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<1>
Accession Number
2029162541
Title
Pecto-Intercostal Fascial Plane Block: Effect on the Postoperative
Analgesia and Recovery After Off-PUMP Coronary Artery Bypass Surgery.
Source
Anesthesiology and Pain Medicine. 14(1) (no pagination), 2024. Article
Number: e144344. Date of Publication: 29 Feb 2024.
Author
Mahrose R.; Fahim H.M.; Kasem A.A.; Helmy Sakr M.S.; Menshawi M.A.
Institution
(Mahrose, Fahim, Kasem, Menshawi) Intensive Care and Pain Management,
Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Helmy Sakr) Faculty of Medicine, Tanta University, Tanta, Egypt
Publisher
Brieflands
Abstract
Background: Anteromedial chest wall fascial plane blocks may serve as a
valuable addition to postoperative multimodal pain management following
median sternotomy for cardiothoracic surgeries. Objective(s): This
study aimed to evaluate the impact of implementing the pecto-intercostal
fascial plane block (PIFB) in patients scheduled for off-pump coronary
artery bypass (OPCAB) surgery. Method(s): This randomized controlled
study involved 40 adult patients aged 30 to 70 years undergoing OPCAB
surgery. They were randomly assigned to two equal groups: Group PI
received bilateral ultrasound (US)-guided PIFB with 20 mL of bupivacaine
0.25% with adrenaline 2.5 microg/mL, while group C (control group)
received bilateral sham blocks with 20 mL of saline 0.9%. Pain scores in
the postoperative period (primary outcome), perioperative analgesic
consumption, time until extubation, and discharge from the intensive care
unit (ICU) were assessed for both groups. Result(s): Postoperative
pain scores, both at rest and during coughing, were significantly lower in
group PI compared to group C. Group PI required significantly less
fentanyl perioperatively and less tramadol for postoperative rescue
compared to group C. The duration of postoperative ventilation and time to
ICU discharge were significantly shorter in group PI than in group C.
 Conclusion(s): In patients undergoing OPCAB surgery, pre-incisional
ultrasound-guided PIFB can be a beneficial and safe component of
multimodal pain management. It provides improved postoperative pain
control, reduces the need for perioperative opioids, and leads to faster
extubation and ICU discharge. Copyright © 2024, Mahroseetal.

<2>
Accession Number
2030253544
Title
Transcarotid versus transthoracic transcatheter aortic valve replacement:
A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 63 (pp 8-13), 2024. Date of
Publication: June 2024.
Author
Munguti C.; Ndunda P.; Vindhyal M.R.; Abukar A.; Abdel-Jawad M.; Fanari Z.
Institution
(Munguti, Ndunda, Vindhyal, Abdel-Jawad) Internal Medicine, University of
Kansas School of Medicine - Wichita, KS, United States
(Abdel-Jawad) Internal Medicine, Ascension Via Christi St Francis
Hospital, Wichita, KS, United States
(Abukar) Internal Medicine, University of California San Francisco, San
Francisco, CA, United States
(Fanari) Internal Medicine/Cardiology, University of California San
Francisco, Fresno, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transthoracic approaches may be contraindicated in some
patients and may be associated with poorer outcomes. Therefore other
alternative access routes are increasingly being performed. We conducted a
systematic review of the literature on Transcarotid transcatheter aortic
valve replacement (TC-TAVR) and meta-analysis comparing outcomes of
TC-TAVR and other access routes. Method(s): We comprehensively
searched for controlled randomized and non-randomized studies from 4
online databases. We presented data using risk ratios (95 % confidence
intervals) and measured heterogeneity using Higgins' I2.
 Result(s): Sixteen observational studies on Transcarotid TAVR were
included in the analysis; 4 studies compared 180 TC-TAVR patients vs 524
TT-TAVR patients. The mean age and STS score for patients undergoing
TC-TAVR were 80 years and 7.6 respectively. For TT-TAVR patients, the mean
age and STS score were 79.7 years and 8.7 respectively. TC-TAVR patients
had lower 30-day MACE [7.8 % vs 13.7 %; OR 0.54 (95 % CI 0.29-0.99, P =
0.05)] and major or life-threatening bleeding [4.0 % vs 14.2 %; OR 0.25
(95 % CI 0.09-0.67, P = 0.006)]. There was no significant difference in
30-day: mortality [5.0 % vs 8.6 %; OR 0.61 (95 % CI 0.29-1.30, P = 0.20)],
stroke or transient ischemic attack [2.8 % vs 4.0 %; OR 0.65 (95 % CI
0.25-1.73, P = 0.39)] and moderate or severe aortic valve regurgitation
[5.0 % vs 4.6 %; OR 1.14. (95 % CI 0.52-2.52, P = 0.75)]. There was a
trend towards fewer major vascular complications in TC-TAVR [3.0 % vs 7.8
%; OR 0.42 (95 % CI 0.16-1.12, P = 0.08)]. Conclusion(s): Compared
with transthoracic TAVR, TC-TAVR patients had lower odds of 30-day MACE
and life-threatening bleeding and no differences in 30-day mortality,
stroke or TIA, aortic valve regurgitation. Copyright © 2024 The
Authors

<3>
Accession Number
2029856609
Title
Immune checkpoint inhibitors and pericardial disease: a systematic review.
Source
Cardio-Oncology. 10(1) (no pagination), 2024. Article Number: 29. Date of
Publication: December 2024.
Author
Mudra S.E.; Rayes D.L.; Agrawal A.; Kumar A.K.; Li J.Z.; Njus M.; McGowan
K.; Kalam K.A.; Charalampous C.; Schleicher M.; Majid M.; Syed A.;
Yesilyaprak A.; Klein A.L.
Institution
(Mudra, Rayes, Kumar, Li, Njus, McGowan, Kalam, Charalampous) Department
of Internal Medicine, MedStar Georgetown University Hospital, MedStar
Health, Washington, DC, United States
(Agrawal, Kumar, Majid, Syed, Yesilyaprak, Klein) Center for the Diagnosis
and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging,
Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic
Institute, Cleveland Clinic, 9500 Euclid Ave., Desk J1-5, Cleveland, OH
44195, United States
(Schleicher) Floyd D. Loop Memorial Library, Cleveland Clinic, Cleveland,
OH, United States
Publisher
BioMed Central Ltd
Abstract
Introduction: Despite the growing use of immune checkpoint inhibitors
(ICI) in cancer treatment, data regarding ICI-associated pericardial
disease are primarily derived from case reports and case series. ICI
related pericardial disease can be difficult to diagnose and is associated
with significant morbidity. We conducted a systematic review to further
characterize the epidemiology, clinical presentation, and outcomes of this
patient population. Method(s): A search of four databases resulted in
31 studies meeting inclusion criteria. Patients > 18 years old who
presented with ICI mediated pericardial disease were included.
Intervention was medical + surgical therapy and outcomes were development
of cardiac tamponade, morbidity, and mortality. Result(s): Thirty-
eight patients across 31 cases were included. Patients were majority male
(72%) with a median age of 63. Common symptoms included dyspnea (59%) and
chest pain (32%), with 41% presenting with cardiac tamponade. Lung cancer
(81%) was the most prevalent, and nivolumab (61%) and pembrolizumab (34%)
were the most used ICIs. Pericardiocentesis was performed in 68% of
patients, and 92% experienced symptom improvement upon ICI cessation.
Overall mortality was 16%. Discussion(s): This study provides the
most comprehensive analysis of ICI-mediated pericardial disease to date.
Patients affected were most commonly male with lung cancer treated with
either Nivolumab or Pembrolizumab. Diagnosis may be challenging in the
setting of occult presentation with normal EKG and physical exam as well
as delayed onset from therapy initiation. ICI-associated pericardial
disease demonstrates high morbidity and mortality, as evidenced by a
majority of patients requiring pericardiocentesis. Copyright ©
The Author(s) 2024.

<4>
Accession Number
2032455863
Title
Cost effectiveness analysis of a fixed dose combination pill for primary
prevention of cardiovascular disease from an individual participant data
meta-analysis.
Source
eClinicalMedicine. 73 (no pagination), 2024. Article Number: 102651. Date
of Publication: July 2024.
Author
Lamy A.; Tong W.; Joseph P.; Gao P.; Huffman M.D.; Roshandel G.;
Malekzadeh R.; Lopez-Jaramillo P.; Pais P.; Xavier D.; Avezum A.; Dans
A.L.; Gamra H.; Yusuf S.
Institution
(Lamy, Tong, Joseph, Gao, Yusuf) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Joseph, Yusuf) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Huffman) The George Institute for Global Health, University of New South
Wales, Sydney, Australia
(Huffman) Cardiovascular Division and Global Health Center, Washington
University in St. Louis, St. Louis, United States
(Roshandel) Golestan Research Center of Gastroenterology and Hepatology,
Golestan University of Medical Sciences, Gorgan, Iran, Islamic Republic of
(Malekzadeh) Digestive Oncology Research Center, Digestive Disease
Research Institute, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Lopez-Jaramillo) Masira Research Institute, Medical School, Universidad
de Santander, Bucaramanga, Colombia
(Pais) St. John's Research Institute, Bangalore, India
(Xavier) St. John's Medical College, Bangalore, India
(Avezum) International Research Center, Hospital Alemao Oswaldo Cruz, Sao
Paulo, Brazil
(Dans) University of the Philippines, Manila, Philippines
(Gamra) Fattouma Bourguiba Hospital and University of Monastir, Monastir,
Tunisia
Publisher
Elsevier Ltd
Abstract
Background: Cardiovascular disease (CVD) continues to impart a large
burden on the global population, especially in lower income countries
where affordability limits the use of cardiovascular medicines. A fixed
dose combination strategy of at least 2 blood pressure lowering
medications and a statin with aspirin in a single pill has been shown to
reduce the risk of incident CVD by 38% in primary prevention in a recent
meta-analysis. We report the in-trial (median follow-up: 5 years)
cost-effectiveness of a fixed dose combination (FDC) pill in different
income groups based on data from that meta-analysis. Method(s):
Countries were categorized using World Bank economic groups: Lower Middle
Income Countries (LMIC), Upper Middle Income Countries (UMIC) and High
Income Countries (HIC). Country specific costs were obtained for
hospitalized events, procedures, and non-study medications (2020 USD). FDC
price was based on the cheapest equivalent substitute (CES) for each
component. Finding(s): For the CES-FDC pill versus control the
difference in cost was $346 (95% CI: $294-$398) per participant in Lower
Middle Income Countries, $838 (95% CI: $781-$895) in Upper Middle Income
Countries and $42 (95% CI: -$155 to $239) (cost-neutral) in High Income
Countries. During the study period the CES-FDC pill was associated with
incremental gain in quality-adjusted life years of 0.06 (95% CI:
0.04-0.08) resulting in an incremental cost-effectiveness ratio (ICER) of
$5767 (95% CI: 5735-$5799), $13,937 (95% CI: $13,893-$14,041) and $700
(95% CI: $662-$738) respectively. In subgroups analyses, the highest 10
years CVD risk subgroup had ICERs of $2033, $7322 and -$6000/QALY.
 Interpretation(s): A FDC pill produced at CES costs is cost-neutral
in HIC. Governments of LMI and UMI countries should assess these results
based on the ICER threshold accepted in their own country and own specific
health care priorities but should consider prioritizing this strategy for
patients with high 10 years CVD risk as a first step. Funding(s):
Population Health Research Institute. Copyright © 2024 The
Author(s)

<5>
Accession Number
2032408935
Title
Postoperative quality of life and pain after upper hemisternotomy and
conventional median sternotomy for aortic valve replacement: results of a
randomized clinical trial.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 38(5) (no
pagination), 2024. Article Number: ivae083. Date of Publication: 01 May
2024.
Author
Klop I.D.G.; Van Putte B.P.; Kloppenburg G.T.L.; Klautz R.J.M.; Sprangers
M.A.G.; Nieuwkerk P.T.; Klein P.
Institution
(Klop, Van Putte, Kloppenburg, Klein) Department of Cardiothoracic
Surgery, St Antonius Hospital, Nieuwegein, Netherlands
(Van Putte, Klautz) Department of Cardiothoracic Surgery, AMC Heart
Centre, Amsterdam University Medical Center, Amsterdam, Netherlands
(Sprangers, Nieuwkerk) Department of Medical Psychology, Amsterdam UMC
Location University of Amsterdam, Amsterdam, Netherlands
(Sprangers) Department of Mental Health, Amsterdam Public Health,
Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Surgical aortic valve replacement through conventional
sternotomy yields excellent results. Minimally invasive techniques are
deemed equally safe and serve as a viable and less traumatic alternative.
However, it is unclear how both surgical techniques affect
patient-reported outcomes. The objective of this trial is to compare
postoperative cardiac-related quality of life and postoperative pain after
upper hemisternotomy and conventional surgical aortic valve replacement.
 METHOD(S): In this single-centre, open-label, investigator-initiated
randomized clinical trial, patients were randomized to upper
hemisternotomy or conventional full median sternotomy. Patients unable to
undergo randomization were monitored prospectively (registry group).
Primary outcome was cardiac-specific quality of life, measured with the
Kansas City Cardiomyopathy Questionnaire up to 1 year postoperatively.
 RESULT(S): Patients undergoing upper hemisternotomy had a
significantly higher physical limitation domain score across all
postoperative time points than patients undergoing conventional surgical
aortic valve replacement (estimated mean difference 2.12 points; P 1/4
0.014). Patients undergoing upper hemisternotomy were more likely to have
a pain score <30 the first 2 days postoperatively than patients undergoing
conventional surgical aortic valve replacement (odds ratio 2.63; P 1/4
0.007). This was associated with reduced opioid analgesic intake.
Postoperative surgical outcome did not differ between both groups.
 CONCLUSION(S): Surgical aortic valve replacement through both
conventional sternotomy and upper hemisternotomy resulted in clinically
similar and important improvements in quality of life, with a small
advantage for upper hemisternotomy, while there was no compromise in
safety. Copyright © The Author(s) 2024.

<6>
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Accession Number
2032325390
Title
Effects of Vibration Therapy on the Physical Function of Critically Ill
Adults Trial: A Randomized Controlled Trial.
Source
Critical Care Medicine. 52(6) (pp 910-919), 2024. Date of Publication: 01
Jun 2024.
Author
Doi S.; Nakanishi N.; Kawahara Y.; Nomura K.; Shima M.; Shiraishi M.; Oto
J.
Institution
(Doi, Kawahara, Nomura, Shima, Shiraishi) Department of Nursing, Tokushima
University Hospital, Tokushima, Japan
(Nakanishi) Division of Disaster and Emergency Medicine, Department of
Surgery Related, Kobe University, Graduate School of Medicine, Kobe, Japan
(Oto) Department of Emergency and Critical Care Medicine, Tokushima
University, Graduate School of Biomedical Sciences, Tokushima, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Vibration therapy uses vibration to rehabilitate physical
functions. Recently, it has been demonstrated to be safe for critically
ill patients. However, its effects on physical functions are unclear.
DESIGN: Randomized controlled trial. SETTING: A single-center, ICU.
PATIENTS: Patients were randomly assigned to either vibration therapy
coupled with protocolized mobilization or protocolized mobilization alone.
We included patients who could sit at the edge of the bed or in a
wheelchair during their ICU stay. The exclusion criteria were based on the
early mobilization inhibition criteria. INTERVENTIONS: The primary outcome
was the Functional Status Score for the ICU (FSS-ICU) at ICU discharge.
Secondary outcomes were the Medical Research Council score, ICU-acquired
weakness, delirium, ICU Mobility Scale (IMS), and ventilator- and ICU-free
days. For safety assessment, vital signs were monitored during the
intervention. MEASUREMENTS AND MAIN RESULTS: Among 180 patients, 86 and 90
patients remained in the vibration therapy and control groups,
respectively. The mean age was 69 +/- 13 vs. 67 +/- 16 years in the
vibration therapy and control groups, and the Acute Physiology and Chronic
Health Evaluation (APACHE) II score was 19 (14-25) vs. 18 (13-23). The
total FSS-ICU at ICU discharge was 24 (18-27) and 21 (17-26) in the
intervention and control groups, respectively (p = 0.09), and the
supine-to-sit ability significantly improved in the intervention group (p
< 0.01). The secondary outcomes were not significantly different. Vital
signs remained stable during vibration therapy. In the predefined subgroup
analysis, FSS-ICU improved in the population with a higher body mass index
(>= 23 kg/m2), lower APACHE II scores (< 19), and higher IMS
scores (>= 6). CONCLUSION(S): Vibration therapy did not improve the
total FSS-ICU. However, the supine-to-sit ability in the FSS-ICU improved
without any adverse event. Copyright © 2024 Lippincott Williams
and Wilkins. All rights reserved.

<7>
Accession Number
2032488205
Title
Repeat Mitral Valve Interventions After Transcatheter Edge-to-Edge Repair:
The COAPT Trial.
Source
American Journal of Cardiology. 223 (pp 7-14), 2024. Date of Publication:
15 Jul 2024.
Author
Shahim B.; Cohen D.J.; Asch F.M.; Bax J.; George I.; Ruck A.; Ben-Yehuda
O.; Kar S.; Lim D.S.; Saxon J.T.; Zhou Z.; Lindenfeld J.; Abraham W.T.;
Mack M.J.; Stone G.W.
Institution
(Shahim, Cohen, Zhou) Clinical Trials Center, Cardiovascular Research
Foundation, New York, New York, United States
(Shahim, Ruck) Department of Medicine, Karolinska Institutet, Stockholm,
Sweden
(Shahim, Ruck) Cardiology Unit, Karolinska University Hospital, Stockholm,
Sweden
(Cohen) St. Francis Hospital, Roslyn, New York, United States
(Asch) MedStar Health Research Institute, Washington, DC, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(George) NewYork-Presbyterian Hospital/Columbia University Irving Medical
Center, New York, New York, United States
(Ben-Yehuda) Sulpizio Cardiovascular Institute, University of California -
San Diego, San Diego, California, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim, Saxon) Division of Cardiology, University of Virginia,
Charlottesville, VA, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
College of Medicine, Columbus, OH, United States
(Mack) Baylor Scott and White Heart Hospital Plano, Plano, Texas, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
The frequency and effectiveness of repeat mitral valve interventions
(RMVI) after transcatheter edge-to-edge repair (TEER) for secondary mitral
regurgitation (MR) are unknown. We aimed to examine the rate of and
outcomes after RMVI after TEER in the Cardiovascular Outcomes Assessment
of the MitraClip Percutaneous Therapy for Heart Failure Patients with
Functional Mitral Regurgitation (COAPT) trial. Only 3.9% of COAPT trial
patients required a repeat mitral valve intervention during 4-year
follow-up which was successful in 90% of cases but was associated with an
increased rate of heart failure (HF) hospitalizations (HFH). The COAPT
trial randomized HF patients with severe secondary MR to TEER with the
MitraClip device plus guideline-directed medical therapy (GDMT) versus
GDMT alone. We evaluated the characteristics and outcomes of patients who
had an RMVI during 4-year follow-up. A MitraClip implant was attempted in
293 patients randomized to TEER+GDMT, 10 of whom underwent an RMVI
procedure (9 repeat TEER and 1 surgical mitral valve replacement) after 4
years of follow-up (cumulative incidence 3.90%, 95% confidence interval
[CI] 2.08 to 7.08; median 182 days after the initial procedure). Patients
with RMVI had larger mitral annular diameters, fewer clips implanted, and
were more likely to have >=3+MR at discharge compared with those without
RMVI. Reasons for RMVI included failed index procedure because of
difficult transseptal puncture (n = 2) or tamponade (n = 1); residual or
recurrent severe MR after an initially successful procedure (n = 5);
partial clip detachment (n = 1); and site-assessed mitral stenosis (n =
1). RMVI was successful in 8/10 (80%) patients. Patients who underwent
RMVI had higher 4-year rates of HFH but similar mortality compared with
those without RMVI. The annualized incidence rates of all HFH in patients
who underwent RMVI were 234 events per 100 person-years (95% CI 139 to
395) pre-RMVI and 46 per 100 person-years (95% CI 25 to 86) post-RMVI as
compared with 32 events per 100 patient-years (95% CI 28 to 36) in
patients without RMVI. The rate ratio of HFH was reduced after RMVI in
patients who underwent RMVI (0.20, 95% CI 0.09 to 0.45). In conclusion,
the cumulative incidence of RMVI after 4 years was 3.9% in patients who
underwent TEER for severe secondary MR in the COAPT trial. Patients who
underwent RMVI were at increased risk of HFH which was reduced after the
RMVI procedure. Clinical Trial Registration: Clinical Trial Name:
Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation (The COAPT
Trial) (COAPT) ClinicalTrial.gov Identifier: NCT01626079
URL:https://clinicaltrials.gov/ct2/show/NCT01626079 Copyright ©
2024 Elsevier Inc.

<8>
Accession Number
2032405901
Title
Safety and efficacy of minimal transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Heart and Lung. 67 (pp 158-168), 2024. Date of Publication: 01 Sep 2024.
Author
Yifan D.; Zhen F.; Yue M.; Xun S.; Jiapei G.; Li Z.; Jing Z.
Institution
(Yifan, Zhen, Yue, Xun, Jiapei, Li, Jing) Clinical Medical College,
Yangzhou University, Yangzhou 225001, China
(Yifan, Li) Taizhou People's Hospital affiliated to Nanjing Medical
University, Tai zhou 225300, China
(Yifan, Zhen, Jiapei, Li) Medical College of Yangzhou University, Yang
zhou 225001, China
(Yue) Medical School of Nanjing University, Nanjing 21000, China
(Xun) alian Medical University, Dalian 116000, China
(Jing) Northern Jiangsu People's Hospital, Yangzhou 225001, China
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a preferred
treatment for patients with highly critical aortic stenosis (AS), which is
a difficult and complicated procedure, leaving a heavy economical burden
on patients and national health insurance. Minimalist TAVR can simplify a
part of the operation procedures, but the surgical efficacy and safety are
still under debated. Objective(s): Explore the effectiveness and
safety of minimalist TAVR in the treatment of patients with aortic
stenosis. Method(s): A systematic search of PubMed, Web of Science,
and Embase databases was conducted for studies involving application of
minimalist TAVR in patients with severe aortic stenosis, two researchers
independently screened the literature, extracted data and Meta-analysis
was performed using STATA 16.0 software. Result(s): Nine studies,
involving a total of 3,148 AS patients, were included. Minimalist TAVR has
similar surgical success rates compared to standardized TAVR,
intraoperative fluoroscopy time, dosage of contrast agent, and total
operative time were superior to standard TAVR. Regarding surgical
complications, the incidence of permanent pacemaker placement and moderate
to severe paravalvular leakage were similar for both TAVR, the risk of
major vascular complications and major bleeding events in the minimalist
TAVR was significantly lower than the standard TAVR. The risk of overall
death, stroke, and cardiovascular-related readmission within 30 days was
similar in both procedures. Conclusion(s): Patients with severe
aortic stenosis treated with minimalist TAVR have similar short-term
efficacy as well as 30-day clinical outcomes to standard TAVR, while
minimalist TAVR could reduce the risk of major vascular complications and
bleeding complications. Copyright © 2024

<9>
Accession Number
2021592156
Title
Cardioprotective Effects of Glucose-Insulin-Potassium Infusion in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 36(2) (pp 167-181), 2024.
Date of Publication: Summer 2024.
Author
Hagerman A.; Schorer R.; Putzu A.; Keli-Barcelos G.; Licker M.
Institution
(Hagerman, Schorer, Putzu, Keli-Barcelos) Dept. of Acute Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Licker) University of Geneva, Faculty of Medicine, Geneva, Switzerland
Publisher
W.B. Saunders
Abstract
The infusion of glucose-insulin-potassium (GIK) has yielded conflicting
results in terms of cardioprotective effects. We conducted a meta-analysis
to examine the impact of perioperative GIK infusion in early outcome after
cardiac surgery. Randomized controlled trials (RCTs) were eligible if they
examined the efficacy of GIK infusion in adults undergoing cardiac
surgery. The main study endpoint was postoperative myocardial infarction
(MI) and secondary outcomes were hemodynamics, any complications and
hospital resources utilization. Subgroup analyses explored the impact of
the type of surgery, GIK composition and timing of administration. Odds
ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were
calculated with a random-effects model. Fifty-three studies (n=6129) met
the inclusion criteria. Perioperative GIK infusion was effective in
reducing MI (k=32 OR 0.66[0.48, 0.89] P=0.0069), acute kidney injury (k=7
OR 0.57[0.4, 0.82] P=0.0023) and hospital length of stay (k=19 MD
-0.89[-1.63, -0.16] days P=0.0175). Postoperatively, the GIK-treated group
presented higher cardiac index (k=14 MD 0.43[0.29, 0.57] L/min P<0.0001)
and lesser hyperglycemia (k=20 MD -30[-47, -13] mg/dL P=0.0005) than in
the usual care group. The GIK-associated protection for MI was effective
when insulin infusion rate exceeded 2 mUI/kg/min and after coronary artery
bypass surgery. Certainty of evidence was low given imprecision of the
effect estimate, heterogeneity in outcome definition and risk of bias.
Perioperative GIK infusion is associated with improved early outcome and
reduced hospital resource utilization after cardiac surgery. Supporting
evidence is heterogenous and further research is needed to standardize the
optimal timing and composition of GIK solutions. Copyright © 2022
The Author(s)

<10>
Accession Number
644364372
Title
Hemodynamic changes in the prone position according to fluid loading after
anaesthesia induction in patients undergoing lumbar spine surgery: a
randomized, assessor-blind, prospective study.
Source
Annals of medicine. 56(1) (pp 2356645), 2024. Date of Publication: 01 Dec
2024.
Author
Lee S.; Kim D.Y.; Han J.; Kim K.; You A.H.; Kang H.Y.; Park S.W.; Kim
M.K.; Kim J.E.; Choi J.-H.
Institution
(Lee, Kim, Han, You, Kang, Park, Kim, Choi) Department of Anesthesiology
and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee
University Hospital, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Anam Hospital, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart
Hospital, Hallym University College of Medicine, Seoul, South Korea
Abstract
INTRODUCTION: A change from the supine to prone position causes
hemodynamic alterations. We aimed to evaluate the effect of fluid
preloading in the supine position, the subsequent hemodynamic changes in
the prone position and postoperative outcomes. PATIENTS AND METHODS:
This prospective, assessor-blind, randomized controlled trial was
conducted between March and June 2023. Adults scheduled for elective
orthopaedic lumbar surgery under general anaesthesia were enrolled. In
total, 80 participants were randomly assigned to fluid maintenance (M) or
loading (L) groups. Both groups were administered intravenous fluid at a
rate of 2ml/kg/h until surgical incision; Group L was loaded with an
additional 5ml/kg intravenous fluid for 10min after anaesthesia induction.
The primary outcome was incidence of hypotension before surgical incision.
Secondary outcomes included differences in the mean blood pressure (mBP),
heart rate, pleth variability index (PVi), stroke volume variation (SVV),
pulse pressure variation (PPV), stroke volume index and cardiac index
before surgical incision between the two groups. Additionally,
postoperative complications until postoperative day 2 and postoperative
hospital length of stay were investigated. RESULT(S): Hypotension was
prevalent in Group M before surgical incision and could be predicted by a
baseline PVi >16. The mBP was significantly higher in Group L immediately
after fluid loading. The PVi, SVV and PPV were lower in Group L after
fluid loading, with continued differences at 2-3 time points for SVV and
PPV. Other outcomes did not differ between the two groups.
 CONCLUSION(S): Fluid loading after inducing general anaesthesia could
reduce the occurrence of hypotension until surgical incision in patients
scheduled for surgery in the prone position. Additionally, hypotension
could be predicted in patients with a baseline PVi >16. Therefore,
intravenous fluid loading is strongly recommended in patients with high
baseline PVi to prevent hypotension after anaesthesia induction and in the
prone position. TRIAL NUMBER: KCT0008294 (date of registration: 16 March
2023).

<11>
Accession Number
2029991284
Title
Klotho as an Early Marker of Acute Kidney Injury Following Cardiac
Surgery: A Systematic Review.
Source
Journal of Cardiovascular Development and Disease. 11(5) (no pagination),
2024. Article Number: 135. Date of Publication: May 2024.
Author
Mylonas K.S.; Karakitsos P.; Tajik A.; Pagliuso D.; Emadzadeh H.; Soukouli
I.; Hemmati P.; Avgerinos D.V.; Stavridis G.T.; Boletis J.N.
Institution
(Mylonas, Avgerinos, Stavridis) Department of Cardiac Surgery, Onassis
Cardiac Surgery Center, Athens 17674, Greece
(Karakitsos) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Tajik, Emadzadeh) School of Medicine, St. George's University, True Blue,
Grenada
(Pagliuso) York University, Toronto, ON M3J 1P3, Canada
(Soukouli, Boletis) Department of Nephrology and Renal Transplantation,
Laiko General Hospital, National and Kapodistrian University of Athens,
Athens 11527, Greece
(Hemmati) Department of Cardiothoracic Surgery, Baptist Health Medical
Center, Little Rock, AR 72205, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Acute kidney injury is a common complication following cardiac surgery
(CSA-AKI). Serum creatinine levels require a minimum of 24-48 h to
indicate renal injury. Nevertheless, early diagnosis remains critical for
improving patient outcomes. A PRISMA-compliant systematic review of the
PubMed and CENTRAL databases was performed to assess the role of Klotho as
a predictive biomarker for CSA-AKI (end-of-search date: 17 February 2024).
An evidence quality assessment of the four included studies was performed
with the Newcastle-Ottawa scale. Among the 234 patients studied, 119
(50.8%) developed CSA-AKI postoperatively. Serum Klotho levels above 120
U/L immediately postoperatively correlated with an area under the curve
(AUC) of 0.806 and 90% sensitivity. Additionally, a postoperative serum
creatinine to Klotho ratio above 0.695 showed 94.7% sensitivity and 87.5%
specificity, with an AUC of 92.4%, maintaining its prognostic validity for
up to three days. Urinary Klotho immunoreactivity was better maintained in
samples obtained via direct catheterization rather than indwelling
catheter collection bags. Storage at -80 degreeC was necessary for delayed
testing. Optimal timing for both serum and urine Klotho measurements was
from the end of cardiopulmonary bypass to the time of the first ICU lab
tests. In conclusion, Klotho could be a promising biomarker for the early
diagnosis of CSA-AKI. Standardization of measurement protocols and larger
studies are needed to validate these findings. Copyright © 2024
by the authors.

<12>
Accession Number
2029937465
Title
Landiolol for Treatment of New-Onset Atrial Fibrillation in Critical Care:
A Systematic Review.
Source
Journal of Clinical Medicine. 13(10) (no pagination), 2024. Article
Number: 2951. Date of Publication: May 2024.
Author
Levy B.; Slama M.; Lakbar I.; Maizel J.; Kato H.; Leone M.; Okada M.
Institution
(Levy) Service de Medecine Intensive et Reanimation Brabois, CHRU Nancy,
Pole Cardio-Medico-Chirurgical, Universite de Lorraine,
Vandoeuvre-les-Nancy 54511, France
(Slama, Maizel) Intensive Care Unit, Amiens Picardie University Hospital,
Amiens 80054, France
(Lakbar, Leone) Department of Anesthesiology and Intensive Care Unit,
Hopital Nord, Assistance Publique Hopitaux de Marseille, Aix Marseille
University, Marseille 13385, France
(Kato) Department of Anesthesiology and Intensive Care, Hopital Bicetre,
Assistance Publique Hopitaux de Paris, 78 rue du General, Leclerc, Le
Kremlin-Bicetre 94270, France
(Okada) Department of Emergency Medicine, Asahikawa Medical University,
Asahikawa 078-8510, Japan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: new-onset atrial fibrillation remains a common complication in
critical care settings, often necessitating treatment when the correction
of triggers is insufficient to restore hemodynamics. The treatment
strategy includes electric cardioversion in cases of hemodynamic
instability and either rhythm control or rate control in the absence of
instability. Landiolol, an ultrashort beta-blocker, effectively controls
heart rate with the potential to regulate rhythm. Objectives This review
aims to compare the efficacy of landiolol in controlling heart rate and
converting to sinus rhythm in the critical care setting. Method(s):
We conducted a comprehensive review of the published literature from 2000
to 2022 describing the use of landiolol to treat atrial fibrillation in
critical care settings, excluding both cardiac surgery and medical cardiac
care settings. The primary outcome assessed was sinus conversion following
landiolol treatment. Result(s): Our analysis identified 17
publications detailing the use of landiolol for the treatment of 324
critical care patients. While the quality of the data was generally low,
primarily comprising non-comparative studies, landiolol consistently
demonstrated similar efficacy in controlling heart rate and facilitating
conversion to sinus rhythm in both non-surgical (75.7%) and surgical
(70.1%) settings. The incidence of hypotension associated with landiolol
use was 13%. Conclusion(s): The use of landiolol in critical care
patients with new-onset atrial fibrillation exhibited comparable efficacy
and tolerance in both non-surgical and surgical settings. Despite these
promising results, further validation through randomized controlled trials
is necessary. Copyright © 2024 by the authors.

<13>
Accession Number
2029937417
Title
The Enhanced Recovery after Surgery Approach in Heart Valve Surgery: A
Systematic Review of Clinical Studies.
Source
Journal of Clinical Medicine. 13(10) (no pagination), 2024. Article
Number: 2903. Date of Publication: May 2024.
Author
Malvindi P.G.; Bifulco O.; Berretta P.; Galeazzi M.; Alfonsi J.; Cefarelli
M.; Zingaro C.; Zahedi H.M.; Munch C.; Di Eusanio M.
Institution
(Malvindi, Bifulco, Berretta, Galeazzi, Alfonsi, Cefarelli, Zingaro, Di
Eusanio) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti delle Marche Polytechnic University of Marche, Ancona 60121, Italy
(Zahedi, Munch) Cardiac Anaesthesia and Intensive Care Unit, Lancisi
Cardiovascular Center, Ospedali Riuniti delle Marche, Ancona 60121, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Enhanced recovery after surgery (ERAS) protocols aim to reduce
postoperative complications and promote earlier recovery. Although it is
well established in noncardiac surgery fields, the ERAS approach has only
recently been adopted in cardiac surgery. The aim of this review is to
evaluate the status and implementation of ERAS protocols in patients
undergoing heart valve surgery and to summarise associated clinical
results. Method(s): A literature search for the period January 2015
and January 2024 was performed through online databases. Clinical studies
(randomised controlled trials and cohort studies) on patients undergoing
heart valve surgical procedures and comparing ERAS and conventional
approaches were included. The data extracted covered studies and
populations characteristics, early outcomes and the features of each ERAS
protocol. Result(s): There were 14 studies that fulfilled the final
search criteria and were ultimately included in the review. Overall, 5142
patients were identified in the 14 studies, with 2501 in ERAS groups and
2641 patients who were representative of control groups. Seven experiences
exclusively included patients who underwent heart valve surgery. Twelve
out of fourteen protocols involved multiple interventions from the
preoperative to postoperative phase, while two studies reported actions
limited to intraoperative and postoperative care. We found high
heterogeneity among the included protocols regarding key actions targeted
for improvement and measured outcomes. All the studies showed that ERAS
pathways can be safely adopted in cardiac surgery and in most of the
experiences were associated with shorter mechanical ventilation time,
reduced postoperative opioid use and reduced ICU and hospital stays.
 Conclusion(s): As demonstrated in noncardiac surgery, the adoption of
structured ERAS protocols has the potential to improve results in patients
undergoing heart valve surgery. Further evidence based on larger
populations is needed, including more homogenous pathways and reporting
further outcomes in terms of patient satisfaction, recovery and quality of
life after surgery. Copyright © 2024 by the authors.

