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<1>
Accession Number
2032900834
Title
The effect of a selenium-based anti-inflammatory strategy on postoperative
functional recovery in high-risk cardiac surgery patients - A nested
sub-study of the sustain CSX trial.
Source
Life Sciences. 351 (no pagination), 2024. Article Number: 122841. Date of
Publication: 15 Aug 2024.
Author
Ott S.; Lee Z.-Y.; Muller-Wirtz L.M.; Cangut B.; Roessler J.; Patterson
W.; Thomas C.M.; Bekele B.M.; Windpassinger M.; Lobdell K.; Grant M.C.;
Arora R.C.; Engelman D.T.; Fremes S.; Velten M.; O'Brien B.; Ruetzler K.;
Heyland D.K.; Stoppe C.
Institution
(Ott, Lee, Thomas, O'Brien) Deutsches Herzzentrum der Charite, Department
of Cardiac Anaesthesiology and Intensive Care Medicine, Berlin, Germany
(Ott, Lee, Bekele, O'Brien) Charite - Universitatsmedizin Berlin,
corporate member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin, Germany
(Ott, O'Brien) DZHK (German Centre for Cardiovascular Research), Partner
Site Berlin, Berlin, Germany
(Ott, Roessler, Ruetzler) Outcomes Research Consortium, Anesthesiology
Institute, Cleveland Clinic, Cleveland, OH 44195, United States
(Lee) Department of Anaesthesiology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
(Muller-Wirtz) Department of Anaesthesiology, Intensive Care and Pain
Therapy, Saarland University Medical Center and Saarland University
Faculty of Medicine, Saarland, Homburg 66424, Germany
(Muller-Wirtz, Patterson) Outcomes Research Consortium, Department of
Anesthesiology, Cleveland Clinic, OH, United States
(Cangut) Department of Cardiovascular Surgery, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Roessler) Institute of Anaesthesiology, University Hospital Zurich,
Zurich 8091, Switzerland
(Thomas) Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Department of
Infectious Diseases and Respiratory Medicine, Berlin, Germany
(Bekele) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Augustenburger Platz 1, Berlin 13353,
Germany
(Windpassinger) Department of Anesthesia, Critical Care and Pain Medicine,
Division of General Anesthesia and Intensive Care Medicine, Medical
University Vienna, Vienna, Austria
(Lobdell) Department of Thoracic and Cardiovascular Surgery, Sanger Heart
and Vascular Institute, Carolinas Medical Center, Charlotte, NC 28203,
United States
(Grant) Department of Anesthesiology and Critical Care Medicine, The Johns
Hopkins Medical Institutions, Baltimore, MD, United States
(Grant) Armstrong Institute for Patient Safety and Quality, The Johns
Hopkins Medical Institutions, Baltimore, MD, United States
(Arora) Division of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals, Cleveland, OH, United States
(Engelman) Heart and Vascular Program, Baystate Health and University of
Massachusetts Chan Medical School-Baystate, 759 Chestnut Street,
Springfield, MA 01199, United States
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, Department of Surgery, University of Toronto, 2075
Bayview Avenue, M4N 3M5, Toronto, Canada
(Velten) Department of Anesthesiology and Pain Management, Division of
Cardiovascular and Thoracic Anesthesiology, University of Texas
Southwestern Medical Center, Dallas, TX 75390, United States
(O'Brien) St Bartholomew's Hospital and Barts Heart Centre, Department of
Perioperative Medicine, London EC1A 7BE, United Kingdom
(Ruetzler) Department of General Anesthesia, Anesthesiology Institute,
Cleveland Clinic, Cleveland, United States
(Heyland) Clinical Evaluation Research Unit, Department of Critical Care
Medicine, Queen's University, Kingston, ON, Canada
(Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital, Wurzburg, Wurzburg, Germany
(Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine,
Charite Berlin, Berlin, Germany
Publisher
Elsevier Inc.
Abstract
Aim: The cardiac surgery-related ischemia-reperfusion-related oxidative
stress triggers the release of cytotoxic reactive oxygen and nitrogen
species, contributing to organ failure and ultimately influencing
patients' short- and long-term outcomes. Selenium is an essential
co-factor for various antioxidant enzymes, thereby contributing to the
patients' endogenous antioxidant and anti-inflammatory defense mechanisms.
Given these selenium's pleiotropic functions, we investigated the effect
of a high-dose selenium-based anti-inflammatory perioperative strategy on
functional recovery after cardiac surgery. <br/>Material(s) and Method(s):
This prospective study constituted a nested sub-study of the SUSTAIN CSX
trial, a double-blinded, randomized, placebo-controlled multicenter trial
to investigate the impact of high-dose selenium supplementation on
high-risk cardiac surgery patients' postoperative recovery. Functional
recovery was assessed by 6-min walk distance, Short Form-36 (SF-36) and
Barthel Index questionnaires. <br/>Key Findings: 174 patients were
included in this sub-study. The mean age (SD) was 67.3 (8.9) years, and
78.7 % of the patients were male. The mean (SD) predicted 30-day mortality
by the European System for Cardiac Operative Risk Evaluation II score was
12.6 % (9.4 %). There was no difference at hospital discharge and after
three months in the 6-min walk distance between the selenium and placebo
groups (131 m [IQR: not performed - 269] vs. 160 m [IQR: not performed -
252], p = 0.80 and 400 m [IQR: 299-461] vs. 375 m [IQR: 65-441], p =
0.48). The SF-36 and Barthel Index assessments also revealed no clinically
meaningful differences between the selenium and placebo groups.
<br/>Significance: A perioperative anti-inflammatory strategy with
high-dose selenium supplementation did not improve functional recovery in
high-risk cardiac surgery patients.<br/>Copyright &#xa9; 2024

<2>
Accession Number
2032720123
Title
Antiplatelet Therapy, Pretreatment, and Primary PCI: Every Minute Counts.
Source
Journal of the American College of Cardiology. 83(25) (pp 2640-2642),
2024. Date of Publication: 25 Jun 2024.
Author
Silvain J.; Montalescot G.; Guedeney P.
Institution
(Silvain, Montalescot, Guedeney) Sorbonne Universite, ACTION Study Group,
INSERM UMRS1166, ICAN-Institut de Cardiologie, Hopital Pitie-Salpetriere
(AP-HP), Paris, France
Publisher
Elsevier Inc.

<3>
Accession Number
2029845130
Title
Pro-opiomelanocortin and ACTH-cortisol dissociation during pediatric
cardiac surgery.
Source
Endocrine Connections. 13(6) (no pagination), 2024. Article Number:
e240078. Date of Publication: June 2024.
Author
Teblick A.; Vanhorebeek I.; Derese I.; Jacobs A.; Haghedooren R.; Maebe
S.; Zeilmaker-Roest G.A.; Wildschut E.D.; Langouche L.; Van den Berghe G.
Institution
(Teblick, Vanhorebeek, Derese, Jacobs, Haghedooren, Maebe, Langouche, Van
den Berghe) Clinical Division and Laboratory of Intensive Care Medicine,
Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
(Zeilmaker-Roest, Wildschut) Department of Neonatal & Pediatric Intensive
Care, Division of Pediatric Intensive Care, Erasmus MC - Sophia Children's
Hospital, Rotterdam, Netherlands
Publisher
BioScientifica Ltd.
Abstract
In critically ill adults, high plasma cortisol in the face of low ACTH
coincides with high pro-opiomelanocortin (POMC) levels. Glucocorticoids
further lower ACTH without affecting POMC. We hypothesized that in
pediatric cardiac surgery-induced critical illness, plasma POMC is
elevated, plasma ACTH transiently rises intraoperatively but becomes
suppressed post-operatively, and glucocorticoid administration amplifies
this phenotype. From 53 patients (0-36 months), plasma was obtained
pre-operatively, intraoperatively, and on post-operative days 1 and 2.
Plasma was also collected from 24 healthy children. In patients, POMC was
supra-normal pre-operatively (P < 0.0001) but no longer thereafter (P >
0.05). ACTH was never high in patients. While in glucocorticoid-naive
patients ACTH became suppressed by post-operative day 1 (P < 0.0001),
glucocorticoid-treated patients had already suppressed ACTH
intraoperatively (P <= 0.0001). Pre-operatively high POMC, not accompanied
by increased plasma ACTH, suggests a centrally activated HPA axis with
reduced pituitary processing of POMC into ACTH. Increasing systemic
glucocorticoid availability with glucocorticoid treatment accelerated the
suppression of plasma ACTH. Significance statement Glucocorticoids are
often administered during pediatric cardiac surgery. In critically ill
children, endogenous systemic glucocorticoid availability is elevated
already upon ICU admission while ACTH levels are normal. This hormonal
constellation suggests the presence of active feedback inhibition of ACTH.
In this study, we have documented that intraoperative administration of
glucocorticoids accelerates the suppression of ACTH, resulting in low
plasma ACTH already upon ICU admission. Pre-operative plasma POMC, the
ACTH precursor, but not ACTH, was increased. This is compatible with a
centrally activated HPA axis prior to surgery in young children but
reduced processing of POMC into ACTH within the pituitary. These findings
suggest that glucocorticoid treatment in the context of pediatric cardiac
surgery may amplify pre-existing impaired pituitary processing of the
prohormone POMC.<br/>Copyright &#xa9; 2024 the author(s).

<4>
Accession Number
2029844584
Title
Comparative Study of Transverse Abdominis Plane Block (TAP) with 0.5%
Bupivacaine and 0.75% Ropivacaine in the Duration of PostOperative
Analgesia in Lower Abdominal Surgeries.
Source
International Journal of Pharmaceutical and Clinical Research. 16(5) (pp
832-837), 2024. Date of Publication: 2024.
Author
Janakiramulu E.; Suggala K.K.
Institution
(Janakiramulu, Suggala) Dept. of Anesthesia, Mamata Medical College,
Khammam, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: The Transversus Abdominis Plane (TAP) block is a recently
introduced regional anesthesia method utilized for postoperative pain
control, with the potential to serve as the primary anesthetic in a
growing array of surgical procedures. TAP block enhances postoperative
pain management by reducing postoperative visual analog scale scores,
opioid requirements, and the time elapsed before the initial
administration of rescue analgesia in patients undergoing lower abdominal
surgeries. Aims and Objectives: In our research, we employed the TAP block
as the exclusive anesthetic method for elective patients undergoing Lower
Abdominal Surgeries. We then compared the effectiveness of two distinct
local anesthetics, namely 0.5% Bupivacaine and 0.75% Ropivacaine, in terms
of their duration of anesthesia and analgesia as well as their impact on
cardiovascular stability. <br/>Material(s) and Method(s): A prospective
randomized clinical trial involved 60 patients classified as ASA I and II
who met the specified inclusion and exclusion criteria. These patients
were divided equally into two groups: Group B, which received an injection
of 0.5% bupivacaine, and Group R, which received an injection of 0.75%
ropivacaine. The dosage administered did not surpass 2.5 mg/kg body weight
for any participant. Results and <br/>Conclusion(s): Our study revealed
that both drugs provide effective anesthesia for Lower abdominal Surgeries
while maintaining hemodynamic stability. However, 0.75% Ropivacaine
exhibited a significant delay in the onset of anesthesia (13.46 +/-3.2
min) compared to 0.5% Bupivacaine (7.86 +/-2.47 min) (P value <0.001).
Furthermore, 0.75% Ropivacaine resulted in prolonged postoperative
analgesia (675.54 +/-30.31 min) compared to 0.5% Bupivacaine (573 +/-45.72
minutes) (P value <0.001). This suggests that the Transversus Abdominis
Plane (TAP) block can serve as the sole anesthetic technique for Lower
abdominal surgeries.<br/>Copyright &#xa9; 2024, Dr. Yashwant Research Labs
Pvt. Ltd.. All rights reserved.

<5>
Accession Number
2022668827
Title
Hyperlactatemia and poor outcome After postcardiotomy veno-arterial
extracorporeal membrane oxygenation: An individual patient data
meta-Analysis.
Source
Perfusion (United Kingdom). 39(5) (pp 956-965), 2024. Date of Publication:
July 2024.
Author
Biancari F.; Kaserer A.; Perrotti A.; Ruggieri V.G.; Cho S.-M.; Kang J.K.;
Dalen M.; Welp H.; Jonsson K.; Ragnarsson S.; Hernandez Perez F.J.; Gatti
G.; Alkhamees K.; Loforte A.; Lechiancole A.; Rosato S.; Spadaccio C.;
Pettinari M.; Mariscalco G.; Makikallio T.; Sahli S.D.; L'Acqua C.; Arafat
A.A.; Albabtain M.A.; AlBarak M.M.; Laimoud M.; Djordjevic I.; Krasivskyi
I.; Samalavicius R.; Puodziukaite L.; Alonso-Fernandez-Gatta M.; Spahn
D.R.; Fiore A.
Institution
(Biancari) Heart and Lung Center, Helsinki University Hospital, Helsinki,
Finland
(Biancari, Makikallio) Department of Medicine, South-Karelia Central
Hospital, University of Helsinki, Lappeenranta, Finland
(Kaserer, Sahli, Spahn) Institute of Anesthesiology, University and
University Hospital Zurich, Zurich, Switzerland
(Perrotti) Department of Thoracic and Cardio-Vascular Surgery, University
Hospital Jean Minjoz, Besancon, France
(Ruggieri) Division of Cardiothoracic and Vascular Surgery, Robert Debre
University Hospital, Reims, France
(Cho, Kang) Departments of Neurology, Anesthesiology and Critical Care
Medicine, Johns Hopkins University School of Medicine, Baltimore, United
States
(Dalen) Department of Molecular Medicine and Surgery, and Cardiac Surgery,
Karolinska Institutet, Stockholm, Sweden
(Welp) Department of Cardiothoracic Surgery, Munster University Hospital,
Munster, Germany
(Jonsson) Department of Cardiac Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Ragnarsson) Department of Cardiothoracic Surgery, University of Lund,
Lund, Sweden
(Hernandez Perez) Puerta de Hierro University Hospital, Madrid, Spain
(Gatti) Cardio-Thoracic and Vascular Department, University Hospital of
Trieste, Trieste, Italy
(Alkhamees) Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
(Loforte) Department of Cardiothoracic, Transplantation and Vascular
Surgery, S. Orsola Hospital, Bologna, Italy
(Lechiancole) Cardiothoracic Department, University Hospital of Udine,
Udine, Italy
(Rosato) Center for Global Health, Italian National Institute, Rome, Italy
(Spadaccio) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Pettinari) Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg,
Genk 3600, Belgium
(Mariscalco) Department of Intensive Care Medicine and Cardiac Surgery,
Glenfield Hospital, Leicester, United Kingdom
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Italy
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt
(Albabtain) Cardiology Clinical Pharmacy, Prince Sultan Cardiac Center,
Riyadh, Saudi Arabia
(AlBarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh,
Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, King Faisal
Specialist Hospital and Research Center, Riyadh, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo,
Egypt
(Djordjevic, Krasivskyi) Department of Cardiothoracic Surgery, University
Hospital Cologne, Cologne, Germany
(Samalavicius, Puodziukaite) 2nd Department of Anesthesia, Vilnius
University Hospital Santaros Klinikos, Vilnius, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Salamanca,
Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid,
Spain
(Fiore) Department of Cardiac Surgery, Hopitaux Universitaires Henri
Mondor, Creteil, France
Publisher
SAGE Publications Ltd
Abstract
Introduction: Postcardiotomy veno-arterial extracorporeal membrane
oxygenation (V-A-ECMO) is associated with significant mortality.
Identification of patients at very high risk for death is elusive and the
decision to initiate V-A-ECMO is based on clinical judgment. The
prognostic impact of pre-V-A-ECMO arterial lactate level in these
critically ill patients has been herein evaluated. <br/>Method(s): A
systematic review was conducted to identify studies on postcardiotomy
VA-ECMO for the present individual patient data meta-analysis.
<br/>Result(s): Overall, 1269 patients selected from 10 studies were
included in this analysis. Arterial lactate level at V-A-ECMO initiation
was increased in patients who died during the index hospitalization
compared to those who survived (9.3 vs 6.6 mmol/L, p < 0.0001).
Accordingly, in hospital mortality increased along quintiles of
pre-V-A-ECMO arterial lactate level (quintiles: 1, 54.9%; 2, 54.9%; 3,
67.3%; 4, 74.2%; 5, 82.2%, p < 0.0001). The best cut-off for arterial
lactate was 6.8 mmol/L (in-hospital mortality, 76.7% vs. 55.7%, p <
0.0001). Multivariable multilevel mixed-effect logistic regression model
including arterial lactate level significantly increased the area under
the receiver operating characteristics curve (0.731, 95% CI 0.702-0.760 vs
0.679, 95% CI 0.648-0.711, DeLong test p < 0.0001). Classification and
regression tree analysis showed the in-hospital mortality was 85.2% in
patients aged more than 70 years with pre-V-A-ECMO arterial lactate level
>=6.8 mmol/L. <br/>Conclusion(s): Among patients requiring postcardiotomy
V-A-ECMO, hyperlactatemia was associated with a marked increase of
in-hospital mortality. Arterial lactate may be useful in guiding the
decision-making process and the timing of initiation of postcardiotomy
V-A-ECMO.<br/>Copyright &#xa9; The Author(s) 2023.

<6>
Accession Number
2018849399
Title
Outcomes of transcarotid artery revascularization: A systematic review.
Source
Interventional Neuroradiology. 30(3) (pp 396-403), 2024. Date of
Publication: June 2024.
Author
Wu H.; Wang Z.; Li M.; Sun P.; Wei S.; Xie B.; Zhang C.; Zhang L.; Bai H.
Institution
(Wu, Wang, Li, Sun, Wei, Xie, Zhang, Zhang, Bai) Department of Vascular
and Endovascular Surgery, First Affiliated Hospital of Zhengzhou
University, Henan, China
(Wu, Bai) Key Vascular Physiology and Applied Research Laboratory of
Zhengzhou City, Henan, China
Publisher
SAGE Publications Inc.
Abstract
Background: Ischemic stroke and disability caused by carotid artery
stenosis have always been worldwide problems. At present, carotid
endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS) have
been commonly used to treat carotid artery stenosis. Recently,
transcarotid artery revascularization (TCAR) seems to be another option.
<br/>Method(s): We searched PubMed and Embase to find literatures
comparing TCAR with TFCAS and CEA. The primary outcomes were stroke,
myocardial infarction (MI), transient ischemic attack (TIA), death,
cranial nerve injure (CNI), and operative time. Secondary outcomes were
stroke, death, MI in the elderly; cost; radiation; and entry site
complication. <br/>Result(s): Initial search of the literature included
165 articles, of which 12 studies were chosen in the end. These studies
demonstrated high technical success rate of TCAR. Patients who received
TCAR had lower risks of death, stroke/death and less radiation exposure
compared to TFCAS. In meta analysis, the risk of stroke was significantly
lower in TCAR group than TFCAS (OR 0.63; 95%CI 0.47-0.85). And there was
no significant difference in TIA and MI. TCAR was associated with shorter
operative time, lower risk of CNI and less blood loss compared to CEA. In
older patients, the effect of TCAR was significantly better than that of
TFCAS. <br/>Conclusion(s): TCAR is associated with a lower risk of
perioperative stroke compared to TFCAS. TCAR is also associated with
shorter operative time, lower risk of CNI and less blood loss compared to
CEA. TCAR may be a promising treatment option besides TFCAS and
CEA.<br/>Copyright &#xa9; The Author(s) 2022.

<7>
Accession Number
2032953326
Title
Coronary Artery Bypass Graft Failure in Women: Incidence and Clinical
Implications.
Source
Journal of the American College of Cardiology. 84(2) (pp 182-191), 2024.
Date of Publication: 09 Jul 2024.
Author
Sandner S.; Redfors B.; An K.R.; Harik L.; Heise R.; Di Franco A.; Fremes
S.E.; Hare D.L.; Kulik A.; Lamy A.; Peper J.; Ruel M.; ten Berg J.M.;
Willemsen L.M.; Zhao Q.; Zhu Y.; Wojdyla D.M.; Bhatt D.L.; Alexander J.H.;
Gaudino M.
Institution
(Sandner, An, Harik, Heise, Di Franco, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(An) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
(Fremes) Schulich Heart Centre Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Hare) Department of Cardiology, Austin Health, University of Melbourne,
Melbourne, VIC, Australia
(Kulik) Division of Cardiac Surgery, Boca Raton Regional Hospital and
Florida Atlantic Hospital, Boca Raton, FL, United States
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Peper, ten Berg, Willemsen) Department of Cardiology, St Antonius
Hospital, Nieuwegein, Netherlands
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Zhao, Zhu) Ruijin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
(Wojdyla) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine, Mount Sinai, New
York, NY, United States
(Alexander) Department of Medicine and Duke Clinical Research Institute,
Duke University, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Women have worse outcomes after coronary artery bypass surgery
(CABG) than men. <br/>Objective(s): This study aimed to determine the
incidence of CABG graft failure in women, its association with cardiac
events, and whether it contributes to sex-related differences in outcomes.
<br/>Method(s): A pooled analysis of individual patient data from
randomized clinical trials with systematic imaging follow-up was
performed. Multivariable logistic regression models were used to assess
the association of graft failure with myocardial infarction and repeat
revascularization between CABG and imaging (primary outcome) and death
after imaging (secondary outcome). Mediation analysis was performed to
evaluate the effect of graft failure on the association between female sex
and risk of death. <br/>Result(s): Seven randomized clinical trials (N =
4,413, 777 women) were included. At a median imaging follow-up of 1.03
years, graft failure was significantly more frequent among women than men
(37.3% vs 32.9% at the patient-level and 20.5% vs 15.8% at the graft
level; P = 0.02 and P < 0.001, respectively). In women, graft failure was
associated with an increased risk of myocardial infarction and repeat
revascularization (OR: 3.94; 95% CI: 1.79-8.67) and death (OR: 3.18; 95%
CI: 1.73-5.85). Female sex was independently associated with the risk of
death (direct effect, HR: 1.84; 95% CI: 1.35-2.50) but the association was
not mediated by graft failure (indirect effect, HR: 1.04; 95% CI:
0.86-1.26). <br/>Conclusion(s): Graft failure is more frequent in women
and is associated with adverse cardiac events. The excess mortality risk
associated with female sex among CABG patients is not mediated by graft
failure.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<8>
Accession Number
2032936348
Title
Impact of a bundle of care (intravenous iron, erythropoietin and
transfusion metabolic adjustment) on post-operative transfusion incidence
in cardiac surgery: a single-centre, randomised, open-label,
parallel-group controlled pilot trial.
Source
The Lancet Regional Health - Europe. 43 (no pagination), 2024. Article
Number: 100966. Date of Publication: August 2024.
Author
Saour M.; Blin C.; Zeroual N.; Mourad M.; Amico M.; Gaudard P.; Picot
M.-C.; Colson P.H.
Institution
(Saour, Blin, Zeroual, Mourad, Gaudard, Colson) Anaesthesiology and
Critical Care Medicine Department, Arnaud de Villeneuve Hospital,
University of Montpellier Hospital Centre, University of Montpellier,
Montpellier, France
(Amico, Picot) Clinical Research and Epidemiology Unit, University of
Montpellier Hospital Centre, University of Montpellier, Montpellier,
France
(Gaudard) University of Montpellier, CNRS (Scientific Research Centre),
INSERM, PhyMedExp, Montpellier, France
(Colson) University of Montpellier, CNRS (Scientific Research Centre),
INSERM, Functional Genome Unit, Montpellier, France
Publisher
Elsevier Ltd
Abstract
Background: Red blood cell (RBC) transfusions are frequent in patients
after cardiac surgery. This study assessed whether a bundle of care
including pre-operative and post-operative administration of
erythropoietin (EPO) with intravenous iron supplementation, and
restrictive transfusion adjusted for ScvO<inf>2</inf> could result in
reduced postoperative transfusions. <br/>Method(s): In this single-centre,
randomised, open-label, parallel-group controlled pilot study, patients
undergoing elective cardiac surgery with high risk of transfusion in a
University Hospital were enrolled by the investigator and the
randomisation procedure using a central internet-based system was made by
the clinical research assistant. Since the trial was open-label, no
masking was used. Patients were assigned (1:1) to either the STOP group
(40,000 IU subcutaneous EPO combined with 20 mg/kg intravenous ferric
carboxymaltose if Hb < 13 g/dL the day before surgery or at ICU admission,
and RBC transfusion if Hb <= 8 g/dL and ScvO<inf>2</inf> <= 65%, or
additional EPO dose if 8 < Hb < 13 g/dL) or to the control group (RBC
transfusion if Hb <= 8 g/dL, or, if 8 < Hb < 13 g/dL, intravenous iron
sucrose 200 mg or 300 mg according to weight). Primary outcome was the
incidence of postoperative RBC transfusion up to hospital discharge or
postoperative day 28. The trial is registered with ClinicalTrials.gov,
NCT04141631. <br/>Finding(s): Between Jan 20, 2020, and Sept 6, 2022,
among 128 patients enrolled, 123 (male, 54.4%, 67/123) were included in
the full analysis set: 62 in the STOP group and 61 in the control group.
Nine patients (14.5%, 9/62) in the STOP group required RBC transfusion vs
19 (31.2%, 19/61) in the control group (odds ratio 0.37 [95% CI:
0.15-0.91], p = 0.03). The median length of follow up to transfusion was
2.6 days (1.5; 4.6) and 3.3 (1.6; 4.2) in control and STOP groups
respectively (p = 0.61). <br/>Interpretation(s): The bundle of care may
reduce postoperative RBC transfusion. The findings should be taken with
caution due to the unblinded and exploratory nature of the study.
<br/>Funding(s): University of Montpellier Hospital and Vifor
Pharma.<br/>Copyright &#xa9; 2024

<9>
Accession Number
2029878329
Title
App-Based Mental Training to Reduce Atrial Fibrillation-Related Symptoms
After Pulmonary Vein Isolation: MENTAL AF Trial.
Source
Journal of the American Heart Association. 13(11) (no pagination), 2024.
Article Number: e033500. Date of Publication: 04 Jun 2024.
Author
Lurz J.; Hengelhaupt L.; Unterhuber M.; Stenzel L.; Hilbert S.; Schober
A.R.; Dinov B.; Darma A.; Dagres N.; Hindricks G.; Lurz P.; Bollmann A.
Institution
(Lurz, Hengelhaupt, Hilbert, Darma, Bollmann) Department of
Electrophysiology, Heart Center Leipzig at University Leipzig, Leipzig,
Germany
(Lurz, Schober, Lurz) Department of Cardiology, University Medical Center
of the Johannes Gutenberg University Mainz, Mainz, Germany
(Unterhuber, Schober) Department of Cardiology, Heart Center Leipzig at
University Leipzig, Leipzig, Germany
(Unterhuber) Department of Cardiology, San Maurizio Hospital, Bolzano,
Italy
(Stenzel) Institute of Sport Science, Martin Luther University
Halle-Wittenberg, Saale, Halle, Germany
(Dinov) Medical Clinic I, Cardiology and Angiology, Medical University of
Giessen, Giessen, Germany
(Dagres, Hindricks) Deutsches Herzzentrum der Charite, Berlin, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Even after atrial fibrillation (AF) catheter ablation, many
patients still experience relevant symptom burden. The objective of the
MENTAL AF trial was to determine whether app-based mental training (MT)
during the 3 months following pulmonary vein isolation reduces AF-related
symptoms. METHODS AND RESULTS: Patients scheduled for pulmonary vein
isolation were enrolled and randomized 1:1 to either app-based MT or usual
care. Of 174 patients, 76 in the MT and 75 in the usual care group were
included in the final analysis. The intervention was delivered by a daily
10-minute app-based MT. The primary outcome was the intergroup difference
of the mean AF6 sum score, an AF-specific questionnaire, during the
3-month study period. Secondary outcomes included quality-of-life measures
such as the AFEQT (Atrial Fibrillation Effect on Quality of Life). Mean
age (SD) was 61 (8.7) years and 61 (41%) were women. The mean AF6 sum
score over the study period was 8.9 (6.9) points in the MT group and 12.5
(10.1) in the usual care group (P=0.011). This referred to a reduction in
the AF6 sum score compared with baseline of 75% in MT and 52% for usual
care (P<0.001). The change in the AFEQT Global Score was 22.6 (16.3) and
15.7 (22.1), respectively; P=0.026. <br/>CONCLUSION(S): MENTAL AF showed
that app-based MT as an adjunctive treatment tool following pulmonary vein
isolation was feasible. App-based MT was found to be superior to standard
care in reducing AF-related symptom burden and improving health-related
quality of life.<br/>Copyright &#xa9; 2024 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<10>
Accession Number
2032720243
Title
Correction: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and
Management of Atrial Fibrillation: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines (Journal of the American College of Cardiology (2024) 83(1)
(109-279), (S0735109723064653), (10.1016/j.jacc.2023.08.017)).
Source
Journal of the American College of Cardiology. 83(25) (pp 2714), 2024.
Date of Publication: 25 Jun 2024.
Author
Anonymous
Publisher
Elsevier Inc.
Abstract
Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM,
Deswal A, Eckhardt L, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL,
Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta
KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP,
Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente
AM, Van Wagoner DR 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and
Management of Atrial Fibrillation: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines J Am Coll Cardiol. 2024;83:109-279. In the article by Joglar et
al, "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of
Atrial Fibrillation: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines," which published ahead of print on November 30, 2023, and
appeared in the January 2, 2024, issue of the journal (J Am Coll Cardiol.
2024;83:109-279), a correction was needed. 1. On page 143, in Table 8, in
the row for the "Risk Factor," "Hypertension," the entry for the "ATRIA"
column was inadvertently omitted. It has been updated to read, "1."2. On
page 177, in Figure 17, the last row, in the third box from the left, the
asterisk has been moved from the top portion of the box after "IV
Amiodarone" to the bottom portion of the box after "Verapamil,
diltiazem."<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation and the American Heart Association, Inc. Published by Elsevier.

<11>
Accession Number
2030246756
Title
Transcatheter Therapy for the Tricuspid Valve: A Focused Review of
Edge-to-Edge Repair and Orthotopic Valve Replacement.
Source
Current Cardiology Reports. 26(6) (pp 459-474), 2024. Date of Publication:
June 2024.
Author
Madhavan M.V.; Agarwal V.; Hahn R.T.
Institution
(Madhavan, Agarwal, Hahn) NewYork-Presbyterian Hospital, Columbia
University Irving Medical Center, 177 Fort Washington Avenue, New York, NY
10032, United States
(Madhavan, Hahn) Cardiovascular Research Foundation, New York, NY, United
States
Publisher
Springer
Abstract
Purpose of Review: Patients with severe tricuspid regurgitation (TR) are
at risk for significant morbidity and mortality. Transcatheter tricuspid
valve interventions (TTVI) may offer patients less invasive treatment
alternatives to surgery. This review evaluates the most common class of
device currently used worldwide to treat TR, tricuspid transcatheter
edge-to-edge repair (T-TEER) and orthotopic transcatheter tricuspid valve
replacement (TTVR), both of which are now approved in the USA and Europe.
Recent Findings: The first pivotal randomized clinical trial, TRILUMINATE,
demonstrated that T-TEER can safely reduce TR and is associated with
improved health status outcomes. However, results of this trial have
raised questions about whether this device can provide sufficient TR
reduction to impact clinical outcomes. Orthotopic TTVR has recently gained
attention with initial data suggesting near-complete TR elimination.
<br/>Summary: The current review examines the technical features and
anatomic limitations of the most commonly used devices for T-TEER and
orthotopic TTVR, discusses the current clinical data for these devices,
and offers a theoretical construct for device selection.<br/>Copyright
&#xa9; The Author(s) 2024.

