double-blind randomized clinical trial, 60 patients candidate for
coronary artery bypass surgery above the age of 18 were included and
randomly divided into two groups of intervention, receiving an infusion of
Amiodarone (3 mg/kg) 10 min (in 100 cc Normal saline) before declamping of
the aorta, and a control group, receiving 100 cc of saline 10 min before
declamping of the aorta. The patient's demographic, clinical features, and
hospital and clinical course were recorded. <br/>Result(s): After
undergoing operation, 22 (36.67%) of patients were developed arrhythmia.
The Amiodarone group demonstrated significantly lower reperfusion
ventricular fibrillation (RVF) rates (26.7% vs. 70%; p =.001) and AF
occurrence (13.3% vs. 60%; p <.001) during the initial 24 h after surgery
compared to the placebo group. There was no significant difference between
the two groups regarding the need for D/C shock after removing the aortic
clamp. (p =.117) Furthermore, the intensive care unit stay among the
amiodaron group was significantly lower than the control group (2.43 vs.
3.07 days; p =.013). <br/>Conclusion(s): The predictive properties in the
administration of single intravenous low-dose Amiodarone 10 min before the
declamping of the aorta can significantly lower the rates of RVF and AF
after coronary artery bypass grafting, while also decreasing
hospitalization duration.<br/>Copyright &#xa9; 2024 The Authors. Journal
of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of
Japanese Heart Rhythm Society.

<129>
Accession Number
2027585380
Title
Comments to: Efficacy of intraoperative thoracoscopic intercostal nerve
blocks in nonintubated and intubated video-assisted thoracic surgery: A
randomized study.
Source
Journal of the Formosan Medical Association. (no pagination), 2023. Date
of Publication: 2023.
Author
Tai Y.-T.
Institution
(Tai) Department of Anesthesiology, School of Medicine, College of
Medicine, Taipei Medical University, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, Wan Fang Hospital, Taipei Medical
University, Taiwan (Republic of China)
Publisher
Elsevier B.V.

<130>
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.

<131>
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.

<132>
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.

<133>
Accession Number
2030113550
Title
Colchicine to Prevent Atrial Fibrillation Recurrence After Catheter
Ablation: A Randomized, Placebo-Controlled Trial.
Source
Circulation: Arrhythmia and Electrophysiology. 17(1) (pp 2-10), 2024. Date
of Publication: 01 Jan 2024.
Author
Benz A.P.; Amit G.; Connolly S.J.; Singh J.; Acosta-Velez J.G.; Conen D.;
Deif B.; Divakaramenon S.; McIntyre W.F.; Mtwesi V.; Roberts J.D.; Wong
J.A.; Zhao R.; Healey J.S.
Institution
(Benz, Connolly, Singh, Conen, McIntyre, Roberts, Wong, Zhao, Healey)
Population Health Research Institute, Division of Cardiology, Department
of Medicine, Hamilton, ON, Canada
(Amit, Acosta-Velez, Divakaramenon, Roberts, Wong, Healey) Cardiac
Electrophysiology and Pacing, Division of Cardiology, Department of
Medicine, Hamilton, ON, Canada
(Healey) McMaster University, Hamilton, ON, Canada
(Benz) Department of Cardiology, University Medical Center Mainz, Johannes
Gutenberg-University, Germany
(Deif) Royal Victoria Hospital, Barrie, ON, Canada
(Mtwesi) Division of Cardiology, Department of Internal Medicine, School
of Clinical Medicine, Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, South Africa
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Inflammation may promote atrial fibrillation (AF) recurrence
after catheter ablation. This study aimed to evaluate a short-term
anti-inflammatory treatment with colchicine following ablation of AF.
<br/>METHOD(S): Patients scheduled for ablation were randomized to receive
colchicine 0.6 mg twice daily or placebo for 10 days. The first dose of
the study drug was administered within 4 hours before ablation. Atrial
arrhythmia recurrence was defined as AF, atrial flutter, or atrial
tachycardia >30 s on two 14-day Holters performed immediately and at 3
months following ablation. <br/>RESULT(S): The modified intention-to-treat
population included 199 patients (median age, 61 years; 22% female; 70%
first procedure) who underwent radiofrequency (79%) or cryoballoon
ablation (21%) of AF. Antiarrhythmic drugs were prescribed at discharge in
149 (75%) patients. Colchicine did not prevent atrial arrhythmia
recurrence at 2 weeks (31% versus 32%; hazard ratio [HR], 0.98 [95% CI,
0.59-1.61]; P=0.92) or at 3 months following ablation (14% versus 15%; HR,
0.95 [95% CI, 0.45-2.02]; P=0.89). Postablation chest pain consistent with
pericarditis was reduced with colchicine (4% versus 15%; HR, 0.26 [95% CI,
0.09-0.77]; P=0.02) and colchicine increased diarrhea (26% versus 7%; HR,
4.74 [95% CI, 1.95-11.53]; P<0.001). During a median follow-up of 1.3
years, colchicine did not reduce a composite of emergency department
visit, cardiovascular hospitalization, cardioversion, or repeat ablation
(29 versus 25 per 100 patient-years; HR, 1.18 [95% CI, 0.69-1.99];
P=0.55). <br/>CONCLUSION(S): Colchicine administered for 10 days following
catheter ablation did not reduce atrial arrhythmia recurrence or
AF-associated clinical events, but did reduce postablation chest pain and
increase diarrhea.<br/>Copyright &#xa9; 2023 American Heart Association,
Inc.

