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<1>
Accession Number
2022693536
Title
Anatomic, stage-based repair of secondary mitral valve disease.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1733-1744),
2024. Date of Publication: May 2024.
Author
Drake D.H.; Zhang P.; Zimmerman K.G.; Morrow C.D.; Sidebotham D.A.
Institution
(Drake) Department of Cardiac Surgery, University of Michigan Medical
School, Ann Arbor, Mich, United States
(Drake) Department of Surgery, Munson Medical Center, Traverse City, Mich,
United States
(Zhang) Department of Surgery, University of Michigan Medical School, Ann
Arbor, Mich, United States
(Zimmerman) Department of Cardiology, Henry Ford Health System, Detroit,
Mich, United States
(Morrow) Health Systems, Management & Policy, Colorado School of Public
Health, Aurora, Colo, United States
(Sidebotham) Department of Cardiothoracic Anaesthesia and Cardiothoracic
Intensive Care, Auckland City Hospital, Auckland, New Zealand
Publisher
Elsevier Inc.
Abstract
Objective: Intervention for repair of secondary mitral valve disease is
frequently associated with recurrent regurgitation. We sought to determine
if there was sufficient evidence to support inclusion of anatomic indices
of leaflet dysfunction in the management of secondary mitral valve
disease. <br/>Method(s): We performed a systematic review and
meta-analysis of published reports comparing anatomic indices of leaflet
dysfunction with the complexity of valve repair and the outcome from
intervention. Patients were stratified by the severity of leaflet
dysfunction. A secondary analysis was performed comparing outcomes when
procedural complexity was optimally matched to severity of leaflet
dysfunction and when intervention was not matched to dysfunction.
<br/>Result(s): We identified 6864 publications, of which 65 met inclusion
criteria. An association between the severity of leaflet dysfunction and
the procedural complexity was highly predictive of satisfactory freedom
from recurrent regurgitation. Patients were categorized into 4 groups
based on stratification of leaflet dysfunction. Satisfactory results were
achieved in 93.7% of patients in whom repair complexity was appropriately
matched to severity of leaflet dysfunction and in 68.8% in whom repair was
not matched to dysfunction (odds ratio, 0.148; 95% confidence interval,
0.119-0.184; P < .0001). <br/>Conclusion(s): For patients with secondary
mitral valve disease, satisfactory outcome from valve repair improves when
procedural complexity is matched to anatomic indices of leaflet
dysfunction. Anatomic indices of leaflet dysfunction should be considered
when planning interventions for secondary mitral regurgitation. Routine
inclusion of anatomic indices in trial design and reporting should
facilitate comparison of results and strengthen guidelines. There are
sufficient data to support anatomic staging of secondary mitral valve
disease.<br/>Copyright &#xa9; 2023 The American Association for Thoracic
Surgery

<2>
Accession Number
2021703568
Title
Intimal hyperplasia, saphenous vein graft disease, and clinical outcomes:
Insights from the CTSN VEST randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(5) (pp 1782-1792.e5),
2024. Date of Publication: May 2024.
Author
Goldstein D.J.; Chang H.L.; Mack M.J.; Voisine P.; Gammie J.S.; Marks
M.E.; Iribarne A.; Vengrenyuk Y.; Raymond S.; Taylor B.S.; Dagenais F.;
Ailawadi G.; Chu M.W.A.; DiMaio J.M.; Narula J.; Moquete E.G.; O'Sullivan
K.; Williams J.B.; Crestanello J.A.; Scavo V.; Puskas J.D.; Acker M.A.;
Gillinov M.; Gelijns A.C.; O'Gara P.T.; Moskowitz A.J.; Alexander J.H.;
Bagiella E.
Institution
(Goldstein) Department of Cardiovascular and Thoracic Surgery, Montefiore
Medical Center, Bronx, NY, United States
(Chang, Marks, Raymond, Moquete, O'Sullivan, Gelijns, Moskowitz, Bagiella)
Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Mack, DiMaio) Cardiothoracic Surgery, Baylor Scott & White Health, Plano,
Tex, United States
(Voisine, Dagenais) Department of Surgery, Institut de Cardiologie et
Pneumologie de Quebec, Quebec City, Quebec, Canada
(Gammie) Johns Hopkins Heart and Vascular Institute, Johns Hopkins Health
System, Baltimore, Md, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
NH, Lebanon
(Vengrenyuk) Division of Cardiology, Mount Sinai Hospital and Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Taylor) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, Md, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Narula) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Williams) Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh,
NC, United States
(Crestanello) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, Minn, United States
(Scavo) Cardiovascular and Thoracic Surgery, Lutheran Medical Group, Fort
Wayne, Ind, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY, United States
(Acker) Division of Cardiovascular Surgery, University of Pennsylvania,
Hospital of the University of Pennsylvania, Philadelphia, Pa, United
States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
Mass, United States
(Alexander) Division of Cardiology, Department of Medicine, Duke
University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Diffuse intimal hyperplasia and graft irregularity adversely
affect the long-term patency of saphenous vein grafts (SVGs) and clinical
outcomes of patients undergoing coronary artery bypass grafting (CABG).
The VEST trial evaluated the efficacy of external graft support in
limiting the development of intimal hyperplasia (IH) at 1 year
postsurgery. In the present secondary analysis, we explored the
associations between graft disease and IH and clinical events. We also
examined risk factors for early graft occlusion. <br/>Method(s): VEST is a
within-patient randomized, multicenter trial that enrolled 224 patients
with multivessel coronary disease undergoing CABG surgery, of whom 203
were evaluated by 1 year postsurgery. Intimal hyperplasia, lumen
uniformity, graft stenosis, and graft perfusion were measured by
intravascular ultrasound and angiography. Major cardiac and
cerebrovascular events (MACCE; including death, myocardial infarction,
stroke, and revascularization) were recorded over a median follow-up of 3
years. <br/>Result(s): Worse lumen uniformity, greater stenosis, and worse
graft perfusion were associated with higher IH values and an increased
incidence of clinical events. Consistent with previous findings, we
identified endoscopic vein harvesting, female sex, and transit time flow
measurement of pulsatility index and flow as risk factors for SVG
occlusion during the first year postsurgery. <br/>Conclusion(s): In this
secondary analysis of the VEST trial, we observed an association between
intimal hyperplasia area and clinical measures of SVG disease at 1 year
postsurgery. More severe SVG disease and larger areas of IH were
associated with a higher incidence of 3-year MACCE. Ongoing follow-up to 5
years will further elucidate the impact of SVG disease on long-term
clinical outcomes of CABG.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<3>
Accession Number
2031995601
Title
Long-Term Outcomes of Bioprosthetic Valves in the Mitral Position: A
Pooled Meta-Analysis of Reconstructed Time-to-Event Individual Patient
Data.
Source
American Journal of Cardiology. 221 (pp 64-73), 2024. Date of Publication:
15 Jun 2024.
Author
Koulouroudias M.; Di Mauro M.; Chiariello G.; Meani P.; Lorusso R.
Institution
(Koulouroudias, Di Mauro, Chiariello, Meani, Lorusso) Cardiovascular
Research Institute (CARIM), University of Maastricht, Maastricht,
Netherlands
(Koulouroudias) Department of Cardiac Surgery, Trent Cardiac Centre,
Nottingham University Hospitals, Nottingham, United Kingdom
(Di Mauro) Department of Cardiology, "Pierangeli" Hospital, Pescara, Italy
(Chiariello) Cardiovascular Sciences Department, Agostino Gemelli
Foundation Polyclinic, IRCCS, Rome, Italy
(Lorusso) Heart and Vascular Centre, Maastricht University Medical Centre,
Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Bioprosthetic mitral valve replacement (bMVR) use is increasing; however,
data regarding long-term durability are 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. 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 Risk Of Bias In Non-randomised Studies of Interventions
(ROBINS-I) tool was used to assess methodologic quality. Kaplan-Meier
curves were digitized to extract individual patient data and reconstructed
estimates for overall survival, freedom from structural valve
deterioration (SVD), and freedom from reoperation. A total of 20 studies
(16,465 patients) were included. A total of 9 studies reported on porcine
valves, 6 reported on bovine, and 7 did not specify the valve type. The
overall survival after bMVR at 15 years was 40% (confidence interval 38%
to 42%), freedom from reoperation at 15 years was 79% (confidence interval
76% to 82%), and freedom from SVD at 15 years was 64% (58% to 70%).
Freedom from SVD was improved in the 70+ years age group (93% up to 25
years, hazard ratio 6.6 [2.5 to 17] for 18 to 59 vs >70 years, p <0.0001).
There was no difference in valve durability or survival between bovine
pericardial or porcine valves. In this meta-analysis of patients who
underwent bMVR using newer generation valves, the inverse relation between
age and SVD was reiterated in the 70+ years age group. The prosthesis type
made no difference in the outcomes.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<4>
Accession Number
2031935062
Title
Treatment with inhaled Argon: a systematic review of pre-clinical and
clinical studies with meta-analysis on neuroprotective effect.
Source
eBioMedicine. 103 (no pagination), 2024. Article Number: 105143. Date of
Publication: May 2024.
Author
Merigo G.; Florio G.; Madotto F.; Magliocca A.; Silvestri I.; Fumagalli
F.; Cerrato M.; Motta F.; De Giorgio D.; Panigada M.; Zanella A.;
Grasselli G.; Ristagno G.
Institution
(Merigo) Department of Biomedical Sciences for Health, University of
Milan, Milan, Italy
(Merigo, Madotto, Panigada, Zanella, Grasselli, Ristagno) Department of
Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda
Ospedale Maggiore Policlinico, Milan, Italy
(Florio, Magliocca, Silvestri, Zanella, Grasselli, Ristagno) Department of
Pathophysiology and Transplantation, University of Milan, Milan, Italy
(Fumagalli, Cerrato, Motta, De Giorgio) Department of Acute Brain and
Cardiovascular Injury, Istituto di Ricerche Farmacologiche Mario Negri
IRCCS, Milan, Italy
Publisher
Elsevier B.V.
Abstract
Background: Argon (Ar) has been proposed as a potential therapeutic agent
in multiple clinical conditions, specifically in organ protection.
However, conflicting data on pre-clinical models, together with a great
variability in Ar administration protocols and outcome assessments, have
been reported. The aim of this study was to review evidence on treatment
with Ar, with an extensive investigation on its neuroprotective effect,
and to summarise all tested administration protocols. <br/>Method(s):
Using the PubMed database, all existing pre-clinical and clinical studies
on the treatment with Ar were systematically reviewed (registration:
https://doi.org/10.17605/OSF.IO/7983D). Study titles and abstracts were
screened, extracting data from relevant studies post full-text review.
Exclusion criteria included absence of full text and non-English language.
Furthermore, meta-analysis was also performed to assess Ar potential as
neuroprotectant agent in different clinical conditions: cardiac arrest,
traumatic brain injury, ischemic stroke, perinatal hypoxic-ischemic
encephalopathy, subarachnoid haemorrhage. Standardised mean differences
for neurological, cognitive and locomotor, histological, and physiological
measures were evaluated, through appropriate tests, clinical, and
laboratory variables. In vivo studies were evaluated for risk of bias
using the Systematic Review Center for Laboratory Animal Experimentation
tool, while in vitro studies underwent assessment with a tool developed by
the Office of Health Assessment and Translation. <br/>Finding(s): The
systematic review detected 60 experimental studies (16 in vitro, 7 ex
vivo, 31 in vivo, 6 with both in vitro and in vivo) investigating the role
of Ar. Only one clinical study was found. Data from six in vitro and
nineteen in vivo studies were included in the meta-analyses. In
pre-clinical models, Ar administration resulted in improved neurological,
cognitive and locomotor, and histological outcomes without any change in
physiological parameters (i.e., absence of adverse events).
<br/>Interpretation(s): This systematic review and meta-analysis based on
experimental studies supports the neuroprotective effect of Ar, thus
providing a rationale for potential translation of Ar treatment in humans.
Despite adherence to established guidelines and methodologies, limitations
in data availability prevented further analyses to investigate potential
sources of heterogeneity due to study design. <br/>Funding(s): This study
was funded in part byItalian Ministry of Health-Current researchIRCCS and
byMinistero della Salute Italiano,Ricerca Finalizzata, project no.RF
2019-12371416.<br/>Copyright &#xa9; 2024 The Author(s)

<5>
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.

<6>
Accession Number
2031980664
Title
Reply to Sethuraman.
Source
European Journal of Cardio-thoracic Surgery. 64(1) (no pagination), 2023.
Article Number: ezad246. Date of Publication: 01 Jul 2023.
Author
Dusseaux M.-M.; Grego V.; Baste J.-M.; Selim J.
Institution
(Dusseaux, Grego, Selim) Department of Anaesthesiology and Critical Care,
CHU Rouen, Rouen F-76000, France
(Baste, Selim) Univ Rouen Normandy, INSERM EnVI, UMR 1096, Rouen, France
(Baste) Department of Thoracic Surgery, CHU, Rouen F-76000, France
Publisher
European Association for Cardio-Thoracic Surgery

<7>
Accession Number
2032095509
Title
Mid-Regional proadrenomedullin (MR-PROADM) may be a new marker of severity
status of patient with systemic inflammatory response-pilot project.
Source
Clinica Chimica Acta. Conference: IFCC WorldLab Dubai 2024. Dubai United
Arab Emirates. 558(Supplement 1) (no pagination), 2024. Article Number:
118878. Date of Publication: 01 May 2024.
Author
Lahoda Brodska H.; Svobodova E.; Francova I.; Tomsovic M.; Zima T.
Institution
(Svobodova) Department of Anesthesiology and Intensive Care of The General
University Hospital and of The First Faculty of Medicine of Charles
University, Czechia
(Lahoda Brodska, Francova, Tomsovic, Zima) Institute of Medical
Biochemistry and Laboratory Diagnostics of The General University Hospital
and of The First Faculty of Medicine of Charles University, Czechia
Publisher
Elsevier B.V.
Abstract
Background-Aim: MR-proADM is a biomarker of microcirculatory and
endothelial damage. It can predict organ damage and the risk of increase
of motrality in patients with septic shock. Our study aimed to evaluate
the plazmatic level of MR pro ADM in patients with systematic inflammatory
response (SIRS) and to compare it to SOFA and to selected biomarkers (the
ability of MR-proADM to describe the severity of patient status).
<br/>Method(s): With IRB approval, a patient cohort (n = 73; 146 samples)
with SIRS was enrolled. The cohort was divided into four groups. Group A
(17) sepsis patients with proven infect, group B (23) patients after
cardiosurgery with extracorporeal circulation without any infect, group C
(16) patients with proven ARDS in COVID-19 and group D (17) patients with
COVID pneumonia without ARDS. Biomarkers proadrenomedulin (MR pro ADM
nmol/l; C-reactive protein, CRP mg/l; procalcitonin, PCT ug/l; presepsin,
PRE pg/ml and interleukin-6, IL-6 ng/l; were assessed and SOFA score was
calculated. Data are displayed as median (1st and 3rd quartile), for
significant correlation: p < 0,05. <br/>Result(s): The medians in group A
were as follows: MR pro ADM 3,74 (2,43-6,17) PCT 9,87 (4,35-54,8), PRE
1273 (579-3715), CRP 313(227-388), IL-6 520 (319-1027) and SOFA 11
(10-13); in group B: MR pro ADM 1,0 (0,74-1,26), PCT 0,5 (0,31-1,1), PRE
437 (298-509), CRP 80 (61-96), IL-6 187 (100-285) and SOFA 3 (2-4); in
group C: MR pro ADM 1,6 (1,1-2,29) PCT 1,0 (0,24-1,75), PRE 1049
(543-1922), CRP 138 (87-204), IL-6 67 (29-177) and SOFA 9 (5-12); in group
D: MR pro ADM 0,85 (0,5-1,1) PCT 0,861 (0,61-1,12), PRE 573 (462-680), CRP
50 (16-139), IL-6 35 (20-74) and SOFA 1 (1-2). Medians of MR pro ADM are
significantly different between group A and B and between C and D. MR pro
ADM significantly correlates with SOFA (in groups A+ B (0,735), C+D
(0,587)), PCT in group A+ B has the best correlation with MR pro ADM
(0,691), with SOFA 0,565, CRP 0,46, PRE 0,47. No significant correlation
between MR-pro ADM and PCT, CRP, IL-6 but with PRE (0,501) in C+D group.
<br/>Conclusion(s): MR pro ADM correlates with SOFA in patients with SIRS
from selected inflammatory markers in the best way, it is an excellent
marker for detection of high risk of worsening of patient status. It could
be used as a triage marker.<br/>Copyright &#xa9; 2024

<8>
Accession Number
2032070355
Title
Beyond the incision: exploring acute pain management strategies following
cardiac surgeries.
Source
Anaesthesia, Pain and Intensive Care. 28(2) (pp 358-371), 2024. Date of
Publication: April 2024.
Author
Zahid M.A.; Kumar V.; Saddique F.; Khan B.; Saleh M.; Ahmed S.
Institution
(Zahid) Consultant General and Cardiothoracic Anesthetist, National
Medical Center, Karachi, Pakistan
(Kumar) NFT Consultant Aga Khan University Hospital, Karachi, Pakistan
(Saddique) Shifa Foundation Outreach Program, Baltistan, Gilgit, Pakistan
(Khan) Sindh Institute of Urology and Transplantation, Karachi, Pakistan
(Saleh) Jinnah Postgraduate Medical Center, Karachi, Pakistan
(Ahmed) National Institute of Cardiovascular Diseases, Karachi, Pakistan
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
This narrative review explores the importance of multimodal pain
management options for postoperative cardiac surgery, focusing on
maximizing pain alleviation while minimizing opioids usage and adverse
consequences. It examines various pharmacological and non-pharmacological
techniques, including opioids, NSAIDs, acetaminophen, gabapentinoids,
alpha-2 agonists, local anesthetics, and ketamine, to maximize pain relief
and improve patient outcomes. The review emphasizes the significance of a
multimodal approach, combining different agents for better pain relief and
patient outcomes. Non-pharmacological treatments, such as progressive
muscle relaxation, deep breathing exercises, distraction techniques,
massage therapy, and transcutaneous electrical nerve stimulation (TENS),
also play a role in pain management, promoting comprehensive patient
comfort and well-being. These methods are helpful additions to existing
pharmaceutical therapies and promote comprehensive patient comfort. In
conclusion, multimodal pain management techniques are crucial in
postoperative cardiac surgery, as they provide optimal pain relief,
increased patient satisfaction, and overall improvement in outcomes.
Healthcare professionals must continuously evaluate, modify, and improve
pain management strategies to provide the highest level of care to
patients in this high-stakes environment.<br/>Copyright &#xa9; 2024
Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights
reserved.