<12>
Accession Number
2032962557
Title
A review regarding the article 'impact of simulation-based training on
transesophageal echocardiography learning: A systemic review and
meta-analysis of randomized controlled trials'.
Source
Current Problems in Cardiology. 49(9) (no pagination), 2024. Article
Number: 102717. Date of Publication: September 2024.
Author
Su Y.; Yuan D.
Institution
(Su) Department of Anesthesiology, West China Hospital, Sichuan
University/West China School of Nursing, Sichuan, Chengdu 610041, China
(Yuan) Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan Province,
Chengdu 610041, China
Publisher
Elsevier Inc.
Abstract
Transesophageal echocardiography (TEE) has emerged as a critical imaging
technique for anesthesiologists, enabling them to monitor and detect
significant cardiothoracic conditions in both cardiac and noncardiac
surgical patients throughout the perioperative period. Given the expanding
applications of TEE, its integration into the anesthesiology residency
curriculum at an early stage is crucial. This ensures that residents have
ample time to develop their TEE skills, thereby facilitating meaningful
clinical application post-residency. While studies have demonstrated the
successful use of simulators and web-based modules in TEE education, there
is currently a lack of educational materials that provide a structured
curriculum specifically designed to teach the fundamentals of TEE to
residents. Furthermore, simulation training in TEE prior to patient
exposure may contribute to enhanced patient safety and comfort. By
providing residents with the opportunity to practice their TEE skills in a
controlled, risk-free environment, simulation training can help to
mitigate the potential risks associated with real-world patient care. TEE
has become an indispensable tool for anesthesiologists, and its
integration into the residency curriculum is essential. The use of
simulation-based training, particularly in a virtual reality setting,
offers a promising avenue for enhancing TEE education and fostering the
development of competent practitioners.<br/>Copyright &#xa9; 2024

<13>
Accession Number
2032958207
Title
Rigid ring vs. flexible band for tricuspid valve repair in patients with
tricuspid valve regurgitation: A systematic review and meta-analysis.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
22 (no pagination), 2024. Article Number: 200296. Date of Publication:
September 2024.
Author
Abdelaal S.A.; Hefnawy M.T.; Ewais E.; Mostafa N.; Abozaid A.M.; Mouffokes
A.; Moustapha A.; Mohamed M.; Ghaith H.S.; Ramadan A.; Kengo N.E.; Negida
A.
Institution
(Abdelaal) Kharkiv National Medical University, Kharkiv, Ukraine
(Hefnawy, Ewais, Moustapha, Mohamed, Negida) Faculty of Medicine, Zagazig
University, Zagazig, Egypt
(Abozaid) Faculty of Medicine, Tanta University, Tanta, Egypt
(Mouffokes) Faculty of Medicine, University of Oran 1 Ahmed Ben Bella,
Oran, Algeria
(Ghaith) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ramadan) Faculty of Medicine, South Valley University, Qena, Egypt
(Kengo) Faculty of Medicine and Biomedical Sciences, University of Garoua,
Garoua, Cameroon
(Hefnawy) Medical Affairs Department, Volaris LLC, Dubai, United Arab
Emirates
(Ewais) Faculty of Nursing, Ain Shams University, Cairo, Egypt
(Mostafa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Elsevier B.V.
Abstract
Background & objectives: Rigid ring and Flexible band are techniques used
to repair tricuspid valve regurgitation. The comparison between both
techniques' effectiveness is controversial in the literature. We conducted
this systematic review and meta-analysis to compare the safety and
efficacy of rigid ring versus flexible band for tricuspid valve repair in
patients with tricuspid valve regurgitation. <br/>Method(s): We conducted
a PRISMA-compliant systematic review and meta-analysis. A systematic
search was performed in major databases, including PubMed, Scopus, Web of
Science, and Cochrane CENTRAL to identify relevant published studies. Data
were extracted and analyzed using Stata (version 17 for Mac) and Revman
(version 5.4 for Windows). <br/>Result(s): Twelve studies were included in
this meta-analysis. Total number of patients was 4259. The rigid ring
wasn't superior to the flexible band in terms of postoperative tricuspid
regurgitation RR 0.74, 95 % CI (0.43-1.27) (P = 0.29). However, the
results were not homogeneous. After employing sensitivity analysis, the
significance of the pooled effect estimate didn't change, showing no
significant difference between the two annuloplasty RR 0.72, 95%CI
(0.45-1.15). On the other hand, the rigid ring was associated with a
higher bypass time than the flexible band (RR 4.85, P = 0.00). There were
no differences between the two groups in terms of hospital stay, ICU
stays, prolonged ventilation, mechanical ventilation time, annuloplasty
size, stroke, concomitant mitral valve surgery, concomitant aortic valve
surgery, atrial fibrillation, pacemaker implantation, low cardiac output,
in-hospital death, or late death (all P > 0.05). <br/>Conclusion(s): Our
study findings suggested no difference between rigid ring compared to
flexible band regarding the rates of postoperative tricuspid
regurgitation; however, rigid ring may encompass a higher bypass time.
Therefore, further research is required to ensure our
findings.<br/>Copyright &#xa9; 2024 The Authors

<14>
Accession Number
2032895351
Title
Mitral Regurgitation Quantification, Management, and Guidelines: A 2024
Update.
Source
Annals of Clinical Cardiology. 6(1) (pp 4-16), 2024. Date of Publication:
2024.
Author
Alqouba M.; Alhumaidi M.; Al Jarallah M.; Dashti R.; Khalil M.; Al Mulla
K.; Sharma R.M.; Tse G.; Rajan R.
Institution
(Alqouba, Alhumaidi) Department of Medicine, Faculty of Medicine, Kuwait
University, Kuwait
(Al Jarallah, Dashti, Khalil, Al Mulla, Rajan) Department of Cardiology,
Sabah Al Ahmad Cardiac Center, Al-Amiri Hospital, Kuwait City, Kuwait
(Sharma) Department of Medicine, Faculty of Medicine and Health Sciences,
Royal College of Surgeons in Ireland, Dublin, Ireland
(Tse, Rajan) Cardiovascular Analytics Group, Hong Kong, Hong Kong
Publisher
Wolters Kluwer Medknow Publications
Abstract
A comparison of the recommendations for the diagnosis and treatment of
mitral regurgitation (MR), the second-most common valvular heart ailment
in high-income countries, from the European Society of Cardiology/European
Association for Cardio-Thoracic Surgery 2021 and American College of
Cardiology/American Heart Association 2020 guidelines. We systematically
reviewed and contrasted the guidelines on the diagnosis and treatment of
MR to inform clinical judgment. A multimodal approach comprising a
comprehensive history and physical examination, echocardiography, and, in
some cases, cardiac magnetic resonance imaging, is the preferred method
for diagnosis, treatment guidance, and follow-up in patients with valvular
heart disease. Both guidelines agreed on the multidisciplinary approach of
the heart team and the definition and grading of severe primary MR. There
was substantial agreement on the thresholds for intervention, such as the
onset of symptoms, left ventricular failure, and hypertrophy; however,
there were differences among asymptomatic individuals with preserved
ventricular function. While there was a consensus on the need for
intervention in patients with severe secondary MR and those who continued
to experience symptoms despite optimization of medical therapy, there was
a disagreement regarding whether a transcatheter or surgical
repair/replacement should be performed.<br/>&#xa9; 2024 Copyright: Annals
of Clinical Cardiology.

<15>
Accession Number
2032973050
Title
Machine-learning approaches for risk prediction in transcatheter aortic
valve implantation: Systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Jacquemyn X.; Van Onsem E.; Dufendach K.; Brown J.A.; Kliner D.; Toma C.;
Serna-Gallegos D.; Sa M.P.; Sultan I.
Institution
(Jacquemyn, Van Onsem) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Belgium
(Dufendach, Brown, Serna-Gallegos, Sa, Sultan) Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United
States
(Dufendach, Brown, Kliner, Toma, Serna-Gallegos, Sa, Sultan) UPMC Heart
and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Kliner, Toma) Department of Interventional Cardiology, University of
Pittsburgh, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: With the expanding integration of artificial intelligence (AI)
and machine learning (ML) into the structural heart domain, numerous ML
models have emerged for the prediction of adverse outcomes after
transcatheter aortic valve implantation (TAVI). We aim to identify,
describe, and critically appraise ML prediction models for adverse
outcomes after TAVI. Key objectives consisted in summarizing model
performance, evaluating adherence to reporting guidelines, and
transparency. <br/>Method(s): We searched PubMed, SCOPUS, and Embase
through August 2023. We selected published machine learning models
predicting TAVI outcomes. Two reviewers independently screened articles,
extracted data, and assessed the study quality according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Outcomes included summary C-statistics and model risk of bias assessed
with the Prediction Model Risk of Bias Assessment Tool. C-statistics were
pooled using a random-effects model. <br/>Result(s): Twenty-one studies
(118,153 patients) employing various ML algorithms (76 models) were
included in the systematic review. Predictive ability of models varied:
11.8% inadequate (C-statistic <0.60), 26.3% adequate (C-statistic
0.60-0.70), 31.6% acceptable (C-statistic 0.70-0.80), and 30.3%
demonstrated excellent (C-statistic >0.80) performance. Meta-analyses
revealed excellent predictive performance for early mortality
(C-statistic: 0.81; 95% confidence interval [CI], 0.65-0.91), acceptable
performance for 1-year mortality (C-statistic: 0.76; 95% CI, 0.67-0.84),
and acceptable performance for predicting permanent pacemaker implantation
(C-statistic: 0.75; 95% CI, 0.51-0.90). <br/>Conclusion(s): ML models for
TAVI outcomes exhibit adequate-to-excellent performance, suggesting
potential clinical utility. We identified concerns in methodology and
transparency, emphasizing the need for improved scientific reporting
standards.<br/>Copyright &#xa9; 2024 The American Association for Thoracic
Surgery

<16>
Accession Number
2030338356
Title
Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After
Surgical Bioprosthetic Valve Replacement: Rationale and Design of the
ENBALV Trial.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Izumi C.; Amano M.; Fukushima S.; Yaku H.; Eishi K.; Sakaguchi T.; Minami
M.; Yamamoto H.; Onda K.; Omae K.
Institution
(Izumi, Amano) Department of Heart Failure and Transplant, National
Cerebral and Cardiovascular Center, 6-1 Kishibe Shimmachi, Suita-City,
Osaka 564-8565, Japan
(Fukushima) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
(Eishi) Department of Cardiovascular Surgery, Hakujyuji Hospital, Fukuoka,
Japan
(Sakaguchi) Department of Cardiovascular Surgery, Hyogo Medical
University, Nishinomiya, Japan
(Minami, Yamamoto, Onda, Omae) Department of Data Science, National
Cerebral and Cardiovascular Center, Suita, Japan
Publisher
Springer
Abstract
Background and Purpose: Anticoagulant therapy with vitamin K antagonists
is recommended within 3 to 6 months after bioprosthetic valve replacement
to prevent thromboembolic events. However, data regarding whether direct
oral anticoagulants can be an alternative to warfarin in such patients are
limited. The purpose of this study is to compare the efficacy and safety
of edoxaban versus warfarin within 3 months after bioprosthetic valve
replacement. <br/>Method(s): The ENBALV trial is an
investigator-initiated, phase 3, randomized, open-label, multicenter
study. It involves patients aged 18 to 85 years undergoing bioprosthetic
valve replacement at the aortic and/or mitral position. They are
randomized 1:1 to receive either edoxaban or warfarin. Administration of
edoxaban or warfarin is to be continued for 12 weeks after surgery. The
primary outcome is the occurrence rate of stroke or systemic embolism at
12 weeks after surgery. The net clinical outcome is a composite of stroke,
systemic embolism, or major bleeding, which is included in the secondary
outcomes. <br/>Conclusion(s): The ENBALV trial demonstrates the efficacy
and safety of edoxaban compared with warfarin in patients early after
bioprosthetic valve replacement, including patients with sinus rhythm,
which will bring a significant benefit to patients in clinical practice.
Trial Registration: Japan Registry of Clinical Trials (jRCT) 2051210209.
30 Mar 2022
https://jrct.niph.go.jp/latest-detail/jRCT2051210209.<br/>Copyright &#xa9;
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<17>
Accession Number
644578254
Title
Subclinical valve leaflet thrombosis following bioprosthetic aortic valve
replacement.
Source
Current opinion in cardiology. (no pagination), 2024. Date of
Publication: 20 Jun 2024.
Author
Giuliani C.; Zanuttini A.; Salaun E.; Cote N.; Clavel M.A.; Pibarot P.
Institution
(Giuliani) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Universite Laval, Quebec, Canada
Abstract
PURPOSE OF REVIEW: Subclinical leaflet thrombosis (SLT) is often an
incidental finding characterized by a thin layer of thrombus involving
one, two or three leaflets, with typical appearance on multi-detector
computed tomography (MDCT) of hypo-attenuating defect at the aortic side
of the leaflet, also called hypo-attenuating leaflet thickening (HALT).
SLT may occur following both transcatheter aortic replacement (TAVR) or
biological surgical aortic valve replacement (SAVR). The aim of this
review is to present an overview of the current state of knowledge on the
incidence, diagnosis, clinical impact, and management of SLT following
TAVR or SAVR. RECENT FINDINGS: SLT occurs in 10-20% of patients following
TAVR and is somewhat more frequent than following SAVR (5-15%). SLT may
regress spontaneously without treatment in about 50% of the cases but may
also progress to clinically significant valve thrombosis in some cases.
Oral anticoagulation with vitamin K antagonist is reasonable if SLT is
detected by echocardiography and/or MDCT during follow-up and is generally
efficient to reverse SLT. SLT is associated with mild increase in the risk
of stroke but has no impact on survival. SLT has been linked with
accelerated structural valve deterioration and may thus impact valve
durability and long-term outcomes. SUMMARY: SLT is often an incidental
finding on echocardiography or MDCT that occurs in 10-20% of patients
following TAVR or 5-15% following biological SAVR and is associated with a
mild increase in the risk of thrombo-embolic event with no significant
impact on mortality but may be associated with reduced valve
durability.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<18>
Accession Number
644577708
Title
The Ross Operation Over 55 Years Later: Comparing Surgical Techniques and
Outcomes.
Source
Surgical technology international. 44 (no pagination), 2024. Date of
Publication: 19 Jun 2024.
Author
Nappi F.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord,
Saint-Denis, France
Abstract
The Ross procedure is often considered the best option for a small group
of patients. Some critics argue that harvesting the pulmonary artery again
can cause problems, such as exposing the native pulmonary autograft to
systemic pressures and requiring further intervention. However, the
pulmonary autograft is a living tissue that can adjust to growing
conditions and undergo remodelling. The pathophysiology of living tissue,
harvesting techniques, indications for use of pulmonary autograft in
aortic valve disease, contraindications, and variations of pulmonary
autograft as an aortic conduit are discussed in this seminar. Following
recent updates from high-volume centres, the indications,
contraindications, techniques, and variations of pulmonary autograft as an
aortic conduit and, in the absence of substantial well-designed randomised
controlled trials, areas where the Ross procedure needs to be reaffirmed
as part of the surgical armamentarium are also discussed. Furthermore,
increasing evidence suggests that the Ross procedure produces better
long-term results than traditional aortic valve replacement in young and
middle-aged adults. To enable cardiologists and surgeons to make
appropriate decisions for their patients with aortic valve disease, the
author provides a complete review of the most recent published studies on
the Ross procedure.

<19>
Accession Number
644576979
Title
TRISCEND II: Novel Randomized Trial Design for Transcatheter Tricuspid
Valve Replacement.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 17 Jun 2024.
Author
Grayburn P.A.; Kodali S.K.; Hahn R.T.; Lurz P.; Thourani V.H.;
Kozorovitsky E.R.; Gilmore S.Y.; Vinekar C.; Zhang B.; Boulware K.;
Krzmarzick A.M.; Nguyen D.; Vu M.T.; Feldman T.; Mack M.J.; Leon M.B.
Institution
(Grayburn) Baylor Scott & White: The Heart Hospital Plano, Plano, TX, USA;
Baylor Scott & White Research Institute Cardiac Imaging Core Laboratory,
Plano, TX, USA
(Kodali, Hahn, Leon) Columbia University Irving Medical Center, New York,
NY, USA
(Lurz) University Medical Centre Mainz, Mainz, Germany
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Kozorovitsky, Gilmore, Vinekar, Zhang, Boulware, Krzmarzick, Nguyen, Vu,
Feldman) Edwards Lifesciences, Irvine, CA, United States
(Mack) Baylor Scott & White: The Heart Hospital Plano, Plano, TX, United
States
Abstract
BACKGROUND: Severe tricuspid regurgitation remains largely undertreated
given limited treatment options. Transcatheter tricuspid valve
interventions have emerged as a promising therapy for these patients, and
the TRISCEND II pivotal trial is the first randomized controlled trial to
evaluate transcatheter tricuspid valve replacement (TTVR).
<br/>OBJECTIVE(S): The TRISCEND II pivotal trial studies the transcatheter
EVOQUE tricuspid valve replacement system using an FDA Breakthrough Device
Designation - a program intended to provide timely access to medical
devices by speeding up development, assessment, and review.
<br/>METHOD(S): The TRISCEND II trial is a prospective, multicenter trial
that randomizes patients with symptomatic severe tricuspid regurgitation
to treatment with either TTVR in conjunction with optimal medical therapy
or optimal medical therapy alone. The trial's novel 2-phase design
evaluates 30-day safety and 6-month effectiveness endpoints for the first
150 patients in the initial phase and a 1-year safety and effectiveness
endpoint for the full cohort of 400 patients in the second phase.
<br/>RESULT(S): The TRISCEND II trial's 2-phase trial design provided an
opportunity for early review and led to the first commercial approval of a
TTVR system. <br/>CONCLUSION(S): The design of the TRISCEND II trial will
likely inform future transcatheter tricuspid device trials. CONDENSED
ABSTRACT: The TRISCEND II pivotal trial is the first randomized controlled
trial of transcatheter tricuspid valve replacement (TTVR). It was designed
under the FDA's Breakthrough Device Program to bring a novel TTVR therapy
to patients with limited treatment options. A 2-phase design allowed for
early review of safety and effectiveness outcomes followed by a
full-cohort safety and effectiveness endpoint in the second phase at 1
year. This approach led to approval of the first commercial transcatheter
therapy for tricuspid valve replacement.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.

<20>
Accession Number
644576636
Title
Long-Term Outcomes of Tricuspid Valve Replacement with Mechanical versus
Tissue Valves: Meta-Analysis of Reconstructed Time-to-Event Data.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 17 Jun 2024.
Author
Sa M.P.; Iyanna N.; Tabrizi N.S.; Jacquemyn X.; Ahmad D.; Brown J.A.;
Yousef S.; Serna-Gallegos D.; Yoon P.D.; Sultan I.
Institution
(Sa) UPMC Heart and Vascular Institute, University of Pittsburgh Medical
Center, Pittsburgh, PA, USA; Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:
michel_pompeu@yahoo.com.br
(Iyanna, Ahmad, Brown, Yousef, Serna-Gallegos, Yoon, Sultan) UPMC Heart
and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, USA; Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, USA
(Tabrizi) Albany Medical College, Albany, NY, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
Abstract
Tricuspid valve replacement (TVR) with mechanical versus tissue valves
remains a controversial subject. To evaluate the long-term effects of
types of valves on patient-relevant outcomes, we performed a systematic
review with meta-analysis of reconstructed time-to-event data of studies
published by March 15, 2024 (according to PRISMA). Twenty-one studies met
our eligibility criteria and included 7,166 patients (mechanical: 2,495
patients, 34.8%). Patients who underwent mechanical TVR had lower risk of
death in comparison with those who received a tissue valve (HR 0.77; 95%CI
0.70-0.84, P<0.001). Mechanical TVR was associated with lifetime gain as
evidence by the restricted mean survival time which was 2.2 years longer
in patients who underwent TVR with mechanical valves (12.4 years vs. 10.2
years, P<0.001). Our landmark analysis for reoperations revealed the
following: from the timepoint 0 to 7 years, we found no difference in the
risk of reoperation between mechanical and tissues valves (HR 0.98; 95%CI
0.60-1.61, P=0.946); however, from the timepoint 7 years onwards, we found
that mechanical TVR had a lower risk of reoperation in the follow-up (HR
0.24; 95%CI 0.08-0.72, P=0.001). Meta-regression analysis demonstrated a
modulating effect of atrial fibrillation on the association between
mechanical valves and mortality; HRs for all-cause death tended to
decrease in the presence of populations with larger proportion of atrial
fibrillation (P=0.018). In conclusion, our results suggest that TVR with
mechanical valves, whenever considered clinically reasonable and accepted
by patients as an option, can offer a better long-term survival and lower
risk of reoperation in the long run.<br/>Copyright &#xa9; 2024. Published
by Elsevier Inc.

<21>
Accession Number
644576492
Title
Cardiac shockwave therapy in addition to coronary bypass surgery improves
myocardial function in ischaemic heart failure: the CAST-HF trial.
Source
European heart journal. (no pagination), 2024. Date of Publication: 20
Jun 2024.
Author
Holfeld J.; Nagele F.; Polzl L.; Engler C.; Graber M.; Hirsch J.; Schmidt
S.; Mayr A.; Troger F.; Pamminger M.; Theurl M.; Schreinlechner M.;
Sappler N.; Ruttmann-Ulmer E.; Schaden W.; Cooke J.P.; Ulmer H.; Bauer A.;
Gollmann-Tepekoylu C.; Grimm M.
Institution
(Holfeld, Nagele, Polzl, Engler, Graber, Hirsch, Schmidt, Ruttmann-Ulmer,
Gollmann-Tepekoylu, Grimm) University Clinic of Cardiac Surgery, Medical
University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
(Nagele, Graber, Cooke) Center for Cardiovascular Regeneration, Houston
Methodist Research Institute, Houston, TX, United States
(Mayr, Troger, Pamminger) Department of Radiology, Medical University of
Innsbruck, Innsbruck, Austria
(Theurl, Schreinlechner, Sappler, Bauer) Department of Internal Medicine
III, Medical University of Innsbruck, Innsbruck, Austria
(Schaden) Research Center in Cooperation with AUVA, Ludwig Boltzmann
Institute for Traumatology, Vienna, Austria
(Schaden) International Medical Director of SoftWave Tissue Regeneration
Technologies, Kennesaw, GA, United States
(Ulmer) Institute of Medical Statistics and Informatics, Medical
University of Innsbruck, Innsbruck, Austria
Abstract
BACKGROUND AND AIMS: In chronic ischaemic heart failure, revascularisation
strategies control symptoms but are less effective in improving left
ventricular ejection fraction (LVEF). The aim of this trial is to
investigate the safety of cardiac shockwave therapy (SWT) as a novel
treatment option and its efficacy in increasing cardiac function by
inducing angiogenesis and regeneration in hibernating myocardium.
<br/>METHOD(S): In this single-blind, parallel-group, sham-controlled
trial (cardiac shockwave therapy for ischemic heart failure, CAST-HF;
NCT03859466) patients with LVEF <=40% requiring surgical revascularisation
were enrolled. Patients were randomly assigned to undergo direct cardiac
SWT or sham treatment in addition to coronary bypass surgery. The primary
efficacy endpoint was the improvement in LVEF measured by cardiac magnetic
resonance imaging from baseline to 360 days. <br/>RESULT(S): Overall, 63
patients were randomized, out of which 30 patients of the SWT group and 28
patients of the Sham group attained 1-year follow-up of the primary
endpoint. Greater improvement in LVEF was observed in the SWT group (DELTA
from baseline to 360 days: SWT 11.3%, SD 8.8; Sham 6.3%, SD 7.4, P =
.0146). Secondary endpoints included the 6-minute walking test, where
patients randomized in the SWT group showed a greater DELTA from baseline
to 360 days (127.5 m, SD 110.6) than patients in the Sham group (43.6 m,
SD 172.1) (P = .028) and Minnesota Living with Heart Failure Questionnaire
score on day 360, which was 11.0 points (SD 19.1) for the SWT group and
17.3 points (SD 15.1) for the Sham group (P = .15). Two patients in the
treatment group died for non-device-related reasons. <br/>CONCLUSION(S):
In conclusion, the CAST-HF trial indicates that direct cardiac SWT, in
addition to coronary bypass surgery improves LVEF and physical capacity in
patients with ischaemic heart failure.<br/>Copyright &#xa9; The Author(s)
2024. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved. For commercial re-use, please
contact reprints@oup.com for reprints and translation rights for reprints.
All other permissions can be obtained through our RightsLink service via
the Permissions link on the article page on our site-for further
information please contact

<22>
Accession Number
2032876224
Title
Effects of Non-Invasive Ventilation with different modalities in patients
undergoing heart surgery: Protocol for a randomized controlled clinical
trial.
Source
PLoS ONE. 19(6 June) (no pagination), 2024. Article Number: e0304569. Date
of Publication: June 2024.
Author
Araujo E.R.; Nogueira I.D.B.; e Silva Barbosa P.E.; De Miranda Silva
Nogueira P.A.
Institution
(Araujo) Postgraduate Program in Physiotherapy (PPGFIS), Laboratory of
Measures and Evaluation in Health, Federal University of Rio Grande do
Norte (UFRN), Rio Grande do Norte, Natal, Brazil
(Nogueira, De Miranda Silva Nogueira) Department of Physical Therapy,
Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte,
Natal, Brazil
(e Silva Barbosa) Center of Technology Strategies in Health, State
University of Paraiba, Campina Grande, Brazil
Publisher
Public Library of Science
Abstract
The thoracic surgical procedure leads to a reduction in respiratory muscle
strength. To restore it, certain strategies must be employed.
Physiotherapy utilizes resources and techniques such as deep breathing
stimulation, cough stimulation, use of incentive spirometers,
mobilization, and ambulation. However, at times these resources and
techniques may prove insufficient, and additional measures, such as
Non-Invasive Ventilation (NIV), are employed Pieczkoski (2017).
Non-Invasive Positive Pressure Ventilation (NPPV) has been utilized to
expedite pulmonary function recovery as well as to prevent and treat
postoperative pulmonary complications Nasrala 2018. NIV diminishes the
risk of ventilator-associated complications due to its non-invasive
nature. Consequently, NIV has been adopted to avert postextubation
complications in postoperative patients Liu 2020. The objective of this
study is to conduct a randomized clinical trial and assess the efficacy of
NIV in comparison to conventional physiotherapy in terms of pulmonary
function among patients undergoing cardiac surgery at a selected hospital
in Campina Grande, Paraiba, Brazil.<br/>Copyright &#xa9; 2024 Araujo et
al. This is an open access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<23>
Accession Number
2031327781
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Cardiology Clinics. 42(3) (pp 373-387), 2024. Date of Publication: August
2024.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
W.B. Saunders

<24>
Accession Number
2030303182
Title
The evolution of TAVI performance overtime: an overview of systematic
reviews.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
314. Date of Publication: December 2024.
Author
Angioletti C.; Moretti G.; Manetti S.; Pastormerlo L.; Vainieri M.;
Passino C.
Institution
(Angioletti, Moretti, Vainieri) Management and Healthcare Laboratory,
Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy
(Manetti) Department of Management Engineering, Politecnico di Milano,
Milano, Italy
(Pastormerlo, Passino) Fondazione Toscana G. Monasterio, Pisa, Italy
(Passino) Health Science Interdisciplinary Center, Sant'Anna School of
Advanced Studies, Pisa, Italy
Publisher
BioMed Central Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
well-established treatment for high and intermediate-risk patients with
severe aortic stenosis (AS). Recent studies have demonstrated
non-inferiority of TAVI compared to surgery in low-risk patients. In the
past decade, numerous literature reviews (SLRs) have assessed the use of
TAVI in different risk groups. This is the first attempt to provide an
overview of SRs (OoSRs) focusing on secondary studies reporting clinical
outcomes/process indicators. This research aims to summarize the findings
of extant literature on the performance of TAVI over time. <br/>Method(s):
A literature search took place from inception to April 2024. We searched
MEDLINE and the Cochrane Library for SLRs. SLRs reporting at least one
review of clinical indicators were included. Subsequently, a two-step
inclusion process was conducted: [1] screening based on title and
abstracts and [2] screening based on full-text papers. Relevant data were
extracted and the quality of the reviews was assessed. <br/>Result(s): We
included 33 SLRs with different risks assessed via the Society of Thoracic
Surgeons (STS) score. Mortality rates were comparable between TAVI and
Surgical Aortic Valve Replacement (SAVR) groups. TAVI is associated with
lower rates of major bleeding, acute kidney injury (AKI) incidence, and
new-onset atrial fibrillation. Vascular complications, pacemaker
implantation, and residual aortic regurgitation were more frequent in TAVI
patients. <br/>Conclusion(s): This study summarizes TAVI performance
findings over a decade, revealing a shift to include both high and
low-risk patients since 2020. Overall, TAVI continues to evolve,
emphasizing improved outcomes, broader indications, and addressing
challenges.<br/>Copyright &#xa9; The Author(s) 2024.

<25>
Accession Number
2030221619
Title
Delayed cold-stored vs. room temperature stored platelet transfusions in
bleeding adult cardiac surgery patients-a randomized multicentre pilot
study (PLTS-1).
Source
Pilot and Feasibility Studies. 10(1) (no pagination), 2024. Article
Number: 90. Date of Publication: December 2024.
Author
Bartoszko J.; Peer M.; Grewal D.; Ansari S.; Callum J.; Karkouti K.
Institution
(Bartoszko, Peer, Grewal, Ansari, Karkouti) Department of Anesthesia and
Pain Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Grewal, Ansari, Karkouti) Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Callum) University of Toronto Quality in Utilization, Education and
Safety in Transfusion Research Program, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care, Department of
Medicine, University of Toronto, Toronto, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Platelets stored at 1-6 degreeC are hypothesized to be more
hemostatically active than standard room temperature platelets (RTP)
stored at 20-24 degreeC. Recent studies suggest converting RTP to
cold-stored platelets (Delayed Cold-Stored Platelets, DCSP) may be an
important way of extending platelet lifespan and increasing platelet
supply while also activating and priming platelets for the treatment of
acute bleeding. However, there is little clinical trial data supporting
the efficacy and safety of DCSP compared to standard RTP. <br/>Method(s):
This protocol details the design of a multicentre, two-arm,
parallel-group, randomized, active-control, blinded, internal pilot trial
to be conducted at two cardiac surgery centers in Canada. The study will
randomize 50 adult (>= 18 years old) patients undergoing at least
moderately complex cardiac surgery with cardiopulmonary bypass and
requiring platelet transfusion to receive either RTP as per standard of
care (control group) or DCSP (intervention group). Patients randomized to
the intervention group will receive ABO-identical, buffy-coat,
pathogen-reduced, platelets in platelet additive solution maintained at 22
degreeC for up to 4 days then placed at 4 degreeC for a minimum of 24 h,
with expiration at 14 days after collection. The duration of the
intervention is from the termination of cardiopulmonary bypass to 24 h
after, with a maximum of two doses of DCSP. Thereafter, all patients will
receive RTP. The aim of this pilot is to assess the feasibility of a
future RCT comparing the hemostatic effectiveness of DCSP to RTP (defined
as the total number of allogeneic blood products transfused within 24 h
after CPB) as well as safety. Specifically, the feasibility objectives of
this pilot study are to determine (1) recruitment of >= 15% eligible
patients per center per month); (2) appropriate platelet product available
for >= 90% of patients randomized to the cold-stored platelet group; (3)
Adherence to randomization assignment (> 90% of patients administered
assigned product). <br/>Discussion(s): DCSP represents a promising
logistical solution to address platelet supply shortages and a potentially
more efficacious option for the management of active bleeding. No
prospective clinical studies on this topic have been conducted. This
proposed internal pilot study will assess the feasibility of a larger
definitive study. Trial registration: NCT 06147531
(clinicaltrials.gov).<br/>Copyright &#xa9; The Author(s) 2024.

<26>
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. 26(7) (pp 161-174),
2024. Date of Publication: July 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.
<br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<27>
Accession Number
2029830085
Title
The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy
of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke
Recurrence.
Source
Journal of Stroke. 26(2) (pp 231-241), 2024. Date of Publication: May
2024.
Author
Xu Q.; Meng X.; Li H.; Xie X.; Jing J.; Lin J.; Jiang Y.; Zhao X.; Li Z.;
Liu L.; Wang A.; Wang Y.
Institution
(Xu, Meng, Li, Xie, Jing, Lin, Jiang, Wang, Zhao, Li, Liu, Wang, Wang)
Department of Neurology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Xu, Meng, Li, Xie, Jing, Lin, Jiang, Wang, Zhao, Li, Liu, Wang, Wang)
China National Clinical Research Center for Neurological Diseases,
Beijing, China
(Xu, Meng, Wang, Wang, Wang) Department of Clinical Epidemiology and
Clinical Trial, Capital Medical University, Beijing, China
(Xu, Wang) Beijing Municipal Key Laboratory of Clinical Epidemiology,
Beijing, China
(Wang) Advanced Innovation Center for Human Brain Protection, Beijing
Tiantan Hospital, Capital Medical University, Beijing, China
Publisher
Korean Stroke Society
Abstract
Background and Purpose Non-high-density lipoprotein cholesterol
(non-HDL-C), which represents the total cholesterol content of all
pro-atherogenic lipoproteins, has recently been included as a new target
for lipid-lowering therapy in high-risk atherosclerotic patients in
multiple guidelines. Herein, we aimed to explore the relationship between
non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus
clopidogrel-aspirin in preventing stroke recurrence. Methods This study
comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel
in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II)
trial, from which 5,901 patients with complete data on non-HDL-C were
included and categorized by median non-HDL-C levels, using a cutoff of 3.5
mmol/L. The primary efficacy and safety outcomes were recurrent stroke and
severe or moderate bleeding within 90 days. Results Ticagrelor-aspirin
significantly reduced the risk of recurrent stroke in patients with low
non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95%
confidence interval [CI], 0.40-0.74), but not in those with high non-HDL-C
(107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67-1.16),
compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed
as a continuous variable, the benefit of ticagrelor-aspirin for recurrent
stroke decreased as non-HDL-C levels increased. No significant differences
in the treatment assignments across the non-HDL-C groups were observed in
terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in
the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C
group; P for interaction=0.425). Conclusion CHANCE-2 participants with low
non-HDL-C levels received more clinical benefit from ticagrelor-aspirin
versus clopidogrel-aspirin compared to those with high non-HDL-C,
following minor ischemic stroke or transient ischemic
attack.<br/>Copyright &#xa9; 2024 Korean Stroke Society.

