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<1>
Accession Number
2031585390
Title
Gastrointestinal complications after cardiac surgery.
Source
Trauma Surgery and Acute Care Open. 9(1) (no pagination), 2024. Article
Number: e001324. Date of Publication: 09 Apr 2024.
Author
Schwarzova K.; Damle S.; Sellke F.W.; Robich M.P.
Institution
(Schwarzova, Damle) Department of Surgery, Ascension Saint Agnes Hospital,
Baltimore, MD, United States
(Sellke) Department of Cardiac Surgery, Warren Alpert Medical School,
Brown University, Providence, RI, United States
(Robich) Department of Cardiac Surgery, Johns Hopkins Medical Institutions
Campus, Baltimore, MD, United States
Publisher
BMJ Publishing Group
Abstract
Gastrointestinal complications after cardiac surgery are relatively rare
entities but carry a high mortality. We identified over 70 articles
written since 2010 using the PubMed database. We included 40 in our
review. The most common complications include paralytic ileus,
gastrointestinal bleeding, and bowel ischemia. Patients who undergo
cardiac procedures are at risk for poor perfusion of the gastrointestinal
tract and, thus, at risk for resulting complications. Risk factors for
these complications include peri-operative use of vasopressors, prolonged
operative time, and the time of cardiopulmonary bypass. Presentation of
gastrointestinal complications tends to differ as patients after open
heart surgery can remain intubated, and exams can be limited. Early
recognition and aggressive therapy are paramount. We aim to provide a
review that will help the reader get familiar with the most common
gastrointestinal complications that can negatively affect outcomes after
cardiac surgery.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024.

<2>
[Use Link to view the full text]
Accession Number
2031842479
Title
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting
in Patients with Left Main Disease with and Without Diabetes: Findings
from a Pooled Analysis of 4 Randomized Clinical Trials.
Source
Circulation. 149(17) (pp 1328-1338), 2024. Date of Publication: 23 Apr
2024.
Author
Gaba P.; Sabik J.F.; Murphy S.A.; Bellavia A.; O'Gara P.T.; Smith P.K.;
Serruys P.W.; Kappetein A.P.; Park S.-J.; Park D.-W.; Christiansen E.H.;
Holm N.R.; Nielsen P.H.; Sabatine M.S.; Stone G.W.; Bergmark B.A.
Institution
(Gaba, Murphy, Bellavia, Sabatine, Bergmark) TIMI Study Group, Brigham and
Women's Hospital, Boston, MA, United States
(Gaba, Murphy, Bellavia, O'Gara, Sabatine, Bergmark) Division of
Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Sabik) Department of Surgery, University Hospitals Cleveland, Medical
Center, OH, United States
(Smith) Duke University, School of Medicine, Duke Clinical Research
Institute, Durham, NC, United States
(Serruys) National Heart and Lung Institute, Imperial College London,
United Kingdom
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University,
Medical Centre, Rotterdam, Netherlands
(Park, Park) Department of Cardiology, Asan Medical Center, Seoul, South
Korea
(Christiansen, Holm, Nielsen) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Stone) The Zena and Michael A Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Diabetes may be associated with differential outcomes in
patients undergoing left main coronary revascularization with percutaneous
coronary intervention (PCI) or coronary artery bypass grafting (CABG). The
aim of this study was to investigate outcomes in patients with left main
disease with and without diabetes randomized to PCI versus CABG.
<br/>METHOD(S): Individual patient data were pooled from 4 trials (SYNTAX
[Synergy Between PCI With Taxus and Cardiac Surgery], PRECOMBAT [Premier
of Randomized Comparison of Bypass Surgery Versus Angioplasty Using
Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery
Disease], NOBLE [Nordic-Baltic-British Left Main Revascularisation Study],
and EXCEL [Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for
Effectiveness of Left Main Revascularization]) that randomized patients
with left main disease to PCI or CABG. Patients were considered suitable
for either approach. Patients were categorized by diabetes status.
Kaplan-Meier event rates, Cox model hazard ratios, and interactions were
assessed. <br/>RESULT(S): Among 4393 patients, 1104 (25.1%) had diabetes.
Patients with diabetes experienced higher rates of 5-year death (158/1104
[Kaplan-Meier rate, 14.7%] versus 297/3289 [9.3%]; P<0.001), spontaneous
myocardial infarction (MI; 67/1104 [6.7%] versus 114/3289 [3.7%];
P<0.001), and repeat revascularization (189/1104 [18.5%] versus 410/3289
[13.2%]; P<0.001). Rates of all-cause mortality did not differ after PCI
versus CABG in those with (84/563 [15.3%] versus 74/541 [14.1%]; hazard
ratio, 1.11 [95% CI, 0.82-1.52]) or without (155/1634 [9.7%] versus
142/1655 [8.9%]; hazard ratio, 1.08 [95% CI, 0.86-1.36;
P<inf>intHR</inf>=0.87) diabetes. Rates of stroke within 1 year were lower
with PCI versus CABG in the entire population, with no heterogeneity based
on diabetes status (P<inf>intHR</inf>=0.51). The 5-year rates of
spontaneous MI and repeat coronary revascularization were higher after PCI
regardless of diabetes status (spontaneous MI: 45/563 [8.9%] versus 22/541
[4.4%] in diabetes and 82/1634 [5.3%] versus 32/1655 [2.1%] in no
diabetes, P<inf>intHR</inf>=0.47; repeat revascularization: 127/563
[24.5%] versus 62/541 [12.4%] in diabetes and 254/1634 [16.3%] versus
156/1655 [10.1%] in no diabetes, P<inf>intHR</inf>=0.18). For spontaneous
MI and repeat revascularization, there were greater absolute risk
differences beyond 1 year in patients with diabetes (4.9% and 9.9%)
compared with those without (2.1% and 4.3%; P<inf>intARD</inf>=0.047 and
0.016). <br/>CONCLUSION(S): In patients with left main disease considered
equally suitable for PCI or CABG and with largely low to intermediate
SYNTAX scores, diabetes was associated with higher rates of death and
cardiovascular events through 5 years. Compared with CABG, PCI resulted in
no difference in the risk of death and a lower risk of early stroke
regardless of diabetes status, and a higher risk of spontaneous MI and
repeat coronary revascularization, with larger late absolute excess risks
in patients with diabetes. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifiers: NCT01205776,
NCT0146651, NCT00422968, and NCT00114972.<br/>Copyright &#xa9; 2024
Lippincott Williams and Wilkins. All rights reserved.

<3>
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Accession Number
2031809294
Title
Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic
Shock.
Source
New England Journal of Medicine. 390(15) (pp 1382-1393), 2024. Date of
Publication: 18 Apr 2024.
Author
Moller J.E.; Engstrom T.; Jensen L.O.; Eiskjaer H.; Mangner N.; Polzin A.;
Schulze P.C.; Skurk C.; Nordbeck P.; Clemmensen P.; Panoulas V.; Zimmer
S.; Schafer A.; Werner N.; Frydland M.; Holmvang L.; Kjaergaard J.;
Sorensen R.; Lonborg J.; Lindholm M.G.; Udesen N.L.J.; Junker A.; Schmidt
H.; Terkelsen C.J.; Christensen S.; Christiansen E.H.; Linke A.; Woitek
F.J.; Westenfeld R.; Mobius-Winkler S.; Wachtell K.; Ravn H.B.; Lassen
J.F.; Boesgaard S.; Gerke O.; Hassager C.
Institution
(Moller) the Department of Cardiology, Odense University Hospital, J.B.
Winslovvej 4, Odense C DK-5000, Denmark
(Moller, Engstrom, Frydland, Holmvang, Kjaergaard, Sorensen, Lonborg,
Boesgaard, Hassager) Department of Cardiology, Copenhagen University
Hospital-Rigshospitalet, Copenhagen, Denmark
(Engstrom, Holmvang, Hassager) Department of Clinical Medicine, University
of Copenhagen, Copenhagen, Denmark
(Moller, Jensen, Udesen, Junker, Lassen) Departments of Cardiology,
Odense, Denmark
(Schmidt, Ravn) Departments of Anesthesiology and Intensive Care, Odense,
Denmark
(Gerke) Departments of Nuclear Medicine, Odense University Hospital,
Odense, Denmark
(Moller, Jensen, Ravn, Lassen) Department of Clinical Research, University
of Southern Denmark, Odense, Denmark
(Eiskjaer, Terkelsen, Christiansen) Departments of Cardiology, Aarhus
University Hospital, Denmark
(Christensen) Departments of Anesthesiology and Intensive Care Medicine,
Aarhus University Hospital, Aarhus, Denmark
(Clemmensen, Lindholm) Department of Cardiology, Zealand University
Hospital, Roskilde, Denmark
(Mangner, Linke, Woitek) Department of Internal Medicine and Cardiology,
Heart Center Dresden, University Hospital, Technische Universitat Dresden,
Dresden, Germany
(Polzin, Westenfeld) Department of Cardiology, Pulmonology, and Vascular
Medicine, University Hospital Dusseldorf, Medical Faculty of the Heinrich
Heine University Dusseldorf, and the Cardiovascular Research Institute
Dusseldorf, Dusseldorf, Germany
(Schulze, Mobius-Winkler) Department of Internal Medicine I, Cardiology,
Angiology, and Intensive Medical Care, University Hospital Jena, Jena,
Germany
(Skurk) Department of Cardiology, Angiology, and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, and
Deutsches, Zentrum fur Herz Kreislauf Forschung, Berlin, Germany
(Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Clemmensen) Department of Cardiology, University Heart and Vascular
Center, University Clinic Hamburg-Eppendorf, Hamburg, Germany
(Zimmer) Department of Cardiology, University Hospital Bonn, Bonn
Department of Cardiology and Angiology, Hannover Medical School, Hannover,
Germany
(Schafer) Department of Internal Medicine III, Heart Center Trier,
Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Panoulas, Werner) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St. Thomas' NHS Foundation Trust, Harefield Hospital,
Harefield, United Kingdom
(Wachtell) Greenberg Division of Cardiology, Department of Medicine, Weill
Cornell Medicine, New York, United States
Publisher
Massachussetts Medical Society
Abstract
background The effects of temporary mechanical circulatory support with a
microaxial flow pump on mortality among patients with ST-segment elevation
myocardial infarction (STEMI) complicated by cardiogenic shock remains
unclear. METHODS In an international, multicenter, randomized trial, we
assigned patients with STEMI and cardiogenic shock to receive a microaxial
flow pump (Impella CP) plus standard care or standard care alone. The
primary end point was death from any cause at 180 days. A composite safety
end point was severe bleeding, limb ischemia, hemolysis, device failure,
or worsening aortic regurgitation. RESULTS A total of 360 patients
underwent randomization, of whom 355 were included in the final analysis
(179 in the microaxial-flow-pump group and 176 in the standard-care
group). The median age of the patients was 67 years, and 79.2% were men.
Death from any cause occurred in 82 of 179 patients (45.8%) in the
microaxial-flow-pump group and in 103 of 176 patients (58.5%) in the
standard-care group (hazard ratio, 0.74; 95% confidence interval [CI],
0.55 to 0.99; P=0.04). A composite safety end-point event occurred in 43
patients (24.0%) in the microaxial-flow-pump group and in 11 (6.2%) in the
standard-care group (relative risk, 4.74; 95% CI, 2.36 to 9.55).
Renal-replacement therapy was administered to 75 patients (41.9%) in the
microaxial-flow-pump group and to 47 patients (26.7%) in the standard-care
group (relative risk, 1.98; 95% CI, 1.27 to 3.09). CONCLUSIONS The routine
use of a microaxial flow pump with standard care in the treatment of
patients with STEMI-related cardiogenic shock led to a lower risk of death
from any cause at 180 days than standard care alone. The incidence of a
composite of adverse events was higher with the use of the microaxial flow
pump. (Funded by the Danish Heart Foundation and Abiomed; DanGer Shock
ClinicalTrials.gov number, NCT01633502.)<br/>Copyright &#xa9; 2024
Massachussetts Medical Society. All rights reserved.

<4>
Accession Number
2031386473
Title
Evaluating Various Modes of Ventilation during Cardiopulmonary Bypass and
its Postoperative effect on Pulmonary Dysfunction.
Source
Journal of Cardiovascular Disease Research. 15(3) (pp 1547-1552), 2024.
Date of Publication: 2024.
Author
Gupta S.; Hashmi N.A.; Dev S.; Singh D.P.
Institution
(Gupta) Department of Cardiac Anaesthesia, Mahatma Gandhi Medical College,
Jaipur, India
(Hashmi) Department of General Medicine, People's College of Medical
Sciences and Research Centre, M.P, Bhopal, India
(Dev) Department of Oral and Maxillofacial Surgery, PDM Dental College and
Research Institute, Bahadurgarh, India
(Singh) Department of Dentistry, Government Medical College, Chittorgarh,
India
Publisher
EManuscript Technologies
Abstract
Background: Cardiopulmonary bypass (CPB) is a crucial component of cardiac
surgery, yet it often leads to postoperative pulmonary dysfunction (PPD).
Various modes of ventilation during CPB have been employed, but their
comparative effects on PPD remain unclear. <br/>Material(s) and Method(s):
This study aimed to compare different modes of ventilation-namely,
conventional ventilation (CV) and protective ventilation (PV)-during CPB
and assess their impact on PPD. A total of 100 patients undergoing cardiac
surgery were randomly assigned to either the CV group or the PV group.
Demographic data, intraoperative variables, and postoperative outcomes
were recorded. PPD was assessed through pulmonary function tests (PFTs)
postoperatively. <br/>Result(s): In the CV group, PPD was observed in 45%
of patients, with a mean reduction in forced vital capacity (FVC) of 25%
and forced expiratory volume in one second (FEV1) of 30%. Contrastingly,
in the PV group, PPD occurred in only 20% of patients, with a mean
reduction in FVC of 15% and FEV1 of 20%. The incidence of pneumonia was
also significantly lower in the PV group (p < 0.05). <br/>Conclusion(s):
Protective ventilation during CPB appears to mitigate the incidence and
severity of postoperative pulmonary dysfunction compared to conventional
ventilation. Employing protective ventilation strategies may contribute to
improved postoperative outcomes and reduced pulmonary complications
following cardiac surgery.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

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

<6>
Accession Number
2028946735
Title
External validation of the PC-ECMO score in postcardiotomy veno-arterial
extracorporeal membrane oxygenation.
Source
International Journal of Artificial Organs. 47(4) (pp 313-317), 2024. Date
of Publication: April 2024.
Author
Biancari F.; Juvonen T.; Cho S.-M.; Hernandez Perez F.J.; L'Acqua C.;
Arafat A.A.; AlBarak M.M.; Laimoud M.; Djordjevic I.; Samalavicius R.;
Alonso-Fernandez-Gatta M.; Sahli S.D.; Kaserer A.; Dominici C.; Makikallio
T.
Institution
(Biancari, Makikallio) Department of Medicine, South-Karelia Central
Hospital, University of Helsinki, Etela-Karjala, Lappeenranta, Finland
(Biancari, Juvonen) Heart and Lung Center, Helsinki University Hospital,
Uusimaa, Helsinki, Finland
(Juvonen) Research Unit of Surgery, Anesthesia and Intensive Care,
University of Oulu, Oulu, Finland
(Cho) Divisions of Neurosciences, Critical Care and Cardiac Surgery,
Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Hernandez Perez) Puerta de Hierro University Hospital, Madrid, Spain
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Lombardy, Milan, Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan, Italy
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Gharbia
Governorate, Tanta, Egypt
(AlBarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, Faisal Specialist
Hospital and Research Center, King, Riyadh, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo,
Egypt
(Djordjevic) Department of Cardiothoracic Surgery, University Hospital
Cologne, Cologne, Germany
(Samalavicius) Second Department of Anesthesia, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Castilla y
Leon, Salamanca, Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid,
Spain
(Sahli, Kaserer) Institute of Anesthesiology, University and University
Hospital Zurich, Zurich, Switzerland
(Dominici) Department of Cardiac Surgery, Campus Biomedico, Lazio, Rome,
Italy
Publisher
SAGE Publications Ltd
Abstract
Reliable stratification of the risk of early mortality after
postcardiotomy veno-arterial extracorporeal membrane oxygenation
(V-A-ECMO) remains elusive. In this study, we externally validated the
PC-ECMO score, a specific risk scoring method for prediction of
in-hospital mortality after postcardiotomy V-A-ECMO. Overall, 614 patients
who required V-A-ECMO after adult cardiac surgery were gathered from an
individual patient data meta-analysis of nine studies on this topic. The
AUC of the logistic PC-ECMO score in predicting in-hospital mortality was
0.678 (95%CI 0.630-0.726; p < 0.0001). The AUC of the logistic PC-ECMO
score in predicting on V-A-ECMO mortality was 0.652 (95%CI 0.609-0.695; p
< 0.0001). The Brier score of the logistic PC-ECMO score for in-hospital
mortality was 0.193, the slope 0.909, the calibration-in-the-large 0.074
and the expected/observed mortality ratio 0.979. 95%CIs of the calibration
belt of fit relationship between observed and predicted in-hospital
mortality were never above or below the bisector (p = 0.072). The present
findings suggest that the PC-ECMO score may be a valuable tool in clinical
research for stratification of the risk of patients requiring
postcardiotomy V-A-ECMO.<br/>Copyright &#xa9; The Author(s) 2024.

<7>
Accession Number
2029629197
Title
Year in Review 2023: Noteworthy Literature in Cardiothoracic Critical
Care.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2024. Date of Publication: 2024.
Author
Alber S.; Tanabe K.; Hennigan A.; Tregear H.; Gilliland S.
Institution
(Alber, Tanabe, Hennigan, Tregear, Gilliland) University of Colorado,
Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
This article reviews noteworthy investigations and society recommendations
published in 2023 relevant to the care of critically ill cardiothoracic
surgical patients. We reviewed 3,214 articles to identify 18 publications
that add to the existing literature across a variety of topics including
resuscitation, nutrition, antibiotic management, extracorporeal membrane
oxygenation (ECMO), neurologic care following cardiac arrest, coagulopathy
and transfusion, steroids in pulmonary infections, and updated guidelines
in the management of acute respiratory distress syndrome
(ARDS).<br/>Copyright &#xa9; The Author(s) 2024.

<8>
Accession Number
2029137386
Title
Triiodothyronine Supplementation for Children Undergoing Cardiopulmonary
Bypass: A Meta-Analysis.
Source
Pediatric Cardiology. 45(5) (pp 1100-1109), 2024. Date of Publication:
June 2024.
Author
Radman M.R.; Slee A.E.; Marwali E.M.; Portman M.A.
Institution
(Radman) Division of Cardiac Critical Care, Department of Pediatrics,
Seattle Children's Hospital, University of Washington, 4800 Sand Point Way
NE, RC.2.820, Seattle, WA 98105, United States
(Slee) New Arch Consulting, Issaquah, WA, United States
(Marwali) Division of Pediatric Cardiac Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Portman) Division of Cardiology, Department of Pediatrics, Seattle
Children's Hospital, University of Washington, Seattle, WA, United States
Publisher
Springer
Abstract
Specific pediatric populations have exhibited disparate responses to
triiodothyronine (T3) repletion during and after cardiopulmonary bypass
(CPB). <br/>Objective(s): To determine if T3 supplementation improves
outcomes in children undergoing CPB. We searched randomized controlled
trials (RCT) evaluating T3 supplementation in children aged 0-3 years
undergoing CPB between 1/1/2000 and 1/31/2022. We calculated Hazard ratios
(HR) for time to extubation (TTE), ICU length of stay (LOS), and hospital
LOS. 5 RCTs met inclusion criteria with available patient-level data. Two
were performed in United States (US) and 3 in Indonesia with 767 total
subjects (range 29- 220). Median (IQR) age 4.1 (1.6, 8.0) months; female
43%; RACHS-1 scores: 1-1%; 2-55%; 3-27%; 4-13%; 5-0.1%; 6-3.9%; 54% of
subjects in US vs 46% in Indonesia. Baseline TSH and T3 were lower in
Indonesia (p < 0.001). No significant difference occurred in TTE between
treatment groups overall [HR 1.09 (CI, 0.94-1.26)]. TTE numerically
favored T3-treated patients aged 1-5 months [HR 1.24 (CI, 0.97-1.60)]. TTE
HR for the Indonesian T3 group was 1.31 (CI, 1.04-1.65) vs. 0.95 (CI,
0.78-1.15) in US. The ICU LOS HR for the Indonesian T3 group was 1.19 vs.
0.89 in US (p = 0.046). There was a significant T3 effect on hospital LOS
[HR 1.30 (CI, 1.01-1.67)] in Indonesia but not in US [HR 0.99 (CI,
0.78-1.23)]. T3 supplementation in children undergoing CPB is simple,
inexpensive, and safe, showing benefit in resource-limited settings.
Differences in effects between settings likely relate to depression in
baseline thyroid function often associated with
malnutrition.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2024.

<9>
Accession Number
2027585380
Title
Comments on "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. 123(5) (pp 629-630), 2024.
Date of Publication: May 2024.
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.