<14>
Accession Number
2029910276
Title
Prognostic value of left atrial strain in aortic stenosis: A systematic
review.
Source
Echocardiography. 41(5) (no pagination), 2024. Article Number: e15829.
Date of Publication: May 2024.
Author
Lacy S.C.; Thomas J.D.; Syed M.A.; Kinno M.
Institution
(Lacy) Department of Internal Medicine, Loyola University Medical Center,
Maywood, IL, United States
(Thomas) Division of Cardiology, Northwestern University Feinberg School
of Medicine, Chicago, IL, United States
(Syed, Kinno) Division of Cardiovascular Medicine, Loyola University
Medical Center, Maywood, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Aortic stenosis (AS) is a common valvular heart disease with high
morbidity and mortality. Recently, the association between peak atrial
longitudinal strain (PALS) and AS clinical outcomes has been identified.
This systematic review evaluates the prognostic value of PALS for adverse
events in AS. Method(s): We performed a systematic literature review
to identify clinical studies that evaluated Speckle-Tracking
Echocardiography (STE)-derived PALS to predict adverse outcomes in
patients with AS. We excluded studies that compared echocardiography to
computed tomography and studies that focused on diseases other than AS.
 Result(s): We included 18 studies reporting on 2660 patients.
Patients with symptomatic AS had decreased PALS when compared to patients
with asymptomatic AS. Patients with AS who had adverse events had
decreased PALS when compared to patients with AS with no events. Each unit
increase of PALS was independently associated with decreased risk for the
primary endpoint. PALS cut-off values were associated with increased risk
for the primary endpoint. Conclusion(s): This systematic review
suggests PALS as an independent predictor for cardiovascular events in
patients with AS and highlights the importance of evaluating LA mechanics
for AS prognosis. Copyright © 2024 Wiley Periodicals LLC.

<15>
Accession Number
2032465440
Title
Transcatheter or Surgical Replacement for Failed Bioprosthetic Aortic
Valves.
Source
JAMA Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Tran J.H.; Itagaki S.; Zeng Q.; Leon M.B.; O'Gara P.T.; Mack M.J.;
Gillinov A.M.; El-Hamamsy I.; Tang G.H.L.; Mikami T.; Bagiella E.;
Moskowitz A.J.; Adams D.H.; Gelijns A.C.; Borger M.A.; Egorova N.N.
Institution
(Tran, Itagaki, El-Hamamsy, Tang, Mikami, Adams) Department of
Cardiovascular Surgery, Mount Sinai Hospital, Icahn School of Medicine at
Mount Sinai, 1190 Fifth Ave, New York, NY 10029, United States
(Tran, Itagaki, Zeng, Bagiella, Moskowitz, Gelijns, Egorova) Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Leon) Division of Cardiology, Columbia University Irving Medical Center,
New York, NY, United States
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Mack) Cardiac and Thoracic Surgery, Baylor Scott & White Health, Dallas,
TX, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
Publisher
American Medical Association
Abstract
Importance: The use of valve-in-valve (ViV) transcatheter aortic valve
replacement (TAVR) has been rapidly expanding as an alternative treatment
to redo surgical aortic valve replacement (SAVR) for failed bioprosthetic
valves despite limited long-term data. Objective(s): To assess
mortality and morbidity in patients undergoing intervention for failed
bioprosthetic SAVR. Design, Setting, and Participant(s): This was a
retrospective population-based cohort analysis conducted between January
1, 2015, and December 31, 2020, with a median (IQR) follow-up time of 2.3
(1.1-4.0) years. A total of 1771 patients with a history of bioprosthetic
SAVR who underwent ViV-TAVR or redo SAVR in California, New York, and New
Jersey were included. Data were obtained from the California Department of
Health Care Access and Information, the New York Statewide Planning and
Research Cooperative System, and the New Jersey Discharge Data Collection
System. Exclusion criteria included undergoing TAVR or redo SAVR within 5
years from initial SAVR, as well as infective endocarditis, concomitant
surgical procedures, and out-of-state residency. Propensity matching
yielded 375 patient pairs. Data were analyzed from January to December
2023. Intervention(s): ViV-TAVR vs redo SAVR. Main Outcomes and
Measurements: The primary outcome was all-cause mortality. Secondary
outcomes were stroke, heart failure hospitalization, reoperation, major
bleeding, acute kidney failure, new pacemaker insertion, and infective
endocarditis. Result(s): From 2015 through 2020, the proportion of
patients undergoing ViV-TAVR vs redo SAVR increased from 159 of 451
(35.3%) to 498 or 797 (62.5%). Of 1771 participants, 653 (36.9%) were
female, and the mean (SD) age was 74.4 (11.3) years. Periprocedural
mortality and stroke rates were similar between propensity-matched groups.
The ViV-TAVR group had lower periprocedural rates of major bleeding (2.4%
vs 5.1%; P =.05), acute kidney failure (1.3% vs 7.2%; P <.001), and new
pacemaker implantations (3.5% vs 10.9%; P <.001). The 5-year all-cause
mortality rate was 23.4% (95% CI, 15.7-34.1) in the ViV-TAVR group and
13.3% (95% CI, 9.2-18.9) in the redo SAVR group. In a landmark analysis,
no difference in mortality was observed up to 2 years (hazard ratio, 1.03;
95% CI, 0.59-1.78), but after 2 years, ViV-TAVR was associated with higher
mortality (hazard ratio, 2.97; 95% CI, 1.18-7.47) as well as with a higher
incidence of heart failure hospitalization (hazard ratio, 3.81; 95% CI,
1.57-9.22). There were no differences in 5-year incidence of stroke,
reoperation, major bleeding, or infective endocarditis. Conclusions
and Relevance: Compared with redo SAVR, ViV-TAVR was associated with a
lower incidence of periprocedural complications and a similar incidence of
all-cause mortality through 2 years' follow-up. However, ViV-TAVR was
associated with higher rates of late mortality and heart failure
hospitalization. These findings may be influenced by residual confounding
and require adjudication in a randomized clinical trial.. Copyright
© 2024 American Medical Association. All rights reserved.

<16>
Accession Number
644361237
Title
Comparison of dexmedetomidine versus propofol sedation on microcirculation
and organ injuries in critically ill surgical patients: A randomized
controlled pilot study.
Source
Clinical hemorheology and microcirculation. (no pagination), 2024. Date
of Publication: 18 May 2024.
Author
Chen P.-Y.; Huang H.-H.; Chan W.-S.; Liu C.-M.; Wu T.-T.; Chen J.-H.; Chao
A.; Tien Y.-W.; Chiu C.-T.; Yeh Y.-C.
Institution
(Chen, Huang, Liu, Chen, Chao, Chiu, Yeh) Department of Anesthesiology,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Chan) Department of Anesthesiology, Far Eastern Memorial Hospital, Taiwan
(Republic of China)
(Wu) Department of Anesthesiology, National Taiwan University Hospital,
Hsin-Chu Branch ,Hsinchu City, Taiwan (Republic of China)
(Tien) Department of Surgery, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
Abstract
BACKGROUND: Recent studies have shown that dexmedetomidine may improve
microcirculation and prevent organ failure. However, most evidence was
obtained from experimental animals and patients receiving cardiac surgery
with cardiopulmonary bypass. This study aimed to investigate the effect of
dexmedetomidine on microcirculation and organ injuries in critically ill
general surgical patients. METHOD(S): In this prospective randomized
trial, patients admitted to the surgical intensive care unit after general
surgery were enrolled and randomly allocated to the dexmedetomidine or
propofol groups. Patients received continuous dexmedetomidine or propofol
infusions to meet their requirement of sedation according to their
grouping. At each time point, sublingual microcirculation images were
obtained using the incident dark field video microscope. RESULT(S):
Overall, 60 patients finished the trial and were analyzed.
Microcirculation parameters did not differ significantly between two
groups. Heart rate at 4 h after ICU admission and mean arterial pressures
at 12 h and 24 h after ICU admission were lower in the dexmedetomidine
group than in the propofol group. At 24 h, serum aspartate
aminotransferase (41 (25-118) vs 86 (34-129) U/L, p = 0.035) and alanine
aminotransferase (50 (26-160) vs 68 (35-172) U/L, p = 0.019) levels were
significantly lower in the dexmedetomidine group than in the propofol
group. CONCLUSION(S): Microcirculation parameters did not differ
significantly between the dexmedetomidine and propofol groups. At 24 h
after ICU admission, serum liver enzyme levels were lower in patients
receiving dexmedetomidine as compared to propofol.

<17>
Accession Number
2028873929
Title
An Accessible Pre-Rehabilitation Bundle for Patients Undergoing Elective
Heart Valve Surgery with Limited Resources: The TIME Randomized Clinical
Trial.
Source
Reviews in Cardiovascular Medicine. 24(11) (no pagination), 2023. Article
Number: 308. Date of Publication: 2023.
Author
Luo Z.; Zhang X.; Wang Y.; Huang W.; Chen M.; Yang M.; Yu P.
Institution
(Luo, Zhang, Huang, Yang, Yu) Department of Rehabilitation Medicine, West
China Hospital, Sichuan University, Sichuan, Chengdu 610041, China
(Wang, Chen) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Sichuan, Chengdu 610041, China
Publisher
IMR Press Limited
Abstract
Background: Despite gradually increasing evidence for pre-rehabilitation
for heart valve surgery, it remains underused, especially in developing
countries with limited resources. The study aimed to investigate the
feasibility and effects of an innovative three-day pre-rehabilitation
bundle for patients undergoing elective heart valve surgery.
 Method(s): This was a single-center, assessor-blind, randomized
clinical trial. A total of 165 patients were randomly assigned to either
usual care (control group, n = 83) or usual care with an additional 3-day
pre-rehabilitation bundle (Three-day of Inspiratory muscle training,
aerobic Muscle training, and Education (TIME) group, n = 82). The main
outcome of the study was the incidence of postoperative pulmonary
complications (PPCs). Secondary outcomes included the feasibility of the
intervention, duration of the non-invasive ventilator, length of stay, and
PPCs-related medical costs on discharge. Result(s): Of 165 patients
53.94% were male, the mean age was 63.41 years, and PPCs were present in
26 of 82 patients in the TIME group and 44 of 83 in the control group
(odds ratio (OR), 0.60 95% CI, 0.41-0.87, p = 0.006). The feasibility of
the pre-rehabilitation bundle was good, and no adverse events were
observed. Treatment satisfaction and motivation scored on 10-point scales,
were 9.1 +/- 0.8 and 8.6 +/- 1.4, respectively. The TIME group also had
fewer additional PPCs-related medical costs compared to the control group
(6.96 vs. 9.57 thousand CNY (1.01 vs. 1.39 thousand USD), p < 0.001).
 Conclusion(s): The three-day accessible pre-rehabilitation bundle
reduces the incidence of PPCs, length of stay, and PPCs-related medical
costs in patients undergoing elective valve surgery. It may provide an
accessible model for the expansion of pre-rehabilitation in countries and
regions with limited medical resources. Clinical Trial Registration: This
trial was based on the Consolidated Standards of Reporting Trials
(CONSORT) guidelines. This trial was registered in the Chinese Clinical
Trial Registry (identifier ChiCTR2000039671). Copyright © 2023
IMR Press Limited. All rights reserved.

<18>
Accession Number
625422931
Title
Impact of Patient and Lesion Characteristics on Drug-Coated Balloon
Angioplasty in the Femoropopliteal Artery: A Pooled Analysis of Four
Randomized Controlled Multicenter Trials.
Source
CardioVascular and Interventional Radiology. 42(4) (pp 495-504), 2019.
Date of Publication: 15 Apr 2019.
Author
Albrecht T.; Ukrow A.; Werk M.; Tepe G.; Zeller T.; Meyer D.-R.; Kutschera
M.; Speck U.; Waliszewski M.
Institution
(Albrecht, Ukrow) Department of Radiology and Interventional Therapy,
Vivantes Klinikum Neukolln, Berlin, Germany
(Werk) Department of Radiology, Martin-Luther-Hospital, Berlin, Germany
(Tepe) Department of Radiology, RoMed Klinikum Rosenheim, Rosenheim,
Germany
(Zeller) Department of Angiology, Herzzentrum Bad Krozingen, Bad
Krozingen, Germany
(Meyer) Department of Diagnostic and Interventional Radiology, Hubertus
Hospital, Berlin, Germany
(Kutschera, Speck) Experimental Radiology, Department of Radiology,
Charite, Berlin, Germany
(Waliszewski) Medical Scientific Affairs, B.Braun Melsungen AG, Berlin,
Germany
(Waliszewski) Department of Internal Medicine and Cardiology, Charite -
Universitatsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
(Albrecht) Institut fur Radiologie und Interventionelle Therapie, Vivantes
Klinikum Neukolln, Rudower Str. 48, Berlin 12351, Germany
Publisher
Springer Science and Business Media, LLC
Abstract
Objectives: The principal objective of this pooled analysis was to
investigate various patient and lesion characteristics on late lumen loss
(LLL) after drug-coated balloon (DCB) angioplasty. Background(s):
Four randomized controlled trials (THUNDER, FEMPAC, PACIFIER, CONSEQUENT)
were pooled to investigate the influence of various patient and lesion
characteristics on DCB angioplasty and on plain old balloon angioplasty
(POBA) in patients with femoropopliteal artery disease. Method(s):
Angiographic data from 355 patients were pooled to assess the impact of
patient (demographics, cardiovascular risk factors, cardiovascular
co-morbidities, Rutherford stages) and lesion-/procedure-related
(location, occlusion, length, restenosis, calcification, subintimal
crossing, post-dilatation, dissection, stenting) characteristics on LLL.
Linear regression models were utilized with LLL as the dependent variable
to determine the predictive value of cardiovascular and
lesion-/procedure-related factors. Result(s): Observational
statistics revealed that LLL was lower in the DCB group as compared to
POBA independent of all tested patient variables. LLL after DCB was also
independent of most lesion and procedural characteristics except for
lesion length and bailout stenting. LLL increased with lesion length in
both treatment groups. Bailout stenting did not improve LLL in the DCB
group but did so in the POBA group (0.74 +/- 1.07 mm vs. 1.22 +/- 1.36 mm,
p = 0.043). Conclusion(s): DCB was superior to POBA for all tested
patient subgroups and lesion subgroups. Our results suggest that all
patients and lesions benefit to a similar degree from the use of DCB.
DCB-PTA should therefore be preferred to POBA in all patients with
steno-occlusive femoropopliteal lesions. Copyright © 2018,
Springer Science+Business Media, LLC, part of Springer Nature and the
Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

<19>
Accession Number
2029395457
Title
COMPARATIVE EFFICACY OF DEXMEDETOMIDINE AND CLONIDINE IN CARDIAC VALVULAR
SURGERIES: A PROSPECTIVE RANDOMIZED CONTROLLED STUDY.
Source
International Journal of Medicine and Public Health. 14(2) (pp 49-55),
2024. Date of Publication: April-June 2024.
Author
Syed Mohammed Jazeel S.; Dhivakar S.; Vivekanandhan N.; Sri Hari Vignesh
R.
Institution
(Syed Mohammed Jazeel) Koodankulam Government Hospital, Tamilnadu,
Tirunelveli, India
(Dhivakar) Manamadurai Government Hospital, Tamilnadu, Sivagangai, India
(Vivekanandhan, Sri Hari Vignesh) Department of Anaesthesia, Palakkad
Institute of Medical Sciences, Palakkad, Kerala, Walayar, India
Publisher
Pink Petals Publications Pvt Ltd
Abstract
Background: Dexmedetomidine and Clonidine, both alpha2-adrenergic
agonists, are commonly used in cardiac surgery for their hemodynamic
stabilizing properties. However, comparative data on their efficacy in
cardiac valvular surgeries remain limited. Material(s) and Method(s):
We conducted a prospective randomized controlled study involving 60
patients undergoing elective cardiac valvular surgeries between September
2019 and August 2020. Patients were randomized to receive either Clonidine
or Dexmedetomidine. Intra-operative hemodynamics, anesthetic requirements,
and post-operative recovery times were compared between the two groups.
 Result(s): Dexmedetomidine demonstrated superior efficacy in reducing
heart rate, systolic blood pressure, diastolic blood pressure, and mean
arterial pressure compared to Clonidine. Patients receiving
Dexmedetomidine required lower doses of inhalational anesthetics, opioids,
and muscle relaxants. Additionally, Dexmedetomidine was associated with
shorter durations of mechanical ventilation (398.00 +/- 51.47 vs. 475.67
+/- 35.15 minutes, P < 0.0001) and length of stay in the post-operative
ICU (53.90 +/- 3.75 vs. 60.60 +/- 3.78 hours, P < 0.0001) compared to
Clonidine. Conclusion(s): Dexmedetomidine offers superior
intra-operative hemodynamic stability, reduced anesthetic requirements,
and faster post-operative recovery compared to Clonidine in patients
undergoing cardiac valvular surgeries. Copyright © 2024, Pink
Petals Publications Pvt Ltd. All rights reserved.

<20>
Accession Number
2029348616
Title
Comparison of Thoracoscopy-Guided Thoracic Paravertebral Block and
Ultrasound-Guided Thoracic Paravertebral Block in Postoperative Analgesia
of Thoracoscopic Lung Cancer Radical Surgery: A Randomized Controlled
Trial.
Source
Pain and Therapy. 13(3) (pp 577-588), 2024. Date of Publication: June
2024.
Author
Xu X.; Xie Y.-X.; Zhang M.; Du J.-H.; He J.-X.; Hu L.-H.
Institution
(Xu, Xie, Zhang, Du, Hu) Department of Anesthesiology, The Affiliated
Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo
315040, China
(He) Department of Thoracic Surgery, The Affiliated Lihuili Hospital of
Ningbo University, No. 57 Xingning road, Ningbo 315040, China
Publisher
Adis
Abstract
Introduction: Ultrasound-guided thoracic paravertebral block (UTPB) is
widely used for postoperative analgesia in thoracic surgery. However, it
has many disadvantages. Thoracoscopy-guided thoracic paravertebral block
(TTPB) is a new technique for thoracic paravertebral block (TPB). In this
study, we compared the use of TTPB and UTPB for pain management after
thoracoscopic radical surgery for lung cancer. Method(s): In total,
80 patients were randomly divided 1:1 into the UTPB group and the TTPB
group. The surgical time of TPB, the success rate of the first puncture,
block segment range, visual analog scale (VAS) scores at 2, 6, 12, 24, and
48 h post operation, and the incidence of postoperative adverse reactions
were compared between the two groups. Result(s): The surgical time of
TPB was significantly shorter in the TTPB group than in the UTPB group
(2.2 +/- 0.3 vs. 5.7 +/- 1.7 min, t = - 12.411, P < 0.001). The success
rate of the first puncture and the sensory block segment were
significantly higher in the TTPB group than in the UTPB group (100% vs.
76.9%, chi2 = 8.309, P < 0.001; 6.5 +/- 1.2 vs. 5.1 +/- 1.3
levels, t = - 5.306, P < 0.001, respectively). The VAS scores were
significantly higher during rest and coughing at 48 h post operation than
at 2, 6, 12, and 24 h post operation in the TTPB group. The VAS scores
were significantly lower during rest and coughing at 12 and 24 h post
operation in the TTPB group than in the UTPB group (rest: 2.5 +/- 0.4 vs.
3.4 +/- 0.6, t = 7.325, P < 0.001; 2.5 +/- 0.5 vs. 3.5 +/- 0.6, t = 7.885,
P < 0.001; coughing: 3.4 +/- 0.6 vs. 4.2 +/- 0.7, t = 5.057, P < 0.001;
3.4 +/- 0.6 vs. 4.2 +/- 0.8, t = 4.625, P < 0.001, respectively). No
significant difference was observed in terms of postoperative adverse
reactions between the two groups. Conclusion(s): Compared with UTPB,
TTPB shows advantages, such as simpler and more convenient surgery,
shorter surgical time, a higher success rate of the first puncture, wider
block segments, and superior analgesic effect. TTPB can effectively reduce
postoperative pain due to thoracoscopic lung cancer radical surgery. Trial
Registration: https://www.chictr.org.cn, identifier ChiCTR2300072005,
prospectively registered on 31/05/2023. Copyright © The Author(s)
2024.

<21>
Accession Number
2029281348
Title
L-carnitine decreases myocardial injury in children undergoing open-heart
surgery: A randomized controlled trial.
Source
European Journal of Pediatrics. 183(6) (pp 2783-2789), 2024. Date of
Publication: June 2024.
Author
El Feky W.; El-Afify D.; Abdelhai D.; Elkashlan M.; Fakhreldin A.; El
Amrousy D.
Institution
(El Feky) Cardiothoracic Surgery Department, Faculty of Medicine, Kafr
Elsheikh University, Kafr Elsheikh, Egypt
(El-Afify) Clinical Pharmacy Department, Faculty of Pharmacy, Tanta
University, Tanta, Egypt
(Abdelhai) Clinical Pathology Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Elkashlan) Anesthesia Department, Elmenshawy Hospital, Ministry of
Health, Tanta, Egypt
(Fakhreldin) Pediatric Department, Faculty of Medicine, Aswan University,
Aswan, Egypt
(El Amrousy) Pediatric Department, Faculty of Medicine, Tanta University,
Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Abstract: Myocardial injury in open-heart surgery is related to several
factors including ischemia-reperfusion injury, generation of reactive
oxygen species, increased production of inflammatory mediators, and
enhancement of apoptosis of cardiomyocytes. The aim of this study was to
study the effect of L-carnitine on myocardial injury in children
undergoing open-heart surgery. This clinical trial was performed on 60
children with congenital heart disease (CHD) who underwent open-heart
surgery. They were randomized into two groups: L-carnitine group who
received L-carnitine 50 mg\kg\day once daily for 1 month before cardiac
surgery and control group who received placebo for 1 month before cardiac
surgery. Left ventricular cardiac function was assessed by conventional
echocardiography to measure left ventricular ejection fraction (LVEF) and
two-dimensional speckle tracking echocardiography (2D-STE) to determine
left ventricular global longitudinal strain (2D-LV GLS). Blood samples
were obtained pre-operatively at baseline before the administration of
L-carnitine or placebo and 12 h post-operatively to measure the level of
malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3,
creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had
significantly lower post-operative level of oxidative stress marker (MDA),
apoptosis markers (fas and caspase-3), and myocardial injury markers
(CK-MB and troponin I), but they had significantly higher SOD
post-operative level compared to the control group. In addition,
post-operative LVEF and 2D-LVGLS were significantly lower in the control
group compared to L-carnitine group. Conclusion(s): L-carnitine can
reduce myocardial injury, improve post-operative left ventricular cardiac
function, and may provide myocardium protection in children with CHD who
underwent open-heart surgery. Trial registration: The clinical trial was
registered at www.pactr.org with registration number PACTR202010570607420
at 29/10/2020 before recruiting the patients. (Table
presented.) Copyright © The Author(s) 2024.

<22>
Accession Number
2019352711
Title
Technical Aspects of Percutaneous Deep Venous Arterialization Using
Off-the-Shelf Devices.
Source
Journal of Endovascular Therapy. 31(3) (pp 350-359), 2024. Date of
Publication: June 2024.
Author
Huang I.; Nakama T.; Ichihashi S.; Pua U.
Institution
(Huang, Pua) Department of Radiology, Tan Tock Seng Hospital, Singapore
(Nakama) Tokyo Bay Medical Center, Tokyo, Japan
(Ichihashi) Department of Radiology, Nara Medical University, Nara, Japan
Publisher
SAGE Publications Inc.
Abstract
Purpose: Chronic limb-threatening ischemia (CLTI) represents the clinical
end stage of lower extremity peripheral arterial disease (PAD). Although
conventional open and endovascular revascularization options are
available, some CLTI patients do not respond to these treatments,
generally due to small vessel occlusive disease, with only limited or no
clinical improvement achieved. This article aims to provide insights
related to pertinent venous anatomy of the leg and below the ankle and a
technical review of percutaneous deep venous arterialization (pDVA)
creation using commonly-available devices. Technique: For patients with
"no-option" CLTI, the risk of major amputation and mortality remains high.
Although arterial revascularization remains the optimal treatment of CLTI,
some patients with severely-diseased or gracile distal arteries have poor
outcome. Deep venous arterialization (DVA), in a subset of patients with
tibial anatomy amenable to DVA creation, represents the last-ditch attempt
before these patients are deemed to have "no-hope" at limb salvage, and
major amputation becomes necessary. Refinement in technique and
advancement in device development have been shown to allow pDVA to be
created with respectable outcomes for the "no-option" CLTI patient
population. Conclusion(s): The pDVA has garnered increasing interest
among endovascular specialists to further understand the anatomical and
technical key points of this procedure, and it may yet prove to be a
useful addition in the armamentarium in our battle against CLTI. Clinical
Impact: Percutaneous deep venous arterialisation provides another option
in the treatment of challenging "no-option" CLTI patients, and
off-the-shelf devices will allow this procedure to be performed in centers
where dedicated devices are not available. Copyright © The
Author(s) 2022.

<23>
Accession Number
2032283454
Title
Long-term outcomes comparison of mitral valve repair or replacement for
secondary mitral valve regurgitation. An updated systematic review and
reconstructed time-to-event study-level meta-analysis.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102636. Date of Publication: July 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Benassi F.; Grassa G.; Pattuzzi C.; Maestri F.;
Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) University of Parma, Department of
Medicine and Surgery, Parma, Italy
(Formica, Gallingani, Benassi, Grassa, Pattuzzi, Maestri, Nicolini)
Cardiac Surgery Unit, University Hospital of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Publisher
Elsevier Inc.
Abstract
Background and aim. The ideal surgical intervention for secondary mitral
regurgitation (SMR), a disease of the left ventricle not the mitral valve
itself, is still debated. We performed an updated systematic review and
study-level meta-analysis investigating mitral valve repair (MVr) versus
mitral valve replacement (MVR) for adult patients with SMR, with or
without coronary artery disease (CAD). Methods. PubMed, CENTRAL and EMBASE
were searched for studies comparing MVr versus MVR. Randomized trial or
observational studies were considered eligible. Primary endpoint was
long-term mortality for any cause. Kaplan-Meier survival curves were
reconstructed and compared with Cox linear regression. Landmark analysis
and time-varying hazard ratio (HR) were analyzed. Sensitivity analyses
included meta-regression and separate sub-analysis. A random effects model
was used. Results. Twenty-three studies (MVr=3,727 and MVR=2,839) were
included. One study was a randomized trial, and 19 studies were adjusted.
The mean weighted follow-up was 3.7+/-2.8 years. MVR was associated with
significative greater late mortality (HR=1.26; 95 % CI, 1.14-1.39;
P<0.0001) at 10-year follow-up. There was a time-varying trend showing an
increased risk of mortality in the first 2 years after MVR (HR=1.38; 95 %
CI, 1.21-1.56; P<0.0001), after which this difference dissipated (HR=0.94;
95 % CI, 0.81-1.09; P=0.41). Separate sub-analyses showed comparable
long-term mortality in patients with concomitant coronary surgery >=90 %,
left ventricle ejection fraction <=40 %, and sub-valvular apparatus
preservation rate of 100 %. Conclusions. Compared to repair, MVR is
associated with higher probability of mortality in the first 2 years
following surgery, after which the two procedures showed comparable late
mortality rate. Copyright © 2024 The Author(s)

<24>
Accession Number
2032273441
Title
Quantitative flow ratio versus fractional flow reserve for Heart Team
decision-making in multivessel disease: the randomised, multicentre
DECISION QFR trial.
Source
EuroIntervention. 20(9) (pp 561-570), 2024. Date of Publication: 2024.
Author
Asano T.; Tanigaki T.; Hoshino M.; Yasunaga M.; Nonaka H.; Emori H.;
Katagiri Y.; Miyazaki Y.; Sotomi Y.; Kogame N.; Kuramitsu S.; Saito A.;
Miyata K.; Takaoka Y.; Kanie T.; Yamasaki M.; Yoshino K.; Wakabayashi N.;
Ouchi K.; Kodama H.; Shiina Y.; Tamaki R.; Nishihata Y.; Masuda K.; Suzuki
T.; Reiber J.H.C.; Okamura T.; Higuchi Y.; Kakuta T.; Misumi H.; Abe K.;
Komiyama N.; Tanabe K.; Matsuo H.
Institution
(Asano, Saito, Miyata, Takaoka, Kanie, Kodama, Shiina, Nishihata, Masuda,
Suzuki, Komiyama) Department of Cardiovascular Medicine, St. Luke's
International Hospital, St. Luke's International University, Tokyo, Japan
(Tanigaki, Matsuo) Department of Cardiovascular Medicine, Gifu Heart
Center, Gifu, Japan
(Hoshino, Kakuta) Division of Cardiovascular Medicine, Tsuchiura Kyodo
General Hospital, Tsuchiura, Japan
(Yasunaga, Higuchi) Cardiovascular Division, Osaka Police Hospital, Osaka,
Japan
(Nonaka, Tanabe) Division of Cardiology, Mitsui Memorial Hospital, Tokyo,
Japan
(Emori) Department of Cardiovascular Medicine, Wakayama Medical
University, Wakayama, Japan
(Katagiri) Department of Cardiovascular Medicine, Sapporo Higashi
Tokushukai Hospital, Sapporo, Japan
(Miyazaki, Okamura) Division of Cardiology, Department of Medicine and
Clinical Science, Yamaguchi University Graduate School of Medicine, Ube,
Japan
(Sotomi) Department of Cardiovascular Medicine, Osaka University Graduate
School of Medicine, Osaka, Japan
(Kogame) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Tokyo, Japan
(Kuramitsu) Sapporo Cardiovascular Clinic, Sapporo Heart Center, Sapporo,
Japan
(Yamasaki, Yoshino, Tamaki, Misumi, Abe) Department of Cardiovascular
Surgery, St. Luke's International Hospital, St. Luke's International
University, Tokyo, Japan
(Wakabayashi, Ouchi) Department of Radiology, St. Luke's International
Hospital, St. Luke's International University, Tokyo, Japan
(Reiber) Department of Radiology, Leiden University Medical Center,
Leiden, Netherlands
Publisher
Europa Group
Abstract
BACKGROUND: Vessel-level physiological data derived from pressure wire
measurements are one of the important determinant factors in the optimal
revascularisation strategy for patients with multivessel disease (MVD).
However, these may result in complications and a prolonged procedure time.
AIMS: The feasibility of using the quantitative flow ratio (QFR), an
angiography-derived fractional flow reserve (FFR), in Heart Team
discussions to determine the optimal revascularisation strategy for
patients with MVD was investigated. METHOD(S): Two Heart Teams were
randomly assigned either QFR- or FFR-based data of the included patients.
They then discussed the optimal revascularisation mode (percutaneous
coronary intervention [PCI] or coronary artery bypass grafting [CABG]) for
each patient and made treatment recommendations. The primary endpoint of
the trial was the level of agreement between the treatment recommendations
of both teams as assessed using Cohen's kappa. RESULT(S): The trial
included 248 patients with MVD from 10 study sites. Cohen's kappa in the
recommended revascularisation modes between the QFR and FFR approaches was
0.73 [95% confidence interval {CI}: 0.62-0.83]. As for the
revascularisation planning, agreements in the target vessels for PCI and
CABG were substantial for both revascularisation modes (Cohen's kappa=0.72
[95% CI: 0.66-0.78] and 0.72 [95% CI: 0.66-0.78], respectively). The team
assigned to the QFR approach provided consistent recommended
revascularisation modes even after being made aware of the FFR data
(Cohen's kappa=0.95 [95% CI:0.90-1.00]). CONCLUSION(S): QFR provided
feasible physiological data in Heart Team discussions to determine the
optimal revascularisation strategy for MVD. The QFR and FFR approaches
agreed substantially in terms of treatment recommendations. Copyright
© Europa Digital & Publishing 2024. All rights reserved.

