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

<2>
Accession Number
2032307023
Title
A Randomized Controlled Trial of Nonfasting vs Fasting Before
Interventional Coronary Procedures: The TONIC Trial.
Source
JACC: Cardiovascular Interventions. 17(10) (pp 1200-1210), 2024. Date of
Publication: 27 May 2024.
Author
Boukantar M.; Chiaroni P.-M.; Gallet R.; Zamora P.; Truong T.; Mangiameli
A.; Rostain L.; Tuffreau-Martin A.-S.; Natella P.-A.; Oubaya N.; Teiger E.
Institution
(Boukantar, Chiaroni, Gallet, Zamora, Truong, Mangiameli, Rostain,
Tuffreau-Martin, Teiger) Interventional Cardiology, Henri Mondor Hospital,
Creteil, France
(Natella) Clinical Research Unit, Henri Mondor Hospital, Creteil, France
(Oubaya) University Paris Est Creteil, INSERM, IMRB, Creteil, France
(Oubaya) AP-HP, Hopitaux Henri-Mondor, Department of Public Health,
Creteil, France
Publisher
Elsevier Inc.
Abstract
Background: Fasting before coronary procedures is currently recommended to
reduce complications despite the lack of scientific evidence.
 Objective(s): The TONIC (Comparison Between Fasting and No Fasting
Before Interventional Coronary Intervention on the Occurrence of Adverse
Events) noninferiority trial investigated the safety and comfort of a
nonfasting strategy (ad libitum food and drinks) vs traditional fasting
(>6 hours for solid food and liquids) before coronary procedures.
 Method(s): In this monocentric, prospective, single-blind randomized
controlled trial, 739 patients undergoing coronary procedures were
included and randomized to a fasting or a nonfasting strategy. Emergency
procedures were excluded. The primary endpoint was a composite of
vasovagal reaction, hypoglycemia (defined by blood sugar <=0.7 g/L), and
isolated nausea and/or vomiting. Noninferiority margin was 4%. Secondary
endpoints were contrast-induced nephropathy and patients' satisfaction.
 Result(s): Among the 739 procedures (697 elective and 42 semiurgent),
517 angiographies, and 222 angioplasties (including complex and high-risk
procedures) were performed. The primary endpoint occurred in 30 of 365
nonfasting patients (8.2%) vs 37 of 374 fasting patients (9.9%),
demonstrating noninferiority (absolute between-group difference, -1.7%;
1-sided 95% CI upper limit: 1.8%). No food-related adverse event occurred,
and contrast-related acute kidney injuries were similar between groups.
Overall, procedure satisfaction and perceived pain were similar in both
groups, but nonfasting patients reported less hunger and thirst (P <
0.01). In case of redo coronary procedures, most patients (79%) would
choose a nonfasting strategy. Conclusion(s): The TONIC randomized
trial demonstrates the noninferiority of a nonfasting strategy to the
usual fasting strategy for coronary procedures regarding safety, while
improving patients' comfort. Copyright © 2024 American College of
Cardiology Foundation

<3>
Accession Number
2028951622
Title
Surgical risk stratification in patients with cirrhosis.
Source
Hepatology International. 18(3) (pp 876-891), 2024. Date of Publication:
June 2024.
Author
Ostojic A.; Mahmud N.; Reddy K.R.
Institution
(Ostojic) Division of Gastroenterology, Department of Internal Medicine,
University Hospital Center Zagreb, Kispaticeva 12, Zagreb 10000, Croatia
(Mahmud, Reddy) Division of Gastroenterology and Hepatology, University of
Pennsylvania, 2 Dulles, 3400 Spruce Street, HUP, Philadelphia, PA 19104,
United States
Publisher
Springer
Abstract
Individuals with cirrhosis experience higher morbidity and mortality rates
than the general population, irrespective of the type or scope of surgery.
This increased risk is attributed to adverse effects of liver disease,
encompassing coagulation dysfunction, altered metabolism of anesthesia and
sedatives, immunologic dysfunction, hemorrhage related to varices,
malnutrition and frailty, impaired wound healing, as well as diminished
portal blood flow, overall hepatic circulation, and hepatic oxygen supply
during surgical procedures. Therefore, a frequent clinical dilemma is
whether surgical interventions should be pursued in patients with
cirrhosis. Several risk scores are widely used to aid in the
decision-making process, each with specific advantages and limitations.
This review aims to discuss the preoperative risk factors in patients with
cirrhosis, describe and compare surgical risk assessment models used in
everyday practice, provide insights into the surgical risk according to
the type of surgery and present recommendations for optimizing those with
cirrhosis for surgical procedures. As the primary focus is on currently
available risk models, the review describes the predictive value of each
model, highlighting its specific advantages and limitations. Furthermore,
for models that do not account for the type of surgical procedure to be
performed, the review suggests incorporating both patient-related and
surgery-related risks into the decision-making process. Finally, we
provide an algorithm for the preoperative assessment of patients with
cirrhosis before elective surgery as well as guidance perioperative
management. Copyright © Asian Pacific Association for the Study
of the Liver 2024.

<4>
Accession Number
2020153019
Title
Midterm outcomes of endovascular treatment for infected aortic aneurysms:
Single center experience.
Source
Vascular. 32(2) (pp 303-309), 2024. Date of Publication: April 2024.
Author
Suwanruangsri V.; Bokerd S.; Chinchalongporn W.; Chanchitsopon V.; Inlao
P.; Kaviros P.
Institution
(Suwanruangsri, Bokerd, Chinchalongporn, Chanchitsopon, Inlao, Kaviros)
Division of Vascular Surgery, Department of Surgery, Maharat Nakhon
Ratchasima Hospital, Nakhon Ratchasima, Thailand
Publisher
SAGE Publications Ltd
Abstract
Objective: The standard treatment of infected aortic aneurysms is open
surgical repair but mortality rates remain high with the common cause of
death being sepsis. Endovascular treatment of infected aortic aneurysms is
another option and here we report the midterm outcomes of endovascular
treatment for infected aortic aneurysms. Method(s): Thirty-four
patients with infected aortic aneurysms underwent endovascular and hybrid
repair between December 2012 and June 2021. The patients were evaluated
for early and midterm outcomes including postoperative mortality,
morbidity, recurrent aortic infection, and midterm survival.
 Result(s): There were 34 patients who presented with infected aortic
aneurysms with a mean age of 66.7 years (range, 26-89). Most of the
patients presented with abdominal pain (94.1%) and fever (50.0%). The rate
of positive blood culture for organisms was 32.4%. Salmonella was the most
common organism. The procedures for treatment were endovascular repair
using straight endograft, aorto-uni-iliac (AUI) endograft, bifurcated
endograft, and thoracic endograft. Other procedures were endovascular
repair with sandwich technique, chimney or periscope technique, and hybrid
operation. The rate of in-hospital mortality and morbidity were 11.8% and
17.6%, respectively. Mean follow-up time was 21 months (range, 1-70).
During the follow-up period, 7 (23.3%) patients had recurrent infection of
aortic aneurysms and 5 patients required reoperation. Four patients died
from septicemia and one patient died from cardiac disease. Male patients
were more likely to have recurrent infection compared to females. The
cumulative survival at 1 year and 2 years were 86.3% and 80.5%,
respectively. Conclusion(s): In this retrospective review of the
endovascular treatment in the patients who presented with infected aortic
aneurysms showed acceptable early and midterm outcomes. Copyright
© The Author(s) 2022.

<5>
Accession Number
2032505521
Title
Electronic nudges increase influenza vaccination utilization after
myocardial infarction: the nationwide NUDGE-FLU implementation trial.
Source
European Heart Journal. 45(20) (pp 1856-1858), 2024. Date of Publication:
21 May 2024.
Author
Bhatt A.S.; Johansen N.D.; Modin D.; Claggett B.L.; Dueger E.L.; Samson
S.I.; Loiacono M.M.; Kober L.; Solomon S.D.; Sivapalan P.; Jensen J.U.S.;
Martel C.J.-M.; Vaduganathan M.; Biering-Sorensen T.
Institution
(Bhatt) Kaiser Permanente San Francisco Medical Center, Division of
Research, San Francisco, CA, United States
(Bhatt) Department of Medicine, Stanford University Division of
Cardiovascular Medicine, Palo Alto, CA, United States
(Bhatt, Vaduganathan) Center for Cardiometabolic Implementation Science,
Brigham and Women's Hospital, Boston, MA, United States
(Johansen, Modin, Biering-Sorensen) Department of Cardiology, Copenhagen
University Hospital-Herlev and Gentofte, Copenhagen, Denmark
(Johansen, Modin, Biering-Sorensen) Center for Translational Cardiology
and Pragmatic Randomized Trials, Department of Biomedical Sciences,
Faculty of Health and Medical Sciences, University of Copenhagen, Gentofte
Hospitalsvej 8, 3.th., Hellerup 2900, Denmark
(Claggett, Solomon, Vaduganathan) Cardiovascular Division, Brigham and
Women's Hospital, Boston, MA, United States
(Dueger, Samson) Sanofi, Lyon, France
(Loiacono) Sanofi, Swiftwater, PA, United States
(Kober, Jensen) Department of Clinical Medicine, Faculty of Health and
Medical Sciences, University of Copenhagen, Denmark
(Kober, Biering-Sorensen) Department of Cardiology, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Sivapalan, Jensen) Department of Medicine, Respiratory Medicine Section,
Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
(Martel) Epidemiological Infectious Disease Preparedness, Statens Serum
Institut, Copenhagen, Denmark
(Biering-Sorensen) Steno Diabetes Center Copenhagen, Borgmester Ib Juuls
Vej 83, Herlev 2730, Denmark
Publisher
Oxford University Press

<6>
Accession Number
2032459942
Title
Effects of high-dose glucose-insulin-potassium on acute coronary syndrome
patients receiving reperfusion therapy: a meta-analysis.
Source
World Journal of Emergency Medicine. 15(3) (pp 181-189), 2024. Date of
Publication: 01 May 2024.
Author
Yang Z.; Liu H.; Lu D.; Cao S.; Xu F.; Li C.
Institution
(Yang, Liu, Lu, Cao, Xu, Li) Department of Emergency Medicine, Qilu
Hospital of Shandong University, Jinan 250012, China
(Yang, Liu, Lu, Cao, Xu, Li) Shandong Provincial Clinical Research Center
for Emergency and Critical Care Medicine, Institute of Emergency and
Critical Care Medicine, Shandong University, Chest Pain Center, Qilu
Hospital of Shandong University, Jinan 250012, China
(Yang, Liu, Lu, Cao, Xu, Li) Key Laboratory of Emergency and Critical Care
Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral
Resuscitation Research of Shandong Province, Shandong Provincial
Engineering Laboratory for Emergency and Critical Care Medicine, Qilu
Hospital of Shandong University, Jinan 250012, China
(Yang, Liu, Lu, Cao, Xu, Li) Shandong Key Laboratory: Magnetic Field-free
Medicine & Functional Imaging (MF), Qilu Hospital of Shandong University,
Jinan 250012, China
(Yang, Liu, Lu, Cao, Xu) National Medical Products Administration (NMPA),
Key Laboratory for Clinical Research and Evaluation of Innovative Drug,
Qilu Hospital of Shandong University, Jinan 250012, China
Publisher
Second Affiliated Hospital, Zhejiang University School of Medicine
Abstract
BACKGROUND: This meta-analysis aimed to assess the efficacy of high-dose
glucose-insulin-potassium (GIK) therapy on clinical outcomes in acute
coronary syndrome (ACS) patients receiving reperfusion therapy.
 METHOD(S): We searched the PubMed, Web of Science, MEDLINE, Embase,
and Cochrane Library databases from inception to April 26, 2022, for
randomized controlled trials (RCTs) that compared high-dose GIK and
placebos in ACS patients receiving reperfusion therapy. The primary
endpoint was major adverse cardiovascular events (MACEs). RESULT(S):
Eleven RCTs with 884 patients were ultimately included. Compared with
placebos, high-dose GIK markedly reduced MACEs (risk ratio [RR] 0.57, 95%
confidence interval [95% CI]: 0.35 to 0.94, P=0.03) and the risk of heart
failure (RR 0.48, 95% CI: 0.25 to 0.95, P=0.04) and improved the left
ventricular ejection fraction (LVEF) (mean difference [MD] 2.12, 95% CI:
0.40 to 3.92, P=0.02) at 6 months. However, no difference was observed in
all-cause mortality at 30 d or 1 year. Additionally, high-dose GIK was
significantly associated with increased incidences of phlebitis (RR 4.78,
95% CI: 1.36 to 16.76, P=0.01), hyperglycemia (RR 9.06, 95% CI: 1.74 to
47.29, P=0.009) and hypoglycemia (RR 6.50, 95% CI: 1.28 to 33.01, P=0.02)
but not reinfarction, hyperkalemia or secondary reperfusion. In terms of
oxidative stress-lowering function, high-dose GIK markedly reduced
superoxide dismutase (SOD) activity but not glutathione peroxidase
(GSH-Px) or catalase (CAT) activity. CONCLUSION(S): Patients with ACS
receiving reperfusion therapy exhibited a reduction in MACEs and good
oxidative stress-lowering efficacy in response to high-dose GIK. Moreover,
with a higher incidence of complications such as phlebitis, hyperglycemia,
and hypoglycemia. Furthermore, there were no observed survival benefits
associated with high-dose GIK. More trials with long-term follow-up are
still needed. Copyright © 2024 Second Affiliated Hospital,
Zhejiang University School of Medicine. All rights reserved.

<7>
Accession Number
2032147260
Title
Half back stitch for root reimplantation.
Source
JTCVS Techniques. 25 (pp 19-23), 2024. Date of Publication: June 2024.
Author
Kim W.K.; Ku M.; Kim H.R.; Kim J.B.
Institution
(Kim) Department of Thoracic and Cardiovascular Surgery, Hanyang
University Seoul Hospital, Hanyang University College of Medicine, Seoul,
South Korea
(Ku, Kim, Kim) Department of Thoracic and Cardiovascular Surgery, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
Publisher
Elsevier Inc.

<8>
Accession Number
2031182556
Title
Complications of Radial vs Femoral Access for Coronary Angiography and
Intervention: What Do the Data Tell Us?.
Source
American Journal of Medicine. 137(6) (pp 483-489), 2024. Date of
Publication: June 2024.
Author
Krittanawong C.; Uppalapati L.; Virk H.U.H.; Qadeer Y.K.; Irshad U.; Wang
Z.; Sharma S.; Jneid H.
Institution
(Krittanawong) Cardiology Division, NYU Langone Health and NYU School of
Medicine, New York, NY, United States
(Uppalapati, Qadeer) Department of Medicine, Baylor College of Medicine,
Houston, Texas, United States
(Virk, Irshad) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Ohio, United
States
(Wang) Robert D. and Patricia E. Kern Center for the Science of Health
Care Delivery
(Wang) Division of Health Care Policy and Research, Department of Health
Sciences Research, Mayo Clinic, Rochester, Minn, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Houston
Publisher
Elsevier Inc.
Abstract
In the last decades, radial access, as an alternative to femoral access,
has rapidly evolved and emerged as the preferred vascular access for
coronary angiography and percutaneous coronary intervention (PCI). The use
of radial access for PCI can reduce access-site bleeding, particularly
retroperitoneal bleeding, and risk of developing pseudoaneurysm, while
also improving patient comfort after procedure (eg, early ambulation).
However, radial access requires a longer learning curve to develop
technical skills, and the data on radial artery graft for coronary artery
bypass graft after radial access remain insufficient. Further, recent
clinical trials have shown conflicts regarding whether radial access is
associated with lower mortality in patients with ST-elevation myocardial
infarction. Despite these recent investigations, it is still debated
whether there are benefits associated with radial access over femoral
access for PCI. In this review, we will evaluate radial access compared
with femoral access for PCI on clinical outcomes and further discuss the
usefulness of radial access. Copyright © 2024 Elsevier Inc.

<9>
Accession Number
2029481193
Title
BRIDGING THE GAP: A SYSTEMATIC REVIEW OF BARIATRIC SURGERY'S EFFECTS ON
CARDIAC HEALTH.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(5) (pp
587-599), 2024. Date of Publication: 01 May 2024.
Author
Ali M.H.; Malik S.; Zahid M.J.; Khan M.A.; Saleem M.; Ahmad S.; Waqas M.;
Toru H.K.; Faheem A.; Farooq A.
Institution
(Ali, Zahid, Khan, Saleem, Ahmad, Waqas, Toru, Faheem) Hayatabad Medical
Complex, Peshawar, Pakistan
(Malik) Khyber Teaching Hospital, Peshawar, Pakistan
(Farooq) Rehman Medical Institute, Peshawar, Pakistan
Publisher
Codon Publications
Abstract
Objective: This study compares preoperative and post-operative cardiac
imaging measures to examine the effects of bariatric surgery on heart
shape and function in obese patients. Methodology: Using PubMed, MedLine,
Ovid, and Cinhal, this work searched the literature for bariatric,
metabolic, weight loss, and obesity surgery as well as echocardiography,
MRI, cardiac imaging, cardiac dimensions, & ventricular dimensions.
Studies included had an initial follow-up of three months and reported on
heart structural and function parameters obtained by MRI or
echocardiography. Study excluded had conflicting or no preoperative or
postoperative data. The Newcastle-Ottawa scale was used for quality
assessment; PRISMA guidelines were followed for statistical analysis,
which computed and pooled results using a model of random effects with 95%
confidence intervals, weighted mean differences, and DerSimonian & Laird
modelling. We looked at inter-study heterogeneity with the I2 statistic.
 Result(s): Bariatric surgery greatly improves a number of cardiac
indices, including left atrium diameter (1.967 mm, 95% CI 0.980-2.954),
left ventricular end-diastolic volume (13.28 ml, 95% CI 5.22-21.34 ml), as
well as left ventricular mass index (11.2, 95% confidence intervals (CI)
8.2-14.1%). Positive increases were noted for the left ventricular
ejection fraction (1.198, 95% CI 0.050-2.347) and the E/A ratio (0.189,
95% CI 0.113-0.265). Conclusion(s): In obese patients, bariatric
surgery has been shown to have beneficial impacts on diastolic function,
systolic function, and cardiac structure. The alteration of the enteric
cardiac axis may be a contributing factor to these outcomes. However,
future research endeavours should prioritize the acquisition of more
robust evidence to precisely determine the most effective bariatric
procedures for preventing and treating a diverse spectrum of
obesity-related cardiac pathologies, in addition to further developing
strategies for managing obesity cardiomyopathy. Copyright © 2024,
Codon Publications. All rights reserved.

<10>
Accession Number
2029423760
Title
Prominent crista terminalis mimicking a right atrial mass: a systematic
literature review and meta-analysis.
Source
Acta Radiologica. 65(6) (pp 588-600), 2024. Date of Publication: June
2024.
Author
Matusik P.S.; Mikrut K.; Bryll A.; Podolec M.; Popiela T.J.; Matusik P.T.
Institution
(Matusik, Bryll, Popiela) Department of Diagnostic Imaging, University
Hospital, Krakow, Poland
(Matusik, Popiela) Chair of Radiology, Jagiellonian University Medical
College, Krakow, Poland
(Mikrut) Department of Cardiology, The Ohio State University Wexner
Medical Center, Columbus, OH, United States
(Bryll) Jagiellonian University Medical College, Krakow, Poland
(Podolec) Department of Coronary Artery Disease and Heart Failure, St John
Paul II Hospital, Krakow, Poland
(Podolec) Center for Innovative Medical Education, Jagiellonian University
Medical College, Krakow, Poland
(Matusik) Department of Electrocardiology, Institute of Cardiology,
Faculty of Medicine, Jagiellonian University Medical College, Krakow,
Poland
(Matusik) Department of Electrocardiology, St John Paul II Hospital,
Krakow, Poland
Publisher
SAGE Publications Inc.
Abstract
The crista terminalis is an anatomical structure localized on the
posterolateral wall of the right atrium (RA). We performed a systematic
review of the literature and meta-analysis concerning cases of unusual
prominent crista terminalis mimicking RA mass. Moreover, we described the
differential diagnosis of cardiac masses with the use of echocardiography,
computed tomography, and cardiac magnetic resonance (CMR). We also
emphasize the potential importance of this structure in
electrophysiological procedures, including its role in exaggerated
arrhythmias. Prominent crista terminalis may be a potential obstacle
during invasive cardiac procedures or catheter ablation target. In
analyzed cases, the crista terminalis was often erroneously interpreted as
pathologic and at first confused with a thrombus or tumor during
transthoracic echocardiography examination. The correct final diagnoses
were mostly made with used transesophageal echocardiography or CMR. The
most important imaging findings suggestive of prominent crista terminalis
rather than tumor were a similar echogenicity/intensity with adjacent
myocardium, the location on posterolateral wall of the RA, the phasic
change in size, and no enhancement after contrast injection. We describe
up to date and detailed imaging features for the differential diagnostics
of selected intracardiac masses using various imaging techniques,
including multimodality cardiac imaging. Familiarity with the anatomy and
the imaging findings of the prominent crista terminalis will reduce
misdiagnosis and avoid additional tests and unwarranted clinical
interventions, while in patients considered for invasive cardiac
procedures it might increase their efficacy and safety. Copyright
© The Foundation Acta Radiologica 2024.

