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<1>
Accession Number
2033382697
Title
Combined pectoralis and serratus anterior plane blocks with or without
liposomal bupivacaine for minimally invasive thoracic surgery: A
randomized clinical trial.
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111550. Date of Publication: October 2024.
Author
Marciniak D.; Raymond D.; Alfirevic A.; Yalcin E.K.; Bakal O.; Pu X.;
Kelava M.; Duncan A.; Hargrave J.; Bauer A.; Bustamante S.; Lam L.; Murthy
S.; Sessler D.I.; Turan A.
Institution
(Marciniak, Alfirevic, Kelava, Duncan, Hargrave, Bauer, Bustamante)
Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
(Raymond, Murthy) Department of Thoracic and Cardiovascular Surgery,
Cleveland Clinic, Cleveland, OH, United States
(Yalcin, Pu, Sessler, Turan) Department of Outcomes Research, Cleveland
Clinic, Cleveland, OH, United States
(Yalcin, Turan) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Bakal) Department of Anesthesiology, UT Health San Antonio, San Antonio,
TX, United States
(Pu) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Lam) Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Marciniak, Raymond) DM and DR contributed equally to this study.
Publisher
Elsevier Inc.
Abstract
Background: Minimally invasive thoracic surgery is associated with
substantial pain that can impair pulmonary function. Fascial plane blocks
may offer a favorable alternative to opioids, but conventional local
anesthetics provide a limited duration of analgesia. We therefore tested
the primary hypothesis that a mixture of liposomal bupivacaine and plain
bupivacaine improves the overall benefit of analgesia score (OBAS) during
the first three postoperative days compared to bupivacaine alone.
Secondarily, we tested the hypotheses that liposomal bupivacaine improves
respiratory mechanics, and decreases opioid consumption. <br/>Method(s):
Adults scheduled for robotically or video-assisted thoracic surgery with
combined ultrasound-guided pectoralis II and serratus anterior plane block
were randomized to bupivacaine or bupivacaine combined with liposomal
bupivacaine. OBAS was measured on postoperative days 1-3 and was analyzed
with a linear mixed regression model. Postoperative respiratory mechanics
were estimated using a linear mixed model. Total opioid consumption was
estimated with a simple linear regression model. <br/>Result(s): We
analyzed 189 patients, of whom 95 were randomized to the treatment group
and 94 to the control group. There was no significant treatment effect on
total OBAS during the initial three postoperative days, with an estimated
geometric mean ratio of 0.93 (95% CI: 0.76, 1.14; p = 0.485). There was no
observed treatment effect on respiratory mechanics, total opioid
consumption, or pain scores. Average pain scores were low in both groups.
<br/>Conclusion(s): Liposomal bupivacaine did not improve OBAS during the
initial postoperative three days following minimally invasive thoracic
procedures. Furthermore, there was no improvement in respiratory
mechanics, no reduction in opioid consumption, and no decrease in pain
scores. Thus, the data presented here does not support the use of
liposomal bupivacaine over standard bupivacaine to enhance analgesia after
minimally invasive thoracic surgery. Summary statement: For minimally
invasive thoracic procedures, addition of liposomal bupivacaine to plain
bupivacaine for thoracic fascial plane blocks does not improve OBAS,
reduce opioid requirements, improve postoperative respiratory mechanics,
or decrease pain scores.<br/>Copyright &#xa9; 2024 The Authors

<2>
Accession Number
2030198795
Title
The Effectiveness and Safety of Leadless Pacemakers: An Updated
Meta-Analysis.
Source
Current Cardiology Reports. 26(8) (pp 789-799), 2024. Date of Publication:
August 2024.
Author
Oliveira V.M.R.; Rivera A.; Oliveira I.C.; de Sousa A.M.; Nishikubo
M.E.P.; Serpa F.; da Silva Menezes Junior A.
Institution
(Oliveira, Oliveira, de Sousa, Nishikubo, da Silva Menezes Junior)
Department of Medicine, Federal University of Goias, Goiania, Brazil
(Rivera) Department of Medicine, Nove de Julho University, Sao Bernardo Do
Campo, Brazil
(Serpa) Division of Cardiology, Beth Israel Deaconess Center, Harvard
Medical School, Boston, United States
Publisher
Springer
Abstract
Background: Leadless pacemakers (LPs) are promising alternatives to
traditional transvenous pacemakers (TVPs), but their comparative
effectiveness and safety in clinical outcomes remain uncertain.
<br/>Method(s): We systematically searched PubMed, Embase, Scopus,
Cochrane, and ClinicalTrials.gov for studies comparing LPs and TVPs. A
restricted maximum likelihood random-effects model was used for all
outcomes. Heterogeneity was assessed using I² statistics. We
performed a subgroup analysis with studies with multivariate-adjusted
data. <br/>Result(s): We included 21 studies involving 47,229 patients, of
whom 12,199 (25.8%) underwent LP implantation. Compared with TVPs, LPs
were associated with a significantly lower risk of overall complications
(OR 0.61; 95% CI 0.45-0.81; p < 0.01), dislodgement (OR 0.34; 95% CI
0.20-0.56; p < 0.01), and pneumothorax (OR 0.27; 95% CI 0.16-0.46; p <
0.01). No significant difference in all-cause mortality was observed in
the overall analysis (OR 1.43; 95% CI 0.65-3.15; p = 0.35) and in studies
with multivariate-adjusted data (OR 1.34; 95% CI 0.65-2.78; p = 0.43).
However, LPs were associated with a higher risk of pericardial effusion
(OR 2.47; 95% CI 1.39-4.38; p < 0.01) and cardiac tamponade (OR 3.75; 95%
CI 2.41-5.83; p < 0.01). LPs also demonstrated a lower pacing capture
threshold (MD -0.19 V; 95% CI [-0.23 V]-[-0.16 V]; p < 0.01), but no
significant difference in impedance (MD 32.63 ohms; 95% CI [-22.50
ohms]-[87.76 ohms]; p = 0.25). <br/>Conclusion(s): These findings suggest
that LPs were associated with lower overall complication rates and similar
effectiveness to TVPs. However, randomized controlled trials are warranted
to validate these results. Graphical Abstract: (Figure
presented.)<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<3>
Accession Number
2028114393
Title
Effect of colchicine on perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery in patients undergoing major thoracic
surgery (COP-AF): an international randomised trial.
Source
The Lancet. 402(10413) (pp 1627-1635), 2023. Date of Publication: 04 Nov
2023.
Author
Conen D.; Ke Wang M.; Popova E.; Chan M.T.V.; Landoni G.; Reimer C.; Reyes
J.C.T.; Grande A.M.; Tallada A.G.; Sessler D.I.; Fleischmann E.; Kabon B.;
Voltolini L.; Cruz P.; Gutierrez-Soriano L.; Tandon V.; Martinez-Tellez
E.; Guerra-Londono J.J.; DuMerton D.; Wong R.H.L.; McGuire A.L.; Kidane
B.; Roux D.P.; Shargall Y.; Vincent J.; Xu L.; Li Z.; Jolly S.S.; Healey
J.S.; Devereaux P.J.; Wang M.K.; Wells J.R.; McIntyre W.F.; Srinathan
S.K.; Amir M.; Bangdiwala S.I.; Bossard M.; Chan M.T.; Eikelboom J.W.;
Jolly S.; Montes F.R.; Schmartz D.; Wang C.Y.; Ofori S.N.; Blum S.;
Alvarez-Garcia J.; Lo Bianco G.; Traquair H.; Guerrero-Pinedo F.A.;
Oleynick C.; Meyre P.B.; Mendez-Zurita F.; Chiarella-Redfern H.; Marcucci
M.; Donati F.; Gonzalez-Osuna A.; Minervini F.; Moreno Weidmann Z.;
Guerra-Ramos J.M.; Dion G.; Ramos-Pachon A.; Borges F.K.; de Sa
Boasquevisque D.; Mosconi M.G.; Amarenco P.; Mitchell L.B.; Wyse G.; Cheng
D.; McAlister F.A.; Wells G.A.; Baskaran G.; Burns A.T.; Gennaccaro J.;
Howe R.; Mastrangelo L.; Pettit S.; Popovic M.; Shahbaz S.; Tosh M.;
Zucchetto S.J.; Heenan L.; Lee S.F.; Hoetzenecker K.; Schweiger T.;
Reiterer C.; Zotti O.; Bsuchner P.; Hochreiter B.; Taschner A.;
Adamowitsch N.; Horvath K.; Hantakova N.; Bidgoli J.; Huybrechts I.;
Cappeliez S.; Neary J.D.; Finley C.; Agzarian J.; Hanna W.; Abdulrahman
M.; Lawrence K.; Gregus K.; Quraishi F.; Wikkerink S.; Wallace C.; Prine
M.; Gregus E.; Hare J.; Lombardo K.; Fezia B.; Columbus T.; Rushton J.;
Reid K.; Parlow J.; Chung W.; Karizhenskaia M.; Malik A.; Tanzola R.;
Giles A.; McLean S.R.; McGuire A.; Lohser J.; Lim S.; Grey R.; Yee J.;
Grant K.; Lee A.L.; Choi J.J.; Dewar L.R.; Durkin C.; Schisler T.; Hecht
P.; Hughes B.; Liu R.; Tan L.; Gowing S.; Buduhan G.; Enns S.; Poole E.;
Graham K.; Dubik N.; Chin A.; Maziak D.E.; Seely A.J.; Gilbert S.;
Villeneuve P.J.; Sundaresan S.; Gingrich M.; Fazekas A.; Bucciero K.;
Malthaner R.A.; Lewis D.; Fortin D.; Qiabi M.; Nayak R.; Plourde M.M.;
Haider T.; Murphy R.; Sellers D.; Donahoe L.; Lefebvre M.; Lanthier L.; Ko
M.A.; Parente D.; Cheung V.; Schieman C.; Bessissow A.; Wong R.H.; Joynt
G.M.; Lam C.K.; Lau R.W.; Wan I.Y.; Underwood M.J.; Wu W.K.; Wong W.T.;
Choi G.Y.; Lee E.; Hui K.Y.; Fung B.; Chan C.S.; Ng F.K.; Thung K.H.;
Castaneda L.C.; Tellez L.J.; Ortiz-Ramirez L.M.; Baiardo-Redaelli M.;
Belletti A.; Dieci E.; Monaco F.; Muriana P.; Nakhnoukh C.; Novellis P.;
Turi S.; Viscardi S.; Veronesi G.; Bongiolatti S.; Salvicchi A.; Gatteschi
L.; Indino R.; Tombelli S.; Ravasin A.; Salimbene O.; Rosboch G.L.;
Balzani E.; Ceraolo E.; Neitzert L.; Brazzi L.; Londero F.; Grossi W.;
Massullo D.; Fiorelli S.; Margaritora S.; Hashim S.A.; Krishnasamy S.; See
W.S.; Nawaz M.A.; Bilal H.; Trujillo Reyes J.C.; Belda Sanchis J.; Planas
Canovas G.; Libreros Nino A.; Parera Ruiz A.; Cladellas Gutierrez E.;
Guarino M.; Urrutia Cuchi G.; Argilaga Nogues M.; Rovira Juan A.;
Medina-Aedo M.; Turro Castillejo M.A.; Gil Sanchez J.M.; Arauz-Sarmiento
I.; Herranz Perez G.; Chavarria Murillo S.; Garcia-Osuna A.;
Rodriguez-Arias A.; Berga Garrote N.; Martin Grande A.; Parise Roux D.;
Gajate Martin L.; De Pablo Pajares A.; Candela Toha A.M.; Moreno Mata N.;
Munoz Molina G.; Caballero Silva U.; Cabanero A.; Fra Fernandez S.;
Cavestany Garcia-Matres C.; Simon L.; Montenegro C.; Pozo S.;
Gonzalez-Tallada A.; Gonzalez Suarez S.; Ribas Ball M.; De Nadal Clanchet
M.; Perez Velez J.; Sanchez-Pedrosa G.; Duque P.; Gonzalez G.; Huerta L.;
Rodriguez L.; Garutti I.; Ruiz-Villa L.; Marti-Ejarque M.D.M.; Gili-Bueno
M.; Maddio Vieyra R.M.; Fibla J.J.; Duran N.; de Temple Pla M.;
Rodriguez-Fuster A.; Bermejo-Martinez S.; Carraminana A.; Opitz I.;
Etienne H.; Cata J.P.; Rajaram R.; Corrales G.; Vaporciyan A.; Mehran R.;
Sepesi B.; Walsh G.; Rice D.; Cukierman D.S.; Swisher S.; Marchant B.E.;
Harris L.C.; Cusson B.D.; Miller S.A.; Ayad S.; Araujo J.; Marquez-Roa L.;
Hofstra R.L.; Wudel L.J.; Minear S.C.; Teixeira C.; Pimentel M.; Popoff
A.M.; Marsack K.; Meehan S.; Chen T.H.; Essandoh M.; Poppers J.S.
Institution
(Conen, Ke Wang, McIntyre, Wells, Ofori, Vincent, Xu, Li, Eikelboom,
Jolly, Healey, Devereaux) Population Health Research Institute, Hamilton,
ON, Canada
(Conen, Ke Wang, McIntyre, Tandon, Ofori, Xu, Eikelboom, Jolly, Healey,
Devereaux) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Conen, McIntyre, Jolly, Devereaux) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Popova) Institut d'Investigacio Biomedica Sant Pau, Barcelona, Spain
(Popova) Centro Cochrane Iberoamericano, Barcelona, Spain
(Chan) The Chinese University of Hong Kong, Hong Kong Special
Administrative Region, Shatin, Hong Kong
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Landoni) School of Medicine, Vita-Salute University San Raffaele, Milan,
Italy
(Cata, Guerra-Londono) Department of Anesthesiology and Perioperative
Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Reimer) Department of Anesthesiology, Queen's University, Kingston Health
Sciences Centre, Kingston, ON, Canada
(McLean) Vancouver Acute Department of Anesthesia and Perioperative
Medicine, Vancouver General Hospital, Vancouver, BC, Canada
(Srinathan, Kidane) Department of Surgery, University of Manitoba,
Winnipeg, MB, Canada
(Reyes, Martinez-Tellez) Department of Thoracic Surgery, Hospital de la
Santa Creu i Sant Pau, Barcelona, Spain
(Grande, Roux) Hospital Universitario Ramon y Cajal, Madrid, Spain
(Tallada) Department of Anesthesiology, Vall d'Hebron Hospital
Universitari, Barcelona, Spain
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Fleischmann, Kabon) Department of Anesthesia, Intensive Care Medicine and
Pain Medicine, Medical University of Vienna, Vienna, Austria
(Voltolini) Thoracic Surgery Unit, University Hospital Careggi, Florence,
Italy
(Cruz) Service of Anesthesiology and Reanimation, General University
Hospital Gregorio Maranon, Madrid, Spain
(Maziak) Division of Thoracic Surgery, Department of Surgery, The Ottawa
Hospital, University of Ottawa, Ottawa, ON, Canada
(Gutierrez-Soriano) Anesthesiology Department, Anesthesiology Research
Group, Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota, Colombia
(DuMerton) Kingston Health Sciences Centre, Kingston, ON, Canada
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, The
Chinese University of Hong Kong, Hong Kong Special Administrative Region,
Hong Kong
(McGuire) Division of Thoracic Surgery, Vancouver General Hospital,
Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
(Shargall) Division of Thoracic Surgery, Department of Surgery, Faculty of
Health Sciences, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier B.V.
Abstract
Background: Higher levels of inflammatory biomarkers are associated with
an increased risk of perioperative atrial fibrillation and myocardial
injury after non-cardiac surgery (MINS). Colchicine is an
anti-inflammatory drug that might reduce the incidence of these
complications. <br/>Method(s): COP-AF was a randomised trial conducted at
45 sites in 11 countries. Patients aged 55 years or older and undergoing
major non-cardiac thoracic surgery were randomly assigned (1:1) to receive
oral colchicine 0.5 mg twice daily or matching placebo, starting within 4
h before surgery and continuing for 10 days. Randomisation was done with
use of a computerised, web-based system, and was stratified by centre.
Health-care providers, patients, data collectors, and adjudicators were
masked to treatment assignment. The coprimary outcomes were clinically
important perioperative atrial fibrillation and MINS during 14 days of
follow-up. The main safety outcomes were a composite of sepsis or
infection, and non-infectious diarrhoea. The intention-to-treat principle
was used for all analyses. This trial is registered with
ClinicalTrials.gov, NCT03310125. <br/>Finding(s): Between Feb 14, 2018,
and June 27, 2023, we enrolled 3209 patients (mean age 68 years [SD 7],
1656 [51.6%] male). Clinically important atrial fibrillation occurred in
103 (6.4%) of 1608 patients assigned to colchicine, and 120 (7.5%) of 1601
patients assigned to placebo (hazard ratio [HR] 0.85, 95% CI 0.65 to 1.10;
absolute risk reduction [ARR] 1.1%, 95% CI -0.7 to 2.8; p=0.22). MINS
occurred in 295 (18.3%) patients assigned to colchicine and 325 (20.3%)
patients assigned to placebo (HR 0.89, 0.76 to 1.05; ARR 2.0%, -0.8 to
4.7; p=0.16). The composite outcome of sepsis or infection occurred in 103
(6.4%) patients in the colchicine group and 83 (5.2%) patients in the
placebo group (HR 1.24, 0.93-1.66). Non-infectious diarrhoea was more
common in the colchicine group (134 [8.3%] events) than the placebo group
(38 [2.4%]; HR 3.64, 2.54-5.22). <br/>Interpretation(s): In patients
undergoing major non-cardiac thoracic surgery, administration of
colchicine did not significantly reduce the incidence of clinically
important atrial fibrillation or MINS but increased the risk of mostly
benign non-infectious diarrhoea. <br/>Funding(s): Canadian Institutes of
Health Research, Accelerating Clinical Trials Consortium, Innovation Fund
of the Alternative Funding Plan for the Academic Health Sciences Centres
of Ontario, Population Health Research Institute, Hamilton Health
Sciences, Division of Cardiology at McMaster University, Canada; Hanela
Foundation, Switzerland; and General Research Fund, Research Grants
Council, Hong Kong.<br/>Copyright &#xa9; 2023 Elsevier Ltd

<4>
Accession Number
2033394327
Title
Efficacy of aromatherapy with Lavandula angustifolia oil on postoperative
pain after cardiac surgery: A randomized clinical trial.
Source
Explore. 20(6) (no pagination), 2024. Article Number: 103034. Date of
Publication: 01 Nov 2024.
Author
Silva L.C.D.M.A.; dos Santos K.V.G.; dos Santos J.J.D.S.; Camara
R.P.D.P.O.A.; Bezerra e Silva S.Y.; Silva H.M.M.D.; Ribeiro K.R.B.; Dantas
D.V.; Dantas R.A.N.
Institution
(Silva, dos Santos, Camara, Bezerra e Silva, Silva, Ribeiro, Dantas,
Dantas) Graduate Program in Nursing, Department of Nursing, Federal
University of Rio Grande do Norte, 59078-970, Rio Grande do Norte, Natal,
Brazil
(dos Santos) Natal Heart Hospital, Natal 59075-050, Rio Grande do Norte,
Brazil
Publisher
Elsevier Inc.
Abstract
Objective: To evaluate the effect of aromatherapy through inhalation of
Lavandula angustifolia essential oil in relieving pain during the
immediate postoperative period of patients undergoing cardiac surgery.
<br/>Method(s): A single-blind, randomized and controlled clinical trial,
with 52 patients in the immediate postoperative period of cardiac surgery
were randomly distributed into experimental (n = 26) and control (n = 26)
groups. The primary outcome was whether or not pain was relieved and
secondary outcomes included changes in vital signs, sleep and facial
relaxation. The control group received industry standard care and
application of an essential oil-free ceramic diffuser necklace. The
experimental group received the inhalation intervention with pure
Lavandula angustifolia essential oil, with a drop of the oil on a ceramic
diffuser necklace at a distance of 15-20 cm from the patient's nose for 30
min. Pain was measured using the Numerical Visual Scale, and vital signs
using the multiparametric monitor before the intervention, 10 minutes
after its start and 30 minutes after the total end of inhalation. Face
relaxation was assessed before and after the intervention and sleep was
assessed at the end of inhalation. <br/>Result(s): There was a decrease in
pain levels (p < 0.001) 30 min after the end of inhalation in the
Experimental Group, with a decrease in the measurements of Mean Blood
Pressure (p= 0.008) and Respiratory Rate (p = 0.011). Furthermore, facial
relaxation and sleep had a large effect size of 2.54 and 1.28,
respectively. <br/>Conclusion(s): Lavandula angustifolia essential oil was
effective in relieving pain, causing sleep and relaxation, proving to be a
low-cost and easy-to-use tool that the nursing team can use in their
care.<br/>Copyright &#xa9; 2024 The Author(s)

<5>
Accession Number
2032712301
Title
Electroencephalography-Guided Anesthesia and Delirium in Older Adults
after Cardiac Surgery: The ENGAGES-Canada Randomized Clinical Trial.
Source
JAMA. 332(2) (pp 112-123), 2024. Date of Publication: 09 Jul 2024.
Author
Deschamps A.; Ben Abdallah A.; Jacobsohn E.; Saha T.; Djaiani G.;
El-Gabalawy R.; Overbeek C.; Palermo J.; Courbe A.; Cloutier I.; Tanzola
R.; Kronzer A.; Fritz B.A.; Schmitt E.M.; Inouye S.K.; Avidan M.S.
Institution
(Deschamps, Overbeek, Palermo, Courbe) Montreal Heart Institute,
Department of Anesthesiology and Pain Medicine, Universite de Montreal,
Montreal, QC, Canada
(Ben Abdallah, Kronzer, Fritz, Avidan) Department of Anesthesiology,
Washington University, School of Medicine, St Louis, MO, United States
(Jacobsohn) Department of Anesthesiology Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, MB, Canada
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston, ON, Canada
(Djaiani) Department of Anesthesia, University of Toronto, Toronto, ON,
Canada
(El-Gabalawy) Departments of Clinical Health Psychology and
Anesthesiology, University of Manitoba, Winnipeg, MB, Canada
(Cloutier) Montreal Health Innovations Coordinating Center, Montreal Heart
Institute, Montreal, QC, Canada
(Schmitt, Inouye) Department of Medicine, Beth Israel-Deaconess Medical
Center, The Marcus Institute for Aging Research, Hebrew Senior Life,
Harvard Medical School, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: Intraoperative electroencephalogram (EEG) waveform
suppression, suggesting excessive general anesthesia, has been associated
with postoperative delirium. <br/>Objective(s): To assess whether
EEG-guided anesthesia decreases the incidence of delirium after cardiac
surgery. <br/>Design, Setting, and Participant(s): Randomized,
parallel-group clinical trial of 1140 adults 60 years or older undergoing
cardiac surgery at 4 Canadian hospitals. Recruitment was from December
2016 to February 2022, with follow-up until February 2023.
<br/>Intervention(s): Patients were randomized in a 1:1 ratio (stratified
by hospital) to receive EEG-guided anesthesia (n = 567) or usual care (n =
573). Patients and those assessing outcomes were blinded to group
assignment. <br/>Main Outcomes and Measures: The primary outcome was
delirium during postoperative days 1 through 5. Intraoperative measures
included anesthetic concentration and EEG suppression time. Secondary
outcomes included intensive care and hospital length of stay. Serious
adverse events included intraoperative awareness, medical complications,
and 30-day mortality. <br/>Result(s): Of 1140 randomized patients (median
[IQR] age, 70 [65-75] years; 282 [24.7%] women), 1131 (99.2%) were
assessed for the primary outcome. Delirium during postoperative days 1 to
5 occurred in 102 of 562 patients (18.15%) in the EEG-guided group and 103
of 569 patients (18.10%) in the usual care group (difference, 0.05% [95%
CI, -4.57% to 4.67%]). In the EEG-guided group compared with the usual
care group, the median volatile anesthetic minimum alveolar concentration
was 0.14 (95% CI, 0.15 to 0.13) lower (0.66 vs 0.80) and there was a
7.7-minute (95% CI, 10.6 to 4.7) decrease in the median total time spent
with EEG suppression (4.0 vs 11.7 min). There were no significant
differences between groups in median length of intensive care unit
(difference, 0 days [95% CI, -0.31 to 0.31]) or hospital stay (difference,
0 days [95% CI, -0.94 to 0.94]). No patients reported intraoperative
awareness. Medical complications occurred in 64 of 567 patients (11.3%) in
the EEG-guided group and 73 of 573 (12.7%) in the usual care group.
Thirty-day mortality occurred in 8 of 567 patients (1.4%) in the
EEG-guided group and 13 of 573 (2.3%) in the usual care group.
<br/>Conclusions and Relevance: Among older adults undergoing cardiac
surgery, EEG-guided anesthetic administration to minimize EEG suppression,
compared with usual care, did not decrease the incidence of postoperative
delirium. This finding does not support EEG-guided anesthesia for this
indication. Trial Registration: ClinicalTrials.gov Identifier:
NCT02692300.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<6>
Accession Number
2029466144
Title
A systematic review about the importance of neuropsychological features in
heart failure: is at heart the only failure?.
Source
Neurological Sciences. 45(8) (pp 3611-3624), 2024. Date of Publication:
August 2024.
Author
Chiatto L.M.; Corallo F.; Calabro R.S.; Cardile D.; Pagano M.; Cappadona
I.
Institution
(Chiatto, Corallo, Calabro, Cardile, Pagano, Cappadona) IRCCS Centro
Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, Messina
98124, Italy
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Heart failure can lead to cognitive impairment that is estimated to be
present in over a quarter of patients. It is important to intervene at a
cognitive level to promote brain plasticity through cognitive training
programs. Interventions transformed by technology offer the promise of
improved cognitive health for heart failure patients. This review was
conducted on studies evaluating the role of cognitive rehabilitation in
patients with heart failure. We examined clinical trials involving
patients with heart failure. Our search was performed on Pubmed, Web of
Science and Cochrane library databases. Of the initial 256 studies, 10
studies met the inclusion criteria. Cognitive rehabilitation training has
important implications for the treatment and prevention of cognitive
decline in heart failure patients with significant recovery for delayed
recall memory and a significant time effect for total recall memory and
delayed, psychomotor speed and IADL performance. It is important to
include the assessment of cognitive functioning in the routine clinical
examinations of patients with heart failure, discover the relationship
between cognitive function and heart failure, and target cognitive
rehabilitation programs that promote brain plasticity.<br/>Copyright
&#xa9; Fondazione Societa Italiana di Neurologia 2024.

<7>
Accession Number
2033426679
Title
Effectiveness of a home-based music-paced physical activity programme on
exercise-related outcomes after cardiac rehabilitation: a randomized
controlled trial.
Source
European Journal of Cardiovascular Nursing. 23(5) (pp 510-520), 2024. Date
of Publication: 01 Jul 2024.
Author
Chair S.Y.; Cheng H.Y.; Lo S.W.S.; Sit J.W.H.; Wong E.M.L.; Leung K.C.;
Wang Q.; Choi K.C.; Leung T.S.Y.
Institution
(Chair, Cheng, Lo, Sit, Choi) The Nethersole School of Nursing, Faculty of
Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
(Wong) School of Nursing, Tung Wah College, Hong Kong
(Leung, Leung) Department of Medicine and Rehabilitation, Tung Wah Eastern
Hospital, Hong Kong
(Wang) School of Nursing, Shenzhen University, Shenzhen, China
Publisher
Oxford University Press
Abstract
Aims A randomized controlled trial was conducted to examine the effects of
a home-based music-paced physical activity programme guided by
Information-Motivation-Strategy (IMS) model and Self-determination theory
on exercise-related outcomes for patients with coronary heart disease
(CHD) after cardiac rehabilitation (CR). Methods and results A total of
130 patients with CHD from a regional CR centre in Hong Kong were
recruited and randomly allocated into intervention (n = 65) or control
groups (n = 65). The intervention group received theory-guided practical
sessions on performing prescribed home-based physical activity with
individualized synchronized music, and follow-up telephone calls. The
primary outcome was exercise capacity. Secondary outcomes included
exercise self-efficacy, physical activity level, and exercise
self-determination. Data were collected at baseline, 3 months, and 6
months after study entry. The generalized estimating equations model was
used to assess the intervention effects. Patients with CHD in the
intervention group demonstrated significantly greater improvements in
exercise capacity at 3 months [beta = 35.68, 95% confidence interval (CI)
2.69-68.68, P = 0.034] and significantly improved exercise self-efficacy
at 6 months (beta = 3.72, 95% CI 0.11-7.32, P = 0.043) when compared with
the control group. However, no significant group differences were found in
physical activity level and exercise self-determination. Conclusion The
study findings provide evidence on an innovation on improving the exercise
capacity and exercise self-efficacy of patients with CHD. The music-paced
physical activity guided by the IMS model and Self-determination theory
requires further investigation on its long-term effects in future
studies.<br/>Copyright &#xa9; The Author(s) 2024.