<10>
Accession Number
2027355572
Title
The effect of back massage with frankincense and myrrh oil before the
cardiac electrophysiological procedure on back pain intensity and comfort:
A single-blind randomized controlled trial.
Source
Explore. 20(3) (pp 352-361), 2024. Date of Publication: 01 May 2024.
Author
Ozdemir U.; Tasci S.; Doner A.; Ozdemir Alkanat H.; Inanc M.T.
Institution
(Ozdemir, Tasci, Doner) Department of Internal Medicine Nursing, Erciyes
University Faculty of Health Sciences, Kayseri, Turkey
(Ozdemir Alkanat) Department of Internal Medicine Nursing, Giresun
University Faculty of Health Sciences, Giresun, Turkey
(Inanc) Internal Medicine Scientist, Department of Cardiology, Erciyes
University Faculty of Medicine, Kayseri, Turkey
Publisher
Elsevier Inc.
Abstract
Context: Back pain is one of the most common problems experienced by
patients after the cardiac electrophysiological study procedure. In
addition, limitation of movement after the procedure negatively affects
the comfort and satisfaction of patients. <br/>Objective(s): The aim of
this study was to determine the effect of back massage with frankincense
and myrrh oil on back pain severity and comfort in patients who were to
undergo cardiac electrophysiological study. <br/>Method(s): This is a
randomized controlled study with a pretest-posttest design. This study was
conducted from October 2020 to March 2021, at the angio unit of a heart
hospital at a university in Turkey. The study was completed with 30
patients in each group, a total of 90 people. Data were collected using a
patient information form, a Visual Analogue Scale (VAS) and the General
Comfort Questionnaire (GCQ). The intervention group and the placebo group
received back massage with frankincense and myrrh essential oil and with
jojoba fixed oil respectively. No intervention was applied to the control
group. <br/>Result(s): There was no statistically significant difference
between the post-procedure VAS values according to the groups. Except for
sociocultural comfort, there were significant differences between the
groups in terms of GCQ total scores and subscales at the first and last
follow-up. <br/>Conclusion(s): Back massage with frankincense and myrrh
oil increased overall comfort, physical comfort, the psychospiritual
comfort. Additional research with a rigorous design is needed to determine
its effect on pain.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<11>
Accession Number
2031885766
Title
Remote ischaemic preconditioning for transcatheter aortic valve
replacement: a protocol for a systematic review with meta-analysis and
trial sequential analysis.
Source
BMJ Open. 14(4) (no pagination), 2024. Article Number: e080200. Date of
Publication: 25 Apr 2024.
Author
Zhang W.; Du L.; Chen G.; Du B.; Zhang L.; Zheng J.
Institution
(Zhang, Chen, Du, Zhang, Zheng) Department of Anesthesiology, West China
Hospital, Sichuan University, Sichuan, Chengdu, China
(Du) Department of Anesthesiology, Sichuan Cancer Hospital and Institute,
Sichuan Cancer Center, University of Electronic Science and Technology of
China, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction Transcatheter aortic valve replacement (TAVR) has become an
important treatment in patients with aortic valve disease with the
continuous advancement of technology and the improvement of outcomes.
However, TAVR-related complications still increase patient morbidity and
mortality. Remote ischaemic preconditioning (RIPC) is a simple procedure
that provides perioperative protection for many vital organs. However, the
efficiency of RIPC on TAVR remains unclear based on inconsistent
conclusions from different clinical studies. Therefore, we will perform a
protocol for a systematic review and meta-analysis to identify the
efficiency of RIPC on TAVR. Methods and analysis English databases
(PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library),
Chinese electronic databases (Wanfang Database, VIP Database and China
National Knowledge Infrastructure) and trial registry databases will be
searched from inception to December 2023 to identify randomised controlled
trials of RIPC on TAVR. We will calculate mean differences or standardised
mean differences with 95% CIs for continuous data, and the risk ratio (RR)
with 95% CIs for dichotomous data by Review Manager version 5.4.
Fixed-effects model or random-effects model will be used according to the
degree of statistical heterogeneity assessed by the I-square test. We will
evaluate the risk of bias using the Cochrane risk-of-bias tool 2 and
assess the evidence quality of each outcome by the Grading of
Recommendations Assessment, Development and Evaluation. The robustness of
outcomes will be evaluated by trial sequential analysis. In addition, we
will evaluate the publication bias of outcomes by Funnel plots and Egger's
regression test. Ethics and dissemination Ethical approval was not
required for this systematic review protocol. The results will be
disseminated through peer-reviewed publications.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<12>
Accession Number
2030905324
Title
Prolonged Non-Steroidal Anti-Inflammatory Drug Exposure After Pleurodesis
Increases Pneumothorax Recurrence: A Retrospective Cohort Study.
Source
Heart Lung and Circulation. 33(4) (pp 538-542), 2024. Date of Publication:
April 2024.
Author
Brookes J.D.L.; Cochrane A.D.; Smith J.A.
Institution
(Brookes, Cochrane, Smith) Department of Cardiothoracic Surgery, Monash
Health, Clayton, VIC, Australia
(Brookes, Cochrane, Smith) Department of Surgery, School of Clinical
Sciences at Monash Health, Monash University, Clayton, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Introduction: The use of non-steroidal anti-inflammatory drugs (NSAID) in
patients undergoing pleurodesis remains controversial. Although many
surgeons are comfortable prescribing NSAIDs post-operatively, some oppose
this practice due to concerns of suppressing the inflammatory response and
quality of pleurodesis. Only a small body of inconsistent publications
exists with respect to guiding therapy in this common clinical scenario.
<br/>Method(s): A retrospective cohort study was undertaken assessing
effect of NSAID exposure on pleurodesis outcomes. An institutional
thoracic surgery database was reviewed yielding 147 patients who underwent
pleurodesis for pneumothorax between 2010 and 2018. Medical records and
imaging were reviewed for patient characteristics, NSAID exposure,
recurrent pneumothorax and other adverse events. <br/>Result(s): There was
no overall difference between rates of recurrence and procedural failure
of pleurodesis (Relative Risk [RR] 1.67 [95% CI 0.74-3.77]). However,
NSAID exposure of >48 hours was associated with increased risk of
recurrent pneumothorax (RR 2.16 [95% CI 1.05-4.45]). There was no
increased rate of other adverse events related to NSAID usage.
<br/>Conclusion(s): NSAID exposure does not increase failure rates or
other adverse events following pleurodesis for pneumothorax. However,
prolonged NSAID exposure post-pleurodesis may increase procedural failure
rates. Further large volume randomised control trials are
required.<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)

<13>
Accession Number
644112827
Title
Regional antibiotic delivery for sternal wound infection prophylaxis a
systematic review and meta-analysis of randomized controlled trials.
Source
Scientific reports. 14(1) (pp 9690), 2024. Date of Publication: 27 Apr
2024.
Author
Kowalewski M.; Kolodziejczak M.M.; Urbanowicz T.; De Piero M.E.; Mariani
S.; Pasierski M.; Makhoul M.; Comanici M.; Dabrowski E.J.; Matteucci M.;
Massimi G.; Litwinowicz R.; Kowalowka A.; Wanha W.; Jiritano F.; Martucci
G.; Raffa G.M.; Malvindi P.G.; Kuzma L.; Suwalski P.; Lorusso R.; Meani
P.; Lazar H.
Institution
(Kowalewski, Pasierski, Suwalski) Clinical Department of Cardiac Surgery
and Transplantology, National Medical Institute of the Ministry of
Interior and Administration, Woloska 137, Warsaw 02-507, Poland
(Kowalewski, De Piero, Mariani, Matteucci, Massimi, Lorusso)
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Kowalewski, Kolodziejczak, Urbanowicz, Pasierski, Makhoul, Matteucci,
Massimi, Litwinowicz, Kowalowka, Wanha, Jiritano, Martucci, Raffa,
Malvindi, Suwalski, Meani) Thoracic Research Centre, Innovative Medical
Forum, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan
University of Medical Sciences, Poznan, Poland
(Makhoul, Comanici) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
(Dabrowski, Kuzma) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok, Poland
(Matteucci) Cardiac Surgery Unit, Department of Medicine and Surgery, ASST
dei Sette Laghi, University of Insubria, Varese, Italy
(Massimi) Cardiac Surgery Unit, Santa Maria della Misericordia Hospital,
Perugia, Italy
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Upper-Silesian Heart Center, Medical University of Silesia, Katowice,
Poland
(Wanha) Department of Invasive Cardiology, School of Medicine in Katowice,
Medical University of Silesia, Katowice, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo Per i trapianti e Terapie ad alta specializzazione
(IRCCS-ISMETT), Palermo, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti Delle Marche, Polytechnic University of Marche, Ancona, Italy
(Meani) Department of Cardiothoracic and Vascular Anesthesia and Intensive
Care Unit, IRCCS Policlinico, San Donato Milanese, Milan, Italy
(Lazar) Boston University School of Medicine, Boston, MA, United States
Abstract
Despite evidence suggesting the benefit of prophylactic regional
antibiotic delivery (RAD) to sternal edges during cardiac surgery, it is
seldom performed in clinical practice. The value of topical vancomycin and
gentamicin for sternal wound infections (SWI) prophylaxis was further
questioned by recent studies including randomized controlled trials
(RCTs). The aim of this systematic review and meta-analysis was to
comprehensively assess the safety and effectiveness of RAD to reduce the
risk of SWI.We screened multiple databases for RCTs assessing the
effectiveness of RAD (vancomycin, gentamicin) in SWI prophylaxis. Random
effects meta-analysis was performed. The primary endpoint was any SWI;
other wound complications were also analysed. Odds Ratios served as the
primary statistical analyses. Trial sequential analysis (TSA) was
performed.Thirteen RCTs (N=7,719 patients) were included. The odds of any
SWI were significantly reduced by over 50% with any RAD: OR (95%CIs): 0.49
(0.35-0.68); p<0.001 and consistently reduced in vancomycin (0.34
[0.18-0.64]; p<0.001) and gentamicin (0.58 [0.39-0.86]; p=0.007) groups
(psubgroup=0.15). Similarly, RAD reduced the odds of SWI in diabetic and
non-diabetic patients (0.46 [0.32-0.65]; p<0.001 and 0.60 [0.44-0.83];
p=0.002 respectively). Cumulative Z-curve passed the TSA-adjusted boundary
for SWIs suggesting adequate power has been met and no further trials are
needed. RAD significantly reduced deep (0.60 [0.43-0.83]; p=0.003) and
superficial SWIs (0.54 [0.32-0.91]; p=0.02). No differences were seen in
mediastinitis and mortality, however, limited number of studies assessed
these endpoints. There was no evidence of systemic toxicity, sternal
dehiscence and resistant strains emergence. Both vancomycin and gentamicin
reduced the odds of cultures outside their respective serum
concentrations' activity: vancomycin against gram-negative strains: 0.20
(0.01-4.18) and gentamicin against gram-positive strains: 0.42
(0.28-0.62); P<0.001. Regional antibiotic delivery is safe and effectively
reduces the risk of SWI in cardiac surgery patients.<br/>Copyright &#xa9;
2024. The Author(s).

<14>
Accession Number
2031938021
Title
Effectiveness of mechanical circulatory support devices in reversing
pulmonary hypertension among heart transplant candidates: A systematic
review.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102579. Date of Publication: July 2024.
Author
Albulushi A.; Al-Riyami M.B.; Al-Rawahi N.; Al-Mukhaini M.
Institution
(Albulushi, Al-Riyami, Al-Rawahi, Al-Mukhaini) Division of Adult
Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary hypertension (PH) poses a significant challenge in
the selection of candidates for heart transplantation, impacting their
eligibility and post-transplant outcomes. Mechanical circulatory support
(MCS) devices, particularly left ventricular assist devices (LVADs), have
emerged as a therapeutic option to manage PH in this patient population.
This systematic review aims to evaluate the effectiveness of MCS devices
in reversing fixed pulmonary hypertension in heart transplant candidates.
<br/>Method(s): A comprehensive literature search was conducted across
multiple databases, including PubMed, Scopus, and Web of Science, to
identify studies that evaluated the effectiveness of MCS devices in
reversing fixed pulmonary hypertension in heart transplant candidates.
Data on pulmonary vascular resistance, PH reversal, heart transplant
eligibility, and post-transplant outcomes were extracted and synthesized.
<br/>Result(s): The review included studies that demonstrated the
potential of MCS devices, especially LVADs, to significantly reduce
pulmonary vascular resistance and reverse fixed pulmonary hypertension in
heart transplant candidates. These findings suggest that MCS devices can
improve transplant eligibility and may positively impact post-transplant
survival rates. However, the literature also indicates a need for further
comparative studies to optimize MCS device selection and treatment
protocols. <br/>Conclusion(s): MCS devices, particularly LVADs, play a
crucial role in the management of fixed pulmonary hypertension in heart
transplant candidates, improving their eligibility for transplantation and
potentially enhancing post-transplant outcomes. Future research should
focus on comparative effectiveness studies to guide clinical
decision-making and optimize patient care in this challenging clinical
scenario.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<15>
Accession Number
2029645686
Title
Cryoanalgesia as the Essential Element of Enhanced Recovery after Surgery
(ERAS) in Children Undergoing Thoracic Surgery-Scoping Review.
Source
Journal of Personalized Medicine. 14(4) (no pagination), 2024. Article
Number: 411. Date of Publication: April 2024.
Author
Zacha S.; Biernawska J.
Institution
(Zacha) Department of Pediatric Orthopedics and Oncology of
Musculoskeletal System, Pomeranian Medical University in Szczecin,
Szczecin 70-252, Poland
(Biernawska) Department of Anesthesiology and Intensive Therapy,
Pomeranian Medical University in Szczecin, Szczecin 70-252, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This article aims to present cryoanalgesia as an inventive strategy for
pain alleviation among pediatric patients. It underlines the tremendous
need to align pain management with the principles of the enhanced recovery
after surgery (ERAS) approach. The aim of the study was to review the
patient outcomes of nerve cryoanalgesia during surgery reported with
regard to ERAS in the literature. The literature search was performed
using PubMed and Embase to identify articles on the use of cryoanalgesia
in children. It excluded editorials, reviews, meta-analyses, and
non-English articles. The analysis focused on the study methods, data
analysis, patient selection, and patient follow-up. This review includes a
total of 25 articles. Three of the articles report the results of
cryoanalgesia implemented in ERAS protocol in children. The research
outcome indicates shortened hospital stay, potential reduction in opioid
dosage, and significant progress in physical rehabilitation. This paper
also describes the first intraoperative utilization of intercostal nerve
cryoanalgesia during the Nuss procedure in Poland, highlighting its
effectiveness in pain management. Adding the cryoanalgesia procedure to
multimodal analgesia protocol may facilitate the implementation of the
ERAS protocol in pediatric patients.<br/>Copyright &#xa9; 2024 by the
authors.

<16>
Accession Number
2031903793
Title
High-Sensitivity Cardiac Troponin I and T Kinetics Differ following
Coronary Bypass Surgery: A Systematic Review and Meta-Analysis.
Source
Clinical Chemistry. 68(12) (pp 1564-1575), 2022. Date of Publication: 01
Dec 2022.
Author
Denessen E.J.; Heuts S.; Daemen J.H.; Van Doorn W.P.; Vroemen W.H.; Sels
J.-W.; Segers P.; Van't Hof A.W.; Maessen J.G.; Bekers O.; Van Der Horst
I.C.; Mingels A.M.
Institution
(Denessen, Van Doorn, Vroemen, Bekers, Mingels) Central Diagnostic
Laboratory, Maastricht University Medical Center+, Maastricht, Netherlands
(Denessen, Van Doorn, Sels, Van't Hof, Maessen, Bekers, Van Der Horst,
Mingels) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Daemen) Department of Surgery, Division of General Thoracic Surgery,
Zuyderland Medical Center, Heerlen, Netherlands
(Sels, Van Der Horst) Department of Intensive Care Medicine, Maastricht
University Medical Center+, Maastricht, Netherlands
(Sels, Van't Hof) Department of Cardiology, Maastricht University Medical
Center+, Maastricht, Netherlands
(Van't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Oxford University Press
Abstract
BACKGROUND: Cardiac troponin I and T are both used for diagnosing
myocardial infarction (MI) after coronary artery bypass grafting (CABG),
also known as type 5 MI (MI-5). Different MI-5 definitions have been
formulated, using multiples of the 99th percentile upper reference limit
(10x, 35x, or 70x URL), with or without supporting evidence. These
definitions are arbitrarily chosen based on conventional assays and do not
differentiate between troponin I and T. We therefore investigated the
kinetics of high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT)
following CABG. <br/>METHOD(S): A systematic search was applied to MEDLINE
and EMBASE databases including the search terms "coronary artery bypass
grafting"AND "high-sensitivity cardiac troponin."Studies reporting hs-cTnI
or hs-cTnT on at least 2 different time points were included. Troponin
concentrations were extracted and normalized to the assay-specific URL.
<br/>RESULT(S): For hs-cTnI and hs-cTnT, 17 (n=1661 patients) and 15
studies (n=2646 patients) were included, respectively. Preoperative
hs-cTnI was 6.1x URL (95% confidence intervals: 4.9-7.2) and hs-cTnT 1.2x
URL (0.9-1.4). Mean peak was reached 6-8 h postoperatively (126x URL,
99-153 and 45x URL, 29-61, respectively). Subanalysis of hs-cTnI
illustrated assay-specific peak heights and kinetics, while subanalysis of
surgical strategies revealed 3-fold higher hs-cTnI than hs-cTnT for
on-pump CABG and 5-fold for off-pump CABG. <br/>CONCLUSION(S):
Postoperative hs-cTnI and hs-cTnT following CABG surpass most current
diagnostic cutoff values. hs-cTnI was almost 3-fold higher than hs-cTnT,
and appeared to be highly dependent on the assay used and surgical
strategy. There is a need for assay-specific hs-cTnI and hs-cTnT cutoff
values for accurate, timely identification of MI-5. <br/>Copyright &#xa9;
American Association for Clinical Chemistry 2022.

<17>
Accession Number
644111476
Title
The prophylactic use of negative pressure wound therapy after cardiac
surgery: a meta-analysis.
Source
The Journal of hospital infection. (no pagination), 2024. Date of
Publication: 25 Apr 2024.
Author
Fiocco A.; Dini M.; Lorenzoni G.; Gregori D.; Colli A.; Besola L.
Institution
(Fiocco, Dini, Colli, Besola) Cardiac Surgery Unit, Department of
Surgical, Medical and Molecular Pathology and Critical Care Medicine,
University of Pisa, Pisa, Italy
(Lorenzoni, Gregori) Unit of Biostatistics, Epidemiology and Public
Health, Department of Cardiac, Thoracic, Vascular Sciences, Public Health,
University of Padova, Padova, Italy
Abstract
BACKGROUND: Surgical site infections (SSi) pose a frequent complication in
cardiac surgery patients and lead to increased patient discomfort and
extended hospitalization. AIM: This meta-analysis evaluates the protective
role of single-use-negative-pressure-wound-therapy (sNPWT) devices on
closed surgical wounds after cardiac surgery, and explores their potential
preventive application across all cardiac surgery patients.
<br/>METHOD(S): A comprehensive literature search was conducted on PubMed
and Elsevier, focusing on studies related to "negative pressure wound
therapy" or "PICO negative pressure wound therapy" combined with "cardiac
surgery" or "sternotomy," published between 2000 and 2022. Inclusion
criteria encompassed case-control studies comparing sNPWT with traditional
dressing on closed cardiac surgical incisions in adult patients undergoing
median sternotomy without immediate postoperative infective complications,
with available details on SSIs. A retrospective analysis of cases treated
with sNPWT in our Center was also performed. FINDINGS: The meta-analysis
revealed a protective role of sNPWT, indicating a 44% risk reduction in
overall SSIs (OR 0.56) and a 40% risk reduction in deep wound infections
(OR 0.60). Superficial wound infections, however, showed non-significant
protective effects. A single-center study aligned with the meta-analysis
findings, confirming the efficacy of sNPWT and was included in the
meta-analysis. <br/>CONCLUSION(S): The meta-analysis and the single-centre
study collectively support the protective role of negative pressure wound
therapy against overall and deep surgical site infections, suggesting its
potential prophylactic use on all cardiac surgery
population.<br/>Copyright &#xa9; 2024. Published by Elsevier Ltd.

<18>
Accession Number
644109810
Title
Effects of open-label sesame oil applied to cardiac surgery patients in
preventing amiodarone-induced phlebitis: A randomized controlled trial.
Source
Nursing in critical care. (no pagination), 2024. Date of Publication: 27
Apr 2024.
Author
Gulsen M.; Arslan S.
Institution
(Gulsen, Arslan) Surgical Nursing Department, Faculty of Health Sciences,
Cukurova University, Adana, Turkey
Abstract
BACKGROUND: Amiodarone is a prophylactic rhythm-regulating drug used to
prevent arrhythmia; However, especially during infusion, it has the
potential to cause a number of complications, especially phlebitis. AIM:
The aim of the study is to determine the effects of sesame oil, which has
the potential to prevent phlebitis that may occur during amiodarone
infusion administered to patients after cardiac surgery. DESIGN: This
prospective, two-arm (1:1), block randomized controlled interventional
study. <br/>METHOD(S): This study was conducted with 44 patients treated
in the coronary intensive care unit of a university hospital, who received
parenteral infusion of amiodarone. Sesame oil was applied superficially by
applying 10 drops to a 10cm perimeter of the cannula for 10min. This
application was repeated every 8h during the 24-h amiodarone infusion. No
intervention was made to the patients in the control group. However,
standard nursing care measures and a standard transparent dressing were
applied to the patients in both groups during the peripheral catheter
application phase. Patients in the intervention and control groups were
evaluated in terms of phlebitis at the end of every 24h using the Visual
Infusion Phlebitis Scale. The study was reported according to the CONSORT
declaration. <br/>RESULT(S): Phlebitis symptoms occurred in 15/22 (68.2%)
of the patients in the intervention group on the first day, 3/22 (13.6%)
on the second day and 2/22 (9.1%) of the patients on the third day, while
in the control group, 20/22 (90.9%) of the patients had phlebitis on the
first day and 2/22 (9.1%) on the second day. The incidence of phlebitis
was 20/22 (90.9%) in the intervention group and 22/22 (100%) in the
control group. There was no statistically significant difference in
phlebitis symptoms between groups. <br/>CONCLUSION(S): The research
results showed that the application of sesame oil did not significantly
reduce the frequency of phlebitis. However, a trend indicating delayed
onset of phlebitis symptoms was observed in the sesame oil group.
Nevertheless, larger sample studies are needed. These studies are expected
to assist in determining the effects of sesame oil on phlebitis more
precisely and provide stronger support for the results. RELEVANCE TO
CLINICAL PRACTICE: Training of nurses on non-pharmacological methods
should be supported and opportunities should be given for their
application.<br/>Copyright &#xa9; 2024 The Authors. Nursing in Critical
Care published by John Wiley & Sons Ltd on behalf of British Association
of Critical Care Nurses.

<19>
Accession Number
2029538975
Title
Association between diabetes mellitus and primary restenosis following
endovascular treatment: a comprehensive meta-analysis of randomized
controlled trials.
Source
Cardiovascular Diabetology. 23(1) (no pagination), 2024. Article Number:
132. Date of Publication: December 2024.
Author
Sun X.; Zhang C.; Ma Y.; He Y.; Zhang X.; Wu J.
Institution
(Sun, He) Department of General Surgery (Vascular Surgery), Affiliated
Hospital of Southwest Medical University, Luzhou 646000, China
(Sun) Department of Interventional Medicine, Affiliated Hospital of
Southwest Medical University, Luzhou 646000, China
(Wu) Department of Pharmacology, Basic Medicine Research Innovation Center
for Cardiometabolic Diseases, Ministry of Education, and Laboratory for
Cardiovascular Pharmacology, School of Pharmacy, Southwest Medical
University, Luzhou 646000, China
(Sun) Laboratory of Nucleic Acids in Medicine for National High-Level
Talents, Nucleic Acid Medicine of Luzhou Key Laboratory, Southwest Medical
University, Luzhou 646000, China
(Sun, Wu) Key Laboratory of Medical Electrophysiology, Ministry of
Education and Medical Electrophysiological Key Laboratory of Sichuan
Province, Collaborative Innovation Center for Prevention and Treatment of
Cardiovascular Disease of Sichuan Province, Institute of Cardiovascular
Research, Southwest Medical University, Luzhou 646000, China
(Sun, Wu) Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou,
Luzhou 646000, China
(Ma) Department of Ophthalmology, Affiliated Hospital of Southwest Medical
University, Luzhou 646000, China
(Zhang) Chongqing Clinical Research Center for Reproductive Medicine,
Center for Reproductive Medicine, Women and Children's Hospital of
Chongqing Medical University, Chongqing, China
(Sun) School of Cardiovascular Medicine and Sciences, Faculty of Life
Science and Medicine, King's College London British Heart Foundation
Centre of Research Excellence, King's College London, London SE5 9NU,
United Kingdom
(Zhang) Department of General Surgery, Center of Vascular and
Interventional Surgery, The Third People's Hospital of Chengdu, The
Affiliated Hospital of Southwest Jiaotong University & amp;The Second
Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu
610031, China
Publisher
BioMed Central Ltd
Abstract
Importance: Diabetes mellitus (DM) is thought to be closely related to
arterial stenotic or occlusive disease caused by atherosclerosis. However,
there is still no definitive clinical evidence to confirm that patients
with diabetes have a higher risk of restenosis. <br/>Objective(s): This
meta-analysis was conducted to determine the effect of DM on restenosis
among patients undergoing endovascular treatment, such as percutaneous
transluminal angioplasty (PTA) or stenting. Data sources and study
selection: The PubMed/Medline, EMBASE and Cochrane Library electronic
databases were searched from 01/1990 to 12/2022, without language
restrictions. Trials were included if they satisfied the following
eligibility criteria: (1) RCTs of patients with or without DM; (2) lesions
confined to the coronary arteries or femoral popliteal artery; (3)
endovascular treatment via PTA or stenting; and (4) an outcome of
restenosis at the target lesion site. The exclusion criteria included the
following: (1) greater than 20% of patients lost to follow-up and (2) a
secondary restenosis operation. Data extraction and synthesis: Two
researchers independently screened the titles and abstracts for relevance,
obtained full texts of potentially eligible studies, and assessed
suitability based on inclusion and exclusion criteria. Disagreements were
resolved through consultation with a third researcher. Treatment effects
were measured by relative ratios (RRs) with 95% confidence intervals (CIs)
using random effects models. The quality of the evidence was assessed
using the Grading of Recommendations Assessment, Development and
Evaluation (GRADE) criteria. <br/>Main Outcomes and Measures: The main
observation endpoint was restenosis, including > 50% stenosis at
angiography, or TLR of the primary operation lesion during the follow-up
period. <br/>Result(s): A total of 31,066 patients from 20 RCTs were
included. Patients with DM had a higher risk of primary restenosis after
endovascular treatment (RR = 1.43, 95% CI: 1.25-1.62; p = 0.001).
Conclusions and relevance: This meta-analysis of all currently available
RCTs showed that patients with DM are more prone to primary restenosis
after endovascular treatment.<br/>Copyright &#xa9; The Author(s) 2024.