<25>
[Use Link to view the full text]
Accession Number
2032151411
Title
In-hospital initiation of a PCSK9 inhibitor in patients with acute
coronary syndrome: A systematic review and meta-analysis of randomized
controlled trials.
Source
Medicine (United States). 103(10) (pp E37416), 2024. Date of Publication:
08 Mar 2024.
Author
Shi W.; Xu Y.; Zhou L.; Wang W.; Huang W.; Zhou B.
Institution
(Shi, Xu, Zhou) Department of Cardiology, The Sixth People's Hospital of
Chengdu, Chengdu 610000, China
(Wang) Department of Cardiac Ultrasound, Peking Union Medical College
Hospital, Beijing 100005, China
(Huang, Zhou) Department of Cardiology, The First Affiliated Hospital of
Chongqing Medical University, Chongqing 400016, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9)
inhibitors have been shown to be effective and safe in patients with
stable angina and previous myocardial infarction. However, evidence for
initiating their use in patients hospitalized with acute coronary syndrome
(ACS) is limited. This systematic review and meta-analysis was performed
to provide more clinical evidence. Method(s): PubMed, Embase, OVID,
Cochrane Library and ClinicalTrials.gov were systematically searched for
eligible randomized controlled trials up to March 20, 2023. The risk
ratios, standardized mean differences and 95% confidence intervals were
calculated for primary and secondary outcomes. The bias risk of the
included studies was assessed using the Cochrane RoB 2 criteria.
 Result(s): About 8 randomized controlled trials involving 1255
inpatients with ACS were included. PCSK9 inhibitor treatment significantly
reduced low-density lipoprotein cholesterol (LDL-C) (SMD -1.28, 95% CI
-1.76 to -0.8, P = .001), triglycerides (TG) (SMD -0.93, 95% CI -1.82 to
-0.05, P = .03), total cholesterol (SMD -1.36, 95% CI -2.01 to -0.71, P =
.001), and apolipoprotein B (Apo B) (SMD -0.81, 95% CI -1.09 to -0.52, P =
.001) within approximately 1 month. PCSK9 inhibitor treatment
significantly reduced the total atheroma volume (TAV) (SMD -0.33, 95% CI
-0.59 to -0.07, P = .012). It also significantly increased minimum fibrous
cap thickness (FCT) (SMD 0.41, 95% CI 0.22-0.59, P = .001) in long-term
follow-up (>6 months). PCSK9 inhibitor treatment significantly reduced the
risk of readmission for unstable angina (RR 0.32, 95% CI 0.12-0.91, P =
.032) in short-term follow-up (<6 months). There were no significant
differences in all-cause mortality, cardiovascular death, myocardial
infarction, ischemic stroke, coronary revascularization or heart failure.
Only nasopharyngitis (RR 1.71, 95% CI 1.01-2.91, P = .047) adverse events
were significantly observed in the PCSK9 inhibitor group.
 Conclusion(s): Application of a PCSK9 inhibitor in hospitalized
patients with ACS reduced lipid profiles and plaque burdens and was well
tolerated with few adverse events. Copyright © 2024 Lippincott
Williams and Wilkins. All rights reserved.

<26>
Accession Number
2032369786
Title
impact of subclinical hypothyroidism on outcomes after coronary artery
bypass grafting: a systematic review and meta-analysis.
Source
Journal of Cardiovascular Surgery. 65(2) (pp 155-160), 2024. Date of
Publication: April 2024.
Author
Larik M.O.; Shahid A.R.; Shiraz M.I.; Urooj M.
Institution
(Larik, Shahid, Shiraz, Urooj) department of Medicine, dow international
Medical College, Karachi, Pakistan
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Coronary artery bypass grafting (CABG) is a surgical
procedure that restores blood flow to heart muscle by bypassing the
blocked or narrowed coronary arteries. on the other hand, subclinical
hypothyroidism (sCh) is characterized by an elevated serum concentration
of thyroid stimulating hormone with normal levels of serum free thyroxine.
With limited research into the impact of sCh on postoperative CaBg
outcomes, this systematic review and meta-analysis was performed. eVideNCe
aCQuisiTioN: an electronic search of PubMed, Cochrane library, and scopus
was performed from inception to april 2023. After the inclusion of five
studies, a total of 2,786 patients were pooled in this quantitative
synthesis. EVIDENCE SYNTHESIS: It was observed that SCH significantly
increased cardiovascular mortality (OR: 2.80; 95% CI: 1.37, 5.72;
P=0.005), and all-cause mortality (OR: 2.62; 95% CI: 1.80, 3.80;
P<0.00001). However, no significant differences were observed for
secondary outcomes, including major adverse cardiac events, incidence of
postoperative stroke, and incidence of postoperative myocardial
infarction. CONCLUSION(S): To the best of our knowledge, this is the
first meta-analysis conducted that evaluates the impact of SCH on outcomes
after CaBg. The preoperative assessment of thyroid function may be
considered prior to cardiovascular procedures, particularly within CaBg.
however, future comprehensive studies, with individual participant-level
data, are necessary in order to arrive at a valid conclusion and
recommendation. Copyright © 2024 Edizioni Minerva Medica. All
rights reserved.

<27>
Accession Number
2029834575
Title
Same-day discharge after percutaneous coronary procedures-Structured
review and comprehensive meta-analysis.
Source
Wiener Klinische Wochenschrift. 136(Suppl 3) (pp 44-60), 2024. Date of
Publication: May 2024.
Author
Brandt M.C.; Alber H.; Berger R.; Binder R.K.; Mascherbauer J.; Niessner
A.; Schmid M.; Wernly B.; Frick M.
Institution
(Brandt) Department of Internal Medicine II, Paracelsus Medical
University, Salzburg, Austria
(Alber) Department of Cardiology, Public Hospital Klagenfurt am
Woerthersee, Klagenfurt am Woerthersee, Austria
(Berger) Department of Internal Medicine, Brothers of Saint John of God
Eisenstadt, Eisenstadt, Austria
(Binder) Department of Cardiology and Intensive Care, Klinikum Wels, Wels,
Austria
(Mascherbauer) Department of Internal Medicine 3/Cardiology, University
Hospital St. Polten, Karl Landsteiner University of Health Sciences,
Krems, Austria
(Niessner) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090,
Austria
(Schmid) Department of Cardiology, Ordensklinikum Linz Elisabethinen,
Linz, Austria
(Wernly) Department of Internal Medicine, General Hospital Oberndorf,
Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria
(Frick) Department of Internal Medicine I and Cardiology, Teaching
Hospital Feldkirch, Feldkirch, Austria
Publisher
Springer
Abstract
Introduction: Percutaneous coronary intervention is a well-established
revascularization strategy for patients with coronary artery disease. The
safety and feasibility of performing these procedures on a same-day
discharge basis for selected patients has been studied in a large number
of mostly nonrandomized trials. An up to date literature review should
focus on trials with radial access, representing the current standard for
coronary procedures in Austria and other European countries.
 Method(s): The aim of this consensus statement is to review the most
recent evidence for the safety and feasibility of performing same-day
discharge procedures in selected patients. A structured literature search
was performed using prespecified search criteria, focusing on trials with
radial access procedures. Result(s): A total of 44 clinical trials
and 4 large meta-analyses were retrieved, spanning 21 years of clinical
evidence from 2001 to 2022. The outcome data from a wide range of clinical
settings were unanimous in showing no negative effect on early (24h) or
late (30 day) major adverse events after same-day discharge coronary
procedures. Based on nine prospective trials a comprehensive meta-analysis
was compiled. Using 1-month major adverse events data the pooled odds
ratio of same-day discharge versus overnight stay procedures was 0.66 (95%
confidence interval, CI 0.35-01.24; p= 0.19; I2 0%), indicating
a noninferiority in carefully selected patients. Conclusion(s):
Outcome data from same-day discharge coronary intervention trials with
radial access confirm the robust safety profile showing no increase in the
risk of major adverse events compared to overnight stay. Copyright
© The Author(s) 2024.

<28>
Accession Number
2029420472
Title
Direct oral anticoagulants vs Vitamin-K antagonists in solid organ
transplant recipients: A systematic review and meta-analysis.
Source
Pakistan Journal of Medical Sciences. 40(6) (pp 1267-1273), 2024. Date of
Publication: July 2024.
Author
He C.; Yao C.
Institution
(He, Yao) Department of Pharmacy, The Second Affiliated Hospital and
Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West
Road, Zhejiang Province, Wenzhou 325000, China
Publisher
Professional Medical Publications
Abstract
Objective: Oure review aimed to examine evidence on the safety and
efficacy of direct oral anticoagulants (DOAC) vs Vitamin K antagonists
(VKA) in patients with solid organ transplants. Method(s): PubMed,
Embase, and Web of Science libraries were searched from inception to
25th November 2023 for all studies comparing DOAC with VKA in
solid organ recipients. Result(s): Nine studies were included with
patients who had undergone kidney, heart, or liver transplants.
Meta-analysis showed that patients receiving DOAC had a significantly
reduced risk of composite bleeding as compared to those with VKA (RR: 0.45
95% CI: 0.30, 0.68 I2=25%). However, the risk of major bleeding
was not significantly different between the two groups (RR: 0.76 95% CI:
0.40, 1.42 I2=37%). Pooled analysis showed that the risk of VTE
(RR: 0.90 95% CI: 0.72, 1.13 I2=0%) and ischemic stroke (RR:
0.87 95% CI: 0.39, 1.94 I2=12%) was not significantly different
between DOAC and VKA groups. Conclusion(s): Limited data shows that
DOAC are safe and effective in patients with solid organ transplants. The
overall risk of bleeding may be reduced with the use of DOAC. There is a
need for randomized controlled trials comparing DOAC and VKA in such
patients to obtain high-quality evidence. Copyright © 2024,
Professional Medical Publications. All rights reserved.

<29>
Accession Number
642479971
Title
Chronic systemic glucocorticoid therapy is associated with increased risk
of major vascular complications and cardiac tamponade after transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
Minerva cardiology and angiology. 72(3) (pp 284-291), 2024. Date of
Publication: 01 Jun 2024.
Author
Chiabrando J.G.; Lombardi M.; Seropian I.M.; Valle Raleigh J.M.; Vergallo
R.; Larribau M.; Agatiello C.R.; Trani C.; Burzotta F.
Institution
(Chiabrando) Unit of Interventional Cardiology, Italian Hospital of Buenos
Aires, Buenos Aires, Argentina
(Chiabrando) Unit of Interventional Cardiology, Spanish Hospital of
Mendoza, Mendoza, Argentina
(Lombardi, Trani, Burzotta) Department of Cardiovascular Sciences, IRCCS
A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic
University, Rome, Italy
(Lombardi, Vergallo) Department of Internal Medicine and Medical
Specialties (DIMI), University of Genoa, Genoa, Italy
(Seropian, Valle Raleigh, Agatiello) Unit of Interventional Cardiology,
Italian Hospital of Buenos Aires, Buenos Aires, Argentina
(Vergallo) Cardiothoracic and Vascular Department (DICATOV), IRCCS San
Martino Polyclinic Hospital, Genoa, Italy
(Larribau) Unit of Interventional Cardiology, Spanish Hospital of Mendoza,
Mendoza, Argentina
Abstract
INTRODUCTION: TAVI-related complications, such as conduction disturbances,
vascular complications or death may be related to increased inflammatory
response. The aim of this study was to elucidate the efficacy and safety
of the systemic glucocorticoid therapy regarding the adverse events after
TAVI deployment. EVIDENCE ACQUISITION: We conducted a systemic search of
PubMed, a reference list of relevant articles, and Medline. The main
efficacy outcomes of interest were all-cause death, cardiac and
non-cardiac death, permanent pacemaker implantation (PPM), new left bundle
branch block (LBBB), stroke, and myocardial infarction (MI). Safety
endpoints were major vascular complications, major bleeding events, and
cardiac tamponade. EVIDENCE SYNTHESIS: A total of 7 studies including data
from 3439 patients with a median follow-up was 30 days. Systemic
glucocorticoid compared to the control group were associated with an
increased risk of non-cardiac death (Relative Risk [RR] 5.90 95%CI [2.95;
11.80], P<0.001) major vascular complications (RR 1.78, 95%CI [1.22 -
2.61], P=0.003) and cardiac tamponade (RR 3.42, 95%CI [1.69 - 6.92],
P<0.001). However, there were no differences in all-cause death, cardiac
death, new LBBB, stroke, MI, or major bleeding events (all P values
>0.05). CONCLUSION(S): Glucocorticoid therapy before the TAVI
procedure was associated with an increase in non-cardiac death, major
vascular events and cardiac tamponade. There were no differences in the
risk of all-cause death, cardiac death, PPM or LBBB, stroke, or MI.

<30>
Accession Number
2032384438
Title
Comprehensive analysis of donor-site chest deformities after autologous
costal cartilage microtia reconstruction: A systematic review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 94 (pp 128-140),
2024. Date of Publication: July 2024.
Author
Kim J.; Park C.; Oh K.S.; Lim S.Y.
Institution
(Kim, Park, Lim) Department of Plastic Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Oh) Department of Plastic surgery, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
Publisher
Churchill Livingstone
Abstract
Background: Autologous costal cartilage has gained widespread acceptance
as an important material for ear reconstruction in patients with microtia.
Despite its recognition as being "worth the trade-off," attention should
be directed toward donor-site deformities. This systematic review focused
on existing English literature related to microtia reconstruction and
aimed to reveal the incidence of chest wall deformities and assess the
effectiveness of the various proposed surgical techniques aimed at
reducing donor-site morbidities. Method(s): A comprehensive search
was conducted on Pubmed and OVID using the keywords "microtia," and "chest
deformity" or "rib harvest." Articles were screened based on predefined
inclusion and exclusion criteria. Data acquisition encompassed patient
demographics, employed surgical techniques, methods for evaluating chest
deformity, and incidence of associated complications. Result(s):
Among the 362 identified articles, 21 met the inclusion criteria. A total
of 2600 cases involving 2433 patients with microtia were analyzed in this
review. Perichondrium preservation during cartilage harvesting led to a
significant reduction in chest deformities. However, the wide incidence
range (0% to 50%) and the lack of specific assessment methods suggested
potential underestimation. Computed tomography revealed reduced chest wall
growth in the transverse and sagittal directions, resulting in decreased
thoracic area. Innovative surgical techniques have shown promising results
in reducing chest deformities. Conclusion(s): Although a quantitative
analysis was not feasible, objective evidence of deformities was
established through computed tomography scans. This analysis highlighted
the need for dedicated studies with larger sample sizes to further advance
our understanding of chest wall deformities in microtia
reconstruction. Copyright © 2024

<31>
Accession Number
644352019
Title
Comparison of Fibrinogen Concentrate and Cryoprecipitate in Children
Undergoing Cardiac Surgery: Final Results of a Pilot Feasibility Trial.
Source
Anesthesia and Analgesia. Conference: Society for the Advancement of
Patient Blood Management 2023 Annual Meeting. Nashville, TN United States.
138(5 Supplement) (pp 47-48), 2024. Date of Publication: May 2024.
Author
Raphael J.; Hostege M.; Fernandez L.; McNaull P.
Institution
(Raphael, Hostege, Fernandez, McNaull) Thomas Jefferson University
Hospital, Philadelphia, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Fibrinogen concentrate has similar hemostatic efficacy as cryoprecipitate
in children undergoing surgery for congenital heart disease. Background
Bleeding after pediatric cardiac surgery is associated with increased
morbidity and mortality. Acquired hypofibrinogenemia is a key factor in
coagulopathy after cardiopulmonary bypass (CPB). While transfusion of
cryoprecipitate is the standard of care for fibrinogen replacement in the
USA, recent guidelines recommend use of fibrinogen concentrate (FC) as an
alternative to cryoprecipitate. A recent large RCT in adult cardiac
surgery patients reported that FC has similar hemostatic efficacy compared
to cryoprecipitate with no increase in thromboembolic events. In pediatric
cardiac surgery, however, data regarding use of FC for post-CPB bleeding
is limited. The current trial is a prospective pilot and feasibility study
to compare FC and cryoprecipitate in pediatric cardiac surgery. The goal
of this study was to enroll children (age <=24 months) with clinically
significant post-CPB bleeding and hypofibrinogenemia to receive
cryoprecipitate or FC for fibrinogen replacement. We report final results
of 31 patients. Conclusion A randomized trial to compare FC and
cryoprecipitate for post-CPB bleeding in children is feasible. This study
suggests that FC has similar efficacy to cryoprecipitate for fibrinogen
supplementation after cardiac surgery in children. These results need to
be reconfirmed in a larger appropriately powered multicenter trial with
standardized patient management and transfusion practices to minimize
blood product use in pediatric patients. Results Between November 2021 and
March 2023, 91 children were screened and 31 (34%) were randomized, of
whom 26 (15 cryoprecipitate and 11 FC) were treated. 5 children randomized
to FC were not treated due to lack of bleeding after CPB (n=3), avoidance
of CPB (n=1) or lack of evidence of hypofibrinogenemia (n=1). Mean age and
weight were 5.5 and 4.8 months and 5.3 kg and 6.3 kg in the
cryoprecipitate and FC groups, respectively. There was no difference in
mean RACHS-1 score between groups, as well as no significant difference in
CPB time, aortic clamp time or rate of DHCA between groups. There was no
difference between groups in exposure to allogeneic blood transfusion
after study product administration as well as no difference in
intraoperative bleeding or 48 hours chest drain output between groups. No
patient required a second dose of study medication or re-exploration.
There were no differences in other secondary outcomes between both groups.
Study Design/Methods After IRB approval and parental informed consent,
patients were randomized to receive cryoprecipitate (8-10 mL/kg) or FC
(Fibryga, Octapharma; 70 mg/kg) for post-CPB bleeding with
hypofibrinogenemia (FIBTEM MCF < 10mm). In the event of continued
bleeding, a second dose of cryoprecipitate or FC was administered
according to randomization group allocation. The primary feasibility
outcome was the percent of patients enrolled. The primary efficacy outcome
was allogeneic blood product transfusion within the first 24 hours after
study product administration. Secondary outcomes included: individual
blood products administration (RBC, platelets, FFP) over the first
postoperative 48 hours and by POD 7, bleeding over the first postoperative
48 hours, surgical re-exploration for bleeding, length of ICU and hospital
stay, thromboembolic events, and a composite of 30-day mortality, acute
kidney injury, stroke, severe myocardial dysfunction or myocardial
infarction and sepsis. Data were reported as mean +/- SD for continuous
variables or percent for categorical variables. Continuous variables were
analyzed using the student's t-test or Mann-Whitney U-test and categorical
variables were analyzed using chi square or Fisher exact test as
appropriate. The primary analysis followed the intention to treat (ITT)
principle.

<32>
Accession Number
644352000
Title
Perioperative Erythropoietic Stimulating Agents is Associated with
Decreased Thrombotic Adverse Events Postoperatively When Compared to
Perioperative Red Blood Cell Transfusion.
Source
Anesthesia and Analgesia. Conference: Society for the Advancement of
Patient Blood Management 2023 Annual Meeting. Nashville, TN United States.
138(5 Supplement) (pp 14-15), 2024. Date of Publication: May 2024.
Author
Choi U.; Nicholson R.; Frank S.; Hensley N.
Institution
(Choi, Nicholson, Frank, Hensley) Department of Anesthesiology and
Critical Care Medicine, Baltimore, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Compared to perioperative RBC transfusions, perioperative ESA reduced
30-day postoperative mortality, VTE, PE, DIC, RBC transfusion risks, and
increased hemoglobin in surgical and cardiovascular surgical patients;
co-administration of iron improved mortality but did not impact
thromboembolic risk. Background Perioperative red blood cell (RBC)
transfusions increase postoperative venous thromboembolic (VTE) events.
Erythropoietic stimulating agents (ESA) increase VTE risk in patients with
cancer. A prior cancer study found that iron co-administration decreases
VTE, but its impact on ESA vs. RBC-associated postoperative VTE risks in a
broader population is unknown. Conclusion Compared to RBC, ESA reduced
30-day postoperative mortality, VTE, PE, DIC, RBC transfusion, and
increased hemoglobin in surgical and cardiovascular surgical patients.
Iron improved mortality but did not impact thromboembolic risk; further
study is needed on iron's impact on postoperative risks. Results When
compared with perioperative RBC transfusion, perioperative ESA without
iron was associated with lower risk of mortality (Risk Ratio (RR) 0.74
[95% Confidence Interval (CI) 0.66-0.84]), VTE (RR 0.51 [0.46-0.58]), PE
(RR 0.39 [0.32-0.47]), DIC (RR 0.35 [0.17-0.71]), RBC transfusion (RR
0.003 [0.002-0.006]), and higher mean hemoglobin (10.10 vs. 9.71 g/dL,
p=0.007) (Table 1). This trend persisted when comparing ESA and iron
administration with perioperative RBC transfusion. When comparing ESA with
and without iron, lack of iron was only associated with mortality increase
(RR 1.38 [1.20-1.59]). Cardiovascular surgical patients receiving ESA were
at lower postoperative risk of mortality (p<0.0001), VTE (p<0.0001), PE
(p<0.0001), DIC (ESA without iron vs. RBC: p=0.008, ESA with iron vs. RBC:
p<0.0001), RBC (p<0.0001). Postoperative hemoglobin level differed between
patients receiving ESA and iron vs. RBC (10.08 vs. 9.62, p<0.0001) but not
between those receiving ESA without iron (10.08 vs. 9.85, p=0.15). Study
Design/Methods A US claims and EHR database (TriNetX Diamond Network) of
213 million patients was queried from 2006 to 2023. We compared patients
aged >=18 diagnosed with iron deficiency anemia (IDA) (ICD-10-CM D50)
within 3 months preoperatively who received perioperative ESA (RxNorm
105694, 283838) with or without iron (VA TN410) but not RBC (ICD-10-PCS
30233P0-1, 30233N0-1, HCPCS P9057, P9021-2, P9038-40, P9016) with patients
who received perioperative RBC but not ESA. We conducted sub-analyses: 1)
all surgeries (CPT 1003143) and 2) cardiovascular surgeries (1006056). We
propensity score matched for age at surgery, ethnicity, race, sex,
overweight and obesity (ICD E66), type 2 diabetes (E11), hyperlipidemia
(E78), essential hypertension (I10), ischemic heart diseases (I20-I25),
neoplasms (C00-D49), nicotine dependence (F17), outpatient (CPT 1013626)
and inpatient (1013659) services, and hemoglobin (9014, g/dL) levels <7,
7-12, and >12 to account for anemia severity. Outcomes included 30-day
postoperative mortality, VTE (ICD-10-CM I82.4, I82.6, I82.90, I82.A1,
I82.B1, I82.C1, I82.890), pulmonary embolism (PE) (I26), disseminated
intravascular coagulation (DIC) (D65), RBC transfusions, and hemoglobin.

<33>
Accession Number
644350741
Title
Effect of concomitant tricuspid annuloplasty on postoperative wound
complications in heart failure patients undergoing mitral valve repair.
Source
International wound journal. 21(5) (pp e14835), 2024. Date of Publication:
01 May 2024.
Author
Hou Y.; Guo L.; Li Y.; Cai J.
Institution
(Hou, Cai) Department of Infectious Diseases, Naval Medical Center, Naval
Medical University, Shanghai, China
(Hou) Department of Second Internal Medicine, Naval Hospital of Eastern
Theater Command, Zhoushan, Zhejiang, China
(Guo) Department of Cardiology, Changde First People's Hospital, Hunan,
China
(Li) Department of Respiratory and Critical Care Medicine, 906rd Hospital,
Joint Logistic Support Force of Chinese People's Liberation Army, Ningbo,
Zhejiang, China
Abstract
Tricuspid valve repair (TVR) combined with mitral valve surgery (MVS) has
been a controversial issue. It is not clear whether the combined surgery
has any influence on the occurrence of postoperative complications. The
aim of this study was to compare the occurrence of complications including
wound infection, wound bleeding, and mortality after MVS combined with or
without TVR. By meta-analysis, a total of 1576 papers were collected from
3 databases, and 7 of them were included. We provided the necessary data
of 7 included studies such as the authors, publication date, country,
surgical approach and case number, patient age, and so on. Statistical
analysis was carried out with RevMan 5.3 software. We found that patients
with heart failure accepting MVS combined with or without TVR, performed
no statistically significant difference in postoperative wound infection
(OR: 0.88; 95% CI: 0.29, 2.62; P = 0.81), wound bleeding (OR: 0.74; 95%
CI: 0.3, 1.48; P = 0.39), and mortality (OR: 1.05; 95% CI: 0.42, 2.61; P =
0.92). In conclusion, current evidence indicated that the combined surgery
had no additional risk of postoperative complications, and might be an
effective alternative surgical approach to mitral valve diseases accompany
with tricuspid regurgitation. However, for the limited case size, it was
required to support the findings with a large number of cases in further
studies. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<34>
Accession Number
2032451999
Title
The Danish-Norwegian randomized trial on beta-blocker therapy after
myocardial infarction: Design, rationale, and baseline characteristics.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(3) (pp
175-183), 2024. Date of Publication: 01 Apr 2024.
Author
Kristensen A.M.D.; Munkhaugen J.; Halvorsen S.; Olsen M.H.; Bakken A.;
Sehested T.S.G.; Ruddox V.; Lange T.; Fagerland M.W.; Torp-Pedersen C.;
Prescott E.; Atar D.
Institution
(Kristensen, Prescott) Department of Cardiology, Copenhagen University
Hospital-Bispebjerg and Frederiksberg, Copenhagen 2000, Denmark
(Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Trust,
Institute of Behavioural Medicine, University of Oslo, Drammen 3004,
Norway
(Halvorsen, Bakken, Atar) Department of Cardiology, Oslo University
Hospital Ulleval, University of Oslo, Oslo 0450, Norway
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Department of Internal Medicine 1, Holbaek Hospital, Holbaek
4300, Denmark
(Sehested) Department of Cardiology, Zealand University Hospital Roskilde,
Roskilde 4000, Denmark
(Lange) Section of Biostatistics, Department of Public Health, University
of Copenhagen, Copenhagen 1353, Denmark
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Oslo
University Hospital, Oslo 0317, Norway
(Torp-Pedersen) Department of Cardiology, Copenhagen University
Hospital-North Zealand Hospital, Hillerod 3400, Denmark
Publisher
Oxford University Press
Abstract
Background and aims: The evidence for beta-blocker therapy after
myocardial infarction (MI) is randomized trials conducted more than 30
years ago, and the continued efficacy has been questioned. Design and
methods: The ongoing Danish (DANBLOCK) and Norwegian (BETAMI) randomized
beta-blocker trials are joined to evaluate the effectiveness and risks of
long-Term beta-blocker therapy after MI. Patients with normal or mildly
reduced left ventricular ejection fraction (LVEF >= 40%) will be
randomized to open-label treatment with beta-blockers or no such therapy.
The event-driven trial will randomize ~5700 patients and continue until
950 primary endpoints have occurred. As of July 2023, 5228 patients have
been randomized. Of the first 4000 patients randomized, median age was 62
years, 79% were men, 48% had a ST-segment elevation myocardial infarction
(STEMI), and 84% had a normal LVEF. The primary endpoint is a composite of
adjudicated recurrent MI, incident heart failure (HF), coronary
revascularization, ischaemic stroke, all-cause mortality, malignant
ventricular arrhythmia, or resuscitated cardiac arrest. The primary safety
endpoint includes a composite of recurrent MI, HF, all-cause mortality,
malignant ventricular arrhythmia, or resuscitated cardiac arrest 30 days
after randomization. Secondary endpoints include each of the components of
the primary endpoint, patient-reported outcomes, and other clinical
outcomes linked to beta-blocker therapy. The primary analysis will be
conducted according to the intention-To-Treat principle using a Cox
proportional hazards regression model. End of follow-up is expected in
December 2024. Conclusion(s): The combined BETAMI-DANBLOCK trial will
have the potential to affect current clinical practice for beta-blocker
therapy in patients with normal or mildly reduced LVEF after
MI. Copyright © 2023 The Author(s).

<35>
Accession Number
2029407190
Title
Ultrasound-guided erector spinae plane block in posterior lumbar surgery
(Review).
Source
Biomedical Reports. 20(6) (no pagination), 2024. Article Number: 95. Date
of Publication: 2024.
Author
Deng K.; Huang K.; Wu G.-F.
Institution
(Deng, Huang) Department of Orthopedics, The First Affiliated Hospital of
Yangtze University, Hubei, Jingzhou 434300, China
(Wu) Department of Orthopedics, Southern University of Science and
Technology Hospital, Guangdong, Shenzhen 518052, China
Publisher
Spandidos Publications
Abstract
The erector spinae plane block (ESPB) is a novel fascial planar block
technique, which is used to reduce postoperative pain in several surgical
procedures, including breast, thoracic, spine and hip surgery. Due to its
recognizable anatomy and low complication rate, the application of ESPB
has been significantly increased. However, it is rarely used in clinical
practice for postoperative analgesia after posterior lumbar spine surgery,
while the choice of adjuvant drugs, block levels and drug doses remain
controversial. Based on the current literature review, ropivacaine and
dexmedetomidine could be considered as the best available drug
combination. The present review aimed to analyze the currently available
clinical evidence and summarize the benefits and challenges of ESPB in
spinal surgery, thus providing novel insights into the application of ESPB
in the postoperative management of posterior lumbar surgery. Copyright
© 2024 Deng et al.

<36>
Accession Number
2032463661
Title
Randomized Trial of Remote Assessment of Patients After an Acute Coronary
Syndrome.
Source
Journal of the American College of Cardiology. 83(23) (pp 2250-2259),
2024. Date of Publication: 11 Jun 2024.
Author
Alshahrani N.S.; Hartley A.; Howard J.; Hajhosseiny R.; Khawaja S.;
Seligman H.; Akbari T.; Alharbi B.A.; Bassett P.; Al-Lamee R.; Francis D.;
Kaura A.; Kelshiker M.A.; Peters N.S.; Khamis R.
Institution
(Alshahrani, Hartley, Howard, Hajhosseiny, Alharbi, Al-Lamee, Francis,
Kaura, Kelshiker, Peters, Khamis) National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Alshahrani, Alharbi) King Khalid University, Abha, Saudi Arabia
(Hartley, Howard, Hajhosseiny, Khawaja, Seligman, Akbari, Al-Lamee,
Francis, Kaura, Kelshiker, Peters, Khamis) Imperial College Healthcare NHS
Trust, London, United Kingdom
(Bassett) Statsconsultancy Ltd, Buckinghamshire, Amersham, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Telemedicine programs can provide remote diagnostic
information to aid clinical decisions that could optimize care and reduce
unplanned readmissions post-acute coronary syndrome (ACS).
 Objective(s): TELE-ACS (Remote Acute Assessment of Patients With High
Cardiovascular Risk Post-Acute Coronary Syndrome) is a randomized
controlled trial that aims to compare a telemedicine-based approach vs
standard care in patients following ACS. Method(s): Patients were
suitable for inclusion with at least 1 cardiovascular risk factor and
presenting with ACS and were randomized (1:1) before discharge. The
primary outcome was time to first readmission at 6 months. Secondary
outcomes included emergency department (ED) visits, major adverse
cardiovascular events, and patient-reported symptoms. The primary analysis
was performed according to intention to treat. Result(s): A total of
337 patients were randomized from January 2022 to April 2023, with a 3.6%
drop-out rate. The mean age was 58.1 years. There was a reduced rate of
readmission over 6 months (HR: 0.24; 95% CI: 0.13-0.44; P < 0.001) and ED
attendance (HR: 0.59; 95% CI: 0.40-0.89) in the telemedicine arm, and
fewer unplanned coronary revascularizations (3% in telemedicine arm vs 9%
in standard therapy arm). The occurrence of chest pain (9% vs 24%),
breathlessness (21% vs 39%), and dizziness (6% vs 18%) at 6 months was
lower in the telemedicine group. Conclusion(s): The TELE-ACS study
has shown that a telemedicine-based approach for the management of
patients following ACS was associated with a reduction in hospital
readmission, ED visits, unplanned coronary revascularization, and
patient-reported symptoms. (Telemedicine in High-Risk Cardiovascular
Patients Post-ACS [TELE-ACS]; NCT05015634) Copyright © 2024
American College of Cardiology Foundation

<37>
Accession Number
2032361328
Title
Cardiac Devices and Kidney Disease.
Source
Seminars in Nephrology. (no pagination), 2024. Article Number: 151513.
Date of Publication: 2024.
Author
Walther C.P.
Institution
(Walther) Selzman Institute for Kidney Health, Section of Nephrology,
Department of Medicine, Baylor College of Medicine, Houston, TX
Publisher
W.B. Saunders
Abstract
A growing variety of cardiac devices are available to monitor or support
cardiovascular function. The entwined nature of cardiovascular disease and
kidney disease makes the relationship of these devices with kidney disease
a multifaceted question relating to the use of these devices in
individuals with kidney disease and to the effects of the devices and
device placement on kidney health. Cardiac devices can be categorized
broadly into cardiac implantable electronic devices, structural devices,
and circulatory assist devices. Cardiac implantable electronic devices
include devices for monitoring and managing cardiac electrical activity
and devices for monitoring hemodynamics. Structural devices modify cardiac
structure and include valve prostheses, valve repair clips, devices for
treating atrial septal abnormalities, left atrial appendage closure
devices, and interatrial shunt devices. Circulatory assist devices support
the failing heart or support cardiac function during high-risk cardiac
procedures. Evidence for the use of these devices in individuals with
kidney disease, effects of the devices on kidney health and function,
specific considerations with devices in kidney disease, and important
knowledge gaps are surveyed in this article. With the growing prevalence
of combined cardiorenal disease and the increasing variety of cardiac
devices, kidney disease considerations are an important aspect of device
therapy. Copyright © 2024 Elsevier Inc.