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

<10>
Accession Number
2032018447
Title
Exploring the Impact of Cardiac Rehabilitation Programs on Health-Related
Quality of Life and Physiological Outcomes in Patients Post Coronary
Artery Bypass Grafts: A Systematic Review.
Source
Reviews in Cardiovascular Medicine. 25(4) (no pagination), 2024. Article
Number: 2504145. Date of Publication: 2024.
Author
Subih M.; Elshatarat R.A.; Sawalha M.A.; Almarwani A.M.; Alhadidi M.;
Alrahahleh M.; Elneblawi N.H.; Saleh Z.T.; Abdelkader R.; Almagharbeh
W.T.; Eltayeb M.M.; Mohamed N.A.
Institution
(Subih, Alhadidi) School of Nursing, Al-Zaytoonah University of Jordan,
Amman 11733, Jordan
(Elshatarat, Elneblawi) Department of Medical and Surgical Nursing,
College of Nursing, Taibah University, Madinah 42353, Saudi Arabia
(Sawalha) Department of Maternal, Child and Family Health Nursing, Faculty
of Nursing, The Hashemite University, Zarqa 13133, Jordan
(Almarwani) Department of Psychiatric Nursing, College of Nursing, Taibah
University, Madinah 42353, Saudi Arabia
(Alrahahleh) Department of Nursing, Queen Alia Heart Institute, Amman
11855, Jordan
(Saleh) Department of Clinical Nursing, School of Nursing, The University
of Jordan, Amman 11942, Jordan
(Abdelkader) Faculty of Nursing, Applied Science Private University, Amman
11937, Jordan
(Almagharbeh) Medical Surgical Nursing Department, Faculty of Nursing,
University of Tabuk, Tabuk 47512, Saudi Arabia
(Eltayeb, Mohamed) Department of Medical Surgical Nursing, College of
Nursing, Prince Sattam Bin Abdulaziz University, AlKharj 16278, Saudi
Arabia
Publisher
IMR Press Limited
Abstract
Background: This systematic review explores the impact of cardiac
rehabilitation programs (CRPs) on health-related quality of life (HRQoL)
and physiological outcomes post-coronary artery bypass graft (CABG)
surgery. Acknowledging the increasing importance of CRPs in post-CABG
care, the study emphasizes the need for a comprehensive evaluation of
their effectiveness. The primary objective is to investigate how CRPs
influence HRQoL and physiological outcomes in post-CABG patients, offering
insights into the multifaceted impact of these rehabilitation programs.
<br/>Method(s): A systematic literature review approach was employed to
identify relevant studies published between 2013 and 2023. Inclusion
criteria encompassed clinical randomized trials and quasi-experimental
studies, with a focus on CRP interventions and their impact on HRQoL and
physiological parameters. <br/>Result(s): The review reveals a diverse
array of CRP approaches, including exercise training, home-based programs,
and telemonitored interventions. Despite methodological variations, a
consistent positive impact on HRQoL and physiological outcomes is observed
across studies. Noteworthy interventions, such as those incorporating
family caregivers, demonstrate holistic benefits. However, limitations
include methodological variability and the exclusion of qualitative
studies. <br/>Conclusion(s): This systematic review underscores the
substantial positive impact of CRPs on HRQoL and physiological outcomes in
post-CABG patients. The diverse approaches and consistent improvements
across studies provide a robust foundation for healthcare practitioners
and researchers. Future efforts should focus on standardizing CRP
interventions and conducting well-designed trials to further enhance the
evidence base, facilitating more targeted and effective rehabilitation
strategies for CABG patients.<br/>Copyright: &#xa9; 2024 The Author(s).
Published by IMR Press.

<11>
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

<12>
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.

<13>
Accession Number
2031979958
Title
Perceptions of Dutch general practitioners towards eHealth for patients
with type-2 diabetes: a qualitative study.
Source
Family Practice. 40(1) (pp 91-97), 2023. Date of Publication: 01 Feb 2023.
Author
Vonken L.; Hussein H.; Crutzen R.; Vluggen S.
Institution
(Vonken, Crutzen) Maastricht University, Care and Public Health Research
Institute, Department of Health Promotion, PO Box 616, Maastricht 6200 MD,
Netherlands
(Hussein, Vluggen) Maastricht University, Care and Public Health Research
Institute, Department of Health Services Research, PO Box 616, Maastricht
6200, Netherlands
Publisher
Oxford University Press
Abstract
Background: eHealth provides a viable option to facilitate type-2 diabetes
mellitus self-management and adherence. To this end, a web-based
computer-tailored eHealth programme, My Diabetes Profile (MDP), was
developed and implemented in Dutch diabetes care. To fully utilize the
potential of eHealth, the reach of effective programmes like MDP should be
maximized. Therefore, it is vital to explore perceptions of general
practitioners (GPs) regarding eHealth and factors that influence GPs'
decision to adopt eHealth programmes. <br/>Objective(s): To shed light on
Dutch GPs' perceptions towards eHealth in general and specifically, the
adoption of MDP. <br/>Method(s): Interviews were conducted among a
heterogeneous sample of 16 Dutch GPs. The interview guide, based on the
Diffusion of Innovations Theory, addressed perceptions about eHealth in
general, characteristics of MDP, organizational characteristics, and
external influences on adoption. Audio-recordings were transcribed and
analysed using deductive coding in NVivo. <br/>Result(s): Nearly all GPs
used some form of eHealth and listed many benefits and few drawbacks about
eHealth. Sometimes, GPs were unaware of what eHealth encompassed;
programmes resembling MDP were not mentioned. COVID-19 immensely increased
eHealth uptake, especially for remote communication. Regarding MDP, the
organizational and external influences on adoption were limited, while
characteristics of the innovation were deemed more important. GPs
expressed benefits of MDP (e.g. uncomplex, user-friendly, tailored) other
than attributed to eHealth in general and fewer drawbacks.
<br/>Conclusion(s): While GPs' opinions about eHealth and MDP were
positive, the concept of MDP was relatively unfamiliar. Future research
should focus on targeting GPs' awareness of eHealth
possibilities.<br/>Copyright &#xa9; The Author(s) 2022.

<14>
Accession Number
2031971841
Title
Health status and cognitive function for risk stratification in chronic
coronary and peripheral artery disease.
Source
European Journal of Preventive Cardiology. 30(7) (pp 535-545), 2023. Date
of Publication: 01 May 2023.
Author
Smolderen K.G.; Mena-Hurtado C.; Eikelboom J.W.; Bosch J.; Xie F.;
Ramasundarahettige C.; Bhatt D.L.; Anand S.S.
Institution
(Smolderen, Mena-Hurtado) Department of Internal Medicine, Yale
University, School of Medicine, Vascular Medicine Outcomes Program, 789
Howard Avenue, New Haven, CT 06519, United States
(Smolderen) Department of Psychiatry, Yale University, School of Medicine,
New Haven, CT, United States
(Eikelboom, Ramasundarahettige, Anand) Hamilton Health Sciences,
Population Health Research Institute, McMaster University, 237, Barton St
East, Hamilton, ON L8L 2X2, Canada
(Bosch, Anand) Department of Medicine, McMaster University, 1280 Main
Street West, Hamilton, ON L8S 4K1, Canada
(Bosch) School of Rehabilitation ScienceIAHS, McMaster University, Room
403, 1400 Main Street, West Hamilton, ON L8S 1C7, Canada
(Xie) Centre for Health Economics and Policy Analysis, McMaster
University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
(Xie, Ramasundarahettige, Anand) Department of Health Evidence and Impact,
McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
(Bhatt) Mount Sinai Heart, Icahn School of Medicine, Mount Sinai Health
System, 1 Gustave Levy Place, Box 1030, New York, NY 10029, United States
Publisher
Oxford University Press
Abstract
Background and aims It is unclear whether health status and cognitive
function assessments can augment traditional coronary artery disease (CAD)
and peripheral artery disease (PAD) biomedical risk prediction frameworks.
We examined the association between health status and cognitive function
and subsequent adverse cardiovascular and limb events in CAD and PAD.
Methods and results Stable CAD and PAD patients from the international,
multi-centre COMPASS trial completed the visual analogue scale (VAS) of
the EQ-5D-3L to assess overall health status, and the Digit Symbol
Substitution test (DSST) to assess cognitive function. Main outcomes were
incident development of major adverse cardiovascular events, and the
combined endpoint major adverse cardiovascular or limb events. The EQ VAS
(per 10 unit increase) and DSST (per 5 unit increase) were added to fully
adjusted (medications, demographics, cardiovascular history and risk
factors) hierarchical Cox regression models. A total of 23 433 patients
were in the CAD cohort and 6899 in the PAD cohort. Among both the CAD and
PAD groups, higher scores on the EQ VAS (CAD: HR = 0.89, 95%CI 0.88-0.89;
PAD HR = 0.89, 95%CI 0.88-0.89) and DSST (CAD HR = 0.95, 95%CI 0.94-0.95)
(PAD HR = 0.95, 95%CI 0.94-0.95) were associated with a lower risk of a
major adverse cardiovascular or limb events. Population attributable risks
associated with the lower two quartiles vs. upper quartiles for the EQ-5D
and DSST scores were 7% and 16%, respectively in the CAD cohort; and for
PAD, at 14% and 18%, respectively. Conclusions Adding health status and
cognitive functioning information to biomedical evaluations can augment
cardiovascular risk-stratification in CAD and PAD.<br/>Copyright &#xa9;
The Author(s) 2022.

<15>
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.

<16>
Accession Number
2022989968
Title
Head-to-head comparison between left atrial appendage occlusion and
non-vitamin K oral anticoagulants in non-valvular atrial fibrillation
patients: A systematic review and meta-analysis study.
Source
Trends in Cardiovascular Medicine. 34(4) (pp 225-233), 2024. Date of
Publication: May 2024.
Author
Waranugraha Y.; Lin L.-Y.; Tsai C.-T.
Institution
(Waranugraha) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Brawijaya, Universitas Brawijaya Brawijaya
University Hospital, Malang, Indonesia
(Lin, Tsai) Division of Cardiology, Department of Internal Medicine,
National Taiwan University College of Medicine and Hospital, Taipei,
Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Left atrial appendage occlusion (LAAO) was found to be non-inferior to
warfarin. In non-valvular atrial fibrillation (AF), there is still a
scarcity of data comparing LAAO versus non-vitamin K oral anticoagulants
(NOACs). Our purpose was to compare the clinical benefits between LAAO and
NOACs in non-valvular AF patients. The patient, intervention, comparison,
and outcome principles were used to develop the research question in this
systematic review and meta-analysis. Literature searches were conducted in
online scientific databases such as ProQuest, PubMed, and ScienceDirect.
All important information was extracted. The random-effect model was
applied to estimate all pooled effects. The Mantel-Haenszel statistical
method was used to determine the pooled risk ratio (RR) and 95% confidence
interval (CI). A total of 4411 participants from 5 studies were involved.
LAAO significantly decreased the cardiovascular mortality risk compared to
NOACs (RR = 0.56; 95% CI = 0.42 to 0.75; p <0.01). Major bleeding risk in
the LAAO group was significantly lower than in the NOACs group (RR = 0.66;
RR = 0.53 to 0.82; p <0.01). A significantly lower risk of major bleeding
or non-major bleeding in the patients receiving LAAO than NOACs was also
observed in this meta-analysis (RR = 0.66; 95% CI = 0.54 to 0.81; p
<0.01). LAAO was superior to the NOACs in reducing cardiovascular
mortality, major bleeding, and major or non-major bleeding risks in
non-valvular AF patients. In high-risk thromboembolism and bleeding
patients, LAAO can be considered first as a long-term treatment
strategy.<br/>Copyright &#xa9; 2023

<17>
Accession Number
644163637
Title
The efficacy and safety of intraoperative intravenous amiodarone in
patients undergoing on-pump coronary artery bypass grafting surgery: a
systemic review and PRISMA-compliant meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 274), 2024. Date of
Publication: 03 May 2024.
Author
Deng J.-H.; Jia B.; Yao Y.-T.
Institution
(Deng, Jia) Department of Anesthesiology, Guangdong Provincial Hospital of
Chinese Medicine, Guangdong Province, (The Second Affiliated Hospital of
Guangzhou University of Chinese Medicine), Guangzhou 510000, China
(Yao) Department of Anaesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing
100037, China
Abstract
BACKGROUND: To evaluate the clinical efficacy and safety of intraoperative
intravenous amiodarone for arrhythmia prevention in on-pump coronary
artery bypass grafting (CABG) patients. <br/>METHOD(S): A meta-analysis of
randomized controlled trials was conducted. Pubmed, Embase, Cochrane
Library, Ovid, China National Knowledge Infrastructure, and the Wan Fang
database until July 1th, 2023. The primary outcomes of interest included
the incidences of intra- and post-operative atrial fibrillation (POAF),
ventricular fibrillation, or any arrhythmia, including atrial
fibrillation, ventricular fibrillation, ventricular tachycardia, premature
ventricular contraction, and sinus bradycardia. For continuous and
dichotomous variables, treatment effects were calculated as the weighted
mean difference (WMD)/risk ratio (RR) and 95% confidence interval (CI).
<br/>RESULT(S): A database search yielded 7 randomized controlled trials
including 608 patients, where three studies, including three treatments
(amiodarone, lidocaine, and saline), contributed to the clinical outcome
of atrial fibrillation, ventricular fibrillation, or any arrhythmia.
Meta-analysis demonstrated that amiodarone can significantly reduce the
incidence of POAF (RR, 0.39; 95%CI: 0.20, 0.77; P=0.007, I2=0%) in
patients undergoing on-pump CABG; there was no statistically significant
influence on intra-operative atrial fibrillation, intra- and
post-operative ventricular fibrillation, or any arrhythmia.
<br/>CONCLUSION(S): The current study suggests that intraoperative
administration of intravenous amiodarone may be safe and effective in
preventing POAF in patients undergoing on-pump CABG. More well-designed
clinical trials are needed to validate this result.<br/>Copyright &#xa9;
2024. The Author(s).

<18>
Accession Number
2032080205
Title
Negative selection bias for women inclusion in a clinical trial.
Source
International Journal of Cardiology. 408 (no pagination), 2024. Article
Number: 132138. Date of Publication: 01 Aug 2024.
Author
Landi A.; Heg D.; Frigoli E.; Routledge H.; Malik F.-T.-N.; Pourbaix S.;
Alasnag M.; Smits P.C.; Valgimigli M.
Institution
(Landi, Frigoli, Valgimigli) Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale (EOC), Lugano CH-6900, Switzerland
(Landi, Valgimigli) Faculty of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Heg) Department of Clinical Research, University of Bern, Switzerland
(Routledge) Worcestershire Royal Hospital, Worcester, United Kingdom
(Malik) National Heart Foundation Hospital & Research Institute, Dhaka,
Bangladesh
(Pourbaix) Department of Cardiology, CHR Citadelle Liege, Liege, Belgium
(Alasnag) Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi
Arabia
(Smits) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
(Valgimigli) University of Bern, Bern, Switzerland
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Despite the growing awareness towards the importance of
adequate representation of women in clinical trials among patients treated
with percutaneous coronary intervention (PCI), available evidence
continues to demonstrate a skewed distribution of study populations in
favour of men. <br/>Methods and Results: In this pre-specified analysis
from the MASTER DAPT screening log and trial, we aimed to investigate the
existence of a negative selection bias for women inclusion in a randomized
clinical trial. A total of 2847 consecutive patients who underwent
coronary revascularization across 65 participating sites, during a median
of 14 days, were entered in the screening log, including 1749 (61.4%)
non-high bleeding risk (HBR) and 1098 (38.6%) HBR patients, of whom 109
(9.9%) consented for trial participation. Female patients were less
represented in consented versus non-consented HBR patients (22% versus
30%, absolute standardized difference: 0.18) and among non-consented
eligible versus consented eligible patients (absolute standardized
difference 0.14). The observed sex gap was primarily due investigators'
choice not to offer study participation to females because deemed at very
high risk of bleeding and/or ischemic complications, and only marginally
to a slightly higher propensity of females compared to males to refuse
study participation. <br/>Conclusion(s): Female HBR patients undergoing
PCI are less prevalent, but also less likely to participate in the trial
than male patients, mainly due to investigators' preference.<br/>Copyright
&#xa9; 2024 Elsevier B.V.

<19>
Accession Number
2029143584
Title
To Compare the Efficacy of Sub-Pecto-Interfascial Block with Erector
Spinae Plane Block in Postoperative Pain Management in Patients Undergoing
Cardiac Surgery.
Source
Journal of Cardiac Critical Care. 8(2) (pp 101-108), 2024. Date of
Publication: April-June 2024.
Author
Singh R.; Choudhury A.; Chauhan S.; Hote M.
Institution
(Singh, Choudhury, Chauhan) Departments of Cardiac Anaesthesia and
Critical Care and All India Institute of Medical Sciences, Delhi, India
(Hote) Departments of Cardiothoracic Vascular Surgery, All India Institute
of Medical Sciences, Delhi, India
Publisher
Scientific Scholar LLC
Abstract
Objectives: Pain following sternotomy has always been an issue of major
concern for anesthesiologists. The incidence of pain is as high as 49% at
rest following coronary artery bypass grafting. We planned to utilize the
sub-pecto-interfascial plane (SIP) block and erector spinae plane (ESP)
block to determine its efficacy and quality of analgesia as compared to
conventional intravenous analgesia. <br/>Material(s) and Method(s): After
the Institutional Ethics Committee's approval, we recruited 105 patients
and randomized them into three groups. Group 1 received conventional
analgesia, group 2 SIP, and group 3 ESP block. Group 2 and Group 3
received allocated blocks after induction of balanced general anesthesia
under ultrasound guidance. With high-frequency linear probe (13 MHz)
planes identified, a mixture of injection ropivacaine (0.375%) and
dexmedetomidine (1.1 mcg/mL) was deposited. In group 2, six injections of
6 mL each at the 2^nd, 4^th, and 6^th
intercostal spaces in the bilateral parasternal region. In group 3, two
injections of 20 mL of the above-mentioned mixture on each side above the
transverse process of the T5 vertebra under the erector spinae muscle
plane were injected. All patients were monitored throughout the
procedures, and their vitals were recorded. Heart rate, systolic blood
pressure, and diastolic blood pressure were noted at baseline, at skin
incision, at sternotomy, and 30 min post-extubation. Patients were
followed for total fentanyl consumption, pain score (numerical rating
scale [NRS] score), and peak inspiratory flow rate, which were noted at
extubation and 2, 4, 6, 8, 12, and 24 hours post-extubation. Levels of
C-reactive protein (CRP), cortisol, and prolactin were done at baseline
and 24 h after surgery. Extubation time, time of first oral intake, and
total length of intensive care unit (ICU) stay were also compared between
the groups. <br/>Result(s): Total fentanyl consumption was significantly
lower (P < 0.005) in group 2 and group 3 compared to group 1. Patient
receiving blocks were significantly lower NRS score compared to the
control group. Spirometry has shown improved results in block groups
catering to early discharge from ICU. Rise in levels of CRP, cortisol, and
prolactin were much higher in group 1 as compared to group 2 and group 3.
<br/>Conclusion(s): The application of ESP and SIP blocks is far superior
than conventional parenteral analgesics in terms of pain score, total
opioid's consumption, hemodynamic maintenance, spirometry efforts, and
length of ICU stays.<br/>Copyright &#xa9; 2024 Published by Scientific
Scholar on behalf of Journal of Cardiac Critical Care TSS.