<20>
Accession Number
2029538835
Title
Impact of perioperative low-molecular-weight heparin therapy on clinical
events of elderly patients with prior coronary stents implanted > 12
months undergoing non-cardiac surgery: a randomized, placebo-controlled
trial.
Source
BMC Medicine. 22(1) (no pagination), 2024. Article Number: 171. Date of
Publication: December 2024.
Author
Wang B.; Su Y.; Ma C.; Xu L.; Mao Q.; Cheng W.; Lu Q.; Zhang Y.; Wang R.;
Lu Y.; He J.; Chen S.; Chen L.; Li T.; Gao L.
Institution
(Wang, Su, Xu, Cheng, Lu, Zhang, Wang, Lu, He, Chen, Li, Gao) Department
of Comprehensive Surgery, The Second Medical Center & amp; National
Clinical Research Center for Geriatric Diseases, Chinese PLA General
Hospital, Beijing 100853, China
(Ma) Health Management Institute, The Second Medical Center & amp;
National Clinical Research Center for Geriatric Diseases, Chinese PLA
General Hospital, Beijing, China
(Mao) National Research Institute for Family Planning, Beijing, China
(Chen) Department of Thoracic Surgery of The First Medical Center, General
Hospital of Chinese People's Liberation Army, Beijing 100853, China
Publisher
BioMed Central Ltd
Abstract
Background: Little is known about the safety and efficacy of discontinuing
antiplatelet therapy via LMWH bridging therapy in elderly patients with
coronary stents implanted for > 12 months undergoing non-cardiac surgery.
This randomized trial was designed to compare the clinical benefits and
risks of antiplatelet drug discontinuation via LMWH bridging therapy.
<br/>Method(s): Patients were randomized 1:1 to receive subcutaneous
injections of either dalteparin sodium or placebo. The primary efficacy
endpoint was cardiac or cerebrovascular events. The primary safety
endpoint was major bleeding. <br/>Result(s): Among 2476 randomized
patients, the variables (sex, age, body mass index, comorbidities,
medications, and procedural characteristics) and percutaneous coronary
intervention information were not significantly different between the
bridging and non-bridging groups. During the follow-up period, the rate of
the combined endpoint in the bridging group was significantly lower than
in the non-bridging group (5.79% vs. 8.42%, p = 0.012). The incidence of
myocardial injury in the bridging group was significantly lower than in
the non-bridging group (3.14% vs. 5.19%, p = 0.011). Deep vein thrombosis
occurred more frequently in the non-bridging group (1.21% vs. 0.4%, p =
0.024), and there was a trend toward a higher rate of pulmonary embolism
(0.32% vs. 0.08%, p = 0.177). There was no significant difference between
the groups in the rates of acute myocardial infarction (0.81% vs. 1.38%),
cardiac death (0.24% vs. 0.41%), stroke (0.16% vs. 0.24%), or major
bleeding (1.22% vs. 1.45%). Multivariable analysis showed that LMWH
bridging, creatinine clearance < 30 mL/min, preoperative hemoglobin < 10
g/dL, and diabetes mellitus were independent predictors of ischemic
events. LMWH bridging and a preoperative platelet count of < 70 x
10⁹/L were independent predictors of minor bleeding events.
<br/>Conclusion(s): This study showed the safety and efficacy of
perioperative LMWH bridging therapy in elderly patients with coronary
stents implanted > 12 months undergoing non-cardiac surgery. An
alternative approach might be the use of bridging therapy with half-dose
LMWH. Trial registration: ISRCTN65203415.<br/>Copyright &#xa9; The
Author(s) 2024.

<21>
Accession Number
2031750632
Title
Continuous stellate ganglion block for ventricular arrhythmias: case
series, systematic review, and differences from thoracic epidural
anaesthesia.
Source
Europace. 26(4) (no pagination), 2024. Article Number: euae074. Date of
Publication: 01 Apr 2024.
Author
Dusi V.; Angelini F.; Baldi E.; Toscano A.; Gravinese C.; Frea S.;
Compagnoni S.; Morena A.; Saglietto A.; Balzani E.; Giunta M.; Costamagna
A.; Rinaldi M.; Trompeo A.C.; Rordorf R.; Anselmino M.; Savastano S.; De
Ferrari G.M.
Institution
(Dusi, Morena, Anselmino, De Ferrari) Cardiology, Department of Medical
Sciences, University of Turin, Corso Dogliotti 14, Torino 10126, Italy
(Dusi, Angelini, Gravinese, Frea, Morena, Saglietto, Anselmino, De
Ferrari) Division of Cardiology, Cardiovascular and Thoracic Department,
'Citta della Salute e della Scienza' Hospital, Corso Bramante 88/90,
Torino 10126, Italy
(Baldi, Rordorf, Savastano) Arrhythmia and Electrophysiology Unit,
Division of Cardiology, Fondazione Irccs Policlinico San Matteo, Pavia,
Italy
(Toscano, Giunta, Costamagna, Trompeo) Department of Anaesthesia, Critical
Care and Emergency, 'Citta della Salute e della Scienza' Hospital, Torino,
Italy
(Compagnoni) Department of Molecular Medicine, Section of Cardiology,
University of Pavia, Viale Golgi 19, Pavia 27100, Italy
(Balzani, Rinaldi) Department of Surgical Sciences, University of Turin,
Torino, Italy
(Rinaldi) Department of Cardiovascular and Thoracic Surgery, 'Citta della
Salute e della Scienza' Hospital, Torino, Italy
Publisher
Oxford University Press
Abstract
Aims: Percutaneous stellate ganglion block (PSGB) through single-bolus
injection and thoracic epidural anaesthesia (TEA) have been proposed for
the acute management of refractory ventricular arrhythmias (VAs). However,
data on continuous PSGB (C-PSGB) are scant. The aim of this study is to
report our dual-centre experience with C-PSGB and to perform a systematic
review on C-PSGB and TEA. <br/>Methods and Results: Consecutive patients
receiving C-PSGB at two centres were enrolled. The systematic literature
review follows the latest Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) criteria. Our case series (26 patients, 88%
male, 60 +/- 16 years, all with advanced structural heart disease, left
ventricular ejection fraction 23 +/- 11%, 32 C-PSGBs performed, with a
median duration of 3 days) shows that C-PSGB is feasible and safe and
leads to complete VAs suppression in 59% and to overall clinical benefit
in 94% of cases. Overall, 61 patients received 68 C-PSGBs and 22 TEA, with
complete VA suppression in 63% of C-PSGBs (61% of patients). Most TEA
procedures (55%) were performed on intubated patients, as opposed to 28%
of C-PSGBs (P = 0.02); 63% of cases were on full anticoagulation at
C-PSGB, none at TEA (P < 0.001). Ropivacaine and lidocaine were the most
used drugs for C-PSGB, and the available data support a starting dose of
12 and 100 mg/h, respectively. No major complications occurred, yet TEA
discontinuation rate due to side effects was higher than C-PSGB (18 vs.
1%, P = 0.01). <br/>Conclusion(s): Continuous PSGB seems feasible, safe,
and effective for the acute management of refractory VAs. The
antiarrhythmic effect may be accomplished with less concerns for
concomitant anticoagulation compared with TEA and with a lower side-effect
related discontinuation rate.<br/>Copyright &#xa9; 2024 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<22>
Accession Number
2031743593
Title
Moderate aortic stenosis in the dysfunctional ventricle: should it be
treated?.
Source
European Heart Journal, Supplement. 26(Supplement_1) (pp i113-i116), 2024.
Date of Publication: 01 Apr 2024.
Author
Sciatti E.; Calabrese A.; Duino V.; D'isa S.; Di Odoardo L.A.F.; D'elia
E.; Senni M.
Institution
(Sciatti, Calabrese, Duino, D'isa, Di Odoardo, D'elia, Senni)
Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
(Senni) Milano-Bicocca University, Milan, Italy
Publisher
Oxford University Press
Abstract
Moderate aortic stenosis is associated with a worse prognosis than milder
degrees. Pathophysiologically, this condition in a dysfunctional ventricle
could lead to a further mechanism of haemodynamic worsening, so its
treatment should lead to clinical advantages for the patient. The low risk
of complications associated with percutaneous correction of aortic valve
disease (transcatheter aortic valve implantation) should also be
considered, which would seem to favour an interventional approach even in
the aforementioned condition. However, sparse data and small population
studies make this approach still controversial. Three randomized
controlled trials are underway to shed definitive light on the
topic.<br/>Copyright &#xa9; The Author(s) 2024.

<23>
Accession Number
2031822137
Title
Thorax support vest to prevent sternal wound infections in cardiac surgery
patients-a systematic review and meta-analysis.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 38(4) (no
pagination), 2024. Article Number: ivae055. Date of Publication: 01 Apr
2024.
Author
Caldonazo T.; Dell'Aquila M.; Cancelli G.; Harik L.; Soletti G.; Fischer
J.; Kirov H.; Rahouma M.; Ibrahim M.; Demetres M.; An K.R.; Girardi L.;
Doenst T.; Gaudino M.
Institution
(Caldonazo, Fischer, Kirov, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
(Caldonazo, Dell'Aquila, Cancelli, Harik, Soletti, Rahouma, An, Girardi,
Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Ibrahim) Department of General Surgery, Maimonides Medical Center,
Brooklyn, NY, United States
(Ibrahim) Nuffield Department of Surgical Sciences, University of Oxford,
Oxford, United Kingdom
(Demetres) Samuel J. Wood Library & CV Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(An) Division of Cardiac Surgery, Department of Surgery, University of
Toronto, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
OBJECTIVES: Midline sternotomy is the main surgical access for cardiac
surgeries. The most prominent complication of sternotomy is sternal wound
infection (SWI). The use of a thorax support vest (TSV) that limits thorax
movement and ensures sternal stability has been suggested to prevent
postoperative SWI. <br/>METHOD(S): We performed a meta-analysis to
evaluate differences in clinical outcomes with and without the use of TSV
after cardiac surgery in randomized trials. The primary outcome was deep
SWI (DSWI). Secondary outcomes were superficial SWI, sternal wound
dehiscence, and hospital length of stay (LOS). A trial sequential analysis
was performed. Fixed (F) and random effects (R) models were calculated.
<br/>RESULT(S): A total of 4 studies (3820 patients) were included.
Patients who wore the TSV had lower incidence of DSWI [odds ratio (OR) 1/4
F: 0.24, 95% confidence interval (CI), 0.13-0.43, P < 0.01; R: 0.24,
0.04-1.59, P 1/4 0.08], sternal wound dehiscence (OR 1/4 F: 0.08, 95% CI,
0.02-0.27, P < 0.01; R: 0.10, 0.00-2.20, P 1/4 0.08) and shorter hospital
LOS (standardized mean difference 1/4 F: -0.30, -0.37 to -0.24, P < 0.01;
R: -0.63, -1.29 to 0.02, P 1/4 0.15). There was no difference regarding
the incidence of superficial SWI (OR 1/4 F: 0.71, 95% CI, 0.34-1.47, P 1/4
0.35; R: 0.64, 0.10, 4.26, P 1/4 0.42). The trial sequential analysis,
however, showed that the observed decrease in DSWI in the TSV arm cannot
be considered conclusive based on the existing evidence.
<br/>CONCLUSION(S): This meta-analysis suggests that the use of a TSV
after cardiac surgery could potentially be associated with a reduction in
sternal wound complications. However, despite the significant treatment
effect in the available studies, the evidence is not solid enough to
provide strong practice recommendations.<br/>Copyright &#xa9; The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<24>
Accession Number
2031798534
Title
Charting new frontiers in paediatric cardiomyopathies: Lessons from the
ESC EORP Cardiomyopathy and Myocarditis Registry in paediatric age.
Source
European Heart Journal. 45(16) (pp 1455-1457), 2024. Date of Publication:
21 Apr 2024.
Author
Sabatino J.; Budts W.; Di Salvo G.
Institution
(Sabatino) Department of Experimental and Clinical Medicine, 'Magna
Graecia' University of Catanzaro, Viale Europa, Catanzaro 88100, Italy
(Sabatino, Di Salvo) Pediatric Research Institute 'Citta della Speranza',
Padova, Italy
(Budts) Division of Congenital and Structural Cardiology, University
Hospitals Leuven, Leuven, Belgium
(Budts) KU Leuven Department of Cardiovascular Sciences, KU
Leuven-University of Leuven, Leuven, Belgium
(Di Salvo) Division of Pediatric Cardiology, Department for Women's and
Children's Health, University of Padua, Padova, Italy
Publisher
Oxford University Press

<25>
Accession Number
2031845569
Title
Ventricular Pseudoaneurysm and Free Wall Rupture After Acute Myocardial
Infarction: JACC Focus Seminar 4/5.
Source
Journal of the American College of Cardiology. 83(19) (pp 1902-1916),
2024. Date of Publication: 14 May 2024.
Author
Lorusso R.; Cubeddu R.J.; Matteucci M.; Ronco D.; Moreno P.R.
Institution
(Lorusso, Matteucci, Ronco) Cardio-Thoracic Surgery Department, Maastricht
University Medical Centre (MUMC), Maastricht, Netherlands
(Lorusso, Matteucci, Ronco) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Cubeddu) NCH Rooney Heart Institute, Section for Structural Heart
Disease, NCH Healthcare System, Naples, FL, United States
(Cubeddu, Moreno) Igor Palacios Fellow Fouldation, Boston, MA, United
States
(Matteucci) Cardiac Surgery Unit, ASSTSette Laghi, Varese, Italy
(Ronco) Cardiac Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda,
Milan, Italy
(Moreno) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Postinfarction ventricular free-wall rupture is a rare mechanical
complication, accounting for <0.01% to 0.02% of cases. As an
often-catastrophic event, death typically ensues within minutes due to
sudden massive hemopericardium resulting in cardiac tamponade. Early
recognition is pivotal, and may allow for pericardial drainage and open
surgical repair as the only emergent life-saving procedure. In cases of
contained rupture with pseudo-aneurysm (PSA) formation, hospitalization
with subsequent early surgical intervention is warranted. Not uncommonly,
PSA may go unrecognized in asymptomatic patients and diagnosed late during
subsequent cardiac imaging. In these patients, the unsettling risk of
complete rupture demands early surgical repair. Novel developments, in the
field of transcatheter-based therapies and multimodality imaging, have
enabled percutaneous PSA repair as a feasible alternate strategy for
patients at high or prohibitive surgical risk. Contemporary advancements
in the diagnosis and treatment of postmyocardial infarction ventricular
free-wall rupture and PSA are provided in this review.<br/>Copyright
&#xa9; 2024 American College of Cardiology Foundation

<26>
Accession Number
2031845553
Title
Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial
Infarction at Presentation.
Source
Journal of the American College of Cardiology. 83(19) (pp 1855-1866),
2024. Date of Publication: 14 May 2024.
Author
Lowry M.T.H.; Shah A.S.V.; Mills N.L.; Strachan F.E.; Tuck C.; Anand A.;
Akinlade O.M.; Barker S.; Blades J.; Boeddinghaus J.; Bularga A.; de
Bakker M.; Chapman A.R.; Doudesis D.; Ferry A.V.; Fujisawa T.; Georgiev
K.; Kimenai D.M.; Lee K.K.; Lyell I.; Li Z.; Lowry M.T.; McKinlay L.;
McDermott M.; McPherson J.; Mendusic F.; Sorbie A.; Souter G.; Schulberg
S.D.; Taggart C.; Thurston A.J.; Tew Y.Y.; Perez-Vicencio D.; Wang Y.;
Wereski R.; Williams K.; Newby D.E.; Fox K.A.; Berry C.; Walker S.; Weir
C.J.; Ford I.; Gray A.; Collinson P.O.; Apple F.S.; Reid A.; Cruikshank
A.; Findlay I.; Amoils S.; McAllister D.A.; Maguire D.; Stevens J.; Norrie
J.; Shah A.S.; Andrews J.P.; Adamson P.D.; Moss A.; Anwar M.S.; Hung J.;
Malo J.; Fischbacher C.M.; Croal B.L.; Leslie S.J.; Keerie C.; Parker
R.A.; Walker A.; Harkess R.; Wackett T.; Weir C.; Armstrong R.; Stirling
L.; MacDonald C.; Sadat I.; Finlay F.; Harrison K.; Linksted P.; Lavenberg
S.
Institution
(Li, Wereski, Anand, Lowry, Doudesis, McDermott, Ferry, Tuck, Chapman,
Lee, Mills, Kimenai) BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, United Kingdom
(Chapman) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Shah) Department of Non-Communicable Disease, London School of Hygiene
and Tropical Medicine, London, United Kingdom
(Mills) Usher Institute, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Myocardial infarction can be ruled out in patients with a
single cardiac troponin measurement. Whether use of a uniform rule-out
threshold has resulted in sex differences in care remains unclear.
<br/>Objective(s): The purpose of this study was to evaluate
implementation of a uniform rule-out threshold in females and males with
possible myocardial infarction, and to derive and validate sex-specific
thresholds. <br/>Method(s): The implementation of a uniform rule-out
threshold (<5 ng/L) with a high-sensitivity cardiac troponin I assay was
evaluated in consecutive patients presenting with possible myocardial
infarction. The proportion of low-risk patients discharged from the
emergency department and incidence of myocardial infarction or cardiac
death at 30 days were determined. Sex-specific thresholds were derived and
validated, and proportion of female and male patients were stratified as
low-risk compared with uniform threshold. <br/>Result(s): In 16,792
patients (age 58 +/- 17 years; 46% female) care was guided using a uniform
threshold. This identified more female than male patients as low risk (73%
vs 62%), but a similar proportion of low-risk patients were discharged
from the emergency department (81% for both) with fewer than 5 (<0.1%)
patients having a subsequent myocardial infarction or cardiac death at 30
days. Compared with a uniform threshold of <5 ng/L, use of sex-specific
thresholds would increase the proportion of female (61.8% vs 65.9%) and
reduce the proportion of male (54.8% vs 47.8%) patients identified as low
risk. <br/>Conclusion(s): Implementation of a uniform rule-out threshold
for myocardial infarction was safe and effective in both sexes.
Sex-specific rule-out thresholds should be considered, but their impact on
effectiveness and safety may be limited.<br/>Copyright &#xa9; 2024

<27>
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.

<28>
Accession Number
2029545021
Title
Effect of thoracic paravertebral nerve block on delirium in patients after
video-assisted thoracoscopic surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
Frontiers in Neurology. 15 (no pagination), 2024. Article Number: 1347991.
Date of Publication: 2024.
Author
Zhou X.; Mao W.; Zhao L.; Zhu H.; Chen L.; Xie Y.; Li L.
Institution
(Zhou, Mao, Zhao, Zhu, Chen, Xie, Li) Department of Anesthesiology, The
Second Clinical Medical College, North Sichuan Medical College, Nanchong
Central Hospital, Nanchong, China
Publisher
Frontiers Media SA
Abstract
Background: Nerve blocks are widely used in various surgeries to alleviate
postoperative pain and promote recovery. However, the impact of nerve
block on delirium remains contentious. This study aims to systematically
evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the
incidence of delirium in patients post Video-Assisted Thoracoscopic
Surgery (VATS). <br/>Method(s): We conducted a systematic search of
PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases in
June 2023. The search strategy combined free-text and Medical Subject
Headings (MeSH) terms, including perioperative cognitive dysfunction,
delirium, postoperative cognitive dysfunction, paravertebral nerve block,
thoracic surgery, lung surgery, pulmonary surgery, and
esophageal/esophagus surgery. We utilized a random effects model for the
analysis and synthesis of effect sizes. <br/>Result(s): We included a
total of 9 RCTs involving 1,123 participants in our study. In VATS, TPVB
significantly reduced the incidence of delirium on postoperative day three
(log(OR): -0.62, 95% CI [-1.05, -0.18], p = 0.01, I² = 0.00%)
and postoperative day seven (log(OR): -0.94, 95% CI [-1.39, -0.49], p <
0.001, I² = 0.00%). Additionally, our study indicates the
effectiveness of TPVB in postoperative pain relief (g: -0.82, 95% CI
[-1.15, -0.49], p < 0.001, I² = 72.60%). <br/>Conclusion(s):
The comprehensive results suggest that in patients undergoing VATS, TPVB
significantly reduces the incidence of delirium and notably diminishes
pain scores. Systematic review registration: CRD42023435528.
https://www.crd.york.ac.uk/PROSPERO.<br/>Copyright &#xa9; 2024 Zhou, Mao,
Zhao, Zhu, Chen, Xie and Li.

<29>
Accession Number
2031823200
Title
Risk factors associated with saphenous vein graft aneurysm after coronary
artery bypass graft.
Source
Annals of Medicine and Surgery. 85(11) (pp 5604-5610), 2023. Date of
Publication: 08 Nov 2023.
Author
Ghosh B.; Sibi Krishna T.; Boini A.; Castillo Miranda J.C.D.; Sinha M.;
Bansal R.; Visconti-Lopez F.J.; Mesfin Girma S.; Aliye Asfaw Y.
Institution
(Ghosh) Dhaka Medical College Hospital, Dhaka, Bangladesh
(Sibi Krishna) University of Perpetual Hellp System Dalta, Rizal,
Philippines
(Boini) Davao Medical School Foundation, Philippines
(Castillo Miranda) Universidad Peruana Cayetano Heredia, Lima, Peru
(Visconti-Lopez) Sociedad Cientifica de Estudiantes de Medicina, UPC,
Lima, Peru
(Bansal) Government Medical College and Hospital, Chandigarh, India
(Sinha) Kasturba Medical College, Karnataka, Mangalore, India
(Mesfin Girma) College of Health Sciences, Addis Ababa University, Addis
Ababa, Ethiopia
(Aliye Asfaw) University of Gondar, Collage of Medicine and Health,
Gondar, Ethiopia
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Saphenous vein graft aneurysm (SVGA) is a rare but
life-threatening complication following coronary artery bypass grafting
(CABG). The authors aim to identify the potential risk factors that lead
to SVGA in post-CABG patients. <br/>Method(s): A systematic review of
original studies, observational studies, systematic reviews,
meta-analyses, case studies, and case series was conducted using PubMed,
Web of Science, Scopus, EMBASE, and Google Scholar involving adult
patients (>18) with SVGA after CABG using MESH terminology in a broad
search strategy. All searches were performed and analyzed according to
PRISMA and duplicates were removed via Rayyan. Two independent
investigators extracted and assessed the data involving demographics, and
baseline data related to CABG and its manifestations. <br/>Result(s): Out
of 487 finalized articles, 14 of them matched the inclusion requirements
and reported 12 cases of SVGAs following CABG. Atherosclerosis with
intimal calcification was the most common risk factor followed by
infection. Others included hyperlipidemia, pneumonia, and cardiac
pathologies mostly related to the ventricles and valves.
<br/>Conclusion(s): Atherosclerosis associated with intimal calcification
is the most common risk factor. Patient outcomes seem to improve upon
early identification and regular follow-up imaging. The exclusion criteria
indicated the study's limits, and future studies that address these
constraints may be able to better understand the risk variables involved
in the genesis of SVGA.<br/>Copyright &#xa9; 2023 Lippincott Williams and
Wilkins. All rights reserved.