<38>
Accession Number
2032344775
Title
Benefits of using a support bra in women undergoing coronary artery bypass
graft surgery: A randomized trial.
Source
Clinics. 79 (no pagination), 2024. Article Number: 100370. Date of
Publication: 01 Jan 2024.
Author
Silva T.R.D.A.; Ono J.N.; Miname F.C.B.R.; Gowdak L.H.W.; Mioto B.M.;
Santos R.B.D.; Dallan L.R.P.; Machado Cesar L.A.
Institution
(Silva, Ono, Miname, Gowdak, Mioto, Santos, Dallan, Machado Cesar)
Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de Sao
Paulo (FMUSP), SP, Sao Paulo, Brazil
Publisher
Universidade de Sao Paulo. Museu de Zoologia
Abstract
Background: Approximately 30 % of cardiac surgeries are conducted on women
by median sternotomy, which often causes discomfort such as pain, affects
quality of life, and delayed recovery compared with men. Breast size is
related to operative wound complications, such as incisional pain, sternum
dehiscence, and infection, which may affect hospital costs due to
prolonged hospital stays. Objective(s): To evaluate breast size and
operative wound complications and the effect of breast support on the
incidence of pain, infection, and quality of life in women after coronary
artery bypass grafting. Method(s): Women were randomly assigned to
one of three groups: group A (surgical breast support), group B (ordinary
breast support), and group C (no-support). Observations were taken daily
between the second and seventh postoperative days and at 30, 60, and 180
days. Pain was assessed using the Short-Form 36 Health Survey (SF36) for
quality of life and a verbal numerical scale. The authors used the
nonparametric Kruskal-Wallis and Friedman tests to examine variance. The
authors used the Pearson correlation coefficient or the Spearman
correlation for correlations between variables. A multivariate study was
conducted to evaluate the occurrence of infection, and the logistic
regression model with "stepwise" variable selection was used. A linear
regression model with the "stepwise" variable selection was also used for
hospitalization. The authors used SPSS 17.0 software for Windows, with a
significance level of p < 0.05. Result(s): There was no difference in
pain evaluation between the groups in 190 women (p > 0.05). When comparing
quality of life, there was a statistically significant difference in the
functional capacity domain at 30 and 60 days, with group A having the best
functional capacity (p < 0.05). The larger the breast size, the longer the
hospital stay (p < 0.001) and the higher the probability of infection (p =
0.032). Patients with a history of stroke had a 3.8 higher incidence of
infection (p = 0.040). Conclusion(s): The use of surgical support did
not affect acute pain or sternal infection rate in the 6-month follow-up.
However, it was effective in the functional capacity domain 30 days after
surgery and maintained at 60 days. Copyright © 2024 HCFMUSP

<39>
Accession Number
2032196061
Title
A COMPARISON BETWEEN 2 DIFFERENT PROPORTIONS OF KETAMINE-PROPOFOL AND
PROPOFOL-FENTANYL FOR PROCEDURAL SEDATION AND ANALGESIA FOR MINOR
GYNAECOLOGICAL PROCEDURES: A PROSPECTIVE RANDOMIZED CONTROL TRIAL.
Source
International Journal of Academic Medicine and Pharmacy. 6(2) (pp
756-760), 2024. Date of Publication: 2024.
Author
Somanathan R.M.; Arul J.; Shahul Hameed K.
Institution
(Somanathan, Arul, Shahul Hameed) Government Stanley Medical College,
Chennai, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Procedural Sedation and Analgesia (PSA) involves a reduction
in patient's degree of awareness while maintaining airway control and
haemodynamics at the same time. This study aims to compare
Ketamine-Propofol and Propofol-Fentanyl for Procedural Sedation in minor
gynaecological procedures. Aim and objectives: To study the duration and
level of sedation, hemodynamic and respiratory profiles, quality of
analgesia of Ketamine-Propofol and Propofol-Fentanyl for Procedural
Sedation in minor gynaecological procedures. Material(s) and
Method(s): Three groups of thirty patients were selected and allotted into
three groups. Group 1- Received ketamine-propofol intravenously (IV) in
ratio of 1:1. Group 2 - Received ketamine-propofol in ratio of 1:2. Group
3 - Received fentanyl-propofol mixture. All the three study drugs were
given till a Ramsay Sedation Score of 5-6 was achieved. Result(s):
Three groups were demographically similar. Duration of surgery was
similar. Heart rate, respiratory rate, systolic and diastolic blood
pressure were similar between the groups. Ramsay sedation score,
EVANS/PRST Score and Wong Bakers pain score were significant at 15 min, at
end of procedure and 15 min after procedure. Conclusion(s): We
conclude that propofol: fentanyl group had better postoperative pain
relief and faster recovery time. Copyright © 2024 Society for
Healthcare and Research Development. All rights reserved.

<40>
Accession Number
2032147337
Title
Efficacy and Safety of Botulinum Toxin Type A for the Prevention of
Postoperative Atrial Fibrillation.
Source
JACC: Clinical Electrophysiology. 10(5) (pp 930-940), 2024. Date of
Publication: May 2024.
Author
Piccini J.P.; Ahlsson A.; Dorian P.; Gillinov A.M.; Kowey P.R.; Mack M.J.;
Milano C.A.; Noiseux N.; Perrault L.P.; Ryan W.; Steinberg J.S.; Voisine
P.; Waldron N.H.; Gleason K.J.; Titanji W.; Leaback R.D.; O'Sullivan A.;
Ferguson W.G.; Benussi S.; Akhter S.A.; Andreas M.; Castella M.;
Dalrymple-Hay M.; El-Eshmawi A.; Groh M.; Hanke T.; Jeanmart H.; Katz M.;
McCullough J.N.; Melby S.; Miller J.; Romano M.A.; Podgoreanu M.V.; Sharma
V.; Shults C.; Teman N.; Whitson B.A.; Wickbom A.; Vallabhajosyula P.; Yau
T.
Institution
(Piccini) Department of Electrophysiology, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Ahlsson) Cardiovascular Division, Karolinska Institute, Stockholm, Sweden
(Dorian) Division of Cardiology, St Michael's Hospital, Toronto, ON,
Canada
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Kowey) Division of Cardiovascular Research, Lankenau Heart Institute,
Wynnewood, PA, United States
(Mack, Ryan) Department of Thoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Milano) Division of Cardiothoracic Surgery, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Noiseux) Division of Cardiac Surgery, Centre Hospitalier de l'Universite
de Montreal, Centre de Recherche du Centre Hospitalier de l'Universite de
Montreal, QC, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Universite de
Montreal, Montreal, Quebec City, QC, Canada
(Steinberg) Clinical Cardiovascular Research Center, University of
Rochester School of Medicine and Dentistry, Rochester, NY, United States
(Voisine) Division of Cardiac Surgery, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, QC, Canada
(Waldron) Department of Anesthesiology and Critical Care, Mayo Clinic,
Jacksonville, FL, United States
(Gleason, Titanji, Leaback, O'Sullivan, Ferguson) AbbVie Inc, North
Chicago, IL, United States
(Benussi) Department of Cardiothoracic Surgery, University of Brescia,
Brescia, Italy
(Akhter) East Carolina University Brody School of Medicine, Greenville,
NC, United States
(Andreas) Medical University of Vienna, Vienna, Austria
(Benussi) University of Brescia, Brescia, Italy
(Castella) Hospital Clinic de Barcelona, Barcelona, Spain
(Dalrymple-Hay) University Hospital Plymouth NHS Trust, Plymouth, United
Kingdom
(El-Eshmawi) Icahn School of Medicine at Mount Sinai - The Mount Sinai
Medical Center, New York, NY, United States
(Groh) Mission Hospital, Asheville, NC, United States
(Hanke) Asklepios Klinik Harburg-Hamburg, Hamburg, Germany
(Jeanmart) CIUSS du NIM site Hopital du Sacre-Coeur de Montreal, Montreal,
Canada
(Katz) Medical University of South Carolina, Charleston, SC, United States
(McCullough) Dartmouth Hitchcock Medical Center, Lebanon, NH, United
States
(Melby) Washington University School of Medicine, St. Louis, MO, United
States
(Miller) Emory St Joseph's Hospital, Atlanta, GA, United States
(Noiseux) Centre Hospitalier de l'Universite de Montreal, Centre de
Recherche du CHUM, QC, Canada
(Romano) University of Michigan Health System, Ann Arbor, MI, United
States
(Perrault) Montreal Heart Institute/ Universite de Montreal, Montreal,
Canada
(Piccini) Duke Clinical Research Institute/Duke University Medical Center,
Durham, NC, United States
(Podgoreanu) Duke University Medical Center, Durham, NC, United States
(Ryan) Baylor Scott & White Health, Dallas, TX, United States
(Sharma) University of Utah Health, Salt Lake City, UT, United States
(Shults) Medstar Heart and Vascular Institute, Washington, DC, United
States
(Teman) University of Virginia, Charlottesville, VA, United States
(Voisine) IUCPQ, QC, Canada
(Whitson) Ohio State University - Davis Heart and Lung Institute,
Columbus, OH, United States
(Wickbom) Orebro University Hospital Sweden, Orebro, Sweden
(Vallabhajosyula) Yale New Haven Hospital, New Haven, CT, United States
(Yau) Toronto General Hospital, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is associated with
increased morbidity and mortality. Epicardial injection of botulinum toxin
may suppress POAF. Objective(s): This study sought to assess the
safety and efficacy of AGN-151607 for the prevention of POAF after cardiac
surgery. Method(s): This phase 2, randomized, placebo-controlled
trial assessed the safety and efficacy of AGN-151607, 125 U and 250 U vs
placebo (1:1:1), for the prevention of POAF after cardiac surgery.
Randomization was stratified by age (<65, >=65 years) and type of surgery
(nonvalvular/valve surgery). The primary endpoint was the occurrence of
continuous AF >=30 seconds. Result(s): Among 312 modified
intention-to-treat participants (placebo, n = 102; 125 U, n = 104; and 250
U, n = 106), the mean age was 66.9 +/- 6.8 years; 17% were female; and 64%
had coronary artery bypass graft (CABG) only, 12% had CABG + valve, and
24% had valve surgery. The primary endpoint occurred in 46.1% of the
placebo group, 36.5% of the 125-U group (relative risk [RR] vs placebo:
0.80; 95% CI: 0.58-1.10; P = 0.16), and 47.2% of the 250-U group (RR vs
placebo: 1.04; 95% CI: 0.79-1.37; P = 0.78). The primary endpoint was
reduced in the 125-U group in those >=65 years of age (RR: 0.64; 95% CI:
0.43-0.94; P = 0.02) with a greater reduction in CABG-only participants
>=65 years of age (RR: 0.49; 95% CI: 0.27-0.87; P = 0.01).
Rehospitalization and rates of adverse events were similar across the 3
groups. Conclusion(s): There were no significant differences in the
rate of POAF with either dose compared with placebo; however, there was a
lower rate of POAF in participants >=65 years undergoing CABG only and
receiving 125 U of AGN-151607. These hypothesis-generating findings
require investigation in a larger, adequately powered randomized clinical
trial. (Botulinum Toxin Type A [AGN-151607] for the Prevention of
Post-operative Atrial Fibrillation in Adult Participants Undergoing
Open-chest Cardiac Surgery [NOVA]; NCT03779841); A Phase 2, Multi-Center,
Randomized, Double-Blind, Placebo-Controlled, Dose Ranging Study to
Evaluate the Efficacy and Safety of Botulinum Toxin Type A [AGN 151607]
Injections into the Epicardial Fat Pads to Prevent Post-Operative Atrial
Fibrillation in Patients Undergoing Open-Chest Cardiac Surgery;
2017-004399-68) Copyright © 2024 American College of Cardiology
Foundation

<41>
Accession Number
2032302083
Title
Computerized clinical decision support to improve stroke prevention
therapy in primary care management of atrial fibrillation: a cluster
randomized trial.
Source
American Heart Journal. 273 (pp 102-110), 2024. Date of Publication: July
2024.
Author
Cox J.; Hamilton L.; Thabane L.; Foster G.; MacKillop J.; Xie F.; Ciaccia
A.; Choudhri S.; Nemis-White J.; Parkash R.
Institution
(Cox, Parkash) Division of Cardiology, Department of Medicine, Dalhousie
University, Halifax, NS, Canada
(Cox) Department of Community Health and Epidemiology, Dalhousie
University, Halifax, NS, Canada
(Hamilton) QEII Health Sciences Centre, Nova Scotia Health Authority,
Halifax, Nova Scotia, Canada
(Thabane, Xie) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Thabane) Departments of Anesthesia/Pediatrics, McMaster University,
Hamilton, ON, Canada
(Thabane) Biostatistics Unit, Centre for Evaluation of Medicine, McMaster
University, Hamilton, ON, Canada
(Thabane) Population Health Research Institute (PHRI), Hamilton Health
Sciences, McMaster University, Hamilton, ON, Canada
(Thabane, Foster) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Foster) Biostatistics Unit, St. Joseph's Healthcare, Hamilton, ON, Canada
(MacKillop) Sydney Primary Care Medical Clinic, Sydney, Nova Scotia,
Canada
(Xie) Centre for Health Economics and Policy Analysis, McMaster
University, Canada
(Ciaccia) Medical Affairs - Cardiovascular Medicine, Bayer Inc,
Mississauga, ON, Canada
(Choudhri) Medical and Scientific Affairs, Bayer Inc, Mississauga, ON,
Canada
(Nemis-White) Strive Health Management Consulting Ltd., Halifax, NS,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Despite guidelines supporting antithrombotic therapy use in
atrial fibrillation (AF), under-prescribing persists. We assessed whether
computerized clinical decision support (CDS) would enable guideline-based
antithrombotic therapy for AF patients in primary care. Method(s):
This cluster randomized trial of CDS versus usual care (UC) recruited
participants from primary care practices across Nova Scotia, following
them for 12 months. The CDS tool calculated bleeding and stroke risk
scores and provided recommendations for using oral anticoagulants (OAC)
per Canadian guidelines. Result(s): From June 14, 2014 to December
15, 2016, 203 primary care providers (99 UC, 104 CDS) with access to
high-speed Internet were recruited, enrolling 1,145 eligible patients (543
UC, 590 CDS) assigned to the same treatment arm as their provider. Patient
mean age was 72.3 years; most were male (350, 64.5% UC, 351, 59.5% CDS)
and from a rural area (298, 54.9% UC, 315, 53.4% CDS). At baseline, a
higher than anticipated proportion of patients were receiving
guideline-based OAC therapy (373, 68.7% UC, 442, 74.9% CDS; relative risk
[RR] 0.97 (95% confidence interval [CI], 0.87-1.07; P = .511)). At 12
months, prescription data were available for 538 usual care and 570 CDS
patients, and significantly more CDS patients were managed according to
guidelines (415, 77.1% UC, 479, 84.0% CDS; RR 1.08 (95% CI, 1.01-1.15; P =
.024)). Conclusion(s): Notwithstanding high baseline rates, primary
care provider access to the CDS over 12 months further optimized the
prescribing of OAC therapy per national guidelines to AF patients
potentially eligible to receive it. This suggests that CDS can be
effective in improving clinical process of care. Trial Registration:
Clinical Trials NCT01927367.
https://clinicaltrials.gov/ct2/show/NCT01927367?term=NCT01927367&draw=2&ra
nk=1 Copyright © 2024 The Authors

<42>
Accession Number
2031045878
Title
Mitral Regurgitation "Proportionality" in Functional Mitral Regurgitation
and Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair: A
Systematic Review and Meta-Analysis.
Source
Structural Heart. 8(3) (no pagination), 2024. Article Number: 100284. Date
of Publication: May 2024.
Author
Moonen A.; Cao J.; Celermajer D.S.; Ng M.K.C.
Institution
(Moonen, Cao, Celermajer, Ng) Faculty of Medicine, University of Sydney,
Sydney, NSW, Australia
(Cao) Department of Cardiology, St Vincent's Hospital, Sydney, NSW,
Australia
(Celermajer, Ng) Department of Cardiology, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
(Celermajer, Ng) Heart Research Institute, Sydney, NSW, Australia
Publisher
Cardiovascular Research Foundation
Abstract
Background: Certain patients with functional mitral regurgitation survive
longer with fewer heart failure hospitalizations after undergoing
transcatheter edge-to-edge repair (TEER); however, clinical markers
identifying who will benefit have not been established. The
'proportionality' of mitral regurgitation (MR) severity compared to left
ventricular size has been hypothesized to predict clinical outcome.
 Method(s): We sought to combine existing studies to compare outcomes
between 'proportionate' MR and 'disproportionate' MR in patients
undergoing TEER. PubMed and Medline were searched from January 2018 until
May 2023. Data was extracted and synthesized by 2 independent authors
using random effects models with risk ratios (RRs) for binary outcomes.
The primary outcome was a combined endpoint of all-cause mortality or
heart failure hospitalization (ACM/HFH). Other outcomes of interest
included ACM and residual >2+ MR after TEER. Result(s): Six trials
with a total of 1594 patients (mean age 71 years, 66% male) were included,
which assessed MR proportionality using either a ratio of estimated
regurgitant orifice area to left ventricular end-diastolic volume
(EROA:LVEDV) or regurgitant fraction. Seven hundred and five (mean age 70
years, 75% male) were classified as proportionate MR, and 889 (mean age 72
years, 60% male) had disproportionate MR. There was no significant
association between MR proportionality (by EROA:LVEDV) and ACM (RR 0.79,
95% confidence interval [CI] 0.44-1.42). Proportionality did not
significantly associate with ACM/HFH, though there were divergent effect
signals when proportionality was measured by EROA:LVEDV (RR 0.80, 95% CI
0.45-1.44) or regurgitant fraction (RR 1.48, 95% CI 0.53-4.11).
Disproportionate MR showed a greater association with residual MR > 2+
post-TEER that did not meet statistical significance (RR 1.86, 95% CI
0.77-4.49). Conclusion(s): In patients undergoing TEER for functional
mitral regurgitation, MR proportionality was not significantly associated
with ACM/HFH, all-cause mortality, or residual MR. Copyright ©
2024

<43>
Accession Number
2029885667
Title
Prognostic value of elevated lipoprotein (a) in patients with acute
coronary syndromes: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1362893. Date of Publication: 2024.
Author
Wang G.; Xia M.; Liang C.; Pu F.; Liu S.; Jia D.
Institution
(Wang, Xia, Liang, Pu) The Clinical College of North Sichuan Medical
College, Sichuan, Nanchong, China
(Liu, Jia) Department of General Practice, Sichuan Mianyang 404 Hospital,
The Second Affiliated Hospital of North Sichuan Medical College, Sichuan,
Mianyang, China
Publisher
Frontiers Media SA
Abstract
Background: Elevated lipoprotein (a) level was recognized as an
independent risk factor for significant adverse cardiovascular events in
acute coronary syndrome (ACS) patients. Despite this recognition, the
consensus in the literature regarding the prognostic significance of
elevated lipoprotein (a) in ACS was also limited. Consequently, we
conducted a thorough systematic review and meta-analysis to evaluate the
prognostic relevance of elevated lipoprotein (a) level in individuals
diagnosed with ACS. Methods and Results: A thorough literature review
was conducted by systematically searching PubMed, Embase, and Cochrane
databases until September 2023. This review specifically examined cohort
studies exploring the prognostic implications of elevated lipoprotein (a)
level in relation to major adverse cardiovascular events (MACE), including
death, stroke, non-fatal myocardial infarction (MI), and coronary
revascularization, in patients with ACS. The meta-analysis utilized
aggregated multivariable hazard ratios (HR) and their respective 95%
confidence intervals (CI) to evaluate prognostic implications between high
and low lipoprotein (a) levels [the cut-off of high lipoprotein (a) level
varies from 12.5 to 60 mg/dl]. Among 18,168 patients in the identified
studies, elevated lipoprotein (a) was independently associated with
increased MACE risk (HR 1.26; 95% CI: 1.17-1.35, P < 0.00001) and
all-cause mortality (HR 1.36; 95% CI: 1.05-1.76, P = 0.02) in ACS
patients. In summary, elevated lipoprotein (a) levels independently
forecast MACE and all-cause mortality in ACS patients. Assessing
lipoprotein (a) levels appears promising for risk stratification in ACS,
offering valuable insights for tailoring secondary prevention strategies.
Systematic Review Registration: PROSPERO (CRD42023476543). Copyright
2024 Wang, Xia, Liang, Pu, Liu and Jia.

<44>
Accession Number
2029870059
Title
Global prevalence of sexual dysfunction in cardiovascular patients: a
systematic review and meta-analysis.
Source
Systematic Reviews. 13(1) (no pagination), 2024. Article Number: 136. Date
of Publication: December 2024.
Author
Ziapour A.; Kazeminia M.; Rouzbahani M.; Bakhshi S.; Montazeri N.;
Yildirim M.; Tadbiri H.; Moradi F.; Janjani P.
Institution
(Ziapour, Rouzbahani, Bakhshi, Montazeri, Moradi, Janjani) Cardiovascular
Research Center, Health Institute, Imam-Ali Hospital, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Kazeminia) Student Research Committee, Kermanshah University of Medical
Sciences, Kermanshah, Iran, Islamic Republic of
(Yildirim) Department of Psychology, Faculty of Science and Letters, Agri
Ibrahim Cecen University, Agri, Turkey
(Yildirim) Graduate Studies and Research, Lebanese American University,
Beirut, Lebanon
(Tadbiri) Islamic Azad University, Tehran Medical Branch, Tehran, Iran,
Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Sexual dysfunction poses a significant challenge for patients
with cardiac conditions. Concerning the prevalence of sexual disorders in
cardiovascular patients, several seminal studies conducted in various
regions of the world have provided diverse facts and figures pertaining to
sexual dysfunction among cardiovascular patients. Therefore, the present
study aimed to analyze, summarize, and integrate the findings of seminal
studies on the effect of underlying factors and estimate the global rate
of sexual disorders in cardiovascular patients. Method(s): The
present systematic review and meta-analysis included studies conducted in
2003-2023. To find the relevant published academic papers, SID, MagIran,
PubMed, Scopus, Web of Science (WOS), and Google Scholar databases were
searched for keywords using MeSH/Emtree until January 14, 2023. The
GRADEpro software was used to evaluate the quality of evidence. The
heterogeneity of studies was checked using the I2 index. Result(s):
An initial number of 2122 studies were found in the first search.
Following a precise screening process based on predefined inclusion
criteria, a total of 17 studies were deemed suitable for inclusion in the
meta-analysis. The global prevalence of sexual disorders in cardiovascular
patients was estimated at 62.6% (95% CI: 49.8-73.8%). As the results of
the meta-regression showed that as the sample size increased, there was a
significant decrease in the overall prevalence of sexual disorders among
cardiovascular patients. Additionally, as the study years progressed, both
age and JBI score exhibited an upward trend. Conclusion(s): The
present findings showed a high prevalence of sexual disorders among
cardiovascular patients. Therefore, it is recommended that experts and
health policymakers enhance their focus on effectively preventing and
controlling these disorders. Besides the evidence achieved very low
certainty, it is important for the treatment team to prioritize the sexual
relations of cardiovascular patients and focus on improving their sexual
function. This should be seen as an essential aspect of their overall
recovery process. Copyright © The Author(s) 2024.

<45>
Accession Number
2029420448
Title
Effectiveness of preoperative and perioperative pulmonarrehabilitation
nursing program for the management of patients undergoing thoracic
surgery: A systematic review and meta-analysis.
Source
Pakistan Journal of Medical Sciences. 40(6) (pp 1280-1286), 2024. Date of
Publication: July 2024.
Author
Xu M.; Yang X.; Guo L.
Institution
(Xu, Yang, Guo) Department of Thoracic Surgery, Shanghai Pulmonary
Hospital, 507 Zhengmin Road, Shanghai 200439, China
Publisher
Professional Medical Publications
Abstract
Background & Objective: Several studies have investigated the
effectiveness of preoperative or perioperative pulmonary rehabilitation in
thoracic surgery patients, but the results are inconsistent and
inconclusive. This study attempts to summarize the existing data on the
effect of the preoperative and perioperative pulmonary rehabilitation
nursing program for the management of patients undergoing thoracic
surgery. Method(s): Systematic search was done in PubMed Central,
SCOPUS, EMBASE, MEDLINE, Google Scholar, and ScienceDirect for papers
published until December 2022 and reporting data of postoperative
complications and pulmonary health status in patients undergoing thoracic
surgery and receiving preoperative or perioperative pulmonary
rehabilitation nursing intervention or standard care. Meta-analysis was
done by random-effects model and pooled standardised mean differences
(SMD) or odds ratios (OR) along with 95% confidence intervals (CIs) were
reported. Result(s): Eighteen studies were included and analysed.
Pooled SMD was 0.44 (95%CI:-0.21 to 1.08) for forced expiratory volume
(FEV-1),-0.34 (95%CI:-0.94 to 0.26) for peak expiratory flow (PEF), 0.61
(95%CI:-0.60 to 1.81) for forced vital capacity (FVC), 0.42 (95%CI:-0.13
to 0.98) for diffusing capacity of carbon monoxide (DLCO). Pooled SMD for
length of hospital stay was-0.64 (95%CI:-1.09 to-0.19). Pooled OR was 0.87
[95%CI: 0.32 to 2.37] for all-cause mortality, 0.35 [95%CI: 0.25 to 0.50]
for postoperative pulmonary complications, 0.98 [95%CI: 0.45 to 2.12] for
respiratory failure, 0.52 [95%CI: 0.38 to 0.78] for pneumonia and 0.50
[95%CI: 0.33 to 0.76] for atelectasis. Conclusion(s): Perioperative
pulmonary rehabilitation nursing program is effective in reducing the
postoperative lung complications and shortening the length of hospital
stay in patients undergoing thoracic surgery. Copyright © 2024,
Professional Medical Publications. All rights reserved.

<46>
Accession Number
2028390179
Title
Neurodevelopment outcomes in the first 5 years of the life of children
with transposition of the great arteries surgically corrected in the
neonatal period: Systematic review and meta-analysis.
Source
Cardiology in the Young. 33(12) (pp 2471-2480), 2023. Date of Publication:
15 Dec 2023.
Author
Soares C.; Vieira R.J.; Costa S.; Moita R.; Andrade M.; Guimaraes H.
Institution
(Soares, Costa, Guimaraes) Faculty of Medicine, Porto University, Porto,
Portugal
(Vieira) Department of Community Medicine, Information and Health Decision
Sciences (MEDCIDS), Faculty of Medicine of Porto University, Porto,
Portugal
(Vieira) Centre for Health Technology and Services Research, Health
Research Network (CINTESIS@RISE), Faculty of Medicine of Porto University,
Porto, Portugal
(Costa, Moita) Neonatology Department, Centro Hospitalar Universitario Sao
Joao, Porto, Portugal
(Andrade) Pediatrics Department, Centro Hospitalar Universitario Sao Joao,
Porto, Portugal
Publisher
Cambridge University Press
Abstract
Congenital Heart Defects are the most common abnormalities at birth,
resulting in many short- and long-term consequences. Objective(s): In
patients with transposition of the great arteries, surgical correction may
achieve definitive treatment, so a thorough knowledge of the long-term
outcomes, particularly neurodevelopment outcomes, is essential. Therefore,
we conducted a systematic review and meta-analysis to study the
neurodevelopment outcomes in the first 5 years of the life of children
submitted to corrective surgery for transposition of the great arteries in
the neonatal period. Method(s): A total of 17 studies from 18 reports
were included, assessing 809 individuals with surgically corrected
transposition of the great arteries. The neurodevelopmental outcomes were
assessed with the Bayley Scales of Infant and Toddler Development (BSID)
and the Wechsler Intelligence Scale for Children (WISC). Result(s):
Mean Mental Development Index (MDI) and Psychomotor Development Index
(PDI) were within the average values from 1 to 3 years of age, although
the proportion of children scoring more than 1 standard deviation below
the mean in PDI, MDI, motor, and language composite scores was
significantly higher than in the general population. From 4 to 5 years,
mean full-scale global intelligence quotient (IQ), verbal IQ, and
performance IQ scores did not differ significantly from the general
population. Conclusion(s): This study revealed neurodevelopment
scores within the normal range at 5 years of age in children submitted to
corrective surgery for transposition of the great arteries in the neonatal
period. However, these early outcomes may not adequately predict long-term
outcomes. Further studies are needed to identify specific risk factors and
early markers of later impairment to guide the establishment of early
interventions. Copyright © The Author(s), 2023. Published by
Cambridge University Press.

<47>
Accession Number
2029904734
Title
Computed tomography imaging in preprocedural planning of transcatheter
valvular heart interventions.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2024.
Date of Publication: 2024.
Author
Lopes V.; Almeida P.C.; Moreira N.; Ferreira L.A.; Teixeira R.; Donato P.;
Goncalves L.
Institution
(Lopes, Moreira, Teixeira, Goncalves) Cardiology Department, Hospitais da
Universidade de Coimbra, Unidade Local de Saude de Coimbra, Coimbra,
Portugal
(Almeida, Ferreira, Donato) Medical Imaging Department, Hospitais da
Universidade de Coimbra, Unidade Local de Saude de Coimbra, Coimbra,
Portugal
(Teixeira, Donato, Goncalves) Faculty of Medicine, Univ Coimbra, Coimbra,
Portugal
(Donato) Univ Coimbra, Coimbra Institute for Biomedical Imaging and
Translation Research (CIBIT), Coimbra, Portugal
(Donato, Goncalves) Clinical Academic Center of Coimbra (CACC), Coimbra,
Portugal
(Goncalves) Coimbra Institute for Clinical and Biomedical Research (iCBR),
Faculty of Medicine, Univ Coimbra, Coimbra, Portugal
(Goncalves) Center for Innovative Biomedicine and Biotechnology (CIBB),
Univ Coimbra, Coimbra, Portugal
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiac Computed Tomography (CCT) has become a reliable imaging modality
in cardiology providing robust information on the morphology and structure
of the heart with high temporal and isotropic spatial resolution. For the
past decade, there has been a paradigm shift in the management of valvular
heart disease since previously unfavorable candidates for surgery are now
provided with less-invasive interventions. Transcatheter heart valve
interventions provide a real alternative to medical and surgical
management and are often the only treatment option for valvular heart
disease patients. Successful transcatheter valve interventions rely on
comprehensive multimodality imaging assessment. CCT is the mainstay
imaging technique for preprocedural planning of these interventions. CCT
is critical in guiding patient selection, choice of procedural access,
device selection, procedural guidance, as well as allowing postprocedural
follow-up of complications. This article aims to review the current
evidence of the role of CCT in the preprocedural planning of patients
undergoing transcatheter valvular interventions. Graphical Abstract:
(Figure presented.) Copyright © The Author(s), under exclusive
licence to Springer Nature B.V. 2024.

<48>
Accession Number
2029879439
Title
The efficacy and safety of sodium-glucose cotransporter-2 inhibitors in
solid organ transplant recipients: A scoping review.
Source
Pharmacotherapy. (no pagination), 2024. Date of Publication: 2024.
Author
Mreyoud H.; Walter K.; Wilpula E.; Park J.M.
Institution
(Mreyoud, Walter, Wilpula, Park) Michigan Medicine, Ann Arbor, MI, United
States
(Park) College of Pharmacy, University of Michigan, Ann Arbor, MI, United
States
Publisher
American College of Clinical Pharmacy
Abstract
Sodium glucose co-transporter 2 (SGLT2) inhibitors are used for the
treatment of diabetes and for their cardiovascular and kidney benefits in
patients with or without diabetes. Use in solid organ transplant
recipients is controversial because transplant recipients were excluded
from the major clinical trials assessing SGLT2 inhibitors. The goal of
this review was to assess the available literature regarding the use of
SGLT2 inhibitors in solid organ transplant recipients. A PubMed search was
conducted for studies published in English through December 31, 2023.
Studies were excluded if they were meta-analyses, review articles,
commentaries, single case reports, or in vitro studies, or did not involve
the use of SGLT2 inhibitors in solid organ transplant recipients with a
diabetic, cardiovascular, or kidney outcome being assessed. In the final
review, 20 studies were included: kidney (n = 15), heart (n = 4), and
liver/lung/kidney (n = 1) transplant recipients. SGLT2 inhibitors had
similar A1c reduction efficacy and were found to be weight neutral with
possible weight reduction effects. Cardiovascular and kidney outcomes were
not adequately assessed in the available studies. Adverse effects were
reported to occur at a similar rate in transplant recipients compared to
the general population. SGLT2 inhibitors were initiated >=1-year
post-transplant in most transplant recipients included in these studies.
The overall safety and antihyperglycemic efficacy of SGLT2 inhibitors in
kidney and heart transplant recipients is similar to the general
population. Data assessing SGLT2 inhibitors use in solid organ transplant
recipients for longer durations are needed. Copyright © 2024 The
Author(s). Pharmacotherapy: The Journal of Human Pharmacology and Drug
Therapy published by Wiley Periodicals LLC on behalf of Pharmacotherapy
Publications, Inc.

<49>
Accession Number
2029463605
Title
Balloon pulmonary valvuloplasty: A systematic review.
Source
Indian Heart Journal. 76(2) (pp 86-93), 2024. Date of Publication: 01 Mar
2024.
Author
Rao P.S.
Institution
(Rao) Children's Heart Institute, University of Texas-Houston McGovern
Medical School, Children's Memorial Hermann Hospital, Houston, TX, United
States
Publisher
Elsevier B.V.
Abstract
There is conclusive evidence for relief of pulmonary valve obstruction
immediately after balloon pulmonary valvuloplasty (BPV) and at follow-up.
Development of infundibular obstruction is seen in more severe PS cases
and in older subjects. Reappearance of PS was observed in approximately 10
% of patients following BPV. The reasons for recurrence were found to be
balloon/annulus ratio less than 1.2 and immediate post-BPV pulmonary valve
peak gradients greater than 30 mmHg. Recurrent stenosis is successfully
addressed by repeating BPV with lager balloons than used initially.
Long-term results revealed continue relief of obstruction, but with
development of pulmonary insufficiency, some patients requiring
replacement of the pulmonary valve. It was concluded that BPV is the
treatment of choice in the management valvar PS and that balloon/annuls
ratio used for BPV should be lowered to 1.2 to 1.25. It was also suggested
that strategies should be developed to prevent/reduce pulmonary
insufficiency at long-term follow-up. Copyright © 2023
Cardiological Society of India

<50>
Accession Number
644331563
Title
The Use of AI in Pediatric Congenital Heart Disease: How Far Have We
Come?.
Source
Journal of Clinical and Translational Science. Conference: Association for
Clinical and Translational Science 2024. Las Vegas, NV United States.
8(Supplement 1) (pp 99), 2024. Date of Publication: April 2024.
Author
Venna A.; Mehta R.; Reitz J.; Briscoe J.; D'Udekem Y.
Institution
(Venna, Mehta, Reitz, Briscoe, D'Udekem) Children's National Hospital,
United States
Publisher
Cambridge University Press
Abstract
OBJECTIVES/GOALS: Artificial Intelligence (AI) is gaining popularity in a
variety of disciplines. While clinical applications for AI have increased
in recent years, the use of AI in pediatric congenital heart disease (CHD)
is limited. The goal of this systematic review was to assess how AI is
currently used in this patient population and to describe knowledge gaps.
METHODS/STUDY POPULATION: A systematic search was performed up to July
2023 using PubMed and Scopus databases and revealed 814 articles. Upon
initial screening, 161 duplicates, 76 non-AI articles, and an additional
318 irrelevant articles were removed. A total of 259 full-text articles
were reviewed for relevance. Articles that did not include a retrospective
or prospective review of human subject data were excluded. Articles that
had only results in the adult, prenatal, or non-CHD population were
excluded. The remaining 68 articles were included in this review.
RESULTS/ANTICIPATED RESULTS: Of the 68 articles in this review, 19 were
performed within cardiac surgery, 41 were within cardiology, and the
remaining 8 included articles were combined cardiac surgery and
cardiology. Upon initial review, 24 used AI for diagnostic purposes, 40
for predicting survival or adverse outcomes, 2 for developing training
tools, and 2 for surveillance of CHD trends. We anticipate that upon
further review of these 68 articles, there will be a wide variety in the
types of AI models that were used. The results will reveal a multitude of
challenges and limitations that future studies will need to further
address. DISCUSSION/SIGNIFICANCE: While technical innovations in pediatric
CHD have dramatically improved survival rates, we have hit a plateau in
improving the complications of these patients. AI has created an
opportunity to build new diagnostic, predictive, teaching, and
surveillance tools for advancing CHD care, but it seems we still have a
long way to go.