<28>
Accession Number
2028938467
Title
Prevalence of spinal deformity development after surgical management of a
congenital heart disease among children: a systematic review and
meta-analysis.
Source
European Spine Journal. 33(5) (pp 2088-2096), 2024. Date of Publication:
May 2024.
Author
Balubaid R.N.; Aljedani R.S.; Moglan A.; Hennawi Y.B.; Mousa A.H.;
Alosaimi M.
Institution
(Balubaid, Aljedani, Moglan, Alosaimi) College of Medicine, King Saud Bin
Abdulaziz University For Health Sciences, Jeddah, Saudi Arabia
(Hennawi) Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi
Arabia
(Mousa) College of Medicine and Surgery, Batterjee Medical College,
Jeddah, Saudi Arabia
(Balubaid, Aljedani, Moglan, Hennawi, Mousa, Alosaimi) King Abdullah
International Medical Research Center, Jeddah, Saudi Arabia
(Alosaimi) Department of Orthopedic, King Abdulaziz Medical City, Jeddah,
Saudi Arabia
(Alosaimi) King Khalid National Guard Hospital, King Abdulaziz Medical
City, National Guard, Jeddah, Saudi Arabia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Open heart surgery is the most common treatment for
congenital heart disease. Thoracotomy, sternotomy, or a combination of
both are the main approaches used in open heart surgeries. In cardiac
surgery, there have been concerns that these surgeries increase the
likelihood of spinal deformities. Therefore, this systematic review and
meta-analysis provided updated evidence on the prevalence of spinal
deformities following congenital heart surgery. <br/>Method(s): EMBASE,
Medline, ScienceDirect, and Google Scholar were used to search for studies
published until 2022. We include randomized clinical trials and
observational studies that reported the prevalence of spinal deformities
(scoliosis and kyphosis) after congenital heart surgery among participants
without these deformities before surgery. Two independent reviewers
independently screened literature identified from the databases. Two
reviewers independently conducted screening of studies identified during
the search, data extraction, and quality assessment of the included
studies. <br/>Result(s): In total, 688 studies were screened; 13
retrospective and one prospective cohort studies were included,
encompassing 2294 participants. The pooled prevalence of spinal
deformities (scoliosis and kyphosis) after open heart surgery performed on
skeletally immature patients was 23.1% (95% confidence interval [CI] =
23.1-35.3; I² = 97.5%). <br/>Conclusion(s): This review
suggests that the prevalence of spinal deformities was high among patients
who underwent sternotomy or thoracotomy.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature 2024.

<29>
Accession Number
2028525913
Title
Aortic versus axillary cannulation in acute type A aortic dissection
repair: A meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 32(4) (pp 234-243), 2024. Date
of Publication: May 2024.
Author
Yamashita Y.; Sicouri S.; Dokollari A.; Rodriguez R.; Goldman S.M.;
Ramlawi B.
Institution
(Yamashita, Sicouri, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Dokollari) Department of Cardiac Surgery, St Boniface Hospital,
University of Manitoba, Winnipeg, MB, Canada
(Rodriguez, Goldman, Ramlawi) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Wynnewood, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Research comparing the effectiveness of central aortic
cannulation to axillary artery cannulation in repairing acute type A
aortic dissection is limited and controversial. This meta-analysis aimed
to compare early outcomes of central aortic cannulation versus axillary
artery cannulation for surgery for acute aortic dissection type A.
<br/>Method(s): A comprehensive systematic search was conducted across
PubMed/MEDLINE, Scopus, and the Cochrane Central Register of Controlled
Trials up to September 1, 2023. The primary endpoints were operative
mortality and incidence of postoperative stroke. Secondary endpoints
encompassed cardiopulmonary bypass time, myocardial ischemic time,
hypothermic circulatory arrest time, postoperative temporary neurological
dysfunction, combination of stroke and temporary neurological dysfunction,
as well as the need for reexploration for bleeding, renal replacement
therapy, and tracheotomy. A random-effect model was utilized to calculate
the pooled effect size. <br/>Result(s): Eleven studies met our eligibility
criteria, enrolling a total of 7204 patients (2760 underwent aortic
cannulation and 4444 underwent axillary cannulation). The operative
mortality and incidence of postoperative stroke did not show statistical
differences between the two groups, with a pooled odds ratio of 1.07 (95%
confidence interval: 0.73-1.55) and 1.17 (0.95-1.42), respectively.
Similarly, none of the secondary endpoints exhibited significant
statistical differences between the two groups. <br/>Conclusion(s): Aortic
cannulation can be a viable alternative to axillary artery cannulation for
repair of acute aortic dissection type A, as both approaches present
similar early clinical outcomes.<br/>Copyright &#xa9; The Author(s) 2024.

<30>
Accession Number
2023093447
Title
A review and meta-analysis of conventional sternotomy versus minimally
invasive mitral valve surgery for degenerative mitral valve disease
focused on the last decade of evidence.
Source
Perfusion (United Kingdom). 39(5) (pp 988-997), 2024. Date of Publication:
July 2024.
Author
Hussain S.; Swystun A.G.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Hussain) University of Bristol, Bristol, United Kingdom
(Swystun) University of Bradford, Bradford, United Kingdom
(Caputo, Angelini, Vohra) Department of Cardiac Surgery, Bristol Heart
Institute, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objectives: Early meta-analyses comparing minimally invasive mitral valve
surgery (MIMVS) with conventional sternotomy (CS) have determined the
safety of MIMVS. We performed this review and meta-analysis based on
studies from 2014 onwards to examine the differences in outcomes between
MIMVS and CS. Specifically, some outcomes of interest included renal
failure, new onset atrial fibrillation, mortality, stroke, reoperation for
bleeding, blood transfusion and pulmonary infection. <br/>Method(s): A
systematic search was performed in six databases for studies comparing
MIMVS with CS. Although the initial search identified 821 papers in total,
nine studies were suitable for the final analysis. All studies included
compared CS with MIMVS. The Mantel - Haenszel statistical method was
chosen due the use of inverse variance and random effects. A meta-analysis
was performed on the data. <br/>Result(s): MIMVS had significantly lower
odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new
onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001),
reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and
reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had
shorter ICU stay (WMD: -0.42; 95% CI -0.59 to -0.24, p < 0.001) and
shorter time to discharge (WMD: -2.79; 95% CI -3.86 to -1.71, p < 0.001).
<br/>Conclusion(s): In the modern era, MIMVS for degenerative disease is
associated with improved short-term outcomes when compared to the
CS.<br/>Copyright &#xa9; The Author(s) 2023.

<31>
Accession Number
2032867401
Title
An update on the mechanisms and risk factors for anesthesia-related
cardiac arrest in children: a narrative review.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(5) (no
pagination), 2024. Article Number: 844519. Date of Publication: 01 Sep
2024.
Author
Braz L.G.; Braz J.R.C.; Tiradentes T.A.A.; Porto D.D.S.M.; Beserra C.M.;
Vane L.A.; Nascimento Junior P.D.; Modolo N.S.P.; Braz M.G.
Institution
(Braz, Braz, Tiradentes, Porto, Beserra, Vane, Nascimento Junior, Modolo,
Braz) Universidade Estadual Paulista (UNESP), Faculdade de Medicina de
Botucatu, Departamento de Especialidades Cirurgicas e Anestesiologia,
Comissao de Estudos de Parada Cardiaca e Mortalidade em Anestesia, SP,
Botucatu, Brazil
Publisher
Elsevier Editora Ltda
Abstract
The relation between surgery and anesthesia safety in children and a
country's Human Development Index (HDI) value has been described
previously. The aim of this narrative review was to provide an update on
the mechanisms and risk factors of Anesthesia-Related Cardiac Arrest
(ARCA) in pediatric surgical patients in countries with different HDI
values and over time (pre-2001 vs. 2001-2024). Electronic databases were
searched up to March 2024 for studies reporting ARCA events in children.
HDI values range from 0 to 1 (very-high-HDI countries: >= 0.800, high-HDI
countries: 0.700-0.799, medium-HDI countries: 0.550-0.699, and low-HDI
countries: < 0.550). Independent of time, the proportion of children who
suffered perioperative Cardiac Arrest (CA) attributed to
anesthesia-related causes was higher in very-high-HDI countries (50%) than
in countries with HDI values less than 0.8 (15-36%), but ARCA rates were
higher in countries with HDI values less than 0.8 than in very-high-HDI
countries. Regardless of the HDI value, medication-related factors were
the most common mechanism causing ARCA before 2001, while
cardiovascular-related factors, mainly hypovolemia, and
respiratory-related factors, including difficulty maintaining patent
airways and adequate ventilation, were the major mechanisms in the present
century. Independent of HDI value and time, a higher number of ARCA events
occurred in children with heart disease and/or a history of cardiac
surgery, those aged younger than one year, those with ASA physical status
III-V, and those who underwent emergency surgery. Many ARCA events were
determined to be preventable. The implementation of specialized pediatric
anesthesiology and training programs is crucial for anesthesia safety in
children.<br/>Copyright &#xa9; 2024

<32>
Accession Number
2032859207
Title
Epidemiology, Clinical Manifestations, and Outcome of Mucormycosis in
Solid Organ Transplant Recipients: A Systematic Review of Reported Cases.
Source
Open Forum Infectious Diseases. 11(6) (no pagination), 2024. Article
Number: ofae043. Date of Publication: 01 Jun 2024.
Author
Palomba E.; Colaneri M.; Azzara C.; Fava M.; MacCaro A.; Renisi G.; Viero
G.; Kaur H.; Chakrabarti A.; Gori A.; Lombardi A.; Bandera A.
Institution
(Palomba, Colaneri, Gori) Department of Infectious Diseases, Luigi Sacco
Hospital, Milan, Italy
(Palomba, Colaneri, Gori) Centre for Multidisciplinary Research in Health
Science, University of Milan, Milan, Italy
(Azzara, Fava, MacCaro, Renisi, Viero, Lombardi, Bandera) Infectious
Diseases Unit, Foundation Irccs Ca' Granda Ospedale Maggiore Policlinico,
Milan, Italy
(Kaur) Department of Medical Microbiology, Postgraduate Institute of
Medical Institution and Research, Chandigarh, India
(Chakrabarti) Department of Infectious Disease and Microbiology,
Doodhadhari Burfani Hospital and Research Institute, Haridwar, India
(Lombardi, Bandera) Department of Physiopathology and Transplantation,
University of Milan, Milan, Italy
Publisher
Oxford University Press
Abstract
Mucormycosis is an emerging disease primarily affecting the
immunocompromised host, but scarce evidence is available for solid organ
transplant recipients (SOTRs). We systematically reviewed 183 cases
occurring in SOTRs, exploring epidemiology, clinical characteristics,
causative pathogens, therapeutic approaches, and outcomes. Kidney
transplants accounted for half of the cases, followed by heart (18.6%),
liver (16.9%), and lung (10.4%). Diagnosis showed a dichotomous
distribution, with 63.7% of cases reported within 100 days of
transplantation and 20.6% occurring at least 1 year after transplant. The
90-day and 1-year mortality rates were 36.3% and 63.4%, respectively.
Disseminated disease had the highest mortality at both time points (75%
and 93%). Treatment with >3 immunosuppressive drugs showed a significant
impact on 90-day mortality (odds ratio [OR], 2.33; 95% CI, 1.02-5.66; P =.
0493), as did a disseminated disease manifestation (OR, 8.23; 95% CI,
2.20-36.71; P =. 0027) and the presence of diabetes (OR, 2.35; 95% CI,
1.01-5.65; P =. 0497). Notably, prophylaxis was administered to 12 cases
with amphotericin B. Further investigations are needed to validate these
findings and to evaluate the potential implementation of prophylactic
regimens in SOTRs at high risk.<br/>Copyright &#xa9; 2024 The Author(s).
Published by Oxford University Press on behalf of Infectious Diseases
Society of America.

<33>
Accession Number
2032851762
Title
Optimizing Oral Anticoagulation Therapy: Impact of Pharmacists
Intervention in Patient Knowledge and International Normalized Ratio (INR)
Control.
Source
Journal of Young Pharmacists. 16(2) (pp 328-333), 2024. Date of
Publication: 2024.
Author
Thomas A.; Ruby A.H.; Mendgule S.; Deshpande A.; Patted S.; Hiremath A.;
Bhandari R.
Institution
(Thomas, Ruby, Mendgule, Deshpande, Patted, Hiremath, Bhandari) Department
of Pharmacy Practice, KLE College of Pharmacy, Belagavi KLE Academy for
Higher Education and Research (KAHER), Karnataka, Belagavi, India
Publisher
EManuscript Technologies
Abstract
Background: Oral Anticoagulant is a therapy indicated for thromboembolic
disorders, which requires close observation of the international
normalized ratio and patient education for better therapeutic outcomes.
Management of Oral Anticoagulation Therapy (OAT) in cardiovascular disease
is one greater concern because of numerous drug-related problems and
non-compliance towards medications due to poor knowledge. As a result, the
pharmacist offers patient counseling to improve knowledge. Therefore, the
objective of this study is to compare the knowledge score of the patients
about anticoagulation therapy and its impact on international normalized
ratio levels in patients undergoing oral anticoagulation therapy.
<br/>Material(s) and Method(s): A randomized controlled study among 102
patients in the Cardiology department. Patient information leaflet and
patient counseling on oral anticoagulation therapy were given as
Interventions. Knowledge level was assessed from the baseline and followed
in the first and third months. <br/>Result(s): A total of 102 patients
actively participated in the study. Considering the area of knowledge, no
more significant difference was seen in either group (U=1018,
p-value=0.058) during the pre-test. Following the intervention, a notable
disparity was observed in the Intervention group (U=528.00, p=0.0001). The
mean INR is significantly different between the control and intervention
groups in the therapeutic range (t=-5.80, p=0.0001*) and the
supratherapeutic range (t=-3.42, p=0.002*). <br/>Conclusion(s): A
collaborative educational approach with a pharmacist helps to improve the
patient's knowledge of anticoagulation control. Establishing a
pharmacist-managed anticoagulation service for the benefit of patients so
that a clinical pharmacist can manage anticoagulation effectively and
provide the best treatment.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

<34>
Accession Number
2029809532
Title
Transfusion Thresholds for Acute Coronary Syndromes-Insights From the
TRICS-III Randomized Controlled Trial, Systematic Review, and
Meta-Analysis.
Source
Journal of the American Heart Association. 12(1) (no pagination), 2023.
Article Number: e028497. Date of Publication: 03 Jan 2023.
Author
Mistry N.; Hare G.M.T.; Shehata N.; Belley-Cote E.; Papa F.; Kramer R.S.;
Saha T.; Wijeysundera D.N.; Ko D.; Verma S.; Mazer C.D.
Institution
(Mistry, Hare, Papa, Wijeysundera, Mazer) Department of Anesthesia, St.
Michael's Hospital, Toronto, ON, Canada
(Mistry, Verma, Mazer) Institute of Medical Sciences, Canada
(Hare, Papa, Wijeysundera, Mazer) Department of Anesthesiology and Pain
Medicine, University of Toronto, ON, Canada
(Hare, Mazer) Department of Physiology, University of Toronto, ON, Canada
(Hare, Wijeysundera, Verma, Mazer) Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada
(Shehata) Division of Hematology, Sinai Health System, Toronto, ON, Canada
(Shehata) Department of Medicine, University of Toronto, ON, Canada
(Belley-Cote) Population Health Research Institute, McMaster University,
Hamilton Health Sciences, Hamilton, ON, Canada
(Kramer) Maine Medical Center Cardiovascular Institute, Portland, ME,
United States
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Kingston, ON, Canada
(Ko) Schulich Heart Centre Sunnybrook, Health Sciences Centre, Toronto,
ON, Canada
(Verma) Division of Cardiac Surgery, St. Michael's Hospital, Toronto, ON,
Canada
(Verma) Department of Surgery, University of Toronto, ON, Canada
(Verma) Department of Pharmacology and Toxicology, University of Toronto,
ON, Canada
Publisher
American Heart Association Inc.
Abstract
Both anemia and red blood cell transfusion are associated with morbidity
and mortality in patients hospitalized for acute coronary syndromes
(ACSs); these exposures are tightly linked, and their attributable risks
are difficult to isolate. To reduce unnecessary blood exposure,
transfusion should only be administered if/when its net benefits outweigh
the risks associated with anemia. Hemoglobin thresholds are currently used
for evaluating the severity of anemia and for guiding transfusion therapy;
however, there is controversy surrounding the optimal hemoglobin threshold
for transfusion in this patient population.¹ Randomized
controlled trials (RCT) comparing hemoglobin-guided restrictive versus
liberal transfusion strategies are difficult to interpret,² and
there is a paucity of available data on long-term outcomes. We therefore
performed a subset analysis of patients with acute myocardial infarction
(AMI) in the TRICS-III (Transfusion Thresholds in Cardiac Surgery) RCT to
add evidence addressing this important clinical question and further
interpret the results using a systematic-review, meta-analysis, and
trial-sequential analysis. The previously described³
multinational TRICS-III trial (NCT02042898) randomly assigned patients
with a moderate-to-high risk of death undergoing cardiac surgery on
cardiopulmonary bypass to a restrictive transfusion strategy (transfuse at
a hemoglobin level <7.5 g/dL) or liberal strategy (operating room and
intensive care unit: transfuse at a hemoglobin level <9.5 g/ dL; ward:
<8.5 g/dL). Appropriate ethical board review and approval were obtained
from each participating site, and informed consent was obtained from all
participants. Patients with AMI were those with a recent myocardial
infarction (MI) (<90 days of surgery) undergoing coronary artery bypass
graft surgery and >=1 of the following enrichment criteria: unstable
angina, critical preoperative state, use of preoperative intra-aortic
balloon pump, and/or undergoing emergency surgery. The primary outcome was
a per-protocol analysis of major adverse cardiac events (MACE) defined as
allcause death, MI, and revascularization at 6 months. We next performed a
systematic search of the MEDLINE and EMBASE databases from inception to
April 18, 2022, to identify RCTs evaluating restrictive versus liberal
transfusion in patients hospitalized for ACSs. The primary outcome was
MACE, defined as all-cause death, MI, and revascularization (when
available), at the longest available timepoint.<br/>Copyright &#xa9; 2022
The Authors. Published on behalf of the American Heart Association, Inc.,
by Wiley.

<35>
Accession Number
2032856250
Title
The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in
Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Wang W.; Yang W.; Liu A.; Liu J.; Yuan C.
Institution
(Wang, Yuan) Department of Anesthesiology, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Yang) Department of Anesthesiology, Deyang People's Hospital, Sichuan,
Deyang, China
(Liu) Department of Anesthesiology, Heze Municipal Hospital, Shandong,
Heze, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the analgesic effect of erector spinae plane block
in adults undergoing median sternotomy cardiac surgery. Design and
setting: The Cochrane, Embase, and PubMed databases from inception to
January 2024 were searched. The study has been registered in the
International Prospective Register of Systematic Reviews (CRD42023470375).
<br/>Participant(s): Eight randomized controlled trials involving 543
patients, comparing with no block or sham block, were included, whether it
was a single injection or continuous. <br/>Measurements and Main Results:
The primary outcomes were pain scores and opioid consumption. Erector
spinae plane block reduced pain scores immediately after extubation (mean
difference [MD], -1.19; 95% confidence interval [CI], -1.67 to -0.71; p
for heterogeneity = 0.10), at 6 hours after extubation (MD, -1.96; 95% CI,
-2.85 to -1.08; p for heterogeneity < 0.0001), and at 12 hours after
extubation (MD, -0.98; 95% CI, -1.55 to -0.40; p for heterogeneity <
0.00001). The decrease in pain scores reached the minimal clinically
important difference within 6 hours. Opioid consumption 24 hours after
surgery decreased by 35.72 mg of oral morphine equivalents (95% CI, -50.88
to -20.57; p for heterogeneity < 0.0001). Sensitivity analysis confirmed
the stability of results. The quality of primary outcomes was rated as
very low to moderate. <br/>Conclusion(s): Erector spinae plane block
decreased pain scores within 12 hours after extubation, reached the
minimal clinically important difference within 6 hours, and decreased
opioid consumption 24 hours after surgery, based on data of very low to
moderate quality. However, high-quality randomized controlled trials are
necessary to validate these findings.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<36>
Accession Number
2030267343
Title
Perioperative transfusion study (PETS): Does a liberal transfusion
protocol improve outcome in high-risk cardiovascular patients undergoing
non-cardiac surgery? A randomised controlled pilot study.
Source
Transfusion Medicine. (no pagination), 2024. Date of Publication: 2024.
Author
Ali S.; Roubos S.; Hoeks S.E.; Verbrugge S.J.C.; Koopman-van Gemert
A.W.M.M.; Stolker R.J.; van Lier F.
Institution
(Ali, Roubos, Hoeks, Stolker, van Lier) Department of Anaesthesiology,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Verbrugge) Department of Anaesthesiology, Franciscus Gasthuis &
Vlietland, Rotterdam, Netherlands
(Koopman-van Gemert) Department of Anaesthesiology, Albert Schweitzer
Hospital, Dordrecht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Small studies have shown that patients with advanced coronary
artery disease might benefit from a more liberal blood transfusion
strategy. The goal of this pilot study was to test the feasibility of a
blood transfusion intervention in a group of vascular surgery patients who
have elevated cardiac troponins in rest. <br/>Method(s): We conducted a
single-centre, randomised controlled pilot study. Patients with a
preoperative elevated high-sensitive troponin T undergoing non-cardiac
vascular surgery were randomised between a liberal transfusion regime
(haemoglobin >10.4 g/dL) and a restrictive transfusion regime (haemoglobin
8.0-9.6 g/dL) during the first 3 days after surgery. The primary outcome
was defined as a composite endpoint of all-cause mortality, myocardial
infarction or unscheduled coronary revascularization. <br/>Result(s): In
total 499 patients were screened; 92 were included and 50 patients were
randomised. Postoperative haemoglobin was different between the
intervention and control group; 10.6 versus 9.8, 10.4 versus 9.4, 10.9
versus 9.4 g/dL on day one, two and three respectively (p < 0.05). The
primary outcome occurred in four patients (16%) in the liberal transfusion
group and in two patients (8%) in control group. <br/>Conclusion(s): This
pilot study shows that the studied transfusion protocol was able to create
a clinically significant difference in perioperative haemoglobin levels.
Randomisation was possible in 10% of the screened patients. A large
definitive trial should be possible to provide evidence whether a liberal
transfusion strategy could decrease the incidence of postoperative
myocardial infarction in high risk surgical patients.<br/>Copyright &#xa9;
2024 The Author(s). Transfusion Medicine published by John Wiley & Sons
Ltd on behalf of British Blood Transfusion Society.

<37>
Accession Number
644557146
Title
Postoperative atrial fibrillation is associated with late mortality
independently of patient comorbidities: a systematic review and
reconstructed individual patient data meta-analysis.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2024. Berlin Germany. 26(Supplement 1) (pp i390-i391), 2024. Date of
Publication: May 2024.
Author
Kawczynski M.; Van Der Heijden C.; Maessen J.G.; Schotten U.; Bidar E.;
Maessen B.
Institution
(Kawczynski, Schotten) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Van Der Heijden, Maessen, Bidar, Maessen) Maastricht University Medical
Centre (MUMC), Cardiothoracic surgery, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
Background: Early postoperative atrial fibrillation (POAF) is the most
common complication within the first days after cardiac surgery. It is
hypothesized to result from perioperative stressors such as inflammation,
oxidative stress, and increased adrenergic tone, along with an advanced
arrhythmogenic substrate resulting from advanced age and cardiovascular
comorbidities including hypertension, heart failure, or chronic
obstructive pulmonary disease (COPD).[1, 2] Although prior studies have
demonstrated an association between in-hospital POAF and late mortality or
stroke, it is questionable whether these long-term adverse events result
from the occurrence of early-POAF or, rather, from the advanced
cardiovascular risk profile that partly underlies the development of
early-POAF.[3] Purpose: To investigate the association of early-POAF with
late mortality (primary outcome) and stroke (secondary outcome) in
patients undergoing cardiac surgery after adjustment for age and the
cardiovascular risk profile. <br/>Method(s): A systematic search, covering
PubMed, EMBASE, and the Cochrane Library, was conducted to identify
studies reporting on late mortality after cardiac surgery in patients with
and without new-onset POAF during hospitalization. Articles meeting the
criteria, which included Kaplan-Meier (KM) curves along with risk tables,
were included for a pooled analysis of late mortality and stroke.
Individual time-to-event data were reconstructed from the KM curves and
incorporated into a multivariable frailty Cox model. The model included
adjustments for age, sex, preoperative cardiovascular comorbidity profile
(hypertension, diabetes mellitus [DM], peripheral artery disease [PAD],
history of stroke, heart failure, and COPD), type of surgery, and a
frailty term (study variable). <br/>Result(s): In total, 28 studies were
included in the analysis for late mortality (N=112931), and 9 studies in
the analysis for late stroke (N=35004). Overall, 31039 patients had
early-POAF with a pooled incidence of 29.7% (95% CI: 25.7-34.1%). Patients
developing POAF were older (68.5 vs. 64.1 years old, p<0.001), had a more
frequent history of PAD (9.5% vs. 7.8%, p=0.026), a history of stroke
(9.3% vs. 7.6%, p<0.001), heart failure (17.2% vs. 15.1%, p<0.001), and
COPD (12.5% vs. 9.7%, p<0.001). Unadjusted analysis showed that POAF was
strongly associated with increased late mortality (Hazard Ratio [HR]=1.64,
95% CI: 1.59 to 1.69, p<0.001) and late stroke (HR=1.46, 95% CI: 1.36 to
1.58, p<0.001) (Figure 1). POAF was an independent predictor for late
mortality (HR=1.46, 95% CI: 1.36 to 1.58, p<0.001) but not for late stroke
(HR=1.10, 95% CI: 0.85 to 1.43, p=0.48) after adjustment for age,
cardiovascular comorbidity profile, type of surgery, and frailty (study
term). <br/>Conclusion(s): Early-POAF after cardiac surgery is an
independent predictor of mortality in the years following discharge after
cardiac surgery, regardless of age, cardiovascular comorbidity profile,
and type of surgery.

<38>
Accession Number
644557098
Title
Influence of audiovisual distraction on the feeling of stress, analgesic
sedation and patient satisfaction during electrophysiological ablation
procedures on the heart.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2024. Berlin Germany. 26(Supplement 1) (pp i174-i175), 2024. Date of
Publication: May 2024.
Author
Kupusovic J.; Raschke R.; Wakili R.
Institution
(Kupusovic, Raschke, Wakili) University Hospital Frankfurt, Frankfurt,
Germany
Publisher
Oxford University Press
Abstract
Background: Distraction using audiovisual stimuli has mostly been
researched in a paediatric population with the results showing an
inhibiting effect on stress and anxiety as well as the subjective
perception of pain. <br/>Purpose(s): We designed a study to test if
audiovisual distraction may reduce the level of sedatives and analgesics
by reducing anxiety and stress during electrophysiological intervention
(EP). <br/>Method(s): We conducted a clinical intervention pilot study
that was carried out in a randomized controlled manner. Consecutive 70
patients undergoing EP with subsequent ablation were randomized 1:1 to
control (CTL) or intervention group (AVD). In addition to standardized
sedation, all patients in AVD group received audiovisual glasses. Feeling
of fear and stress was assessed through blood pressure changes. The
patient satisfaction was assessed with Client Satisfaction Questionnaire,
ZUF-8. Numeric scale (NRS) was used to quantify the perceived pain during
the procedure. The difference between the subjective estimated duration of
the procedure and the actual duration of the procedure was compared.
<br/>Result(s): The study included predominantly male patients (58.6%)
with a mean age of 56 years. Technical aptitude was well balanced between
both groups with the majority of patients in both groups owning a
smartphone or a tablet (86.1% vs 85.7% for CTL and AVD respectively,
p=0.92), and majority of patients in both groups using a computer, laptop
or tablet on a weekly basis (58% vs 57.1% for CTL and AVD group
respectively, p=0.97). The baseline feelings of anxiety were well balanced
within both groups (Figure 1). Our analysis revealed no significant
difference between the mean blood pressure values of the CTL and AVD
groups (systolic: 135 vs. 141 mmHg; p = 0.32; diastolic: 74 vs. 72 mmHg; p
= 0.45). Patient satisfaction score was comparable in both groups (26.5
vs. 26.8 points, p = 0.36). Average response for perceived pain using NRS
scale as well as perceived procedure duration was similar between the
groups (Figure 2). AVD group required a lower dose of Midazolam than CTL
group (0.005 mg/kg/h vs 0.007 mg/kg/h, p = 0.07). Majority of patients
(31.4%) in AVD group stated: " The audiovisual glasses made me feel
distracted at times." 10% of the AVD patients stated: " The audiovisual
glasses made me feel completely distracted and more relaxed."
<br/>Conclusion(s): The use of audiovisual glasses has no influence on the
patients' feelings of anxiety and stress during EP. The use of audiovisual
glasses can temporarily induce distraction during EP, while they do not
seem to be sufficient in reducing pain intensity during ablation therapy.
Patients undergoing EP do not seem to be the target patient group for AVD
use. (Figure Presented).

<39>
Accession Number
644556703
Title
Pacemaker dependency after Cox Maze procedure concomitant with cardiac
surgery, The road between Scylla and Charybdis.
Source
Europace. Conference: European Heart Rhythm Association Congress, EHRA
2024. Berlin Germany. 26(Supplement 1) (pp i650), 2024. Date of
Publication: May 2024.
Author
Hassan M.; Keller D.; Radakovic D.; Madrahimov N.; Leyh R.; Bening C.
Institution
(Hassan, Keller, Radakovic, Madrahimov, Leyh, Bening) University Hospital
Wuerzburg, Wuerzburg, Germany
Publisher
Oxford University Press
Abstract
Background: The Cox Maze (CM) procedure is a well-established treatment
for atrial fibrillation. However, recent trials report alarming rates of
pacemaker implantation (PMI) during hospitalization after CM. As PMI,
generator replacement and Lead management are sometimes accompanied by
complications, such as infection or bleeding and represent a burden for
patients and healthcare systems. We thought to investigate the rates of
pacemaker dependency 6 months after pacemaker implantation regarding the
applied energy source and the performed lesion set, to determine whether
PPM implantation timing and specific conduction disturbances as
indications are associated with late pacemaker dependency. <br/>Method(s):
We performed a retrospective review of 3695 patients underwent elective
cardiac surgery in our institution between the years 2005 and 2022.
Patients who use of devices for rhythm control, resynchronisation therapy,
implantablecardioverter defibrillator (ICD) or both were excluded from the
present study. A total of 283 patients met the inclusion criteria; Various
energy sources, including cryoablation (n= 123) and radiofrequency (n=
160) were used. Left atrial (n= 228) and biatrial (n= 55) ablation was
performed The distribution of the preoperative and perioperative variables
was similar. <br/>Result(s): There was no statistical difference in the
incidence pacemaker dependency regarding the applied energy source whether
radiofrequencyablation or cryoablation (25% vs. 30%; p = 0.2
respectively). On the other hand, biatrial ablation led to a significant
pacemaker dependency rate compared with isolated left-sided ablation
(78,2% vs 14.9%; P = .001 respectively), moreover Sinus node dysfunction
as indication for PPM implantation was predictive of being not PPM
dependent (OR 6.59; 95% CI, 1.67-26.06; P = .007). <br/>Conclusion(s):
Concomitant CM procedure showed a pacemaker implantation rate of 7,4%.
Univariate and multivariate analysis showed biatrial lesion set as the
only statistically significant predictor for pacemaker dependency after CM
procedure. Further large-scale randomized controlled studies are needed to
elucidate the Impact of the CM on the late pacemaker dependency.