<11>
Accession Number
2029281899
Title
Treatment effects of empagliflozin in hospitalized heart failure patients
across the range of left ventricular ejection fraction - Results from the
EMPULSE trial.
Source
European Journal of Heart Failure. 26(4) (pp 963-970), 2024. Date of
Publication: April 2024.
Author
Tromp J.; Kosiborod M.N.; Angermann C.E.; Collins S.P.; Teerlink J.R.;
Ponikowski P.; Biegus J.; Ferreira J.P.; Nassif M.E.; Psotka M.A.;
Brueckmann M.; Blatchford J.P.; Steubl D.; Voors A.A.
Institution
(Tromp) Saw Swee Hock School of Public Health, National University of
Singapore & the National University Health System, Singapore, Singapore
(Tromp) Duke-NUS Medical School, Singapore, Singapore
(Kosiborod, Nassif) Saint Luke's Mid America Heart Institute, Kansas City,
MO, United States
(Kosiborod, Nassif) School of Medicine, University of Missouri-Kansas
City, Kansas City, MO, United States
(Kosiborod) George Institute for Global Health, Sydney, NSW, Australia
(Kosiborod) University of New South Wales, Sydney, NSW, Australia
(Angermann) Comprehensive Heart Failure Centre and Department of Medicine
I (Cardiology), University and University Hospital of Wurzburg, Wurzburg,
Germany
(Collins) Department of Emergency Medicine, Vanderbilt University Medical
Center and Geriatric Research and Education Clinical Care, Tennessee
Valley Healthcare Facility VA Medical Center, Nashville, TN, United States
(Teerlink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center and School of Medicine, University of California San Francisco, San
Francisco, CA, United States
(Ponikowski, Biegus) Institute of Heart Diseases, Medical University,
Wroclaw, Poland
(Ferreira) Cardiovascular Research and Development Center, Department of
Surgery and Physiology, Faculty of Medicine of the University of Porto,
Porto, Portugal
(Psotka) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Brueckmann) Boehringer Ingelheim International GmbH, Ingelheim, Germany
(Brueckmann) First Department of Medicine, Faculty of Medicine Mannheim,
University of Heidelberg, Mannheim, Germany
(Blatchford) Elderbrook Solutions GmbH on behalf of Boehringer Ingelheim
Pharma GmbH & Co. KG, Biberach, Germany
(Steubl) Boehringer Ingelheim International, Ingelheim, Germany
(Steubl) Department of Nephrology, Klinikum rechts der Isar, Faculty of
Medicine, Technical University, Munich, Germany
(Voors) University of Groningen Department of Cardiology, University
Medical Center Groningen, Groningen, Netherlands
Publisher
John Wiley and Sons Ltd
Abstract
Aim: The EMPULSE (EMPagliflozin in patients hospitalised with acUte heart
faiLure who have been StabilizEd) trial showed that, compared to placebo,
the sodium-glucose cotransporter 2 inhibitor empagliflozin (10 mg/day)
improved clinical outcomes of patients hospitalized for acute heart
failure (HF). We investigated whether efficacy and safety of empagliflozin
were consistent across the spectrum of left ventricular ejection fraction
(LVEF). Methods and Results: A total of 530 patients hospitalized for
acute de novo or decompensated HF were included irrespective of LVEF. For
the present analysis, patients were classified as HF with reduced (HFrEF,
LVEF <=40%), mildly reduced (HFmrEF, LVEF 41-49%) or preserved (HFpEF,
LVEF >=50%) ejection fraction at baseline. The primary endpoint was a
hierarchical outcome of death, worsening HF events (HFE) and quality of
life over 90 days, assessed by the win ratio. Secondary endpoints included
individual components of the primary endpoint and safety. Out of 523
patients with baseline data, 354 (67.7%) had HFrEF, 54 (10.3%) had HFmrEF
and 115 (22.0%) had HFpEF. The clinical benefit (hierarchical composite of
all-cause death, HFE and Kansas City Cardiomyopathy Questionnaire total
symptom score) of empagliflozin at 90 days compared to placebo was
consistent across LVEF categories (<=40%: win ratio 1.35 [95% confidence
interval 1.04, 1.75]; 41-49%: win ratio 1.25 [0.66, 2.37)] and >=50%: win
ratio 1.40 [0.87, 2.23], p<inf>interaction</inf> = 0.96) with a favourable
safety profile. Results were consistent across individual components of
the hierarchical primary endpoint. Conclusion(s): The clinical
benefit of empagliflozin proved consistent across LVEF categories in the
EMPULSE trial. These results support early in-hospital initiation of
empagliflozin regardless of LVEF. Copyright © 2024 The Authors.
European Journal of Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology.

<12>
Accession Number
2030023255
Title
Infection of Transcatheter Valvular Devices.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Hatab T.; Zaid S.; Thakkar S.J.; Bou Chaaya R.G.; Goel S.S.; Reardon M.J.
Institution
(Hatab, Thakkar, Bou Chaaya, Goel) Department of Cardiology, Houston
Methodist DeBakey Heart & amp; Vascular Center, Allison Family
Distinguished Chair of Cardiovascular Research, 6550 Fannin Street, Office
1401, Houston, TX 77030, United States
(Zaid) Baylor School of Medicine and the Michael E DeBakey VAMC, Houston,
TX, United States
(Reardon) Division of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart & amp; Vascular Center, Allison Family Distinguished Chair of
Cardiovascular Research, 6550 Fannin Street, Office 1401, Houston, TX
77030, United States
Publisher
Springer
Abstract
Purpose of Review: This review explores the epidemiology, clinical traits,
and diagnosis of Transcatheter Aortic Valve Replacement-Associated
Infective Endocarditis (TAVR-IE) and mitral transcatheter edge-to-edge
repair infective endocarditis (TEER-IE), focusing on a multimodal imaging
approach. It addresses the rising prevalence of TAVR and TEER, emphasizing
the need to understand long-term complications and clinical consequences,
which poses significant challenges despite advancements in valve
technology. Recent Findings: Studies report a variable incidence of
TAVR-IE and TEER-IE influenced by diverse patient risk profiles and
procedural factors. Younger age, male gender, and certain comorbidities
emerge as patient-related risk factors. Procedure-related factors include
intervention location, valve type, and technical aspects.
Microbiologically, Staphylococcus aureus, Viridans Group Streptococcus,
and Enterococcus are frequently encountered pathogens. Summary:
TAVR-IE and TEER-IE diagnosis involves a multimodal imaging approach due
to limitations in echocardiography. Blood cultures and imaging aid
identification, with Fluorescence in situ hybridization is showing
promise. Treatment encompasses medical management with antibiotics and,
when necessary, surgical intervention. The management approach requires a
multidisciplinary "Endocarditis Team." This review underscores the need
for continued research to refine risk prediction, enhance diagnostic
accuracy, and optimize management strategies for TAVR-IE, considering the
evolving landscape of transcatheter interventions. Copyright ©
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<13>
Accession Number
2029544912
Title
Randomized investigation of the MitraClip device in heart failure: Design
and rationale of the RESHAPE-HF2 trial design.
Source
European Journal of Heart Failure. 26(4) (pp 984-993), 2024. Date of
Publication: April 2024.
Author
Anker S.D.; Friede T.; von Bardeleben R.S.; Butler J.; Fatima K.; Diek M.;
Heinrich J.; Hasenfuss G.; Schillinger W.; Ponikowski P.
Institution
(Anker, Diek) Department of Cardiology (CVK) of German Heart Center
Charite, German Centre for Cardiovascular Research (DZHK) partner site
Berlin, Charite Universitatsmedizin, Berlin, Germany
(Friede) Department of Medical Statistics, University Medical Center
Gottingen, German Centre for Cardiovascular Research (DZHK), partner site
Gottingen, Gottingen, Germany
(von Bardeleben) Zentrum fur Kardiologie, Johannes-Gutenberg-Universitat,
Mainz, Germany
(Butler) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Fatima) Department of Research, Baylor Scott and White Research
Institute, Dallas, TX, United States
(Heinrich) Clinical Trial Unit, University Medical Center Gottingen,
Gottingen, Germany
(Hasenfus) Heart Research Center Gottingen, Clinic for Cardiology and
Pneumology, University Medical Center Gottingen, Gottingen, Germany
(Schillinger) Heart Center, Department of Cardiology,
Georg-August-University Gottingen, Gottingen, Germany
(Ponikowski) Institute of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The safety and effectiveness of the MitraClip device to treat
functional mitral regurgitation (FMR) has been tested in previous clinical
trials yielding somewhat heterogeneous results in heart failure (HF)
patients. Over time, the MitraClip device system has been modified and
clinical practice evolved to consider also less severely diseased HF
patients with FMR for this therapeutic option. The RESHAPE-HF2 trial aims
to assess the safety and effectiveness of the MitraClip device system on
top of medical therapy considered optimal in the treatment of clinically
significant FMR in symptomatic patients with chronic HF. Method(s):
The RESHAPE-HF2 is an investigator-initiated, prospective, randomized,
parallel-controlled, multicentre trial designed to evaluate the use of the
MitraClip device (used in the most up-to-date version as available at
sites) plus optimal standard of care therapy (device group) compared to
optimal standard of care therapy alone (control group). Eligible subjects
have signs and symptoms of HF (New York Heart Association [NYHA] class
II-IV despite optimal therapy), and have moderate-to-severe or severe FMR,
as confirmed by a central echocardiography core laboratory; have an
ejection fraction between >=20% and <=50% (initially 15-35% for NYHA class
II patients, and 15-45% for NYHA class III/IV patients); have been
adequately treated per applicable standards, and have received appropriate
revascularization and cardiac resynchronization therapy, if eligible; had
a HF hospitalization or elevated natriuretic peptides (B-type natriuretic
peptide [BNP] >=300 pg/ml or N-terminal proBNP >=1000 pg/ml) in the last
90 days; and in whom isolated mitral valve surgery is not a recommended
treatment option. The trial has three primary endpoints, which are these:
(i) the composite rate of total (first and recurrent) HF hospitalizations
and cardiovascular death during 24 months of follow-up, (ii) the rate of
total (i.e. first and recurrent) HF hospitalizations within 24 months, and
(iii) the change from baseline to 12 months in the Kansas City
Cardiomyopathy Questionnaire overall score. The three primary endpoints
will be analysed using the Hochberg procedure to control the familywise
type I error rate across the three hypotheses. Conclusion(s): The
RESHAPE-HF2 trial will provide sound evidence on the MitraClip device and
its effects in HF patients with FMR. The recruitment was recently
completed with 506 randomized patients. Copyright © 2024 The
Authors. European Journal of Heart Failure published by John Wiley & Sons
Ltd on behalf of European Society of Cardiology.

<14>
Accession Number
2032577709
Title
Overview and comparison of contemporary Society for Vascular Surgery,
American Heart Association/American College of Cardiology, and European
Society for Vascular Surgery guidelines for the management of patients
with intermittent claudication.
Source
Seminars in Vascular Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Tan L.T.; McDermott K.M.; Hicks C.W.
Institution
(Tan, McDermott, Hicks) Department of Surgery, The Johns Hopkins Hospital,
Johns Hopkins University School of Medicine, 600 North Wolfe Street,
Halsted 668, MD, Baltimore 21287
Publisher
W.B. Saunders
Abstract
Intermittent claudication (IC) is a phenotype of peripheral artery disease
that is characterized by pain in the lower extremity muscles during
activity that is relieved by rest. Medical management, risk factor
control, smoking cessation, and exercise therapy have historically been
the mainstays of treatment for IC, but advances in endovascular technology
have led to increasing use of peripheral vascular interventions in this
patient population. There are meaningful differences in published society
guidelines and appropriate use criteria relevant to the management of IC,
especially regarding indications for peripheral vascular interventions.
The current review aims to highlight similarities and differences between
major society recommendations for the management of IC, and to discuss
practice trends, disparities, and evidence gaps in the use of peripheral
vascular interventions for IC in the context of existing
guidelines. Copyright © 2024 Elsevier Inc.

<15>
Accession Number
2030057439
Title
Correction to: Letermovir prophylaxis for cytomegalovirus in
lung-transplant recipients: a comprehensive study with literature review
of off-label use and real-world experiences (Clinical and Experimental
Medicine, (2024), 24, 1, (68), 10.1007/s10238-024-01330-2).
Source
Clinical and Experimental Medicine. 24(1) (no pagination), 2024. Article
Number: 116. Date of Publication: December 2024.
Author
Hirama T.; Shundo Y.; Ohsumi A.; Watanabe T.; Okada Y.
Institution
(Hirama, Watanabe, Watanabe, Okada) Department of Thoracic Surgery,
Institute of Development, Aging and Cancer, Tohoku University, Miyagi,
Sendai, Japan
(Hirama, Okada) Division of Organ Transplantation, Tohoku University
Hospital, Miyagi, Sendai, Japan
(Shundo) Department of Respiratory Medicine, Faculty of Medicine, Fukuoka
University, Fukuoka, Fukuoka, Japan
(Ohsumi) Department of Thoracic Surgery, Kyoto University Hospital, Kyoto,
Kyoto, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Correction to: Clinical and Experimental Medicine (2024) 24:68
https://doi.org/10.1007/s10238-024-01330-2 In the original version of this
article, the affiliations of the second-last author, "Tatsuaki Watanabe,"
were incorrectly listed as affiliation 1, 2, 3, 4, but his correct
affiliation should be only 1 "Department of Thoracic Surgery, Institute of
Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan".
And the order of references in the article was incorrect. The current
order of references in the article: 1. Limaye AP, Budde K, Humar A, et al.
Letermovir versus valganciclovir for prophylaxis of cytomegalovirus in
high-risk kidney transplant recipients: a randomized clinical trial. JAMA.
2023;330(1):33-42. https://doi.org/10.1001/jama.2023.9106. 2. Linder KA,
Kovacs C, Mullane KM, et al. Letermovir treatment of cytomegalovirus
infection or disease in solid organ and hematopoietic cell transplant
recipients. Transpl Infect Dis. 2021;23(4):e13687.
https://doi.org/10.1111/tid.13687. 3. Razonable RR, Humar A.
Cytomegalovirus in solid organ transplant recipients-guidelines of the
american society of transplantation infectious diseases community of
practice. Clin Transplant. 2019;33(9):1-23.
https://doi.org/10.1111/ctr.13512. 4. Nikkuni E, Hirama T, Hayasaka K, et
al. Recovery of physical function in lung transplant recipients with
sarcopenia. BMC Pulm Med. 2021;21(1):124.
https://doi.org/10.1186/s12890-021-01442-5. 5. Kumata S, Hirama T,
Watanabe Y, et al. The fraction of sensitization among lung transplant
recipients in a transplant center in Japan. BMC Pulm Med. 2020;20(1):256.
https://doi.org/10.1186/s12890-020-01299-0. 6. Hirama T, Tomiyama F,
Notsuda H, et al. Outcome and prognostic factors after lung
transplantation for bronchiectasis other than cystic fibrosis. BMC Pulm
Med. 2021;21(1):261. https://doi.org/10.1186/s12890-021-01634-z. 7. Hirama
T, Akiba M, Shundo Y, et al. Efficacy and safety of mRNA SARS-CoV-2
vaccines in lung transplant recipients. J Infect Chemother.
2022;28(8):1153-8. https://doi.org/10.1016/j.jiac.2022.04.019. 8. Ui M,
Hirama T, Akiba M, Honda M, Kikuchi T, Okada Y. Cellular and humoral
immune responses after a third dose of SARS-CoV-2 mRNA vaccine in lung
transplant recipients in Japan. Vaccine. 2023;41(31):4534-40.
https://doi.org/10.1016/j.vaccine.2023.06.011. 9. Hirama T, Okada Y. Roles
of respirologists in lung transplantation in Japan: narrative review. J
Thorac Dis. 2023;15(9):5174-81. https://doi.org/10.21037/jtd-22-1716. 10.
Katahira M, Hirama T, Eba S, et al. Impact of postoperative continuous
renal replacement therapy in lung transplant recipients. Transplant
Direct. 2020;6(6): e562. https://doi.org/10.1097/TXD.0000000000001013. 11.
Katada Y, Nakagawa S, Nagao M, et al. Risk factors of breakthrough
aspergillosis in lung transplant recipients receiving itraconazole
prophylaxis. J Infect Chemother. 2022;28(1):54-60.
https://doi.org/10.1016/j.jiac.2021.09.020. 12. Saullo JL, Baker AW,
Snyder LD, et al. Cytomegalovirus prevention in thoracic organ
transplantation: A single-center evaluation of letermovir prophylaxis. J
Heart Lung Transplant. 2022;41(4):508-15.
https://doi.org/10.1016/j.healun.2021.12.005. 13. Singha A, Burcham PK,
Logan A, et al. Letermovir for cytomegalovirus prophylaxis in lung
transplant patients with valganciclovir-induced leukopenia.
Transplantology. 2021;2(2):129-39.
https://doi.org/10.3390/transplantology2020013. 14. Aryal S, Katugaha SB,
Cochrane A, et al. Single-center experience with use of letermovir for CMV
prophylaxis or treatment in thoracic organ transplant recipients. Transpl
Infect Dis. 2019;21(6): e13166. https://doi.org/10.1111/tid.13166. 15.
Veit T, Munker D, Barton J, et al. Letermovir in lung transplant
recipients with cytomegalovirus infection: a retrospective observational
study. Am J Transplant. 2021;21(10):3449-55.
https://doi.org/10.1111/ajt.16718. 16. Paraskeva M, Bailey M, Levvey BJ,
et al. Cytomegalovirus replication within the lung allograft is associated
with bronchiolitis obliterans syndrome. Am J Transplant.
2011;11(10):2190-6. https://doi.org/10.1111/j.1600-6143.2011.03663.x. 17.
Fishman JA, Rubin RH. Infection in organ-transplant recipients. N Engl J
Med. 1998;338(24):1741-51. https://doi.org/10.1056/NEJM199806113382407.
18. Rubin RH. The indirect effects of cytomegalovirus infection on the
outcome of organ transplantation. JAMA. 1989;261(24):3607-9. 19. Johansson
I, Martensson G, Nystrom U, Nasic S, Andersson R. Lower incidence of CMV
infection and acute rejections with valganciclovir prophylaxis in lung
transplant recipients. BMC Infect Dis. 2013;13:582.
https://doi.org/10.1186/1471-2334-13-582. 20. Hammond SP, Martin ST,
Roberts K, et al. Cytomegalovirus disease in lung transplantation: impact
of recipient seropositivity and duration of antiviral prophylaxis. Transpl
Infect Dis. 2013;15(2):163-70. https://doi.org/10.1111/tid.12036. 21.
Finlen Copeland CA, Davis WA, Snyder LD, et al. Long-term efficacy and
safety of 12 months of valganciclovir prophylaxis compared with 3 months
after lung transplantation: a single-center, long-term follow-up analysis
from a randomized, controlled cytomegalovirus prevention trial. J Heart
Lung Transplant. 2011;30(9):990-6.
https://doi.org/10.1016/j.healun.2011.02.017. 22. Palmer SM, Limaye AP,
Banks M, et al. Extended valganciclovir prophylaxis to prevent
cytomegalovirus after lung transplantation: a randomized, controlled
trial. Ann Intern Med. 2010;152(12):761-9.
https://doi.org/10.7326/0003-4819-152-12-201006150-00003. 23. Cherrier L,
Nasar A, Goodlet KJ, Nailor MD, Tokman S, Chou S. Emergence of letermovir
resistance in a lung transplant recipient with ganciclovir-resistant
cytomegalovirus infection. Am J Transplant. 2018;18(12):3060-4.
https://doi.org/10.1111/ajt.15135. 24. McCrea JB, Macha S, Adedoyin A, et
al. Pharmacokinetic drug-drug interactions between letermovir and the
immunosuppressants cyclosporine, tacrolimus, sirolimus, and mycophenolate
mofetil. J Clin Pharmacol. 2019;59(10):1331-9.
https://doi.org/10.1002/jcph.1423. 25. Marshall WL, McCrea JB, Macha S, et
al. Pharmacokinetics and tolerability of letermovir coadministered with
azole antifungals (posaconazole or voriconazole) in healthy subjects. J
Clin Pharmacol. 2018;58(7):897-904. https://doi.org/10.1002/jcph.1094. 26.
Nakashima T, Inamoto Y, Fukushi Y, et al. Drug interaction between
letermovir and voriconazole after allogeneic hematopoietic cell
transplantation. Int J Hematol. 2021;113(6):872-6.
https://doi.org/10.1007/s12185-021-03105-x. 27. Hikasa S, Shimabukuro S,
Osugi Y, et al. Tacrolimus Concentration after Letermovir Initiation in
Hematopoietic Stem Cell Transplantation Recipients Receiving Voriconazole:
A Retrospective. Observational Study Int J Med Sci. 2020;17(7):859-64.
https://doi.org/10.7150/ijms.42011. 28. Kotton CN, Kumar D, Caliendo AM,
et al. The third international consensus guidelines on the management of
cytomegalovirus in solid organ transplantation. Transplant Publ online.
2018. https://doi.org/10.1097/TP.0000000000002191. The order of references
should have been. 1. Limaye AP, Budde K, Humar A, et al. Letermovir vs
Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney
Transplant Recipients: A Randomized Clinical Trial. JAMA.
2023;330(1):33-42. https://doi.org/10.1001/jama.2023.9106. 2. Razonable
RR, Humar A. Cytomegalovirus in solid organ transplant
recipients-Guidelines of the American Society of Transplantation
Infectious Diseases Community of Practice. Clin Transplant.
2019;33(9):1-23. https://doi.org/10.1111/ctr.13512. 3. Kotton CN, Kumar D,
Caliendo AM, et al. The Third International Consensus Guidelines on the
Management of Cytomegalovirus in Solid Organ Transplantation.
Transplantation. Published online 2018.
https://doi.org/10.1097/TP.0000000000002191. 4. Nikkuni E, Hirama T,
Hayasaka K, et al. Recovery of physical function in lung transplant
recipients with sarcopenia. BMC Pulm Med. 2021;21(1):124.
https://doi.org/10.1186/s12890-021-01442-5. 5. Kumata S, Hirama T,
Watanabe Y, et al. The fraction of sensitization among lung transplant
recipients in a transplant center in Japan. BMC Pulm Med. 2020;20(1):256.
https://doi.org/10.1186/s12890-020-01299-0. 6. Hirama T, Tomiyama F,
Notsuda H, et al. Outcome and prognostic factors after lung
transplantation for bronchiectasis other than cystic fibrosis. BMC Pulm
Med. 2021;21(1):261. https://doi.org/10.1186/s12890-021-01634-z. 7. Hirama
T, Akiba M, Shundo Y, et al. Efficacy and safety of mRNA SARS-CoV-2
vaccines in lung transplant recipients. J Infect Chemother.
2022;28(8):1153-1158. https://doi.org/10.1016/j.jiac.2022.04.019. 8. Ui M,
Hirama T, Akiba M, Honda M, Kikuchi T, Okada Y. Cellular and humoral
immune responses after a third dose of SARS-CoV-2 mRNA vaccine in lung
transplant recipients in Japan. Vaccine. 2023;41(31):4534-4540.
https://doi.org/10.1016/j.vaccine.2023.06.011. 9. Hirama T, Okada Y. Roles
of respirologists in lung transplantation in Japan: narrative review. J
Thorac Dis. 2023;15(9):5174-5181. https://doi.org/10.21037/jtd-22-1716.
10. Katahira M, Hirama T, Eba S, et al. Impact of Postoperative Continuous
Renal Replacement Therapy in Lung Transplant Recipients. Transplant
Direct. 2020;6(6):e562. https://doi.org/10.1097/TXD.0000000000001013. 11.
Katada Y, Nakagawa S, Nagao M, et al. Risk factors of breakthrough
aspergillosis in lung transplant recipients receiving itraconazole
prophylaxis. J Infect Chemother. 2022;28(1):54-60.
https://doi.org/10.1016/j.jiac.2021.09.020. 12. Saullo JL, Baker AW,
Snyder LD, et al. Cytomegalovirus prevention in thoracic organ
transplantation: A single-center evaluation of letermovir prophylaxis. J
Heart Lung Transplant. 2022;41(4):508-515.
https://doi.org/10.1016/j.healun.2021.12.005. 13. Singha A, Burcham PK,
Logan A, et al. Letermovir for Cytomegalovirus Prophylaxis in Lung
Transplant Patients with Valganciclovir-Induced Leukopenia.
Transplantology. 2021;2(2):129-139.
https://doi.org/10.3390/transplantology2020013. 14. Aryal S, Katugaha SB,
Cochrane A, et al. Single-center experience with use of letermovir for CMV
prophylaxis or treatment in thoracic organ transplant recipients. Transpl
Infect Dis. 2019;21(6):e13166. https://doi.org/10.1111/tid.13166. 15. Veit
T, Munker D, Barton J, et al. Letermovir in lung transplant recipients
with cytomegalovirus infection: A retrospective observational study. Am J
Transplant. 2021;21(10):3449-3455. https://doi.org/10.1111/ajt.16718. 16.
Paraskeva M, Bailey M, Levvey BJ, et al. Cytomegalovirus replication
within the lung allograft is associated with bronchiolitis obliterans
syndrome. Am J Transplant. 2011;11(10):2190-2196.
https://doi.org/10.1111/j.1600-6143.2011.03663.x 17. Fishman JA, Rubin RH.
Infection in organ-transplant recipients. N Engl J Med.
1998;338(24):1741-1751. https://doi.org/10.1056/NEJM199806113382407. 18.
Rubin RH. The indirect effects of cytomegalovirus infection on the outcome
of organ transplantation. JAMA. 261(24):3607-3609. 19. Johansson I,
Martensson G, Nystrom U, Nasic S, Andersson R. Lower incidence of CMV
infection and acute rejections with valganciclovir prophylaxis in lung
transplant recipients. BMC Infect Dis. 2013;13:582.
https://doi.org/10.1186/1471-2334-13-582. 20. Hammond SP, Martin ST,
Roberts K, et al. Cytomegalovirus disease in lung transplantation: impact
of recipient seropositivity and duration of antiviral prophylaxis. Transpl
Infect Dis. 2013;15(2):163-170. https://doi.org/10.1111/tid.12036. 21.
Finlen Copeland CA, Davis WA, Snyder LD, et al. Long-term efficacy and
safety of 12 months of valganciclovir prophylaxis compared with 3 months
after lung transplantation: a single-center, long-term follow-up analysis
from a randomized, controlled cytomegalovirus prevention trial. J Heart
Lung Transplant. 2011;30(9):990-996.
https://doi.org/10.1016/j.healun.2011.02.017. 22. Palmer SM, Limaye AP,
Banks M, et al. Extended valganciclovir prophylaxis to prevent
cytomegalovirus after lung transplantation: a randomized, controlled
trial. Ann Intern Med. 2010;152(12):761-769.
https://doi.org/10.7326/0003-4819-152-12-201006150-00003. 23. Linder KA,
Kovacs C, Mullane KM, et al. Letermovir treatment of cytomegalovirus
infection or disease in solid organ and hematopoietic cell transplant
recipients. Transpl Infect Dis. 2021;23(4):e13687.
https://doi.org/10.1111/tid.13687. 24. Cherrier L, Nasar A, Goodlet KJ,
Nailor MD, Tokman S, Chou S. Emergence of letermovir resistance in a lung
transplant recipient with ganciclovir-resistant cytomegalovirus infection.
Am J Transplant. 2018;18(12):3060-3064. https://doi.org/10.1111/ajt.15135.
25. McCrea JB, Macha S, Adedoyin A, et al. Pharmacokinetic Drug-Drug
Interactions Between Letermovir and the Immunosuppressants Cyclosporine,
Tacrolimus, Sirolimus, and Mycophenolate Mofetil. J Clin Pharmacol.
2019;59(10):1331-1339. https://doi.org/10.1002/jcph.1423. 26. Marshall WL,
McCrea JB, Macha S, et al. Pharmacokinetics and Tolerability of Letermovir
Coadministered With Azole Antifungals (Posaconazole or Voriconazole) in
Healthy Subjects. J Clin Pharmacol. 2018;58(7):897-904.
https://doi.org/10.1002/jcph.1094. 27. Nakashima T, Inamoto Y, Fukushi Y,
et al. Drug interaction between letermovir and voriconazole after
allogeneic hematopoietic cell transplantation. Int J Hematol.
2021;113(6):872-876. https://doi.org/10.1007/s12185-021-03105-x. 28.
Hikasa S, Shimabukuro S, Osugi Y, et al. Tacrolimus Concentration after
Letermovir Initiation in Hematopoietic Stem Cell Transplantation
Recipients Receiving Voriconazole: A Retrospective, Observational Study.
Int J Med Sci. 2020;17(7):859-864. https://doi.org/10.7150/ijms.42011. The
original article has been corrected. Copyright © The Author(s),
under exclusive licence to Springer Nature Switzerland AG 2024.

