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<1>
Accession Number
2034048298
Title
Comprehensive perioperative blood management in patients undergoing
elective bypass cardiac surgery: Benefit effect of health care education
and systematic correction of iron deficiency and anemia on red blood cell
transfusion.
Source
Journal of Clinical Anesthesia. 98 (no pagination), 2024. Article Number:
111560. Date of Publication: November 2024.
Author
Charbonneau H.; Savy S.; Savy N.; Pasquie M.; Mayeur N.; Angles O.; Balech
V.; Berthelot A.-L.; Croute-Bayle M.; Decramer I.; Duterque D.; Julien V.;
Mallet L.; M'rini M.; Quedreux J.-F.; Richard B.; Sidobre L.; Taillefer
L.; Thibaud A.; Abouliatim I.; Berthoumieu P.; Garcia O.; Soula P.; Vahdat
O.; Breil C.; Brunel P.; Sciacca G.
Institution
(Charbonneau, Mayeur, Angles, Balech, Berthelot, Croute-Bayle, Decramer,
Duterque, Julien, Mallet, M'rini, Quedreux, Richard, Sidobre, Taillefer,
Thibaud) Department of Anesthesiology and Intensive Care Unit, Clinique
Pasteur, Toulouse, France
(Savy, Pasquie) Clinical Research Committee, Clinique Pasteur, Toulouse,
France
(Savy) Toulouse Institute of Mathematics, UMR5219 - University of
Toulouse, CNRS - UPS IMT, Toulouse, France
(Abouliatim, Berthoumieu, Garcia, Soula, Vahdat, Breil, Brunel, Sciacca)
Department of Cardiothoracic and Vascular Surgery, Clinique Pasteur,
Toulouse, France
Publisher
Elsevier Inc.
Abstract
Study objective: The aim of this study was to investigate the efficacy of
a two-step patient blood management (PBM) program in red blood cell (RBC)
transfusion requirements among patients undergoing elective
cardiopulmonary bypass (CPB) surgery. Design(s): Prospective,
non-randomized, two-step protocol design. Setting(s): Cardiac surgery
department of Clinique Pasteur, Toulouse, France. Patient(s): 897
patients undergoing for elective CPB surgery. Intervention(s): We
conducted a two-steps protocol: PBMe and PBMc. PBMe involved a short
quality improvement program for health care workers, while PBMc introduced
a systematic approach to pre- and postoperative correction of
deficiencies, incorporating iron injections, oral vitamins, and
erythropoiesis-stimulating agents. Measurements: The PBM program's
effectiveness was evaluated through comparison with a pre-PBM
retrospective cohort after propensity score matching. The primary
objective was the proportion of patients requiring RBC transfusions during
their hospital stay. Secondary objectives were also analyzed. Main
Result(s): After matching, 343 patients were included in each group.
Primary outcomes were observed in 35.7% (pre-PBM), 26.7% (PBMe), and 21.1%
(PBMc) of patients, resulting in a significant reduction (40.6%) in the
overall RBC transfusion rate. Both the PBMe and PBMc groups exhibited
significantly lower risks of RBC transfusion compared to the pre-PBM
group, with adjusted odds ratios of 0.59 [95% CI 0.44-0.79] and 0.44 [95%
CI 0.32-0.60], respectively. Secondary endpoints included reductions in
transfusions exceeding 2 units, total RBC units transfused, administration
of allogeneic blood products, and total bleeding volume recorded on Day 1.
There were no significant differences noted in mortality rates or the
duration of hospital stays. Conclusion(s): This study suggests that
health care education and systematic deficiency correction are associated
with reduced RBC transfusion rates in elective CPB surgery. However,
further randomized, controlled studies are needed to validate these
findings and refine their clinical application. Copyright © 2024
Elsevier Inc.

<2>
Accession Number
2030992860
Title
Magnesium sulphate to prevent perioperative atrial fibrillation in cardiac
surgery: a randomized clinical trial: A protocol description of the
PeriOperative Magnesium Infusion to Prevent Atrial fibrillation Evaluated
(POMPAE) trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 540. Date of
Publication: December 2024.
Author
Meerman M.; Buijser M.; van den Berg L.; van den Heuvel A.-M.; Hoohenkerk
G.; van Driel V.; Munsterman L.; de Vroege R.; Bailey M.; Bellomo R.;
Ludikhuize J.
Institution
(Meerman, van den Berg, Ludikhuize) Department of Intensive Care,
HagaZiekenhuis, The Hague, Netherlands
(Buijser, van den Heuvel, van Driel) Department of Cardiology,
HagaZiekenhuis, The Hague, Netherlands
(Hoohenkerk) Department of Cardiothoracic Surgery, HagaZiekenhuis, The
Hague, Netherlands
(Munsterman) Department of Cardiac Anaesthesia, HagaZiekenhui, The Hague,
Netherlands
(de Vroege) Department of Perfusion, HagaZiekenhuis, The Hague,
Netherlands
(Bailey) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Health, Melbourne,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) is a common and
potentially serious complication post cardiac surgery. Hypomagnesaemia is
common after cardiac surgery and recent evidence indicates that
supplementation of magnesium may prevent POAF. We aim to investigate the
effectiveness of continuous intravenous magnesium sulphate administration
in the perioperative period to prevent POAF as compared to placebo.
 Method(s): The (POMPAE) trial is a phase 2, single-center,
double-blinded randomized superiority clinical study. It aims to assess
the impact of perioperative continuous intravenous magnesium
administration on the occurrence of cardiac surgery-related POAF. A total
of 530 patients will be included. Eligible patients will be randomized in
1:1 ratio to the intervention or placebo group with stratification based
on the presence of valvular surgery. The objective of the infusion is to
maintain ionized magnesium levels between 1.5 and 2.0 mmol/L.
 Discussion(s): The primary outcome measure is the incidence of de
novo POAF within the first 7 days following surgery, with censoring at
hospital discharge. This trial may generate crucial evidence for the
prevention of POAF and reduce clinical adverse events in patients
following cardiac surgery. Trial registration: The POMPAE trial was
registered at ClinicalTrials.gov under the following identifier
NTC05669417, https://clinicaltrials.gov/ct2/show/NCT05669417. Registered
on December 30, 2022. Protocol version: Version 3.3, dated
13-01-2023. Copyright © The Author(s) 2024.

<3>
Accession Number
2031990299
Title
A systematic review of existing appropriate use criteria in cardiovascular
disease from the last 15 years.
Source
Seminars in Vascular Surgery. 37(2) (pp 101-110), 2024. Date of
Publication: June 2024.
Author
Le Q.; Mills A.; Denton A.; Weaver M.L.
Institution
(Le) University of Virginia School of Medicine, Charlottesville, VA,
United States
(Mills) Department of Surgery, University of Virginia, Charlottesville,
VA, United States
(Denton) Claude Moore Health Sciences Library, University of Virginia,
Charlottesville, VA, United States
(Weaver) Division of Vascular and Endovascular Surgery, University of
Virginia Health System, 1215 Lee Street, PO Box 800679, Charlottesville,
VA 22908-0679, United States
Publisher
W.B. Saunders
Abstract
Appropriate use criteria (AUC) aim to impact the provision of high-value
care. This scoping review identified AUC regarding the procedural and
operative treatment of cardiovascular disease and described the evolution
of AUC in this space over time, including changes in the focus, strategy,
and language of AUC. The summative presentation of these AUC identifies
elements of AUC that may lead to successes in, and barriers to,
implementation across disease processes, specialties, and societies. AUC
topics include coronary artery disease, peripheral artery disease,
valvular disease, venous disease, renal artery stenosis, and mesenteric
ischemia, among others. Copyright © 2024 Elsevier Inc.

<4>
Accession Number
2030982453
Title
Prognosis in Patients with ST-Segment Elevation Myocardial Infarction
Reperfused by PHDP: 1-Year MACEs Follow-Up.
Source
Clinical and Applied Thrombosis/Hemostasis. 30 (no pagination), 2024. Date
of Publication: January-December 2024.
Author
Dou J.; Gao J.; Yang H.-H.; Guo R.; Jiang C.; Zhou J.; Yu X.; Guo J.;
Zhang J.; Luo D.
Institution
(Dou, Gao, Yang, Guo, Jiang) School of Medicine, Chengde Medical
University, Hebei, Chengde 067000, China
(Zhou, Yu, Guo, Zhang, Luo) Department of Cardiology, Chengde Central
Hospital/Second Clinical College of Chengde Medical University, Hebei,
Chengde 067000, China
Publisher
SAGE Publications Inc.
Abstract
This study explored 1-year follow-up of Parmaco-invasive strategy with
half-dose recombinant human prourokinase (PHDP) in patients with acute
ST-segment elevation myocardial infarction (STEMI). The follow-up
endpoints were major adverse cardiovascular events (MACEs) occurring
within 30 days and 1 year, as well as postoperative bleeding events. The
study ultimately included 150 subjects, with 75 in the primary
percutaneous coronary intervention (PPCI) group and 75 in the PHDP group.
This study found that the PHDP group had a shorter FMC-reperfusion time
(42.00 min vs 96.00 min, P < 0.001). During PCI, the PHDP group had a
lower percutaneous transluminal coronary angioplasty (PTCA) (P = 0.021),
intropin (P = 0.002) and tirofiban (P < 0.001) use. And the incidence of
intraoperative arrhythmia, malignant arrhythmia, and slow flow/no-reflow
was lower in the PHDP group (P < 0.001). At the 30-day follow-up, there
was a significantly higher proportion of patients in the PPCI group who
were readmitted due to unstable angina (P = 0.037). After 1 year of
follow-up, there was no statistically significant difference in MACEs
between the two groups (P = 0.500). The incidence of postoperative major
bleeding, intracranial bleeding, and minor bleeding did not differ between
the PHDP and PPCI groups (P > 0.05). The PHDP facilitates early treatment
of infarct-related vessels, shortens FMC-reperfusion time, and does not
increase the risk of MACEs. Copyright © The Author(s) 2024.

<5>
Accession Number
2030931528
Title
Benefits of intensive lipid-lowering therapies in patients with acute
coronary syndrome: a systematic review and meta-analysis.
Source
Annals of Medicine. 56(1) (no pagination), 2024. Article Number: 2389470.
Date of Publication: 2024.
Author
Wu X.-D.; Ye X.-Y.; Liu X.-Y.; Lin Y.; Lin X.; Li Y.-Y.; Ye B.-H.; Sun
J.-C.
Institution
(Wu, Liu, Lin, Lin, Li, Ye) Department of General Medicine, The First
people's hospital of Wenling, Zhejiang, Taizhou, China
(Ye) Shanghai Jiao Tong University, Shanghai, China
(Sun) Department of Cardiology, Taizhou Municipal Hospital, Zhejiang,
Taizhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Previous meta-analyses have investigated the efficacy of
lipid-lowering therapies for atherosclerotic cardiovascular disease;
however, few have focused on patients with acute coronary syndrome (ACS).
This meta-analysis aimed to compare the benefits of intensive
lipid-lowering therapy with those of background statin therapy in patients
with ACS. Method(s): Searches were performed on PubMed, Embase, the
Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov
databases for articles published until April 13, 2023. Randomized
controlled trials that compared intensive lipid-lowering therapies and
background statin therapies in patients with prior ACS and recorded the
outcome of three-point major cardiovascular events (MACE) were included.
The risk ratio (RR) with 95% confidence interval (CI) was used as a
measure of primary and secondary outcomes. Result(s): Nine trials
involving 38,640 patients with ACS were identified. Pooled results
suggested that intensive lipid-lowering therapies are associated with a
reduction in the risk of three-point MACE (RR, 0.88; 95% CI, 0.83-0.94; p
< 0.001), recurrent ACS (RR, 0.82; 95% CI, 0.71-0.96; p = 0.013), nonfatal
myocardial infarction (MI) (RR, 0.87; 95% CI, 0.81-0.93; p < 0.001),
stroke (RR, 0.83; 95% CI, 0.73-0.94; p = 0.003), and unstable
angina-related hospitalization (RR, 0.57; 95% CI, 0.33-0.99; p = 0.046),
but not all-cause mortality (RR, 0.94; 95% CI, 0.82-1.07; p = 0.329),
cardiovascular disease-related mortality (RR, 0.96; 95% CI, 0.88-1.06; p =
0.457) or coronary revascularization (RR, 0.89; 95% CI, 0.79-1.00; p =
0.057). Conclusion(s): Intensive lipid-lowering therapies may reduce
the risk of three-point MACE, recurrent ACS, nonfatal MI, stroke, and
hospitalization for unstable angina in patients with ACS undergoing
background statin therapy. These results may assist in clinical
decision-making for the secondary prevention of cardiovascular events to
initiate intensive lipid-lowering therapies immediately after
ACS. Copyright © 2024 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<6>
Accession Number
2034108959
Title
The search for the holy grail: the balance between the risk of thrombosis
and bleeding in patients.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(5) (pp
367-369), 2024. Date of Publication: 01 Aug 2024.
Author
Agewall S.
Institution
(Agewall) Institute of Clinical Sciences, Karolinska Institute of
Danderyd, Stockholm, Sweden
Publisher
Oxford University Press

<7>
Accession Number
2034108953
Title
Long-term effects of phosphodiesterase-5 inhibitors on cardiovascular
outcomes and death: a systematic review and meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(5) (pp
403-412), 2024. Date of Publication: 01 Aug 2024.
Author
Soulaidopoulos S.; Terentes-Printzios D.; Ioakeimidis N.; Tsioufis K.P.;
Vlachopoulos C.
Institution
(Soulaidopoulos, Terentes-Printzios, Ioakeimidis, Tsioufis, Vlachopoulos)
First Cardiology Department, Hippokration Hospital, Athens Medical School,
National and Kapodistrian University of Athens, Athens 11527, Greece
Publisher
Oxford University Press
Abstract
Aims: Phosphodiesterase 5 inhibitors (PDE5i), which are widely used for
the treatment of erectile dysfunction (ED), have been found to exhibit
systemic vascular benefits by improving endothelial function. In this
context, we sought to evaluate the effects of PDE5i on long-term
cardiovascular outcomes and mortality. Methods and Results: A
comprehensive search of electronic databases was conducted up to 30 May
2023. Cohort studies comparing PDE5i treatment at any dose with other ED
treatment, placebo or no treatment and minimum follow-up duration of 6
months were considered eligible. The primary endpoints were: (1) major
adverse cardiovascular events (MACE) and (2) all-cause mortality. Pooled
risk ratios (RR) with 95% confidence intervals (CI) were calculated.
Sixteen studies were included (1 257 759 subjects - 10.5% treated with
PDE5i). The majority of patients (99.4%) were men [median age 61.5 years
(range 30-72.8)]. The median follow-up duration was 4.3 years (range 6
months-7.5 years). PDE5i use was associated with a significant reduction
in the composite of MACE (RR 0.78, 95% CI 0.69-0.89). Moreover, the
analysis of pooled data from 13 studies, demonstrated that the use of
PDE5i was associated with a significantly lower risk of all-cause
mortality (RR 0.70, 95% CI 0.56-0.87). Conclusion(s): The use of
PDE5i primarily in men with or without known coronary artery disease was
associated with a lower risk for cardiovascular events and overall
mortality. This information underlines that PDE5i could provide clinical
benefit beyond ED treatment and could instigate the conduction of further,
large-scale randomized clinical trials. Copyright © 2024 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<8>
Accession Number
2034108946
Title
Antithrombotic therapy in patients after transcatheter aortic valve
implantation: a network meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(5) (pp
454-464), 2024. Date of Publication: 01 Aug 2024.
Author
Turgeon R.D.; Ellis U.M.; Barry A.R.
Institution
(Turgeon, Barry) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC V6T 1Z3, Canada
(Turgeon) St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
(Ellis) Woodward Library, University of British Columbia, Vancouver, BC
V6T 1Z3, Canada
(Barry) Jim Pattison Outpatient Care and Surgery Centre, Lower Mainland
Pharmacy Services, Surrey, BC V3T 0G9, Canada
Publisher
Oxford University Press
Abstract
Aims: The optimal antithrombotic therapy to balance the risk of thrombosis
and bleeding in patients who undergo transcatheter aortic valve
implantation (TAVI) is unknown. This systematic review/network
meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the
efficacy and safety of different oral anticoagulant (OAC) and antiplatelet
regimens in patients post-TAVI. Methods and Results: MEDLINE, Embase,
CENTRAL, and ClinicalTrials.gov were searched from inception to April
2023. Co-primary outcomes were all-cause death and major bleeding. We
conducted Bayesian network meta-analyses to compare all interventions
simultaneously. For each outcome, we generated odds ratios (ORs) with 95%
credible intervals using a random-effects model with informative priors,
and ranked interventions based on mean surface under the cumulative
ranking curve. We included 11 RCTs (n = 6415), including 1 unpublished
RCT. Three trials enrolled patients with an indication for an OAC. Overall
risk of bias was low or with some concerns. Median age was 81 years.
Median follow-up was 6 months. The combination of OAC plus single
antiplatelet therapy (SAPT) increased the risk of all-cause death compared
with dual antiplatelet therapy (DAPT) (OR 1.78, 95% credible interval
1.15-2.77). No other comparisons for all-cause death were significantly
different. For major bleeding, SAPT reduced the risk compared with DAPT,
direct-acting OAC, and OAC + SAPT (OR 0.20-0.40), and DAPT reduced the
risk compared with OAC + SAPT. SAPT and DAPT ranked best for all-cause
death, while SAPT ranked best for major bleeding. Conclusion(s): In
post-TAVI patients, SAPT may provide the optimal balance of reducing
thrombotic events while minimizing the risk of bleeding. Copyright
© 2023 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology.

<9>
Accession Number
2034056265
Title
Hypothermic oxygenated perfusion of the donor heart in heart
transplantation: the short-term outcome from a randomised, controlled,
open-label, multicentre clinical trial.
Source
The Lancet. 404(10453) (pp 670-682), 2024. Date of Publication: 17 Aug
2024.
Author
Rega F.; Lebreton G.; Para M.; Michel S.; Schramm R.; Begot E.;
Vandendriessche K.; Kamla C.; Gerosa G.; Berman M.; Boeken U.; Clark S.;
Ranasinghe A.; Ius F.; Forteza A.; Pivodic A.; Hennig F.; Guenther S.;
Zuckermann A.; Knosalla C.; Dellgren G.; Wallinder A.; Van Cleemput J.;
Degezelle K.; Wert L.; Yeter R.; Lichtenber A.; Aubin H.; Gorler A.; Freyt
S.; McDiamud A.; Jungschleger J.; Mukadam M.; Turner P.; Mullen R.;
Hernandez F.; Ospina V.; Jonsson K.; Ternstrom L.; Al Kalbany H.; Djavidi
N.; Fabozzo A.; Pradegan N.; Aliabadi-Zuckermann A.; Osorio E.
Institution
(Rega, Vandendriessche, Degezelle) Department of Cardiac Surgery,
University Hospitals Leuven, Leuven, Belgium
(Lebreton, Begot, Al Kalbany, Djavidi) Cardiac Surgery Department,
Pitie-Salpetriere Hospital, APHP, Sorbonne University, Paris, France
(Para) Department of Cardiovascular Surgery and Transplantation, Bichat
Hospital, Universite Paris Cite, Paris, France
(Michel, Kamla) Clinic of Cardiac Surgery, Ludwig-Maximilians-University
of Munich, Munich, Germany
(Michel, Kamla) Munich Heart Alliance, German Center for Cardiovascular
Research, Munich, Germany
(Schramm, Guenther) Clinic for Thoracic and Cardiovascular Surgery, Heart
and Diabetes Center North Rhine Westfalia, Ruhr-University Bochum, Bad
Oeynhausen, Germany
(Gerosa, Fabozzo, Pradegan) Department of Cardiac, Thoracic, Vascular
Sciences and Public Health, University of Padua, Padua, Italy
(Berman) Cardiothoracic Surgery, Royal Papworth Hospital NHS Foundation
Trust, Cambridge, United Kingdom
(Boeken, Lichtenber, Aubin) Department of Cardiac Surgery, Medical
Faculty, Heinrich Heine University, Duesseldorf, Germany
(Clark) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Ranasinghe) Cardiac Surgery, Queen Elizabeth Hospital, University
Hospitals Birmingham NHS Trust, Birmingham, United Kingdom
(Ius) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Forteza, Ospina) Department of Cardiac Surgery, Puerta de Hierro
Majadahonda University Hospital, Madrid, Spain
(Pivodic) APNC Sweden, Molndal, Sweden
(Hennig, Knosalla) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite, Berlin, Germany
(Hennig, Knosalla) Charite-Universitatsmedizin Berlin, corporate member of
Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin,
Germany
(Hennig, Knosalla) German Center for Cardiovascular Research, Berlin,
Germany
(Zuckermann, Aliabadi-Zuckermann, Osorio) Department of Cardiac Surgery,
Medical University of Vienna, Vienna, Austria
(Dellgren, Jonsson, Ternstrom) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Wallinder) XVIVO Perfusion, Gothenburg, Sweden
(Van Cleemput) Department of Cardiology, University Hospitals Leuven,
Leuven, Belgium
(Wert, Yeter) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany
(Gorler, Freyt) Department of Cardiothoracic, Transplant and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(McDiamud, Jungschleger) Cardiothoracic Centre, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Mukadam, Turner) Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, Queen Elizabeth Hospital, University Hospitals Birmingham
NHS Trust, Birmingham, United Kingdom
(Mullen) Cardiothoracic Surgery, Royal Papworth Hospital NHS Foundation
Trust, Cambridge, United Kingdom
(Hernandez) Department of Cardiology, Puerta de Hierro Majadahonda
University Hospital, Madrid, Spain
Publisher
Elsevier B.V.
Abstract
Background: Static cold storage (SCS) remains the gold standard for
preserving donor hearts before transplantation but is associated with
ischaemia, anaerobic metabolism, and organ injuries, leading to patient
morbidity and mortality. We aimed to evaluate whether continuous,
hypothermic oxygenated machine perfusion (HOPE) of the donor heart is safe
and superior compared with SCS. Method(s): We performed a
multinational, multicentre, randomised, controlled, open-label clinical
trial with a superiority design at 15 transplant centres across eight
European countries. Adult candidates for heart transplantation were
eligible and randomly assigned in a 1:1 ratio. Donor inclusion criteria
were age 18-70 years with no previous sternotomy and donation after brain
death. In the treatment group, the preservation protocol involved the use
of a portable machine perfusion system ensuring HOPE of the resting donor
heart. The donor hearts in the control group underwent ischaemic SCS
according to standard practices. The primary outcome was time to first
event of a composite of either cardiac-related death, moderate or severe
primary graft dysfunction (PGD) of the left ventricle, PGD of the right
ventricle, acute cellular rejection at least grade 2R, or graft failure
(with use of mechanical circulatory support or re-transplantation) within
30 days after transplantation. We included all patients who were randomly
assigned, fulfilled inclusion and exclusion criteria, and received a
transplant in the primary analysis and all patients who were randomly
assigned and received a transplant in the safety analyses. This trial was
registered with ClicalTrials.gov (NCT03991923) and is ongoing.
 Finding(s): A total of 229 patients were enrolled between Nov 25,
2020, and May 19, 2023. The primary analysis population included 204
patients who received a transplant. There were no patients who received a
transplant lost to follow-up. All 100 donor hearts preserved with HOPE
were transplantable after perfusion. The primary endpoint was registered
in 19 (19%) of 101 patients in the HOPE group and 31 (30%) of 103 patients
in the SCS group, corresponding to a risk reduction of 44% (hazard ratio
0.56; 95% CI 0.32-0.99; log-rank test p=0.059). PGD was the primary
outcome event in 11 (11%) patients in the HOPE group and 29 (28%) in the
SCS group (risk ratio 0.39; 95% CI 0.20-0.73). In the HOPE group, 63 (65%)
patients had a reported serious adverse event (158 events) versus 87 (70%;
222 events) in the SCS group. Major adverse cardiac transplant events were
reported in 18 (18%) and 33 (32%) patients in the HOPE and SCS group (risk
ratio 0.56; 95% CI 0.34-0.92). Interpretation(s): Although there was
not a significant difference in the primary endpoint, the 44% risk
reduction associated with HOPE was suggested to be a clinically meaningful
benefit. Post-transplant complications, measured as major adverse cardiac
transplant events, were reduced. Analysis of secondary outcomes suggested
that HOPE was beneficial in reducing primary graft dysfunction. HOPE in
donor heart preservation addresses the existing challenges associated with
graft preservation and the increasing complexity of donors and heart
transplantation recipients. Future investigation will help to further
elucidate the benefit of HOPE. Funding(s): XVIVO
Perfusion. Copyright © 2024 Elsevier Ltd