<30>
Accession Number
2030924981
Title
The effect of CTCA guided selective invasive graft assessment on coronary
angiographic parameters and outcomes: Insights from the BYPASS-CTCA trial.
Source
Journal of Cardiovascular Computed Tomography. 18(3) (pp 291-296), 2024.
Date of Publication: 01 May 2024.
Author
Kelham M.; Beirne A.-M.; Rathod K.S.; Andiapen M.; Wynne L.; Ramaseshan
R.; Learoyd A.E.; Forooghi N.; Moon J.C.; Davies C.; Bourantas C.V.;
Baumbach A.; Manisty C.; Wragg A.; Ahluwalia A.; Pugliese F.; Mathur A.;
Jones D.A.
Institution
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Baumbach, Wragg,
Ahluwalia, Mathur, Jones) Centre for Cardiovascular Medicine and Devices,
Faculty of Medicine & Dentistry, Queen Mary University of London, United
Kingdom
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Forooghi, Bourantas,
Baumbach, Wragg, Mathur, Jones) Barts Interventional Group, Barts Heart
Centre, Barts Health NHS Trust, London, United Kingdom
(Kelham, Beirne, Rathod, Andiapen, Wynne, Ramaseshan, Forooghi, Bourantas,
Baumbach, Manisty, Wragg, Ahluwalia, Pugliese, Mathur, Jones) NIHR Barts
Biomedical Research Centre, Barts Heart Centre and William Harvey Research
Institute, Queen Mary University of London, United Kingdom
(Learoyd, Ahluwalia, Jones) Barts Cardiovascular Clinical Trials Unit,
Faculty of Medicine & Dentistry, Queen Mary University of London, United
Kingdom
(Moon, Davies, Manisty, Pugliese) Department of Cardiac Imaging, Barts
Heart Centre, Barts Health NHS Trust, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Computed tomography cardiac angiography (CTCA) is recommended
for the evaluation of patients with prior coronary artery bypass graft
(CABG) surgery. The BYPASS-CTCA study demonstrated that CTCA prior to
invasive coronary angiography (ICA) in CABG patients leads to significant
reductions in procedure time and contrast-induced nephropathy (CIN),
alongside improved patient satisfaction. However, whether CTCA information
was used to facilitate selective graft cannulation at ICA was not protocol
mandated. In this post-hoc analysis we investigated the influence of CTCA
facilitated selective graft assessment on angiographic parameters and
study endpoints. <br/>Method(s): BYPASS-CTCA was a randomized controlled
trial in which patients with previous CABG referred for ICA were
randomized to undergo CTCA prior to ICA, or ICA alone. In this post-hoc
analysis we assessed the impact of selective ICA (grafts not invasively
cannulated based on the CTCA result) following CTCA versus non-selective
ICA (imaging all grafts irrespective of CTCA findings). The primary
endpoints were ICA procedural duration, incidence of CIN, and patient
satisfaction post-ICA. Secondary endpoints included the incidence of
procedural complications and 1-year major adverse cardiac events.
<br/>Result(s): In the CTCA cohort (n = 343), 214 (62.4%) patients had
selective coronary angiography performed, whereas 129 (37.6%) patients had
non-selective ICA. Procedure times were significantly reduced in the
selective CTCA + ICA group compared to the non-selective CTCA + ICA group
(-5.82min, 95% CI -7.99 to -3.65, p < 0.001) along with reduction of CIN
(1.5% vs 5.8%, OR 0.26, 95% CI 0.10 to 0.98). No difference was seen in
patient satisfaction with the ICA, however procedural complications (0.9%
vs 4.7%, OR 0.21, 95% CI 0.09-0.87) and 1-year major adverse cardiac
events (13.1% vs 20.9%, HR 0.55, 95% CI 0.32-0.96) were significantly
lower in the selective group. <br/>Conclusion(s): In patients with prior
CABG, CTCA guided selective angiographic assessment of bypass grafts is
associated with improved procedural parameters, lower complication rates
and better 12-month outcomes. Taken in addition to the main findings of
the BYPASS-CTCA trial, these results suggest a synergistic approach
between CTCA and ICA should be considered in this patient group.
Registration: ClinicalTrials.gov, NCT03736018.<br/>Copyright &#xa9; 2024
Society of Cardiovascular Computed Tomography

<31>
Accession Number
2029584225
Title
Individualized rotation of left double lumen endobronchial tube to improve
placement success rate: a randomized controlled trial.
Source
Respiratory Research. 25(1) (no pagination), 2024. Article Number: 184.
Date of Publication: December 2024.
Author
Zhou H.; Fei Y.; Zhang Y.; Quan X.; Yi J.
Institution
(Zhou, Fei, Quan, Yi) Department of Anaesthesiology, Peking Union Medical
College Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, China
(Zhang) Medical Research Centre, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: In conventional practice, the left double lumen tube (DLT) is
rotated 90degree counterclockwise when the endobronchial cuff passes
glottis. Success rate upon the first attempt is < 80%, likely owing to
varying morphology of the bronchial bifurcation. <br/>Method(s): We
conducted a randomized controlled trial to compare 90degree
counterclockwise rotation versus individualized degree of rotation in
adult patients undergoing elective thoracic surgery using left DLT. The
degree of rotation in the individualized group was based on the angle of
the left main bronchi as measured on computed tomography (CT). The primary
outcome was the first attempt left DLT placement success rate.
<br/>Result(s): A total of 556 patients were enrolled: 276 in the control
group and 280 in the individualized group. The average angle of the left
main bronchi was 100.6+/-9.5degree (range 72degree to 119degree). The
first attempt left DLT placement success rate was 82.6% (228/276) in the
control group versus 91.4% (256/280) in the individualized group (P=0.02,
chi2 test). The rate of carina mucosal injury, as measured at 30 min after
the start of surgery under fibreoptic bronchoscopy, was significantly
lower in individualized group than control group (14.0% versus 19.6%,
P=0.041). The individualized group also had lower rate of postoperative
sore throat (29.4% versus 44.0%, P<0.001) and hoarseness (16.8% versus
24.7%, P<0.05). <br/>Conclusion(s): Individualized rotation of left DLT
based on the angle of the left main bronchi on preoperative CT increased
first attempt success rate in adult patients undergoing elective thoracic
surgery. Trial registration: The trial is registered at Chinese Clinical
Trial Registry (ChiCTR2100053349; principal investigator Xiang Quan, date
of registration November 19, 2021).<br/>Copyright &#xa9; The Author(s)
2024.

<32>
Accession Number
2029544912
Title
Randomized investigation of the MitraClip device in heart failure: Design
and rationale of the RESHAPE-HF2 trial design.
Source
European Journal of Heart Failure. (no pagination), 2024. Date of
Publication: 2024.
Author
Anker S.D.; Friede T.; von Bardeleben R.S.; Butler J.; Fatima K.; Diek M.;
Heinrich J.; Hasenfuss G.; Schillinger W.; Ponikowski P.
Institution
(Anker, Diek) Department of Cardiology (CVK) of German Heart Center
Charite, German Centre for Cardiovascular Research (DZHK) partner site
Berlin, Charite Universitatsmedizin, Berlin, Germany
(Friede) Department of Medical Statistics, University Medical Center
Gottingen, German Centre for Cardiovascular Research (DZHK), partner site
Gottingen, Gottingen, Germany
(von Bardeleben) Zentrum fur Kardiologie, Johannes-Gutenberg-Universitat,
Mainz, Germany
(Butler) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Fatima) Department of Research, Baylor Scott and White Research
Institute, Dallas, TX, United States
(Heinrich) Clinical Trial Unit, University Medical Center Gottingen,
Gottingen, Germany
(Hasenfus) Heart Research Center Gottingen, Clinic for Cardiology and
Pneumology, University Medical Center Gottingen, Gottingen, Germany
(Schillinger) Heart Center, Department of Cardiology,
Georg-August-University Gottingen, Gottingen, Germany
(Ponikowski) Institute of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The safety and effectiveness of the MitraClip device to treat
functional mitral regurgitation (FMR) has been tested in previous clinical
trials yielding somewhat heterogeneous results in heart failure (HF)
patients. Over time, the MitraClip device system has been modified and
clinical practice evolved to consider also less severely diseased HF
patients with FMR for this therapeutic option. The RESHAPE-HF2 trial aims
to assess the safety and effectiveness of the MitraClip device system on
top of medical therapy considered optimal in the treatment of clinically
significant FMR in symptomatic patients with chronic HF. <br/>Method(s):
The RESHAPE-HF2 is an investigator-initiated, prospective, randomized,
parallel-controlled, multicentre trial designed to evaluate the use of the
MitraClip device (used in the most up-to-date version as available at
sites) plus optimal standard of care therapy (device group) compared to
optimal standard of care therapy alone (control group). Eligible subjects
have signs and symptoms of HF (New York Heart Association [NYHA] class
II-IV despite optimal therapy), and have moderate-to-severe or severe FMR,
as confirmed by a central echocardiography core laboratory; have an
ejection fraction between >=20% and <=50% (initially 15-35% for NYHA class
II patients, and 15-45% for NYHA class III/IV patients); have been
adequately treated per applicable standards, and have received appropriate
revascularization and cardiac resynchronization therapy, if eligible; had
a HF hospitalization or elevated natriuretic peptides (B-type natriuretic
peptide [BNP] >=300 pg/ml or N-terminal proBNP >=1000 pg/ml) in the last
90 days; and in whom isolated mitral valve surgery is not a recommended
treatment option. The trial has three primary endpoints, which are these:
(i) the composite rate of total (first and recurrent) HF hospitalizations
and cardiovascular death during 24 months of follow-up, (ii) the rate of
total (i.e. first and recurrent) HF hospitalizations within 24 months, and
(iii) the change from baseline to 12 months in the Kansas City
Cardiomyopathy Questionnaire overall score. The three primary endpoints
will be analysed using the Hochberg procedure to control the familywise
type I error rate across the three hypotheses. <br/>Conclusion(s): The
RESHAPE-HF2 trial will provide sound evidence on the MitraClip device and
its effects in HF patients with FMR. The recruitment was recently
completed with 506 randomized patients.<br/>Copyright &#xa9; 2024 The
Authors. European Journal of Heart Failure published by John Wiley & Sons
Ltd on behalf of European Society of Cardiology.

<33>
Accession Number
2029544283
Title
A systematic review of cardiac surgery clinical prediction models that
include intra-operative variables.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Jones C.; Taylor M.; Sperrin M.; Grant S.W.
Institution
(Jones, Sperrin) Division of Informatics, Imaging and Data Science,
Faculty of Biology, Medicine and Health, Manchester Academic Health
Science Centre, University of Manchester, Manchester, United Kingdom
(Jones) Department of Clinical Perfusion, University Hospital Southampton
NHS Foundation Trust, Southampton General Hospital, Southampton, United
Kingdom
(Taylor) Department of Cardiothoracic Surgery, Manchester University
Hospital Foundation Trust, Wythenshawe Hospital, Manchester, United
Kingdom
(Grant) Division of Cardiovascular Sciences, ERC, Manchester University
Hospitals Foundation Trust, University of Manchester, Manchester, United
Kingdom
(Grant) South Tees Academic Cardiovascular Unit, South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: Most cardiac surgery clinical prediction models (CPMs) are
developed using pre-operative variables to predict post-operative
outcomes. Some CPMs are developed with intra-operative variables, but none
are widely used. The objective of this systematic review was to identify
CPMs with intra-operative variables that predict short-term outcomes
following adult cardiac surgery. <br/>Method(s): Ovid MEDLINE and EMBASE
databases were searched from inception to December 2022, for studies
developing a CPM with at least one intra-operative variable. Data were
extracted using a critical appraisal framework and bias assessment tool.
Model performance was analysed using discrimination and calibration
measures. <br/>Result(s): A total of 24 models were identified. Frequent
predicted outcomes were acute kidney injury (9/24 studies) and
peri-operative mortality (6/24 studies). Frequent pre-operative variables
were age (18/24 studies) and creatinine/eGFR (18/24 studies). Common
intra-operative variables were cardiopulmonary bypass time (16/24 studies)
and transfusion (13/24 studies). Model discrimination was acceptable for
all internally validated models (AUC 0.69-0.91). Calibration was poor
(15/24 studies) or unreported (8/24 studies). Most CPMs were at a high or
indeterminate risk of bias (23/24 models). The added value of
intra-operative variables was assessed in six studies with statistically
significantly improved discrimination demonstrated in two.
<br/>Conclusion(s): Weak reporting and methodological limitations may
restrict wider applicability and adoption of existing CPMs that include
intra-operative variables. There is some evidence that CPM discrimination
is improved with the addition of intra-operative variables. Further work
is required to understand the role of intra-operative CPMs in the
management of cardiac surgery patients.<br/>Copyright &#xa9; The Author(s)
2024.

<34>
Accession Number
2028652449
Title
Use of high-flow nasal cannula versus other noninvasive ventilation
techniques or conventional oxygen therapy for respiratory support
following pediatric cardiac surgery: A systematic review and
meta-analysis.
Source
Paediatric Anaesthesia. 34(6) (pp 519-531), 2024. Date of Publication:
June 2024.
Author
Elmitwalli I.; Abdelhady E.; Kalsotra S.; Gehred A.; Tobias J.; Olbrecht
V.A.
Institution
(Elmitwalli, Kalsotra, Tobias, Olbrecht) Department of Anesthesiology and
Pain Medicine, Nationwide Children's Hospital, Columbus, OH, United States
(Abdelhady) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Gehred) Grant Morrow III Library, Nationwide Children's Hospital and The
Ohio State University, Columbus, OH, United States
(Tobias, Olbrecht) Department of Anesthesiology and Pain Medicine, The
Ohio State University College of Medicine, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Noninvasive respiratory support may be provided to decrease
the risk of postextubation failure following surgery. Despite these
efforts, approximately 3%-27% of infants and children still experience
respiratory failure after tracheal extubation following cardiac surgery.
This systematic review evaluates studies comparing the efficacy of
high-flow nasal cannula to conventional oxygen therapy such as nasal
cannula and other noninvasive ventilation techniques in preventing
postextubation failure in this patient population. <br/>Method(s): A
systematic and comprehensive search was conducted in major databases
including MEDLINE, EMBASE, Web of Science, and Central. The search
encompassed articles focusing on the prophylactic use of high-flow nasal
cannula following tracheal extubation in pediatric patients undergoing
cardiac surgery for congenital heart disease. The inclusion criteria for
this review consisted of randomized clinical trials as well as
observational, cohort, and case-control studies. <br/>Result(s): A total
of 1295 studies were screened and 12 studies met the inclusion criteria.
These 12 studies included a total of 1565 children, classified into three
groups: seven studies compared high-flow nasal cannula to noninvasive
ventilation techniques, four studies compared high-flow nasal cannula to
conventional oxygen therapy, and one observational single-arm study
explored the use of high-flow nasal cannula with no control group. There
was no significant difference in the incidence of tracheal reintubation
between high-flow nasal cannula and conventional oxygen therapy (risk
ratio [RR] = 0.67, 95% confidence interval [CI]: 0.24-1.90, p =.46).
However, there was a lower incidence of tracheal reintubation in patients
who were extubated to high-flow nasal cannula versus those extubated to
noninvasive ventilation techniques (RR = 0.45, 95% CI: 0.32-0.63, p <.01).
The high-flow nasal cannula group also demonstrated a lower mortality rate
compared to the noninvasive ventilation techniques group (RR = 0.31, 95%
CI: 0.16-0.61, p <.01) as well as a shorter postoperative length of stay
(mean difference = -8.76 days, 95% CI: -13.08 to -4.45, p <.01) and
shorter intensive care length of stay (mean difference = -4.63 days, 95%
CI: -9.16 to -0.11, p =.04). <br/>Conclusion(s): High-flow nasal cannula
is more effective in reducing the rate of postextubation failure compared
to other forms of noninvasive ventilation techniques following surgery for
congenital heart disease in pediatric-aged patients. high-flow nasal
cannula is also associated with lower mortality rates and shorter length
of stay. However, when comparing high-flow nasal cannula to conventional
oxygen therapy, the findings were inconclusive primarily due to a limited
number of scientific studies available on this specific comparison. Future
study is needed to further define the benefit of high-flow nasal cannula
compared to conventional oxygen therapy and various types of noninvasive
ventilation techniques.<br/>Copyright &#xa9; 2024 John Wiley & Sons Ltd.

<35>
[Use Link to view the full text]
Accession Number
643441981
Title
Vascular complications and outcomes following transcatheter aortic valve
replacement in patients on chronic steroid therapy: a meta-analysis.
Source
International journal of surgery (London, England). 110(4) (pp 2421-2429),
2024. Date of Publication: 01 Apr 2024.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Hanif M.; Vadhera A.; Gautam S.; Raut A.;
Rafaqat S.; Borra V.R.; Khandait H.; Shrestha A.B.; Iglesias J.
Institution
(Ang) Department of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Chia) Department of Medicine, International Medical University, Malaysia
(Jaiswal) JCCR Cardiology Research, Varanasi, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, United States
(Vadhera) Department of Medicine, Maulana Azad Medical College, New Delhi,
India
(Gautam) Department of Internal Medicine, Maimonides Medical Center,
United States
(Raut) Department of Internal Medicine, Nepal Medical College, Nepal
(Rafaqat) Department of Zoology (Molecular Physiology), Lahore College for
Women University, Lahore, Pakistan
(Borra) Department of Internal Medicine, University of Texas Rio Grande
Valley, Edinburg, TX, United States
(Khandait) Department of Internal Medicine, Trinitas Regional Medical
Center/RWJ Barnabas Health, Elizabeth, NJ, United States
(Shrestha) Department of Internal Medicine, Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Iglesias) Department of Critical Care, Rutgers Health/Community Medical
Center, NJ, United States
Abstract
BACKGROUND: Chronic steroid (CS) therapy was reportedly linked to
increased vascular complications following percutaneous coronary
intervention. However, its association with vascular complications after
transcatheter aortic valve replacement (TAVR) remained uncertain, with
conflicting results being reported. <br/>OBJECTIVE(S): The authors aimed
to compare the rate of vascular complications and outcomes between
patients with and without CS use after TAVR. <br/>METHOD(S): The authors
conducted a comprehensive literature search in PubMed, Embase, and
Cochrane databases from their inception until 18th April 2022 for relevant
studies. Endpoints were described according to Valve Academic Research
Consortium-2 definitions. Effect sizes were pooled using DerSimonian and
Laird random-effects model as risk ratio (RR) with 95% CI. <br/>RESULT(S):
Five studies with 6136 patients undergoing TAVR were included in the
analysis. The included studies were published between 2015 and 2022. The
mean ages of patients in both study groups were similar, with the CS group
averaging 80 years and the nonsteroid group averaging 82 years. Notably, a
higher proportion of patients in the CS group were female (56%) compared
to the nonsteroid group (54%). CS use was associated with a significantly
higher risk of major vascular complications (12.5 vs. 6.7%, RR 2.32, 95%
CI: 1.73-3.11, P <0.001), major bleeding (16.8 vs. 13.1%, RR 1.61, 95% CI:
1.27-2.05, P <0.001), and aortic annulus rupture (2.3 vs. 0.6%, RR 4.66,
95% CI: 1.67-13.01, P <0.001). There was no significant difference in
terms of minor vascular complications (RR 1.43, 95% CI: 1.00-2.04, P
=0.05), in-hospital mortality (2.3 vs. 1.4%, RR 1.86, 95% CI: 0.74-4.70, P
=0.19), and 30-day mortality (2.9 vs. 3.1%, RR 1.14, 95% CI: 0.53-2.46, P
=0.74) between both groups. <br/>CONCLUSION(S): Our study showed that CS
therapy is associated with increased major vascular complications, major
bleeding, and annulus rupture following TAVR. Further large multicenter
studies or randomized controlled trials are warranted to validate these
findings.<br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<36>
Accession Number
642686117
Title
The Application Value of Esketamine and Dexmedetomidine in Preventing
Postoperative Delirium and Hyperalgesia in Elderly Patients with Thoracic
Anesthesia.
Source
Alternative therapies in health and medicine. 30(3) (pp 80-85), 2024. Date
of Publication: 01 Mar 2024.
Author
Lu Y.; Yin G.; Jin C.; Gu K.; Bao D.; Xu W.; Yang Z.
Abstract
Objective: Our aim was to evauate the application value of esesketamine
and dexmedetomidine in preventing postoperative hyperalgesia in elderly
patients who received thoracic anesthesia. <br/>Method(s): A total of 94
elderly patients who underwent thoracic anesthesia in Sanmen People's
Hospital from January 2021 to October 2022 were selected and divided into
a dexmedetomidine group (n = 47) and an esketamine group (n = 47) by the
random number table method. All patients were continuously received
intravenous (IV) remifentanil. In the dexmedetomidine group,
dexmedetomidine 0.7 mug/kg was administered IV, followed by 0.2 to 0.5
mug/kg/h to maintain anesthesia, while in the esketamine group, esketamine
0.5 mg/kg was given IV 20 min after induction of anesthesia was completed.
<br/>Result(s): Visual analogue scale (VAS) scores in the esketamine group
were lower than in the dexmedetomidine group at 1, 6, 12 and 24 h
postoperatively (P < .05), and Ramsay sedation scores were not
statistically different from those in the dexmedetomidine group (P > .05).
At 3 d postoperatively, the Mini-Mental State Examination (MMSE) scores in
the dexmedetomidine group were lower than 1 d preoperatively; at 5 d
postoperatively, the negative mood and Pittsburgh Sleep Quality Index
(PSQI) scores were significantly higher in both groups than 1 d
preoperatively; at 14 d postoperatively, the PSQI scores were higher in
both groups than 1 d preoperatively, and there was no statistical
difference between the negative mood scores at 1 d before surgery (P >
.05). At 5 d postoperatively in the esketamine group, the negative mood
scores were lower than in the dexmedetomidine group at 5 d postoperatively
and the PSQI scores at 5 and 14 d postoperatively were lower than in the
dexmedetomidine group (P < .05). <br/>Conclusion(s): Both esketamine and
dexmedetomidine can be used to prevent postoperative delirium and
nociceptive hypersensitivity after anesthesia in elderly patients with
thoracic surgery. However, esketamine is superior to dexmedetomidine in
analgesic effect, improvement of negative mood and sleep and stabilization
of intraoperative hemodynamics, leading to better effect in preventing
delirium and hyperalgesia after anesthesia.

<37>
Accession Number
2031636435
Title
Effectiveness of Cardiac Rehabilitation With mHealth Through Smartphone
Functionalities: A Systematic Review Protocol.
Source
CJC Open. 6(4) (pp 672-676), 2024. Date of Publication: April 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

<38>
Accession Number
2031869853
Title
Application of Three-Dimensional Printing Technology in the Perioperative
Management of Cardiac Tumours: A Review and Analysis.
Source
Reviews in Cardiovascular Medicine. 25(3) (no pagination), 2024. Date of
Publication: 2024.
Author
Wang H.; Liang J.; Zhang G.; He D.; Du B.; Ren Z.; Dai Z.; Lee H.; Li D.
Institution
(Wang, Zhang, He, Du, Ren, Dai, Lee, Li) Department of Cardiovascular
Surgery, The Affiliated Suzhou Hospital, Nanjing Medical University,
Suzhou Municipal Hospital, Gusu School, Nanjing Medical University,
Jiangsu, Suzhou 215008, China
(Liang) The State Key Laboratory for Manufacturing Systems Engineering,
Xi'an Jiaotong University, Shaanxi, Xi'an 710000, China
Publisher
IMR Press Limited
Abstract
Background: Multimodal imaging plays a crucial role in evaluating
suspected cardiac tumours. In recent years, three-dimensional (3D)
printing technology has continued to advance such that image-based
3D-printed models have been incorporated into the auxiliary diagnosis and
treatment of cardiac tumour diseases. The purpose of this review is to
analyze the existing literature on the application of 3D printing in
cardiac tumour surgery to examine the current status of the application of
this technology. <br/>Method(s): By searching PubMed, Cochrane, Scopus and
Google Scholar, as well as other resource databases, a completed review of
the available literature was performed. Effect sizes from published
studies were investigated, and results are presented concerning the use of
3D surgical planning in the management of cardiac tumours. <br/>Result(s):
According to the reviewed literature, our study comes to the point that 3D
printing is a valuable technique for planning surgery for cardiac tumours.
As shown in the review report, Mucinous and sarcomatous tumours are the
most commonly used tumours for 3D printing, magnetic resonance imaging
(MRI) and computed tomography (CT) are the most commonly used technologies
for preparing 3D printing models, the main printing technology is
stereolithography, and the most used 3D modeling software is Mimics. The
printing time and cost required for 3D printing are affected by factors
such as the size of the type, complexity, the printed material and the 3D
printing technology used. The reported research shows that 3D printing can
understand the anatomy of complex tumour cases, virtual surgical
simulation, as well as facilitate doctor-patient communication and
clinical teaching. <br/>Conclusion(s): These results show that the
development of 3D printing technology has brought more accurate and safe
perioperative treatment options for patients with cardiac tumours.
Therefore, 3D printing technology is expected to become a routine clinical
diagnosis and treatment tool for cardiac tumours. <br/>Copyright &#xa9;
2024 The Author(s).