<16>
Accession Number
644396888
Title
The effect of 3D modeling on family quality of life, surgical success, and
patient outcomes in congenital heart diseases: objectives and design of a
randomized controlled trial.
Source
The Turkish journal of pediatrics. 66(2) (pp 237-250), 2024. Date of
Publication: 23 May 2024.
Author
Akca Sumengen A.; Ismailoglu A.V.; Ismailoglu P.; Gumus T.; Celiker A.;
Namlisesli D.; Poyraz E.; Ozcevik Subasi D.; Zeren Erdem C.; Cakir G.N.
Institution
(Akca Sumengen, Zeren Erdem, Cakir) Department of Nursing, Faculty of
Health Sciences, Yeditepe University, Istanbul, Turkey
(Akca Sumengen) Capstone College of Nursing, University of Alabama, AL,
United States
(Ismailoglu) Department of Anatomy, School of Medicine, Acibadem
University, Istanbul, Turkey
(Ismailoglu) Department of Anatomy, School of Medicine, Marmara
University, Istanbul, Turkey
(Ismailoglu) Department of Physiotherapy and Rehabilitation, Faculty of
Health Sciences, Fenerbahce University, Istanbul, Turkey
(Ismailoglu) Department of Anatomy, School of Medicine, Recep Tayyip
Erdogan University, Rize, Turkey
(Gumus) Department of Radiology, School of Medicine, Koc University
Research and Training Hospital, Istanbul, Turkey
(Celiker, Poyraz) Pediatric Cardiology Department, American Hospital,
Istanbul, Turkey
(Namlisesli) Department of Electrical and Electronics Engineering, Faculty
of Engineering, Yeditepe University, Istanbul, Turkey
(Ozcevik Subasi) Occupational Nurse, Ozsubasi Architecture Company
Abstract
BACKGROUND: Understanding the severity of the disease from the parents'
perspective can lead to better patient outcomes, improving both the
child's health-related quality of life and the family's quality of life.
The implementation of 3-dimensional (3D) modeling technology in care is
critical from a translational science perspective. AIM: The purpose of
this study is to determine the effect of 3D modeling on family quality of
life, surgical success, and patient outcomes in congenital heart diseases.
Additionally, we aim to identify challenges and potential solutions
related to this innovative technology. METHOD(S): The study is a
two-group pretest-posttest randomized controlled trial protocol. The
sample size is 15 in the experimental group and 15 in the control group.
The experimental group's heart models will be made from their own computed
tomography (CT) images and printed using a 3D printer. The experimental
group will receive surgical simulation and preoperative parent education
with their 3D heart model. The control group will receive the same parent
education using the standard anatomical model. Both groups will complete
the Sociodemographic Information Form, the Surgical Simulation Evaluation
Form - Part I-II, and the Pediatric Quality of Life Inventory (PedsQL)
Family Impacts Module. The primary outcome of the research is the average
PedsQL Family Impacts Module score. Secondary outcome measurement includes
surgical success and patient outcomes. Separate analyses will be conducted
for each outcome and compared between the intervention and control groups.
 CONCLUSION(S): Anomalies that can be clearly understood by parents
according to the actual size and dimensions of the child's heart will
affect the preoperative preparation of the surgical procedure and the
recovery rate in the postoperative period.

<17>
Accession Number
2030025831
Title
Effects of Chinese traditional five-element music intervention on
postoperative delirium and sleep quality in elderly patients after
non-cardiac surgery: a randomized controlled trial.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 47.
Date of Publication: December 2024.
Author
Han S.; Cai Z.; Cao L.; Li J.; Huang L.
Institution
(Han, Huang) Department of Anesthesiology, The Second Hospital of Hebei
Medical University, Hebei, Shijiazhuang 050061, China
(Han, Cao, Li) Department of Anesthesiology, Hebei General Hospital,
Hebei, Shijiazhuang 050051, China
(Cai) Department of Anesthesiology, Bethune International Peace Hospital,
Hebei, Shijiazhuang 050082, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative delirium (POD) is a common neurologic disorder
among elderly patients after non-cardiac surgery, which leads to various
negative outcomes. Sleep disorder is considered an important cause of POD.
The objective of this study was to investigate whether the Chinese
traditional five-element music intervention could reduce POD by improving
sleep quality in elderly patients undergoing non-cardiac surgery.
 Method(s): A total of 132 patients aged 65 to 90 years who underwent
non-cardiac surgery were randomized to two groups: the intervention (n =
60) and the control group (n = 63). Patients in the intervention group
were subjected to the Chinese traditional five-element music intervention
during the perioperative, while patients in the control group had no music
intervention. POD was evaluated using the Confusion Assessment Method
(CAM) in the first 5 days after surgery. The Richards-Campbell Sleep
Questionnaire (RCSQ) was used to assess subjective sleep quality. The
levels of nocturnal melatonin and cortisol in saliva were measured on the
preoperative and the first 2 postoperative days. Result(s): The
incidence of POD within 5 days was 27.0% in the control group and 11.7% in
the intervention group. Preoperative PSQI and MMSE scores were associated
with POD. The RCSQ scores on the first postoperative day were
significantly decreased in the two groups compared to the preoperative
day. Compared to the control group, the RCSQ scores showed a significant
improvement in the intervention group on the first postoperative day.
Compared to the control group, the level of saliva melatonin in the
intervention group showed a significant increase on the first
postoperative day. However, there was no statistical difference in
cortisol levels between the two groups. Conclusion(s): Chinese
traditional five-element music intervention decreased the incidence of POD
in elderly patients who underwent noncardiac surgery via improving sleep
quality, which may be associated with increased levels of
melatonin. Copyright © The Author(s) 2024.

<18>
Accession Number
2029563315
Title
Review of Evidence Supporting the AristaTM Absorbable Powder Hemostat.
Source
Medical Devices: Evidence and Research. 17 (pp 173-188), 2024. Date of
Publication: 2024.
Author
Lybarger K.S.
Institution
(Lybarger) Sarah Cannon Cancer Center - HCA MidAmerica, Kansas City, MO,
United States
Publisher
Dove Medical Press Ltd
Abstract
Background: Uncontrolled and diffuse bleeding is a dreaded event during
open and laparoscopic surgery that may lead to postoperative
complications, obstruction of the surgical field that reduces
visualization, and prolonged operating times. Powder hemostats can be used
to control bleeding and are easy to use, have a safe profile, and can
achieve broad coverage area at a low cost. Method(s): A strategic
literature search of peer-reviewed, English language studies was conducted
to capture evidence on the clinical efficacy and safety of a Microporous
Polysaccharide Hemosphere (MPH) based Hemostat (AristaTM Absorbable
Hemostat (AristaTM AH)). Result(s): Six preclinical studies were
found which supported the use of MPH in various animal models of
laparoscopic and open surgery, all of which demonstrated its safety and
efficacy. Five single-arm and 11 comparative clinical studies similarly
supported the efficacy and safety of MPH in various surgery types,
including cardiac, renal, and dermatologic surgery. Conclusion(s):
Published evidence supports the safe and effective use of MPH across a
variety of surgical settings. Copyright © 2024 LyBarger.

<19>
Accession Number
2029563216
Title
Hemadsorption to Contain Postoperative Cell-Free Hemoglobin and
Haptoglobin Preservation for Extended Cardiopulmonary Bypass Time in
Cardiac Surgery for Acute Kidney Injuries Prevention.
Source
Brazilian Journal of Cardiovascular Surgery. 39(3) (no pagination), 2024.
Article Number: e20230272. Date of Publication: 2024.
Author
Condello I.; Morvillo J.B.; Fiore F.; Teora V.; Nasso G.; Speziale G.
Institution
(Condello, Fiore, Teora, Nasso, Speziale) Department of Cardiac Surgery,
Anthea Hospital, GVM Care & Research, Bari, Italy
(Morvillo) Department of Cardiac Surgery, Biomedic Research Institute of
Murcia (IMIB), Virgen de la Arrixaca University Hospital, Murcia, Spain
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Prevention of acute kidney injury during cardiopulmonary
bypass (CPB) is still a challenge and has been the object of numerous
studies. The incidence of acute kidney injury in the context of CPB is
related to a multifactorial etiology. The role of hemadsorption in
relation to cell-free hemoglobin and haptoglobin preservation is not well
defined in the literature on CPB during cardiac surgery procedures.
 Method(s): This is a single-center pilot randomized report including
20 patients undergoing elective CPB procedures with an expected time > 120
minutes for each extracorporeal procedure. Patients were randomly
allocated to either standard of care (n=10) or Jafron HA380 (n=10) during
CPB. The primary outcome measured was the incidence of postoperative acute
kidney injuries. Result(s): The Jafron study group vs. control group
reported postoperative values for cell-free hemoglobin at 10 minutes after
CPB (mg/L) (11.6 +/- 0.6 vs. 29.9 +/- 0.3) (P-value 0.021), haptoglobin 10
minutes after CPB (mg/dl) (129.16 +/- 1.22 vs. 59.17 +/- 1.49) (P-value
0.017), creatinine peak after CPB (mg/dL) (0.92 +/- 0.17 vs. 1.32 +/- 0.9)
(P-value 0.030), and acute kidney injury after 48 hours (number of
patients) (one vs. four) (P-value 0.027). Conclusion(s): This pilot
study suggested that the use of Hemoperfusion Cartridge HA380 Jafron for
extended CPB time for complex cardiac surgery procedures was safe and
effective and is associated with a better postoperative preservation of
haptoglobin with a reduction of cell-free hemoglobin values and less
incidence of acute kidney injury, though larger studies are warranted to
confirm our result. Copyright © 2024, Sociedade Brasileira de
Cirurgia Cardiovascular. All rights reserved.

<20>
Accession Number
2029545741
Title
Comparison of the Effects of Full Median Sternotomy vs. Mini-Incision on
Postoperative Pain in Cardiac Surgery: A Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(4) (no pagination), 2024.
Article Number: e20230154. Date of Publication: 2024.
Author
Junior A.J.C.; Avelino P.S.; Lopes J.B.
Institution
(Junior) Faculdade de Medicina da Bahia, Universidade Federal da Bahia
(FMB/UFBA), Bahia, Salvador, Brazil
(Avelino) Faculdade de Medicina, Universidade Salvador (UNIFACS), Bahia,
Salvador, Brazil
(Lopes) Department of Anesthesiology and Surgery, Faculdade de Medicina da
Bahia, Universidade Federal da Bahia (FMB/UFBA), Bahia, Salvador, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: It is not yet clear whether cardiac surgery by mini-incision
(minimally invasive cardiac surgery [MICS]) is overall less painful than
the conventional approach by full sternotomy (FS). A meta-analysis is
necessary to investigate polled results on this topic. Method(s):
PubMed/MEDLINE, Cochrane CENTRAL, Latin American and Caribbean Health
Sciences Literature (or LILACS), and Scientific Electronic Library Online
(or SciELO) were searched for all clinical trials, reported until 2022,
comparing FS with MICS in coronary artery bypass grafting (CABG), mitral
valve surgery (MVS), and aortic valve replacement (AVR), and postoperative
pain outcome was analyzed. Main summary measures were the method of
standardized mean differences (SMD) with a 95% confidence interval (CI)
and P-values (considered statistically significant when < 0.05).
 Result(s): In AVR, the general estimate of postoperative pain effect
favored MICS (SMD 0.87 [95% CI 0.04 to 1.71], P=0.04). However, in the
sensitivity analysis, there was no difference between the groups (SMD 0.70
[95% CI-0.69 to 2.09], P=0.32). For MVS, it was not possible to perform a
meta-analysis with the included studies, because they had different
methodologies. In CABG, the general estimate of the effect of
postoperative pain did not favor any of the approaches (SMD-0.40 [95%
CI-1.07 to 0.26], P=0.23), which was confirmed by sensitivity analysis
(SMD-0.02 [95% CI-0.71 to 0.67], P=0.95). Conclusion(s): MICS was not
globally less painful than the FS approach. It seems that postoperative
pain is more related to the degree of tissue retraction than to the size
of the incision. Copyright © 2024, Sociedade Brasileira de
Cirurgia Cardiovascular. All rights reserved.

<21>
Accession Number
2032488688
Title
Left Atrial Appendage Occlusion versus Direct Oral Anticoagulants in the
Prevention of Ischaemic Stroke in Patients with Atrial Fibrillation.
Source
Cerebrovascular Diseases. (no pagination), 2024. Date of Publication:
2024.
Author
Elsheikh S.; Alobaida M.; Bucci T.; Buckley B.J.R.; Gupta D.; Irving G.;
Hill A.M.; Lip G.Y.H.; Abdul-Rahim A.H.
Institution
(Elsheikh, Alobaida, Bucci, Buckley, Gupta, Hill, Lip, Abdul-Rahim)
Liverpool Centre for Cardiovascular Science, University of Liverpool,
Liverpool John Moores University and Liverpool Heart and Chest Hospital,
Liverpool, United Kingdom
(Elsheikh, Alobaida, Lip, Abdul-Rahim) Cardiovascular and Metabolic
Medicine, Institute of Life Course and Medical Sciences, Faculty of Health
and Life Sciences, University of Liverpool, Liverpool, United Kingdom
(Elsheikh, Irving, Hill, Abdul-Rahim) Mersey and West Lancashire Teaching
Hospitals Nhs Trust, St Helens, United Kingdom
(Alobaida) Department of Basic Science, Prince Sultan Bin Abdulaziz
College for Emergency Medical Services, King Saud University, Riyadh,
Saudi Arabia
(Bucci) Department of General and Specialised Surgery, Sapienza University
of Rome, Rome, Italy
(Buckley) Cardiovascular Health Sciences, Research Institute for Sport and
Exercise Sciences, Liverpool John Moores University, Liverpool, United
Kingdom
(Irving) Health Research Institute, Edge Hill University, Ormskirk, United
Kingdom
(Elsheikh, Lip) Danish Center for Clinical Health Services Research,
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Publisher
S. Karger AG
Abstract
Introduction: Existing randomised controlled trials assessing the safety
and efficacy of left atrial appendage occlusion (LAAO) in atrial
fibrillation (AF) were of relatively small sample size or included
patients who could receive oral anticoagulant treatment after device
implantation. We compared the outcomes of patients with newly diagnosed AF
who received percutaneous LAAO or direct oral anticoagulant (DOAC)
treatment, in a large population from a global federated health network
(TriNetX). Method(s): Patients with AF treated with percutaneous LAAO
were matched with those treated with DOAC between December 1, 2010, and
October 1, 2018. Outcomes were all-cause mortality, ischaemic stroke, and
intracranial haemorrhage (ICH) at 5 years. Result(s): We included 200
patients with AF, who received either LAAO or DOAC. The risk of all-cause
mortality, ischaemic stroke, and ICH at 5 years was not significantly
different between the two groups (risk ratio [RR] for all-cause mortality:
1.52, 95% confidence interval (CI): 0.97 2.38, RR for ischaemic stroke:
1.09, 95% CI: 0.51 2.36, and RR for ICH: 1.0, 95% CI: 0.44 2.30).
 Conclusion(s): Patients newly diagnosed with AF, eligible for DOAC,
showed similar 5-year risk of death, ischaemic stroke, and ICH when
comparing those who underwent percutaneous LAAO to those receiving DOAC.
Future randomised controlled trials are needed to confirm the findings and
advise changes in guidelines. Copyright © 2024 S. Karger AG,
Basel.

<22>
Accession Number
2030049806
Title
Clinical trial evaluation: the EDOSURE clinical trial program.
Source
Future Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Griffin M.; Lip G.Y.H.
Institution
(Griffin, Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University, Liverpool Heart & Chest
Hospital, Liverpool L14 3PE, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg 9260, Denmark
Publisher
Taylor and Francis Ltd.
Abstract
EDOSURE is a trial program of the direct oral anticoagulant drug edoxaban,
comprising ten randomized clinical trials of which eight are currently
published. They evaluate the use of edoxaban in the treatment of
nonvalvular atrial fibrillation and acute venous thromboembolism,
including in special circumstances such as patients undergoing cardiac
procedures, cancer-associated venous thromboembolism, and elderly patients
whose bleeding risk precludes conventional anticoagulation strategies. As
a result of the collective evidence generated by EDOSURE, edoxaban is now
recommended as a treatment option by numerous international guidelines.
This review summarizes the context, rationale, and key findings of the
studies. Copyright © 2024 Informa UK Limited, trading as Taylor &
Francis Group.