<51>
Accession Number
2032464308
Title
Rationale and design of a single-center randomized trial to compare the
graft patency between the radial artery and the no-touch saphenous vein in
coronary artery bypass grafting surgery (GRAFT-CAB Study).
Source
American Heart Journal. 274 (pp 46-53), 2024. Date of Publication: August
2024.
Author
Zhang F.; Tian M.; Zhang H.; Zhou X.; Liu R.; Jin Z.; Zhang C.; Wang X.
Institution
(Zhang, Tian, Wang, Zhang, Zhou, Liu, Liu, Jin, Zhang, Wang) Department of
Surgery, National Center for Cardiovascular Disease, China and Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
Publisher
Elsevier Inc.
Abstract
Background: Previous studies suggested only the radial artery and the
No-touch (NT) technique were effective in reducing graft occlusion after
coronary artery bypass grafting (CABG) surgery. However, there is no
randomized trial comparing these 2 graft conduits. The optimum second
conduit for CABG remains undetermined. Material(s) and Method(s):
This study is a prospective, single-center randomized clinical trial,
aiming to compare the graft patency between the radial artery and the NT
vein graft. All patients undergoing isolated CABG with left internal
mammary artery (LIMA) plus at least 2 additional grafts will be considered
eligible. About 774 cases (516 in the radial artery group and 258 in the
NT vein group) will be enrolled in over 1 to 2 years. Participants will be
randomized and allocated to two bypass strategies: the LIMA plus 1 radial
artery and 1 conventional vein graft, or the LIMA plus 2 NT vein grafts.
The primary outcome is graft occlusion at 1 year after CABG evaluated by
CT angiography. The secondary outcomes include graft occlusion at 3 and 5
years and major adverse cardiac or cerebrovascular events at 1, 3, and 5
years follow-ups. Discussion(s): This study will define whether or
not the NT vein has a lower graft occlusion rate than the radial artery in
short and mid-term follow-ups, and provide new evidence for the second
conduit choice in CABG surgery. Trial registration: ClinicalTrials.gov
NCT06014047. Registered on October 15th, 2023. Copyright © 2024

<52>
Accession Number
2032455877
Title
Perioperative management and outcomes in patients receiving low-dose
rivaroxaban and/or aspirin: a subanalysis of the Cardiovascular Outcomes
for People Using Anticoagulation Strategies (COMPASS) trial.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2024. Date of
Publication: 2024.
Author
Douketis J.D.; Yi Q.; Bhatt D.L.; Muehlhofer E.; Wang M.K.; Connolly S.;
Yusuf S.; Maggioni A.P.; Eikelboom J.W.
Institution
(Douketis, Wang, Connolly, Eikelboom) Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Douketis, Eikelboom) Thrombosis and Atherosclerosis Research Institute,
McMaster University, Hamilton, ON, Canada
(Yi, Eikelboom) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(Bhatt, Wang, Connolly, Yusuf) Mt. Sinai Fuster Heart Hospital, Icahn
School of Medicine at Mt. Sinai, New York, NY, United States
(Muehlhofer) Bayer AG Research & Development, Wuppertal, Germany
(Maggioni) Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy
Publisher
Elsevier B.V.
Abstract
Background: No study has investigated the perioperative management and
clinical outcomes in patients who are receiving rivaroxaban 2.5 mg twice a
day and acetylsalicylic acid (ASA) 81 to 100 mg daily. Objective(s):
To assess perioperative management and outcomes in patients who are
receiving low-dose rivaroxaban, 2.5 mg twice-daily, and low-dose ASA, 81
to 100 mg daily. To assess perioperative management and outcomes in
patients who are receiving low-dose rivaroxaban, 2.5 mg twice-daily, and
low-dose ASA, 81 to 100 mg daily. Method(s): Subanalysis of the
Cardiovascular Outcomes for People Using Anticoagulation Strategies
(COMPASS) trial was performed to assess perioperative management and
clinical outcomes in patients with stable coronary or peripheral artery
disease who were randomized to receive rivaroxaban 2.5 mg twice a day plus
ASA 100 mg daily, rivaroxaban 5 mg twice a day, or ASA 100 mg daily.
Patients studied required a surgery/procedure during the trial. The study
outcomes, which included myocardial infarction, angina, stroke, acute limb
ischemia, bleeding, and death, were assessed according to treatment
allocation. Result(s): There were 2632 patients studied (mean age, 68
years; 80% male) who had a surgery/procedure, comprising percutaneous
coronary interventions (~43%), carotid or other arterial angioplasty
(~15%), pacemaker or internal cardiac defibrillator implantation (~9%),
and coronary artery bypass graft surgery (~7%). Perioperative study drug
management varied, with about one-third of patients not interrupting study
drug and the remainder interrupting it between 1 and >=10 days
preprocedure. The incidences of adverse outcomes across treatment groups
were 12.7% to 15.3% for myocardial ischemia, 0.8% to 1.2% for stroke, 0.1%
to 0.2% for venous thromboembolism, and 3.1% to 4.2% for any bleeding.
There was no statistically significant difference in outcome rates across
treatment groups. Conclusion(s): In patients in the COMPASS trial who
required a surgery/procedure, there was no significant difference in
perioperative adverse outcomes whether patients were receiving rivaroxaban
2.5 mg twice a day and ASA 100 mg daily, rivaroxaban 5 mg twice a day, or
ASA alone. Copyright © 2024 International Society on Thrombosis
and Haemostasis

<53>
Accession Number
644341473
Title
Cost-effectiveness of population screening for aortic stenosis.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2024. Date of Publication: 22 May 2024.
Author
Motazedian P.; Prosperi-Porta G.; Hibbert B.; Jalal H.; Labinaz M.;
Burwash I.G.; Abdel-Razek O.; Santo P.D.; Simard T.; Wells G.; Coyle D.
Institution
(Motazedian, Prosperi-Porta, Labinaz, Burwash, Abdel-Razek, Santo)
University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON,
Canada
(Motazedian, Jalal, Santo, Wells, Coyle) School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
(Hibbert, Simard) Division of Cardiology, Mayo Clinic, Rochester, MN,
United States
(Hibbert) Division of Cardiology, Harvard University, Boston, MA, United
States
(Abdel-Razek) Department of Medicine, Ottawa, ON, Canada
Abstract
BACKGROUND AND AIMS: Aortic stenosis (AS) is a progressive disease
predominantly affecting elderly patients that carries significant
morbidity and mortality without aortic valve replacement, the only proven
treatment. Our objective was to determine the cost-effectiveness of AS
screening using transthoracic echocardiography (TTE) in a geriatric
population from the perspective of the publicly funded healthcare system
in Canada. METHOD(S): Markov models estimating the cost-effectiveness
ratio (ICER) for AS screening with a one-time TTE were developed. The
model included diagnosed and undiagnosed AS health states,
hospitalizations, TAVR and post-TAVR health states. Primary analysis
included screening at 70 and 80 years of age with intervention at symptom
onset, with scenario analysis included for early intervention at the time
of severe asymptomatic AS diagnosis. Monte Carlo simulation of 5000
replications was completed with a lifetime horizon and 1.5% discount for
costs and outcomes. RESULT(S): Screening for AS at the age of 70
years was associated with an ICER of $156,722 and screening at 80 years of
age was associated with an ICER of $28,005, suggesting that screening at
80 years of age is cost-effective when willingness-to-pay per QALY is
$50,000. Scenario analysis with early intervention was not cost-effective
with an ICER of $142,157 at 70 years, and $124,651 at 80 years.
 CONCLUSION(S): Screening for AS at 80 years of age with a one-time
TTE, in a Canadian population, improves quality of life and is
cost-effective in a publicly funded healthcare system providing TAVR is
reserved for symptomatic patients. Copyright © The Author(s)
2024. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<54>
Accession Number
644336553
Title
The Effect of Providing Education to Patients Undergoing Coronary
Angiography on Vital Signs.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2024. Date of
Publication: 22 May 2024.
Author
Veremci S.; Pamuk Cebeci S.
Institution
(Veremci) Eskisehir Osmangazi University/Institute of Health Sciences,
Department of Fundamentals of Nursing, Eskisehir, Turkey
(Pamuk Cebeci) Eskisehir Osmangazi University/Faculty of Health Sciences,
Department of Fundamentals of Nursing, Eskisehir, Turkey
Abstract
PURPOSE: This study was conducted to determine the effect of providing
preprocedural education to patients undergoing coronary angiography on
their vital signs. DESIGN: The study was a randomized controlled
experimental study with a pretest/post-test control group design.
 METHOD(S): The study was conducted in the Cardiology Service of a
hospital in Eskisehir between November 2021 and April 2022. Power analysis
identified that it was appropriate to include 79 individuals in the
experimental group, 79 individuals in the control group, and a total of
158 individuals. The experimental group was trained using the "Structured
Education Manual" prepared by the researchers. FINDINGS: The education had
an influence on the stabilization of vital signs after the procedure
compared to preprocedure. When the comparison of vital signs before and
after the education was analyzed, systolic blood pressure and diastolic
blood pressure differed significantly between 11 measurements in both
groups (P < .05). The systolic and diastolic blood pressure of the
experimental group measured before the procedure was higher than their
other measurements after the procedure. Heart rate, respiratory rate, and
saturation value in both groups displayed a statistically significant
difference between 11 measurements (P < .05). In the experimental group,
heart rate and respiratory rate before the procedure were higher than the
postprocedure measurements. The saturation value of the experimental group
at 150 minutes after the procedure was higher than the other measurements.
 CONCLUSION(S): Education given to patients before undergoing a
coronary angiography procedure had a positive effect on the patients'
vital signs. It is recommended that patients undergoing a coronary
angiography procedure be provided with audio-visual training by nurses
before the procedure. Copyright © 2024 The American Society of
PeriAnesthesia Nurses. All rights reserved.

<55>
Accession Number
644335938
Title
Changes in the term neonatal electroencephalogram with general anesthesia
- a systematic review with narrative synthesis.
Source
Anesthesiology. (no pagination), 2024. Date of Publication: 22 May 2024.
Author
Corlette S.J.; Walker S.M.; Cornelissen L.; Brasher C.; Bower J.; Davidson
A.J.
Institution
(Corlette) Department of Anaesthesia and Pain Management, Royal Children's
Hospital, Melbourne, Victoria, Australia; Specialist anesthesiologist;
(Corlette) Department of Paediatrics, Melbourne Medical School, University
of Melbourne, Melbourne, Victoria, Australia; PhD candidate;
(Corlette) Murdoch Children's Research Institute, Melbourne, Victoria,
Australia; PhD candidate;
(Walker) Paediatric Pain Research Group, Developmental Neurosciences, UCL
Great Ormond Street Institute of Child Health, London, UK; Professor of
Paediatric Anaesthesia and Pain Medicine;
(Cornelissen) Department of Anesthesiology, Critical Care & Pain Medicine,
Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical
School, Boston, Massachusetts, USA. Assistant Professor of Anesthesia.
Current address: Eisai Inc., Clinical Evidence Generation - Deep Human
Biology Learning, Nutley, New Jersey, USA
(Brasher, Davidson) Department of Anaesthesia and Pain Management, Royal
Children's Hospital, Melbourne, Victoria, Australia; Specialist
Anesthesiologist;
(Brasher) Department of Critical Care, Melbourne Medical School,
University of Melbourne, Melbourne, Victoria, Australia; Associate
Professor;
(Bower) Royal Children's Hospital, Melbourne, Victoria, Australia; Music
Therapist;
(Bower) Faculty of Fine Arts and Music, University of Melbourne,
Melbourne, Victoria, Australia; Postdoctoral Fellow;
(Davidson) Department of Paediatrics, Melbourne Medical School, University
of Melbourne, Melbourne, Victoria, Australia; Professor;
adavi@unimelb.edu.au
(Davidson) Murdoch Children's Research Institute, Melbourne, Victoria,
Australia; Director, Melbourne Children's Trial Centre;
Abstract
While effects of general anesthesia on neuronal activity in the human
neonatal brain are incompletely understood, electroencephalography (EEG)
provides some insight and may identify age-dependent differences. A
systematic search (MEDLINE, Embase, PUBMED, Cochrane Library to November
2023) retrieved English language publications reporting EEG during general
anesthesia for cardiac or non-cardiac surgery in term neonates (37 to 44
weeks post-menstrual age). Data were extracted and risk of bias (ROBINS-I
Cochrane tool) and quality of evidence (GRADE checklist) assessed. From
1155 abstracts, nine publications (157 neonates; 55.7% male) fulfilled
eligibility criteria. Data were limited and study quality was very low.
The occurrence of discontinuity, a characteristic pattern of alternating
higher and lower amplitude EEG segments, was reported with general
anesthesia (94 of 119 neonates, six publications) and with hypothermia (23
of 23 neonates, two publications). Decreased power in the delta (0.5-4Hz)
frequency range was also reported with increasing anesthetic dose (39
neonates; three publications). While evidence gaps were identified, both
increasing sevoflurane concentration and decreasing temperature are
associated with increasing discontinuity. Copyright © 2024 The
Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the
American Society of Anesthesiologists.

<56>
Accession Number
2032392818
Title
Coronary Artery Bypass Grafting versus Percutaneous Coronary Intervention
in Patients with Chronic Total Occlusion.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2023. Date of
Publication: 2023.
Author
Kirov H.; Fischer J.; Caldonazo T.; Tasoudis P.; Runkel A.; Soletti G.;
Cancelli G.; Dell'aquila M.; Mukharyamov M.; Doenst T.
Institution
(Kirov, Fischer, Caldonazo, Runkel, Mukharyamov, Doenst) Department of
Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
(Tasoudis) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, United States
(Soletti, Cancelli, Dell'aquila) Weill Cornell Medicine, New York, NY,
United States
Publisher
Georg Thieme Verlag
Abstract
Objectives: Mechanisms of coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) differ as CABG provides surgical
collateralization and may prolong life by preventing future myocardial
infarctions (MIs). However, evidence for CABG in patients with chronic
total occlusion (CTO) has not been fully elucidated and the impact of PCI
is discussed controversially. Method(s): We performed a meta-analysis
of studies comparing outcomes in patients with/without multivessel disease
undergoing CABG or PCI for CTO. The primary outcome was long-term
all-cause mortality (>=5 years). Secondary outcomes were MIs, repeat
revascularization, cardiac mortality, major adverse cardiovascular events,
and stroke, as well as short-term mortality (30 days/in-hospital) and
stroke. A pooled Kaplan-Meier survival curve after reconstruction analysis
was generated. Random-effects models were used. Result(s): Six
studies totaling 12,504 patients were included. In the pooled Kaplan-Meier
analysis, PCI showed a significantly higher risk of death in the follow-up
compared with CABG (hazard ratio [HR]: 2.12, 95% confidence interval [CI]:
1.88-2.38, p < 0.01). During the observation period, PCI was also
associated with higher rates of MI (odds ratio [OR]: 2.86, 95% CI:
1.82-4.48, p < 0.01) and more repeat revascularization (OR: 4.88, 95% CI:
1.99-11.91, p = 0.0005). The other outcomes did not show significant
differences. Conclusion(s): CABG is associated with superior survival
to PCI over time in patients with CTO who are eligible for both PCI and
CABG. This survival advantage is associated with fewer events of MI and
repeat revascularization. Copyright © 2024. Thieme. All rights
reserved.

<57>
[Use Link to view the full text]
Accession Number
2030570221
Title
An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting:
STOPDAPT-3 Randomized Trial.
Source
Circulation. 149(8) (pp 585-600), 2024. Date of Publication: 20 Feb 2024.
Author
Natsuaki M.; Watanabe H.; Morimoto T.; Yamamoto K.; Obayashi Y.; Nishikawa
R.; Ando K.; Domei T.; Suwa S.; Ogita M.; Isawa T.; Takenaka H.; Yamamoto
T.; Ishikawa T.; Hisauchi I.; Wakabayashi K.; Onishi Y.; Hibi K.; Kawai
K.; Yoshida R.; Suzuki H.; Nakazawa G.; Kusuyama T.; Morishima I.; Ono K.;
Kimura T.
Institution
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Japan
(Watanabe, Takenaka, Yamamoto, Kimura) Division of Cardiology, Hirakata
Kohsai Hospital, Hirakata, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Nishinomiya, Japan
(Yamamoto, Ando, Domei) Department of Cardiology, Kokura Memorial
Hospital, Kitakyusyu, Japan
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Graduate
School of Medicine, Kyoto University, Japan
(Suwa, Ogita) Department of Cardiology, Juntendo University, Shizuoka
Hospital, Izunokuni, Japan
(Isawa) Department of Cardiology, Sendai Kousei Hospital, Japan
(Ishikawa, Hisauchi) Department of Cardiology, Dokkyo Medical University,
Saitama Medical Center, Koshigaya, Japan
(Wakabayashi) Department of Cardiology, Showa University, Koto Toyosu
Hospital, Tokyo, Japan
(Onishi) Department of Cardiology, Hiratsuka Kyosai Hospital, Japan
(Hibi) Division of Cardiology, Yokohama City University, Medical Center,
Japan
(Kawai) Division of Cardiology, Chikamori Hospital, Kochi, Japan
(Yoshida) Division of Cardiology, Japanese Red Cross Aichi Medical Center,
Nagoya Daini Hospital, Nagoya, Japan
(Suzuki) Division of Cardiology, Showa University, Fujigaoka Hospital,
Yokohama, Japan
(Nakazawa) Department of Cardiology, Kindai University, Faculty of
Medicine, Osakasayama, Japan
(Kusuyama) Division of Cardiology, Tsukazaki Hospital, Himeji, Japan
(Morishima) Department of Cardiology, Ogaki Municipal Hospital, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Bleeding rates on dual antiplatelet therapy (DAPT) within 1
month after percutaneous coronary intervention (PCI) remain high in
clinical practice, particularly in patients with acute coronary syndrome
or high bleeding risk. Aspirin-free strategy might result in lower
bleeding early after PCI without increasing cardiovascular events, but its
efficacy and safety have not yet been proven in randomized trials.
 METHOD(S): We randomly assigned 6002 patients with acute coronary
syndrome or high bleeding risk just before PCI either to prasugrel (3.75
mg/day) monotherapy or to DAPT with aspirin (81-100 mg/day) and prasugrel
(3.75 mg/day) after loading of 20 mg of prasugrel in both groups. The
coprimary end points were major bleeding (Bleeding Academic Research
Consortium 3 or 5) for superiority and cardiovascular events (a composite
of cardiovascular death, myocardial infarction, definite stent thrombosis,
or ischemic stroke) for noninferiority with a relative 50% margin.
 RESULT(S): The full analysis set population consisted of 5966
patients (no-aspirin group, 2984 patients; DAPT group, 2982 patients; age,
71.6+/-11.7 years; men, 76.6%; acute coronary syndrome, 75.0%). Within 7
days before randomization, aspirin alone, aspirin with P2Y12 inhibitor,
oral anticoagulants, and intravenous heparin infusion were given in 21.3%,
6.4%, 8.9%, and 24.5%, respectively. Adherence to the protocol-specified
antiplatelet therapy was 88% in both groups at 1 month. At 1 month, the
no-aspirin group was not superior to the DAPT group for the coprimary
bleeding end point (4.47% and 4.71%; hazard ratio, 0.95 [95% CI,
0.75-1.20]; P<inf>superiority</inf>=0.66). The no-aspirin group was
noninferior to the DAPT group for the coprimary cardiovascular end point
(4.12% and 3.69%; hazard ratio, 1.12 [95% CI, 0.87-1.45]; P<inf>non</inf>
<inf>inferiority</inf>=0.01). There was no difference in net adverse
clinical outcomes and each component of coprimary cardiovascular end
point. There was an excess of any unplanned coronary revascularization
(1.05% and 0.57%; hazard ratio, 1.83 [95%CI, 1.01-3.30]) and subacute
definite or probable stent thrombosis (0.58% and 0.17%; hazard ratio, 3.40
[95% CI, 1.26-9.23]) in the no-aspirin group compared with the DAPT group.
 CONCLUSION(S): The aspirin-free strategy using low-dose prasugrel
compared with the DAPT strategy failed to attest superiority for major
bleeding within 1 month after PCI but was noninferior for cardiovascular
events within 1 month after PCI. However, the aspirin-free strategy was
associated with a signal suggesting an excess of coronary events.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04609111. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<58>
Accession Number
2029869936
Title
Optical coherence tomography (OCT) - versus angiography-guided strategy
for percutaneous coronary intervention: a meta-analysis of randomized
trials.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
262. Date of Publication: December 2024.
Author
Wang Y.; Yang X.; Wu Y.; Li Y.; Zhou Y.
Institution
(Wang, Yang) Department of Cardiology, Ningbo Medical Treatment Center
Lihuili Hospital, 57 Xingning Road, Ningbo 315000, China
(Wu, Zhou) Department of Cardiology, The First Affiliated Hospital, School
of Medicine, Zhejiang University, 79 Qingchun Road, Zhejiang, Hangzhou
310003, China
(Li) Department of Coronary Care Unit, Ningbo Medical Treatment Center
Lihuili Hospital, 57 Xingning Road, Ningbo 315000, China
Publisher
BioMed Central Ltd
Abstract
Background: Optical coherence tomography (OCT) guidance in percutaneous
coronary intervention (PCI) has been shown to improve procedural outcomes.
However, evidence supporting its superiority over angiography-guided PCI
in terms of clinical outcomes is still emerging and limited. This study
aimed to compare the efficacy and safety of OCT-guided PCI versus
angiography-guided PCI in patients with coronary artery disease (CAD).
 Method(s): A systematic search of electronic databases was conducted
to identify randomized control trials (RCTs) comparing the clinical
outcomes of OCT-guided and angiography-guided PCI in patients with CAD.
Clinical endpoints including all-cause mortality, myocardial infarction
(MI), target lesion revascularization (TLR), stent thrombosis and major
adverse cardiac events (MACE) were assessed. Result(s): Eleven RCTs,
comprising 2,699 patients in the OCT-guided group and 2,968 patients in
the angiography-guided group met inclusion criteria. OCT-guided PCI was
associated with significantly lower rates of cardiovascular death(RR 0.56;
95%CI: 0.32-0.98; p = 0.04; I2 = 0%), stent thrombosis(RR 0.56;
95%CI: 0.33-0.95; p = 0.03; I2 = 0%), and MACE (RR 0.79; 95%CI:
0.66-0.95; p = 0.01; I2 = 5%). The incidence of all-cause death
(RR 0.71; 95%CI: 0.49-1.02; p = 0.06; I2 = 0%), myocardial
infarction (RR 0.86; 95%CI: 0.67-1.10; p = 0.22; I2 = 0%) and
TLR (RR 0.98; 95%CI: 0.73-1.33; p = 0.91; I2 = 0%) was
non-significantly lower in the OCT-guided group. Conclusion(s): Among
patients undergoing PCI, OCT-guided PCI was associated with lower
incidences of cardiovascular death, stent thrombosis and MACE compared to
angiography-guided PCI. Trial registration: PROSPERO registration number:
CRD42023484342. Copyright © The Author(s) 2024.

<59>
Accession Number
2029868121
Title
Efficacy and safety of video double-lumen tube intubation in lateral
position in patients undergoing thoracic surgery: a randomized controlled
trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 179. Date
of Publication: December 2024.
Author
Rao Q.; Li P.; Zhang G.; Zeng J.; Pu Q.; Yu H.
Institution
(Rao, Yu, Zeng, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu 610041, China
(Li) Department of Anesthesiology, Wu'an First People's Hospital, Handan,
China
(Zhang) Department of Anesthesiology, West China (Airport) Hospital,
Sichuan University, Chengdu, China
(Pu) Department of Thoracic Surgery, West China Hospital, Sichuan
University, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Video double-lumen tube (VDLT) intubation in lateral position
is a potential alternative to intubation in supine position in patients
undergoing thoracic surgery. This non-inferiority trial assessed the
efficacy and safety of VDLT intubation in lateral position.
 Method(s): Patients (18-70 yr) undergoing right thoracoscopic lung
surgery were randomized to either the left lateral position group (group
L) or the supine position group (group S). The VDLT was placed under video
larygoscopy. The primary endpoint was the intubation time. Secondary
endpoints included VDLT displacement rate, intubation failure rate, the
satisfaction of surgeon and nurse, and intubation-related adverse events.
 Result(s): The analysis covered 80 patients. The total intubation
time was 52.0 [20.4]s in group L and 34.3 [13.2]s in group S, with a mean
difference of 17.6 s [95% confidence interval (CI): 9.9 s to 25.3 s; P =
0.050], failing to demonstrate non-inferiority with a non-inferiority
margin of 10 s. Group L, compared with group S, had significantly lower
VDLT displacement rate (P = 0.017) and higher nurse satisfaction (P =
0.026). No intubation failure occurred in any group. Intubation
complications (P = 0.802) and surgeon satisfaction (P = 0.415) were
comparable between two groups. Conclusion(s): The lateral VDLT
intubation took longer time than in the supine position, and
non-inferiority was not achieved. The incidence of displacement as the
secondary endpoint was lower in the L group, possibly due to changing body
positions beforehand. The indication of lateral VDLT intubation should be
based on a balance between the safety of airway management and the lower
incidence of displacement. Trial registration: The study was registered at
Chictr.org.cn with the number ChiCTR2200064831 on
19/10/2022. Copyright © The Author(s) 2024.

<60>
Accession Number
2023530211
Title
Effect of periprocedural furosemide-induced diuresis with matched isotonic
intravenous hydration in patients with chronic kidney disease undergoing
transcatheter aortic valve implantation.
Source
Clinical Research in Cardiology. 113(6) (pp 801-811), 2024. Date of
Publication: June 2024.
Author
Voigtlander-Buschmann L.; Schafer S.; Schmidt-Lauber C.; Weimann J.;
Shenas M.; Giraldo Cortes J.; Kuta P.M.; Zeller T.; Twerenbold R.;
Seiffert M.; Schofer N.; Schneeberger Y.; Schafer A.; Schirmer J.;
Reichenspurner H.; Blankenberg S.; Conradi L.; Schafer U.
Institution
(Voigtlander-Buschmann, Schafer, Weimann, Shenas, Giraldo Cortes, Zeller,
Twerenbold, Seiffert, Schofer, Blankenberg) Department of Cardiology,
University Heart and Vascular Center Hamburg, Hamburg, Germany
(Schmidt-Lauber) III. Department of Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Kuta) Institute for Clinical Chemistry and Laboratory Medicine,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schneeberger, Schafer, Schirmer, Reichenspurner, Conradi) Department of
Cardiovascular Surgery, University Heart and Vascular Center Hamburg,
Hamburg, Germany
(Schafer) Department of Cardiology, Heart and Vessel Center Bad Bevensen,
Bad Bevensen, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Acute kidney injury (AKI) after transcatheter aortic valve
implantation (TAVI) is a serious complication which is associated with
increased mortality. The RenalGuard system was developed to reduce the
risk of AKI after contrast media exposition by furosemide-induced diuresis
with matched isotonic intravenous hydration. The aim of this study was to
examine the effect of the RenalGuard system on the occurrence of AKI after
TAVI in patients with chronic kidney disease. Method(s): The present
study is a single-center randomized trial including patients with severe
aortic valve stenosis undergoing TAVI. Overall, a total of 100 patients
treated by TAVI between January 2017 and August 2018 were randomly
assigned to a periprocedural treatment with the RenalGuard system or
standard treatment by pre- and postprocedural intravenous hydration.
Primary endpoint was the occurrence of AKI after TAVI, and secondary
endpoints were assessed according to valve academic research consortium 2
criteria. Result(s): Overall, the prevalence of AKI was 18.4% (n =
18). The majority of these patients developed mild AKI according to stage
1. Comparing RenalGuard to standard therapy, no significant differences
were observed in the occurrence of AKI (RenalGuard: 21.3%; control group:
15.7%; p = 0.651). In addition, there were no differences between the
groups with regard to 30-day and 12-month mortality and
procedure-associated complication rates. Conclusion(s): In this
randomized trial, we did not detect a reduction in AKI after TAVI by using
the RenalGuard system. A substantial number of patients with chronic
kidney disease developed AKI after TAVI, whereas the majority presented
with mild AKI according to stage 1 (ClinicalTrials.gov number
NCT04537325). Graphical abstract: (Figure presented.) Copyright ©
The Author(s) 2023.

<61>
Accession Number
2032182550
Title
Comparison between propofol and total inhalational anaesthesia on
cardiovascular outcomes following on-pump cardiac surgery in higher-risk
patients: a randomised controlled pilot and feasibility study.
Source
Open Heart. 11(1) (no pagination), 2024. Article Number: e002630. Date of
Publication: 09 May 2024.
Author
Milne B.; John M.; Evans R.; Robertson S.; Scanaill P.O.; Murphy G.J.;
Landoni G.; Marber M.; Clayton T.; Kunst G.
Institution
(Milne, Scanaill, Kunst) Department of Anaesthetics and Pain Therapy,
King's College Hospital NHS Foundation Trust, London, United Kingdom
(John) Department of Anaesthesia, Guy's and St Thomas' Hospitals NHS
Trust, London, United Kingdom
(Evans, Robertson, Clayton) London School of Hygiene and Tropical
Medicine, Medical Statistics, 1 Keppel Street, London WC1E 7HT, United
Kingdom
(Murphy) Department of Cardiovascular Sciences, College of Life Sciences,
University of Leicester, Leicester, United Kingdom
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Marber, Kunst) School of Cardiovascular and Metabolic Medicine &
Sciences, King's College London, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives Myocardial revascularisation and cardiopulmonary bypass (CPB)
can cause ischaemia-reperfusion injury, leading to myocardial and other
end-organ damage. Volatile anaesthetics protect the myocardium in
experimental studies. However, there is uncertainty about whether this
translates into clinical benefits because of the coadministration of
propofol and its detrimental effects, restricting myocardial protective
processes. Methods In this single-blinded, parallel-group randomised
controlled feasibility trial, higher-risk patients undergoing elective
coronary artery bypass graft (CABG) surgery with an additive European
System for Cardiac Operative Risk Evaluation >=5 were randomised to
receive either propofol or total inhalational anaesthesia as single agents
for maintenance of anaesthesia. The primary outcome was the feasibility of
recruiting and randomising 50 patients across two cardiac surgical
centres, and secondary outcomes included the feasibility of collecting the
planned perioperative data, clinically relevant outcomes and assessments
of effective patient identification, screening and recruitment. Results
All 50 patients were recruited within 11 months in two centres, allowing
for a 13-month hiatus in recruitment due to the COVID-19 pandemic.
Overall, 50/108 (46%) of eligible patients were recruited. One patient
withdrew before surgery and one patient did not undergo surgery. All but
one completed in-hospital and 30-day follow-up. Conclusions It is feasible
to recruit and randomise higher-risk patients undergoing CABG surgery to a
study comparing total inhalational and propofol anaesthesia in a timely
manner and with high acceptance and completion rates. Trial registration
number NCT04039854. Copyright © Author(s) (or their employer(s))
2024.

<62>
Accession Number
2028594005
Title
Comparison of remimazolam-based and propofol-based total intravenous
anesthesia on hemodynamics during anesthesia induction in patients
undergoing transcatheter aortic valve replacement: a randomized controlled
trial.
Source
Journal of Anesthesia. 38(3) (pp 330-338), 2024. Date of Publication: June
2024.
Author
Kotani T.; Ida M.; Naito Y.; Kawaguchi M.
Institution
(Kotani, Ida, Naito, Kawaguchi) Department of Anesthesiology, Nara Medical
University Kashihara, Shijo 840, Nara 634-8522, Japan
Publisher
Springer
Abstract
Purpose: This study aimed to compare the hemodynamic effects of
remimazolam- and propofol-based total intravenous anesthesia in patients
who underwent transcatheter aortic valve replacement. Method(s): This
was a single-center, single-blind, randomized controlled trial set at Nara
Medical University, Kashihara, Japan. We included 36 patients aged >= 20
years scheduled to undergo elective transfemoral transcatheter aortic
valve replacement (TAVR) under general anesthesia. The participants were
randomly assigned to the remimazolam and propofol groups (n = 18 each).
Remimazolam- or propofol-based total intravenous anesthesia was initiated
at 12 mg/kg/min or 2.5 mcg/mL via target-controlled infusion,
respectively, along with remifentanil. After confirming the loss of
consciousness, the administration rate was adjusted using
electroencephalographic monitoring. The primary outcome was the rate of
arterial hypotension, defined as a mean arterial pressure < 60 mmHg, from
anesthesia induction until the beginning of the surgical incision. The
total doses of ephedrine and phenylephrine were also assessed.
 Result(s): During anesthesia induction, the arterial hypotension
rates were 11.9% and 21.6% in the remimazolam and propofol groups,
respectively (P = 0.01). The total dose of ephedrine was higher in the
propofol group (14.4 mg) than in the remimazolam group (1.6 mg) (P <
0.001); however, the total dose of phenylephrine was not significantly
different between the two groups (propofol 0.31 mg vs. remimazolam: 0.17
mg, P = 0.10). Conclusion(s): Remimazolam-based total intravenous
anesthesia resulted in a lower hypotension rate than propofol-based total
intravenous anesthesia during induction in patients undergoing TAVR.
Remimazolam-based total intravenous anesthesia can be used safely during
anesthetic induction in patients with severe aortic
stenosis. Copyright © The Author(s) under exclusive licence to
Japanese Society of Anesthesiologists 2024.