<134>
Accession Number
2028524204
Title
Brain-Type Glycogen Phosphorylase (PYGB) in the Pathologies of Diseases: A
Systematic Review.
Source
Cells. 13(3) (no pagination), 2024. Article Number: 289. Date of
Publication: February 2024.
Author
Yang C.; Wang H.; Shao M.; Chu F.; He Y.; Chen X.; Fan J.; Chen J.; Cai
Q.; Wu C.
Institution
(Yang, Wang, Chu, He, Chen, Fan, Chen, Wu) Institutes of Biomedical
Sciences, Shanxi University, Taiyuan 030006, China
(Shao) School of Medicine & Holistic Integrative Medicine, Nanjing
University of Chinese Medicine, Nanjing 210023, China
(Cai) Shanghai Key Laboratory of Molecular Imaging, Shanghai University of
Medicine and Health Sciences, Shanghai 201318, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Glycogen metabolism is a form of crucial metabolic reprogramming in cells.
PYGB, the brain-type glycogen phosphorylase (GP), serves as the
rate-limiting enzyme of glycogen catabolism. Evidence is mounting for the
association of PYGB with diverse human diseases. This review covers the
advancements in PYGB research across a range of diseases, including
cancer, cardiovascular diseases, metabolic diseases, nervous system
diseases, and other diseases, providing a succinct overview of how PYGB
functions as a critical factor in both physiological and pathological
processes. We present the latest progress in PYGB in the diagnosis and
treatment of various diseases and discuss the current limitations and
future prospects of this novel and promising target.<br/>Copyright &#xa9;
2024 by the authors.

<135>
Accession Number
2028437328
Title
Periprocedural Risk Predictors Affecting Long-Term Prognosis in Patients
With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery
Bypass Grafting.
Source
Texas Heart Institute Journal. 51(1) (no pagination), 2024. Article
Number: e238199. Date of Publication: Jan-Jun 2024.
Author
Dokollari A.; Sicouri S.; Hosseinian L.; Erten O.; Ramlawi B.; Bisleri G.;
Bonacchi M.; Sicouri N.; Torregrossa G.; Sutter F.P.
Institution
(Dokollari, Sicouri, Erten, Ramlawi, Torregrossa) Department of Cardiac
Surgery Research, Lankenau Institute for Medical Research, Main Line
Health, Wynnewood, PA, United States
(Dokollari, Hosseinian, Ramlawi, Sicouri, Torregrossa, Sutter) Department
of Cardiac Surgery, Lankenau Heart Institute, Lankenau Medical Center,
Main Line Health, Wynnewood, PA, United States
(Bisleri) Cardiac Surgery Department, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Bonacchi) Cardiac Surgery Unit, Department of Experimental and Clinical
Medicine, University of Florence, Firenze, Italy
Publisher
Texas Heart Institute
Abstract
Objective: This study sought to identify periprocedural risk predictors
that affect long-term prognosis in patients with chronic obstructive
pulmonary disease (COPD) undergoing isolated coronary artery bypass
grafting (CABG). <br/>Method(s): All consecutive 4,871 patients undergoing
isolated CABG between May 2005 and June 2021 were included. Patients with
and without COPD were compared for baseline demographics and preoperative
char-acteristics. A propensity-matched analysis was used to compare the 2
groups. The primary outcome was long-term incidence of all-cause death.
<br/>Result(s): After matching, 767 patients each were included in the
COPD and non-COPD groups; mean age was 71.6 and 71.4 years (P = .7),
respectively; 29.3% and 32% (P = .2) were women, respectively.
Intraop-eratively, median (IQR) operating room time was higher in the COPD
group than in the non-COPD group (5.9 [5.2-7.0] hours vs 5.8 [5.1-6.7]
hours, respectively; P = .01). Postoperatively, intensive care unit stay
(P = .03), hospital length of stay (P = .0004), and fresh frozen plasma
transfusion units (P = .012) were higher in the COPD group than in the
non-COPD group. Thirty-day mortality was not different between groups
(1.3% in the COPD group vs 1% in the non-COPD group; P = .4). Median
follow-up time was 4.0 years. The rate of all-cause death was higher in
the COPD group than in the non-COPD group (138 patients [18.3%] vs 109
patients [14.5%], respectively; P = .042). Periprocedural risk predictors
for all-cause death in patients with COPD were atrial fibrillation,
diabetes, male sex, dialysis, ejection fraction less than 50%, peripheral
vascular disease, and Society of Thoracic Surgeons Predicted Risk of
Mortality score greater than 4%. <br/>Conclusion(s): Patients with COPD
undergoing isolated CABG had a significantly higher incidence of all-cause
death than those without COPD. Herein, risk predictors are provided for
all-cause death in patients undergoing isolated CABG.<br/>Copyright &#xa9;
2024, Texas Heart Institute. All rights reserved.