<40>
Accession Number
644556563
Title
SARS-COV2 INFECTIONS IN HEART TRANSPLANT RECIPIENTS: VACCINES STILL ARE
OUR GREATEST WEAPON.
Source
European Heart Journal, Supplement. Conference: 55th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
26(Supplement 2) (pp ii91), 2024. Date of Publication: April 2024.
Author
Tedeschi A.; Ammirati E.; Garascia A.; Palazzini M.; Masciocco G.; Gentile
P.; Monticelli M.; Leidi F.
Institution
(Tedeschi, Ammirati, Garascia, Palazzini, Masciocco, Gentile, Monticelli,
Leidi) 1Ospedale Guglielmo da Saliceto, Piacenza; Grande Ospedale
Metropolitano Niguarda, Milano
Publisher
Oxford University Press
Abstract
Long-term clinical follow-ups are needed to assess the effectiveness of
vaccine and booster doses against severe acute respiratory syndrome
coronavirus 2 (SARS-CoV2) infection for heart transplant (HT) recipients,
particularly in an epidemiological landscape characterized by rapidly
changing viral variants. Among patients who received HT at Niguarda
Hospital from January 2008 to March 2022, we compared the clinical
outcomes of those who developed SARS-CoV2 infection between March 2020 and
January 2023, according to their vaccination status (vaccinated Vs
unvaccinated). Of 377 patients, 98 (25,9%) developed SARS-CoV2 infection
during the study period. 24 (27.5 %) developed infection before receiving
the vaccination, whilst 74 (75,5%) almost after 2 weeks from receiving the
first dose. The unvaccinated cohort demonstrated a higher incidence of
death, pneumonia, requiring of oxygen supplementation, non-invasive and
invasive ventilation therapy. Furthermore, we assess an additional
protective effect against mortality offered from booster doses. Vaccine
administration in HT patients is associated with a lower rate of death and
severe disease, particularly in those patients who received one or two
booster doses.

<41>
Accession Number
644556463
Title
WHAT IS THE EXPERIENCE OF CARDIAC SURGERY PATIENTS REGARDING THE NURSING
CARE THEY RECEIVE? SCOPING REVIEW.
Source
European Heart Journal, Supplement. Conference: 55th Congress of the
Italian Association of Hospital Cardiologists, ANMCO. Rimini Italy.
26(Supplement 2) (pp ii124), 2024. Date of Publication: April 2024.
Author
Ulisse A.; Moro A.; Magon G.; Cislaghi A.; Stella M.; Bonino E.; Caccamo
D.; Dimito M.; Adamini L.
Institution
(Ulisse, Moro, Magon, Cislaghi, Stella, Bonino, Caccamo, Dimito, Adamini)
1Fondazione IRCCS Policlinico di Milano Ca Granda, Milano; Istituto
Europeo di Oncologia, Milano
Publisher
Oxford University Press
Abstract
Introduction: The patient experience is recognized as a key indicator of
the quality of healthcare. Patients' expectations and experiences
significantly influence health outcomes, including the effects of
treatments in specialized settings, such as cardiac surgery.
Cardiovascular disease is one of the world's major public health problems,
and people who survive a heart attack become 'chronically ill', resulting
in economic costs to society. <br/>Aim(s): The aim of this scoping review
is to investigate and highlight the experiences of patients undergoing
cardiac surgery, identifying which factors are considered significant and
which have led to patient discomfort, in order to improve nursing care.
<br/>Method(s): A scoping review was conducted in June and July 2023 and
the scoping followed the guidelines outlined by Joanna Briggs Institute.
The drafted review protocol is aligned with the PRISMA guidelines. The
search for relevant articles was conducted using 6 databases (PubMed,
Cinahl, Web of Science, PsycInfo, Scopus, Embase), and articles extracted
from secondary bibliographies were also considered. All paper with a
qualitative approach, as this is the methodology that provides the best
understanding of the patient experiences about nursing care, written in
Italian or in English, in the field of cardiac surgery and referring to
the review question were included. <br/>Result(s): The analysis of the
qualitative data extracted from the 43 articles identified 4 themes -
communication, perceived professionalism, nurse-patient relationship,
patient needs, and criticality - and 43 subthemes, which were
differentiated into 16 'positive' and 27 'negative' subthemes, depending
on the meaning reported by patients. For each subtheme, the frequency of
recurrence was calculated since they do not all have the same weight and
recurrence. <br/>Conclusion(s): This review has extrapolated from the
patient experience which areas of nursing care are considered significant
by patients and which need improvement and more attention. In order to
increase personalized and patient-centered nursing care, it is now
necessary to consider the experiences, and emotions of patients undergoing
cardiac surgery to nip worries and anxieties in the bud, promote rapid
recovery in the postoperative period, and foster improvement in the
quality of nursing care.

<42>
Accession Number
644556290
Title
EFFECT OF A 2-4 WEEK HOME-BASED PREHABILITATION INTERVENTION ON
OBJECTIVELY MEASURED PREOPERATIVE PHYSICAL ACTIVITY IN PATIENTS UNDERGOING
ELECTIVE MAJOR CARDIAC AND NONCARDIAC SURGERY. DATA FROM A RANDOMIZED
CONTROLLED TRIAL.
Source
Swiss Medical Weekly. Conference: Annual Meeting of the Swiss Societies of
Cardiology and Cardiac Surgery 2024. Lausanne Switzerland. 154(Supplement
278) (pp 84S-85S), 2024. Date of Publication: June 2024.
Author
Vetsch T.; Engel D.; Beilstein C.; Wuethrich P.; Eser P.; Wilhelm M.
Institution
(Vetsch, Engel, Beilstein, Wuethrich) Inselspital Bern, Department of
Anaesthesiology and Pain Medicine, Bern, Switzerland
(Vetsch, Eser, Wilhelm) Inselspital Bern, Centre for Rehabilitation and
Sports Medicine, Bern, Switzerland
Publisher
SMW supporting association
Abstract
Introduction: Low functional capacity in patients undergoing major
elective surgery is associated with postoperative complications.
Prehabilitation aims to increase functional capacity by increasing
preoperative physical activity. Low functional capacity in patients
eligible for major surgery is associated with high age and comorbid
burden. In this population, center-based prehabilitation is not feasible.
Therefore, we developed a multimodal home-based prehabilitation
intervention. We hypothesize that home-based prehabilitation leads to an
increase in physical activity in patients undergoing major cardiac and
noncardiac surgery. <br/>Material(s) and Method(s): We included patients
aged over 65 with a proven low functional capacity measured by
cardiopulmonary exercise testing. The intervention group received the
prehabilitation intervention 2-4 weeks before surgery. As part of the
intervention, patients were prescribed a walking regimen according to
physical activity guidelines. All patients were provided a wrist-worn
tri-axial accelerometer at the baseline visit. Physical activity was
estimated by calculating the average Euclidean Norm Minus One (ENMO,
milligravity [mg]) per day. Baseline characteristics were tested by
Wilcoxon rank-sum test and a linear model for the primary outcome was
performed to adjust for confounders. <br/>Result(s): 37 patients scheduled
for cardiac and 62 for non-cardiac surgery were included (Table 1). Mean
group difference in daily physical activity levels in non-cardiac surgery
patients was 3.01 mg (p = 0.03, 95% CI 0.3, 5.6). Mean group difference in
daily physical activity levels in cardiac surgery patients was 0.27 mg (p
= 0.95, 95% CI -4.1, 5.0) (Figure 1). Patients undergoing cardiac surgery
had higher overall activity levels compared to non-cardiac also when
adjusted for age. <br/>Conclusion(s): Home-based prehabilitation increases
preoperative physical activity levels in patients undergoing major
noncardiac surgery but not in patients undergoing major cardiac surgery.
Higher activity levels in cardiac surgery patients may be explained by
previous exercise-based rehabilitation and physical activity
recommendations at routine cardiac follow-up visits. (Figure Presented).

<43>
Accession Number
2032939140
Title
Prognostic Value of CT-Derived Myocardial Biomarkers: Extracellular Volume
Fraction and Strain in Patients with Severe Aortic Stenosis Undergoing
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Academic Radiology. (no pagination), 2024. Date of Publication: 2024.
Author
He X.; Li Y.; Wang Y.; Tian W.; Li Z.; Ge L.; Wang G.; Chen Z.
Institution
(He, Li, Wang, Tian, Li, Wang, Chen) Department of Radiology, The First
Hospital of Lanzhou University, The First Clinical Medical College of
Lanzhou University, Intelligent Imaging Medical Engineering Research
Center of Gansu Province, Accurate Image Collaborative Innovation
International Science and Technology Cooperation Base of Gansu Province,
Gansu Province Clinical Research Center for Radiology Imaging, Lanzhou
73000, China
(Ge) Evidence-Based Social Sciences Research Centre, School of Public
Health, Lanzhou University, Lanzhou 730030, China
Publisher
Elsevier Inc.
Abstract
Rationale and Objectives: This study aimed to investigate the prognostic
value of preoperative CT scan-derived myocardial biomarkers in patients
with severe aortic stenosis (AS) undergoing transcatheter aortic valve
replacement (TAVR). <br/>Material(s) and Method(s): In April 2024, three
databases (PubMed, Web of Science and Embase) were searched to identify
studies. A random-effects model for meta-analysis was conducted to
calculate pooled hazard ratios (HR) and 95% confidence intervals (CI) to
assess the prognostic value. The I² statistic was used to
assess heterogeneity. Meta-regression analysis was conducted to appraise
which variables yielded a significant impact on the HR of included
biomarkers. <br/>Result(s): 11 studies were identified, of which six
studies involved 678 patients reporting extracellular volume fraction
(ECV), one study involved 300 patients reporting ECV and left ventricular
global longitudinal strain (LVGLS), three studies involved 868 patients
reporting LVGLS and one study involved 376 patients reporting LVGLS and
peak left atrial longitudinal strain (PALS). The endpoints included
all-cause mortality, major adverse cardiovascular events (MACE) and a
composite outcome of the previous two. The meta-analysis revealed that
ECV, whether considered as a dichotomous variable (pooled HR: 3.87, 95%
CI: 2.63-5.70, I² = 0%), or as a continuous variable (pooled
HR: 1.12, 95% CI: 1.05-1.19, I² = 66%), and LVGLS, whether
considered as a dichotomous variable (pooled HR: 1.70, 95% CI: 1.30-2.22,
I² = 0%) or a continuous variable (pooled HR: 1.07, 95% CI:
1.04-1.10, I² = 0%) were all significant predictors for
outcomes in patients with severe AS after TAVR. Age, sex, follow-up time
and mean pressure gradient had a significant impact on the model of ECV
(continuous). <br/>Conclusion(s): The higher CT-derived ECV and impaired
LVGLS are able to predict worse outcomes in patients with severe AS who
have undergone TAVR.<br/>Copyright &#xa9; 2024 The Association of
University Radiologists

<44>
Accession Number
2032938098
Title
Effect of Ciprofol on Left Ventricular Myocardial Strain and Myocardial
Work in Children Undergoing Cardiac Surgery: A Single-center Double-blind
Randomized Noninferiority Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Qin X.; Dan Y.; Wang H.; Sun L.; Ji W.; Bai J.; Mamtili I.; Zhang K.;
Zheng J.
Institution
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
Shanghai Children's Medical Center, Shanghai Jiao Tong University School
of Medicine, Shanghai, China
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
National Children's Medical Center, Shanghai, China
(Qin, Mamtili) Department of Anesthesiology, Shanghai Xuhui Central
Hospital, Shanghai, China
(Bai, Zhang) Department of Anesthesiology, Shanghai Children's Medical
Center Hainan Branch, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Wang) GE Healthcare, Shanghai, China
Publisher
W.B. Saunders
Abstract
Objective: The current work was designed to compare the effects of
ciprofol and propofol on left ventricular systolic function and myocardial
work by noninvasive speckle-tracking echocardiography in children
undergoing surgical repair of atrial septal or ventricular septal defects.
<br/>Design(s): A single-center double-blind randomized noninferiority
study was conducted. <br/>Setting(s): The research occurred at a tertiary
care center affiliated with Shanghai Jiao Tong University, China.
<br/>Participant(s): One hundred and twelve children aged 1 month to 16
years undergoing atrial septal or ventricular septal defect surgery with
cardiopulmonary bypass were included. <br/>Intervention(s): One hundred
and twelve children were allocated randomly to receive ciprofol (n = 67)
or propofol (n = 45) in a 1.5:1 ratio. Ciprofol or propofol were
intravenously infused at loading doses of 0.4 mg/kg or 2.0 mg/kg,
respectively, over 30 seconds, depending on the physical condition of each
patient. When the bispectral index was maintained between 45 and 55 after
induction, transthoracic echocardiography, including apical two-chamber,
three-chamber, and four-chamber views, were collected bedside.
<br/>Measurements and Main Results: Of the 112 patients enrolled, 104
completed the study. Global longitudinal strain in the ciprofol and
propofol groups after anesthesia was -17.3% (95% confidence interval [CI]
-18.0% to -16.6%) and -17.8% (95% CI -18.7 to -17.0%) in the full analysis
set and -17.5% (95% CI -18.2% to -16.9%) and -17.8% (95% CI -18.7% to
-17.0%) in the per-protocol set, respectively. The noninferiority margin
was set at 2% and confirmed with a lower limit of two-sided 95% CI for the
intergroup difference of 1.58% in the full analysis set and 1.34% in the
per-protocol set. There were no significant differences between the groups
in left ventricular systolic and diastolic function and myocardial work
indices. Postoperative vasoactive-inotropic score, NT-proBNP, duration of
mechanical ventilation, and the length of stay in the cardiac intensive
care unit and hospital were also comparable between the two groups (all p
> 0.05). <br/>Conclusion(s): Ciprofol did not show different effects on
myocardial function and postoperative outcomes from propofol. Further, on
the sensitive cardiac systole marker global longitudinal strain, ciprofol
demonstrated noninferiority to propofol. Ciprofol might be an alternative
solution for cardiac anesthesia in children with congestive heart disease
with mild lesion.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<45>
Accession Number
2032937760
Title
Effect of Low-dose Ketamine Infusion on Opioid Consumption in Children
Undergoing Open Cardiac Surgery: A Randomized Controlled Double-Blind
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Abdelfattah M.; Abdelbaser I.; Awad K.A.; Atallah A.M.; Sanad M.;
Sayedalahl M.
Institution
(Abdelfattah, Abdelbaser, Awad, Sayedalahl) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Atallah) Faculty of Medicine, 6th October University, 6th of October
City, Egypt
(Sanad) Department of Cardiothoracic Surgery, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to evaluate the effect of low-dose
ketamine infusion on the perioperative consumption of opioids in pediatric
open cardiac surgery. <br/>Design(s): A randomized, controlled,
double-blinded single-center study was conducted. <br/>Setting(s): The
study took place in a tertiary care children's hospital.
<br/>Participant(s): Patients of both sexes aged 2-12 years who underwent
cardiac surgery were included. <br/>Intervention(s): Patients in the
ketamine group received a bolus of 0.3 mg/kg of ketamine before skin
incision followed by continuous intraoperative infusion of 0.25 mg/kg/h
and postoperative infusion of 0.1 mg/kg/h for 24 h. Patients in the
control groups received volumes of normal saline either bolus or
continuous infusion like that of the ketamine group. <br/>Measurements and
Main Results: The primary outcome was the total dose of fentanyl consumed
over the first 24 hours postoperatively. Secondary outcomes were
intraoperative fentanyl consumption, time to extubation, modified
objective pain score, and incidence of vomiting, pruritus, diplopia, or
hallucinations. A total of 80 patients were recruited but the final
analysis was done on 35 patients in the ketamine group and 34 in the
control group. Fentanyl consumption during surgery and in the first 24
hours postoperatively was significantly lower in the ketamine than the
control group. Patients in both the ketamine and control groups had
similar times to extubation. Modified objective pain scores were
significantly lower in the ketamine group than the control group. None of
the patients in either group had diplopia or hallucinations.
<br/>Conclusion(s): Low-dose ketamine infusion in children undergoing open
cardiac surgery reduced intra- and postoperative opioid consumption and
postoperative pain scores. Moreover, ketamine did not cause diplopia or
hallucinations.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<46>
Accession Number
2030314915
Title
Comparing different postoperative sedation strategies for patients in the
intensive care unit after cardiac surgery: A systematic review of
randomized controlled trials and network meta-analysis.
Source
Basic and Clinical Pharmacology and Toxicology. (no pagination), 2024.
Date of Publication: 2024.
Author
Hu Q.; Liu X.; Xiang Y.; Lei X.; Yu H.; Liu L.; Feng J.
Institution
(Hu, Lei) Department of Critical Care Medicine, The Affiliated Hospital,
Southwest Medical University, Luzhou, China
(Liu) The Third Central Clinical College, Tianjin Medical University,
Tianjin, China
(Liu, Yu, Liu, Feng) Department of Anesthesiology, The Affiliated
Hospital, Southwest Medical University, Luzhou, China
(Liu, Liu, Feng) Anesthesiology and Critical Care Medicine Key Laboratory
of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou,
China
(Xiang) Department of Biochemistry and Molecular Biology, School of Basic
Medical Sciences, Southwest Medical University, Luzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Various postoperative sedation protocols with different
anaesthetics lead to profound effects on the outcomes for post-cardiac
surgery patients. However, a comprehensive analysis of optimal
postoperative sedation strategies for patients in the intensive care unit
(ICU) after cardiac surgery is lacking. <br/>Method(s): We systematically
searched for randomized controlled trials (RCTs) in databases including
PubMed and Embase. The primary outcome measured the duration of mechanical
ventilation (MV) in the ICU, and the secondary outcome encompassed the
length of stay (LOS) in the ICU and hospital and the monitoring adverse
events. <br/>Result(s): The literature included 18 RCTs (1652 patients)
with 13 sedation regimens. Dexmedetomidine plus ketamine and sevoflurane
were associated with a significantly reduced duration of MV when compared
with propofol. Our results also suggested that dexmedetomidine plus
ketamine may associated with a shorter LOS in ICU, and sevoflurane
associated with a shorter LOS in the hospital, respectively.
<br/>Conclusion(s): The combination of dexmedetomidine and ketamine seems
to be a better option for adult patients needing sedation after cardiac
surgery, and the incidence of side effects is lower with dexmedetomidine.
These findings have potential implications for medication management in
the perioperative pharmacotherapy of cardiac surgery
patients.<br/>Copyright &#xa9; 2024 Nordic Association for the Publication
of BCPT (former Nordic Pharmacological Society). Published by John Wiley &
Sons Ltd.

<47>
Accession Number
644567986
Title
Long-term outcomes in surgically intervened empyema patients: a systematic
review.
Source
ANZ journal of surgery. (no pagination), 2024. Date of Publication: 19
Jun 2024.
Author
Jolliffe J.; Dunne B.; Eckhaus J.; Antippa P.
Institution
(Jolliffe, Dunne, Eckhaus, Antippa) Department of Thoracic Surgery, Royal
Melbourne Hospital, Melbourne, VIC, Australia
Abstract
BACKGROUND: Pleural empyema is significant cause of morbidity and
mortality. Debate in the literature exists regarding the best initial and
definitive therapy, with recent research demonstrating superior short-term
outcomes with initial surgical intervention. Despite this, the impact of
surgical intervention on long-term outcomes has been incompletely
described. A systematic review was undertaken to assess the current
evidence evaluating the long-term impact of surgical intervention.
<br/>METHOD(S): A systematic review was undertaken according to PRISMA
guidelines utilizing three databases. Articles included all papers where
patients received surgical intervention for empyema with outcomes
evaluated beyond 90days. Two reviewers extracted and reviewed the
articles. Grey literature was included. <br/>RESULT(S): Eleven studies and
two abstracts were extracted. One study and two abstracts evaluated the
quality of life outcomes, two studies evaluated dyspnoea outcomes, seven
studies evaluated long-term lung function and two studies evaluated
mortality and re-admissions. 60-65% of patients had no dyspnoea between 2
and 7years follow-up. In six of seven studies, normal lung function was
achieved in patients with chronic fibrothorax with FEV1% and FVC%
improvements between 14-30% and 13-50%, respectively. The results from
such biased cohorts could not be extrapolated to conclude that surgical
intervention results in better outcomes than ICC drainage. Risk of bias
was severe for all 11 studies. <br/>CONCLUSION(S): Surgical intervention
potentially improves post-operative lung function, long-term dyspnoea, and
mortality. The impact this has on quality of life remains unknown. Future
prospective trials with homogenous comparative groups are required to
better define the role of surgery and its impact on long-term
outcomes.<br/>Copyright &#xa9; 2024 Royal Australasian College of
Surgeons.

<48>
Accession Number
644564241
Title
Ventricular septal defect complicating acute myocardial infarction:
diagnosis and management. A Clinical Consensus Statement of the
Association for Acute CardioVascular Care (ACVC) of the ESC, the European
Association of Percutaneous Cardiovascular Interventions (EAPCI) of the
ESC and the ESC Working Group on Cardiovascular Surgery.
Source
European heart journal. (no pagination), 2024. Date of Publication: 18
Jun 2024.
Author
Schlotter F.; Huber K.; Hassager C.; Halvorsen S.; Vranckx P.; Poss J.;
Krychtiuk K.; Lorusso R.; Bonaros N.; Calvert P.A.; Montorfano M.; Thiele
H.
Institution
(Schlotter, Poss, Thiele) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at University of Leipzig, Leipzig, Germany
(Huber) Departments of Cardiology and Intensive Care Medicine, Clinic
Ottakring and Sigmund Freud University, Medical School, Vienna, Austria
(Hassager) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval and
University of Oslo, Oslo, Norway
(Vranckx) Department of Cardiology and Intensive Care Medicine, Heart
Center Hasselt, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Krychtiuk) Division of Cardiology, Department of Internal Medicine II,
Medical University of Vienna, Vienna, Austria
(Krychtiuk) Duke Clinical Research Institute, Durham, NC, United States
(Lorusso) Department of Cardiothoracic Surgery, Maastricht University
Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Calvert) Department of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Abstract
Ventricular septal defects are a rare complication after acute myocardial
infarction with a mortality close to 100% if left untreated. However, even
surgical or interventional closure is associated with a very high
mortality and currently no randomized controlled trials are available
addressing the optimal treatment strategy of this disease. This
state-of-the-art review and clinical consensus statement will outline the
diagnosis, hemodynamic consequences and treatment strategies of
ventricular septal defects complicating acute myocardial infarction with a
focus on current available evidence and a focus on major research
questions to fill the gap in evidence.<br/>Copyright &#xa9; The Author(s)
2024. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved. For commercial re-use, please
contact reprints@oup.com for reprints and translation rights for reprints.
All other permissions can be obtained through our RightsLink service via
the Permissions link on the article page on our site-for further
information please contact

<49>
Accession Number
644562862
Title
Ultrasound-Guided Transfemoral Access for Coronary Procedures: A Pooled
Learning Curve Analysis From the FAUST and UNIVERSAL Trials.
Source
Circulation. Cardiovascular interventions. (pp e013817), 2024. Date of
Publication: 18 Jun 2024.
Author
d'Entremont M.-A.; Seto A.H.; Alrashidi S.; Alansari O.; Brochu B.;
Lemaire-Paquette S.; Heenan L.; Skuriat E.; Tyrwhitt J.; Raco M.; Tsang
M.B.; Valettas N.; Velianou J.; Sheth T.; Sibbald M.; Mehta S.R.;
Pinilla-Echeverri N.; Schwalm J.-D.; Natarajan M.K.; Abu-Fadel M.; Kelly
A.; Akl E.; Tawadros S.; Faidi W.; Bauer J.; Moxham R.; Nkurunziza J.;
Dutra G.; Winter J.; Couture EL.; Jolly S.S.
Institution
(d'Entremont, Heenan, Skuriat, Tyrwhitt, Sheth, Mehta, Schwalm, Natarajan,
Jolly) Population Health Research Institute, Hamilton, ON, Canada
(M.-A.d., L.H., E.S., J.T., T.S., S.R.M., J.-D.S., M.K.N., S.S.J.)
(d'Entremont, Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Tawadros,
Faidi, Bauer, Moxham, Nkurunziza, Dutra, Jolly) Hamilton Health Sciences,
ON, Canada (M.-A.d., S.A., O.A., M.R., M.B.T., N.V., J.V., T.S., M.S.,
S.R.M., N.P.-E., J.-D.S., M.K.N., A.K., S.T., W.F., J.B., R.M., J.N.,
G.D., S.S.J.)
(d'Entremont, Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Bauer,
Nkurunziza, Jolly) Department of Medicine, McMaster University, Hamilton,
ON, Canada (M.-A.d., S.A., O.A., M.R., M.B.T., N.V., J.V., T.S., M.S.,
S.R.M., N.P.-E., J.-D.S., M.K.N., A.K., J.B., J.N., S.S.J.)
(d'Entremont, Lemaire-Paquette, Couture) Centre Hospitalier Universitaire
de Sherbrooke, S.L.-P, QC, Canada
(Seto) Long Beach VA Medical Center
(Brochu) CK Hui Heart Center, Edmonton, AB, Canada
(Abu-Fadel) Oklahoma Heart Hospital (M.A.-F.)
(Akl) McGill University Faculty of Medicine and Health Sciences, Montreal,
QC, Canada
(Winter) Clinica Alemana de Santiago, Universidad de Desarrollo, Chile
Abstract
BACKGROUND: The learning curve for new operators performing
ultrasound-guided transfemoral access (TFA) remains uncertain.
<br/>METHOD(S): We performed a pooled analysis of the FAUST (Femoral
Arterial Access With Ultrasound Trial) and UNIVERSAL (Routine Ultrasound
Guidance for Vascular Access for Cardiac Procedures) trials, both
multicenter randomized controlled trials of 1:1 ultrasound-guided versus
non-ultrasound-guided TFA for coronary procedures. Outcomes included the
composite of major bleeding or vascular complications and successful
common femoral artery cannulation. Participants were stratified by the
operators' accrued case volume. We used adjusted repeated-measurement
logistic regression, with random intercepts for operator clustering, for
comparison against the non-ultrasound-guided TFA group and to model the
learning curve. <br/>RESULT(S): The FAUST and UNIVERSAL trials randomized
a total of 1624 patients, of which 810 were randomized to
non-ultrasound-guided TFA and 814 to ultrasound-guided TFA (cases 1-10,
391; 11-20, 183; and >20, 240). Participants who had operators who
performed >20 ultrasound-guided TFAs had a decreased risk for the primary
end point (5/240 [2.1%] versus 64/810 [7.9%]; adjusted odds ratio, 0.26
[95% CI, 0.09-0.61]) compared with non-ultrasound-guided TFA. Operators
who performed >20 ultrasound-guided procedures had increased odds of
successfully cannulating the common femoral artery (224/246 [91.1%] versus
327/382 [85.6%]; adjusted odds ratio, 1.76 [95% CI, 1.08-2.89]) compared
with non-ultrasound-guided TFA. The learning curve plots demonstrated
growing competence with increasing accrued cases. <br/>CONCLUSION(S): New
operators should perform at least 20 ultrasound-guided TFA to decrease
access site complications and increase proper cannulation compared with
non-ultrasound-guided TFA. Additional accrued cases may lead to increased
proficiency. Training programs should consider these findings in the
transradial era.

<50>
Accession Number
2030201175
Title
Simultaneous Heart and Kidney Transplantation: A Systematic Review and
Proportional Meta-Analysis of Its Characteristics and Long-Term Variables.
Source
Transplant International. 37 (no pagination), 2024. Article Number: 12750.
Date of Publication: 2024.
Author
Sampaio N.Z.; Faleiro M.D.; Vieira L.V.D.S.; Lech G.E.; Viana S.W.;
Tavares C.P.O.; Mattiazzi A.D.; Burke G.W.
Institution
(Sampaio) University of Araraquara, Araraquara, Brazil
(Faleiro) Federal University of Minas Gerais, Minas Gerais, Belo
Horizonte, Brazil
(Vieira) Federal University of Piaui, Piaui, Teresina, Brazil
(Lech) Pontifical Catholic University of Rio Grande do Sul, Rio Grande do
Sul, Porto Alegre, Brazil
(Viana) Kursk State Medical University, Kursk Oblast, Kursk, Russian
Federation
(Tavares) Salvador University, Bahia, Salvador, Brazil
(Mattiazzi, Burke) Leonard M. Miller School of Medicine, University of
Miami, Miami, FL, United States
Publisher
Frontiers Media SA
Abstract
Patients with end-stage heart disease who undergo a heart transplant
frequently have simultaneous kidney insufficiency, therefore simultaneous
heart and kidney transplantation is an option and it is necessary to
understand its characteristics and long-term variables. The recipient
characteristics and operative and long-term variables were assessed in a
meta-analysis. A total of 781 studies were screened, and 33 were
thoroughly reviewed. 15 retrospective cohort studies and 376 patients were
included. The recipient's mean age was 51.1 years (95% CI 48.52-53.67) and
84% (95% CI 80-87) were male. 71% (95% CI 59-83) of the recipients were
dialysis dependent. The most common indication was ischemic cardiomyopathy
[47% (95% CI 41-53)] and cardiorenal syndrome [22% (95% CI 9-35)]. Also,
33% (95% CI 20-46) of the patients presented with delayed graft function.
During the mean follow-up period of 67.49 months (95% CI 45.64-89.33),
simultaneous rejection episodes of both organ allografts were described in
5 cases only. Overall survival was 95% (95% CI 88-100) at 30 days, 81%
(95% CI 76-86) at 1 year, 79% (95% CI 71-87) at 3, and 71% (95% CI 59-83)
at 5 years. Simultaneous heart and kidney transplantation is an important
option for concurrent cardiac and renal dysfunction and has acceptable
rejection and survival rates.<br/>Copyright &#xa9; 2024 Sampaio, Faleiro,
Vieira, Lech, Viana, Tavares, Mattiazzi and Burke.

<51>
Accession Number
2006128502
Title
Cardiac graft assessment in the era of machine perfusion: Current and
future biomarkers.
Source
Journal of the American Heart Association. 10(4) (pp 1-29), 2021. Article
Number: e018966. Date of Publication: 16 Feb 2021.
Author
Bona M.; Wyss R.K.; Arnold M.; Mendez-Carmona N.; Sanz M.N.; Gunsch D.;
Barile L.; Carrel T.P.; Longnus S.L.
Institution
(Bona, Wyss, Arnold, Mendez-Carmona, Sanz, Carrel, Longnus) Department of
Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern,
Switzerland
(Bona, Wyss, Arnold, Mendez-Carmona, Sanz, Carrel, Longnus) Department for
BioMedical Research, University of Bern, Switzerland
(Gunsch) Department of Anesthesiology and Pain Medicine/Institute for
Diagnostic, Interventional and Paediatric Radiology, Bern University
Hospital, Inselspital, University of Bern, Switzerland
(Barile) Laboratory for Cardiovascular Theranostics, Cardiocentro Ticino
Foundation and Faculty of Biomedical Sciences, Universita Svizzera
Italiana, Lugano, Switzerland
Publisher
American Heart Association Inc.
Abstract
Heart transplantation remains the treatment of reference for patients
experiencing end-stage heart failure; unfortu-nately, graft availability
through conventional donation after brain death is insufficient to meet
the demand. Use of extended-criteria donors or donation after circulatory
death has emerged to increase organ availability; however, clinical
protocols require optimization to limit or prevent damage in hearts
possessing greater susceptibility to injury than conventional grafts. The
emergence of cardiac ex situ machine perfusion not only facilitates the
use of extended-criteria donor and donation after circulatory death hearts
through the avoidance of potentially damaging ischemia during graft
storage and transport, it also opens the door to multiple opportunities
for more sensitive monitoring of graft quality. With this review, we aim
to bring to-gether the current knowledge of biomarkers that hold
particular promise for cardiac graft evaluation to improve precision and
reliability in the identification of hearts for transplantation, thereby
facilitating the safe increase in graft availability. Information about
the utility of potential biomarkers was categorized into 5 themes: (1)
functional, (2) metabolic, (3) hormone/prohormone, (4) cellular
damage/death, and (5) inflammatory markers. Several promising biomarkers
are identified, and recommendations for potential improvements to current
clinical protocols are provided.<br/>Copyright &#xa9; 2021 The Authors.