<10>
Accession Number
2033175162
Title
Continuous Glucose Monitoring and the Effect of Liraglutide in Cardiac
Surgery Patients: A Substudy of the Randomized Controlled GLOBE Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(9) (pp 1965-1971),
2024. Date of Publication: September 2024.
Author
Oosterom-Eijmael M.J.P.; Hermanides J.; van Raalte D.H.; Kouw I.W.K.;
DeVries J.H.; Hulst A.H.
Institution
(Oosterom-Eijmael, Hermanides, Hulst) Department of Anesthesiology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, van Raalte, DeVries) Department of Endocrinology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, van Raalte, Hulst) Amsterdam Cardiovascular Sciences
Research Institute, Amsterdam, Netherlands
(Hermanides) Amsterdam Public Health Research Institute, Amsterdam,
Netherlands
(Kouw) Department of Intensive Care Medicine, Intensive Care Research,
Gelderse Vallei Hospital, Ede, Netherlands
(Kouw) Wageningen University & Research, Division of Human Nutrition and
Health, Wageningen, Netherlands
(DeVries, Hulst) Amsterdam Gastroenterology Endocrinology Metabolism,
Amsterdam, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: The objectives of the current research were to evaluate the
accuracy and reliability of continuous glucose monitoring (CGM) in
patients undergoing cardiac surgery and assess the impact of preoperative
liraglutide administration on perioperative glucose control as captured by
CGM. Design(s): This was a prospective, single-center, prespecified
analysis of the GLOBE trial, a randomized controlled trial comparing
preoperative liraglutide treatment to placebo in patients undergoing
cardiac surgery. Setting(s): The work took place at a single-center
academic hospital in the Netherlands. Participant(s): Twenty-five
patients undergoing cardiac surgery were recruited from the hospital's
cardiac surgery department. Intervention(s): Participants received
the Dexcom G5 CGM system from the day before surgery until discharge from
the intensive care unit after surgery. Additionally, participants were
randomized to receive either preoperative liraglutide or placebo.
 Measurements and Main Results: Arterial blood gas (ABG) glucose
measurements were collected as a reference and matched to CGM readings to
assess accuracy and reliability. In 240 paired CGM-ABG glucose
measurements, the mean absolute relative difference was 14.4 +/- 12.5%.
Temporary sensor interruption occurred mainly intraoperatively (92% of
patients). The median duration of intraoperative sensor interruption was
65 (48-95) minutes. Liraglutide increased glycemic time in range 72%
versus 47% in the control group (absolute difference 25%, 95% confidence
interval -41.4 to -8.9, p = .004). Conclusion(s): Despite
intraoperative sensor interruption, CGM seems an accurate method for
semi-invasive, real-time assessment of blood glucose levels. CGM can
provide a detailed observation of the pre- and postoperative glycemic
trajectory, demonstrating increased time in range following perioperative
liraglutide treatment compared with placebo. Copyright © 2024 The
Author(s)

<11>
Accession Number
2033099780
Title
Effects of Balanced Versus Saline-based Solutions on Acute Kidney Injury
in Off-pump Coronary Artery Bypass Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(9) (pp 1923-1931),
2024. Date of Publication: September 2024.
Author
Nam J.-S.; Kim W.-J.; Seo W.-W.; Lee S.-W.; Joung K.-W.; Chin J.-H.; Choi
D.-K.; Choi I.-C.
Institution
(Nam, Kim, Seo, Lee, Joung, Chin, Choi, Choi) Department of Anesthesiology
and Pain Medicine, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: To determine whether balanced solutions can reduce the
incidence of acute kidney injury after off-pump coronary artery bypass
surgery compared with saline. Design(s): Randomized controlled trial.
 Setting(s): Single tertiary care center. Participant(s):
Patients who underwent off-pump coronary artery bypass surgery between
June 2014 and July 2020. Intervention(s): Balanced solution-based
chloride-restrictive intravenous fluid strategy. Measurements and
Main Results: The primary outcome was acute kidney injury within 7
postoperative days, as defined by the 2012 Kidney Disease: Improving
Global Outcomes Clinical Practice Guideline. The incidence of acute kidney
injury was 4.4% (8/180) in the balanced group and 7.3% (13/178) in the
saline group. The difference was not statistically significant (risk
difference, -2.86%; 95% confidence interval [CI], -7.72% to 2.01%; risk
ratio, 0.61, 95% CI, 0.26 to 1.43; p = 0.35). Compared with the balanced
group, the saline group had higher levels of intraoperative serum chloride
and lower base excess, which resulted in a lower pH. Conclusion(s):
In patients undergoing off-pump bypass surgery with a normal estimated
glomerular filtration rate, the intraoperative balanced solution-based
chloride-restrictive intravenous fluid administration strategy did not
decrease the rate of postoperative acute kidney injury compared with the
saline-based chloride-liberal intravenous fluid administration
strategy. Copyright © 2024 Elsevier Inc.

<12>
Accession Number
2030953093
Title
Narrative Review: Surgical and Hybrid Management of Atrial Fibrillation.
Source
Cardiology and Therapy. 13(3) (pp 493-528), 2024. Date of Publication:
September 2024.
Author
Trohman R.G.
Institution
(Trohman) Section of Electrophysiology, Division of Cardiology, Department
of Internal Medicine, Rush University Medical Center, 1653 W. Congress,
Chicago, IL 60612, United States
Publisher
Adis
Abstract
Although significant strides have been made in non-pharmacologic
management of atrial fibrillation (AF), these treatments remain a work in
progress. While catheter ablation is often effective for management of
paroxysmal AF, it is less successful in patients with persistent or
longstanding persistent AF. This review was undertaken to clarify the
risks, benefits, and alternatives to catheter ablation for
non-pharmacologic AF management. In order to clarify the roles of surgical
and hybrid ablation, this narrative review was undertaken by searching
MEDLINE to identify peer-reviewed clinical trials, randomized controlled
trials, meta-analyses, review articles, and other clinically relevant
studies. The search was limited to English-language reports published
between 1960 and 2023. Atrial fibrillation was searched using the terms
surgical ablation, catheter ablation, hybrid ablation, stroke prevention,
left atrial occlusion, and atrial excision. Google and Google Scholar, as
well as bibliographies of identified articles, were also reviewed for
additional references. The Cox-maze surgical approach is still the most
efficacious non-pharmacological treatment for AF. Hybrid ablation,
combining cardiac surgical and catheter ablation techniques, has become an
attractive option for persistent or longstanding persistent
AF. Copyright © The Author(s) 2024.

<13>
Accession Number
2034131460
Title
Acute Normovolemic Hemodilution in Head and Neck Reconstructive Surgery.
Source
Journal of Oral and Maxillofacial Surgery. Conference: AAOMS Annual
Meeting. Orange County Convention Center, United States. 82(9 Supplement)
(pp S22-S23), 2024. Date of Publication: September 2024.
Author
Naik K.; Schubert E.; Singh V.; Kaleem A.; Brockhoff H.C.
Institution
(Naik) High Desert Oral & Facial Surgery/University Medical Center of El
Paso, El Paso, TX, United States
Publisher
W.B. Saunders
Abstract
Abstract Acute normovolemic hemodilution (ANH) is a well-established blood
conservation strategy most discussed in cardiothoracic and orthopedic
surgery literature. Simply, the technique involves drawing a predetermined
volume of blood from a patient at the beginning of surgery and transfusing
the same autologous blood to the patient when most of the anticipated
blood loss is complete. The immediate goal of ANH is to reduce the need
for allogeneic blood transfusions in patients undergoing surgery with high
anticipated blood loss. Additionally, the use of less allogeneic blood
products reduces rates of allograft transfusion reactions and saves
critical hospital resources [1]. Cancer patients who receive allogeneic
blood during surgery and hospitalization have been shown to have reduced
recurrence and all-cause mortality [2]. Our study is a single-center,
retrospective study of 110 consecutive patients at High Desert Oral and
Facial Surgery and University Medical Center of El Paso. The first 55
patients (control group) underwent free tissue transfer for head and neck
reconstruction without ANH. The following 55 patients (study group)
underwent free tissue transfer for head and neck reconstruction with ANH.
Patients were excluded if they had preoperative anemia, history of kidney
failure requiring hemodilution, history of liver failure, or American
Society of Anesthesiologist (ASA) Class IV or greater. The ANH protocol
involved a 500cc blood draw after induction and prior to the start of the
operative portion of the case. This blood was administered after the
completion of the ablative portion and flap harvest when most anticipated
blood loss was complete. Transfusion criteria were hemoglobin less than 7
g/dL or hemodynamic instability requiring the sustained use of
vasopressors. Data was collected on age, total blood loss, hemoglobin and
hematocrit both pre- and post-operatively, and use of allogeneic blood
transfusion. The study group received less allogenic blood both
intraoperatively (p< 0.05) and in the postoperative period (p< 0.05).
There was no statistical difference between the groups in the average age,
percentage of each sex, intraoperative blood loss, percentage of patients
undergoing reconstruction for oncologic versus benign disease. Major and
minor flap complications were lower in the ANH group but not statistically
different. Acute normovolemic hemodilution is an established strategy for
blood conservation in other surgical disciplines. It is effective in
reducing allogeneic blood transfusion in head and neck reconstructive
patients. References 1. Monk T. G. (2005). Acute normovolemic
hemodilution. Anesthesiology clinics of North America, 23(2), 271-vi.
https://doi.org/10.1016/j.atc.2005.03.002 2. Petrelli, F., Ghidini, M.,
Ghidini, A., Sgroi, G., Vavassori, I., Petro, D., Cabiddu, M., Aiolfi, A.,
Bonitta, G., Zaniboni, A., & Rausa, E. (2021). Red blood cell transfusions
and the survival in patients with cancer undergoing curative surgery: a
systematic review and meta-analysis. Surgery today, 51(10), 1535-1557.
https://doi.org/10.1007/s00595-020-02192-3 Copyright © 2024

<14>
Accession Number
2031023779
Title
Effect of early administration of tetracosactide on mortality and host
response in critically ill patients requiring rescue surgery: a
sensitivity analysis of the STOPSHOCK phase 3 randomized controlled trial.
Source
Military Medical Research. 11(1) (no pagination), 2024. Article Number:
56. Date of Publication: December 2024.
Author
Noera G.; Bertolini A.; Calza L.; Gori M.; Pitino A.; D'Arrigo G.; Egan
C.G.; Tripepi G.
Institution
(Noera) Health Ricerca e Sviluppo, Global Contractor for STOPSHOCK
National Plan of Military Research Ministry of Defence, Rome 00187, Italy
(Bertolini) Department of Medicine and Division of Clinical Pharmacology,
School of Medicine, UNIMORE, Policlinico, Modena 41124, Italy
(Calza) IRET Foundation, Ozzano Dell' Emilia, Bologna 40064, Italy
(Gori, Pitino) Institute of Clinical Physiology (IFC-CNR), Section of
Rome, Rome 00185, Italy
(D'Arrigo, Tripepi) National Research Council-Institute of Clinical
Physiology, Reggio Calabria 89124, Italy
(Egan) CE Medical Writing SRLS, Pisa 56021, Italy
Publisher
BioMed Central Ltd
Abstract
Background: Undifferentiated shock is recognized as a criticality state
that is transitional in immune-mediated topology for casual risk of lethal
microcirculatory dysfunction. This was a sensitivity analysis of a drug
(tetracosactide; TCS10) targeting melanocortin receptors (MCRs) in a phase
3 randomized controlled trial to improve cardiovascular surgical rescue
outcome by reversing mortality and hemostatic disorders. Method(s):
Sensitivity analysis was based on a randomized, two-arm, multicenter,
double-blind, controlled trial. The Naive Bayes classifier was performed
by density-based sensitivity index for principal strata as proportional
hazard model of 30-day surgical risk mortality according to European
System for Cardiac Operative Risk Evaluation inputs-outputs in 100
consecutive cases (from August to September 2013 from Emilia Romagna
region, Italy). Patients included an agent-based TCS10 group (10 mg,
single intravenous bolus before surgery; n = 56) and control group (n =
44) and the association with cytokines, lactate, and bleeding-blood
transfusion episodes with the prior-risk log-odds for mortality rate in
time-to-event was analyzed. Result(s): Thirty-day mortality was
significantly improved in the TCS10 group vs. control group (0 vs. 8
deaths, P < 0.0001). Baseline levels of interleukin (IL)-6, IL-10, and
lactate were associated with bleeding episodes, independent of TCS10
treatment [odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.39-2.79;
OR = 1.53, 95%CI 1.17-2.12; and OR = 2.92, 95%CI 1.40-6.66, respectively],
while baseline level of Fms-like tyrosine kinase 3 ligand (Flt3L) was
associated with lower bleeding rates in TCS10-treated patients (OR = 0.31,
95%CI 0.11-0.90, P = 0.03). For every 8 TCS10-treated patients, 1 bleeding
case was avoided. Blood transfusion episodes were significantly reduced in
the TCS10 group compared to the control group (OR = 0.32, 95%CI 0.14-0.73,
P = 0.01). For every 4 TCS10-treated patients, 1 transfusion case was
avoided. Conclusion(s): Sensitivity index underlines the quality
target product profile of TCS10 in the runway of emergency casualty care.
To introduce the technology readiness level in real-life critically ill
patients, further large-scale studies are required. Trial registration:
European Union Drug Regulating Authorities Clinical Trials Database
(EudraCT Number: 2007-006445-41). Copyright © The Author(s) 2024.

<15>
Accession Number
2030581496
Title
Tranexamic acid-a promising hemostatic agent with limitations: a narrative
review.
Source
Korean Journal of Anesthesiology. 77(4) (pp 411-422), 2024. Date of
Publication: Aug 2024.
Author
Kim D.J.; Cho S.Y.; Jung K.T.
Institution
(Kim, Cho, Jung) Department of Anesthesiology and Pain Medicine, Chosun
University Hospital, Chosun University College of Medicine and Medical
School, Gwangju, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Tranexamic acid (TXA) is a synthetic antifibrinolytic agent that has been
used for several decades to reduce blood loss during surgery and after
trauma. TXA was traditionally used to reduce bleeding in various clinical
settings such as menorrhagia, hemophilia, or other bleeding disorder.
Numerous studies have demonstrated the efficacy of TXA in reducing blood
loss and the need for transfusions. Interest in the potential applications
of TXA beyond its traditional use has been growing recently, with studies
investigating the use of TXA in postpartum hemorrhage, cardiac surgery,
trauma, neurosurgery, and orthopedic surgery. Despite its widespread use
and expanding indications, data regarding the safe and appropriate use of
TXA is lacking. Recent clinical trials have found various potential risks
and limitations in the long-term benefits of TXA. This narrative review
summarizes the clinical applications and limitations of TXA. Copyright
© 2024, Korean Society of Anesthesiologists. All rights reserved.

<16>
Accession Number
2034101734
Title
Evaluating the Effect of periopeRaTIve empaGliflOzin on cardiac surgery
associated acute kidney injury: Rationale and design of the VERTIGO study.
Source
Clinical Kidney Journal. 17(8) (no pagination), 2024. Article Number:
sfae229. Date of Publication: 01 Aug 2024.
Author
Coca A.; Bustamante-Munguira E.; Fidalgo V.; Fernandez M.; Abad C.; Franco
M.; Gonzalez-Pinto A.; Daniel Pereda; Canovas S.; Bustamante-Munguira J.
Institution
(Coca) Department of Nephrology, Hospital Clinico Universitario,
Valladolid, Spain
(Coca, Bustamante-Munguira) Department of Medicine, Dermatology, and
Toxicology, Facultad de Medicina, Universidad de Valladolid, Valladolid,
Spain
(Bustamante-Munguira, Franco) Department of Intensive Care Medicine,
Hospital Clinico Universitario, Valladolid, Spain
(Fidalgo) Department of Nephrology, Hospital Virgen de la Concha, Zamora,
Spain
(Fernandez, Canovas) Department of Cardiovascular Surgery, Hospital
Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
(Abad) Department of Immunology, Hospital Clinico Universitario,
Valladolid, Spain
(Gonzalez-Pinto) Department of Cardiovascular Surgery, Hospital General
Universitario Gregorio Maranon, Madrid, Spain
(Daniel Pereda) Department of Cardiovascular Surgery, Hospital Clinic de
Barcelona, Barcelona, Spain
(Bustamante-Munguira) Department of Cardiovascular Surgery, Hospital
Clinico Universitario, Valladolid, Spain
(Bustamante-Munguira) Department of Surgery, Facultad de Medicina,
Universidad de Valladolid, Valladolid, Spain
Publisher
Oxford University Press
Abstract
Background. Cardiac surgery-Associated acute kidney injury( CSA-AKI) is a
serious complication in patients undergoing cardiac surgery with
extracorporeal circulation( ECC) that increases postoperative
complications and mortality. CSA-AKI develops due to a combination of
patient-and surgery-related risk factors that enhance renal
ischemia-reperfusion injury. Sodium-glucose cotransporter 2 inhibitors(
SGLT2i) such as empagliflozin reduce renal glucose reabsorption, improving
tubulo-glomerular feedback, reducing inflammation and decreasing
intraglomerular pressure. Preclinical studies have observed that SGLT2i
may provide significant protection against renal ischemia-reperfusion
injury due to their effects on inadequate mitochondrial function, reactive
oxygen species activity or renal peritubular capillary congestion, all
hallmarks of CSA-AKI. The VERTIGO( EValuating the Effect of periopeRaTIve
empaGliflOzin) trial is a Phase 3, investigator-initiated, randomized,
double-blind, placebo-controlled, multicenter study that aims to explore
whether empagliflozin can reduce the incidence of adverse renal outcomes
in cardiac surgery patients. Methods. The VERTIGO study( EudraCT:
2021-004938-11) will enroll 608 patients that require elective cardiac
surgery with ECC. Patients will be randomly assigned in a 1:1 ratio to
receive either empagliflozin 10 mg orally daily or placebo. Study
treatment will start 5 days before surgery and will continue during the
first 7 days postoperatively. All participants will receive standard care
according to local practice guidelines. The primary endpoint of the study
will be the proportion of patients that develop major adverse kidney
events during the first 90 days after surgery, defined as >= 25% renal
function decline, renal replacement therapy initiation or death.
Secondary, tertiary and safety endpoints will include rates of AKI during
index hospitalization, postoperative complications and observed adverse
events. Conclusions. The VERTIGO trial will describe the efficacy and
safety of empagliflozin in preventing CSA-AKI. Patient recruitment is
expected to start in May 2024. Copyright © The Author(s) 2024.

<17>
Accession Number
2034091385
Title
EFFECT OF GLARGINE INSULIN ON GLYCEMIC CONTROL IN PATIENTS OF TYPE 2
DIABETES MELLITUS UNDERGOING ON-PUMP CORONARY ARTERY BYPASS GRAFT.
Source
International Journal of Academic Medicine and Pharmacy. 6(4) (pp
192-198), 2024. Date of Publication: 2024.
Author
Chakrabarti A.; Waghchaure S.; Vyas V.
Institution
(Chakrabarti, Waghchaure) Department of Anesthesiology, School of
Medicine, D. Y. Patil Deemed to be University, Sector 7, Nerul,
Maharashtra, Navi Mumbai 400706, India
(Vyas) MGM Medical College, Vashi, Maharashtra, Navi Mumbai 400703, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Diabetes mellitus increases the risk of cardiovascular
complications and worsens outcomes in patients undergoing coronary artery
bypass grafting (CABG). Continuous intravenous insulin infusion (CIII) is
commonly used for perioperative glucose management, but insulin glargine,
a long-acting insulin analog, may offer a more stable alternative with
fewer complications. This study aimed to compare the effectiveness of
preoperative insulin glargine in combination with CIII versus CIII alone
for controlling perioperative blood glucose levels, and to evaluate the
impact on postoperative complications, ICU stay, and hospital stay in CABG
patients. Material(s) and Method(s): In this prospective study, 60
CABG patients were divided into two groups: Group 1 received CIII, while
Group 2 was administered CIII with glargine preoperatively. Blood glucose
levels, postoperative complications, and lengths of ICU and hospital stays
were compared between the groups. Result and Conclusion(s): Group 2
(insulin glargine) showed significantly lower blood glucose levels from
the start of bypass until 24 hours post-surgery compared to Group 1. Group
2 also had fewer complications, including no sternal wound infections, and
shorter ICU and hospital stays (p < 0.01). Additionally, the insulin
infusion rate was significantly lower in Group 2 (p < 0.01). Addition of
preoperative insulin Glargine was more effective that CIII alone for
glucose control in CABG patients, leading to better glycemic control,
fewer complications, and reduced ICU and hospital stays. These results
suggest that supplementing CIII with insulin Glargine, instead of relying
on CIII alone, could be a preferable alternative for managing glucose in
CABG procedures. Copyright © 2024 Society for Healthcare and
Research Development. All rights reserved.