<23>
Accession Number
644397263
Title
Promising therapies for adults with symptomatic obstructive hypertrophic
cardiomyopathy: 2023 and beyond.
Source
Expert opinion on pharmacotherapy. (no pagination), 2024. Date of
Publication: 30 May 2024.
Author
Gaballa A.; Jadam S.; Desai M.Y.
Institution
(Gaballa, Jadam, Desai) Hypertrophic Cardiomyopathy Center, Cleveland
Clinic, Cleveland, OH, United States
Abstract
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic
heart disease with an estimated prevalence in the general population of
0.2% to 0.6%. Clinically, HCM can range from no symptoms to severe
symptoms such as heart failure or sudden cardiac death. Currently, the
management of HCM involves lifestyle modifications, familial screening,
genetic counseling, pharmacotherapy to manage symptoms, sudden cardiac
death risk assessment, septal reduction therapy, and heart transplantation
for specific patients. Multicenter randomized controlled trials have only
recently explored the potential of cardiac myosin inhibitors (CMIs) such
as mavacamten as a directed pharmacological approach for managing HCM.
AREAS COVERED: We will assess the existing medical treatments for HCM:
beta-blockers, calcium channel blockers, disopyramide, and different CMIs.
We will also discuss future HCM pharmacotherapy guidelines and underline
this patient population's unfulfilled needs. EXPERT OPINION: Mavacamten is
the first-in-class CMI approved by the FDA to target HCM pathophysiology
specifically. Mavacamten should be incorporated into the standard therapy
for oHCM in case of symptom persistence despite using maximally tolerated
beta blockers and/or calcium channel blockers. Potential drug-drug
interactions should be assessed before initiating this drug. More studies
are needed on the use of CMIs in patients with kidney and/or liver failure
and pregnant/breastfeeding patients.

<24>
Accession Number
644395321
Title
Effect of Narrow Chest on Minimally Invasive Mitral Valve Surgery via
Right Minithoracotomy.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2024. Date of Publication: 30 May 2024.
Author
Sawa S.; Nakamura Y.; Nakayama T.; Kuroda M.; Nakamae K.; Niitsuma K.;
Ushijima M.; Yasumoto Y.; Yoshiyama D.; Furutachi A.; Ito Y.; Tsuruta R.
Institution
(Sawa, Nakamura, Nakayama, Kuroda, Nakamae, Niitsuma, Ushijima, Yasumoto,
Yoshiyama, Furutachi, Ito, Tsuruta) Department of Cardiovascular Surgery,
Chibanishi General Hospital
Abstract
BACKGROUND: The effect of a narrow chest on minimally invasive mitral
valve surgery (MIMVS) is unclear.Methods and Results: We enrolled 206
MIMVS patients and measured anteroposterior diameter (APD) between the
sternum and vertebra, transverse thoracic diameter (TD), right and left
APD of the hemithorax (RD and LD, respectively), and the Haller index (HI;
TD/APD ratio) on computed tomography. Preoperative characteristics and
operative outcomes were compared between patients with a narrow chest
(Group N; HI >2.5; n=53) and those with a normal chest (control [C]; HI
<=2.5; n=153), and the correlations of these measurements with operation
time were evaluated in 133 patients undergoing an isolated mitral
procedure. Groups N and C differed significantly in APD (89.4 vs. 114.3
mm, respectively; P<0.001), TD (251.5 vs. 240.3 mm, respectively;
P=0.002), RD (152.5 vs. 172.5 mm, respectively; P<0.001), LD (155.0 vs.
172.4 mm, respectively; P<0.001), and HI (2.84 vs. 2.12, respectively;
P<0.001). Procedural characteristics were comparable, except for a longer
aortic cross-clamp time (ACCT) in Group N (118.7 vs. 105.8 min; P=0.047).
Rates of surgical death, re-exploration, cerebral infarction, and
prolonged ventilation were comparable between the 2 groups. TD was
significantly correlated with ACCT (R2=0.037, P=0.028) in patients
undergoing an isolated mitral procedure. CONCLUSION(S): Early MIMVS
outcomes in patients with narrow chests are satisfactory. TD prolongs ACCT
during MIMVS.

<25>
Accession Number
644390748
Title
Anticoagulation for post-operative atrial fibrillation after isolated
coronary artery bypass grafting: a meta-analysis.
Source
European heart journal. (no pagination), 2024. Date of Publication: 29
May 2024.
Author
van de Kar M.R.D.; van Brakel T.J.; Van't Veer M.; van Steenbergen G.J.;
Daeter E.J.; Crijns H.J.G.M.; van Veghel D.; Dekker L.R.C.; Otterspoor
L.C.
Institution
(van de Kar, van Brakel, Van't Veer, van Steenbergen, van Veghel, Dekker,
Otterspoor) Department of Cardiology and Cardiothoracic Surgery, Catharina
Hospital, P.O. Box 1350, Eindhoven 5602 ZA, Netherlands
(Van't Veer, Dekker) Department of Biomedical Engineering, Eindhoven
University of Technology, Eindhoven, Netherlands
(Daeter) Department of Cardiothoracic Surgery, Antonius Hospital, Utrecht,
Netherlands
(Crijns) Department of Cardiology and Cardiovascular Research Centre
Maastricht (CARIM), Maastricht UMC+, Maastricht, Netherlands
Abstract
BACKGROUND AND AIMS: This study aimed to evaluate clinical outcomes in
patients developing post-operative atrial fibrillation (POAF) after
coronary artery bypass grafting (CABG) and characterize variations in oral
anticoagulation (OAC) use, benefits, and complications. METHOD(S): A
systematic search identified studies on new-onset POAF after CABG and OAC
initiation. Outcomes included risks of thromboembolic events, bleeding,
and mortality. Furthermore, a meta-analysis was conducted on these
outcomes, stratified by the use or non-use of OAC. RESULT(S): The
identified studies were all non-randomized. Among 1 698 307 CABG patients,
POAF incidence ranged from 7.9% to 37.6%. Of all POAF patients, 15.5%
received OAC. Within 30 days, thromboembolic events occurred at rates of
1.0% (POAF: 0.3%; non-POAF: 0.8%) with 2.0% mortality (POAF: 1.0%;
non-POAF: 0.5%). Bleeding rates were 1.1% for POAF patients and 2.7% for
non-POAF patients. Over a median of 4.6 years, POAF patients had 1.73
thromboembolic events, 3.39 mortality, and 2.00 bleeding events per 100
person-years; non-POAF patients had 1.14, 2.19, and 1.60, respectively. No
significant differences in thromboembolic risks [effect size -0.11 (-0.36
to 0.13)] and mortality [effect size -0.07 (-0.21 to 0.07)] were observed
between OAC users and non-users. However, OAC use was associated with
higher bleeding risk [effect size 0.32 (0.06-0.58)]. CONCLUSION(S):
In multiple timeframes following CABG, the incidence of complications in
patients who develop POAF is low. The use of OAC in patients with POAF
after CABG is associated with increased bleeding risk. Copyright
© 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

<26>
Accession Number
644382786
Title
Systematic review and meta-analysis of the impact of sex on outcomes after
aortic valve replacement.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2024. Date of Publication: 29 May 2024.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Alaklabi A.M.; Kang J.J.H.;
Nagendran J.
Institution
(El-Andari, Bozso, Fialka, Kang, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Alaklabi) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
Abstract
AIMS: In recent years, extensive literature has been produced
demonstrating inferior outcomes for women when compared with men
undergoing heart valve interventions. Herein, we seek to analyze the
literature comparing outcomes between men and women undergoing surgical
aortic valve replacement (SAVR). METHOD(S): A systematic literature
search of PubMed, MEDLINE, and Embase was conducted for articles comparing
differences in outcomes between adult men and women undergoing SAVR. One
thousand nine hundred and ninety titles were screened, of which 75 full
texts were reviewed, and a total of 19 manuscripts met the inclusion
criteria and were included in this review. RESULT(S): Pooled
estimates of mortality demonstrated that women tended to have lower rates
of survival within the first 30 days post-SAVR, although mid-term and
long-term mortality did not differ significantly up to 10 years
postoperatively. Pooled estimates of postoperative data indicated no
difference in the rates of stroke and postoperative bleeding. Rates of
aortic valve reoperation and acute kidney injury favored women.
 CONCLUSION(S): Despite the inferior outcomes for women post-SAVR that
have been reported in recent years, the results of this meta-analysis
demonstrate comparable results between the sexes with comparable mid- to
long-term mortality in data pooled from the literature. Although mortality
favored men in the short term, rates of aortic valve reoperation and acute
kidney injury favored women. Future investigation into this field should
focus on identifying discrepancies in diagnosis and initial surgical
management in order to address any potential factors contributing to
discrepant short-term outcomes. GRAPHICAL ABSTRACT:
http://links.lww.com/JCM/A651. Copyright © 2024 Italian
Federation of Cardiology - I.F.C. All rights reserved.

<27>
Accession Number
644382542
Title
Non-ST-elevation acute coronary syndromes with previous coronary artery
bypass grafting: a meta-analysis of invasive vs. conservative management.
Source
European heart journal. (no pagination), 2024. Date of Publication: 28
May 2024.
Author
Kelham M.; Vyas R.; Ramaseshan R.; Rathod K.; de Winter R.J.; de Winter
R.W.; Bendz B.; Thiele H.; Hirlekar G.; Morici N.; Myat A.; Michalis L.K.;
Sanchis J.; Kunadian V.; Berry C.; Mathur A.; Jones D.A.
Institution
(Kelham, Ramaseshan, Rathod, Mathur, Jones) Centre for Cardiovascular
Medicine and Devices, Faculty of Medicine & Dentistry, Queen Mary
University of London, London, United Kingdom
(Kelham, Vyas, Ramaseshan, Rathod, Mathur, Jones) Barts Interventional
Group, Barts Heart Centre, Barts Health NHS Trust, West Smithfield,
London, UK
(de Winter) Department of Cardiology Heart Center, Universiteit van
Amsterdam, Amsterdam, Netherlands
(de Winter) Department of Cardiology, Vrije Universiteit Amsterdam,
Amsterdam, Netherlands
(Bendz) Department of Cardiology, Oslo University Hospital and Institute
of Clinical Medicine, University of Oslo, Oslo, Norway
(Thiele) Heart Center Leipzig at University of Leipzig and Leipzig Heart
Science, Leipzig, Germany
(Hirlekar) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Morici) IRCCS S. Maria Nascente-Fondazione Don Carlo Gnocchi ONLUS,
Milan, Italy
(Myat) Medical Director (Cardiology), London, United Kingdom
(Michalis) 2nd Department of Cardiology, Faculty of Medicine, School of
Health Sciences, University of Ioannina and University Hospital of
Ioannina, University Campus, Ioannina 45110, Greece
(Sanchis) Cardiology Department, University Clinic Hospital of Valencia,
INCLIVA University of Valencia, Valencia, Spain
(Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne
Hospitals NHS Foundation Trust and Translational and Clinical Research
Institute, Faculty of Medical Sciences, Newcastle University, Newcastle
upon Tyne, United Kingdom
(Berry) British Heart Foundation Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Mathur, Jones) NIHR Barts Biomedical Research Centre, Queen Mary
University of London, Charterhouse Square, London, United Kingdom
Abstract
BACKGROUND AND AIMS: A routine invasive strategy is recommended in the
management of higher risk patients with non-ST-elevation acute coronary
syndromes (NSTE-ACSs). However, patients with previous coronary artery
bypass graft (CABG) surgery were excluded from key trials that informed
these guidelines. Thus, the benefit of a routine invasive strategy is less
certain in this specific subgroup. METHOD(S): A systematic review and
meta-analysis of randomized controlled trials (RCTs) was conducted. A
comprehensive search was performed of PubMed, EMBASE, Cochrane, and
ClinicalTrials.gov. Eligible studies were RCTs of routine invasive vs. a
conservative or selective invasive strategy in patients presenting with
NSTE-ACS that included patients with previous CABG. Summary data were
collected from the authors of each trial if not previously published.
Outcomes assessed were all-cause mortality, cardiac mortality, myocardial
infarction, and cardiac-related hospitalization. Using a random-effects
model, risk ratios (RRs) with 95% confidence intervals (CIs) were
calculated. RESULT(S): Summary data were obtained from 11 RCTs,
including previously unpublished subgroup outcomes of nine trials,
comprising 897 patients with previous CABG (477 routine invasive, 420
conservative/selective invasive) followed up for a weighted mean of 2.0
(range 0.5-10) years. A routine invasive strategy did not reduce all-cause
mortality (RR 1.12, 95% CI 0.97-1.29), cardiac mortality (RR 1.05, 95% CI
0.70-1.58), myocardial infarction (RR 0.90, 95% CI 0.65-1.23), or
cardiac-related hospitalization (RR 1.05, 95% CI 0.78-1.40).
 CONCLUSION(S): This is the first meta-analysis assessing the effect
of a routine invasive strategy in patients with prior CABG who present
with NSTE-ACS. The results confirm the under-representation of this
patient group in RCTs of invasive management in NSTE-ACS and suggest that
there is no benefit to a routine invasive strategy compared to a
conservative approach with regard to major adverse cardiac events. These
findings should be validated in an adequately powered RCT. Copyright
© The Author(s) 2024. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<28>
Accession Number
2032497034
Title
Assessment of Coronary Stenoses for Percutaneous Coronary Intervention: A
Systematic Review and Network Meta-Analysis of Randomized Trials.
Source
American Journal of Cardiology. 223 (pp 29-39), 2024. Date of Publication:
15 Jul 2024.
Author
d'Entremont M.-A.; Tiong D.; Sadeghirad B.; McGrath B.P.; Cioffi G.M.;
Garni T.A.; Cheema Z.M.; Layland J.; Revaiah P.C.; Serruys P.W.; Stone
G.W.; Jolly S.S.
Institution
(d'Entremont, Jolly) Population Health Research Institute, Hamilton, ON,
Canada
(d'Entremont, Tiong, McGrath, Cioffi, Garni, Cheema, Jolly) Hamilton
Health Sciences, Hamilton, ON, Canada
(d'Entremont, Tiong, McGrath, Cioffi, Garni, Cheema, Jolly) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke (CHUS),
Sherbrooke, Quebec, Canada
(Sadeghirad) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Sadeghirad) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Layland) Monash University, Melbourne, Australia
(Revaiah, Serruys) CORRIB Research Centre for Advanced Imaging and Core
Laboratory, University of Galway, Galway, Ireland
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, United States
Publisher
Elsevier Inc.
Abstract
Evidence regarding the comparative efficacy of the different methods to
determine the significance of coronary stenoses in the catheterization
laboratory is lacking. We aimed to compare all available methods guiding
the decision to perform percutaneous coronary intervention (PCI). We
searched Medline, Embase, and CENTRAL until October 5, 2023. We included
trials that randomized patients with greater than 30% stenoses who were
considered for PCI and reported major adverse cardiovascular events
(MACE). We performed a frequentist random-effects network meta-analysis
and assessed the certainty of evidence using the Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) approach.
We included 15 trials with 16,333 participants with a mean weighted
follow-up of 34 months. The trials contained a median of 49.3%
(interquartile range: 32.6%, 100%) acute coronary syndrome participants.
Quantitative flow ratio (QFR) was associated with a decreased risk of MACE
compared with coronary angiography (CA) (risk ratio [RR] 0.68, 95%
confidence interval [CI] 0.56 to 0.82, high certainty), fractional flow
reserve (FFR) (RR 0.73, 95% CI 0.58 to 0.92, moderate certainty), and
instantaneous wave-free ratio (iFR) (RR 0.63, 95% CI 0.49 to 0.82,
moderate certainty), and ranked first for MACE (88.1% probability of being
the best). FFR (RR 0.93, 95% CI 0.82 to 1.06, moderate certainty) and iFR
(RR 1.07, 95% CI 0.90 to 1.28, moderate certainty) likely did not decrease
the risk of MACE compared with CA. Intravascular imaging may not be
associated with a significant decrease in MACE compared with CA (RR 0.85,
95% CI 0.62 to 1.17, low certainty) when used to guide the decision to
perform PCI. In conclusion, a decision to perform PCI based on QFR was
associated with a decreased risk of MACE compared with CA, FFR, and iFR in
a mixed stable coronary disease and acute coronary syndrome population.
These hypothesis-generating findings should be validated in large,
randomized, head-to-head trials. Copyright © 2024 The Author(s)

<29>
Accession Number
2032464308
Title
Rationale and design of a single-center randomized trial to compare the
graft patency between the radial artery and the no-touch saphenous vein in
coronary artery bypass grafting surgery (GRAFT-CAB Study).
Source
American Heart Journal. 274 (pp 46-53), 2024. Date of Publication: August
2024.
Author
Zhang F.; Tian M.; Zhang H.; Zhou X.; Liu R.; Jin Z.; Zhang C.; Wang X.
Institution
(Zhang, Tian, Wang, Zhang, Zhou, Liu, Liu, Jin, Zhang, Wang) Department of
Surgery, National Center for Cardiovascular Disease, China and Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
Publisher
Elsevier Inc.
Abstract
Background: Previous studies suggested only the radial artery and the
No-touch (NT) technique were effective in reducing graft occlusion after
coronary artery bypass grafting (CABG) surgery. However, there is no
randomized trial comparing these 2 graft conduits. The optimum second
conduit for CABG remains undetermined. Material(s) and Method(s):
This study is a prospective, single-center randomized clinical trial,
aiming to compare the graft patency between the radial artery and the NT
vein graft. All patients undergoing isolated CABG with left internal
mammary artery (LIMA) plus at least 2 additional grafts will be considered
eligible. About 774 cases (516 in the radial artery group and 258 in the
NT vein group) will be enrolled in over 1 to 2 years. Participants will be
randomized and allocated to two bypass strategies: the LIMA plus 1 radial
artery and 1 conventional vein graft, or the LIMA plus 2 NT vein grafts.
The primary outcome is graft occlusion at 1 year after CABG evaluated by
CT angiography. The secondary outcomes include graft occlusion at 3 and 5
years and major adverse cardiac or cerebrovascular events at 1, 3, and 5
years follow-ups. Discussion(s): This study will define whether or
not the NT vein has a lower graft occlusion rate than the radial artery in
short and mid-term follow-ups, and provide new evidence for the second
conduit choice in CABG surgery. Trial registration: ClinicalTrials.gov
NCT06014047. Registered on October 15th, 2023. Copyright © 2024

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

<31>
Accession Number
2029594448
Title
Disparities in Cardiovascular Disease-Related Outcomes Among Cancer
Survivors in the United States: A Systematic Review of the Literature.
Source
Heart Lung and Circulation. 33(5) (pp 576-604), 2024. Date of Publication:
May 2024.
Author
Bikomeye J.C.; Awoyinka I.; Kwarteng J.L.; Beyer A.M.; Rine S.; Beyer
K.M.M.
Institution
(Bikomeye, Awoyinka, Kwarteng, Rine, Beyer) Institute for Health and
Equity, Medical College of Wisconsin, Milwaukee, WI, United States
(Bikomeye, Awoyinka, Rine, Beyer) PhD Program in Public and Community
Health, Division of Epidemiology & Social Sciences, Institute for Health
and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
(Beyer) Department of Medicine and Physiology, Division of Cardiology,
Medical College of Wisconsin, Milwaukee, WI, United States
(Awoyinka, Kwarteng, Beyer) MCW Cancer Center, Medical College of
Wisconsin, Milwaukee, WI, United States
Publisher
Elsevier Ltd
Abstract
Background: Cancer and cardiovascular disease (CVD) are major causes of
morbidity and mortality in the United States (US). Cancer survivors have
increased risks for CVD and CVD-related mortality due to multiple factors
including cancer treatment-related cardiotoxicity. Disparities are rooted
in differential exposure to risk factors and social determinants of health
(SDOH), including systemic racism. This review aimed to assess SDOH's role
in disparities, document CVD-related disparities among US cancer
survivors, and identify literature gaps for future research.
 Method(s): Following the Peer Review of Electronic Search Strategies
(PRESS) guidelines, MEDLINE, PsycINFO, and Scopus were searched on March
15, 2021, with an update conducted on September 26, 2023. Articles
screening was performed using the Preferred Reporting Items for Systematic
Review and Meta-Analysis (PRISMA) 2020, a pre-defined Population,
Exposure, Comparison, Outcomes, and Settings (PECOS) framework, and the
Rayyan platform. A modified version of the Newcastle-Ottawa Scale was used
to assess the risk of bias, and RAW Graphs for alluvial charts. This
review is registered with PROSPERO under ID #CRD42021236460.
 Result(s): Out of 7,719 retrieved articles, 24 were included, and
discussed diverse SDOH that contribute to CVD-related disparities among
cancer survivors. The 24 included studies had a large combined total
sample size (n=7,704,645; median=19,707). While various disparities have
been investigated, including rural-urban, sex, socioeconomic status, and
age, a notable observation is that non-Hispanic Black cancer survivors
experience disproportionately adverse CVD outcomes when compared to
non-Hispanic White survivors. This underscores historical racism and
discrimination against non-Hispanic Black individuals as fundamental
drivers of CVD-related disparities. Conclusion(s): Stakeholders
should work to eliminate the root causes of disparities. Clinicians should
increase screening for risk factors that exacerbate CVD-related
disparities among cancer survivors. Researchers should prioritise the
investigation of systemic factors driving disparities in cancer and CVD
and develop innovative interventions to mitigate risk in cancer
survivors. Copyright © 2023 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