<20>
Accession Number
2029136363
Title
Conservative Versus Surgical Therapy in Patients With Infective
Endocarditis and Surgical Indication-Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 13(7) (no pagination), 2024.
Article Number: e033404. Date of Publication: 02 Apr 2024.
Author
Caldonazo T.; Hagel S.; Doenst T.; Kirov H.; Sa M.P.; Jacquemyn X.;
Tasoudis P.; Franz M.; Diab M.
Institution
(Caldonazo, Doenst, Kirov, Diab) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Hagel) Institute for Infectious Diseases and Infection Control (S.H.),
Friedrich-Schiller-University Jena, Jena, Germany
(Sa) Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, PA, United States
(Sa) UPMC Heart and Vascular Institute, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Franz) Division of Cardiology, Department of Internal Medicine,
Friedrich-Schiller-University Jena, Jena, Germany
(Diab) Department of Cardiothoracic Surgery, Cardiovascular Center
Rotenburg, Rotenburg an der Fulda, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Infective endocarditis represents a life-threatening disease
with high mortality rates. A fraction of patients receives exclusively
conservative antibiotic treatment due to their comorbidities and high
operative risk, despite fulfilling criteria for surgical therapy. The aim
of the present study is to compare outcomes in patients with infective
endocarditis and indication for surgical therapy in those who underwent or
did not undergo valve surgery. METHODS AND RESULTS: Three databases were
systematically assessed. A pooled analysis of Kaplan-Meier-derived
reconstructed time-to-event data from studies with longer follow-up
comparing conservative and surgical treatment was per-formed. A landmark
analysis to further elucidate the effect of surgical intervention on
mortality was carried out. Four studies with 3003 patients and median
follow-up time of 7.6 months were included. Overall, patients with an
indication for surgery who were surgically treated had a significantly
lower risk of mortality compared with patients who received conservative
treatment (hazard ratio [HR], 0.27 [95% CI, 0.24-0.31], P<0.001). The
survival analysis in the first year showed superior survival for patients
who underwent surgery when compared with those who did not at 1 month
(87.6% versus 57.6%; HR, 0.31 [95% CI, 0.26-0.37], P<0.01), at 6 months
(74.7% versus 34.6%) and at 12 months (73.3% versus 32.7%).
<br/>CONCLUSION(S): Based on the findings of this study-level
meta-analysis, patients with infective endocarditis and formal indication
for surgical intervention who underwent surgery are associated with a
lower risk of short-and long-term mortality when compared with
conservative treatment.<br/>Copyright &#xa9; 2024 The Authors.

<21>
Accession Number
2029693781
Title
Improved tricuspid regurgitation after transcatheter aortic valve
replacement is associated with better survival: Systematic review and
meta-analysis with reconstructed time-to-event data.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Ltd
Abstract
Background: This meta-analysis compared survival outcomes among patients
experiencing improvement in untreated significant tricuspid regurgitation
(TR) following transcatheter aortic valve replacement (TAVR) for severe
aortic stenosis, in contrast to those without improvement. <br/>Method(s):
MEDLINE and EMBASE were searched through January 2024. Pooled hazard
ratios (HR) with 95% confidence intervals (CI) were computed. Employing
network meta-analysis, a comparison involving four post-procedural TR
categories (improved, no improvement, worsened, and no change) was
executed. Subsequently, these categories were amalgamated into two groups
(less TR after TAVR and same or greater TR after TAVR), and a standard
meta-analysis was conducted. Kaplan-Meier curves depicting long-term
all-cause mortality were reconstructed utilizing individual patient data
derived from the studies. <br/>Result(s): A systematic review identified
seven non-randomized studies encapsulating 698 patients. Network
meta-analysis revealed that improved TR after TAVR correlated with
significantly lower long-term all-cause mortality compared to the
remaining cohorts. Similarly, pooled all-cause mortality of standard
meta-analysis demonstrated significant reduction in patients whose TR was
sub-baseline than those exhibiting same or greater TR after TAVR (HR [95%
CI] = 0.43 [0.32-0.58], p <.01). The hazard ratio, derived from
reconstructed time-to-event data, showed a lower long-term all-cause
mortality in patients with less TR after TAVR relative to the other cohort
(HR [95% CI] = 0.46 [0.32-0.67], p <.01). <br/>Conclusion(s): This
meta-analysis revealed that improved TR after TAVR correlates with
superior long-term survival. The benefits of simultaneous or staged
intervention on the tricuspid valve in individuals undergoing TAVR warrant
validation in future investigations.<br/>Copyright &#xa9; The Author(s)
2024.

<22>
Accession Number
644162431
Title
Stroke risk after transcatheter aortic valve replacement in patients with
carotid stenosis: A systematic review and meta-analysis.
Source
International journal of cardiology. (pp 132085), 2024. Date of
Publication: 01 May 2024.
Author
Garagoli F.; Chiabrando J.G.; Seropian I.M.; Lombardi M.; Agatiello C.R.;
Recalde M.L.F.; Vergallo R.; Porto I.; Bluro I.M.
Institution
(Garagoli, Recalde, Bluro) Department of Cardiology, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Chiabrando) Department of Interventional Cardiology, Sanatorio Anchorena,
Buenos Aires, Argentina
(Seropian, Agatiello) Department of Interventional Cardiology, Hospital
Italiano de Buenos Aires, Buenos Aires, Argentina
(Lombardi) Department of Internal Medicine and Medical Specialties (DIMI),
University of Genoa, Viale Benedetto XV, Genoa 6 - 16132, Italy
(Vergallo, Porto) Department of Internal Medicine and Medical Specialties
(DIMI), University of Genoa, Viale Benedetto XV, 6 - 16132, Genoa, Italy;
Cardiothoracic and Vascular Department (DICATOV), IRCCS San Martino
Hospital, Viale Mali Benedetto XV, 6 - 16132, Genoa, Italy
Abstract
BACKGROUND: Stroke is a feared complication of transcatheter aortic valve
replacement (TAVR). Patients undergoing TAVR typically have multiple
comorbidities, such as carotid artery stenosis (CAS). We conducted the
present meta-analysis to determine the risk of stroke and mortality
following TAVR in patients with CAS. <br/>METHOD(S): We searched
PubMed/Medline, Scopus, ScienceDirect, and Cochrane Clinical Trials
databases for clinical studies that compared CAS >=50% and CAS >=70%
versus non-CAS TAVR population. The endpoints included the 30-day
incidence of stroke or transient ischemic attack (TIA) and 30-day
all-cause of mortality. <br/>RESULT(S): We identified seven studies that
included 12,418 patients in the CAS group and 102,316 in the control
group. CAS >=50% was not associated with an increased risk of 30-day
stroke or TIA after TAVR [risk ratio (RR): 1.38; 95% confidence interval
(95% CI): 0.95-2.02; p=0.09]. However, patients with CAS >=70% had an
increased risk of stroke or TIA (RR: 1.43; 95% CI: 1.02-2.01; p=0.04). No
difference in 30-day all-cause mortality was observed between CAS >=50% or
CAS >=70% and control groups (RR: 1.09; 95% CI: 0.79-1.52; p=0.59 and RR:
1.11; 95% CI: 0.85-1.45; p=0.43, respectively). <br/>CONCLUSION(S): CAS
>=70% was associated with an increased risk of stroke or TIA following
TAVR compared with patients without CAS.<br/>Copyright &#xa9; 2024.
Published by Elsevier B.V.

<23>
Accession Number
644162204
Title
Comparison of Down Sizing Strategy (HANGZHOU Solution) and Standard
Annulus Sizing Strategy in type 0 bicuspid aortic stenosis patients
undergoing transcatheter aortic valve replacement: Rationale and design of
a randomized clinical trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 01
May 2024.
Author
Guo Y.; Liu X.; Li R.; Ng S.; Liu Q.; Wang L.; Hu P.; Ren K.; Jiang J.;
Fan J.; He Y.; Zhu Q.; Lin X.; Li H.; Wang J.
Institution
(Guo, Li, Ng, Liu, Wang, Hu, Ren, Jiang, Fan, He, Zhu, Lin, Li) Department
of Cardiology of The Second Affiliated Hospital, School of Medicine,
Zhejiang University; State Key Laboratory of Transvascular Implantation
Devices; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou
310009, China
(Liu, Wang) Department of Cardiology of The Second Affiliated Hospital,
School of Medicine, Zhejiang University; State Key Laboratory of
Transvascular Implantation Devices; Cardiovascular Key Laboratory of
Zhejiang Province, Hangzhou 310009, China; (Research Center for Life
Science and Human Health), Binjiang Institute of Zhejiang University,
Hangzhou, 310053, China
Abstract
BACKGROUND: There has not been a consensus on the prothesis sizing
strategy in type 0 bicuspid aortic stenosis (AS) patients undergoing
transcatheter aortic valve replacement (TAVR). Modifications to standard
annular sizing strategies might be required due to the distinct anatomical
characteristics. We have devised a Down Sizing Strategy for TAVR using a
self-expanding valve specifically for patients with type 0 bicuspid AS.
The primary aim of this study is to compare the safety and efficacy of
Down Sizing Strategy with the Standard Annulus Sizing Strategy in TAVR for
patients with type 0 bicuspid AS. TRIAL DESIGN: It is a prospective,
multi-center, superiority, single-blinded, randomized controlled trial
comparing the Down Sizing and Standard Annulus Sizing Strategy in patients
with type 0 bicuspid aortic stenosis undergoing transcatheter aortic valve
replacement. Eligible participants will include patients with severe type
0 bicuspid AS, as defined by criteria such as mean gradient across aortic
valve >=40 mmHg, peak aortic jet velocity >=4.0 m/s, aortic valve area
(AVA) <=1.0 cm2, or AVA index <=0.6 cm2/m2. These patients will be
randomly assigned, in a 1:1 ratio, to either the Down Sizing Strategy
group or the Standard Sizing Strategy group. In the Down Sizing Strategy
group, a valve one size smaller will be implanted if the "waist sign"
manifests along with less than mild regurgitation during balloon
pre-dilatation. The primary end point of the study is a composite of
VARC-3 defined device success, absence of both permanent pacemaker
implantation due to high-degree atrioventricular block and new-onset
complete left bundle branch block. <br/>CONCLUSION(S): This study will
compare the safety and efficacy of Down Sizing Strategy with the Standard
Annulus Sizing Strategy and provide valuable insights into the optimal
approach for sizing in TAVR patients with type 0 bicuspid AS. We
hypothesize that the Down Sizing Strategy will demonstrate superiority
when compared to the Standard Annulus Sizing Strategy. (Down Sizing
Strategy (HANGZHOU Solution) vs Standard Sizing Strategy TAVR in Bicuspid
Aortic Stenosis (Type 0) (TAILOR-TAVR), NCT05511792).<br/>Copyright &#xa9;
2024 Elsevier Ltd. All rights reserved.

<24>
Accession Number
644162168
Title
A comment on "Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials".
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 03 May 2024.
Author
Zheng J.; Chen Z.
Institution
(Zheng) First Clinical Medical School, Guangzhou Medical University,
Guangzhou, Guangdong, China
(Chen) Second Clinical Medical School, Guangzhou Medical University,
Guangzhou, Guangdong, China

<25>
Accession Number
2031980167
Title
Effects of Magnesium Sulphate, Dexmedetomidine and Lignocaine on
Perioperative Haemodynamic and Postoperative Analgesia in Patients
Undergoing Laparoscopic Abdominal Surgeries: A Randomised Clinical Study.
Source
Journal of Clinical and Diagnostic Research. 18(5) (pp UC27-UC32), 2024.
Date of Publication: 01 May 2024.
Author
Roy I.; Magda Hembrom B.P.; Das A.; Choudhury A.
Institution
(Roy, Das, Choudhury) Department of Anaesthesiology, Chittaranjan Seva
Sadan, College of Obstetrics and Gynaecology, West Bengal, Kolkata, India
(Magda Hembrom) Department of Anaesthesiology, R.G. Kar Medical College
and Hospital, West Bengal, Kolkata, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Laparoscopic surgeries currently represent the mainstay of
surgical modalities. Pneumoperitoneum imposes significant intraoperative
haemodynamic alterations, which are more pronounced in elderly patients
and those with co-morbid conditions. Inadequate pain relief in the
perioperative period may result in various physiological and psychological
traumas. <br/>Aim(s): To investigate the effects of magnesium sulphate,
dexmedetomidine, and lignocaine on the haemodynamic responses and
postoperative analgesia in patients undergoing laparoscopic abdominal
surgeries. <br/>Material(s) and Method(s): This double-blinded, randomised
clinical study was conducted in the general surgery operation theatre,
Post-anaesthetic Care Unit (PACU), and the male and female surgery ward of
RG Kar Medical College and Hospital, Kolkata, West Bengal, India from
March 1, 2021, to March 1, 2022. The study involved 105 subjects assigned
to Group-L, who received an injection of lignocaine as a loading dose of
1.5 mg/kg intravenously over 2-4 minutes before induction, followed by a
continuous infusion of 2 mg/kg/hour throughout the surgery. Group-M
received a loading dose of MgSO<inf>4</inf> at 30 mg/ kg over 15 minutes
before induction, followed by 15 mg/kg/hour throughout the surgery, and
Group-D received a loading dose of dexmedetomidine at 1 mcg/kg over 10
minutes before induction, followed by a continuous infusion of 0.5
mcg/kg/min throughout the surgery. Data on Heart Rate (HR), Mean Arterial
Pressure (MAP), and the total dose of rescue analgesic administered in the
postoperative 24 hours were recorded and analysed using Analysis of
Variance (ANOVA) and Tukey's Honestly Significant Difference (HSD) test,
as well as the Chi-square test where applicable. A p-value of less than
0.05 was considered statistically significant. <br/>Result(s): The groups
were comparable in terms of demographic variables and baseline
haemodynamic status. The average age in Group-D was 39.13+/-9.48 years, in
Group-M was 37.30+/-8.14 years, and in Group-L was 36.5+/-7.2 years
(p=0.26). Group-D had 60% males, Group-M had 57% males, and Group-L had
60% males. The mean Body Mass Index (BMI) of Group-D was 25.9+/-2.03
(kg/m²), Group-L (Lignocaine) was 24.7+/-2.7, and
Group-M(MagnesiumSulphate)was23.8+/-3.2.Dexmedetomidine was found to be
superior in maintaining haemodynamic stability throughout the
perioperative period (Preinduction HR: Group-D=79.43, Group-L=79.06,
Group-M=82.09; Postinduction HR: Group-D=86.49, Group-M=65.91,
Group-L=72.69). There was a significant decrease in postintubation MAP,
most pronounced in the Magnesium Sulphate and Dexmedetomidine groups.
Post-pneumoperitoneum, the surge in MAP was most effectively prevented by
Dexmedetomidine. The lowest amount of rescue analgesic (injection
Diclofenac in mg) was used in the Dexmedetomidine group (55.86+/-5.05),
followed by the Lignocaine group (126.43+/-17.69). Patients in the
Magnesium group required the highest amount of rescue analgesic
(156.43+/-7.91). The number of patients receiving rescue analgesia was
significantly higher in the Lignocaine and Magnesium Sulphate groups
(Group-D: 6.5+/-3.14565, Group-L: 14.75+/-7.36, Group-M: 18.25+/-8.057).
<br/>Conclusion(s):Dexmedetomidinewasmoreeffectiveinmaintaining
haemodynamic stability throughout the perioperative period and exhibited
superior postoperative analgesic properties. Magnesium Sulphate and
lignocaine were more effective in preventing postintubation
surges.<br/>Copyright &#xa9; 2024 JCDR Research and Publications Pvt Ltd.
All rights reserved.

<26>
Accession Number
2031970164
Title
Comparison Between the Protective Effect of Isoflurane and Propofol on
Myocardium During Coronary Artery Bypass Grafting: A Systematic Review and
Meta-Analysis of Randomized Controlled Trials.
Source
Brazilian Journal of Cardiovascular Surgery. 39(3) (no pagination), 2024.
Article Number: e20210424. Date of Publication: 2024.
Author
Bao Q.; Lei M.; Xiao D.; Xie J.
Institution
(Bao, Lei, Xiao, Xie) Department of Anesthesiology, Sir Run Run Shaw
Hospital, School of Medicine, Zhejiang University, Zhejiang, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: Intravenous non-volatile anaesthetics like propofol are
commonly used in cardiac surgeries across several countries. Volatile
anaesthetics like isoflurane may help in protecting the myocardium and
minimize ischaemia-reperfusion injury. Hence, we did this review to
compare the cardioprotective effect of isoflurane and propofol among
patients undergoing coronary artery bypass grafting (CABG).
<br/>Method(s): We conducted a search in the databases Medical Literature
Analysis and Retrieval System Online (or MEDLINE), Embase, PubMed Central,
ScienceDirect, Google Scholar, and Cochrane Library from inception until
April 2021. We carried out a meta-analysis with random-effects model and
reported pooled risk ratio (RR) or standardized mean difference (SMD) with
95% confidence interval (CI) depending on the type of outcome.
<br/>Result(s): We analysed 13 studies including 808 participants. Almost
all were low-quality studies. For cardiac index, the pooled SMD was 0.14
(95% CI:-0.22 to 0.50); for cardiac troponin I, pooled SMD was 0.10 (95%
CI:-0.28 to 0.48). For mortality, the RR was 3.00 (95% CI: 0.32 to 28.43);
for MI, pooled RR was 1.58 (95% CI: 0.59 to 4.20); and for inotropic drug
use, pooled RR was 1.04 (95% CI: 0.90 to 1.21). For length of intensive
care unit stay, the pooled SMD was 0.13 (95% CI:-0.29 to 0.55), while
pooled SMD for mechanical ventilation time was-0.02 (95% CI:-0.54 to
0.51). <br/>Conclusion(s): Isoflurane did not have significant
cardioprotective effect compared to propofol following CABG. Hence, the
anaesthetists need to check some viable alternatives to manage these
patients and reduce the rate of postoperative complications.<br/>Copyright
&#xa9; 2024, Sociedade Brasileira de Cirurgia Cardiovascular. All rights
reserved.