<52>
Accession Number
2032813325
Title
Invasive vs. conservative management of older patients with
non-ST-elevation acute coronary syndrome: individual patient data
meta-analysis.
Source
European Heart Journal. 45(23) (pp 2052-2062), 2024. Date of Publication:
14 Jun 2024.
Author
Kotanidis C.P.; Mills G.B.; Bendz B.; Berg E.S.; Hildick-Smith D.;
Hirlekar G.; Milasinovic D.; Morici N.; Myat A.; Tegn N.; Sanchis J.;
Savonitto S.; De Servi S.; Fox K.A.A.; Pocock S.; Kunadian V.
Institution
(Kotanidis, Mills, Kunadian) Translational and Clinical Research
Institute, Faculty of Medical Sciences, Newcastle University, 4th Floor
William Leech Building, Newcastle upon Tyne NE2 4HH, United Kingdom
(Kotanidis, Mills, Kunadian) Cardiothoracic Centre, Freeman Hospital,
Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle
upon Tyne NE7 7DN, United Kingdom
(Bendz, Berg, Tegn) Department of Cardiology, Oslo University Hospital,
Oslo, Norway
(Bendz, Berg, Tegn) Institute of Clinical Medicine, University of Oslo,
Oslo, Norway
(Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex NHS
Foundation Trust, Brighton, United Kingdom
(Hirlekar) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Hirlekar) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Milasinovic) Department of Cardiology, University Clinical Center of
Serbia, Belgrade, Serbia
(Milasinovic) Medical Faculty, University of Belgrade, Belgrade, Serbia
(Morici) IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
(Myat) Medpace UK, London, United Kingdom
(Sanchis) Department of Cardiology, Hospital Clinico Universitario,
INCLIVA, Universitat de Valencia, CIBER-Cardiovascular, Valencia, Spain
(Savonitto) Clinica San Martino, Malgrate, Italy
(De Servi) Department of Molecular Medicine, University of Pavia, Pavia,
Italy
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
Oxford University Press
Abstract
Background and Older patients with non-ST-elevation acute coronary
syndrome (NSTEACS) are less likely to receive guideline-Aims recommended
care including coronary angiography and revascularization. Evidence-based
recommendations regarding interventional management strategies in this
patient cohort are scarce. This meta-analysis aimed to assess the impact
of routine invasive vs. conservative management of NSTEACS by using
individual patient data (IPD) from all available randomized controlled
trials (RCTs) including older patients Methods MEDLINE, Web of Science and
Scopus were searched between 1 January 2010 and 11 September 2023. RCTs
investigating routine invasive and conservative strategies in persons >70
years old with NSTEACS were included. Observational studies or trials
involving populations outside the target range were excluded. The primary
endpoint was a composite of all-cause mortality and myocardial infarction
(MI) at 1 year. One-stage IPD meta-analyses were adopted by use of
random-effects and fixed-effect Cox models. This meta-analysis is
registered with PROSPERO (CRD42023379819) Results Six eligible studies
were identified including 1479 participants. The primary endpoint occurred
in 181 of 736 (24.5%) participants in the invasive management group
compared with 215 of 743 (28.9%) participants in the conservative
management group with a hazard ratio (HR) from random-effects model of
0.87 (95% CI 0.63-1.22; P = .43). The hazard for MI at 1 year was
significantly lower in the invasive group compared with the conservative
group (HR from random-effects model 0.62, 95% CI 0.44-0.87; P = .006).
Similar results were seen for urgent revascularization (HR from
random-effects model 0.41, 95% CI 0.18-0.95; P = .037). There was no
significant difference in mortality Conclusions No evidence was found that
routine invasive treatment for NSTEACS in older patients reduces the risk
of a composite of all-cause mortality and MI within 1 year compared with
conservative management. However, there is convincing evidence that
invasive treatment significantly lowers the risk of repeat MI or urgent
revascularisation. Further evidence is needed from ongoing larger clinical
trials. Structured Graphical Abstract Key Question Older patients with
non-ST-elevation acute coronary syndrome (NSTEACS) are less likely to
receive coronary angiography and revascularization. Evidence-based
recommendations regarding interventional strategies are scarce. The
present study compared routine invasive with conservative management of
older patients with NSTEACS using individual patient data from all
contemporary randomized controlled trials. Key Finding At one-year
follow-up, routine invasive management was associated with a significantly
reduced risk of myocardial infarction or urgent revascularization. No
benefit was observed for mortality or a composite of all-cause mortality
and myocardial infarction. Take Home Message This study provides robust
evidence that a routine invasive strategy is superior to conservative
approaches in reducing the risk of myocardial infarction and urgent
revascularization at one year. It supports the consideration of routine
invasive management in older patients with NSTEACS. Individual patient
data from six randomized controlled trials 313 457 106 186 250 167 Italian
Elderly ACS After Eighty MOSCA 80+ study RINCAL MOSCA-FRAIL 1479 Routine
invasive strategy Initial conservative strategy 736 743 One-year outcomes
Composite of all-cause mortality and MI - random effects HR 0.87 (95% CI
0.63-1.22) Composite of all-cause mortality and MI - fixed effects HR 0.82
(95% CI 0.67-1.00) All-cause mortality HR 1.03 (95% CI 0.69-1.53)
Cardiovascular mortality HR 0.89 (95% CI 0.57-1.40) MI HR 0.62 (95% CI
0.44-0.87) Urgent revascularization HR 0.41 (95% CI 0.18-0.95) Composite
of all-cause mortality and MI - troponin positive HR 0.81 (95% CI
0.58-1.12) Composite of all-cause mortality and MI - troponin negative HR
1.71 (95% CI 0.69-4.25) Using individual patient-level data we show that
the risk of myocardial infarction and unplanned urgent revascularization
is lower in older patients with non-ST-elevation acute coronary syndrome
(NSTEACS) treated with a routine invasive strategy compared to a
conservative medical approach. The risk of a composite endpoint of
all-cause mortality and reinfarction showed weaker evidence of a
potentially lower risk for an invasive strategy, while we observed no
evident difference for all-cause mortality, cardiovascular death, and
stroke. CI, confidence interval; HR, hazard ratio; MI, myocardial
infarction.<br/>Copyright &#xa9; 2024 Oxford University Press. All rights
reserved.

<53>
Accession Number
2032812972
Title
Effect of varying cuff sizes with identical inner diameter on endotracheal
intubation in critically ill adults A sealed tracheal controlled trial.
Source
Medicine (United States). 103(24) (no pagination), 2024. Date of
Publication: 14 Jun 2024.
Author
Yan-Nan Z.; Hai-Yan S.; Wang-Qin S.; Jia-Hai S.; Yan-Ping Z.; Yang-Hui X.;
Hong-Lei W.
Institution
(Yan-Nan, Yang-Hui, Hong-Lei) Nursing Department, Affiliated Hospital of
Nantong University, Jiangsu, Nantong, China
(Hai-Yan) Nursing Department, The People's Hospital of Rugao, Affiliated
Rugao Hospital of Nantong University, Jiangsu, Nantong City, China
(Wang-Qin) Nursing Department, Nantong Third People's Hospital, Jiangsu,
Nantong, China
(Jia-Hai) Department of Cardiothoracic Surgery, Affiliated Hospital of
Nantong University, Jiangsu, Nantong, China
(Yan-Ping) Intensive Care Unit, Southeast University Affiliated Zhong Da
Hospital, Jiangsu, Nanjing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The present study aims to determine the impact of different
cuff diameters on the cuff pressure of endotracheal tubes (ETTs) when the
trachea is adequately sealed. <br/>Method(s): In the present single-center
clinical trial, adult patients who underwent cardiothoracic surgery were
assigned to use ETTs from 2 brands (GME and GZW). The primary endpoint
comprised of the following: cuff diameter, inner diameter of the ETT,
manufacturer, and the number of subjects with tracheal leakage when the
cuff pressure was 30 cm H<inf>2</inf>O. <br/>Result(s): A total of 298
patients were assigned into 2 groups, based on the 2 distinct brands of
ETTs: experimental group (n = 122, GME brand) and control group (n = 176,
GZW brand). There were no significant differences in baseline
characteristics. However, the cuff diameter was significantly smaller in
the control group, when compared to the experimental group (P = .001), and
the incidence of tracheal leakage was significantly higher in the control
group (P = .001). Furthermore, the GME brand ETT had a significantly
larger cuff diameter, when compared to the GZW brand ETT.
<br/>Conclusion(s): The cuff size would mismatch the tracheal area in
clinical practice. Therefore, chest computed tomography is recommended to
routinely evaluate the tracheal cross-sectional area during anesthesia, in
order to ensure the appropriate cuff size selection.<br/>Copyright &#xa9;
2024 Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
2032800235
Title
Effect of Respiratory Proprioceptive Neuromuscular Facilitation in Phase
One Cardiac Rehabilitation - A Randomized Controlled Trial.
Source
Nepalese Heart Journal. 21(1) (pp 3-9), 2024. Date of Publication: May
2024.
Author
Naik V.; Vernekar S.
Institution
(Naik, Vernekar) Department of Cardiovascular and Pulmonary Physiotherapy,
KAHER Institute of Physiotherapy, Karnataka, Belagavi, India
Publisher
Cardiac Society of Nepal
Abstract
Background: Patients undergoing coronary artery bypass graft (CABG) and
valve replacement surgery often develop pulmonary complications in early
post-operative period as results of decreased lung function and impaired
cough reflex. The recent study aimed to determine and compare
effectiveness of respiratory PNF to conventional physiotherapy in
improving the pulmonary function and airway clearance in early period of
CABG and valve replacement patients. <br/>Method(s): A Randomized control
trial was conducted on 46 subjects with median sternotomy incision.
Participants were assigned to either Group A (n=23) received phase one of
cardiac rehabilitation or Group B (n=23) received phase one of cardiac
rehabilitation and respiratory PNF. The sessions were carried for 30 min
for five consecutive days twice a day. Outcome measure in the present
study were peak flow meter, thoracic expansion, sputum volume, respiratory
rate, heart rate and blood pressure. The outcome measures were evaluated
on baseline and post 5 days of the intervention. <br/>Result(s): within
group analysis revealed that both the interventional and control groups
improved significantly on all outcome measure with p-value less (p<0.005)
than in all parameters expect for blood pressure, whereas a significant
difference was seen in between group analysis in blood pressure (0.0500)
and hear rate (0.0210). <br/>Conclusion(s): the study concluded that phase
one cardiac rehabilitation along with respiratory PNF are effective in
improving the lung function, rate and depth of breathing, sputum
clearance.<br/>Copyright &#xa9; 2024 Cardiac Society of Nepal. All rights
reserved.

<55>
Accession Number
2032774912
Title
Risk of bleeding with concomitant use of oral anticoagulants and aspirin:
A systematic review and meta-analysis.
Source
American Journal of Health-System Pharmacy. 81(12) (pp 494-508), 2024.
Date of Publication: 15 Jun 2024.
Author
Ghule P.; Panic J.; Malone D.C.
Institution
(Ghule, Malone) College of Pharmacy, University of Utah, Salt Lake City,
UT, United States
(Panic) Froedtert and the Medical College of Wisconsin, Milwaukee, WI,
United States
Publisher
Oxford University Press
Abstract
Purpose: Oral anticoagulants (OACs) and aspirin can trigger bleeding
events when used alone or in combination. The purpose of this study was to
compare the risk of any type of bleeding in individuals exposed to a
combination of OAC and aspirin with the risk in those taking an OAC or
aspirin alone. <br/>Method(s): MEDLINE and Web of Science were queried in
January 2021 for eligible articles. Studies were included if they were
either randomized controlled trials (RCTs) or observational studies and
evaluated the number of any bleeding events in two groups, one with
exposure to both OAC and aspirin and one with exposure to OAC alone or
aspirin alone. Pooled odds ratios were calculated using a random-effects
model. <br/>Result(s): Forty-two studies were included. In an analysis of
15 RCTs and 19 observational studies evaluating OAC plus aspirin versus
OAC alone, a significant difference in the risk of bleeding was observed
in the combination groups, with an odds ratio [OR] of, 1.36 (95% CI,
1.15-1.59) for RCTs and an OR of 1.42 (95% CI-, 1.09-1.87) for
observational studies. When OAC plus aspirin was compared to aspirin
alone, a higher rate of bleeding was found in the combination group (OR,
2.36; 95%CI, 1.91-2.92) in the analysis of 15 RCTs, but no significant
difference was found among 10 observational studies (OR, 1.93; 95% Cl,
0.99-3.75). <br/>Conclusion(s): The risk of any type of bleeding was
significantly increased among patients taking aspirin plus OAC compared to
those taking OAC alone in both RCTs and observational studies. Evaluation
of RCTs comparing OAC plus aspirin to aspirin alone suggests increased
bleeding risk as well.<br/>Copyright &#xa9; 2024 American Society of
Health-System Pharmacists. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site - for
further information please contact journals.permissions@oup.com.

<56>
Accession Number
2032876290
Title
Serum proteomics study on cognitive impairment after cardiac valve
replacement surgery: a prospective observational study.
Source
PeerJ. 12(6) (no pagination), 2024. Article Number: e17536. Date of
Publication: 2024.
Author
Ma H.; Wei Y.; Chen W.; Chen S.; Wang Y.; Cao S.; Wang H.
Institution
(Ma) Department of Anesthesiology, Medical College of Soochow University,
Jiangsu Province, Soochow, China
(Ma) Department of Anesthesiology, Zunyi Maternal and Child Health Care
Hospital, Guizhou Province, Zunyi, China
(Wei) Department of Anesthesiology, Longgang District Maternity and Child
Healthcare Hospital of Shenzhen City, Guangdong Province, Shenzhen, China
(Chen, Chen, Wang, Wang) Department of Anesthesiology, The Affiliated
Hospital of Zunyi Medical University, Guizhou Province, Zunyi, China
(Cao) Department of Pain Medicine, The Tenth Affiliated Hospital, Southern
Medical University, Guangdong Province, Dongguan, China
(Wang) Department of Anesthesiology, Zunyi Medical University, Guizhou
Province, Zunyi, China
Publisher
PeerJ Inc.
Abstract
Objective. The incidence of perioperative neurocognitive disorders (PND)
is high, especially after cardiac surgeries, and the underlying mechanisms
remain elusive. Here, we conducted a prospective observational study to
observe serum proteomics differences in PND patients after cardiac valve
replacement surgery. Methods. Two hundred and twenty-six patients who
underwent cardiac valve surgery were included. They were categorized based
on scoring into non-PND group (group non-P) and PND group (group P'). The
risk factors associated with PND were analyzed. These patients were
further divided into group C and group P by propensity score matching
(PSM) to investigate the serum proteome related to the PND by serum
proteomics. Results. The postoperative 6-week incidence of PND was 16.8%.
Risk factors for PND include age, chronic illness, sufentanil dosage, and
time of cardiopulmonary bypass (CPB). Proteomics identified 31
down-regulated proteins and six up-regulated proteins. Finally, GSTO1,
IDH1, CAT, and PFN1 were found to be associated with PND. Conclusion. The
occurrence of PND can impact some oxidative stress proteins. This study
provided data for future studies about PND to general anaesthesia and
surgeries.<br/>Copyright &#xa9; 2024 Ma et al.

<57>
Accession Number
2032706462
Title
LANDMARK comparison of early outcomes of newer-generation Myval
transcatheter heart valve series with contemporary valves (Sapien and
Evolut) in real-world individuals with severe symptomatic native aortic
stenosis: a randomised non-inferiority trial.
Source
The Lancet. 403(10445) (pp 2695-2708), 2024. Date of Publication: 22 Jun
2024.
Author
Baumbach A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Ijsselmuiden A.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios
V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De Sousa
Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.; Webster M.;
Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Angeras O.; Kim
W.-K.; Rothe J.; Kristic I.; Peral V.; Garg S.; Elzomor H.; Tobe A.;
Morice M.-C.; Onuma Y.; Soliman O.; Serruys P.W.; Siqueira D.; Pinto I.;
Cervone A.; Assef J.; Vilela A.; Paladino A.; Ramos A.; Rezende M.;
Ghorayeb S.; Braga Silva T.R.; Gjorgjievska S.; Hadzibegovic I.; Jurin I.;
Sipic T.; Pavlovic N.; Rudez I.; Manola S.; GALLET DE SAINT-AURIN R.;
BOUKANTAR M.; NICOLAS E.; ENNEZAT P.V.; URIEN J.M.; Vincent F.; Delhaye
C.; Denimal T.; Cosenza A.; Pamart T.; Porouchani S.; Pontana F.;
Montaigne D.; Balmette V.; Bechiri M.; Chen E.; Janah D.; Renker M.;
Westermann D.; Valina C.; Ferenc M.; Loffelhardt N.; Rahimi F.; Breitbart
P.; Franke K.; Czerny M.; Diab N.; Sick P.; Adeishvili M.; Mangner N.;
Haussig S.; Sveric K.; Crusius L.; Roehlig M.; Koliastasis L.; Drakopoulou
M.; Katsaros O.; Ktenopoulos N.; Ioanniadis A.; Evangelou S.; Ninios I.;
Molnar L.; Papp R.; Arnold-Bela F.; Demeterne Kiss O.; Nagy A.; Czimbalmos
C.; Pellegrinni D.; Montonati C.; Pellicano M.; Guagliumi G.; Tespili M.;
Barbara B.; Filippo R.; Marco A.; Ciro V.; Luca F.; Eustachio A.; Giacomo
I.; Cannone G.; Brambilla N.; Testa L.; Avondo S.; Valvo R.; Clarke R.;
Fish M.; Kosowski M.; Krawczyk M.; Kubler P.; Kotwica T.; Teles R.;
Goncalves P.; Raposo L.; Brito J.; Leal S.; Freitas P.; Ribeiras R.;
Poliacikova P.; Mihailovic P.M.; Terseglav S.; Steblovnik K.; Cercek M.;
Vitez L.; Sustersic M.; Kovac A.; Kogoj P.; Dimitrovska L.; Arana J.R.D.;
Martinez S.S.; Dieguez A.R.; Barrero A.; Gonzalez-Bartol E.; Aristizabal
C.; Frutos A.S.; Luna J.P.S.; Gomez M.G.; Gabella T.R.; Nelson V.Q.;
Medina J.N.; Ojeda S.; de Lezo J.S.; Romero M.; Gonzalez-Manzanares R.;
Alvarado M.; Mesa D.; Perea J.; Petursson P.; Alchay M.; Andreen S.;
Gameren M.V.; Heijer P.D.; Meuwissen M.; CHENG J.M.; Vos J.; Scholzel
B.E.; Simsek C.; Hubbers S.; Van den Branden B.J.L.; Stens N.A.; Versteeg
G.A.A.; Rooijakkers M.J.P.; Gehlmann H.R.; Verkroost M.W.A.; Geuzebroek
G.S.C.; Van Wely M.H.; Van Geuns R.J.; van Nunen L.X.; van Garsse
L.A.F.M.; Timmers L.; ten Berg J.; Kraaijeveld A.O.; Dickinson M.G.;
Dessing T.C.; Mokhles M.M.
Institution
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(Baumbach) Cleveland Clinic, London, United Kingdom
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(Amat-Santos) CIVERCV, Centro de Investigacion Biomedica en red -
Enfermedades Cardiovasculares, University Clinical Hospital of Valladolid,
Valladolid, Spain
(Amat-Santos) Department of Cardiology, University Clinical Hospital of
Valladolid, Valladolid, Spain
(Hudec) Department of Acute Cardiology, Middle-Slovak Institute Of
Cardiovascular Diseases, Banska Bystrica, Slovakia
(Bunc) Department of Cardiology, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Ijsselmuiden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Ijsselmuiden) Department of Interventional Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(Ijsselmuiden) Zuyderland Hospital, Limburg, Netherlands
(Laanmets) Department of Invasive Cardiology, North Estonia Medical
Centre, Tallinn, Estonia
(Unic) Department of Cardiac and Transplant Surgery, University Hospital
Dubrava, Zagreb, Croatia
(Merkely) Heart and Vascular Centre, Semmelweis University Heart and
Vascular Centre, Budapest, Hungary
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Ninios) Department of Cardiology, European Interbalkan Medical Center,
Thessaloniki, Greece
(Protasiewicz) Department of Cardiology, Institute of Heart Diseases,
Wroclaw Medical University, Wroclaw, Poland
(Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Martin) Department of Interventional Cardiology, University Hospital of
Gran Canaria Dr Negrin, Las Palmas, Spain
(Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao
Paulo, Brazil
(De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon,
Lisbon, Portugal
(van Belle) Department of Interventional Cardiology, Lille University,
Lille, France
(Linke) Department of Internal Medicine and Cardiology, University Clinic,
Heart Center Dresden, University of Technology Dresden, Dresden, Germany
(Ielasi) Department of Interventional Cardiology, IRCCS Galeazzi
Sant'Ambrogio Hospital, Milan, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Webster) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Toutouzas) Department of Cardiology, Hippokration Hospital, Athens,
Greece
(Teiger) Department of Medico-surgical Cardiovascular and Anaesthesiology,
Henri-Mondor University Hospital, Creteil, France
(Bedogni) Department of Clinical Cardiology, San Donato Hospital, Milan,
Italy
(Voskuil) Department of Interventional Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Pan) Department of Cardiology, University Hospital Reina Sofia,
University of Cordoba, Cordoba, Spain
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angeras) Department of Clinical and Molecular Medicine, Gothenburg
University, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giessen, Germany
(Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
(Rothe) Department of Cardiology and Angiology, University Heart Center
Freiburg Bad Krozingen, University Medical Center Freiburg, Freiburg,
Germany
(Rothe) Department of Cardiology and Angiology, Faculty of Medicine,
University of Freiburg, Freiburg, Germany
(Kristic) Department of Cardiology, University Hospital of Split, Split,
Croatia
(Peral) Department of Cardiology, Son Espases University Hospital, Palma,
Spain
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Elzomor, Tobe, Onuma, Soliman, Serruys) Department of Cardiology, School
of Medicine, University of Galway, Galway, Ireland
(Morice) Cardiovascular European Research Center, Paris, France
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation is an established,
guideline-endorsed treatment for severe aortic stenosis. Precise sizing of
the balloon-expandable Myval transcatheter heart valve (THV) series with
the aortic annulus is facilitated by increasing its diameter in 1.5 mm
increments, compared with the usual 3 mm increments in valve size. The
LANDMARK trial aimed to show non-inferiority of the Myval THV series
compared with the contemporary THVs Sapien Series (Edwards Lifesciences,
Irvine, CA, USA) or Evolut Series (Medtronic, Minneapolis, MN, USA).
<br/>Method(s): In this prospective, multinational, randomised,
open-label, non-inferiority trial across 31 hospitals in 16 countries
(Germany, France, Sweden, the Netherlands, Italy, Spain, New Zealand,
Portugal, Greece, Hungary, Poland, Slovakia, Slovenia, Croatia, Estonia,
and Brazil), 768 participants with severe symptomatic native aortic
stenosis were randomly assigned (1:1) to the Myval THV or a contemporary
THV. Eligibility was primarily decided by the heart team in accordance
with 2021 European Society of Cardiology guidelines. As per the criteria
of the third Valve Academic Research Consortium, the primary endpoint at
30 days was a composite of all-cause mortality, all stroke, bleeding
(types 3 and 4), acute kidney injury (stages 2-4), major vascular
complications, moderate or severe prosthetic valve regurgitation, and
conduction system disturbances resulting in a permanent pacemaker
implantation. Non-inferiority of the study device was tested in the
intention-to-treat population using a non-inferiority margin of 10.44% and
assuming an event rate of 26.10%. This trial is registered with
ClinicalTrials.gov, NCT04275726, and EudraCT, 2020-000137-40, and is
closed to new participants. <br/>Finding(s): Between Jan 6, 2021, and Dec
5, 2023, 768 participants with severe symptomatic native aortic stenosis
were randomly assigned, 384 to the Myval THV and 384 to a contemporary
THV. 369 (48%) participants had their sex recorded as female, and 399
(52%) as male. The mean age of participants was 80.0 years (SD 5.7) for
those treated with the Myval THV and 80.4 years (5.4) for those treated
with a contemporary THV. Median Society of Thoracic Surgeons scores were
the same in both groups (Myval 2.6% [IQR 1.7-4.0] vs contemporary 2.6%
[1.7-4.0]). The primary endpoint showed non-inferiority of the Myval (25%)
compared with contemporary THV (27%), with a risk difference of -2.3%
(one-sided upper 95% CI 3.8, p<inf>non-inferiority</inf><0.0001). No
significant difference was seen in individual components of the primary
composite endpoint. <br/>Interpretation(s): In individuals with severe
symptomatic native aortic stenosis, the Myval THV met its primary endpoint
at 30 days. <br/>Funding(s): Meril Life Sciences.<br/>Copyright &#xa9;
2024 Elsevier Ltd

<58>
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. 133(1) (pp 222-225), 2024. Date of
Publication: July 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

<59>
Accession Number
2030262904
Title
Editorial: Reviews in bioresorbable scaffold.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1437555. Date of Publication: 2024.
Author
Rai V.; Iglesias J.F.; Bossard M.; Dahal K.; Chang C.C.; Tomaniak M.
Institution
(Rai) Department of Translational Research, Western University of Health
Sciences, Pomona, CA, United States
(Iglesias) Department of Cardiology, Geneva University Hospitals, Geneva,
Switzerland
(Bossard) Cardiology Division, Heart Center, Luzerner Kantonsspital,
Luzern, Switzerland
(Dahal) School of Medicine, Creighton University, Omaha, NE, United States
(Chang) Division of Cardiology, Department of Medicine, Taipei Veterans
General Hospital, Taipei, Taiwan (Republic of China)
(Tomaniak) 1st Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
Publisher
Frontiers Media SA

<60>
Accession Number
2030246571
Title
Hemostatic effects of tranexamic acid in cardiac surgical patients with
antiplatelet therapy: a systematic review and meta-analysis.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 58.
Date of Publication: December 2024.
Author
Tian L.; Li X.; He L.; Ji H.; Yao Y.
Institution
(Tian, Ji, Yao) Department of Anesthesiology, National Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing 100037, China
(Li, He) Department of Anesthesiology, Yunnan Fuwai Cardiovascular
Hospital, Kunming 650102, China
Publisher
BioMed Central Ltd
Abstract
Background: The purpose of the current study was to assess the efficacy of
tranexamic acid (TXA) on reducing bleeding in cardiac surgical patients
with preoperative antiplatelet therapy (APT). <br/>Method(s): Five
electronic databases were searched systematically for
randomized-controlled trials (RCTs) assessing the impact of intravenous
TXA on post-operative bleeding on cardiac surgical patients with
preoperative APT until May 2024. Primary outcome of interest was
post-operative blood loss. Secondary outcomes of interest included the
incidence of reoperation due to post-operative bleeding, post-operative
transfusion requirements of red blood cells (RBC), fresh-frozen plasma
(FFP), and platelet concentrates. Mean difference (MD) with 95% confidence
interval (CI) or odds ratios (OR) with 95% CI was employed to analyze the
data. Subgroup and meta-regression analyses were performed to assess the
possible influence of TXA administration on reducing bleeding and
transfusion requirements. <br/>Result(s): A total of 12 RCTs with 3018
adult cardiac surgical patients (TXA group, 1510 patients; Control group,
1508 patients) were included. The current study demonstrated that TXA
significantly reduced post-operative blood loss (MD = - 0.38 L, 95% CI: -
0.73 to - 0.03, P = 0.03; MD = - 0.26 L, 95% CI: - 0.28 to - 0.24, P <
0.00001; MD = - 0.37 L, 95% CI: - 0.63 to - 0.10, P = 0.007) in patients
receiving dual antiplatelet therapy (DAPT), aspirin, or clopidogrel,
respectively. Patients in TXA group had significantly lower incidence of
reoperation for bleeding as compared to those in Control group. The
post-operative transfusion of RBC and FFP requirements was significantly
lower in TXA group than Control group. Subgroup analyses showed that
studies with DAPT discontinued on the day of surgery significantly
increased the risk of post-operative blood loss [(MD: - 1.23 L; 95% CI: -
1.42 to - 1.04) vs. (MD: - 0.16 L; 95% CI: - 0.27 to - 0.05); P < 0.00001
for subgroup difference] and RBC transfusion [(MD: - 3.90 units; 95% CI: -
4.75 to - 3.05) vs. (MD: - 1.03 units; 95% CI: - 1.96 to - 0.10); P <
0.00001 for subgroup difference] than those with DAPT discontinued less
than 5-7 days preoperatively. <br/>Conclusion(s): This meta-analysis
demonstrated that TXA significantly reduced post-operative blood loss and
transfusion requirements for cardiac surgical patients with preoperative
APT. These potential clinical benefits may be greater in patients with
aspirin and clopidogrel continued closer to the day of surgery. Trial
registration number: CRD42022309427.<br/>Copyright &#xa9; The Author(s)
2024.

<61>
Accession Number
2030226541
Title
A 23-year bibliometric analysis of the development of global research on
hereditary renal carcinoma.
Source
Frontiers in Oncology. 14 (no pagination), 2024. Article Number: 1364997.
Date of Publication: 2024.
Author
Lan X.; Feng M.; Lv J.; Zhang L.; Hu P.; Wang Y.; Zhang Y.; Wang S.; Liu
C.
Institution
(Lan, Feng, Lv, Zhang, Hu, Wang, Zhang, Wang, Liu) Department of Urology,
Qingdao Central Hospital, University of Health and Rehabilitation
Sciences, Qingdao, China
(Liu) Institute of Biochemical Engineering, College of Materials Science
and Engineering Qingdao University, Qingdao, China
Publisher
Frontiers Media SA
Abstract
Objectives: Medical research continues to be extensively devoted to
investigating the pathogenesis and treatment approaches of hereditary
renal cancer. By aspect including researchers, institutions, countries,
journals, and keywords, we conduct a bibliometric analysis of the
literature pertaining to hereditary renal cancer over the last 23 years.
<br/>Method(s): From the Web of Science Core Collection, we conducted a
search for publications published between January 1, 2000 and November 28,
2023. Reviews and original articles were included. <br/>Result(s): A
cumulative count of 2,194 publications met the specified criteria for
inclusion. The studies of the included articles involved a collective of
2,402 institutions representing 80 countries. Notably, the United States
exhibited the highest number of published documents, constituting
approximately 45.49% of the total. The preeminent institution in this
discipline is the National Cancer Institute (NCI), which maintains a
publication volume of 8.98%. In addition to being the most prolific author
(125 publications), Linehan WM's works received the highest number of
citations (11,985). In a comprehensive count, 803 journals have published
related articles. In the top 10 most recent occurrences were the terms
"hereditary leiomyomatosis" and "fumarate hydratase." <br/>Conclusion(s):
This is the first bibliometric analysis of the literature on hereditary
renal cancer. This article offers a thorough examination of the present
status of investigations concerning hereditary renal cancer during the
previous 23 years.<br/>Copyright &#xa9; 2024 Lan, Feng, Lv, Zhang, Hu,
Wang, Zhang, Wang, Liu and Liu.

<62>
Accession Number
2030204230
Title
Harnessing the power of artificial intelligence in predicting all-cause
mortality in transcatheter aortic valve replacement: a systematic review
and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1343210. Date of Publication: 2024.
Author
Sazzad F.; Ler A.A.L.; Furqan M.S.; Tan L.K.Z.; Leo H.L.; Kuntjoro I.; Tay
E.; Kofidis T.
Institution
(Sazzad, Ler, Tan, Kofidis) Department of Surgery, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore, Singapore
(Furqan) Department of Biomedical Informatics, Yong Loo Lin School of
Medicine, National University of Singapore, Singapore, Singapore
(Leo) Department of Biomedical Engineering, College of Design and
Engineering, National University of Singapore, Singapore, Singapore
(Kuntjoro, Tay) Department of Cardiology, National University Heart
Centre, Singapore, National University Hospital, Singapore, Singapore
(Tay) Asian Heart & Vascular Centre (AHVC), Mount Elizabeth Medical
Centre, Singapore, Singapore
Publisher
Frontiers Media SA
Abstract
Objectives: In recent years, the use of artificial intelligence (AI)
models to generate individualised risk assessments and predict patient
outcomes post-Transcatheter Aortic Valve Implantation (TAVI) has been a
topic of increasing relevance in literature. This study aims to evaluate
the predictive accuracy of AI algorithms in forecasting post-TAVI
mortality as compared to traditional risk scores. <br/>Method(s):
Following the Preferred Reporting Items for Systematic Reviews and
Meta-analyses for Systematic Reviews (PRISMA) standard, a systematic
review was carried out. We searched four databases in total-PubMed,
Medline, Embase, and Cochrane-from 19 June 2023-24 June, 2023.
<br/>Result(s): From 2,239 identified records, 1,504 duplicates were
removed, 735 manuscripts were screened, and 10 studies were included in
our review. Our pooled analysis of 5 studies and 9,398 patients revealed a
significantly higher mean area under curve (AUC) associated with AI
mortality predictions than traditional score predictions (MD: -0.16, CI:
-0.22 to -0.10, p < 0.00001). Subgroup analyses of 30-day mortality (MD:
-0.08, CI: -0.13 to -0.03, p = 0.001) and 1-year mortality (MD: -0.18, CI:
-0.27 to -0.10, p < 0.0001) also showed significantly higher mean AUC with
AI predictions than traditional score predictions. Pooled mean AUC of all
10 studies and 22,933 patients was 0.79 [0.73, 0.85]. <br/>Conclusion(s):
AI models have a higher predictive accuracy as compared to traditional
risk scores in predicting post-TAVI mortality. Overall, this review
demonstrates the potential of AI in achieving personalised risk assessment
in TAVI patients. Registration and protocol: This systematic review and
meta-analysis was registered under the International Prospective Register
of Systematic Reviews (PROSPERO), under the registration name "All-Cause
Mortality in Transcatheter Aortic Valve Replacement Assessed by Artificial
Intelligence" and registration number CRD42023437705. A review protocol
was not prepared. There were no amendments to the information provided at
registration. Systematic Review Registration: https://www.crd.york.ac.uk/,
PROSPERO (CRD42023437705).<br/>Copyright 2024 Sazzad, Ler, Furqan, Tan,
Leo, Kuntjoro, Tay and Kofidis.