<39>
Accession Number
2031843461
Title
A double-blind, randomised, placebo-controlled trial of the coronary sinus
Reducer in refractory angina: design and rationale of the ORBITA-COSMIC
trial.
Source
EuroIntervention. 20(3) (pp E216-E223), 2024. Date of Publication: 05 Feb
2024.
Author
Foley M.J.; Rajkumar C.A.; Ahmed-Jushuf F.; Simader F.; Pathimagaraj R.H.;
Nijjer S.; Sen S.; Petraco R.; Clesham G.; Johnson T.; Harrell F.E.;
Kellman P.; Francis D.; Shun-Shin M.; Howard J.; Cole G.D.; Al-Lamee R.
Institution
(Foley, Rajkumar, Ahmed-Jushuf, Simader, Pathimagaraj, Nijjer, Sen,
Petraco, Francis, Shun-Shin, Howard, Cole, Al-Lamee) National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Foley, Rajkumar, Pathimagaraj, Nijjer, Sen, Petraco, Francis, Shun-Shin,
Howard, Cole, Al-Lamee) Imperial College Healthcare NHS Trust, London,
United Kingdom
(Clesham) Essex Cardiothoracic Centre, Basildon, United Kingdom
(Johnson) Bristol Heart Institute, University Hospitals Bristol NHS
Foundation Trust, Bristol, United Kingdom
(Harrell) Vanderbilt University School of Medicine, Nashville, TN, United
States
(Kellman) National Heart, Lung, and Blood Institute, National Institutes
of Health, Department of Health and Human Services, Bethesda, MD, United
States
Publisher
Europa Group
Abstract
The coronary sinus Reducer (CSR) is an hourglass-shaped device which
creates an artificial stenosis in the coronary sinus. Whilst
placebo-controlled data show an improvement in angina, these results are
unreplicated and are the subject of further confirmatory research. The
mechanism of action of this unintuitive therapy is unknown. The Coronary
Sinus Reducer Objective Impact on Symptoms, MRI Ischaemia, and
Microvascular Resistance (ORBITA-COSMIC) trial is a randomised,
placebo-controlled, double-blind trial investigating the efficacy of the
CSR. Patients with (i) established epicardial coronary artery disease,
(ii) angina on maximally tolerated antianginal medication, (iii) evidence
of myocardial ischaemia and (iv) no further options for percutaneous
coronary intervention or coronary artery bypass grafting will be enrolled.
Upon enrolment, angina and quality-of-life questionnaires, treadmill
exercise testing and quantitative stress perfusion cardiac magnetic
resonance (CMR) imaging will be performed. Participants will record their
symptoms daily on a smartphone application throughout the trial. After a
2-week symptom assessment phase, participants will be randomised in the
cardiac catheterisation laboratory to CSR or a placebo procedure. After 6
months of blinded follow-up, all prerandomisation tests will be repeated.
A prespecified subgroup will undergo invasive coronary physiology
assessment at prerandomisation and follow-up. The primary outcome is
stress myocardial blood flow on CMR. Secondary outcomes include angina
frequency, quality of life and treadmill exercise time.<br/>Copyright
&#xa9; Europa Digital & Publishing 2024 All rights reserved.

<40>
Accession Number
2031831169
Title
Fascia Iliaca Block Reduces Remifentanil Requirement in Conscious Sedation
for Transcatheter Aortic Valve Implantation.
Source
Circulation Journal. 88(4) (pp 475-482), 2024. Date of Publication: April
2024.
Author
Kinoshita H.; Yamamoto M.; Adachi Y.; Yamaguchi R.; Takemura A.
Institution
(Kinoshita) Department of Dental Anesthesiology, Institute of Biomedical
Sciences, Tokushima University Graduate School, Tokushima, Japan
(Kinoshita) Department of Anesthesiology and Intensive Care, Hamamatsu
Medical University, Hamamatsu, Japan
(Kinoshita) Department of Anesthesiology, Toyohashi Heart Center,
Toyohashi, Japan
(Yamamoto, Adachi, Yamaguchi, Takemura) Department of Cardiology,
Toyohashi Heart Center, Toyohashi, Japan
Publisher
Japanese Circulation Society
Abstract
Background: Whether nerve block improves the quality of conscious sedation
(CS) in patients undergoing transcatheter aortic valve implantation (TAVI)
is unclear. This study investigated whether fascia iliaca block (FIB)
reduced the remifentanil requirement and relieved pain in CS for TAVI.
<br/>Methods and Results: This prospective study randomized 72 patients
scheduled for elective TAVI under CS into 2 groups, with (FIB) and without
(control) FIB (n=36 in each group). The sedation targeted a Bispectral
Index <90 with a Richmond Agitation-Sedation Scale of -2 to -1.
Dexmedetomidine (0.7 mug/kg, i.v.) combined with remifentanil (0.03
mug/kg/min, i.v.) and propofol (0.3 mg/kg/h, i.v.) was used to commence
sedation. FIB using 30 mL of 0.185% ropivacaine was implemented 2 min
before TAVI. Patient sedation was maintained with dexmedetomidine (0.4
mug/kg/h, i.v.) supplemented with remifentanil (0-0.02 mug/kg/min, i.v.).
Remifentanil (20 mug, i.v.) was used as a rescue dose for intraprocedural
pain. Compared with the control group, FIB reduced the both the total
(median [interquartile range] 83.0 [65.0-98.0] vs. 34.5 [26.0/45.8)] mug;
P<0.001) and continuous (25.3 [20.9/31.5] vs. 9.5 [6.8/12.5] ng/kg/min;
P<0.001) doses of remifentanil administered. <br/>Conclusion(s): FIB
reduced the remifentanil requirement and relieved pain in patients
undergoing TAVI with CS. Therefore, FIB improved the quality of CS in
TAVI.<br/>Copyright &#xa9; 2024 Japanese Circulation Society. All rights
reserved.

<41>
Accession Number
2029554075
Title
Upper extremity versus lower extremity for secondary access during
transcatheter aortic valve implantation: rationale and design of the
randomised TAVI XS trial.
Source
Netherlands Heart Journal. (no pagination), 2024. Date of Publication:
2024.
Author
Rooijakkers M.J.P.; Versteeg G.A.A.; Hemelrijk K.I.; Aarts H.M.; Overduin
D.C.; van Ginkel D.-J.; Vlaar P.J.; van Wely M.H.; van Nunen L.X.; van
Geuns R.J.; van Garsse L.A.F.M.; Geuzebroek G.S.C.; Verkroost M.W.A.;
Rodwell L.; Heijmen R.H.; Tonino P.A.L.; ten Berg J.M.; Delewi R.; van
Royen N.
Institution
(Rooijakkers, Versteeg, van Wely, van Nunen, van Geuns, van Royen)
Department of Cardiology, Radboud University Medical Centre, Nijmegen,
Netherlands
(Hemelrijk, Aarts, Delewi) Department of Cardiology, Amsterdam University
Medical Centre, Amsterdam, Netherlands
(Overduin, van Ginkel, ten Berg) Department of Cardiology, St. Antonius
Hospital, Nieuwegein, Netherlands
(Vlaar, Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(van Garsse, Geuzebroek, Verkroost, Heijmen) Department of Cardiothoracic
Surgery, Radboud University Medical Centre, Nijmegen, Netherlands
(Rodwell) Department of Health Sciences, Section Biostatistics, Radboud
Institute for Health Sciences, Nijmegen, Netherlands
(ten Berg) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Background: During transcatheter aortic valve implantation (TAVI),
secondary access is required for angiographic guidance and temporary
pacing. The most commonly used secondary access sites are the femoral
artery (angiographic guidance) and the femoral vein (temporary pacing). An
upper extremity approach using the radial artery and an upper arm vein
instead of the lower extremity approach using the femoral artery and
femoral vein may reduce clinically relevant secondary access site-related
bleeding complications, but robust evidence is lacking. Trial design: The
TAVI XS trial is a multicentre, randomised, open-label clinical trial with
blinded evaluation of endpoints. A total of 238 patients undergoing
transfemoral TAVI will be included. The primary endpoint is the incidence
of clinically relevant bleeding (i.e. Bleeding Academic Research
Consortium (BARC) type 2, 3 or 5 bleeding) of the randomised secondary
access site (either diagnostic or pacemaker access, or both) within 30
days after TAVI. Secondary endpoints include time to mobilisation after
TAVI, duration of hospitalisation, any BARC type 2, 3 or 5 bleeding, and
early safety at 30 days according to Valve Academic Research Consortium-3
criteria. <br/>Conclusion(s): The TAVI XS trial is the first randomised
trial comparing an upper extremity approach to a lower extremity approach
with regard to clinically relevant secondary access site-related bleeding
complications. The results of this trial will provide important insights
into the safety and efficacy of an upper extremity approach in patients
undergoing transfemoral TAVI.<br/>Copyright &#xa9; The Author(s) 2024.

<42>
Accession Number
644096370
Title
Thoracoscopic blood patch instillation for persistent air leak in
pneumothorax: a case series and systematic review.
Source
Monaldi archives for chest disease = Archivio Monaldi per le malattie del
torace. (no pagination), 2024. Date of Publication: 05 Apr 2024.
Author
Kedia Y.; Madan M.; Kaushik R.; Kumar R.; Mahendran A.J.; Ish P.; Talukdar
T.; Gupta N.
Institution
(Kedia) Department of Pulmonary and Critical Care Medicine, VMMC and
Safdarjung Hospital, New Delhi, India
(Madan, Kaushik, Ish, Gupta, Talukdar, Gupta) Department of Pulmonary and
Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India
(Kumar) Department of Pulmonary Medicine, VMMC and Safdarjung Hospital,
New Delhi, India
(Mahendran) Department of Pulmonary and Critical Care Medicine, VMMC and
Safdarjung Hospital, Delhi, India
Abstract
Persistent air leaks in patients with pneumothorax can lead to significant
morbidity. If a patient with persistent air leak is medically unfit for
thoracic surgery, medical pleurodesis via chest tube or thoracoscopy is
either an option. Thoracoscopy offers the advantage of visualizing the
site of the air leak and enabling direct instillation of the pleurodesis
agent or glue at that location. Autologous blood patch instillation via
chest tube has been reported to be a cheap and very effective technique
for the management of persistent air leaks. However, thoracoscopic blood
patch instillation has not been reported in the literature. We report two
cases of secondary spontaneous pneumothorax in which patients had
persistent air leaks for more than seven days and were subjected to
thoracoscopy to locate the site of the leak. In the same sitting, 50 mL of
autologous blood patch was instilled directly at the leak site.
Post-procedure, the air leak subsided in both patients, and the chest tube
was removed with complete lung expansion. We also conducted a systematic
review of the use of medical thoracoscopic interventions for treating
persistent air leaks.

<43>
Accession Number
644084825
Title
Effects of dexmedetomidine on renal function after cardiac surgery for
infective endocarditis: An interim analysis of a randomized controlled
trial.
Source
Asian journal of surgery. (no pagination), 2024. Date of Publication: 23
Apr 2024.
Author
Ham S.Y.; Shim J.-K.; Lee S.; Ko S.H.; Soh S.; Kwak Y.-L.
Institution
(Ham, Shim, Ko, Soh, Kwak) Department of Anesthesiology and Pain Medicine,
Yonsei University College of Medicine, Seoul, Republic of Korea;
Anesthesia and Pain Research Institute, Yonsei University College of
Medicine, Seoul, Republic of Korea
(Lee) Department of Thoracic and Cardiovascular Surgery, Yonsei University
College of Medicine, Seoul, South Korea
Abstract
BACKGROUND: Patients undergoing cardiac surgery for infective endocarditis
(IE) are at a high risk of postoperative acute kidney injury (AKI) owing
to heightened systemic inflammation. Therefore, we aimed to investigate
the effect of dexmedetomidine on postoperative AKI in patients who
underwent cardiac surgery for IE. <br/>METHOD(S): A total of 63 patients
who underwent cardiac surgery for IE were randomly assigned to receive
either intravenous dexmedetomidine infusion of 0.4 mug kg-1 h-1 (DEX
group) or normal saline infusion (control group) for 24 h after induction
of anesthesia. The occurrence of AKI within seven days postoperation,
epinephrine, norepinephrine, and interleukin-6 levels, as well as
postoperative morbidities, were assessed. An intertrim analysis was
conducted using Pocock's alpha spending function at alpha = 0.05 and beta
= 0.2. <br/>RESULT(S): This trial was early terminated according to the
results of interim analysis performed when 60 % of the pre-set number of
patients have been collected. The incidence of AKI was significantly lower
in the DEX group than in the control group (32.3 % vs. 9.4 %, p = 0.025).
Patients in the DEX group had significantly lower epinephrine levels than
those in the control group, whereas norepinephrine and interleukin-6
levels were similar. Perioperative mean arterial pressure or heart rate
did not differ between the groups. <br/>CONCLUSION(S): Dexmedetomidine
administration for 24 h starting from induction of anesthesia
significantly reduced the incidence of postoperative AKI after cardiac
surgery for IE (by 29 % vs. control) without hemodynamic side effects.
This was accompanied by a significant attenuation of postoperative
increase in serum epinephrine levels.<br/>Copyright &#xa9; 2024 Asian
Surgical Association and Taiwan Society of Coloproctology. Published by
Elsevier B.V. All rights reserved.

<44>
Accession Number
644083349
Title
The impact of permanent pacemaker implantation on long-term survival
following cardiac surgery; A systematic review and meta-analysis.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 22 Apr 2024.
Author
Sakurai Y.; Mehaffey J.H.; Kuno T.; Yokoyama Y.; Takagi H.; Denning D.A.;
Kaneko T.; Badhwar V.
Institution
(Sakurai, Denning) Department of Surgery, Marshall University Joan Edwards
School of Medicine, Huntington, WV, United States
(Mehaffey, Badhwar) Department of Cardiovascular and Thoracic Surgery,
West Virginia University, Morgantown, WV, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, NY, United States
(Yokoyama) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St
Louis, St Louis, Mo, United States
Abstract
OBJECTIVES: The long-term impact of permanent pacemaker (PPM) implantation
on survival following cardiac surgery remains ill defined. We aimed to
investigate the impact of PPM on survival and explore factors driving
outcomes using meta-regression according to the type of surgery.
<br/>METHOD(S): MEDLINE, EMBASE, and CENTRAL were searched through October
2023 to identify studies reporting the long-term outcomes of PPM
implantation. The primary outcome was all-cause mortality during
follow-up. The secondary outcome was heart failure rehospitalization. The
subgroup analysis and meta-regression analysis were performed according to
the type of surgery. <br/>RESULT(S): A total of 28 studies met the
inclusion criteria. 183,555 patients (n = 6,298; PPM, n = 177,257; no PPM)
were analyzed for all-cause mortality, with a weighted median follow-up of
79.7 months. PPM implantation was associated with increased risks of
all-cause mortality during follow-up (HR 1.22; 1.08-1.38, P < 0.01) and
heart failure rehospitalization (HR 1.24; 1.01-1.52, P = 0.04).
Meta-regression demonstrated the adverse impact of PPM was less prominent
in patients undergoing mitral or tricuspid valve surgery, while studies
with a higher proportion with aortic valve replacement were associated
with worse outcomes. Similarly, a higher proportion with atrioventricular
block as an indication of PPM was associated with worse survival.
<br/>CONCLUSION(S): PPM implantation following cardiac surgery is
associated with a higher risk of long-term all-cause mortality and heart
failure rehospitalization. This impact is more prominent in patients
undergoing aortic valve surgery or atrioventricular block as an indication
than those undergoing mitral or tricuspid valve surgery.<br/>Copyright
&#xa9; 2024. Published by Elsevier Inc.

<45>
Accession Number
644078398
Title
Use of Wearable Devices to Monitor Postoperative Activity following
Cardiac Surgery. A Systematic Scoping Review.
Source
European journal of cardiovascular nursing. (no pagination), 2024. Date
of Publication: 22 Apr 2024.
Author
Edney J.; McDonall J.; Khaw D.; Hutchinson A.F.
Institution
(Edney) Cardiac Ward at Epworth HealthCare, 189 Bridge Rd, Richmond,
Melbourne, Victoria, Australia
(McDonall, Khaw, Hutchinson) Deakin University School of Nursing &
Midwifery, Institute of Health Transformation - Centre for Quality and
Patient Safety Research - Epworth HealthCare Partnership, Melbourne, VIC,
Australia
Abstract
AIM: There is an emerging trend of using wearable digital technology to
monitor patient activity levels in acute care contexts. However, the
overall extent and quality of evidence for their use in acute cardiac
surgery care is unclear. The purpose of this systematic scoping review was
to evaluate current literature regarding the use of wearable activity
trackers/accelerometers to monitor patient activity levels in the first
30-days following cardiac surgery. <br/>METHOD(S): A systematic scoping
review was conducted. A search of CINAHL and MEDLINE Complete databases
identified all peer reviewed research evidence published in English
between 2010 and 2023. Studies evaluating the use of wearable, technology
in adults who had undergone coronary bypass graft surgery (CAGS),
and/valve replacement (VR) were included. Study data was summarised
thematically. <br/>RESULT(S): A total of 853 citations were identified.
Once duplicates were removed, 816 studies were screened by title and
abstract, 54 full-text studies were assessed for eligibility and 11
studies included. Accelerometers were able to capture changing exercise
and physical activity levels over an acute care admission. Device use was
acceptable to clinicians and patients. Low activity levels in the early
postoperative period were associated with longer length of stay and higher
30-day readmissions. <br/>CONCLUSION(S): Wearable devices are acceptable
and feasible to use in acute care. Use of wearable activity trackers by
acute cardiac patients may increase patient participation in exercise and
identify more sedentary patients who are a greater risk of increased
length of stay and hospital readmission.<br/>Copyright &#xa9; The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<46>
Accession Number
644084347
Title
Efficacy of selenium on patients undergoing cardiac surgery: a
meta-analysis of randomized controlled trials.
Source
Journal of cardiothoracic surgery. 19(1) (pp 264), 2024. Date of
Publication: 24 Apr 2024.
Author
Sarhan A.M.; Awad A.K.; Alassiri A.K.; Abd-Alkhaleq M.S.; Al-Asmar R.;
Gonnah A.R.
Institution
(Sarhan) Faculty of Medicine, October 6 University, Cairo, Egypt
(Awad) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Alassiri) Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi
Arabia
(Abd-Alkhaleq) Faculty of Medicine, October 6 University, Cairo, Egypt
(Al-Asmar) Faculty of Medicine, University of Jordan, Amman, Jordan
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
Abstract
INTRODUCTION: Postoperative complications pose significant challenges in
cardiac surgery and with the evolution of selenium as a potential
anti-inflammatory agent, some studies reported its inefficiency. Thus, we
conducted our meta-analysis to evaluate the impact of selenium
supplementation on cardiac surgery patients. <br/>METHOD(S): Different
databases such as PubMed, Embase, and Cochrane Library from inception till
January 2024 were searched identifying a total of seven
randomized-controlled trials involving selenium supplementation after
cardiac surgery. Risk ratio (RR) and Mean difference (MD) were calculated
with a 95% confidence interval (CI). <br/>RESULT(S): The selenium
intervention significantly raised the incidence of Acute Kidney injury (RR
0.76; 95% CI: 0.59, 0.98; P=0.04) while significantly reducing the
duration of hospital stay (MD -1.33; 95% CI: -2.51, -0.16; P=0.03) and
postoperative CRP levels (SMD -0.18; 95% CI: -0.34, -0.02; P=0.03). The
effect of selenium intervention on days spent in ICU (MD -0.01; 95% CI:
-0.28, 0.25; P=0.92), mortality (RR 1.07; 95% CI: 0.84, 1.37; P=0.57) and
incidence of hospital acquired infections (RR 0.98; 95% CI: 0.76, 1.26;
P=0.88) is insignificant. <br/>CONCLUSION(S): Selenium supplementation did
not significantly reduce major postoperative complications in cardiac
surgery patients. However, its ability to modulate inflammation, as
reflected in decreased C-reactive protein levels, highlights its potential
role in managing the inflammatory response. Future investigations should
focus on optimized selenium supplementation strategies in conjunction with
other antioxidants to enhance its benefits.<br/>Copyright &#xa9; 2024. The
Author(s).

<47>
Accession Number
644075832
Title
Cognitive Training for Reduction of Delirium in Patients Undergoing
Cardiac Surgery: A Randomized Clinical Trial.
Source
JAMA network open. 7(4) (pp e247361), 2024. Date of Publication: 01 Apr
2024.
Author
Jiang Y.; Xie Y.; Fang P.; Shang Z.; Chen L.; Zhou J.; Yang C.; Zhu W.;
Hao X.; Ding J.; Yin P.; Wang Z.; Cao M.; Zhang Y.; Tan Q.; Cheng D.; Kong
S.; Lu X.; Liu X.; Sessler D.I.
Institution
(Jiang, Fang, Shang, Zhu, Hao, Ding, Yin, Wang, Cao, Zhang, Lu, Liu)
Department of Anesthesiology, First Affiliated Hospital of Anhui Medical,
University, Hefei, Anhui, China
(Xie, Yang) Department of Anesthesiology, First Affiliated Hospital of
University of Science and Technology of China, Hefei, Anhui, China
(Chen, Tan, Cheng) Department of Anesthesiology, Nanjing First Hospital,
Nanjing Medical University, Nanjing, Jiangsu, China
(Zhou, Kong) School of International Pharmaceutical Business, China
Pharmaceutical University, Nanjing, Jiangsu, China
(Sessler) Outcomes Research Consortium, Department of Anesthesiology,
Cleveland Clinic, Cleveland, OH, United States
Abstract
IMPORTANCE: Postoperative delirium is a common and impactful
neuropsychiatric complication in patients undergoing coronary artery
bypass grafting surgery. Cognitive training may enhance cognitive reserve,
thereby reducing postoperative delirium. <br/>OBJECTIVE(S): To determine
whether preoperative cognitive training reduces the incidence of delirium
in patients undergoing coronary artery bypass grafting. DESIGN, SETTING,
and PARTICIPANTS: This prospective, single-blind, randomized clinical
trial was conducted at 3 university teaching hospitals in southeastern
China with enrollment between April 2022 and May 2023. Eligible
participants included those scheduled for elective coronary artery bypass
grafting who consented and enrolled at least 10 days before surgery.
INTERVENTIONS: Participating patients were randomly assigned 1:1,
stratified by site, to either routine care or cognitive training, which
included substantial practice with online tasks designed to enhance
cognitive functions including memory, imagination, reasoning, reaction
time, attention, and processing speed. MAIN OUTCOMES AND MEASURES: The
primary outcome was occurrence of delirium during postoperative days 1 to
7 or until hospital discharge, diagnosed using the Confusion Assessment
Method or the Confusion Assessment Method for Intensive Care Units.
Secondary outcomes were postoperative cognitive dysfunction, delirium
characteristics, and all-cause mortality within 30 days following the
operation. <br/>RESULT(S): A total of 218 patients were randomized and 208
(median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male
[69.2%]) were included in final analysis, with 102 randomized to cognitive
training and 106 randomized to routine care. Of all participants, 95
(45.7%) had only a primary school education and 54 (26.0%) had finished
high school. In the cognitive training group, 28 participants (27.5%)
developed delirium compared with 46 participants (43.4%) randomized to
routine care. Those receiving cognitive training were 57% less likely to
develop delirium compared with those receiving routine care (adjusted odds
ratio [aOR] 0.43; 95% CI, 0.23-0.77; P=.007). Significant differences were
observed in the incidence of severe delirium (aOR, 0.46; 95% CI,
0.25-0.82; P=.01), median (IQR) duration of delirium (0 [0-1] days for
cognitive training vs 0 [0-2] days for routine care; P=.008), and median
(IQR) number of delirium-positive days (0 [0-1] days for cognitive
training vs 0 [0-2] days for routine care; P=.007). No other secondary
outcomes differed significantly. CONCLUSIONS AND RELEVANCE: In this
randomized trial of 208 patients undergoing coronary artery bypass
grafting, preoperative cognitive training reduced the incidence of
postoperative delirium. However, our primary analysis was based on fewer
than 75 events and should therefore be considered exploratory and a basis
for future larger trials. Trial Registration: Chinese Clinical Trial
Registry Identifier: ChiCTR2200058243.