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

<33>
Accession Number
2032384438
Title
Comprehensive analysis of donor-site chest deformities after autologous
costal cartilage microtia reconstruction: A systematic review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 94 (pp 128-140),
2024. Date of Publication: July 2024.
Author
Kim J.; Park C.; Oh K.S.; Lim S.Y.
Institution
(Kim, Park, Lim) Department of Plastic Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Oh) Department of Plastic surgery, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
Publisher
Churchill Livingstone
Abstract
Background: Autologous costal cartilage has gained widespread acceptance
as an important material for ear reconstruction in patients with microtia.
Despite its recognition as being "worth the trade-off," attention should
be directed toward donor-site deformities. This systematic review focused
on existing English literature related to microtia reconstruction and
aimed to reveal the incidence of chest wall deformities and assess the
effectiveness of the various proposed surgical techniques aimed at
reducing donor-site morbidities. Method(s): A comprehensive search
was conducted on Pubmed and OVID using the keywords "microtia," and "chest
deformity" or "rib harvest." Articles were screened based on predefined
inclusion and exclusion criteria. Data acquisition encompassed patient
demographics, employed surgical techniques, methods for evaluating chest
deformity, and incidence of associated complications. Result(s):
Among the 362 identified articles, 21 met the inclusion criteria. A total
of 2600 cases involving 2433 patients with microtia were analyzed in this
review. Perichondrium preservation during cartilage harvesting led to a
significant reduction in chest deformities. However, the wide incidence
range (0% to 50%) and the lack of specific assessment methods suggested
potential underestimation. Computed tomography revealed reduced chest wall
growth in the transverse and sagittal directions, resulting in decreased
thoracic area. Innovative surgical techniques have shown promising results
in reducing chest deformities. Conclusion(s): Although a quantitative
analysis was not feasible, objective evidence of deformities was
established through computed tomography scans. This analysis highlighted
the need for dedicated studies with larger sample sizes to further advance
our understanding of chest wall deformities in microtia
reconstruction. Copyright © 2024

<34>
[Use Link to view the full text]
Accession Number
2032325082
Title
Pragmatic Trial of Messaging to Providers About Treatment of
Hyperlipidemia (PROMPT-LIPID): A Randomized Clinical Trial.
Source
Circulation: Cardiovascular Quality and Outcomes. 17(5) (pp E010335),
2024. Date of Publication: 01 May 2024.
Author
Shah N.N.; Ghazi L.; Yamamoto Y.; Kumar S.; Martin M.; Simonov M.; Riello
R.J.; Faridi K.F.; Ahmad T.; Wilson F.P.; Desai N.R.
Institution
(Shah, Faridi, Ahmad, Wilson, Desai) Section of Cardiovascular Medicine,
Yale University School of Medicine, New Haven, CT, United States
(Ghazi) Department of Epidemiology, School of Public Health, University of
Alabama, Birmingham, AL, United States
(Yamamoto, Kumar, Martin, Simonov, Riello, Ahmad, Wilson, Desai) Clinical
and Translational Research Accelerator, Yale School of Medicine, New
Haven, CT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Lipid-lowering therapy (LLT) is underutilized for very
high-risk atherosclerotic cardiovascular disease. PROMPT-LIPID (PRagmatic
Trial of Messaging to Providers about Treatment of HyperLIPIDemia) sought
to determine whether electronic health record (EHR) alerts improve 90-day
LLT intensification in patients with very high-risk atherosclerotic
cardiovascular disease. METHOD(S): PROMPT-LIPID was a pragmatic trial
in which cardiovascular and internal medicine clinicians within Yale New
Haven Health (New Haven, CT) were cluster-randomized to receive an EHR
alert with individualized LLT recommendations or no alert for outpatients
with very high-risk atherosclerotic cardiovascular disease and LDL-C
(low-density lipoprotein cholesterol), >=70 mg/dL. The primary outcome was
90-day LLT intensification (change to high-intensity statin and addition
of ezetimibe or PCSK9i [proprotein subtilisin/kexin type 9 inhibitors]).
Secondary outcomes included LDL-C level, proportion of patients with LDL-C
of <70 or < 55 mg/dL, rate of major adverse cardiovascular events, ED
visit incidence, and 6-month mortality. Results were analyzed using
logistic and linear regression clustered at the provider level.
 RESULT(S): The no-alert group included 47 clinicians and 1370
patients (median age, 71 years; 50.1% female, median LDL-C, 93 mg/dL); the
alert group included 49 clinicians and 1130 patients (median age, 72
years; 47% female, median LDL-C 91, mg/dL). The primary outcome was
observed in 14.1% of patients in the alert group as compared with 10.4% in
the no-alert group. There were no differences in any secondary outcomes at
6 months. Among 542 patients whose clinicians (n=46) did not dismiss the
EHR alert recommendations, LLT intensification was significantly greater
(21.2% versus 10.4%, odds ratio, 2.33 [95% CI, 1.48-3.66]).
 CONCLUSION(S): With a real-time, targeted, individualized EHR alert
as compared with usual care, the proportion of patients with
atherosclerotic cardiovascular disease with LLT intensification was
numerically higher but not statistically significant. Among clinicians who
did not dismiss the alert, there was a > 2-fold increase in LLT
intensification. EHR alerts, coupled with strategies to reduce clinician
dismissal, may help address persistent gaps in LDL-C management.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04394715,
https://www.clinicaltrials.gov/ct2/show/study/NCT04394715. Copyright
© 2024 Lippincott Williams and Wilkins. All rights reserved.

<35>
Accession Number
2032491508
Title
Chronic systemic glucocorticoid therapy is associated with increased risk
of major vascular complications and cardiac tamponade after transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
Minerva Cardiology and Angiology. 72(3) (pp 284-291), 2024. Date of
Publication: June 2024.
Author
Chiabrando J.G.; Lombardi M.; Seropian I.M.; Valle Raleigh J.M.; Vergallo
R.; Larribau M.; Agatiello C.R.; Trani C.; Burzotta F.
Institution
(Chiabrando, Seropian, Valle Raleigh, Agatiello) Unit of Interventional
Cardiology, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
(Chiabrando, Larribau) Unit of Interventional Cardiology, Spanish Hospital
of Mendoza, Mendoza, Argentina
(Lombardi, Trani, Burzotta) Department of Cardiovascular Sciences, IRCCS
A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic
University, Rome, Italy
(Lombardi, Vergallo) Department of Internal Medicine and Medical
Specialties (DIMI), University of Genoa, Genoa, Italy
(Vergallo) Cardiothoracic and Vascular Department (DICATOV), IRCCS San
Martino Polyclinic Hospital, Genoa, Italy
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: TAVI-related complications, such as conduction disturbances,
vascular complications or death may be related to increased inflammatory
response. The aim of this study was to elucidate the efficacy and safety
of the systemic glucocorticoid therapy regarding the adverse events after
TAVI deployment. EVIDENCE ACQUISITION: We conducted a systemic search of
PubMed, a reference list of relevant articles, and Medline. The main
efficacy outcomes of interest were all-cause death, cardiac and
non-cardiac death, permanent pacemaker implantation (PPM), new left bundle
branch block (LBBB), stroke, and myocardial infarction (MI). Safety
endpoints were major vascular complications, major bleeding events, and
cardiac tamponade. EVIDENCE SYNTHESIS: A total of 7 studies including data
from 3439 patients with a median follow-up was 30 days. Systemic
glucocorticoid compared to the control group were associated with an
increased risk of non-cardiac death (Relative Risk [RR] 5.90 95%CI [2.95;
11.80], P<0.001) major vascular complications (RR 1.78, 95%CI [1.22 -
2.61], P=0.003) and cardiac tamponade (RR 3.42, 95%CI [1.69 - 6.92],
P<0.001). However, there were no differences in all-cause death, cardiac
death, new LBBB, stroke, MI, or major bleeding events (all P values
>0.05). CONCLUSION(S): Glucocorticoid therapy before the TAVI
procedure was associated with an increase in non-cardiac death, major
vascular events and cardiac tamponade. There were no differences in the
risk of all-cause death, cardiac death, PPM or LBBB, stroke, or
MI. Copyright © 2023 EDIZIONI MINERVA MEDICA.

<36>
Accession Number
2032488868
Title
Evaluation of the Efficacy of Transcatheter Intervention, Surgery, and
Pharmacological Treatment of Functional Mitral Regurgitation - A Bayesian
Network Meta-Analysis with >=12-Month Follow-up.
Source
Heart Surgery Forum. 27(5) (pp E533-E550), 2024. Date of Publication:
2024.
Author
Cheng Q.; Ding S.-Y.; Wang R.-H.; Han J.-S.; Ye Y.-Z.; Li X.-M.; Ma Y.-T.;
Yu Z.-X.
Institution
(Cheng, Ding, Wang, Han, Li, Ma, Yu) Department of Cardiology, Heart
Center, The First Affiliated Hospital, Xinjiang Medical University,
Xinjiang, Urumqi 830054, China
(Ye) Department of Cardiac Function, Heart Center, The First Affiliated
Hospital, Xinjiang Medical University, Xinjiang, Urumqi 830054, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Aim: Evaluate, using a Bayesian network meta-analysis system, the
long-term prognosis of patients with functional mitral regurgitation (FMR)
undergoing individual or combined treatment with percutaneous
intervention, surgical intervention, or optimal medical therapy. Compare
the prognostic outcomes of the different treatment modalities.
 Method(s): Computerized searches of Embase, PubMed, and the Cochrane
Library databases were performed. Randomized controlled trials (RCTs) and
observational studies were searched to compare prognoses following
transcatheter interventions, surgery, and optimal pharmacological
treatment for FMR, all with a construction timeframe of 21 October 2023.
The primary endpoint event was all-cause mortality. The secondary endpoint
events were heart failure readmission rate, mitral regurgitation (MR) <=2+
improvement rate, New York Heart Association (NYHA) improvement rate
(improvement to I-II), and degree of left ventricular ejection fraction
(LVEF) improvement. Result(s): Twenty-six (26) papers were included,
comprising 10 RCTs and 16 observational studies involving 5443 patients. A
network meta-analysis showed no significant difference in prognosis for
all-cause mortality among transcatheter interventions, surgical
procedures, and optimal pharmacological treatments. For heart failure
readmission rates, mitral valve surgery was superior to MitraClip (odds
ratio (OR) = 11.82;95% confidence interval (CI): 1.67, 90.13). For NYHA
(improvement to I-II) improvement rates, the results showed no significant
differences for the various mitral interventions. For MR <=2+ improvement
rates, the MitraClip (OR = 3.07;95% CI: 2.42, 3.76),
MitraClip+Guideline-directed medical therapy (GDMT) (OR = 2.93;95% CI:
2.38, 3.52), mitral valve surgery (OR = 3.01;95% CI: 2.24, 3.8), and
annuloplasty (OR = 4.31;95% CI: 3.12, 5.58) were superior to GDMT, and
mitral valve surgery (OR = 0.07;95% CI: - 0.45, 0.62) was superior to
MitraClip+GDMT. For the degree of improvement in LVEF, Carillon+GDMT (mean
difference (MD) = -0.97;95% CI: -1.72, -0.22) was superior to GDMT, mitral
valve surgery was superior to Carillon+ GDMT (MD = 4.67;95% CI: 0.92,
8.39);Mitra- Clip+GDMT (MD = 4.01;95% CI: 1.28, 6.66), GDMT (MD = 3.71;95%
CI: 0.04, 7.35), and annuloplasty were superior to mitral valve surgery
(MD = -6.42;95% CI: -11.96, -0.78). Conclusion(s): There were no
significant differences among the three treatment modalities of
transcatheter intervention, surgery, and optimal drug therapy in improving
all-cause mortality hard endpoint events, and no significant differences
were seen in the rates of heart failure readmission and NYHA improvement
(improvement to I-II). However, surgery was superior to transcatheter
intervention and optimal drug therapy in terms of improvement in the
degree of regurgitation and LVEF. Copyright © 2024 Forum
Multimedia Publishing, LLC.

<37>
Accession Number
2032488866
Title
Effect of Early Rehabilitation Exercise on Lower Limb Function and
Psychological State After Coronary Artery Bypass Grafting: A Randomized
Controlled Trial.
Source
Heart Surgery Forum. 27(5) (pp E520-E527), 2024. Date of Publication:
2024.
Author
Ma H.; Huang S.; You M.; Yang J.; Zong R.; Zhang C.
Institution
(Ma, Huang, You, Yang, Zong, Zhang) Department of Cardiovascular Surgery,
The First Affiliated Hospital, Anhui Medical University, Anhui, Hefei
230021, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: While early rehabilitation exercise has been shown to improve
cardiopulmonary function and functional outcomes after revascularization
in individuals who have undergone coronary artery bypass grafting (CABG),
further research is still needed to fully understand the importance of
psychological status and limb functional rehabilitation following CABG.
Therefore, the purpose of this study was to investigate the effects of
early rehabilitation exercise on lower limb function and mental health
after coronary artery bypass grafting. Method(s): Eighty patients who
underwent CABG were randomly divided into a routine exercise group and an
early rehabilitation exercise group. The degree of lower limb swelling,
the amount of incision complications, the first time the patient got out
of bed after the operation, the length of postoperative hospital stay,
activity tolerance and postoperative psychological state were compared
between the two groups. Result(s): The incidence of postoperative
lower extremity oedema was 30% in the early rehabilitative exercise group
as compared to 52.5% in the routine exercise group. Between the two
groups, there was a statistically significant difference (p < 0.05) in the
incidence of postoperative lower limb edema as well as the amount of
swelling in the thighs and ankles on postoperative days 1, 3, and 5. In
the routine exercise group, the first time the patients got out of bed was
3.45 +/-1.09 days, and the length of postoperative hospitalization was
12.75 +/-5.06 days. In the early rehabilitation exercise group, the first
time the patients got out of bed was 1.93 +/-0.57 days, and the length of
postoperative hospitalization was 9.50 +/-2.92 days. There were
statistically significant differences in these two indices between the two
groups (p < 0.05). The activity tolerance of patients in the routine
exercise group was 46.10 +/-19.09 min at 2 months after surgery and 69.88
+/-19.05 min at 3 months after surgery. The activity tolerance of patients
in the early rehabilitation exercise group was 56.40 +/-17.42 min at 2
months after surgery and 105 +/-23.04 min at 3 months after surgery, and
there was a significant difference in activity tolerance between the two
groups at these time points following surgery (p < 0.05). In addition,
there were statistically significant differences in the Patient Health
Questionnaire-9, Generalized Anxiety Self-Assessment Scale-7 and
Pittsburgh Sleep Quality Index scores between the two groups (p < 0.05).
 Conclusion(s): Early rehabilitation exercises can promote the
recovery of lower limb function after CABG to a certain extent, shorten
the postoperative bed rest time and hospital stay, and effectively improve
postoperative psychological wellbeing and sleep quality. Copyright
© 2024 Forum Multimedia Publishing, LLC.

<38>
Accession Number
2032488205
Title
Repeat Mitral Valve Interventions After Transcatheter Edge-to-Edge Repair:
The COAPT Trial.
Source
American Journal of Cardiology. 223 (pp 7-14), 2024. Date of Publication:
15 Jul 2024.
Author
Shahim B.; Cohen D.J.; Asch F.M.; Bax J.; George I.; Ruck A.; Ben-Yehuda
O.; Kar S.; Lim D.S.; Saxon J.T.; Zhou Z.; Lindenfeld J.; Abraham W.T.;
Mack M.J.; Stone G.W.
Institution
(Shahim, Cohen, Zhou) Clinical Trials Center, Cardiovascular Research
Foundation, New York, New York, United States
(Shahim, Ruck) Department of Medicine, Karolinska Institutet, Stockholm,
Sweden
(Shahim, Ruck) Cardiology Unit, Karolinska University Hospital, Stockholm,
Sweden
(Cohen) St. Francis Hospital, Roslyn, New York, United States
(Asch) MedStar Health Research Institute, Washington, DC, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(George) NewYork-Presbyterian Hospital/Columbia University Irving Medical
Center, New York, New York, United States
(Ben-Yehuda) Sulpizio Cardiovascular Institute, University of California -
San Diego, San Diego, California, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim, Saxon) Division of Cardiology, University of Virginia,
Charlottesville, VA, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
College of Medicine, Columbus, OH, United States
(Mack) Baylor Scott and White Heart Hospital Plano, Plano, Texas, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
The frequency and effectiveness of repeat mitral valve interventions
(RMVI) after transcatheter edge-to-edge repair (TEER) for secondary mitral
regurgitation (MR) are unknown. We aimed to examine the rate of and
outcomes after RMVI after TEER in the Cardiovascular Outcomes Assessment
of the MitraClip Percutaneous Therapy for Heart Failure Patients with
Functional Mitral Regurgitation (COAPT) trial. Only 3.9% of COAPT trial
patients required a repeat mitral valve intervention during 4-year
follow-up which was successful in 90% of cases but was associated with an
increased rate of heart failure (HF) hospitalizations (HFH). The COAPT
trial randomized HF patients with severe secondary MR to TEER with the
MitraClip device plus guideline-directed medical therapy (GDMT) versus
GDMT alone. We evaluated the characteristics and outcomes of patients who
had an RMVI during 4-year follow-up. A MitraClip implant was attempted in
293 patients randomized to TEER+GDMT, 10 of whom underwent an RMVI
procedure (9 repeat TEER and 1 surgical mitral valve replacement) after 4
years of follow-up (cumulative incidence 3.90%, 95% confidence interval
[CI] 2.08 to 7.08; median 182 days after the initial procedure). Patients
with RMVI had larger mitral annular diameters, fewer clips implanted, and
were more likely to have >=3+MR at discharge compared with those without
RMVI. Reasons for RMVI included failed index procedure because of
difficult transseptal puncture (n = 2) or tamponade (n = 1); residual or
recurrent severe MR after an initially successful procedure (n = 5);
partial clip detachment (n = 1); and site-assessed mitral stenosis (n =
1). RMVI was successful in 8/10 (80%) patients. Patients who underwent
RMVI had higher 4-year rates of HFH but similar mortality compared with
those without RMVI. The annualized incidence rates of all HFH in patients
who underwent RMVI were 234 events per 100 person-years (95% CI 139 to
395) pre-RMVI and 46 per 100 person-years (95% CI 25 to 86) post-RMVI as
compared with 32 events per 100 patient-years (95% CI 28 to 36) in
patients without RMVI. The rate ratio of HFH was reduced after RMVI in
patients who underwent RMVI (0.20, 95% CI 0.09 to 0.45). In conclusion,
the cumulative incidence of RMVI after 4 years was 3.9% in patients who
underwent TEER for severe secondary MR in the COAPT trial. Patients who
underwent RMVI were at increased risk of HFH which was reduced after the
RMVI procedure. Clinical Trial Registration: Clinical Trial Name:
Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation (The COAPT
Trial) (COAPT) ClinicalTrial.gov Identifier: NCT01626079
URL:https://clinicaltrials.gov/ct2/show/NCT01626079 Copyright ©
2024 Elsevier Inc.

<39>
Accession Number
2032395046
Title
Sodium-Glucose Cotransporter-2 Inhibitors and Cardiovascular Protection
among Patients with Type 2 Diabetes Mellitus: A Systematic Review.
Source
Journal of Diabetes Research. 2024 (no pagination), 2024. Article Number:
9985836. Date of Publication: 2024.
Author
Yankah R.K.; Anku E.K.; Eligar V.
Institution
(Yankah) Diabetes Specialist Clinic, Cape Coast Teaching Hospital, Cape
Coast, Ghana
(Anku) Dietherapy and Nutrition Unit, Cape Coast Teaching Hospital, P.O.
Box CC 1363, Cape Coast, Ghana
(Eligar) Department of Diabetes and Endocrinology, Imperial College London
Diabetes Centre, Abu Dhabi, United Arab Emirates
Publisher
Hindawi Limited
Abstract
Background: Accumulating evidence has demonstrated the positive effects of
sodium-glucose cotransporter-2 (SGLT2) inhibitors in managing patients
with type 2 diabetes mellitus (T2DM). SGLT2 inhibitors protect patients
with T2DM from cardiovascular complications and are generally safe.
 Aim(s): The aim of this study is to assess the cardiovascular effects
of SGLT2 inhibitors in patients with T2DM. Method(s): A systematic
review was conducted using published English literature in PubMed and
Google Scholar databases. Result(s): Most of the studies showed
significant positive cardiovascular effects of SGLT2 inhibitors in
patients with and without established cardiovascular disease (CVD).
Empagliflozin reduced the risk of cardiovascular death, hospitalization
for heart failure (HHF), cardiovascular death or heart failure, and major
adverse cardiovascular events (MACE) such as nonfatal stroke, nonfatal
myocardial infarction, and cardiovascular death regardless of the number
of cardiovascular risk factors. The effects of empagliflozin on
cardiovascular events and mortality in patients with coronary artery
bypass graft (CABG) were assessed. Further, the efficacy of empagliflozin
in three different phenotypic groups, namely, younger patients with
shorter duration of T2DM and highest glomerular filtration rate, women
without coronary artery disease, and older adults with advanced coronary
artery disease plus several comorbidities, was also assessed. The effects
of canagliflozin were evaluated in patients with and without a history of
CVD and with different body weights, and in those with and without prior
heart failure. Treatment with canagliflozin based on
multivariable-predicted cardiovascular risk factors prevented heart
failure events more than treatment based on glycated hemoglobin and
albuminuria alone. The efficacy of dapagliflozin was evaluated in patients
with or at risk of atherosclerotic cardiovascular disease (ASCVD), heart
failure status, and left ventricular ejection fraction (LVEF), as well as
the elderly population. A reduction in HHF or cardiovascular death and
insignificant reduction in MACE were noted. Furthermore, significant
reduction in the risk of cardiovascular death and all-cause mortality in
patients with heart failure with reduced ejection fraction (HFrEF) was
also observed. Sotagliflozin was studied for its cardiovascular outcomes
in patients with chronic kidney disease with or without albuminuria and
resulted in a reduction in cardiovascular-related deaths and HHF.
 Conclusion(s): SGLT2 inhibitors have beneficial cardiovascular
effects in patients with T2DM and should be incorporated into their
management. Copyright © 2024 Richard K. Yankah et al.

<40>
Accession Number
2030655428
Title
Which trial do we need? Percutaneous mechanical aspiration versus medical
management alone for treatment of right-sided valvular infective
endocarditis.
Source
Clinical Microbiology and Infection. 30(6) (pp 703-706), 2024. Date of
Publication: June 2024.
Author
Hillenbrand M.; Mourad A.; Holland T.L.; Turner N.A.
Institution
(Hillenbrand, Mourad, Holland, Turner) Division of Infectious Diseases,
Department of Medicine, Duke University Medical Center, Durham, NC, United
States
(Holland) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
Publisher
Elsevier B.V.