<18>
Accession Number
2029206187
Title
Comparative analysis of two multitask approaches to cognitive training in
cardiac surgery patients.
Source
Russian Journal of Cardiology. 29(3) (pp 122-128), 2024. Article Number:
5653. Date of Publication: 2024.
Author
Tarasova I.V.; Kukhareva I.N.; Temnikova T.B.; Kupriyanova D.S.; Syrova
I.D.; Sosnina A.S.; Trubnikova O.A.; Barbarash O.L.
Institution
(Tarasova, Kukhareva, Temnikova, Kupriyanova, Syrova, Sosnina, Trubnikova,
Barbarash) Research Institute for Complex Issues of Cardiovascular
Diseases, Kemerovo, Russian Federation
Publisher
Silicea-Poligraf
Abstract
Aim. To compare the incidence of postoperative cognitive dysfunction and
neuropsychological changes in the early postoperative period of coronary
artery bypass grafting (CABG) in patients who underwent two versions of
multitask cognitive training, which involved various cognitive and motor
tasks, as well as in a control group. Material and methods. The study
included 100 patients after elective CABG. All patients were randomly
divided into three following groups: cognitive training (CT) 1 (postural
balance combined with mental arithmetic, verbal fluency, and unusual
object use tasks) (n=30), CT 2 (simple visual-motor response combined with
task on mental arithmetic, verbal fluency and unusual object use) (n=35)
and without training (standard postoperative therapy) (n=35). All patients
underwent extensive neuropsychological testing before CABG. Reexamination
with assessment of postoperative cognitive dysfunction (POCD) was carried
out on days 2-3 and upon completion of 5-7 days of training or on days
11-12 after CABG. Results. The presence of POCD on days 2-3 was found in
100% of patients in the study groups. On days 11-12 of CABG, POCD
persisted in 17 people (56,7%) from the CT 1 group, in 24 (68,6%) from the
CT 2 group, and in 28 (80%) patients in the control group. Significant
differences were obtained in the POCD prevalence in the CT 1 and control
groups (odds ratio =3,06; 95% confidence interval: 1,02-9,18, p=0,04), but
not CT 2 and control groups (odds ratio =1,83; 95% confidence interval:
0,64-5,47, p=0,28). Conclusion. Multitask training using a combination of
postural balance and mental arithmetic tasks, verbal fluency, and unusual
object use had a greater effect in reducing the POCD incidence in patients
after CABG compared with standard postoperative care. The results of this
study may be used to develop cognitive rehabilitation programs in
cardiology and cardiac surgery. Copyright © 2024,
Silicea-Poligraf. All rights reserved.

<19>
Accession Number
2034162568
Title
Valve-in-valve transcatheter mitral valve replacement versus redo-surgical
mitral valve replacement for degenerated bioprosthetic mitral valves: A
systematic review and meta-analysis.
Source
International Journal of Cardiology. 415 (no pagination), 2024. Article
Number: 132448. Date of Publication: 15 Nov 2024.
Author
Nasir M.M.; Amir S.; Shahid A.; Rehman W.U.; Haris M.; Ikram A.; Mubariz
M.; Ahmed J.; Khan U.; Iqbal A.G.; Saeed H.; Noori M.A.M.
Institution
(Nasir, Amir, Shahid, Haris, Ikram, Ahmed) Department of Internal
Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Rehman) Department of Internal Medicine, United Health Services Hospital,
Johnson City, NY, United States
(Mubariz) Department of Internal Medicine, Akhtar Saeed Medical and Dental
College, Lahore, Pakistan
(Khan) Division of Cardiovascular Medicine, University of Maryland, School
of Medicine, Baltimore, MD, United States
(Iqbal) Department of Internal Medicine, UNC Nash General Hospital, NC,
United States
(Saeed) RWJBarnabas Health/Trinitas Regional Medical Center, NJ, United
States
(Noori) Department of Cardiovascular Medicine, St Joseph's University
Medical Center, Paterson, NJ, United States
Publisher
Elsevier Ireland Ltd
Abstract
Bioprosthetic mitral valve degeneration is traditionally treated with
Redo-SMVR, but the latest ViV-TMVR procedure offers a less invasive and
lower risk alternative. A systematic literature search was conducted on
Cochrane Central, Scopus, and Medline (PubMed interface) electronic
databases from inception till 15th April 2024. We used risk ratios (RR)
for dichotomous outcomes and mean differences (MD) for continuous
outcomes. We included a total of eleven studies with 11,931 patients in
the final quantitative and qualitative analysis. When comparing ViV-TMVR
with Redo-SMVR, no significant difference was found for 30-day mortality
(P = 0.13) and 1-year mortality (P = 0.91), whereas patients in the
ViV-TMVR showed significantly reduced incidence of stroke (P < 0.00001),
In-hospital mortality (P), bleeding complications (P = 0.003), AKI (P =
0.0006), arrhythmias (P = 0.01), LVOT obstruction (P = 0.04), and PPI (P <
0.00001). Furthermore, no significant difference was observed between
either group when comparing vascular complications (P = 0.97), 2-year
mortality (P = 0.60) and 3-year mortality. ViV-TMVR was associated with a
significant risk of paravalvular leakage (P = 0.008). Although, ViV-TMVR
reduces the risk of complications associated with Redo-SMVR, larger
studies are imperative to reach conclusive results. Copyright ©
2024 Elsevier B.V.

<20>
Accession Number
2034135052
Title
Mitral Valve Transcatheter Edge-to-Edge Repair With PASCAL Vs MitraClip: A
Systematic Review and Meta-analysis.
Source
Journal of Invasive Cardiology. 35(11) (no pagination), 2023. Date of
Publication: November 2023.
Author
Oliveri F.; Amri I.A.; Cabezas J.M.; Bingen B.; Van Der Kley F.; Arslan
F.; Scherptong R.; Mazzarotto P.; Bollati M.; Pepe A.; Tua L.; Bongiorno
A.; Fasolino A.; Gentile F.R.; Colombo D.; Ghio S.; Ferlini M.; Munafo A.
Institution
(Oliveri, Pepe, Tua, Bongiorno, Fasolino, Gentile, Colombo, Munafo)
Department of Molecular Medicine, Division of Cardiology, University of
Pavia, Pavia, Italy
(Oliveri, Amri, Cabezas, Bingen, Van Der Kley, Arslan, Scherptong)
Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Mazzarotto, Bollati) Cardiology Unit, Ospedale Maggiore, Lodi, Italy
(Tua) Interventional Cardiology, Policlinico San Donato, Milan, Italy
(Ghio, Ferlini) Division of Cardiology, Fondazione IRCCS Policlinico San
Matteo, Pavia, Italy
Publisher
Cliggott Publishing Co.
Abstract
Background. Transcatheter edge-to-edge repair (TEER) using the MitraClip
(Abbott Vascular) system has emerged as a standard treatment for patients
with symptomatic severe secondary or inoperable primary mitral
regurgitation (MR). The relatively recent approval of the PASCAL
Transcatheter Valve Repair System (Edwards Lifesciences) has expanded the
options of TEER devices. However, evidence comparing PASCAL with MitraClip
systems is still limited. Methods. We conducted a systematic literature
research and meta-analysis in PubMed, Medline, and EMBASE databases for
studies comparing PASCAL and MitraClip systems. Results. Four
observational studies and 1 randomized controlled trial, involving 1315
patients total, were eligible for inclusion. All patients exhibited
symptomatic (NYHA II-IV) MR grades 3+ or 4+. Baseline characteristics were
comparable across all included studies. The clinical outcomes were
assessed according to the Mitral Valve Academic Research Consortium
consensus. The procedural success rates for the 2 devices were comparable
in terms of achieving post-procedural MR grades of less than or equal to
2+ and less than or equal to 1+. Furthermore, most patients improved their
clinical status, with no significant differences between patients treated
with PASCAL and those treated with MitraClip. In terms of safety, both
procedures exhibited low overall mortality rates and occurrence of major
adverse events (MAE), without significant difference between the 2
devices. These findings remained consistent in both short- and long-term
follow-up assessments. Conclusions. Our study revealed similar
effectiveness and safety profiles between the PASCAL and MitraClip devices
in patients experiencing significant symptomatic MR. Copyright ©
2023 Cliggott Publishing Co.. All rights reserved.

<21>
Accession Number
2034072510
Title
Preventing or Minimizing Acute Kidney Injury in Patients Undergoing
Transcatheter Aortic Valve Replacement.
Source
Journal of Invasive Cardiology. 33(1) (pp E32-E39), 2021. Date of
Publication: 01 Jan 2021.
Author
Tandar A.; Sharma V.; Ibrahim M.; Jones T.; Morgan D.; Montzingo C.; Lee
J.; Birgenheier N.; Silverton N.; Abraham A.; Welt F.G.P.; Glotzbach J.P.
Institution
(Tandar, Ibrahim, Jones, Abraham, Welt) The Division of Cardiovascular
Medicine, University of Utah School of Medicine, Salt Lake City, UT,
United States
(Sharma, Glotzbach) The Division of Cardiothoracic Surgery, University of
Utah School of Medicine, Salt Lake City, UT, United States
(Morgan, Montzingo, Lee, Birgenheier, Silverton) The Division of Cardiac
Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT,
United States
Publisher
Cliggott Publishing Co.
Abstract
Background. Transcatheter aortic valve implantation (TAVI) is now
routinely performed in patients with aortic stenosis with low mortality
and complication rates. Although periprocedural risks have been
substantially minimized, procedure- and contrast-induced acute kidney
injury (AKI) remains a major concern. AKI remains a frequent complication
of contrast-guided interventional procedures and is associated with a
significantly adverse prognosis. We review the currently available
clinical data related to AKI, with emphasis on contrast-induced
nephropathy (CIN), and discuss a novel, integrated approach aiming to
minimize AKI risk in high-risk patients. A stepwise algorithm is also
proposed for the management of these complex patients. Copyright
© 2021 Cliggott Publishing Co.. All rights reserved.

<22>
Accession Number
2034071546
Title
Clinical Impact of Medical Therapy Versus Revascularization in Patients
With Chronic Coronary Total Occlusions.
Source
Journal of Invasive Cardiology. 33(1) (pp E2-E8), 2021. Date of
Publication: January 2021.
Author
Alvarez-Contreras L.; Flores-Umanzor E.; Cepas-Guillen P.;
Ferreira-Gonzalez I.; Freixa X.; Regueiro A.; Brugaletta S.; Sabate M.;
Martin-Yuste V.
Institution
(Alvarez-Contreras, Flores-Umanzor, Cepas-Guillen, Freixa, Regueiro,
Brugaletta, Sabate, Martin-Yuste) Cardiology Department, Clinic
Cardiovascular Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
(Ferreira-Gonzalez) Cardiology Department, Vall d'hebron Hospital, CIBER
de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain
(Martin-Yuste) Service de Cardiologie, Centre Hospital-ier de Saintonge,
Saintes, France
Publisher
Cliggott Publishing Co.
Abstract
Background. Chronic total occlusions (CTOs) are prevalent angiographic
findings in patients with suspected coronary artery disease. Conflicting
results of randomized controlled trials and registries have not clarified
the therapeutic approach for patients with CTO in clinical practice.
Therefore, we sought to analyze variables influencing the decision-making
process and their relationship with clinical outcomes according to the
type of selected therapy. Methods. A total of 1248 consecutive patients
with at least 1 CTO were identified between 2010 and 2014 at our
institution. Clinical and angiographic variables were collected to allow
the calculation of several predictive scores. Primary outcome was
all-cause death at the longest follow-up available. Other endpoints of
interest included cardiac mortality and myocardial infarction. Medical
therapy (MT) alone was indicated in 719 patients (58%), whereas
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) were used in 240 (19%) and 298 (24%), respectively. Age,
acute myocardial infarction, previous CABG, and age, creatinine, ejection
fraction (ACEF) score were independently associated with the decision for
MT alone. Conversely, the presence of multivessel disease, left main
coronary artery involvement, and high SYNTAX score favored the decision
for CABG. At a median follow-up of 4.3 years, revascularization strategies
were independently associated with all-cause mortality and cardiac
mortality (hazard ratio [HR], 0.42; 95% confidence interval [CI]
0.27-0.65; P<.001 and HR, 0.32; 95% CI, 0.17-0.60; P<.001, respectively)
for PCI and (HR, 0.39; 95% CI, 0.26-0.58 and HR, 0.51; 95% CI, 0.32-0.81;
P<.01, respectively) for CABG. Conclusion. Several clinical and
angiographic parameters influence the decision-making process of patients
with CTO. CTO revascularization with either PCI or CABG appeared to be
associated with improved clinical outcomes at long-term follow-up as
compared with MT alone. Copyright © 2021 Cliggott Publishing Co..
All rights reserved.

<23>
Accession Number
2034072566
Title
The Effects of Corticosteroids on Survival in Pediatric and Nonelderly
Adult Patients Undergoing Cardiac Surgery: A Meta-analysis of Randomized
Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Losiggio R.; Lomivorotov V.; D'Andria Ursoleo J.; Kotani Y.; Monaco F.;
Milojevic M.; Yavorovskiy A.; Lee T.C.; Landoni G.; Oriani A.; Prima
A.L.D.; Mucchetti M.; Ortalda A.; Calabro M.G.; Zangrillo A.
Institution
(Losiggio, D'Andria Ursoleo, Monaco, Landoni) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State College of Medicine, Penn State Milton S. Hershey Medical
Centre, Hershey, PA, United States
(Kotani) Department of Intensive Care Medicine, Kameda Medical Centre,
Kamogawa, Japan
(Milojevic) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Yavorovskiy) Department of Anesthesiology and Intensive Care, I.M.
Sechenov First Moscow State Medical University of the Russian Ministry of
Health, Moscow, Russian Federation
(Lee) Division of Infectious Diseases, Department of Medicine, McGill
University Health Centre, Montreal, QC, Canada
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
(Oriani, Prima, Mucchetti, Ortalda, Calabro, Zangrillo) Department. of
Anesthesia and Intensive Care, IRCCS San RaffaeleScientific Institute,
Milan, Italy
(Zangrillo) School of Medicine, Vita-Salute San Raffaele.University,
Milan, Italy
Publisher
W.B. Saunders

<24>
Accession Number
2034072285
Title
Effect of Preoperative Clopidogrel on Outcomes of Isolated Coronary Artery
Bypass Grafting.
Source
Annals of Thoracic Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Choi K.; Schaff H.V.; Villavicencio M.A.; Dearani J.A.; Stulak J.M.;
Greason K.L.; Spadaccio C.; Todd A.; Crestanello J.A.
Institution
(Choi, Schaff, Villavicencio, Dearani, Stulak, Greason, Spadaccio,
Crestanello) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
Minnesota, United States
(Todd) Division of Clinical Trials and Biostatistics, Department of
Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, United
States
Publisher
Elsevier Inc.
Abstract
Background: We analyzed The Society of Thoracic Surgeons Database to
investigate risks and optimal timing for coronary artery bypass grafting
(CABG) after clopidogrel administration. Method(s): Patients were
categorized based on clopidogrel use within 5 days and further stratified
by days from the last dose (0 to 5 days). Controls were patients who did
not receive clopidogrel within 5 days of surgery. The primary outcome was
operative mortality, and secondary outcomes included mediastinal
reexploration for bleeding and blood product use. Result(s): Among
148,317 isolated CABG, 19,553 patients (13.2%) received clopidogrel within
5 days. Minimal differences in operative mortality (2.8% vs 2.1%, P <
.001), but higher rates of mediastinal reexploration (3.5% vs 2.1%, P <
.001) and blood product utilization (72.7% vs 56.8%, P < .001) were
observed in the clopidogrel group. The adjusted odds ratio of operative
mortality peaked on the day of clopidogrel administration but was
comparable to controls thereafter. The odds of reexploration were highest
on day 0, decreasing gradually to a plateau after day 3. Patients who
underwent operations on day 3 after clopidogrel administration had similar
odds of operative mortality and mediastinal reexploration for bleeding and
shorter total and preoperative lengths of stay but higher blood product
use compared with day 5. Conclusion(s): CABG within 5 days from
clopidogrel is associated with a modest increase in operative mortality
and reexploration for bleeding and a substantial increase in blood product
use. Risks decreased with increasing time from discontinuation, plateauing
after 3 days from clopidogrel. CABG at 3 days yields comparable outcomes
as 5 days, reducing the waiting period. Copyright © 2024 The
Society of Thoracic Surgeons

<25>
Accession Number
645019644
Title
The Use of Immunomodulators, Biologic Therapies, and Small Molecules in
Patients With Inflammatory Bowel Disease and Solid Organ Transplant.
Source
Journal of clinical gastroenterology. (no pagination), 2024. Date of
Publication: 14 Aug 2024.
Author
Ghusn W.; Mourad F.H.; Francis F.F.; Pasha S.; Farraye F.A.; Hashash J.G.
Institution
(Ghusn) Division of Gastroenterology and Hepatology, Mayo Clinic, MN,
United States
(Ghusn) Department of Internal Medicine, Boston Medical Center, MA, United
States
(Mourad) Division of Gastroenterology and Hepatology, Department of
Internal Medicine, American University of Beirut, Beirut, Lebanon
(Francis) Division of Gastroenterology, Hepatology, Nutrition, University
of Pittsburgh Medical Center, PA, United States
(Pasha) Division of Gastroenterology and Hepatology, Mayo Clinic, AZ,
United States
(Farraye, Hashash) Division of Gastroenterology and Hepatology, Mayo
Clinic, FL, Puerto Rico
Abstract
Patients with inflammatory bowel diseases (IBDs) may require solid organ
transplants (SOTs) for multiple reasons, making its prevalence slightly
higher than the general population. Although immunosuppression used in SOT
may help control IBD-related inflammation, many patients still require
additional immunosuppressive medications. We aim to assess the
effectiveness and safety of the combination of SOT-related
immunosuppression and IBD medications in patients with liver, kidney, or
heart transplantation. We conducted a clinical review using PubMed,
Scopus, MEDLINE, Embase, and Google Scholar databases for our search. We
included data from systematic reviews, meta-analyses, case series, and
case reports to assess the safety, effectiveness, and side effect profile
of immunomodulators, biologic therapies, and small molecules in patients
with SOT. Our review encompassed 25 liver, 6 kidney, and 1 heart
transplant studies involving patients with IBD. Common liver transplant
immunosuppressants included tacrolimus, mycophenolate mofetil,
cyclosporine, and steroids. Anti-TNF agents, widely used in all SOT types,
showed no significant safety issues, though infections and malignancies
were noted. Patients with liver transplant on tacrolimus responded well to
anti-integrins and ustekinumab without major complications. For kidney
transplants, cyclosporine and tacrolimus were prevalent, and their
combination with anti-TNF or ustekinumab was generally safe, with rare
reports of malignancy or infection. Hence, the use of anti-TNF,
anti-integrin agents, and ustekinumab appears to be safe in patients with
SOT, regardless of their transplant related immunosuppression. More
studies are needed in patients with kidney and heart transplants and in
patients treated with small molecules for their IBD. Copyright ©
2024 Wolters Kluwer Health, Inc. All rights reserved.

<26>
Accession Number
2032384438
Title
Comprehensive analysis of donor-site chest deformities after autologous
costal cartilage microtia reconstruction: A systematic review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 94 (pp 128-140),
2024. Date of Publication: July 2024.
Author
Kim J.; Park C.; Oh K.S.; Lim S.Y.
Institution
(Kim, Park, Lim) Department of Plastic Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Oh) Department of Plastic surgery, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
Publisher
Churchill Livingstone
Abstract
Background: Autologous costal cartilage has gained widespread acceptance
as an important material for ear reconstruction in patients with microtia.
Despite its recognition as being "worth the trade-off," attention should
be directed toward donor-site deformities. This systematic review focused
on existing English literature related to microtia reconstruction and
aimed to reveal the incidence of chest wall deformities and assess the
effectiveness of the various proposed surgical techniques aimed at
reducing donor-site morbidities. Method(s): A comprehensive search
was conducted on Pubmed and OVID using the keywords "microtia," and "chest
deformity" or "rib harvest." Articles were screened based on predefined
inclusion and exclusion criteria. Data acquisition encompassed patient
demographics, employed surgical techniques, methods for evaluating chest
deformity, and incidence of associated complications. Result(s):
Among the 362 identified articles, 21 met the inclusion criteria. A total
of 2600 cases involving 2433 patients with microtia were analyzed in this
review. Perichondrium preservation during cartilage harvesting led to a
significant reduction in chest deformities. However, the wide incidence
range (0% to 50%) and the lack of specific assessment methods suggested
potential underestimation. Computed tomography revealed reduced chest wall
growth in the transverse and sagittal directions, resulting in decreased
thoracic area. Innovative surgical techniques have shown promising results
in reducing chest deformities. Conclusion(s): Although a quantitative
analysis was not feasible, objective evidence of deformities was
established through computed tomography scans. This analysis highlighted
the need for dedicated studies with larger sample sizes to further advance
our understanding of chest wall deformities in microtia
reconstruction. Copyright © 2024

<27>
Accession Number
2033208430
Title
Comparison of Propofol-Based Total Intravenous Anesthesia versus Volatile
Anesthesia with Sevoflurane for Postoperative Delirium in Adult Coronary
Artery Bypass Grafting Surgery: A Prospective Randomized Single-Blinded
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(9) (pp 1932-1940),
2024. Date of Publication: September 2024.
Author
Varsha A.V.; Unnikrishnan K.P.; Saravana Babu M.S.; Raman S.P.; Koshy T.
Institution
(Varsha, Unnikrishnan, Saravana Babu, Raman, Koshy) Cardiothoracic and
Vascular Anaesthesiology Division, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Thiruvananthapuram, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the incidence of delirium and early (at 1 week)
postoperative cognitive dysfunction (POCD) between propofol-based total
intravenous anesthesia (TIVA) and volatile anesthesia with sevoflurane in
adult patients undergoing elective coronary artery bypass graft surgery
(CABG) with cardiopulmonary bypass (CPB). Design(s): This was a
prospective randomized single-blinded study. Setting(s): The study
was conducted at a single institution, the Sree Chitra Tirunal Institute
for Medical Sciences and Technology, a tertiary care institution and
university-level teaching hospital. Participant(s): Seventy-two
patients undergoing elective CABG under CPB participated in this study.
 Intervention(s): This study was conducted on 72 adult patients (>18
years) undergoing elective CABG under CPB who were randomized to receive
propofol or sevoflurane. Anesthetic depth was monitored to maintain the
bispectral index between 40 and 60. Delirium was assessed using the
Confusion Assessment Method for the Intensive Care Unit. Early POCD was
diagnosed when there was a reduction of >2 points in the Montreal
Cognitive Assessment score compared to baseline. Cerebral oximetry changes
using near-infrared spectroscopy (NIRS), atheroma grades, and
intraoperative variables were compared between the 2 groups. Measurements
& Main Results: Seventy-two patients were randomized to receive propofol
(n = 36) or sevoflurane (n = 36). The mean patient age was 59.4 +/- 8.6
years. The baseline and intraoperative variables, including atheroma
grades, NIRS values, hemoglobin, glycemic control, and oxygenation, were
comparable in the 2 groups. Fifteen patients (21.7%) patients developed
delirium, and 31 patients (44.9%) had early POCD. The incidence of
delirium was higher with sevoflurane (n = 12; 34.2%) compared to propofol
(n = 3; 8.8%) (odds ratio [OR], 1.72; 95% confidence interval [CI],
1.13-2.62; p = 0.027)*. POCD was higher with sevoflurane (n = 20; 57.1%)
compared to propofol (n = 11; 32.3%) (OR, 1.63; 95% CI, 1.01-2.62; p =
0.038)*. In patients aged >65 years, delirium was higher with sevoflurane
(7/11; 63.6%) compared to propofol (1/7; 14.2%) (p = 0.03)*.
 Conclusion(s): Propofol-based TIVA was associated with a lower
incidence of delirium and POCD compared to sevoflurane in this cohort of
patients undergoing CABG under CPB. Large-scale, multicenter randomized
trials with longer follow-up are needed to substantiate the clinical
relevance of this observation. Copyright © 2024

<28>
Accession Number
2033009462
Title
Effectiveness of Adaptive Support Ventilation in Facilitating Weaning from
Mechanical Ventilation in Postoperative Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(9) (pp 1978-1986),
2024. Date of Publication: September 2024.
Author
Tsai Y.-C.; Jhou H.-J.; Huang C.-W.; Lee C.-H.; Chen P.-H.; Hsu S.-D.
Institution
(Tsai, Hsu) Division of Traumatology, Department of Surgery, Tri-Service
General Hospital, National Defense Medical Center, Taipei, Taiwan
(Republic of China)
(Tsai) Division of Plastic Surgery, Department of Surgery, Tri-Service
General Hospital, National Defense Medical Center, Taipei, Taiwan
(Republic of China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Changhua,
Taiwan (Republic of China)
(Huang) Division of Plastic Surgery, Department of Surgery, Cathay General
Hospital, Taipei, Taiwan (Republic of China)
(Lee, Chen) Division of Hematology and Oncology, Department of Internal
Medicine, Tri-Service General Hospital, National Defense Medical Center,
Taipei, Taiwan (Republic of China)
Publisher
W.B. Saunders
Abstract
Objective: This meta-analysis aims to evaluate the effectiveness of
adaptive support ventilation (ASV) in facilitating postoperative weaning
from mechanical ventilation in cardiac surgery patients. Design(s): A
systematic review and meta-analysis to assess ASV in weaning postoperative
cardiac surgery patients. Outcomes included early extubation, reintubation
rates, time to extubation, and lengths of intensive care units and
hospital stays. Setting(s): We searched electronic databases from
inception to March 2023 and included randomized controlled trials that
compared ASV with conventional ventilation methods in this population.
 Participant(s): Postoperative cardiac surgery patients.
 Measurements and Main Results: A random effects model was used for
meta-analysis, and trial sequential analysis (TSA) was conducted to assess
result robustness. The meta-analysis included 11 randomized controlled
trials with a total of 1027 randomized patients. ASV was associated with a
shorter time to extubation compared to conventional ventilation (random
effects, mean difference -68.30 hours; 95% confidence interval, -115.50 to
-21.09) with TSA providing a conclusive finding. While ASV indicated
improved early extubation rates, no significant differences were found in
reintubation rates or lengths of intensive care unit and hospital stays,
with these TSA results being inclusive. Conclusion(s): ASV appears to
facilitate a shorter time to extubation in postoperative cardiac surgery
patients compared to conventional ventilation, suggesting benefits in
accelerating the weaning process and reducing mechanical ventilation
duration. Copyright © 2024 Elsevier Inc.