<63>
Accession Number
2029954853
Title
Five-Year Outcomes After Bicuspid Aortic Valve Replacement With a Novel
Tissue Bioprosthesis.
Source
Annals of Thoracic Surgery. 118(1) (pp 173-179), 2024. Date of
Publication: July 2024.
Author
Bavaria J.E.; Mumtaz M.A.; Griffith B.; Svensson L.G.; Pibarot P.; Borger
M.A.; Thourani V.H.; Blackstone E.H.; Puskas J.D.
Institution
(Bavaria) Department of Cardiovascular Surgery, Hospital of the University
of Pennsylvania, Philadelphia, Pennsylvania, United States
(Mumtaz) Department of Cardiovascular and Thoracic Surgery, UPMC Central
Pennsylvania, Harrisburg, Pennsylvania, United States
(Griffith) Department of Surgery, University of Maryland Medical Center,
Baltimore, Maryland, United States
(Svensson, Blackstone) Department of Thoracic and Cardiovascular Surgery,
Cleveland Clinic, Cleveland, Ohio, United States
(Pibarot) Department of Cardiology, Quebec Heart and Lung Institute, Laval
University, Quebec, Canada
(Borger) University Department of Cardiac Surgery, Heart Center Leipzig,
Leipzig, Germany
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, Georgia, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: This study investigated the safety and effectiveness of
surgical aortic valve replacement with RESILIA tissue (Edwards
Lifesciences) through 5 years in patients with native bicuspid aortic
valves. Outcomes were compared with those for patients with tricuspid
aortic valves. <br/>Method(s): Of 689 patients from the COMMENCE
(ProspeCtive, nOn-randoMized, MulticENter) trial who received the study
valve, 645 had documented native valve morphology and core
laboratory-evaluable echocardiograms from any postoperative visit, which
were used to model hemodynamic outcomes over 5 years. Linear mixed-effects
models were used to estimate longitudinal changes in mean gradient and
effective orifice area. <br/>Result(s): Patients with native bicuspid
aortic valves (n = 214) were more than a decade younger than those with
tricuspid aortic valves (n = 458; 59.8 +/- 12.4 years vs 70.2 +/- 9.5
years; P < .001). The bicuspid aortic valve cohort exhibited no structural
valve deterioration over 5 years, and rates of paravalvular leak and
transvalvular regurgitation were low (0.7% and 2.9%, respectively [all
mild] at 5 years). These outcomes mirrored those in patients with native
tricuspid aortic valves. The model-estimated postoperative mean gradient
and effective orifice area, as well as the rate of change of these
outcomes, adjusted for age, body surface area, and bioprosthesis size, did
not differ between the 2 cohorts. <br/>Conclusion(s): Among patients with
bicuspid aortic valves, RESILIA tissue valves demonstrated excellent
outcomes to 5 years, including no structural valve deterioration and very
low rates of paravalvular and transvalvular regurgitation. These results
are encouraging for RESILIA tissue durability in young
patients.<br/>Copyright &#xa9; 2024 The Authors

<64>
Accession Number
2029775007
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) (no pagination), 2024.
Article Number: e034401. Date of Publication: 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
(Minten, Otsuki, Takahashi, Fearon) Division of Cardiovascular Medicine,
Stanford University, Palo Alto, CA, United States
(Bennett, Dubois) Department of Cardiovascular Medicine, University
Hospitals Leuven (UZ Leuven), Leuven, Belgium
Publisher
American Heart Association Inc.
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. <br/>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.<br/>Copyright &#xa9; 2024 The
Authors.

<65>
Accession Number
2029730445
Title
Quantium Consciousness Index and Quantium Noxious Index in Ketamine
Subdose Administration Compared with Fentanyl and Midazolam in
Postoperative ICU Patients: A Prospective, Observational Study.
Source
Indian Journal of Critical Care Medicine. 28(6) (pp 581-586), 2024. Date
of Publication: 01 Jun 2024.
Author
Masharto A.R.; Lubis A.P.; Bangun C.G.; Wahyuni A.S.
Institution
(Masharto, Lubis, Bangun) Department of Anesthesiology and Intensive Care,
Faculty Medicine, Universitas Sumatera Utara, Medan, Indonesia
(Wahyuni) Department of Community Medicine, Faculty of Medicine,
Universitas Sumatera Utara, Medan, Indonesia
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Aims and background:In postoperative patients in the intensive care units
(ICUs), not only analgesics are needed but also sedation so that the
patient can remain calm during treatment, especially patients with
mechanical ventilation. By using the measurement parameters of the quantum
consciousness index (qCON) and quantum noxious index (qNOX) in measuring
the depth of sedation and adequacy of analgesics, the use of subdose
ketamine instead of fentanyl and midazolam as sedative, analgesic agents
can be performed as a new alternative to nociceptive monitoring methods
with more objective results. This study aims to obtain results of
comparing qCON and qNOX in postoperative patients by administering subdose
ketamine compared with a combination of fentanyl and midazolam in RSUP
Haji Adam Malik Medan. <br/>Material(s) and Method(s): A randomized
clinical trial with a double-blind approach has been used in this study. A
total of 44 experimental samples were gathered and randomly split into two
groups after meeting the criteria for inclusion. Group A administered a
ketamine subdose, whereas Group B administered a mixture of fentanyl and
midazolam. The research data obtained were tested using Statistical
Product and Science Service (SPSS). <br/>Result(s): There were differences
in the median, minimum, and maximum values of qCON and qNOX in the groups
given subdose ketamine and fentanyl and midazolam, but these were not
statistically significant (p > 0.05) at T0, T1, and T2.
<br/>Conclusion(s): Administering a subdose of ketamine can provide
sedation and analgesia comparable to fentanyl and midazolam.<br/>Copyright
&#xa9; The Author(s). 2024 Open Access.

<66>
Accession Number
2029043367
Title
Prognostic value of right ventricular free-wall longitudinal strain in
aortic stenosis: A systematic review and meta-analysis.
Source
Journal of Cardiology. 84(2) (pp 80-85), 2024. Date of Publication: August
2024.
Author
Lee C.-Y.; Nabeshima Y.; Kitano T.; Parasca C.A.; Calin A.; Popescu B.A.;
Takeuchi M.
Institution
(Lee) School of Medicine, National Taiwan University, Taipei, Taiwan
(Republic of China)
(Nabeshima) Department of Cardiology, Saga University, School of Medicine,
Saga, Japan
(Kitano) Second Department of Internal Medicine, University of
Occupational and Environmental Health, School of Medicine, Kitakyushu,
Japan
(Parasca, Calin, Popescu) Cardiothoracic Department, University of
Medicine and Pharmacy "Carol Davia", Bucharest, Romania
(Parasca, Calin, Popescu) Cardiology and Cardiovascular Surgery
Department, Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.
C. Iliescu", Bucharest, Romania
(Takeuchi) Department of Laboratory and Transfusion Medicine, Hospital of
University of Occupational and Environmental Health, Kitakyushu, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Assessment of right ventricular (RV) function in aortic
stenosis (AS) may improve risk stratification. However, whether the
prognostic value of RV free-wall longitudinal strain (RVfwLS) is better
than that of other right heart or pulmonary circulation parameters remains
uncertain. This study assessed and compared the prognostic value of RVfwLS
with traditional parameters in the AS population using a systematic review
and meta-analysis. <br/>Method(s): We selected studies reporting the
hazard ratio (HR) of RVfwLS in patients with AS. We also collected data
regarding the HR of systolic pulmonary arterial pressure (SPAP),
fractional area change (FAC), and tricuspid annulus plane systolic
excursion (TAPSE). To ensure comparability, we standardized the HR using
within-study standard deviations. The comparison between the prognostic
value of RVfwLS and other parameters was conducted as a ratio of HR.
<br/>Result(s): This meta-analysis included 9 studies comprising a total
of 2547 patients, with 679 events. The pooled HR of RVfwLS was 1.56 (95 %
CI: 1.39-1.75, p < 0.001). When examining the ratio of HR between RVfwLS
and conventional parameters, all comparisons were statistically
non-significant [RVfwLS/SPAP: 1.28 (95 % CI: 0.99-1.65, p = 0.06);
RVfwLS/FAC: 1.24 (95 % CI: 0.90-1.72, p = 0.14); and RVfwLS/TAPSE:1.07 (95
% CI: 0.75-1.52, p = 0.60)]. <br/>Conclusion(s): This meta-analysis
establishes a substantial association between RVfwLS and adverse outcomes
in the AS population. However, comparative analysis between RVfwLS and
SPAP, FAC, or TAPSE did not support the prognostic superiority of
RVfwLS.<br/>Copyright &#xa9; 2023 Elsevier Ltd

<67>
Accession Number
2027275404
Title
Treatment of hypoplastic left heart syndrome: A systematic review and
meta-analysis of randomised controlled trials.
Source
Cardiology in the Young. 34(3) (pp 659-666), 2024. Date of Publication: 19
Mar 2024.
Author
Kim A.Y.; Woo W.; Saxena A.; Tanidir I.C.; Yao A.; Kurniawati Y.; Thakur
V.; Shin Y.R.; Shin J.I.; Jung J.W.; Barron D.J.
Institution
(Kim, Jung) Division of Pediatric Cardiology, Department of Pediatrics,
Severance Cardiovascular Hospital, Yonsei University, College of Medicine,
KOR, Seoul, South Korea
(Kim, Jung) Department of Pediatrics, Yonsei University, College of
Medicine, Seoul, South Korea
(Woo) Department of Thoracic and Cardiovascular Surgery, Gangnam Severance
Hospital, Yonsei University, College of Medicine, Seoul, South Korea
(Saxena) Department of Cardiology, All India Institute of Medical
Sciences, New Delhi, India
(Tanidir) Department of Pediatric Cardiology, Basaksehir Cam and Sakura
City Hospital, Istanbul, Turkey
(Yao) Department of Health Service Promotion, University of Tokyo, Japan
(Kurniawati) Department of Pediatric Cardiology, National Cardiovascular
Center Harapan Kita, Jakarta, Indonesia
(Thakur, Shin) Department of Pediatrics, Labatt Family Heart Center, The
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
(Shin) Department of Cardiovascular Surgery, Yonsei University, College of
Medicine, Seoul, South Korea
(Shin) Severance Underwood Meta-research Center, Institute of Convergence
Science, Yonsei University, Seoul, South Korea
(Barron) Division of Cardiovascular Surgery, Department of Surgery, The
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Publisher
Cambridge University Press
Abstract
Background: This meta-analysis aimed to consolidate existing data from
randomised controlled trials on hypoplastic left heart syndrome.
<br/>Method(s): Hypoplastic left heart syndrome specific randomised
controlled trials published between January 2005 and September 2021 in
MEDLINE, EMBASE, and Cochrane databases were included. Regardless of
clinical outcomes, we included all randomised controlled trials about
hypoplastic left heart syndrome and categorised them according to their
results. Two reviewers independently assessed for eligibility, relevance,
and data extraction. The primary outcome was mortality after Norwood
surgery. Study quality and heterogeneity were assessed. A random-effects
model was used for analysis. <br/>Result(s): Of the 33 included randomised
controlled trials, 21 compared right ventricle-to-pulmonary artery shunt
and modified Blalock-Taussig-Thomas shunt during the Norwood procedure,
and 12 regarded medication, surgical strategy, cardiopulmonary bypass
tactics, and ICU management. Survival rates up to 1 year were superior in
the right ventricle-to-pulmonary artery shunt group; this difference began
to disappear at 3 years and remained unchanged until 6 years. The right
ventricle-to-pulmonary artery shunt group had a significantly higher
reintervention rate from the interstage to the 6-year follow-up period.
Right ventricular function was better in the modified
Blalock-Taussig-Thomas shunt group 1-3 years after the Norwood procedure,
but its superiority diminished in the 6-year follow-up. Randomised
controlled trials regarding medical treatment, surgical strategy during
cardiopulmonary bypass, and ICU management yielded insignificant results.
<br/>Conclusion(s): Although right ventricle-to-pulmonary artery shunt
appeared to be superior in the early period, the two shunts applied during
the Norwood procedure demonstrated comparable long-term prognosis despite
high reintervention rates in right ventricle-to-pulmonary artery shunt due
to pulmonary artery stenosis. For medical/perioperative management of
hypoplastic left heart syndrome, further randomised controlled trials are
needed to deliver specific evidence-based recommendations.<br/>Copyright
&#xa9; The Author(s), 2023. Published by Cambridge University Press.

<68>
Accession Number
2026735709
Title
Echocardiographic image collection and evaluation in infants with CHD:
Lessons learned from the imaging core lab for the Residual Lesion Score
study.
Source
Cardiology in the Young. 34(3) (pp 570-575), 2024. Date of Publication: 22
Mar 2024.
Author
Levine J.C.; Colan S.; Trachtenberg F.; Marcus E.; Ferguson M.; Parthiban
A.; Taylor C.; Dragulescu A.; Goot B.; Lacro R.V.; McFarland C.;
Narasimhan S.; O'Connor M.; Schamberger M.; Srivistava S.; Taylor M.;
Nathan M.
Institution
(Levine, Colan, Marcus, Nathan) Department Cardiology, Boston Children's
Hospital, Harvard Medical School, Boston, MA, United States
(Trachtenberg) Healthcore, Watertown, MA, United States
(Ferguson) Department of Pediatrics, Emory University, School of Medicine,
Atlanta, GA, United States
(Parthiban) Department of Pediatrics, Texas Children's Hospital, Baylor
College of Medicine, Houston, TX, United States
(Taylor) Department of Pediatrics, Medical University, South Carolina
Children's Hospital, Charleston, SC, United States
(Dragulescu) Department of Paediatrics, The Hospital for Sick Children,
University of Toronto, Toronto, ON, Canada
(Goot) Department of Pediatrics, Children's Wisconsin, Medical College of
Wisconsin, Milwaukee, WI, United States
(Lacro) Department Cardiology, Boston Children's Hospital, Boston, MA,
United States
(McFarland) Department of Pediatrics, Primary Children's Hospital,
University of Utah, Salt Lake City, UT, United States
(Narasimhan) Department of Pediatric Cardiology, Masonic Children's
Hospital, University of Minnesota, Minneapolis, MN, United States
(O'Connor) Department of Pediatrics, Children's Hospital of Philadelphia,
University of Pennsylvania, Philadelphia, PA, United States
(Schamberger) Department of Pediatrics, Riley Children's Hospital, Indiana
University, School of Medicine, Indianapolis, IN, United States
(Srivistava) Department of Pediatrics, Nemours/Alfred I. DuPont Hospital
for Children, Wilmington, DE, United States
(Taylor) Department of Pediatrics, Cincinnati Children's Medical Center,
University of Cincinnati, Cincinnati, OH, United States
Publisher
Cambridge University Press
Abstract
Many factors affect patient outcome after congenital heart surgery,
including the complexity of the heart disease, pre-operative status,
patient specific factors (prematurity, nutritional status and/or presence
of comorbid conditions or genetic syndromes), and post-operative residual
lesions. The Residual Lesion Score is a novel tool for assessing whether
specific residual cardiac lesions after surgery have a measurable impact
on outcome. The goal is to understand which residual lesions can be
tolerated and which should be addressed prior to leaving the operating
room. The Residual Lesion Score study is a large multicentre prospective
study designed to evaluate the association of Residual Lesion Score to
outcomes in infants undergoing surgery for CHD. This Pediatric Heart
Network and National Heart, Lung, and Blood Institute-funded study
prospectively enrolled 1,149 infants undergoing 5 different congenital
cardiac surgical repairs at 17 surgical centres. Given the contribution of
echocardiographic measurements in assigning the Residual Lesion Score, the
Residual Lesion Score study made use of a centralised core lab in addition
to site review of all data. The data collection plan was designed with the
added goal of collecting image quality information in a way that would
permit us to improve our understanding of the reproducibility,
variability, and feasibility of the echocardiographic measurements being
made. There were significant challenges along the way, including the
coordination, de-identification, storage, and interpretation of very large
quantities of imaging data. This necessitated the development of new
infrastructure and technology, as well as use of novel statistical
methods. The study was successfully completed, but the size and complexity
of the population being studied and the data being extracted required more
technologic and human resources than expected which impacted the length
and cost of conducting the study. This paper outlines the process of
designing and executing this complex protocol, some of the barriers to
implementation and lessons to be considered in the design of future
studies.<br/>Copyright &#xa9; The Author(s), 2023. Published by Cambridge
University Press.

<69>
Accession Number
2024958386
Title
Fetal cardiac intervention in hypoplastic left heart syndrome with intact
or restrictive atrial septum, systematic review, and meta-analysis.
Source
Prenatal Diagnosis. 44(6-7) (pp 747-757), 2024. Date of Publication: June
2024.
Author
Mustafa H.J.; Aghajani F.; Jawwad M.; Shah N.; Abuhamad A.; Khalil A.
Institution
(Mustafa) Division of Maternal-Fetal Medicine, Indiana University School
of Medicine, Indianapolis, IN, United States
(Mustafa) The Fetal Center at Riley Children's and Indiana University
Health, Indiana University School of Medicine, Indianapolis, IN, United
States
(Aghajani) BCNatal Fetal Medicine Research Center (Hospital Clinic and
Hospital Sant Joan de Deu), Universitat de Barcelona, Barcelona, Spain
(Jawwad) Department of Medicine and Surgery, Dow University of Health
Sciences, Karachi, Pakistan
(Shah) Department of Internal Medicine, College of Medical Sciences,
Bharatpur, Nepal
(Abuhamad) Division of Maternal-Fetal Medicine, Eastern Virginia Medical
School, Norfolk, VA, United States
(Khalil) Fetal Medicine Unit, St George's Hospital, St George's University
of London, London, United Kingdom
(Khalil) Vascular Biology Research Centre, Molecular and Clinical Sciences
Research Institute, St George's University of London, London, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
To investigate outcomes of fetuses with hypoplastic left heart syndrome
(HLHS) with an intact or restrictive atrial septum (I/RAS) managed
expectantly or with fetal atrial septal intervention (FASI PubMed, Scopus,
and Web of Science were searched systematically from inception until April
2023. Outcomes were classified by those who had FASI and those who had
expectant management (EM). To estimate the overall proportion of each
endpoint, a meta-analysis of proportions was employed using a
random-effects model. Heterogeneity was assessed using the I²
value. Thirty-two studies reporting on 746 fetuses with HLHS and I/RAS met
our inclusion criteria. Eleven studies (123 fetuses) were in the FASI
group and 21 studies (623 fetuses) were in the EM group. Among the 123
FASI cases, 107 (87%) were reported to be technically successful. The mean
gestational age (GA) at diagnosis was comparable between the groups (26.2
weeks FASI vs. 24.4 weeks EM group). The mean GA at FASI was 30.4 weeks
(95% CI 28.5, 32.5). The mean GA at delivery was also comparable (37.7
weeks FASI vs. 38.1 weeks EM group). Neonatal outcomes, including live
birth, neonatal death, and survival to hospital discharge pooled
proportions, were also comparable between groups (live birth: 92% (95% CI
64, 99) FASI versus 93% (95% CI 79, 98) in EM, neonatal death: 32% (95% CI
11, 65) FASI versus 30% (95% CI 21, 41) EM, survival to hospital
discharge: 37% (95% CI 25, 52) FASI versus 52% (95% CI 42, 61) EM). Age at
neonatal death was higher in the FASI group (mean: 17 days FASI vs. 7.2
days EM group). There was a lower rate of postnatal atrial restrictive
septum in the FASI group 38% (95% CI 17, 63) compared to the EM group 88%
(95% CI 57, 98). Our review shows variations across centers in the
selection criteria and techniques used for FASI. Although survival
including livebirth, neonatal death, and survival to hospital discharge
did not differ between groups, the procedure may translate into a less
restrictive septum at birth. Future multicenter studies are needed to
better identify the subset of cases that might have improved outcomes, use
standardized definitions, unified techniques, utilize core outcome set,
and assess long-term benefits.<br/>Copyright &#xa9; 2023 John Wiley & Sons
Ltd.

<70>
Accession Number
2032854968
Title
Povidone Iodine vs Chlorhexidine Gluconate in Alcohol for Preoperative
Skin Antisepsis: A Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
Widmer A.F.; Atkinson A.; Kuster S.P.; Wolfensberger A.; Klimke S.;
Sommerstein R.; Eckstein F.S.; Schoenhoff F.; Beldi G.; Gutschow C.A.;
Marschall J.; Schweiger A.; Jent P.
Institution
(Widmer, Klimke) Division of Infectious Diseases and Hospital
Epidemiology, University Hospital Basel, University of Basel, Basel,
Switzerland
(Atkinson) Pediatric Research Centre, University Children's Hospital
Basel, Basel, Switzerland
(Atkinson, Marschall) Division of Infectious Diseases, Department of
Internal Medicine, Washington University, School of Medicine in St. Louis,
St Louis, MO, United States
(Kuster, Wolfensberger) Department of Infectious Diseases and Hospital
Epidemiology, University Hospital Zurich, University of Zurich, Zurich,
Switzerland
(Sommerstein, Marschall, Jent) Department of Infectious Diseases,
Inselspital Bern University Hospital, University of Bern, Bern,
Switzerland
(Sommerstein) Department of Health Science and Medicine, University of
Lucerne, Lucerne, Switzerland
(Eckstein) Department of Cardiac Surgery, University Hospital Basel,
University of Basel, Basel, Switzerland
(Schoenhoff) Department of Cardiac Surgery, Inselspital Bern University
Hospital, University of Bern, Bern, Switzerland
(Beldi) Department of Visceral Surgery and Medicine, Inselspital Bern
University Hospital, University of Bern, Bern, Switzerland
(Gutschow) Department of Visceral and Transplantation Surgery, University
Hospital Zurich, University of Zurich, Zurich, Switzerland
(Schweiger) Division of Internal Medicine, Cantonal Hospital Zug, Baar,
Switzerland
Publisher
American Medical Association
Abstract
Importance: Preoperative skin antisepsis is an established procedure to
prevent surgical site infections (SSIs). The choice of antiseptic agent,
povidone iodine or chlorhexidine gluconate, remains debated.
<br/>Objective(s): To determine whether povidone iodine in alcohol is
noninferior to chlorhexidine gluconate in alcohol to prevent SSIs after
cardiac or abdominal surgery. <br/>Design, Setting, and Participant(s):
Multicenter, cluster-randomized, investigator-masked, crossover,
noninferiority trial; 4403 patients undergoing cardiac or abdominal
surgery in 3 tertiary care hospitals in Switzerland between September 2018
and March 2020 were assessed and 3360 patients were enrolled (cardiac, n =
2187 [65%]; abdominal, n = 1173 [35%]). The last follow-up was on July 1,
2020. <br/>Intervention(s): Over 18 consecutive months, study sites were
randomly assigned each month to either use povidone iodine or
chlorhexidine gluconate, each formulated in alcohol. Disinfectants and
skin application processes were standardized and followed published
protocols. <br/>Main Outcomes and Measures: Primary outcome was SSI within
30 days after abdominal surgery and within 1 year after cardiac surgery,
using definitions from the US Centers for Disease Control and Prevention's
National Healthcare Safety Network. A noninferiority margin of 2.5% was
used. Secondary outcomes included SSIs stratified by depth of infection
and type of surgery. <br/>Result(s): A total of 1598 patients (26 cluster
periods) were randomly assigned to receive povidone iodine vs 1762
patients (26 cluster periods) to chlorhexidine gluconate. Mean (SD) age of
patients was 65.0 years (39.0-79.0) in the povidone iodine group and 65.0
years (41.0-78.0) in the chlorhexidine gluconate group. Patients were
32.7% and 33.9% female in the povidone iodine and chlorhexidine gluconate
groups, respectively. SSIs were identified in 80 patients (5.1%) in the
povidone iodine group vs 97 (5.5%) in the chlorhexidine gluconate group, a
difference of 0.4% (95% CI, -1.1% to 2.0%) with the lower limit of the CI
not exceeding the predefined noninferiority margin of -2.5%; results were
similar when corrected for clustering. The unadjusted relative risk for
povidone iodine vs chlorhexidine gluconate was 0.92 (95% CI, 0.69-1.23).
Nonsignificant differences were observed following stratification by type
of surgical procedure. In cardiac surgery, SSIs were present in 4.2% of
patients with povidone iodine vs 3.3% with chlorhexidine gluconate
(relative risk, 1.26 [95% CI, 0.82-1.94]); in abdominal surgery, SSIs were
present in 6.8% with povidone iodine vs 9.9% with chlorhexidine gluconate
(relative risk, 0.69 [95% CI, 0.46-1.02]). <br/>Conclusions and Relevance:
Povidone iodine in alcohol as preoperative skin antisepsis was noninferior
to chlorhexidine gluconate in alcohol in preventing SSIs after cardiac or
abdominal surgery. Trial Registration: ClinicalTrials.gov Identifier:
NCT03685604.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<71>
Accession Number
644523219
Title
Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects:
A Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 13(12) (pp e033686), 2024. Date
of Publication: 18 Jun 2024.
Author
El-Andari R.; Moolla M.; John K.; Slingerland A.; Campbell S.; Nagendran
J.; Hong Y.; Mathew A.
Institution
(El-Andari, Nagendran, Hong) Division of Cardiac Surgery, Department of
Surgery, Mazankowski Alberta Heart Institute University of Alberta
Edmonton Alberta Canada, Canada
(Moolla, Mathew) Division of Cardiology, Department of Medicine,
Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta
Canada, Canada
(John) Division of Internal Medicine, Department of Medicine Tufts
University Medford MA USA
(Slingerland) Faculty of Medicine and Dentistry University of Alberta
Edmonton Alberta Canada, Canada
(Campbell) University of Alberta Library Edmonton Alberta Canada, Canada
Abstract
BACKGROUND: Sinus venosus atrial septal defect (SVASD) is a rare
congenital cardiac anomaly comprising 5% to 10% of all atrial septal
defects. Although surgical closure is the standard treatment for SVASD,
data on outcomes have been confined to small cohorts. Thus, we conducted a
systematic review of the outcomes of SVASD repair. METHODS AND RESULTS:
The primary outcome was death. Secondary outcomes encompassed atrial
fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular
accident, reoperation, residual septal defect, superior vena cava
obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences
of outcomes were calculated using a random-effects model. Forty studies
involving 1320 patients who underwent SVASD repair were included. The
majority were male patients (55.4%), with 88.0% presenting with associated
anomalous pulmonary venous connection. The weighted mean age was
18.6+/-12.5years, and the overall weighted mean follow-up period was
8.6+/-10.4years. The in-hospital mortality rate was 0.24%, with a 30-day
mortality rate of 0.5% reported in 780 patients. Incidences of atrial
fibrillation, sinus node dysfunction, pacemaker insertion, and
cerebrovascular accident over the long-term follow-up were 3.3%
(2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03%
(0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of
surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena
cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein
obstruction in 1.4% (0.7%-2.49%). <br/>CONCLUSION(S): This is the first
comprehensive analysis of outcomes following surgical repair of SVASD. The
findings affirm the safety and effectiveness of surgery, establishing a
reference point for evaluating emerging transcatheter therapies. Safety
and efficacy profiles comparable to surgical repair are essential for
widespread adoption of transcatheter treatments.

<72>
[Use Link to view the full text]
Accession Number
2032859131
Title
Loss-of-Resistance Versus Dynamic Pressure-Sensing Technology for
Successful Placement of Thoracic Epidural Catheters: A Randomized Clinical
Trial.
Source
Anesthesia and Analgesia. 139(1) (pp 201-210), 2024. Date of Publication:
01 Jul 2024.
Author
Ranganath Y.S.; Ramanujam V.; Al-Hassan Q.; Sibenaller Z.; Seering M.S.;
Singh T.S.S.; Punia S.; Parra M.C.; Wong C.A.; Sondekoppam R.V.
Institution
(Ranganath) Department of Anesthesia, Indiana University School of
Medicine, Indianapolis, IN, United States
(Ramanujam) Department of Anesthesiology, Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Al-Hassan) Almoosa Specialist Hospital Al-Mubarraz, Saudi Arabia
(Sibenaller, Seering, Singh, Punia, Parra, Wong, Sondekoppam) Department
of Anesthesia, University of Iowa Carver College of Medicine, Iowa City,
IA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The traditional loss-of-resistance (LOR) technique for
thoracic epidural catheter placement can be associated with a high primary
failure rate. In this study, we compared the traditional LOR technique and
dynamic pressure-sensing (DPS) technology for primary success rate and
secondary outcomes pertinent to identifying the thoracic epidural space.
<br/>METHOD(S): This pragmatic, randomized, patient- and assessor-blinded
superiority trial enrolled patients ages 18 to 75 years, scheduled for
major thoracic or abdominal surgeries at a tertiary care teaching
hospital. Anesthesiology trainees (residents and fellows) placed thoracic
epidural catheters under faculty supervision and rescue. The primary
outcome was the success rate of thoracic epidural catheter placement,
evaluated by the loss of cold sensation in the thoracic dermatomes 20
minutes after injecting the epidural test dose. Secondary outcomes
included procedural time, ease of catheter placement, the presence of a
positive falling meniscus sign, early hemodynamic changes, and unintended
dural punctures. Additionally, we explored outcomes that included number
of attempts, needle depth to epidural space, need for faculty to rescue
the procedure from the trainee, patient-rated procedural discomfort, pain
at the epidural insertion site, postoperative pain scores, and opioid
consumption over 48 hours. <br/>RESULT(S): Between March 2019 and June
2020, 133 patients were enrolled; 117 were included in the final analysis
(n = 57 for the LOR group; n = 60 for the DPS group). The primary success
rate of epidural catheter placement was 91.2% (52 of 57) in the LOR group
and 96.7% (58 of 60) in the DPS group (95% confidence interval [CI] of
difference in proportions: -0.054 [-0.14 to 0.03]; P =.264). No difference
was observed in procedural time between the 2 groups (median interquartile
range [IQR] in minutes: LOR 5.0 [7.0], DPS 5.5 [7.0]; P =.982). The number
of patients with epidural analgesia onset at 10 minutes was 49.1% (28 of
57) in the LOR group compared to 31.7% (19 of 60) in the DPS group (P
=.062). There were 2 cases of unintended dural punctures in each group.
Other secondary or exploratory outcomes were not significantly different
between the groups. <br/>CONCLUSION(S): Our trial did not establish the
superiority of the DPS technique over the traditional LOR method for
identifying the thoracic epidural space (Clinicaltrials.gov identifier:
NCT03826186).<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<73>
[Use Link to view the full text]
Accession Number
2032859119
Title
Esketamine: Less Drowsiness, More Analgesia.
Source
Anesthesia and Analgesia. 139(1) (pp 78-91), 2024. Date of Publication: 01
Jul 2024.
Author
Mion G.; Himmelseher S.
Institution
(Mion) Department of Anesthesia, Intensive Care and Perioperative
Medicine, Ghu AP-HP Centre, Universite Paris - Cite, Cochin Hospital,
Paris, France
(Himmelseher) Department of Anesthesiology and Intensive Care Medicine,
Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Racemic ketamine is a 1:1 mixture of 2 enantiomers that turn light in
opposite direction: Dextrorotatory esketamine is approximately 4 times
more affine for the N-methyl-D-aspartate (NMDA) receptor than levorotatory
arketamine, which may explain why esketamine is about twice as potent as
an analgesic and anesthetic as the racemate. Esketamine has attracted
renewed interest in view of the opioid crisis, racemic ketamine's abuse,
and esketamine's approval for expanded use. We evaluated the anesthesia
literature concerning mental, cardiovascular, cerebral, and
antinociceptive effects of esketamine published in English between 1980
and 2022. The review shows that esketamine and racemic ketamine are not
"the same" at clinically equivalent analgesic and anesthetic dose:
Psychomimetic effects seem to be essentially related to NMDA receptor
blockade and esketamine is not devoid of unwanted mental impact. However,
it probably involves less cholinergic inhibition. Cognitive disturbances
during arousal, awakening, and recovery from the drug are less, and less
pronounced with esketamine. The drug allows for an approximately 50% dose
reduction in anesthesia and analgesia which goes along with a higher
clearance and shorter recovery time as compared to racemic ketamine. In
comparison of esketamine with placebo, esketamine shows cardiocirculatory
stabilizing and neuroprotective effects which can be seen in anesthesia
induction, cardiac surgery, and analgesia and sedation in brain injury.
Evidence of esketamine's antinociceptive efficacy is inconsistent,
although a recent meta-analysis reports improved pain relief after surgery
in a study with short observation time. To better define esketamine's
place, direct head-to-head comparison with the racemate at
equi-analgesic/anesthetic dose is warranted.<br/>Copyright &#xa9; 2024
Lippincott Williams and Wilkins. All rights reserved.