<27>
Accession Number
2031970163
Title
Is Incentive Spirometry Superior to Standard Care in Postoperative Cardiac
Surgery on Clinical Outcomes and Length of Hospital and Intensive Care
Unit Stay? A Systematic Review with Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(3) (no pagination), 2024.
Article Number: e20220319. Date of Publication: 2024.
Author
Silva H.V.C.; Lunardi A.C.; Pinto A.C.P.N.; de Macedo J.R.F.F.; Dos Santos
E.C.
Institution
(Silva, Pinto, Dos Santos) Department of Biological and Health Sciences,
Universidade Federal do Amapa, Amapa, Macapa, Brazil
(Lunardi) Programa de Pos-Graduacao Stricto Sensu em Fisioterapia,
Universidade Cidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
(Lunardi) Department of Physical Therapy, Escola de Medicina, Universidade
de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
(Pinto) Department of Physical Therapy, University of Pittsburgh, PA,
United States
(de Macedo) Department of Health Sciences, Catholic University of Louvain,
Brussels, Belgium
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Cardiac surgery is a frequent surgical procedure and may
present a high risk of complications. Among the prophylactic strategies
studied to decrease the rates of negative outcomes, respiratory care seems
to reduce pulmonary complications. Incentive spirometry (IS) is a
low-cost, respiratory exercise technique, used for the prevention and
treatment of postoperative pulmonary complications (PPC). The aim of this
review was to evaluate whether IS is superior to respiratory care,
mobilization exercises, and noninvasive ventilation on PPC, and clinical
outcomes. <br/>Method(s): Systematic review. Medical Literature Analysis
and Retrieval System Online (or MEDLINE), Embase, Cochrane Central
Register of Controlled Trials (or CENTRAL), Physiotherapy Evidence
Database (or PEDro), Cumulative Index of Nursing and Allied Health (or
CINAHL), Latin American and Caribbean Health Sciences Literature (or
LILACS), Scientific Electronic Library Online (or SciELO), Allied, Scopus,
and OpenGrey databases, clinical trial registration sites, conferences,
congresses, and symposiums were searched. <br/>Result(s): Twenty-one
randomized trials and one quasi-randomized trial (1,677 participants) were
included. For partial pressure of oxygen (PaO2), IS was inferior to
respiratory care (mean difference [MD]-4.48; 95% confidence interval
[CI]-8.32 to-0.63). Flow-oriented IS was inferior to respiratory care on
PaO2 (MD-4.53; 95% CI-8.88 to-0.18). However, compared to respiratory
care, flow-oriented IS was superior on recovery vital capacity.
<br/>Conclusion(s): This meta-analysis revealed that IS was not superior
to standard respiratory care for PPCs and clinical outcomes, therefore its
use should not be widely recommended until further studies with high
quality be performed to ensure this clinical guidance.<br/>Copyright
&#xa9; 2024, Sociedade Brasileira de Cirurgia Cardiovascular. All rights
reserved.

<28>
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.

<29>
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.

<30>
Accession Number
2029677784
Title
Intermittent intravenous paracetamol versus continuous morphine in infants
undergoing cardiothoracic surgery: a multi-center randomized controlled
trial.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 143. Date of
Publication: December 2024.
Author
Zeilmaker-Roest G.; de Vries-Rink C.; van Rosmalen J.; van Dijk M.; de
Wildt S.N.; Knibbe C.A.J.; Koomen E.; Jansen N.J.G.; Kneyber M.C.J.; Maebe
S.; Van den Berghe G.; Haghedooren R.; Vlasselaers D.; Bogers A.J.J.C.;
Tibboel D.; Wildschut E.D.
Institution
(Zeilmaker-Roest, de Vries-Rink, van Dijk, de Wildt, Tibboel, Wildschut)
Department of Neonatal and Pediatric Intensive Care, Division of Pediatric
Intensive Care, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80,
Rotterdam 3015 CN, Netherlands
(Zeilmaker-Roest, de Vries-Rink, Bogers) Department of Cardiothoracic
Surgery, Erasmus MC, Rotterdam, Netherlands
(van Rosmalen) Department of Biostatistics, Erasmus MC, Rotterdam,
Netherlands
(van Rosmalen) Department of Epidemiology, Erasmus MC, Rotterdam,
Netherlands
(de Wildt) Department of Pharmacology and Toxicology, Radboud University
Medical Center, Nijmegen, Netherlands
(Knibbe) Division of Systems Pharmacology and Pharmacy, Leiden Academic
Centre for Drug Research, Leiden University, Leiden, Netherlands
(Knibbe) Department of Clinical Pharmacy, St. Antonius Hospital
Nieuwegein/Utrecht, Utrecht, Netherlands
(Koomen, Jansen) Department of Pediatrics, Division of Pediatric Critical
Care Medicine, Wilhelmina Children's Hospital, University Medical Center
Utrecht, Utrecht, Netherlands
(Jansen) Department of Pediatrics, Beatrix Children's Hospital, University
Medical Center Groningen, Groningen, Netherlands
(Kneyber) Department of Pediatrics, Division of Pediatric Critical Care
Medicine, Beatrix Children's Hospital, University Medical Center
Groningen, Groningen, Netherlands
(Van den Berghe, Haghedooren, Vlasselaers) Department of Intensive Care
Medicine, UZ Leuven, Louvain, Belgium
(Maebe) Department of Pediatrics, Maastricht University Medical Center+,
MosaKids Children's Hospital, Maastricht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: To determine whether intermittent intravenous (IV) paracetamol
as primary analgesic would significantly reduce morphine consumption in
children aged 0-3 years after cardiac surgery with cardiopulmonary bypass.
<br/>Method(s): Multi-center, randomized, double-blinded, controlled trial
in four level-3 Pediatric Intensive Care Units (PICU) in the Netherlands
and Belgium. Inclusion period; March 2016-July 2020. Children aged 0-3
years, undergoing cardiac surgery with cardiopulmonary bypass were
eligible. Patients were randomized to continuous morphine or intermittent
IV paracetamol as primary analgesic after a loading dose of 100 mcg/kg
morphine was administered at the end of surgery. Rescue morphine was given
if numeric rating scale (NRS) pain scores exceeded predetermined cutoff
values. Primary outcome was median weight-adjusted cumulative morphine
dose in mcg/kg in the first 48 h postoperative. For the comparison of the
primary outcome between groups, the nonparametric Van Elteren test with
stratification by center was used. For comparison of the proportion of
patients with one or more NRS pain scores of 4 and higher between the two
groups, a non-inferiority analysis was performed using a non-inferiority
margin of 20%. <br/>Result(s): In total, 828 were screened and finally 208
patients were included; parents of 315 patients did not give consent and
305 were excluded for various reasons. Fourteen of the enrolled 208
children were withdrawn from the study before start of study medication
leaving 194 patients for final analysis. One hundred and two patients
received intermittent IV paracetamol, 106 received continuous morphine.
The median weight-adjusted cumulative morphine consumption in the first 48
h postoperative in the IV paracetamol group was 5 times lower (79%) than
that in the morphine group (median, 145.0 (IQR, 115.0-432.5) mcg/kg vs
692.6 (IQR, 532.7-856.1) mcg/kg; P < 0.001). The rescue morphine
consumption was similar between the groups (p = 0.38). Non-inferiority of
IV paracetamol administration in terms of NRS pain scores was proven;
difference in proportion - 3.1% (95% CI - 16.6-10.3%). <br/>Conclusion(s):
In children aged 0-3 years undergoing cardiac surgery, use of intermittent
IV paracetamol reduces the median weight-adjusted cumulative morphine
consumption in the first 48 h after surgery by 79% with equal pain relief
showing equipoise for IV paracetamol as primary analgesic. Trial
Registration Clinicaltrials.gov, Identifier: NCT05853263; EudraCT Number:
2015-001835-20.<br/>Copyright &#xa9; The Author(s) 2024.

<31>
Accession Number
2029700167
Title
Individual dipeptidyl peptidase-4 inhibitors and acute kidney injury in
patients with type 2 diabetes: A systematic review and network
meta-analysis.
Source
Basic and Clinical Pharmacology and Toxicology. (no pagination), 2024.
Date of Publication: 2024.
Author
Mitsuboshi S.; Morizumi M.; Kotake K.; Kaseda R.; Narita I.
Institution
(Mitsuboshi) Department of Pharmacy, Kaetsu Hospital, Niigata, Japan
(Morizumi) Department of Pharmacy, Ohno Memorial Hospital, Osaka, Japan
(Kotake) Department of Pharmacy, Okayama Saiseikai General Hospital,
Okayama, Japan
(Kaseda, Narita) Division of Clinical Nephrology and Rheumatology, Niigata
University Graduate School of Medical and Dental Sciences, Niigata, Japan
Publisher
John Wiley and Sons Inc
Abstract
This network meta-analysis of randomized controlled trials aimed to
determine whether any individual dipeptidyl peptidase-4 (DPP-4) inhibitors
increase the risk of acute kidney injury (AKI). The Medical Literature
Analysis and Retrieval System Online via PubMed, the Cochrane Central
Register of Controlled Trials and ClinicalTrials.gov were systematically
searched to identify relevant studies. The primary outcome was AKI. A
frequentist network meta-analysis was performed using a random-effects
model to account for heterogeneity. Twenty-nine studies involving 56 117
participants were included. There were 918 cases of AKI (1.63%). The risk
of bias was generally considered to be low. The only DPP-4 inhibitor that
significantly increased the frequency of AKI when compared with placebo
was sitagliptin (risk ratio 1.65, 95% confidence interval 1.22-2.23).
However, because one study showed significant outliers in the funnel plot,
in a highly heterogeneous population composed solely of patients
undergoing surgery for coronary artery bypass graft, we conducted a
post-hoc sensitivity analysis to exclude this study. The results showed no
statistically significant difference in the risk of AKI between
sitagliptin and placebo. Individual DPP-4 inhibitors do not appear to
increase the risk of AKI. However, sitagliptin may be associated with AKI
in patients with underlying severe cardiovascular disease.<br/>Copyright
&#xa9; 2024 Nordic Association for the Publication of BCPT (former Nordic
Pharmacological Society). Published by John Wiley & Sons Ltd.

<32>
Accession Number
2029291230
Title
Telesimulation Training for Endoscopic Mitral Valve Surgery: An Air-Pilot
Training Concept for Distance Training.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 19(2) (pp 169-174), 2024. Date of Publication: March/April 2024.
Author
Cheheili Sobbi S.; Imran Hamid U.; Arjomandi Rad A.; Fillet M.; Maesen J.;
Sardari Nia P.
Institution
(Cheheili Sobbi, Imran Hamid, Arjomandi Rad, Maesen, Sardari Nia)
Department of Cardiothoracic Surgery, Heart and Vascular Centre,
Maastricht University Medical Centre, Netherlands
(Fillet, Maesen) Maastricht University, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of this study was to validate and assess the
feasibility and impact of telesimulation training on surgical skills using
a portable mitral valve telesimulator. <br/>Method(s): A telesimulation
course composed of 3 online modules was designed based on backwards
chaining, preassessment and postassessment, performance feedback, hands-on
training on a telesimulator, and the theoretical content. A fully
3-dimensional-printed and transportable telesimulator was developed and
sent out to the participants with instruments that were needed. Feedback
about the platform was obtained from participants to validate its value as
a training tool. Theoretical and technical assessments were carried out
before and after the course. Technical assessments were based on the
accuracy and time taken to place sutures at the anterior and posterior
mitral annulus. <br/>Result(s): In total, 11 practicing cardiac surgeons
from Oceania, Asia, Europe, and North America completed the course.
Theoretical preassessment and postassessment showed that participants
scored significantly higher on postassessment (mean 87.5% vs 68.1%, P <
0.004). The participant evaluation scores of the simulator as a tool for
endoscopic mitral valve surgery was 4 to 5 out of 5. There was a
significant improvement in the speed (median 14.5 vs 39.5 s, P < 0.005)
and the accuracy to place sutures in the mitral valve annulus following
course completion (P < 0.001). <br/>Conclusion(s): Here we validated the
educational value of a novel telesimulation platform and validated the
feasibility to teach participants at a distance the knowledge and skills
for endoscopic mitral valve surgery. Future studies will be required to
validate the improvement in skills during surgery.<br/>Copyright &#xa9;
The Author(s) 2024.

<33>
Accession Number
2023778534
Title
Systematic Review and Meta-Analysis of Transradial Access for Carotid
Artery Stenting.
Source
Angiology. 75(6) (pp 517-526), 2024. Date of Publication: July 2024.
Author
Du M.; Hu Y.; Zhu D.; Cao W.; Li P.; Qi D.; Wu C.; He J.; Ye S.; Li S.;
Fang Y.
Institution
(Du, Hu, Zhu, Cao, Li, Qi, Wu, He, Ye, Li, Fang) Department of
Neurovascular Disease, Shanghai Fourth People's Hospital, School of
Medicine, Tongji University, Shanghai, China
Publisher
SAGE Publications Inc.
Abstract
There is an increasing number of studies on the transradial approach (TRA)
for carotid artery stenting. We aimed to summarize the published data on
TRA vs the transfemoral approach (TFA). We searched Science Direct,
Embase, PubMed, and Web of Science databases for the relevant literature.
Primary outcomes included surgical success and cardiovascular and
cerebrovascular complication rates; secondary outcomes included the rates
of vascular access-related and other complications. We also compared the
crossover rate, success rate, and complications between TRA and TFA
carotid stenting. This is the first such meta-analysis regarding TRA and
TFA. Twenty studies on TRA carotid stenting were included (n = 1300).
Among 19 studies, the success rate of TRA carotid stenting was.951 (95%
confidence interval [CI]:.926-.975); death rate was.022 (.011-.032);
stroke rate was.005 (.001-.008); radial artery occlusion rate was.008
(.003-.013); and forearm hematoma rate was.003 (-.000 to.006). Among 4
studies comparing TRA and TFA, the success rate was lower (odds ratio:.02;
95% CI:.00-.23) and crossover rate was higher (odds ratio: 40.16; 95% CI:
4.41-365.73) with TRA. Thus, transradial neuro-interventional surgery has
a lower success rate than TFA.<br/>Copyright &#xa9; The Author(s) 2023.

<34>
Accession Number
2023167337
Title
The role of pericardial fluid biomarkers in predicting post-operative
atrial fibrillation, a comprehensive review of current literature.
Source
Trends in Cardiovascular Medicine. 34(4) (pp 244-247), 2024. Date of
Publication: May 2024.
Author
Liblik K.; Zucker J.; Baranchuk A.; Fernandez A.L.; Zhang S.; Diasty M.E.
Institution
(Liblik, Zucker, Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Baranchuk, Zhang) Division of Cardiology, Department of Medicine, Queen's
University, Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University Hospital, Santiago de
Compostela, Spain
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Post-operative atrial fibrillation (POAF) is a common complication of
cardiac surgery which is associated with longer hospital stay, diminished
quality of life, and increased mortality. Yet, the pathophysiology of POAF
is poorly understood and it is unclear which patients are at highest risk.
Pericardial fluid (PCF) analysis is emerging as an important tool for the
early detection of biochemical and molecular changes in the cardiac
tissue. With the epicardium acting as a semi-permeable membrane, the
composition of PCF reflects the activity of the cardiac interstitium.
Emerging research on PCF composition has identified promising biomarkers
which may help stratify the risk for developing POAF. These include
inflammatory molecules, such as interleukin-6, mitochondrial
deoxyribonucleic acid, and myeloperoxidase, as well as natriuretic
peptides. Additionally, PCF appears to be superior to serum analysis in
detecting changes in these molecules during the early postoperative period
after cardiac surgery. The aim of the present narrative review is to
summarize the current literature on the temporal changes in the levels of
potential biomarkers in PCF after cardiac surgery and their association
with the development of new-onset postoperative atrial
fibrillation.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<35>
Accession Number
2031226539
Title
Prospective Randomized Pilot Trial on the Effects of Mild Hypercapnia on
Cerebral Oxygen Saturation in Patients Undergoing Off-Pump Coronary Artery
Bypass Grafting.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(6) (pp 1322-1327),
2024. Date of Publication: June 2024.
Author
Bhandari C.; Gandhi H.; Panwar A.; Haranal M.; Pandya H.
Institution
(Bhandari, Gandhi, Panwar) Department of Cardiac Anesthesia, U. N. Mehta
Institute of Cardiology and Research Center (affiliated with B. J. Medical
College), New Civil Hospital Campus, Ahmedabad, Asarwa, India
(Haranal) Department CVTS, U. N. Mehta Institute of Cardiology and
Research Center (affiliated with B. J. Medical College), New Civil
Hospital Campus, Ahmedabad, Asarwa, India
(Pandya) Department of Research, U. N. Mehta Institute of Cardiology and
Research Center (affiliated with B. J. Medical College), New Civil
Hospital Campus, Ahmedabad, Asarwa, India
Publisher
W.B. Saunders
Abstract
Objective and Design: A single-center prospective randomized controlled
study was conducted to assess the effect of targeted mild hypercapnia
(TMH) on cerebral oxygen saturation (rSO<inf>2</inf>) in patients
undergoing off-pump coronary artery bypass grafting (CABG). Setting and
Participants: A prospective randomized controlled study involving 100
patients undergoing off-pump CABG at U. N. Mehta Hospital, Ahmedabad,
Gujarat, India. <br/>Intervention(s): Patients were randomized to either
the TMH (PaCO<inf>2</inf> 45-55 mmHg) or the targeted normocapnia (TN;
PaCO<inf>2</inf> 35-45 mmHg) group, containing 50 patients in each group.
Measurements: Monitoring of rSO<inf>2</inf>, heart rate, mean arterial
pressure (MAP), PaCO<inf>2</inf>, and peripheral oxygen saturation was
done at baseline, after induction, after left internal mammary artery
harvesting, at each grafting (distal and proximal), after protamine, and
after shifting to the intensive care unit. The standardized
minimental-state examination (SMMSE) was performed preoperatively and at
8, 12, and 24 hours postextubation. Data were analyzed using an
independent sample t test. <br/>Result(s): The TMH group had higher MAP
during grafting (p < 0.001) and higher rSO<inf>2</inf> on both sides
during distal and proximal grafting (p < 0.001) and after protamine (p <
0.05), as compared to the TN group. Compared to preoperative values, SMMSE
scores in the TN group were significantly lower at 12 and 24 hours
postextubation (p < 0.001). <br/>Conclusion(s): TMH during grafting
increased the cerebral blood flow and rSO<inf>2</inf> when hemodynamic
instability was very common. It has a protective role on the brain and
helps maintain cognition postoperatively.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<36>
[Use Link to view the full text]
Accession Number
644146155
Title
Transcatheter or Surgical Treatment of Aortic-Valve Stenosis.
Source
The New England journal of medicine. 390(17) (pp 1572-1583), 2024. Date of
Publication: 02 May 2024.
Author
Blankenberg S.; Seiffert M.; Vonthein R.; Baumgartner H.; Bleiziffer S.;
Borger M.A.; Choi Y.-H.; Clemmensen P.; Cremer J.; Czerny M.; Diercks N.;
Eitel I.; Ensminger S.; Frank D.; Frey N.; Hagendorff A.; Hagl C.; Hamm
C.; Kappert U.; Karck M.; Kim W.-K.; Konig I.R.; Krane M.; Landmesser U.;
Linke A.; Maier L.S.; Massberg S.; Neumann F.-J.; Reichenspurner H.;
Rudolph T.K.; Schmid C.; Thiele H.; Twerenbold R.; Walther T.; Westermann
D.; Xhepa E.; Ziegler A.; Falk V.
Institution
(Blankenberg, Seiffert, Vonthein, Baumgartner, Bleiziffer, Borger, Choi,
Clemmensen, Cremer, Czerny, Diercks, Eitel, Ensminger, Frank, Frey,
Hagendorff, Hagl, Hamm, Kappert, Karck, Kim, Konig, Krane, Landmesser,
Linke, Maier, Massberg, Neumann, Reichenspurner, Rudolph, Schmid, Thiele,
Twerenbold, Walther, Westermann, Xhepa, Ziegler, Falk) From the Department
of Cardiology and the Center for Population Health Innovation, University
Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf (S. Blankenberg, M.S., P.C., N.D., R.T., A.Z.), German
Center for Cardiovascular Research (Deutsches Zentrum fur
Herz-Kreislauf-Forschung [DZHK]) partner site Hamburg-Kiel-Lubeck (S.
Blankenberg, M.S., P.C., J.C., N.D., I.E., S.E., D.F., I.R.K., H.R.,
R.T.), and the Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg (H.R.), Hamburg, the Department of Cardiology and
Angiology, BG University Hospital Bergmannsheil, Ruhr University Bochum,
Bochum (M.S.), the Institute of Medical Biometry and Statistics,
University of Lubeck (R.V., I.R.K.), the Departments of Cardiology,
Angiology, and Intensive Care Medicine (I.E.) and Cardiovascular Surgery
(S.E.), University Hospital of Schleswig-Holstein, Lubeck, the Department
of Cardiology III-Adult Congenital and Valvular Heart Disease, University
Hospital Munster, Muster (H.B.)
Abstract
BACKGROUND: Among low-risk patients with severe, symptomatic aortic
stenosis who are eligible for both transcatheter aortic-valve implantation
(TAVI) and surgical aortic-valve replacement (SAVR), data are lacking on
the appropriate treatment strategy in routine clinical practice.
<br/>METHOD(S): In this randomized noninferiority trial conducted at 38
sites in Germany, we assigned patients with severe aortic stenosis who
were at low or intermediate surgical risk to undergo either TAVI or SAVR.
Percutaneous- and surgical-valve prostheses were selected according to
operator discretion. The primary outcome was a composite of death from any
cause or fatal or nonfatal stroke at 1 year. <br/>RESULT(S): A total of
1414 patients underwent randomization (701 to the TAVI group and 713 to
the SAVR group). The mean (+/-SD) age of the patients was 74+/-4 years;
57% were men, and the median Society of Thoracic Surgeons risk score was
1.8% (low surgical risk). The Kaplan-Meier estimate of the primary outcome
at 1 year was 5.4% in the TAVI group and 10.0% in the SAVR group (hazard
ratio for death or stroke, 0.53; 95% confidence interval [CI], 0.35 to
0.79; P<0.001 for noninferiority). The incidence of death from any cause
was 2.6% in the TAVI group and 6.2% in the SAVR group (hazard ratio, 0.43;
95% CI, 0.24 to 0.73); the incidence of stroke was 2.9% and 4.7%,
respectively (hazard ratio, 0.61; 95% CI, 0.35 to 1.06). Procedural
complications occurred in 1.5% and 1.0% of patients in the TAVI and SAVR
groups, respectively. <br/>CONCLUSION(S): Among patients with severe
aortic stenosis at low or intermediate surgical risk, TAVI was noninferior
to SAVR with respect to death from any cause or stroke at 1 year. (Funded
by the German Center for Cardiovascular Research and the German Heart
Foundation; DEDICATE-DZHK6 ClinicalTrials.gov number,
NCT03112980.).<br/>Copyright &#xa9; 2024 Massachusetts Medical Society.