<63>
Accession Number
2026080568
Title
Does dexmedetomidine reduce the risk of acute kidney injury after cardiac
surgery? A meta-analysis of randomized controlled trials.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(3) (no
pagination), 2024. Article Number: 744446. Date of Publication: 01 May
2024.
Author
Zhao C.; Liu S.; Zhang H.; Gao M.
Institution
(Zhao, Zhang, Gao) Capital Medical University, Beijing Shijitan Hospital,
Department of Intensive Care Unit, Beijing, China
(Liu) Capital Medical University, Beijing Chest Hospital, Beijing
Tuberculosis and Thoracic Tumor Research Institute, Department of
Pharmacy, Beijing, China
Publisher
Elsevier Editora Ltda
Abstract
Background: Acute Kidney Injury (AKI) is a common complication after
cardiac surgery and has been associated with poor outcomes.
Dexmedetomidine (DEX) has been shown to confer direct renoprotection based
on some animal and clinical studies, but data from other trials came to
the opposite conclusion following cardiac surgery. This meta-analysis was
conducted to evaluate the effects of perioperative DEX administration on
the occurrence of AKI and the outcomes after cardiac surgery.
 Method(s): We searched databases including EMBASE, PubMed, and
Cochrane CENTRAL for Randomized Controlled Trials (RCTs) focused on DEX
for AKI in adult patients after cardiac surgery. The primary outcome was
incidence of AKI. Secondary outcomes were Mechanical Ventilation (MV)
duration, Intensive Care Unit (ICU) Length Of Stay (LOS), hospital LOS and
mortality. Result(s): Fifteen trials enrolling 2907 study patients
were collected in the meta-analyses. Compared with controls, DEX reduced
the incidence of postoperative AKI (Odds Ratio [OR = 0.66]; 95% Confidence
Interval [95% CI 0.48-0.91]; p = 0.01), and there was no significant
difference between groups in postoperative mortality (OR = 0.63; 95% CI
0.32-1.26; p = 0.19), MV duration (Weighted Mean Difference [WMD = -0.44];
95% CI -1.50-0.63; p = 0.42), ICU LOS (WMD = -1.19; 95% CI -2.89-0.51; p =
0.17), and hospital LOS (WMD = -0.31; 95% CI -0.76-0.15; p = 0.19).
 Conclusion(s): Perioperative DEX reduced the incidence of
postoperative AKI in adult patients undergoing cardiac surgery. No
significant decrease existed in mortality, MV duration, ICU LOS and
hospital LOS owing to DEX administration. Copyright © 2024

<64>
Accession Number
2032308097
Title
Impact of Intravascular Imaging-Guided Stent Optimization According to
Clinical Presentation in Patients Undergoing Complex PCI.
Source
JACC: Cardiovascular Interventions. 17(10) (pp 1231-1243), 2024. Date of
Publication: 27 May 2024.
Author
Choi K.H.; Kim C.J.; Lee J.M.; Song Y.B.; Lee J.-Y.; Lee S.-J.; Lee S.Y.;
Kim S.M.; Yun K.H.; Cho J.Y.; Ahn H.-S.; Nam C.-W.; Yoon H.-J.; Park Y.H.;
Lee W.S.; Jeong J.-O.; Song P.S.; Kim S.E.; Doh J.-H.; Jo S.-H.; Yoon
C.-H.; Kang M.G.; Koh J.-S.; Lee K.Y.; Lim Y.-H.; Cho Y.-H.; Cho J.-M.;
Jang W.J.; Chun K.-J.; Hong D.; Park T.K.; Yang J.H.; Choi S.-H.; Gwon
H.-C.; Hahn J.-Y.
Institution
(Lee, Choi, Lee, Song, Hong, Park, Yang, Choi, Gwon, Hahn) Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Kim, Ahn) The Catholic University of Korea, Uijeongbu St. Mary's
Hospital, Seoul, South Korea
(Lee, Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Lee, Kim) Chungbuk National University Hospital, Chungbuk National
University College of Medicine, Cheongju, South Korea
(Lee) Chung-Ang University College of Medicine, Chung-Ang University
Gwangmyeong Hospital, Gwangmyeong, South Korea
(Yun) Wonkwang University Hospital, Iksan, South Korea
(Cho, Nam, Yoon) Keimyung University Dongsan Hospital, Daegu, South Korea
(Park) Samsung Changwon Hospital, Sungkyunkwan University School of
Medicine, Changwon, South Korea
(Lee) Chung-Ang University College of Medicine, Chung-Ang University
Hospital, Seoul, South Korea
(Jeong, Song) Chungnam National University Hospital, Chungnam National
University College of Medicine, Daejeon, South Korea
(Kim, Doh) Inje University Ilsan Paik Hospital, Goyang, South Korea
(Jo) Cardiovascular Center, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Yoon) Seoul National University Bundang Hospital, Seongnam-si,
Gyeonggi-do, South Korea
(Kang, Koh) Gyeongsang National University School of Medicine, Gyeongsang
National University Hospital, Jinju, South Korea
(Lee) The Catholic University of Korea, Incheon St. Mary's Hospital,
Seoul, South Korea
(Lim) Hanyang University Seoul Hospital, College of Medicine, Hanyang
University, Seoul, South Korea
(Cho) Hanyang University Myongji Hospital, Goyang, South Korea
(Cho) Kyung Hee University Hospital at Gangdong, Seoul, South Korea
(Jang) Ewha Womans University College of Medicine, Seoul, South Korea
(Chun) Pusan National University Yangsan Hospital, Yangsan, South Korea
Publisher
Elsevier Inc.
Abstract
Background: It is unclear whether the beneficial effects of intravascular
imaging-guided stent optimization vary by clinical presentation during
complex percutaneous coronary intervention (PCI). Objective(s): In
this prespecified, stratified subgroup analysis from RENOVATE-COMPLEX-PCI
(Randomized Controlled Trial of Intravascular Imaging Guidance versus
Angiography-Guidance on Clinical Outcomes After Complex PCI), we sought to
compare the outcomes between intravascular imaging vs angiography guidance
according to clinical presentation. Method(s): Patients with complex
coronary artery lesions were randomly assigned to undergo either
intravascular imaging-guided PCI or angiography-guided PCI in a 2:1 ratio.
The primary endpoint was target vessel failure (TVF), which is a composite
of cardiac death, target vessel-related myocardial infarction, or
clinically driven target vessel revascularization. Result(s): Of
1,639 patients, 832 (50.8%) presented with acute coronary syndrome (ACS)
and 807 (49.2%) with chronic coronary syndrome. During a median follow-up
of 2.1 years (Q1-Q3: 1.4-3.0 years), there was no significant interaction
between the treatment effect of intravascular imaging and clinical
presentation (P for interaction = 0.19). Among patients with ACS, the
incidences of TVF were 10.4% in the intravascular imaging group and 14.6%
in the angiography group (HR: 0.74; 95% CI: 0.48-1.15; P = 0.18). Among
patients with CCS, the incidences of TVF were 5.0% in the intravascular
imaging group and 10.4% in the angiography group (HR: 0.46; 95% CI:
0.27-0.80; P = 0.006). Achieving stent optimization by intravascular
imaging resulted in a reduced risk of TVF among patients with ACS who were
randomly assigned to intravascular imaging-guided PCI for complex coronary
lesions (optimized vs unoptimized, 6.5% vs 14.1%; HR: 0.49; 95% CI:
0.27-0.87; P = 0.02) but not those with CCS (5.4% vs 4.7%, HR: 1.18; 95%
CI: 0.53-2.59; P = 0.69). Conclusion(s): No significant interaction
was observed between the benefits of intravascular imaging and clinical
presentation in the risk of TVF. Stent optimization by intravascular
imaging was particularly important for ACS patients. (Intravascular
Imaging- Versus Angiography-Guided Percutaneous Coronary Intervention For
Complex Coronary Artery Disease [RENOVATE]; NCT03381872) Copyright
© 2024 American College of Cardiology Foundation

<65>
Accession Number
2032307023
Title
A Randomized Controlled Trial of Nonfasting vs Fasting Before
Interventional Coronary Procedures: The TONIC Trial.
Source
JACC: Cardiovascular Interventions. 17(10) (pp 1200-1210), 2024. Date of
Publication: 27 May 2024.
Author
Boukantar M.; Chiaroni P.-M.; Gallet R.; Zamora P.; Truong T.; Mangiameli
A.; Rostain L.; Tuffreau-Martin A.-S.; Natella P.-A.; Oubaya N.; Teiger E.
Institution
(Boukantar, Chiaroni, Gallet, Zamora, Truong, Mangiameli, Rostain,
Tuffreau-Martin, Teiger) Interventional Cardiology, Henri Mondor Hospital,
Creteil, France
(Natella) Clinical Research Unit, Henri Mondor Hospital, Creteil, France
(Oubaya) University Paris Est Creteil, INSERM, IMRB, Creteil, France
(Oubaya) AP-HP, Hopitaux Henri-Mondor, Department of Public Health,
Creteil, France
Publisher
Elsevier Inc.
Abstract
Background: Fasting before coronary procedures is currently recommended to
reduce complications despite the lack of scientific evidence.
 Objective(s): The TONIC (Comparison Between Fasting and No Fasting
Before Interventional Coronary Intervention on the Occurrence of Adverse
Events) noninferiority trial investigated the safety and comfort of a
nonfasting strategy (ad libitum food and drinks) vs traditional fasting
(>6 hours for solid food and liquids) before coronary procedures.
 Method(s): In this monocentric, prospective, single-blind randomized
controlled trial, 739 patients undergoing coronary procedures were
included and randomized to a fasting or a nonfasting strategy. Emergency
procedures were excluded. The primary endpoint was a composite of
vasovagal reaction, hypoglycemia (defined by blood sugar <=0.7 g/L), and
isolated nausea and/or vomiting. Noninferiority margin was 4%. Secondary
endpoints were contrast-induced nephropathy and patients' satisfaction.
 Result(s): Among the 739 procedures (697 elective and 42 semiurgent),
517 angiographies, and 222 angioplasties (including complex and high-risk
procedures) were performed. The primary endpoint occurred in 30 of 365
nonfasting patients (8.2%) vs 37 of 374 fasting patients (9.9%),
demonstrating noninferiority (absolute between-group difference, -1.7%;
1-sided 95% CI upper limit: 1.8%). No food-related adverse event occurred,
and contrast-related acute kidney injuries were similar between groups.
Overall, procedure satisfaction and perceived pain were similar in both
groups, but nonfasting patients reported less hunger and thirst (P <
0.01). In case of redo coronary procedures, most patients (79%) would
choose a nonfasting strategy. Conclusion(s): The TONIC randomized
trial demonstrates the noninferiority of a nonfasting strategy to the
usual fasting strategy for coronary procedures regarding safety, while
improving patients' comfort. Copyright © 2024 American College of
Cardiology Foundation

<66>
Accession Number
2032296888
Title
Robotic-assisted free flap harvesting for diverse soft tissue
reconstruction: a PRISMA scoping review of clinical outcomes over the last
decade.
Source
Journal of the Pakistan Medical Association. 74(4) (pp S136-S144), 2024.
Date of Publication: April 2024.
Author
Arif F.; Ahmed O.; Rahman M.F.; Yasmeen S.; Shaikh S.A.
Institution
(Arif, Ahmed, Rahman, Yasmeen, Shaikh) Department of Plastic Surgery, Aga
Khan University Hospital, Karachi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Introduction: The aim of our study was to assess the advantages and
limitations of robotic technology in diverse reconstructive procedures.
 Method(s): A scoping review was conducted in Oct'23, on published
studies from 2013 to 2023, focussing on robotic-assisted free flap
harvesting. Three databases Ovid-MEDLINE, Scopus, and PubMed were
searched. Original research studies reporting robotic-assisted free flap
harvest were included. Studies on lesion excision, microvascular
anastomosis, local flap harvest, robotic-assisted flap inset, review
articles, abstract-only studies, non-English documents, and animal studies
were excluded from this review. Result(s): Sixteen studies met the
inclusion criteria out of a total of 318, searched initially. These
studies included a total of 128 patients, who underwent robotic-assisted
free flap harvest for the reconstruction of various defects, with 140 free
flaps harvested. The most common flaps harvested by robotic technique were
deep inferior epigastric artery perforator (DIEP) flap 120 (85.7%), radial
forearm free (RFF) flap 11 (7.9%), latissimus dorsii flap 4 (2.9%), rectus
abdominus flap 4 (2.9%), and omental flap 1 (0.7%). Breast reconstruction
was the major procedure done i.e. 120 (85.7%) followed by head and neck 11
(7.9%) and limb defects 9 (6.4%) reconstruction procedures. The reported
clinical outcomes were acceptable in all the studies with a 99% flap
success rate and minimal complications. Variability in operating time was
observed depending upon surgical steps undertaken with robotic systems.
 Conclusion(s): This scoping review highlights the role of
robotic-assisted free flap harvesting in plastic surgery and its potential
benefits on clinical outcomes, due to its high precision and minimal
invasiveness. However, challenges like cost effectiveness, resource
distribution and learning curve are there. Copyright © 2024
Pakistan Medical Association. All rights reserved.

<67>
Accession Number
2031182267
Title
Palliative Care Across the Spectrum of Heart Failure.
Source
JACC: Heart Failure. 12(6) (pp 973-989), 2024. Date of Publication: June
2024.
Author
Gelfman L.P.; Blum M.; Ogunniyi M.O.; McIlvennan C.K.; Kavalieratos D.;
Allen L.A.
Institution
(Gelfman, Blum) Brookdale Department of Geriatrics and Palliative
Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Gelfman) James J. Peters Veterans Affairs Medical Center, Geriatric
Research Education and Clinical Center, Bronx, NY, United States
(Ogunniyi) Division of Cardiology, Department of Medicine, Emory
University School of Medicine, Atlanta, GA, United States
(Ogunniyi) Grady Health System, Atlanta, GA, United States
(McIlvennan, Allen) Division of Cardiology, Department of Medicine,
University of Colorado School of Medicine, Aurora, CO, United States
(Kavalieratos) Division of Palliative Medicine, Department of Family and
Preventive Medicine, Emory University School of Medicine, Atlanta, GA,
United States
Publisher
Elsevier Inc.
Abstract
Persons with heart failure (HF) often suffer from poor symptom control,
decreased quality of life, and poor communication with their health care
providers. These needs are particularly acute in advanced HF, a leading
cause of death in the United States. Palliative care, when offered
alongside HF disease management, offers improved symptom control, quality
of life, communication, and caregiver satisfaction as well as reduced
caregiver anxiety. The dynamic nature of the clinical trajectory of HF
presents distinct symptom patterns, changing functional status, and
uncertainty, which requires an adaptive, dynamic model of palliative care
delivery. Due to a limited specialty-trained palliative care workforce,
patients and their caregivers often cannot access these benefits,
especially in the community. To meet these needs, new models are required
that are better informed by high-quality data, engage a range of health
care providers in primary palliative care principles, and have clear
triggers for specialty palliative care engagement, with specific
palliative interventions tailored to patient's illness trajectory and
changing needs. Copyright © 2024

<68>
Accession Number
2031047913
Title
Effect of Adding Early Bedside Cycling to Inpatient Cardiac Rehabilitation
on Physical Function and Length of Stay After Heart Valve Surgery: A
Randomized Controlled Trial.
Source
Archives of Physical Medicine and Rehabilitation. 105(6) (pp 1050-1057),
2024. Date of Publication: June 2024.
Author
Ahmad A.M.; Abusarea S.A.; Fouad B.Z.; Guirguis S.A.; Shafie W.A.
Institution
(Ahmad, Abusarea, Guirguis) Department of Physical Therapy for
Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy,
Cairo University, Giza, Egypt
(Fouad) Department of Cardiology, National Heart Institute, Giza, Egypt
(Shafie) Intensive Care Unit, National Heart Institute, Giza, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To assess whether adding bedside cycling to inpatient cardiac
rehabilitation (CR) early after heart valve surgery could lead to better
physical function and shorter length of hospital stays. Design(s):
This is a single-centered, randomized, controlled, parallel-group
intervention study. Setting(s): This study was conducted at the
National Heart Institute from December 2022 to June 2023.
 Participant(s): Thirty-one patients following heart valve surgery
completed this study after being randomized into 2 groups: an intervention
group (n<inf>1</inf>=16) and an active control group (n<inf>2</inf>=15).
Eligibility criteria were heart valve surgery with median sternotomy,
clinical stability, and age from 20 to 40 years. Intervention(s): The
intervention group received early bedside cycling for the lower limbs,
using a mini bike, in addition to an inpatient CR program, and the control
group received the inpatient CR program alone. Main Outcome
Measure(s): The primary outcome was the physical functional capacity
assessed by the 6-minute walk distance (6MWD). The secondary outcomes were
the Barthel Index (BI), the forced vital capacity (FVC), the length of
intensive care unit (ICU) stay, the total length of hospital stay, and the
physical component summary (PCS) of the 12-item Short Form (SF-12) Health
Survey. Result(s): Compared with the control group, the intervention
group showed significantly greater 6MWD (P<.001), BI score (P<.001), and
FVC (P=.006) at hospital discharge, and shorter ICU stay (P=.002) and
total hospital stay (P=.015). At 1-month follow-up, the intervention group
showed a non-significantly higher PCS mean score than the control group
(P=.057). Conclusion(s): Adding early bedside cycling to a usual
inpatient CR program after heart valve surgery could induce significantly
greater short-term physical functional capacity as assessed by the 6MWD,
better activities of daily living as evaluated by the BI, higher pulmonary
function as measured by the FVC, and shorter lengths of ICU and total
hospital stays than the usual inpatient CR program alone. Copyright
© 2024 American Congress of Rehabilitation Medicine

<69>
Accession Number
2029869685
Title
Efficacy of ultrasound-guided stellate ganglion block in relieving acute
postoperative pain: a systematic review and meta-analysis.
Source
Journal of International Medical Research. 52(5) (no pagination), 2024.
Date of Publication: May 2024.
Author
Zhao Y.; Xiao X.
Institution
(Zhao, Xiao) Department of Anesthesiology, Beihai People's Hospital,
Beihai, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The efficacy of ultrasound-guided stellate ganglion block (SGB)
in alleviating postoperative pain remains unclear. This meta-analysis was
performed to determine the efficacy of ultrasound-guided SGB in relieving
acute postoperative pain in patients undergoing surgery with general
anesthesia. Method(s): This systematic review and meta-analysis
focused on randomized controlled trials comparing SGB with control or
placebo. The primary outcome was the pain score at 24 hours after surgery.
A random-effects model was used to calculate the mean difference (MD) or
risk ratio with a confidence interval (CI) of 95%. Result(s): Eight
studies involving 470 patients were included in the meta-analysis. The
results revealed that ultrasound-guided SGB was significantly associated
with a lower pain score at 24 hours after surgery (MD = -0.74; 95% CI =
-1.39, -0.08; I2 = 86%; low evidence) and at 8 hours after
surgery (MD = -0.65; 95% CI = -1.03, -0.28; I2 = 29%; moderate
evidence). Conclusion(s): Ultrasound-guided SGB is effective in
alleviating acute postoperative pain. However, considering the limited
number of trials performed to date, more large-scale and high-quality
randomized controlled trials are required to confirm these
findings. Copyright © The Author(s) 2024.

<70>
Accession Number
2029331649
Title
Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist
devices: A systematic review and individual patient data meta-analysis.
Source
Artificial Organs. 48(6) (pp 577-585), 2024. Date of Publication: June
2024.
Author
Patil S.; Ahmad D.; Shah K.; Vishnevsky A.; Ruggiero N.; Rajapreyar I.N.;
Rame J.E.; Alvarez R.; Rajagopal K.; Entwistle J.W.; Massey H.;
Tchantchaleishvili V.
Institution
(Patil, Ahmad, Rajagopal, Entwistle, Massey, Tchantchaleishvili) Division
of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United
States
(Shah) The Lawrenceville School, Lawrenceville, NJ, United States
(Vishnevsky, Ruggiero, Rajapreyar, Rame, Alvarez) Division of Cardiology,
Thomas Jefferson University, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Purpose: LVAD outflow graft stenosis continues to remain prevalent with a
high complication rate. We sought to pool the existing evidence on
indications, utilization patterns, and outcomes of transcatheter
interventions for outflow graft stenosis in the HeartMate 3 LVAD.
 Method(s): An electronic search was performed to identify all studies
in the English literature reporting on HeartMate 3 LVAD outflow graft
stenting. Patient-level data were extracted for analysis. Result(s):
Thirteen published reports and one unpublished case comprising a total of
28 patients were included. Median patient age was 68.5 years
[Interquartile range: 58, 71] and 25.9% (7/27) were female. Dyspnea [60.7%
(17/28)] was the most common presenting symptom. Low flow alarms were
present in 60% (15/25) of patients. Findings included external compression
[35.7% (10/28)], graft twist [21.4% (6/28)], graft twist and external
compression [14.3% (4.28)], intraluminal thrombus [10.7% (3/28)], graft
twist and intraluminal thrombus [3.6% (1/28)], and pseudoaneurysm of
outflow graft [3.6% (1/28)]. Median time from LVAD implantation to
stenting was 2.1 years [1.4, 3]. Immediate flow normalization after
stenting was observed in 85.7% (24/28). The 30-day mortality was 12%
(3/25). Overall mortality was 12% (3/25) at a median follow-up of 3.9
months [1, 17]. Conclusion(s): Outflow graft stenting in the
HeartMate 3 LVAD appears to be a reasonable treatment option for outflow
graft stenosis, with low overall rates of complications and mortality.
Further refinement of indications and approaches may improve
outcomes. Copyright © 2024 International Center for Artificial
Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

<71>
Accession Number
2032369818
Title
Anticoagulation and antiplatelet agent use among patients with von
Willebrand disease and cardiac disease.
Source
Blood Advances. 8(9) (pp 2244-2247), 2024. Date of Publication: 14 May
2024.
Author
Merz L.E.; AbdelHameid D.; Kanaan D.M.; Farah S.; Manzo P.; Connell N.T.
Institution
(Merz, Connell) Division of Hematology, Department of Medicine, Brigham
and Women's Hospital, Boston, MA, United States
(Merz) Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United
States
(AbdelHameid) Department of Dermatology, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Kanaan, Manzo) Department of Pharmacy Services, United States
(Farah) Department of Data Science, Brigham and Women's Hospital, Boston,
MA, United States
(Connell) Harvard Medical School, Boston, MA, United States
Publisher
American Society of Hematology

<72>
Accession Number
2032350869
Title
Use of standard Del Nido cardioplegia for the intracardiac repair of
tetralogy of Fallot: A systematic review and meta-analysis of randomized
controlled trials.
Source
Health Sciences Review. 11 (no pagination), 2024. Article Number: 100179.
Date of Publication: June 2024.
Author
Usmani S.U.R.; Hasan S.U.; Ahmed S.H.; Pervez N.; Zia A.; Chen Q.; Gill
G.; Rowe G.; Alvi S.; Zubair M.M.
Institution
(Usmani, Hasan, Pervez, Zia) Department of Surgery, Dow University of
Health Sciences, Baba-e-Urdu Rd, Karachi 74200, Pakistan
(Ahmed) Division of Plastic and Reconstructive Surgery, Department of
Surgery, University of Florida, Gainesville, FL 32610, United States
(Chen, Gill, Rowe) Department of Cardiac Surgery, Cedars-Sinai Hospital,
8700 Beverly Blvd, Los Angeles, CA 90048, United States
(Alvi) Tufts Medical Centre, 800 Washington St, Boston, MA 02111, United
States
(Zubair) Department of Pediatric Cardiac Surgery, C.S. Mott Children's
Hospital, University of Michigan Health, 1540 E Hospital Dr, Ann Arbor, MI
48109, United States
Publisher
Elsevier Ltd
Abstract
This meta-analysis compares the efficacy of the standard Del Nido
cardioplegia with other agents during intra-cardiac tetralogy of Fallot
repair. Meta-analysis was performed on studies comparing standard Del Nido
cardioplegia with other types of cardioplegia. Outcomes were pooled using
inverse variance and random effects analysis models to calculate the
standardized mean difference (SMD) and odds ratio (OR). The SMD for ICU
length of stay, duration of mechanical ventilation, and time taken for the
heart to return to normal rhythm were -0.06 (P = 0.67), -0.21 (P = 0.06),
and 0.23 (P = 0.48), respectively. The OR for the incidence of
postoperative arrhythmias was 0.65 (P = 0.32). The standardized mean
differences for twenty-four-hour post-operative IL-6, TNF-alpha, and cTnI
levels were 0.29 (P = 0.16), -0.27 (P = 0.01), and -0.60 (P = 0.01),
respectively. Del Nido cardioplegia is protective on the myocardium, with
lower levels of inflammatory cytokines 24 h post-operation and a
significantly reduced incidence of post-operative
arrhythmias. Copyright © 2024

<73>
Accession Number
2032315955
Title
Pyridostigmine to Reduce the duration of postoperative Ileus after
Colorectal surgery (PyRICo-RCT): randomized clinical trial.
Source
British Journal of Surgery. 111(5) (no pagination), 2024. Article Number:
znae121. Date of Publication: 01 May 2024.
Author
Traeger L.; Bedrikovetski S.; Fitzsimmons T.; Nguyen T.-M.; Moore J.W.;
Lewis M.; Sammour T.
Institution
(Traeger, Bedrikovetski, Fitzsimmons, Nguyen, Moore, Lewis, Sammour)
Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide,
SA, Australia
(Traeger, Bedrikovetski, Fitzsimmons, Moore, Sammour) Adelaide Medical
School, Faculty of Health and Medical Sciences, University of Adelaide,
Adelaide, SA, Australia
Publisher
Oxford University Press
Abstract
Background: Postoperative ileus, driven by the cholinergic
anti-inflammatory pathway, is the most common complication in patients
undergoing colorectal surgery. By inhibiting acetylcholinesterase,
pyridostigmine can potentially modulate the cholinergic anti-inflammatory
pathway and accelerate gastrointestinal recovery. This study aimed to
assess the efficacy of pyridostigmine in improving gastrointestinal
recovery after colorectal surgery. Method(s): This double-blinded RCT
enrolled adult patients undergoing elective colorectal surgery at two
hospitals in South Australia. Patients were randomized to 60 mg oral
pyridostigmine or placebo twice daily starting 6 h after surgery until the
first passage of stool. The primary outcome was GI-2, a validated
composite measure of time to first stool and tolerance of oral diet.
Secondary outcomes included incidence of postoperative ileus (defined as
GI-2 greater than 4 days), duration of hospital stay, and 30-day
complications, evaluated by intention-to-treat univariate analysis.
 Result(s): Of 130 patients recruited (mean(s.d.) age 58.4(16.4)
years; 73 men, 56%), 65 were allocated to each arm. The median GI-2 was 1
day shorter with pyridostigmine compared with placebo (2 (i.q.r. 1-3)
versus 3 (2-4) days; P = 0.015). However, there were no significant
differences in postoperative ileus (17.2 versus 21.5%; P = 0.532) or
duration of hospital stay (median 5 (i.q.r. 4-8.75) versus 5 (4-7.5) days;
P = 0.921). Similarly, there were no significant differences in overall
complications, anastomotic leak, cardiac complications, or
patient-reported side effects. Conclusion(s): Pyridostigmine resulted
in a quicker return of GI-2 and was well tolerated. Larger multicentre
studies are required to determine the optimal dosing and evaluate the
impact of pyridostigmine in different surgical settings. Registration
number: ACTRN12621000530820 (https://anzctr.org.au). Copyright ©
The Author(s) 2024. Published by Oxford University Press on behalf of BJS
Foundation Ltd. All rights reserved.

<74>
Accession Number
2026199038
Title
Surgical outcomes of double-orifice mitral valve repair in patients with
atrioventricular canal defects: A systematic review and meta-analysis.
Source
Cardiology in the Young. 33(9) (pp 1506-1516), 2023. Date of Publication:
01 Sep 2023.
Author
Ghosh S.; Halder V.; Mittal A.; Mishra A.; Haranal M.; Aggarwal P.; Singh
H.; Barwad P.; Naganur S.; Thingnam S.K.S.
Institution
(Ghosh, Naganur) Department of Cardiology, PGIMER, Chandigarh, India
(Halder, Haranal, Barwad, Thingnam) Deartment of CTVS, UNMICRC, Ahmedabad,
India
(Mittal, Mishra, Aggarwal, Singh) Department of CTVS, PGIMER, Chandigarh,
India
Publisher
Cambridge University Press
Abstract
Introduction: Double-orifice mitral valve or left atrioventricular valve
is a rare congenital cardiac anomaly that may be associated with an
atrioventricular septal defect. The surgical management of double-orifice
mitral valve/double-orifice left atrioventricular valve with
atrioventricular septal defect is highly challenging with acceptable
clinical outcomes. This meta-analysis is aimed to evaluate the surgical
outcomes of double-orifice mitral valve/double-orifice left
atrioventricular valve repair in patients with atrioventricular septal
defect. Methods and Results: A total of eight studies were retrieved
from the literature by searching through PubMed, Google Scholar, Embase,
and Cochrane databases. Using Bayesian hierarchical models, we estimated
the pooled proportion of incidence of double-orifice mitral
valve/double-orifice left atrioventricular valve with atrioventricular
septal defect as 4.88% in patients who underwent surgical repair (7
studies; 3295 patients; 95% credible interval [CI] 4.2-5.7%). As compared
to pre-operative regurgitation, the pooled proportions of post-operative
regurgitation were significantly low in patients with moderate status: 5.1
versus 26.39% and severe status: 5.7 versus 29.38% [8 studies; 171
patients]. Moreover, the heterogeneity test revealed consistency in the
data (p < 0.05). Lastly, the pooled estimated proportions of early and
late mortality following surgical interventions were low, that is, 5 and
7.4%, respectively. Conclusion(s): The surgical management of
moderate to severe regurgitation showed corrective benefits
post-operatively and was associated with low incidence of early mortality
and re-operation. Copyright © The Author(s), 2023. Published by
Cambridge University Press.

<75>
Accession Number
644303843
Title
Differential Effect of Aortic Valve Replacement for Severe Aortic Stenosis
on Hyperemic and Resting Epicardial Coronary Pressure Indices.
Source
Journal of the American Heart Association. 13(10) (pp e034401), 2024. Date
of Publication: 21 May 2024.
Author
Minten L.; Bennett J.; Otsuki H.; Takahashi K.; Fearon W.F.; Dubois C.
Institution
(Minten, Bennett, Dubois) Department of Cardiovascular Sciences Katholieke
Universiteit Leuven Leuven Belgium, Belgium
(Minten, Otsuki, Takahashi, Fearon) Division of Cardiovascular Medicine
Stanford University Palo Alto CA
(Bennett, Dubois) Department of Cardiovascular Medicine University
Hospitals Leuven (UZ Leuven) Leuven Belgium, Belgium
Abstract
BACKGROUND: Coronary pressure indices to assess coronary artery disease
are currently underused in patients with aortic stenosis due to many
potential physiological effects that might hinder their interpretation.
Studies with varying sample sizes have provided us with conflicting
results on the effect of transcatheter aortic valve replacement (TAVR) on
these indices. The aim of this meta-analysis was to study immediate and
long-term effects of TAVR on fractional flow reserve (FFR) and
nonhyperemic pressure ratios (NHPRs). METHODS AND RESULTS: Lesion-specific
coronary pressure data were extracted from 6 studies, resulting in 147
lesions for immediate change in FFR analysis and 105 for NHPR analysis. To
investigate the long-term changes, 93 lesions for FFR analysis and 68 for
NHPR analysis were found. Lesion data were pooled and compared with paired
t tests. Immediately after TAVR, FFR decreased significantly
(-0.0130+/-0.0406 SD, P: 0.0002) while NHPR remained stable
(0.0003+/-0.0675, P: 0.9675). Long-term after TAVR, FFR decreased
significantly (-0.0230+/-0.0747, P: 0.0038) while NHPR increased
nonsignificantly (0.0166+/-0.0699, P: 0.0543). When only borderline NHPR
lesions were considered, this increase became significant
(0.0249+/-0.0441, P: 0.0015). Sensitivity analysis confirmed our results
in borderline lesions. CONCLUSION(S): TAVR resulted in small
significant, but opposite, changes in FFR and NHPR. Using the standard
cut-offs in patients with severe aortic stenosis, FFR might underestimate
the physiological significance of a coronary lesion while NHPRs might
overestimate its significance. The described changes only play a
clinically relevant role in borderline lesions. Therefore, even in
patients with aortic stenosis, an overtly positive or negative
physiological assessment can be trusted.

<76>
Accession Number
643384583
Title
Peripheral nerve block and cognitive impairment after thoracic surgery: a
systematic review and meta-analysis.
Source
Minerva anestesiologica. 90(5) (pp 417-426), 2024. Date of Publication: 01
May 2024.
Author
Zhang Y.; Liu M.; He J.; Zhang H.; Zhang M.; Li J.
Institution
(Zhang, Liu, He, Zhang, Zhang) Department of Anesthesiology, Hebei General
Hospital, Shijiazhuang, Hebei, China
(Zhang) Graduate Faculty, North China University of Science and
Technology, Tangshan, Hebei, China
(Li) Department of Anesthesiology, Hebei General Hospital, Shijiazhuang,
Hebei, China
Abstract
INTRODUCTION: Postoperative cognitive impairment is common in surgical
patients, including postoperative delirium and postoperative cognitive
dysfunction. Several studies investigating the association between
peripheral nerve block and the risk of cognitive impairment after thoracic
surgery showed conflicting results. Therefore, we conducted the current
systematic review and meta-analysis to determine the effects of peripheral
nerve block on postoperative cognitive impairment in thoracic surgical
patients. EVIDENCE ACQUISITION: Eligible randomized controlled trials were
retrieved from PubMed, Cochrane Library, Web of Science and Embase
databases. The primary outcomes were the incidence of postoperative
delirium or cognitive dysfunction and the MMSE scores. Furthermore, VAS
scores, levels of TNF-alpha and IL-6, as well as the duration of
hospitalization were analyzed as secondary outcomes. EVIDENCE SYNTHESIS:
Ten articles including 1279 participants were selected for this
meta-analysis. The results showed that peripheral nerve block could lessen
the incidence of postoperative delirium or cognitive dysfunction (OR=0.39,
95% CI [0.27 to 0.56]), the scores of VAS (MD=-1.35 [95% CI: -2.30 to
-0.40]), the values of TNF-alpha (SMD=-1.13 [95% CI: -1.49 to -0.76]) and
IL-6 (SMD=-1.65 [95% CI: -1.87 to -1.42]), as well as the length of
hospitalization (MD=-0.70 [95% CI: -0.96 to -0.43]). In addition,
peripheral nerve block was linked to a significant increase in MMSE scores
(MD=2.16 [95% CI: 1.40 to 2.91]). CONCLUSION(S): This meta-analysis
revealed positive effects of peripheral nerve block on improving
postoperative cognitive impairment in patients following thoracic surgery.