<8>
Accession Number
2033420702
Title
Profiles of sulfonylurea use in Diabetes Mellitus type 2: an analysis of
clinical practice over the last 10 years.
Source
Diabetes Research and Clinical Practice. 214 (no pagination), 2024.
Article Number: 111781. Date of Publication: August 2024.
Author
Baccetti F.; Crisafulli C.; Andreozzi F.; Mannino G.C.; Nicolucci A.;
Michelli A.; Miranda C.; Candido R.; Di Bartolo P.; Di Cianni G.; Russo
G.T.; Mannino D.
Institution
(Baccetti) ASL North-West Tuscany, Carrara, Italy
(Crisafulli) ASP of Catania, Catania, Italy
(Andreozzi, Mannino) Department of Medical and Surgical Sciences,
University Magna Graecia of Catanzaro, Catanzaro, Italy
(Andreozzi) Research Centre for the Prevention and Treatment of Metabolic
Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro,
Italy
(Nicolucci) CORESEARCH-Center for Outcomes Research and Clinical
Epidemiology, Pescara, Italy
(Michelli) Department of Internal Medicine, SC Diabetes and Center for
Treatment of Diabetic Foot, Gorizia, Monfalcone, Italy
(Miranda) Clinic of Endocrinology and Metabolic Diseases, Pordenone
Hospital, Pordenone, Italy
(Candido) Diabetes Center, ASUGI University Hospital Giuliano Isontina,
Trieste, Italy
(Di Bartolo) Diabetes Unit, Local Healthcare Authority of Romagna,
Ravenna, Italy
(Di Cianni) ASL North-West Tuscany, Diabetes and Metabolic Diseases,
Livorno Hospital, Livorno, Italy
(Russo) Department of Clinical and Experimental Medicine, University
Hospital G. Martino, Messina, Italy
(Mannino) Section of Endocrinology and Diabetes, Bianchi Melacrino Morelli
Hospital, Reggio Calabria, Italy
(Mannino) AMD Annals Initiative, AMD Foundation, Rome, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Aims: Describing the evolution over time in the use of sulfonylureas (SUs)
and the characteristics of patients at first prescription and at
interruption of treatment with SUs. <br/>Method(s): Retrospective
evaluation of data from the Italian Association of Diabetologists (AMD)
Annals registry (2010-2020), about T2D patients who started treatment with
SUs. The longitudinal probability of remaining on SUs was estimated by
Kaplan Meier survival curves. <br/>Result(s): SU prescription decreased
from 30.7 % (2010) to 12.9 % (2020). Patients started on SU were 68.2 +/-
11.2 years old, mostly males (55.5 %), with diabetes duration = 10.1 +/-
8.3 years, BMI = 29.7 +/- 5.5 kg/m2, and HbA1c = 8.3 +/- 1.7 % [67
mmol/mol]. After one year, the probability of staying on SU was 85.4 %,
75.9 % after two years, 68.2 % after 3 years, 56.6 % after 5 years.
Patients who discontinued SUs had higher BMI and HbA1c, were younger, more
often males and treated with insulin. Over time, the percentage of
subjects switched to metformin, DPP4i, SGLT2i, and GLP1RA increased,
whereas use of glinides, glitazones, acarbose and insulin declined.
<br/>Conclusion(s): These data suggest a consensus, slowly, but
increasingly aligning with the current National indications of dismissing
SUs for the treatment of T2D. The new drugs for diabetes should represent
a preferable choice in all patients who do not have specific
contraindications.<br/>Copyright &#xa9; 2024 The Authors

<9>
Accession Number
2030646628
Title
Cardiac Rehabilitation in Saudi Arabia: Current Status and Future
Directions.
Source
Current Cardiology Reports. (no pagination), 2024. Date of Publication:
2024.
Author
Osailan A.M.
Institution
(Osailan) Department of Health and Rehabilitation Sciences, College of
Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj,
Saudi Arabia
Publisher
Springer
Abstract
Purpose of Review: Cardiovascular diseases (CVDs) are the leading cause of
mortality in Saudi Arabia. Cardiac rehabilitation (CR) is one of the
well-known interventions to control and minimize the burden of CVDs.
Despite recommendations, CR utilization remains suboptimal in Saudi Arabia
due to many reasons, including limited awareness, logistical barriers,
shortage of specialized facilities and trained professionals, and
perceptions about CVDs illness. This review is to evaluate the current
status, effectiveness, accessibility, and challenges of CR utilization in
Saudi Arabia, and to explore potential future directions for improving
these services. The review addresses key questions regarding the incidence
of CVDs, the characteristics of existing CR programs, barriers to CR
access, and stakeholder perspectives. Recent Findings: Recent studies
demonstrate that the effectiveness of CR, particularly exercise training,
in improving outcomes for post-coronary artery bypass grafting (CABG)
patients is well-documented, though data on its impact on other cardiac
conditions is limited. There are significant barriers to CR utilization in
Saudi Arabia, including limited awareness, logistical challenges, a
shortage of specialized facilities and trained professionals, and cultural
perceptions about CVD. Stakeholder perspectives highlight the necessity
for culturally sensitive and inclusive approaches, particularly in
addressing gender-specific needs and enhancing patient-provider
communication. The Saudi Vision 2030 presents opportunities to expand and
enhance CR services in alignment with international standards.
<br/>Summary: This review found that while CR is a crucial intervention
for managing CVDs, its utilization in Saudi Arabia is suboptimal due to
various barriers. To improve CR access and effectiveness, future
strategies should focus on increasing public and professional awareness,
developing infrastructure, training healthcare professionals, and
fostering public-private partnerships. These measures are essential to
making CR more accessible and tailored to the diverse needs of the Saudi
population, ultimately enhancing the quality of cardiovascular care and
patient outcomes in the region.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<10>
Accession Number
2033468065
Title
Comparative Acute Thrombogenicity of the CLAAS Foam Implant and Watchman
FLX in an In Vitro Blood Loop Model.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 87), 2024. Date of
Publication: August 2024.
Author
Gray W.A.; Devellian C.; Baker L.; Levine A.; Kaplan A.V.
Institution
(Gray) Lankenau Heart Institute, Wynnewood, PA, United States
(Devellian, Levine) Conformal Medical, Inc., Nashua, NH, United States
(Baker) Insight Medical Consulting, Northboro, MA, United States
(Kaplan) Dartmouth-Hitchcock Medical Center, NH, Lebanon
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) is emerging as an
important stroke prevention strategy for patients with atrial
fibrillation. However, device-related thrombus (DRT) has been reported in
approximately 2-4% of patients and is associated with cerebral vascular
events. The Conformal CLAAS device (Conformal Medical, Inc., Nashua, NH)
is composed of a foam cup with an embedded nitinol skeleton covered by an
ePTFE (fluoropolymer) cover. The WATCHMAN FLXTM (Boston Scientific Corp.,
Marlboro, MA) is composed of a nitinol frame covered by a polyethylene
terephthalate (PET) cover. In this study, we evaluated the relative
thrombogenicity of the CLAAS Device by comparing it to the Watchman FLX in
an acute radiolabeled in vitro blood loop model. <br/>Method(s): CLAAS (27
mm, Regular Size) (n=3) and Watchman FLX (27mm) (n=3) devices were
inserted into the wall of a 25.4 mm inner diameter loop system which
recirculated heparinized bovine blood admixed with radiolabeled platelets
for 90 or 120 minutes. After run completion, samples were gently rinsed
and evaluated qualitatively. <br/>Result(s): Evaluation of the blood loop
exposed surface of the comparator device showed complete coverage with
adherent clot on all devices. The blood loop exposed surface of the CLAAS
device was incompletely covered with adherent clot which was thinner.
Compared to the comparator device, platelet deposition on the CLAAS
devices was lower by approximately 44%. <br/>Conclusion(s): In this model,
the CLAAS device appeared to have less thrombus formation when compared to
a commercially available LAA Closure Device. Data from an ongoing large
randomized clinical trial will be needed to understand the impact of these
findings. [Formula presented]<br/>Copyright &#xa9; 2024

<11>
Accession Number
2033468010
Title
Transcatheter vs. Surgical Valve Replacement in Severe Aortic Stenosis
with Small Annulus: A Meta-Analytical Review of Two-Year Outcomes.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 85), 2024. Date of
Publication: August 2024.
Author
Ellauzi R.; Kumar A.; Ismayl M.; Hamza I.; Hamza T.; Anavekar N.
Institution
(Ellauzi) Henry Ford Hospital, Detroit, MI, United States
(Kumar) Cleveland Clinic, Akron, OH, United States
(Ismayl, Anavekar) Mayo Clinic, Rochester, MN, United States
(Hamza) The University of Texas Medical Branch, Galveston, TX, United
States
(Hamza) Houston Methodist Hospital, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal approach for severe aortic stenosis (AS) patients
with small aortic annulus (SAA) remains uncertain when comparing
transcatheter (TAVR) and surgical aortic valve replacement (SAVR).
<br/>Method(s): We conducted a pooled analysis of data from observational
studies and randomized controlled trials that compared TAVR and SAVR in
patients with severe aortic stenosis and small aortic annulus. The key
endpoints evaluated were all-cause mortality, stroke, and myocardial
infarction over a 2-year follow-up period. We used inverse variance method
with Paule-Mandel estimator for tau^2 and Hartung-Knapp adjustment for
random effects model accounting for small study effect and heterogeneity
in the current analysis. All analysis was carried out using R version
4.0.3. <br/>Result(s): The meta-analysis incorporated data from three
studies, evaluating a total of 279 TAVR and 231 SAVR patients with severe
aortic stenosis and small aortic annulus. The analysis demonstrated no
significant difference in all-cause mortality at 2 years follow-up, with a
pooled risk ratio of 0.82 (95% CI [0.56; 1.21]), and no heterogeneity (I2
= 0%) [Figure, PANEL A]. The risk of stroke was comparable between TAVR
and SAVR, with a risk ratio of 1.34 (95% CI [0.06; 28.44]) and moderate
heterogeneity (I2 = 59%) [Figure, PANEL B]. Myocardial infarction was also
comparable between TAVR and SAVR, yielding a risk ratio of 0.66 (95% CI
[0.10; 4.15]) with no detected heterogeneity (I2 = 0%) [Figure, PANEL C].
<br/>Conclusion(s): In patients with severe aortic stenosis and small
aortic annulus, TAVR and SAVR reported comparable results in all-cause
mortality, stroke, and myocardial infarction at 2 years. Selection of
valve replacement therapy should be individualized, considering these
findings. [Formula presented]<br/>Copyright &#xa9; 2024

<12>
Accession Number
2033467982
Title
Outcomes of Transcatheter Mitral Valve Replacement with Sapien
Transcatheter Heart Valve for Degenerated Bioprostheses and Failed
Annuloplasty Rings: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 90), 2024. Date of
Publication: August 2024.
Author
Aoun J.; Agrawal A.; Khan S.; Akbar U.A.; Zhu Z.; Kleiman N.S.; Reardon
M.J.; Lone A.N.; Laird R.; Arshad H.; Atkins M.; Faza N.; Little S.H.;
Goel S.
Institution
(Aoun, Agrawal, Khan, Akbar, Zhu, Kleiman, Reardon, Lone, Laird, Arshad,
Atkins, Faza, Little, Goel) Houston Methodist, DeBakey Heart & Vascular
Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Transcatheter mitral valve replacement (TMVR) with Sapien
transcatheter heart valve (THV) is currently the mainstay of therapy for
patients with degenerative bioprosthetic valves and failed surgical mitral
valve repairs who are unsuitable for surgical interventions.
<br/>Purpose(s): We aimed to compare the outcomes of these procedures.
<br/>Method(s): We searched electronic databases (OVID Medline, Embase,
SCOPUS, web of Science and Cochrane, between 2015 and 2022). We focused on
all-cause mortality, stroke, acute kidney injury (AKI), infective
endocarditis (IE), major bleeding, permanent pacemaker (PPM), and residual
mitral regurgitation (MR) after intervention. We performed random-effects
meta-analysis and estimated percentages with 95% confidence intervals for
valve in ring (ViR), and valve in valve (ViV). We estimated p-interaction
(p-int) across the interventions. Outcomes were assessed at 30 days and 1
year. <br/>Result(s): Of 30 studies (n =5,233), at 30 days, compared with
ViR, ViV showed no significant differences for all-cause mortality (6.2%
vs. 7.2%), stroke (2.4% vs.3.4%), AKI (8.2% vs. 13.0%), IE (4.7% vs.
0.5%), major bleeding (7.9% vs. 7.0%), and PPM (2.8% vs. 6.3%). There were
similar rates of residual MR<=1+ and MR<=2+, however residual MR >=3+ were
lower in ViV than ViR (0.8% vs. 12.5%) (p<0.01). At 1-year, compared with
ViR, ViV had lower proportion of all-cause mortality (10.4% vs. 22.5%) and
AKI (ViV: 1.4%; ViR: 13.3%), but no significant differences for stroke
(4.4% vs. 3.3%), IE (0.5% vs. 0.5%), major bleeding (3.3% vs. 6.7%), and
PPM (2.8% vs. 0.5%). There were similar rates of residual MR<=1+ and
MR<=2+, however residual MR>=3+ were lower in ViV (3.3% vs. 18.5%) than
ViR (p<0.01). <br/>Conclusion(s): In this meta-analysis, we have
demonstrated that TMVR with Sapien valve for degenerative bioprostheses
and failed annuloplasty rings result in favorable short-term survival
rates at 30 days and 1-year<br/>Copyright &#xa9; 2024

<13>
Accession Number
2033467936
Title
Routine Invasive Versus Conservative Management of Non-ST Elevation Acute
Coronary Syndromes in Patients With Previous Coronary Artery Bypass
Grafting: A Systematic Review and Meta-Analysis of Randomised Clinical
Trials.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 17-18), 2024. Date of
Publication: August 2024.
Author
Kelham M.; Vyas R.; Rameseshan R.; Rathod K.; de Winter R.J.; de Winter
R.W.; Bendz B.; Thiele H.; Hirlekar G.; Morici N.; Myat A.; Michalis L.;
Sanchis J.; Kunadian V.; Berry C.; Mathur A.; Jones D.
Institution
(Kelham, Vyas, Rameseshan, Rathod, Jones) St Bartholomew's, London, United
Kingdom
(de Winter, de Winter) Amsterdam UMC, Amsterdam, Netherlands
(Bendz) Oslo University Hospital and Institute of Clinical Medicine, Oslo,
Norway
(Thiele) Heart Center Leipzig, Leipzig, Germany
(Hirlekar) Sahlgrenska University Hospital, Gothenburg, Sweden
(Morici) IRCCS S. Maria Nascente, Milan, Italy
(Myat) Medical Director Medpace UK, London, United Kingdom
(Michalis) University of Ioannina and University Hospital of Ioannina,
Ioannina, Greece
(Sanchis) University Clinic Hospital of Valencia, Valencia, Spain
(Kunadian) Faculty of Medical Sciences, Newcastle University, Newcastle,
United Kingdom
(Berry) British Heart Foundation Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Mathur) Centre for Cardiovascular Medicine and Devices, Faculty of
Medicine & Dentistry, Queen Mary University of London, London, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: A routine invasive strategy is recommended in the management
of higher risk patients with non-ST elevation acute coronary syndromes
(NSTE-ACS). However, patients with previous coronary artery bypass graft
surgery (CABG) were excluded from key trials that informed these
guidelines. Thus, the benefit of a routine invasive strategy is less
certain in this specific subgroup. <br/>Method(s): A systematic review and
meta-analysis of randomized controlled trials (RCT) was conducted.
Eligible studies were RCTs of routine invasive versus a conservative or
selective invasive strategy in patients presenting with NSTE-ACS that
included patients with previous CABG. Summary data was 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 with
95% confidence intervals were calculated. <br/>Result(s): Summary data was
obtained from eleven RCTs, including previously unpublished subgroup
outcomes of nine trials, comprising 897 patients with previous CABG (477
routine invasive, 420 conservative/selective invasive). 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). <br/>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 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.
Prospero registration: CRD42022332048<br/>Copyright &#xa9; 2024

<14>
Accession Number
2033467849
Title
Transcarotid vs. Transaxillary/Subclavian Transcatheter Aortic Valve
Replacement (TAVR): A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 79), 2024. Date of
Publication: August 2024.
Author
Shrestha D.B.; Dawadi S.; Oli P.; Shtembari J.; Pant K.; Mattumpuram J.
Institution
(Shrestha, Shtembari) Mount Sinai Hospital, Chicago, IL, United States
(Dawadi) Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
(Oli) Province Hospital, Birendranagar, Nepal
(Pant) OSF UIC Peoria, Peoria, IL, United States
(Mattumpuram) University of Louisville School of Medicine, Louisville, KY,
United States
Publisher
Elsevier Inc.
Abstract
BACKGROUND Transcatheter Aortic Valve Replacement (TAVR) is the treatment
of choice in patients with severe Aortic stenosis. Trans-femoral access
has been the choice for the procedure and has been widely adopted. In
certain populations of patients where transfemoral access is difficult or
not possible to obtain, non-femoral access is used. Trans-carotid (TCa) or
Trans axillary/ subclavian (TAx/Sc) are safer and less invasive than other
non-femoral approaches. This meta-analysis aimed to compare the safety of
the trans-carotid and trans-axillary/subclavian approach for TAVR. METHODS
A comprehensive and systematic search was performed on PubMed, Medline,
Scopus, and Embase to identify studies comparing TCa vs TAx/ Sc access for
TAVR from inception to October 2023. Data analysis was done using Revman
Web. Odds Ratio (OR) with a 95% confidence interval used for effect
measure. RESULTS Seven studies with a total of 6227 patients were included
in the analysis. (TCa: 2566; TAx/ Sc: 3661). Transcarotid TAVR was
associated with lower odds of composite stroke and all-cause mortality (OR
0.76 CI 0.63- 0.92) (Fig.). TAx/ Sc approach had a favorable trend for
all-cause mortality (OR 0.84, CI 0.64- 1.08) (Fig.), stroke and /or TIA
(OR 0.85 CI 0.50-1.43) (Fig.), major vascular complication (0.73 CI 0.50-
1.06) and new requirement of permanent pacemaker (OR 0.87 CI 0.74-1.01)
however, it didn't reach statistical significance. CONCLUSION Transcarotid
TAVR had lower odds of composite stroke and all-cause mortality. Although
the trend favors the trans-carotid approach, there was no statistical
difference between the two groups for individual outcomes (stroke,
all-cause mortality, etc.). Large prospective randomized clinical trials
comparing the two approaches are necessary to guide the clinicians for the
approaches. [Formula presented]<br/>Copyright &#xa9; 2024

<15>
Accession Number
2033466721
Title
Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Implantation in Patients with Small Aortic Annuli: A Meta-Analysis of 6984
Patients.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 79), 2024. Date of
Publication: August 2024.
Author
Yassin M.; Elkasaby M.; Altobaishat O.; Rashed M.; Omar I.; Mansour M.;
Khalefa B.B.; Bani-Salameh A.; Hasan M.; Al Hennawi H.; Abdelaziz A.
Institution
(Yassin) Faculty of Medicine, Helwan University, Cairo, Egypt
(Elkasaby, Rashed, Hasan, Abdelaziz) Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
(Altobaishat, Bani-Salameh) Faculty of Medicine, Jordan University of
Science and Technology, Irbid, Jordan
(Omar) Faculty of Pharmacy, South Valley University, Qena, Egypt
(Mansour) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Al Hennawi) Jefferson Abington Hospital, Abington, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Limited data is available on the impact of different types of
valves on patients with small aortic annuli (SAA) undergoing transcatheter
aortic valve implantation (TAVI) for aortic stenosis (AS). We aim to
compare self-expandable (SEV) and balloon-expandable valves (BEV) in AS
for patients with SAA undergoing TAVI. <br/>Method(s): PubMed, Scopus,
Cochrane CENTRAL, Embase, and Web of Science were searched from inception
until August 2, 2023. We included studies that compared SEV to BEV in
patients with SAA undergoing TAVI. We used Review Manager software for
statistical analysis. We used the risk ratio (RR) and their corresponding
95% confidence intervals (CI) to compare dichotomous outcomes and the mean
difference and its 95% CI for continuous outcomes. <br/>Result(s): We
included twenty studies comprising 3800 patients for SEV and 3184 patients
for BEV. Patients who received SEV had a significantly lower risk of
moderate to severe patient prosthesis mismatch (PPM) (RR = 0.51, 95% CI
[0.45, 0.58], p<0.0001) (I² = 0%, p=0.65) (Figure. 1), and
long-term stroke (RR = 2.15, 95% CI [1.09, 4.27], p=0.03) (I² =
0%, p=0.76). On the other hand, BEV was associated with a lower risk of
permanent pacemaker implantation (PPI) (RR = 1.61, 95% CI [1.25, 2.08],
p=0.0002) (I² = 2%, p=0.43). There were no differences in these
outcomes in the short term: all-cause mortality (p=0.57), cardiovascular
mortality (p=0.57), stroke (0.05), and myocardial infarction (MI) (p=
0.76). Also, long-term all-cause mortality, MI, and PPI were not
significant with these values (p=0.46), (p=0.34), and (p=0.09),
respectively. <br/>Conclusion(s): Patients with SAA who underwent TTVI
with SEV reported a lower risk of moderate to severe PPM and long-term
stroke. BEV was associated with decreased PPI. [Formula
presented]<br/>Copyright &#xa9; 2024

<16>
Accession Number
2033466701
Title
Role of LA Strain Assessed by Speckle-Tracking Echocardiography in
Predicting POAF After Coronary Artery Bypass Grafting: A Systematic Review
and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 40), 2024. Date of
Publication: August 2024.
Author
Bulaeva N.; Berdibekov B.; Mrikaev D.; Golukhova E.
Institution
(Bulaeva, Berdibekov, Mrikaev, Golukhova) Bakulev Scientific Center for
Cardiovascular Surgery, Moscow, Russian Federation
Publisher
Elsevier Inc.
Abstract
Background: The current study aimed to conduct a systematic review and
meta-analysis with the objective of evaluating left atrial (LA) strain
using speckle-tracking echocardiography for predicting new onset
postoperative atrial fibrillation (POAF) in patients undergoing coronary
artery bypass grafting (CABG). <br/>Material(s) and Method(s): We searched
PubMed, Google Scholar for studies that investigated the prognostic value
of LA strain using speckle-tracking echocardiography as predictors of POAF
in patients undergoing CABG. To determine the weighted mean difference of
LA strain, was performed a pooled analysis of mean values of global LA
strain, LA reservoir strain (PALS - peak atrial longitudinal atrial
strain), conduit (LACS - left atrial conduit strain) and contraction
(LACtS - left atrial contractile strain). Odds ratios (OR) were extracted
from multivariate models reporting on the association of PALS and POAF and
described as pooled estimates with 95% confidence intervals (CI). Results.
12 studies were retrieved from 404 publications for this systematic review
and meta-analysis. In total, 1093 patients, mean age 60,5 years were
included in the analysis. Meta-analysis showed the showed that patients
with POAF had lower global LA strain than patients without POAF (weighted
mean difference - 5.03%; 95% CI: -6.89 to -3.16; p <0.001). In addition,
patients with POAF had lower values of LA strain in the reservoir phase
(PALS), conduit (LACS) and contraction (LACtS), these weighted mean
difference were - 9.90% (95% CI: - 12.95 to - 6.85; p <0.001), - 4.17%
(95% CI: -6.05 to -2.29; p<0.001) and - 6.17% (95% CI: - 12 .01 to - 0.33;
p=0.04), respectively (Figure 1). Moreover, pooled analysis of OR showed
that PALS was an independent predictor of POAF after CABG (OR: 0.88 per 1%
increase of PALS; 95% CI: 0.82-0.94; p<0.0001).Conclusions. LA strain
assessed using speckle-tracking echocardiography provides important
additional information for predicting new-onset POAF in patients
undergoing isolated CABG.<br/>Copyright &#xa9; 2024

<17>
Accession Number
2033466633
Title
Jetstream Atherectomy With Paclitaxel-Coated Balloons: Three-Year Outcome
of the Prospective Randomized JET-RANGER Study.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 48-49), 2024. Date of
Publication: August 2024.
Author
Shammas N.W.; Shammas G.A.; Christensen L.; Jones-Miller S.
Institution
(Shammas, Shammas, Christensen, Jones-Miller) Midwest Cardiovascular
Research Foundation, Davenport, IA, United States
Publisher
Elsevier Inc.
Abstract
Background: The JET-RANGER study (NCT03206762) was a multicenter (11 US
centers) randomized trial, core lab adjudicated, designed to demonstrate
the superiority of Jetstream + Paclitaxel coated balloon (JET+PCB) versus
angioplasty (PTA) + PCB in treating femoropopliteal (FP) arterial disease.
The 1-year and 2-year data have already been presented. The 3-year data is
being presented in this report. This study was stopped early during the
COVID pandemic and the FDA warning on paclitaxel. <br/>Method(s): The JET
Ranger Trial initially had 47 patients with 48 lesions (31 JET arm and 16
PTA Arm; randomized 2:1). There were 43 patients who completed the 1-year
follow-up. At 3-year follow-up the JET arm had 20 patients and the PTA arm
14 patients. Kaplan Meier Survival analysis was performed to estimate the
freedom from TLR. Bailout stenting was not considered a TLR in this
analysis. Comparison of survival curves was done by Wilcoxon. Major and
minor amputation, all-cause mortality, target vessel revascularization
(TVR), bypass surgery and stent thrombosis were also measured at the
3-year follow up. Statistical significance was determined by a p-value <
0.05. <br/>Result(s): The probability of freedom from TLR was numerically
higher but statistically not significant in the JET+PCB vs PTA+PCB at 3
years when bailout stenting was not considered a TLR (88.0% vs 67.8%,
p=0.1380), but was significantly higher in the JET+PCB arm vs PTA+PCB arm
when bailout stenting was considered as a TLR (88.1 vs 23.4%, p<0.0001
respectively). There was also no significant difference in the change of
ABI between the PTA + PCB and JET + PCB from baseline and 3-year
(p-value=0.310). There was a significant mean difference between 3-year
and baseline Walking Impairment Questionnaire (WIQ) (23.1 +/- 26.3,
p-value = 0.0110) in the PTA + PCB arm but not the JET + PCB arm (4.9 +/-
22.5, p=0.3640). There was also no statistical difference between the JET
+ PCB and PTA + PCB arms for Rutherford Category (RCC) improvement by one
or more category (p-value= 1.000). There were no minor or major
amputations for either arm throughout the 3-year follow up. A total of 5
JET+PCB patients died, none related to device or procedure (2 cardiac
arrest, 2 cancers, 1 myocardial infarction). <br/>Conclusion(s): JET + PCB
had similar freedom from TLR to PTA + PCB when bailout stenting was not
considered a TLR, and no significant improvement in ABI and RCC at 3-year
follow-up when compared to PTA + PCB. No statistical difference in
amputation or mortality was seen between the 2 arms.<br/>Copyright &#xa9;
2024

<18>
Accession Number
2033466520
Title
A Systematic Review of Reported Cases of Ellis Type 4 Coronary Artery
Perforation During Percutaneous Coronary Intervention.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 32), 2024. Date of
Publication: August 2024.
Author
Majeed H.
Institution
(Majeed) University of New Mexico, Albuquerque, NM, United States
Publisher
Elsevier Inc.
Abstract
Background: Ellis type 4 coronary artery perforation (CAP4), also referred
to as Ellis type 3 cavity-spilling perforation, is a rare but
life-threatening complication of percutaneous coronary intervention
characterized by extravasation of blood into a cardiac chamber, anatomic
cavity, or coronary sinus or vessel. CAP4 is uncommon, accounting for 1.9%
to 3.0% of all CAP. <br/>Method(s): A literature search was performed
using PubMed and Google Scholar for reported cases of CAP4 using the
keywords: "type 4 coronary artery perforation" and "type 3 cavity-spilling
coronary artery perforation" and identified 13 cases (Table). We extracted
key elements of each case including: 1) cause of perforation, 2)
perforation vessel and cavity, 3) management, and 4) clinical outcomes.
<br/>Result(s): The majority of CAP4 occurred in the LAD. The most
involved cavity was the left ventricle - other cavities included the right
ventricle and coronary veins as well as sinus. Common etiologies of CAP4
included guidewire perforation (62%) and balloon dilation (31%).
Perforation was managed with reversal of anticoagulation in 46% of cases,
prolonged balloon inflation in 54% of cases, and covered stent deployment
in 15% of cases. No patients required surgical repair or
pericardiocentesis and perforations were successfully sealed in all cases.
In-hospital mortality was 0%. <br/>Conclusion(s): CAP4 is a rare
complication of percutaneous coronary intervention and can be caused by
guidewire perforation, balloon inflation, or stent expansion. CAP4 was
successfully sealed with conservative management in all cases and did not
require pericardiocentesis or surgery. There were no major acute or
chronic complications, and no in-hospital mortality was observed. [Formula
presented]<br/>Copyright &#xa9; 2024

<19>
Accession Number
2033466507
Title
Trends in Outcomes of Multi-Transcatheter Strategy for the Treatment of
Combined Aortic Stenosis and Mitral Regurgitation.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2024.
Washington United States. 65(Supplement) (pp 88), 2024. Date of
Publication: August 2024.
Author
Lupu L.; Ben-Dor I.; Haberman D.; Chitturi K.; Chaturvedi A.; Abusnina W.;
Merdler I.; Reddy P.; Rogers T.; Satler L.; Waksman R.
Institution
(Lupu, Ben-Dor, Haberman, Chitturi, Chaturvedi, Abusnina, Merdler, Reddy,
Rogers, Satler, Waksman) Medstar Washington Hospital Center, Washington,
DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Significant progress has been achieved in transcatheter
treatments for aortic stenosis (AS) and mitral regurgitation (MR).
However, data on multi-valve disease treated with the transcatheter
approach is limited. The study aim was to report on the outcome of a
multi-transcatheter strategy for treating combined AS and MR disease.
<br/>Method(s): We conducted a systematic review of the PubMed database to
identify studies on interventions for combined AS and MR. We focused on
short-term periprocedural mortality, including both staged and
same-admission procedures. To ensure contemporary relevance, we limited
our inclusion to studies published in the past ten years. <br/>Result(s):
We identified six studies meeting the inclusion criteria, including 1,483
patients who underwent transcatheter aortic valve replacement (TAVR) and
mitral transcutaneous edge-to-edge repair (M-TEER) or transcatheter mitral
valve replacement (TMVR) from 2017 to 2023. During the past 6 years,
In-hospital mortality decreased from 7.5% to 0.8% for staged TAVR and
M-TEER and from 10.8% to 6.5% for same-admission TAVR and M-TEER.
Same-admission TAVR and M-TEER patients had a higher rate of non-elective
admissions, heart failure, and cardiogenic shock, suggesting a higher-risk
population. Overall, TAVR+TMVR mortality has trended downward from 16.67%
to 13.13%. <br/>Conclusion(s): Our findings suggest the feasibility and
safety of a multi-transcatheter approach to address combined severe AS and
severe MR. With the observed trend of decreasing in-hospital mortality,
this strategy should be considered for patients with multivalve disease.
[Formula presented]<br/>Copyright &#xa9; 2024

<20>
Accession Number
2033483399
Title
Infective endocarditis.
Source
The Lancet. 404(10450) (pp 377-392), 2024. Date of Publication: 27 Jul
2024.
Author
Li M.; Kim J.B.; Sastry B.K.S.; Chen M.
Institution
(Li, Chen) Division of Cardiology, the First Affiliated Hospital of
Nanjing Medical University, Nanjing, Jiangsu, China
(Kim) Department of Thoracic and Cardiovascular Surgery, Aortic Center,
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Sastry) Department of Cardiology, Renova Century Hospital, Telangana,
Hyderabad, India
Publisher
Elsevier B.V.
Abstract
First described more than 350 years ago, infective endocarditis represents
a global health concern characterised by infections affecting the native
or prosthetic heart valves, the mural endocardium, a septal defect, or an
indwelling cardiac device. Over recent decades, shifts in causation and
epidemiology have been observed. Echocardiography remains pivotal in the
diagnosis of infective endocarditis, with alternative imaging modalities
gaining significance. Multidisciplinary management requiring expertise of
cardiologists, cardiovascular surgeons, infectious disease specialists,
microbiologists, radiologists and neurologists, is imperative. Current
recommendations for clinical management often rely on observational
studies, given the limited number of well conducted randomised controlled
trials studying infective endocarditis due to the rarity of the disease.
In this Seminar, we provide a comprehensive overview of optimal clinical
practices in infective endocarditis, highlighting key aspects of
pathophysiology, pathogens, diagnosis, management, prevention, and
multidisciplinary approaches, providing updates on recent research
findings and addressing remaining controversies in diagnostic accuracy,
prevention strategies, and optimal treatment.<br/>Copyright &#xa9; 2024
Elsevier Ltd

<21>
Accession Number
644806531
Title
Safety and effectiveness of using Disposable Ultrasonic shears to
coagulate 5-7 mm blood vessels: protocol for a prospective, multicenter,
randomized, parallel controlled, non-inferiority clinical trial.
Source
BMC surgery. 24(1) (pp 212), 2024. Date of Publication: 19 Jul 2024.
Author
Wang X.; Li C.; Fan J.; Hu J.; Wang M.; Li H.
Institution
(Wang, Li, Li) Department of Thoracic Surgery, Ruijin Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
(Fan) Department of Thoracic Surgery, Second Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Hu) Department of Thoracic Surgery, First Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Hu) Key Laboratory of Clinical Evaluation Technology for Medical Device
of Zhejiang Province, Hangzhou, China
(Wang) Department of Thoracic Surgery, Ninth People's Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
Abstract
BACKGROUND: The ultrasonic scalpel is widely used during surgery. It is
safe and effective to close the pulmonary artery branch vessels of 7 mm or
below with an ultrasonic energy device as reported. However, there have
been no multicenter randomized clinical trial to assess the safety and
effectiveness of using ultrasonic scalpel to coagulate 5-7 mm blood
vessels in thoracic surgery. <br/>METHOD(S): This is a prospective,
multicenter, randomized, parallel controlled, non-inferiority clinical
trial. A total of 144 eligible patients planning to undergo lung or
esophageal surgery will be randomly allocated to the experimental group
and the control group. The investigational product (Disposable Ultrasonic
Shears manufactured by Reach Surgical, Inc.) and the control product
(Harmonic Ace+7, 5 mm Diameter Shears with Advanced Hemostasis) will be
used in each group. The primary endpoint is the success rate of
coagulating target blood vessels during surgery. Secondary endpoints
include postoperative rebleeding, intraoperative bleeding volume, drainage
volume, surgical duration, etc. Postoperative follow-up before and after
discharge will be performed. DISCUSSION: This clinical trial aims to
evaluate the safety and effectiveness of using the investigational product
(Disposable Ultrasonic Shears manufactured by Reach Surgical, Inc.) and
that of the control product (Harmonic Ace+7, 5 mm Diameter Shears with
Advanced Hemostasis) to coagulate 5-7 mm blood vessels in thoracic
surgery. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06002737. The trial
was prospectively registered on 16 August 2023, https://www.
CLINICALTRIALS: gov/study/NCT06002737 .<br/>Copyright &#xa9; 2024. The
Author(s).