<37>
Accession Number
2029090707
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) The Xuzhou
Clinical College of Xuzhou Medical University, Jiangsu, Xuzhou, China
(Qi, Zhou, Zheng, Dong, Li, Wang, Xu, Wang, Zhou) Department of
Anesthesiology, Xuzhou Central Hospital, Jiangsu, Xuzhou, China
(Qi, Zhou, Wang, Zhou) Jiangsu Province Key Laboratory of Anesthesiology
Xuzhou Medical University, Jiangsu, Xuzhou, China
(Li) College of Anesthesiology, Xuzhou Medical University, Jiangsu,
Xuzhou, China
(Zhang, Yang) Department of Cardiothoracic Surgery, Xuzhou Central
Hospital, Jiangsu, Xuzhou, China
Publisher
Dove Medical Press Ltd
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.

<38>
Accession Number
2031945003
Title
Machine learning in cardiac surgery: a narrative review.
Source
Journal of Thoracic Disease. 16(4) (pp 2644-2653), 2024. Date of
Publication: 30 Apr 2024.
Author
Miles T.J.; Ghanta R.K.
Institution
(Miles, Ghanta) Michael E. DeBakey Department of Surgery, Baylor College
of Medicine, Houston, TX, United States
(Miles, Ghanta) Applied Statistics and Machine Learning for the
Advancement of Surgery, Department of Surgery, Baylor College of Medicine,
Houston, TX, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Machine learning (ML) is increasingly being
utilized to provide data driven solutions to challenges in medicine.
Within the field of cardiac surgery, ML methods have been employed as risk
stratification tools to predict a variety of operative outcomes. However,
the clinical utility of ML in this domain is unclear. The aim of this
review is to provide an overview of ML in cardiac surgery, particularly
with regards to its utility in predictive analytics and implications for
use in clinical decision support. <br/>Method(s): We performed a narrative
review of relevant articles indexed in PubMed since 2000 using the MeSH
terms "Machine Learning", "Supervised Machine Learning", "Deep Learning",
or "Artificial Intelligence" and "Cardiovascular Surgery" or "Thoracic
Surgery". Key Content and Findings: ML methods have been widely used to
generate pre-operative risk profiles, consistently resulting in the
accurate prediction of clinical outcomes in cardiac surgery. However,
improvement in predictive performance over traditional risk metrics has
proven modest and current applications in the clinical setting remain
limited. <br/>Conclusion(s): Studies utilizing high volume,
multidimensional data such as that derived from electronic health record
(EHR) data appear to best demonstrate the advantages of ML methods. Models
trained on post cardiac surgery intensive care unit data demonstrate
excellent predictive performance and may provide greater clinical utility
if incorporated as clinical decision support tools. Further development of
ML models and their integration into EHR's may result in dynamic clinical
decision support strategies capable of informing clinical care and
improving outcomes in cardiac surgery.<br/>Copyright &#xa9; Journal of
Thoracic Disease. All rights reserved.

<39>
Accession Number
2031944996
Title
Extracorporeal membrane oxygenation for general thoracic surgery: case
series and narrative review.
Source
Journal of Thoracic Disease. 16(4) (pp 2637-2643), 2024. Date of
Publication: 30 Apr 2024.
Author
Campany M.E.; Donato B.B.; Santos P.R.D.; Alwardt C.M.; Sell-Dottin K.;
Blakeman S.; Hung P.; Sen A.; DeValeria P.; Schaheen L.; D'Cunha J.
Institution
(Campany, Hung) Mayo Clinic Alix School of Medicine, Scottsdale, AZ,
United States
(Donato) Department of General Surgery, Mayo Clinic, Phoenix, AZ, United
States
(Santos, Alwardt, Sell-Dottin, DeValeria, D'Cunha) Department of
Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, United States
(Blakeman) Department of Nursing, Mayo Clinic, Phoenix, AZ, United States
(Sen) Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ,
United States
(Schaheen) Norton Thoracic Institute, St. Joseph's Hospital and Medical
Center, Phoenix, AZ, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Extracorporeal membrane oxygenation (ECMO) has
historically been utilized as a temporary life support option for patients
with severe cardiac and pulmonary dysfunction. Recent advancements have
enabled the safe application of ECMO in a wider variety of patients; we
present a review of its use in patients undergoing general thoracic
procedures supported by a case series at our institution. <br/>Method(s):
We review current literature focusing on ECMO applications in thoracic
surgery outside of the traditional use. Additionally, we offer three cases
of ECMO utilization to illustrate success stories and key lessons learned
regarding the use of ECMO in general thoracic surgery. Key Content and
Findings: Technologic advancements and enhanced safety profiles have
enabled the safe application of ECMO in a wide array of patients far
beyond the historic indications of cardiogenic shock and acute respiratory
distress syndrome (ARDS). It is now feasible to consider ECMO for
management of acute thoracic emergencies, as well as to better facilitate
operative safety in complex general thoracic surgical procedures. Both
venovenous and venoarterial ECMO can be utilized in carefully selected
patients to provide cardiopulmonary support while enabling improved
visualization and increased mobilization without concern for respiratory
and/or cardiac compromise. <br/>Conclusion(s): Enthusiasm for the use of
ECMO has increased in recent years. What was once considered a salvage
therapy in cases of life-threatening cardiopulmonary decompensation now
plays an increasingly important role in the safe conduct of complex
thoracic surgery procedures, provides much needed time for organ recovery,
and offers acute resuscitation options. This shift broadens our ability to
deliver life-saving care to patients that previously would have otherwise
had limited treatment options.<br/>Copyright &#xa9; 2024 AME Publishing
Company. All rights reserved.

<40>
Accession Number
2029717468
Title
The influence of preoperative or intraoperative methadone on postcardiac
surgery pain and opioid administration: a systematic review and
meta-analysis.
Source
Cardiothoracic Surgeon. 32(1) (no pagination), 2024. Article Number: 8.
Date of Publication: December 2024.
Author
Goldblatt J.; Crawford L.; Ross J.; Edelman J.; Pavey W.
Institution
(Goldblatt, Crawford, Ross) Department of Cardiothoracic Surgery, Princess
Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102,
Australia
(Edelman) Department of Cardiothoracic Surgery, Fiona Stanley Hospital,
Perth, Australia
(Pavey) Department of Cardiac Anaesthesia, Fiona Stanley Hospital, Perth,
Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Opioid analgesia remains a cornerstone of the management of
perioperative pain in cardiac surgical patients. Emerging evidence
suggests that intermediate and long-term postoperative opioid dependence
is underappreciated and associated with adverse patient outcomes.
Methadone has emerged in the cardiothoracic and non-cardiothoracic
anesthesia literature as an option that may provide lasting analgesic
benefit and may be associated with a reduction in overall perioperative
opioid requirements. Main body: This study was a systematic literature
review and meta-analysis that aimed to provide evidence supporting the use
of perioperative or intraoperative methadone in adult cardiac surgical
patients, particularly with respect to objective measures of postoperative
pain and opioid requirements prior to and at discharge from the hospital.
Electronic searches of three research databases were performed: PubMed
(1972 to October 2023), Ovid MEDLINE (1946 to October 2023), and EMBASE
(1978 to October 2023). This search yielded a total of 190 articles, 7 of
which met the relevant inclusion and exclusion criteria. This included
five randomized controlled trials and two large retrospective cohort
studies. <br/>Conclusion(s): Preoperative or intraoperative methadone led
to reduced pain scores at 24 h postoperatively and reduced opioid
requirements at discharge. Methadone may be effective at reducing
perioperative pain scores and opioid requirements postoperatively,
including at discharge. The literature on this subject has important
limitations, and further research in larger randomized controlled trials
is needed.<br/>Copyright &#xa9; Crown 2024.

<41>
Accession Number
2032006156
Title
Probiotics may alleviate intestinal damage induced by cardiopulmonary
bypass in children.
Source
European Journal of Cardio-thoracic Surgery. 65(4) (no pagination), 2024.
Article Number: ezae152. Date of Publication: 01 Apr 2024.
Author
Toritsuka D.; Aoki M.; Higashida A.; Fukahara K.; Nishida N.; Hirono K.;
Hane M.; Sugimoto T.; Asahara T.; Yoshimura N.
Institution
(Toritsuka, Aoki, Fukahara, Yoshimura) Department of Cardiovascular
Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
(Higashida) Department of Cardiovascular Surgery, Kobe Children's
Hospital, Kobe, Japan
(Nishida, Hirono) Department of Pediatrics, Graduate School of Medicine,
University of Toyama, Toyama, Japan
(Hane, Sugimoto, Asahara) Yakult Central Institute, Yakult Honsha Co.,
Ltd, Tokyo, Japan
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Intestinal ischaemia-reperfusion injury induced by
cardiopulmonary bypass causes intestinal epithelial barrier dysfunction,
leading to dysbiosis and bacterial translocation. We conducted a
randomized prospective study with 2 objectives: (i) to investigate
epithelial barrier dysfunction and bacterial translocation induced by
cardiopulmonary bypass and changes in the gut microbiota and (ii) to
verify whether probiotics can improve these conditions. <br/>METHOD(S):
Between 2019 and 2020, patients 0-15 years old scheduled to undergo
cardiac surgery using cardiopulmonary bypass were enrolled and randomly
allocated to 2 groups: the intervention group received probiotics and the
control group did not receive probiotics. We analysed the microbiota in
faeces and blood, organic acid concentrations in faeces, plasma intestinal
fatty acid-binding protein and immunological responses. <br/>RESULT(S):
Eighty-two patients were enrolled in this study. The characteristics of
the patients were similar in both groups. The total number of obligate
anaerobes was higher in the intervention group than in the control group
after postoperative day 7. We identified 4 clusters within the
perioperative gut microbiota, and cluster changes showed a corrective
effect of probiotics on dysbiosis after postoperative day 7. Organic acid
concentrations in faeces, incidence of bacterial translocation, intestinal
fatty acid-binding protein levels and immunological responses, except for
interleukin -17A, were not markedly different between the 2 groups.
<br/>CONCLUSION(S): Administration of probiotics was able to correct
dysbiosis but did not sufficiently alleviate the intestinal damage induced
by cardiopulmonary bypass. More effective methods should be examined to
prevent disturbances induced by cardiac surgery using cardiopulmonary
bypass. Clinical trial registration number:
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037
174 UMIN000035556.<br/>Copyright &#xa9; 2024 European Association for
Cardio-Thoracic Surgery. All rights reserved.

<42>
Accession Number
2031980652
Title
Paravertebral block combined with serratus anterior plane block after
video-assisted thoracic surgery: a prospective randomized controlled
trial.
Source
European Journal of Cardio-thoracic Surgery. 64(1) (no pagination), 2023.
Article Number: ezad170. Date of Publication: 01 Jul 2023.
Author
Dusseaux M.-M.; Greg V.; Baste J.-M.; Besnier E.; Boujibar F.; Koscianski
G.; Yahia M.M.B.; Compere V.; Clavier T.; Vannier M.; Selim J.
Institution
(Dusseaux, Greg, Besnier, Koscianski, Yahia, Compere, Clavier, Selim)
Department of Anaesthesiology and Critical Care, CHU Rouen, Rouen F-76000,
France
(Baste, Besnier, Boujibar, Clavier, Selim) Univ Rouen Normandy, INSERM
EnVI, UMR 1096, Rouen F-76000, France
(Baste, Boujibar) Department of Thoracic Surgery, CHU Rouen, Rouen
F-76000, France
(Vannier) Department of Biostatistics, Rouen University Hospital, Rouen
F-76000, France
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Adequate pain management after thoracoscopic surgery is a
major issue in the prevention of respiratory complications. The
combination of the paravertebral block (PVB) with the serratus anterior
plane block (SAPB) may decrease postoperative pain. The objective of this
study was to evaluate the impact of the combination of PVB and SAPB on the
consumption of morphine and pain after video- or robot-assisted thoracic
surgery. <br/>METHOD(S): The main objective of this randomized controlled
trial was to compare the cumulative postoperative morphine consumption at
24 h between a group having PVB (PVB group) and a group having PVB and
SAPB (PV-SAPB group). Postoperative pain at 6 and 24 h and
morphine-related complications were also assessed. <br/>RESULT(S): A total
of 112 patients were included with 56 in each group. There was no
difference in median cumulative morphine consumption at 24 h between the 2
groups (P = 0.1640). At 6 h, the median postoperative pain was higher in
the PVB group compared to the PV-SAPB group (3 [0; 4] vs 2 [0; 3], P =
0.0231). There were no differences between the 2 groups for pain at 24 h
and morphine-related complications. <br/>CONCLUSION(S): We did not find
any difference in morphine consumption between the 2 groups. Our results
suggest that the combination of PVB and SAPB for video-assisted thoracic
surgery or robot-assisted thoracic surgery is safe effective and reliable
and could be an alternative to PVB alone in certain
indications.<br/>Copyright &#xa9; The Author(s) 2023.