<74>
[Use Link to view the full text]
Accession Number
2032859118
Title
Associations Between Nonanemic Iron Deficiency and Postoperative Outcomes
in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Anesthesia and Analgesia. 139(1) (pp 47-57), 2024. Date of Publication: 01
Jul 2024.
Author
Peri V.; Devlin P.; Perry L.; Richards T.; Miles L.F.
Institution
(Peri, Devlin, Miles) Department of Anaesthesia, Austin Health, Melbourne,
Australia
(Perry, Miles) Department of Critical Care, Melbourne Medical School, The
University of Melbourne, Melbourne, Australia
(Richards) Department of Anaesthesiology and Perioperative Medicine,
Central Clinical School, Monash University, Melbourne, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Preoperative screening for iron deficiency is a part of
patient blood management protocols. This systematic review, meta-analysis,
and meta-regression reviews the association between nonanemic iron
deficiency and postoperative outcomes in patients undergoing cardiac
surgery. We aimed to determine whether preoperative screening for
nonanemic iron deficiency should be recommended in patients undergoing
cardiac surgery. <br/>METHOD(S): Electronic databases MEDLINE (Ovid),
Embase (Ovid), and Scopus were searched from inception until December 9,
2022. Studies were considered for inclusion if they (1) used an
observational study design; (2) enrolled adult patients undergoing cardiac
surgery; and (3) included an iron-deficient and iron-replete group,
defined using serum ferritin and/or transferrin saturation. The primary
outcome was the length of acute hospital stay. Secondary outcomes included
length of intensive care unit stay, requirement for allogeneic red blood
cell transfusion, number of red blood cell units transfused, days alive
and at home at postoperative days 30 and 90, all-cause postoperative
complications, postoperative infection, mortality, and hospital
readmission. Meta-regression was performed to assess the effects of study
and patient-level factors on the associations between nonanemic iron
deficiency and specific outcomes. Individual study quality was assessed
using the Risk of Bias in Non-Randomized Studies of Exposures (ROBINS-E)
tool. The Grading of Recommendations, Assessment, Development, and
Evaluations (GRADE) framework was used to determine the quality of
evidence for each outcome. <br/>RESULT(S): Eight studies (2683 patients)
were included. No significant association was observed between nonanemic
iron deficiency and any of the primary or secondary outcomes except for an
increased requirement for allogeneic red blood cell transfusion (odds
ratio [OR], 1.39 [95% confidence interval, CI, 1.16-1.68; P <.001;
I² 2.8%]). Meta-regression did not identify any potential
sources of heterogeneity to explain variation in individual study results.
The quality of evidence was rated as "low" or "very low" for all outcomes.
<br/>CONCLUSION(S): Few high-quality studies are available to assess
associations between nonanemic iron deficiency and outcomes after cardiac
surgery. Acknowledging these limitations, the presence of preoperative
nonanemic iron deficiency was not associated with a change in the primary
outcome of length of hospital stay, or any patient-centered secondary
outcome compared to those without iron deficiency. There was an
association with increased requirement for allogeneic red blood cell
transfusion, but this did not impact the reported patient-centered
outcomes.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<75>
Accession Number
2032843253
Title
Pilot study to evaluate the use of remote patient monitoring to guide the
timing of valve intervention in patients with severe asymptomatic aortic
stenosis (APRAISE-AS): study protocol for a randomised controlled trial
delivered in two tertiary cardiac centres in the UK.
Source
BMJ Open. 14(6) (no pagination), 2024. Article Number: e086587. Date of
Publication: 10 Jun 2024.
Author
Khan N.; Steeds R.P.; Kyte D.; Fabritz L.; Collis P.; Chua W.; Stubbs C.;
Mehta S.; Sun Y.; Nulty M.; Kirkham K.; Cotton J.M.
Institution
(Khan, Steeds, Fabritz, Chua) Department of Cardiology (QEHB), University
Hospitals Birmingham Nhs Foundation Trust, Birmingham, United Kingdom
(Khan, Steeds, Collis) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Kyte) School of Allied Health and Community, University of Worcester,
Worcester, United Kingdom
(Kyte) Centre for Patient Reported Outcomes Research, Institute for
Applied Health Research, University of Birmingham, Birmingham, United
Kingdom
(Fabritz) University Center of Cardiovascular Sciences, Department of
Cardiology, University Heart and Vascular Center, University Hospital
Hamburg Eppendorf, Hamburg, Germany
(Stubbs, Mehta, Sun, Nulty, Kirkham) Birmingham Clinical Trials Unit,
Institute for Applied Health Research, University of Birmingham,
Birmingham, United Kingdom
(Cotton) Department of Cardiology, The Royal Wolverhampton Hospitals Nhs
Trust, Wolverhampton, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Aortic stenosis (AS) is common affecting >13% of adults over
the age of 75 years. In people who develop symptoms, without valve
replacement, prognosis is dismal with mortality as high as 50% at 1 year.
In asymptomatic patients, the timing of valve intervention is less well
defined and a strategy of watchful waiting is recommended. Many, however,
may develop symptoms and attribute this to age related decline, rather
than worsening AS. Timely intervention in asymptomatic severe AS is
critical, since delayed intervention often results in poor outcomes.
Proactive surveillance of symptoms, quality of life and functional
capacity should enable timely identification of people who will benefit
from aortic valve replacement. There are no data however, to support the
clinical and cost effectiveness of such an approach in a healthcare
setting in the UK. The aim of this pilot trial is to test the feasibility
of a full-scale randomised controlled trial (RCT) to determine the utility
of proactive surveillance in people with asymptomatic severe AS to guide
the timing of intervention. Methods and analysis APRAISE-AS is a
multi-centre, non-blinded, two-arm, parallel group randomised controlled
trial of up to 66 participants aged >18 years with asymptomatic severe AS.
Participants will be randomised to either standard care or standard care
supplemented with the APRAISE-AS intervention. Primary outcomes will
capture; adherence to and participant acceptability of the intervention,
recruitment and retention rates, and completeness of data collection. The
findings will be used to inform the sample size and most appropriate
outcome measure(s) for a full-scale RCT and health economic evaluation.
Ethics and dissemination Ethical approval was granted by the Black Country
REC, reference: 22/WM/0214. Results will be submitted for publication in
peer-reviewed journals and disseminated at local, regional and national
meetings where appropriate. Trial registration number ISRCTN19413194
registered on 14.07.2023.<br/>Copyright &#xa9; 2024 BMJ Publishing Group.
All rights reserved.

<76>
Accession Number
2032854881
Title
Rectus sheath block added to parasternal block may improve postoperative
pain control and respiratory performance after cardiac surgery: a
superiority single-blinded randomized controlled clinical trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Strumia A.; Pascarella G.; Sarubbi D.; Di Pumpo A.; Costa F.; Conti M.C.;
Rizzo S.; Stifano M.; Mortini L.; Cassibba A.; Schiavoni L.; Mattei A.;
Ruggiero A.; Agro F.E.; Carassiti M.; Cataldo R.
Institution
(Strumia, Pascarella, Sarubbi, Di Pumpo, Costa, Conti, Rizzo, Stifano,
Mortini, Schiavoni, Mattei, Agro, Carassiti, Cataldo) Operative Research
Unit of Anesthesia and Intensive Care, Fondazione Policlinico
Universitario Campus Bio-Medico, Roma, Italy
(Cassibba, Ruggiero, Agro, Carassiti, Cataldo) Research Unit of
Anaesthesia and Intensive Care, Department of Medicine, Campus Bio-Medico
University, Roma, Italy
Publisher
BMJ Publishing Group
Abstract
Background: The population undergoing cardiac surgery confronts challenges
from uncontrolled post-sternotomy pain, with possible adverse effects on
outcome. While the parasternal block can improve analgesia, its coverage
may be insufficient to cover epigastric area. In this non-blinded
randomized controlled study, we evaluated the analgesic and respiratory
effect of adding a rectus sheath block to a parasternal block.
<br/>Method(s): 58 patients undergoing cardiac surgery via median
sternotomy were randomly assigned to receive parasternal block with rectus
sheath block (experimental) or parasternal block with epigastric exit
sites of chest drains receiving surgical infiltration of local anesthetic
(control). The primary outcome of this study was pain at rest at
extubation. We also assessed pain scores at rest and during respiratory
exercises, opiate consumption and respiratory performance during the first
24 hours after extubation. <br/>Result(s): The median (IQR) maximum pain
scores (on a 0-10 Numeric Rate Scale (NRS)) at extubation were 4 (4, 4) in
the rectus sheath group and 5 (4, 5) in the control group (difference 1, p
value=0.03). Rectus sheath block reduced opioid utilization by 2 mg over
24 hours (IC 95% 0.0 to 2.0; p<0.01), reduced NRS scores at other time
points, and improved respiratory performance at 6, 12, and 24 hours after
extubation. <br/>Conclusion(s): The addition of a rectus sheath block with
a parasternal block improves analgesia for cardiac surgery requiring chest
drains emerging in the epigastric area. Trial registration number:
NCT05764616. <br/>Copyright &#xa9; American Society of Regional Anesthesia
& Pain Medicine 2024. No commercial re-use. See rights and permissions.
Published by BMJ.

<77>
Accession Number
2030225841
Title
The emerging role of robotics in plastic and reconstructive surgery: a
systematic review and meta-analysis.
Source
Journal of Robotic Surgery. 18(1) (no pagination), 2024. Article Number:
254. Date of Publication: December 2024.
Author
Awad L.; Reed B.; Bollen E.; Langridge B.J.; Jasionowska S.; Butler
P.E.M.; Ponniah A.
Institution
(Awad, Reed, Bollen, Langridge, Jasionowska, Butler, Ponniah) Charles
Wolfson Centre of Reconstructive Surgery, University College London, Royal
Free Hospital, London, United Kingdom
(Awad, Reed, Langridge, Jasionowska, Butler, Ponniah) Department of
Plastic Surgery, Royal Free Hospital, London, United Kingdom
(Awad, Langridge, Butler) Department of Surgery and Interventional
Sciences, University College London, Royal Free Hospital, London, United
Kingdom
Publisher
Springer Nature
Abstract
The role of robotics has grown exponentially. There is an active interest
amongst practitioners in the transferability of the potential benefits
into plastic and reconstructive surgery; however, many plastic surgeons
report lack of widespread implementation, training, or clinical exposure.
We report the current evidence base, and surgical opportunities, alongside
key barriers, and limitations to overcome, to develop the use of robotics
within the field. This systematic review of PubMed, Medline, and Embase
has been conducted in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PROSPERO (ID: CRD42024524237).
Preclinical, educational, and clinical articles were included, within the
scope of plastic and reconstructive surgery. 2, 181, articles were
screened; 176 articles met the inclusion criteria across lymph node
dissection, flap and microsurgery, vaginoplasty, craniofacial
reconstruction, abdominal wall reconstruction and transoral robotic
surgery (TOR). A number of benefits have been reported including technical
advantages such as better visualisation, improved precision and accuracy,
and tremor reduction. Patient benefits include lower rate of complications
and quicker recovery; however, there is a longer operative duration in
some categories. Cost presents a significant barrier to implementation.
Robotic surgery presents an exciting opportunity to improve patient
outcomes and surgical ease of use, with feasibility for many
subspecialities demonstrated in this review. However, further higher
quality comparative research with careful case selection, which is
adequately powered, as well as the inclusion of cost-analysis, is
necessary to fully understand the true benefit for patient care, and
justification for resource utilisation.<br/>Copyright &#xa9; Crown 2024.

<78>
Accession Number
2029730222
Title
Comparison of effects of telmisartan versus valsartan on post-induction
hypotension during noncardiac surgery: a prospective observational study.
Source
Korean Journal of Anesthesiology. 77(3) (pp 335-344), 2024. Date of
Publication: Jun 2024.
Author
Oh C.-S.; Park J.Y.; Kim S.-H.
Institution
(Oh, Park, Kim) Department of Anesthesiology and Pain Medicine, Konkuk
University Medical Center, Seoul, South Korea
(Oh, Kim) Institute of Biomedical Science and Technology, Konkuk
University School of Medicine, Seoul, South Korea
(Kim) Department of Medical Education, Konkuk University School of
Medicine, Seoul, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Telmisartan is considered more potent than valsartan.
Hemodynamic response during anesthesia induction may be influenced by
anti-hypertension (HTN) medication. The present study compared the effect
of anti-HTN medications on post-induction hypotension during noncardiac
surgeries. <br/>Method(s): This observational study standardized the
anesthetic regimen across patients, with hypotension defined as mean blood
pressure (BP) of less than 65 mmHg. The hemodynamic changes within 5 min
before and after endotracheal intubation, and within 10 min before and
after surgical incision were measured. Transthoracic echocardiographic
evaluation of the left ventricle (LV) during anesthesia induction was
performed. The primary endpoint was the decline in mean BP after
anesthetic administration in telmisartan and valsartan groups.
Multivariate logistic regression analysis was used to identify predictors
of post-induction hypotension. <br/>Result(s): Data from 157 patients
undergoing noncardiac surgery were analyzed. No significant differences
were found in mean BP decline between the two groups during anesthesia
induction. Hemodynamic changes and LV ejection fraction (EF) during
anesthesia induction were similar between the groups. Age and preoperative
initial mean BP in operation room (OR) were associated with post-induction
hypotension in both groups. <br/>Conclusion(s): The angiotensin receptor
blocker (ARB) type did not influence post-induction hypotension during
anesthesia induction. Age and preoperative initial mean BP in OR were
associated with post-induction hypotension in patients taking
ARBs.<br/>Copyright &#xa9; The Korean Society of Anesthesiologists, 2024.

<79>
[Use Link to view the full text]
Accession Number
2032708728
Title
Global research progress on radiofrequency ablation in cardiology: A
bibliometric analysis (2004-2023).
Source
Medicine (United States). 103(23) (pp e38498), 2024. Date of Publication:
07 Jun 2024.
Author
Liang M.; Zhang J.; Li G.; Wang P.
Institution
(Liang, Wang) Department of Cardiology, Yuxi People's Hospital, Yuxi City,
China
(Zhang) Department of Emergency, First People's Hospital of Yunnan
Province, China
(Li) Department of Cardiology, Zhongshan Hospital, Yunnan Province, Yuxi
City, China
Publisher
Lippincott Williams and Wilkins
Abstract
In recent years, significant advancements in radiofrequency ablation
technology have notably enhanced arrhythmia treatment in cardiology.
Technological advancements and increasing clinical adoption have made
radiofrequency ablation a key therapy in improving life quality for
patients with conditions like atrial fibrillation (AF). Consequently,
there has been a marked increase in research output, underscoring the
technology's significance and its potential in cardiology. Aims to
comprehensively analyze cardiology's radiofrequency ablation research
trends, identifying leading countries and institutions in international
collaborations, key researchers' contributions, and evolving research
hotspots. The study, based on the Web of Science Core Collection database,
reviewed the literatures from 2004 to 2023. CiteSpace 6.2.R7 Basic was
used for bibliometric analysis, which examined annual publication trends,
international collaboration networks, key authors, leading research
institutions, major journals, keyword co-occurrence and clustering trends.
Analyzing 3423 relevant articles, this study reveals a consistent growth
in cardiology radiofrequency ablation research since 2004. The analysis
shows that the United States, Germany, and France hold central roles in
the international collaboration network, with leading authors from premier
US and European institutions. Keyword cluster analysis identifies "atrial
flutter" and "ventricular tachycardia" as current research focal points.
Cardiology radiofrequency ablation research shows a growth trend, led by
the United States and European countries. Research hotspots are
concentrated on the diverse applications of radiofrequency ablation
technology and the treatment of AF. Future studies may increasingly focus
on technological innovation and the deepening of clinical
applications.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<80>
Accession Number
2032072257
Title
Safety and efficacy of protamine in the reversal of heparin in
transcatheter aortic valve replacement.
Source
Journal of Cardiology. 84(2) (pp 143-145), 2024. Date of Publication:
August 2024.
Author
Lee P.Y.; Viswanathan R.; Chaudhry T.; Hossain A.; Lee T.; Sharma A.;
Allencherril J.
Institution
(Lee, Viswanathan, Chaudhry, Lee) Department of Medicine, Rutgers New
Jersey Medical School, Newark, NJ, United States
(Hossain, Sharma) Division of Cardiology, Rutgers New Jersey Medical
School, Newark, NJ, United States
(Allencherril) Department of Medicine, University of Texas Medical Branch,
Galveston, TX, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)

<81>
Accession Number
2030181030
Title
Impact of telemedical management on hospitalization and mortality in heart
failure patients with diabetes: a post-hoc subgroup analysis of the
TIM-HF2 trial.
Source
Cardiovascular Diabetology. 23(1) (no pagination), 2024. Article Number:
198. Date of Publication: December 2024.
Author
Koehler F.; Koehler J.; Bramlage P.; Vettorazzi E.; Wegscheider K.; Lezius
S.; Spethmann S.; Iakoubov R.; Vijayan A.; Winkler S.; Melzer C.; Schutt
K.; Dessapt-Baradez C.; Paar W.; Koehler K.; Muller-Wieland D.
Institution
(Koehler, Melzer, Koehler) Centre for Cardiovascular Telemedicine,
Deutsches Herzzentrum der Charite (DHZC), Chariteplatz 1, Berlin 10117,
Germany
(Koehler, Spethmann, Melzer, Koehler) Charite - Universitatsmedizin
Berlin, Corporate member of Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Berlin, Germany
(Koehler) German Centre for Cardiovascular Research (DZHK), Partner Site,
Berlin, Germany
(Koehler, Iakoubov) Department of Internal Medicine II, School of
Medicine, University Hospital Rechts der Isar, Technical University of
Munich, Munich, Germany
(Bramlage, Vijayan) Institute for Pharmacology and Preventive Medicine,
Cloppenburg, Germany
(Vettorazzi, Wegscheider, Lezius) Institute of Medical Biometry and
Epidemiology, Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
(Spethmann) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Chariteplatz 1, Berlin 10117,
Germany
(Winkler) Clinic for Internal Medicine and Cardiology, BG Klinikum
Unfallkrankenhaus Berlin, Berlin, Germany
(Schutt, Muller-Wieland) Department of Internal Medicine I, RWTH Aachen
University Hospital, Aachen, Germany
(Dessapt-Baradez) Sanofi, Reading, United Kingdom
(Paar) Sanofi-Aventis Deutschland GmbH, Berlin, Germany
Publisher
BioMed Central Ltd
Abstract
Background: The TIM-HF2 study demonstrated that remote patient management
(RPM) in a well-defined heart failure (HF) population reduced the
percentage of days lost due to unplanned cardiovascular hospital
admissions or all-cause death during 1-year follow-up (hazard ratio 0.80)
and all-cause mortality alone (HR 0.70). Higher rates of hospital
admissions and mortality have been reported in HF patients with diabetes
compared with HF patients without diabetes. Therefore, in a post-hoc
analysis of the TIM-HF2 study, we investigated the efficacy of RPM in HF
patients with diabetes. <br/>Method(s): TIM-HF2 study was a randomized,
controlled, unmasked (concealed randomization), multicentre trial,
performed in Germany between August 2013 and May 2018. HF-Patients in NYHA
class II/III who had a HF-related hospital admission within the previous
12 months, irrespective of left ventricular ejection fraction, and were
randomized to usual care with or without added RPM and followed for 1
year. The primary endpoint was days lost due to unplanned cardiovascular
hospitalization or due to death of any cause. This post-hoc analysis
included 707 HF patients with diabetes. <br/>Result(s): In HF patients
with diabetes, RPM reduced the percentage of days lost due to
cardiovascular hospitalization or death compared with usual care (HR 0.66,
95% CI 0.48-0.90), and the rate of all-cause mortality alone (HR 0.52, 95%
CI 0.32-0.85). RPM was also associated with an improvement in quality of
life (mean difference in change in global score of Minnesota Living with
Heart Failure Questionnaire score (MLHFQ): - 3.4, 95% CI - 6.2 to - 0.6).
<br/>Conclusion(s): These results support the use of RPM in HF patients
with diabetes. Clinical trial registration: ClinicalTrials.gov
NCT01878630.<br/>Copyright &#xa9; The Author(s) 2024.

<82>
Accession Number
2030173701
Title
Temperature effect on coagulation function in mild hypothermic patients
undergoing thoracic surgeries: thromboelastography (TEG) versus standard
tests.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 55.
Date of Publication: December 2024.
Author
Hui S.; Zhang Q.; Lang J.; Yi J.
Institution
(Hui, Lang, Yi) Department of Anesthesiology, Peking Union Medical College
Hospital, No. 1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing 100730, China
(Zhang) Department of Anesthesiology, Hebei Petrochina Central Hospital,
No. 51 Xin Kai Road, Langfang 065000, China
Publisher
BioMed Central Ltd
Abstract
Purpose: Our previous research has revealed that mild hypothermia leads to
excessive bleeding in thoracic surgeries, while the underlying mechanism
stayed unrevealed by the standard coagulation tests. The research question
in this study was as follows: "How does mild hypothermia impair the
hemostatic function in patients receiving thoracic surgeries?". The
purpose was to detect the disturbed coagulation processes by comparing the
TEG parameters in patients receiving active vs. passive warming during
thoracic surgeries. <br/>Method(s): Standard coagulation tests and
thromboelastography (TEG) were adopted to compare the hemostatic functions
in patients receiving active vs. passive warming during thoracic
surgeries. Furthermore, blood samples from passive warming group were
retested for TEG at actual core body temperatures. <br/>Result(s):
Sixty-four eligible patients were included in this study. TEG revealed
that mild hypothermia significantly disturbed coagulation by decreasing MA
(59.4 +/- 4.5 mm vs. 64.2 +/- 5.7 mm, p = 0.04) and alpha angle (70.4 +/-
5.2degree vs. 74.9 +/- 4.4degree, p = 0.05) and prolonging ACT (122.2 +/-
19.3 s vs. 117.3 +/- 15.2 s, p = 0.01) and K time (1.9 +/- 1.0 s vs. 1.3
+/- 0.4 min, p = 0.02). TEGs conducted under core body temperatures
revealed more impaired coagulation than those incubated at 37 degreeC.
Furthermore, postoperative shivering and waking time were significantly
increased in mild hypothermic patients. <br/>Conclusion(s): Mild
hypothermia significantly impaired coagulation function in patients
receiving thoracic surgeries, which could be detected by TEGs other than
the standard coagulation tests. Temperature-adjusted TEGs may provide a
preferable method of hemostatic monitoring and transfusion guidance in
thoracic surgeries, which warrants further clinical
investigations.<br/>Copyright &#xa9; The Author(s) 2024.

<83>
Accession Number
2030163948
Title
Systematic review of drug-drug interactions of
delta-9-tetrahydrocannabinol, cannabidiol, and Cannabis.
Source
Frontiers in Pharmacology. 15 (no pagination), 2024. Article Number:
1282831. Date of Publication: 2024.
Author
Nachnani R.; Knehans A.; Neighbors J.D.; Kocis P.T.; Lee T.; Tegeler K.;
Trite T.; Raup-Konsavage W.M.; Vrana K.E.
Institution
(Nachnani, Neighbors, Kocis, Raup-Konsavage, Vrana) Department of
Pharmacology, Penn State University College of Medicine, Hershey, PA,
United States
(Knehans) Department of Library, Penn State University College of
Medicine, Hershey, PA, United States
(Kocis) Department of Pharmacy, Penn State University College of Medicine,
Hershey, PA, United States
(Lee, Tegeler, Trite) PA Options for Wellness, Harrisburg, PA, United
States
Publisher
Frontiers Media SA
Abstract
Background: The recent exponential increase in legalized medical and
recreational cannabis, development of medical cannabis programs, and
production of unregulated over-the-counter products (e.g., cannabidiol
(CBD) oil, and delta-8-tetrahydrocannabinol (delta-8-THC)), has the
potential to create unintended health consequences. The major cannabinoids
(delta-9-tetrahydrocannabinol and cannabidiol) are metabolized by the same
cytochrome P450 (CYP) enzymes that metabolize most prescription
medications and xenobiotics (CYP3A4, CYP2C9, CYP2C19). As a result, we
predict that there will be instances of drug-drug interactions and the
potential for adverse outcomes, especially for prescription medications
with a narrow therapeutic index. <br/>Method(s): We conducted a systematic
review of all years to 2023 to identify real world reports of documented
cannabinoid interactions with prescription medications. We limited our
search to a set list of medications with predicted narrow therapeutic
indices that may produce unintended adverse drug reactions (ADRs). Our
team screened 4,600 reports and selected 151 full-text articles to assess
for inclusion and exclusion criteria. <br/>Result(s): Our investigation
revealed 31 reports for which cannabinoids altered pharmacokinetics and/or
produced adverse events. These reports involved 16 different Narrow
Therapeutic Index (NTI) medications, under six drug classes, 889
individual subjects and 603 cannabis/cannabinoid users. Interactions
between cannabis/cannabinoids and warfarin, valproate, tacrolimus, and
sirolimus were the most widely reported and may pose the greatest risk to
patients. Common ADRs included bleeding risk, altered mental status,
difficulty inducing anesthesia, and gastrointestinal distress.
Additionally, we identified 18 instances (58%) in which clinicians
uncovered an unexpected serum level of the prescribed drug. The quality of
pharmacokinetic evidence for each report was assessed using an internally
developed ten-point scale. <br/>Conclusion(s): Drug-drug interactions with
cannabinoids are likely amongst prescription medications that use common
CYP450 systems. Our findings highlight the need for healthcare providers
and patients/care-givers to openly communicate about cannabis/cannabinoid
use to prevent unintended adverse events. To that end, we have developed a
free online tool (www.CANN-DIR.psu.edu) to help identify potential
cannabinoid drug-drug interactions with prescription
medications.<br/>Copyright &#xa9; 2024 Nachnani, Knehans, Neighbors,
Kocis, Lee, Tegeler, Trite, Raup-Konsavage and Vrana.

<84>
Accession Number
2032822973
Title
Surgery compared to fibrinolytic therapy for symptomatic left-sided
prosthetic heart valve thrombosis (SAFE-PVT): Rationale and design of a
randomized controlled trial.
Source
Indian Heart Journal. (no pagination), 2024. Date of Publication: 2024.
Author
Devasenapathy N.; Devagourou V.; Hote M.P.; Rajashekar P.; Kidambi B.;
Singal A.; Mantoo M.R.; Soni M.; Purohit G.; Singh S.; Karthikeyan G.
Institution
(Devasenapathy, Soni) The George Institute of Global Health, New Delhi,
India
(Devagourou, Hote, Rajashekar, Kidambi, Singal, Mantoo, Purohit, Singh,
Karthikeyan) Cardiothoracic Sciences Centre, All India Institute of
Medical Sciences, New Delhi, India
(Karthikeyan) Translational Health Science and Technology Institute,
Haryana, Faridabad, India
Publisher
Elsevier B.V.
Abstract
Background: Left-sided mechanical prosthetic heart valve thrombosis (PVT)
occurs because of suboptimal anticoagulation and is common in low-resource
settings. Urgent surgery and fibrinolytic therapy (FT) are the two
treatment options available for this condition. Urgent surgery is a
high-risk procedure but results in successful restoration of valve
function more often and is the treatment of choice in developed countries.
In low-resource countries, FT is used as the default treatment strategy,
though it is associated with lower success rates and a higher rate of
bleeding and embolic complications. There are no randomized trials
comparing the two modalities. <br/>Method(s): We performed a single center
randomized controlled trial comparing urgent surgery (valve replacement or
thrombectomy) with FT (low-dose, slow infusion tissue plasminogen
activator, tPA) in patients with symptomatic left-sided PVT. The primary
outcome was the occurrence of a complete clinical response, defined as
discharge from hospital with completely restored valve function, in the
absence of stroke, major bleeding or non-CNS systemic embolism. Outcome
assessment was done by investigators blinded to treatment allocation. The
principal safety outcome was the occurrence of a composite of in-hospital
death, non-fatal stroke, non-fatal major bleed or non-CNS systemic
embolism. Outcomes will be assessed both in the intention-to-treat, and in
the as-treated population. We will also report outcomes at one year of
follow-up. The trial has completed recruitment. <br/>Conclusion(s): This
is the first randomized trial to compare urgent surgery with FT for the
treatment of left-sided PVT. The results will provide evidence to help
clinicians make treatment choices for these patients. (Clinical trial
registration: CTRI/2017/10/010159).<br/>Copyright &#xa9; 2024
Cardiological Society of India

<85>
Accession Number
2032817248
Title
The Impact of Acute Kidney Injury on Chronic Kidney Disease After Cardiac
Surgery: A Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Lindhardt R.B.; Rasmussen S.B.; Riber L.P.; Lassen J.F.; Ravn H.B.
Institution
(Lindhardt, Rasmussen, Ravn) Department of Anesthesiology and Intensive
Care, Odense University Hospital, Odense, Denmark
(Lindhardt, Rasmussen, Riber, Lassen, Ravn) Department of Clinical
Research, Health Faculty, University of Southern Denmark, Odense, Denmark
(Riber) Department of Cardiac, Thoracic and Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Lassen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the impact of acute kidney injury on transition to
chronic kidney disease (CKD) after cardiac surgery and to determine
frequency of incident CKD in these patients. <br/>Design(s): A systematic
review and meta-analysis of observational studies. <br/>Setting(s):
Electronic databases Medline and Embase were systematically searched from
1974 to February 6, 2023. <br/>Participant(s): Eligible studies were
original observational studies on adult cardiac surgery patients, written
in the English language, and with clear kidney disease definitions.
Exclusion criteria were studies with previously transplanted populations,
populations with preoperative kidney impairment, ventricular assist device
procedures, endovascular procedures, a kidney follow-up period of <90
days, and studies not presenting necessary data for effect size
calculations. <br/>Intervention(s): Patients developing postoperative
acute kidney injury after cardiac surgery were compared with patients who
did not develop acute kidney injury. <br/>Measurements and Main Results:
The search identified 4,329 unique studies, 87 underwent full-text review,
and 12 were included for analysis. Mean acute kidney injury occurrence
across studies was 16% (minimum-maximum: 8-50), while mean occurrence of
CKD was 24% (minimum-maximum: 3-35), with high variability depending on
definitions and follow-up time. Acute kidney injury was associated with
increased odds of CKD in all individual studies. The pooled odds ratio
across studies was 5.67 (95% confidence interval, 3.34-9.64; p < 0.0001).
<br/>Conclusion(s): Acute kidney injury after cardiac surgery was
associated with a more than 5-fold increased odds of developing CKD.
New-onset CKD occurred in almost 1 in 4 patients in the years after
surgery.<br/>Copyright &#xa9; 2024 The Authors