<48>
Accession Number
2031825610
Title
Risk of extended major adverse cardiovascular event endpoints with
tofacitinib versus TNF inhibitors in patients with rheumatoid arthritis: a
post hoc analysis of a phase 3b/4 randomised safety study.
Source
RMD Open. 10(2) (no pagination), 2024. Article Number: e003912. Date of
Publication: 12 Apr 2024.
Author
Buch M.H.; Bhatt D.L.; Charles-Schoeman C.; Giles J.T.; Mikuls T.; Koch
G.G.; Ytterberg S.; Nagy E.; Jo H.; Kwok K.; Connell C.A.; Masri K.R.;
Yndestad A.
Institution
(Buch) Centre for Musculoskeletal Research, Division of Musculoskeletal
and Dermatological Sciences, The University of Manchester, Manchester,
United Kingdom
(Buch) NIHR Manchester Biomedical Research Centre, Manchester, United
Kingdom
(Bhatt) Mount Sinai Heart, Icahn School of Medicine, Mount Sinai Health
System, New York, NY, United States
(Charles-Schoeman) Division of Rheumatology, Department of Medicine,
University of California, Los Angeles, CA, United States
(Giles) Division of Rheumatology, Columbia University, College of
Physicians and Surgeons, New York, NY, United States
(Mikuls) Department of Medicine, University of Nebraska Medical Center,
Omaha, NE, United States
(Koch) University of North Carolina, Chapel Hill Department of
Biostatistics, Chapel Hill, NC, United States
(Ytterberg) Division of Rheumatology, Mayo Clinic, Rochester, MN, United
States
(Nagy) Pfizer Ltd., Tadworth, United Kingdom
(Jo, Kwok) Pfizer Inc., New York, NY, United States
(Connell) Pfizer Inc., Groton, CT, United States
(Masri) Pfizer Inc., Collegeville, PA, United States
(Yndestad) Pfizer Inc., Oslo, Norway
Publisher
BMJ Publishing Group
Abstract
Objectives Compare the risk of extended major adverse cardiovascular (CV)
event (MACE) composite outcomes and component events in patients with
rheumatoid arthritis (RA) treated with tofacitinib versus tumour necrosis
factor inhibitors (TNFi) in Oral Rheumatoid Arthritis Trial (ORAL)
Surveillance. Methods Patients with RA aged >=50 years and with >=1
additional CV risk factor received tofacitinib 5 mg or 10 mg two times per
day or TNFi. MACE (non-fatal myocardial infarction (MI), non-fatal stroke
or CV death (MACE-3)) was extended by sequential addition of CV events
(hospitalisation for unstable angina (MACE-4), coronary revascularisation
(MACE-5), transient ischaemic attack (MACE-6), peripheral vascular disease
(MACE-7)), heart failure (HF) hospitalisation (MACE-8) and venous
thromboembolism (VTE; (MACE-8 plus VTE)). HRs (tofacitinib vs TNFi) were
evaluated for MACE and individual components. Results HRs for MACE-4 to
MACE-8 with combined and individual tofacitinib doses versus TNFi were
similar. Risk of MACE-8 plus VTE appeared similar with tofacitinib 5 mg
two times per day versus TNFi (HR 1.12 (0.82 to 1.52)), but higher with
tofacitinib 10 mg two times per day versus TNFi (HR 1.38 (1.02 to 1.85)).
Risk of MI was higher with tofacitinib versus TNFi, but difference in risk
of other individual CV events was not suggested. Across extended MACE
definitions, risk appeared higher with tofacitinib versus TNFi in those
with atherosclerotic CV disease or age >=65 years. Conclusion In ORAL
Surveillance, risk of composite CV endpoints combining all ischaemic CV
events and HF did not appear different with tofacitinib versus TNFi. The
totality of CV risk was higher with tofacitinib 10 mg two times per day
versus TNFi, driven by an increase in VTE.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2024.

<49>
Accession Number
2029591910
Title
Exploring the Link between Anticoagulation, Cognitive Impairment and
Dementia in Atrial Fibrillation: A Systematic Review.
Source
Journal of Clinical Medicine. 13(8) (no pagination), 2024. Article Number:
2418. Date of Publication: April 2024.
Author
Agarwal A.; Mostafa M.A.; Ahmad M.I.; Soliman E.Z.
Institution
(Agarwal, Mostafa, Soliman) Epidemiological Cardiology Research Center,
Section on Cardiovascular Medicine, Department of Medicine, Wake Forest
University School of Medicine, Winston Salem, NC 27157, United States
(Ahmad) Department of Medicine, Section on Hospital Medicine, Medical
College of Wisconsin, Wauwatosa, WI 53226, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The impact of oral anticoagulants (OACs) on cognitive
impairment and dementia in patients with atrial fibrillation (AF) is not
well characterized. This systematic review aims to address this knowledge
gap. <br/>Method(s): SCOPUS and PubMed searches were conducted to identify
articles in the English language investigating the association between the
use of OACs and cognitive impairment and dementia. We excluded
non-original research studies and studies that did not report data on
cognitive impairment or included patients who underwent open heart surgery
or had psychiatric illnesses or cancer. <br/>Result(s): Out of 22 studies
(n = 606,404 patients), 13 studies (n = 597,744 patients) reported a
reduction in cognitive impairment/dementia in those undergoing
thromboprophylaxis. Using direct oral anticoagulants (DOACs) was
associated with a lower incidence of cognitive impairment in 10 studies (n
= 284,636 patients). One study found that patients undergoing dual therapy
(n = 6794 patients) had a greater incidence of cognitive impairment
compared to those undergoing monotherapy (n = 9994 patients). Three
studies (n = 61,991 patients) showed that AF patients on DOACs had a lower
likelihood of dementia diagnosis than those on vitamin K antagonists
(VKAs). Dementia incidence was lower when VKAs were under good control.
<br/>Conclusion(s): The use of oral anticoagulants has the potential to
prevent cognitive impairment and dementia in patients with AF. Since most
of the published research on this subject is observational in nature, more
randomized controlled trials are needed to fully understand the effect of
anticoagulants on cognitive function.<br/>Copyright &#xa9; 2024 by the
authors.

<50>
Accession Number
2031852143
Title
COMPARATIVE EVALUATION OF SEVOFLURANE AND ISOFLURANE IN FAST TRACK
ANAESTHESIA FOR VALVULAR CARDIAC SURGERY: A RANDOMIZED STUDY.
Source
International Journal of Current Pharmaceutical Research. 16(2) (pp
24-27), 2024. Date of Publication: March 2024.
Author
Meena D.K.; Charan P.; Sharma A.
Institution
(Meena, Sharma) Department of Anaesthesiology, RVRS Government Medical
College, Rajasthan, Bhilwara, India
(Charan) Department of Anaesthesiology, SMS Medical College, Rajasthan,
Jaipur, India
Publisher
Innovare Academics Sciences Pvt. Ltd
Abstract
Objective: Contemporary valvular cardiac surgery has evolved with the
adoption of expedited postoperative recovery, known as fast-tracking. This
paradigm shift results from advancements in anaesthetic agents, surgical
techniques, and myocardial protection strategies. Fast-track anaesthesia
aims to reduce intensive care unit (ICU) stays and overall hospital length
of stay (LOS), optimizing resource utilization. Cardioprotective
properties of volatile anaesthetic agents, especially in mitigating
ischemic myocardial damage, have garnered attention. <br/>Method(s): A
hospital-based, randomized, comparative study was conducted at the
Department of Anaesthesiology, S. M. S Medical College, Jaipur. 70
undergoing valvular heart surgery under general anaesthesia, were randomly
assigned to two groups: Group A (Sevoflurane) and Group B (Isoflurane).
Inclusion criteria encompassed ASA grade II to IV patients aged 20 to 50
y, with a body weight of 30-65 kg, and willingness to provide written
consent. Anaesthesia induction and maintenance involved the administration
of Sevoflurane or Isoflurane based on group allocation. Hemodynamic
parameters were recorded at various surgical stages. <br/>Result(s): Heart
rate, systolic blood pressure, and cardiac output were statistically
insignificant between groups at different surgical stages (p>0.05).
Intraoperative variables demonstrated no significant differences, except
for a transient decrease in systolic blood pressure post-induction in both
groups. <br/>Conclusion(s): The study underscores the comparable efficacy
of Sevoflurane and Isoflurane in valvular cardiac surgery, supported by
similar hemodynamic profiles. Understanding the nuances of volatile
anaesthetic agents is crucial for their optimal clinical application,
considering challenges like beta-blocker usage and perioperative
hyperglycemia.<br/>Copyright &#xa9; 2024 The Authors. Published by
Innovare Academic Sciences Pvt Ltd. This is an open access article under
the CC BY license.

<51>
Accession Number
2031885852
Title
Clinical Utility of Computed Tomography-Derived Myocardial Extracellular
Volume Fraction: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 17(5) (pp 516-528), 2024. Date of
Publication: May 2024.
Author
Kato S.; Misumi Y.; Horita N.; Yamamoto K.; Utsunomiya D.
Institution
(Kato, Misumi, Utsunomiya) Department of Diagnostic Radiology, Yokohama
City University Graduate School of Medicine, Yokohama, Japan
(Horita) Chemotherapy Center, Yokohama City University Graduate School of
Medicine, Yokohama, Japan
(Yamamoto) Department of Biostatistics, Yokohama City University School of
Medicine, Yokohama, Japan
Publisher
Elsevier Inc.
Abstract
Background: Computed tomography (CT)-derived extracellular volume fraction
(ECV) is a noninvasive method to quantify myocardial fibrosis. Although
studies suggest CT is a suitable measure of ECV, clinical use remains
limited. <br/>Objective(s): A meta-analysis was performed to determine the
clinical value of CT-derived ECV in cardiovascular diseases.
<br/>Method(s): Electronic database searches of PubMed, Web of Science
Core Collection, Cochrane advanced search, and EMBASE were performed. The
most pivotal analysis entailed the comparison of ECV ascertained through
CT-ECV among the control, aortic stenosis, and cardiac amyloidosis
cohorts. The diagnostic test accuracy for detecting cardiac amyloidosis
was assessed using summary receiver-operating characteristics curve.
<br/>Result(s): Pooled CT-derived ECV values were 28.5% (95% CI:
27.3%-29.7%) in the control, 31.9% (95% CI: 30.2%-33.8%) in the aortic
stenosis, and 48.9% (95% CI: 44.5%-53.3%) in the cardiac amyloidosis
group. ECV was significantly elevated in aortic stenosis (P = 0.002) (vs
controls) but further elevated in cardiac amyloidosis (P < 0.001) (vs
aortic stenosis). CT-derived ECV had a high diagnostic accuracy for
cardiac amyloidosis, with sensitivity of 92.8% (95% CI: 86.7%-96.2%),
specificity of 84.8% (95% CI: 68.6%-93.4%), and area under the summary
receiver-operating characteristic curve of 0.94 (95% CI: 0.88-1.00).
<br/>Conclusion(s): This study is the first comprehensive systematic
review and meta-analysis of CT-derived ECV evaluation in cardiac disease.
The high diagnostic accuracy of CT-ECV suggests the usefulness of CT-ECV
in the diagnosis of cardiac amyloidosis in preoperative CT planning for
transcatheter aortic valve replacement.<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<52>
Accession Number
2031869863
Title
Embolic Events in Infective Endocarditis: A Comprehensive Review.
Source
Reviews in Cardiovascular Medicine. 25(3) (no pagination), 2024. Date of
Publication: 2024.
Author
Cabezon G.; Pulido P.; Diaz J.L.; De Miguel-Alava M.; Vilacosta I.;
Garcia-Azorin D.; Lozano A.; Ona A.; Arenillas J.F.; Roman J.-A.S.
Institution
(Cabezon, Pulido, Diaz, De Miguel-Alava, Lozano, Ona, Roman) Instituto de
Ciencias del Corazon (ICICOR), Cardiology Department, Hospital Clinico
Universitario, Valladolid 47003, Spain
(Diaz, Vilacosta, Roman) Ciber de Enfermedades Cardiovasculares (CIBER
CV), Instituto de investigacion Carlos III, Madrid 28029, Spain
(Vilacosta) Instituto Cardiovascular, Hospital Clinico San Carlos,
Instituto de Investigacion Sanitaria, Hospital Clinico San Carlos (IdSSC),
Madrid 28040, Spain
(Garcia-Azorin, Arenillas) Servicio de Neurologia, Hospital Clinico
Universitario de Valladolid, Valladolid 47003, Spain
Publisher
IMR Press Limited
Abstract
Infective endocarditis (IE) is a life-threating entity with three main
complications: heart failure (HF), uncontrolled infection (UI) and embolic
events (EEs). HF and UI are the main indications of cardiac surgery and
have been studied thoroughly. On the other hand, much more uncertainty
surrounds EEs, which have an abrupt and somewhat unpredictable behaviour.
EEs in the setting of IE have unique characteristics that must be
explored, such as the potential of hemorrhagic transformation of stroke.
Accurately predicting which patients will suffer EEs seems to be pivotal
to achieve an optimal management of the disease, but this complex process
is still not completely understood. The indication of cardiac surgery in
order to prevent EEs in the absence of HF or UI is in question as
scientific evidence is controversial and mainly of a retrospective nature.
This revision addresses these topics and try to summarize the evidence and
recommendations about them. <br/>Copyright &#xa9; 2024 The Author(s).

<53>
Accession Number
2031869859
Title
Electroencephalography Monitoring for Preventing Postoperative Delirium
and Postoperative Cognitive Decline in Patients Undergoing Cardiothoracic
Surgery: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 25(4) (no pagination), 2024. Date of
Publication: 2024.
Author
Xue S.; Xu A.-X.; Liu H.; Zhang Y.
Institution
(Xue, Xu, Zhang) Department of Anesthesiology and Perioperative Medicine,
The Second Hospital of Anhui Medical University, Anhui, Hefei 230061,
China
(Xue, Xu, Zhang) Key Laboratory of Anesthesiology and Perioperative
Medicine of Anhui Higher Education Institutes, Anhui Medical University,
Anhui, Hefei 230038, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA 95817, United States
Publisher
IMR Press Limited
Abstract
Background: Patients undergoing cardiothoracic surgery frequently
encounter perioperative neurocognitive disorders (PND), which can include
postoperative delirium (POD) and postoperative cognitive decline (POCD).
Currently, there is not enough evidence to support the use of
electroencephalograms (EEGs) in preventing POD and POCD among
cardiothoracic surgery patients. This meta-analysis examined the
importance of EEG monitoring in POD and POCD. <br/>Method(s): Cochrane
Library, PubMed, and EMBASE databases were searched to obtain the relevant
literature. This analysis identified trials based on the inclusion and
exclusion criteria. The Cochrane tool was used to evaluate the
methodological quality of the included studies. Review Manager software
(version 5.3) was applied to analyze the data. <br/>Result(s): Four
randomized controlled trials (RCTs) were included in this meta-analysis,
with 1096 participants. Our results found no correlation between EEG
monitoring and lower POD risk (relative risk (RR): 0.81;95% CI:
0.55-1.18;p = 0.270). There was also no statistically significant
difference between the EEG group and the control group in the red cell
transfusions (RR: 0.86;95% CI: 0.51-1.46;p = 0.590), intensive care unit
(ICU) stay (mean deviation (MD): -0.46;95% CI: -1.53-0.62;p = 0.410),
hospital stay (MD: -0.27;95% CI: -2.00-1.47;p = 0.760), and mortality (RR:
0.33;95% CI: 0.03-3.59;p = 0.360). Only one trial reported an incidence of
POCD, meaning we did not conduct data analysis on POCD risk.
<br/>Conclusion(s): This meta-analysis did not find evidence supporting
EEG monitoring as a potential method to reduce POD incidence in
cardiothoracic surgery patients. In the future, more high-quality RCTs
with larger sample sizes are needed to validate the relationship between
EEG monitoring and POD/POCD further. <br/>Copyright &#xa9; 2024 The
Author(s).

<54>
Accession Number
2031746614
Title
Managing One-Lung Ventilation in Tracheostomized Patients: A 6-Year
Retrospective Analysis.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2024. Date of
Publication: 2024.
Author
Golditz T.; Schmidt J.; Ackermann A.; Danzl A.; Birkholz T.; Sirbu H.;
Irouschek A.
Institution
(Golditz, Schmidt, Ackermann, Danzl, Birkholz, Irouschek) Department of
Anesthesiology, Faculty of Medicine, University Hospital Erlangen,
Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Bayern,
Germany
(Sirbu) Department of Thoracic Surgery, Universitatsklinikum Erlangen,
Erlangen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background To ensure safe and optimal surgical conditions in thoracic
surgery, one-lung ventilation is crucial. Various techniques exist to
achieve one-lung ventilation. Tracheotomized patients who require one-lung
ventilation represent a unique and rare subgroup that demands specialized
knowledge and skills. The very limited literature has discussed
alternative methods, no randomized controlled trials have addressed this
issue yet. Methods We performed a retrospective analysis of patients who
underwent one-lung ventilation in the Department of Thoracic Surgery of a
German University Hospital between 2016 and 2021. The study assessed
patient demographics, airway management techniques, ventilation
parameters, and adverse events. Results In 3,197 anesthesia procedures
during the observation period, 152 patients had an existing tracheostomy,
of which 56 required one-lung ventilation. Among others in 42 cases, a
tracheostomy tube was combined with a bronchial blocker, and in 10 cases,
a double-lumen tracheostomy tube was used. There were no severe
complications. Intraoperative dislocations that required repositioning of
the device occurred in six patients (13.3%) with bronchial blockers and
one patient with double-lumen tracheostomy tube (10%). Conclusion The
management of one-lung ventilation in tracheotomized patients presents
unique challenges. While double-lumen tracheostomy tubes have specific
advantages, we recommend considering their use carefully. For most
tracheotomized patients, bronchial blockers in conjunction with a
tracheostomy tube are used, which offers safety and practicality,
irrespective of the tracheostomy's age or type. Further research and
randomized controlled trials are warranted to establish best practices for
one-lung ventilation in this unique patient population.<br/>Copyright
&#xa9; 2024 Georg Thieme Verlag. All rights reserved.

<55>
Accession Number
644082507
Title
Efficacy and Safety of Botulinum Toxin Type A for the Prevention of
Postoperative Atrial Fibrillation.
Source
JACC. Clinical electrophysiology. (no pagination), 2024. Date of
Publication: 25 Mar 2024.
Author
Piccini J.P.; Ahlsson A.; Dorian P.; Gillinov A.M.; Kowey P.R.; Mack M.J.;
Milano C.A.; Noiseux N.; Perrault L.P.; Ryan W.; Steinberg J.S.; Voisine
P.; Waldron N.H.; Gleason K.J.; Titanji W.; Leaback R.D.; O'Sullivan A.;
Ferguson W.G.; Benussi S.
Institution
(Piccini) Department of Electrophysiology, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Ahlsson) Cardiovascular Division, Karolinska Institute, Stockholm, Sweden
(Dorian) Division of Cardiology, St Michael's Hospital, Toronto, ON,
Canada
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Kowey) Division of Cardiovascular Research, Lankenau Heart Institute,
Wynnewood, PA, United States
(Mack, Ryan) Department of Thoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Milano) Division of Cardiothoracic Surgery, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Noiseux) Division of Cardiac Surgery, Centre Hospitalier de l'Universite
de Montreal, Centre de Recherche du Centre Hospitalier de l'Universite de
Montreal, QC, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Universite de
MontrealQuebec City, Montreal, QC, Canada
(Steinberg) Clinical Cardiovascular Research Center, University of
Rochester School of Medicine and Dentistry, Rochester, NY, United States
(Voisine) Division of Cardiac Surgery, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, QC, Canada
(Waldron) Department of Anesthesiology and Critical Care, Mayo Clinic,
Jacksonville, FL, United States
(Gleason, Titanji, Leaback, O'Sullivan, Ferguson) AbbVie Inc, North
Chicago, IL, United States
(Benussi) Department of Cardiothoracic Surgery, University of Brescia,
Brescia, Italy
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is associated with
increased morbidity and mortality. Epicardial injection of botulinum toxin
may suppress POAF. <br/>OBJECTIVE(S): This study sought to assess the
safety and efficacy of AGN-151607 for the prevention of POAF after cardiac
surgery. <br/>METHOD(S): This phase 2, randomized, placebo-controlled
trial assessed the safety and efficacy of AGN-151607, 125 U and 250 U vs
placebo (1:1:1), for the prevention of POAF after cardiac surgery.
Randomization was stratified by age (<65, >=65 years) and type of surgery
(nonvalvular/valve surgery). The primary endpoint was the occurrence of
continuous AF >=30 seconds. <br/>RESULT(S): Among 312 modified
intention-to-treat participants (placebo, n = 102; 125 U, n = 104; and 250
U, n = 106), the mean age was 66.9 +/- 6.8 years; 17% were female; and 64%
had coronary artery bypass graft (CABG) only, 12% had CABG + valve, and
24% had valve surgery. The primary endpoint occurred in 46.1% of the
placebo group, 36.5% of the 125-U group (relative risk [RR] vs placebo:
0.80; 95% CI: 0.58-1.10; P = 0.16), and 47.2% of the 250-U group (RR vs
placebo: 1.04; 95% CI: 0.79-1.37; P = 0.78). The primary endpoint was
reduced in the 125-U group in those >=65 years (RR: 0.64; 95% CI:
0.43-0.94; P = 0.02) with a greater reduction in CABG-only participants
>=65 years (RR: 0.49; 95% CI: 0.27-0.87; P = 0.01). Rehospitalization and
rates of adverse events were similar across the 3 groups.
<br/>CONCLUSION(S): There were no significant differences in the rate of
POAF with either dose compared with placebo; however, there was a lower
rate of POAF in participants >=65 years undergoing CABG only and receiving
125 U of AGN-151607. These hypothesis-generating findings require
investigation in a larger, adequately powered randomized clinical trial.
(Botulinum Toxin Type A [AGN-151607] for the Prevention of Post-operative
Atrial Fibrillation in Adult Participants Undergoing Open-chest Cardiac
Surgery [NOVA]; NCT03779841); A Phase 2, Multi-Center, Randomized,
Double-Blind, Placebo-Controlled, Dose Ranging Study to Evaluate the
Efficacy and Safety of Botulinum Toxin Type A [AGN 151607] Injections into
the Epicardial Fat Pads to Prevent Post-Operative Atrial Fibrillation in
Patients Undergoing Open-Chest Cardiac Surgery;
2017-004399-68).<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<56>
Accession Number
644080008
Title
Partial CArdiac Denervation to prevent PostOperative Atrial Fibrillation
after coronary artery bypass grafting (pCAD-POAF): study protocol for a
randomized controlled trial.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 20 Apr 2024.
Author
Yang Z.; Tiemuerniyazi X.; Huang S.; Song Y.; Xu F.; Feng W.
Institution
(Yang, Tiemuerniyazi, Huang, Song, Xu, Feng) Department of Cardiovascular
Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases,
National Clinical Research Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Abstract
Postoperative atrial fibrillation (POAF) is commonly seen in patients
undergoing coronary artery bypass grafting (CABG), increasing the risk of
morbidity, mortality and hospital expenses. This study is aimed to
evaluate the effect of partial cardiac denervation, which is achieved by
cutting off the ligament of Marshall and resecting the fat pad along the
Waterston groove, on the prevention of POAF after CABG. Patients planned
for CABG at our center will be screened for eligibility for this study. A
total of 430 patients will be randomized into intervention (partial
cardiac denervation) group and control group. Intraoperative
high-frequency electrical stimulation and further histologic analysis will
be performed among certain number of patients to confirm the existence of
ganglia. All of the patients will be continuously monitored for the
incidence of POAF through electrophysiologic device until the 6th day
postoperatively, and required to complete a 30-day follow-up (twelve lead
electrocardiogram and echocardiogram assesment) after discharge. The
primary endpoint is the incidence of POAF, while the secondary endpoints
are the cost-effectiveness and safety outcomes. In conclusion, this trial
will evaluate whether partial cardiac denervation through cutting off the
ligament of Marshall and resecting the fat pad along the Waterston groove
can reduce the incidence of POAF after CABG. If this procedure is revealed
to be effective and safe, it may provide a potential therapeutic approach
to prevent POAF in this group of patients.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.

<57>
Accession Number
2029335935
Title
The effects of telerehabilitation in adults with complex biventricular
congenital heart conditions: protocol for a multi-centre, randomised
controlled trial-CH-FIT.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 239. Date of
Publication: December 2024.
Author
Wood G.; Scheer A.; Saundankar J.; Tran D.; Cordina R.; Maiorana A.
Institution
(Wood, Scheer, Maiorana) School of Allied Health, Curtin University,
Perth, WA, Australia
(Wood) School of Science and Technology, Faculty of Science, Agriculture,
Business and Law, University of New England, Armidale, NSW, Australia
(Saundankar) Perth Children's Hospital, Cardiology, Nedlands, Australia
(Saundankar) Sir Charles Gairdner Hospital, Cardiology, Nedlands,
Australia
(Tran, Cordina) Department of Cardiology, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
(Tran, Cordina) Sydney Medical School, Central Clinical School, Faculty of
Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
(Maiorana) Allied Health Department, Fiona Stanley Hospital, Perth, WA,
Australia
Publisher
BioMed Central Ltd
Abstract
Background: Accumulated evidence suggests that exercise training exerts
beneficial effects on people with congenital heart conditions. These
findings are predominantly derived from small, single-centre exercise
trials conducted in outpatient rehabilitation facilities. In recent years,
the delivery of exercise interventions remotely has increased through
digital communications technology (telerehabilitation). However, very
little research to date has been conducted into the efficacy of
telerehabilitation in people with a congenital heart condition.
<br/>Aim(s): To evaluate the effects of a telehealth-delivered exercise
intervention in people with a history of a surgical biventricular repair
due to a congenital heart condition. <br/>Method(s): One hundred eligible
adolescent (>= 16 years) and adult participants living with a complex
biventricular congenital heart condition will be recruited from four
Australian sites and randomised to either (1) a 16-week
telehealth-delivered combined (aerobic and resistance) exercise training
programme of moderate-to-vigorous intensity or (2) usual care (control
group), in a 1:1 allocation, with an 8-month follow-up. Outcomes of
interest: The primary outcome will be the change in aerobic capacity
expressed as peak oxygen uptake (VO<inf>2peak</inf>). Secondary outcomes
will include changes in vascular function, muscle oxygenation, metabolic
profile, body composition and musculoskeletal fitness, neurohormonal
activation, neurocognitive function, physical activity levels, dietary and
nutritional status, and quality of life. Outcomes will be assessed at
baseline, 16 weeks, and 12 months (to determine longer-term maintenance
potential). <br/>Discussion(s): If found to be efficacious,
telerehabilitation may be an alternative option for delivering exercise,
improving health outcomes, and increasing accessibility to exercise
programmes. Efficacy data is required to quantify the clinical
significance of this delivery mode of exercise. Trial registration:
ACTRN12622000050752 Trial registration date: 17 January 2022 Trial
registration URL:
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382635&sh
owOriginal=true&isReview=true Trial registry name: Australian and New
Zealand Clinical Trials Registry<br/>Copyright &#xa9; The Author(s) 2024.