<43>
Accession Number
2032046197
Title
Novel stroke prevention strategies following catheter ablation for atrial
fibrillation.
Source
Revista Espanola de Cardiologia. (no pagination), 2024. Date of
Publication: 2024.
Author
Ding W.Y.; Calvert P.; Lip G.Y.H.; Gupta D.
Institution
(Ding, Calvert, Lip, Gupta) Liverpool Centre for Cardiovascular Science,
University of Liverpool, Liverpool John Moores University and Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
(Lip) Danish Centre for Clinical Health Services Research, Department of
Clinical Medicine, Aalborg University, Aalborg, Denmark
Publisher
Ediciones Doyma, S.L.
Abstract
Stroke prevention following successful catheter ablation of atrial
fibrillation remains a controversial topic. Oral anticoagulation is
associated with a significant reduction in stroke risk in the general
atrial fibrillation population but may be associated with an increased
risk of major bleeding, and the benefit: risk ratio must be considered.
Improvement in successful catheter ablation and widespread use of cardiac
monitoring devices may allow for novel anticoagulation strategies in a
subset of patients with atrial fibrillation, which may optimize stroke
prevention while minimizing bleeding risk. In this review, we discuss
stroke risk in atrial fibrillation and the effects of successful catheter
ablation on thromboembolic risk. We also explore novel strategies for
stroke prevention following successful catheter ablation.<br/>Copyright
&#xa9; 2024 Sociedad Espanola de Cardiologia

<44>
Accession Number
2032045953
Title
Systematic review and meta-analysis of randomized and nonrandomized
studies on fractional flow reserve-guided revascularization.
Source
Revista Espanola de Cardiologia. (no pagination), 2024. Date of
Publication: 2024.
Author
Mangiacapra F.; Paolucci L.; Johnson N.P.; Viscusi M.M.; Ussia G.P.;
Grigioni F.; De Bruyne B.; Barbato E.
Institution
(Mangiacapra, Paolucci, Viscusi, Ussia, Grigioni) Research Unit of
Cardiovascular Science, Department of Medicine and Surgery, Universita
Campus Bio-Medico di Roma, Roma, Italy
(Mangiacapra, Paolucci, Viscusi, Ussia, Grigioni) Fondazione Policlinico
Universitario Campus Bio-Medico, Roma, Italy
(Johnson) Division of Cardiology, Department of Medicine, Weatherhead PET
Center, McGovern Medical School at UTHealth and Memorial Hermann Hospital,
Houston, TX, United States
(Viscusi, De Bruyne, Barbato) Cardiovascular Center, OLV Clinic, Aalst,
Belgium
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Roma, Italy
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Several studies have investigated the
effectiveness of fractional flow reserve (FFR) guidance in improving
clinical outcomes after myocardial revascularization, yielding conflicting
results. The aim of this study was to compare clinical outcomes in
patients with coronary artery disease following FFR-guided or
angiography-guided revascularization. <br/>Method(s): Both randomized
controlled trials (RCTs) and nonrandomized intervention studies were
included. Coprimary endpoints were all-cause death, myocardial infarction,
and major adverse cardiovascular events (MACE). The study is registered
with PROSPERO (CRD42022344765). <br/>Result(s): A total of 30 studies
enrolling 393 588 patients were included. FFR-guided revascularization was
associated with significantly lower rates of all-cause death (OR, 0.63;
95%CI, 0.53-0.73), myocardial infarction (OR, 0.70; 95%CI, 0.59-0.84), and
MACE (OR, 0.77; 95%CI, 0.70-0.85). When only RCTs were considered, no
significant difference between the 2 strategies was observed for any
endpoints. However, the use of FFR was associated with reduced rates of
revascularizations and treated lesions. Metaregression suggested that the
higher the rate of revascularized patients the lower the benefit of FFR
guidance on MACE reduction compared with angiography guidance (P =.012).
Similarly, higher rates of patients with acute coronary syndromes were
associated with a lower benefit of FFR-guided revascularization (P =.039).
<br/>Conclusion(s): FFR-guided revascularization was associated with lower
rates of all-cause death, myocardial infarction and MACE compared with
angiographic guidance, with RCTs and nonrandomized intervention studies
yielding conflicting data. The benefits of FFR-guidance seem to be less
evident in studies with high revascularization rates and with a high
prevalence of patients with acute coronary syndrome.<br/>Copyright &#xa9;
2024

<45>
Accession Number
2031990299
Title
A systematic review of existing appropriate use criteria in cardiovascular
disease from the last 15 years.
Source
Seminars in Vascular Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Le Q.; Mills A.; Denton A.; Weaver M.L.
Institution
(Le) University of Virginia School of Medicine, Charlottesville, VA,
United States
(Mills) Department of Surgery, University of Virginia, Charlottesville,
VA, United States
(Denton) Claude Moore Health Sciences Library, University of Virginia,
Charlottesville, VA, United States
(Weaver) Division of Vascular and Endovascular Surgery, University of
Virginia Health System, 1215 Lee Street, PO Box 800679, Charlottesville,
VA 22908-0679, United States
Publisher
W.B. Saunders
Abstract
Appropriate use criteria (AUC) aim to impact the provision of high-value
care. This scoping review identified AUC regarding the procedural and
operative treatment of cardiovascular disease and described the evolution
of AUC in this space over time, including changes in the focus, strategy,
and language of AUC. The summative presentation of these AUC identifies
elements of AUC that may lead to successes in, and barriers to,
implementation across disease processes, specialties, and societies. AUC
topics include coronary artery disease, peripheral artery disease,
valvular disease, venous disease, renal artery stenosis, and mesenteric
ischemia, among others.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<46>
Accession Number
644153779
Title
Gabapentin as a novel adjunct for postoperative irritability after
superior cavopulmonary connection operation in children.
Source
Cardiology in the young. (pp 1-7), 2024. Date of Publication: 03 May
2024.
Author
Thibault C.; Ramsey E.Z.; Collier H.; Shu D.; Faerber J.; Schwartz E.;
Chen J.; Goldberg D.J.; Yehya N.; Gardner M.M.
Institution
(Thibault, Yehya, Gardner) Department of Anesthesiology and Critical Care,
Children's Hospital of Philadelphia, Philadelphia, PA, United States
(Thibault) Department of Pediatrics, Universite de Montreal, Montreal, QC,
Canada
(Thibault) Division of Critical Care Medicine, Department of Pediatrics,
CHU Sainte-Justine, Montreal, QC, Canada
(Ramsey, Collier) Department of Pharmacy Services, Children's Hospital of
Philadelphia, Philadelphia, PA, United States
(Shu) Department of Biostatistics, Epidemiology and Informatics,
University of Pennsylvania, Philadelphia, PA, United States
(Shu) Clinical Futures, Research Institute, Children's Hospital of
Philadelphia, Philadelphia, PA, United States
(Faerber) Department of Biomedical and Health Informatics, Data Science
and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia,
PA, United States
(Schwartz, Goldberg) Division of Cardiology, Children's Hospital of
Philadelphia, Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, PA, United States
(Chen) Division of Cardiothoracic Surgery, Children's Hospital of
Philadelphia, Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, PA, United States
Abstract
OBJECTIVES: Describing our institution's off-label use of gabapentin to
treat irritability after superior cavopulmonary connection surgery and its
impact on subsequent opiate and benzodiazepine requirements.
<br/>METHOD(S): This is a single-center retrospective cohort study
including infants who underwent superior cavopulmonary connection
operation between 2011 and 2019. <br/>RESULT(S): Gabapentin was
administered in 74 subjects (74/323, 22.9%) during the observation period,
with a median (IQR) starting dose of 5.7 (3.3, 15.0) mg/kg/day and a
maximum dose of 10.7 (5.5, 23.4) mg/kg/day. Infants who underwent surgery
in 2015-19 were more likely to receive gabapentin compared with those who
underwent surgery in 2011-14 (p < 0.0001). Infants prescribed gabapentin
were younger at surgery (137 versus 146 days, p = 0.007) and had longer
chest tube durations (1.8 versus 0.9 days, p < 0.001), as well as longer
postoperative intensive care (5.8 versus 3.1 days, p < 0.0001) and
hospital (11.5 versus 7.0 days, p < 0.0001) lengths of stays. The year of
surgery was the only predisposing factor associated with gabapentin
administration in multivariate analysis. In adjusted linear regression,
infants prescribed gabapentin on postoperative day 0-4 (n = 64) had
reduced benzodiazepine exposure in the following 3 days (-0.29 mg/kg, 95%
CI -0.52 - -0.06, p = 0.01) compared with those not prescribed gabapentin,
while no difference was seen in opioid exposure (p = 0.59).
<br/>CONCLUSION(S): Gabapentin was used with increasing frequency during
the study period. There was a modest reduction in benzodiazepine
requirements associated with gabapentin administration and no reduction in
opioid requirements. A randomised controlled trial could better assess
gabapentin's benefits postoperatively in children with congenital heart
disease.

<47>
Accession Number
644148770
Title
Incidence and assessment of delirium following open cardiac surgery; A
systematic review and meta-analysis.
Source
European journal of cardiovascular nursing. (no pagination), 2024. Date
of Publication: 02 May 2024.
Author
Petersson N.B.; Hansen M.H.; Hjelmborg J.V.B.; Instenes I.; Christoffersen
A.S.; Larsen K.L.; Schmidt H.; Riber L.P.S.; Norekval T.M.; Borregaard B.
Institution
(Petersson, Hansen, Christoffersen, Larsen, Riber, Borregaard) Department
of Cardiothoracic and Vascular Surgery, Odense University Hospital,
Odense, Denmark
(Hjelmborg) Department of Public Health, Epidemiology, Biostatistics and
Biodemography, University of Southern Denmark, Odense C, Denmark
(Instenes, Norekval) Department of Heart Disease, Haukeland University
Hospital, Bergen, Norway
(Larsen, Riber, Borregaard) Faculty of Health Science, University of
Southern Denmark, Odense, Denmark
(Schmidt) Department of Anaesthesiology and Intensive Care, Odense
University Hospital, Odense, Denmark
(Norekval) Department of Clinical Science, University of Bergen, Bergen,
Norway
(Borregaard) Department of Cardiology, Odense University Hospital, Odense,
Denmark
Abstract
AIM: This systematic review and meta-analysis sought i) to provide an
overview of the incidence of delirium following open cardiac surgery and
ii) to investigate how incidences of delirium are associated with
different assessment tools. METHODS AND RESULTS: A systematic search of
studies investigating delirium following open cardiac surgery were
conducted in Medline (Ovid), EMBASE, PsycINFO, CiNAHL and the Cochrane
Database. Only studies with patients diagnosed or screened with a
validated tool were included. Studies published from 2005 to 2021 were
included in the meta-analysis.Of 7,126 individual studies retrieved, 106
met the inclusion criteria for the meta-analysis, hereof 31% of high
quality. The weighted pooled incidence of delirium following open cardiac
surgery across all studies was 23% (95% CI 20-26%), however we found a
considerable heterogeneity (I2 = 99%), which could not be explained by
subgroups or further sensitivity analyses. The most commonly applied
screening tool for delirium is CAM/CAM-ICU. The lowest estimates of
delirium were found by applying the Delirium Observation Scale (incidence
14%, 95% CI 8-20%), and the highest estimates in studies using "other"
screening tools (Organic Brain Symptom Scale, Delirium Symptom Interview)
pooled incidence of 43%, (95% CI 19 - 66%), however, only two studies
applied these. <br/>CONCLUSION(S): Delirium following open cardiac surgery
remains a complication with a high incidence of overall 23%, when applying
a validated tool for screening or diagnosis. Nevertheless, this systematic
review and meta-analyses highlight the significant inconsistency in
current evidence regarding assessment tools and regimens. REGISTRATION:
Prospero CRD42020215519.<br/>Copyright &#xa9; The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further information
please contact

<48>
Accession Number
2030835054
Title
Self-Apposing Stents in Coronary Chronic Total Occlusions: A Pilot Study.
Source
Heart Lung and Circulation. 33(4) (pp 500-509), 2024. Date of Publication:
April 2024.
Author
Elborae A.; Hassan M.; Meguid M.A.; Bakry K.; Samir A.; Brilakis E.;
Kandil H.; ElGuindy A.
Institution
(Elborae, Hassan, Meguid, Bakry, Samir, Kandil) Department of
Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza,
Egypt
(Elborae, Bakry, Samir, ElGuindy) Department of Cardiology, Aswan Heart
Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
(Brilakis) Allina Health Minneapolis Heart Institute, Minneapolis, MN,
United States
Publisher
Elsevier Ltd
Abstract
Objectives: This pilot study assessed the 12-month angiographic and
clinical outcomes of self-apposing (SA) stents in patients undergoing
chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
<br/>Background(s): Self-apposing (SA) stents may decrease incomplete
strut apposition and stent strut coverage that are common after CTO PCI.
<br/>Method(s): We compared 20 patients who underwent CTO PCI using SA
drug-eluting stents (DESs) with 20 matched control patients who underwent
CTO PCI using balloon-expandable (BE)-DESs. All patients were followed up
clinically for 12 months and had coronary angiography with optical
coherence tomography at the end of the follow-up period. The primary end
points were stent strut malapposition and strut coverage. The secondary
end point was composite major adverse cardiovascular events (MACEs) at 12
months. <br/>Result(s): Both groups had high prevalence of diabetes
mellitus, and most of the treated lesions were complex, with 62% having a
J-CTO score of >=3. All CTO PCI techniques were allowed for
recanalisation, and 75% of the procedures were guided by intravascular
ultrasound. At 12 months, the SA-DES group had fewer malapposed struts (0%
[interquartile range (IQR) 0%-0%] vs 4.5% [IQR 0%-20%]; p<0.001) and
uncovered struts (0.08% [IQR 0%-1.6%] vs 8.2% [IQR 0%-16%]; p<0.001).
However, they showed significantly higher rates of MACEs due to
clinically-driven target lesion revascularisation (45% vs 15%; p=0.038).
<br/>Conclusion(s): In this pilot study, compared with conventional
BE-DESs, SA-DESs used in CTO PCI were associated with fewer malapposed and
uncovered stent struts but also with significantly higher rates of
in-stent restenosis and MACEs, mainly caused by clinically driven target
lesion revascularisation.<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)

<49>
Accession Number
2030672182
Title
Myocardial Fibrosis by Magnetic Resonance and Outcomes in Chagas Disease:
A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 17(5) (pp 552-555), 2024. Date of
Publication: May 2024.
Author
Gomez-Ochoa S.A.; Rojas L.Z.; Hernandez-Vargas J.A.; Trujillo-Caceres
S.J.; Hurtado-Ortiz A.; Licht-Ardila M.; Guarin-Aragon M.A.; Rochitte
C.E.; Morillo C.A.; Echeverria L.E.
Publisher
Elsevier Inc.

<50>
Accession Number
2029608599
Title
Levels of autonomy in FDA-cleared surgical robots: a systematic review.
Source
npj Digital Medicine. 7(1) (no pagination), 2024. Article Number: 103.
Date of Publication: December 2024.
Author
Lee A.; Baker T.S.; Bederson J.B.; Rapoport B.I.
Institution
(Lee, Baker, Bederson, Rapoport) Department of Neurosurgery, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Lee, Baker, Bederson, Rapoport) Sinai BioDesign, Icahn School of Medicine
at Mount Sinai, New York, NY, United States
(Baker) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Nature Research
Abstract
The integration of robotics in surgery has increased over the past decade,
and advances in the autonomous capabilities of surgical robots have
paralleled that of assistive and industrial robots. However,
classification and regulatory frameworks have not kept pace with the
increasing autonomy of surgical robots. There is a need to modernize our
classification to understand technological trends and prepare to regulate
and streamline surgical practice around these robotic systems. We present
a systematic review of all surgical robots cleared by the United States
Food and Drug Administration (FDA) from 2015 to 2023, utilizing a
classification system that we call Levels of Autonomy in Surgical Robotics
(LASR) to categorize each robot's decision-making and action-taking
abilities from Level 1 (Robot Assistance) to Level 5 (Full Autonomy). We
searched the 510(k), De Novo, and AccessGUDID databases in December 2023
and included all medical devices fitting our definition of a surgical
robot. 37,981 records were screened to identify 49 surgical robots. Most
surgical robots were at Level 1 (86%) and some reached Level 3
(Conditional Autonomy) (6%). 2 surgical robots were recognized by the FDA
to have machine learning-enabled capabilities, while more were reported to
have these capabilities in their marketing materials. Most surgical robots
were introduced via the 510(k) pathway, but a growing number via the De
Novo pathway. This review highlights trends toward greater autonomy in
surgical robotics. Implementing regulatory frameworks that acknowledge
varying levels of autonomy in surgical robots may help ensure their safe
and effective integration into surgical practice.<br/>Copyright &#xa9; The
Author(s) 2024.

<51>
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%, P0.05). <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.

<52>
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.

<53>
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.

<54>
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

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

<56>
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.

<57>
Accession Number
2028603091
Title
Minimally invasive procedures for right side infective endocarditis: A
targeted literature review.
Source
Catheterization and Cardiovascular Interventions. 103(6) (pp 1050-1061),
2024. Date of Publication: 01 May 2024.
Author
Wang W.; Itagaki S.; Egorova N.
Institution
(Wang, Egorova) Department of Population Health Science and Policy, Icahn
School of Medicine at Mount Sinai, New York City, NY, United States
(Itagaki) Department of Surgery, Icahn School of Medicine at Mount Sinai,
New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Right-side infective endocarditis (RSIE) is caused by
microorganisms and develops into intracardiac and extracardiac
complications with high in-hospital and 1-year mortality. Treatments
involve antibiotic and surgical intervention. However, those presenting
with extremes e.g. heart failure, or septic shock who are not ideal
candidates for conventional medical therapy might benefit from minimally
invasive procedures. <br/>Objective(s): This review summarizes existing
observational studies that reported minimally invasive procedures to
debulk vegetation due to infective endocarditis either on valve or cardiac
implantable electronic devices. <br/>Method(s): A targeted literature
review was conducted to identify studies published in PubMed/MEDLINE,
EMBASE, and Cochrane Central Database from January 1, 2015 to June 5,
2023. The efficacy and/or effectiveness of minimally invasive procedural
interventions to debulk vegetation due to RSIE were summarized following
PRISMA guidelines. <br/>Result(s): A total of 11 studies with 208 RSIE
patients were included. There were 9 studies that assessed the
effectiveness of the AngioVac system and 2 assessed the Penumbra system.
Overall procedure success rate was 87.9%. Among 8 studies that reported
index hospitalization, 4 studies reported no death, while the other 4
studies reported 10 deaths. <br/>Conclusion(s): This study demonstrates
that multiple systems can provide minimally invasive procedure options for
patients with RSIE with high procedural success. However, there are mixed
results regarding complications and mortality rates. Further large cohort
studies or randomized clinical trials are warranted to assess and/or
compare the efficacy and safety of these systems.<br/>Copyright &#xa9;
2024 Wiley Periodicals LLC.

<58>
Accession Number
2028439142
Title
Eosinophilic myocarditis: systematic review.
Source
Heart. 110(10) (pp 687-693), 2024. Date of Publication: 01 May 2024.
Author
Techasatian W.; Gozun M.; Vo K.; Yokoyama J.; Nagamine T.; Shah P.; Vu K.;
Zhang J.; Nishimura Y.
Institution
(Techasatian, Gozun, Vo, Yokoyama, Nagamine, Shah, Nishimura) Department
of Medicine, UH Manoa JABSOM, Honolulu, HI, United States
(Vu, Zhang) Queen's Heart Institute, Queen's Medical Center, Honolulu, HI,
United States
Publisher
BMJ Publishing Group
Abstract
Objective In clinical practice, patients with eosinophilic myocarditis
(EM) may forgo the gold standard diagnostic procedure, endomyocardial
biopsy (EMB), although it is highly recommended in guidelines. This
systematic review aims to summarise current approaches in diagnosing and
treating EM with a particular emphasis on the utilisation and value of
alternative diagnostic methods. Methods Following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses statement, we searched
MEDLINE and EMBASE for all peer-reviewed articles using the keywords
"eosinophilic myocarditis" from their inception to 10 September 2022.
results We included 239 articles, including 8 observational studies and
274 cases, in this review.The median patient age was 45 years. Initial
presentations were non-specific, including dyspnoea (50.0%) and chest pain
(39.4%).The aetiologies of EM were variable with the most common being
idiopathic (28.8%) and eosinophilic granulomatosis polyangiitis (19.3%);
others included drug-induced (13.1%) and hypereosinophilic syndrome
(12.8%). 82.4% received an EM diagnosis by EMB while 17.6% were diagnosed
based on clinical reasoning and cardiac MRI (CMR). CMR-diagnosed patients
exhibited a better risk profile at diagnosis, particularly higher left
ventricular ejection fraction and less need for inotropic or mechanical
circulatory supports. Glucocorticoids were the primary treatment with
variability in dosages and regimens. Conclusion EMB is the mainstay for
diagnostic testing for EM. CMR is potentially helpful for screening in
appropriate clinical scenarios. Regarding treatment, there is no consensus
regarding the optimal dosage of corticosteroids. Large clinical trials are
warranted to further explore the utility of CMR in the diagnosis of EM and
steroid regimen in treating EM.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2024. No commercial re-use. See rights and permissions.
Published by BMJ.