<136>
Accession Number
2027736607
Title
Surpoint algorithm for improved guidance of ablation for ventricular
tachycardia (SURFIRE-VT): A pilot study.
Source
Journal of Cardiovascular Electrophysiology. 35(4) (pp 625-638), 2024.
Date of Publication: April 2024.
Author
Sanders D.; Du-Fay-de-Lavallaz J.M.; Winterfield J.; Santangeli P.; Liang
J.; Rhodes P.; Ravi V.; Badertscher P.; Mazur A.; Larsen T.; Sharma P.S.;
Huang H.D.
Institution
(Sanders, Ravi, Mazur, Larsen, Sharma, Huang) Department of Cardiology,
Rush University Medical Center, Chicago, IL, United States
(Du-Fay-de-Lavallaz, Badertscher) Department of Cardiology, University
Hospital of Basel, Basel, Switzerland
(Winterfield) Department of Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Santangeli) Department of Cardiology, Cleveland Clinic, Cleveland, OH,
United States
(Liang) Department of Cardiology, University of Michigan, Ann Arbor, MI,
United States
(Rhodes) Biosense-Webster, Irvine, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The utility of ablation index (AI) to guide ventricular
tachycardia (VT) ablation in patients with structural heart disease is
unknown. The aim of this study was to assess procedural characteristics
and clinical outcomes achieved using AI-guided strategy (target value 550)
or conventional non-AI-guided parameters in patients undergoing
scar-related VT ablation. <br/>Method(s): Consecutive patients (n = 103)
undergoing initial VT ablation at a single center from 2017 to 2022 were
evaluated. Patient groups were 1:1 propensity-matched for baseline
characteristics. Single lesion characteristics for all 4707 lesions in the
matched cohort (n = 74) were analyzed. The impact of ablation
characteristics was assessed by linear regression and clinical outcomes
were evaluated by Cox proportional hazard model. <br/>Result(s): After
propensity-matching, baseline characteristics were well-balanced between
AI (n = 37) and non-AI (n = 37) groups. Lesion sets were similar (scar
homogenization [41% vs. 27%; p =.34], scar dechanneling [19% vs. 8%; p
=.18], core isolation [5% vs. 11%; p =.4], linear and elimination late
potentials/local abnormal ventricular activities [35% vs. 44%; p =.48],
epicardial mapping/ablation [11% vs. 14%; p =.73]). AI-guided strategy had
21% lower procedure duration (-47.27 min, 95% confidence interval [CI]
[-81.613, -12.928]; p =.008), 49% lower radiofrequency time per lesion
(-13.707 s, 95% CI [-17.86, -9.555]; p <.001), 21% lower volume of fluid
administered (1664 cc [1127, 2209] vs. 2126 cc [1750, 2593]; p =.005).
Total radiofrequency duration (-339 s [-24%], 95%CI [-776, 62]; p =.09)
and steam pops (-155.6%, 95% CI [19.8%, -330.9%]; p =.08) were
nonsignificantly lower in the AI group. Acute procedural success (95% vs.
89%; p =.7) and VT recurrence (0.97, 95% CI [0.42-2.2]; p =.93) were
similar for both groups. Lesion analysis (n = 4707) demonstrated a plateau
in the magnitude of impedance drops once reaching an AI of 550-600.
<br/>Conclusion(s): In this pilot study, an AI-guided ablation strategy
for scar-related VT resulted in shorter procedure time and average
radiofrequency time per lesion with similar acute procedural and
intermediate-term clinical outcomes to a non-AI-guided approach utilizing
traditional ablation parameters.<br/>Copyright &#xa9; 2024 Wiley
Periodicals LLC.