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

<42>
Accession Number
2029910275
Title
Effect of concomitant tricuspid annuloplasty on postoperative wound
complications in heart failure patients undergoing mitral valve repair.
Source
International Wound Journal. 21(5) (no pagination), 2024. Article Number:
e14835. Date of Publication: May 2024.
Author
Hou Y.; Guo L.; Li Y.; Cai J.
Institution
(Hou, Cai) Department of Infectious Diseases, Naval Medical Center, Naval
Medical University, Shanghai, China
(Hou) Department of Second Internal Medicine, Naval Hospital of Eastern
Theater Command, Zhejiang, Zhoushan, China
(Guo) Department of Cardiology, Changde First People's Hospital, Hunan,
Changde, China
(Li) Department of Respiratory and Critical Care Medicine, The 906rd
Hospital, Joint Logistic Support Force of Chinese People's Liberation
Army, Zhejiang, Ningbo, China
Publisher
John Wiley and Sons Inc
Abstract
Tricuspid valve repair (TVR) combined with mitral valve surgery (MVS) has
been a controversial issue. It is not clear whether the combined surgery
has any influence on the occurrence of postoperative complications. The
aim of this study was to compare the occurrence of complications including
wound infection, wound bleeding, and mortality after MVS combined with or
without TVR. By meta-analysis, a total of 1576 papers were collected from
3 databases, and 7 of them were included. We provided the necessary data
of 7 included studies such as the authors, publication date, country,
surgical approach and case number, patient age, and so on. Statistical
analysis was carried out with RevMan 5.3 software. We found that patients
with heart failure accepting MVS combined with or without TVR, performed
no statistically significant difference in postoperative wound infection
(OR: 0.88; 95% CI: 0.29, 2.62; P = 0.81), wound bleeding (OR: 0.74; 95%
CI: 0.3, 1.48; P = 0.39), and mortality (OR: 1.05; 95% CI: 0.42, 2.61; P =
0.92). In conclusion, current evidence indicated that the combined surgery
had no additional risk of postoperative complications, and might be an
effective alternative surgical approach to mitral valve diseases accompany
with tricuspid regurgitation. However, for the limited case size, it was
required to support the findings with a large number of cases in further
studies. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<43>
Accession Number
2029393548
Title
Effect of an intravenous acetaminophen/ibuprofen fixed-dose combination on
postoperative opioid consumption and pain after video-assisted thoracic
surgery: a double-blind randomized controlled trial.
Source
Surgical Endoscopy. 38(6) (pp 3061-3069), 2024. Date of Publication: June
2024.
Author
Lee H.-J.; Choi S.; Yoon S.; Bahk J.-H.
Institution
(Lee, Choi, Yoon, Yoon, Bahk) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu,
Seoul 03080, South Korea
(Lee, Yoon, Bahk) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul
03080, South Korea
Publisher
Springer
Abstract
Background: Video-assisted thoracoscopic surgery (VATS) often induces
significant postoperative pain, potentially leading to chronic pain and
decreased quality of life. This study aimed to evaluate the
acetaminophen/ibuprofen combination effectiveness in reducing analgesic
requirements and pain intensity in patients undergoing VATS. Study design:
This is a double-blinded randomized controlled trial. Method(s):
Adult patients scheduled for elective VATS for lung resection were
randomized to receive either intravenous acetaminophen and ibuprofen
(intervention group) or 100 mL normal saline (control group). Treatments
were administered post-anesthesia induction and every 6 h for three
cycles. The primary outcome was total analgesic consumption at 24 h
postoperatively. Secondary outcomes were cumulative analgesic consumption
at 2 and 48 h; analgesic-related side effects at 2, 24, and 48 h; quality
of recovery at 24 h and 48 h postoperatively; pain intensity at rest and
during coughing; and rescue analgesics use. Chronic postsurgical pain
(CPSP) was assessed through telephone interviews 3 months postoperatively.
 Result(s): The study included 96 participants. The intervention group
showed significantly lower analgesic consumption at 24 h and 48 h
postoperatively (24 h: median difference: - 100 microg equivalent
intravenous fentanyl [95% confidence interval (CI) - 200 to - 5 mug], P =
0.037; 48 h: median difference: - 140 mug [95% CI - 320 to - 20 mug], P =
0.035). Compared to the controls, the intervention group exhibited a
significantly lower quality of recovery 24 h post-surgery, with no
significant difference at 48 h. All pain scores except for coughing at 48
h post-surgery were significantly lower in the intervention group compared
to the controls. No significant differences were observed between the
groups in postoperative nausea and vomiting occurrence, hospital stay
length, and CPSP. Conclusion(s): Perioperative administration of
acetaminophen/ibuprofen significantly decreased analgesic needs in
patients undergoing VATS, providing an effective postoperative pain
management strategy, and potentially minimizing the need for stronger
analgesics. Copyright © The Author(s) 2024.

<44>
Accession Number
2030001106
Title
Hemodynamic changes in the prone position according to fluid loading after
anaesthesia induction in patients undergoing lumbar spine surgery: a
randomized, assessor-blind, prospective study.
Source
Annals of Medicine. 56(1) (no pagination), 2024. Article Number: 2356645.
Date of Publication: 2024.
Author
Lee S.; Kim D.Y.; Han J.; Kim K.; You A.H.; Kang H.Y.; Park S.W.; Kim
M.K.; Kim J.E.; Choi J.-H.
Institution
(Lee, Kim, Han, You, Kang, Park, Kim, Choi) Department of Anesthesiology
and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee
University Hospital, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Korea University
Anam Hospital, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart
Hospital, Hallym University College of Medicine, Seoul, South Korea
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: A change from the supine to prone position causes
hemodynamic alterations. We aimed to evaluate the effect of fluid
preloading in the supine position, the subsequent hemodynamic changes in
the prone position and postoperative outcomes. Patients and Methods:
This prospective, assessor-blind, randomized controlled trial was
conducted between March and June 2023. Adults scheduled for elective
orthopaedic lumbar surgery under general anaesthesia were enrolled. In
total, 80 participants were randomly assigned to fluid maintenance (M) or
loading (L) groups. Both groups were administered intravenous fluid at a
rate of 2 ml/kg/h until surgical incision; Group L was loaded with an
additional 5 ml/kg intravenous fluid for 10 min after anaesthesia
induction. The primary outcome was incidence of hypotension before
surgical incision. Secondary outcomes included differences in the mean
blood pressure (mBP), heart rate, pleth variability index (PVi), stroke
volume variation (SVV), pulse pressure variation (PPV), stroke volume
index and cardiac index before surgical incision between the two groups.
Additionally, postoperative complications until postoperative day 2 and
postoperative hospital length of stay were investigated. Result(s):
Hypotension was prevalent in Group M before surgical incision and could be
predicted by a baseline PVi >16. The mBP was significantly higher in Group
L immediately after fluid loading. The PVi, SVV and PPV were lower in
Group L after fluid loading, with continued differences at 2-3 time points
for SVV and PPV. Other outcomes did not differ between the two groups.
 Conclusion(s): Fluid loading after inducing general anaesthesia could
reduce the occurrence of hypotension until surgical incision in patients
scheduled for surgery in the prone position. Additionally, hypotension
could be predicted in patients with a baseline PVi >16. Therefore,
intravenous fluid loading is strongly recommended in patients with high
baseline PVi to prevent hypotension after anaesthesia induction and in the
prone position. Trial number: KCT0008294 (date of registration: 16 March
2023). Copyright © 2024 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<45>
Accession Number
2032491168
Title
Cytomegalovirus infection and cardiovascular outcomes in abdominal organ
transplant recipients: A systematic review and meta-analysis.
Source
Transplantation Reviews. 38(4) (no pagination), 2024. Article Number:
100860. Date of Publication: December 2024.
Author
Arvanitis P.; Davis M.R.; Farmakiotis D.
Institution
(Arvanitis, Farmakiotis) Division of Infectious Diseases, The Warren
Alpert Medical School of Brown University, Providence, RI, United States
(Davis) The Warren Alpert Medical School of Brown University, Providence,
RI, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Despite advancements in Cytomegalovirus (CMV) management,
its impact on graft function, mortality, and cardiovascular (CV) health of
organ transplant recipients (OTR) remains a significant concern. We
investigated the association between CMV infection and CV events (CVE) in
organ (other than heart) transplant recipients. Method(s): We
conducted a comprehensive literature search in PubMed and EMBASE,
including studies that reported on CMV infection or disease and
post-transplantation CVE. Studies of heart transplant recipients were
excluded. Result(s): We screened 3875 abstracts and 12 clinical
studies were included in the final analysis, mainly in kidney and liver
transplant recipients. A significant association was observed between CMV
infection and an increased risk of CVE, with a pooled unadjusted hazard
ratio (HR) of 1.99 (95% Confidence Intervals [CI] 1.45-2.73) for CMV
infection and 1.59 (95% CI 1.21-2.10) for CMV disease. Pooled adjusted HR
were 2.17 (95% CI 1.47-3.20) and 1.77 (95% CI 0.83-3.76), respectively.
Heterogeneity was low (I2 = 0%) for CMV infection, suggesting
consistent association across studies, and moderate-to-high for CMVdisease
(I2 = 50% for unadjusted, 53% for adjusted HR).
 Discussion(s): We found a significant association between CMV
infection and CV risk in abdominal OTR, underscoring the importance of
proactive CMV surveillance and early treatment. Future research should aim
for more standardized methodologies to fully elucidate the relationship
between CMV and CV outcomes, potentially informing novel preventive and
therapeutic strategies that could benefit the CV health of
OTR. Copyright © 2024 Elsevier Inc.

<46>
Accession Number
2032463661
Title
Randomized Trial of Remote Assessment of Patients After an Acute Coronary
Syndrome.
Source
Journal of the American College of Cardiology. 83(23) (pp 2250-2259),
2024. Date of Publication: 11 Jun 2024.
Author
Alshahrani N.S.; Hartley A.; Howard J.; Hajhosseiny R.; Khawaja S.;
Seligman H.; Akbari T.; Alharbi B.A.; Bassett P.; Al-Lamee R.; Francis D.;
Kaura A.; Kelshiker M.A.; Peters N.S.; Khamis R.
Institution
(Alshahrani, Hartley, Howard, Hajhosseiny, Alharbi, Al-Lamee, Francis,
Kaura, Kelshiker, Peters, Khamis) National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Alshahrani, Alharbi) King Khalid University, Abha, Saudi Arabia
(Hartley, Howard, Hajhosseiny, Khawaja, Seligman, Akbari, Al-Lamee,
Francis, Kaura, Kelshiker, Peters, Khamis) Imperial College Healthcare NHS
Trust, London, United Kingdom
(Bassett) Statsconsultancy Ltd, Buckinghamshire, Amersham, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Telemedicine programs can provide remote diagnostic
information to aid clinical decisions that could optimize care and reduce
unplanned readmissions post-acute coronary syndrome (ACS).
 Objective(s): TELE-ACS (Remote Acute Assessment of Patients With High
Cardiovascular Risk Post-Acute Coronary Syndrome) is a randomized
controlled trial that aims to compare a telemedicine-based approach vs
standard care in patients following ACS. Method(s): Patients were
suitable for inclusion with at least 1 cardiovascular risk factor and
presenting with ACS and were randomized (1:1) before discharge. The
primary outcome was time to first readmission at 6 months. Secondary
outcomes included emergency department (ED) visits, major adverse
cardiovascular events, and patient-reported symptoms. The primary analysis
was performed according to intention to treat. Result(s): A total of
337 patients were randomized from January 2022 to April 2023, with a 3.6%
drop-out rate. The mean age was 58.1 years. There was a reduced rate of
readmission over 6 months (HR: 0.24; 95% CI: 0.13-0.44; P < 0.001) and ED
attendance (HR: 0.59; 95% CI: 0.40-0.89) in the telemedicine arm, and
fewer unplanned coronary revascularizations (3% in telemedicine arm vs 9%
in standard therapy arm). The occurrence of chest pain (9% vs 24%),
breathlessness (21% vs 39%), and dizziness (6% vs 18%) at 6 months was
lower in the telemedicine group. Conclusion(s): The TELE-ACS study
has shown that a telemedicine-based approach for the management of
patients following ACS was associated with a reduction in hospital
readmission, ED visits, unplanned coronary revascularization, and
patient-reported symptoms. (Telemedicine in High-Risk Cardiovascular
Patients Post-ACS [TELE-ACS]; NCT05015634) Copyright © 2024
American College of Cardiology Foundation

<47>
Accession Number
2032451999
Title
The Danish-Norwegian randomized trial on beta-blocker therapy after
myocardial infarction: Design, rationale, and baseline characteristics.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(3) (pp
175-183), 2024. Date of Publication: 01 Apr 2024.
Author
Kristensen A.M.D.; Munkhaugen J.; Halvorsen S.; Olsen M.H.; Bakken A.;
Sehested T.S.G.; Ruddox V.; Lange T.; Fagerland M.W.; Torp-Pedersen C.;
Prescott E.; Atar D.
Institution
(Kristensen, Prescott) Department of Cardiology, Copenhagen University
Hospital-Bispebjerg and Frederiksberg, Copenhagen 2000, Denmark
(Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Trust,
Institute of Behavioural Medicine, University of Oslo, Drammen 3004,
Norway
(Halvorsen, Bakken, Atar) Department of Cardiology, Oslo University
Hospital Ulleval, University of Oslo, Oslo 0450, Norway
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Department of Internal Medicine 1, Holbaek Hospital, Holbaek
4300, Denmark
(Sehested) Department of Cardiology, Zealand University Hospital Roskilde,
Roskilde 4000, Denmark
(Lange) Section of Biostatistics, Department of Public Health, University
of Copenhagen, Copenhagen 1353, Denmark
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Oslo
University Hospital, Oslo 0317, Norway
(Torp-Pedersen) Department of Cardiology, Copenhagen University
Hospital-North Zealand Hospital, Hillerod 3400, Denmark
Publisher
Oxford University Press
Abstract
Background and aims: The evidence for beta-blocker therapy after
myocardial infarction (MI) is randomized trials conducted more than 30
years ago, and the continued efficacy has been questioned. Design and
methods: The ongoing Danish (DANBLOCK) and Norwegian (BETAMI) randomized
beta-blocker trials are joined to evaluate the effectiveness and risks of
long-Term beta-blocker therapy after MI. Patients with normal or mildly
reduced left ventricular ejection fraction (LVEF >= 40%) will be
randomized to open-label treatment with beta-blockers or no such therapy.
The event-driven trial will randomize ~5700 patients and continue until
950 primary endpoints have occurred. As of July 2023, 5228 patients have
been randomized. Of the first 4000 patients randomized, median age was 62
years, 79% were men, 48% had a ST-segment elevation myocardial infarction
(STEMI), and 84% had a normal LVEF. The primary endpoint is a composite of
adjudicated recurrent MI, incident heart failure (HF), coronary
revascularization, ischaemic stroke, all-cause mortality, malignant
ventricular arrhythmia, or resuscitated cardiac arrest. The primary safety
endpoint includes a composite of recurrent MI, HF, all-cause mortality,
malignant ventricular arrhythmia, or resuscitated cardiac arrest 30 days
after randomization. Secondary endpoints include each of the components of
the primary endpoint, patient-reported outcomes, and other clinical
outcomes linked to beta-blocker therapy. The primary analysis will be
conducted according to the intention-To-Treat principle using a Cox
proportional hazards regression model. End of follow-up is expected in
December 2024. Conclusion(s): The combined BETAMI-DANBLOCK trial will
have the potential to affect current clinical practice for beta-blocker
therapy in patients with normal or mildly reduced LVEF after
MI. Copyright © 2023 The Author(s).

<48>
Accession Number
2032319195
Title
Strategies to address recruitment to a randomised trial of surgical and
non-surgical treatment for cancer: Results from a complex recruitment
intervention within the Mesothelioma and Radical Surgery 2 (MARS 2) study.
Source
BMJ Open. 14(5) (no pagination), 2024. Article Number: e079108. Date of
Publication: 16 May 2024.
Author
Mills N.; Farrar N.; Warnes B.; Ashton K.E.; Harris R.; Rogers C.A.; Lim
E.; Elliott D.
Institution
(Mills, Farrar, Warnes, Ashton, Harris, Rogers, Elliott) Bristol Medical
School, University of Bristol, Faculty of Health Sciences, Bristol, United
Kingdom
(Lim) Academic Division of Thoracic Surgery, Royal Brompton Hospital,
London, United Kingdom
(Lim) National Heart and Lung Institute, Imperial College London, Faculty
of Medicine, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives Recruiting to randomised trials is often challenging
particularly when the intervention arms are markedly different. The
Mesothelioma and Radical Surgery 2 randomised controlled trial (RCT)
compared standard chemotherapy with or without (extended) pleurectomy
decortication surgery for malignant pleural mesothelioma. Anticipating
recruitment difficulties, a QuinteT Recruitment Intervention was embedded
in the main trial phase to unearth and address barriers. The trial
achieved recruitment to target with a 4-month COVID-19 pandemic-related
extension. This paper presents the key recruitment challenges, and the
strategies delivered to optimise recruitment and informed consent. Design
A multifaceted, flexible, mixed-method approach to investigate recruitment
obstacles drawing on data from staff/patient interviews, audio recorded
study recruitment consultations and screening logs. Key findings were
translated into strategies targeting identified issues. Data collection,
analysis, feedback and strategy implementation continued cyclically
throughout the recruitment period. Setting Secondary thoracic cancer care.
Results Respiratory physicians, oncologists, surgeons and nursing
specialists supported the trial, but recruitment challenges were evident.
The study had to fit within a framework of a thoracic cancer service
considered overstretched where patients encountered multiple healthcare
professionals and treatment views, all of which challenged recruitment.
Clinician treatment biases, shaped in part by the wider clinical and
research context alongside experience, adversely impacted several aspects
of the recruitment process by restricting referrals for study
consideration, impacting eligibility decisions, affecting the neutrality
in which the study and treatment was presented and shaping patient
treatment expectations and preferences. Individual and group recruiter
feedback and training raised awareness of key equipoise issues, offered
support and shared good practice to safeguard informed consent and
optimise recruitment. Conclusions With bespoke support to overcome
identified issues, recruitment to a challenging RCT of surgery versus no
surgery in a thoracic cancer setting with a complex recruitment pathway
and multiple health professional involvement is possible. Trial
registration number ISRCTN ISRCTN44351742, Clinical Trials.gov
NCT02040272. Copyright © 2024 Author(s). Published by BMJ.

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

<50>
Accession Number
2029435170
Title
Bivalirudin versus heparin in contemporary percutaneous coronary
interventions for patients with acute coronary syndrome: A systematic
review and meta-analysis.
Source
Cardiology Journal. 31(2) (pp 309-320), 2024. Date of Publication: 26 Apr
2024.
Author
Zhang J.; Chen Z.; Wang D.; Li C.; Luo F.; He Y.
Institution
(Zhang, Chen, Li, He) Department of Cardiology, West China Hospital of
Sichuan University, Chengdu, China
(Wang) Department of Clinical Sciences, Liverpool School of Tropical
Medicine, Liverpool, United Kingdom
(Luo) Department of Rehabilitation, Community Health Center of Huaxing,
Wuhou District, Sichuan, Chengdu, China
Publisher
Via Medica
Abstract
Background: Bivalirudin is associated with fewer major bleeding events
than heparin in patients undergoing percutaneous coronary intervention
(PCI), but confounding effects of concomitant glycoprotein IIb/IIIa
inhibitors, routine femoral artery access, and less potent effects of
clopidogrel limits meaningful comparisons. The present study is a
systematic review and meta-analysis to compare bivalirudin to heparin in
contemporary practice. Method(s): The Cochrane Library, PubMed,
EMBASE, and Ovid MEDLINE databases were searched for relevant studies,
including comparisons between bivalirudin and heparin in the current
medical era from inception to December 23, 2021. Studies reporting
incidences of major adverse cardiac events (MACE) and net adverse clinical
events (NACE) in patients undergoing PCI and meeting the inclusion
criteria were retained. Data extraction was performed by three independent
reviewers. Result(s): The meta-analysis included 8 studies. Compared
to heparin, bivalirudin during PCI was associated with a lower NACE risk,
lower all-cause death, and similar MACE risk, with a pooled risk ratio of
0.82 (95% confidence interval [CI] 0.69-0.97, p = 0.02), 0.83 (95% CI
0.74-0.94, p = 0.002), and 0.93 (95% CI 0.78-1.10, p = 0.38),
respectively. Moreover, the reduction in NACE was mainly attributed to
reduced bleeding (22% reduction in the risk of major bleeding, 95% CI
0.63-0.97, p = 0.03). Conclusion(s): These findings suggest that
bivalirudin use during PCI reduced the risk of NACE and all-cause death
but did not reduce the risk of MACE compared with heparin use in PCI. More
studies specifically designed for anticoagulation strategies and a
personalized anticoagulation regimen to comprehensively balance bleeding
and ischemia risks are required. Copyright © 2024 Via Medica.