<59>
Accession Number
2031888135
Title
Echocardiographic Outcomes With Transcatheter Edge-to-Edge Repair for
Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients.
Source
JACC: Cardiovascular Imaging. 17(5) (pp 471-485), 2024. Date of
Publication: May 2024.
Author
Marcoff L.; Koulogiannis K.; Aldaia L.; Mediratta A.; Chadderdon S.M.;
Makar M.M.; Ruf T.F.; Gossler T.; Zaroff J.G.; Leung G.K.; Ku I.A.;
Nabauer M.; Grayburn P.A.; Wang Z.; Hawthorne K.M.; Fowler D.E.;
Dal-Bianco J.P.; Vannan M.A.; Bevilacqua C.; Meineri M.; Ender J.; Forner
A.F.; Puthumana J.J.; Mansoor A.H.; Lloyd D.J.; Voskanian S.J.; Ghobrial
A.; Hahn R.T.; Mahmood F.; Haeffele C.; Ong G.; Schneider L.M.; Wang D.D.;
Sekaran N.K.; Koss E.; Mehla P.; Harb S.; Miyasaka R.; Ivannikova M.;
Stewart-Dehner T.; Mitchel L.; Raissi S.R.; Kalbacher D.; Biswas S.; Ho
E.C.; Goldberg Y.; Smith R.L.; Hausleiter J.; Lim D.S.; Gillam L.D.
Institution
(Marcoff, Koulogiannis, Aldaia, Mediratta, Gillam) Morristown Medical
Center, Atlantic Health System, Morristown, NJ, United States
(Chadderdon) Oregon Health and Science University, Portland, OR, United
States
(Makar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Ruf, Gosler) University Medical Centre Mainz, Mainz, Germany
(Zaroff, Leung, Ku) Kaiser Permanente San Francisco Medical Center, San
Francisco, CA, United States
(Nabauer, Hausleiter) Munich University Hospital, Munich, Germany
(Grayburn, Wang, Smith) Baylor Scott and White: The Heart Hospital, Plano,
TX, United States
(Hawthorne) Lankenau Medical Center, Wynnewood, PA, United States
(Fowler, Lim) University of Virginia Health System Hospital,
Charlottesville, VA, United States
(Dal-Bianco) Massachusetts General Hospital, Boston, MA, United States
(Vannan) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA,
United States
(Bevilacqua, Meineri, Ender, Forner) Leipzig Heart Center, Leipzig,
Germany
(Puthumana) Northwestern University, Chicago, IL, United States
(Mansoor) UPMC Harrisburg, Harrisburg, PA, United States
(Lloyd, Voskanian, Ghobrial) Los Robles Regional Medical Center, Thousand
Oaks, CA, United States
(Hahn) Columbia University Medical Center, New York, NY, United States
(Mahmood) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Haeffele) Stanford University Medical Center, Stanford, CA, United States
(Ong) St. Michael's Hospital, Toronto, ON, Canada
(Schneider) Ulm University Hospital, Ulm, Germany
(Wang) Henry Ford Hospital, Detroit, MI, United States
(Sekaran) Intermountain Medical Center, Salt Lake City, UT, United States
(Koss) Northwell-North Shore, Manhasset, NY, United States
(Mehla) Thomas Jefferson University, Philadelphia, PA, United States
(Harb, Miyasaka) Cleveland Clinic Foundation, Cleveland, OH, United States
(Ivannikova) Ruhr University Bochum, Bochum, Germany
(Stewart-Dehner) The Christ Hospital, Cincinnati, OH, United States
(Mitchel) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Raissi) Ascension Saint Thomas Hospital, Nashville, TN, United States
(Kalbacher) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Biswas) Swedish Medical Center, Seattle, WA, United States
(Ho) Montefiore Medical Center, Bronx, NY, United States
(Goldberg) Northwell-Lenox Hill, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The CLASP IID randomized trial (Edwards PASCAL TrAnScatheter
Valve RePair System Pivotal Clinical Trial) demonstrated the safety and
effectiveness of the PASCAL system for mitral transcatheter edge-to-edge
repair (M-TEER) in patients at prohibitive surgical risk with significant
symptomatic degenerative mitral regurgitation (DMR). <br/>Objective(s):
This study describes the echocardiographic methods and outcomes from the
CLASP IID trial and analyzes baseline variables associated with residual
mitral regurgitation (MR) <=1+. <br/>Method(s): An independent
echocardiographic core laboratory assessed echocardiographic parameters
based on American Society of Echocardiography guidelines focusing on MR
mechanism, severity, and feasibility of M-TEER. Factors associated with
residual MR <=1+ were identified using logistic regression.
<br/>Result(s): In 180 randomized patients, baseline echocardiographic
parameters were well matched between the PASCAL (n = 117) and MitraClip (n
= 63) groups, with flail leaflets present in 79.2% of patients. Baseline
MR was 4+ in 76.4% and 3+ in 23.6% of patients. All patients achieved MR
<=2+ at discharge. The proportion of patients with MR <=1+ was similar in
both groups at discharge but diverged at 6 months, favoring PASCAL (83.7%
vs 71.2%). Overall, patients with a smaller flail gap were significantly
more likely to achieve MR <=1+ at discharge (adjusted OR: 0.70; 95% CI:
0.50-0.99). Patients treated with PASCAL and those with a smaller flail
gap were significantly more likely to sustain MR <=1+ to 6 months
(adjusted OR: 2.72 and 0.76; 95% CI: 1.08-6.89 and 0.60-0.98,
respectively). <br/>Conclusion(s): The study used DMR-specific
echocardiographic methodology for M-TEER reflecting current guidelines and
advances in 3-dimensional echocardiography. Treatment with PASCAL and a
smaller flail gap were significant factors in sustaining MR <=1+ to 6
months. Results demonstrate that MR <=1+ is an achievable benchmark for
successful M-TEER. (Edwards PASCAL TrAnScatheter Valve RePair System
Pivotal Clinical Trial [CLASP IID]; NCT03706833)<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<60>
Accession Number
2031877667
Title
The role of left ventricular global work index on the prediction of
cardiovascular mortality after transcatheter aortic valve implantation.
Source
International Journal of Cardiology. 406 (no pagination), 2024. Article
Number: 132101. Date of Publication: 01 Jul 2024.
Author
Chen B.; Zhang Q.
Institution
(Chen) Department of Clinical Laboratory, Wenchang People's Hospital,
Hainan, Wenchang 571300, China
(Zhang) Department of Cardiology, Zhejiang Provincial People's Hospital
Bijie Hospital, Guizhou, Bijie, China
Publisher
Elsevier Ireland Ltd

<61>
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.

<62>
Accession Number
2031843480
Title
Antithrombotic therapy for stable coronary artery disease and atrial
fibrillation in patients with and without revascularisation: the AFIRE
trial.
Source
EuroIntervention. 20(7) (pp E425-E435), 2024. Date of Publication: April
2024.
Author
Noda T.; Nochioka K.; Kaikita K.; Akao M.; Ako J.; Matoba T.; Nakamura M.;
Miyauchi K.; Hagiwara N.; Kimura K.; Hirayama A.; Matsui K.; Ogawa H.;
Yasuda S.
Institution
(Noda, Nochioka, Yasuda) Department of Cardiovascular Medicine, Tohoku
University, Graduate School of Medicine, Sendai, Japan
(Kaikita) Department of Internal Medicine, Division of Cardiovascular
Medicine and Nephrology, Faculty of Medicine, University of Miyazaki,
Miyazaki, Japan
(Akao) Department of Cardiology, National Hospital Organization Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University School of
Medicine, Sagamihara, Japan
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Meguro, Japan
(Miyauchi) Department of Cardiovascular Medicine, Juntendo Tokyo Koto
Geriatric Medical Center Koto City, Japan
(Hagiwara) Department of Cardiology, Tokyo Women's Medical University,
Shinjuku City, Japan
(Kimura) Cardiovascular Center, Yokohama City University Medical Center,
Yokohama, Japan
(Hirayama) Department of Medicine, Osaka Anti-tuberculosis Association,
Osaka Fukujyuji Hospital, Osaka, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
Publisher
Europa Group
Abstract
BACKGROUND: The Atrial Fibrillation and Ischemic Events with Rivaroxaban
in Patients with Stable Coronary Artery Disease (AFIRE) trial demonstrated
non-inferior efficacy endpoints for rivaroxaban monotherapy versus
combination therapy (rivaroxaban plus a single antiplatelet) and superior
safety endpoints in patients with atrial fibrillation and stable coronary
artery disease. AIMS: This post hoc analysis investigated whether the
AFIRE trial results reflected the presence or absence of prior
revascularisation. <br/>METHOD(S): Among 2,215 patients, 1,697 (76.6%) had
previously undergone revascularisation, and the remaining 518 (23.4%) had
not undergone prior revascularisation. The primary efficacy endpoint was a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularisation, or death from any cause, while the
primary safety endpoint was major bleeding. <br/>RESULT(S): In 1,697
patients with prior revascularisation, the efficacy and safety endpoints
were superior for monotherapy versus combination therapy (efficacy: hazard
ratio [HR] 0.62, 95% confidence interval [CI]: 0.45-0.85; p=0.003; safety:
HR 0.62, 95% CI: 0.39-0.98; p=0.042). Among 518 without prior
revascularisation, there were no significant differences in endpoints
(efficacy: HR 1.19, 95% CI: 0.67-2.12; p=0.554; safety: HR 0.47, 95% CI:
0.18-1.26; p=0.134). There was borderline interaction of the efficacy
endpoints (p=0.055) between two treatments. The safety benefit of
monotherapy on any bleeding was significant in patients without prior
revascularisation (HR 0.59, 95% CI: 0.38-0.93; p=0.022).
<br/>CONCLUSION(S): In high-risk thrombosis patients with a history of
prior revascularisation, rivaroxaban monotherapy versus combination
therapy demonstrated favourable safety and efficacy
outcomes.<br/>Copyright &#xa9; 2024 Europa Group. All rights reserved.

<63>
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.

<64>
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.

<65>
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)

<66>
Accession Number
2031347062
Title
The Influence of Audiovisual Distraction on Pain Reduction During
Transcatheter Aortic Valve Implantation Under Monitored Anesthesia Care: A
Prospective Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(6) (pp 1353-1360),
2024. Date of Publication: June 2024.
Author
Pitts L.; Hellner N.; Kofler M.; Ryschka M.; Unbehaun A.; O'Brien B.;
Kempfert J.; Hommel M.
Institution
(Pitts, Kofler, Unbehaun, Kempfert) Department of Cardiothoracic and
Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Pitts, Hellner, Kofler, Ryschka, Unbehaun, O'Brien, Kempfert, Hommel)
Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Hellner, Ryschka, O'Brien, Hommel) Department of Cardiac Anesthesiology
and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin,
Germany
(Kofler, O'Brien, Kempfert) German Center for Cardiovascular Research,
Berlin, Germany
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of an audiovisual distraction system
on the dose of remifentanil for perioperative sedation during
transcatheter aortic valve implantation under monitored anesthesia care.
<br/>Design(s): Single-center prospective randomized nonblinded study.
<br/>Setting(s): Tertiary referral academic hospital. <br/>Participant(s):
Ninety patients who underwent transfemoral transcatheter aortic valve
implantation between July 2019 and July 2021. <br/>Intervention(s):
Patients were randomized to use either a novel audiovisual distraction
system during the intervention (n = 45) or standard care without an
audiovisual distraction system (n = 45). <br/>Measurements and Main
Results: Standardized questionnaires were given to each patient at
admission and before and after the intervention to assess their levels of
anxiety. Primary endpoints were the average and peak infusion rates of
remifentanil. All patients were considered for the final analysis
according to an intention-to-treat design. No relevant differences in pre-
and postinterventional anxiety status were observed between the groups.
Similarly, there were no significant differences in reported pain scores
(p = 0.364). The average infusion rate (p = 0.028) and peak infusion rate
(p = 0.025) of remifentanil were lower in the group with an audiovisual
distraction system. <br/>Conclusion(s): Audiovisual distraction is a
useful adjunct to reduce the dose of remifentanil under monitored
anesthesia care during transcatheter aortic valve implantation. Larger
studies are needed to evaluate potential positive effects on patient
satisfaction, incidence of delirium, and possible economic
benefits.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<67>
Accession Number
644136981
Title
Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces
Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve
Replacement under Cardiopulmonary Bypass.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 30(1) (no
pagination), 2024. Date of Publication: 2024.
Author
Yuan B.; Huang X.; Wen J.; Peng M.
Institution
(Yuan, Huang, Wen) Department of Anesthesiology, Zhongshan City People's
Hospital, Zhongshan, Guangdong, China
(Peng) Pharmacy Intravenous Admixture Services, Zhongshan City People's
Hospital, Zhongshan, Guangdong, China
Abstract
PURPOSE: The study aims to assess the effects of dexmedetomidine (Dex)
pretreatment on patients during cardiac valve replacement under
cardiopulmonary bypass. <br/>METHOD(S): For patients in the Dex group (n =
52), 0.5 mug/kg Dex was given before anesthesia induction, followed by 0.5
mug/kg/h pumping injection before aortic occlusion. For patients in the
control group (n = 52), 0.125 ml/kg normal saline was given instead of
Dex. <br/>RESULT(S): The patients in the Dex group had longer time to
first dose of rescue propofol than the control group (P = 0.003). The Dex
group required less total dosage of propofol than the control group (P =
0.0001). The levels of cardiac troponin I (cTnI), creatine kinase
isoenzyme MB (CK-MB), malondialdehyde (MDA), and tumor necrosis
factor-alpha (TNF-alpha) were lower in the Dex group than the control
group at T4, 8 h after the operation (T5), and 24 h after the operation
(T6) (P <0.01). The Dex group required less time for mechanical
ventilation than the control group (P = 0.003). <br/>CONCLUSION(S): The
study suggests that 0.50 microg/kg Dex pretreatment could reduce propofol
use and the duration of mechanical ventilation, and confer myocardial
protection without increased adverse events during cardiac valve
replacement.

<68>
Accession Number
644136954
Title
Intraoperative Goal-Directed Perfusion in Cardiac Surgery with
Cardiopulmonary Bypass: The Roles of Delivery Oxygen Index and Cardiac
Index.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 30(1) (no
pagination), 2024. Date of Publication: 2024.
Author
Pratomo B.Y.; Sudadi S.; Setianto B.Y.; Novenanto T.T.; Raksawardana Y.K.;
Rayhan A.; Kurniawaty J.
Institution
(Pratomo, Sudadi, Kurniawaty) Department of Anesthesiology and Intensive
Care, Faculty of Medicine, Public Health and Nursing, Dr. Sardjito General
Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
(Setianto) Department of Cardiology, Faculty of Medicine, Public Health
and Nursing, Dr. Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta, Indonesia
(Novenanto, Raksawardana) Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada, Yogyakarta, Indonesia
(Rayhan) Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Abstract
PURPOSE: Goal-directed perfusion (GDP) refers to individualized
goal-directed therapy using comprehensive monitoring and optimizing the
delivery of oxygen during cardiopulmonary bypass (CPB). This study aims to
determine whether the intraoperative GDP protocol method has better
outcomes compared to conventional methods. <br/>METHOD(S): We searched the
PubMed, Central, and Scopus databases up to October 12, 2023. We primarily
examined the GDP protocol in adult cardiac surgery, using CPB with oxygen
delivery index (DO2I) and cardiac index (CI) as the main parameters.
<br/>RESULT(S): In all, 1128 participants from seven studies were included
in our analysis. The results showed significant differences in the
duration of intensive care unit (ICU) stays (p = 0.01), with a mean
difference of -0.33 (-0.59 to 0.07), and hospital length of stay (LOS) (p
= 0.0002), with a mean difference of -0.84 (-1.29 to -0.39). There was
also a notable reduction in postoperative complications (p <0.00001), odds
ratio (OR) of 0.43 (0.32-0.60). However, there was no significant decrease
in mortality rate (p = 0.54), OR of 0.77 (0.34-1.77). <br/>CONCLUSION(S):
Postoperative acute kidney injury and ICU and hospital LOS are
significantly reduced when GDP protocols with indicators of flow
management, oxygen delivery index, and CI are used in intraoperative
cardiac surgery using CPB.