<22>
Accession Number
644806148
Title
Impact of nitric oxide via cardiopulmonary bypass on pediatric heart
surgery: a meta-analysis of randomized controlled trials.
Source
Journal of cardiothoracic surgery. 19(1) (pp 461), 2024. Date of
Publication: 19 Jul 2024.
Author
Zhao M.; Zhang Q.; Lin Y.; Chen Y.; Cao H.
Institution
(Zhao, Zhang, Lin, Chen, Cao) Fujian Children's Hospital (Fujian Branch of
Shanghai Children's Medical Center), College of Clinical Medicine for
Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou
350014, China
(Zhao, Zhang, Lin, Chen, Cao) Fujian Maternity and Child Health Hospital,
College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics,
Fujian Medical University, Fuzhou 350000, China
(Zhao, Zhang, Lin, Chen, Cao) NHC Key Laboratory of Technical Evaluation
of Fertility Regulation for Non-Human Primate (Fujian Maternity and Child
Health Hospital), Fuzhou 350000, China
Abstract
OBJECTIVE: The impact of nitric oxide (NO) administered via
cardiopulmonary bypass (CPB) on pediatric heart surgery remains
controversial. The objective of this study is to conduct a comprehensive
systematic review and meta-analysis to examine the impact of NO
administered via CPB on pediatric heart surgery. <br/>METHOD(S): This
study searched 7 electronic databases to identify Randomized Controlled
Trials (RCTs) on the impact of NO administration during CPB on
postoperative outcomes in pediatric heart surgery. The searched databases
included Embase, Medline (though PubMed), Cochrane Library, Web of
Science, Wan Fang database, China National Knowledge Infrastructure
(CNKI), and ClinicalTrials.gov from their inception to November 2, 2022.
The included RCTs compared NO administration during CPB with standard CPB
procedures or placebo gas treatment in pediatric heart surgery.
fixed-effects models and/or random-effects models were used to estimate
the effect size with 95% confidence interval (CI). Heterogeneity among
studies was indicated by p-values and I2. All analyses were performed
using Review Manager software (version 5.4) in this study. <br/>RESULT(S):
A total of 6 RCTs including 1,739 children were identified in this study.
The primary outcome was duration of postoperative mechanical ventilation,
with the length of hospital and intensive care unit (ICU) stay as the
second outcomes. Through a pooled analysis, we found that exogenous NO
administered via CPB for pediatric heart surgery could not shorten the
duration of postoperative mechanical ventilation when compared with the
control group (standardized mean difference (SMD) -0.07, CI [-0.16, 0.02],
I2=45%, P=0.15). Additionally, there were also no difference between the
two groups in terms of length of hospital stay (mean difference (MD)
-0.29, CI [-1.03, 0.46], I2=32%, P=0.45) and length of ICU stay (MD -0.22,
CI [-0.49 to 0.05], I2=72%, P=0.10). <br/>CONCLUSION(S): This
meta-analysis showed that exogenous NO administration via CBP had no
benefits on the duration of mechanical ventilation, the length of
postoperative hospital, and ICU stay after pediatric heart
surgery.<br/>Copyright &#xa9; 2024. The Author(s).

<23>
Accession Number
2033458485
Title
A wide scope, pan-comparative, systematic meta-analysis of the efficacy of
prophylactic strategies for cardiac surgery-associated acute kidney
injury.
Source
Biomedicine and Pharmacotherapy. 178 (no pagination), 2024. Article
Number: 117152. Date of Publication: September 2024.
Author
Martin-Fernandez M.; Casanova A.G.; Jorge-Monjas P.; Morales A.I.; Tamayo
E.; Lopez Hernandez F.J.
Institution
(Martin-Fernandez) Department of Cell Biology, Genetics, Histology and
Pharmacology, Faculty of Medicine, Universidad de Valladolid, Valladolid
47005, Spain
(Martin-Fernandez, Jorge-Monjas, Tamayo) Centro de Investigacion Biomedica
en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos
III, Madrid, Spain
(Martin-Fernandez, Jorge-Monjas, Morales, Tamayo, Lopez Hernandez) Group
of Biomedical Research on Critical Care (BioCritic), Valladolid, Spain
(Casanova, Morales, Lopez Hernandez) Instituto de Investigacion Biomedica
de Salamanca (IBSAL) de la Fundacion Instituto de Ciencias de la Salud de
Castilla y Leon (ICSCYL), Salamanca, Spain
(Casanova, Morales, Lopez Hernandez) National Network for Kidney Research
REDINREN, RD016/0009/0025, Instituto de Salud Carlos III, Madrid, Spain
(Casanova, Morales, Lopez Hernandez) Department of Physiology and
Pharmacology, Universidad de Salamanca (USAL), Salamanca, Spain
(Casanova, Morales, Lopez Hernandez) Group of Translational Research on
Renal and Cardiovascular Diseases (TRECARD), Salamanca, Spain
(Jorge-Monjas, Tamayo) Department of Anesthesiology and Critical Care,
Clinical University Hospital of Valladolid, Valladolid, Spain
(Jorge-Monjas, Tamayo) Department of Surgery, Faculty of Medicine,
Universidad de Valladolid, Valladolid 47005, Spain
Publisher
Elsevier Masson s.r.l.
Abstract
Acute kidney injury (AKI) is the most common complication of cardiac
surgery. Cardiac surgery-associated AKI (CSA-AKI) is caused by systemic
and renal hemodynamic impairment and parenchymal injury. Prophylaxis of
CSA-AKI remains an unmet priority, for which preventive strategies based
on drug therapies, hydration procedures, and remote ischemic
preconditioning (RIPC) have been tested in pre-clinical and clinical
studies, with variable success. Contradicting reports and scarce or
insufficiently pondered information have blurred conclusions. Therefore,
with an aim to contribute to consolidating the available information, we
carried out a wide scope, pan-comparative meta-analysis including the
accessible information about the most relevant nephroprotective approaches
assayed. After a thorough examination of 1892 documents retrieved from
PubMed and Web of Science, 150 studies were used for the meta-analysis.
Individual odds ratios of efficacy at reducing AKI incidence, need for
dialysis, and plasma creatinine elevation were obtained for each alleged
protectant. Also, the combined class effect of drug families and
protective strategies was also meta-analyzed. Our results show that no
drug family or procedure affords substantial protection against CSA-AKI.
Only, a mild but significant reduction in the incidence of CSA-AKI by
preemptive treatment with dopaminergic and adrenergic drugs, vasodilators,
and the RIPC technique. The integrated analysis suggests that single-drug
approaches are unlikely to cope with the variety of individual
pathophysiological scenarios potentially underlying CSA-AKI. Accordingly,
a theragnostic approach involving the etiopathological diagnosis of kidney
frailty is necessary to guide research towards the development of
pharmacological combinations concomitantly and effectively addressing the
key mechanisms of CSA-AKI.<br/>Copyright &#xa9; 2024 The Authors

<24>
Accession Number
2033452423
Title
Extracorporeal membrane oxygenation versus cardiopulmonary bypass during
transcatheter aortic valve implantation: a meta-analysis of survival
benefits.
Source
World Journal of Emergency Medicine. 15(4) (pp 306-310), 2024. Date of
Publication: 01 Jul 2024.
Author
Liu H.; Wang L.; Hao X.; Du Z.; Li C.; Wang H.; Hou X.
Institution
(Liu, Wang, Hao, Du, Li, Wang, Hou) Centre for Cardiac Intensive Care,
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
Publisher
Second Affiliated Hospital, Zhejiang University School of Medicine

<25>
Accession Number
2033446359
Title
The Klotho protein and FGF23 as well-known players in the aging process
but underestimated in the process of individual development and selected
diseases of childhood and adolescence - a systematic review.
Source
Pediatria i Medycyna Rodzinna. 20(1) (pp 17-28), 2024. Date of
Publication: 2024.
Author
Wiernik A.; Hyla-Klekot L.; Brauner P.; Kudela G.; Partyka M.; Koszutski
T.
Institution
(Wiernik, Hyla-Klekot, Brauner, Kudela, Koszutski) Department of
Paediatric Surgery and Urology, Medical University of Silesia, Katowice,
Poland
(Partyka) Department of Laboratory Diagnostics, Upper Silesian Children's
Health Centre named after Saint John Paul II, Independent Public Clinical
Hospital No. 6, Medical University of Silesia, Katowice, Poland
Publisher
Medical Communications
Abstract
Introduction and objective: The FGF23-Klotho endocrine axis plays a
pivotal role not only in processes associated with aging but also in
metabolic pathways, with implications for paediatric disorders. The aim of
this study was to systematically review the existing literature on Klotho
and FGF23 in the paediatric population. <br/>Material(s) and Method(s):
Based on the PubMed and Web of Science databases, we conducted a
PRISMA-guided search using (klotho) AND (children); (FGF23) AND
(children), adhering strictly to the PRISMA guidelines, and assessed
evidence quality. <br/>Result(s): The systematic review included 66
studies. Altered Klotho and FGF23 serum levels were observed in paediatric
metabolic conditions (chronic kidney disease, diabetes), cardiovascular,
and growth and musculoskeletal disorders. In some of them, Klotho and
FGF23 serum levels changed with disorder treatment. Elevated FGF23 and
Klotho deficiency in renal failure adversely impacted the cardiovascular
system. Lower Klotho levels were found in preterm neonates, especially
with bronchopulmonary dysplasia. Early Klotho supplementation in a
bronchopulmonary dysplasia model mitigated lung tissue changes and
improved the cardiac function. Children with lower Klotho levels
undergoing cardiac surgeries faced a higher risk of postoperative
complications, especially acute kidney injury. In X-linked
hypophosphataemia, excess FGF23 led to musculoskeletal consequences. FGF23
serum levels aided the diagnosis of hypophosphataemic rickets, and
anti-FGF23 antibody emerged as a common X-linked hypophosphataemia
treatment. <br/>Conclusion(s): Klotho and FGF23 serve as promising early
markers for paediatric metabolic disorders, offering a valuable tool for
assessing complication risks. Klotho supplementation holds promise as a
treatment method for specific paediatric disorders, while anti-FGF23
antibody is already established in X-linked hypophosphataemia
treatment.<br/>Copyright &#xa9; 2024 Wiernik et al.

<26>
Accession Number
2033440373
Title
Effects of intranasal dexmedetomidine versus intranasal midazolam as
premedication in children with tetralogy of Fallot undergoing corrective
cardiac surgery: A randomized trial.
Source
Annals of Pediatric Cardiology. 17(2) (pp 109-115), 2024. Date of
Publication: 2024.
Author
Srivastava S.; Das S.; Makhija N.; Chauhan S.
Institution
(Srivastava, Das, Makhija, Chauhan) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: This prospective, randomized, double-blind trial was done to
compare intranasal dexmedetomidine and intranasal midazolam as
premedication for sedation and ease of child-parent separation in
pediatric patients of tetralogy of Fallot (TOF) undergoing corrective
cardiac surgery. Materials and Methods : Forty children with TOF, between
1 and 10 years, undergoing corrective cardiac surgery were included in the
study and, after randomization, were given intranasal midazolam (0.2
mg/kg) or intranasal dexmedetomidine (1 microg/kg), 30 min before shifting
to the operation room (OR). Patients were assessed for sedation and
child-parent separation, along with hemodynamic parameters, respiratory
rate, and oxygen saturation (SpO2) 30 min after drug administration, at
the time of shifting inside the OR, and at the time of induction of
anesthesia. Results : Both groups had comparable child-parent scores,
hemodynamic parameters, SpO2, and respiratory rate. However, the
dexmedetomidine group had significantly better sedation levels than the
midazolam group patients at the time of shifting inside the OR
(dexmedetomidine group: 3.55 +/- 0.82 vs. midazolam group: 2.80 +/- 0.83;
P = 0.007) and at the time of induction of anesthesia (dexmedetomidine
group: 3.40 +/- 0.75 vs. midazolam group: 2.70 +/- 0.86; P = 0.009).
<br/>Conclusion(s): Intranasal dexmedetomidine provides better sedation
than midazolam, with similar child-parent separation scores and
hemodynamic parameters, respiratory rate, and SpO2. No adverse events were
observed in both groups. A study on a larger population will help in
further establishing the safety and superiority of dexmedetomidine and
will further its regular use as an intranasal premedication.<br/>Copyright
&#xa9; 2024 Annals of Pediatric Cardiology <br/> Published by Wolters
Kluwer - Medknow.

<27>
Accession Number
2033405345
Title
Pulmonary artery catheter use and in-hospital outcomes in cardiac surgery:
a systematic review and meta-analysis.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 39(1) (no
pagination), 2024. Article Number: ivae129. Date of Publication: 01 Jul
2024.
Author
Rong L.Q.; Luhmann G.; Franco A.D.; Dimagli A.; Perry L.A.; Martinez A.P.;
Demetres M.; Mazer C.D.; Bellomo R.; Gaudino M.
Institution
(Rong, Luhmann, Martinez) Department of Anesthesiology, Weill Cornell
Medicine, New York, NY, United States
(Franco, Dimagli, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
(Perry) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Perry, Bellomo) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Mazer) Departments of Anaesthesia and Critical Care, Keenan Research
Centre for Biomedical Science, Li Ka Shing Knowledge Institute of St
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesia, University of Toronto, Toronto, ON,
Canada
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
Publisher
Oxford University Press
Abstract
OBJECTIVES: To determine the association of intraoperative pulmonary
artery catheter (PAC) use with in-hospital outcomes in cardiac surgical
patients. <br/>METHOD(S): MEDLINE, Embase, and Cochrane Library (Wiley)
databases were screened for studies that compared cardiac surgical
patients receiving intraoperative PAC with controls and reporting
in-hospital mortality. Secondary outcomes included intensive care unit
length of stay, cost of hospitalization, fluid volume administered,
intubation time, inotropes use, acute kidney injury (AKI), stroke,
myocardial infarction (MI), and infections. <br/>RESULT(S): Seven studies
(25 853 patients, 88.6% undergoing coronary artery bypass graft surgery)
were included. In-hospital mortality was significantly increased with PAC
use [odds ratio (OR) 1.57; 95% confidence interval (CI) 1.12-2.20, P 1/4
0.04]; PAC use was also associated with greater intraoperative inotrope
use (OR 2.61; 95% CI 1.54-4.41) and costs [standardized mean difference
(SMD) 1/4 0.20; 95% CI 0.16-0.23], longer intensive care unit stay (SMD
1/4 0.29; 95% CI 0.25-0.33), and longer intubation time (SMD 1/4 0.44; 95%
CI 0.12-0.76). <br/>CONCLUSION(S): PAC use is associated with
significantly increased odds of in-hospital mortality, but the amount and
quality of the available evidence is limited. Prospective randomized
trials testing the effect of PAC on the outcomes of cardiac surgical
patients are urgently needed.<br/>Copyright &#xa9; The Author(s) 2024.

<28>
Accession Number
2033404793
Title
Remote ischemic conditioning reduces postoperative bleeding in adult
cardiac surgical patients: a systematic review and meta-analysis.
Source
Journal of Cardiovascular Surgery. 65(3) (pp 280-288), 2024. Date of
Publication: June 2024.
Author
Chen L.-L.; Yao Y.-T.
Institution
(Chen) Department of Anesthesiology, Fuwai Hospital Chinese Academy of
Medical Sciences, Guangdong, Shenzhen, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: The current study was designed to systemically investigate
the impact of remote ischemic conditioning (RIC) on intra- and
postoperative bleeding and transfusion in patients undergoing cardiac
surgery. EVIDENCE ACQUISITION: We included all randomized controlled
trials (RCTs) comparing RIC with control on intra- and postoperative blood
loss and blood transfusion. The inclusion criteria were as follows: 1)
adult patients undergoing cardiac surgery; 2) RCT; 3) perioperative
administration of RIC compared to control; 4) outcomes of interest
reported. Exclusion criteria included: 1) case reports, reviews, or
abstracts; 2) animal or cell studies; 3) duplicate publications; 4)
studies lacking information about outcomes of interest. EVIDENCE
SYNTHESIS: Databases search yielded 24 RCTs including 3530 patients, 1765
patients were allocated into RIC group and 1765 into control group. The
current study suggested that RIC administration was associated with
reduced postoperative blood loss (WMD=-57.89; 95% CI: -89.89 to -25.89;
P=0.0004). RIC did not affect the volume of intraoperative blood loss
(WMD=-4.02; 95% CI: -14.09 to 6.05; P=0.43), the volume of intra- and
postoperative transfusion of red blood cell (RBC) (WMD=-15.66; 95% CI:
-39.35 to 8.03; P=0.20), the re-exploration for bleeding (WMD=-0.01; 95%
CI: -0.03 to 0.01; P=0.21). <br/>CONCLUSION(S): The current study
demonstrated that, RIC reduced post-operative blood loss in adult patients
undergoing cardiac surgeries. It also indicated that, RIC reduced
intra-operative RBC transfusion in adult patients undergoing coronary
artery bypass grafting. However, RIC did not influence intra-operative
bleeding, post-operative blood transfusion.<br/>Copyright &#xa9; 2024
EDIZIONI MINERVA MEDICA.

<29>
Accession Number
2033404456
Title
Comparative Efficacy of Percutaneous Coronary Intervention Versus Coronary
Artery Bypass Grafting in the Treatment of Ischemic Heart Disease: A
Systematic Review and Meta-Analysis of Recent Randomized Controlled
Trials.
Source
Cardiology Research. 15(3) (pp 153-168), 2024. Date of Publication: 2024.
Author
Llerena-Velastegui J.; Zumbana-Podaneva K.; Velastegui-Zurita S.;
Mejia-Mora M.; Perez-Tomassetti J.; Cabrera-Cruz A.; Haro-Arteaga P.; de
Jesus A.C.F.S.; Coelho P.M.; Sanahuja-Montiel C.
Institution
(Llerena-Velastegui, Zumbana-Podaneva, Velastegui-Zurita, Mejia-Mora)
Pontifical Catholic University of Ecuador, Medical School, Quito, Ecuador
(Llerena-Velastegui) Center for Health Research in Latin America (CISeAL),
Research Center, Quito, Ecuador
(Perez-Tomassetti) University of the Americas, Medical School, Quito,
Ecuador
(Cabrera-Cruz) Catholic University of Santiago de Guayaquil, Medical
School, Guayaquil, Ecuador
(Haro-Arteaga) University of La Rioja, Logrono, Spain
(de Jesus, Coelho) Faculdade de Minas - FAMINAS-BH, Medical School, Belo
Horizonte, Brazil
(Sanahuja-Montiel) University of Medical Sciences, Medical School, San
Jose, Costa Rica
Publisher
Elmer Press
Abstract
Background: Ischemic heart disease (IHD) is a major global health issue
and a leading cause of death. This study compares the effectiveness of
percutaneous coronary intervention (PCI) and coronary artery bypass
grafting (CABG) in the management of IHD, focusing on their impact on
revascularization, myocardial infarction (MI), and post-procedural stroke.
This study aimed to evaluate and compare the effectiveness of PCI and CABG
in treating IHD based on an exhaustive literature review of the past 5
years, emphasizing recent advancements and outcomes in IHD management.
<br/>Method(s): A comprehensive literature review analyzed 32 randomized
controlled trials (RCTs) retrieved from databases such as PubMed, Cochrane
Library, and Google Scholar. The study specifically assessed the
incidences of revascularization, stroke, and MI in patients treated with
either PCI or CABG. The comparison between CABG and PCI exclusively
focused on lesions with a SYNTAX score exceeding 32. <br/>Result(s): Our
findings highlight CABG's significant efficacy over PCI in reducing
revascularization and MI. The aggregated Mantel-Haenszel (M-H) value for
revascularization was 1.85 (95% confidence interval (CI): 1.65 - 2.07),
signifying CABG's advantage. Additionally, CABG demonstrated superior
performance in diminishing MI occurrences (M-H = 2.71, 95% CI: 1.13 -
6.53). In contrast, PCI was more effective in reducing stroke (M-H = 0.80,
95% CI: 0.60 - 1.10). <br/>Conclusion(s): The study confirms CABG's
superiority in reducing revascularization and MI in IHD patients,
highlighting PCI's effectiveness in reducing stroke risk. These findings
underscore the importance of personalized treatment strategies in IHD
management and emphasize the need for ongoing research and evidence-based
guidelines to aid in treatment selection for IHD patients.<br/>Copyright
&#xa9; Journal compilation

<30>
Accession Number
2030665607
Title
Effects of starting one lung ventilation and applying individualized PEEP
right after patients are placed in lateral decubitus position on
intraoperative oxygenation for patients undergoing thoracoscopic pulmonary
lobectomy: study protocol for a randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 500. Date of
Publication: December 2024.
Author
Wang Q.-Y.; Zhou Y.; Wang M.-R.; Jiao Y.-Y.
Institution
(Wang, Zhou, Wang, Jiao) Department of Anesthesiology, Peking University
Third Hospital, NO. 49, North Garden Road, Haidian District, Beijing,
China
Publisher
BioMed Central Ltd
Abstract
Background: For patients receiving one lung ventilation in thoracic
surgery, numerous studies have proved the superiority of lung protective
ventilation of low tidal volume combined with recruitment maneuvers (RM)
and individualized PEEP. However, RM may lead to overinflation which
aggravates lung injury and intrapulmonary shunt. According to CT results,
atelectasis usually forms in gravity dependent lung regions, regardless of
body position. So, during anesthesia induction in supine position,
atelectasis usually forms in the dorsal parts of lungs, however, when
patients are turned into lateral decubitus position, collapsed lung tissue
in the dorsal parts would reexpand, while atelectasis would slowly
reappear in the lower flank of the lung. We hypothesize that applying
sufficient PEEP without RM before the formation of atelectasis in the
lower flank of the lung may beas effective to prevent atelectasis and thus
improve oxygenation as applying PEEP with RM. <br/>Method(s): A total of
84 patients scheduled for elective pulmonary lobe resection necessitating
one lung ventilation will be recruited and randomized totwo parallel
groups. For all patients, one lung ventilation is initiated the right
after patients are turned into lateral decubitus position. For patients in
the study group, individualized PEEP titration is started the moment one
lung ventilation is started, while patients in the control group will
receive a recruitment maneuver followed by individualized PEEP titration
after initiation of one lung ventilation. The primary endpoint will be
oxygenation index measured at T4. Secondary endpoints will include
intrapulmonary shunt, respiratory mechanics, PPCs, and hemodynamic
indicators. <br/>Discussion(s): Numerous previous studies compared the
effects of individualized PEEP applied alone with that applied in
combination with RM on oxygenation index, PPCs, intrapulmonary shunt and
respiratory mechanics after atelectasis was formed in patients receiving
one lung ventilation during thoracoscopic surgery. In this study, we will
apply individualized PEEP before the formation of atelectasis while not
performing RM in patients allocated to the study group, and then we're
going to observe its effects on the aspects mentioned above. The results
of this trial will provide a ventilation strategy that may be conductive
to improving intraoperative oxygenation and avoiding the detrimental
effects of RM for patients receiving one lung ventilation. Trial
registration: www.Chictr.org.cn ChiCTR2400080682. Registered on February
5, 2024.<br/>Copyright &#xa9; The Author(s) 2024.

<31>
Accession Number
2030337129
Title
A Bibliometric Study on Junctional Ectopic Tachycardia: Time and Trends
have much to Tell!.
Source
Journal of Cardiac Critical Care. 8(3) (pp 139-146), 2024. Date of
Publication: July-September 2024.
Author
Jose J.; Magoon R.; Choudhary N.; Suresh V.; Kumar M.
Institution
(Jose) Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Karnataka, Bengaluru, India
(Magoon, Kumar) Department of Cardiac Anaesthesia, Atal Bihari Vajpayee
Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, India
(Choudhary) Department of Anaesthesiology, Pain Medicine and Critical
Care, All India Institute of Medical Sciences, New Delhi, India
(Suresh) Department of Anesthesia and Intensive Care, Jaber Al Ahmad Al
Sabah Hospital, Arabian Gulf, Kuwait
Publisher
Scientific Scholar LLC
Abstract
Objectives: Junctional ectopic tachycardia (JET), an arrhythmia of
substantial clinical relevance, is no less than an eternal nemesis in
cardiac critical care. Hence, we hereby present a bibliometric study
evaluating the research trends in the subject. <br/>Material(s) and
Method(s): A Scopus search-based bibliometric analysis of the keyword
"Junctional Tachycardia" OR "Junctional Ectopic Tachycardia" restricted to
original articles and reviews was undertaken after excluding the
veterinary-related papers. The metadata thus obtained was analyzed using
Scimago Graphica 1.0.42 and VOSviewer version 1.6.20 to generate a
graphical representation of the trends and the timelines based on the
author keywords. <br/>Result(s): A total of 926 papers of interest were
identified and selected for the analysis, which revealed the geographical
distribution of productivity being primarily concentrated in the Western
developed nations, topic receptiveness largely appreciated in
cardiovascular-related journals, and increased yearly output of the
JET-associated papers. Further perusal identified 79 most frequently
observed author keywords when limited to a minimum of 5 co-occurrences,
which were grouped into seven color-coded clusters by VOSviewer, and
mapped into keyword as well as author network, overlay, and density
projections. <br/>Conclusion(s): Bibliometric analysis of JET papers from
1967 to 2024 shows a growing interest in the topic, awaiting newer
insights into the molecular mechanisms and the preventative treatment
strategies.<br/>Copyright &#xa9; 2024 Published by Scientific Scholar on
behalf of Journal of Cardiac Critical Care TSS.