<29>
Accession Number
644162168
Title
A comment on 'Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials'.
Source
International journal of surgery (London, England). 110(8) (pp 5222-5223),
2024. Date of Publication: 01 Aug 2024.
Author
Zheng J.; Chen Z.
Institution
(Zheng) First Clinical Medical School, Guangzhou Medical University
(Chen) Second Clinical Medical School, Guangzhou Medical University,
Guangzhou, Guangdong, China

<30>
Accession Number
644023429
Title
Clinical outcomes of on-pump versus off-pump coronary-artery bypass
surgery: a meta-analysis.
Source
International journal of surgery (London, England). 110(8) (pp 5063-5070),
2024. Date of Publication: 01 Aug 2024.
Author
He L.; Tiemuerniyazi X.; Chen L.; Yang Z.; Huang S.; Nan Y.; Song Y.; Feng
W.
Institution
(He) Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Abstract
BACKGROUND: The ongoing debate regarding off-pump coronary artery bypass
grafting (CABG) and on-pump CABG has endured for over three decades.
Although numerous randomized controlled trials (RCTs) and meta-analyses
have been reported, new evidence has emerged. Therefore, an updated and
comprehensive meta-analysis to guide clinical practice is essential.
MATERIALS AND METHODS: A comprehensive search for eligible articles
published after 2000, reporting RCTs involving at least 100 patients and
comparing off-pump CABG with on-pump CABG, was performed throughout the
databases including Embase, Ovid Medline, and Web of Science. The primary
interested outcomes included the short-term incidence of stroke and
long-term mortality. The primary analysis utilized fixed-effect model with
the inverse variance method. The Grade of Recommendations Assessment,
Development, and Evaluation (GRADE) was used to evaluate the certainty of
evidence. RESULT(S): After thorough screening, 39 articles were
included, consisting of 28 RCTs and involving a total of 16 090 patients.
Off-pump CABG significantly reduced the incidence of short-term stroke
(1.27 vs. 1.78%, OR: 0.74, P =0.03, high certainty). However, it was
observed to be associated with increased mid-term coronary reintervention
(2.77 vs. 1.85%, RR: 1.49, P <0.01, high certainty) and long-term
mortality (21.8 vs. 21.0%, RR: 1.09, P =0.02, moderate certainty).
 CONCLUSION(S): Off-pump CABG significantly reduces the short-term
incidence of stroke, but it also increases the incidence of mid-term
coronary reintervention. Moreover, it may increase long-term
mortality. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<31>
Accession Number
2034092835
Title
Venous thromboembolism chemoprophylaxis is not supported following spine
surgery: a meta-analysis of randomized controlled trials.
Source
Spine Journal. Conference: NASS 39th Annual Meeting. McCormick Place, West
Building, Chicago United States. 24(9 Supplement) (pp S80), 2024. Date of
Publication: September 2024.
Author
Muralidharan A.; Baumann A.; Piche J.D.; Gong D.; Walley K.; Kashlan O.;
Patel R.R.D.; Aleem I.
Institution
(Muralidharan, Piche, Gong, Walley, Kashlan) University of Michigan, Ann
Arbor, MI, United States
(Baumann) College of Medicine, Northeast Ohio Medical University,
Rootstown, OH, United States
(Patel) University of Michigan, Department of Orthopaedic Surgery, Ann
Arbor, MI, United States
(Aleem) University of Michigan Health System, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
BACKGROUND CONTEXT: Postoperative venous thromboembolism (VTE) is an
overall rare complication following spine surgery. Pharmacologic VTE
prophylaxis remains controversial in this patient population, as potential
risks associated with anticoagulants, namely epidural hematoma, must be
considered. PURPOSE: The aim of this meta-analysis is to compile and
analyze existing evidence in previous large-scale, randomized studies
comparing pharmacologic and nonpharmacologic VTE prophylaxis after spine
surgery, in hopes to guide postoperative decision making that can improve
individual patient outcomes and health systems at large. STUDY
DESIGN/SETTING: Systematic review and meta-analysis of randomized
controlled trials. PATIENT SAMPLE: After screening 927 articles, a total
of 7 studies were eligible for final inclusion. These included 1,509
patients, of whom 1,151 received pharmacologic VTE prophylaxis and 358
received mechanical VTE prophylaxis. All patients (n=1,151) who received
PPX of any kind (Coumadin, aspirin, LWMH, HDHE, DHE, rivaroxaban, or
parnaparin) with spine surgery had a mean age of 54.54 +/- 7.44 years,
whereas all patients (n=358) who did not receive PPX with spine surgery
had a mean age of 49.40 +/- 11.75 years. Of all included patients, 1,207
patients (79.99%) had lumbar surgery. Of the remaining 302 patients, 54
patients (3.58%) had cervical or thoracic surgery with the rest of the
patients (n=248, 16.43%) having surgery in an undefined region. OUTCOME
MEASURES: The extracted outcome measures of interest were occurrence of
VTE, bleeding, and epidural hematoma. Bleeding was divided further into
significant or severe bleeding. Severe bleeding included cases of fatal
bleeding, bleeding-induced reoperation, or need for greater than two
transfusions postoperatively. METHOD(S): We conducted a comprehensive
literature search of several electronic databases, including PubMed,
Embase, Web of Science, and Cochrane Central Register of Controlled Trials
from inception to May 8, 2023. Two authors independently extracted data,
including study characteristics, patient demographics, treatment arms,
surgery inclusion/exclusion, and follow-up duration. RESULT(S):
Moderate-quality evidence demonstrated there was no significant difference
between groups in rates of VTE (p=0.639; RR: 1.01; 95% CI: 0.96, 1.06) or
DVT (p=0.064; RR: 1.03; 95% CI: 1.00, 1.07). There was also no significant
difference between groups in risk of severe bleeding (p=0.377; RR: 1.04,
95% CI: 0.95, 1.14) or significant bleeding (p=0.517; RR: 1.02; 95% CI:
0.96, 1.08). CONCLUSION(S): Moderate-quality evidence does not
support the routine use of pharmacologic DVT prophylaxis following
elective spine surgery. Future high-quality randomized
comparative-effectiveness trials with sufficient power to evaluate safety
and efficacy given the rarity of complications are warranted. FDA
Device/Drug Status: This abstract does not discuss or include any
applicable devices or drugs. Copyright © 2024

<32>
Accession Number
2034064972
Title
Impact of lipoprotein(a) on valvular and cardiovascular outcomes in
patients with calcific aortic valve stenosis.
Source
Atherosclerosis. Conference: EAS 2024. Padova Italy. 395(Supplement 1) (no
pagination), 2024. Article Number: 118419. Date of Publication: August
2024.
Author
Girard A.; Paulin A.; Purage H.M.; Clavel M.-A.; Pibarot P.; Krege J.;
Mathieu P.; Theriault S.; Arsenault B.
Institution
(Girard, Paulin, Purage, Clavel, Pibarot, Mathieu, Arsenault) Quebec Heart
and Lung Institute, Quebec, Canada
(Clavel, Arsenault) Department Of Medicine, Laval University, Quebec,
Canada
(Krege) Eli Lilly, Indianapolis, United States
(Mathieu) Department Of Surgery, Laval University, Quebec, Canada
(Theriault) Department Of Molecular Biology, Medical Biochemistry And
Pathology, Laval University, Quebec, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Lipoprotein(a) (Lp[a]) is an independent risk factor
for calcific aortic valve stenosis (CAVS) incidence. Whether patients with
CAVS and high Lp(a) levels are at higher risk of cardiovascular or
valvular events is unknown. We sought to establish the association between
Lp(a) levels and cardiovascular and valvular outcomes in patients with
CAVS. Method(s): We identified 1962 patients with CAVS in the UK
Biobank using an electronic health record-based CAVS diagnosis who had a
minimal follow-up time of 2.5 years. Cox proportional hazard regression
was used to evaluate the effect of Lp(a) on aortic valve replacement
(AVR), a composite endpoint of AVR and cardiac death, and cardiovascular
and valvular events (composite of AVR, myocardial infarction, stroke,
heart failure, cardiac death, and coronary artery bypass grafting). The
maximal follow-up time was set to 5 years. Result(s): During the
follow-up, 198 patients underwent AVR, 260 had AVR or cardiac death and
435 had at least one event from the cardiovascular and valvular composite
endpoint. Participants with Lp(a) levels (>=125 nmol/L) were at higher
risk of AVR (hazard ratio [HR]=1.58, 95% CI: 1.17-2.12), AVR or cardiac
death (HR=1.43, 95% CI: 1.10-1.86) and cardiovascular and valvular events
(HR=1.36, 95% CI: 1.11-1.68) compared to patients with Lp(a) levels <125
nmol/L. Point estimates were comparable in women and men and younger
versus older patients. Conclusion(s): In patients with CAVS, Lp(a)
levels predicted a higher risk of cardiovascular and valvular endpoints.
The impact of Lp(a)-lowering therapies on cardiovascular and valvular
outcomes should be assessed in a long-term randomized clinical
trial. Copyright © 2024

<33>
Accession Number
2034064930
Title
Unraveling the potential of coronary artery calcium scoring in
non-cardiovascular disease risk: A critical review.
Source
Atherosclerosis. Conference: EAS 2024. Padova Italy. 395(Supplement 1) (no
pagination), 2024. Article Number: 117713. Date of Publication: August
2024.
Author
Cortiana V.; Vaghela H.; Bakhle R.; Santhosh T.; Kaiwan O.
Institution
(Cortiana) University of Bologna, Bologna, Italy
(Vaghela) Pandit Deendayal Upadhyay Medical College, Gujarat, Rajkot,
India
(Bakhle) Medical College Baroda, Gujarat, India
(Santhosh) Dr. Somervell memorial CSI medical college, Kerala, India
(Kaiwan) Northeast Ohio Medical University, Ravenna, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: With the tremendous success of Coronary Artery
Calcium (CAC) scoring in cardiology, its potential in assessing
non-cardiovascular diseases is being explored. Emerging evidence suggests
that higher CAC scores are associated with increased risk of
non-cardiovascular diseases and all-cause mortality. With this review the
authors aim to compile evidence on the potential of CAC in assessing
non-cardiovascular diseases. Method(s): A literature review was done
on scholarly databases of PubMed, Scopus, Google Scholar, Embase and Web
of Science using appropriate keywords to explore the evolving role of CAC
for non-cardiovascular diseases. Result(s): A growing body of
literature validates the role of CAC scoring for screening and risk
assessment of non-cardiovascular diseases. In pulmonology, studies have
concluded a direct link between CAC scores and diagnosis of chronic
obstructive pulmonary disease (COPD), pulmonary embolism, and pneumonia.
In endocrinology, a direct association has been observed between CAC
scores and incidence of diabetes, gestational diabetes, chronic kidney
diseases (CKD), and osteoporosis. In gastroenterology, an association has
been concluded between CAC scores and non-alcoholic fatty liver disease
(NAFLD), hepatic steatosis, nephrolithiasis, and in predicting early
post-operative cardiovascular complications in liver transplant
recipients. In neurology, CAC scores can predict the incidence of stroke
and dementia. In psychiatry, CAC scores have been employed for estimating
risk of erectile dysfunction and personality disorders. Several autoimmune
diseases like psoriasis, systemic lupus erythematosus (SLE), and
malignancies (e.g., lung and colorectal cancer) have also been associated
with CAC scores. Conclusion(s): The review of literature strongly
suggests an association of CAC scores with various diseases, which can
facilitate early disease diagnosis and prognosis. Furthermore, CAC can
help assess the risk of cardiovascular conditions developing secondary to
many non-cardiovascular diseases. With ample data and research studies,
the application of CAC in non-cardiovascular diseases can be justified and
its role in providing preventative care can be further
explored. Copyright © 2024

<34>
Accession Number
2034064700
Title
Bempedoic acid efficacy and safety in 7,597 non-diabetic patients, with
and without metabolic syndrome, from the randomized, placebo-controlled
clear outcomes trial.
Source
Atherosclerosis. Conference: EAS 2024. Padova Italy. 395(Supplement 1) (no
pagination), 2024. Article Number: 118373. Date of Publication: August
2024.
Author
Taub P.; Plutzky J.; Li N.; Bloedon L.; Brennan D.; Nissen S.; Lincoff
A.M.; Nicholls S.
Institution
(Taub) University of California San Diego, San Diego, United States
(Plutzky) Brigham and Women's Hospital, Harvard Medical School, Boston,
United States
(Li, Bloedon) Esperion Therapeutics, Inc., Ann Arbor, United States
(Brennan, Nissen, Lincoff) Cleveland Clinic, Cleveland, United States
(Nicholls) Monash University, Victorian Heart Institute, Melbourne,
Australia
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: Bempedoic acid (BA) reduced LDL-C and cardiovascular
(CV) events in 13,970 statin intolerant patients with, or at high risk
for, CV disease with LDL-C >=100 mg/dL. Metabolic syndrome (MetS) patients
are a high-risk primary prevention cohort and have high rates of
progression to diabetes. We evaluated the impact of BA on clinical and
laboratory parameters in patients with and without MetS at baseline.
 Method(s): Comparison of treatment effect was performed in a post-hoc
analysis of the primary 4-point major adverse CV event (MACE-4; CV death,
nonfatal myocardial infarction, nonfatal stroke, or coronary
revascularization) endpoint. Change in biomarkers (lipids and hsCRP),
parameters of glycemia (new-onset diabetes [NOD], HbA1c and fasting
glucose), and weight were assessed. Result(s): The analysis included
3,824 patients with MetS (BA N=1,913; placebo N= 1,911) and 3,773 without
MetS (BA N= 1,935; placebo N= 1,838). BA reduced the risk of MACE-4
similarly in patients with or without MetS (Table 1). Similar
placebo-corrected reductions in LDL-C were observed with BA at 6 months in
patients with or without MetS. Patients with MetS experienced a greater
placebo-corrected reduction in hsCRP at 6 months than patients without
MetS. BA was not associated with an increased risk of NOD, nor significant
changes in HbA1c or fasting plasma glucose compared to placebo. Greater
mean (95%CI) reduction in weight (kg) from baseline to 36 month was
observed for MetS on BA [-1.1 (-1.4,-0.8)] vs placebo [-0.3 (-0.6,-0.0)].
Safety was generally comparable between MetS and treatment groups, with
higher rates of hyperuricemia in patients with MetS randomized to BA.
[Formula presented] Conclusion(s): Bempedoic acid is a suitable
therapy for patients with and without MetS who require additional lipid
lowering. In patients with MetS on BA there was a small but significant
reduction in weight and hsCRP with no increase in NOD. Copyright
© 2024

<35>
Accession Number
2034064664
Title
Functional significance of intermediate coronary lesions in patients with
stable coronary artery disease.
Source
Atherosclerosis. Conference: EAS 2024. Padova Italy. 395(Supplement 1) (no
pagination), 2024. Article Number: 118244. Date of Publication: August
2024.
Author
Stan M.; Mikhaliev K.; Zharinov O.; Khokhlov A.; Stan O.; Todurov B.
Institution
(Stan, Khokhlov) Interventional, Endovascular And Angiography Department,
Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
(Mikhaliev) Scientific Department Of Internal Medicine, SIS "RPC PCM" SAD,
Kyiv, Ukraine
(Zharinov) Department Of Functional Diagnostics, Shupyk National
Healthcare University of Ukraine, Kyiv, Ukraine
(Stan) Diagnostic Consultancy Department, Heart Institute of the Ministry
of Health of Ukraine, Kyiv, Ukraine
(Todurov) Ceo, Heart Institute of the Ministry of Health of Ukraine, Kyiv,
Ukraine
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: To assess a functional significance of intermediate
coronary lesions (of 50-90 % stenosis) in patients with stable coronary
artery disease (SCAD). Method(s): The cross-sectional single-center
study consecutively enrolled 123 SCAD patients (mean age 62+/-9 years;
males - 73,2 %) with intermediate coronary lesions (stenosis 50-90 %) (by
invasive coronary angiography). We analyzed the angiographic and
functional data from 128 coronary lesions, originated from the territories
of left anterior descending artery (n=60 [46,9 %]), circumflex artery
(n=38 [29,7 %]) and right coronary artery (n=30 [23,4 %]). The functional
significance of coronary lesions was assessed by functional flow reserve
(FFR). The hemodynamically significant lesion was considered in case of
FFR <=0,80 a.u. Result(s): We observed an increase of hemodynamic
significance of coronary lesions along with an increase of their stenosis
degree: FFR (median, 95 % confidence interval) 0,90 [0,89-0,91) a.u.
(stenosis 50-59 % [n=32]); 0,89 (0,82-0,90) a.u. (60-69 % [n=24]); 0,76
[0,73-0,81] a.u. (70-79 % [n=44]; p<0,001 vs. 50-59 % and 60-69 %); 0,63
[0,60-0,70] a.u. (80-90 %; p<0,001 vs. 50-59 %, 60-69 % and 70-79 %)
(correlation between FFR and degree of stenosis: rho= -0,795; p<0,001
[n=128]). The majority of (50-59 %) and (60-69 %) lesions were
hemodynamically non-significant: 30 (of 32) and 19 (of 24), respectively.
On the contrary, all the (80-90 %) lesions (n=28) were significant. The
(70-79%) lesions (n=44) included two hemodynamically opposite
<<clusters>>: non-significant (N=16) and significant (N=28) ones
(correlation between FFR and degree of stenosis: rho = -0,483; p<0,001
[n=44]). Conclusion(s): SCAD patients with intermediate coronary
lesions (50-90 %) demonstrated an increase of functional compromise along
with an increase of their anatomical significance. A functional
heterogeneity by FFR value was inherent to the group of (70-79 %) lesions.
The prioritizing of intermediate coronary lesions to be functionally
assessed should be considered for better SCAD patients' selection for
myocardial revascularization. Copyright © 2024

<36>
Accession Number
2034064307
Title
Apolipoprotein e concentrations are predictive of recurrent strokes:
Insights from the SPARCL trial.
Source
Atherosclerosis. Conference: EAS 2024. Padova Italy. 395(Supplement 1) (no
pagination), 2024. Article Number: 118505. Date of Publication: August
2024.
Author
Chemello K.; Guedon A.F.; Techer R.; Lambert G.; Gallo A.
Institution
(Chemello, Techer, Lambert) Universite de La Reunion, Inserm, UMR1188
Diabete Atherothrombose Therapies Reunion Ocean Indien (DeTROI), Saint
Pierre, Reunion
(Guedon) Departement Hospitalo-universitaire Inflammation Immunopathologie
Biotherapie (dmui3), Sorbonne Universite, APHP, Service de Medecine
Interne, Paris, France
(Gallo) Lipidology And Cardiovascular Prevention Unit, Department Of
Nutrition, Ap-hp, Hopital Pitie-salpetriere, Sorbonne Universite, Inserm
UMR1166, Paris, France
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: In the SPARCL (Stroke Prevention by Aggressive
Reduction in Cholesterol levels) trial, atorvastatin (80mg per day) was
compared to placebo in patients with recent stroke or transient ischemic
attack (TIA) and no known coronary artery disease. Given the central role
of apolipoprotein E (apoE) in lipoprotein metabolism and in the central
nervous system, we assessed the contribution of apoE to subsequent
cerebrovascular and cardiovascular events in this trial. Method(s):
ApoE concentrations and major isoforms (E2/E3/E4) were determined by
liquid-chromatography-mass-spectrometry in plasma samples collected at
baseline from 4,348 SPARCL participants (2,180 randomized to atorvastatin
and 2,168 to placebo). Patients in the lowest quartile (<3.62mg/dL) were
compared with those in the highest quartiles of apoE concentrations.
Hazard-ratios (HR) were calculated using Cox proportional regression
models after adjustment for age, sex, type of entry event (stroke or TIA),
time since entry event, body mass index, low-density lipoprotein
cholesterol, high-density lipoprotein cholesterol, triglycerides, arterial
hypertension and diabetes at baseline. Result(s): We found a
significant association, independent of apoE isoforms, between low apoE
concentrations and the risk of recurrent strokes or cerebrovascular events
[HR (95% Confidence-Intervals) 1.401 (1.154-1.701), P<0.001 and 1.467
(1.260-1.708) P<0.001], driven by a higher incidence of ischemic strokes
and TIA. In contrast, low apoE concentrations were associated with a
reduced incidence of hemorrhagic strokes in the placebo arm of SPARCL
[0.095 (0.013-0.708), P=0.022]. There was also an association between low
apoE concentrations and the risk of subsequent coronary events [1.373
(1.064-1.373), P=0.015] that was significant only in the placebo arm of
SPARCL and primarily driven by a higher incidence of coronary
revascularization procedures and unstable angina. Conclusion(s): Low
apoE concentrations contribute to the risk of recurrence of
cerebrovascular events and to a lower extent to incident coronary events
in patients with a history of stroke or TIA (SPARCL-
NTC00147602). Copyright © 2024

<37>
[Use Link to view the full text]
Accession Number
2034079803
Title
Effectiveness and safety of enhanced postoperative care units for
non-cardiac, non-neurological surgery: a systematic review protocol.
Source
JBI Evidence Synthesis. 22(8) (pp 1626-1635), 2024. Date of Publication:
14 Mar 2024.
Author
Tran L.; Stern C.; Harford P.; Ludbrook G.; Whitehorn A.
Institution
(Tran, Stern, Harford, Whitehorn) JBI, Faculty of Health and Medical
Sciences, School of Public Health, The University of Adelaide, SA,
Australia
(Tran, Ludbrook) Department of Anaesthesia, Royal Adelaide Hospital,
Central Adelaide Local Health Network, Adelaide, SA, Australia
(Tran, Harford, Ludbrook) Royal Adelaide Hospital, Central Adelaide Local
Health Network, Adelaide, SA, Australia
(Ludbrook) Discipline of Acute Care Medicine, The University of Adelaide,
Adelaide, SA, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The proposed systematic review will evaluate the evidence on
the effectiveness and safety of enhanced post-operative care (EPC) units
on patient and health service outcomes in adult patients following
non-cardiac, non-neurological surgery. Introduction: The increase in
surgical procedures globally has placed a significant economic and
societal burden on health care systems. Recognizing this challenge, EPC
units have emerged as a model of care, bridging the gap between
traditional, ward-level care and intensive care. EPC offers benefits such
as higher staff-to-patient ratios, close patient monitoring (eg, invasive
monitoring), and access to critical interventions (eg, vasopressor
support). However, there is a lack of well-established guidelines and
empirical evidence regarding the safety and effectiveness of EPC units for
adult patients following surgery. Inclusion criteria: This review will
include studies involving adult patients (>=18 years) undergoing any
elective or emergency non-cardiac, non-neurological surgery, who have been
admitted to an EPC unit. Experimental, quasi-experimental, and
observational study designs will be eligible. Method(s): This review
will follow the JBI methodology for systematic reviews of effectiveness.
The search strategy will identify published and unpublished studies from
the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), and Scopus, as well
as gray literature sources, from 2010 to the present. Two independent
reviewers will screen studies, extract data, and critically appraise
selected studies using standardized JBI assessment tools. Where feasible,
a statistical meta-analysis will be performed to combine study findings.
The certainty of evidence will be assessed using the Grading of
Recommendations, Assessment, Development and Evaluation (GRADE)
methodology. Copyright © 2024 JBI.