<69>
Accession Number
2032019952
Title
Comparison of arterial hypotension incidence during general anesthesia
induction - target-controlled infusion vs. bolus injection of propofol: a
randomized clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(4) (no
pagination), 2024. Article Number: 844503. Date of Publication: 01 Jul
2024.
Author
Vale A.G.G.; Goveia C.S.; Guimaraes G.M.N.; Terra L.R.; Ladeira L.C.A.;
Essado G.A.
Institution
(Vale, Terra, Essado) Hospital Universitario de Brasilia, DF, Brasilia,
Brazil
(Goveia, Guimaraes, Ladeira) Universidade de Brasilia, Departamento de
Anestesiologia, DF, Brasilia, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: The incidence of arterial hypotension during induction of
general anesthesia is influenced by the method of propofol administration,
but there is a dearth of randomized clinical trials comparing bolus
injection and target-controlled infusion in relation to arterial
hypotension. This study seeks to compare the incidence of arterial
hypotension between these two methods of propofol administration.
<br/>Method(s): This prospective, randomized, single-center, non-blinded
study included 60 patients (aged 35 to 55 years), classified as ASA
physical status I or II, who were undergoing non-cardiac surgeries. They
were randomly allocated using a computer to two groups based on the method
of propofol administration during the induction of general anesthesia: the
Target Group, receiving target-controlled infusion at 4
mug.mL^-1, and the Bolus Group, receiving a bolus infusion of 2
mg.kg^-1. Both groups also received midazolam 2 mg, fentanyl 3
mug.kg^-1, and rocuronium 0.6 mg.kg^-1. Over the first
10 minutes of anesthesia induction, Mean Arterial Pressure (MAP), Heart
Rate (HR), level of Consciousness (qCON), and Suppression Rate (SR) were
recorded every 2 minutes. <br/>Result(s): Twenty-seven patients remained
in the TCI group, while 28 were in the Bolus group. Repeated measure
analysis using mixed-effects models could not reject the null hypothesis
for the effect of group-time interactions in MAP (p = 0.85), HR (p =
0.49), SR (p = 0.44), or qCON (p = 0.72). The difference in means for qCON
(60.2 for TCI, 50.5 for bolus, p < 0.001), MAP (90.3 for TCI, 86.2 for
bolus, p < 0.006), HR (76.2 for TCI, 76.9 for bolus, p = 0.93), and SR
(0.01 for TCI, 5.5 for bolus, p < 0.001), irrespective of time (whole
period means), revealed some significant differences. <br/>Conclusion(s):
Patients who received propofol bolus injection exhibited a lower mean
arterial pressure, a greater variation in the level of consciousness, and
a higher suppression rate compared to those who received it as a
target-controlled infusion. However, the interaction effect between groups
and time remains inconclusive.<br/>Copyright &#xa9; 2024 Sociedade
Brasileira de Anestesiologia

<70>
Accession Number
2031979899
Title
Incidence and prognosis of COVID-19 amongst heart transplant recipients: a
systematic review and meta-analysis.
Source
European Journal of Preventive Cardiology. 29(6) (pp e224-e226), 2022.
Date of Publication: 01 Apr 2022.
Author
Ahmed F.; Abid M.; Maniya T.; Usman M.S.; Fudim M.
Institution
(Ahmed, Abid) Department of Medicine, Dow University of Health Sciences,
Mission Rd, Saddar, Karachi 74200, Pakistan
(Maniya) Department of Medicine, Ziauddin University, Shahrah-e-Ghalib Rd,
Block 6 Clifton, Karachi 74200, Pakistan
(Usman) Department of Medicine, University of Mississippi Medical Center,
2500 North State Street, Jackson, MS 39216, United States
(Fudim) Division of Cardiology, Duke University Medical Center, 2301 Ervin
Rd, Durham, NC 27710, United States
(Fudim) Duke Clinical Research Institute, Durham, NC 27701, United States
Publisher
Oxford University Press

<71>
Accession Number
2031958453
Title
Decision analysis in cardiac surgery: A scoping review and methodological
primer.
Source
European Journal of Cardio-thoracic Surgery. 65(4) (no pagination), 2024.
Article Number: ezae123. Date of Publication: 01 Apr 2024.
Author
Vervoort D.; Lee G.S.; Lia H.; Afzal A.M.; Tam D.Y.; Ouzounian M.;
Takkenberg J.J.M.; Wijeysundera H.C.; Fremes S.E.
Institution
(Vervoort, Tam, Wijeysundera, Fremes) Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Vervoort, Tam, Ouzounian, Fremes) Division of Cardiac Surgery, University
of Toronto, Toronto, ON, Canada
(Lee, Lia, Fremes) Temerty Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Afzal) Schulich School of Medicine & Dentistry, University of Western
Ontario, London, ON, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, Toronto, ON, Canada
(Takkenberg) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Wijeysundera, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Randomized controlled trials are the gold standard for
evidence generation in medicine but are limited by their real-world
generalizability, resource needs, shorter follow-up durations and
inability to be conducted for all clinical questions. Decision analysis
(DA) models may simulate trials and observational studies by using
existing data and evidence-and expert-informed assumptions and extend
analyses over longer time horizons, different study populations and
specific scenarios, helping to translate population outcomes to
patient-specific clinical and economic outcomes. Here, we present a
scoping review and methodological primer on DA for cardiac surgery
research. <br/>METHOD(S): A scoping review was performed using the
PubMed/MEDLINE, EMBASE and Web of Science databases for cardiac surgery DA
studies published until December 2021. Articles were summarized
descriptively to quantify trends and ascertain methodological consistency.
<br/>RESULT(S): A total of 184 articles were identified, among which
Markov models (N = 92, 50.0%) were the most commonly used models. The most
common outcomes were costs (N = 107, 58.2%), quality-adjusted life-years
(N = 96, 52.2%) and incremental cost-effectiveness ratios (N = 89, 48.4%).
Most (N = 165, 89.7%) articles applied sensitivity analyses, most
frequently in the form of deterministic sensitivity analyses (N = 128,
69.6%). Reporting of guidelines to inform the model development and/or
reporting was present in 22.3% of articles. <br/>CONCLUSION(S): DA methods
are increasing but remain limited and highly variable in cardiac surgery.
A methodological primer is presented and may provide researchers with the
foundation to start with or improve DA, as well as provide readers and
reviewers with the fundamental concepts to review DA
studies.<br/>Copyright &#xa9; 2024 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<72>
Accession Number
644142883
Title
Effectiveness of the Bilateral and Bilevel Erector Spinae Plane Block
(ESPB) in Pediatric Idiopathic Scoliosis Surgery: A Randomized,
Double-Blinded, Controlled Trial.
Source
Journal of pediatric orthopedics. (no pagination), 2024. Date of
Publication: 01 May 2024.
Author
Domagalska M.; Ciftsi B.; Janusz P.; Reysner T.; Daroszewski P.; Kowalski
G.; Wieczorowska-Tobis K.; Kotwicki T.
Institution
(Domagalska, Reysner, Kowalski, Wieczorowska-Tobis) Chair and Department
of Palliative Medicine, Poznan University of Medical Sciences
(Ciftsi) Departments of Spine Disorders and Pediatric Orthopedics
(Janusz, Kotwicki) Organization and Management in Health Care, Poznan
University of Medical Sciences, Poznan, Poland
(Daroszewski) Department of Anesthesiology and Reanimation, Istanbul
Medipol University, Istanbul, Turkey
Abstract
BACKGROUND: This study aimed to compare the effect of the
ultrasound-guided bilateral and bilevel erector spinae plane block (ESPB)
on pain scores, opioid requirement, intraoperative motor-evoked potentials
(MEPs), and stress response to surgery expressed by the
neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio
(PLR) versus standard analgesia methods following idiopathic scoliosis
surgery. <br/>METHOD(S): This was a prospective, double-blinded,
randomized controlled trial. Sixty patients aged 10 to 18 years and
physical status ASA 1 or 2 were randomized into 2 equal groups, each
receiving an ESPB or sham block. The primary outcome was the pain scores
(Numerical Rating Scale, NRS) within 48 hours after spinal correction and
fusion surgery for idiopathic thoracic scoliosis. The secondary outcomes
were total opioid consumption, NLR, and PLR levels at 12 and 24 hours
postoperatively and intraoperative MEPs. <br/>RESULT(S): ESPB patients
presented lower NRS scores, signifying less pain, at all time points (30,
60, 90, 120min; and 6, 12, 24, and 48h after surgery), all P<0.0001. The
total opioid consumption, the incidence of nausea or vomiting, and the
need for remifentanil and propofol during surgery were significantly lower
in the ESPB group. The surgery-induced stress response expressed by NLR
and PLR was considerably lower in the ESPB group. ESPB did not affect the
intraoperative MEP's amplitude. <br/>CONCLUSION(S): ESPB is effective for
postoperative analgesia, can reduce opioid consumption in patients
undergoing scoliosis surgery, and reduces the stress response to surgery.
ESPB does not interfere with neuromonitoring.Level I.<br/>Copyright &#xa9;
2024 The Author(s). Published by Wolters Kluwer Health, Inc.

<73>
Accession Number
644141691
Title
Transcatheter versus Surgical Aortic Valve Replacement for Severe Aortic
Valve Stenosis: Meta-Analysis with Trial Sequential Analysis.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 12 Apr 2024.
Author
Jacquemyn X.; Sa M.P.; Rega F.; Verbrugghe P.; Meuris B.; Serna-Gallegos
D.; Brown J.A.; Clavel M.-A.; Pibarot P.; Sultan I.
Institution
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Sa, Serna-Gallegos, Brown, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, Pennsylvania; UPMC Heart and
Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh,
Pennsylvania
(Rega, Verbrugghe, Meuris) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium; Department of Cardiac Surgery, University
Hospitals Leuven, Leuven, Belgium
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada;
Department of Medicine, Faculty of Medicine, Universite Laval, Quebec
City, Quebec, Canada
Abstract
OBJECTIVES: Randomized controlled trials (RCTs) comparing transcatheter
aortic valve implantation (TAVI) to surgical aortic valve replacement
(SAVR) demonstrate conflicting evidence, particularly in low-risk
patients. We aim to reevaluate the evidence using Trial Sequential
Analysis (TSA), balancing type I and II errors, and compare to
conventional meta-analysis (cMA). <br/>METHOD(S): Databases were searched
for RCTs, which were divided into higher-risk and lower-risk RCTs
according to a pragmatic risk classification. Primary outcomes were death,
and a composite endpoint of death or disabling stroke assessed at 1 year
and maximum follow-up. cMA and TSA were performed, and the required
information size (RIS) was calculated considering a type I error of 5% and
a power of 90%. <br/>RESULT(S): Eight RCTs (n=5274 higher-risk and 3661
lower-risk patients) were included. Higher-risk trials showed no
significant reduction in death at 1 year with TAVI (RR 0.93, 95% CI:
0.81-1.08, P=0.345). Lower-risk trials suggested lower death risk on cMA
(RR 0.67, 95% CI: 0.47-0.96, P=0.031), but TSA indicated potential
spurious evidence (P=0.116), necessitating more data for conclusive
benefit (RIS=5944 [59.8%]). For death or disabling stroke at 1 year,
higher-risk trials lacked evidence (RR 0.90, 95% CI: 0.79-1.02, P=0.108).
In lower-risk trials, TAVI indicated lower risk in cMA (RR 0.68, 95% CI:
0.50-0.93, P=0.014), but TSA suggested potential spurious evidence
(P=0.053), necessitating more data for conclusive benefit (RIS=5122
[69.4%]). Follow-up results provided inconclusive evidence for both
primary outcomes across risk categories. <br/>CONCLUSION(S): cMA methods
may have prematurely declared an early reduction of negative outcomes
following TAVI when compared with SAVR.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.

<74>
Accession Number
644138438
Title
ARTIFICIAL INTELLIGENCE: THE FUTURE OF CARDIOTHORACIC SURGERY.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 27 Apr 2024.
Author
Vaidya Y.P.; Shumway S.J.
Institution
(Vaidya, Shumway) Department of Cardiothoracic Surgery, University of
Minnesota, Minneapolis MN, United States
Abstract
BACKGROUND: Artificial intelligence (AI) is a rapidly emerging field of
computer science with a significant predicted impact in cardiothoracic
surgery. We investigate the role of this tool in the preoperative
planning, intraoperative assistance, and postoperative management of
patients. We also describe the future applications in the field and
provide an insight on the advancements we have made at our institution.
<br/>METHOD(S): We assessed the literature in the Medline and Google
Scholar databases that describe the use of artificial intelligence in
thoracic, congenital, and adult cardiac surgery. All articles published
until December 2023 were included in this review. <br/>RESULT(S): AI is a
technology gaining increasing application in cardiothoracic surgery. Using
computer algorithms to assess large sets of data, specific outcomes of
interest can be predicted with an accuracy better than skilled humans.
With studies showing the validity and benefits of its use, AI has proven
to be an effective tool in all phases of care of cardiothoracic patients.
<br/>CONCLUSION(S): The integration of AI in cardiothoracic surgery
represents a paradigm shift in clinical medicine. The transformative
potential is evident in the ability to improve diagnosis and risk
assessment, make personalized treatment plans, and aid in surgical
decision making. While the results are undoubtedly promising, addressing
ethical concerns and patient privacy is paramount to maintain a balance
for success. As we navigate these challenges, the future of cardiothoracic
surgery looks bright with more effective, efficient, and patient-centric
practices on the horizon.<br/>Copyright &#xa9; 2024. Published by Elsevier
Inc.

<75>
Accession Number
2031869843
Title
Comparison of Jailed Wire and Jailed Balloon for Prevention of Side Branch
Occlusion in Provisional Stenting: Evidence from a Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 25(3) (no pagination), 2024. Date of
Publication: 2024.
Author
Li D.; Liu H.; Dai H.; Gao C.; Yang P.; Guo W.
Institution
(Li, Liu, Dai, Gao, Yang, Guo) Department of Cardiology, The Second
Affiliated Hospital, Air Force Medical University, Shaanxi, Xi'an 710038,
China
Publisher
IMR Press Limited
Abstract
Background: Side branch (SB) occlusion after main vessel stenting is the
main complication in treating coronary bifurcation lesions by provisional
stenting. The Jailed Wire Technique (JWT), recommended by the European
Bifurcation Club, is a standard technique to deal with this issue. The
Jailed Balloon Technique (JBT) has been found to be more effective than
the JWT in clinical practice by some interventionists, but it has not been
widely accepted. In this meta-analysis, we compared the efficacy and
safety of JBT and JWT. <br/>Method(s): The literature comparing JBT and
JWT was systematically reviewed. Stata/MP 17.0 was used to perform a
metaanalysis. The primary endpoints were major adverse cardiac events
(MACE), cardiac death, myocardial infarction (MI) and target lesion
revascularization (TLR). The secondary endpoints were SB occlusion and SB
dissection. Aggregated odds ratios and 95% confidence intervals were
calculated. A sensitivity analysis was conducted if I2 was >50% or p <
0.01. <br/>Result(s): Thirteen studies involving 1789 patients were
enrolled. JBT was found to have a significantly lower incidence of MACE,
SB occlusion and dissection. The incidence of cardiac death, MI and TLR
were also lower in the JBT group, though the differences were not
significant. <br/>Conclusion(s): JBT prevents SB occlusion more
effectively and does not increase immediate or long-term complications.
JBT, or its modified versions, can be used to treat SBs with a high risk
of occlusion.<br/>Copyright &#xa9; 2024 The Author(s).

<76>
Accession Number
2031791869
Title
Effects of Scalene Muscle Stretching on Slow Vital Capacity and Chest
Expansion in Patients After Coronary Artery Bypass Grafting: An
Interventional Study.
Source
Cardiovascular Innovations and Applications. 9 (no pagination), 2024.
Article Number: 11. Date of Publication: 2024.
Author
Vyas M.; Mehta M.; Oza F.; Ratnoo B.
Institution
(Vyas, Ratnoo) Cardio-Respiratory Disorders, U. N. Mehta Institute of
Cardiology and Research Centre, B. J. Medical College, New Civil Hospital
Campus, Asarwa, Ahmedabad 380006, India
(Mehta, Oza) U. N. Mehta Institute of Cardiology and Research Centre, B.
J. Medical College, New Civil Hospital Campus, Asarwa, Ahmedabad 380006,
India
Publisher
Compuscript Ltd
Abstract
Background: Coronary artery bypass grafting (CABG) is a coronary
revascularization technique associated with diminished pulmonary function.
During the first week after CABG, slow vital capacity (SVC) decreases by
30%-60%. Scalene muscles affect pulmonary function because they attach to
the 1^st and 2^nd ribs. Shorter scalene muscles can
decrease inhalation volume and chest expansion. Very few studies have
assessed the effects of scalene stretching on SVC and chest expansion in
patients post-CABG. Therefore, this study was aimed at determining the
effects of scalene muscle stretching on SVC and chest expansion in such
patients. <br/>Method(s): A total of 74 patients post-CABG (phase 2)
meeting the inclusion criteria were randomly allocated to two groups: an
intervention group (n = 30) performing scalene muscle stretching and a
control group (n = 30) performing active neck exercise. Pre & Post SVC and
chest expansion were measured in all patients. A total of 14 patients were
excluded. Statistical analysis was conducted in SPSS software (version
20.0). <br/>Result(s): SVC showed significant increase (P < 0.05) in the
intervention group compared with the control group. Chest expansion was
statistically non-significant between groups (P > 0.05). Conclusion and
clinical implications: Scalene muscle stretching improves SVC in patients
post-CABG (phase 2). Hence, scalene stretching should be included in
programs for improving respiratory function.<br/>Copyright &#xa9; 2024
Cardiovascular Innovations and Applications. Creative Commons
Attribution-NonCommercial 4.0 International License

<77>
Accession Number
2031968298
Title
Untangling the Complex Multidimensionality of the Social Determinants of
Cardiovascular Health: A Systematic Review.
Source
Canadian Journal of Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Vyas N.; Zaheer A.; Wijeysundera H.C.
Institution
(Vyas, Zaheer, Wijeysundera) Schulich Heart Program, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, ON, Canada
(Wijeysundera) Temerty Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Wijeysundera) ICES, Toronto, ON, Canada
(Wijeysundera) Institute of Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: The cardiovascular literature is limited by the lack of
consensus on what are the best metrics for reporting social determinants
of health (SDH) or social deprivation, and if they should be reported as a
single metric or separately by their domains. <br/>Method(s): A systematic
review of the literature on cardiovascular surgeries and procedures was
conducted, identifying articles from January 1, 2010, to December 31,
2023, that studied the relationship between health outcomes after
cardiovascular procedures or surgeries and SDH/social deprivation. The
cardiovascular procedures/surgeries of interest were coronary and valve
surgeries and procedures including coronary artery bypass grafting (CABG),
percutaneous coronary intervention (PCI), valve replacement or repair, and
transcatheter aortic valve intervention. <br/>Result(s): After screening
638 articles, we identified 47 papers that met our inclusion and exclusion
criteria. The most common procedure evaluated was CABG and PCI; 46 of the
studies focused on these 2 procedures. Almost all of the articles reported
a different metric for SDH/social deprivation (41 different metrics);
despite this, all of the metrics showed a consistent relationship with
worse outcomes associated with greater degrees of SDH/deprivation. Only 9
reported on the individual domains of SDH/social deprivation; 3 studies
showed a discordant relationship. <br/>Conclusion(s): Although our
systematic review identified numerous articles evaluating the relationship
between SDH/social deprivation in cardiovascular disease, there was
substantial heterogeneity in which metric was used and how it was
reported. This reinforces the need for standards as to the best metrics
for SDH/social deprivation as well as best practices for
reporting.<br/>Copyright &#xa9; 2024 The Authors

<78>
Accession Number
644125524
Title
Comparison of the outcomes of concurrent versus staged TAVR combined with
PCI in patients with severe aortic stenosis and coronary artery disease: a
systematic review and meta-analysis.
Source
Coronary artery disease. (no pagination), 2024. Date of Publication: 29
Apr 2024.
Author
Zhang X.; Geng W.; Yan S.; Zhang K.; Liu Q.; Li M.
Institution
(Zhang) Department of Cardiology, Baoding First Central Hospital, China
Abstract
BACKGROUND: The optimal timing for percutaneous coronary intervention
(PCI) in patients undergoing transcatheter aortic valve replacement (TAVR)
remains uncertain. This research aims to evaluate the results of patients
diagnosed with severe aortic valve stenosis and coronary artery disease
who undergo either simultaneous or staged PCI therapy during TAVR
procedures. <br/>METHOD(S): We retrieved all relevant studies from our
self-constructed databases up to January 2, 2024, encompassing databases
such as Embase, Medline, Cochrane Library, and PubMed. <br/>RESULT(S): A
total of nine studies were included, and the results showed that both
surgical modalities had good safety profiles in the early and long-term
stages. For early endpoint events, the risk of all-cause mortality and
major bleeding within 30 years was similar in the staged TAVR + PCI and
the contemporaneous TAVR + PCI (P > 0.05). Additionally, the risk of
myocardial infarction, stroke, acute kidney injury and pacemaker
implantation within 30 days or perioperatively is similar (P > 0.05). For
long-term endpoint events, the risk of all-cause mortality, myocardial
infarction and stroke was similar in the two groups at >=2 years (P >
0.05). <br/>CONCLUSION(S): In patients undergoing TAVR who required
coronary revascularization, no significant differences were observed in
the early and long-term outcomes between those receiving concurrent TAVR
and PCI versus staged surgery.<br/>Copyright &#xa9; 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.