<32>
Accession Number
644761403
Title
Preoperative coronary interventions for preventing acute myocardial
infarction in the perioperative period of major open vascular or
endovascular surgery.
Source
Cochrane Database of Systematic Reviews. 2024(7) (no pagination), 2024.
Article Number: CD014920. Date of Publication: 03 Jul 2024.
Author
Botelho F.E.; Flumignan R.L.G.; Shiomatsu G.Y.; de Castro-Santos G.;
Cacione D.G.; Leite J.O.; Baptista-Silva J.C.C.
Institution
(Botelho, Shiomatsu, de Castro-Santos) Department of Surgery, Universidade
Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
(Flumignan, Cacione, Baptista-Silva) Department of Surgery, Division of
Vascular and Endovascular Surgery, Universidade Federal de Sao Paulo, Sao
Paulo, Brazil
(Flumignan, Baptista-Silva) Cochrane Brazil, Universidade Federal de Sao
Paulo, Sao Paulo, Brazil
(Leite) Department of Surgery, University of Cincinnati, Cincinnati, OH,
United States
Publisher
John Wiley and Sons Ltd
Abstract
Background: Postoperative myocardial infarction (POMI) is associated with
major surgeries and remains the leading cause of mortality and morbidity
in people undergoing vascular surgery, with an incidence rate ranging from
5% to 20%. Preoperative coronary interventions, such as coronary artery
bypass grafting (CABG) or percutaneous coronary interventions (PCI), may
help prevent acute myocardial infarction in the perioperative period of
major vascular surgery when used in addition to routine perioperative
drugs (e.g. statins, angiotensin-converting enzyme inhibitors, and
antiplatelet agents), CABG by creating new blood circulation routes that
bypass the blockages in the coronary vessels, and PCI by opening up
blocked blood vessels. There is currently uncertainty around the benefits
and harms of preoperative coronary interventions. <br/>Objective(s): To
assess the effects of preoperative coronary interventions for preventing
acute myocardial infarction in the perioperative period of major open
vascular or endovascular surgery. <br/>Search Method(s): We searched the
Cochrane Vascular Specialised Register, CENTRAL, MEDLINE Ovid, Embase
Ovid, LILACS, and CINAHL EBSCO on 13 March 2023. We also searched the
World Health Organization International Clinical Trials Registry Platform
and ClinicalTrials.gov. <br/>Selection Criteria: We included all
randomised controlled trials (RCTs) or quasi-RCTs that compared the use of
preoperative coronary interventions plus usual care versus usual care for
preventing acute myocardial infarction during major open vascular or
endovascular surgery. We included participants of any sex or any age
undergoing major open vascular surgery, major endovascular surgery, or
hybrid vascular surgery. <br/>Data Collection and Analysis: We used
standard Cochrane methods. Our primary outcomes of interest were acute
myocardial infarction, all-cause mortality, and adverse events resulting
from preoperative coronary interventions. Our secondary outcomes were
cardiovascular mortality, quality of life, vessel or graft secondary
patency, and length of hospital stay. We reported perioperative and
long-term outcomes (more than 30 days after intervention). We assessed the
certainty of the evidence using the GRADE approach. <br/>Main Result(s):
We included three RCTs (1144 participants). Participants were randomised
to receive either preoperative coronary revascularisation with PCI or CABG
plus usual care or only usual care before major vascular surgery. One
trial enrolled participants if they had no apparent evidence of coronary
artery disease. Another trial selected participants classified as high
risk for coronary disease through preoperative clinical and laboratorial
testing. We excluded one trial from the meta-analysis because participants
from both the control and the intervention groups were eligible to undergo
preoperative coronary revascularisation. We identified a high risk of
performance bias in all included trials, with one trial displaying a high
risk of other bias. However, the risk of bias was either low or unclear in
other domains. We observed no difference between groups for perioperative
acute myocardial infarction, but the evidence is very uncertain (risk
ratio (RR) 0.28, 95% confidence interval (CI) 0.02 to 4.57; 2 trials, 888
participants; very low-certainty evidence). One trial showed a reduction
in incidence of long-term (> 30 days) acute myocardial infarction in
participants allocated to the preoperative coronary interventions plus
usual care group, but the evidence was very uncertain (RR 0.09, 95% CI
0.03 to 0.28; 1 trial, 426 participants; very low-certainty evidence).
There was little to no effect on all-cause mortality in the perioperative
period when comparing the preoperative coronary intervention plus usual
care group to usual care alone, but the evidence is very uncertain (RR
0.79, 95% CI 0.31 to 2.04; 2 trials, 888 participants; very low-certainty
evidence). The evidence is very uncertain about the effect of preoperative
coronary interventions on long-term (follow up: 2.7 to 6.2 years)
all-cause mortality (RR 0.74, 95% CI 0.30 to 1.80; 2 trials, 888
participants; very low-certainty evidence). One study reported no adverse
effects related to coronary angiography, whereas the other two studies
reported five deaths due to revascularisations. There may be no effect on
cardiovascular mortality when comparing preoperative coronary
revascularisation plus usual care to usual care in the short term (RR
0.07, 95% CI 0.00 to 1.32; 1 trial, 426 participants; low-certainty
evidence). Preoperative coronary interventions plus usual care in the
short term may reduce length of hospital stay slightly when compared to
usual care alone (mean difference -1.17 days, 95% CI -2.05 to -0.28; 1
trial, 462 participants; low-certainty evidence). We downgraded the
certainty of the evidence due to concerns about risk of bias, imprecision,
and inconsistency. None of the included trials reported on quality of life
or vessel graft patency at either time point, and no study reported on
adverse effects, cardiovascular mortality, or length of hospital stay at
long-term follow-up. Authors' conclusions: Preoperative coronary
interventions plus usual care may have little or no effect on preventing
perioperative acute myocardial infarction and reducing perioperative
all-cause mortality compared to usual care, but the evidence is very
uncertain. Similarly, limited, very low-certainty evidence shows that
preoperative coronary interventions may have little or no effect on
reducing long-term all-cause mortality. There is very low-certainty
evidence that preoperative coronary interventions plus usual care may
prevent long-term myocardial infarction, and low-certainty evidence that
they may reduce length of hospital stay slightly, but not cardiovascular
mortality in the short term, when compared to usual care alone. Adverse
effects of preoperative coronary interventions were poorly reported in
trials. Quality of life and vessel or graft patency were not reported. We
downgraded the certainty of the evidence most frequently for high risk of
bias, inconsistency, or imprecision. None of the analysed trials provided
significant data on subgroups of patients who could potentially experience
more substantial benefits from preoperative coronary intervention (e.g.
altered ventricular ejection fraction). There is a need for evidence from
larger and homogeneous RCTs to provide adequate statistical power to
assess the role of preoperative coronary interventions for preventing
acute myocardial infarction in the perioperative period of major open
vascular or endovascular surgery.<br/>Copyright &#xa9; 2024 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<33>
Accession Number
2033470996
Title
Hypoattenuated Leaflet Thickening: A Comprehensive Review of Contemporary
Data.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Samadzadeh Tabrizi N.; Fishberger G.; Musuku S.R.; Shapeton A.D.
Institution
(Fishberger) University of South Florida Morsani College of Medicine,
Tampa, FL, United States
(Samadzadeh Tabrizi, Musuku) Department of Anesthesiology, Albany Medical
Center, Albany, NY, United States
(Shapeton) Veterans Affairs Boston Healthcare System, Department of
Anesthesia, Critical Care and Pain Medicine, and Tufts University School
of Medicine, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Nearly one-third of patients who undergo surgical aortic valve replacement
(SAVR) or transcatheter aortic valve replacement (TAVR) develop
hypoattenuated leaflet thickening (HALT) within a year. HALT typically
represents subclinical leaflet thrombosis in asymptomatic patients, and as
a result it often is detected incidentally. However, HALT also may worsen
in severity, resulting in leaflet immobility and/or valve deterioration.
The clinical significance of HALT is a topic of ongoing debate, and
currently there is no consensus on the screening and management of HALT in
patients following TAVR or SAVR. This review provides a comprehensive
evaluation of the available evidence on risk factors, preventative
measures, treatment, and prognosis for this growing patient
cohort.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<34>
Accession Number
2033414792
Title
Estimating the effect of bariatric surgery on cardiovascular events using
observational data?.
Source
Epidemiology. (no pagination), 2024. Article Number: 1765. Date of
Publication: 2024.
Author
Madenci A.L.; Kurgansky K.E.; Dickerman B.A.; Gerlovin H.; Wanis K.N.;
Smith A.D.; Trinqart L.; Gagnon D.R.; Cho K.; Gaziano J.M.; Casas J.P.;
Robins J.M.; Hernan M.A.
Institution
(Madenci, Dickerman, Wanis, Robins, Hernan) CAUSALab, Department of
Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,
United States
(Madenci) Boston Children's Hospital, Harvard Medical School, Boston, MA,
United States
(Kurgansky, Gerlovin, Smith, Gagnon, Cho, Gaziano, Casas) Veterans Affairs
Boston Healthcare System, Boston, MA, United States
(Gaziano) Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Wanis) Department of Surgery, Western University, London, ON, Canada
(Trinqart) Institute for Clinical Research and Health Policy Studies,
Tufts Medical Center, Boston, MA, United States
(Trinqart) Tufts Clinical and Translational Science Institute, Tufts
University, Boston, MA, United States
(Gagnon) Boston University School of Public Health, Boston, MA, United
States
(Robins, Hernan) Department of Biostatistics, Harvard T.H. Chan School of
Public Health, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Observational studies have estimated strongly protective
effects of bariatric surgery on cardiovascular disease, but with
oversimplified definitions of the intervention, eligibility criteria, and
follow-up, which deviate from those in a randomized trial. We describe
studying the effect of bariatric surgery on cardiovascular disease without
introducing these sources of bias, which may not be entirely possible with
existing observational data. <br/>METHOD(S): We propose target trials
among persons with diabetes: (1) bariatric operation (vs. no operation)
among individuals who have undergone pre-operative preparation (lifestyle
modifications, screening) and (2) pre-operative preparation and bariatric
surgery (vs. neither pre-operative nor operative component).
<br/>RESULT(S): We emulated both target trials using observational data of
U.S. veterans. Comparing bariatric surgery with no surgery (target trial
#1; 8,087 individuals), the 7-year cardiovascular risk was 18.0% (95% CI,
6.9 to 32.7) in the surgery group and 18.9% (95% CI, 17.7 to 20.1) in the
no surgery group (risk difference -0.9, 95% CI -12.0 to 14.0). Comparing
pre-operative components plus surgery vs. neither (target trial #2; 10,065
individuals), the 7-year cardiovascular risk was 17.4% (95% CI, 13.6 to
22.0) in the surgery group and 18.8% (95% CI, 17.8 to 19.9) in the no
surgery group (risk difference -1.4, 95% CI -5.1 to 3.2). Body mass index
and hemoglobin A1c were reduced with bariatric interventions in both
emulations. <br/>CONCLUSION(S): Within limitations of available
observational data, our estimates do not provide evidence that bariatric
surgery reduces cardiovascular disease and support equipoise for a
randomized trial of bariatric surgery for cardiovascular disease
prevention. <br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<35>
Accession Number
2033121932
Title
Effects of Rapid Uptitration of Neurohormonal Blockade on Effective,
Sustainable Decongestion and Outcomes in STRONG-HF.
Source
Journal of the American College of Cardiology. 84(4) (pp 323-336), 2024.
Date of Publication: 23 Jul 2024.
Author
Biegus J.; Mebazaa A.; Davison B.; Cotter G.; Edwards C.; Celutkiene J.;
Chioncel O.; Cohen-Solal A.; Filippatos G.; Novosadova M.; Sliwa K.; Adamo
M.; Arrigo M.; Lam C.S.P.; Ter Maaten J.M.; Deniau B.; Barros M.;
Cerlinskaite-Bajore K.; Damasceno A.; Diaz R.; Gayat E.; Kimmoun A.; Pang
P.S.; Pagnesi M.; Saidu H.; Takagi K.; Tomasoni D.; Voors A.A.; Metra M.;
Ponikowski P.
Institution
(Biegus, Ponikowski) Institute of Heart Diseases, Wroclaw Medical
University, Wroclaw, Poland
(Mebazaa, Davison, Cotter, Cohen-Solal, Deniau, Gayat) Universite Paris
Cite, INSERM UMR-S 942(MASCOT), Paris, France
(Mebazaa, Deniau, Gayat) Department of Anesthesiology and Critical Care
and Burn Unit, Saint-Louis and Lariboisiere Hospitals, FHU PROMICE, DMU
Parabol, APHP Nord, Paris, France
(Davison, Cotter, Edwards, Novosadova, Barros, Takagi) Momentum Research
Inc, Durham, NC, United States
(Davison, Cotter) Heart Initiative, Durham, NC, United States
(Celutkiene, Cerlinskaite-Bajore) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof.
C.C.Iliescu,", University of Medicine "Carol Davila,", Bucharest, Romania
(Cohen-Solal) Department of Cardiology, APHP Nord, Lariboisiere University
Hospital, Paris, France
(Filippatos) National and Kapodistrian University of Athens, School of
Medicine, Attikon University Hospital, Athens, Greece
(Sliwa) Cape Heart Institute, Division of Cardiology, Department of
Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town,
South Africa
(Adamo, Pagnesi, Tomasoni, Metra) Cardiology, ASST Spedali Civili and
Department of Medical and Surgical Specialties, Radiological Sciences, and
Public Health, University of Brescia, Brescia, Italy
(Arrigo) Department of Internal Medicine, Stadtspital Zurich, Zurich,
Switzerland
(Lam) National Heart Centre Singapore and Duke-National University of
Singapore, Singapore
(Ter Maaten, Voors) University of Groningen, Department of Cardiology,
University Medical Centre Groningen, Groningen, Netherlands
(Damasceno) Faculty of Medicine, Eduardo Mondlane University, Maputo,
Mozambique
(Diaz) Estudios Clinicos Latinoamerica, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Kimmoun) Universite de Lorraine, Nancy, France, INSERM, Defaillance
Circulatoire Aigue et Chronique, Service de Medecine Intensive et
Reanimation Brabois, CHRU de Nancy, Vandoeuvre-les-Nancy, France
(Pang) Department of Emergency Medicine, Department of Medicine, Indiana
University School of Medicine, Indianapolis, IN, United States
(Saidu) Department of Medicine, Murtala Muhammed Specialist
Hospital/Bayero University Kano, Kano, Nigeria
Publisher
Elsevier Inc.
Abstract
Background: Comprehensive uptitration of neurohormonal blockade targets
fundamental mechanisms underlying development of congestion and may be an
additional approach for decongestion after acute heart failure (AHF).
<br/>Objective(s): This hypothesis was tested in the STRONG-HF (Safety,
Tolerability, and Efficacy of Rapid Optimization, Helped by N-Terminal
Pro-Brain Natriuretic Peptide Testing of Heart Failure Therapies) trial.
<br/>Method(s): In STRONG-HF, patients with AHF were randomized to the
high-intensity care (HIC) arm with fast up-titration of neurohormonal
blockade or to usual care (UC). Successful decongestion was defined as an
absence of peripheral edema, pulmonary rales, and jugular venous pressure
<6 cm. <br/>Result(s): At baseline, the same proportion of patients in
both arms had successful decongestion (HIC 48% vs UC 46%; P = 0.52). At
day 90, higher proportion of patients in the HIC arm (75%) experienced
successful decongestion vs the UC arm (68%) (P = 0.0001). Each separate
component of the congestion score was significantly better in the HIC arm
(all, P < 0.05). Additional markers of decongestion also favored the HIC:
weight reduction (adjusted mean difference: -1.36 kg; 95% CI: -1.92 to
-0.79 kg), N-terminal pro-B-type natriuretic peptide level, and lower
orthopnea severity (all, P < 0.001). More effective decongestion was
achieved despite a lower mean daily dose of loop diuretics at day 90 in
the HIC arm. Among patients with successful decongestion at baseline,
those in the HIC arm had a significantly better chance of sustaining
decongestion at day 90. Successful decongestion in all subjects was
associated with a lower risk of 180-day HF readmission or all-cause death
(HR: 0.40; 95% CI: 0.27-0.59; P < 0.0001). <br/>Conclusion(s): In
STRONG-HF, intensive uptitration of neurohormonal blockade was associated
with more efficient and sustained decongestion at day 90 and a lower risk
of the primary endpoint.<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<36>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2024

<37>
Accession Number
2030618398
Title
Effect of inferior caval valve implantation on circulating immune cells
and inflammatory mediators in severe tricuspid regurgitation.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
373. Date of Publication: December 2024.
Author
Mattig I.; Hewing B.; Knebel F.; Meisel C.; Ludwig A.; Konietschke F.;
Stangl V.; Stangl K.; Laule M.; Dreger H.
Institution
(Dreger) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Campus Virchow-Klinikum Augustenburger
Platz 1, Berlin 13353, Germany
(Mattig, Hewing, Knebel, Ludwig, Stangl, Stangl, Laule, Dreger) Charite -
Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin
and Humboldt-Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Mattig, Hewing, Knebel) Berlin Institute of Health at Charite -
Universitatsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin,
Germany
(Mattig, Knebel, Stangl, Stangl, Laule, Dreger) Partner Site Berlin, DZHK
(German Centre for Cardiovascular Research), Berlin, Germany
(Knebel) Sana Klinikum Lichtenberg, Innere Medizin II: Schwerpunkt
Kardiologie, Berlin, Germany
(Hewing) Department of Cardiology III - Adult Congenital and Valvular
Heart Disease, University Hospital Muenster, Muenster, Germany
(Meisel) Labor Berlin - Charite Vivantes Services GmbH, Berlin, Germany
(Konietschke) Institute for Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin
and Humboldt-Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Mattig, Hewing, Knebel, Ludwig, Stangl, Stangl, Laule) Department of
Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum
der Charite, Campus Charite Mitte, Chariteplatz 1, Berlin 10117, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Interventional valve implantation into the inferior vena cava
(CAVI) lowers venous congestion in patients with tricuspid regurgitation
(TR). We evaluated the impact of a reduction of abdominal venous
congestion following CAVI on circulating immune cells and inflammatory
mediators. <br/>Method(s): Patients with severe TR were randomized to
optimal medical therapy (OMT) + CAVI (n = 8) or OMT (n = 10). In the OMT +
CAVI group, an Edwards Sapien XT valve was implanted into the inferior
vena cava. Immune cells and inflammatory mediators were measured in the
peripheral blood at baseline and three-month follow-up. <br/>Result(s):
Leukocytes, monocytes, basophils, eosinophils, neutrophils, lymphocytes,
B, T and natural killer cells and inflammatory markers (C-reactive
protein, interferon-gamma, interleukin-2, -4, -5, -10, and tumor necrosis
factor-alpha) did not change substantially between baseline and
three-month follow-up within the OMT + CAVI and OMT group.
<br/>Conclusion(s): The present data suggest that reduction of venous
congestion following OMT + CAVI may not lead to substantial changes in
systemic inflammation within a short-term follow-up. Clinical trial
registration: NCT02387697 Graphical Abstract: (Figure
presented.)<br/>Copyright &#xa9; The Author(s) 2024.

<38>
Accession Number
2033413332
Title
The utility of the Montreal cognitive assessment (MoCA) in detecting
cognitive impairment in surgical populations - A systematic review and
meta-analysis.
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111551. Date of Publication: October 2024.
Author
Danquah M.O.; Yan E.; Lee J.W.; Philip K.; Saripella A.; Alhamdah Y.; He
D.; Englesakis M.; Chung F.
Institution
(Danquah, Yan, Philip, Saripella, Alhamdah, He, Chung) Department of
Anesthesia and Pain Management, Toronto Western Hospital, University
Health Network, University of Toronto, Toronto, ON, Canada
(Yan, Alhamdah, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Lee) University of Saskatchewan College of Medicine, Saskatoon, SK,
Canada
(He) Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital,
Sinai Health, Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: To determine the diagnostic accuracy of the Montreal
Cognitive Assessment (MoCA) in detecting cognitive impairment (CI) and
assess the association of MoCA scores with adverse postoperative outcomes
in surgical populations. <br/>Design(s): Systematic review and
meta-analysis. <br/>Setting(s): Perioperative setting. <br/>Patient(s):
Adults undergoing elective or emergent surgery screened for CI
preoperatively using the MoCA. Measurements: The outcomes included the
diagnostic accuracy of the MoCA in screening for CI and the pooled
prevalence of CI in various surgical populations. CI and its association
with adverse events including delirium, hospital length-of-stay (LOS),
postoperative complications, discharge destination, and mortality was
determined. <br/>Main Result(s): Twenty-six studies (5059 patients, 18
non-cardiac studies, 8 cardiac studies) were included. With a MoCA cut-off
score of <26, the prevalence of preoperative CI was 48% (95% CI: 41%-54%).
The MoCA had 0.87 (95% CI: 0.79-0.93) sensitivity, 0.72 (95% CI:
0.62-0.80) specificity, PPV of 0.74 (95% CI: 0.65-0.81), and NPV of 0.86
(95% CI: 0.77-0.92) when validated against Petersen criteria, the
Diagnostic and Statistical Manual of Mental Disorders, or the National
Institute on Aging and the Alzheimer's Association criteria to identify
CI. Using the MoCA as a screening tool, the LOS was 3.75 (95% CI:
-0.03-7.53, P = 0.05, not significant) days longer in the CI group after
non-cardiac surgeries and 3.33 (95% CI: 1.24-5.41, P < 0.002) days longer
after cardiac surgeries than the non-cognitively impaired group.
<br/>Conclusion(s): MoCA had been validated in the surgical population.
MoCA with a cut-off score of <26 was shown to have 87% sensitivity and 72%
specificity in identifying CI. A positive screen in MoCA was associated
with a 3-day longer hospital LOS in cardiac surgery in the CI group than
in the non-CI group.<br/>Copyright &#xa9; 2024

<39>
Accession Number
2033405188
Title
Distal Ventricular Pacing for Drug-Refractory Mid-Cavity Obstructive
Hypertrophic Cardiomyopathy: A Randomized, Placebo-Controlled Trial of
Personalized Pacing.
Source
Circulation: Arrhythmia and Electrophysiology. 17(7) (pp e012570), 2024.
Date of Publication: 01 Jul 2024.
Author
Malcolmson J.W.; Hughes R.K.; Husselbury T.; Khan K.; Learoyd A.E.; Lees
M.; Wicks E.C.; Smith J.; Simms A.D.; Moon J.C.; Lopes L.R.; O'Mahony C.;
Sekhri N.; Elliott P.M.; Petersen S.E.; Dhinoja M.B.; Mohiddin S.A.
Institution
(Malcolmson, Husselbury, Lees, Moon, Sekhri, Elliott, Petersen, Dhinoja,
Mohiddin) Barts Heart Center, St Bartholomew's Hospital, Barts Health NHS
Trust, London, United Kingdom
(Malcolmson, Khan, Learoyd, Petersen, Mohiddin) William Harvey Research
Institute, NIHR, Barts Biomedical Research Centre, Queen Mary University
of London, United Kingdom
(Hughes, Wicks, Moon, Lopes, O'Mahony, Elliott) Institute of
Cardiovascular Science, University College London, United Kingdom
(Wicks) Inherited Cardiovascular Diseases Unit, John Radcliffe Hospital,
London, United Kingdom
(Smith) Raigmore Hospital, NHS Highland, Inverness, United Kingdom
(Simms) Yorkshire Heart Centre, Leeds Teaching Hospital NHS Trust, Leeds,
United Kingdom
(Petersen) Health Data Research UK, London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Patients with refractory, symptomatic left ventricular (LV)
mid-cavity obstructive (LVMCO) hypertrophic cardiomyopathy have few
therapeutic options. Right ventricular pacing is associated with modest
hemodynamic and symptomatic improvement, and LV pacing pilot data suggest
therapeutic potential. We hypothesized that site-specific pacing would
reduce LVMCO gradients and improve symptoms. <br/>METHOD(S): Patients with
symptomatic-drug-refractory LVMCO were recruited for a randomized, blinded
trial of personalized prescription of pacing (PPoP). Multiple LV and
apical right ventricular pacing sites were assessed during an invasive
hemodynamic study of multisite pacing. Patient-specific pacing-site and
atrioventricular delays, defining PPoP, were selected on the basis of
LVMCO gradient reduction and acceptable pacing parameters. Patients were
randomized to 6 months of active PPoP or backup pacing in a crossover
design. The primary outcome examined invasive gradient change with
best-site pacing. Secondary outcomes assessed quality of life and exercise
following randomization to PPoP. <br/>RESULT(S): A total of 17 patients
were recruited; 16 of whom met primary end points. Baseline New York Heart
Association was 3+/-0.6, despite optimal medical therapy. Hemodynamic
effects were assessed during pacing at the right ventricular apex and at a
mean of 8 LV sites. The gradients in all 16 patients fell with pacing,
with maximum gradient reduction achieved via LV pacing in 14 (88%)
patients and right ventricular apex in 2. The mean baseline gradient of
80+/-29 mm Hg fell to 31+/-21 mm Hg with best-site pacing, a 60% reduction
(P<0.0001). One cardiac vein perforation occurred in 1 case, and 15
subjects entered crossover; 2 withdrawals occurred during crossover. Of
the 13 completing crossover, 9 (69%) chose active pacing in PPoP
configuration as preferred setting. PPoP was associated with improved
6-minute walking test performance (328.5+/-99.9 versus 285.8+/-105.5 m;
P=0.018); other outcome measures also indicated benefit with PPoP.
<br/>CONCLUSION(S): In a randomized placebo-controlled trial, PPoP reduces
obstruction and improves exercise performance in severely symptomatic
patients with LVMCO. REGISTRATION: URL: https://clinicaltrials.gov/study;
Unique Identifier: NCT03450252.<br/>Copyright &#xa9; 2024 Lippincott
Williams and Wilkins. All rights reserved.

<40>
Accession Number
2030646108
Title
Perioperative fluid management for adult cardiac surgery: network
meta-analysis pooling on twenty randomised controlled trials.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 76.
Date of Publication: December 2024.
Author
Ma Y.-T.; Xian-Yu C.-Y.; Yu Y.-X.; Zhang C.
Institution
(Ma, Xian-Yu, Zhang) Center for Evidence-Based Medicine and Clinical
Research, Taihe Hospital, Hubei University of Medicine, No.32, Renmin
South Road, Hubei, Shiyan 442000, China
(Yu) Department of Surgery, Taihe Hospital, Hubei University of Medicine,
No.32, South Renmin Road, Hubei, Shiyan 442000, China
Publisher
BioMed Central Ltd
Abstract
Background: The aim of this study was to evaluate colloids and
crystalloids used in perioperative fluid therapy for cardiac surgery
patients to further investigate the optimal management strategies of
different solutions. <br/>Method(s): RCTs about adult surgical patients
allocated to receive perioperative fluid therapy for electronic databases,
including Ovid MEDLINE, EMBase, and Cochrane Central Register of
Controlled Trials, were searched up to February 15, 2023. <br/>Result(s):
None of the results based on network comparisons, including mortality,
transfuse PLA, postoperative chest tube output over the first 24 h
following surgery, and length of hospital stay, were statistically
significant. Due to the small number of included studies, the results,
including acute kidney injury, serum creatinine, serum microglobulin, and
blood urea nitrogen, are from the direct comparison. For transfusion of
RBCs, significant differences were observed in the comparisons of 3%
gelatine vs. 6% HES 200/0.5, 4% albumin vs. 5% albumin, 4% gelatine vs. 5%
albumin, 5% albumin vs. 6% HES 200/0.5, and 6% HES 130/0.4 vs. 6% HES
200/0.5. In transfusion of FFP, significant differences were observed in
comparisons of 3% gelatine vs. 4% gelatine, 3% gelatine vs. 6% HES
200/0.5, 5% albumin vs. 6% HES 200/0.5, 4% gelatine vs. 5% albumin, 4%
gelatine vs. 6% HES 200/0.4, and 6% HES 130/0.4 vs. 6% HES 200/0.5. For
urinary output at 24 h after surgery, the results are deposited in the
main text. <br/>Conclusion(s): This study showed that 3% gelatin and 5%
albumin can reduce the transfuse RBC and FFP. In addition, the use of
hypertonic saline solution can increase urine output, and 5% albumin and
6% HES can shorten the length of ICU stay. However, none of the
perioperative fluids showed an objective advantage in various outcomes,
including mortality, transfuse PLA, postoperative chest tube output over
the first 24 h following surgery, and length of hospital stay. The
reliable and sufficient evidences on the injury of the kidney, including
acute kidney injury, serum creatinine, serum microglobulin, and blood urea
nitrogen, was still lacking. In general, perioperative fluids had
advantages and disadvantages, and there were no evidences to support the
recommendation of the optimal perioperative fluid for cardiac
surgery.<br/>Copyright &#xa9; The Author(s) 2024.

<41>
Accession Number
2030459378
Title
Twenty percent human albumin solution fluid bolus administration therapy
in patients after cardiac surgery-II: a multicentre randomised controlled
trial.
Source
Intensive Care Medicine. 50(7) (pp 1075-1085), 2024. Date of Publication:
July 2024.
Author
Wigmore G.J.; Deane A.M.; Presneill J.J.; Eastwood G.; Serpa Neto A.;
Maiden M.J.; Bihari S.; Baker R.A.; Bennetts J.S.; Ghanpur R.; Anstey
J.R.; Raman J.; Bellomo R.; Peck L.; Young H.; Dovenya W.; Maeda A.; Xu
K.; Spano S.; Yanase F.; Horton M.; Pearce S.; Power P.; Trickey J.; Barge
D.; Byrne K.; Haeusler M.; MacIsaac C.; Snowdon M.
Institution
(Wigmore, Deane, Presneill, Serpa Neto, Maiden, Bellomo) Department of
Critical Care, Melbourne Medical School, Faculty of Medicine, Dentistry
and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
(Wigmore) Department of Anaesthesia and Pain Medicine, Western Health,
Melbourne, VIC, Australia
(Deane, Presneill, Maiden, Anstey, Bellomo) Department of Intensive Care,
Royal Melbourne Hospital, Melbourne, VIC, Australia
(Presneill, Serpa Neto, Bellomo) Australian and New Zealand Intensive Care
Research Centre (ANZIC-RC), School of Public Health and Preventive
Medicine, Monash University, Melbourne, VIC, Australia
(Eastwood, Serpa Neto, Raman, Bellomo) Department of Intensive Care,
Austin Hospital, Melbourne, VIC, Australia
(Serpa Neto) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(Maiden) Intensive Care Unit, Barwon Health, Geelong, VIC, Australia
(Bihari) College of Medicine and Public Health, Flinders University,
Adelaide, SA, Australia
(Bihari) Department of ICCU, Flinders Medical Centre, Adelaide, SA,
Australia
(Baker, Bennetts) Flinders Medical Centre and College of Medicine and
Public Health Flinders University, Cardiothoracic Quality and Outcomes,
Adelaide, SA, Australia
(Ghanpur) Department of Intensive Care, Warringal Private Hospital,
Melbourne, VIC, Australia
(Raman) University of Melbourne, Melbourne, VIC, Australia
(Raman) St. Vincent's Hospital, Melbourne, VIC, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, VIC, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: After cardiac surgery, fluid bolus therapy (FBT) with 20% human
albumin may facilitate less fluid and vasopressor administration than FBT
with crystalloids. We aimed to determine whether, after cardiac surgery,
FBT with 20% albumin reduces the duration of vasopressor therapy compared
with crystalloid FBT. <br/>Method(s): We conducted a multicentre,
parallel-group, open-label, randomised clinical trial in six intensive
care units (ICUs) involving cardiac surgery patients deemed to require
FBT. We randomised 240 patients to receive up to 400 mL of 20% albumin/day
as FBT, followed by 4% albumin for any subsequent FBT on that day, or to
crystalloid FBT for at least the first 1000 mL, with use of crystalloid or
4% albumin FBT thereafter. The primary outcome was the cumulative duration
of vasopressor therapy. Secondary outcomes included fluid balance.
<br/>Result(s): Of 480 randomised patients, 466 provided consent and
contributed to the primary outcome (mean age 65 years; median EuroSCORE II
1.4). The cumulative median duration of vasopressor therapy was 7
(interquartile range [IQR] 0-19.6) hours with 20% albumin and 10.8 (IQR
0-22.8) hours with crystalloids (difference - 3.8 h, 95% confidence
interval [CI] - 8 to 0.4; P = 0.08). Day one fluid balance was less with
20% albumin FBT (mean difference - 701 mL, 95% CI - 872 to - 530).
<br/>Conclusion(s): In patients after cardiac surgery, when compared to a
crystalloid-based FBT, 20% albumin FBT was associated with a reduced
positive fluid balance but did not significantly reduce the duration of
vasopressor therapy.<br/>Copyright &#xa9; The Author(s) 2024.

<42>
Accession Number
2029500467
Title
Efficacy of early administration of sacubitril/valsartan after coronary
artery revascularization in patients with acute myocardial infarction
complicated by moderate-to-severe mitral regurgitation: a randomized
controlled trial.
Source
Heart and Vessels. 39(8) (pp 673-686), 2024. Date of Publication: August
2024.
Author
Yin H.; Ma L.; Tang X.; Li R.; Zhou Y.; Shi J.; Zhang J.
Institution
(Yin, Zhang) Tianjin Medical University, Tianjin 300000, China
(Yin, Ma, Tang, Zhou) Department of Cardiology, The First Hospital of
Qinhuangdao, Hebei, Qinhuangdao 066000, China
(Zhou, Shi) The First Hospital of Qinhuangdao, Hebei, Qinhuangdao 066000,
China
(Li) Department of Critical Care Medicine, People's Hospital of Yangjiang,
Guangdong, Yangjiang 529500, China
(Zhang) Depatment of Cardiology, Cangzhou Central Hospital, Tianjin
Medical University Teaching Hospital, Hebei, Cangzhou 061000, China
Publisher
Springer
Abstract
Effects of angiotensin receptor/neprilysin inhibitors (ARNI) on
ventricular remodeling in patients with heart failure, especially heart
failure with reduced ejection fraction (HFrEF), are better than those of
angiotensin-converting enzyme inhibitors (ACEI). Acute myocardial
infarction (AMI) complicated by mitral regurgitation exacerbates
ventricular remodeling and increases the risk of heart failure. There is
limited evidence on the effects of early administration of ARNI in
patients with AMI complicated by mitral regurgitation. The aim of this
trial was to examine the effectiveness and the safety of early
administration of sacubitril/valsartan after coronary artery
revascularization in patients with AMI complicated by moderate-to-severe
mitral regurgitation. This was a randomized, single-blind, parallel-group,
controlled trial. From June 2021 to June 2022, we enrolled 142 consecutive
patients with AMI complicated by moderate-to-severe mitral regurgitation
and followed them for 12 months. The patients received standard treatment
for AMI and were randomly assigned to receive ARNI or benazepril. The
primary efficacy end points were the differences in mitral regurgitant jet
area (MRJA), mitral regurgitant volume (MRV), concentration of n-terminal
pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection
fraction (LVEF), and left ventricular end-diastolic volume and
end-systolic volume (LVEDV and LVESV) between groups and within groups at
baseline, 1, 3, 6, and 12 months. Secondary end points included the rates
of heart failure hospitalization, all-cause mortality, refractory angina,
malignant arrhythmias, recurrent myocardial infarction, and stroke. Safety
end points included the rates of hyperkalemia, renal dysfunction,
hypotension, angioedema, and cough. The ARNI group had significantly lower
NT-proBNP levels than the benazepril group at 1 month and later (P <
0.001). MRJA and MRV significantly improved in the ARNI group compared
with the benazepril group at 12 months (MRJA: - 3.21 +/- 2.18
cm² vs. - 1.83 +/- 2.81 cm², P < 0.05; MRV: - 27.22
+/- 15.22 mL vs. - 13.67 +/- 21.02 mL, P < 0.001). The ARNI group also
showed significant reductions in LVEDV and LVESV (P < 0.05) and
improvement in LVEF (P < 0.05). Secondary end point analysis showed a
significantly higher rate of heart failure hospitalization in the
benazepril group compared with the ARNI group (HR = 2.03, 95% CI
1.12-3.68, P = 0.021). Safety end point analysis showed a higher rate of
hypotension in the ARNI group (P < 0.05). Early use of
sacubitril/valsartan after coronary artery revascularization in patients
with AMI complicated by moderate-to-severe mitral regurgitation can
significantly reduce mitral regurgitation, improve ventricular remodeling,
and decrease heart failure hospitalization. Nevertheless, caution is
needed to avoid hypotension. Chinese Clinical Trial Registry
(ChiCTR2100054255) registered on December 11, 2021.<br/>Copyright &#xa9;
Springer Nature Japan KK, part of Springer Nature 2024.