<58>
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

<59>
Accession Number
2031377660
Title
Effectiveness of mobile health applications on clinical outcomes and
health behaviors in patients with coronary heart disease: A systematic
review and meta-analysis.
Source
International Journal of Nursing Sciences. 11(2) (pp 258-275), 2024. Date
of Publication: April 2024.
Author
Zhu Y.; Zhao Y.; Wu Y.
Institution
(Zhu, Zhao, Wu) School of Nursing, Capital Medical University, Beijing,
China
Publisher
Chinese Nursing Association
Abstract
Objective: Mobile health applications (apps) have gained significant
popularity and widespread utilization among patients with coronary heart
disease (CHD). The objective of this study is to evaluate the effects of
mHealth apps on clinical outcomes and health behaviors in patients with
CHD. <br/>Method(s): Databases were searched from inception until December
2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL,
China National Knowledge Infrastructure (CNKI), Chinese BioMedical
Literature Service System (SinoMed), Wanfang Data, China Science and
Technology Journal Database (VIP), for randomized controlled trials (RCTs)
regarding the effectiveness of mHealth apps in patients with CHD. Two
researchers conducted a comprehensive review of the literature, extracting
relevant data and evaluating each study's methodological quality
separately. The meta-analysis was performed utilizing Review Manager v5.4
software. <br/>Result(s): A total of 34 RCTs were included, with 5,319
participants. The findings demonstrated that using mHealth apps could
decrease the incidence of major adverse cardiac events (RR = 0.68, P =
0.03), readmission rate (RR = 0.56, P < 0.001), total cholesterol (WMD =
-0.19, P = 0.03), total triglycerides (WMD = -0.24, P < 0.001), waist
circumference (WMD = -1.92, P = 0.01), Self-Rating Anxiety Scale score
(WMD = -6.70, P < 0.001), and Self-Rating Depression Scale score (WMD =
-7.87, P < 0.001). They can also increase the LVEF (WMD = 6.50, P <
0.001), VO<inf>2</inf> max (WMD = 1.89, P < 0.001), 6-min walk distance
(6MWD) (WMD = 19.43, P = 0.004), Morisky Medication Adherence Scale-8
score (WMD = 0.96, P = 0.004), and medication adherence rate (RR = 1.24, P
= 0.03). Nevertheless, there is no proof that mHealth apps can lower
low-density lipoprote in cholesterol, blood pressure, BMI, or other
indicator (P > 0.05). <br/>Conclusion(s): Mobile health apps have the
potential to lower the incidence of major adverse cardiac events (MACEs),
readmission rates, and blood lipids in patients with CHD. They can also
help enhance cardiac function, promote medication adherence, and alleviate
symptoms of anxiety and depression. To further corroborate these results,
larger-scale, multi-center RCTs with longer follow-up periods are
needed.<br/>Copyright &#xa9; 2024 The Authors

<60>
Accession Number
2031053935
Title
Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in
the Operating Room: A Cluster Randomized Clinical Trial.
Source
JAMA. 331(15) (pp 1279-1286), 2024. Date of Publication: 16 Apr 2024.
Author
Ruetzler K.; Bustamante S.; Schmidt M.T.; Almonacid-Cardenas F.; Duncan
A.; Bauer A.; Turan A.; Skubas N.J.; Sessler D.I.
Institution
(Ruetzler, Schmidt, Almonacid-Cardenas, Duncan, Turan, Sessler) Outcomes
Research Consortium, Department of Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Ruetzler, Turan) Division of Multi-Specialty Anesthesiology, Department
of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Bustamante, Duncan, Bauer, Skubas) Division of Cardiothoracic
Anesthesiology, Department of Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
Publisher
American Medical Association
Abstract
Importance: Endotracheal tubes are typically inserted in the operating
room using direct laryngoscopy. Video laryngoscopy has been reported to
improve airway visualization; however, whether improved visualization
reduces intubation attempts in surgical patients is unclear.
<br/>Objective(s): To determine whether the number of intubation attempts
per surgical procedure is lower when initial laryngoscopy is performed
using video laryngoscopy or direct laryngoscopy. <br/>Design, Setting, and
Participant(s): Cluster randomized multiple crossover clinical trial
conducted at a single US academic hospital. Patients were adults aged 18
years or older having elective or emergent cardiac, thoracic, or vascular
surgical procedures who required single-lumen endotracheal intubation for
general anesthesia. Patients were enrolled from March 30, 2021, to
December 31, 2022. Data analysis was based on intention to treat.
<br/>Intervention(s): Two sets of 11 operating rooms were randomized on a
1-week basis to perform hyperangulated video laryngoscopy or direct
laryngoscopy for the initial intubation attempt. <br/>Main Outcomes and
Measures: The primary outcome was the number of operating room intubation
attempts per surgical procedure. Secondary outcomes were intubation
failure, defined as the responsible clinician switching to an alternative
laryngoscopy device for any reason at any time, or by more than 3
intubation attempts, and a composite of airway and dental injuries.
<br/>Result(s): Among 8429 surgical procedures in 7736 patients, the
median patient age was 66 (IQR, 56-73) years, 35% (2950) were women, and
85% (7135) had elective surgical procedures. More than 1 intubation
attempt was required in 77 of 4413 surgical procedures (1.7%) randomized
to receive video laryngoscopy vs 306 of 4016 surgical procedures (7.6%)
randomized to receive direct laryngoscopy, with an estimated proportional
odds ratio for the number of intubation attempts of 0.20 (95% CI,
0.14-0.28; P <.001). Intubation failure occurred in 12 of 4413 surgical
procedures (0.27%) using video laryngoscopy vs 161 of 4016 surgical
procedures (4.0%) using direct laryngoscopy (relative risk, 0.06; 95% CI,
0.03-0.14; P <.001) with an unadjusted absolute risk difference of -3.7%
(95% CI, -4.4% to -3.2%). Airway and dental injuries did not differ
significantly between video laryngoscopy (41 injuries [0.93%]) vs direct
laryngoscopy (42 injuries [1.1%]). Conclusion and Relevance: In this study
among adults having surgical procedures who required single-lumen
endotracheal intubation for general anesthesia, hyperangulated video
laryngoscopy decreased the number of attempts needed to achieve
endotracheal intubation compared with direct laryngoscopy at a single
academic medical center in the US. Results suggest that video laryngoscopy
may be a preferable approach for intubating patients undergoing surgical
procedures. Trial Registration: ClinicalTrials.gov Identifier:
NCT04701762.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<61>
Accession Number
2031832971
Title
Evaluation on mortality predictors after emergent percutaneous coronary
intervention in acute myocardial infarction with ventricular arrhythmias:
Details not to be ignored?.
Source
International Journal of Cardiology. 406 (no pagination), 2024. Article
Number: 132079. Date of Publication: 01 Jul 2024.
Author
Al A.; Babayigit E.; Gorenek B.
Institution
(Al, Babayigit, Gorenek) Eskisehir Osmangazi University, Faculty of
Medicine, Department of Cardiology, Eskisehir, Turkey
Publisher
Elsevier Ireland Ltd

<62>
Accession Number
644056113
Title
Two Hour Protocol Using Sensitive Troponin I and Stress Testing in the
Emergency Department for the Early Management of Chest Pain.
Source
Critical Pathways in Cardiology. Conference: 18th Congress of the
Cardiovascular Patient Care Center. San Antonio, TX United States. 14(3)
(pp 120), 2015. Date of Publication: September 2015.
Author
Dadkhah S.; Almuwaqqat Z.; Suliman S.; Nguyen Q.; Sargsyan M.; Oktay A.
Institution
(Dadkhah, Almuwaqqat, Suliman, Nguyen, Sargsyan, Oktay) Presence Saint
Francis Hospital, Evanston, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The introduction of cardiac biomarkers in the emergency
department (ED) constituted a milestone in the care of patients with chest
pain. Patients presenting with atypical chest pain and non-diagnostic ECG
with negative serial cardiac markers may be suitable for early discharge
and shorter hospital stays. Since 1992, our chest pain protocol includes
using 4-hour serial biomarkers from ED admission in combination with
stress testing to evaluate these patients. To determine whether a new
accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI)
(Mitsubishi PATHFAST) 2 hours after admission to the ED along with stress
testing is safe, and whether it can reduce length of stay and overall
costs. <br/>Method(s): We conducted a single center randomized trial at
Presence St. Francis Hospital in Illinois, enrolling 64 consecutive
patients with atypical chest pain and non-diagnostic ECG. Sixty patients
completed the protocol and were randomized to either a 2-hour or 4-hour
protocol using both I-STAT and Mitsubishi PATHFAST cTnI. Troponin I were
evaluated at 0 and at 2 hours from ED presentation with and additional
draw for patients in the 4-hour rule out-group. Twenty-nine patients were
randomized to the 2-hour protocol and 31 patients to the 4-hour protocol.
Patients with normal serial biomarkers were then evaluated with stress
testing and qualified for earlier discharge if the stress test was
negative, while those with a positive biomarker at any time were admitted.
36 patients had exercise treadmill stress test and 24 patients had either
nuclear or Echo stress test. <br/>Result(s): 53 patients had a normal
stress test and were discharged home. One patient in the 4-hour group with
normal serial troponins had a cardiac arrest during the recovery period of
a regular stress test. The subsequent angiogram showed severe LAD stenosis
requiring a stent. The PATHFAST cTnI was positive 45 minutes after the
arrest, while the I-Stat cTnI was normal. Six patients had a positive
PATHFAST cTnI and a normal I-STAT cTnI at 2 hours. Two out of these 6
patients went for coronary angiography. One patient had severe tortuous
coronaries but no significant obstructive lesion and one had a severe CAD
who needed CABG. Three of the 6 patients had a normal stress test and one
patient left against medical advice. The mean cost difference between the
2- and 4-hour group was $4,431. None of the patients with a normal stress
test at 6-month follow-up had a cardiac event. <br/>Conclusion(s): Using
the sensitive troponin I assay and stress test 2 hours afterED admission
is safe and cost effective.

<63>
Accession Number
2029473958
Title
Intravenous infusion of dexmedetomidine during the surgery to prevent
postoperative delirium and postoperative cognitive dysfunction undergoing
non-cardiac surgery: a meta-analysis of randomized controlled trials.
Source
European Journal of Medical Research. 29(1) (no pagination), 2024. Article
Number: 239. Date of Publication: December 2024.
Author
Wang D.; Liu Z.; Zhang W.; Zu G.; Tao H.; Bi C.
Institution
(Wang, Liu, Zhang, Tao, Bi) Department of Anaesthesiology, Dalian
Municipal Central Hospital Affiliated to Dalian University of Technology,
Liaoning, Dalian, China
(Liu, Zhang) China Medical University, Shenyang, China
(Wang) Dalian Medical University, Dalian, China
(Zu) Department of Gastroenterology, Dalian Municipal Central Hospital
Affiliated to Dalian University of Technology, Liaoning, Dalian, China
Publisher
BioMed Central Ltd
Abstract
Background: Dexmedetomidine plays a pivotal role in mitigating
postoperative delirium and cognitive dysfunction while enhancing the
overall quality of life among surgical patients. Nevertheless, the
influence of dexmedetomidine on such complications in various anaesthesia
techniques remains inadequately explored. As such, in the present study, a
meta-analysis was conducted to comprehensively evaluate its effects on
postoperative delirium and cognitive dysfunction. <br/>Method(s): A number
of databases were searched for randomised controlled trials comparing
intravenous dexmedetomidine to other interventions in preventing
postoperative delirium and cognitive dysfunction in non-cardiac and
non-neurosurgical patients. These databases included PubMed, Embase, and
Cochrane Library. Statistical analysis and graphing were performed using
Review Manager, STATA, the second version of the Cochrane risk-of-bias
tool for randomised controlled trials, and GRADE profiler. <br/>Main
Result(s): This meta-analysis comprised a total of 24 randomised
controlled trials, including 20 trials assessing postoperative delirium
and 6 trials assessing postoperative cognitive dysfunction. Across these
24 studies, a statistically significant positive association was observed
between intravenous administration of dexmedetomidine and a reduced
incidence of postoperative delirium (RR: 0.55; 95% CI 0.47 to 0.64, p <
0.00001, I² = 2%) and postoperative cognitive dysfunction (RR:
0.60; 95% CI 0.38 to 0.96, p = 0.03, I² = 60%). Subgroup
analysis did not reveal a significant difference in the incidence of
postoperative delirium between the general anaesthesia and non-general
anaesthesia groups, but a significant difference was observed in the
incidence of postoperative cognitive dysfunction. Nonetheless, when the
data were pooled, it was evident that the utilisation of dexmedetomidine
was associated with an increased incidence of hypotension (RR: 1.42; 95%
CI 1.08 to 1.86, p = 0.01, I² = 0%) and bradycardia (RR: 1.66;
95% CI 1.23 to 2.26, p = 0.001, I² = 0%) compared with other
interventions. However, there was no significantly higher occurrence of
hypertension in the DEX groups (RR = 1.35, 95% CI 0.81-2.24, p = 0.25,
I² = 0%). <br/>Conclusion(s): Compared with other
interventions, intravenous dexmedetomidine infusion during non-cardiac and
non-neurosurgical procedures may significantly reduce the risk of
postoperative delirium and cognitive dysfunction. The results of subgroup
analysis reveal a consistent preventive effect on postoperative delirium
in both general and non-general anaesthesia groups. Meanwhile, continuous
infusion during general anaesthesia was more effective in reducing the
risk of cognitive dysfunction. Despite such findings, hypotension and
bradycardia were more frequent in patients who received dexmedetomidine
during surgery.<br/>Copyright &#xa9; The Author(s) 2024.

<64>
Accession Number
644031236
Title
To repair or to replace in mitral valve infective endocarditis? an updated
meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 247), 2024. Date of
Publication: 18 Apr 2024.
Author
Awad A.K.; Wilson K.; Elnagar M.A.; Elbadawy M.A.; Fathy M.H.
Institution
(Awad, Wilson, Elnagar, Elbadawy, Fathy) Faculty of Medicine, Ain-Shams
University, Cairo, Egypt
(Awad) Department of Cardiothoracic Surgery, Ain-Shams University
Hospitals, Cairo, Egypt
Abstract
BACKGROUND: Valve infective endocarditis (IE) is a potentially
life-threatening condition that affects patients' livelihoods. Current
surgical options in mitral valve IE include mitral valve repair (MVr) or
replacement (MVR). While each procedure boasts its merits, doubt remains
as to which type of surgery is superior. <br/>METHOD(S): We searched
PubMed, Scopus, Web of Science, and Cochrane literature databases for
studies comparing MVR and MVr in mitral valve IE. Any randomized
controlled trial (RCT) or observational studies that compare MVR vs. MVr
in mitral valve IE were eligible. Our dichotomous outcomes were extracted
in the form of event and total, and risk and hazard ratio (RR)(HR) with
95% confidence interval (CI) and were pooled and calculated using RevMan
5.0. <br/>RESULT(S): Our study included 23 studies with a total population
of 11,802 patients. Compared to MVR, MVr had statistically significant
lower risks of both early mortality with RR [0.44; 95% CI, 0.38-0.51;
p<0.001] and long-term follow-up mortality with HR [0.70; 95% CI,
0.58-0.85; p=0.0004]. Moreover, MVr was associated with a statistically
significant lower risk of IE recurrence with RR [0.43; 95% CI, 0.32-0.58;
p<0.001]; however, no statistically significant differences between both
groups in terms of re-operations with RR [0.83; 95% CI, 0.41-1.67;
p=0.60]. <br/>CONCLUSION(S): Our results suggest that MVr was superior in
terms of in-hospital mortality, long-term survival, and risk of recurrence
without significance in valve reoperation. Therefore, MVr is appropriate
as a primary treatment choice and should be considered whenever possible
in most IE patients.<br/>Copyright &#xa9; 2024. The Author(s).

<65>
Accession Number
643748070
Title
Effectiveness of non-pharmacological interventions in improving sleep
quality after cardiac surgery: A systematic review and meta-analysis.
Source
Journal of clinical nursing. 33(6) (pp 2084-2098), 2024. Date of
Publication: 01 Jun 2024.
Author
Soh P.Q.P.; Wong W.H.T.; Roy T.; Tam W.W.S.
Institution
(Soh, Wong, Roy, Tam) Alice Lee Centre for Nursing Studies, Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Soh) Tan Tock Seng Hospital, Singapore
(Wong) Singapore General Hospital, Singapore
Abstract
BACKGROUND: Sleep disturbance is highly prevalent among post-operative
cardiac patients, with negative impacts on surgical recovery and
rehabilitation. Post-operative pain and anxiety commonly seen in cardiac
surgery patients are associated with poor sleep. Sleep medications
commonly used are not ideal with prolonged usage, and non-pharmacological
interventions can be good alternatives or complements. AIM: To examine
effectiveness of non-pharmacological interventions in post-operative
cardiac settings on sleep quality, pain intensity and anxiety. DESIGN:
Systematic review and meta-analysis. <br/>METHOD(S): PubMed, CENTRAL,
Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were
searched on 12 October 2022. Randomised controlled trials of
non-pharmacological interventions examining sleep quality for adult
post-operative cardiac patients were included. Included studies were
appraised using Cochrane Risk of Bias tool version 1. Meta-analysis was
conducted using RevMan version 5.4.1, and heterogeneity was assessed using
I2 statistics and Cochran Q's test. <br/>RESULT(S): Eighteen studies
involving 1701 participants were identified. Coronary artery bypass graft
was most common. Non-pharmacological interventions varied in types and
duration. All intervention groups were compared to usual care, placebo, no
interventions or active comparators. Statistically significant improvement
in sleep quality (SMD = -.91, 95% CI = -1.17 to -.65) was found among
intervention groups that explored cognitive behavioural therapy,
relaxation techniques, exercise, massage, acupressure, aromatherapy,
music, eye mask and earplugs. Pain intensity was reduced (SMD = -.63, 95%
CI = -1.05 to -.20) with cognitive behavioural therapy, relaxation
techniques, massage, music and eye mask. Anxiety was improved (SMD = -.21,
95% CI = -.38 to -.04) with exercise and music. <br/>CONCLUSION(S): The
overall use of non-pharmacological interventions can optimise sleep after
cardiac surgery. Further research with greater methodological rigour is
needed to investigate different intervention-related characteristics while
considering potential confounders. RELEVANCE TO CLINICAL PRACTICE:
Post-operative cardiac settings can consider incorporating
non-pharmacological interventions. Patients and healthcare providers can
be better informed about the use of such interventions to improve sleep.
REGISTRATION: PROSPERO CRD42022384991.<br/>Copyright &#xa9; 2024 The
Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

<66>
Accession Number
642814894
Title
Anaesthesia-related cognitive dysfunction following cardiothoracic surgery
in late middle-age and younger adults: A scoping review.
Source
Nursing in critical care. 29(3) (pp 457-465), 2024. Date of Publication:
01 May 2024.
Author
Varpaei H.A.; Robbins L.B.; Ling J.; Lehto R.H.; Bender C.M.
Institution
(Varpaei, Robbins, Ling, Lehto) College of Nursing, Michigan State
University, East Lansing, MI, United States
(Bender) Nursing and Clinical and Translational Science Institute,
University of Pittsburgh, Pittsburgh, PA, United States
Abstract
BACKGROUND: The incidence of postoperative cognitive dysfunction (POCD) is
notably high after cardiac surgery, ranging from 25% to 30%, and is
associated with a lower quality of life, increased patient dependency, and
heightened mortality. Anaesthesia during cardiothoracic surgery
significantly contributes to the risk of POCD in older adults by adversely
affecting the brain, including reductions in blood flow and oxygen levels.
AIM: This review aimed to evaluate factors associated with
anaesthesia-related postoperative cognitive dysfunction (POCD) among
adults younger than 65years who underwent cardiothoracic surgeries. STUDY
DESIGN: A systematic keyword search, following the scoping review
framework, was performed in the PubMed and CINAHL databases. Original
English-language studies that included adults younger than 65years and
addressed cognitive function after surgery along with anaesthesia
management were included. Retrospective studies, animal research and in
vitro and in vivo studies were excluded. <br/>RESULT(S): Twenty-three
articles were included (65.2% interventional studies). All studies lacked
theoretical or conceptual frameworks. Ketamine's neuroprotective potential
is questionable, and intravenous lidocaine may be considered a possible
early agent for preventing POCD, but long-term effectiveness is uncertain.
Compared to inhalational anaesthesia, total intravenous anaesthesia (TIVA)
may be related to a decreased incidence of POCD. Variation in POCD
assessment impacted the lack of homogeneity in obtained data. Moreover,
the shorter-term timing of POCD evaluation such as in early days after
surgery could be greatly influenced by medication and delirium.
<br/>CONCLUSION(S): Although strategies such as TIVA, the use of
neuroprotective anaesthetics and comprehensive preoperative assessments
are suggested to prevent POCD, this multifactorial phenomenon cannot be
explicitly attributed solely to anaesthetics or anaesthesia-related
techniques. Use of standardized, reliable and valid tools for POCD
assessment is encouraged for cross-study comparison. RELEVANCE TO CLINICAL
PRACTICE: Nurses and certified nurse anaesthetists must be aware of risk
factors for postoperative delirium and POCD so they can assess patients
before and after surgery. Patients and caregivers need to be educated
about cognitive changes after surgery and advised to report them to their
health care provider if they occur.<br/>Copyright &#xa9; 2023 The Authors.
Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of
British Association of Critical Care Nurses.