<137>
Accession Number
2030655480
Title
Five Year Results of Endovascular versus Medical Therapy in Acute Type B
Aortic Intramural Haematoma: Meta-Analysis of Reconstructed Time to Event
Data.
Source
European Journal of Vascular and Endovascular Surgery. 67(4) (pp 584-592),
2024. Date of Publication: April 2024.
Author
Sa M.P.; Jacquemyn X.; Tasoudis P.; Dufendach K.; Singh M.J.; de la Cruz
K.I.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Dufendach, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Dufendach, Singh, Serna-Gallegos, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Centre, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Tasoudis) Department of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Singh) Division of Vascular Surgery, University of Pittsburgh Medical
Centre, Pittsburgh, PA, United States
(de la Cruz) Division Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
W.B. Saunders Ltd
Abstract
Objective: To evaluate outcomes in the follow up of thoracic endovascular
aortic repair (TEVAR) vs. medical therapy in patients with acute type B
aortic intramural haematoma (IMH). <br/>Data Sources: The following
sources were searched for articles meeting the inclusion criteria and
published by July 2023: PubMed/MEDLINE, EMBASE, CENTRAL/CCTR (Cochrane
Controlled Trials Register). Review Methods: This systematic review with
pooled meta-analysis of time to event data followed the Preferred
Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
reporting guidelines, and its protocol was registered on the public
platform PROSPERO (CRD42023456222). The following were analysed: overall
survival (all cause mortality), aortic related mortality, and restricted
mean survival time. Certainty of evidence was evaluated through the
Grading of Recommendations, Assessment, Development, and Evaluations
(GRADE) tool. <br/>Result(s): Eight studies met the eligibility criteria,
including 1 015 patients (440 in the TEVAR group and 575 in the medical
therapy group). All studies were observational, and the pooled cohort had
a median follow up of 5.1 years. Compared with patients who received
medical therapy alone, those who underwent TEVAR had a statistically
significantly lower risk of all cause death (HR 0.44, 95% CI 0.30 - 0.65;
p < .001; GRADE certainty: low), lower risk of aortic related death (HR
0.04, 95% CI 0.01 - 0.31; p = .002; GRADE certainty: low) and lifetime
gain (restricted mean survival time was overall 201 days longer with
TEVAR; p < .001). <br/>Conclusion(s): Thoracic endovascular aortic repair
may be associated with lower risk of all cause and aortic related death
compared with medical therapy in patients with acute type B IMH; however,
the underlying data are not strong enough to draw robust clinical
conclusions. Randomised controlled trials with large sample sizes and
longer follow up are warranted to elucidate this question.<br/>Copyright
&#xa9; 2023 European Society for Vascular Surgery