<51>
Accession Number
2029420059
Title
Translational Research of the Acute Effects of Negative Emotions on
Vascular Endothelial Health: Findings From a Randomized Controlled Study.
Source
Journal of the American Heart Association. 13(9) (no pagination), 2024.
Article Number: e032698. Date of Publication: 07 May 2024.
Author
Shimbo D.; Cohen M.T.; McGoldrick M.; Ensari I.; Diaz K.M.; Fu J.; Duran
A.T.; Zhao S.; Suls J.M.; Burg M.M.; Chaplin W.F.
Institution
(Shimbo, McGoldrick, Diaz, Fu, Duran, Zhao) Columbia University Irving
Medical Center, New York, NY, United States
(Cohen, Chaplin) St. John's University, New York, NY, United States
(Ensari) Department of Artificial Intelligence and Human Health, Icahn
School of Medicine at Mount Sinai, Hasso Plattner Institute for Digital
Health at Mount Sinai, New York, NY, United States
(Suls) Institute for Health System Science, Feinstein Institute for
Medical Research/Northwell Health, New York, NY, United States
(Burg) Yale School of Medicine, New Haven, CT, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Provoked anger is associated with an increased risk of
cardiovascular disease events. The underlying mechanism linking provoked
anger as well as other core negative emotions including anxiety and
sadness to cardiovascular disease remain unknown. The study objective was
to examine the acute effects of provoked anger, and secondarily, anxiety
and sadness on endothelial cell health. METHODS AND RESULTS: Apparently
healthy adult participants (n=280) were randomized to an 8-minute anger
recall task, a depressed mood recall task, an anxiety recall task, or an
emotionally neutral condition. Pre-/post-assessments of endothelial health
including endothelium-dependent vasodilation (reactive hyperemia index),
circulating endothelial cell-derived microparticles (CD62E+, CD31+/CD42-,
and CD31+/Annexin V+) and circulating bone marrow-derived endothelial
progenitor cells (CD34+/CD133+/kinase insert domain receptor+ endothelial
progenitor cells and CD34+/kinase insert domain receptor+ endothelial
progenitor cells) were measured. There was a groupxtime interaction for
the anger versus neutral condition on the change in reactive hyperemia
index score from baseline to 40 minutes (P=0.007) with a mean+/-SD change
in reactive hyperemia index score of 0.20+/-0.67 and 0.50+/-0.60 in the
anger and neutral conditions, respectively. For the change in reactive
hyperemia index score, the anxiety versus neutral condition group by time
interaction approached but did not reach statistical significance
(P=0.054), and the sadness versus neutral condition group by time
interaction was not statistically significant (P=0.160). There were no
consistent statistically significant groupxtime interactions for the
anger, anxiety, and sadness versus neutral condition on endothelial
cell-derived microparticles and endothelial progenitor cells from baseline
to 40 minutes. CONCLUSION(S): In this randomized controlled
experimental study, a brief provocation of anger adversely affected
endothelial cell health by impairing endothelium-dependent
vasodilation. Copyright © 2024 The Authors. Published on behalf
of the American Heart Association, Inc., by Wiley.

<52>
Accession Number
2029407190
Title
Ultrasound-guided erector spinae plane block in posterior lumbar surgery
(Review).
Source
Biomedical Reports. 20(6) (no pagination), 2024. Article Number: 95. Date
of Publication: 2024.
Author
Deng K.; Huang K.; Wu G.-F.
Institution
(Deng, Huang) Department of Orthopedics, The First Affiliated Hospital of
Yangtze University, Hubei, Jingzhou 434300, China
(Wu) Department of Orthopedics, Southern University of Science and
Technology Hospital, Guangdong, Shenzhen 518052, China
Publisher
Spandidos Publications
Abstract
The erector spinae plane block (ESPB) is a novel fascial planar block
technique, which is used to reduce postoperative pain in several surgical
procedures, including breast, thoracic, spine and hip surgery. Due to its
recognizable anatomy and low complication rate, the application of ESPB
has been significantly increased. However, it is rarely used in clinical
practice for postoperative analgesia after posterior lumbar spine surgery,
while the choice of adjuvant drugs, block levels and drug doses remain
controversial. Based on the current literature review, ropivacaine and
dexmedetomidine could be considered as the best available drug
combination. The present review aimed to analyze the currently available
clinical evidence and summarize the benefits and challenges of ESPB in
spinal surgery, thus providing novel insights into the application of ESPB
in the postoperative management of posterior lumbar surgery. Copyright
© 2024 Deng et al.

<53>
Accession Number
2032519495
Title
Early Outcomes in Robotic Versus Mini-Thoracotomy Versus Conventional
Sternotomy for Mitral Valve Surgery.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S10), 2024. Date of
Publication: June 2024.
Author
Indja B.; Chang J.W.; Chan S.; Flynn C.
Institution
(Indja, Chang, Chan, Flynn) St George Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: The approaches to mitral valve surgery includes conventional
sternotomy (CS), mini-thoracotomy (MI), and robotic surgery (RS). The
avoidance of a sternotomy is increasingly sought after due to the proposed
benefits related to a faster recovery and return to regular activities but
this is countered by concerns, such as achieving more technically
demanding valve repairs and the purported increased stroke risk of
peripheral cannulation for cardiopulmonary bypass. Method(s): An
electronic search of two medical databases was performed from 2000 to
2023. Studies which compared early outcomes of mitral valve surgery via
CS, MI or a RS were included. A network meta-analysis was performed to
compare early outcomes using NetMetaXL software. Result(s): 17
studies with a total of 6,205 patients were included. While
cardiopulmonary bypass time and cross clamp time were longer in the MI and
RS groups as compared with CS, there was no significant difference in
early mortality (RS vs MI OR 0.76, 95% CI 0.1-4.99; RS vs MS OR 0.52, 95%
CI 0.06-3.99; MI vs MS OR 0.7, 95% CI 0.27-1.64), stroke/TIA (RS vs MS OR
0.23, 95% CI 0.02-1.6; RS vs MI OR 0.26, 95% CI 0.03-1.57; MI vs MS OR
0.88, 95% CI 0.36-2.48) or the rate of mitral repair (RS vs MI OR 0.62,
95% CI 0.08-4.36; RS vs CS OR 0.46, 95% CI 0.06-3.48; MI vs CS OR 0.78,
95% CI 0.33-1.45). The RS group had a significantly shorter length of
hospital stay as compared to MI and CS groups. Conclusion(s): Robotic
and mini-thoracotomy approaches to mitral valve surgery have similar early
outcomes with no difference in early mortality, in the ability to achieve
mitral valve repair, or in neurological complications. Copyright
© 2024

<54>
Accession Number
2032519360
Title
Mild Versus Moderate Hypothermia for Cerebral Protection in Aortic
Surgery: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S16), 2024. Date of
Publication: June 2024.
Author
Singh N.; Nand P.
Institution
(Singh, Nand) Cardiothoracic Surgical Unit, Auckland City Hospital,
Auckland, Aotearoa, New Zealand
Publisher
Elsevier Ltd
Abstract
Purpose: Open thoracic aortic surgery remains the mainstay of treatment
for type A aortic dissections and aortic arch aneurysms. In order to
provide neurological protection when operating on the aortic arch and its
corresponding head and neck vessels, hypothermia is commonly used
intraoperatively to reduce cerebral metabolic demand and minimise the
impacts resulting from temporarily reduced intracerebral blood flow. Most
centres use moderate (20-28degreeC) or deep (14-20degreeC) hypothermic
circulatory arrest for this purpose. However, these low temperatures are
known to have negative consequences on visceral organ function and
coagulopathy. We hence aimed to investigate whether mild hypothermia
(>28degreeC) achieves acceptable postoperative neurological outcomes
(stroke rates) as compared to moderate hypothermia during aortic arch
surgery. Method(s): A systematic review and meta-analysis of all
randomised and non-randomised studies investigating the above study aim
was undertaken as per the PRISMA guidelines. Review Manager 5.4 software
was utilised for statistical analyses. Result(s): Nine observational
studies met inclusion criteria with a total sample size of 1,357 patients.
No randomised controlled trials were available on this topic. Mild
hypothermia (with selective cerebral perfusion) correlated with
statistically significantly reduced postoperative permanent neurological
dysfunction (strokes) as compared to moderate hypothermia (odds ratio
0.39, 95% confidence interval 0.24-0.64; p=0.0001). Mild hypothermia also
correlated with significantly reduced rates of postoperative acute renal
failure (odds ratio 0.51, 95% confidence interval 0.33-0.80; p=0.003).
 Conclusion(s): Mild hypothermia- in conjunction with selective
cerebral perfusion-may be a safe alternative to moderate hypothermia for
providing neurological protection during circulatory arrest in aortic arch
surgery. However, robust randomised data is required to corroborate this
theory. Copyright © 2024

<55>
Accession Number
2032519323
Title
Does Screening Carotid Ultrasound Prior to Cardiac Surgery Remain
Relevant?.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S37), 2024. Date of
Publication: June 2024.
Author
Indja B.; Chang J.W.
Institution
(Indja, Chang) Liverpool Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Carotid duplex ultrasound is regularly performed on patients
prior to cardiac surgery to ascertain risk of postoperative stroke and
identify patients who would benefit from staged or synchronous procedures.
Increasingly evidence suggests that, for asymptomatic patients with
carotid disease, the increased risk of stroke is not related to the
carotid stenosis. Method(s): We conducted a systematic review and
meta-analysis to assess the prevalence of carotid stenosis in a cardiac
surgical population from 2000 to 2022, and to determine the relationship
between carotid disease and postoperative stroke. Result(s): 25
studies with a total of 42,369 patients who underwent cardiac surgery were
included. The prevalence of 50%-99% carotid stenosis in asymptomatic
patients was similar 19% (95% CI 0.18-0.20). Asymptomatic patients with
carotid disease (excluding occlusions) had a significantly increased risk
of post-operated stroke (RR 2.04, 95% CI 1.21-3.42). However, patients
with carotid disease did not have a significantly increased risk of stroke
in the ipsilateral anterior territory (RR 1.43, 95% CI 0.99-2.06). In
patients with 50%-99% carotid stenosis, the risk of having a stroke
directly related to the lesion (ipsilateral anterior territory) was no
greater than having a stroke in a contralateral or posterior circulation
territory (RR 0.92, 95% CI 0.57-1.49). Stroke ipsilateral to a carotid
stenosis accounted for less than 6% of all strokes in this cohort.
 Conclusion(s): Carotid disease is common in patients undergoing
cardiac surgery and certainly identifies a subset of this population at
increased risk of neurological complications. However, the risk of having
a stroke related to a carotid lesion is shown to be no greater than the
risk of having a stroke from other aetiologies, with carotid stenosis
accounting for less than 6% of all strokes after cardiac
surgery. Copyright © 2024

<56>
Accession Number
2032519298
Title
Long Term Outcomes of Minimally Invasive Versus Conventional Sternotomy
for Mitral Valve Surgery: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S42), 2024. Date of
Publication: June 2024.
Author
Indja B.; Chang J.W.; Flynn C.
Institution
(Indja, Chang, Flynn) St George Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Minimally invasive mitral valve surgery (MI) is a
well-established technique with the goal of avoiding a sternotomy and its
associated complications and reducing patient recovery time. Multiple
studies have demonstrated similar early outcomes and safety of MI as
compared to median sternotomy (MS); however, to date, long term outcomes
have been less clearly established. To our knowledge, this is the first
meta-analysis looking at long-term outcomes of MI versus MS for mitral
valve surgery. Method(s): A search of three online medical databases
was performed capturing studies from inception to June 2023. All studies
reporting on long term outcomes of patients undergoing mitral valve
surgery via a MI versus a MS approach were included. Reconstructed
individual patient data was utilised to perform an enhanced secondary
survival analysis. Result(s): 14 studies were included with a total
of 10,382 patients. Mitral valve repair was performed in 86% and 78% of
the MI and MS groups, respectively. Survival at two, four, six and eight
years was 95.8%, 93.3%, 89.7% and 86.9% for the MI group and 94%, 90.8%,
85.7% and 78.8% for the MS group. A significant difference in survival
favouring MI group was evident by four years (p<0.001). Freedom from
reintervention at two, four, six and eight years for the MI group was
96.9%, 96.1%, 95% and 93.3% and for the MS group 98.3%, 97.2%, 96.9% and
96.9%. Conclusion(s): With appropriate patient selection and surgeon
experience, minimally invasive approaches to mitral valve repair provides
excellent long-term survival and freedom from
reintervention. Copyright © 2024

<57>
Accession Number
2032519194
Title
Traditional Risk Prediction Models in Acute Kidney Injury in Patients
Undergoing Cardiac Surgery: A Systematic Review.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S54), 2024. Date of
Publication: June 2024.
Author
Jolliffe J.; Sharma V.; Thungathurthi K.; Leow K.; Seevanayagam S.
Institution
(Jolliffe, Sharma, Thungathurthi, Leow, Seevanayagam) Austin Health,
Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Acute Kidney Injury after Cardiac Surgery (CS-AKI) remains a
significant cause of morbidity and mortality. To assist in early
recognition, numerous risk prediction models have been developed over the
last two decades. This review systematically evaluates the current body of
evidence for non-machine learning renal risk prediction models.
 Method(s): A Systematic Review of 5 databases was undertaken
according to PRISMA guidelines. Studies were included if they had derived
and validated a renal risk prediction model in patients who had undergone
cardiac surgery. Machine learning models were excluded. Outcomes measured
were pre, intra or post-operative variable use within the models and
metrics for prediction. Result(s): After systematic review, 44
studies were selected, resulting in a pooled population of 907,993. 24
studies developed renal risk prediction models whilst 31 externally
validated these models. When externally validated in Caucasian populations
(N=19), pre-operative prediction models offered reliable prediction for
dialysis and severe AKI with area under the receiver operating curve (AUC)
between 0.7-0.93. Models using intra-operative or post-operative variables
(N=14) had acceptable prediction of severe stage AKI and dialysis with
AUCs between 0.7-0.81. Pre-operative predictor models were the most
externally validated. AKI prediction worsened for with reducing severity
of AKI. Validation of non-Caucasian populations was limited with only 11
(25%) of studies undertaken in this group. Conclusion(s):
Pre-operative renal risk prediction models offer the most validated and
accurate prediction for dialysis and severe CS-AKI. External validation of
prediction tools for less-severe AKI and in non-Caucasian populations is
required. Copyright © 2024

<58>
Accession Number
2032519177
Title
Stopping Versus Continuing Aspirin Before Coronary Artery Bypass Graft
Surgery: A Meta-Analysis of Randomised Controlled Trials.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S51-S52), 2024. Date of
Publication: June 2024.
Author
Gupta A.; Zaka A.; Lombardo A.; Kovoor J.; Bacchi S.; Smith J.; Bennetts
J.; Maddern G.
Institution
(Gupta, Zaka, Lombardo, Kovoor, Bacchi, Smith, Bennetts, Maddern)
University of Adelaide, Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Introduction: Although consensus guidelines demonstrate clear benefit for
the continuation of aspirin in patients awaiting coronary artery bypass
grafting (CABG) following an acute coronary syndrome where risk of
re-infarction outweighs bleeding risk, the evidence remains unclear in the
case of elective CABG. We performed the largest to date systematic review
and meta-analysis to compare outcomes between CABG patients who stopped
and continued aspirin perioperatively. Method(s): PubMed, MEDLINE and
CENTRAL databases were searched up to 25 July 2022 for randomised control
trials that evaluated patients undergoing CABG. Summary odds ratios were
calculated using a random effects model for dichotomous and continuous
variables. Subgroup and sensitivity analyses were conducted in order to
explore sources of heterogeneity. Result(s): Sixteen eligible studies
were included with a total of 6,188 patients. Patients who continued
aspirin perioperatively demonstrated an increased risk of all-cause
mortality (OR 1.37 [0.81-2.33]) and reduced risk of perioperative
myocardial infarction (OR 0.81 [0.55-1.18]), however, neither were
statistically significant. No significant difference was observed between
low-dose and higher doses of aspirin. There was minimal heterogeneity
amongst included studies (I2=0%, p=0.97 and I2=33%,
p=0.13, respectively). Continuing aspirin produced a modest increase in
postoperative blood loss (mean difference 66.12 mL [-1.45-133.69]), as was
a dose greater than 100mg (216.87 [-152.99-586.72], p=0.60), which was not
statistically significant. Conclusion(s): Continuing aspirin before
CABG is not associated with a significantly increased risk of all-cause
mortality, perioperative myocardial infarction, or postoperative
bleeding. Copyright © 2024

<59>
Accession Number
2032519110
Title
Valve Durability Following Surgery for Rheumatic Heart Disease.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S5-S6), 2024. Date of
Publication: June 2024.
Author
Skiba R.; Baker R.; Rice G.; Bennetts J.
Institution
(Skiba, Baker, Rice, Bennetts) Flinders Medical Centre, Adelaide, SA,
Australia
Publisher
Elsevier Ltd
Abstract
Introduction: Rheumatic heart disease (RHD) is a preventable chronic
cardiovascular condition that disproportionately affects Indigenous
Australians. RHD significantly impacts the lifespan of Indigenous
individuals, with valvular damage risk increasing with recurrent ARF
episodes. Decision-making regarding surgical intervention is complex, and
durability of repair or prostheses must be considered. In Indigenous
individuals, there is a trend toward using bioprosthetic valves in
surgical interventions, raising concerns about structural valve
deterioration [1]. Cardiac surgery outcomes in Indigenous Australians with
rheumatic heart disease have been inadequately explored in the existing
literature. An ANZSCTS database review in 2014 highlighted a significant
number of Indigenous patients requiring multiple valve operation, with an
increasing trend of using bioprosthetic valves [2]. Method(s): We
propose to review data from our institutional database from 2000 to 2023,
identifying Indigenous patients who have undergone surgery for RHD. We
will review which valve was selected (bioprosthetic versus mechanical; and
manufacturer), the patient characteristics, perioperative outcomes and
their long term follow up, identifying time until redo surgery or death.
References: [1] Ralph AP, Noonan S, Wade V, Currie BJ. The 2020 Australian
guideline for prevention, diagnosis and management of acute rheumatic
fever and rheumatic heart disease. Med J Aust 2021;214:220-7. [2] Russell
EA, Tran L, Baker RA, Bennetts JS, Brown A, Reid CM, et al. A review of
valve surgery for rheumatic heart disease in Australia. BMC Cardiovasc
Disord 2014;14:134. Copyright © 2024

<60>
Accession Number
2032519100
Title
A Systematic Review and Meta-Analysis of Surgical Approaches to Isolated
Tricuspid Valve Surgery.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S32), 2024. Date of
Publication: June 2024.
Author
Tan C.; Zhu A.; Huang L.; Robinson B.; Bannon P.
Institution
(Tan, Zhu, Huang, Robinson, Bannon) Royal Prince Alfred Hospital, Sydney,
NSW, Australia
Publisher
Elsevier Ltd
Abstract
Objectives: Tricuspid valve, once known as the 'forgotten valve', is now
gaining interest in the surgical space. Timing, type of procedure and
strategies to approaching tricuspid valve surgery (TVS) remains debatable.
Beating heart (BH) technique offers an advantage over arrested heart (AH),
with no ischaemic time and low risk of embolisation in TVS. However, there
is a paucity of evidence available that compares both techniques.
Therefore, we performed a meta-analysis comparing BH and AH techniques in
isolated TVS. Method(s): A systematic review was performed across 6
electronic databases from inception to May 2023. Inclusion criteria were
studies that reported outcomes of both BH and AH isolated TVS. Studies
were identified and data extracted by two independent reviewers, with a
3rd reviewer where there were discrepancies. Data were extracted and
pooled using random-effects models and Review Manager 5.4 software.
 Result(s): From 1,617 abstracts identified, 7 studies were included
with a total of 7,306 patients who had isolated TVS. Pooled mean number of
patients who had AH surgery was 617+/-1,451 and BH was 403+/-897. There
were a mean number of 278+/-587 males in the AH group and 185+/-385 in the
BH group. The pre-operative EuroSCORE II was higher in the BH than the AH
group (9.4+/-8.7 vs 6.1+/-4.9). BH group had higher 30-day mortality rate
than AH group (9.6% vs 6.5%). However, BH surgery had higher rates of
freedom from mortality (p=0.0002); lower rates of post-operative stroke
(p=0.04); lower rate of re-operation for bleeding (p=0.003), but a higher
rate of post-operative pacemaker implantation (p=0.002).
 Conclusion(s): Although BH strategy offers poor short-term outcomes,
it offers better long-term mortality and morbidity outcomes than AH in
patients undergoing isolated TVS. We propose earlier timing, beating heart
surgery, and a heart-team strategy for isolated TVS. Copyright ©
2024

<61>
Accession Number
2032519089
Title
Efficacy of Machine Learning Derived Models to Predict AKI in Patients
Undergoing Cardiac Surgery.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S38-S39), 2024. Date of
Publication: June 2024.
Author
Jolliffe J.; Sharma V.; Thungathurthi K.; Leow K.; Seevanayagam S.
Institution
(Jolliffe, Sharma, Thungathurthi, Leow, Seevanayagam) Austin Health,
Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Acute Kidney Injury after Cardiac Surgery (CS-AKI) effects
30%-50% of patients. Yet, prediction of CS-AKI remains challenging with
current models only reliably predicting the need for dialysis. Machine
learning may offer a more accurate method of CS-AKI prediction. This
review systematically evaluates the accuracy of machine learning renal
risk prediction models. Method(s): A systematic review of 5 databases
was undertaken according to PRISMA guidelines. Machine learning, cardiac
surgery, and acute kidney injury were included as search terms. Inclusion
criteria were renal risk prediction models, in patients who underwent
cardiac surgery, derived utilising machine learning techniques. Outcomes
recorded were definitions of AKI machine learning type and metrics for
prediction. Result(s): After systematic review, 17 studies were
selected, cumulating in a population of 165,530 across 14 countries.
Logistic regression (n=5, 29%), neural networks (n=6, 35%), extreme
gradient boosting (n=7, 41%) and random forest (n=5, 29%) were the most
used ML techniques. 34,864 patients across 16 studies were internally
validated with acceptable to excellent prediction for all severities of
AKI achieved, with areas under the receiver operating curve (AUC) between
0.74-0.87. Logistic regression nomograms and extreme gradient boosting
reliably predicted AKI in all evaluated papers with AUCs between
0.74-0.93. Neural networks and random forest models reliably predicted AKI
with AUCs between 0.75-0.872. 2002 patients were externally validated with
AUCs of 0.755-0.933. Conclusion(s): Machine learning models for
CS-AKI prediction are promising and well validated internally. A lack of
external validation, testing and validation in diverse cohorts limits
their current acceptance and application. Copyright © 2024