<86>
Accession Number
2029133455
Title
High-sensitive troponinT, interleukin-8, and interleukin-6 link with
post-surgery risk in infant heart surgery.
Source
Acta Anaesthesiologica Scandinavica. 68(6) (pp 745-752), 2024. Date of
Publication: July 2024.
Author
Thorlacius E.M.; Keski-Nisula J.; Vistnes M.; Ojala T.; Molin M.;
Synnergren M.; Romlin B.S.; Ricksten S.-E.; Wahlander H.; Castellheim A.G.
Institution
(Thorlacius, Romlin, Ricksten, Castellheim) Department of Anesthesiology
and Intensive Care medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Thorlacius, Romlin, Ricksten, Wahlander, Castellheim) Region Vastra
Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
(Keski-Nisula) Department of Anesthesia and Intensive Care, Children's
Hospital, Helsinki University Hospital, Helsinki University, Helsinki,
Finland
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital and
Institute for Experimental Medical Research, Oslo University Hospital and
University of Oslo, Oslo, Norway
(Ojala) Department of Pediatric Cardiology, Children's Hospital, Helsinki
University Hospital, Helsinki University, Helsinki, Finland
(Molin) Statistical Consultation Group, Gothenburg, Sweden
(Synnergren) Department of Pediatric Thoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: This study focuses on biomarkers in infants after open heart
surgery, and examines the association of high-sensitive troponin T
(hs-cTnT), interleukin-6 (IL-6), and interleukin-8 (IL-8) with
postoperative acute kidney injury (AKI), ventilatory support time and need
of vasoactive drugs. <br/>Method(s): Secondary exploratory study from a
double-blinded clinical randomized trial (Mile-1) on 70 infants undergoing
open heart surgery with cardiopulmonary bypass (CPB). In this sub-study,
the entire study population was examined without considering the study
drugs. The biomarkers' peak concentration (highest concentration at 2 or 6
h post-CPB) were used for statistical analyses. <br/>Result(s): Peak IL-8,
hs-cTnT, and IL-6 occurred at 2 h post-CPB for 96%, 79%, and 63% of the
patients, respectively. The odds ratio of developing AKI2-3 for IL-6 > 293
pg/mL was 23.4 (95% CI 5.3;104.0), for IL-8 > 100 pg/mL it was 11.5
(3.0;44.2), and for hs-cTnT >5597 pg/mL it was 6.1 (1.5; 24.5). In more
than two third of the patients with the highest peak concentrations of
IL-8, IL-6, and hs-cTnT, there was a need for ventilatory support for >24
h and use of vasoactive drugs at 24 h post-CPB, while in less than one
third of the patients with the lowest peak concentrations of IL-8 and
hs-cTnT such requirements were observed. <br/>Conclusion(s): The peak
biomarker concentrations and CPB-time strongly predicted AKI2-3, with IL-6
and IL-8 emerging as strongest predictors. Furthermore, our findings
suggest that measuring hs-cTnT and IL-8 just 2 h post-CPB-weaning may
assist in identifying infants suitable for early extubation and highlight
those at risk of prolonged ventilation.<br/>Copyright &#xa9; 2024 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<87>
Accession Number
2032865256
Title
Exploring the use of lung ultrasound in the cardiac surgery population: a
scoping review.
Source
Physiotherapy (United Kingdom). Conference: Chartered Society of
Physiotherapy (CSP) 2023. Cardiff Marriott Hotel, Cardiff United Kingdom.
123(Supplement 1) (pp e69-e70), 2024. Date of Publication: June 2024.
Author
Farrell C.; Cooper K.; Hayward S.; Walker C.
Institution
(Farrell, Cooper, Walker) Robert Gordon University, School of Health
Sciences, Aberdeen, United Kingdom
(Cooper) Scottish Centre for Evidence-based, Multi-professional Practice:
a JBI Centre of Excellence, Robert Gordon University, United Kingdom
(Hayward) Blackpool Victoria Hospital, Lancashire Cardiac Centre,
Blackpool, United Kingdom
Publisher
Elsevier Ltd
Abstract
Purpose: Patients receiving cardiac surgery have a high risk of developing
respiratory complications. Lung ultrasound (LUS) is a safe, quick, and
portable diagnostic tool that can accurately detect respiratory
complications without radiation. It is, therefore, becoming a tool of
interest for the research community as well as respiratory
physiotherapists. Mapping the literature will help to identify what is
currently known and guide future research investment. This scoping review
aimed to map the evidence base regarding the use of LUS within the cardiac
surgery population. This review is part of a larger project to explore the
use of LUS within physiotherapy practice. <br/>Method(s): This review was
conducted in accordance with JBI methodology for scoping reviews and
followed an a priori registered open access protocol. We searched: Medline
and CINAHL (via EBSCOhost), Embase (via Ovid), Cochrane Reviews and
Trials, Scopus, Google Scholar, Web of Science, and EThOS. Two reviewers
independently screened and extracted data from 10% of records at each
stage. After achieving excellent agreement, one reviewer independently
screened and extracted data from the remaining records. This review
considered literature published in any language concerning the use of LUS
by any qualified healthcare professional in relation to cardiac surgery in
any setting where cardiac surgery was involved. This included primary
research, reviews of any type, narrative, text and opinion, and conference
abstracts from any year. <br/>Result(s): Ninety records were included in
the review: 70 primary studies, 3 secondary analyses, 6 narrative reviews,
and 11 text and opinion articles. The most common primary study type was
observational (71.1%) with the most common sub-type observational cohort
(47.8%). Intensive care was the most common setting (93.9%). LUS was used
or discussed for ten reasons, with the most common reasons being to
compare or determine diagnostic ability (33.7%) and test the feasibility
of LUS as a new prognostic tool (24.7%). There was variable reporting
regarding LUS methods across all records, e.g., only 26.7% reported the
profession of the LUS operator. When reported, most LUS operators in
primary studies were medical consultants (39.1%), anaesthesiologists
(39.1%), and physiotherapists (8.7%). Only two narrative reviews and one
editorial cited literature suggesting LUS could be operated by
physiotherapists. When reported, LUS was most often conducted or
recommended on day zero postoperatively (51.2%), on paediatric (50.7%)
male (80.7%) patients undergoing congenital cardiac surgery (54.4%) and
used or discussed the protocol recommended by Volpicelli et al. (2012)
(36%). Forty-five records reported interest in B-lines (81.8%) with Lung
Sliding as the second most common artefact (41.8%). The most common
pathologies of focus were pleural effusion (51.2%), atelectasis (40.2%),
pneumothorax (34.1%), pulmonary oedema (28%) and consolidation (25.6%).
Conclusion(s): This scoping review highlights the need for further
investigation to optimise LUS use within cardiac surgery. Methodological
heterogeneity and variable reporting are limitations of the current
evidence base. Future research should focus on standardising methods,
exploring LUS use by non-medical professions, and exploring experiences
and perceptions of LUS. Impact: With further research, LUS may prove to be
a valuable diagnostic and assessment tool for physiotherapists who work
with cardiac surgery patients. Keywords: point-of-care ultrasound, PoCUS,
thoracic ultrasound Funding acknowledgements: This work was
unfunded.<br/>Copyright &#xa9; 2024

<88>
Accession Number
2032867367
Title
Death in low-risk cardiac surgery revisited.
Source
Open Heart. 7(1) (no pagination), 2020. Article Number: e001244. Date of
Publication: 2020.
Author
Liden K.; Ivert T.; Sartipy U.
Institution
(Liden, Ivert, Sartipy) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Ivert, Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
Publisher
BMJ Publishing Group
Abstract
Background A systematic review of low-risk death has been shown successful
in identifying system weaknesses. The aim was to analyse early mortality
in low-risk patients undergoing cardiac surgery and to determine the cause
of death, classify if they were unavoidable or potentially preventable as
a result of technical or system errors. Methods We included all low-risk
patients who underwent cardiac surgery at our institution from 1 September
2009 to 31 August 2019. In patients operated between 2009 and 2011, we
defined low risk as an additive European System for Cardiac Operative Risk
Evaluation (EuroSCORE) I less than or equal to 3, and from 2012 and
onwards as a EuroSCORE II less than or equal to 1.5. The medical records
for the patients who died within 30 days of surgery were thoroughly
examined and the cause of death was classified as cardiac or non-cardiac.
Furthermore, deaths were categorised as not preventable, preventable
(technical error) or preventable (system error). Results During the study
period 3103 low-risk patients underwent surgery, and 11 patients died
within 30 days of the operation (0.35%). Six of these (55%) were
classified as preventable and five non-preventable. Four of the
preventable deaths were classified as technical errors and two were due to
system errors. Conclusions A repeated systematic review of deaths in
patients with a low preoperative risk showed that a majority of deaths
were preventable, and therefore potentially avoidable. Similar to the
previous assessment at our unit, mortality was very low and failure to
communicate remains a modifiable factor that should be
addressed.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2020.

<89>
Accession Number
644529981
Title
The 2023 American Association for Thoracic Surgery (AATS) Expert Consensus
Document: Management of subsolid lung nodules.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 07 Jun 2024.
Author
Chen H.; Kim A.W.; Hsin M.; Shrager J.B.; Prosper A.E.; Wahidi M.M.; Wigle
D.A.; Wu C.C.; Huang J.; Yasufuku K.; Henschke C.I.; Suzuki K.; Tailor
T.D.; Jones D.R.; Yanagawa J.
Institution
(Chen) Division of Thoracic Surgery, Department of Surgery, Fudan
University Shanghai Cancer Center, Shanghai, China
(Kim) Division of Thoracic Surgery, Department of Surgery, University of
Southern California, Los Angeles, Mexico
(Hsin) Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong
Kong Special Administrative Region, China
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, United States
(Prosper) Division of Cardiothoracic Imaging, Department of Radiological
Sciences, University of California at Los Angeles, Los Angeles, Mexico
(Wahidi) Section of Interventional Pulmnology, Division of Pulmonology and
Critical Care, Department of Medicine, Northwestern University Feinberg
School of Medicine, Ill, Chicago, Mexico
(Wigle) Division of Thoracic Surgery, Department of Surgery, Mayo Clinic,
Minn, Rochester, United Kingdom
(Wu) Division of Diagnostic Imaging, Department of Thoracic Imaging, MD
Anderson Cancer Center, Houston, United States
(Huang, Jones) Division of Thoracic Surgery, Department of Surgery,
Memorial Sloan Kettering Cancer Center, New York, NY
(Yasufuku) Division of Thoracic Surgery, Department of Surgery, Toronto
General Hospital, University Health Network, Toronto, ON, Canada
(Henschke) Department of Radiology, Icahn School of Medicine at Mount
Sinai, New York, NY
(Suzuki) Department of General Thoracic Surgery, Juntendo University
Hospital, Tokyo, Japan
(Tailor) Division of Cardiothoracic Imaging, Department of Radiology, Duke
Health, Durham, NC, United States
(Yanagawa) Division of Thoracic Surgery, Department of Surgery, David
Geffen School of Medicine at the University of California at Los Angeles,
Los Angeles, Mexico
Abstract
OBJECTIVE: Lung cancers that present as radiographic subsolid nodules
represent a subtype with distinct biological behavior and outcomes. The
objective of this document is to review the existing literature and report
consensus among a group of multidisciplinary experts, providing specific
recommendations for the clinical management of subsolid nodules.
<br/>METHOD(S): The American Association for Thoracic Surgery Clinical
Practice Standards Committee assembled an international, multidisciplinary
expert panel composed of radiologists, pulmonologists, and thoracic
surgeons with established expertise in the management of subsolid nodules.
A focused literature review was performed with the assistance of a medical
librarian. Expert consensus statements were developed with class of
recommendation and level of evidence for each of 4 main topics: (1)
definitions of subsolid nodules (radiology and pathology), (2)
surveillance and diagnosis, (3) surgical interventions, and (4) management
of multiple subsolid nodules. Using a modified Delphi method, the
statements were evaluated and refined by the entire panel. <br/>RESULT(S):
Consensus was reached on 17 recommendations. These consensus statements
reflect updated insights on subsolid nodule management based on the latest
literature and current clinical experience, focusing on the correlation
between radiologic findings and pathological classifications,
individualized subsolid nodule surveillance and surgical strategies, and
multimodality therapies for multiple subsolid lung nodules.
<br/>CONCLUSION(S): Despite the complex nature of the decision-making
process in the management of subsolid nodules, consensus on several key
recommendations was achieved by this American Association for Thoracic
Surgery expert panel. These recommendations, based on evidence and a
modified Delphi method, provide guidance for thoracic surgeons and other
medical professionals who care for patients with subsolid
nodules.<br/>Copyright &#xa9; 2024 The Authors. Published by Elsevier Inc.
All rights reserved.

<90>
Accession Number
644529727
Title
Continuous Erector Spinae Plane Block for Postoperative Analgesia in
Elderly Patients After Thoracoscopic Lobectomy.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2024. Date of
Publication: 12 Jun 2024.
Author
Sun L.; Mu J.; Yu L.; Hu J.; Hu Y.; He H.
Institution
(Sun, Mu, Yu, Hu, Hu) Department of Anesthesiology, Huzhou Central
Hospital, Huzhou, China
(He) Department of Anesthesiology, Huzhou Central Hospital, Huzhou, China
Abstract
PURPOSE: The purpose of this study was to compare the effect of
ultrasound-guided continuous erector spinae plane block to continuous
thoracic paravertebral block on postoperative analgesia in elderly
patients who underwent thoracoscopic lobectomy. DESIGN: Randomized
controlled trial. <br/>METHOD(S): Elderly patients (N = 50) who underwent
nonemergent thoracoscopic lobectomy in the thoracic surgery department of
our hospital from January 2019 to December 2020 were selected and randomly
divided into continuous erector spinae block (ESPB; n = 25) group and
continuous thoracic paravertebral block (TPVB; n = 25) group. The patients
in the two groups were guided by ultrasound with ESPB or TPVB before
anesthesia induction. The visual analog scale at rest and cough in 2
hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the
supplementary analgesic dosage of tramadol, time of tube placement, the
stay time in postanesthesia care unit (PACU), the first ambulation time
after surgery, the length of postoperative hospital stay and postoperative
complications were recorded. FINDINGS: There were no significant
differences between the two groups in visual analog scale score at rest
and cough at each time point and supplementary analgesic dosage of
tramadol within 48 hours after surgery (P > .05). The time of tube
placement and the postoperative hospital stay in ESPB group was
significantly shorter than that in TPVB group (P < .05). There were no
differences in PACU residence time and first ambulation time between the
two groups (P > .05). There were 4 patients in TPVB group and 2 patients
in ESPB group who had nausea and vomiting (P > .05), 1 case of
pneumothorax and 1 case of fever in the TPVB group. There were no incision
infections or respiratory depression requiring clinical intervention in
either group. <br/>CONCLUSION(S): Both ESPB and TPVB alleviated the
patients postoperative pain effectively for elderly patients underwent
thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a
shorter tube placement time, fewer complications and faster postoperative
recovery.<br/>Copyright &#xa9; 2024 The American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<91>
Accession Number
644526576
Title
Safety and Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke
Attributable to Cardiological Diseases: A Scoping Review.
Source
Journal of the American Heart Association. (pp e034783), 2024. Date of
Publication: 14 Jun 2024.
Author
D'Anna L.; Abu-Rumeileh S.; Merlino G.; Ornello R.; Foschi M.; Diana F.;
Barba L.; Mastrangelo V.; Romoli M.; Lobotesis K.; Bax F.; Kuris F.;
Valente M.; Otto M.; Korompoki E.; Sacco S.; Gigli G.L.; Nguyen T.N.;
Banerjee S.
Institution
(D'Anna, Banerjee) Department of Stroke and Neuroscience Charing Cross
Hospital, Imperial College London NHS Healthcare Trust London United
Kingdom, United Kingdom
(D'Anna, Korompoki, Banerjee) Department of Brain Sciences Imperial
College London London United Kingdom, United Kingdom
(Abu-Rumeileh, Barba, Otto) Department of Neurology
Martin-Luther-University Halle-Wittenberg Halle (Saale) Germany, Germany
(Merlino, Kuris, Gigli) Stroke Unit and Clinical Neurology Udine
University Hospital Udine Italy, Italy
(Ornello, Foschi, Sacco) Department of Biotechnological and Applied
Clinical Sciences University of L'Aquila L'Aquila Italy, Italy
(Diana) Interventional Neuroradiology Vall d'Hebron University Hospital
Barcelona Catalunya Spain, Spain
(Mastrangelo) Neurology and Stroke Unit, Ospedale Infermi Rimin Italy,
Italy
(Romoli) Neurology and Stroke Unit, Department of Neuroscience Bufalini
Hospital, Azienda Unita Sanitaria Locale Romagna Cesena Italy, Italy
(Lobotesis) Neuroradiology, Department of Imaging, Charing Cross Hospital,
Imperial College London NHS Healthcare Trust London United Kingdom, United
Kingdom
(Bax) Philip Kistler Research Center, Department of Neurology
Massachusetts General Hospital and Harvard Medical School Boston MA USA
(Valente) Clinical Neurology Udine University Hospital and Dipartmento di
Area Medica, University of Udine Udine Italy, Italy
(Nguyen) Department of Neurology, Radiology Boston Medical Center Boston
MA USA
Abstract
There is limited evidence on the outcomes and safety of mechanical
thrombectomy (MT) among patients with acute ischemic stroke (AIS) in the
context of cardiac diseases. Our study reviews MT in AIS within the
context of cardiac diseases, aiming to identify existing and emerging
needs and gaps. PubMed and Scopus were searched until December 31, 2023,
using a combination of cardiological diseases and "mechanical
thrombectomy" or "endovascular treatment" as keywords. Study design
included case reports/series, observational studies, randomized clinical
trials, and meta-analyses/systematic reviews. We identified 943 articles,
of which 130 were included in the review. Results were categorized
according to the cardiac conditions. MT shows significant benefits in
patients with atrial fibrillation (n=139) but lacks data for stroke
occurring after percutaneous coronary intervention (n=2) or transcatheter
aortic valve implantation (n=5). MT is beneficial in AIS attributable to
infective endocarditis (n=34), although functional benefit may be limited.
Controversy surrounds the functional outcomes and mortality of patients
with AIS with heart failure undergoing MT (n=11). Despite technical
challenges, MT appears feasible in aortic dissection cases (n=4), and in
patients with left ventricular assist device or total artificial heart
(n=10). Data on AIS attributable to congenital heart disease (n=4)
primarily focus on pediatric cases requiring technical modifications.
Treatment outcomes of MT in patients with cardiac tumors (n=8) vary
because of clot consistency differences. After cardiac surgery stroke, MT
may improve outcomes with early intervention (n=13). Available data
outline the feasibility of MT in patients with AIS attributable to
large-vessel occlusion in the context of cardiac diseases.

<92>
Accession Number
644525728
Title
Transcatheter Aortic Valve Replacement in Low-Risk Patients at Four or
More Years.
Source
The American journal of medicine. (no pagination), 2024. Date of
Publication: 12 Jun 2024.
Author
Connolly J.E.; Andabili S.H.A.; Joseph E.; Resar J.; Rahman F.
Institution
(Connolly, Andabili, Joseph, Resar, Rahman) Department of Medicine,
Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD, United
States
Abstract
INTRODUCTION: Transcatheter aortic valve replacement (TAVR) is accepted as
an alternative to surgical aortic valve replacement (SAVR) in patients
with severe symptomatic aortic valve stenosis (AS). Prior studies have
shown TAVR has comparable or superior outcomes to SAVR in intermediate and
high-risk patients. However, there is paucity of data about outcome of
TAVR versus SAVR in low surgical risk patients evaluated at 4 or more
years post-procedure. <br/>METHOD(S): A systematic review of all published
randomized controlled trials comparing TAVR and SAVR in patients at
low-risk patients was completed. A random-effects model meta-analysis was
performed to study major outcomes including all-cause mortality, stroke,
myocardial infarction, and aortic valve re-intervention. <br/>RESULT(S): 3
randomized trials comprising 2,644 patients (1,371 TAVR and 1,273 SAVR)
with mean age of 74.3 +/- 5.8 were included in this analysis. There was no
significant difference in all-cause and cardiovascular mortality, stroke,
myocardial infarction, and aortic valve reintervention between TAVR and
SAVR groups at long-term follow up. TAVR was associated with higher rate
of pacemaker implantation, while SAVR was associated with more atrial
fibrillation. <br/>CONCLUSION(S): At 4 or more years of follow-up, TAVR is
safe and has comparable outcomes to SAVR in patients with low surgical
risk. Possibility of TAVR and its risks and benefits should be discussed
with patients with low surgical risk.<br/>Copyright &#xa9; 2024. Published
by Elsevier Inc.

<93>
Accession Number
644524082
Title
Randomized feasibility trial for evaluating the impact of primary nursing
on delirium duration during intensive care unit stay.
Source
Intensive & critical care nursing. 84 (pp 103748), 2024. Date of
Publication: 13 Jun 2024.
Author
Kruger L.; Zittermann A.; Mannebach T.; Wefer F.; Becker T.; Lohmeier S.;
Luttermann A.; von Dossow V.; Rojas S.V.; Gummert J.; Langer G.
Institution
(Kruger) Project and Knowledge Management/Care Development Intensive Care,
Care Directorate, Heart and Diabetes Center NRW, Ruhr University Bochum,
Georgstrasse 11, 32345 Bad Oeynhausen, Germany
(Zittermann, Becker, Rojas, Gummert) Clinic for Thoracic and
Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University
Bochum, Georgstrasse 11, 32345 Bad Oeynhausen, Germany
(Mannebach, Lohmeier, Luttermann) Surgical Intensive Care Unit, Heart and
Diabetes Center NRW, Ruhr University Bochum, Georgstrasse 11, 32345 Bad
Oeynhausen, Germany
(Wefer) Care Development, Care Directorate, Heart and Diabetes Center NRW,
Ruhr University Bochum, Georgstrasse 11, 32345 Bad Oeynhausen, Germany;
Institute of Nursing Science, Medical Faculty and University Hospital
Cologne, University of Cologne, Gleueler Strasse 176-178, 50935 Cologne,
Germany
(von Dossow) Institute of Anesthesiology and Pain Therapy, Heart and
Diabetes Center NRW, Ruhr University Bochum, Georgstrasse 11, 32345 Bad
Oeynhausen, Germany
(Langer) Institute of Health and Nursing Sciences, German Center for
Evidence-based Nursing, Martin Luther University Halle-Wittenberg,
Magdeburger Strasse 8, 06112 Halle (Saale), Germany
Abstract
OBJECTIVE: We tested the feasibility of a randomized controlled trial for
comparing primary nursing with standard care. RESEARCH METHODOLOGY:
Elective cardiac surgical patients were eligible for inclusion. Patients
with an intensive care unit stay of >= 3 days were followed up until
intensive care unit discharge. Recruitment period was one year. SETTING:
Two intensive care units at a university hospital specialized in
cardiovascular and diabetic diseases. MAIN OUTCOME MEASURES: Primary
outcomes were recruitment and delivery rate. Primary clinical outcome was
duration of delirium, as assessed by the Confusion Assessment Method for
Intensive Care Units. Secondary outcomes included the incidence of
delirium, anxiety (10-point Numeric Rating Scale), and the satisfaction of
patient relatives (validated questionnaire). <br/>RESULT(S): Of 369
patients screened, 269 could be allocated to primary nursing (n = 134) or
standard care (n = 135), of whom 46 patients and 48 patients,
respectively, underwent an intensive care unit stay >= 3 days. Thus,
recruitment and delivery rates were 73 and 26 %, respectively. During
primary nursing and standard care, 18 and 24 patients developed a
delirium, with a median duration of 32 (IQR: 14-96) and 24 (IQR: 8-44)
hours (P = 0.10). The risk difference of delirium for primary nursing
versus standard care was 11 % and the relative risk was 0.65 (95 % CI:
0.28-1.46; P = 0.29). The extent of anxiety was similar between groups (P
= 0.13). Satisfaction could be assessed in 73.5 % of relatives, without
substantial differences between groups. <br/>CONCLUSION(S): Data
demonstrate that a trial for comparing primary nursing with standard care
is generally feasible. However, the incidence of delirium may be a better
primary outcome parameter than delirium duration, both in terms of
long-term patient outcome and robustness of data quality. IMPLICATIONS FOR
CLINICAL PRACTICE: A randomized clinical trial regarding nursing
organization during intensive care unit stay requires detailed planning of
patient recruitment, data evaluation, and power calculation.<br/>Copyright
&#xa9; 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

<94>
Accession Number
644523918
Title
Hypothermia for expanded criteria organ donors in kidney transplantation
in France (HYPOREME): a multicentre, randomised controlled trial.
Source
The Lancet. Respiratory medicine. (no pagination), 2024. Date of
Publication: 11 Jun 2024.
Abstract
BACKGROUND: Expanded criteria donors help to increase graft availability,
but provide organs with an increased risk of delayed graft function. We
aimed to investigate whether donor hypothermia decreases the risk of
delayed graft function compared with normothermia. <br/>METHOD(S): We did
this multicentre, randomised, controlled, parallel-arm trial at 53
intensive care units and transplant centres in France. We included
expanded criteria donors in whom death was diagnosed based on neurological
criteria, in compliance with French law, and the recipients of their
kidney grafts. Eligible expanded criteria donors were older than 60 years
or were aged 50-59 years and had at least two other risk factors (history
of hypertension, creatinine >132 mumol/L, or cerebrovascular cause of
death). Donors were randomly assigned to hypothermia (34-35degreeC) or
normothermia (36.5-37.5degreeC). Machine perfusion was used routinely.
Randomisation was done using a computer-generated, interactive,
web-response system, in permuted blocks (block size six), stratified by
centre. Outcome assessors were masked; investigator masking was not
feasible. The primary outcome was the proportion of kidney recipients with
delayed graft function, defined as renal replacement therapy within 7 days
after transplantation, assessed in the modified intention-to-treat (mITT)
population, which included all recipients who received at least one kidney
from an expanded criteria donor, with the exception of those under
guardianship. Secondary outcomes in expanded criteria donors were the
number of organs recovered and transplanted, kidney function, body
temperature, total volume of fluids administered, blood pressure and need
for vasopressors and inotropes, and adverse events (cardiovascular events,
metabolic disturbances, and coagulation disorders). Secondary outcomes in
kidney recipients were duration of hospital stay, kidney graft function
and vital status at day 7, day 28, 3 months, and 1 year after
transplantation, and adverse events (infections, cardiovascular events,
and surgical complications). Secondary outcomes were assessed in the mITT
population. The trial was registered at ClinicalTrials.gov, NCT03098706.
FINDINGS: Between Nov 9, 2017, and March 3, 2021, 365 donors were randomly
assigned, of whom 298 (151 [51%] male, 147 [49%] female) provided kidneys
to 526 recipients (323 [61%] male, 203 [39%] female). 251 recipients in
the hypothermia group and 275 recipients in the normothermia group were
included in the analysis. Graft function was delayed in 40 (16%) of 251
recipients in the hypothermia group and 58 (21%) of 275 recipients in the
normothermia group (odds ratio 0.71 [95% CI 0.44-1.13]; p=0.14; absolute
difference -5.2% [95% CI 11.8-1.5]). Compared with donors in the
normothermia group, donors in the hypothermia group had higher highest
mean arterial pressure (115 mm Hg [SD 22] vs 108 mm Hg [20]; p=0.001). 1
year after transplantation, recipients in the hypothermia group had a
lower mean creatinine concentration (152.4 mumol/L [SD 59.1] vs 169.7
mumol/L [51.4]; p=0.0351) and a higher mean creatinine clearance (42.3
mL/min/1.73 m2 [15.8] vs 40.5 mL/min/1.73 m2 [17.9]; p=0.0414) than those
in the normothermia group. No significant differences between groups were
identified for any other secondary outcomes. INTERPRETATION: Hypothermia
in expanded criteria donors whose organs were routinely stored using
machine perfusion did not decrease the frequency of delayed kidney graft
function. However, hypothermia was associated with a lower serum
creatinine concentration and a higher creatinine clearance 1 year after
transplantation. FUNDING: French Ministry of Health and French Intensive
Care Society.<br/>Copyright &#xa9; 2024 Elsevier Ltd. All rights reserved,
including those for text and data mining, AI training, and similar
technologies.

<95>
Accession Number
644521610
Title
Building a cardiogenic shock response team: key considerations necessary
to improve outcomes.
Source
Current opinion in critical care. (no pagination), 2024. Date of
Publication: 11 Jun 2024.
Author
Varma B.; Katz J.N.; Alviar C.L.
Institution
(Varma, Katz, Alviar) Leon H. Charney Division of Cardiovascular Medicine,
New York University Grossman School of Medicine, NYU Langone Medical
Center
(Katz, Alviar) Bellevue Hospital Center, NY, United States
Abstract
PURPOSE OF REVIEW: This review provides key information about cardiogenic
shock (CS) teams, including published evidence and practical
recommendations to create a CS team and program. RECENT FINDINGS: CS is a
complex disease process with a high in-hospital mortality rate ranging
from 30% to 70% according to recent registries and randomized studies. The
explanation for the elevated rates is likely multifactorial, including the
various etiologies of cardiogenic shock as well as delays in recognition
and deployment of appropriate therapies. Accordingly, the use of
cardiogenic shock team has been implemented with the aim of improving
outcomes in these patients. The CS team typically consists of members with
critical care or cardiac critical care expertise, heart failure,
cardiothoracic surgery, and interventional cardiology. A number of
retrospective studies have now supported the benefits of a CS team,
particularly in selecting the appropriate candidates for tailored
mechanical circulatory support therapies and providing interventions in a
timely manner, which have translated into improved outcomes. SUMMARY: CS
teams provides a platform for expedited recognition of CS and timely,
standardized, and multidisciplinary discussions regarding appropriate
management and care.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<96>
Accession Number
644521523
Title
Randomized Trial for Evaluation in Secondary Prevention Efficacy of
Combination Therapy-Statin and Eicosapentaenoic Acid (RESPECT-EPA).
Source
Circulation. (no pagination), 2024. Date of Publication: 14 Jun 2024.
Author
Miyauchi K.; Iwata H.; Nishizaki Y.; Inoue T.; Hirayama A.; Kimura K.;
Ozaki Y.; Murohara T.; Ueshima K.; Kuwabara Y.; Tanaka-Mizuno S.;
Yanagisawa N.; Sato T.; Daida H.
Institution
(Miyauchi, Iwata, Nishizaki, Daida) Department of Cardiovascular Biology
and Medicine, Juntendo University Graduate School of Medicine, Tokyo,
Japan (K.M., H.I., Y.N., H.D.)
(Inoue) Japan Red Cross Society, Nasu Red Cross Hospital, Otawara, Japan
(Inoue) Dokkyo Medical University, Japan (T.I.), Mibu, Tochigi, Japan
(Hirayama) Osaka Fukujyuji Hospital, Japan (A.H.), Japan
(Kimura) Department of Cardiology, Yokohama City University Medical
Center, Japan (K.K.), Kanagawa, Japan
(Ozaki) Department of Cardiology, Fujita Health University, Toyoake, Japan
(Y.O.), Aichi, Japan
(Murohara) Department of Cardiology, Nagoya University Graduate School of
Medicine, Japan (T.M.), Aichi, Japan
(Ueshima) Medical Examination Center, Uji-Takeda Hospital, Japan (K.U.),
Kyoto, Japan
(Kuwabara) Cancer Control Center, Japan (Y.K.), Japan
(Tanaka-Mizuno) Department of Digital Health and Epidemiology, Graduate
School of Medicine, Kyoto University, Japan (S.T.-M.), Japan
(Yanagisawa) Medical Technology Innovation Center, Juntendo University,
Japan. (N.Y.), Tokyo, Japan
(Sato) Department of Biostatistics, Kyoto University School of Public
Health, Japan (T.S.), Japan
(Daida) Faculty of Health Science, Juntendo University, Japan. (H.D.),
Tokyo, Japan
Abstract
BACKGROUND: Low plasma levels of eicosapentaenoic acid (EPA) are
associated with cardiovascular events. This trial aimed to assess the
clinical benefits of icosapent ethyl in patients with coronary artery
disease, a low EPA/arachidonic acid (AA) ratio, and statin treatment.
<br/>METHOD(S): In this prospective, multicenter, randomized, open-label,
blinded end-point study, patients with stable coronary artery disease and
a low EPA/AA ratio (<0.4) were randomized to EPA (1800 of icosapent ethyl
administered daily) or control group. The primary end point was a
composite of cardiovascular death, nonfatal myocardial infarction,
nonfatal ischemic stroke, unstable angina pectoris, and coronary
revascularization. The secondary composite end points of coronary events
included sudden cardiac death, fatal and nonfatal myocardial infarction,
unstable angina requiring emergency hospitalization and coronary
revascularization, or coronary revascularization. <br/>RESULT(S): Overall,
3884 patients were enrolled at 95 sites in Japan. Among them, 2506
patients had a low EPA/AA ratio, and 1249 and 1257 patients were
randomized to the EPA and control group, respectively. The median EPA/AA
ratio was 0.243 (interquartile range, 0.180-0.314) and 0.235
(interquartile range, 0.163-0.310) in the EPA and control group,
respectively. Over a median period of 5 years, the primary end point
occurred in 112 of 1225 patients (9.1%) and 155 of 1235 patients (12.6%)
in the EPA and control group, respectively (hazard ratio, 0.79 [95% CI,
0.62-1.00]; P=0.055). Meanwhile, the secondary composite end point of
coronary events in the EPA group was significantly lower (81/1225 [6.6%]
versus 120/1235 [9.7%] patients; hazard ratio, 0.73 [95% CI, 0.55-0.97]).
Adverse events did not differ between the groups, but the rate of
new-onset atrial fibrillation was significantly higher in the EPA group
(3.1% versus 1.6%; P=0.017). <br/>CONCLUSION(S): Icosapent ethyl treatment
resulted in a numerically lower risk of cardiovascular events that did not
reach statistical significance in patients with chronic coronary artery
disease, a low EPA/AA ratio, and statin treatment. REGISTRATION: URL:
https://www.umin.ac.jp/ctr/; Unique identifier: UMIN000012069.