<138>
Accession Number
2021310675
Title
Surgical and transcatheter aortic valve replacement for severe aortic
stenosis in low-risk elective patients: Analysis of the Aortic Valve
Replacement in Elective Patients From the Aortic Valve Multicenter
Registry.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1714-1723.e4),
2024. Date of Publication: May 2024.
Author
Kowalowka A.R.; Kowalewski M.; Wanha W.; Kolodziejczak M.; Mariani S.; Li
T.; Pasierski M.; Los A.; Stefaniak S.; Malinowski M.; Gocol R.; Hudziak
D.; Bachowski R.; Wojakowski W.; Jemielity M.; Rogowski J.; Lorusso R.;
Suwalski P.; Deja M.
Institution
(Kowalowka, Malinowski, Gocol, Hudziak, Bachowski, Deja) Department of
Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
(Kowalowka, Malinowski, Bachowski, Deja) Department of Cardiac Surgery,
Medical University of Silesia, Faculty of Medical Sciences, Katowice,
Poland
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior, Centre of Postgraduate
Medical Education, Warsaw, Poland
(Kowalewski, Mariani, Lorusso) Cardio-Thoracic Surgery Department, Heart
and Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Kowalewski, Wanha, Kolodziejczak, Mariani, Li, Pasierski, Suwalski)
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus
University, Innovative Medical Forum, Bydgoszcz, Poland
(Wanha, Wojakowski) Department of Cardiology and Structural Heart
Diseases, Medical University of Silesia, Katowice, Poland
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Li) Department of Cardiothoracic, Transplantation and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Los, Rogowski) Department of Cardiac and Vascular Surgery, Medical
University of Gdansk, Gdansk, Poland
(Stefaniak, Jemielity) Department of Cardiac Surgery and Transplantology,
Poznan University of Medical Sciences, Poznan, Poland
Publisher
Elsevier Inc.
Abstract
Objectives: Transcatheter aortic valve implantation (TAVI) remains the
preferred strategy for high-risk or elderly individuals with aortic valve
(AV) stenosis who are not considered to be optimal surgical candidates.
Recent evidence suggests that low-risk patients may benefit from TAVI as
well. The current study evaluates midterm survival in low-risk patients
undergoing elective surgical AV replacement (SAVR) versus TAVI.
<br/>Method(s): The Aortic Valve Replacement in Elective Patients From the
Aortic Valve Multicenter Registry (AVALON) compared isolated elective
transfemoral TAVI or SAVR with sternotomy or minimally invasive approach
in low-risk individuals performed between 2015 and 2019. Propensity score
matching was conducted to determine SAVR controls for TAVI group in a
1-to-3 ratio with 0.2 caliper. <br/>Result(s): A total of 2393 patients
undergoing elective surgery (1765 SAVR and 629 TAVI) with median European
System for Cardiac Operative Risk Evaluation II (EuroSCORE II) score 1.81
(interquartile range [IQR], 1.36 to 2.53]) were initially included. Median
follow-up was 2.72 years (IQR, 1.32-4.08; max 6.0). Propensity score
matching returned 329 TAVI cases and 593 SAVR controls. Thirty-day
mortality was 11 out of 329 (3.32%) in TAVI and 18 out of 593 (3.03%) in
SAVR (risk ratio, 1.10; 95% CI, 0.52-2.37; P = .801) groups, respectively.
At 2 years, survival curves began to diverge in favor of SAVR, which was
associated with 30% lower mortality (hazard ratio, 0.70; 95% CI,
0.496-0.997; P = .048). <br/>Conclusion(s): Our data did not demonstrate a
survival difference between TAVI and SAVR during the first 2 postprocedure
years. After that time, SAVR is associated with improved survival.
Extended observations from randomized trials in low-risk patients
undergoing elective surgery are warranted to confirm these findings and
draw definitive conclusions.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<139>
Accession Number
643877817
Title
Risk Score for Prediction of Dialysis After Transcatheter Aortic Valve
Replacement.
Source
Journal of the American Heart Association. 13(7) (pp e032955), 2024. Date
of Publication: 02 Apr 2024.
Author
Pasceri V.; Pelliccia F.; Mehran R.; Dangas G.; Porto I.; Radico F.;
Biancari F.; D'Ascenzo F.; Saia F.; Luzi G.; Bedogni F.; Amat Santos I.J.;
De Marzo V.; Dimagli A.; Makikallio T.; Stabile E.; Blasco-Turrion S.;
Testa L.; Barbanti M.; Tamburino C.; Fabiocchi F.; Chilmeran A.; Conrotto