<38>
Accession Number
2030624617
Title
Cardioprotective Efficacy of Sevoflurane in Patients With Rheumatic Heart
Disease Undergoing Heart Valve Surgery Under Cardiopulmonary Bypass.
Source
Journal of the Saudi Heart Association. 36(2) (pp 120-127), 2024. Date of
Publication: 2024.
Author
Lam V.T.; Kinh N.Q.; Ly N.M.
Institution
(Lam) Department of Anesthesiology and Pain Management, Vinmec Times City
International Hospital, Vietnam
(Kinh) Anesthesia Surgical Intensive Care Center, Viet Duc University
Hospital, Vietnam
(Ly) Department of Anesthesia and Resuscitation, 108 Military Central
Hospital, Vietnam
Publisher
Saudi Heart Association
Abstract
Objectives: In this study, we investigated whether cardioprotective
properties of sevoflurane were expressed in patients with rheumatic heart
disease undergoing heart valve surgery under cardiopulmonary bypass (CPB).
 Method(s): Fifty patients with rheumatic heart disease undergoing
heart valve surgery under CPB were randomly assigned to receive total
anesthesia with sevoflurane or propofol during surgery. Except for this,
anesthetic and surgical management was the same in all patients. The
primary outcomes were postoperative high-sensitive cardiac troponin T
(hs-cTnT) and creatine kinase-myocardial band (CK-MB) release. The
secondary outcomes were hemodynamic events and short-term clinical
outcomes (within 30 days after surgery). Result(s): The plasma
concentrations of hs-cTnT at 24-hour and CK-MB from 6-hour to 48-hour in
the sevoflurane group were lower than those in the control group (the
propofol group). After aortic unclamping, heartbeat recovery was faster
and the rate of sinus rhythm was higher in the sevoflurane group than in
the control group. Moreover, a lower proportion of pacemaker use and the
need for intraoperative and postoperative inotropes were also found in the
sevoflurane group. Nevertheless, there were no differences between the two
groups regarding short-term clinical outcomes (durations of mechanical
ventilation, intensive care unit stay, hospital stay, morbidity, and
mortality rates). Conclusion(s): Sevoflurane administered during the
entire anesthetic procedure had a myocardial protective effect with less
evidence of myocardial damage in the first 48-hour postoperatively but
short-term clinical outcomes were not significantly different when
compared with the control group in patients with rheumatic heart disease
undergoing heart valve surgery under CPB. Copyright © 2024 Saudi
Heart Association.

<39>
Accession Number
2034120047
Title
Outcomes According to Coronary Disease Complexity and Optimal Thresholds
to Guide Revascularization Approach: FAME 3 Trial.
Source
JACC: Cardiovascular Interventions. 17(16) (pp 1861-1871), 2024. Date of
Publication: 26 Aug 2024.
Author
Dawson L.P.; Kobayashi Y.; Zimmermann F.M.; Takahashi T.; Wong C.C.;
Theriault-Lauzier P.; Pijls N.H.J.; De Bruyne B.; Yeung A.C.; Woo Y.J.;
Fearon W.F.
Institution
(Dawson, Wong, Theriault-Lauzier, Yeung, Woo, Fearon) Stanford University
School of Medicine, Stanford, CA, United States
(Dawson) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, Australia
(Kobayashi) NewYork-Presbyterian Brooklyn Methodist Hospital, Weill
Cornell Medical College, Brooklyn, NY, United States
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Takahashi) Department of Cardiology, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, California, United States
(De Bruyne) Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
(Fearon) VA Palo Alto Medical Systems, Palo Alto, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary disease complexity is commonly used to guide
revascularization strategy in patients with multivessel disease (MVD).
 Objective(s): The aim of this study was to assess the interactive
effects of coronary complexity on percutaneous coronary intervention (PCI)
and coronary artery bypass grafting (CABG) outcomes and identify the
optimal threshold at which PCI can be considered a reasonable option.
 Method(s): A total of 1,444 of 1,500 patients with MVD from the FAME
(Fractional Flow Reserve versus Angiography for Multi-vessel Evaluation) 3
randomized trial were included in the analysis (710 CABG vs 734 PCI).
SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) scores were
transformed into restricted cubic splines, and logistic regression models
were fitted, with multiplicative interaction terms for revascularization
strategy. Optimal thresholds at which PCI is a reasonable alternative to
CABG were determined on the basis of Cox regression model performance.
 Result(s): The mean SYNTAX score (SS) was 25.9 +/- 7.1. SS was
associated with 1-year major adverse cardiac and cerebrovascular events
among PCI patients and 3-year death, myocardial infarction, and stroke
among CABG patients. Significant interactions were present between
revascularization strategy and SS for 1- and 3-year composite endpoints (P
for interaction <0.05 for all). In Cox regression models, outcomes were
comparable between CABG and PCI for the 3-year primary endpoint for SS
<=24 (P = 0.332), with 44% of patients below this threshold and 32% below
the conventional SS threshold of <=22. Conclusion(s): In patients
with MVD without left main disease, PCI and CABG outcomes remain
comparable up to SS values in the mid- rather than low 20s, which allows
the identification of a greater proportion of patients in whom PCI may be
a reasonable alternative to CABG. Copyright © 2024 American
College of Cardiology Foundation

<40>
Accession Number
2034083549
Title
Clinical Impact of Crossover Techniques for Primary Access Hemostasis in
Transfemoral Transcatheter Aortic Valve Replacement Procedures.
Source
Journal of Invasive Cardiology. 33(4) (pp E302-E311), 2021. Date of
Publication: April 2021.
Author
Junquera L.; Urena M.; Latib A.; Munoz-Garcia A.; Nombela-Franco L.;
Faurie B.; Alperi A.; Serra V.; Regueiro A.; Fisher Q.; Himbert D.;
Mangieri A.; Colombo A.; Garcia E.M.; Urquiza R.V.; Jimenez-Quevedo P.;
Pascual I.; Blanco B.G.D.; Sabate M.; Mohammadi S.; Freitas-Ferraz A.B.;
Muntane-Carol G.; Couture T.; Paradis J.-M.; Cote M.; Rodes-Cabau J.
Institution
(Junquera, Mohammadi, Freitas-Ferraz, Muntane-Carol, Couture, Paradis,
Cote, Rodes-Cabau) Quebec Heart & Lung Institute, Laval University,
Quebec, Quebec City, Canada
(Urena, Fisher, Himbert) Assistance Publique-Hopitaux de Paris, Bichat
Hospital, Paris, France
(Latib, Mangieri, Colombo) San Raffaele Scientific Institute, Milan, Italy
(Latib) Montefiore Medical Center, New York, New York, United States
(Munoz-Garcia, Garcia) Hospital Universitario Virgen de la Victoria,
Malaga, Spain
(Nombela-Franco, Urquiza, Jimenez-Quevedo) Cardiovascular Institute.
Hospital Clinico San Carlos, IdISSC, Madrid, Spain
(Faurie) Groupe Hospitalier Mutualiste de Grenoble, Institut
Cardiovasculaire, Grenoble, France
(Alperi, Pascual) Hospital Universitario Central de Asturias, Oviedo,
Spain
(Serra, Blanco) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Regueiro, Sabate) Institut Clinic Cardiovascular, Hospital Clinic,
Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS),
Barcelona, Spain
(Mangieri, Colombo) IRCCS Humanitas Research Hospital, Milan, Italy
Publisher
Cliggott Publishing Co.
Abstract
Objectives. To determine the occurrence of vascular complications (VCs)
following transfemoral transcatheter aortic valve replacement (TAVR) with
new-generation devices according to the use of a crossover technique
(COT). Background. The use of a COT (with/without balloon) has been
associated with a reduction of VCs in TAVR patients. However, scarce data
support its use with second-generation devices. Also, its potential
benefit in obese patients (at high-risk of VCs) has not been elucidated.
Methods. A multicenter study including 2214 patients who underwent full
percutaneous transfemoral TAVR (COT, 1522 patients; no COT, 692 patients).
Thirty-day events were evaluated according to the use of a COT using a
multivariate logistic regression model. A subanalysis was performed in
obese patients. Results. Primary access major VCs (3.5% COT vs 3.9% no
COT; P=.19), major/life-threatening bleeding (3.4% COT vs 2.0% no COT;
P=.33), and mortality rates (2.4% COT vs 2.6% no COT; P=.23) were similar
between groups. However, minor VCs (11.7% COT vs 5.9% no COT; P<.001) and
postprocedural acute renal failure (8.9% COT vs 3.9% no COT; P<.001) were
higher in patients undergoing the COT. In the overall cohort, percutaneous
closure device failure was more frequent in obese patients (4.0% in the
obese group vs 1.9% in the non-obese group; P<.01), but these differences
were no longer significant in those undergoing a COT (3.4% in the obese
group vs 2.0% in the non-obese group; P=.12). Indeed, in the subset of
obese patients, the COT tended to be associated with fewer VCs (3.4% COT
vs 5.9% no COT; P=.09). Conclusions. The use of a COT was not associated
with a reduction of major VCs or improved outcomes. However, some patient
subsets, such as those with higher body mass index, may benefit from the
use of a COT. These findings would suggest the application of a tailored
strategy, following a risk-benefit assessment in each TAVR
candidate. Copyright © 2021 Cliggott Publishing Co.. All rights
reserved.

<41>
Accession Number
2031011308
Title
Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants
Compared with Vitamin K Antagonists in Patients with Atrial Fibrillation
and Type 2 Valvular Heart Disease: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Liang X.; Liu S.; Ji L.; Ma F.; Song G.; Li F.; Liu G.
Institution
(Liang, Liu, Ji, Ma, Song, Li, Liu) Department of Cardiology, The First
Hospital of Hebei Medical University, Hebei, Shijiazhuang, China
(Liu) Hebei Key Laboratory of Cardiac Injury Repair Mechanism Study,
Hebei, Shijiazhuang, China
(Liu) Hebei Key Laboratory of Heart and Metabolism, Hebei, Shijiazhuang,
China
(Liu) Hebei Engineering Research Center of Intelligent Medical Clinical
Application, Hebei, Shijiazhuang, China
(Liu) Hebei International Joint Research Center for Structural Heart
Disease, Hebei, Shijiazhuang, China
Publisher
Springer
Abstract
Purpose: This meta-analysis aimed to evaluate the efficacy and safety of
non-vitamin K antagonist oral anticoagulants (NOACs) compared with vitamin
K antagonists (VKAs) in patients with atrial fibrillation (AF) and type 2
valvular heart disease (VHD). Method(s): We searched the PubMed,
LILACS, and MEDLINE databases to retrieve, randomized controlled trials
(RCTs) comparing NOACs and VKAs in patients with AF and type 2 VHD,
excluding mitral stenosis (moderate to severe, of rheumatic origin) or
mechanical heart valves. The efficacy outcomes assessed were stroke and
systemic embolism (SE), while safety outcomes included major bleeding and
intracranial hemorrhage (ICH). Result(s): Seven RCTs, including
16,070 patients with AF and type 2 VHD, were included. NOACs reduced the
risk of stroke/SE (relative risk [RR], 0.75; 95% confidence interval [CI],
0.64-0.89; P = 0.0005), with no significant difference in major bleeding
(RR, 0.88; 95% CI, 0.64-1.21; P = 0.43). The risk of ICH was reduced with
NOACs (RR, 0.46; 95% CI, 0.27-0.77; P = 0.003). For patients with AF and
bioprosthetic heart valve (five trials, 2805 patients), stroke/SE risks
(RR, 0.65, 95% CI, 0.44-0.96) with NOACs were superior to VKAs. Major
bleeding risks without ENVISAGE TAVI AF trial (RR, 0.53; 95% CI,
0.30-0.94; P = 0.03) with NOACs were superior to VKAs. The risks of ICH
(RR, 0.61; 95% CI 0.34-1.09; P = 0.09) with NOACs were comparable to VKAs.
 Conclusion(s): NOACs demonstrate efficacy and safety in patients with
AF and type 2 VHD and reduce the risk of stroke/SE and ICH when compared
with those with VKAs. Copyright © The Author(s) 2024.

<42>
Accession Number
2030960141
Title
Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes
of Statins Discontinuation: A Systematic Review.
Source
Pharmacoepidemiology and Drug Safety. 33(8) (no pagination), 2024. Article
Number: e5879. Date of Publication: August 2024.
Author
Ageeb S.; Abdelmoghith A.; ElGeed H.; Awaisu A.; ElMansor A.; Owusu Y.
Institution
(Ageeb, Abdelmoghith, ElGeed, Awaisu, Owusu) Department of Clinical
Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University,
Doha, Qatar
(ElMansor) Al Khor Health Center, Primary Health Care Corporation, Doha,
Qatar
Publisher
John Wiley and Sons Ltd
Abstract
Purpose: Statins are widely prescribed for cardiovascular diseases (CVD)
prevention; however, a significant proportion of users discontinue the
medication for various reasons. This review aimed to determine the
prevalence of statin therapy discontinuation, its associated factors, and
adverse cardiovascular outcomes within the first year of discontinuation.
 Method(s): The PubMed, EMBASE, ScienceDirect, SCOPUS, and Google
Scholar databases were systematically searched from their inception to
December 2022. Manual searches were also conducted on the bibliographies
of relevant articles. Studies were included for qualitative data synthesis
and assessed for methodological quality. Result(s): Fifty-two
studies, predominantly cohort studies (n = 38), involving 4 277 061
participants were included. The prevalence of statin discontinuation
within the first year of statin initiation ranged from 0.8% to 70.5%,
which was higher for primary prevention indications. Factors frequently
associated with an increased likelihood of statin discontinuation included
male sex, nonWhite ethnicity, smoking status, and being uninsured.
Conversely, discontinuation was less likely in patients with CVD who
received secondary prevention statin therapy and in patients with
polypharmacy. Furthermore, age showed diverse and inconsistent
relationships with statin discontinuation among various age categories.
Five studies that reported the cardiovascular risk of statin
discontinuation within the first year of initiation showed significantly
increased risk of discontinuation, including all-cause mortality (hazard
ratio: 1.36-3.65). Conclusion(s): Our findings indicate a high
prevalence of statin discontinuation and an increased likelihood of
adverse cardiovascular outcomes within the first year of discontinuation,
despite wide variability across published studies. This review highlights
the importance of addressing the modifiable risk factors associated with
statin discontinuation, such as smoking and lack of insurance
coverage. Copyright © 2024 The Author(s). Pharmacoepidemiology
and Drug Safety published by John Wiley & Sons Ltd.

<43>
Accession Number
2030958290
Title
Application of a simplified transesophageal echocardiography examination
sequence in high-risk cardiac surgery.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 535. Date of
Publication: December 2024.
Author
Wang C.; Tian Y.; Bai B.; He K.; Lu H.; Yu C.; Miao Q.
Institution
(Wang, Tian, Bai, He, Lu, Yu) Department of Anesthesiology, Peking Union
Medical College Hospital, Chinese Academy of Medical Sciences, Beijing,
China
(Miao) Department of Cardiac Surgery, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: In cardiac surgical procedures, patients carrying high-risk
profiles are prone to encompass complicated cardiopulmonary bypass (CPB)
separation. Intraoperative transesophageal echocardiography (TEE), a
readily available tool, is utilized to detect cardiac structural and
functional pathologies as well as to facilitate clinical management of CPB
separation, especially in the episodes of hemodynamic compromise. However,
the conventional TEE examination, always performed in a liberal fashion
without any restriction of view acquisition, is relatively time-consuming;
there appear its flaws in the context of critically severe status. We
therefore developed the perioperative rescue transesophageal
echocardiography (PReTEE), a simplified three-view TEE protocol consisting
of midesophageal four chamber, midesophageal left ventricular long axis,
and transgastric short axis. Method(s): This is a single-center and
randomized controlled trial which will be implemented in Peking Union
Medical College Hospital, Beijing, China. A total of 46 TEE scans are
schemed to be performed by 6 operators participating in and randomly
assigned to either the PReTEE or the conventional TEE group. This study is
purposed to investigate whether the efficiency of discriminating leading
causes of difficult CPB wean-off can be significantly improved via an
abbreviated sequence of TEE views. The primary outcome of interest is the
difference between the groups of PReTEE and the conventional TEE in the
successful discrimination of etiologies in specified 120 s. Cox
proportional hazards model will be further employed to calculate the
outcome difference. Discussion(s): The estimated results of this
trial are oriented at verifying whether a simplified TEE exam sequence can
improve the efficiency of etiologies discrimination during CPB separation
in cardiac surgery. Trial registration: ClinicalTrials.gov NCT05960552.
Registered on 6 July 2023. Copyright © The Author(s) 2024.

<44>
Accession Number
2030958129
Title
The biological applications of near-infrared optical nanomaterials in
atherosclerosis.
Source
Journal of Nanobiotechnology. 22(1) (no pagination), 2024. Article Number:
478. Date of Publication: December 2024.
Author
Shen L.; Bi Y.; Yu J.; Zhong Y.; Chen W.; Zhao Z.; Ding J.; Shu G.; Chen
M.; Lu C.; Ji J.
Institution
(Shen, Bi, Yu, Zhong, Chen, Zhao, Ding, Shu, Chen, Lu, Ji) Key Laboratory
of Imaging Diagnosis and Minimally Invasive Intervention Research, The
Fifth Affiliated Hospital of Wenzhou Medical University, No 289, Kuocang
Road, Lishui 323000, China
(Shen, Bi, Yu, Zhong, Chen, Zhao, Ding, Shu, Chen, Lu, Ji) Department of
Interventional Radiology, The Fifth Affiliated Hospital of Wenzhou Medical
University, No 289, Kuocang Road, Lishui 323000, China
Publisher
BioMed Central Ltd
Abstract
Purpose of review: Atherosclerosis, a highly pathogenic and lethal
disease, is difficult to locate accurately via conventional imaging
because of its scattered and deep lesions. However, second near-infrared
(NIR-II) nanomaterials show great application potential in the tracing of
atherosclerotic plaques due to their excellent penetration and
angiographic capabilities. Recent findings: With the development of
nanotechnology, among many nanomaterials available for the visual
diagnosis and treatment of cardiovascular diseases, optical nanomaterials
provide strong support for various biomedical applications because of
their advantages, such as noninvasive, nondestructive and molecular
component imaging. Among optical nanomaterials of different wavelengths,
NIR-II-range (900 ~ 1700 nm) nanomaterials have been gradually applied in
the visual diagnosis and treatment of atherosclerosis and other vascular
diseases because of their deep biological tissue penetration and limited
background interference. Summary: This review explored in detail the
prospects and challenges of the biological imaging and clinical
application of NIR-II nanomaterials in treating atherosclerosis. Graphical
abstract: (Figure presented.). Copyright © The Author(s) 2024.

<45>
[Use Link to view the full text]
Accession Number
2033984359
Title
Efficacy and outcomes of bempedoic acid versus placebo in patients with
hypercholesterolemia: an updated systematic review and meta-analysis of
randomized controlled trials.
Source
Cardiovascular Endocrinology and Metabolism. 13(3) (no pagination), 2024.
Article Number: e0302. Date of Publication: 20 Jun 2024.
Author
Goyal A.; Shah S.; Dahal K.; Changez M.I.K.; Tariq M.D.; Zuhair V.; Shamim
U.; Abbasi H.Q.; Shrestha A.B.; Sah R.; Sohail A.H.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Shah, Dahal) Department of Internal Medicine, Maharajgunj Medical Campus,
Kathmandu, Nepal
(Changez) Department of Surgery, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Tariq) Department of Internal Medicine, Foundation University Medical
College, Islamabad, Pakistan
(Zuhair) Department of Medicine, Jinnah Sindh Medical University, Karachi,
Pakistan
(Shamim) Department of Internal Medicine, Aga Khan University Hospital,
Karachi, Pakistan
(Abbasi) Department of Internal Medicine, Ayub Medical College,
Abbottabad, Pakistan
(Shrestha) Department of Internal Medicine, M Abdur Rahim Medical College,
Dinajpur, Bangladesh
(Sah) Department of Microbiology, Institute of Medicine, Tribhuvan
University, Maharajgunj, Nepal
(Sah) Department of Microbiology, Dr. D. Y. Patil Medical College,
Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Maharashtra,
Pune, India
(Sohail) Department of Surgery, University of New Mexico Health Sciences,
Albuquerque, NM, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction Bempedoic acid (BA) has shown varied efficacy in managing
hyperlipidemia. We conducted the most extensive up-to-date meta-analysis,
the first to include recent studies by Nissen et al., which boast the
largest sample size. Methods Literature search was done on Medline,
EMBASE, and Cochrane Library. The primary endpoint was a change in
low-density lipoprotein-cholesterol (LDL-C) levels, while secondary
endpoints encompassed changes in lipid parameters, clinical endpoints, and
safety endpoints. The least-square mean (LSM) percent change was utilized
for lipid changes, with statistical significance set at P < 0.05. Results
This analysis included 12 randomized control trials with 22,249
participants. BA exhibited a substantial reduction in LDL-C levels [LSM %
change, -24.34; 95% confidence interval (CI), -27.80 to -20.88; P <
0.0001], total cholesterol levels (LSM % change, -16.62; 95% CI, -21.70 to
-11.54; P < 0.00001) and high-density lipoprotein-cholesterol (HDL-C)
levels (LSM % change, -4.22; 95% CI, -5.51 to -2.92; P < 0.00001) compared
to the placebo. Conclusions BA significantly lowers LDL-C, total
cholesterol, HDL-C, non-HDL-C, high sensitivity C reactive protein, and
apolipoprotein levels. Copyright © 2024 The Author(s). Published
by Wolters Kluwer Health, Inc.