<43>
Accession Number
2028481549
Title
Clinical impact of coronary revascularization over medical treatment in
chronic coronary syndromes: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 78 (pp 60-71), 2024. Date of Publication:
01 Jul 2024.
Author
Panuccio G.; Carabetta N.; Torella D.; De Rosa S.
Institution
(Panuccio, Carabetta, De Rosa) Department of Medical and Surgical
Sciences, Italy
(Torella) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
Publisher
Hellenic Cardiological Society
Abstract
Objective: To provide a quantitative comparison between myocardial
revascularization (REVASC) and optimal medical treatment (OMT) alone in
patients with chronic coronary syndrome (CCS). <br/>Method(s): Pertinent
studies were searched for in PubMed/Medline until 12/03/2023. Randomized
controlled trials that compare REVASC to OMT reporting clinical outcomes
were selected according to PRISMA guidelines. The primary outcome was
cardiovascular death. Two investigators independently assessed the study
quality and extracted data. <br/>Result(s): Twenty-eight randomized
controlled studies (RCTs) including 20692 patients were included in this
meta-analysis. The rate of cardiovascular mortality was significantly
lower among patients treated with myocardial revascularization [risk ratio
(RR) 0.79, 95% CI 0.69-0.90]. Age (p = 0.03), multivessel disease (p <
0.001), and follow-up duration (p = 0.001) were significant moderators of
CV mortality. Subgroup analyses showed a larger benefit in patients
treated with drug-eluting stents and those without chronic total
occlusion. Among secondary outcomes, myocardial infarction was less
frequent in the REVASC group (RR = 0.74; p < 0.001), while no significant
difference was found for all-cause mortality (p = 0.09) nor stroke (p =
0.26). <br/>Conclusion(s): The present analysis showed lower rates of CV
mortality and myocardial infarction in CCS patients treated with
myocardial revascularization compared to OMT. This benefit was larger with
increasing follow-up duration. Personalized treatment based on patient
characteristics and lesion complexity may optimize clinical outcomes in
patients with CCS.<br/>Copyright &#xa9; 2023 Hellenic Society of
Cardiology

<44>
Accession Number
2033332160
Title
Comparison of Effect of Topical Anesthesia with General Anesthesia and
Peribulbar Block with General Anesthesia in Children Undergoing Ophthalmic
Surgery.
Source
European Journal of Cardiovascular Medicine. 13(2) (pp 546-553), 2023.
Date of Publication: 2023.
Author
Ahila R.; Sudhakaran S.; Gowtham G.
Institution
(Ahila) Dept of Anaesthesia, Regional Institute of Ophthalmology,
Government Ophthalmic Hospital, Madras Medical College, Egmore, Chennai,
India
(Gowtham) Dept of Anaesthesia, Regional Institute of Ophthalmology,
Government Ophthalmic Hospital, Madras Medical College, Egmore, Chennai,
India
(Sudhakaran) Dept. of Anaesthesia, Tamil Nadu Government Multi Super
Specialty Hospital, Madras Medical College), Chennai, India
Publisher
Healthcare Bulletin
Abstract
Background: Ophthalmic surgery is a common procedure in pediatric
populations, and anesthesia is used to ensure patient comfort and safety
during the surgery. The aim of this study was to compare the efficacy and
safety of topical anesthesia and peribulbar block as an adjuvant to
general anesthesia in children undergoing ophthalmic surgery.
<br/>Objective(s): The study aimed to evaluate the differences in
hemodynamic changes during surgery, pain relief during and after surgery,
and the duration of postoperative pain relief between the two anesthesia
techniques. It also aimed to examine the occurrence of ocular-cardiac
reflex and changes in intraocular pressure. Methodology: A randomized
control study was conducted with two groups, Group GA-PB, consisting of
general anesthesia with peribulbar block, and Group GA-TA, consisting of
general anesthesia with topical anesthesia. The study population consisted
of 50 children aged 2 to 12 years. The primary outcome measures included
differences in intraoperative hemodynamic changes, the need for pain
relief during and after surgery, and the duration of postoperative pain
relief. The secondary outcome measures included the occurrence of
ocular-cardiac reflex, incidence of postoperative nausea and vomiting, and
changes in intraocular pressure. <br/>Result(s): There was no significant
difference in age and weight between the two groups. The mean preoperative
and intraoperative intraocular pressure did not differ significantly
between the two groups. The GA-PB group showed significantly lower heart
rate during surgery and required less pain relief during and after
surgery. The duration of postoperative pain relief was also longer in the
GA-PB group. There were no significant differences in oxygen saturation,
blood pressure, incidence of ocular-cardiac reflex, or changes in
intraocular pressure between the two groups. <br/>Conclusion(s): The study
concluded that peribulbar block as an adjuvant to general anesthesia was
more effective in reducing pain during and after ophthalmic surgery in
children. It also showed that peribulbar block did not have any adverse
effects on hemodynamic changes, oxygen saturation, or intraocular
pressure. Therefore, peribulbar block can be considered as a safe and
effective option for anesthesia in pediatric ophthalmic
surgeries<br/>Copyright &#xa9; 2023 Healthcare Bulletin. All rights
reserved.

<45>
Accession Number
2033353237
Title
Reporting Minority Race and Ethnicity in Cardiovascular and Thoracic
Journals.
Source
Journal of Surgical Research. 301 (pp 352-358), 2024. Date of Publication:
September 2024.
Author
Khedr S.; Hong J.; Forter-Chee-A-Tow N.; Cygiel G.; Heffernan D.S.; Lee
B.E.; Chao S.Y.
Institution
(Khedr, Hong, Forter-Chee-A-Tow, Cygiel, Chao) Department of General
Surgery, New York Presbyterian-Queens, Queens, New York, United States
(Chao) Department of Surgery, Weill Cornell Medicine, New York, New York,
United States
(Heffernan) Department of Surgery, Brown University, Providence, Rhode
Island, United States
(Lee) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, New York, United States
Publisher
Academic Press Inc.
Abstract
Introduction: Currently, there is no mandatory standard for reporting race
and ethnicity in medical journals, presenting significant barriers to
studying disparities in medical outcomes. We seek to investigate whether
greater recent awareness of diversity and inclusion reflects in reporting
of race and ethnicity by peer-reviewed cardiothoracic articles.
<br/>Method(s): Pubmed was queried for clinical outcomes articles
published from January 2017 to June 2023 in the Journal of Thoracic and
Cardiovascular Surgery, Annals of Thoracic Surgery, Journal of Heart and
Lung Transplantation, and CHEST Journal. Basic science, translational
studies, and international studies were excluded. SAS Studio was used for
statistical analysis. <br/>Result(s): 817 papers were reviewed, 378
reported race/ethnicity with 354 (93%) reporting White, 267 (71%)
reporting Black, 128 (34%) reporting Hispanic, and 119 (31%) reporting
Asian. Over 8-y, there were no statistically significant changes in
percent of articles that included White (odds ratio 0.808 95% confidence
interval [0.624-1.047], P = 0.1068), Black (1.125 [0.984-1.288], P =
0.0857), or Asian (1.096 [0.960-1.250], P = 0.1751) groups. Hispanics were
more likely to be reported in recent years (1.147 [1.006-1.307], P =
0.0397). Subset analysis was performed on cardiac (n = 157) and thoracic
articles (n = 157) with no significant trends for race reporting in these
subsets. <br/>Conclusion(s): Minorities remain underrepresented in
reported patient populations in peer-reviewed cardiothoracic journals.
Future efforts should prioritize accurately representing these populations
in the literature. Inaccurate data and exclusion of minority populations
can contribute to disparities observed in overall outcomes.<br/>Copyright
&#xa9; 2024 Elsevier Inc.

<46>
Accession Number
2032465440
Title
Transcatheter or Surgical Replacement for Failed Bioprosthetic Aortic
Valves.
Source
JAMA Cardiology. 9(7) (pp 631-639), 2024. Date of Publication: 10 Jul
2024.
Author
Tran J.H.; Itagaki S.; Zeng Q.; Leon M.B.; O'Gara P.T.; Mack M.J.;
Gillinov A.M.; El-Hamamsy I.; Tang G.H.L.; Mikami T.; Bagiella E.;
Moskowitz A.J.; Adams D.H.; Gelijns A.C.; Borger M.A.; Egorova N.N.
Institution
(Tran, Itagaki, El-Hamamsy, Tang, Mikami, Adams) Department of
Cardiovascular Surgery, The Mount Sinai Hospital, Icahn School of Medicine
at Mount Sinai, New York, NY, United States
(Tran, Itagaki, Zeng, Bagiella, Moskowitz, Gelijns, Egorova) Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Leon) Division of Cardiology, Columbia University, Irving Medical Center,
New York, NY, United States
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Mack) Cardiac and Thoracic Surgery, Baylor Scott & White Health, Dallas,
TX, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
Publisher
American Medical Association
Abstract
Importance: The use of valve-in-valve (ViV) transcatheter aortic valve
replacement (TAVR) has been rapidly expanding as an alternative treatment
to redo surgical aortic valve replacement (SAVR) for failed bioprosthetic
valves despite limited long-term data. <br/>Objective(s): To assess
mortality and morbidity in patients undergoing intervention for failed
bioprosthetic SAVR. <br/>Design, Setting, and Participant(s): This was a
retrospective population-based cohort analysis conducted between January
1, 2015, and December 31, 2020, with a median (IQR) follow-up time of 2.3
(1.1-4.0) years. A total of 1771 patients with a history of bioprosthetic
SAVR who underwent ViV-TAVR or redo SAVR in California, New York, and New
Jersey were included. Data were obtained from the California Department of
Health Care Access and Information, the New York Statewide Planning and
Research Cooperative System, and the New Jersey Discharge Data Collection
System. Exclusion criteria included undergoing TAVR or redo SAVR within 5
years from initial SAVR, as well as infective endocarditis, concomitant
surgical procedures, and out-of-state residency. Propensity matching
yielded 375 patient pairs. Data were analyzed from January to December
2023. <br/>Intervention(s): ViV-TAVR vs redo SAVR. Main Outcomes and
Measurements: The primary outcome was all-cause mortality. Secondary
outcomes were stroke, heart failure hospitalization, reoperation, major
bleeding, acute kidney failure, new pacemaker insertion, and infective
endocarditis. <br/>Result(s): From 2015 through 2020, the proportion of
patients undergoing ViV-TAVR vs redo SAVR increased from 159 of 451
(35.3%) to 498 or 797 (62.5%). Of 1771 participants, 653 (36.9%) were
female, and the mean (SD) age was 74.4 (11.3) years. Periprocedural
mortality and stroke rates were similar between propensity-matched groups.
The ViV-TAVR group had lower periprocedural rates of major bleeding (2.4%
vs 5.1%; P =.05), acute kidney failure (1.3% vs 7.2%; P <.001), and new
pacemaker implantations (3.5% vs 10.9%; P <.001). The 5-year all-cause
mortality rate was 23.4% (95% CI, 15.7-34.1) in the ViV-TAVR group and
13.3% (95% CI, 9.2-18.9) in the redo SAVR group. In a landmark analysis,
no difference in mortality was observed up to 2 years (hazard ratio, 1.03;
95% CI, 0.59-1.78), but after 2 years, ViV-TAVR was associated with higher
mortality (hazard ratio, 2.97; 95% CI, 1.18-7.47) as well as with a higher
incidence of heart failure hospitalization (hazard ratio, 3.81; 95% CI,
1.57-9.22). There were no differences in 5-year incidence of stroke,
reoperation, major bleeding, or infective endocarditis. <br/>Conclusions
and Relevance: Compared with redo SAVR, ViV-TAVR was associated with a
lower incidence of periprocedural complications and a similar incidence of
all-cause mortality through 2 years' follow-up. However, ViV-TAVR was
associated with higher rates of late mortality and heart failure
hospitalization. These findings may be influenced by residual confounding
and require adjudication in a randomized clinical trial. <br/>Copyright
&#xa9; 2024 American Medical Association. All rights reserved.

<47>
Accession Number
644798315
Title
Effectiveness of ultrasound-guided rhomboid intercostal and sub-serratus
block for perioperative analgesia in male patients undergoing combined
power-assisted liposuction with pull-through excision of the gland for
breast definition and reshaping.
Source
Minerva anestesiologica. 90(7-8) (pp 626-634), 2024. Date of Publication:
01 Jul 2024.
Author
Wahdan A.S.; Loza G.E.; Alayyaf H.A.; Wahdan W.S.; Salama A.K.; Mohamed
M.M.
Institution
(Wahdan) Department of Anesthesia, Surgical ICU and Pain Management,
Faculty of Medicine, Cairo University, Cairo, Egypt
(Loza, Salama, Mohamed) Department of Anesthesia, Surgical ICU and Pain
Management, Faculty of Medicine, Cairo University, Cairo, Egypt
(Alayyaf) Department of Anesthesia, Al-Hada Armed Forces Hospital, Saudi
Arabia
(Wahdan) Department of Plastic and Reconstructive Surgery, Faculty of
Medicine, Cairo University, Cairo, Egypt
Abstract
BACKGROUND: The newly introduced ultrasound guided interfacial rhomboid
intercostal and sub-serratus (RISS) block technique demonstrated promising
efficacy in managing perioperative pain among patients undergoing
abdominal and thoracic procedures. Thus, this study investigated the
efficiency of bilateral ultrasound-guided RISS (US-RISS) as a
perioperative pain control technique in male subjects receiving
gynecomastia surgery. <br/>METHOD(S): This prospective randomized study
involved sixty patients who underwent gynecomastia surgery. Individuals
were randomly divided into two groups: the RISS group (N.=30) and the
control group (N.=30). After anesthesia induction, the patients received
bilateral US-RISS using 40 mL of 0.25% levobupivacaine, or conventional
intravenous analgesia with no intervention, respectively. The primary
outcome was the overall morphine consumption in 24 hours, and the
secondary endpoints involved the time elapsed till rescue analgesia was
requested, the quality of recovery after 24 hours and side effects'
incidence. <br/>RESULT(S): Morphine consumption was noticeably decreased
in the RISS group compared to the control group, with 14.07+/-4.91 mg and
35.83+/-1.70 mg mean values, respectively (P<0.001). Furthermore, in the
RISS group, the initial rescue analgesia request occurred significantly
later than in the control group, with mean values of 15.58+/-1.41 hours
and 0.96+/-0.63 hours, respectively (P<0.001). Additionally, within the
RISS group, there was a high quality of recovery observed, with a low
incidence of opioid-related adverse events in comparison to the control
group. <br/>CONCLUSION(S): Bilateral US-RISS block is a beneficial
intervention in gynecomastia surgery for pain management and improves the
quality of recovery.

<48>
Accession Number
644797030
Title
Outcomes after 4 years' experience with low suction drains. Would it be
safe to go drainless or low suction?.
Source
Journal of cardiothoracic surgery. 19(1) (pp 456), 2024. Date of
Publication: 17 Jul 2024.
Author
Fazlioglu M.; Hammad W.; Piyadeoglu D.; Kutlu C.A.
Institution
(Fazlioglu) Medical Faculty Department of Thoracic Surgery, Tekirdag Namik
Kemal University, Tekirdag, Turkey
(Hammad) Al-Azhar Faculty of Medicine, Cardiothoracic surgery department,
Cairo, Egypt
(Piyadeoglu, Kutlu) School of Medicine, Department of Thoracic Surgery,
Bahcesehir University, Istanbul, Turkey
Abstract
BACKGROUND: The principles of chest drainage have not changed
significantly since 1875 when Bulau introduced the idea of underwater
drainage tube which became a trademark of thoracic surgery. We performed a
prospective, randomized trial comparing omitting pleural drain (drainless
group) versus drainage with small low suction drain (drainage group)
strategies of thoracic surgery when the visceral pleura remains intact.
Aiming to investigate whether these approaches represent safe treatment
options. <br/>METHOD(S): A multi-center, prospective, parallel group,
randomized, controlled trial enrolling patients after thoracic procedures
in which visceral pleura remained intact at the end of surgery between
August 2020 and September 2023. After completion of the procedure a
suction-seal test was conducted on all patients. If suction-seal test was
positive to confirm absence of air leak, patients were randomized to
either receive low auto-suction drain as a solo pleural drain (drainage
group) or not to receive drain (drainless group). <br/>RESULT(S): During
the study period, 111 patients were recruited. Eleven patients had
negative Suction-seal test and were excluded by inserting a traditional
underwater seal. The remaining 100 patients were randomly assigned to
either drainage group with low suction drain (Fig. 1) (n=50) or drainless
group (n=50). <br/>CONCLUSION(S): The results of this study suggest that
either omitting drain or inserting a low auto suction drain safely
substitutes the one-way valve when the visceral pleura remains intact.
Omitting drain or inserting portable small caliber drain encourages early
mobilization and is associated with shorter hospital stay.<br/>Copyright
&#xa9; 2024. The Author(s).

<49>
Accession Number
2033471104
Title
Comment on: "Ultrasound-guided mid-point transverse process to pleura
block versus thoracic paravertebral block in pediatric open-heart surgery:
A randomized controlled non-inferiority study".
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111552. Date of Publication: October 2024.
Author
Udayakumar G.S.; Narayanan V.; Sethuraman R.M.
Institution
(Udayakumar, Narayanan, Sethuraman) Department of Anesthesiology, Sree
Balaji Medical College & Hospital, BIHER, Chennai 600044, India
Publisher
Elsevier Inc.

<50>
Accession Number
2033426675
Title
Post-sternotomy movement strategies in adults: a scoping review.
Source
European Journal of Cardiovascular Nursing. 23(5) (pp 435-440), 2024. Date
of Publication: 01 Jul 2024.
Author
Wiens K.; Hayden K.A.; Park L.; Colwell S.; Coltman C.; King-Shier K.M.
Institution
(Wiens, King-Shier) Faculty of Nursing, University of Calgary, 2500
University Dr NW, Calgary, AB T2N 1N4, Canada
(Wiens, Park, Colwell, Coltman) Foothills Medical Center, Alberta Health
Services, 1403 29 St NW, Calgary, AB T2N 2T9, Canada
(Wiens, Park, Colwell, Coltman, King-Shier) Libin Cardiovascular Institute
of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N
4N1, Canada
(Hayden) Libraries and Cultural Resources, University of Calgary, 2500
University Dr NW, Calgary, AB T2N 1N4, Canada
(King-Shier) Department of Community Health Sciences, Cumming School of
Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB T2N
1N4, Canada
Publisher
Oxford University Press
Abstract
Aims Post-sternotomy movement strategies for adults should be an
evidence-informed approach and support a safe, independent return to daily
activity. Recent new movement strategies have emerged. The aim of this
scoping review was to identify and summarize the available evidence for
post-sternotomy movement strategies in adults. Methods and results The
electronic databases searched included MEDLINE, Embase, Sport Discus,
CINAHL, Academic Search Complete, the Cochrane Library, Scopus, and PEDro.
The search did not have a date limit. After 2405 duplicates were removed,
2978 records were screened, and 12 were included; an additional 2 studies
were identified through reference searching for a total of 14 included
studies. A data extraction table was used, and the findings are summarized
in a tabular and narrative form. Three post-sternotomy movement strategies
were identified in the literature: sternal precautions (SP), modified SP,
and Keep Your Move in the Tube (KYMITTTM). The authors suggested that the
practice of SP was based on expert opinion and not founded in evidence.
However, the evidence from the identified articles suggested that new
movement strategies are safe and allow patients to choose an increased
level of activity that promotes improved functional status and confidence.
Conclusion More prospective cohort studies and multi-centred randomized
control trials are needed; however, the current evidence suggests that
modified SP and KYMITTTM are as safe as SP and can promote a
patient-centred approach. <br/>Copyright &#xa9; The Author(s) 2024.

<51>
Accession Number
2033438070
Title
Transcatheter Aortic Valve Replacement in Low-Risk Patients at Four or
More Years.
Source
American Journal of Medicine. (no pagination), 2024. Date of Publication:
2024.
Author
Connolly J.E.; Andabili S.H.A.; Joseph E.; Resar J.; Rahman F.
Institution
(Connolly, Andabili, Joseph, Resar, Rahman) Department of Medicine,
Division of Cardiology, The Johns Hopkins Hospital, Baltimore, Md, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is accepted as
an alternative to surgical aortic valve replacement (SAVR) in patients
with severe symptomatic aortic valve stenosis. Prior studies have shown
that TAVR has comparable or superior outcomes to SAVR in intermediate and
high-risk patients. However, there is paucity of data about outcome of
TAVR vs SAVR in low-surgical-risk patients evaluated at 4 or more years
post-procedure. <br/>Method(s): A systematic review of all published
randomized controlled trials comparing TAVR and SAVR in low-risk patients
was completed. A random-effects model meta-analysis was performed to study
major outcomes, including all-cause mortality, stroke, myocardial
infarction, and aortic valve reintervention. <br/>Result(s): Three
randomized trials comprising 2644 patients (1371 TAVR and 1273 SAVR) with
a mean age of 74.3 +/- 5.8 years were included in this analysis. There was
no significant difference in all-cause and cardiovascular mortality,
stroke, myocardial infarction, or aortic valve reintervention between the
TAVR and SAVR groups at long-term follow-up. Transcatheter aortic valve
replacement was associated with higher rate of pacemaker implantation,
whereas SAVR was associated with more atrial fibrillation.
<br/>Conclusion(s): At 4 or more years of follow-up, TAVR is safe and has
comparable outcomes to SAVR in low-surgical-risk patients. Possibility of
TAVR and its risks and benefits should be discussed with low-surgical-risk
patients.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<52>
Accession Number
644801180
Title
Left atrial appendage closure for stroke prevention in atrial
fibrillation: current status and perspectives.
Source
European heart journal. (no pagination), 2024. Date of Publication: 19
Jul 2024.
Author
Landmesser U.; Skurk C.; Tzikas A.; Falk V.; Reddy V.Y.; Windecker S.
Institution
(Landmesser, Skurk, Falk) Department of Cardiology, Angiology and
Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC),
Hindenburgdamm 30, Berlin 12203, Germany
(Landmesser, Falk) Berlin Institute of Health (BIH),
Anna-Louisa-Karsch-Strase 2, Berlin 10178, Germany
(Landmesser, Falk) Friede Springer Cardiovascular Prevention
Center@Charite, Hindenburgdamm 30, Berlin 12203, Germany
(Landmesser, Skurk, Falk) DZHK Partner Site Berlin, Germany
(Tzikas) Second Department of Cardiology, Hippocratic University Hospital,
Aristotle University of Thessaloniki Department of Cardiology, Interbalkan
Medical Center, Pylaia, Thessaloniki, Greece
(Falk) Department of Cardiothoracic Surgery, Deutsches Herzzentrum der
Charite (DHZC), Berlin, Germany
(Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart
Hospital, Icahn School of Medicine at Mount Sinai, NY, NY 10029, United
States
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Freiburgstrasse 18, Bern 3010,
Switzerland
Abstract
Atrial fibrillation (AF) is associated with an increased risk of stroke
and systemic embolism, and the left atrial appendage (LAA) has been
identified as a principal source of thromboembolism in these patients.
While oral anticoagulation is the current standard of care, LAA closure
(LAAC) emerges as an alternative or complementary treatment approach to
reduce the risk of stroke or systemic embolism in patients with AF.
Moderate-sized randomized clinical studies have provided data for the
efficacy and safety of catheter-based LAAC, largely compared with vitamin
K antagonists. LAA device iterations, advances in pre- and peri-procedural
imaging, and implantation techniques continue to increase the efficacy and
safety of LAAC. More data about efficacy and safety of LAAC have been
collected, and several randomized clinical trials are currently underway
to compare LAAC with best medical care (including non-vitamin K antagonist
oral anticoagulants) in different clinical settings. Surgical LAAC in
patients with AF undergoing cardiac surgery reduced the risk of stroke on
background of anticoagulation therapy in the LAAOS III study. In this
review, we describe the rapidly evolving field of LAAC and discuss recent
clinical data, ongoing studies, open questions, and current limitations of
LAAC.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<53>
Accession Number
644799967
Title
The place of splenectomy in the therapeutic management of patients with
infective endocarditis and splenic abscess: A single center experience and
a literature review.
Source
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and
Ireland. (no pagination), 2024. Date of Publication: 18 Jul 2024.
Author
Minciuna C.-E.; Tivadar B.; Ilie V.C.; Fota R.D.; Timisescu A.T.; Iliescu
V.A.; Coman I.M.; Droc G.; Iosifescu A.G.; Vasilescu C.
Institution
(Minciuna, Tivadar, Ilie, Vasilescu) General Surgery Department, Fundeni
Clinical Institute, Bucharest, Romania; "Carol Davila" University of
Medicine and Pharmacy, Bucharest, Romania
(Fota) Anesthesia and Intensive Care Department, Fundeni Clinical
Institute, Bucharest, Romania
(Timisescu) C.C. Iliescu Emergency Institute for Cardiovascular Diseases,
Bucharest, Romania
(Iliescu, Coman, Iosifescu) "Carol Davila" University of Medicine and
Pharmacy, Bucharest, Romania; C.C. Iliescu Emergency Institute for
Cardiovascular Diseases, Bucharest, Romania
(Droc) "Carol Davila" University of Medicine and Pharmacy, Bucharest,
Romania; Anesthesia and Intensive Care Department, Fundeni Clinical
Institute, Bucharest, Romania
Abstract
INTRODUCTION: Infective endocarditis(IE) has a low incidence, but it
remains a serious disease with high mortality rates. Only 5 % of these
patients will develop a splenic abscess, and the number of patients that
have IE and a splenic abscess requiring surgery is low. The current
guidelines recommend that splenectomy should be performed prior to valve
replacement, but there is no strong evidence to support this statement and
no evidence to clearly endorse the order in which the surgical
interventions should be performed. The objective of this review and case
series is to establish the proper treatment strategy, to assess the
adequate order of the surgical interventions and to clarify the role of
percutaneous drainage in the management of these patients. MATERIAL AND
METHODS: All patients with infective endocarditis and splenic abscess who
underwent surgery in our institution, between January 2008 and December
2020 were included in this study, excluding patients which had cardiac
device related endocarditis. Literature review on the matter included a
number of 30 studies which were selected from the PubMed database.
<br/>RESULT(S): Assessing the literature and case series no reinfection
was reported for simultaneously performing splenectomy(S) and valvular
surgery(VS) nor for VS followed by S. <br/>CONCLUSION(S): Percutaneous
drainage of the splenic abscesses is a feasible solution as definitive
therapy in high-risk patients or as bridge therapy. Additional studies are
needed, even though they are difficult to conduct, therefore a
national/international infectious endocarditis register may be of use to
clarify these challenges.<br/>Copyright &#xa9; 2024 Royal College of
Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College
of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

<54>
Accession Number
644797072
Title
Artificial intelligence in cardiac surgery: A systematic review.
Source
World journal of surgery. (no pagination), 2024. Date of Publication: 17
Jul 2024.
Author
Sulague R.M.; Beloy F.J.; Medina J.R.; Mortalla E.D.; Cartojano T.D.;
Macapagal S.; Kpodonu J.
Institution
(Sulague) Graduate School of Arts and Sciences, Georgetown University,
Washington, District of Columbia, USA
(Sulague) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Beloy) Ateneo School of Medicine and Public Health, Pasig City,
Philippines
(Medina) Manila Central University College of Medicine, Caloocan City,
Philippines
(Mortalla, Cartojano) Cebu Institute of Medicine, Cebu City, Philippines
(Macapagal) Mayo Clinic, Rochester, MN, United States
(Kpodonu) Beth Israel Deaconess Medical Center, Boston, MA, United States
Abstract
BACKGROUND: Artificial intelligence (AI) has emerged as a tool to
potentially increase the efficiency and efficacy of cardiovascular care
and improve clinical outcomes. This study aims to provide an overview of
applications of AI in cardiac surgery. <br/>METHOD(S): A systematic
literature search on AI applications in cardiac surgery from inception to
February 2024 was conducted. Articles were then filtered based on the
inclusion and exclusion criteria and the risk of bias was assessed. Key
findings were then summarized. <br/>RESULT(S): A total of 81 studies were
found that reported on AI applications in cardiac surgery. There is a
rapid rise in studies since 2020. The most popular machine learning
technique was random forest (n = 48), followed by support vector machine
(n = 33), logistic regression (n = 32), and eXtreme Gradient Boosting (n =
31). Most of the studies were on adult patients, conducted in China, and
involved procedures such as valvular surgery (24.7%), heart transplant
(9.4%), coronary revascularization (11.8%), congenital heart disease
surgery (3.5%), and aortic dissection repair (2.4%). Regarding evaluation
outcomes, 35 studies examined the performance, 26 studies examined
clinician outcomes, and 20 studies examined patient outcomes.
<br/>CONCLUSION(S): AI was mainly used to predict complications following
cardiac surgeries and improve clinicians' decision-making by providing
better preoperative risk assessment, stratification, and prognostication.
While the application of AI in cardiac surgery has greatly progressed in
the last decade, further studies need to be conducted to verify accuracy
and ensure safety before use in clinical practice.<br/>Copyright &#xa9;
2024 International Society of Surgery/Societe Internationale de Chirurgie
(ISS/SIC).

<55>
Accession Number
644796462
Title
Invasive Treatment of Left Main Coronary Artery Disease: From Anatomical
Features to Mechanistic Differences.
Source
Current cardiology reviews. (no pagination), 2024. Date of Publication:
15 Jul 2024.
Author
Kirov H.; Caldonazo T.; Doenst T.
Institution
(Kirov, Caldonazo, Doenst) Department of Cardiothoracic Surgery, Jena
University Hospital, Friedrich Schiller University of Jena, Jena, Germany
Abstract
There is debate on the best treatment for significant stenoses of the left
main (LM) coronary artery. The available evidence is based on four
randomized trials, which were either performed specifically to assess
patients with LM disease (EXCEL, NOBLE, PRECOMBAT) or had a significant
fraction of patients with this disease pattern (SYNTAX). A meta-analysis
revealed no difference in periprocedural and 5-year mortality but
demonstrated a significant reduction of spontaneous myocardial infarction
(MI) with CABG. Furthermore, the recently published SWEDEHEART registry
data have shown survival advantage and fewer MACCE with CABG for LM
disease after adjustment. In general, patients with more severe coronary
artery disease (CAD) appear to have a survival advantage with CABG both
over PCI and medical therapy (independent of the presence or absence of LM
stenosis), which is always associated with a reduction of spontaneous MI
in the CABG arm. Since the nomenclature of LM disease does not
automatically reflect the complexity of CAD, we review the nature of LM
disease in this article. We mechanistically assess the treatment effects
of PCI and CABG for patients with LM disease, which is rarely isolated,
often distal, and mostly associated with varying degrees of single and
multi-vessel disease. We conclude that in patients with isolated LM shaft
lesions and associated diseases of low complexity, the risk of spontaneous
MI is lower, and PCI may achieve similar long-term outcomes compared to
CABG. Thus, heart teams are essential for selecting the best treatment
option and should focus on assessing infarction risk in chronic
CAD.<br/>Copyright&#xa9; Bentham Science Publishers; For any queries,
please email at epub@benthamscience.net.