F.; Costa G.; Stefanini G.; Spaccarotella C.; Macchione A.; La Torre M.;
Bendandi F.; Juvonen T.; Wanha W.; Wojakowski W.; Benedetto U.; Indolfi
C.; Hildick-Smith D.; Zimarino M.
Institution
(Pasceri) San Filippo Neri Hospital Rome Italy, Italy
(Pelliccia) Department of Cardiovascular Sciences University Sapienza Rome
Italy, Italy
(Mehran, Dangas) Icahn School of Medicine at Mount Sinai New York NY
(Porto, De Marzo, Macchione) Chair of Cardiovascular Disease, Department
of Internal Medicine and Specialties University of Genoa Italy, Italy
(Porto, De Marzo, Macchione) Cardiology Unit, Cardiothoracic and Vascular
Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy,
Italy
(Radico, De Marzo, Zimarino) Department of Cardiology ASL2 Abruzzo Chieti
Italy, Italy
(Biancari, Makikallio) Department of Medicine South Karelia Central
Hospital ,University of Helsinki Lappeenranta Finland
(D'Ascenzo, Conrotto, La Torre) Department of Internal Medicine Citta
della Salute e della Scienza Turin Italy, Italy
(Saia, Bendandi) Department of Cardiothoracic Vascular Surgery University
Hospital Bologna Italy, Italy
(Luzi, Stabile) Cardiovascular Department Azienda Ospedaliera Regionale
"San Carlo" Potenza Italy, Italy
(Bedogni, Testa) Department of Cardiology IRCCS Policlinico San Donato,
San Donato Milanese Milan Italy, Italy
(Amat Santos, Blasco-Turrion) Interventional Cardiology Hospital Clinico
Universitario de Valladolid Valladolid Spain, Spain
(Dimagli) Department of Cardiothoracic Surgery Weill Cornell Medicine New
York NY
(Barbanti) Universita degli Studi di Enna "Kore" Enna Italy, Italy
(Tamburino, Costa) Division of Cardiology A.O.U. Policlinico "G.
Rodolico-San Marco" Catania Italy, Italy
(Fabiocchi) Centro Cardiologico Monzino, Italy
(Fabiocchi) Galeazzi-Sant'Ambrogio Hospital, Italy
(Chilmeran, Hildick-Smith) Department of Cardiology Royal Sussex County
Hospital Brighton UK
(Stefanini) IRCCS Humanitas Research Hospital Rozzano-Milan Italy, Italy
(Spaccarotella, Indolfi) Division of Cardiology University Magna Graecia
Catanzaro Italy, Italy
(Juvonen) Heart and Lung Center, Helsinki University Central Hospital
University of Helsinki Finland
(Wanha, Wojakowski) Division of Cardiology and Structural Heart Diseases
Medical University of Silesia Katowice Poland, Poland
(Benedetto) Department of Cardiac Surgery University "G. d'Annunzio"
Chieti Italy, Italy
(Zimarino) Department of Neuroscience, Imaging and Clinical Sciences 'G.
D'Annunzio' University of Chieti-Pescara Italy, Italy
Abstract
BACKGROUND: Dialysis is a rare but serious complication after
transcatheter aortic valve replacement. We analyzed the large multicenter
TRITAVI (transfusion requirements in transcatheter aortic valve
implantation) registry in order to develop and validate a clinical score
assessing this risk. METHODS AND RESULTS: A total of 10071 consecutive
patients were enrolled in 19 European centers. Patients were randomly
assigned (2:1) to a derivation and validation cohort. Two scores were
developed, 1 including only preprocedural variables (TRITAVIpre) and 1
also including procedural variables (TRITAVIpost). In the 6714 patients of
the derivation cohort (age 82+/-6years, 48% men), preprocedural factors
independently associated with dialysis and included in the TRITAVIpre
score were male sex, diabetes, prior coronary artery bypass graft, anemia,
nonfemoral access, and creatinine clearance <30mL/min per m2. Additional
independent predictors among procedural features were volume of contrast,
need for transfusion, and major vascular complications. Both scores showed
a good discrimination power for identifying risk for dialysis with
C-statistic 0.78 for TRITAVIpre and C-statistic 0.88 for TRITAVIpost
score. Need for dialysis increased from the lowest to the highest of 3
risk score groups (from 0.3% to 3.9% for TRITAVIpre score and from 0.1% to
6.2% for TRITAVIpost score). Analysis of the 3357 patients of the
validation cohort (age 82+/-7years, 48% men) confirmed the good
discrimination power of both scores (C-statistic 0.80 for TRITAVIpre and
0.81 for TRITAVIpost score). Need for dialysis was associated with a
significant increase in 1-year mortality (from 6.9% to 54.4%; P=0.0001).
<br/>CONCLUSION(S): A simple preprocedural clinical score can help predict
the risk of dialysis after transcatheter aortic valve replacement.