<46>
[Use Link to view the full text]
Accession Number
2033969671
Title
Patient Characteristics and Early Clinical Outcomes with Impella 5.5: A
Systematic Review and Meta-Analysis.
Source
ASAIO Journal. 70(7) (pp 557-564), 2024. Date of Publication: 01 Jul 2024.
Author
Kwon J.H.; Bentley D.; Cevasco M.; Blumer V.; Kanwar M.K.; Silvestry S.C.;
Daneshmand M.A.; Abraham J.; Shorbaji K.; Kilic A.
Institution
(Kwon, Shorbaji, Kilic) Division of Cardiothoracic Surgery, Medical
University of South Carolina, Charleston, SC, United States
(Bentley) Principle Scientific Affairs, Abiomed, Danvers, MA, United
States
(Cevasco) Division of Cardiovascular Surgery, Hospital of University of
Pennsylvania, Philadelphia, PA, United States
(Blumer) Department of Cardiovascular Medicine, Cleveland Clinic
Foundation, Cleveland, OH, United States
(Kanwar) Cardiovascular Institute, Allegheny Health Network, Pittsburgh,
PA, United States
(Silvestry) Advent Health Transplant Institute, Orlando, FL, United States
(Daneshmand) Division of Cardiothoracic Surgery, Emory University,
Atlanta, GA, United States
(Abraham) Center for Cardiovascular Analytics, Research and Data Science,
Providence Heart Institute, Providence Research Network, Portland, OR,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Data regarding outcomes with Impella 5.5 are limited. The aim of this
systematic review and meta-analysis was to summarize patient and treatment
characteristics and early clinical outcomes among patients supported by
Impella 5.5. A systematic literature search was conducted in PubMed,
Scopus, and Cochrane databases from September 2019 to March 2023. Studies
reporting outcomes in greater than or equal to 5 patients were included
for review. Patient characteristics, treatment characteristics, and early
clinical outcomes were extracted. Outcomes included adverse events,
survival to hospital discharge, and 30 day survival. Random-effect models
were used to estimate pooled effects for survival outcomes. Assessment for
bias was performed using funnel plots and Egger's tests. Fifteen studies
were included for qualitative review, representing 707 patients. Mean
duration of support was 9.9 +/- 8.2 days. On meta-analysis of 13 studies
reporting survival outcomes, survival to hospital discharge was 68% (95%
confidence interval [CI], 58-78%), and 30 day survival was 65% (95% CI,
56-74%) among patients with Impella devices predominantly supported by
Impella 5.5 (>60%). There was significant study heterogeneity for these
outcomes. Among 294 patients with Impella 5.5 only, survival to discharge
was 78% (95% CI, 72-82%) with no significant study heterogeneity. This
data present early benchmarks for outcomes with Impella 5.5 as clinical
experience with these devices accrues. © Copyright ASAIO 2024.

<47>
Accession Number
2032937567
Title
Prevalence and risk factors of postoperative delirium in tumor patients
after free flap reconstruction: A systematic review and meta-analysis of
case-control studies.
Source
Surgery (United States). 176(3) (pp 906-917), 2024. Date of Publication:
September 2024.
Author
Li Y.; Li Z.; Lv Q.; Gu Y.; Qi Y.; Li J.; Liu Y.; Ma G.
Institution
(Li, Liu, Ma) Department of General Plastic Surgery, Plastic Surgery
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Li) First Department of Maxillofacial Surgery, Plastic Surgery Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
(Lv, Gu, Qi, Li) Department of Fat Grafting, Plastic Surgery Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
Publisher
Elsevier Inc.
Abstract
Background: Postoperative delirium is a severe complication of flap
transplantation surgery, adversely affecting surgical prognoses. The
intricate pathophysiology of postoperative delirium renders the
elucidation of its risk factors challenging. This research aims to
delineate the prevalence and the specific risk factors of postoperative
delirium in patients with cancer undergoing free flap reconstruction
through a systematic review and meta-analysis to enlighten proactive
prevention measures. Method(s): The researchers systematically
queried both the international and Chinese databases. Searches were
performed for publications from inception until September 14, 2023, using
the terms "free tissue flaps," "delirium," "neoplasms," and "risk
factors." Data synthesis and statistical analysis were conducted using
Stata SE (version 15.0) to calculate the combined effect size for
identified risk factors. Reported outcomes included weighted mean
differences or odds ratios with their respective 95% confidence intervals.
 Result(s): Twelve case-control studies were included
(n<inf>total</inf> = 3,256). Among them, 515 patients developed
postoperative delirium after free flap surgery, compared with 2,741
patients who did not. The outcomes suggest that the risk factors include
but are not limited to age, male, late neoplasm staging, use of hypnotic
or antipsychotic, history of background diseases, psychiatric review,
tracheotomy, and impaired wound healing. In contrast, early neoplasm
staging and others are the protective factors with statistical
significance. Multivariate analysis further identified significant
correlations between preoperative albumin, perioperative blood
transfusion, sleep disturbance, postoperative visual analog scale,
postoperative albumin, smoking, and the appearance of postoperative
delirium. Conclusion(s): The determined risk factors were grouped
into preoperative, intraoperative, and postoperative categories
substantiated by current data to present instructions for postoperative
delirium prevention. Copyright © 2024 Elsevier Inc.

<48>
Accession Number
2030578848
Title
Pericardial Decompression Syndrome: A Comprehensive Review of a
Controversial Entity.
Source
International Journal of Angiology. 33(3) (pp 139-147), 2024. Date of
Publication: 16 Feb 2024.
Author
Sarode K.; Patel A.; Arrington K.; Makhija R.; Mukherjee D.
Institution
(Sarode, Patel, Arrington, Makhija, Mukherjee) Department of
Cardiovascular Medicine, Texas Tech University Health Sciences Center, El
Paso, TX, United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
Pericardial decompression syndrome is an ambiguous clinical entity which
has generated controversy regarding its existence. Following pericardial
decompression, patients experienced clinical deterioration ranging in
complications from pulmonary edema to death that could not be attributed
to any other distinct clinical pathology. Multiple theories have suggested
the pathophysiology behind pericardial decompression syndrome is related
to preload-afterload mismatch following pericardial decompression,
coronary microvascular ischemia, and stress from high adrenergic state.
Our review aims to describe this syndrome by analyzing demographics,
etiology of pericardial effusion, method of drainage, volume of
pericardial fluid removed, time to decompensation, and clinical outcomes.
A systematic review of MEDLINE/PubMed and Google Scholar literature
databases were queried for case reports, case series, review articles, and
abstracts published in English journals between 1983 and December 2022.
Each author's interpretation of echocardiographic and/or pulmonary
arterial catheterization data provided in the case reports was used to
characterize ventricular dysfunction. Based on our inclusion criteria, 72
cases of pericardial decompression syndrome were included in our review.
Our results showed that phenotypic heterogeneity was present based on
echocardiographic findings of right/left or biventricular failure with
similar proportions in each type of ventricular dysfunction. Time to
decompensation was similar between immediate, subacute, and acute cases
with presentation varying between hypoxic respiratory failure and shock.
This review article highlights theories behind the pathophysiology,
clinical outcomes, and therapeutic options in this high mortality
condition. was downloaded for personal use only. Unauthorized distribution
is strictly prohibited. Copyright © 2024. International College
of Angiology. All rights reserved.

<49>
Accession Number
2030336242
Title
Laparoscopy versus endovascular aneurysm repair for abdominal aortic
aneurysm: A systematic review.
Source
Catheterization and Cardiovascular Interventions. 104(2) (pp 300-317),
2024. Date of Publication: 01 Aug 2024.
Author
Duric B.; Hadjihannas I.; Sugumaran S.; Jagic K.; Patel B.
Institution
(Duric, Hadjihannas, Sugumaran, Patel) Department of Laparoscopic Surgery
and Surgical Skills, Barts Cancer Institute, Queen Mary University of
London, London, United Kingdom
(Duric, Jagic) Department of Medical Education, GKT School of Medical
Education, King's College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Minimally invasive surgery is a useful alternative to open repair for
patients with nonruptured abdominal aortic aneurysms (AAA). We aim to
compare the clinical outcomes for three different minimally invasive
techniques: hand-assisted laparoscopic surgery (HALS), total laparoscopic
surgery (TLS), and endovascular aneurysm repair (EVAR). The electronic
databases MEDLINE, Embase, Web of Science, Google Scholar, and the
Cochrane Library were searched between January and March 2023. Cohort
studies and randomized controlled trials (RCTs) comparing two minimally
invasive techniques were eligible for inclusion. Primary outcomes were
mortality (in-hospital, 30-day, or 1-year) and reintervention rates
(30-day or 1-year). Length of surgery, blood loss, transfusion volume,
conversion to open surgery, major complication rates, length of hospital
stay, and length of intensive care unit (ICU) stay were also evaluated.
Eight cohort studies and one RCT were included comparing patients
undergoing HALS (n = 500), TLS (n = 263), and EVAR (n = 438) for elective
AAA repair. The TLS group had the highest rate of 30-day postoperative
reinterventions (p = 0.00056), the longest surgical duration (p = 0.0311),
and the highest rate of conversion to open surgery (p < 0.001). TLS was
also associated with the most blood loss during surgery, the highest blood
transfusion volumes, and the longest length of ICU stay, although these
results did not reach statistical significance. Subgroup analysis revealed
superior contemporary EVAR outcomes compared to TLS. Laparoscopic surgery
(LAS) and EVAR have comparable mortality rates. However, LAS, particularly
TLS, is significantly less efficacious than EVAR in terms of
intraoperative conversions to open surgery and 30-day reintervention
rates. Further controlled trials with larger sample sizes are needed to
confirm the evidence. Copyright © 2024 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<50>
Accession Number
2034035996
Title
Branch-First Technique of Aortic Arch Replacement: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiac Surgery. 2024 (no pagination), 2024. Article Number:
1869656. Date of Publication: 2024.
Author
Bakr L.; Wijesena T.; De Silva R.; Ali J.M.
Institution
(Bakr, Wijesena, De Silva, Ali) Royal Papworth Hospital NHS Foundation
Trust, Papworth Road, Cambridge Biomedical Campus, Cambridge CB2 0AY,
United Kingdom
Publisher
Wiley-Hindawi
Abstract
Objectives. Aortic arch replacement is a major surgical intervention. This
meta-analysis aims to combine the international literature on the
branch-first technique to describe its outcomes and offer a comparison to
the standard techniques. Methods. PubMed and Cochrane were searched for
studies on the branch-first technique in aortic arch surgery including
those comparing this technique with the conventional ones. Mortality,
neurological complications, bleeding, and renal replacement therapy were
the major endpoints of interest. Subgroup analysis was performed for both
single- and double-armed studies. Odds ratios with 95% confidence interval
were used as summary estimates. The random-effects model was used for all
outcomes. Results. Ten studies from three countries with a total of 498
patients were included. Proportional analysis of the branch-first
technique estimated mortality of (3%, 95% CI [0.02-0.05]), neurological
complications of (8%, 95% CI [0.03-0.13]), re-exploration for bleeding of
(9%, 95% CI [0.05-0.13]), and renal replacement therapy of (9%, 95% CI
[0.05-0.12]). This meta-analysis revealed no significant differences
between the branch-first technique and the conventional technique in
mortality (5% vs. 15%, OR = 0.32, 95% CI [0.08-1.18], p=0.09, I2 = 40%),
neurological complications (10% vs. 16%, OR = 0.53, 95% CI [0.24-1.21],
p=0.13, I2 = 0%), or renal replacement therapy (12% vs. 14%, OR = 0.72,
95% CI [0.33-1.59], p=0.41, I2 = 0%). Conclusions. Branch-first technique
provides a promising alternative approach in aortic arch surgery with no
different surgical risks and potentially reduced operative complexity.
Randomised controlled trials are needed to further investigate the safety
and advantages of this technique. Copyright © 2024 Lubna Bakr et
al.

<51>
Accession Number
2033997275
Title
Are Prospective Studies Too Challenging to Execute for Timing of Resuming
Anticoagulation After ICH in Patients With Mechanical Heart Valves?.
Source
Neurology. 103(4) (no pagination), 2024. Article Number: e209772. Date of
Publication: 05 Aug 2024.
Author
Carhuapoma L.; Zhan W.D.; Ziai W.C.; Hanley D.F.; Shah V.
Institution
(Carhuapoma) The Division of Neurosciences Critical Care, The Johns
Hopkins Hospital, Baltimore, United States
(Zhan, Hanley) Division of Brain Injury Outcomes, Department of Neurology,
United States
(Ziai, Shah) Division of Neurosciences Critical Care Medicine, Departments
of Neurology, Neurosurgery, and Anesthesiology, Critical Care Medicine,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins

<52>
Accession Number
2034040359
Title
Effect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on
Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A
Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Sarhan K.; Elshemy A.; Mamdouh S.; Salah M.; Raheem A.A.E.; Gamal M.;
Nawwar K.; Bakry M.
Institution
(Sarhan, Mamdouh, Salah, Raheem, Gamal, Nawwar, Bakry) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Elshemy) Department of Anesthesia, National Heart Institute, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To assess the effect of ultrasound-guided bilateral erector
spinae plane block (ESPB) on the time to extubation in patients who had
undergone cardiac surgery through a midline sternotomy. Design(s):
Randomized controlled trial. Setting(s): Cairo University Hospital
and National Heart Institute, Egypt. Participant(s): Patients aged 18
to 70 years who underwent a cardiac surgical procedure through a midline
sternotomy. Intervention(s): Recruited patients were randomized to
receive either preoperative single-shot ultrasound-guided bilateral ESPB
or fentanyl infusion. Measurements: The primary outcome was the time to
extubation. Other outcomes included total perioperative fentanyl
consumption, pain score using the numerical rating score (NRS), length of
intensive care unit (ICU) stay, and incidence of perioperative
complications. Main Result(s): Two hundred and nineteen patients were
available for final analysis. The mean time to extubation was
significantly shorter In the ESPB group compared to the control group
(159.5 +/- 109.5 minutes vs 303.2 +/- 95.9 minutes; mean difference,
-143.7 minutes; 95% confidence interval, -171.1 to -116.3 minutes; p =
0.0001). Ultra-fast track (immediate postoperative) extubation was
achieved in 23 patients (21.1%) in the ESPB group compared to only 1
patient (0.9%) in the control group. The ICU stay was significantly
reduced in the ESPB group compared to the control group (mean, 47.2 +/-
13.3 hours vs 78.9 +/- 25.2 hours; p = 0.0001). There was a more
significant reduction in NRS in the ESPB group compared to the control
group for up to 24 hours postoperatively (p = 0.001). Conclusion(s):
Among adult patients undergoing cardiac surgery through a midline
sternotomy, the extubation time was halved in patients who received
single-shot bilateral ESPB compared to patients who received fentanyl
infusion. Copyright © 2024 Elsevier Inc.

<53>
Accession Number
2030960273
Title
Convergent ablation for persistent atrial fibrillation: A UK multicentre
perspective.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Mannakkara N.N.; Khan I.; Ghazanfar A.; Wijesuriya N.; Mehta V.S.; De Vere
F.; Howell S.; Adhya S.; Porter B.; Child N.; Razavi R.; Rinaldi C.A.;
Bosco P.; Blauth C.; Gill J.S.
Institution
(Mannakkara, Khan, Wijesuriya, Mehta, De Vere, Howell, Adhya, Rinaldi,
Bosco, Blauth, Gill) Department of Cardiovascular Services, Guy's and St.
Thomas' Hospital, London, United Kingdom
(Mannakkara, Wijesuriya, Mehta, De Vere, Howell, Razavi, Rinaldi, Gill)
School of Biomedical Engineering and Imaging Sciences, King's College
London, London, United Kingdom
(Ghazanfar, Child) Department of Cardiology, St. Richard's Hospital,
University Hospitals Sussex NHS Foundation Trust, Worthing, United Kingdom
(Adhya) Department of Cardiology, Medway Maritime Hospital, Gillingham,
United Kingdom
(Porter) South West Cardiothoracic Centre, University Hospitals Plymouth
NHS Trust, Plymouth, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide
and remains a major cause of morbidity and mortality. Unfortunately, a
significant proportion of patients have persistent AF, for which
conventional catheter ablation is less effective. However, convergent
ablation has emerged in recent years as a hybrid treatment targeting both
the epicardium and endocardium in a multidisciplinary joint cardiothoracic
and electrophysiology procedure, with promising efficacy outcomes in
recent studies. This treatment is increasingly being performed in the
United Kingdom. This review article discusses the rationale and evidence
behind convergent ablation, along with factors that need to be considered
when setting up a successful ablation service. Copyright © 2024
The Author(s). Journal of Cardiovascular Electrophysiology published by
Wiley Periodicals LLC.

<54>
Accession Number
2034081343
Title
Coronary Computed Tomography Angiography (CCTA) vs Functional Imaging in
the Evaluation of Stable Ischemic Heart Disease.
Source
Journal of Invasive Cardiology. 33(5) (pp E349-E354), 2021. Date of
Publication: May 2021.
Author
Patel V.I.; Roy S.K.; Budoff M.J.
Institution
(Patel) St. Mary Medical Center, Long Beach, CA, United States
(Patel, Roy, Budoff) Lundquist Institute Harbor-UCLA Medical Center,
Torrance, CA, United States
Publisher
Cliggott Publishing Co.
Abstract
Background. Management of patients with stable ischemic heart disease
remains challenging, in part due to the inability of non-invasive testing
to accurately identify those who may benefit from coronary
revascularization. For decades, use of functional testing, such as nuclear
perfusion imaging, stress echocardiography, and exercise
electrocardiography, has remained a pivotal component of algorithms
designed to evaluate anginal pain. Over the past several years, however, a
growing body of evidence has developed to support anatomical imaging, with
special attention given to coronary computed tomography angiography (CCTA)
as the more diagnostically and prognostically accurate non-invasive
testing modality. The results of several large randomized controlled
trials, as well as their subsequent post hoc analyses, have led to the
escalation of CCTA as the first-line test in international guidelines for
the evaluation of stable chest pain in patients with low-to-intermediate
risk of coronary artery disease. Moreover, recognition of CCTA and its
role in improving patient outcomes has driven key change in healthcare
policy coverage, leading to streamlined reimbursement and the elimination
of prior authorization when utilized in the appropriate setting. Given the
rapidly accumulating supportive evidence, the next iteration of the
American College of Cardiology/American Heart Association guidelines for
stable ischemic heart disease should position CCTA as the first-line test
in qualifying patients. Here, we review current literature evaluating
anatomical and functional imaging, and formulate a discussion on clinical
implementation, limitations of currently available data, and direction for
CCTA-based future research. Copyright © 2021 Cliggott Publishing
Co.. All Rights Reserved.

<55>
Accession Number
2034082129
Title
Distal Radial Access in Chronic Total Occlusion Percutaneous Coronary
Intervention: Insights From the PROGRESS-CTO Registry.
Source
Journal of Invasive Cardiology. 33(9) (pp E717-E722), 2021. Date of
Publication: September 2021.
Author
Nikolakopoulos I.; Patel T.; Jefferson B.K.; Sheikh A.M.; Jaber W.; Samady
H.; Khatri J.J.; Yeh R.W.; Tamez H.; Koutouzis M.; Tsiafoutis I.; Jaffer
F.A.; Doing A.H.; Dattilo P.; Uretsky B.F.; Toma C.; Elbarouni B.; Alaswad
K.; Choi J.W.; Lembo N.J.; Parikh M.; Kirtane A.J.; Ali Z.A.; Omer M.;
Vemmou E.; Xenogiannis I.; Karacsonyi J.; Rangan B.V.; Abdullah S.;
Banerjee S.; Garcia S.; Burke M.N.; Brilakis E.S.; Karmpaliotis D.
Institution
(Nikolakopoulos, Omer, Vemmou, Xenogiannis, Karacsonyi, Rangan, Garcia,
Burke, Brilakis) Minneapolis Heart Institute Foundation, Minneapolis Heart
Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Patel, Jefferson) Tristar Centennial Medical Center, Nashville, TN,
United States
(Sheikh) Wellstar Health System, Marietta, GA, United States
(Jaber, Samady) Emory University Hospital Midtown, Atlanta, GA, United
States
(Khatri) Cleveland Clinic, Cleveland, OH, United States
(Yeh, Tamez) Beth Israel Deaconess Medical Center, Boston, MA, United
States
(Koutouzis, Tsiafoutis) Red Cross Hospital, Athens, Greece
(Jaffer) Massachusetts General Hospital, Boston, MA, United States
(Doing, Dattilo) Medical Center of the Rockies, Loveland, CO, United
States
(Uretsky) VA Central Arkansas Healthcare System, Little Rock, AR, United
States
(Toma) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Elbarouni) St. Boniface General Hospital, Winnipeg, MB, Canada
(Alaswad) Henry Ford Hospital, Detroit, MI, United States
(Choi) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Lembo, Parikh, Kirtane, Ali, Karmpaliotis) Columbia University, New York,
NY, United States
(Abdullah, Banerjee) VA North Texas Health Care System, University of
Texas Southwestern Medical Center, Dallas, TX, United States
Publisher
Cliggott Publishing Co.
Abstract
Background. The outcomes of distal radial access (dRA) in chronic total
occlusion percutaneous coronary intervention (CTO-PCI) have received
limited study. Methods. We compared the clinical, angiographic, and
procedural characteristics of 120 CTO-PCIs performed via dRA access with
2625 CTO-PCIs performed via proximal radial access (pRA) in a large,
multicenter registry. Results. The dRA group had lower mean PROGRESS-CTO
score than the pRA group (1.0 +/- 1 vs 1.2 +/- 1, respectively; P=.05),
while J-CTO score (2.4 +/- 1.2 vs 2.3 +/- 1.3; P=.43) and PROGRESS-CTO
Complications score (2.8 +/- 1.8 vs 2.6 +/- 1.9; P=.16) were similar in
the dRA vs pRA groups, respectively. Technical success was similar in the
2 groups (90% dRA vs 86% pRA; P=.14). Concomitant use of femoral access
did not alter procedural success. The incidence of major periprocedural
adverse cardiac events was similar in the 2 groups (0.8% dRA vs 2.4% pRA;
P=.26), whereas the incidence of tamponade requiring pericardiocentesis
was lower with dRA (0% dRA vs 4.69% pRA; P<.001), as was air kerma
radiation dose (median, 1.7 Gy; interquartile range [IQR], 0.97-2.63 Gy in
the dRA group vs median, 2.27 Gy; IQR, 1.2-3.9 Gy in the pRA group;
P<.001). Conclusions. Use of dRA in CTO-PCI is associated with similar
procedural success and risk of complications as compared with
pRA. Copyright Journal of Invasive Cardiology.All rights reserved.