<56>
Accession Number
2033392703
Title
Effects of albiglutide on myocardial infarction and ischaemic heart
disease outcomes in patients with type 2 diabetes and cardiovascular
disease in the Harmony Outcomes trial.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(4) (pp
279-288), 2024. Date of Publication: 01 Jul 2024.
Author
Krychtiuk K.A.; Marquis-Gravel G.; Murphy S.; Alexander K.P.; Chiswell K.;
Green J.B.; Leiter L.A.; Lopes R.D.; Prato S.D.; Jones W.S.; McMurray
J.J.V.; Hernandez A.F.; Granger C.B.
Institution
(Krychtiuk, Marquis-Gravel, Murphy, Alexander, Chiswell, Green, Lopes,
Jones, Hernandez, Granger) Duke Clinical Research Institute, Durham, NC
27701, United States
(Leiter) Li Ka Shing Knowledge Institute, St. Michael's Hospital,
University of Toronto, Toronto, ON M5B 1W8, Canada
(Prato) Section on Diabetes, Department of Clinical and Experimental
Medicine, University of Pisa, Sant'Anna School of Advanced Studies, Pisa
56126, Italy
(McMurray) British Heart Foundation Glasgow Cardiovascular Research
Centre, University of Glasgow, Glasgow, Glasgow G12 8TA, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Large outcome trials have demonstrated cardiovascular benefits of
selected glucagon-like peptide-1 (GLP-1) receptor agonists. We examined
coronary disease outcomes in the Harmony Outcomes trial of the GLP-1
receptor agonist albiglutide. Methods and results Harmony Outcomes was an
event-driven, multicenter, double-blind, and placebo-controlled trial
involving 9463 patients >40 years of age with type-2 diabetes and
established atherosclerotic cardiovascular disease. It tested the effects
of albiglutide on the occurrence of a composite primary endpoint,
consisting of cardiovascular death, myocardial infarction (MI), or stroke.
Within this post-hoc analysis, the effects of albiglutide on MI subtypes
and other ischaemic endpoints were analysed. During the median-follow up
of 1.6 years, a total of 421 patients (4.5%) experienced at least one MI,
with 72 patients having more than one event. Treatment with albiglutide
reduced both first events [hazard ratio (HR) 0.75 (0.62-0.91)] and overall
events [HR 0.75 (0.61-0.91)] as well as first type 1 [HR 0.73 (0.57-0.92)]
and type 2 myocardial infarctions [HR 0.65 (0.46-0.92)]. The effect of
albiglutide treatment was consistent for ST-segment elevation [HR 0.69
(0.38-1.26)] and non-ST elevation (HR 0.86 (0.66-1.2) MI. Conclusion
Treatment with the GLP-1 receptor agonist albiglutide resulted in a 25%
relative risk reduction in MI that was consistent for type of infarction
and presence or absence of ST elevation. Our findings add novel
information about the effects of GLP-1 receptor agonists on ischaemic
events in patients with type 2 diabetes.<br/>Copyright &#xa9; The
Author(s) 2024.

<57>
Accession Number
2032519402
Title
Randomized comparison of TAVI valves: The Compare-TAVI trial.
Source
American Heart Journal. 274 (pp 84-94), 2024. Date of Publication: August
2024.
Author
Terkelsen C.J.; Thim T.; Freeman P.; Dahl J.S.; Norgaard B.L.; Kim W.-Y.;
Tang M.; Sorensen H.T.; Christiansen E.H.; Nissen H.
Institution
(Terkelsen, Thim, Norgaard, Kim, Christiansen) Department of Cardiology,
Aarhus University Hospital, Aarhus, Denmark
(Terkelsen, Norgaard, Kim) Department of Clinical Medicine, Aarhus
University Hospital, Aarhus, Denmark
(Freeman) Department of Cardiology, Aalborg University Hospital, Aalborg,
Denmark
(Dahl, Nissen) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Tang) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Terkelsen) The Danish Heart Foundation, Copenhagen, Denmark
(Sorensen) Department of Clinical Epidemiology, Aarhus University Hospital
and Aarhus University, Aarhus, Denmark
Publisher
Elsevier Inc.
Abstract
Introduction: Based on technical advancements and clinical evidence,
transcatheter aortic valve implantation (TAVI) has been widely adopted.
New generation TAVI valve platforms are continually being developed.
Ideally, new valves should be superior or at least non-inferior regarding
efficacy and safety, when compared to best-in-practice contemporary TAVI
valves. Methods and analysis: The Compare-TAVI trial (ClinicalTrials.gov
NCT04443023) was launched in 2020, to perform a 1:1 randomized comparison
of new vs contemporary TAVI valves, preferably in all comers. Consecutive
cohorts will be launched with sample sizes depending on the choice of
interim analyses, expected event rates, and chosen superiority or
non-inferiority margins. Enrollment has just been finalized in cohort B,
comparing the Sapien 3/Sapien 3 Ultra Transcatheter Heart Valve (THV)
series (Edwards Lifesciences, Irvine, California, USA) and the Myval/Myval
Octacor THV series (Meril Life Sciences Pvt. Ltd., Vapi, Gujarat, India)
balloon expandable valves. This non-inferiority study was aimed to include
1062 patients. The 1-year composite safety and efficacy endpoint comprises
death, stroke, moderate-severe aortic regurgitation, and moderate-severe
valve deterioration. Patients will be followed until withdrawal of
consent, death, or completion of 10-year follow-up, whichever comes first.
Secondary endpoints will be monitored at 30 days, 1, 3, 5, and 10 years.
The Compare-TAVI organization will launch consecutive cohorts wherein
patients scheduled for TAVI are randomized to one of two valves. The aim
is to ensure that the short- and long-term performance and safety of new
valves being introduced is benchmarked against what achieved by
best-in-practice contemporary valves.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<58>
Accession Number
2032511891
Title
Impact of spinal or epidural anaesthesia on perioperative outcomes in
adult noncardiac surgery: a narrative review of recent evidence.
Source
British Journal of Anaesthesia. 133(2) (pp 380-399), 2024. Date of
Publication: August 2024.
Author
Hewson D.W.; Tedore T.R.; Hardman J.G.
Institution
(Hewson, Hardman) Department of Anaesthesia and Critical Care, Queen's
Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham,
United Kingdom
(Hewson, Hardman) Academic Unit of Injury, Recovery and Inflammation
Sciences, School of Medicine, University of Nottingham, Nottingham, United
Kingdom
(Tedore) Department of Anesthesiology, Weill Cornell Medicine, New
York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY,
United States
Publisher
Elsevier Ltd
Abstract
Spinal and epidural anaesthesia and analgesia are important anaesthetic
techniques, familiar to all anaesthetists and applied to patients
undergoing a range of surgical procedures. Although the immediate effects
of a well-conducted neuraxial technique on nociceptive and sympathetic
pathways are readily observable in clinical practice, the impact of such
techniques on patient-centred perioperative outcomes remains an area of
uncertainty and active research. The aim of this review is to present a
narrative synthesis of contemporary clinical science on this topic from
the most recent 5-year period and summarise the foundational scholarship
upon which this research was based. We searched electronic databases for
primary research, secondary research, opinion pieces, and guidelines
reporting the relationship between neuraxial procedures and standardised
perioperative outcomes over the period 2018-2023. Returned citation lists
were examined seeking additional studies to contextualise our narrative
synthesis of results. Articles were retrieved encompassing the following
outcome domains: patient comfort, renal, sepsis and infection,
postoperative cancer, cardiovascular, and pulmonary and mortality
outcomes. Convincing evidence of the beneficial effect of epidural
analgesia on patient comfort after major open thoracoabdominal surgery
outcomes was identified. Recent evidence of benefit in the prevention of
pulmonary complications and mortality was identified. Despite mechanistic
plausibility and supportive observational evidence, there is less certain
experimental evidence to support a role for neuraxial techniques impacting
on other outcome domains. Evidence of positive impact of neuraxial
techniques is best established for the domains of patient comfort,
pulmonary complications, and mortality, particularly in the setting of
major open thoracoabdominal surgery. Recent evidence does not strongly
support a significant impact of neuraxial techniques on cancer, renal,
infection, or cardiovascular outcomes after noncardiac surgery in most
patient groups.<br/>Copyright &#xa9; 2024 The Author(s)

<59>
Accession Number
2030620249
Title
Performance of federated learning-based models in the Dutch TAVI
population was comparable to central strategies and outperformed local
strategies.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1399138. Date of Publication: 2024.
Author
Yordanov T.R.; Ravelli A.C.J.; Amiri S.; Vis M.; Houterman S.; Van der
Voort S.R.; Abu-Hanna A.
Institution
(Yordanov, Ravelli, Van der Voort, Abu-Hanna) Department of Medical
Informatics, Amsterdam University Medical Centers, University of
Amsterdam, Amsterdam, Netherlands
(Yordanov, Ravelli, Vis, Van der Voort, Abu-Hanna) Amsterdam Public Health
Research Institute, Amsterdam University Medical Centers, University of
Amsterdam, Amsterdam, Netherlands
(Amiri) Informatics Institute, University of Amsterdam, Amsterdam,
Netherlands
(Vis) Department of Cardiology, Amsterdam University Medical Centers,
University of Amsterdam, Amsterdam, Netherlands
(Vis) Amsterdam Cardiovascular Sciences Institute, Amsterdam University
Medical Centers, University of Amsterdam, Amsterdam, Netherlands
(Houterman) Netherlands Heart Registration, Utrecht, Netherlands
Publisher
Frontiers Media SA
Abstract
Background: Federated learning (FL) is a technique for learning prediction
models without sharing records between hospitals. Compared to centralized
training approaches, the adoption of FL could negatively impact model
performance. <br/>Aim(s): This study aimed to evaluate four types of
multicenter model development strategies for predicting 30-day mortality
for patients undergoing transcatheter aortic valve implantation (TAVI):
(1) central, learning one model from a centralized dataset of all
hospitals; (2) local, learning one model per hospital; (3) federated
averaging (FedAvg), averaging of local model coefficients; and (4)
ensemble, aggregating local model predictions. <br/>Method(s): Data from
all 16 Dutch TAVI hospitals from 2013 to 2021 in the Netherlands Heart
Registration (NHR) were used. All approaches were internally validated.
For the central and federated approaches, external geographic validation
was also performed. Predictive performance in terms of discrimination [the
area under the ROC curve (AUC-ROC, hereafter referred to as AUC)] and
calibration (intercept and slope, and calibration graph) was measured.
<br/>Result(s): The dataset comprised 16,661 TAVI records with a 30-day
mortality rate of 3.4%. In internal validation the AUCs of central, local,
FedAvg, and ensemble models were 0.68, 0.65, 0.67, and 0.67, respectively.
The central and local models were miscalibrated by slope, while the FedAvg
and ensemble models were miscalibrated by intercept. During external
geographic validation, central, FedAvg, and ensemble all achieved a mean
AUC of 0.68. Miscalibration was observed for the central, FedAvg, and
ensemble models in 44%, 44%, and 38% of the hospitals, respectively.
<br/>Conclusion(s): Compared to centralized training approaches, FL
techniques such as FedAvg and ensemble demonstrated comparable AUC and
calibration. The use of FL techniques should be considered a viable option
for clinical prediction model development.<br/>Copyright 2024 Yordanov,
Ravelli, Amiri, Vis, Houterman, Van der Voort and Abu-Hanna.

<60>
Accession Number
2030617613
Title
Meta-analysis of BITA versus SITA grafting in diabetic patients: evidence
from propensity score-matched studies.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2024. Date
of Publication: 2024.
Author
Nolan J.; Wijaya A.R.; Harta I.K.A.P.
Institution
(Nolan, Wijaya) Faculty of Medicine, Udayana University, Denpasar,
Indonesia
(Harta) Cardiothoracic and Vascular Surgery Department, Prof IGNG Ngoerah
General Hospital, Denpasar, Indonesia
Publisher
Springer
Abstract
Background: It has been demonstrated that the use of bilateral internal
thoracic artery (BITA) grafting in coronary artery bypass grafting (CABG)
improves long-term survival in comparison to the use of a single internal
thoracic artery (SITA) graft. However, the optimal transplantation
technique for diabetic patients remains undetermined. The purpose of this
meta-analysis was to compare the effectiveness and safety of BITA and SITA
CABG in diabetic patients. <br/>Method(s): A comprehensive search of
Google Scholar, Science Direct, and PubMed was conducted for studies with
propensity score-matched comparing between BITA and SITA grafting in
diabetic patients. The main goal was to know mid- to long-term mortality,
and the supplementary results included incidence of deep sternal wound
infection, 30-day mortality, and incidence of reoperation due to
hemorrhage. <br/>Result(s): The meta-analysis included 11 studies
involving 3762 diabetic patients with matched propensity scores. Compared
to SITA grafting, BITA grafting was associated with a significant
reduction in long-term mortality (HR 0.78; 95% CI 0.67-0.91), P = 0.03,
I² = 54%. There were no significant differences between the two
groups in terms of 30-day mortality, reoperation for bleeding,
cerebrovascular accident, or renal failure. <br/>Conclusion(s): BITA
grafting appears to provide better overall survival than SITA grafting in
patients with diabetes. However, using BITA grafting is associated with a
greater risk of deep sternal wound infection. These findings may help
guide the choice of grafting technique in diabetic patients undergoing
CABG.<br/>Copyright &#xa9; The Author(s), under exclusive licence to The
Japanese Association for Thoracic Surgery 2024.

<61>
Accession Number
644777978
Title
Early anticoagulation after aortic valve replacement with porcine
bioprosthesis randomized control trial(ANTIPRO). 3years follow-up.
Source
International journal of cardiology. (pp 132361), 2024. Date of
Publication: 12 Jul 2024.
Author
Dayan V.; Fernandez A.; Loza G.; Parma G.; Robaina R.; Montero J.;
Gonzalez E.; Brusich D.; Florio L.
Institution
(Dayan, Montero, Gonzalez) Instituto Nacional de Cirugia Cardiaca,
Montevideo, Uruguay; Centro Cardiovascular Universitario, Universidad de
la Republica del Uruguay, Montevideo, Uruguay
(Fernandez, Robaina) Instituto Nacional de Cirugia Cardiaca, Montevideo,
Uruguay
(Loza, Parma, Brusich, Florio) Centro Cardiovascular Universitario,
Universidad de la Republica del Uruguay, Montevideo, Uruguay
Abstract
BACKGROUND: Most evidence for anticoagulation in aortic bioprosthesis is
centered on embolic events, bleeding and re-intervention risk. The effect
of anticoagulation on hemodynamics has not been previously assessed. Our
hypothesis was that patients with anticoagulation (AC) early after aortic
valve replacement (AVR) with porcine bioprosthesis have better
hemodynamics at 3years of follow-up. <br/>METHOD(S): This is a follow-up
evaluation of the ANTIPRO trial. All patients undergoing AVR with porcine
bioprosthesis were consecutively recruited. The AC group received
warfarin+aspirin and the non-AC(control) only aspirin. The primary outcome
was mean gradient after 3years of AVR and change in New York Heart
Association (NYHA) class. Secondary outcomes were major and minor bleeding
and embolic events. <br/>RESULT(S): Of 140 participants in the study, 71
were assigned to the AC group and 69 to the control group. Mean age of the
overall population was 72.4(SD: 7.1) years. Global euroSCORE was 7.65(SD:
5.73). At 3years the mean gradient was similar between both groups
(19.4(SD: 9.6mmHg) and 18.6(SD: 8.2mmHg) in the control and AC group
respectively, p=0.7). No differences in functional class at 3years were
found among groups. No differences were found among groups in the
secondary outcomes. <br/>CONCLUSION(S): The addition of 3months of oral
anticoagulation to anti-aggregation treatment did not affect bioprosthetic
hemodynamics nor functional class at years after AVR.<br/>Copyright &#xa9;
2024. Published by Elsevier B.V.

<62>
Accession Number
644772656
Title
Long-Term Outcomes of Mechanical versus Bioprosthetic Aortic Valve
Replacement in Patients Under 50 Years Old: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 12 Jul 2024.
Author
Warraich N.; Sa M.P.; Jacqueymn X.; Ahmad D.; Serna-Gallegos D.; Sultan I.
Institution
(Warraich, Sa, Ahmad, Serna-Gallegos, Sultan) Division of Cardiac Surgery,
Department of Cardiothoracic Surgery, University of Pittsburgh; UPMC Heart
and Vascular Institute, University of Pittsburgh Medical Center
(Jacqueymn) KU Leuven, Belgium
Abstract
To compare long-term outcomes of mechanical versus bioprosthetic aortic
valve replacement (AVR) in patients under the age of 50, we performed a
study-level meta-analysis with reconstructed time-to-event data including
studies published by December of 2023. The primary outcome was overall
survival. Secondary outcomes included reoperation, major bleeding, and
stroke. Five studies met our inclusion criteria with a total of 4245
patients (2311 mechanical, 1934 bioprosthetic). All studies were
observational and the mean age of groups across the studies ranged from
38.2 to 43.0 years. The median follow-up time was 11.4 years (IQR,
6.9-15.0). Bioprosthetic AVR was associated with reduced overall survival
and higher risk of all-cause death (HR, 1.170 [95% CI, 1.002-1.364],
P=0.046), increased risk of reoperation over time (HR, 2.581, [95% CI,
2.102-3.168], P<0.001), decreased risk of major bleeding (HR, 0.500, [95%
CI, 0.367-0.682], P<0.001), and decreased risk of stroke (HR, 0.751, [95%
CI, 0.565-0.998], P=0.049) compared to mechanical AVR in patients under
50. In conclusion, for patients under the age of 50, bioprosthetic AVR is
associated with increased mortality and risk of reoperation compared to
mechanical valves. On the other hand, mechanical AVR is associated with an
increased risk of major bleeding events and stroke. These aspects should
be carefully considered during the selection of valve type in this age
group; however, we should keep in mind that the statistically significant
differences in the risk of all-cause death and stroke might not be
clinically relevant (due to marginal statistical
significance).<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<63>
Accession Number
2033385558
Title
Use of Direct Oral Anticoagulants in Patients With Peripheral Artery
Disease: A Meta-Analysis.
Source
American Journal of Cardiology. 226 (pp 34-35), 2024. Date of Publication:
01 Sep 2024.
Author
Ahmed A.; Hamed M.; Abozaid A.; Elkheshen A.; Fisher M.; Khalife W.; Jneid
H.; Banerjee S.; Elbadawi A.
Institution
(Ahmed) Department of Internal Medicine, Rochester General Hospital,
Rochester, New York, United States
(Hamed, Fisher) Division of Cardiology, Florida Atlantic University, Boca
Raton, FL, United States
(Abozaid) Division of Cardiology, Ain Shams University, Cairo, Egypt
(Elkheshen) Department of Internal Medicine, Texas Tech University Health,
Lubbock, TX, United States
(Khalife, Jneid) Division of Cardiology, University of Texas Medical
Branch, Galveston, Texas, United States
(Banerjee) Division of Cardiology, Baylor University, Dallas, Texas,
United States
(Elbadawi) Division of Cardiology, Christus Good Shepherd Medical Center,
Longview, TX, United States
(Elbadawi) Texas A&M School of Medicine, Bryan, Texas, United States
Publisher
Elsevier Inc.

<64>
Accession Number
2033321287
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. 45(27) (pp 2380-2391), 2024. Date of Publication:
14 Jul 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, United Kingdom
(de Winter) Department of Cardiology Heart Center, Amsterdam UMC,
Universiteit van Amsterdam, Amsterdam, Netherlands
(de Winter) Department of Cardiology, Amsterdam UMC, Vrije Universiteit
Amsterdam, Amsterdam, Netherlands
(Bendz) Department of Cardiology, Oslo University Hospital, Institute of
Clinical Medicine, University of Oslo, Oslo, Norway
(Thiele) Heart Center Leipzig, 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), Medpace UK, London, United Kingdom
(Michalis) Department of Cardiology, Faculty of Medicine, School of Health
Sciences, University of Ioannina, University Hospital of Ioannina,
University Campus, Ioannina 45110, Greece
(Sanchis) Cardiology Department, University Clinic Hospital of Valencia,
INCLIVA University of Valencia, CIBER CV, Valencia, Spain
(Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne
Hospitals NHS Foundation Trust and Translational, 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
Publisher
Oxford University Press
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. Methods 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. Results 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). Conclusions
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.<br/>Copyright &#xa9; The Author(s) 2024.

<65>
Accession Number
2033317575
Title
Controversy. on pump or off pump: What will i do when i grow up? A
narrative systematic review.
Source
European Journal of Cardio-thoracic Surgery. 66(1) (no pagination), 2024.
Article Number: ezae256. Date of Publication: 01 Jul 2024.
Author
Calafiore A.M.; Torregrossa G.; Salerno T.A.; Prapas S.; Benetti F.;
Angelini G.D.; Lima R.D.C.; Di Mauro M.; Taggart D.; Gaudino M.; Puskas
J.D.
Institution
(Calafiore, Prapas) 1st Department of Cardiac Surgery, Henry Dunant
Hospital, Athens, Greece
(Torregrossa) Department of Cardiac Surgery, Lankenau Heart Institute,
Lankenau Medical Center, Main Line Health, Wynnewood, PA, United States
(Salerno) Department of Surgery, Leonard M. Miller School of Medicine,
University of Miami, Miami, FL, United States
(Benetti) Benetti Foundation, Rosario, Argentina
(Angelini) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, Bristol, United Kingdom
(Lima) Department of Cardiovascular Surgery, Faculty of Medical Science,
University of Pernambuco, Recife, Brazil
(Di Mauro) Department of Cardiothoracic Surgery, Cardio-Thoracic Surgery
Unit, Heart and Vascular Centre, Maastricht University Medical Centre
(MUMC), Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Di Mauro) Department of Cardiology, Pierangeli Hospital, Pescara, Italy
(Taggart) Nuffield Department of Surgical Sciences, University of Oxford,
John Radcliffe Hospital, Oxford, United Kingdom
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Hospital, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
The transition from the second to the third millennium happened to be a
turning point in the history of myocardial revascularization on a beating
heart, which moved from technical development to critical evaluation. This
article describes how the initial acceptance and spread of off-pump
coronary artery bypass grafting (OPCABG) was followed by the general
perception that the technique could not fulfill the expectations placed in
it and provides some insight on what should we do with the know-how of
OPCABG in the present and the future of coronary surgical
revascularization.<br/>Copyright &#xa9; 2024 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<66>
Accession Number
2033301104
Title
The Tennessee Heart Health Network effectiveness study: A stepped wedge
cluster randomized controlled trial to assess the effectiveness of
statewide quality improvement cooperative participation on cardiovascular
outcomes.
Source
Contemporary Clinical Trials. 144 (no pagination), 2024. Article Number:
107616. Date of Publication: September 2024.
Author
Surbhi S.; Mahmood A.; Grant C.C.; Mzayek F.; Mamudu H.M.; Butterworth S.;
Ellis A.; Ogunsanmi D.; Chen M.; Ride J.; Hunt G.; Bailey J.E.
Institution
(Surbhi, Mahmood, Grant, Mzayek, Mamudu, Butterworth, Ellis, Ogunsanmi,
Chen, Ride, Hunt, Bailey) Tennessee Population Health Consortium,
University of Tennessee Health Science Center, Memphis, TN, United States
(Surbhi, Mahmood, Grant, Mzayek, Mamudu, Butterworth, Ellis, Ogunsanmi,
Chen, Hunt, Bailey) Center for Health System Improvement, University of
Tennessee Health Science Center, Memphis, TN, United States
(Surbhi, Mahmood, Butterworth, Bailey) Division of General Internal
Medicine, Department of Medicine, University of Tennessee Health Science
Center, Memphis, TN, United States
(Mzayek) Division of Epidemiology, Biostatistics, and Environmental
Health, School of Public Health, University of Memphis, Memphis, TN,
United States
(Surbhi, Grant, Bailey) Department of Preventive Medicine, University of
Tennessee Health Science Center, Memphis, TN, United States
(Mamudu) Department of Health Services Management and Policy, College of
Public Health, East Tennessee State University, Johnson City, TN, United
States
(Mamudu) Center for Cardiovascular Risk Research, College of Public
Health, East Tennessee State University, Johnson City, TN, United States
(Ellis) College of Pharmacy, University of Tennessee Health Science
Center, Memphis, TN, United States
(Ogunsanmi, Chen) Institute for Health Outcomes and Policy, College of
Graduate Health Sciences, University of Tennessee Health Science Center,
Memphis, TN, United States
(Ride) QSource, Center for Health System Improvement, College of Medicine,
University of Tennessee Health Science Center, 956 Court Ave, Coleman
D224, Memphis, TN 38163, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiovascular disease (CVD) is the primary cause of premature
morbidity and mortality in the United States and Tennessee ranks among the
highest in CVD events. While patient-centered outcomes research (PCOR)
evidence-based approaches that reach beyond the traditional doctor-patient
visit hold promise to improve CVD care and prevent serious complications,
most primary care providers lack time, knowledge, and infrastructure to
implement these proven approaches. Statewide primary care quality
improvement (QI) collaboratives hold potential to help address primary
care needs, however, little is known regarding their effectiveness in
improving uptake of PCOR evidence-based population health approaches and
improving CVD outcomes. This study describes the design and implementation
of a stepped-wedge cluster randomized controlled trial to assess the
effectiveness of participation in a statewide quality improvement
cooperative (The Tennessee Heart Health Network [TN-HHN]) on
cardiovascular outcomes. Methods/design: The TN-HHN Effectiveness Study
randomized 77 practices to 4 waves (i.e., clusters), with each wave
beginning three months after the start of the prior wave and lasting for
18 months. All practice clusters received one of three Network
interventions, and outcomes are measured for each three months both in the
control phase and the intervention phase. Primary outcomes include Center
for Medicare and Medicaid Services measures for aspirin use, blood
pressure control, cholesterol control, and smoking cessation (ABCS).
<br/>Conclusion(s): This trial, upon its conclusion, will allow us to
assess the effect of participation in a statewide quality improvement
cooperative on cardiovascular outcomes as well as key contributors to
successful practice transformation.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<67>
Accession Number
2033295562
Title
Vitamin D for the Prevention of Disease: An Endocrine Society Clinical
Practice Guideline.
Source
Journal of Clinical Endocrinology and Metabolism. 109(8) (pp 1907-1947),
2024. Date of Publication: 01 Aug 2024.
Author
Demay M.B.; Pittas A.G.; Bikle D.D.; Diab D.L.; Kiely M.E.;
Lazaretti-Castro M.; Lips P.; Mitchell D.M.; Murad M.H.; Powers S.; Rao
S.D.; Scragg R.; Tayek J.A.; Valent A.M.; Walsh J.M.E.; McCartney C.R.
Institution
(Demay) Department of Medicine, Endocrine Unit, Massachusetts General
Hospital, Harvard Medical School, Boston, MA 02114, United States
(Pittas) Division of Endocrinology, Diabetes and Metabolism, Department of
Medicine, Tufts Medical Center, Boston, MA 02111, United States
(Bikle) Departments of Medicine and Dermatology, University of California
San Francisco, San Francisco VA Medical Center, San Francisco, CA 94158,
United States
(Diab) Department of Internal Medicine, Division of Endocrinology,
Diabetes and Metabolism, University of Cincinnati, Cincinnati, OH 45267,
United States
(Kiely) Cork Centre for Vitamin D and Nutrition Research, School of Food
and Nutritional Sciences, INFANT Research Centre, University College Cork,
Cork T12 Y337, Ireland
(Lazaretti-Castro) Department of Internal Medicine, Division of
Endocrinology, Universidade Federal de Sao Paulo, Sao Paulo 04220-00,
Brazil
(Lips) Endocrine Section, Amsterdam University Medical Center, Internal
Medicine, Amsterdam 1007 MB, Netherlands
(Mitchell) Pediatric Endocrine Unit, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, United States
(Murad) Evidence-Based Practice Center, Mayo Clinic, Rochester, MN 55905,
United States
(Powers) Bone Health and Osteoporosis Foundation, Los Gatos, CA 95032,
United States
(Rao) Division of Endocrinology, Diabetes and Bone & Mineral Disorders,
Henry Ford Health, Detroit, MI 48202, United States
(Rao) College of Human Medicine, Michigan State University, Lansing, MI
48824, United States
(Scragg) School of Population Health, The University of Auckland, Auckland
1142, New Zealand
(Tayek) Department of Internal Medicine, Harbor-UCLA Medical Center,
Torrance, CA 90509, United States
(Tayek) The Lundquist Institute, Torrance, CA 90502, United States
(Valent) Department of Obstetrics & Gynecology, Oregon Health & Science
University, Portland, OR 97239, United States
(Walsh) Division of General Internal Medicine, Department of Medicine,
University of California San Francisco, San Francisco, CA 94143, United
States
(McCartney) Department of Medicine, University of Virginia,
Charlottesville, VA 22908, United States
(McCartney) Department of Medicine, West Virginia University, Morgantown,
WV 26506, United States
Publisher
Endocrine Society
Abstract
Background: Numerous studies demonstrate associations between serum
concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common
disorders, including musculoskeletal, metabolic, cardiovascular,
malignant, autoimmune, and infectious diseases. Although a causal link
between serum 25(OH)D concentrations and many disorders has not been
clearly established, these associations have led to widespread
supplementation with vitamin D and increased laboratory testing for
25(OH)D in the general population. The benefit-risk ratio of this increase
in vitamin D use is not clear, and the optimal vitamin D intake and the
role of testing for 25(OH)D for disease prevention remain uncertain.
<br/>Objective(s): To develop clinical guidelines for the use of vitamin D
(cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the
risk of disease in individuals without established indications for vitamin
D treatment or 25(OH)D testing. <br/>Method(s): A multidisciplinary panel
of clinical experts, along with experts in guideline methodology and
systematic literature review, identified and prioritized 14 clinically
relevant questions related to the use of vitamin D and 25(OH)D testing to
lower the risk of disease. The panel prioritized randomized
placebo-controlled trials in general populations (without an established
indication for vitamin D treatment or 25[OH]D testing), evaluating the
effects of empiric vitamin D administration throughout the lifespan, as
well as in select conditions (pregnancy and prediabetes). The panel
defined "empiric supplementation" as vitamin D intake that (a) exceeds the
Dietary Reference Intakes (DRI) and (b) is implemented without testing for
25(OH)D. Systematic reviews queried electronic databases for publications
related to these 14 clinical questions. The Grading of Recommendations,
Assessment, Development, and Evaluation (GRADE) methodology was used to
assess the certainty of evidence and guide recommendations. The approach
incorporated perspectives from a patient representative and considered
patient values, costs and resources required, acceptability and
feasibility, and impact on health equity of the proposed recommendations.
The process to develop this clinical guideline did not use a risk
assessment framework and was not designed to replace current DRI for
vitamin D. <br/>Result(s): The panel suggests empiric vitamin D
supplementation for children and adolescents aged 1 to 18 years to prevent
nutritional rickets and because of its potential to lower the risk of
respiratory tract infections; for those aged 75 years and older because of
its potential to lower the risk of mortality; for those who are pregnant
because of its potential to lower the risk of preeclampsia, intra-uterine
mortality, preterm birth, small-for-gestational-age birth, and neonatal
mortality; and for those with high-risk prediabetes because of its
potential to reduce progression to diabetes. Because the vitamin D doses
in the included clinical trials varied considerably and many trial
participants were allowed to continue their own vitamin D-containing
supplements, the optimal doses for empiric vitamin D supplementation
remain unclear for the populations considered. For nonpregnant people
older than 50 years for whom vitamin D is indicated, the panel suggests
supplementation via daily administration of vitamin D, rather than
intermittent use of high doses. The panel suggests against empiric vitamin
D supplementation above the current DRI to lower the risk of disease in
healthy adults younger than 75 years. No clinical trial evidence was found
to support routine screening for 25(OH)D in the general population, nor in
those with obesity or dark complexion, and there was no clear evidence
defining the optimal target level of 25(OH)D required for disease
prevention in the populations considered; thus, the panel suggests against
routine 25(OH)D testing in all populations considered. The panel judged
that, in most situations, empiric vitamin D supplementation is
inexpensive, feasible, acceptable to both healthy individuals and health
care professionals, and has no negative effect on health equity.
<br/>Conclusion(s): The panel suggests empiric vitamin D for those aged 1
to 18 years and adults over 75 years of age, those who are pregnant, and
those with high-risk prediabetes. Due to the scarcity of natural food
sources rich in vitamin D, empiric supplementation can be achieved through
a combination of fortified foods and supplements that contain vitamin D.
Based on the absence of supportive clinical trial evidence, the panel
suggests against routine 25(OH)D testing in the absence of established
indications. These recommendations are not meant to replace the current
DRIs for vitamin D, nor do they apply to people with established
indications for vitamin D treatment or 25(OH)D testing. Further research
is needed to determine optimal 25(OH)D levels for specific health
benefits.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the Endocrine Society. All rights reserved.