<77>
Accession Number
2029870651
Title
Difference in coagulation systems of large animal species used in
cardiovascular research: a systematic review.
Source
Journal of Artificial Organs. (no pagination), 2024. Date of Publication:
2024.
Author
Staelens L.; Langenaeken T.; Rega F.; Meuris B.
Institution
(Staelens, Langenaeken, Rega, Meuris) Department of Cardiovascular
Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven,
Herestraat 49, Leuven 3000, Belgium
Publisher
Springer
Abstract
Preclinical testing using animal models is indispensable in cardiovascular
research. However, the translation to clinical practice of these animal
models is questionable since it is not always clear how representative
they are. This systematic review intends to summarize the interspecies
differences in the coagulation profile of animal models used in
cardiovascular research. It aims to guide future research in choosing the
optimal animal species. A literature search of PubMed, Embase, Web of
Science (Core Collection) and Cochrane Library was performed using a
search string that was well defined and not modified during the study. An
overview of the search terms used in each database can be found in the
appendix. Articles describing coagulation systems in large animals were
included. We identified 30 eligible studies of which 15 were included.
Compared to humans, sheep demonstrated a less active external pathway of
coagulation. Sheep had a higher platelet count but the platelet
activatability and response to biomaterials were lower. Both sheep and
pigs displayed no big differences in the internal coagulation system
compared to humans. Pigs showed results very similar to those of humans,
with the exception of a higher platelet count and stronger platelet
aggregation in pigs. Coagulation profiles of different species used for
preclinical testing show strong variation. Adequate knowledge of these
differences is key in the selection of the appropriate species for
preclinical cardiovascular research. Future thrombogenicity research
should compare sheep to pig in an identical experimental
setup. Copyright © The Author(s) 2024.

<78>
Accession Number
2032395046
Title
Sodium-Glucose Cotransporter-2 Inhibitors and Cardiovascular Protection
among Patients with Type 2 Diabetes Mellitus: A Systematic Review.
Source
Journal of Diabetes Research. 2024 (no pagination), 2024. Article Number:
9985836. Date of Publication: 2024.
Author
Yankah R.K.; Anku E.K.; Eligar V.
Institution
(Yankah) Diabetes Specialist Clinic, Cape Coast Teaching Hospital, Cape
Coast, Ghana
(Anku) Dietherapy and Nutrition Unit, Cape Coast Teaching Hospital, P.O.
Box CC 1363, Cape Coast, Ghana
(Eligar) Department of Diabetes and Endocrinology, Imperial College London
Diabetes Centre, Abu Dhabi, United Arab Emirates
Publisher
Hindawi Limited
Abstract
Background: Accumulating evidence has demonstrated the positive effects of
sodium-glucose cotransporter-2 (SGLT2) inhibitors in managing patients
with type 2 diabetes mellitus (T2DM). SGLT2 inhibitors protect patients
with T2DM from cardiovascular complications and are generally safe.
 Aim(s): The aim of this study is to assess the cardiovascular effects
of SGLT2 inhibitors in patients with T2DM. Method(s): A systematic
review was conducted using published English literature in PubMed and
Google Scholar databases. Result(s): Most of the studies showed
significant positive cardiovascular effects of SGLT2 inhibitors in
patients with and without established cardiovascular disease (CVD).
Empagliflozin reduced the risk of cardiovascular death, hospitalization
for heart failure (HHF), cardiovascular death or heart failure, and major
adverse cardiovascular events (MACE) such as nonfatal stroke, nonfatal
myocardial infarction, and cardiovascular death regardless of the number
of cardiovascular risk factors. The effects of empagliflozin on
cardiovascular events and mortality in patients with coronary artery
bypass graft (CABG) were assessed. Further, the efficacy of empagliflozin
in three different phenotypic groups, namely, younger patients with
shorter duration of T2DM and highest glomerular filtration rate, women
without coronary artery disease, and older adults with advanced coronary
artery disease plus several comorbidities, was also assessed. The effects
of canagliflozin were evaluated in patients with and without a history of
CVD and with different body weights, and in those with and without prior
heart failure. Treatment with canagliflozin based on
multivariable-predicted cardiovascular risk factors prevented heart
failure events more than treatment based on glycated hemoglobin and
albuminuria alone. The efficacy of dapagliflozin was evaluated in patients
with or at risk of atherosclerotic cardiovascular disease (ASCVD), heart
failure status, and left ventricular ejection fraction (LVEF), as well as
the elderly population. A reduction in HHF or cardiovascular death and
insignificant reduction in MACE were noted. Furthermore, significant
reduction in the risk of cardiovascular death and all-cause mortality in
patients with heart failure with reduced ejection fraction (HFrEF) was
also observed. Sotagliflozin was studied for its cardiovascular outcomes
in patients with chronic kidney disease with or without albuminuria and
resulted in a reduction in cardiovascular-related deaths and HHF.
 Conclusion(s): SGLT2 inhibitors have beneficial cardiovascular
effects in patients with T2DM and should be incorporated into their
management. Copyright © 2024 Richard K. Yankah et al.

<79>
Accession Number
2032393508
Title
Dexmedetomidine mitigates acute kidney injury after coronary artery bypass
grafting: a prospective clinical trial.
Source
Revista Espanola de Cardiologia. (no pagination), 2024. Date of
Publication: 2024.
Author
Zhang C.; Zhang Y.; Liu D.; Mei M.; Song N.; Zhuang Q.; Jiang Y.; Guo Y.;
Liu G.; Li X.; Ren L.
Institution
(Zhang, Zhang, Liu, Mei, Song, Zhuang, Liu, Li) Department of
Anesthesiology, First Affiliated Hospital of Bengbu Medical University,
Anhui, Bengbu, China
(Jiang) Department of Cardiac Surgery, First Affiliated Hospital of Bengbu
Medical University, Anhui, Bengbu, China
(Guo) Department of Urology, First Affiliated Hospital of Bengbu Medical
University, Anhui, Bengbu, China
(Ren) School of Laboratory Medicine, Bengbu Medical University, Anhui,
Bengbu, China
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: To evaluate the impact of dexmedetomidine
impact on cardiac surgery-associated acute kidney injury (CSA-AKI), kidney
function, and metabolic and oxidative stress in patients undergoing
coronary artery bypass grafting with heart-lung machine support.
 Method(s): A randomized double-masked trial with 238 participants
(50-75 years) undergoing coronary artery bypass grafting was conducted
from January 2021 to December 2022. The participants were divided into Dex
(n = 119) and NS (n = 119) groups. Dex was administered at 0.5 mcg/kg over
10 minutes, then 0.4 mcg/kg/h until the end of surgery; the NS group
received equivalent saline. Blood and urine were sampled at various time
points pre- and postsurgery. The primary outcome measure was the incidence
of CSA-AKI, defined as the occurrence of AKI within 96 hours after
surgery. Result(s): The incidence of CSA-AKI was significantly lower
in the Dex group than in the NS group (18.26% vs 32.46%; P = .014).
Substantial increases were found in estimated glomerular filtration rate
value at T4-T6 (P < .05) and urine volume 24 hours after surgery (P <
.01). Marked decreases were found in serum creatinine level, blood glucose
level at T1-T2 (P < .01), blood urea nitrogen level at T3-T6 (P < .01),
free fatty acid level at T2-T3 (P < .01), and lactate level at T3-T4 (P <
.01). Conclusion(s): Dex reduces CSA-AKI, potentially by regulating
metabolic disorders and reducing oxidative stress. Registered with the
Chinese Clinical Study Registry (No. ChiCTR2100051804). Copyright
© 2024 Sociedad Espanola de Cardiologia

<80>
Accession Number
2032393133
Title
The impact of permanent pacemaker implantation on long-term survival after
cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Sakurai Y.; Mehaffey J.H.; Kuno T.; Yokoyama Y.; Takagi H.; Denning D.A.;
Kaneko T.; Badhwar V.
Institution
(Sakurai, Denning) Department of Surgery, Marshall University Joan Edwards
School of Medicine, Huntington, WVa, United States
(Mehaffey, Badhwar) Department of Cardiovascular and Thoracic Surgery,
West Virginia University, Morgantown, WVa, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
(Yokoyama) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St
Louis, St Louis, Mo, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The long-term impact of permanent pacemaker (PPM) implantation
on survival after cardiac surgery remains ill defined. We aimed to
investigate the effect of PPM on survival and explore factors driving
outcomes using meta-regression according to the type of surgery.
 Method(s): MEDLINE, EMBASE, and the Cochrane Library Central Register
of Controlled Trials were searched through October 2023 to identify
studies reporting the long-term outcomes of PPM implantation. The primary
outcome was all-cause mortality during follow-up. The secondary outcome
was heart failure rehospitalization. The subgroup analysis and
meta-regression analysis were performed according to the type of surgery.
 Result(s): A total of 28 studies met the inclusion criteria. 183,555
patients (n = 6298; PPM, n = 177,257; no PPM) were analyzed for all-cause
mortality, with a weighted median follow-up of 79.7 months. PPM
implantation was associated with increased risks of all-cause mortality
during follow-up (hazard ratio, 1.22; confidence interval, 1.08-1.38, P <
.01) and heart failure rehospitalization (hazard ratio, 1.24; confidence
interval, 1.01-1.52, P = .04). Meta-regression demonstrated the adverse
impact of PPM was less prominent in patients undergoing mitral or
tricuspid valve surgery, whereas studies with a greater proportion with
aortic valve replacement were associated with worse outcomes. Similarly, a
greater proportion with atrioventricular block as an indication of PPM was
associated with worse survival. Conclusion(s): PPM implantation after
cardiac surgery is associated with a greater risk of long-term all-cause
mortality and heart failure rehospitalization. This impact is more
prominent in patients undergoing aortic valve surgery or atrioventricular
block as an indication than those undergoing mitral or tricuspid valve
surgery. Copyright © 2024 The American Association for Thoracic
Surgery

<81>
Accession Number
2032147215
Title
Landiolol for perioperative atrial tachyarrhythmias in cardiac and
thoracic surgery patients: a systematic review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Kowalik K.; Silverman M.; Oraii A.; Conen D.; Belley-Cote E.P.; Healey
J.S.; Um K.J.; Inami T.; Wanner P.M.; Wang M.K.; Pandey A.; Udayashankar
A.; Whitlock R.P.; Devereaux P.J.; McIntyre W.F.
Institution
(Kowalik, Silverman, Pandey, Udayashankar) Michael G. DeGroote School of
Medicine, Hamilton, ON, Canada
(Oraii, Conen, Belley-Cote, Healey, Wanner, Wang, Whitlock, Devereaux,
McIntyre) Population Health Research Institute, Hamilton, ON, Canada
(Um) McMaster University, Hamilton, ON, Canada
(Inami) Nippon Medical School, Tokyo, Japan
Publisher
Elsevier Ltd

<82>
Accession Number
2029887099
Title
Ethnic minorities treated with new-generation drug-eluting coronary stents
in two European randomised clinical trials.
Source
Netherlands Heart Journal. (no pagination), 2024. Date of Publication:
2024.
Author
Ploumen E.H.; Semedo E.; Doggen C.J.M.; Schotborgh C.E.; Anthonio R.L.;
Danse P.W.; Benit E.; Aminian A.; Stoel M.G.; Hartmann M.; van Houwelingen
K.G.; Scholte M.; Roguin A.; Linssen G.C.M.; Zocca P.; von Birgelen C.
Institution
(Ploumen, Semedo, Stoel, Hartmann, van Houwelingen, Zocca, von Birgelen)
Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente,
Enschede, Netherlands
(Ploumen, Semedo, Doggen, von Birgelen) Health Technology and Services
Research, Faculty of Behavioural, Management and Social Sciences,
Technical Medical Centre, University of Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Anthonio) Department of Cardiology, Treant Zorggroep, Scheper Hospital,
Emmen, Netherlands
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Benit) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Scholte) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht,
Netherlands
(Roguin) Department of Cardiology, Hillel Yaffe Medical Centre, Hadera and
B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa,
Israel
(Linssen) Department of Cardiology, Hospital Group Twente, Almelo,
Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Background: Several ethnic minorities have an increased risk of
cardiovascular events, but previous European trials that investigated
clinical outcome after coronary stenting did not assess the patients'
ethnic background. Aim(s): To compare ethnic minority and Western
European trial participants in terms of both cardiovascular risk profile
and 1-year clinical outcome after percutaneous coronary intervention.
 Method(s): In the BIO-RESORT and BIONYX randomised trials, which
assessed new-generation drug-eluting stents, information on patients'
self-reported ethnic background was prospectively collected. Pooled
patient-level data of 5803 patients, enrolled in the Netherlands and
Belgium, were analysed in this prespecified analysis. The main endpoint
was target vessel failure after 1 year. Result(s): Patients were
classified as belonging to an ethnic minority (n= 293, 5%) or of Western
European origin (n= 5510, 95%). Follow-up data were available in 5772 of
5803 (99.5%) patients. Ethnic minority patients were younger, less often
female, more often current smokers, more often medically treated for
diabetes, and more often had a positive family history of coronary artery
disease. The main endpoint target vessel failure did not differ between
ethnic minority and Western European patients (3.5% vs 4.9%, hazard ratio
0.71, 95% confidence interval 0.38-1.33; p= 0.28). There was also no
difference in mortality, myocardial infarction, and repeat
revascularisation rates. Conclusion(s): Despite the unfavourable
cardiovascular risk profile of ethnic minority patients, short-term
clinical outcome after treatment with contemporary drug-eluting stents was
highly similar to that in Western European patients. Further efforts
should be made to ensure the enrolment of more ethnic minority patients in
future coronary stent trials. Copyright © The Author(s) 2024.

<83>
Accession Number
2029886885
Title
Efficacy of Epsilon Aminocaproic Acid Versus Placebo in Coronary Artery
Bypass Graft: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Current Treatment Options in Cardiovascular Medicine. (no pagination),
2024. Date of Publication: 2024.
Author
Rabiee Rad M.; Ghasempour Dabaghi G.; Amani-Beni R.
Institution
(Rabiee Rad, Ghasempour Dabaghi) Interventional Cardiology Research
Center, Cardiovascular Research Institute, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Amani-Beni) School of Medicine, Isfahan University of Medical Science,
Isfahan, Iran, Islamic Republic of
Publisher
Springer
Abstract
Introduction: The aim of this study was to investigate the efficacy of
epsilon aminocaproic acid (EACA) as a prophylactic antifibrinolytic agent
in patients undergoing coronary artery bypass graft (CABG) surgery.
 Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) comparing the efficacy of EACA in CABG surgery
with placebo groups was performed. The outcomes assessed included
postoperative 24-h and total blood loss, pre- and postoperative hemoglobin
change, and blood transfusion requirements. Result(s): A total of 16
RCTs with 897 participants were included in the meta-analysis. The
analysis revealed that EACA significantly reduced 24-h postoperative blood
loss compared to placebo (WMD = -135 ml, 95% CI: -217, -53 ml,
I2 = 65.3%). However, there was no significant difference in
total blood loss between the EACA and placebo groups. EACA administration
also reduced the transfusion rate for platelets (WMD = -0.09, 95% CI:
-0.1, -0.02, I2 = 65.3%), but not for red blood cells, fresh
frozen plasma, or cryoprecipitate. There was no significant difference in
hemoglobin decline between EACA and placebo groups. Conclusion(s):
This meta-analysis suggests the use of EACA as a prophylactic
antifibrinolytic agent in CABG surgery. It effectively reduces
postoperative 24-h 24-h blood loss compared with placebo after coronary
artery bypass graft (CABG) and potentially minimizing the need for
platelet transfusions. There were no significant differences between EACA
and placebo in terms of total blood loss, hemoglobin decline, and the need
for red blood cells, fresh frozen plasma, or cryoprecipitate. Further
research is needed to evaluate optimal dosage regimens and long-term
outcomes of EACA administration. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<84>
Accession Number
2032313460
Title
The safety and efficacy of balanced crystalloid vs. normal saline in
non-cardiac surgeries - A systematic review and meta-analysis.
Source
European Review for Medical and Pharmacological Sciences. 28(9) (pp
3347-3364), 2024. Date of Publication: 2024.
Author
Cao Q.; Pang Q.-Y.; Sun S.-F.; Jiang Y.; Liu H.-L.
Institution
(Cao) Department of Anesthesiology, Dazhou Dachuan District People's
Hospital, Sichuan Province, Dazhou, China
(Pang, Sun, Jiang, Liu) Department of Anesthesiology, Chongqing University
Cancer Hospital, Shapingba District, Chongqing City, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Balanced crystalloid and normal saline are routinely used in
clinical anesthesia, but their safety and efficacy in non-cardiac
surgeries are still unclear. MATERIALS AND METHODS: PubMed, Embase, Web of
Science, Cochrane Library, Wanfang, and CNKI, from January 1980 to March
2023, were searched. Studies comparing balanced crystalloid (BC) with
normal saline (NS) during non-cardiac surgeries were included. The primary
outcomes were clinical outcomes (acidosis, renal insufficiency, and
mortality), and the secondary outcomes were pH value, Na+, Cl- and
creatinine levels, and vasopressor requirement. RESULT(S):
Forty-three RCTs were included in this meta-analysis. Low evidence
revealed that the development of acidosis was lower in the BC group than
in the NS group (OR: 0.05, 95% CI: 0.01-0.43, I2=80.8%, p=0.00), and no
between- group difference exists in renal insufficiency and mortality. At
the end of surgery and on postoperative day 1 (POD 1), the pH value was
higher, and the levels of Na+ and Cl- were lower in the BC group. No
between-group difference exists in creatinine level and vasopressor
requirement. CONCLUSION(S): Perioperative balanced crystalloids can
maintain the stability of acid-base and electrolyte balance and reduce
acidosis compared with saline, but they cannot reduce postoperative renal
insufficiency and mortality. Copyright © 2024 Verduci Editore
s.r.l. All rights reserved.

<85>
Accession Number
2029864026
Title
The role of hemoadsorption in cardiac surgery - a systematic review.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
258. Date of Publication: December 2024.
Author
Matejic-Spasic M.; Lindstedt S.; Lebreton G.; Dzemali O.; Suwalski P.;
Folliguet T.; Geidel S.; Klautz R.J.M.; Baufreton C.; Livi U.; Gunaydin
S.; Deliargyris E.N.; Wendt D.; Thielmann M.
Institution
(Matejic-Spasic, Wendt) CytoSorbents Europe GmbH, Berlin, Germany
(Lindstedt) Department of Cardiothoracic Surgery and Transplantation,
Skane University Hospital, Lund, Sweden
(Lebreton) Thoracic and Cardiovascular Surgery Department,
Pitie-Salpetriere University Hospital, Paris, France
(Dzemali) Department of Cardiac Surgery, University Hospital Zurich,
Zurich, Switzerland
(Dzemali) Department of Cardiac Surgery, City Hospital Triemli, Zurich,
Switzerland
(Suwalski) Department of Cardiac Surgery, Central Clinical Hospital of the
Ministry of the Interior and Administration, Warsaw, Poland
(Folliguet) Department of Cardiac Surgery, Henri Mondor Hospital, Paris,
France
(Geidel) Department of Cardiac Surgery, Asklepios Klinik St. Georg,
Hamburg, Germany
(Klautz) Department of Cardio-Thoracic Surgery, University Medical Center,
Leiden, Netherlands
(Baufreton) Department of Cardiovascular and Thoracic Surgery, University
Hospital, Angers, France
(Livi) Department of Cardiothoracic Surgery, University Hospital, Udine,
Italy
(Gunaydin) Department of Cardiovascular Surgery, University of Health
Sciences, Ankara City Hospital Campus, Ankara, Turkey
(Deliargyris) CytoSorbents Inc, Princeton, NJ, United States
(Wendt, Thielmann) Department of Thoracic- and Cardiovascular Surgery,
Westgerman Heart and Vascular Center, University Duisburg-Essen, Essen,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Extracorporeal blood purification has been widely used in
intensive care medicine, nephrology, toxicology, and other fields. During
the last decade, with the emergence of new adsorptive blood purification
devices, hemoadsorption has been increasingly applied during CPB in
cardiac surgery, for patients at different inflammatory risks, or for
postoperative complications. Clinical evidence so far has not provided
definite answers concerning this adjunctive treatment. The current
systematic review aimed to critically assess the role of perioperative
hemoadsorption in cardiac surgery, by summarizing the current knowledge in
this clinical setting. Method(s): A literature search of PubMed,
Cochrane library, and the database provided by CytoSorbents was conducted
on June 1st, 2023. The search terms were chosen by applying neutral search
keywords to perform a non-biased systematic search, including language
variations of terms "cardiac surgery" and "hemoadsorption". The screening
and selection process followed scientific principles (PRISMA statement).
Abstracts were considered for inclusion if they were written in English
and published within the last ten years. Publications were eligible for
assessment if reporting on original data from any type of study (excluding
case reports) in which a hemoadsorption device was investigated during or
after cardiac surgery. Results were summarized according to sub-fields and
presented in a tabular view. Result(s): The search resulted in 29
publications with a total of 1,057 patients who were treated with
hemoadsorption and 988 control patients. Articles were grouped and
descriptively analyzed due to the remarkable variability in study designs,
however, all reported exclusively on CytoSorb therapy. A total
of 62% (18/29) of the included articles reported on safety and no
unanticipated adverse events have been observed. The most frequently
reported clinical outcome associated with hemoadsorption was reduced
vasopressor demand resulting in better hemodynamic stability.
 Conclusion(s): The role of hemoadsorption in cardiac surgery seems to
be justified in selected high-risk cases in infective endocarditis, aortic
surgery, heart transplantation, and emergency surgery in patients under
antithrombotic therapy, as well as in those who develop a dysregulated
inflammatory response, vasoplegia, or septic shock postoperatively. Future
large randomized controlled trials are needed to better define proper
patient selection, dosing, and timing of the therapy. Copyright ©
The Author(s) 2024.

<86>
Accession Number
2031181937
Title
The outcomes of aortic arch repair between open surgical repair and
debranching endovascular hybrid surgical repair: A systematic review and
meta-analysis.
Source
Journal of Vascular Surgery. 79(6) (pp 1510-1524), 2024. Date of
Publication: June 2024.
Author
Chen C.W.; Hu J.; Li Y.Y.; Chen G.X.; Zhang W.; Chen X.Y.
Institution
(Chen) Division of Liver Surgery, Department of General Surgery, West
China Hospital, Sichuan University, Chengdu, China
(Hu) Division of Health Management Centre, West China Fourth Hospital,
Sichuan University, Chengdu, China
(Li, Chen, Chen) Division of Vascular Surgery, Department of General
Surgery, West China Hospital, Sichuan University, Chengdu, China
(Zhang) Division of Vascular and Endovascular Surgery, Department of
Surgery, University of Washington and Puget Sound VA Health Care System,
Seattle, WA, United States
Publisher
Elsevier Inc.
Abstract
Background: At present, open surgical aortic arch repair (OAR) and
debranching hybrid surgical aortic arch repair (HAR) serve as significant
therapeutic approaches for aortic arch aneurysm or dissection. It remains
unclear which technique is preferable. Our study aimed to compare the
short-term and long-term outcomes of these two procedures. Method(s):
To identify comparison studies of debranching HAR and OAR, a systematic
search of the PubMed, Embase, Web of Science, and Cochrane Library
databases was performed from January 2002 to April 2022. This study was
registered on PROSPERO (CRD42020218080). Result(s): Sixteen
publications (1316 patients), including six propensity score-matching
(PSM) analysis papers, were included in this study. Compared with the HAR
group, the patients who underwent OAR were younger (OAR vs HAR: 67.53 +/-
12.81 vs 71.29 +/- 11.0; P <.00001), had less coronary artery disease (OAR
vs HAR: 22.45% vs 32.6%; P =.007), less chronic obstructive pulmonary
disease (OAR vs HAR: 16.16% vs 23.92%; P =.001), lower rates of previous
stroke (OAR vs HAR: 12.46% vs 18.02%; P =.05), and a lower EuroSCORE
(European System for Cardiac Operative Risk Evaluation) score (OAR vs HAR:
6.27 +/- 1.04 vs 6.9 +/- 3.76; P <.00001). HAR was associated with less
postoperative blood transfusion (OAR vs HAR: 12.23% vs 7.91%; P =.04),
shorter length of intensive care unit stays (OAR vs HAR: 5.92 +/- 7.58
days vs 4.02 +/- 6.60 days; P <.00001) and hospital stays (OAR vs HAR:
21.59 +/- 17.54 days vs 16.49 +/- 18.45 days; P <.0001), lower incidence
of reoperation for bleeding complications (OAR vs HAR: 8.07% vs 3.96%; P
=.01), fewer postoperative pulmonary complication (OAR vs HAR: 14.75% vs
5.02%; P <.0001), and acute renal failure (OAR vs HAR: 7.54% vs 5.17%; P
=.03). In the PSM subgroup, the rates of spinal cord ischemic (OAR vs HAR:
5.75% vs 11.49%; P =.02), stroke (OAR vs HAR: 5.1% vs 17.35%; P =.01), and
permanent paraplegia (OAR vs HAR: 2.79% vs 6.08%; P =.006) were lower in
the OAR group than that in the HAR group. Although there was no
statistically significant difference in 1-year survival rates (HAR vs OAR:
hazard ratio [HR]: 1.54; P =.10), the 3-year and 5-year survivals were
significantly higher in the OAR group than that in the HAR group (HAR vs
OAR: HR: 1.69; P =.01; HAR vs OAR: HR: 1.68; P =.01). In the PSM subgroup,
the OAR group was also significantly superior to the HAR group in terms of
3-year and 5-year survivals (HAR vs OAR: HR: 1.73; P =.04; HAR vs OAR: HR:
1.67; P =.04). The reintervention rate in the HAR group was significantly
higher than that in the OAR group (OAR vs HAR: 8.24% vs 16.01%; P =.01).
The most common reintervention was postoperative bleeding (8.07%) in the
OAR group and endoleak (9.67%) in the HAR group. Conclusion(s): Our
meta-analysis revealed that debranching HAR was associated with fewer
perioperative complications than the OAR group, except for postoperative
permanent paraplegia, reintervention, and stroke events. The OAR group
demonstrated better 3-year and 5-year survivals than the debranching HAR
group. However, patients in the OAR group had fewer comorbid factors and
were younger than those in the HAR group. High-quality studies and
well-powered randomized trials are needed to further evaluate this
evolving field. Copyright © 2023 Society for Vascular Surgery

<87>
Accession Number
2029850361
Title
Comparison of apixaban versus aspirin for the prevention of latent
bioprosthetic aortic valve thrombosis: study protocol for a prospective
randomized trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 324. Date of
Publication: December 2024.
Author
Kopjar T.; Gasparovic H.; Paar M.H.; Lovric D.; Cerina P.; Tokic T.;
Milicic D.
Institution
(Kopjar, Gasparovic, Cerina, Tokic) Department of Cardiac Surgery,
University Hospital Center Zagreb, Kispaticeva 12, Zagreb 10000, Croatia
(Paar) Department of Radiology, University Hospital Center Zagreb, Zagreb,
Croatia
(Lovric, Milicic) Department of Cardiovascular Diseases, University
Hospital Center Zagreb, Zagreb, Croatia
(Kopjar, Gasparovic, Paar, Milicic) University of Zagreb School of
Medicine, Zagreb, Croatia
Publisher
BioMed Central Ltd
Abstract
Background: The optimal antithrombotic strategy early after aortic valve
replacement surgery with a biological valve remains controversial due to
lack of high-quality evidence. Either oral anticoagulants or
acetylsalicylic acid should be considered for the first 3 months.
Hypo-attenuated leaflet thickening on cardiac computed tomography has been
associated with latent bioprosthetic valve thrombosis and may be prevented
with anticoagulation. We hypothesize that anticoagulation with apixaban is
superior to single antiplatelet therapy with acetylsalicylic acid in
reducing hypo-attenuated leaflet thickening of bioprosthetic aortic valve
prostheses. Method(s): In this prospective, open-label, randomized
trial, patients undergoing isolated aortic valve replacement surgery with
rapid deployment bioprosthetic valves will be randomized. The treatment
group will receive 5 mg of apixaban twice a day for the first 3 months and
100 mg of acetylsalicylic acid thereafter. The control group will be
administered 100 mg of acetylsalicylic acid once a day, indefinitely.
After the 3-month treatment period, a contrast-enhanced
electrocardiogram-gated cardiac computed tomography will be performed to
identify hypo-attenuated leaflet thickening of the bioprosthetic valve.
The primary objective of the study is to assess the impact of apixaban on
the prevention of hypo-attenuated leaflet thickening at 3 months. The
secondary and exploratory endpoints will be clinical outcomes and safety
profiles of the two strategies. Discussion(s): Antithrombotic therapy
after aortic valve replacement is used to prevent valve thrombosis and
systemic thromboembolism. Latent bioprosthetic valve thrombosis is a
precursor of clinically significant prosthetic valve dysfunction or
thromboembolic events. The hallmark feature of latent bioprosthetic valve
thrombosis is hypo-attenuated leaflet thickening on cardiac computed
tomography. Subclinical leaflet thrombosis occurs frequently in
bioprosthetic aortic valves, more commonly in transcatheter than in
surgical valves. There is no evidence on the effect of direct oral
anticoagulants on the incidence of hypo-attenuated leaflet thickening
after surgical aortic valve replacement with rapid deployment
bioprostheses. Trial registration: ClinicalTrials.gov NCT06184113.
Registered on December 28, 2023 Copyright © The Author(s) 2024.

<88>
Accession Number
2032248538
Title
Case report: acute myocarditis in two patients with coronary artery
disease presenting with chest pain-thinking outside the box.
Source
European Heart Journal - Case Reports. 8(5) (no pagination), 2024. Article
Number: ytae220. Date of Publication: 01 May 2024.
Author
Amelotti N.; Brusamolino M.; Mapelli M.; Contini M.; Baggiano A.; Fazzari
F.; Pontone G.; Agostoni P.
Institution
(Amelotti, Brusamolino, Mapelli, Contini, Baggiano, Fazzari, Pontone,
Agostoni) Centro Cardiologico Monzino, IRCCS, Via Carlo Parea, 4, Milan
20138, Italy
(Amelotti, Brusamolino, Mapelli, Baggiano, Agostoni) Department of
Clinical Sciences and Community Health, Cardiovascular Section, University
of Milan, Milan, Italy
(Pontone) Department of Biomedical, Surgical and Dental Sciences,
University of Milan, Milan, Italy
Publisher
Oxford University Press
Abstract
Background In a subset of patients, acute myocarditis (AM) may mimic acute
myocardial infarction, with a similar clinical presentation characterized
by chest pain, electrocardiogram (ECG) changes consistent with acute
coronary syndromes (ACS), and serum markers increment. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Case summary
We present two cases of infarct-like myocarditis in patients with known
coronary artery disease (CAD), in which the discrepancy between
transthoracic echocardiogram findings, ECG, and angiography prompted us to
look beyond the simplest diagnosis. In these cases, making a prompt and
correct diagnosis is pivotal to address adequate therapy and establish a
correct prognosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . Discussion The right diagnosis can avoid
unnecessary coronary revascularizations and subsequent antiplatelet
therapy that may be associated with an increased haemorrhagic risk.
Moreover, it allows setting up guideline-directed therapy for myocarditis,
proper follow-up, as well as recommending abstention from physical
activity. Copyright © The Author(s) 2024.

<89>
Accession Number
2032259766
Title
User-defined outcomes of the Danish cardiovascular screening (DANCAVAS)
trial: A post hoc analyses of a population-based, randomised controlled
trial.
Source
PLoS Medicine. 21(5) (no pagination), 2024. Article Number: e1004403. Date
of Publication: May 2024.
Author
Diederichsen A.C.P.; Mejldal A.; Sogaard R.; Hallas J.; Lambrechtsen J.;
Steffensen F.H.; Frost L.; Egstrup K.; Busk M.; Urbonaviciene G.; Karon
M.; Rasmussen L.M.; Lindholt J.S.
Institution
(Diederichsen) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Mejldal) Open Patient Data Explorative Network, Department of Clinical
Research, Odense University Hospital, Odense, Denmark
(Sogaard) Elite Research Centre for Individualised Medicine, Odense
University Hospital, Odense, Denmark
(Hallas) Department of Clinical Pharmacology, University of Southern
Denmark, Odense, Denmark
(Lambrechtsen, Egstrup) Department of Cardiology, Svendborg Hospital,
Svendborg, Denmark
(Steffensen, Busk) Department of Cardiology, Lillebaelt Hospital, Vejle,
Denmark
(Frost, Urbonaviciene) Department of Cardiology, Regional Hospital Central
Jutland, Silkeborg, Denmark
(Karon) Department of Medicine, Nykobing Falster Hospital, Nykobing
Falster, Denmark
(Rasmussen) Department of Clinical Biochemistry and Pharmacology, Odense
University Hospital, Odense, Denmark
(Lindholt) Department of Cardiothoracic, Vascular Surgery Odense
University Hospital Odense, Denmark
Publisher
Public Library of Science
Abstract
Background The Danish cardiovascular screening (DANCAVAS) trial, a
nationwide trial designed to investigate the impact of cardiovascular
screening in men, did not decrease all-cause mortality, an outcome decided
by the investigators. However, the target group may have varied
preferences. In this study, we aimed to evaluate whether men aged 65 to 74
years requested a CT-based cardiovascular screening examination and to
assess its impact on outcomes determined by their preferences. Methods and
findings This is a post hoc study of the randomised DANCAVAS trial. All
men 65 to 74 years of age residing in specific areas of Denmark were
randomised (1:2) to invitation-to-screening (16,736 men, of which 10,471
underwent screening) or usual-care (29,790 men). The examination included
among others a non-contrast CT scan (to assess the coronary artery calcium
score and aortic aneurysms). Positive findings prompted preventive
treatment with atorvastatin, aspirin, and surveillance/surgical
evaluation. The usual-care group remained unaware of the trial and the
assignments. The user-defined outcome was based on patient preferences and
determined through a survey sent in January 2023 to a random sample of
9,095 men from the target group, with a 68.0% response rate (6,182
respondents). Safety outcomes included severe bleeding and mortality
within 30 days after cardiovascular surgery. Analyses were performed on an
intention-to-screen basis. Prevention of stroke and myocardial infarction
was the primary motivation for participating in the screening examination.
After a median follow-up of 6.4 years, 1,800 of 16,736 men (10.8%) in the
invited-to-screening group and 3,420 of 29,790 (11.5%) in the usual-care
group experienced an event (hazard ratio (HR), 0.93 (95% confidence
interval (CI), 0.88 to 0.98; p = 0.010); number needed to invite at 6
years, 148 (95% CI, 80 to 986)). A total of 324 men (1.9%) in the
invited-to-screening group and 491 (1.7%) in the usual-care group had an
intracranial bleeding (HR, 1.17; 95% CI, 1.02 to 1.35; p = 0.029).
Additionally, 994 (5.9%) in the invited-to-screening group and 1,722
(5.8%) in the usual-care group experienced severe gastrointestinal
bleeding (HR, 1.02; 95% CI, 0.95 to 1.11; p = 0.583). No differences were
found in mortality after cardiovascular surgery. The primary limitation of
the study is that exclusive enrolment of men aged 65 to 74 renders the
findings non-generalisable to women or men of other age groups. Conclusion
In this comprehensive population-based cardiovascular screening and
intervention program, we observed a reduction in the user-defined outcome,
stroke and myocardial infarction, but entail a small increased risk of
intracranial bleeding. Copyright © 2024 Diederichsen et al. This
is an open access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the origina author and source are
credited.