<56>
Accession Number
2034082113
Title
Secondary Femoral Access Hemostasis During Transcatheter Aortic Valve
Replacement: Impact of Vascular Closure Devices.
Source
Journal of Invasive Cardiology. 38(8) (pp E604-E613), 2021. Date of
Publication: August 2021.
Author
Junquera L.; Urena M.; Munoz-Garcia A.; Nombela-Franco L.; Faurie B.;
Veiga-Fernandez G.; Alperi A.; Serra V.; Fischer Q.; Himbert D.;
Munoz-Garcia E.; Vera-Urquiza R.; Jimenez-Quevedo P.; de la Torre
Hernandez J.M.; Pascual I.; Del Blanco B.G.; Mohammadi S.; Faroux L.;
Couture T.; Cote M.; Rodes-Cabau J.
Institution
(Junquera, Mohammadi, Faroux, Couture, Cote, Rodes-Cabau) Quebec Heart and
Lung Institute, Laval University, Quebec City, Canada
(Urena, Fischer, Himbert) Assistance Publique-Hopitaux de Paris, Bichat
Hospital, Paris, France
(Munoz-Garcia, Munoz-Garcia) Hospital Universitario Virgen de la Victoria,
Malaga, Spain
(Nombela-Franco, Vera-Urquiza, Jimenez-Quevedo) Instituto Cardiovascular,
Hospital Clinico San Carlos, IdISSC, Madrid, Spain
(Faurie) Groupe Hospitalier Mutualiste de Grenoble, Institut
Cardiovasculaire, Grenoble, France
(Veiga-Fernandez, de la Torre Hernandez) Hospital Marques de Valdecilla,
Santander, Spain
(Alperi, Pascual) Hospital Universitario Central de Asturias, Oviedo,
Spain
(Serra, Del Blanco) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Rodes-Cabau) Hospital Clinic de Barcelona, Barcelona, Spain
Publisher
Cliggott Publishing Co.
Abstract
Background. Vascular and bleeding complications related to secondary
femoral access site are frequent in patients undergoing transcatheter
aortic valve replacement (TAVR), and their occurrence is associated to
poorer outcomes. We aimed to evaluate the clinical impact of vascular
closure devices (VCDs) for secondary femoral access hemostasis in TAVR
procedures. Methods. This was a multicenter study including 4031 patients
who underwent TAVR (mean age, 81 +/- 8 years; mean Society of Thoracic
Surgeons [STS] score, 4.9 [interquartile range, 3.3-7.6]), and had a
secondary femoral access. The 30-day clinical outcomes were analyzed
according to femoral access-site hemostasis (manual compression vs VCD),
and according to the type of VCD (Perclose [Abbott Cardiovascular] vs
Angio-Seal [Terumo Interventional Systems]) using a propensity-matched,
multivariable, logistic regression model. Results. Manual compression was
used in 941 patients (23.3%) and VCDs were used in 3090 patients (76.7%;
Perclose in 1549 patients [38.4%] and Angio-Seal in 1541 patients [38.2%])
for secondary femoral access hemostasis. Vascular complications related to
secondary access site occurred in 162 patients (4%), and were more
frequent in patients who underwent manual compression (7.2%) compared with
VCD hemostasis (3%; adjusted P<.001). In the VCD group, the use of
Angio-Seal (vs Perclose) was associated with a higher rate of vascular
complications (3.7% vs 2.4%, respectively; adjusted P=.02), femoral artery
pseudoaneurysm (1.3% vs 0.4%, respectively; adjusted P<.01), invasive
treatment requirement for treating vascular complications (surgery: 0.8%
vs 0.3%, respectively [adjusted P=.03]; and thrombin injection: 0.9% vs
0%, respectively [adjusted P<.001]). Conclusion. VCDs represented a safer
and more effective alternative compared with manual compression for
secondary femoral access-site hemostasis in patients undergoing TAVR
procedures, and the Perclose VCD was associated with the lowest risk of
vascular complications. Future randomized studies are
warranted. Copyright © 2021 Journal of Invasive Cardiology

<57>
Accession Number
645009139
Title
Routine Protamine Administration for Bleeding in Transcatheter Aortic
Valve Implantation: The ACE-PROTAVI Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2024. Date of Publication: 14 Aug 2024.
Author
Vriesendorp P.A.; Nanayakkara S.; Heuts S.; Ball J.; Chandrasekar J.; Dick
R.; Haji K.; Htun N.M.; McGaw D.; Noaman S.; Palmer S.; Cairo S.; Shulman
M.; Lin E.; Hastings S.; Waldron B.; Proimos G.; Soon K.H.; Yudi M.B.;
Zimmet A.; Stub D.; Walton A.S.
Institution
(Vriesendorp, Nanayakkara, Haji, Htun, Noaman, Palmer, Shulman, Lin,
Hastings, Waldron, Zimmet, Stub, Walton) Heart Centre, Alfred Hospital,
Melbourne, Australia
(Vriesendorp) Heart+Vascular Center, Department of Cardiology, Maastricht
University Medical Center, Maastricht, Netherlands
(Vriesendorp, Heuts) Cardiovascular Research Institute Maastricht,
Maastricht University, Maastricht, Netherlands
(Nanayakkara) Heart Failure Research Group, Baker Heart and Diabetes
Institute, Melbourne, Australia
(Nanayakkara, Ball, Stub, Walton) School of Public Health and Preventive
Medicine, Monash University, Melbourne, Australia
(Heuts) Department of Cardiothoracic Surgery, Maastricht University
Medical Center, Maastricht, Netherlands
(Chandrasekar, Dick, Haji, Noaman, Proimos, Soon, Yudi, Walton) Department
of Cardiology, Epworth HealthCare, Melbourne, Australia
(Chandrasekar) Department of Cardiology, Eastern Health, Melbourne,
Australia
(Chandrasekar) Eastern Health Clinical School, Monash University,
Melbourne, Australia
(McGaw, Stub) Department of Cardiology, Cabrini Health, Melbourne,
Australia
(Palmer, Cairo, Soon) Department of Medicine, University of Melbourne,
Melbourne, Australia
(Cairo, Shulman, Lin, Hastings, Waldron) Cabrini Anaesthetics Department,
Cabrini Health, Melbourne, Australia
(Yudi) Department of Cardiology, Austin Health, Melbourne, Australia
Abstract
Importance: Vascular complications after transfemoral transcatheter aortic
valve implantation (TAVI) remain an important cause of procedure-related
morbidity. Routine reversal of anticoagulation with protamine at the
conclusion of transfemoral TAVI could reduce complications, but data
remain scarce. Objective(s): To evaluate the efficacy and safety of
routine protamine administration after transfemoral TAVI. Design,
Setting, and Participant(s): The ACE-PROTAVI trial was an
investigator-initiated, double-blind, placebo-controlled randomized
clinical trial performed at 3 Australian hospitals between December 2021
and June 2023 with a 1-year follow-up period. All patients accepted for
transfemoral TAVI by a multidisciplinary heart team were eligible for
enrollment. Intervention(s): Eligible patients were randomized 1:1
between routine protamine administration and placebo. Main Outcomes
and Measures: The coprimary outcomes were the rate of hemostasis success
and time to hemostasis (TTH), presented as categorical variables and
compared with a chi2 test or as continuous variables as mean (SD) or
median (IQR), depending on distribution. The major secondary outcome was a
composite of all-cause death, major and minor bleeding complications, and
major and minor vascular complications after 30 days, reported in odds
ratios (ORs) with 95% CIs and P values. Result(s): The study
population consisted of 410 patients: 199 patients in the protamine group
and 211 in the placebo group. The median (IQR) patient age in the
protamine group was 82 (77-85) years, and 68 of 199 patients receiving
protamine (34.2%) were female. The median (IQR) patient age in the placebo
group was 80 (75-85) years, and 89 of 211 patients receiving the placebo
(42.2%) were female. Patients receiving up-front protamine administration
had a higher rate of hemostasis success (188 of 192 patients [97.9%]) than
patients in the placebo group (186 of 203 patients [91.6%]; absolute risk
difference, 6.3%; 95% CI, 2.0%-10.6%; P=.006); in addition, patients
receiving up-front protamine had a shorter median (IQR) TTH (181 [120-420]
seconds vs 279 [122-600] seconds; P=.002). Routine protamine
administration resulted in a reduced risk of the composite outcome in the
protamine group (10 of 192 [5.2%]) vs the placebo group (26 of 203
[12.8%]; OR, 0.37; 95% CI, 0.1-0.8; P=.01). This difference was
predominantly driven by the difference in the prevalence of minor vascular
complications. There were no adverse events associated with protamine use.
 Conclusions and Relevance: In the ACE-PROTAVI randomized clinical
trial, routine administration of protamine increased the rate of
hemostasis success and decreased TTH. The beneficial effect of protamine
was reflected in a reduction in minor vascular complications, procedural
time, and postprocedural hospital stay duration in patients receiving
routine protamine compared with patients receiving placebo. Trial
Registration: anzctr.org.au Identifier: ACTRN12621001261808.

<58>
Accession Number
645008078
Title
Edetate Disodium-Based Chelation for Patients With a Previous Myocardial
Infarction and Diabetes: TACT2 Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 14 Aug 2024.
Author
Lamas G.A.; Anstrom K.J.; Navas-Acien A.; Boineau R.; Nemeth H.; Huang Z.;
Wen J.; Rosenberg Y.; Stylianou M.; Jones T.L.Z.; Joubert B.R.; Yu Q.;
Santella R.M.; Mon A.C.; Ujueta F.; Escolar E.; Nathan D.M.; Fonseca V.A.;
Aude Y.W.; Ehrman J.K.; Elliott T.; Prashad R.; Lewis E.F.; Lopes R.D.;
Farkouh M.E.; Elliott A.-M.; Newman J.D.; Mark D.B.
Institution
(Lamas, Mon, Ujueta, Escolar) Columbia University Division of Cardiology,
Mount Sinai Medical Center, Miami Beach, FL, Puerto Rico
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill
(Navas-Acien, Santella) Department of Environmental Health Sciences,
Columbia University Mailman School of Public Health, NY, United States
(Boineau, Yu) National Center for Complementary and Integrative Health,
National Institutes of Health, Bethesda, MD, Liberia
(Nemeth, Huang, Wen, Lopes, Elliott, Mark) Duke Clinical Research
Institute, Duke University, Durham, NC, United States
(Rosenberg, Stylianou) National Heart, Lung, Blood Institute, National
Institutes of Health, Bethesda, MD, Liberia
(Jones) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, Liberia
(Joubert) National Institute of Environmental Health Sciences, National
Institutes of Health, Durham, NC, United States
(Nathan) Massachusetts General Hospital Diabetes Research Center, Harvard
Medical School, Boston, United States
(Fonseca) Tulane University School of Medicine, New Orleans, LA, United
States
(Aude) DHR Health Heart Institute, McAllen, TX, United States
(Ehrman) Division of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, MI, United States
(Elliott) BC Diabetes Research Institute, Vancouver, BC, Canada
(Prashad) Ocala Research Institute, Ocala, FL, Puerto Rico
(Lewis) Stanford University School of Medicine, Palo Alto, CA, United
States
(Farkouh) University of Toronto, Toronto, ON, Canada
(Newman) New York University School of Medicine, NY, United States
Abstract
Importance: In 2013, the Trial to Assess Chelation Therapy (TACT) reported
that edetate disodium (EDTA)-based chelation significantly reduced
cardiovascular disease (CVD) events by 18% in 1708 patients with a prior
myocardial infarction (MI). Objective(s): To replicate the finding of
TACT in individuals with diabetes and previous MI. Design, Setting,
and Participant(s): A 2x2 factorial, double-masked, placebo-controlled,
multicenter trial at 88 sites in the US and Canada, involving participants
who were 50 years or older, had diabetes, and had experienced an MI at
least 6 weeks before recruitment compared the effect of EDTA-based
chelation vs placebo infusions on CVD events and compared the effect of
high doses of oral multivitamins and minerals with oral placebo. This
article reports on the chelation vs placebo infusion comparisons.
 Intervention(s): Eligible participants were randomly assigned to 40
weekly infusions of an EDTA-based chelation solution or matching placebo
and to twice daily oral, high-dose multivitamin and mineral supplements or
matching placebo for 60 months. This article addresses the chelation
study. Main Outcomes and Measures: The primary end point was the
composite of all-cause mortality, MI, stroke, coronary revascularization,
or hospitalization for unstable angina. Median follow-up was 48 months.
Primary comparisons were made from patients who received at least 1
assigned infusion. Result(s): Of the 959 participants (median age, 67
years [IQR, 60-72 years]; 27% females; 78% White, 10% Black, and 20%
Hispanic), 483 received at least 1 chelation infusion and 476 at least 1
placebo infusion. A primary end point event occurred in 172 participants
(35.6%) in the chelation group and in 170 (35.7%) in the placebo group
(adjusted hazard ratio [HR], 0.93; 95% CI, 0.76-1.16; P=.53). The 5-year
primary event cumulative incidence rates were 45.8% for the chelation
group and 46.5% for the placebo group. CV death, MI, or stroke events
occurred in 89 participants (18.4%) in the chelation group and in 94
(19.7%) in the placebo group (adjusted HR, 0.89; 95% CI, 0.66-1.19). Death
from any cause occurred in 84 participants (17.4%) in the chelation group
and in 84 (17.6%) in the placebo group (adjusted HR, 0.96; 95% CI,
0.71-1.30). Chelation reduced median blood lead levels from 9.03 mug/L at
baseline to 3.46 mug/L at infusion 40 (P<.001). Corresponding levels in
the placebo group were 9.3 mug/L and 8.7 mug/L, respectively.
 Conclusions and Relevance: Despite effectively reducing blood lead
levels, EDTA chelation was not effective in reducing cardiovascular events
in stable patients with coronary artery disease who have diabetes and a
history of MI. Trial Registration: ClinicalTrials.gov Identifier:
NCT02733185.

<59>
Accession Number
2033999539
Title
Non-Anon-B aortic dissection: just for cardiac surgeons? Asystematic
literature review on surgical and endovascular treatment.
Source
Italian Journal of Vascular and Endovascular Surgery. 31(2) (pp 121-134),
2024. Date of Publication: June 2024.
Author
Silvestri O.; Benenati A.; Rinaldi A.; Delguercio L.; Serra R.; Bossone
E.; Carbone A.; Accarino G.; Bracale U.M.; Turchino D.
Institution
(Silvestri, Benenati, Rinaldi, Delguercio, Accarino, Bracale, Turchino)
Department of Public Health, Vascular Surgery Unit, University of Naples
Federico II, Naples, Italy
(Serra) Department of Medical and Surgical Sciences, University of
Catanzaro, Catanzaro, Italy
(Bossone) Department of Public Health, Division of Cardiology, University
of Naples Federico II, Naples, Italy
(Carbone) Unit of Cardiology, Luigi Vanvitelli University of Campania,
Naples, Italy
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Non-Anon-B dissections are fairly rare occurrences,
accounting for just a small percentage of total aortic dissections. For
years, treatment has been non-consensual being mostly confined to the
realm of cardiac surgery. In recent times, due to the development of
endovascular techniques, a procedural shift has occurred favoring less
invasive vascular surgery thus precepting the need for a multidisciplinary
approach and the concept of an aortic team in treating non-Anon-B
dissections. The aim of our study is to report on the state-of-the-art
treatment of non-Anon-B dissections and to determine, through a systematic
review, how often an aortic team is employed in clinical practice.
EVIDENCE ACQUISITION: Areview conducted of all available PubMed/MEDLINE
and Scopus databases in accordance with PRISMAstatement guidelines,
analyzing all studies published between 2000 and 2023. Combined keywords
referring to non-Anon-B dissections and their management, and
investigation of current employment of endovascular techniques in treating
these dissections. Our literature search initially covered a total of 260
articles concerning surgical, endovascular and hybrid treatment. Out of
these, 21 articles were selected for screening, excluding those with no
mention of non-Anon-B dissection and "aortic team." EVIDENCE SYNTHESIS:
Non-Anon-B aortic dissections remain a challenging pathology with several
treatment options, including endovascular, which is increasingly being
employed, and can therefore be considered a valid treatment choice in
aortic dissection management. CONCLUSION(S): While guidelines mention
the importance of an aortic team in treatment, no clear evidence of a
multidisciplinary approach for treating non-Anon-B dissection could be
found in current literature. Copyright © 2024 Edizioni Minerva
Medica. All rights reserved.

<60>
Accession Number
2033999538
Title
Management of congestive heart failure with heart transplantation using
stem cell-derived cardiac muscle: a systematic review.
Source
Italian Journal of Vascular and Endovascular Surgery. 31(2) (pp 115-120),
2024. Date of Publication: June 2024.
Author
Sebayang A.N.; Sembiring Y.E.; Pribadi O.R.
Institution
(Sebayang, Sembiring, Pribadi) Department of Thoracic, Cardiac and
Vascular Surgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo
General Hospital, Surabaya, Indonesia
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Congestive heart failure is a collection of clinical
symptoms resulting from structural or functional abnormalities of the
heart which leads to impaired ventricular filling and ejection ability of
blood to the rest of the body. One of the treatments for this disease is
heart transplantation. Stem cell-derived hearts have been developed, so
there is no need to wait for a donor heart. Myocardium is essentially
impossible to regenerate as heart muscle cells do not return to the cell
cycle. Stem cell-derived myoblasts have been transplanted in experimental
settings to replace lost myocardial tissue. The purpose of this review is
to evaluate the effect of stem cell therapy in heart failure model.
EVIDENCE ACQUISITION: We used PRISMAprotocol to perform systematic review.
PubMed, ScienceDirect, and Cochrane were searched for articles from the
inception to October 2023. Studies reporting stem cell therapy, relevant
outcomes, and using subjects with heart failure models were included. The
main outcome was heart function, assessed by such parameters, including
LVEF, LVSD, LVDD, and LVSV. EVIDENCE SYNTHESIS: Heart transplantation
using stem cell-derived cardiac muscle is not impossible. Myoblasts and
cardiomyocytes derived from bone marrow stem cells will enable autologous
cell transfer into the myocardium. These cells can be easily obtained and
developed in culture. Cardiomyocytes derived from stem cells can be used
to replace all three types of heart muscle cells, and can be developed in
culture. Currently, ethical issues relating to the use of human embryonic
stem cells are a factor to consider. CONCLUSION(S): Cell transfer
therapy has been shown to improve heart function by initiating
cardiomyogenesis in experimental models. These findings suggest that
damaged myocardial function can be repaired with stem cell therapy. Stem
cell-derived cardiomyocytes, especially from embryonic cells or bone
marrow, will allow selective replacement of cardiac cells or atrial or
ventricular cardiomyocytes. Copyright © 2024 Edizioni Minerva
Medica. All rights reserved.

<61>
Accession Number
2033999391
Title
Hypertrophic Obstructive Cardiomyopathy: Short Term and Early Outcome
After Septal Myectomy?.
Source
African Journal of Biological Sciences (South Africa). 6(14) (pp
2246-2255), 2024. Date of Publication: 2024.
Author
Hussein H.A.K.; Khairy M.; Abdelwahab A.M.; Mostafa M.M.
Institution
(Hussein, Khairy, Abdelwahab, Mostafa) Cardiothoracic Surgery Department,
Faculty of Medicine, Assiut University, Assiut, Egypt
Publisher
Institute of Advanced Studies
Abstract
Background: A heterogeneous disease, hypertrophic obstructive
cardiomyopathy (HOCM) is defined by asymmetrically distributed left
ventricular hypertrophy and obstruction of the left ventricular outflow
tract (LVOT). The objective of this investigation was to compare the
outcomes of a proper septal myectomy in patients with HOCM.
 Method(s): We conducted this prospective randomized investigation on
40 diseased persons aged >18 years old, both sexes, with septal myectomy
alone (extended septal myectomy), HOCM with mean pressure gradient across
LVOT > 50 mmHg at rest or upon provocation, New York Heart Association
(NYHA) functional class II to IV, despite the use of optimal medical
treatment, which includes calcium channel blockers, beta-blocking agents,
or both. All patients undergoing extended septal myectomy. Result(s):
Left atrial volume, left ventricular end systolic volume, left ventricular
end diastolic volume and systolic pulmonary artery pressure were
significantly lower before discharge, three and six months than baseline
(P<0.05), while the left ventricle ejection fraction was insignificantly
different. NYHA class, interventricular septum, mitral regurgitation
grade, SAM and LVOT pressure were significantly lower before discharge,
three and six months than baseline. Medication number was insignificantly
different between baseline and before discharge, while significantly lower
in 3 and 6 months. Conclusion(s): After septal reduction surgery,
patients with HOCM may have remarkable changes in their clinical condition
and echocardiogram results. Copyright © 2024 African Science
Publications. All rights reserved.

<62>
Accession Number
2033982947
Title
Hemodynamic Effects of Pressure-Regulated Volume-Controlled Versus
Volume-Controlled Ventilation Mode in Patients with Diastolic Dysfunction
Undergoing Radical Cystectomy- A Cross Over Randomized Study.
Source
African Journal of Biological Sciences (South Africa). 6 (pp 2179-2195),
2024. Date of Publication: 2024.
Author
Ibrahim T.S.; Abdelsalam T.A.; Othman M.M.; Gad M.M.
Institution
(Ibrahim, Abdelsalam, Othman, Gad) Anesthesia Surgical Intensive Care and
Pain management Department, Faculty of Medicine, Mansoura university,
Egypt
Publisher
Institute of Advanced Studies
Abstract
Background: Management of hemodynamics remains one of the core tasks in
perioperative and critical care settings. The basis of hemodynamic
management in patients undergoing major surgery is formed by a rational
titration of fluids, vasopressors and inotropes. Objective(s): The
objective of this study was to investigate whether, the pressure regulated
volume-controlled mode (PRVC) in comparison with the volume-controlled
mode in patients with diastolic dysfunction, was associated with better
hemodynamic alterations and different vasopressors support during
anesthesia for radical cystectomy. Method(s): This study was a
randomized, cross-over single blinded study and included 86 adult patients
of both sexes with American Society of Anesthesiologists (ASA) physical
status I - II with diastolic dysfunction, the patients were randomly
assigned to group 0 (VCV-PRVC) and group 1 (PRVC-VCV) in a cross-over
manner according to a computer-generated randomization sequence.
Hemodynamic variables included stroke volume, stroke volume variation,
stroke index, cardiac output, cardiac index, systemic vascular resistance,
systemic vascular resistance index (SVRI), thoracic fluid content, and
corrected flow time, were measured by a Portable noninvasive cardiometry.
 Result(s): There were no statistically significant differences in
demographic data such as age, sex, ASA physical status, body weight,
height, body surface area (BSA), duration of surgery, anesthesia, cardiac
output, and cardiac index between the two modes of ventilation. Stroke
volume (SV) was significantly higher in the VCV group than in the PRVC
group at the 3-hour mark from the start of the resection. Regarding fluid
status parameters (SVV, FTc, and TFC), there was no statistically
significant difference in stroke volume variation (SVV) or (FTc) between
both modes. As regards to crystalloids, colloids, blood and plasma
transfusions, blood loss, and total fluids, there were no statistically
significant differences between both modes. Conclusion(s): no
significant differences in CO, CI, SV, SVI, and SVV. Both VCV and PRVC
ventilation modes could be used in patients with diastolic dysfunction
undergoing major abdominal surgery, showing. Copyright © 2024
African Science Publications. All rights reserved.