<68>
Accession Number
2031490889
Title
Hybrid Interventions in Congenital Heart Disease: A Review of Current
Practice and Rationale for Use.
Source
Annals of Thoracic Surgery. 118(2) (pp 329-337), 2024. Date of
Publication: August 2024.
Author
Zampi J.D.; Sower C.T.; Lancaster T.S.; Sood V.; Romano J.C.
Institution
(Zampi, Sower) Division of Pediatric Cardiology, Department of Pediatrics,
University of Michigan, Ann Arbor, MI, United States
(Lancaster, Sood, Romano) Section of Pediatric Cardiovascular Surgery,
Department of Surgery, University of Michigan, Ann Arbor, MI, United
States
Publisher
Elsevier Inc.
Abstract
Background: Hybrid interventions have become a common option in the
management for a variety of patients with congenital heart disease. In
this review, we discuss the data that have driven decision making about
hybrid interventions to date. <br/>Method(s): The existing literature on
various hybrid approaches was reviewed and summarized. In addition, the
key tenants to creating a successful hybrid program within a congenital
heart center are elucidated. <br/>Result(s): Hybrid strategies for
single-ventricle patients, pulmonary atresia with intact ventricular
septum, branch pulmonary artery stenosis, and muscular ventricular septal
defect closure have important benefits and limitations compared with
traditional approaches. <br/>Conclusion(s): A growing body of evidence
supports the use of hybrid interventions in congenital heart disease. But
important questions remain regarding improved survival and other long-term
outcomes, such as neurocognition, that might impact widespread adoption as
a primary treatment strategy.<br/>Copyright &#xa9; 2024 The Society of
Thoracic Surgeons

<69>
Accession Number
2031490582
Title
Preoperative Variables of 30-Day Mortality in Adults Undergoing
Percutaneous Coronary Intervention: A Systematic Review.
Source
Heart Lung and Circulation. 33(7) (pp 951-961), 2024. Date of Publication:
July 2024.
Author
Chowdhury M.R.K.; Stub D.; Dinh D.; Karim M.N.; Siddiquea B.N.; Billah B.
Institution
(Chowdhury, Stub, Dinh, Karim, Siddiquea, Billah) Department of
Epidemiology and Preventive Medicine, School of Public Health and
Preventive Medicine, Monash University, Melbourne, VIC, Australia
(Stub) Department of Cardiology, The Alfred Hospital, Melbourne, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background and Aim: Risk adjustment following percutaneous coronary
intervention (PCI) is vital for clinical quality registries, performance
monitoring, and clinical decision-making. There remains significant
variation in the accuracy and nature of risk adjustment models utilised in
international PCI registries/databases. Therefore, the current systematic
review aims to summarise preoperative variables associated with 30-day
mortality among patients undergoing PCI, and the other methodologies used
in risk adjustments. <br/>Method(s): The MEDLINE, EMBASE, CINAHL, and Web
of Science databases until October 2022 without any language restriction
were systematically searched to identify preoperative independent
variables related to 30-day mortality following PCI. Information was
systematically summarised in a descriptive manner following the Checklist
for critical Appraisal and data extraction for systematic Reviews of
prediction Modelling Studies checklist. The quality and risk of bias of
all included articles were assessed using the Prediction Model Risk Of
Bias Assessment Tool. Two independent investigators took part in screening
and quality assessment. <br/>Result(s): The search yielded 2,941 studies,
of which 42 articles were included in the final assessment. Logistic
regression, Cox-proportional hazard model, and machine learning were
utilised by 27 (64.3%), 14 (33.3%), and one (2.4%) article, respectively.
A total of 74 independent preoperative variables were identified that were
significantly associated with 30-day mortality following PCI. Variables
that repeatedly used in various models were, but not limited to, age
(n=36, 85.7%), renal disease (n=29, 69.0%), diabetes mellitus (n=17,
40.5%), cardiogenic shock (n=14, 33.3%), gender (n=14, 33.3%), ejection
fraction (n=13, 30.9%), acute coronary syndrome (n=12, 28.6%), and heart
failure (n=10, 23.8%). Nine (9; 21.4%) studies used missing values
imputation, and 15 (35.7%) articles reported the model's performance
(discrimination) with values ranging from 0.501 (95% confidence interval
[CI] 0.472-0.530) to 0.928 (95% CI 0.900-0.956), and four studies (9.5%)
validated the model on external/out-of-sample data. <br/>Conclusion(s):
Risk adjustment models need further improvement in their quality through
the inclusion of a parsimonious set of clinically relevant variables,
appropriately handling missing values and model validation, and utilising
machine learning methods.<br/>Copyright &#xa9; 2024 The Authors

<70>
Accession Number
2030614401
Title
Reverse left ventricular remodeling after aortic valve replacement for
aortic stenosis: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1407566. Date of Publication: 2024.
Author
Sousa Nunes F.; Amaral Marques C.; Isabel Pinho A.; Sousa-Pinto B.; Beco
A.; Ricardo Silva J.; Saraiva F.; Macedo F.; Leite-Moreira A.; Sousa C.
Institution
(Sousa Nunes, Beco, Ricardo Silva, Saraiva, Leite-Moreira, Sousa)
Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology,
Faculty of Medicine of the University of Porto, Porto, Portugal
(Sousa Nunes) Department of Cardiology, Local Health Unit of Gaia and
Espinho, Vila Nova de Gaia, Portugal
(Amaral Marques, Isabel Pinho, Macedo, Leite-Moreira, Sousa) Department of
Cardiology, Local Health Unit of Sao Joao, Porto, Portugal
(Sousa-Pinto) MEDCIDS-Department of Community Medicine, Information and
Health Decision Sciences, Faculty of Medicine, University of Porto, Porto,
Portugal
(Sousa-Pinto) CINTESIS@RISE-Health Research Network, MEDCIDS, Faculty of
Medicine, University of Porto, Porto, Portugal
Publisher
Frontiers Media SA
Abstract
Reverse left ventricular (LV) remodeling after aortic valve replacement
(AVR), in patients with aortic stenosis, is well-documented as an
important prognostic factor. With this systematic review and
meta-analysis, we aimed to characterize the response of the unloaded LV
after AVR. We searched on MEDLINE/PubMed and Web of Science for studies
reporting echocardiographic findings before and at least 1 month after AVR
for the treatment of aortic stenosis. In total, 1,836 studies were
identified and 1,098 were screened for inclusion. The main factors of
interest were structural and dynamic measures of the LV and aortic valve.
We performed a random-effects meta-analysis to compute standardized mean
differences (SMD) between follow-up and baseline values for each outcome.
Twenty-seven studies met the eligibility criteria, yielding 11,751
patients. AVR resulted in reduced mean aortic gradient (SMD: (Formula
presented.) mmHg, 95% CI: (Formula presented.) to (Formula presented.),
(Formula presented.)), LV mass (SMD: (Formula presented.) g, 95% CI:
(Formula presented.) to (Formula presented.), (Formula presented.)),
end-diastolic LV diameter (SMD: (Formula presented.) mm, 95% CI: (Formula
presented.) to (Formula presented.), (Formula presented.)), end-diastolic
LV volume (SMD: (Formula presented.) ml, 95% CI: (Formula presented.) to
3.51, (Formula presented.)), increased effective aortic valve area (SMD:
1.10 cm², 95% CI: 1.01 to 1.20, (Formula presented.)), and LV
ejection fraction (SMD: 2.35%, 95% CI: 1.31 to 3.40%, (Formula
presented.)). Our results characterize the extent to which reverse
remodeling is expected to occur after AVR. Notably, in our study, reverse
remodeling was documented as soon as 1 month after AVR.<br/>Copyright 2024
Sousa Nunes, Amaral Marques, Isabel Pinho, Sousa-Pinto, Beco, Ricardo
Silva, Saraiva, Macedo, Leite-Moreira and Sousa.

<71>
Accession Number
2030599688
Title
Natural history of initially asymptomatic severe aortic stenosis: a
one-stage meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Tan J.T.A.; He G.S.; Chia J.L.L.; Tan G.Q.X.; Teo Y.N.; Teo Y.H.; Syn
N.L.; Chai P.; Wong R.C.C.; Yeo T.-C.; Kong W.K.F.; Poh K.-K.; Sia C.-H.
Institution
(Tan, He, Chia, Tan, Teo, Syn, Chai, Wong, Yeo, Kong, Poh, Sia) Department
of Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Teo) Department of Medicine, National University Hospital, Singapore,
Singapore
(Chai, Wong, Yeo, Kong, Poh, Sia) Department of Cardiology, National
University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block
Level 9, Singapore 119228, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Current guidelines on the management strategy for patients
with asymptomatic severe aortic stenosis (AS) remain unclear. This
uncertainty stems from the lack of data regarding the natural history of
these patients. To address this gap, we performed a systematic review and
meta-analysis examining the natural history of asymptomatic severe AS
patients receiving conservative treatment. <br/>Method(s): The PubMed,
Cochrane, and Embase databases were searched from inception to 24 January
2024 using the keywords "asymptomatic" AND "aortic" AND "stenosis". We
included studies examining patients with asymptomatic severe AS. In
interventional trials, only data from conservatively managed arms were
collected. A one-stage meta-analysis was conducted using individual
patient data reconstructed from published Kaplan-Meier curves. Sensitivity
analysis was performed for major adverse cardiovascular outcomes in
patients who remained asymptomatic throughout follow-up. <br/>Result(s): A
total of 46 studies were included (n = 9545). The median time to the
development of symptoms was 1.11 years (95% CI 0.90-1.53). 49.36%
(40.85-58.59) of patients who were asymptomatic had suffered a major
adverse cardiovascular event by 5 years. The median event-free time for
heart failure hospitalization (HFH) was 5.50 years (95% CI 5.14-5.91) with
36.34% (95% CI 33.34-39.41) of patients experiencing an HFH by year 5. By
5 years, 79.81% (95% CI 69.26-88.58) of patients developed symptoms
(angina, dyspnoea, syncope and others) and 12.36% (95% CI 10.01-15.22) of
patients died of cardiovascular causes. For all-cause mortality, the
median survival time was 9.15 years (95% CI 8.50-9.96) with 39.43% (CI
33.41-36.40) of patients dying by 5 years. The median time to AVR was 4.77
years (95% CI 4.39-5.17), with 52.64% (95% CI 49.85-55.48) of patients
requiring an AVR by 5 years. <br/>Conclusion(s): Our results reveal poor
cardiovascular outcomes for patients with asymptomatic severe AS on
conservative treatment. A significant proportion eventually requires an
AVR. Further research is needed to determine if early intervention with
AVR is more effective than conservative treatment.<br/>Copyright &#xa9;
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<72>
Accession Number
644112827
Title
Regional antibiotic delivery for sternal wound infection prophylaxis a
systematic review and meta-analysis of randomized controlled trials.
Source
Scientific reports. 14(1) (pp 9690), 2024. Date of Publication: 27 Apr
2024.
Author
Kowalewski M.; Kolodziejczak M.M.; Urbanowicz T.; De Piero M.E.; Mariani
S.; Pasierski M.; Makhoul M.; Comanici M.; Dabrowski E.J.; Matteucci M.;
Massimi G.; Litwinowicz R.; Kowalowka A.; Wanha W.; Jiritano F.; Martucci
G.; Raffa G.M.; Malvindi P.G.; Kuzma L.; Suwalski P.; Lorusso R.; Meani
P.; Lazar H.
Institution
(Kowalewski, Pasierski, Suwalski) Clinical Department of Cardiac Surgery
and Transplantology, National Medical Institute of the Ministry of
Interior and Administration, Woloska 137, Warsaw 02-507, Poland
(Kowalewski, De Piero, Mariani, Matteucci, Massimi, Lorusso)
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Kowalewski, Kolodziejczak, Urbanowicz, Pasierski, Makhoul, Matteucci,
Massimi, Litwinowicz, Kowalowka, Wanha, Jiritano, Martucci, Raffa,
Malvindi, Suwalski, Meani) Thoracic Research Centre, Innovative Medical
Forum, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan
University of Medical Sciences, Poznan, Poland
(Makhoul, Comanici) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
(Dabrowski, Kuzma) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok, Poland
(Matteucci) Cardiac Surgery Unit, Department of Medicine and Surgery, ASST
dei Sette Laghi, University of Insubria, Varese, Italy
(Massimi) Cardiac Surgery Unit, Santa Maria della Misericordia Hospital,
Perugia, Italy
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Upper-Silesian Heart Center, Medical University of Silesia, Katowice,
Poland
(Wanha) Department of Invasive Cardiology, School of Medicine in Katowice,
Medical University of Silesia, Katowice, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo Per i trapianti e Terapie ad alta specializzazione
(IRCCS-ISMETT), Palermo, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti Delle Marche, Polytechnic University of Marche, Ancona, Italy
(Meani) Department of Cardiothoracic and Vascular Anesthesia and Intensive
Care Unit, IRCCS Policlinico, San Donato Milanese, Milan, Italy
(Lazar) Boston University School of Medicine, Boston, MA, United States
Abstract
Despite evidence suggesting the benefit of prophylactic regional
antibiotic delivery (RAD) to sternal edges during cardiac surgery, it is
seldom performed in clinical practice. The value of topical vancomycin and
gentamicin for sternal wound infections (SWI) prophylaxis was further
questioned by recent studies including randomized controlled trials
(RCTs). The aim of this systematic review and meta-analysis was to
comprehensively assess the safety and effectiveness of RAD to reduce the
risk of SWI.We screened multiple databases for RCTs assessing the
effectiveness of RAD (vancomycin, gentamicin) in SWI prophylaxis. Random
effects meta-analysis was performed. The primary endpoint was any SWI;
other wound complications were also analysed. Odds Ratios served as the
primary statistical analyses. Trial sequential analysis (TSA) was
performed.Thirteen RCTs (N=7,719 patients) were included. The odds of any
SWI were significantly reduced by over 50% with any RAD: OR (95%CIs): 0.49
(0.35-0.68); p<0.001 and consistently reduced in vancomycin (0.34
[0.18-0.64]; p<0.001) and gentamicin (0.58 [0.39-0.86]; p=0.007) groups
(psubgroup=0.15). Similarly, RAD reduced the odds of SWI in diabetic and
non-diabetic patients (0.46 [0.32-0.65]; p<0.001 and 0.60 [0.44-0.83];
p=0.002 respectively). Cumulative Z-curve passed the TSA-adjusted boundary
for SWIs suggesting adequate power has been met and no further trials are
needed. RAD significantly reduced deep (0.60 [0.43-0.83]; p=0.003) and
superficial SWIs (0.54 [0.32-0.91]; p=0.02). No differences were seen in
mediastinitis and mortality, however, limited number of studies assessed
these endpoints. There was no evidence of systemic toxicity, sternal
dehiscence and resistant strains emergence. Both vancomycin and gentamicin
reduced the odds of cultures outside their respective serum
concentrations' activity: vancomycin against gram-negative strains: 0.20
(0.01-4.18) and gentamicin against gram-positive strains: 0.42
(0.28-0.62); P<0.001. Regional antibiotic delivery is safe and effectively
reduces the risk of SWI in cardiac surgery patients.<br/>Copyright &#xa9;
2024. The Author(s).

<73>
Accession Number
644763592
Title
Erratum: Author Correction: Regional antibiotic delivery for sternal wound
infection prophylaxis a systematic review and meta-analysis of randomized
controlled trials (Scientific reports (2024) 14 1 DOI:
10.1038/s41598-024-60242-z).
Source
Scientific reports. 14(1) (pp 16283), 2024. Date of Publication: 15 Jul
2024.
Author
Kowalewski M.; Kolodziejczak M.M.; Urbanowicz T.; De Piero M.E.; Mariani
S.; Pasierski M.; Makhoul M.; Comanici M.; Dabrowski E.J.; Matteucci M.;
Massimi G.; Litwinowicz R.; Kowalowka A.; Wanha W.; Jiritano F.; Martucci
G.; Raffa G.M.; Malvindi P.G.; Kuzma L.; Suwalski P.; Lorusso R.; Meani
P.; Lazar H.
Institution
(Kowalewski, Pasierski, Suwalski) Clinical Department of Cardiac Surgery
and Transplantology, National Medical Institute of the Ministry of
Interior and Administration, Woloska 137, Warsaw 02-507, Poland
(Kowalewski, De Piero, Mariani, Matteucci, Massimi, Lorusso)
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Kowalewski, Kolodziejczak, Urbanowicz, Pasierski, Makhoul, Matteucci,
Massimi, Litwinowicz, Kowalowka, Wanha, Jiritano, Malvindi, Suwalski,
Meani) Thoracic Research Centre, Innovative Medical Forum, Collegium
Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan
University of Medical Sciences, Poznan, Poland
(Makhoul, Comanici) Department of Cardiac Surgery, Harefield Hospital,
London, United Kingdom
(Dabrowski, Kuzma) Department of Invasive Cardiology, Medical University
of Bialystok, Bialystok, Poland
(Matteucci) Cardiac Surgery Unit, Department of Medicine and Surgery, ASST
dei Sette Laghi, University of Insubria, Varese, Italy
(Massimi) Cardiac Surgery Unit, Santa Maria della Misericordia Hospital,
Perugia, Italy
(Litwinowicz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Kowalowka) Department of Cardiac Surgery, Faculty of Medical Sciences,
Upper-Silesian Heart Center, Medical University of Silesia, Katowice,
Poland
(Wanha) Department of Invasive Cardiology, School of Medicine in Katowice,
Medical University of Silesia, Katowice, Poland
(Jiritano) Department of Experimental and Clinical Medicine, Magna Graecia
University, Catanzaro, Italy
(Martucci) Department of Anesthesia and Intensive Care, Istituto
Mediterraneo Per i trapianti e Terapie ad alta specializzazione
(IRCCS-ISMETT), Palermo, Italy
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali
Riuniti Delle Marche, Polytechnic University of Marche, Ancona, Italy
(Meani) Department of Cardiothoracic and Vascular Anesthesia and Intensive
Care Unit, IRCCS Policlinico, San Donato Milanese, Milan, Italy
(Lazar) Boston University School of Medicine, Boston, MA, United States

<74>
Accession Number
2030618295
Title
Efficacy and safety of pulsed-field versus conventional thermal ablation
for atrial fibrillation: A systematic review and meta-analysis.
Source
Journal of Arrhythmia. (no pagination), 2024. Date of Publication: 2024.
Author
Amin A.M.; Nazir A.; Abuelazm M.T.; Ibrahim A.A.; Elbenawi H.; Aboutaleb
A.; Ellabban M.; Arnaout M.; Turkmani M.; Abdelazeem B.; Volgman A.S.
Institution
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nazir) Faculty of Medicine, King Edward Medical University, Lahore,
Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Ibrahim) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Aboutaleb) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Ellabban) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Arnaout) Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab
Republic
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Department of Internal Medicine, McLaren Health Care-Oakland,
Pontiac, MI, United States
(Abdelazeem) Department of Cardiology, West Virginia University, West, VA,
United States
(Volgman) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Pulsed-field ablation (PFA) has emerged as an innovative
alternative to radiofrequency (RF) and cryoablation because it selectively
targets myocardial tissue. Thus, we aim to estimate the efficacy and
safety of PFA versus thermal ablation for atrial fibrillation (AF)
ablation. <br/>Method(s): A systematic review and meta-analysis were
retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September
2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR)
and continuous data using mean difference (MD) with a 95% confidence
interval (CI). PROSPERO ID: CRD42023480321. <br/>Result(s): We included 17
studies with a total of 2255 patients. PFA was significantly associated
with a decreased incidence of AF recurrence (RR: 0.66 with 95% CI [0.51,
0.87], p =.003). However, there was no significant difference between PFA
and thermal ablation in arrhythmia recurrence (RR: 0.92 with 95% CI [0.74,
1.46], p =.42). PFA was significantly associated with decreased total
procedure time (MD: -15.15 with 95% CI [-20.23, -10.07], p <.00001),
decreased heart rate change (MD: -7.39 with 95% CI [-12.16, -2.62], p
=.002), decreased phrenic nerve palsy (RR: 0.38 with 95% CI [0.15, 0.98],
p =.05), and reduced esophageal lesions (RR: 0.09 with 95% CI [0.01,
0.69], p =.02). On the contrary, PFA was significantly associated with
increased pericardial tamponade (RR: 6.14 with 95% CI [1.43, 26.33], p
=.01). <br/>Conclusion(s): PFA was significantly associated with decreased
AF recurrence, total procedure time, heart rate change, phrenic nerve
palsy, esophageal lesion, and increased incidence of pericardial tamponade
compared with thermal ablation.<br/>Copyright &#xa9; 2024 The Author(s).
Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on
behalf of Japanese Heart Rhythm Society.

<75>
Accession Number
644762778
Title
Safety and Effectiveness of Acceleration Training as Cardiac
Rehabilitation Immediately After Open Heart Surgery- A Pilot Study.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2024. Date of Publication: 13 Jul 2024.
Author
Kanazawa Y.; Saito S.; Okubo S.; Matsuoka T.; Hirota S.; Yokoyama S.;
Tezuka M.; Takei Y.; Tsuchiya G.; Konishi T.; Ogata K.; Shibasaki I.;
Nakajima T.; Fukuda H.
Institution
(Kanazawa, Okubo, Matsuoka, Hirota, Yokoyama, Tezuka, Takei, Tsuchiya,
Konishi, Ogata, Shibasaki, Fukuda) Department of Cardiac and Vascular
Surgery, School of Medicine, Dokkyo Medical University
(Saito) Division of Cardiovascular Surgery, Department of Surgery, Osaka
University
(Nakajima) Department of Medical KAATSU Training, Dokkyo Medical
University
Abstract
BACKGROUND: We examined the safety and efficacy of acceleration training
(AT) in patients immediately after cardiac surgery.Methods and Results:
This randomized controlled study included patients who underwent
open-heart surgery using cardiopulmonary bypass. Of these patients, 31
received regular cardiac rehabilitation (CR) and 39 received AT in
addition to regular CR (AT group). AT was provided using a vibration
platform (Power PlatePro7TMand Power platepersonal; Performance Health
System, Chicago, IL, USA). The AT group performed 5 static resistance
training sessions: squats, wide stance squats, toe stands, banded squats,
and front lunges. Each vibration session lasted 30 s. We evaluated the
short physical performance battery, anterior mid-thigh thickness, maximum
voluntary isometric contraction of the knee extensors, and serum
intercellular adhesion molecule (ICAM-1) and vascular cell adhesion
molecule (VCAM-1) concentrations as indicators of endothelial function.
The observation period was during hospitalization and lasted approximately
20 days. No adverse events occurred during AT. Ultrasound revealed a
significantly lower reduction in muscle mass at discharge in the AT group.
No significant differences were observed in ICAM-1 and VCAM-1
concentrations between the 2 groups preoperatively, postoperatively, or at
discharge. <br/>CONCLUSION(S): AT is considered safe and effective for
patients immediately after open-heart surgery. AT, along with regular CR,
may prevent skeletal muscle mass loss, muscle weakness, and physical
function loss immediately after open-heart surgery.

<76>
Accession Number
2021650122
Title
Cardiac Point-of-Care Ultrasound and Multi-Disciplinary Improvement
Opportunities in Acute Systolic Heart Failure Management in a Pediatric
Emergency Center.
Source
Pediatric Cardiology. 45(6) (pp 1353-1358), 2024. Date of Publication:
August 2024.
Author
Scott C.; Alade K.; Leung S.K.; Vaughan R.M.; Riley A.F.
Institution
(Scott, Alade, Leung, Vaughan, Riley) Department of Pediatrics, Section of
Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine,
Houston, TX, United States
(Scott, Alade, Leung, Vaughan, Riley) Department of Pediatrics, Section of
Cardiology, Texas Children's Hospital, Baylor College of Medicine,
Houston, TX, United States
Publisher
Springer
Abstract
Cardiac point-of-care ultrasound (POCUS) has the ability to rapidly assess
function and identify systolic heart failure (HF), an often-missed
diagnosis. POCUS has the potential to expedite medical intervention,
improving overall outcomes. There have been limited studies describing
pediatric emergency center (EC) utilization of cardiac POCUS and its
impact on outcomes in pediatric patients. Authors performed a
retrospective chart review at a tertiary children's hospital to identify
all patients admitted from the EC to the Cardiac Intensive Care Unit
(CICU) with acute systolic HF between January 2017 and August 2019.
Outcome measures included EC length of stay (LOS), CICU LOS, and time
until first IV HF medicine was administered. A total of 21 patients and 24
encounters meeting criteria were identified. Cardiac POCUS agreed with
standard echocardiography in 8 of 9 cases. Patients who had a cardiac
POCUS in the EC seemed more likely to receive their first dose of
intravenous heart failure medication while in the Emergency Center (70% vs
43%). There was a trend toward significance, but it did not reach
statistical significance (p = 0.1). EC and CICU LOS were not significantly
different between POCUS and non-POCUS groups. Cardiac POCUS has the
potential to have a valuable role in the early diagnosis of acute systolic
HF in children. However, early diagnosis by POCUS did not translate into
shorter EC or CICU LOS. This pilot data serves as a baseline for efforts
to promote earlier clinical recognition of acute HF and more efficient
collaboration between clinical services.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2023.

<77>
[Use Link to view the full text]
Accession Number
2033271429
Title
Angiographic Characteristics and Clinical Outcomes in Patients with
Chronic Kidney Disease Undergoing Impella-Supported High-Risk Percutaneous
Coronary Intervention: Insights from the cVAD PROTECT III Study.
Source
Circulation: Cardiovascular Interventions. 17(7) (pp e013503), 2024. Date
of Publication: 01 Jul 2024.
Author
Bharadwaj A.S.; Abu-Much A.; Maini A.S.; Zhou Z.; Li Y.; Batchelor W.B.;
Grines C.L.; Baron S.J.; Redfors B.; Lansky A.J.; Basir M.B.; O'Neill W.W.
Institution
(Bharadwaj) Division of Cardiology, Loma Linda University Medical Center,
CA, United States
(Abu-Much, Maini, Zhou, Li, Redfors) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Batchelor) Inova Center of Outcomes Research, Inova Heart and Vascular
Institute, Falls Church, VA, United States
(Grines) Department of Cardiology, Northside Hospital Cardiovascular
Institute, Atlanta, GA, United States
(Baron) Massachusetts General Hospital, Boston, United States
(Baron) Baim Institute for Clinical Research, Boston, MA, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Lansky) Yale University, School of Medicine, New Haven, CT, United States
(Lansky) Barts Heart Centre, Queen Mary University, London, United Kingdom
(Basir, O'Neill) Division of Cardiology, Center for Structural Heart
Disease, Henry Ford Health System, Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Prior studies have found that patients with chronic kidney
disease (CKD) have worse outcomes following percutaneous coronary
intervention (PCI). There are no data about patients with advanced CKD
undergoing Impella-supported high-risk PCI. We, therefore, aimed to
evaluate angiographic characteristics and clinical outcomes in patients
with CKD who received Impella-supported high-risk PCI as part of the
catheter-based ventricular assist device PROTECT III study (A Prospective,
Multi-Center, Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5
System Versus Intra Aortic Balloon Pump [IABP] in Patients Undergoing Non
Emergent High Risk PCI). <br/>METHOD(S): Patients enrolled in the PROTECT
III study were analyzed according to their baseline estimated glomerular
filtration rate (eGFR). The primary outcome was 90-day major adverse
cardiovascular and cerebrovascular events (the composite of all-cause
death, myocardial infarction, stroke/transient ischemic attack, and repeat
revascularization). <br/>RESULT(S): Of 1237 enrolled patients, 1052
patients with complete eGFR baseline assessment were evaluated: 586 with
eGFR >=60 mL/min per 1.73 m², 190 with eGFR >=45 to <60, 105
with eGFR >=30 to <45, and 171 with eGFR <30 or on dialysis. Patients with
lower eGFR (all groups with eGFR <60) were more frequently females and had
a higher prevalence of hypertension, diabetes, anemia, and peripheral
artery disease. The baseline Synergy Between PCI With Taxus and Cardiac
Surgery score was similar between groups (28.2+/-12.6 for all groups).
Patients with lower eGFR were more likely to have severe coronary
calcifications and higher usage of atherectomy. There were no differences
in individual PCI-related coronary complications between groups, but the
rates of overall PCI complications were less frequent among patients with
lower eGFR. Major adverse cardiovascular and cerebrovascular events at 90
days and 1-year mortality were significantly higher among patients with
eGFR <30 mL/min per 1.73 m² or on dialysis. <br/>CONCLUSION(S):
Patients with advanced CKD undergoing Impella-assisted high-risk PCI tend
to have higher baseline comorbidities, severe coronary calcification, and
higher atherectomy usage, yet CKD was not associated with a higher rate of
immediate PCI-related complications. However, 90-day major adverse
cardiovascular and cerebrovascular events and 1-year mortality were
significantly higher among patients with eGFR<30 mL/min per 1.73
m² or on dialysis. Future studies of strategies to improve
intermediate and long-term outcomes of these high-risk patients are
warranted.<br/>Copyright &#xa9; 2024 The Authors.

<78>
Accession Number
2033216169
Title
Effects of ciprofol infusion on hemodynamics during induction and
maintenance of anesthesia and on postoperative recovery in patients
undergoing thoracoscopic lobectomy: Study protocol for a randomized,
controlled trial.
Source
PLoS ONE. 19(7 July) (no pagination), 2024. Article Number: e0305478. Date
of Publication: July 2024.
Author
Guo N.; Cao J.; Duan M.; Zhou F.; Wang W.; Xu L.; Wei C.; Song X.
Institution
(Guo, Cao, Duan, Zhou, Wang, Song) Department of Anesthesiology, The First
Affiliated Hospital of Shandong First Medical University, Shandong
Provincial Qianfoshan Hospital, Jinan, China
(Guo, Cao, Duan, Zhou, Wang, Song) Shandong Institute of Anesthesia and
Respiratory Critical Medicine, Ji nan, China
(Guo, Cao, Duan, Zhou, Wang, Song) Shandong Provincial Clinical Research
Center for Anesthesiology, Ji nan, China
(Xu, Wei) Department of Nursing, The First Affiliated Hospital of Shandong
First Medical University, Shandong Provincial Qianfoshan Hospital, Ji nan,
China
Publisher
Public Library of Science
Abstract
Introduction Ciprofol, a new candidate drug, is effective and safe for the
maintenance of anesthesia in non-cardiothoracic and non-neurological
elective surgery. However, few studies have been conducted on general
anesthesia using ciprofol in patients undergoing thoracoscopic lobectomy.
Therefore, this study aims to observe the effects of ciprofol on
hemodynamics and on postoperative recovery in patients undergoing
thoracoscopic lobectomy. Methods and analysis This randomized controlled
trial will include 136 patients aged 18 E5 years undergoing elective
thoracoscopic lobectomy between April 2023 and December 2024. The
participants will be randomly assigned to the propofol or ciprofol group.
The primary outcome to be assessed is the hemodynamic fluctuation during
the induction and maintenance of anesthesia. The secondary outcomes
involve quality of anesthesia induction and quality of recovery from
anesthesia. The former includes TLOC (time to loss of consciousness), the
use of vasoactive agents, the incidence of injection pain, body movement,
muscle twitching and coughing during induction of anesthesia. The latter
includes TROC (time to recovery of consciousness), post anesthesia care
unit (PACU) time, incidence of postoperative nausea and vomiting (PONV),
postoperative agitation, intraoperative awareness and quality of recovery
(QoR) score. Discussion A number of clinical trials have confirmed that
ciprofol, as a new sedative-hypnotic agent, has advantages of better
tolerance, higher sedation satisfaction score, and lower incidence of
adverse reactions, especially in reducing the incidence of injection pain.
But considering that ciprofol was recently developed, limited data are
available regarding its use for general anesthesia. This study aims to
investigate the effects of ciprofol on hemodynamics and on postoperative
recovery of patients undergoing thoracoscopic lobectomy. The results of
this study may provide evidence for the safe application of ciprofol, a
new choice of general anesthetic for thoracic surgery.<br/>Copyright
&#xa9; 2024 Garzon-Alfaro et al. This is an open access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.