<90>
Accession Number
2029232716
Title
Year in Review 2023: Noteworthy Literature in Cardiothoracic
Transplantation.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 28(2) (pp 106-112),
2024. Date of Publication: June 2024.
Author
Saleem F.; Liang H.; Martin A.K.
Institution
(Saleem, Liang, Martin) Division of Cardiovascular and Thoracic
Anesthesiology, Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Jacksonville, FL, United States
Publisher
SAGE Publications Inc.
Abstract
This review highlights key studies examining perioperative management of
cardiothoracic transplantation published in 2023. Articles were manually
screened after searching Scopus, PubMed, and Google Scholar databases for
manuscripts related to cardiothoracic transplantation, which yielded 343
papers with 15 qualitatively selected as the most salient for readers.
Overarching themes include differences in outcomes across the various
etiologies of end-stage lung disease, novel developments to expand the
donor pool, and multi-organ transplantation. Copyright © The
Author(s) 2024.

<91>
[Use Link to view the full text]
Accession Number
2032310317
Title
Early Outcomes in Patients with LVAD Undergoing Heart Transplant via Use
of the SherpaPak Cardiac Transport System.
Source
Circulation: Heart Failure. 17(5) (pp E010904), 2024. Date of Publication:
01 May 2024.
Author
Lerman J.B.; Patel C.B.; Casalinova S.; Nicoara A.; Holley C.L.; Leacche
M.; Silvestry S.; Zuckermann A.; D'Alessandro D.A.; Milano C.A.; Schroder
J.N.; Devore A.D.
Institution
(Lerman, Patel, Casalinova, Holley, Devore) Department of Medicine,
Division of Cardiology, Duke University Hospital, Durham, NC, United
States
(Nicoara, Milano, Schroder) Department of Surgery, Division of
Cardiovascular and Thoracic Surgery, Duke University Hospital, Durham, NC,
United States
(Leacche) Division of Cardiothoracic Surgery, Corewell Health, Grand
Rapids, MI, United States
(Silvestry) Department of Cardiothoracic Surgery, AdventHealth Transplant
Institute, Orlando, FL, United States
(Zuckermann) Department of Cardiac Surgery, Medical University of Vienna,
Austria
(D'Alessandro) Division of Cardiac Surgery, Department of Surgery,
Massachusetts General Hospital, Boston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Heart transplant (HT) in recipients with left ventricular
assist devices (LVADs) is associated with poor early post-HT outcomes,
including primary graft dysfunction (PGD). As complicated heart explants
in recipients with LVADs may produce longer ischemic times, innovations in
donor heart preservation may yield improved post-HT outcomes. The
SherpaPak Cardiac Transport System is an organ preservation technology
that maintains donor heart temperatures between 4 degreeC and 8 degreeC,
which may minimize ischemic and cold-induced graft injuries. This analysis
sought to identify whether the use of SherpaPak versus traditional cold
storage was associated with differential outcomes among patients with
durable LVAD undergoing HT. METHOD(S): Global Utilization and
Registry Database for Improved Heart Preservation-Heart (NCT04141605) is a
multicenter registry assessing post-HT outcomes comparing 2 methods of
donor heart preservation: SherpaPak versus traditional cold storage. A
retrospective review of all patients with durable LVAD who underwent HT
was performed. Outcomes assessed included rates of PGD, post-HT mechanical
circulatory support use, and 30-day and 1-year survival. RESULT(S):
SherpaPak (n=149) and traditional cold storage (n=178) patients had
similar baseline characteristics. SherpaPak use was associated with
reduced PGD (adjusted odds ratio, 0.56 [95% CI, 0.32-0.99]; P=0.045) and
severe PGD (adjusted odds ratio, 0.31 [95% CI, 0.13-0.75]; P=0.009),
despite an increased total ischemic time in the SherpaPak group.
Propensity matched analysis also noted a trend toward reduced intensive
care unit (SherpaPak 7.5+/-6.4 days versus traditional cold storage
11.3+/-18.8 days; P=0.09) and hospital (SherpaPak 20.5+/-11.9 days versus
traditional cold storage 28.7+/-37.0 days; P=0.06) lengths of stay. The
30-day and 1-year survival was similar between groups. CONCLUSION(S):
SherpaPak use was associated with improved early post-HT outcomes among
patients with LVAD undergoing HT. This innovation in preservation
technology may be an option for HT candidates at increased risk for PGD.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04141605. Copyright © 2024 Lippincott Williams and Wilkins.
All rights reserved.

<92>
Accession Number
2028863805
Title
A Randomized Trial Comparing Standard of Care to Bayesian Warfarin Dose
Individualization.
Source
Clinical Pharmacology and Therapeutics. 115(6) (pp 1316-1325), 2024. Date
of Publication: June 2024.
Author
Xue L.; Ma G.; Holford N.; Qin Q.; Ding Y.; Hannam J.A.; Ding X.; Fan H.;
Ji Z.; Yang B.; Shen H.; Shen Z.; Miao L.
Institution
(Xue, Qin, Ding, Miao) Department of Pharmacy, The First Affiliated
Hospital of Soochow University, Suzhou, China
(Xue) Department of Pharmacology, Faculty of Medicine, University of the
Basque Country (UPV/EHU), Leioa, Spain
(Ma, Holford, Hannam) Department of Pharmacology and Clinical
Pharmacology, University of Auckland, Auckland, New Zealand
(Ding, Fan, Ji, Yang, Shen, Shen) Department of Cardiovascular Surgery,
The First Affiliated Hospital of Soochow University, Suzhou, China
(Ding, Fan, Ji, Yang, Shen, Shen) Institute for Cardiovascular Science,
Soochow University, Suzhou, China
(Miao) National Clinical Research Center for Hematologic Diseases, The
First Affiliated Hospital of Soochow University, Suzhou, China
(Miao) Institute for Interdisciplinary Drug Research and Translational
Sciences, Soochow University, Suzhou, China
Publisher
John Wiley and Sons Inc
Abstract
The quality of warfarin treatment may be improved if management is guided
by the use of models based upon pharmacokinetic-pharmacodynamic theory. A
prospective, two-armed, single-blind, randomized controlled trial compared
management aided by a web-based dose calculator (NextDose) with standard
clinical care. Participants were 240 adults receiving warfarin therapy
following cardiac surgery, followed up until the first outpatient
appointment at least 3 months after warfarin initiation. We compared the
percentage of time spent in the international normalized ratio acceptable
range (%TIR) during the first 28 days following warfarin initiation, and
%TIR and count of bleeding events over the entire follow-up period. Two
hundred thirty-four participants were followed up to day 28 (NextDose: 116
and standard of care: 118), and 228 participants (114 per arm) were
followed up to the final study visit. Median %TIR tended to be higher for
participants receiving NextDose guided warfarin management during the
first 28 days (63 vs. 56%, P = 0.13) and over the entire follow-up period
(74 vs. 71%, P = 0.04). The hazard of clinically relevant minor bleeding
events was lower for participants in the NextDose arm (hazard ratio: 0.21,
P = 0.041). In NextDose, there were 89.3% of proposed doses accepted by
prescribers. NextDose guided dose management in cardiac surgery patients
requiring warfarin was associated with an increase in %TIR across the full
follow-up period and fewer hemorrhagic events. A theory-based,
pharmacologically guided approach facilitates higher quality warfarin
anticoagulation. An important practical benefit is a reduced requirement
for clinical experience of warfarin management. Copyright © 2024
The Authors. Clinical Pharmacology & Therapeutics published by Wiley
Periodicals LLC on behalf of American Society for Clinical Pharmacology
and Therapeutics.

<93>
Accession Number
2028717994
Title
Stroke reduction by cerebral embolic protection devices in transcatheter
aortic valve implantation: A systematic review and Bayesian meta-analysis.
Source
Heart. 110(11) (pp 757-765), 2024. Date of Publication: 01 Jun 2024.
Author
Heuts S.; Gabrio A.; Veenstra L.; Maesen B.; Kats S.; Maessen J.G.; Walton
A.S.; Nanayakkara S.; Lansky A.J.; Van 'T Hof A.W.J.; Vriesendorp P.A.
Institution
(Heuts, Maesen, Kats, Maessen) Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Heuts, Maesen, Maessen, Van 'T Hof, Vriesendorp) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University, Maastricht,
Netherlands
(Gabrio) Methodology and Statistics, Maastricht University, Maastricht,
Netherlands
(Gabrio) Care and Public Health Research Institute (CAPHRI), Maastricht
University, Maastricht, Netherlands
(Veenstra, Van 'T Hof, Vriesendorp) Cardiology, Maastricht University
Medical Center+, Maastricht, Netherlands
(Veenstra, Van 'T Hof) Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
(Walton, Nanayakkara) Cardiovascular Medicine, Alfred Hospital, Melbourne,
VIC, Australia
(Walton, Nanayakkara) Heart Failure Research Group, Baker Heart and
Diabetes Institute, Melbourne, VIC, Australia
(Nanayakkara) Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia
(Lansky) Yale Cardiovascular Research Group, Yale Medical School, New
Haven, CT, United States
Publisher
BMJ Publishing Group
Abstract
Objectives The use of cerebral embolic protection (CEP) during
transcatheter aortic valve implantation (TAVI) has been studied in several
randomised trials. We aimed to perform a systematic review and Bayesian
meta-analysis of randomised CEP trials, focusing on a clinically relevant
reduction in disabling stroke. Methods A systematic search was applied to
three electronic databases, including trials that randomised TAVI patients
to CEP versus standard treatment. The primary outcome was the risk of
disabling stroke. Outcomes were presented as relative risk (RR), absolute
risk differences (ARDs), numbers needed to treat (NNTs) and the 95%
credible intervals (CrIs). The minimal clinically important difference was
determined at 1.1% ARD, per expert consensus (NNT 91). The principal
Bayesian meta-analysis was performed under a vague prior, and secondary
analyses were performed under two informed literature-based priors.
Results Seven randomised studies were included for meta-analysis (n=3996:
CEP n=2126, control n=1870). Under a vague prior, the estimated median RR
of CEP use for disabling stroke was 0.56 (95% CrI 0.28 to 1.19, derived
ARD 0.56% and NNT 179, I 2 =0%). Although the estimated posterior
probability of any benefit was 94.4%, the probability of a clinically
relevant effect was 0-0.1% under the vague and informed literature-based
priors. Results were robust across multiple sensitivity analyses.
Conclusion There is a high probability of a beneficial CEP treatment
effect, but this is unlikely to be clinically relevant. These findings
suggest that future trials should focus on identifying TAVI patients with
an increased baseline risk of stroke, and on the development of new
generation devices. PROSPERO registration number
CRD42023407006. Copyright © Author(s) (or their employer(s))
2024. No commercial re-use. See rights and permissions. Published by BMJ.

<94>
Accession Number
2026943059
Title
Optimal antiplatelet strategy following coronary artery bypass grafting: A
meta-analysis.
Source
Heart. 110(5) (pp 323-330), 2024. Date of Publication: 01 Mar 2024.
Author
Agrawal A.; Kumar A.; Majid M.; Badwan O.; Arockiam A.D.; El Dahdah J.;
Syed A.B.; Schleicher M.; Reed G.W.; Cremer P.C.; Griffin B.P.; Menon V.;
Wang T.K.M.
Institution
(Agrawal, Kumar, Majid, Badwan, Arockiam, El Dahdah, Syed, Reed, Cremer,
Griffin, Menon, Wang) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
OH, United States
Publisher
BMJ Publishing Group
Abstract
Objective Coronary artery bypass grafting (CABG) is an established
revascularisation strategy for multivessel and left main coronary artery
disease. Although aspirin is routinely recommended for patients with CABG,
the optimal antiplatelet regimen after CABG remains unclear. We evaluated
the efficacies and risks of different antiplatelet regimens (dual (DAPT)
versus single (SAPT), and dual with clopidogrel (DAPT-C) versus dual with
ticagrelor or prasugrel (DAPT-T/P)) after CABG. Methods We followed
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines and performed a comprehensive literature search using PubMed,
Ovid Medline, Ovid Embase and Cochrane Central Register of Controlled
Trials. Data were extracted and pooled using random-effects models and
Review Manager (V.5.4). Results Among the 2970 article abstracts screened,
215 full-text articles were reviewed and 38 studies totaling 77 447 CABG
patients were included for analyses. DAPT compared with SAPT was
associated with significantly lower all-cause mortality (OR 0.65 with 95%
CI 0.50 to 0.86; p=0.002), cardiovascular mortality (OR 0.53, 95% CI 0.33
to 0.84; p=0.008), and major adverse cardiac and cerebrovascular events
(MACCE) (OR 0.68, 95% CI 0.51 to 0.91; p=0.01), but higher rates of major
(OR 1.30, 95% CI 1.08 to 1.56; p=0.007) and minor bleeding (OR 1.87, 95%
CI 1.28 to 2.74; p=0.001) after CABG. DAPT-T/P compared with DAPT-C was
associated with significantly lower all-cause (OR 0.43, 95% CI 0.29 to
0.65; p<=0.0001) and cardiovascular mortality (OR 0.44, 95% CI 0.24 to
0.80; p=0.008), and no differences on other cardiovascular or bleeding
outcomes after CABG. Conclusion In patients with CABG, DAPT compared with
SAPT and DAPT-T/P compared with DAPT-C were associated with reduction in
all-cause and cardiovascular mortality, especially in patients with acute
coronary syndrome. Additionally, DAPT was associated with reduction in
MACCE, but higher rates of major and minor bleeding. An individualised
approach to choosing antiplatelet regimen is necessary for patients with
CABG based on ischaemic and bleeding risks. Copyright © Author(s)
(or their employer(s)) 2024. No commercial re-use. See rights and
permissions. Published by BMJ.

<95>
Accession Number
2022285485
Title
Pacemaker implantation associated with tricuspid repair in the setting of
mitral valve surgery: Insights from a Cardiothoracic Surgical Trials
Network randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(6) (pp 2104-2116.e5),
2024. Date of Publication: June 2024.
Author
Ailawadi G.; Voisine P.; Raymond S.; Gelijns A.C.; Moskowitz A.J.; Falk
V.; Overbey J.R.; Chu M.W.A.; Mack M.J.; Bowdish M.E.; Krane M.; Yerokun
B.; Conradi L.; Bolling S.F.; Miller M.A.; Taddei-Peters W.C.; Fenton
K.N.; Jeffries N.O.; Kramer R.S.; Geirsson A.; Moquete E.G.; O'Sullivan
K.; Hupf J.; Hung J.; Beyersdorf F.; Bagiella E.; Gammie J.S.; O'Gara
P.T.; Iribarne A.; Borger M.A.; Gillinov M.
Institution
(Ailawadi, Bolling) Department of Cardiac Surgery, University of Michigan
Health System, Ann Arbor, Mich, United States
(Voisine) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (IUCPQ), Quebec, Canada
(Raymond, Gelijns, Moskowitz, Overbey, Moquete, O'Sullivan, Hupf,
Bagiella) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsche
Herzzentrum Berlin, Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, German Centre for Cardiovascular Research,
DZHK, Partner Site Berlin, Berlin, Germany
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Mack) Cardiac and Thoracic Surgery, Baylor Scott & White Health, Plano,
Tex, United States
(Bowdish) Department of Surgery and Population and Public Health Sciences,
Keck School of Medicine of USC, University of Southern California, Los
Angeles, Calif, United States
(Krane, Geirsson) Division of Cardiac Surgery, Department of Surgery, Yale
School of Medicine, New Haven, Conn, United States
(Yerokun) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University, Durham, NC, United States
(Conradi) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Miller, Taddei-Peters, Fenton) Division of Cardiovascular Sciences,
National Heart, Lung, and Blood Institute, National Institutes of Health,
Bethesda, Md, United States
(Jeffries) National Heart, Lung, and Blood Institute, National Institutes
of Health, Bethesda, Md, United States
(Kramer) Thoracic Surgery (Cardiothoracic Vascular Surgery), Internal
Medicine, Maine Medical Center, Portland, Maine, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston,
Mass, United States
(Beyersdorf) Department of Cardiovascular Surgery, University Heart Center
Freiburg, Freiburg, Germany
(Gammie) Cardiac Surgery, Johns Hopkins Heart and Vascular Institute,
Baltimore, Md, United States
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Boston,
Mass, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
NH, Lebanon
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
Objectives: In a recent trial, tricuspid annuloplasty (TA) during mitral
valve surgery (MVS) for degenerative mitral regurgitation and moderate or
less tricuspid regurgitation (TR) reduced the composite rate of death,
reoperation for TR, or TR progression at 2 years. However, this benefit
was counterbalanced by an increase in implantation of permanent pacemakers
(PPMs). In this study, we analyzed the timing, indications, and risk
factors for these implantations. Method(s): We randomized 401
patients (MVS alone = 203; MVS + TA = 198). Potential risk factors for
PPMs were assessed using multivariable time-to-event models with death and
PPM implantation for heart failure indications as competing risks.
 Result(s): A PPM was implanted in 36 patients (9.6; 95% CI, 6.8-13.0)
within 2 years of randomization, with 30/187 (16.0%) in the MVS + TA and
6/188 (3.2%) in the MVS groups (rate ratio, 5.08; 95% CI, 2.16-11.94; P <
.001). Most (29/36; 80.6%) implantations occurred within 30 days
postoperatively. Independent risk factors for PPM implantation within 2
years were TA (hazard ratio [HR], 5.94; 95% CI, 2.27-15.53; P < .001),
increasing age (5 years, HR, 1.23; 95% CI, 1.01-1.52; P = .04), and left
ventricular ejection fraction (LVEF; HR, 0.96; 95% CI, 0.92-0.99; P =
.02). In the subset of TA recipients (n = 197), age (5 years, HR, 1.05;
95% CI, 1.00-1.10; P = .04) and LVEF (HR, 0.95; 95% CI, 0.91-0.99; P =
.01) were associated with PPM within 2 years. Conclusion(s):
Concomitant TA, age, and baseline LVEF were risk factors for PPM
implantation in patients who underwent MVS for degenerative mitral
regurgitation. Although TA was effective in preventing progression of TR,
innovation is needed to identify ways to decrease PPM implantation
rates. Copyright © 2022 The American Association for Thoracic
Surgery

<96>
Accession Number
2032112925
Title
Left atrial appendage occlusion for recurrent stroke while on oral
anticoagulation: A case series.
Source
European Heart Journal - Case Reports. 8(5) (no pagination), 2024. Article
Number: ytae157. Date of Publication: 01 May 2024.
Author
Costa G.; Grine M.; Simoes M.; Oliveira-Santos M.; Paiva L.; Costa M.;
Goncalves L.
Institution
(Costa, Grine, Simoes, Oliveira-Santos, Paiva, Costa, Goncalves) Servico
de Cardiologia, Centro Hospitalar e Universitario de Coimbra, Praceta
Professor Mota Pinto, Coimbra 3004-561, Portugal
(Costa, Oliveira-Santos, Goncalves) Faculdade de Medicina da Universidade
de Coimbra, Azinhaga de Santa Comba, Celas, Coimbra 3000-548, Portugal
(Goncalves) Coimbra Institute for Clinical and Biomedical Research (ICBR),
Coimbra, Portugal
Publisher
Oxford University Press
Abstract
Background: Clinical practice guidelines recommend oral anticoagulation
(OAC) for stroke prevention in selected patients with atrial fibrillation
(AF). However, some patients still experience thrombo-embolic events
despite adequate anticoagulation. The optimal management of these cases
remains uncertain, leading to practice pattern variability. We present a
series of three cases illustrating the use of left atrial appendage
occlusion (LAAO) as an adjunctive stroke prevention strategy in AF
patients with recurrent thrombo-embolic events despite adequate
anticoagulation. Case summary: Case one describes an 89-year-old female on
apixaban who presented with a thrombus and underwent successful mechanical
thrombectomy. Left atrial appendage occlusion was performed, and no
subsequent thrombo-embolic events were reported. Case 2 involves a
72-year-old female on full-dose apixaban who experienced recurrent strokes
despite adequate anticoagulation. Thrombectomy was performed twice, and
complications arose during LAAO. The patient was discharged on warfarin +
clopidogrel and remained event-free at the six-month follow-up. Case 3
features an 88-year-old female on rivaroxaban who experienced recurrent
cerebral ischaemic events and gastrointestinal bleeding. Left atrial
appendage occlusion using an Amplatzer AmuletTM device was successful, and
the patient remained event-free at the one-year follow-up.
 Discussion(s): This case series emphasizes the complexity of stroke
prevention in AF patients and underscores the need for an individualized
approach. Incorporating LAAO alongside OAC can provide additional stroke
protection for patients with inadequate response to anticoagulation.
Further randomized controlled trials are needed to evaluate the efficacy
and safety of this approach. In light of the limited evidence available,
these cases contribute to the growing body of knowledge on the potential
role of LAAO in secondary stroke prevention in AF patients with recurrent
thrombo-embolic events despite appropriate anticoagulation. Copyright
© 2024 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology.

<97>
Accession Number
2032308340
Title
Colchicine in post-operative Fontan patients.
Source
Cardiology in the Young. 33(6) (pp 910-916), 2023. Date of Publication: 20
Jun 2023.
Author
Goldstein S.A.; Nolan K.; Marchetti K.; Stoscup J.K.; Clewis H.; Jarvis
K.; Halligan N.L.N.; Dahmer M.K.; Schumacher K.R.; Rocchini A.
Institution
(Goldstein) University of Utah, Primary Children's Hospital, Department of
Pediatrics, Division of Pediatric Critical Care, Salt Lake City, UT,
United States
(Nolan, Marchetti, Stoscup, Clewis, Jarvis, Schumacher, Rocchini)
University of Michigan, C.S. Mott Children's Hospital, Department of
Pediatrics, Division of Pediatric Cardiology, Ann Arbor, MI, United States
(Halligan, Dahmer) University of Michigan, C.S. Mott Children's Hospital,
Department of Pediatrics, Division of Pediatric Critical Care, Ann Arbor,
MI, United States
Publisher
Cambridge University Press
Abstract
Background: Prolonged effusions post-Fontan procedure are associated with
morbidity. Fontan patients have higher pro-inflammatory cytokines in chest
tube drainage compared to controls. Colchicine, an anti-inflammatory
medication, decreases effusions in adults after cardiac surgery. We
hypothesised that patients post-Fontan treated with colchicine would have
decreased pro-inflammatory cytokine levels and shorter duration of chest
tube drainage. Method(s): This pilot clinical trial enrolled nine
patients (intention to treat); five completed the protocol (per protocol).
Post-operative Fontan patients 20 months to 5 years receiving colchicine
were compared to a previously published control cohort (n = 25). Per
protocol patients received 0.6 mg colchicine daily starting post-operative
day 2, ending 1 day after chest tube removal. Chest tube samples were
taken on days 1-4, 7 and 10, or until removal and analysed with a
17-cytokine Bio-Plex Assay. Descriptive statistics and basic univariate
comparisons were made. Result(s): There was no difference in duration
of chest tube drainage or length of stay between intention to treat
patients and controls. Per protocol patients had shorter duration of chest
tube drainage compared to controls (6 days [interquartile range 4.7-7],
versus 10 days [7-11], p = 0.007) and shorter length of stay (7 days
[5.5-9] versus 9 days [9-13], p = 0.005). Pro-inflammatory cytokines
trended lower in per protocol patients. Conclusion(s): In this pilot
cohort, patients who completed the colchicine protocol post-Fontan
procedure had shortened duration of chest tube drainage and length of
stay. A decrease of pro-inflammatory cytokines may contribute to the
mechanism of this change. ClinicalTrials.gov: Colchicine in Postoperative
Fontan Patients (CPFP); NCT03575572;
https://clinicaltrials.gov/ct2/show/NCT03575572. Copyright © The
Author(s), 2022. Published by Cambridge University Press.

<98>
Accession Number
2029866482
Title
Does remote ischemic preconditioning affect the systemic inflammatory
response by modulating presepsin levels?.
Source
International Journal of Artificial Organs. (no pagination), 2024. Date
of Publication: 2024.
Author
Bayram B.; Senarslan D.A.; Sengel A.; Ozturk T.; Onur E.; Iskesen I.
Institution
(Bayram, Senarslan, Iskesen) Department of Cardiovascular Surgery, Faculty
of Medicine, Manisa Celal Bayar University, Manisa, Turkey
(Sengel, Ozturk) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Manisa Celal Bayar University, Manisa, Turkey
(Onur) Department of Medical Biochemistry, Faculty of Medicine, Manisa
Celal Bayar University, Manisa, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objective: We investigated the effect of Remote Ischemic Preconditioning
(RIPC) on the inflammatory response during CPB by means of serum presepsin
levels at preoperative and postoperative 1st and 24th h. Method(s):
In this prospective, randomized, cross-sectional study we included 81
patients undergoing coronary artery bypass graft surgery with
cardiopulmonary bypass (CPB). Patients were randomized and RIPC was
applied to 40 patients in the study group before anesthesia. The remaining
41 patients were determined as the control group. The relationships
between RIPC and factors such as presepsin, C-reactive protein (CRP), and
leukocyte levels were investigated. Result(s): There was no
significant difference between the groups in postoperative leukocyte and
CRP values (p = 0.52, p = 0.13, respectively). When the preoperative and
postoperative first hour presepsin values of the patients were compared,
no significant difference was found in the control group (p = 0.17), but a
significant difference was found in the study group (p < 0.05). When the
presepsin values were compared between the groups, a significant
difference was found only in the postoperative first hour value (p <
0.05). Conclusion(s): It was observed that RIPC application caused to
increase the presepsin levels in the postoperative first hour
significantly in the study group (p < 0.05). Copyright © The
Author(s) 2024.

<99>
Accession Number
2032319195
Title
Strategies to address recruitment to a randomised trial of surgical and
non-surgical treatment for cancer: Results from a complex recruitment
intervention within the Mesothelioma and Radical Surgery 2 (MARS 2) study.
Source
BMJ Open. 14(5) (no pagination), 2024. Article Number: e079108. Date of
Publication: 16 May 2024.
Author
Mills N.; Farrar N.; Warnes B.; Ashton K.E.; Harris R.; Rogers C.A.; Lim
E.; Elliott D.
Institution
(Mills, Farrar, Warnes, Ashton, Harris, Rogers, Elliott) Bristol Medical
School, University of Bristol, Faculty of Health Sciences, Bristol, United
Kingdom
(Lim) Academic Division of Thoracic Surgery, Royal Brompton Hospital,
London, United Kingdom
(Lim) National Heart and Lung Institute, Imperial College London, Faculty
of Medicine, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives Recruiting to randomised trials is often challenging
particularly when the intervention arms are markedly different. The
Mesothelioma and Radical Surgery 2 randomised controlled trial (RCT)
compared standard chemotherapy with or without (extended) pleurectomy
decortication surgery for malignant pleural mesothelioma. Anticipating
recruitment difficulties, a QuinteT Recruitment Intervention was embedded
in the main trial phase to unearth and address barriers. The trial
achieved recruitment to target with a 4-month COVID-19 pandemic-related
extension. This paper presents the key recruitment challenges, and the
strategies delivered to optimise recruitment and informed consent. Design
A multifaceted, flexible, mixed-method approach to investigate recruitment
obstacles drawing on data from staff/patient interviews, audio recorded
study recruitment consultations and screening logs. Key findings were
translated into strategies targeting identified issues. Data collection,
analysis, feedback and strategy implementation continued cyclically
throughout the recruitment period. Setting Secondary thoracic cancer care.
Results Respiratory physicians, oncologists, surgeons and nursing
specialists supported the trial, but recruitment challenges were evident.
The study had to fit within a framework of a thoracic cancer service
considered overstretched where patients encountered multiple healthcare
professionals and treatment views, all of which challenged recruitment.
Clinician treatment biases, shaped in part by the wider clinical and
research context alongside experience, adversely impacted several aspects
of the recruitment process by restricting referrals for study
consideration, impacting eligibility decisions, affecting the neutrality
in which the study and treatment was presented and shaping patient
treatment expectations and preferences. Individual and group recruiter
feedback and training raised awareness of key equipoise issues, offered
support and shared good practice to safeguard informed consent and
optimise recruitment. Conclusions With bespoke support to overcome
identified issues, recruitment to a challenging RCT of surgery versus no
surgery in a thoracic cancer setting with a complex recruitment pathway
and multiple health professional involvement is possible. Trial
registration number ISRCTN ISRCTN44351742, Clinical Trials.gov
NCT02040272. Copyright © 2024 Author(s). Published by BMJ.

<100>
Accession Number
2029866483
Title
Simultaneous Transcatheter Aortic Valve Implantation and Endovascular
Aneurysm Repair for Severe Aortic Stenosis and Symptomatic Abdominal
Aortic Aneurysm: Mini Review.
Source
Vascular and Endovascular Surgery. (no pagination), 2024. Date of
Publication: 2024.
Author
Conde Vela C.N.; Gamarra-Valverde N.N.; Inga K.; Vargas Machuca L.A.M.
Institution
(Conde Vela, Vargas Machuca) Department of Cardiology, Peruvian Society of
Cardiology, Lima, Peru
(Gamarra-Valverde, Inga) Faculty of Medicine, Peruvian University Cayetano
Heredia, Lima, Peru
Publisher
SAGE Publications Inc.
Abstract
Background: The treatment of patients with severe aortic stenosis (SAS)
who concomitantly present with abdominal aortic aneurysm (AAA) is not
defined. Aortic valve replacement surgery, performed alone, increases the
risk of AAA rupture. Transcatheter aortic valve replacement (TAVR) and
endovascular abdominal aortic aneurysm repair (EVAR) in the same
intervention, especially in high-risk patients, is a safe alternative.
 Purpose(s): We report a case of simultaneous endovascular treatment
of SAS and AAA and a mini literature review of nineteen cases with similar
characteristics. Research design: Case report and literature review. Data
Collection: An electronic search of PubMed and Scopus was performed from
inception to December 2023. Result(s): Nineteen case reports of
simultaneous transcatheter aortic valve repair and endovascular aneurysm
repair for SAS and symptomatic AAA were identified published in the
literature. Conclusion(s): We regard the simultaneous endovascular
approach to both pathologies as a promising treatment alternative for
selected patients with severe aortic stenosis and abdominal aortic
aneurysm. We highlight the need to conduct randomized clinical trials in
this patient population. Copyright © The Author(s) 2024.

<101>
Accession Number
644301173
Title
A scoping review of incidence and assessment tools for post-intensive care
syndrome following cardiac surgery.
Source
Intensive & critical care nursing. 83 (pp 103718), 2024. Date of
Publication: 17 May 2024.
Author
Phillips E.K.; Monnin C.; Gregora A.; Smith K.; S H Schultz A.;
O'Keefe-McCarthy S.; Arora R.C.; Duhamel T.A.; Chudyk A.M.
Institution
(Phillips) Applied Health Sciences, Faculty of Graduate Studies,
University of Manitoba, Winnipeg, MB, Canada
(Monnin) Neil John Maclean Health Sciences Library, Canada
(Gregora, Smith) Person with lived experience partner, Canada
(S H Schultz) College of Nursing, Rady Faculty of Health Sciences,
University of Manitoba, Winnipeg, MB, Canada; Institute of Cardiovascular
Sciences, St. Boniface General Hospital Albrechtsen Research Centre,
Winnipeg, MB, Canada
(O'Keefe-McCarthy) Department of Nursing, Faculty of Applied Health
Sciences, Brock University, St. Catharines, ON, Canada
(Arora) Harrington Heart and Vascular Institute University Hospitals -
Cleveland Medical Center/Case Western Reserve University, Cleveland, OH,
United States
(Duhamel) Institute of Cardiovascular Sciences, St. Boniface General
Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada; Faculty of
Kinesiology and Recreation Management, University of Manitoba, Winnipeg,
MB, Canada
(Chudyk) Department of Family Medicine, Max Rady College of Medicine,
University of Manitoba, Winnipeg, MB, Canada
Abstract
BACKGROUND: Post-intensive care syndrome is a new or worsening persistent
deterioration in cognitive, mental, and/or physical health following a
prolonged admission to an intensive care unit. Post-intensive care
syndrome remains underexplored following cardiac surgery, with a lack of
understanding of the incidence and tools used to measure the symptoms. A
scoping review was conducted to determine the incidence and to identify
the tools commonly used to measure symptoms of post-intensive care
syndrome following cardiac surgery. METHOD(S): The electronic
databases Medline (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Scopus, and
CINAHL (EBSCOhost) and Google Scholar were searched with keywords and
controlled vocabulary to describe both cardiac surgery and post-intensive
care syndrome (cardiac surgical procedures, heart surgery, and
post-intensive care symptoms) and symptoms (delirium, depression, mobility
and quality of life). Included were articles written in English and
published after 2005 that described cognitive, mental, and physical
symptoms of post-intensive care syndrome following cardiac surgery. 3,131
articles were found, with 565 duplicates, leaving 2,566 articles to be
screened. Of these, seven unique studies were included. RESULT(S):
Five studies explored cognitive health, three mental health, one cognitive
and mental health, and none physical health. No identified studies
reported the overall incidence of post-intensive care syndrome following
cardiac surgery. The incidence of cognitive health issues ranged from 21%
to 38%, and mental health issues ranged from 16% to 99%. In total, 17
different tools were identified - 14 for cognitive health and three for
mental health. No identified studies used the same tools to measure
symptoms. No single tool was found to measure all three domains.
 CONCLUSION(S): This scoping review identified a literature gap
specific to the incidence and inconsistency of assessment tools for
post-intensive care syndrome in cardiac surgery patients. CLINICAL
IMPLICATIONS: This work impacts clinical practice for the bedside nurse by
raising awareness of an emerging health issue. Copyright © 2024
The Author(s). Published by Elsevier Ltd.. All rights reserved.

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