<140>
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.

<141>
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.

<142>
Accession Number
2015939323
Title
Dissemination and Implementation Science in Cardiothoracic Surgery: A
Review and Case Study.
Source
Annals of Thoracic Surgery. 114(2) (pp 373-382), 2022. Date of
Publication: August 2022.
Author
Heiden B.T.; Tetteh E.; Robbins K.J.; Tabak R.G.; Nava R.G.; Marklin G.F.;
Kreisel D.; Meyers B.F.; Kozower B.D.; McKay V.R.; Puri V.
Institution
(Heiden, Robbins, Nava, Kreisel, Meyers, Kozower, Puri) Division of
Cardiothoracic Surgery, Department of Surgery, Washington University Scho
ol of Medicine, St Louis, Missouri, United States
(Tetteh, Tabak, McKay) Brown School of Public Health, Washington
University in St Louis, St Louis, Missouri, United States
(Tabak, Marklin) Institute for Implementation Science, Washington
University in St Louis, St Louis, Missouri, ^dMid-America
Transplant, St Louis, Missouri, United States
Publisher
Elsevier Inc.
Abstract
Dissemination and implementation (D&I) science is the practice of taking
evidence-based interventions and sustainably incorporating them into
routine clinical practice. As a relatively young field, D&I techniques are
underutilized in cardiothoracic surgery. This review offers an overview of
D&I science from the context of the cardiothoracic surgeon. First, we
provide a general introduction to D&I science and basic terminology that
is used in the field. Second, to illustrate D&I techniques in a real-world
example, we discuss a case study for implementing lung protective
management strategies for lung donor optimization nationally. Finally, we
discuss challenges to successful implementation that are unique to
cardiothoracic surgery and give several examples of evidence-based
interventions that have been poorly implemented into surgical practice. We
also provide examples of successful D&I interventions-including
deimplementation strategies-from other surgical subspecialties. We hope
that this review offers additional tools for cardiothoracic surgeons to
explore when introducing evidence-based interventions into routine
practice.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<143>
Accession Number
2031526502
Title
Outcomes of Transcatheter Mitral Valve Repair Using the MitraClip System
in Patients With Atrial Fibrillation. A Meta-Analysis.
Source
American Journal of Cardiology. 219 (pp 47-59), 2024. Date of Publication:
15 May 2024.
Author
Halboni A.; Hamza M.; Dayco J.; Al-Abcha A.; Alhalbouni A.; Zghouzi M.;
Alhusain R.; Sattar Y.; Alraies M.C.
Institution
(Halboni, Dayco, Alhusain) Department of Internal Medicine, Wayne State
University/Detroit Medical Center, Detroit, MI, United States
(Hamza) Department of Medicine, Albany Medical Center, Albany, New York,
United States
(Al-Abcha) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Alhalbouni) School of Medicine, University of Jordan, Amman, Jordan
(Zghouzi) Division of Vascular Medicine, University of Michigan, Ann
Arbor, MI, United States
(Sattar) Division of Cardiology, West Virginia University, Morgantown, WV,
United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Elsevier Inc.
Abstract
Transcatheter mitral valve repair (TMVR) with the MitraClip system is now
approved for degenerative and functional mitral regurgitation (MR). Atrial
fibrillation (AF) is commonly seen in MR. In our study, we perform a
pooled analysis of the existing data to investigate the outcomes of
MitraClip in patients with versus without AF. We conducted a systematic
search of PubMed, Google Scholar, and SCOPUS databases through December,
2022 for studies comparing the outcomes of TMVR using the MitraClip in
patients with preexisting AF versus those without AF. A meta-analysis was
performed to investigate the primary outcomes of all-cause mortality and
heart failure (HF) hospitalization. Secondary outcomes were cardiovascular
mortality, in-hospital mortality, stroke, New York Heart Association class
I or II at follow-up, length of hospital stay, and procedural time. A
total of 10 studies (n = 24,111; AF = 12,789; no AF = 11,322) were
included in the final analysis. Preexisting AF was associated with higher
overall all-cause mortality (odds ratio 1.55, 95% confidence interval 1.32
to 1.83, p <0.0002) and higher overall HF hospitalization rate (odds ratio
1.3, 95% confidence interval 1.08 to 1.56, p <0.0154). There was no
statistically significant difference in cardiovascular mortality,
in-hospital mortality, stroke, length of hospital stay, procedural time,
or New York Heart Association class I/II at follow-up comparing AF versus
no AF. The presence of AF in patients who underwent TMVR with MitraClip is
associated with higher all-cause mortality and HF hospitalization. This
should be taken into consideration in the management of MR
patients.<br/>Copyright &#xa9; 2023