<79>
Accession Number
2033296950
Title
Lowering systolic blood pressure to less than 120 mm Hg versus less than
140 mm Hg in patients with high cardiovascular risk with and without
diabetes or previous stroke: an open-label, blinded-outcome, randomised
trial.
Source
The Lancet. 404(10449) (pp 245-255), 2024. Date of Publication: 20 Jul
2024.
Author
Ai X.; An C.; An Y.; Bai S.; Bai X.; Bi J.; Bin X.; Bu M.; Bu P.; Bu W.;
Cai L.; Cai N.; Cai S.; Cai T.; Cai W.; Cao B.; Cao H.; Cao L.; Cao X.;
Chai H.; Chai Y.; Chai Z.; Chang C.; Chang J.; Chang S.; Chang Y.; Chao
H.; Che H.; Che Q.; Chen D.; Chen F.; Chen G.; Chen H.; Chen J.; Chen L.;
Chen Q.; Chen R.; Chen S.; Chen T.; Chen X.; Chen Y.; Chen Z.; Cheng C.;
Cheng J.; Cheng X.; Chu J.; Cui R.; Cui X.; Cui Y.; Cui Z.; Dai W.; Dai
X.; Ding C.; Ding H.; Ding Q.; Ding Y.; Dong J.; Dong L.; Dong Q.; Dong
Y.; Du B.; Du H.; Du J.; Du L.; Du M.; Du Q.; Du T.; Du X.; Duan R.; Duan
X.; Fan D.; Fan X.; Fang F.; Fang J.; Fang X.; Fang Y.; Feng E.; Feng H.;
Feng L.; Feng R.; Feng Z.; Fu H.; Fu Q.; Gao H.; Gao L.; Gao M.; Gao Q.;
Gao Y.; Ge J.; Geng H.; Geng L.; Gou H.; Gu Q.; Guan L.; Guan S.; Guan W.;
Guan Z.; Guang B.; Guo A.; Guo C.; Guo G.; Guo L.; Guo Q.; Guo Y.; Guo Z.;
Han A.; Han M.; Han S.; Han X.; Han Y.; Hao F.; Hao J.; Hao S.; He C.; He
D.; He M.; He S.; He W.; He X.; He Y.; Hong J.; Hou C.; Hou J.; Hu D.; Hu
J.; Hu L.; Hu M.; Hu Z.; Huang A.; Huang C.; Huang H.; Huang J.; Huang S.;
Huang W.; Huang X.; Hui J.; Hui L.; Hui Z.; Huo F.; Ji R.; Jia G.; Jia H.;
Jia J.; Jia X.; Jiang H.; Jiang J.; Jiang Q.; Jiang X.; Jiang Y.; Jiao Y.;
Jie L.; Jin B.; Jin L.; Jin R.; Jin X.; Jin Y.; Jin Z.; Jing C.; Jing J.;
Jing R.; Kang L.; Kang Y.; Kong J.; Kou S.; Kou X.; Kulaxihan; Lai J.; Lei
L.; Li B.; Li C.; Li D.; Li F.; Li G.; Li H.; Li J.; Li L.; Li M.; Li N.;
Li Q.; Li R.; Li S.; Li T.; Li W.; Li X.; Li Y.; Li Z.; Liang C.; Liang
J.; Liang K.; Liang L.; Liang T.; Liang X.; Liang Y.; Liang Z.; Lie Z.;
Lin Q.; Lin R.; Lin X.; Lin Z.; Liu A.; Liu C.; Liu F.; Liu G.; Liu H.;
Liu J.; Liu L.; Liu Q.; Liu S.; Liu X.; Liu Y.; Liu Z.; Long J.; Lu F.; Lu
H.; Lu J.; Lu W.; Lu Y.; Luan T.; Luo Q.; Luo T.; Luo X.; Luo Y.; Lv J.;
Lv L.; Lv M.; Ma A.; Ma H.; Ma J.; Ma L.; Ma N.; Ma Q.; Ma S.; Ma T.; Ma
X.; Ma Y.; Mai L.; Mei X.; Meng G.; Miao R.; Miao X.; Min T.; Mo S.;
Morigentu; Nan T.; Ni J.; Ni S.; Nie Y.; Ning B.; Ning X.; Niu M.; Niu Q.;
Niu W.; Niu X.; Ou F.; Pan B.; Pan C.; Pan J.; Pan X.; Pan Z.; Pei G.; Pei
L.; Pei M.; Pei Y.; Peng Y.; Pu Z.; Qi F.; Qi L.; Qi M.; Qi Y.; Qian J.;
Qin L.; Qin Z.; Qing L.; Qiu L.; Qiu W.; Qiu X.; Qu Y.; Quan M.; Ren D.;
Ren H.; Ren L.; Ren T.; Ren W.; Ren Y.; Rong Y.; Ruan J.; Shang P.; Shao
M.; Shao X.; Shao Y.; Shen J.; Shen R.; Sheng L.; Shi J.; Shi X.; Shi Y.;
Shu B.; Song B.; Song D.; Song J.; Song W.; Song X.; Song Y.; Su H.; Su
Q.; Su S.; Su X.; Sun C.; Sun F.; Sun G.; Sun J.; Sun M.; Sun R.; Sun S.;
Sun Y.; Sun Z.; Suo M.; Tan B.; Tang C.; Tang Z.; Tao Y.; Tian C.; Tian
H.; Tian J.; Tian X.; Wan H.; Wan Q.; Wan R.; Wang B.; Wang C.; Wang D.;
Wang E.; Wang F.; Wang G.; Wang H.; Wang J.; Wang K.; Wang L.; Wang M.;
Wang P.; Wang Q.; Wang R.; Wang S.; Wang T.; Wang W.; Wang X.; Wang Y.;
Wang Z.; Wei C.; Wei L.; Wei P.; Wei S.; Wei X.; Wen H.; Wen Y.; Wu C.; Wu
H.; Wu L.; Wu Q.; Wu S.; Wu W.; Wu X.; Wu Y.; Wu Z.; Wuhanbilige; Xia J.;
Xia Y.; Xiang J.; Xiao H.; Xiao Y.; Xie M.; Xie Y.; Xin H.; Xing J.; Xiu
G.; Xu B.; Xu C.; Xu E.; Xu J.; Xu S.; Xu W.; Xue N.; Xue T.; Xue W.; Yan
H.; Yan X.; Yan Y.; Yang B.; Yang H.; Yang J.; Yang K.; Yang M.; Yang N.;
Yang P.; Yang X.; Yang Y.; Yang Z.; Yao H.; Yao L.; Ye J.; Ye W.; Yi M.;
Yi S.; Yi W.; Yi Z.; Yin G.; Yu G.; Yu H.; Yu L.; Yu N.; Yu Q.; Yu X.; Yu
Y.; Yuan B.; Zeng C.; Zhai N.; Zhai X.; Zhan H.; Zhang A.; Zhang B.; Zhang
C.; Zhang F.; Zhang G.; Zhang H.; Zhang J.; Zhang L.; Zhang M.; Zhang P.;
Zhang Q.; Zhang R.; Zhang S.; Zhang T.; Zhang W.; Zhang X.; Zhang Y.;
Zhang Z.; Zhao B.; Zhao D.; Zhao F.; Zhao G.; Zhao H.; Zhao J.; Zhao L.;
Zhao Q.; Zhao W.; Zhao X.; Zhao Y.; Zheng S.; Zheng X.; Zhi L.; Zhong H.;
Zhong Q.; Zhong X.; Zhong Y.; Zhou J.; Zhou K.; Zhou L.; Zhou N.; Zhou S.;
Zhou T.; Zhou W.; Zhou X.; Zhou Y.; Zhou Z.; Zhu B.; Zhu J.; Zhu M.; Zhu
Y.; Zong D.; Zuo H.; Zuo Z.
Institution
(Liu, Li, Ge, Yan, Zhang, Zheng, Lu, Li, Gao, Lei, Li) National Clinical
Research Center for Cardiovascular Diseases, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, National Center for
Cardiovascular Diseases, Beijing, China
(Liu) Department of Hypertension, Peking University People's Hospital,
Beijing, China
(Li, Li) Central China Subcenter of National Center for Cardiovascular
Diseases, Henan Cardiovascular Disease Center, Fuwai Central-China
Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou
University, Zhengzhou, China
Publisher
Elsevier B.V.
Abstract
Background: Uncertainty exists about whether lowering systolic blood
pressure to less than 120 mm Hg is superior to that of less than 140 mm
Hg, particularly in patients with diabetes and patients with previous
stroke. <br/>Method(s): In this open-label, blinded-outcome, randomised
controlled trial, participants with high cardiovascular risk were enrolled
from 116 hospitals or communities in China. We used minimised
randomisation to assign participants to intensive treatment targeting
standard office systolic blood pressure of less than 120 mm Hg or standard
treatment targeting less than 140 mm Hg. The primary outcome was a
composite of myocardial infarction, revascularisation, hospitalisation for
heart failure, stroke, or death from cardiovascular causes, assessed by
the intention-to-treat principle. This trial was registered with
ClinicalTrials.gov, NCT04030234. <br/>Finding(s): Between Sept 17, 2019,
and July 13, 2020, 11 255 participants (4359 with diabetes and 3022 with
previous stroke) were assigned to intensive treatment (n=5624) or standard
treatment (n=5631). Their mean age was 64.6 years (SD 7.1). The mean
systolic blood pressure throughout the follow-up (except the first 3
months of titration) was 119.1 mm Hg (SD 11.1) in the intensive treatment
group and 134.8 mm Hg (10.5) in the standard treatment group. During a
median of 3.4 years of follow-up, the primary outcome event occurred in
547 (9.7%) participants in the intensive treatment group and 623 (11.1%)
in the standard treatment group (hazard ratio [HR] 0.88, 95% CI 0.78-0.99;
p=0.028). There was no heterogeneity of effects by diabetes status,
duration of diabetes, or history of stroke. Serious adverse events of
syncope occurred more frequently in the intensive treatment group (24
[0.4%] of 5624) than in standard treatment group (eight [0.1%] of 5631; HR
3.00, 95% CI 1.35-6.68). There was no significant between-group difference
in the serious adverse events of hypotension, electrolyte abnormality,
injurious fall, or acute kidney injury. <br/>Interpretation(s): For
hypertensive patients at high cardiovascular risk, regardless of the
status of diabetes or history of stroke, the treatment strategy of
targeting systolic blood pressure of less than 120 mm Hg, as compared with
that of less than 140 mm Hg, prevents major vascular events, with minor
excess risk. <br/>Funding(s): The Ministry of Science and Technology of
China and Fuwai Hospital. Translation: For the Mandarin translation of the
abstract see Supplementary Materials section.<br/>Copyright &#xa9; 2024
Elsevier Ltd

<80>
Accession Number
2029352246
Title
Single versus dual antiplatelet therapy following percutaneous left atrial
appendage closure-A systematic review and meta-analysis.
Source
European Journal of Clinical Investigation. 54(8) (no pagination), 2024.
Article Number: e14209. Date of Publication: August 2024.
Author
Continisio S.; Montonati C.; Angelini F.; Bocchino P.P.; Carbonaro C.;
Giacobbe F.; Dusi V.; DeFilippo O.; Ielasi A.; Giannino G.; Boldi E.;
Fabris T.; D'Ascenzo F.; DeFerrari G.M.; Tarantini G.
Institution
(Continisio, Boldi) Division of Cardiology, Clinica S. Rocco di
Franciacorta, Brescia, Italy
(Montonati, Ielasi) Division of Cardiology, IRCCS Hospital
Galeazzi-Sant'Ambrogio, Milan, Italy
(Angelini, Bocchino, Dusi, De Filippo, D'Ascenzo, De Ferrari) Division of
Cardiology, Cardiovascular and Thoracic Department, 'Citta della Salute e
della Scienza' Hospital, Turin, Italy
(Carbonaro, Giacobbe, Dusi, Giannino, D'Ascenzo, De Ferrari) Department of
Medical Sciences, University of Turin, Turin, Italy
(Fabris, Tarantini) Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua Medical School, Padua, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: In the last few years, percutaneous LAA occlusion (LAAO) has
become a plausible alternative in atrial fibrillation (AF) patients with
contraindications to anticoagulation therapy. Nevertheless, the optimal
antiplatelet strategy following percutaneous LAAO remains to be defined.
<br/>Method(s): Studies comparing single antiplatelet therapy (SAPT)
versus dual antiplatelet therapy (DAPT) following LAAO were systematically
searched and screened. The outcomes of interest were ischemic stroke,
device-related thrombus (DRT) and major bleeding. A random-effect
meta-analysis was performed comparing outcomes in both groups. The
moderator effect of baseline characteristics on outcomes was evaluated by
univariate meta-regression analyses. <br/>Result(s): Sixteen observational
studies with 3255 patients treated with antiplatelet therapy (SAPT, n =
1033; DAPT, n = 2222) after LAAO were included. Mean age was 74.5 +/- 8.3
years, mean CHA<inf>2</inf>DS<inf>2</inf>-VASc and HAS-BLED scores were
4.3 +/- 1.5 and 3.2 +/- 1.0, respectively. At a weighted mean follow-up of
12.7 months, the occurrence of stroke (RR 1.33; 95% CI 0.64-2.77; p =.44),
DRT (RR 1.52; 95% CI 0.90-2.58; p =.12), and the composite of stroke and
DRT (RR 1.26; 95% CI 0.67-2.37; p =.47) did not differ significantly
between SAPT and DAPT groups. The rate of major bleedings was also not
different between groups (RR 1.41; 95% CI 0.64-3.12; p =.39).
<br/>Conclusion(s): Among AF patients at high bleeding risk undergoing
percutaneous LAAO, a post-procedural minimalistic antiplatelet strategy
with SAPT did not significantly differ from DAPT regimens regarding the
rate of stroke, DRT and major bleeding.<br/>Copyright &#xa9; 2024
Stichting European Society for Clinical Investigation Journal Foundation.
Published by John Wiley & Sons Ltd.

<81>
Accession Number
2029244284
Title
Prognostic significance of echocardiographic deformation imaging in adult
congenital heart disease.
Source
European Journal of Clinical Investigation. 54(8) (no pagination), 2024.
Article Number: e14200. Date of Publication: August 2024.
Author
van Rosendael P.J.; Taha K.; Guglielmo M.; Teske A.J.; van der Harst P.;
Sieswerda G.; Cramer M.J.; van der Zwaan H.B.
Institution
(van Rosendael, Taha, Guglielmo, Teske, van der Harst, Sieswerda, Cramer,
van der Zwaan) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Guglielmo) Department of Cardiology, Haga Teaching Hospital, The Hague,
Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Due to medical and surgical advancements, the population of
adult patients with congenital heart disease (ACHD) is growing. Despite
successful therapy, ACHD patients face structural sequalae, placing them
at increased risk for heart failure and arrhythmias. Left and right
ventricular function are important predictors for adverse clinical
outcomes. In acquired heart disease it has been shown that
echocardiographic deformation imaging is of superior prognostic value as
compared to conventional parameters as ejection fraction. However, in
adult congenital heart disease, the clinical significance of deformation
imaging has not been systematically assessed and remains unclear.
<br/>Method(s): According to the Preferred Reporting Items for Systematic
Reviews checklist, this systematic review included studies that reported
on the prognostic value of echocardiographic left and/or right ventricular
strain by 2-dimensional speckle tracking for hard clinical end-points
(death, heart failure hospitalization, arrhythmias) in the most frequent
forms of adult congenital heart disease. <br/>Result(s): In total, 19
contemporary studies were included. Current data shows that left
ventricular and right ventricular global longitudinal strain (GLS) predict
heart failure, transplantation, ventricular arrhythmias and mortality in
patients with Ebstein's disease and tetralogy of Fallot, and that GLS of
the systemic right ventricle predicts heart failure and mortality in
patients post atrial switch operation or with a congenitally corrected
transposition of the great arteries. <br/>Conclusion(s): Deformation
imaging can potentially impact the clinical decision making in ACHD
patients. Further studies are needed to establish disease-specific
reference strain values and ranges of impaired strain that would indicate
the need for medical or structural intervention.<br/>Copyright &#xa9; 2024
The Authors. European Journal of Clinical Investigation published by John
Wiley & Sons Ltd on behalf of Stichting European Society for Clinical
Investigation Journal Foundation.

<82>
Accession Number
2031046249
Title
Effect of Seated Cervical Spinal Manipulation on Autonomic Nervous System
Activity as Measured by Heart Rate Variability and Plasma Norepinephrine
Levels: A randomized Pre- and Poststudy.
Source
Journal of Manipulative and Physiological Therapeutics. 46(4) (pp
220-228), 2023. Date of Publication: May 2023.
Author
Budgell B.S.; Injeyan H.S.; Teodorczyk-Injeyan J.
Institution
(Budgell) Canadian Memorial Chiropractic College, Toronto, ON, Canada
(Injeyan, Teodorczyk-Injeyan) Department of Research and Innovation,
Canadian Memorial Chiropractic College, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to determine whether seated
cervical manipulation produced changes in autonomic nervous system
activity, as measured by heart rate variability and plasma norepinephrine
levels. <br/>Method(s): Ninety-five healthy young adults (ages 20-48
years) were recruited into a single-blinded physiological study, with 47
randomized to a seated cervical manipulation and 44 randomized to a sham
procedure. Heart rate variability in the frequency domain, and plasma
norepinephrine levels were measured prior to, immediately following, and 5
minutes following the intervention. <br/>Result(s): Electrocardiograms
were obtained from 39 subjects in the sham group and 43 subjects in the
manipulation group. No statistically significant changes were found in
measures of heart rate variability in the frequency domain in either the
manipulation or sham groups. Blood samples were obtained from 22 subjects
in the sham group and 27 subjects in the manipulation group. Plasma
norepinephrine levels, as measured by spectrophotometry, declined in both
groups from pre- to immediately postintervention, and they remained at
decreased levels 5 minutes after the interventions. There were no
statistically significant differences between groups in pre- or
postintervention norepinephrine levels. <br/>Conclusion(s): Measures of
heart rate variability and plasma norepinephrine levels did not show that
seated cervical manipulation produced short-term changes in autonomic
nervous system activity compared to a sham procedure in healthy young
adults.<br/>Copyright &#xa9; 2024

<83>
Accession Number
2033317576
Title
Platelet inhibitor withdrawal and outcomes after coronary artery surgery:
An individual patient data meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 66(1) (no pagination), 2024.
Article Number: ezae265. Date of Publication: 01 Jul 2024.
Author
Schoerghuber M.; Kuenzer T.; Biancari F.; Dalen M.; Hansson E.C.; Jeppsson
A.; Schlachtenberger G.; Siegemund M.; Voetsch A.; Pregartner G.; Lindenau
I.; Zimpfer D.; Berghold A.; Mahla E.; Zirlik A.
Institution
(Schoerghuber, Mahla) Division of Anaesthesiology and Intensive Care
Medicine 2, Medical University of Graz, Graz, Austria
(Kuenzer, Pregartner, Berghold) Institute for Medical Informatics,
Statistics and Documentation, Medical University of Graz, Graz, Austria
(Biancari) Department of Internal Medicine, South-Karelia Central
Hospital, University of Helsinki, Lappeenranta, Finland
(Dalen) Department of Cardiac Surgery, Karolinska University Hospital,
Stockholm, Sweden
(Dalen) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Hansson, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Hansson, Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Schlachtenberger) Department of Cardiothoracic Surgery, University
Hospital of Cologne, Cologne, Germany
(Siegemund) Department of Acute Medicine, University Hospital Basel,
Basel, Switzerland
(Siegemund) Department of Clinical Research, University of Basel, Basel,
Switzerland
(Voetsch) Department of Cardiovascular and Endovascular Surgery,
Paracelsus Medical University, Salzburg, Austria
(Lindenau) Department of Anaesthesiology and Intensive Care Medicine,
Hospital Oberwart, Oberwart, Austria
(Zimpfer) Division of Cardiac Surgery, University Heart Center Graz,
Medical University of Graz, Graz, Austria
(Zirlik) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To evaluate the association between guideline-conforming as
compared to shorter than recommended withdrawal period of P2Y<inf>12</inf>
receptor inhibitors prior to isolated on-pump coronary artery bypass
grafting (CABG) and the incidence of severe bleeding and ischaemic events.
Randomized controlled trials are lacking in this field. <br/>METHOD(S): We
searched PUBMED, Embase and other suitable databases for studies including
patients on P2Y<inf>12</inf> receptor inhibitors undergoing isolated CABG
and reporting bleeding and postoperative ischaemic events from 2013 to
March 2024. The primary outcome was incidence of Bleeding Academic
Research Consortium type 4 (BARC-4) bleeding defined as any of the
following: perioperative intracranial bleeding, reoperation for bleeding,
transfusion of >=5 units of red blood cells, chest tube output of >=2 l.
The secondary outcome was postoperative ischaemic events according to the
Academic Research Consortium 2 Consensus Document. Patient-level data
provided by each observational trial were synthesized into a single
dataset and analysed using a 2-stage IPD-MA. <br/>RESULT(S): Individual
data of 4837 patients from 7 observational studies were synthesized.
BARC-4 bleeding, 30-day mortality and postoperative ischaemic events
occurred in 20%, 2.6% and 5.2% of patients. After adjusting for EuroSCORE
II and cardiopulmonary bypass time, guideline-conforming withdrawal was
associated with decreased BARC-4 bleeding risk in patients on clopidogrel
[adjusted odds ratio (OR) 0.48; 95% confidence intervals (CI) 0.28-0.81; P
= 0.006] and a trend towards decreased risk in patients on ticagrelor
(adjusted OR 0.48; 95% CI 0.22-1.05; P = 0.067). Guideline-conforming
withdrawal was not significantly associated with 30-day mortality risk
(clopidogrel: adjusted OR 0.70; 95% CI 0.30-1.61; ticagrelor: adjusted OR
0.89; 95% CI 0.37-2.18) but with decreased risk of postoperative ischaemic
events in patients on clopidogrel (clopidogrel: adjusted OR 0.50; 95% CI
0.30-0.82; ticagrelor: adjusted OR 0.78; 95% CI 0.45-1.37). BARC-4
bleeding was associated with 30-day mortality risk (adjusted OR 4.76; 95%
CI 2.67-8.47; P < 0.001). <br/>CONCLUSION(S): Guideline-conforming
preoperative withdrawal of ticagrelor and clopidogrel was associated with
a 50% reduced BARC-4 bleeding risk when corrected for EuroSCORE II and
cardiopulmonary bypass time but was not associated with increased risk of
30-day mortality or postoperative ischaemic events. <br/>Copyright &#xa9;
2024 The Author(s).

<84>
Accession Number
644753033
Title
The Reporting of Race and Ethnicity in Cardiothoracic Surgery Literature.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 11 Jul 2024.
Author
Jindani R.; Rodriguez-Quintero J.H.; Olivera J.; Ries S.; Stiles B.M.;
Antonoff M.B.
Institution
(Jindani, Rodriguez-Quintero, Olivera, Stiles) Department of
Cardiothoracic Surgery, Montefiore Medical Center/Albert Einstein College
of Medicine, Bronx, NY, United States
(Ries, Antonoff) Department of Thoracic and Cardiovascular Surgery,
University of Texas MD Anderson Cancer Center, Houston, TX, United States

<85>
Accession Number
644752983
Title
Prognostic relevance of pre-procedural plasma volume status estimation in
patients undergoing transcatheter aortic valve implantation: A
meta-analysis.
Source
Current problems in cardiology. (pp 102749), 2024. Date of Publication:
11 Jul 2024.
Author
Papazoglou A.S.; Moysidis D.V.; Anastasiou V.; Daios S.; Kamperidis V.;
Ziakas A.; Giannakoulas G.
Institution
(Papazoglou) Athens Naval Hospital, Athens, Greece
(Moysidis) 424 Military General Hospital of Thessaloniki, Thessaloniki,
Greece
(Anastasiou, Daios, Kamperidis, Ziakas, Giannakoulas) First Department of
Cardiology, AHEPA University Hospital of Thessaloniki, Thessaloniki,
Greece
Abstract
BACKGROUND: To systematically evaluate the prognostic utility of estimated
plasma volume status (ePVS) on the outcomes of patients undergoing
transcatheter aortic valve implantation (TAVI). <br/>METHOD(S): The
exposure variable of interest was the ePVS, enumerating the percentage
change of the actual plasma volume from the ideal plasma volume, and being
calculated on the basis of weight and hematocrit using sex-specific
constants. A random-effects meta-analysis was performed after a systematic
literature search in PubMed, Scopus and Web Of Science. <br/>RESULT(S):
The systematic literature search yielded 5 eligible observational cohort
studies encompassing a total of 7,121 patients undergoing TAVI. The
meta-analysis suggested that "high ePVS" status was independently
associated with increased risk for 1-year all-cause mortality (pooled
adjusted hazard ratio: 1.63, 95% confidence intervals: 1.36-1.95) compared
to "low ePVS". Also, the pooled unadjusted odds for 1-year mortality,
30-day mortality, peri-procedural stroke, major bleeding, and acute kidney
injury were significantly increased in the "high ePVS" group of patients.
Conversely, the unadjusted risk of pacemaker implantation and major
vascular complications did not differ significantly between the 2 groups.
<br/>CONCLUSION(S): Plasma volume expansion appears to be linked with a
worse peri-procedural and long-term prognostic course in TAVI. Its use in
clinical practice could refine risk stratification and candidate selection
practices.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<86>
Accession Number
644752957
Title
Home-based transitional cardiac telerehabilitation in older adults post
coronary artery bypass grafting: A randomized controlled trial.
Source
Geriatric nursing (New York, N.Y.). 59 (pp 139-149), 2024. Date of
Publication: 11 Jul 2024.
Author
Mahfouz Khalil M.I.; El-Monshed A.H.; Shaala R.S.; El-Sherif S.M.; Mousa
E.F.S.
Institution
(Mahfouz Khalil) Department of Gerontological Nursing, Faculty of Nursing,
Alexandria University, Egypt
(El-Monshed) Department of Nursing, College of Health and Sport Sciences,
University of Bahrain, Manama, Bahrain; Department of Psychiatric and
Mental Health Nursing, Faculty of Nursing-Mansoura University, Egypt.
Electronic address: ahmed_elmonshed@mans.edu.eg
(Shaala) Department of Internal Medicine, Geriatric Unit, Faculty of
Medicine, Alexandria University, Egypt
(El-Sherif) Department of Physical Medicine, Rheumatology and
Rehabilitation, Faculty of Medicine, Alexandria University, Egypt
(Mousa) Department of Geriatric Medicine and Gerontology, Faculty of
Medicine, Helwan University, Egypt
Abstract
This randomized controlled trial evaluated the effectiveness of a 12-week
home-based transitional cardiac telerehabilitation (Hb-T-CTR) program on
health-related quality-of-life and therapeutic self-care in older adults'
post-Coronary Artery Bypass Grafting (CABG). The intervention group (n =
57) underwent Hb-T-CTR, incorporating preoperative counseling,
postoperative education, a culturally adapted video, home visits, and
telephone counseling, while the control group (n = 61) received standard
care. Using the Coronary Revascularization Outcome Questionnaire and the
Sidani Doran Therapeutic Self-Care Measure, data were collected at three
time points. Results showed significant improvements in overall scores for
both health-related quality of life (t1=3.386, P = 0.001; t2=4.224, P <
0.001) and therapeutic self-care (t1=7.104, P < 0.001; t2=4.242, P <
0.001) in the intervention group compared to controls. This telehealth
approach provides convenient and accessible rehabilitation services for
older adults' post-CABG and highlights the importance of integrating
Hb-T-CTR into routine care for personalized rehabilitation. This study
underscores the potential of telehealth tools in overcoming barriers and
enhancing patient-centered interventions.<br/>Copyright &#xa9; 2024
Elsevier Inc. All rights reserved.

<87>
Accession Number
644752714
Title
Effect of Perioperative Active Warming on Postoperative Pain and Shivering
in Preschool Pediatric Patients: A Randomized Controlled Trial.
Source
Indian pediatrics. (no pagination), 2024. Date of Publication: 12 Jul
2024.
Author
Ciftci C.; Kara I.; Buyukcavlak M.; Aslanlar E.
Institution
(Ciftci) Department of Anesthesiology and Reanimation, Konya City
Hospital, University of Health Sciences, Karatay, Konya, Turkey and
Department of Anesthesiology and Reanimation, Faculty of Medicine, Selcuk
University, Selcuklu, Konya, Turkey. Correspondence to: Dr. Cansu Ciftci,
Department of Anesthesiology and Reanimation, University of Health
Sciences, Konya City Hospital, Akabe mah. Adana Cevre Yolu Cd. 135/1,
Karatay, Konya, 42020
(Kara, Aslanlar) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Selcuk University, Selcuklu, Konya, Turkey
(Buyukcavlak) Department of Anesthesiology and Reanimation, Konya City
Hospital, University of Health Sciences, Karatay, Konya, Turkey
Abstract
OBJECTIVE: To evaluate the effects of perioperative active warming on the
core body temperature, postoperative pain, shivering and agitation in
pediatric patients. <br/>METHOD(S): Children aged 2-6 years undergoing
elective surgery, including orthopedic soft tissue surgeries, ear nose
throat surgical procedures and general surgical interventions, all
performed under general anesthesia, were randomized to receive either
active warming (using the forced-air warming gowns, Bair Hugger, in the
pre- and postoperative period, and a carbon fiber blanket in
intraoperative period; Group A), or conventional warming using green
blankets pre-and post-operatively and a carbon fiber blanket
intraoperatively (Group B). Children undergoing emergency surgery,
surgeries involving major body cavities (abdominal, thoracic, cranial
surgery), or those with endocrinological pathologies, or baseline fever,
were excluded. Core body temperature (t-core), postoperative pain,
shivering and agitation scores were compared between the two groups.
<br/>RESULT(S): Seventy children were included, with 35 in each group. No
significant difference was observed between the groups in t-core values at
0 and 15 minutes preoperatively (P > 0.05). However, the value at 30
minutes preoperatively and all subsequent t-core values were higher in
Group A (P < 0.001). Postoperative pain and shivering scores at 0 minutes,
30 minutes and 6 hours were significantly lower in Group A compared to
Group B. No significant difference was observed in agitation scores in the
immediate postoperative period, although, Group A showed reduced agitation
at 30 minutes (P = 0.03). <br/>CONCLUSION(S): Active warming in the pre-
and post-operative period significantly maintained higher core
temperatures and reduced postoperative pain and shivering in children
undergoing surgery compared to those receiving conventional passive
warming measures in the pre- and post-operative period.