<62>
Accession Number
2032519025
Title
Apixaban Versus Warfarin in Patients With Postoperative Atrial
Fibrillation After Cardiac Surgery: A Randomised Controlled Trial.
Source
Heart Lung and Circulation. Conference: ANZSCTS Annual Scientific Meeting.
Wellington New Zealand. 33(Supplement 1) (pp S34), 2024. Date of
Publication: June 2024.
Author
Khuong J.N.; Woldendorp K.; Bassin L.; Marshman D.
Institution
(Khuong, Woldendorp, Bassin, Marshman) Royal North Shore Hospital, Sydney,
NSW, Australia
Publisher
Elsevier Ltd
Abstract
Purpose: Postoperative atrial fibrillation (POAF) occurs in one-third of
all patients after cardiac surgery, however current guidelines have no
specific direction for anticoagulation in POAF. The purpose of this study
is to assess the safety and efficacy of apixaban compared to warfarin
following cardiac surgery for POAF. Method(s): This is a
multi-centre, randomised controlled, non-inferiority trial that includes
patients who have atrial fibrillation (new or pre-existing) after cardiac
surgery. Following randomisation, patients are commenced on either
warfarin (INR target 2.0-3.0) or apixaban. Patients will receive a
transthoracic echocardiogram (TTE) after cardiac surgery prior to
commencement of anticoagulation, and again at 6-week follow-up. The
primary endpoint is reintervention or readmission for pericardial
effusion. Secondary endpoints are stroke, systemic embolism, hospital
length of stay, new pericardial effusion post-surgery, new pericardial
effusion post initiation of anticoagulation, and all-cause mortality at
1-year. Result(s): We will have 6 months of data to present at
ANZSCTS 2023. 20 patients with atrial fibrillation following cardiac
surgery have been enrolled in our study thus far. The average age was 74.5
years, and 85% were male. Among the patients included, 12 were randomised
to warfarin and 8 were randomised to apixaban. All patients had trivial
pericardial effusion (<5mm) on their postoperative transthoracic
echocardiogram. At 6-week follow-up, 2 patients in the warfarin group had
developed a moderate pericardial effusion (11mm-20mm) compared to none in
the apixaban group. These patients were asymptomatic and did not require
intervention for their effusion. Conclusion(s): This will be the
first randomised controlled trial to assess whether apixaban is
non-inferior to warfarin for the incidence of bleeding complications
following all cardiac surgery. These findings may significantly change
management for our patients, and reduce morbidity, mortality and costs to
the healthcare system. Copyright © 2024

<63>
Accession Number
2029949288
Title
Is Cardiac Transplantation Still a Contraindication in Patients with
Muscular Dystrophy-Related End-Stage Dilated Cardiomyopathy? A Systematic
Review.
Source
International Journal of Molecular Sciences. 25(10) (no pagination), 2024.
Article Number: 5289. Date of Publication: May 2024.
Author
Politano L.
Institution
(Politano) Cardiomyology and Medical Genetics, University of Campania
Luigi Vanvitelli, Naples 80138, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Inherited muscular diseases (MDs) are genetic degenerative disorders
typically caused by mutations in a single gene that affect striated muscle
and result in progressive weakness and wasting in affected individuals.
Cardiac muscle can also be involved with some variability that depends on
the genetic basis of the MD (Muscular Dystrophy) phenotype. Heart
involvement can manifest with two main clinical pictures: left ventricular
systolic dysfunction with evolution towards dilated cardiomyopathy and
refractory heart failure, or the presence of conduction system defects and
serious life-threatening ventricular arrhythmias. The two pictures can
coexist. In these cases, heart transplantation (HTx) is considered the
most appropriate option in patients who are not responders to the
optimized standard therapeutic protocols. However, cardiac transplant is
still considered a relative contraindication in patients with inherited
muscle disorders and end-stage cardiomyopathies. High operative risk
related to muscle impairment and potential graft involvement secondary to
the underlying myopathy have been the two main reasons implicated in the
generalized reluctance to consider cardiac transplant as a viable option.
We report an overview of cardiac involvement in MDs and its possible
association with the underlying molecular defect, as well as a systematic
review of HTx outcomes in patients with MD-related end-stage dilated
cardiomyopathy, published so far in the literature. Copyright ©
2024 by the author.

<64>
Accession Number
2032520589
Title
Sevoflurane multiple Wash In/Wash Out at the end of anesthesia to reduce
agitation: A multicenter double-blind randomized controlled trial.
Source
Contemporary Clinical Trials Communications. 39 (no pagination), 2024.
Article Number: 101316. Date of Publication: June 2024.
Author
Landoni G.; Likhvantsev V.V.; Berikashvili L.B.; Yavorovsky A.G.;
Bagdasarov P.S.; Smirnova A.V.; Serkova T.S.; Subbotin V.V.; Kadantseva
K.K.; Ovezov A.M.; Yadgarov M.Y.; Yakovlev A.A.; Lamacchia A.; Gallo L.;
Gracheva N.D.; Ryzhkov P.V.; Zilocchi R.; Vecchi J.D.; Aleinikov M.A.;
Mayuk P.S.; Pivovarova A.A.; Shemetova M.M.
Institution
(Landoni, Lamacchia, Gallo, Zilocchi, Vecchi) Department of Anaesthesia
and Intensive Care, IRCCS San Raffaele Scientific Institute, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Likhvantsev, Berikashvili, Smirnova, Kadantseva, Yadgarov, Yakovlev,
Gracheva, Ryzhkov, Shemetova) Federal Research and Clinical Center of
Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation
(Likhvantsev, Yavorovsky, Bagdasarov, Serkova, Aleinikov, Mayuk) First
University Clinical Federal State Autonomous Educational Institution of
Higher Education I.M. Sechenov First Moscow State Medical University of
the Ministry of Health of the Russian Federation, Moscow, Russian
Federation
(Subbotin, Kadantseva) A. Loginov Moscow Scientific Clinical Center,
Moscow, Russian Federation
(Ovezov, Pivovarova) M. Vladimirsky Moscow Regional Research and Clinical
Institute, Moscow, Russian Federation
(Shemetova) Moscow City Oncological Hospital No.1, Moscow, Russian
Federation
Publisher
Elsevier Inc.
Abstract
Background: Postoperative agitation is common after non-cardiac surgery.
It is associated with postoperative delirium and cognitive dysfunction,
leading to prolonged hospital stay and delayed social readjustment.
Prevention and treatment strategies are lacking. We assessed the efficacy
of a novel approach, the Wash In/Wash Out procedure, in reducing
post-anesthetic agitation. Method(s): This multicenter,
parallel-group, double-blind randomized controlled trial is enrolling 200
patients undergoing open abdominal surgery. Participants are randomly
assigned to either a control group receiving standard recovery methods or
an investigational group undergoing the Wash In/Wash Out procedure. In the
Wash In/Wash Out procedure group, sevoflurane is stopped and then promptly
restarted when the patient shows the first signs of awakening to achieve
an end-tidal concentration of 1 minimum alveolar concentration (MAC) for 5
min. This stop-and-restart cycle is performed three times. The trial's
primary outcome is the rate of postoperative agitation. Secondary outcomes
include rate of postoperative delirium and cognitive dysfunction,
postoperative nausea and vomiting, and length of intensive care and
hospital stay. Discussion(s): The OPERA trial investigates the effect
of the Wash In/Wash Out procedure to reduce post-anesthetic agitation in
non-cardiac surgery. This study could offer a significant contribution to
improving patient outcomes and optimizing recovery protocols in surgical
settings. Copyright © 2024

<65>
Accession Number
2032499658
Title
Comparison of downsizing strategy (HANGZHOU Solution) and standard annulus
sizing strategy in type 0 bicuspid aortic stenosis patients undergoing
transcatheter aortic valve replacement: Rationale and design of a
randomized clinical trial.
Source
American Heart Journal. 274 (pp 65-74), 2024. Date of Publication: August
2024.
Author
Guo Y.; Liu X.; Li R.; Ng S.; Liu Q.; Wang L.; Hu P.; Ren K.; Jiang J.;
Fan J.; He Y.; Zhu Q.; Lin X.; Li H.; Wang J.
Institution
(Guo, Liu, Li, Ng, Liu, Wang, Hu, Ren, Jiang, Fan, He, Zhu, Lin, Li, Wang)
Department of Cardiology, Second Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, China
(Guo, Liu, Li, Ng, Liu, Wang, Hu, Ren, Jiang, Fan, He, Zhu, Lin, Li, Wang)
State Key Laboratory of Transvascular Implantation Devices, Hangzhou
310009, China
(Guo, Liu, Li, Ng, Liu, Wang, Hu, Ren, Jiang, Fan, He, Zhu, Lin, Li, Wang)
Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou 310009, China
(Liu, Wang) Research Center for Life Science and Human Health, Binjiang
Institute of Zhejiang University, Hangzhou 310053, China
Publisher
Elsevier Inc.
Abstract
Background: There has not been a consensus on the prothesis sizing
strategy in type 0 bicuspid aortic stenosis (AS) patients undergoing
transcatheter aortic valve replacement (TAVR). Modifications to standard
annular sizing strategies might be required due to the distinct anatomical
characteristics. We have devised a downsizing strategy for TAVR using a
self-expanding valve specifically for patients with type 0 bicuspid AS.
The primary aim of this study is to compare the safety and efficacy of
downsizing strategy with the Standard Annulus Sizing Strategy in TAVR for
patients with type 0 bicuspid AS. Trial design: It is a prospective,
multi-center, superiority, single-blinded, randomized controlled trial
comparing the Down Sizing and Standard Annulus Sizing Strategy in patients
with type 0 bicuspid aortic stenosis undergoing transcatheter aortic valve
replacement. Eligible participants will include patients with severe type
0 bicuspid AS, as defined by criteria such as mean gradient across aortic
valve >=40 mmHg, peak aortic jet velocity >=4.0 m/s, aortic valve area
(AVA) <=1.0 cm2, or AVA index <=0.6 cm2/m2. These
patients will be randomly assigned, in a 1:1 ratio, to either the Down
Sizing Strategy group or the Standard Sizing Strategy group. In the Down
Sizing Strategy group, a valve one size smaller will be implanted if the
"waist sign" manifests along with less than mild regurgitation during
balloon pre-dilatation. The primary end point of the study is a composite
of VARC-3 defined device success, absence of both permanent pacemaker
implantation due to high-degree atrioventricular block and new-onset
complete left bundle branch block. Conclusion(s): This study will
compare the safety and efficacy of Down Sizing Strategy with the Standard
Annulus Sizing Strategy and provide valuable insights into the optimal
approach for sizing in TAVR patients with type 0 bicuspid AS. We
hypothesize that the Down Sizing Strategy will demonstrate superiority
when compared to the Standard Annulus Sizing Strategy. (Down Sizing
Strategy (HANGZHOU Solution) vs Standard Sizing Strategy TAVR in Bicuspid
Aortic Stenosis (Type 0) (TAILOR-TAVR), NCT05511792). Copyright ©
2024 Elsevier Inc.

<66>
Accession Number
2029901412
Title
Novel inhaled pulmonary vasodilators in adult cardiac surgery: a scoping
review.
Source
Canadian Journal of Anesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
David N.; Lakha S.; Walsh S.; Fried E.; DeMaria S.
Institution
(David, Lakha, Fried, DeMaria) Department of Anesthesiology, Perioperative
and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Walsh) Hunter College, City University of New York, New York, NY, United
States
(David) Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New
York, NY 10029, United States
Publisher
Springer
Abstract
Purpose: Pulmonary hypertension (PH) is a common cause of postoperative
mortality in cardiac surgery that is commonly treated with conventional
inhaled therapies, specifically nitric oxide and prostacyclin. Alternative
therapies include inhaled milrinone and levosimendan, which are receiving
more research interest and are increasing in clinical use as they may cut
costs while allowing for easier administration. We sought to conduct a
scoping review to appraise the evidence base for the use of these two
novel inhaled vasodilators as an intervention for PH in cardiac surgery.
Source: We searched Embase and MEDLINE for relevant articles from 1947 to
2022. Principal findings: We identified 17 studies including 969 patients.
The included studies show that inhaled milrinone and levosimendan are
selective pulmonary vasodilators with potential benefits ranging from ease
of weaning from cardiopulmonary bypass to reduction in ventricular
dysfunction. Nevertheless, high-quality data are limited, and study design
and comparators are extremely heterogeneous, limiting the potential
validity and generalizability of findings. Conclusion(s): The
findings of this scoping review suggest that milrinone and levosimendan
may be effective alternatives to current inhaled therapies for cardiac
dysfunction in the setting of PH. Nevertheless, randomized trials have
focused on specific agents and consistent outcome measures are needed to
better validate the early-stage promise of these agents. Study
registration: Open Science Framework (https://osf.io/z3k6f/); first posted
21 July 2022. Copyright © Canadian Anesthesiologists' Society
2024.

<67>
Accession Number
644370702
Title
Outcomes and Safety of Transcaval Transcatheter Aortic Valve Replacement:
A Systematic Review and Meta-analysis.
Source
The Canadian journal of cardiology. (no pagination), 2024. Date of
Publication: 24 May 2024.
Author
Salihu A.; Ferlay C.; Kirsch M.; Shah P.B.; Skali H.; Fournier S.; Meier
D.; Muller O.; Hugelshofer S.; Skalidis I.; Tzimas G.; Monney P.; Eeckhout
E.; Arangalage D.; Rancati V.; Antiochos P.; Lu H.
Institution
(Salihu, Fournier, Meier, Muller, Hugelshofer, Skalidis, Tzimas, Monney,
Eeckhout, Antiochos) Division of Cardiology, Lausanne University Hospital
and University of Lausanne, Lausanne 1011, Switzerland
(Ferlay) Division of Cardiology, Lausanne University Hospital and
University of Lausanne, 1011 Lausanne, Switzerland; Adult Intensive Care
Unit, Lausanne University Hospital and University of Lausanne, 1011
Lausanne, Switzerland; Division of Cardiac Surgery, Lausanne University
Hospital and University of Lausanne, 1011 Lausanne, Switzerland
(Kirsch) Division of Cardiac Surgery, Lausanne University Hospital and
University of Lausanne, Lausanne 1011, Switzerland
(Shah, Skali) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, United States
(Arangalage) Division of Cardiology, Lausanne University Hospital and
University of Lausanne, 1011 Lausanne, Switzerland; Cardiology Department,
AP-HP, Bichat Hospital and Universite de Paris, Paris, France
(Rancati) Division of Anesthesiology, Lausanne University Hospital and
University of Lausanne, Lausanne 1011, Switzerland
(Lu) Division of Cardiology, Lausanne University Hospital and University
of Lausanne, 1011 Lausanne, Switzerland; Division of Cardiovascular
Medicine, Brigham and Women's Hospital, Harvard Medical School, 02115
Boston MA, USA
Abstract
BACKGROUND: The transcaval (TCv) vascular approach is increasingly
utilized in transcatheter aortic valve replacement (TAVR), in patients
unsuitable for the gold-standard transfemoral approach. We aimed to
evaluate the efficacy, safety, and clinical outcomes associated with
TCv-TAVR. METHOD(S): A systematic review and meta-analysis was
conducted by searching PubMed/MEDLINE, EMBASE and the Cochrane Library for
all articles assessing the TCv approach published until December 2023.
Outcomes included 30-day and 1-year all-cause mortality (ACM), 30-day
rehospitalization, peri-operative and post-operative complications at 30
days. The meta-analysis was registered on the PROSPERO database with the
identifier CRD42024501921. RESULT(S): A total of eight studies with
467 patients were included. TCv-TAVR procedures achieved a success rate of
98.5%. TCv-TAVR was associated with a 30-day ACM rate of 6.4% (95%
confidence interval [CI]: 3.9-8.2%), a one-year ACM rate of 14.4% (95% CI:
2.3- 27.6%) and a 30-day rehospitalization rate at of 4.4% (95% CI:
2.2-10.6%). Postoperative stroke or transient ischemic attack, major
vascular complications and major or life-threatening bleeding occurred in
3.9%, 8.5% and 10.1% of cases, respectively. Cumulative meta-analyses
showed a trend of decreasing rates of vascular complications.
 CONCLUSION(S): The TCv approach in TAVR demonstrated a reassuring
efficacy and safety profile, with mortality and post-operative
complication rates comparable to those reported for supra-aortic
alternative TAVR access routes. The temporal decrease in vascular
complications suggests potential improvements in procedural techniques and
device technology. These findings further support the TCv approach as a
viable option in patients ineligible for the transfemoral
access. Copyright © 2024. Published by Elsevier Inc.

<68>
Accession Number
644368421
Title
Outcome-Based Risk Assessment of Non-HLA Antibodies in Heart
Transplantation: A Systematic Review.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2024. Date of Publication: 23 May 2024.
Author
Panicker A.J.; Prokop L.J.; Hacke K.; Jaramillo A.; Griffiths L.G.
Institution
(Panicker) Mayo Clinic Graduate School of Biomedical Sciences, 200 First
St SW, Rochester, MN 55905, USA; Department of Immunology, Mayo Clinic,
200 First St SW, Rochester, MN 55905, USA; Department of Cardiovascular
Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
(Prokop) Mayo Clinic Libraries, Mayo Clinic, 200 First St SW, Rochester,
United States
(Hacke, Jaramillo) Department of Laboratory Medicine and Pathology, Mayo
Clinic, 5777 E. Mayo Blvd, Phoenix, United States
(Griffiths) Department of Cardiovascular Medicine, Mayo Clinic, 200 First
St SW, Rochester, MN 55905, USA; Department of Physiology & Biomedical
Engineering, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
Abstract
BACKGROUND: Current monitoring after heart transplantation (HT) employs
repeated invasive endomyocardial biopsies (EMB). Although positive EMB
confirms rejection, EMB fails to predict impending, sub-clinical, or
EMB-negative rejection events. While non-HLA antibodies have emerged as
important risk factors for antibody-mediated rejection (AMR) after HT,
their use in clinical risk stratification has been limited. A systematic
review of the role of non-HLA antibodies in rejection pathologies has
potential to guide efforts to overcome deficiencies of EMB in rejection
monitoring. METHOD(S): Databases were searched to include studies on
non-HLA antibodies in HT recipients. Data collected included: number of
patients, type of rejection, non-HLA antigen studied, association of
non-HLA antibodies with rejection, and evidence for synergistic
interaction between non-HLA antibodies and HLA-DSA responses.
 RESULT(S): A total of 56 studies met the inclusion criteria. Strength
of evidence for each non-HLA antibody was evaluated based on the number of
articles and patients in support vs. against their role in mediating
rejection. Importantly, despite previous intense focus on the role of
anti-MHC class I chain-related gene A (MICA) and anti-angiotensin II type
I receptor (AT1R) antibodies in HT rejection, evidence for their
involvement was equivocal. Conversely, strength of evidence for other
non-HLA antibodies supports that differing rejection pathologies are
driven by differing non-HLA antibodies. CONCLUSION(S): This
systematic review underscores the importance of identifying peri-HT
non-HLA antibodies. Current evidence supports the role of non-HLA
antibodies in all forms of HT rejection. Further investigations are
required to define the mechanisms of action of non-HLA antibodies in HT
rejection. Copyright © 2024. Published by Elsevier Inc.

<69>
Accession Number
644367862
Title
Stroke Risk After Mitral Valve Interventions: A Systematic Review and
Network Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 23 May 2024.
Author
Kazemian S.; Bansal K.; Kuno T.; Gupta T.; Goel K.; Khera S.; Alkhouli M.;
Kolte D.
Institution
(Kazemian) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Bansal) Department of Medicine, Saint Vincent Hospital, Worcester, MA,
United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York, NY
(Gupta) Division of Cardiology, University of Vermont Medical Center,
Burlington, VT, United States
(Goel) Division of Cardiology, Vanderbilt University Medical Center,
Nashville, TN, United States
(Khera) Division of Interventional Cardiology, Mount Sinai Hospital, New
York, NY
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Kolte) Cardiology Division, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
Abstract
Previous research indicates varying stroke rates after mitral valve (MV)
interventions. This study aimed to compare post-procedural stroke risks
following transcatheter and surgical MV interventions. Electronic
databases were searched from inception to February 2024 for studies
comparing stroke rates after mitral transcatheter edge-to-edge repair
(mTEER), surgical MV repair/replacement, or guideline-directed medical
therapy (GDMT). Primary endpoints were all-time and early (<30 days)
stroke. Secondary outcomes included new-onset atrial fibrillation and
1-year all-cause mortality. A frequentist network meta-analysis was
employed to compare outcomes. The network meta-analysis included 18
studies (3 randomized clinical trials and 15 observational), with 51,703
patients. mTEER was associated with a decreased risk of all-time (odds
ratio [OR] 0.61, 95% CI 0.41-0.89) and early stroke (OR 0.41, 95% CI
0.33-0.51) compared with surgery, and a similar risk of all-time (OR 1.54,
95% CI 0.76-3.12) and early stroke (OR 2.12, 95% CI 0.53-8.47) compared
with GDMT. Conversely, surgery was associated with an increased risk of
all-time (OR 2.55, 95% CI 1.17-5.57) and early stroke (OR 5.15, 95% CI
1.27-20.84) compared with GDMT. There were no statistically significant
differences in the risk of new-onset atrial fibrillation (OR 0.38, 95% CI
0.11-1.31) and 1-year all-cause mortality (OR 1.43, 95% CI 0.91-2.24)
between mTEER vs. surgery. In conclusion, mTEER was associated with a
lower risk of stroke and similar risks of new-onset atrial fibrillation
and 1-year mortality compared with surgical MV interventions. Further
studies are needed to understand the mechanisms of stroke and to determine
strategies to reduce stroke risk following MV interventions. Copyright
© 2024. Published by Elsevier Inc.

<70>
Accession Number
644367641
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
Lancet (London, England). (no pagination), 2024. Date of Publication: 22
May 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.
Institution
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(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
(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, 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) 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; 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; Department of Clinical and Molecular Medicine,
Gothenburg University, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giessen, Germany; 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; 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
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).
 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. FINDINGS: 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, pnon-inferiority<0.0001). No significant difference was
seen in individual components of the primary composite endpoint.
INTERPRETATION: In individuals with severe symptomatic native aortic
stenosis, the Myval THV met its primary endpoint at 30 days. FUNDING:
Meril Life Sciences. Copyright © 2024 Elsevier Ltd. All rights
reserved, including those for text and data mining, AI training, and
similar technologies.

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