<144>
Accession Number
2028712181
Title
Reply from the authors: A need for randomized prospective trial for early
aortic valve repair in asymptomatic aortic regurgitation.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp e160), 2024.
Date of Publication: May 2024.
Author
Hanet V.; Vancraeynest D.; Gerber B.L.
Institution
(Hanet, Vancraeynest, Gerber) Department of Cardiovascular Diseases,
Cliniques Universitaires St Luc, and Pole de Recherche Cardiovasculaire
(CARD), Institut de Recherche Experimentale et Clinique IREC UCLouvain,
Brussels, Belgium
Publisher
Elsevier Inc.

<145>
Accession Number
2031552629
Title
The protocol of enhanced recovery after cardiac surgery in adult patients:
A stepped wedge cluster randomized trial.
Source
American Heart Journal. 272 (pp 48-55), 2024. Date of Publication: June
2024.
Author
Dou D.; Yuan S.; Jia Y.; Wang Y.; Li Y.; Wang H.; Ding J.; Wu X.; Bie D.;
Liu Q.; An R.; Yan H.; Yan F.
Institution
(Dou, Yuan, Jia, Li, Wang, Ding, Wu, Bie, Liu, An, Yan, Yan) Department of
Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai
Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of
Medical Sciences & Peking Union Medical College, Beijing 100037, China
(Wang) Department of Medical Research & Biometrics Centre, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking
Union Medical College, Beijing 100037, China
Publisher
Elsevier Inc.
Abstract
Background: The enhanced recovery after cardiac surgery is a bundle of
measurements from preoperative to postoperative phases to improve
patients' recovery. <br/>Method(s): This study is a multicenter, stepwise
design, cluster randomized controlled trial. About 3,600 patients
presenting during control and intervention periods are eligible if they
are aged from 18 to 80 years old awaiting elective cardiac surgery with
cardiopulmonary bypass (CPB). About 5 centers are randomly assigned to
staggered start dates for one-way crossover from the control phase to the
intervention phase. In the intervention periods, patients will receive
ERAS strategy including preoperative, intraoperative, and postoperative
approaches. During the control phase, patients receive usual care. The
primary outcome consists of major adverse cardiac and cerebrovascular
events (MACCEs), postoperative pulmonary complications (PPCs), and acute
kidney injury (AKI). <br/>Discussion(s): This study aims to compare the
application of ERAS management protocol and traditional management
protocol in adult cardiac surgery under extracorporeal
circulation.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<146>
Accession Number
2015947896
Title
Epidemiology of infective endocarditis in Africa: a systematic review and
meta-analysis.
Source
The Lancet Global Health. 10(1) (pp e77-e86), 2022. Date of Publication:
January 2022.
Author
Noubiap J.J.; Nkeck J.R.; Kwondom B.S.; Nyaga U.F.
Institution
(Noubiap) Centre for Heart Rhythm Disorders, South Australian Health and
Medical Research Institute, University of Adelaide, Adelaide, SA,
Australia
(Nkeck, Kwondom, Nyaga) Department of Internal Medicine and Specialties,
Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon, Cameroon
(Nkeck) Rheumatology Unit, Orleans Hospital Centre, Orleans, France
Publisher
Elsevier Ltd
Abstract
Background: The epidemiology of infective endocarditis in Africa is
inadequately characterised. We therefore aimed to comprehensively
summarise the available data for the incidence, risk factors, clinical
pattern, microbiology, and outcomes of infective endocarditis in Africa.
<br/>Method(s): We did a systematic review and meta-analysis. We searched
PubMed, Embase, African Index Medicus, and African Journals Online for all
studies reporting primary data for the epidemiology of infective
endocarditis in populations within Africa, published from inception to Jan
14, 2021, irrespective of the language. We used the search terms
"endocarditis", "Africa", and the name of all African countries in the
search strategy. We excluded articles that did not include primary data,
primary studies with a small sample size (<30 participants), and those
that report findings from before 1990. We recorded data for study
characteristics, sample size, criteria used to define infective
endocarditis, risk factors, potential entry site, clinical patterns,
microbiology profile, outcomes including complications such as embolic
events, heart failure, acute kidney injury, and death, and predictors of
death. We used random-effects meta-analysis method to pool estimates. This
study is registered with PROSPERO, CRD42021243842. <br/>Finding(s): We
retrieved 2141 records from the database and bibliographic searches, of
which a total of 42 studies were included in this systematic review.
Rheumatic heart disease was the most common risk factor for infective
endocarditis in adults (52.0% [95% CI 42.4-61.5]), whereas congenital
heart disease was the most common risk factor for infective endocarditis
in children (44.7% [29.5-60.5]). Microbiological testing (mostly blood
cultures) was positive in 48.6% (95% CI 42.2-51.1) of patients with
infective endocarditis, with Staphylococcus species (41.3% [95% CI
36.2-46.5]) and Streptococcus species (34.0% [29.0-39.3]) the most
commonly identified microorganisms. The pooled rate of surgical treatment
of infective endocarditis was 49.1% (95% CI 43.2-55.1). The pooled
in-hospital mortality rate was 22.6% (95% CI 19.5-25.9). Other frequent
complications included heart failure (47.0% [95% CI 38.2-56.0]), acute
kidney injury (22.8% [18.8-27.0]), and embolic events (31.1% [22.2-40.7]).
<br/>Interpretation(s): As the most prevalent risk factor in Africa,
rheumatic heart disease should be central in interventions to reduce the
burden of infective endocarditis on the continent. In tertiary hospitals
with good access to cardiac surgery, the outcomes of infective
endocarditis seem relatively similar to what has been reported in other
parts of the world, especially in high-income countries. <br/>Funding(s):
None.<br/>Copyright &#xa9; 2022 The Author(s). Published by Elsevier Ltd.
This is an Open Access article under the CC BY 4.0 license

<147>
Accession Number
2015940858
Title
Neurologic Dysfunction and Neuroprotection in Transcatheter Aortic Valve
Implantation.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
3224-3236), 2022. Date of Publication: August 2022.
Author
Riley K.J.; Kao L.-W.; Low Y.H.; Card S.; Manalo G.; Fleming J.P.;
Essandoh M.K.; Dalia A.A.; Qu J.Z.
Institution
(Riley, Kao, Low, Card, Manalo, Fleming, Dalia, Qu) Department of
Anesthesia, Critical Care and Pain Medicine, Massachusetts General
Hospital, Harvard Medical School, Boston, MA
(Essandoh) Department of Anesthesiology, The Ohio State University Medical
Center, Columbus, OH, United States
Publisher
W.B. Saunders
Abstract
Transcatheter aortic valve implantation (TAVI) is a fast-growing
procedure. Expanding to low-risk patients, it has surpassed surgical
aortic valve implantation in frequency and has been associated with
excellent outcomes. Stroke is a devastating complication after
transcatheter aortic valve implantation. Silent brain infarcts identified
by diffusion-weighted magnetic resonance imaging are present in most
patients following TAVI. Postoperative delirium and cognitive dysfunction
are common neurologic complications. The stroke and silent brain infarcts
are likely caused by particulate emboli released during the procedure.
Intravascularly positioned cerebral embolic protection devices are
designed to prevent debris from entering the aortic arch vessels to avoid
stroke. Despite promising design, randomized clinical trials have not
demonstrated a reduction in stroke in patients receiving cerebral embolic
protection devices. Similarly, the association of cerebral embolic
protection devices with silent brain infarcts, postoperative delirium, and
cognitive dysfunction is uncertain. Monitored anesthesia care or conscious
sedation is as safe as general anesthesia and is associated with lower
cost, but different anesthetic techniques have not been shown to decrease
stroke risk, postoperative delirium, or cognitive dysfunction.
Anesthesiologists play important roles in providing perioperative care
including management of neurologic events in patients undergoing TAVI.
Large randomized clinical trials are needed that focus on the correlation
between perioperative interventions and neurologic outcomes.<br/>Copyright
&#xa9; 2021 Elsevier Inc.