<67>
Accession Number
2031774883
Title
Ventilatory efficiency as a prognostic factor for postoperative
complications in patients undergoing elective major surgery: a systematic
review.
Source
British Journal of Anaesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Vetsch T.; Eggmann S.; Jardot F.; von Gernler M.; Engel D.; Beilstein
C.M.; Wuethrich P.Y.; Eser P.; Wilhelm M.
Institution
(Vetsch, Jardot, Engel, Beilstein, Wuethrich) Department of
Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Vetsch, Eser, Wilhelm) Centre for Rehabilitation & Sports Medicine,
Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Vetsch) Graduate School for Health Sciences, University of Bern, Bern,
Switzerland
(Eggmann) Department of Physiotherapy, Inselspital, Bern University
Hospital, Bern, Switzerland
(von Gernler) Medical Library, University Library of Bern, University of
Bern, Bern, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Major surgery is associated with high complication rates.
Several risk scores exist to assess individual patient risk before surgery
but have limited precision. Novel prognostic factors can be included as
additional building blocks in existing prediction models. A candidate
prognostic factor, measured by cardiopulmonary exercise testing, is
ventilatory efficiency (VE/VCO<inf>2</inf>). The aim of this systematic
review was to summarise evidence regarding VE/VCO<inf>2</inf> as a
prognostic factor for postoperative complications in patients undergoing
major surgery. <br/>Method(s): A medical library specialist developed the
search strategy. No database-provided limits, considering study types,
languages, publication years, or any other formal criteria were applied to
any of the sources. Two reviewers assessed eligibility of each record and
rated risk of bias in included studies. <br/>Result(s): From 10,082
screened records, 65 studies were identified as eligible. We extracted
adjusted associations from 32 studies and unadjusted from 33 studies. Risk
of bias was a concern in the domains 'study confounding' and 'statistical
analysis'. VE/VCO<inf>2</inf> was reported as a prognostic factor for
short-term complications after thoracic and abdominal surgery.
VE/VCO<inf>2</inf> was also reported as a prognostic factor for mid- to
long-term mortality. Data-driven covariable selection was applied in 31
studies. Eighteen studies excluded VE/VCO<inf>2</inf> from the final
multivariable regression owing to data-driven model-building approaches.
<br/>Conclusion(s): This systematic review identifies VE/VCO<inf>2</inf>
as a predictor for short-term complications after thoracic and abdominal
surgery. However, the available data do not allow conclusions about
clinical decision-making. Future studies should select covariables for
adjustment a priori based on external knowledge. Systematic review
protocol: PROSPERO (CRD42022369944).<br/>Copyright &#xa9; 2024 British
Journal of Anaesthesia

<68>
Accession Number
2029520676
Title
Outcomes of Percutaneous Revascularization in Severe Ischemic Left
Ventricular Dysfunction.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Bista R.; Zghouzi M.; Jasti M.; Lichaa H.; Kerrigan J.; Haddad E.; Alraies
M.C.; Paul T.K.
Institution
(Bista, Zghouzi, Jasti, Lichaa, Kerrigan, Haddad, Paul) University of
Tennessee Health Science Center, Nashville, TN, United States
(Bista, Zghouzi, Jasti, Lichaa, Kerrigan, Haddad, Paul) Ascension St.,
Thomas Hospital, Nashville, TN, United States
(Alraies) Detroit Medical Center, Cardiovascular Institute, Heart
Hospital, Detroit, MI, United States
Publisher
Springer
Abstract
Purpose of Review: This article presents a comprehensive review of
coronary revascularization versus optimal medical therapy (OMT) in
patients with severe ischemic left ventricular dysfunction. Recent
Findings: The REVIVED-BCIS2 trial randomized 700 patients with extensive
coronary artery disease and left ventricular (LV) ejection fraction (LVEF)
<= 35% and viability in more than four dysfunctional myocardial segments
to percutaneous coronary intervention (PCI) plus OMT versus OMT alone.
Over a median duration of 41 months, there was no difference in the
composite of all-cause mortality, heart failure hospitalization, or
improvement in LVEF with PCI plus OMT versus OMT alone at 6 and 12 months,
quality of life scores at 24 months, or fatal ventricular arrhythmia. The
STICH randomized trial was conducted between 2002 and 2007, involving
patients with LV dysfunction and coronary artery disease. The patients
were assigned to either CABG plus medical therapy or medical therapy
alone. At the 5-year follow-up, the trial showed that CABG plus medical
therapy reduced cardiovascular disease-related deaths and hospitalizations
but no reduction in all-cause mortality. However, a 10-year follow-up
showed a significant decrease in all-cause mortality with CABG.
<br/>Summary: The currently available evidence showed no apparent benefit
of PCI in severe ischemic cardiomyopathy as compared to OMT, but that CABG
improves outcomes in this patient population. The paucity of data on the
advantages of PCI in this patient population underscores the critical need
for optimization of medical therapy for better survival and quality of
life until further evidence from RCTs is available.<br/>Copyright &#xa9;
The Author(s) 2024.

<69>
Accession Number
644049100
Title
Effect of S-Ketamine on Postoperative Nausea and Vomiting in Patients
Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.
Source
Drug design, development and therapy. 18 (pp 1189-1198), 2024. Date of
Publication: 2024.
Author
Qi Y.; Zhou M.; Zheng W.; Dong Y.; Li W.; Xu H.; Zhang M.; Yang D.; Wang
L.; Zhou H.
Institution
(Qi, Zhou, Zheng, Dong, Wang, Xu, Zhang, Yang, Wang, Zhou) Xuzhou Clinical
College of Xuzhou Medical University, Xuzhou, Jiangsu, China
(Qi, Zhou, Zheng, Dong, Li, Wang, Xu, Wang, Zhou) Department of
Anesthesiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
(Qi, Zhou, Wang, Zhou) Jiangsu Province Key Laboratory of Anesthesiology
Xuzhou Medical University, Xuzhou, Jiangsu, China
(Li) College of Anesthesiology, Xuzhou Medical University, Xuzhou,
Jiangsu, China
(Zhang, Yang) Department of Cardiothoracic Surgery, Xuzhou Central
Hospital, Xuzhou, Jiangsu, China
Abstract
Purpose: Postoperative nausea and vomiting (PONV) frequently occur in
patients after surgery. In this study, the authors investigated whether
perioperative S-ketamine infusion could decrease the incidence of PONV in
patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy.
<br/>Patients and Methods: This prospective, randomized, double-blinded,
controlled study was conducted a total of 420 patients from September 2021
to May 2023 at Xuzhou Central Hospital in China, who underwent elective
VATS lobectomy under general anesthesia with tracheal intubation. The
patients were randomly assigned to either the S-ketamine group or the
control group. The S-ketamine group received a bolus injection of 0.5
mg/kg S-ketamine and an intraoperative continuous infusion of S-ketamine
at a rate of 0.25 mg/kg/h. The control group received an equivalent volume
of saline. All patients were equipped with patient-controlled intravenous
analgesia (PCIA), with a continuous infusion rate of 0.03 mg/kg/h
S-ketamine in the S-ketamine group or 0.03 mug/kg/h sufentanil in the
control group. The primary outcome was the incidence of PONV. Secondary
outcomes included perioperative opioid consumption, hemodynamics,
postoperative pain, and adverse events. <br/>Result(s): The incidence of
PONV in the S-ketamine group (9.7%) was significantly lower than in the
control group (30.5%). Analysis of perioperative opioid usage revealed
that remifentanil usage was 40.0% lower in the S-ketamine group compared
to the control group (1414.8 mug vs 2358.2 mug), while sufentanil
consumption was 75.2% lower (33.1 mug vs 133.6 mug). The S-ketamine group
demonstrated better maintenance of hemodynamic stability. Additionally,
the visual analogue scale (VAS) scores on postoperative day 1 (POD-1) and
postoperative day 3 (POD-3) were significantly lower in the S-ketamine
group. Finally, no statistically significant difference in other
postoperative adverse reactions was observed between the two groups.
<br/>Conclusion(s): The results of this trial indicate that perioperative
S-ketamine infusion can effectively reduce the incidence of PONV in
patients undergoing VATS lobectomy.<br/>Copyright &#xa9; 2024 Qi et al.

<70>
Accession Number
2031825130
Title
Prospective randomized double-blind study to evaluate the superiority of
Vasopressin versus Norepinephrine in the management of the patient at
renal risk undergoing cardiac surgery with cardiopulmonary bypass (NOVACC
trial).
Source
American Heart Journal. 272 (pp 86-95), 2024. Date of Publication: June
2024.
Author
Guinot P.-G.; Desebbe O.; Besch G.; Guerci P.; Gaudard P.; Lena D.; Mertes
P.M.; Abou-Arab O.; Bouhemad B.; Nguyen M.; Durand B.; Martin A.; Berthoud
V.; Constandache T.; Grosjean S.; Radhouani M.; Anciaux J.-B.; Voizeux P.;
Appriou A.; Kabout V.; Marcand J.; Nays F.; Guilhot M.; Alardin R.; Ilic
D.; Senot T.; Christophe B.; Guillaume B.; Clement L.; Florent L.; Thomas
L.; Guillaume H.; Aurore H.; Helene D.; Tommy G.; Lucas P.; Zoe Z.; Maxime
G.; Amelie B.; Rudy A.; Thomas S.; Aleksandra J.; Dejan I.; Bronnert;
Michel T.; Charles F.
Institution
(Guinot, Bouhemad) Department of Anesthesiology and Critical Care
Medicine, Dijon University Medical Centre, Dijon 21000, France
(Guinot, Bouhemad) University of Burgundy and Franche-Comte, LNC UMR1231,
Dijon F-21000, France
(Desebbe) Sauvegarde Clinic, Ramsay Sante, Lyon, France
(Besch) Department of Anesthesiology and Critical Care Medicine, Besancon
Regional University Medical Centre, Besancon, France
(Besch) EA3920, University of Franche-Comte, Besancon, France
(Guerci) Department of Anesthesia and Critical Care, University Hospital
of Nancy, Nancy, France
(Gaudard) Department of Anesthesia and Critical Care, University Hospital
of Montpellier, Montepellier, France
(Lena) Institut Arnault Tzanck, Saint Laurent du Var, France
(Mertes) Department of Anesthesia and Critical Care, University Hospital
of Strasbourg, Strasbourg, France
(Abou-Arab) Department of Anesthesia and Critical Care, University
Hospital of Amiens, Amiens, France
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgery-associated acute kidney injury (CS-AKI)
affects up to 30% of patients, increasing morbidity and healthcare costs.
This condition results from complex factors like ischemia-reperfusion
injury and renal hemodynamic changes, often exacerbated by surgical
procedures. Norepinephrine, commonly used in cardiac surgeries, may
heighten the risk of CS-AKI. In contrast, vasopressin, a
noncatecholaminergic agent, shows potential in preserving renal function
by favorably affecting renal hemodynamic. Preliminary findings, suggest
vasopressin could reduce the incidence of CS-AKI compared to
norepinephrine. Additionally, vasopressin is linked to a lower incidence
of postoperative atrial fibrillation, another factor contributing to
longer hospital stays and higher costs. This study hypothesizes that
vasopressin could effectively reduce CS-AKI occurrence and severity by
optimizing renal perfusion during cardiac surgeries. Study design: The
NOVACC trial (NCT05568160) is a multicenter, randomized, double blinded
superiority-controlled trial testing the superiority of vasopressin over
norepinephrine in patients scheduled for cardiac surgery with
cardiopulmonary bypass (CPB). The primary composite end point is the
occurrence of acute kidney injury and death. The secondary end points are
neurological, cardiologic, digestive, and vasopressor related
complications at day 7, day 30, day 90, hospital and intensive care unit
lengths of stay, medico-economic costs at day 90. <br/>Conclusion(s): The
NOVACC trial will assess the effectiveness of vasopressin in cardiac
surgery with CPB in reducing acute kidney injury, mortality, and medical
costs. Clinical trial registration: NCT05568160.<br/>Copyright &#xa9; 2024
The Author(s)

<71>
Accession Number
2029423356
Title
A review and analysis of outcomes in randomized clinical trials of plasma
transfusion in patients with bleeding or for the prevention of bleeding:
The BEST collaborative study.
Source
Transfusion. (no pagination), 2024. Date of Publication: 2024.
Author
Apelseth T.O.; Raza S.; Callum J.; Ipe T.; Blackwood B.; Akhtar A.; Hess
J.R.; Marks D.C.; Brown B.; Delaney M.; Wendel S.; Stanworth S.J.
Institution
(Apelseth) Department of Immunology and Transfusion Medicine, Haukeland
University Hospital, Bergen, Norway
(Apelseth) Faculty of Medicine, University of Bergen, Bergen, Norway
(Apelseth) Norwegian Armed Forces Joint Medical Services, Oslo, Norway
(Raza) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, Canada
(Ipe) Our Blood Institute, Oklahoma City, OK, United States
(Ipe) Department of Pathology, University of Arkansas for Medical
Sciences, Little Rock, AR, United States
(Blackwood) Wellcome-Wolfson Institute for Experimental Medicine, Queen's
University, Belfast, United Kingdom
(Akhtar) Royal Victoria Hospital, Belfast, United Kingdom
(Hess) Department of Laboratory Medicine and Pathology, University of
Washington School of Medicine, Seattle, WA, United States
(Marks) Research and Development, Australian Red Cross Lifeblood, Sydney,
Australia
(Brown) American Red Cross, Medical and Scientific Office, Washington, DC,
United States
(Delaney) Childrens National Hospital, Washington, DC, United States
(Wendel) Hospital Sirio Libanes, Sao Paulo, Brazil
(Stanworth) NHSBT, Oxford University Hospitals NHS Trust; Blood
Transfusion Research Unit (BTRU), University of Oxford, Oxford, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Previous systematic reviews have revealed an inconsistency of
outcome definitions as a major barrier in providing evidence-based
guidance for the use of plasma transfusion to prevent or treat bleeding.
We reviewed and analyzed outcomes in randomized controlled trials (RCTs)
to provide a methodology for describing and classifying outcomes. Study
Design and Methods: RCTs involving transfusion of plasma published after
2000 were identified from a prior review (Yang 2012) and combined with an
updated systematic literature search of multiple databases (July 1, 2011
to January 17, 2023). Inclusion of publications, data extraction, and risk
of bias assessments were performed in duplicate. (PROSPERO registration
number is: CRD42020158581). <br/>Result(s): In total, 5579 citations were
identified in the new systematic search and 22 were included. Six
additional trials were identified from the previous review, resulting in a
total of 28 trials: 23 therapeutic and five prophylactic studies. An
increasing number of studies in the setting of major bleeding such as in
cardiovascular surgery and trauma were identified. Eighty-seven outcomes
were reported with a mean of 11 (min-max. 4-32) per study. There was
substantial variation in outcomes used with a preponderance of surrogate
measures for clinical effect such as laboratory parameters and blood
usage. <br/>Conclusion(s): There is an expanding literature on plasma
transfusion to inform guidelines. However, considerable heterogeneity of
reported outcomes constrains comparisons. A core outcome set should be
developed for plasma transfusion studies. Standardization of outcomes will
motivate better study design, facilitate comparison, and improve clinical
relevance for future trials of plasma transfusion.<br/>Copyright &#xa9;
2024 The Authors. Transfusion published by Wiley Periodicals LLC on behalf
of AABB.

<72>
Accession Number
644041742
Title
Transcatheter or Surgical Aortic Valve Replacement in Women with Small
Annuli at Low or Intermediate Surgical Risk.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 17 Apr 2024.
Author
Modine T.; Forrest J.K.; Van Mieghem N.M.; Deeb G.M.; Yakubov S.J.; Ali
W.B.; Tchetche D.; Lam K.Y.; Oh J.K.; Huang J.; Mehran R.; Reardon M.J.
Institution
(Modine) Department of Cardiac Surgery, Cardiologique de Haut Leveque -
(CHU) de Bordeaux, France
(Forrest) Department of Internal Medicine (Cardiology), Yale University
School of Medicine, New Haven, CT, United States
(Van Mieghem) Department of Interventional Cardiology, Cardiovascular
Institute, Thoraxcenter, Erasmus University Medical Centre, Rotterdam,
Netherlands
(Deeb) Department of Cardiothoracic Surgery, University of Michigan, Ann
Arbor, MI, United States
(Yakubov) Department of Interventional Cardiology, Columbus, OH, United
States
(Ali) Department of Surgery, Montreal Heart Institute, Montreal, Canada
(Tchetche) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
(Lam) Department of Cardiothoracic Surgery, Catharina Ziekenhuis,
Eindhoven, Netherlands
(Oh) Department of Medicine (Echocardiography), Mayo Clinic, Rochester,
MN, United States
(Huang) Medtronic, Minneapolis, MN, United States
(Mehran) Icahn School of Medicine at Mount Sinai, NY, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
Abstract
There are limited data from randomized controlled trials assessing the
impact of transcatheter aortic valve replacement (TAVR) or surgery in
women with aortic stenosis and small aortic annuli. We evaluated 2-year
clinical and hemodynamic outcomes following AVR to understand acute valve
performance and early and mid-term clinical outcomes. This post hoc
analysis pooled women enrolled in the randomized, prospective, multicenter
Evolut Low Risk and SURTAVI intermediate risk trials. Women with severe
aortic stenosis at low or intermediate surgical risk who had a
computed-tomography-measured annular perimeter of <= 72.3 mm were included
and underwent self-expanding, supra-annular TAVR or surgery. The primary
endpoint was 2-year all-cause mortality or disabling stroke rate. The
study included 620 women (323 TAVR, 297 surgery) with a mean age of 78
years. At 2 years, all-cause mortality or disabling stroke was 6.5% for
TAVR and 8.0% for surgery, p=0.47. Pacemaker rates were 20.0% for TAVR and
8.3% for surgery, p <0.001. The mean effective orifice area at 2 years was
1.9 +/- 0.5 cm2 for TAVR and 1.6 +/- 0.5 cm2 for surgery, and the mean
gradient was 8.0 +/- 4.1 mmHg vs 12.7 +/- 6.0 mmHg, respectively (both p
<0.001). Moderate or severe patient-prothesis mismatch at discharge
occurred in 10.9% of TAVR and 33.2% of surgery patients, p < 0.001. In
conclusion, in women with small annuli, clinical outcomes to 2 years were
similar between self-expanding, supra-annular TAVR and surgery, with
better hemodynamics in the TAVR group, and fewer pacemakers in the
surgical group.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<73>
Accession Number
644041536
Title
Timing of fractional flow reserve-guided complete revascularization in
patients with ST-segment elevation myocardial infarction with multivessel
disease: Rationale and design of the OPTION-STEMI trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 17
Apr 2024.
Author
Kim M.C.; Ahn J.H.; Hyun D.Y.; Lim Y.; Lee S.H.; Oh S.; Cho K.H.; Sim
D.S.; Hong Y.J.; Kim J.H.; Jeong M.H.; Cho J.H.; Lee S.-R.; Kang D.O.;
Hwang J.-Y.; Youn Y.J.; Jeong Y.-H.; Park Y.; Kim D.-B.; Choo E.-H.; Kim
C.J.; Kim W.; Rhew J.Y.; Lee J.-H.; Yoo S.-Y.; Ahn Y.
Institution
(Kim, Ahn, Hyun, Lim, Lee, Oh, Cho, Sim, Hong, Kim, Jeong) Division of
Cardiology, Department of Internal Medicine, Chonnam National University
Medical School, Chonnam National University Hospital, Gwangju, South Korea
(Cho) St Carollo General Hospital, Suncheon, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Jeonbuk
National University Medical School, Jeonbuk National University Hospital,
Jeonju, South Korea
(Kang) Cardiovascular Center, Department of Internal Medicine, Korea
University College of Medicine, Korea University Guro Hospital, Seoul,
South Korea
(Hwang) Division of Cardiology, Department of Internal Medicine,
Gyeongsang National University College of Medicine, Gyeongsang National
University Hospital, Jinju, South Korea
(Youn) Division of Cardiology, Department of Internal Medicine, Yonsei
University Wonju College of Medicine, Wonju Severance Christian Hospital,
Wonju, South Korea
(Jeong) CAU Thrombosis and Biomarker Center, Chung-Ang University
Gwangmyeong Hospital, Korea and Division of Cardiology, Department of
Internal Medicine, Chung-Ang University College of Medicine, Seoul, South
Korea
(Park) Division of Cardiology, Department of Internal Medicine, Gyeongsang
National University College of Medicine, Gyeongsang National University
Changwon Hospital, Changwon, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Catholic
University of Korea, Bucheon St. Mary's Hospital, Bucheon, South Korea
(Choo) Division of Cardiology, Department of Internal Medicine, Seoul St.
Mary's Hospital, Catholic University of Korea, Seoul, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Catholic
University of Korea, Uijeongbu St. Mary's Hospital, South Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Kyung Hee
University College of Medicine, Kyung Hee University Medical Center,
Seoul, South Korea
(Rhew) Presbyterian Medical Center, Jeonju, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Yonsei
University Wonju College of Medicine, Wonju Severance Christian Hospital,
Korea and Division of Cardiology, Yeungnam University College of Medicine,
Yeungnam University Medical Center, Wonju, Daegu, South Korea
(Yoo) Good Morning Hospital, Korea and Division of Cardiology, Department
of Internal Medicine, University of Ulsan College of Medicine, Gangneung
Asan Hospital, Gangneung, Pyeongtaek, South Korea
(Ahn) Division of Cardiology, Department of Internal Medicine, Chonnam
National University Medical School, Chonnam National University Hospital,
Gwangju, South Korea
Abstract
BACKGROUND: Current guidelines recommend complete revascularization (CR)
in hemodynamically stable patients with ST-segment elevation myocardial
infarction (STEMI) and multivessel coronary artery disease (MVD). With
regard to the timing of percutaneous coronary intervention (PCI) for
non-infarct-related artery (non-IRA), recent randomized clinical trials
have revealed that immediate CR was non-inferior to staged CR. However,
the optimal timing of CR remains uncertain. The OPTION-STEMI trial
compared immediate CR and in-hospital staged CR guided by fractional flow
reserve (FFR) for intermediate stenosis of the non-IRA. <br/>METHOD(S):
The OPTION-STEMI is a multicenter, investigator-initiated, prospective,
open-label, non-inferiority randomized clinical trial. The study included
patients with at least one non-IRA lesion with >=50% stenosis by visual
estimation. Patients fulfilling the inclusion criteria were randomized
into two groups at a 1:1 ratio: immediate CR (i.e., PCI for the non-IRA
performed during primary angioplasty) or in-hospital staged CR. In the
in-hospital staged CR group, PCI for non-IRA lesions was performed on
another day during the index hospitalization. Non-IRA lesions with 50-69%
stenosis by visual estimation were evaluated by FFR, whereas those with
>=70% stenosis were revascularized without FFR. The primary endpoint was
the composite of all-cause death, non-fatal myocardial infarction, and all
unplanned revascularization at 1 year after randomization. Enrolment began
in December 2019 and was completed in January 2024. The follow-up for the
primary endpoint will be completed in January 2025, and primary results
will be available in the middle of 2025. <br/>CONCLUSION(S): The
OPTION-STEMI is a multicenter, non-inferiority, randomized trial that
evaluated the timing of in-hospital CR with the aid of FFR in patients
with STEMI and MVD. TRIAL REGISTRATION: URL: https://www. CLINICALTRIALS:
gov. Unique identifier: NCT04626882; and URL: https://cris.nih.go.kr.
Unique identifier: KCT0004457.<br/>Copyright &#xa9; 2024 The Authors.
Published by Elsevier Inc. All rights reserved.

<74>
Accession Number
644038716
Title
Long term outcomes of bioprosthetic valves in the mitral position: A
pooled meta- analysis of reconstructed time-to-event individual patient
data.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 16 Apr 2024.
Author
Koulouroudias M.; Mauro M.D.; Chiariello G.; Meani P.; Lorusso R.
Institution
(Koulouroudias) Cardiovascular Research Institute (CARIM), University of
Maastricht, Maastricht, The Netherlands; Department of Cardiac Surgery,
Trent Cardiac Centre, Nottingham University Hospitals, Nottingham, United
Kingdom
(Mauro) Cardiovascular Research Institute (CARIM), University of
Maastricht, Maastricht, The Netherlands; Department of Cardiology,
"Pierangeli" Hospital, Pescara, Italy
(Chiariello) Cardiovascular Research Institute (CARIM), University of
Maastricht, Maastricht, The Netherlands; Cardiovascular Sciences
Department, Agostino Gemelli Foundation Polyclinic, IRCCS, Rome, Italy
(Meani) Cardiovascular Research Institute (CARIM), University of
Maastricht, Maastricht, Netherlands
(Lorusso) Cardiovascular Research Institute (CARIM), University of
Maastricht, Maastricht, The Netherlands; Heart and Vascular Centre,
Maastricht University Medical Centre, Maastricht, The Netherlands
Abstract
OBJECTIVES: Bioprosthetic MVR use is on the rise, but data regarding long
term durability is lacking. We sought to perform a reconstructed
individual patient data meta-analysis from published Kaplan Meier curves
to ascertain survival, freedom from valve degeneration and reoperation in
studies published since 2010. We explored the effects of age and valve
type (bovine pericardial or porcine valve) on outcomes. <br/>METHOD(S): We
searched MEDLINE, OVID, Embase and Cochrane CENTRAL for studies reporting
at least 3 years of follow-up after bMVR and published since 2010. The
ROBINS-I tool was used to assess methodological quality. Kaplan Meier
curves were digitized to extract individual patient data and reconstructed
estimates for overall survival, freedom from SVD and freedom from
re-operation. <br/>RESULT(S): 20 studies (16465 patients) were included. 9
studies reported on porcine valves, 6 on bovine and 7 did not specify the
valve type. Overall survival after bMVR at 15 years was 40% (CI 38%-42%),
freedom from re-operation at 15 years was 79% (CI 76%-82%) and freedom
from structural valve degeneration at 15 years was 64% (58%-70%). Freedom
from SVD was improved in the 70+ age group (93% up to 25 years, HR
6.6(2.5-17) for 18-59 VS >70, p<0.0001). There was no difference in valve
durability or survival between bovine pericardial or porcine valves.
<br/>CONCLUSION(S): In this meta-analysis patients of receiving
bioprosthetic mitral valve replacement using newer generation valves, the
inverse relationship between age and SVD was re-iterated in the 70+ age
group. Prosthesis type made no difference in outcomes.<br/>Copyright
&#xa9; 2024. Published by Elsevier Inc.