<63>
Accession Number
644997986
Title
Alternative Operative Procedures in Repeat Mitral Valve Surgery: A
Systematic Review and Meta-Analysis.
Source
British Journal of Surgery. Conference: ASiT Annual Conference 2024.
Bournemouth United Kingdom. 111(Supplement 6) (pp vi25-vi26), 2024. Date
of Publication: July 2024.
Author
Shirke M.; Soh V.; Wee A.; Harky A.
Institution
(Shirke) Nottingham University Hospitals, Nottingham, United Kingdom
(Soh, Wee) Queen's University Belfast, Belfast, United Kingdom
(Harky) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: Median sternotomy remains the gold standard redo mitral valve
surgery. However, this can be physically demanding for patients and affect
mortality and morbidity. Alternative procedures such as the right
anterolateral mini thoracotomy have been explored to mitigate the risks of
a re-sternotomy. This review aims to compare the clinical outcomes of
re-sternotomy (MS) versus right mini thoracotomy (MT) in mitral valve
surgery. Method(s): A systematic, electronic search was performed
according to PRISMA guidelines to identify relevant articles that compared
outcomes of the MS versus MT procedures in patients who have had cardiac
surgery via an MS approach. Result(s): Twelve studies were
identified, enrolling 4,514 patients. Length of hospital stay (MD= -3.71,
95% CI[-4.92, -2.49]), 30-day mortality(OR = 0.59, 95% CI [0.39, 0.90]),
and new-onset renal failure(OR=0.38, 95% CI [0.22, 0.65]) were
statistically significant in favour of the MT approach. Infection
rates(OR=0.56, 95% CI[0.25, 1.21]) and length of ICU stay (MD= -0.55, 95%
CI[-1.16, 0.06]) was lower in the MT group; however, the difference was
not significant. No significant differences were observed in the CPB
time(MD=-2.33, 95% CI [-8.15, 3.50]), aortic cross-clamp time MD= -1.67,
95% CI[-17.07, 13.76]), and rates of stroke(OR=1.03, 95% CI[0.55, 1.92]).
 Conclusion(s): Right MT offers a reduced length of hospital stay, ICU
stay, and a lower risk of new-onset renal failure requiring dialysis and
hence, can be considered a safe alternative. This review calls for robust
trials in the field to further strengthen the evidence.

<64>
Accession Number
644997938
Title
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
in Heart Failure with Reduced Ejection Fraction Patients: A Systematic
Review and Meta-Analysis Stratified by Left Ventricular Ejection Fraction.
Source
British Journal of Surgery. Conference: ASiT Annual Conference 2024.
Bournemouth United Kingdom. 111(Supplement 6) (pp vi25), 2024. Date of
Publication: July 2024.
Author
Hammad A.; Jubouri M.; Al-Tawil M.; Awad W.; Bashir M.
Institution
(Hammad, Jubouri) University of York, York, United Kingdom
(Hammad, Jubouri) University of Hull, Hull, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Awad) Barts Heat Centre, St Batholomew's Hospital, London, United Kingdom
(Bashir) Velindre University NHS Trust, Cardiff, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: The primary objectives were to assess differences in mortality,
repeat revascularization, new postoperative myocardial infarction (MI),
and cerebrovascular accidents (CVA/stroke) between PCI and CABG in HFrEF
patients, stratified by the degree of LVEF reduction. Method(s): A
comprehensive search of electronic databases was conducted, following
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines. Inclusion criteria comprised clinical trials or
observational cohort studies with >=20 patients per group, comparing
long-term outcomes in HFrEF patients (LVEF <50%) who underwent PCI or
CABG. Data was extracted, and quality was assessed using the New Castle
Ottawa (NOS) Risk of Bias tool. Hazard ratios (HRs) were pooled for
time-to-event outcomes, with subgroup analysis based on LVEF.
Heterogeneity was assessed, sensitivity analysis conducted, and
publication bias evaluated. Result(s): Twenty studies involving
25,031 patients met the inclusion criteria. In the severe LVEF reduction
group (<35%), CABG was associated with significantly higher long-term
survival, reduced repeat revascularization, and fewer postoperative MIs
compared to PCI. In patients with moderate LVEF reduction (<40%), there
was no difference in long-term survival, but repeat revascularization was
lower in the CABG group . In the mild LVEF reduction group (<50%), CABG
was associated with superior long-term survival and reduced repeat
revascularization. Stroke rates were similar between PCI and CABG in all
groups. Conclusion(s): Individualized patient care should consider
the degree of LVEF reduction when selecting between PCI and CABG, with
CABG generally favored for improved outcomes in HFrEF patients. However,
clinical presentation, patient characteristics, and cost-effectiveness
should also be considered in the decision-making process.

<65>
Accession Number
2033955335
Title
Effect of remimazolam versus propofol on hypotension after anesthetic
induction in patients undergoing coronary artery bypass grafting: A
randomized controlled trial.
Source
Journal of Clinical Anesthesia. 98 (no pagination), 2024. Article Number:
111580. Date of Publication: November 2024.
Author
Ju J.-W.; Lee D.J.; Chung J.; Lee S.; Cho Y.J.; Jeon Y.; Nam K.
Institution
(Ju, Lee, Chung, Cho, Jeon, Nam) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Lee) Department of Anesthesiology and Pain Medicine, Ajou University
Medical Center, Ajou University School of Medicine, Gyeonggi Province,
Suwon, South Korea
Publisher
Elsevier Inc.
Abstract
Study Objective: There is scarce evidence on the hemodynamic stability of
remimazolam during anesthetic induction in patients with significant
coronary artery disease. This study aims to compare the effects of
remimazolam and propofol on post-induction hypotension in patients
undergoing coronary artery bypass grafting (CABG). Design(s):
Randomized controlled trial. Setting(s): Tertiary teaching hospital.
 Patient(s): Adult patients undergoing isolated CABG.
 Intervention(s): Patients were randomly allocated to received either
remimazolam (n = 50) or propofol (n = 50) for anesthetic induction. The
remimazolam group received an initial infusion at 6 mg/kg/h, which was
later adjusted to 1-2 mg/kg/h to maintain a bispectral index of 40-60
after loss of consciousness. In the propofol group, a 1.5 mg/kg bolus of
propofol was administered, followed by 1-1.5% sevoflurane inhalation as
needed to achieve the target bispectral index. Measurements: The primary
outcome was the area under the curve (AUC) below the baseline mean
arterial pressure (MAP) during the first 10 min after anesthetic
induction. Secondary outcomes included the AUC for MAP <65 mmHg and the
requirement for vasopressors. Main Result(s): The remimazolam group
demonstrated a significantly lower AUC under the baseline MAP compared to
the propofol group (mean [SD], 169.8 [101.0] mmHg.min vs. 220.6 [102.4]
mmHg.min; mean difference [95% confidence interval], 50.8 [10.4-91.2]
mmHg.min; P = 0.014). Additionally, the remimazolam group had a reduced
AUC for MAP <65 mmHg (7.3 [10.3] mmHg.min vs. 13.9 [14.9] mmHg.min; P =
0.007) and a lower frequency of vasopressor use compared to the propofol
group (60% vs. 88%, P = 0.001). Conclusion(s): Remimazolam may offer
improved hemodynamic stability during anesthetic induction in patients
undergoing CABG, suggesting its potential advantage over propofol for
patients with significant coronary artery disease in terms of hemodynamic
stability. Copyright © 2024 Elsevier Inc.

<66>
Accession Number
2033955252
Title
Course of the effects of LDL-cholesterol reduction on cardiovascular risk
over time: A meta-analysis of 60 randomized controlled trials.
Source
Atherosclerosis. 396 (no pagination), 2024. Article Number: 118540. Date
of Publication: September 2024.
Author
Burger P.M.; Dorresteijn J.A.N.; Koudstaal S.; Holtrop J.; Kastelein
J.J.P.; Jukema J.W.; Ridker P.M.; Mosterd A.; Visseren F.L.J.
Institution
(Burger, Dorresteijn, Holtrop, Visseren) Department of Vascular Medicine,
University Medical Centre Utrecht, Utrecht, Netherlands
(Koudstaal) Department of Cardiology, Green Heart Hospital, Gouda,
Netherlands
(Kastelein) Department of Vascular Medicine, Amsterdam University Medical
Centre, Amsterdam, Netherlands
(Jukema) Department of Cardiology, Leiden University Medical Centre,
Leiden, Netherlands
(Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(Ridker) Centre for Cardiovascular Disease Prevention, Brigham and Women's
Hospital, Harvard Medical School, Boston, United States
(Mosterd) Department of Cardiology, Meander Medical Centre, Amersfoort,
Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: Individuals with or at high risk of cardiovascular
disease (CVD) often receive long-term treatment with low-density
lipoprotein cholesterol (LDL-C) lowering therapies, but whether the
effects of LDL-C reduction remain stable over time is uncertain. This
study aimed to establish the course of the effects of LDL-C reduction on
cardiovascular risk over time. Method(s): Randomized controlled
trials (RCTs) of LDL-C lowering therapies were identified through a search
in MEDLINE and EMBASE (1966-January 2023). The primary analyses were
restricted to statins, ezetimibe, and proprotein convertase
subtilisin-kexin type 9 (PCSK9) inhibitors, with other therapies included
in sensitivity analyses. Random-effects meta-analyses were performed to
establish the hazard ratio (HR) for major vascular events (cardiovascular
death, myocardial infarction, unstable angina, coronary revascularization,
or stroke) per 1 mmol/L LDL-C reduction. Course of the effects over time
was assessed using random-effects meta-regression analyses for the
association between follow-up duration, age, and the HR for major vascular
events per 1 mmol/L LDL-C reduction. Additionally, treatment-by-time
interactions were evaluated in an individual participant data
meta-analysis of six atorvastatin trials. Result(s): A total of 60
RCTs were identified (408,959 participants, 51,425 major vascular events).
The HR for major vascular events per 1 mmol/L LDL-C reduction was 0.78 (95
% confidence interval [CI] 0.75-0.81). Follow-up duration was not
associated with a change in the HR for major vascular events (HR for
change per year 0.994; 95 % CI 0.970-1.020; p = 0.66). The HR attenuated
with increasing age in primary prevention (HR for change per 5 years
1.097; 95 % CI 1.031-1.168; p = 0.003), but not secondary prevention (HR
for change per 5 years 0.987; 95 % CI 0.936-1.040; p = 0.63). Consistent
results were found for statin trials only, and all trials combined. In the
individual participant data meta-analysis (31,310 participants, 6734 major
vascular events), the HR for major vascular events did not significantly
change over follow-up time (HR for change per year 0.983; 95 % CI
0.943-1.025; p = 0.42), or age (HR for change per 5 years 1.022; 95 % CI
0.990-1.055; p = 0.18). Conclusion(s): Based on available RCT data
with limited follow-up duration, the relative treatment effects of LDL-C
reduction are stable over time in secondary prevention, but may attenuate
with higher age in primary prevention. Copyright © 2024 The
Authors

<67>
Accession Number
2030923164
Title
Differential response to preoperative exercise training in patients
candidates to cardiac valve replacement.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 280. Date
of Publication: December 2024.
Author
Lopez-Hernandez A.; Gimeno-Santos E.; Navarro-Ripoll R.; Arguis M.J.;
Romano-Andrioni B.; Lopez-Baamonde M.; Teres S.; Sanz-de la Garza M.;
Martinez-Palli G.
Institution
(Lopez-Hernandez, Navarro-Ripoll, Arguis, Lopez-Baamonde, Martinez-Palli)
Anesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Spain
(Lopez-Hernandez, Gimeno-Santos, Navarro-Ripoll, Arguis, Romano-Andrioni,
Lopez-Baamonde, Teres, Martinez-Palli) Prehabilitation Unit, Hospital
Clinic de Barcelona, Barcelona, Spain
(Gimeno-Santos, Navarro-Ripoll, Arguis, Sanz-de la Garza, Martinez-Palli)
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona,
Spain
(Gimeno-Santos) Barcelona of Global Health Institute (ISGlobal) -
Universitat Pompeu Fabra (UPF), Barcelona, Spain
(Romano-Andrioni) Nutrition and Clinical Dietetics, Hospital Clinic de
Barcelona, Barcelona, Spain
(Sanz-de la Garza) Cardiovascular Institute, Hospital Clinic de Barcelona,
Barcelona, Spain
(Gimeno-Santos, Martinez-Palli) CIBER de Enfermedades Respiratorias
(CIBERES), Carlos III Health Institute, Madrid, Spain
Publisher
BioMed Central Ltd
Abstract
Background: There is lack of evidence regarding safety, effectiveness and
applicability of prehabilitation on cardiac surgery population,
particularly in patients candidates to cardiac valve replacement. The aim
of the study is to assess and compare the effect of a multimodal
prehabilitation program on functional capacity in patients with severe
aortic stenosis (AoS) and severe mitral regurgitation (MR) proposed for
valve replacement surgery. Method(s): Secondary analysis from a
randomised controlled trial whose main objective was to analyze the
efficacy of a 4-6 weeks multimodal prehabilitation program in cardiac
surgery on reducing postoperative complications. For this secondary
analysis, only candidates for valve replacement surgery were selected. The
primary outcome was the change in endurance time (ET) from baseline to
preoperative assessment measured by a cycling constant work-rate
cardiopulmonary exercise test. Result(s): 68 patients were included
in this secondary analysis, 34 (20 AoS and 14 MR) were allocated to the
prehabilitation group and 34 (20 AoS and 14 MR) to control group. At
baseline, patients with AoS had better left systolic ventricular function
and lower prevalence of atrial fibrillation compared to MR (p = 0.022 and
p = 0.035 respectively). After prehabilitation program, patients with MR
showed greater improvement in ET than AoS patients (101% vs. 66% increase
from baseline). No adverse events related to the prehabilitation program
were observed. Conclusion(s): A 4-6 week exercise training program is
safe and overall improves functional capacity in patients with severe AoS
and MR. However, exercise response is different according to the cardiac
valve type disfunction, and further studies are needed to know the factors
that predispose some patients to have better training response. Trial
registration: The study has been registered on the Registry of National
Institutes of Health ClinicalTrials.gov (NCT03466606)
(05/03/2018). Copyright © The Author(s) 2024.

<68>
Accession Number
2033907974
Title
The pharmacological and clinical aspects of using gentamicin in cardiac
surgery.
Source
Pharmacia. 71 (pp 1-9), 2024. Date of Publication: 2024.
Author
Mohammed A.; Alkaaby L.S.; Alshawi N.
Institution
(Mohammed) Pharmacy Department, Osol Aldeen University College, Baghdad,
Iraq
(Alkaaby) Iraqi Center for Heart Diseases, Medical city, Baghdad, Iraq
(Alshawi) College of Pharmacy, Baghdad University, Bagdad, Iraq
Publisher
Pensoft Publishers
Abstract
Surgical site infection (SSI) is a serious postoperative complication
after cardiac surgery. The objective of this research is to examine the
efficacy of administering gentamicin in minimizing the incidence of SSI
while closely monitoring the therapeutic level of the drug. Prospective
research included 50 Iraqi patients divided into two groups, 25 in each:
Group 1 received a combination of flucloxacillin and ceftriaxone, while
Group 2 received a combination of flucloxacillin and gentamicin 2 mg/kg of
ideal body weight given before surgery, then 80 mg*3 for 48 hours after
surgery. A total of five patients had an infection at the surgical site,
with four patients in Group 1 and one patient in Group 2. Additionally,
two patients in each group exhibited increased renal indices. Among the
patients in Group 2, the highest concentration of gentamicin in the blood
was <= 2.5 microg/ml for eight patients, while for 17 patients, the
gentamicin concentration in the blood ranged from 3 to 4.4
microg/ml. Copyright © Mohammed A et al.

<69>
Accession Number
2033009404
Title
Association between driving pressure-guided ventilation and postoperative
pulmonary complications in surgical patients: a meta-analysis with trial
sequential analysis.
Source
British Journal of Anaesthesia. 133(3) (pp 647-657), 2024. Date of
Publication: September 2024.
Author
Gu W.-J.; Cen Y.; Zhao F.-Z.; Wang H.-J.; Yin H.-Y.; Zheng X.-F.
Institution
(Gu, Cen, Zhao, Yin) Department of Intensive Care Unit, The First
Affiliated Hospital of Jinan University, Guangzhou, China
(Wang, Zheng) Department of Bone and Joint Surgery and Sports Medicine
Center, The First Affiliated Hospital of Jinan University, Guangzhou,
China
Publisher
Elsevier Ltd
Abstract
Background: Prior studies have reported inconsistent results regarding the
association between driving pressure-guided ventilation and postoperative
pulmonary complications (PPCs). We aimed to investigate whether driving
pressure-guided ventilation is associated with a lower risk of PPCs.
 Method(s): We systematically searched electronic databases for RCTs
comparing driving pressure-guided ventilation with conventional protective
ventilation in adult surgical patients. The primary outcome was a
composite of PPCs. Secondary outcomes were pneumonia, atelectasis, and
acute respiratory distress syndrome (ARDS). Meta-analysis and subgroup
analysis were conducted to calculate risk ratios (RRs) with 95% confidence
intervals (CI). Trial sequential analysis (TSA) was used to assess the
conclusiveness of evidence. Result(s): Thirteen RCTs with 3401
subjects were included. Driving pressure-guided ventilation was associated
with a lower risk of PPCs (RR 0.70, 95% CI 0.56-0.87, P=0.001), as
indicated by TSA. Subgroup analysis (P for interaction=0.04) found that
the association was observed in non-cardiothoracic surgery (nine RCTs,
1038 subjects, RR 0.61, 95% CI 0.48-0.77, P< 0.0001), with TSA suggesting
sufficient evidence and conclusive result; however, it did not reach
significance in cardiothoracic surgery (four RCTs, 2363 subjects, RR 0.86,
95% CI 0.67-1.10, P=0.23), with TSA indicating insufficient evidence and
inconclusive result. Similarly, a lower risk of pneumonia was found in
non-cardiothoracic surgery but not in cardiothoracic surgery (P for
interaction=0.046). No significant differences were found in atelectasis
and ARDS between the two ventilation strategies. Conclusion(s):
Driving pressure-guided ventilation was associated with a lower risk of
postoperative pulmonary complications in non-cardiothoracic surgery but
not in cardiothoracic surgery. Systematic Review Protocol: INPLASY
202410068. Copyright © 2024 British Journal of Anaesthesia

<70>
Accession Number
2031636813
Title
Optimal Percutaneous Treatment Approach to Unprotected Ostial Left
Anterior Descending Artery Disease: A Meta-Analysis and Systematic Review.
Source
Heart Lung and Circulation. 33(8) (pp 1123-1135), 2024. Date of
Publication: August 2024.
Author
Shi H.; Hyasat K.; Deshmukh T.; Ada C.; Chiha J.; Asrress K.; Liou K.
Institution
(Shi, Hyasat, Deshmukh, Ada, Chiha, Asrress, Liou) Department of
Cardiology, Bankstown Hospital, Sydney, NSW, Australia
(Shi, Hyasat, Liou) Faculty of Medicine, University of New South Wales,
Sydney, NSW, Australia
(Chiha, Asrress) School of Medicine, Macquarie University, Sydney, NSW,
Australia
Publisher
Elsevier Ltd
Abstract
Background: The optimal management strategy for significant unprotected
ostial left anterior descending artery (LAD) disease remains undefined.
Merits of the two most common percutaneous approaches are considered in
this quantitative synthesis. Method(s): A meta-analysis was performed
to compare ostial stenting (OS) and crossover stenting (CS) in the
treatment of unprotected ostial LAD stenosis. The primary outcome is the
disparity in target lesion revascularisation (TLR). The Mantel-Haenszel
method was employed with random effect model, chosen a priori to account
for heterogeneity among the included studies. Result(s): Seven
studies comprising 1,181 patients were included in the analyses. Of these,
482 (40.8%) patients underwent CS. Overall, there was a statistically
significant trend in favour of CS (odds ratio 0.51, 95% confidence
interval 0.30-0.86, p=0.01) with respect to the rate of TLR at follow-up.
This remained true when TLR involving the left circumflex artery (LCx) was
considered, even when there was a greater need for unintended intervention
to the LCx during the index procedure (odds ratio 6.68, 95% confidence
interval: 1.69-26.49, p=0.007). Final kissing balloon inflation may reduce
the need for acute LCx intervention. Imaging guidance appeared to improve
clinical outcomes irrespective of approach chosen. Conclusion(s): In
the percutaneous management of unprotected ostial LAD disease, CS into the
left main coronary artery (LMCA) appeared to reduce future TLR.
Integration of intracoronary imaging was pivotal to procedural success.
The higher incidence of unintended LCx intervention in the CS arm may be
mitigated by routine final kissing balloon inflation, although the
long-term implication of this remains unclear. In the absence of
randomised trials, clinicians' discretion remains critical. Copyright
© 2024

<71>
Accession Number
2030904185
Title
The Usefulness of Coregistration with iFR in Tandem or Long Diffuse
Coronary Lesions: The iLARDI Randomized Clinical Trial.
Source
Journal of Clinical Medicine. 13(15) (no pagination), 2024. Article
Number: 4342. Date of Publication: August 2024.
Author
Hidalgo F.; Gonzalez-Manzanares R.; Suarez de Lezo J.; Gallo I.; Alvarado
M.; Perea J.; Maestre-Luque L.C.; Resua A.; Romero M.; Lopez-Benito M.;
Perez de Prado A.; Ojeda S.; Pan M.
Institution
(Hidalgo, Gonzalez-Manzanares, Suarez de Lezo, Gallo, Alvarado, Perea,
Maestre-Luque, Resua, Romero, Ojeda, Pan) Department of Cardiology, Reina
Sofia University Hospital, Cordoba 14004, Spain
(Hidalgo, Gonzalez-Manzanares, Suarez de Lezo, Gallo, Alvarado, Perea,
Maestre-Luque, Resua, Romero, Ojeda, Pan) Maimonides Biomedical Research
Institute of Cordoba (IMIBIC), Cordoba 14004, Spain
(Hidalgo, Gonzalez-Manzanares, Suarez de Lezo, Romero, Ojeda, Pan) Centro
de Investigacion Biomedica en Red Enfermedades Cardiovasculares (CIBERCV),
Madrid 28029, Spain
(Romero, Ojeda, Pan) Department of Medicine, University of Cordoba,
Cordoba 14004, Spain
(Lopez-Benito, Perez de Prado) Department of Cardiology, University
Hospital of Leon, Leon 24008, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background. Despite technical advancements, patients with sequential or
diffuse coronary lesions undergoing percutaneous coronary intervention
(PCI) have an increased risk of cardiovascular events at follow-up. We
aimed to analyze the utility of a SyncVision/iFR (S-iFR)-guided PCI
strategy versus an angiography-guided strategy in patients with this type
of lesions. Methods. Randomized, multicenter, controlled, and open-label
trial to compare S-iFR versus angiography-guided PCI in patients with
sequential or diffuse angiographic coronary stenosis (ClinicalTrials.gov
identifier: NCT04283734). The primary endpoint was the implanted stent
length. The main secondary endpoint was targeting vessel failure (TVF) at
one year. Results. A total of 100 patients underwent randomization, with
49 patients assigned to the S-iFR group and 51 to the angiography-guided
PCI group. There were no differences between groups regarding clinical and
anatomical characteristics. The baseline iFR was 0.71 +/- 0.16 vs. 0.67
+/- 0.19 (p = 0.279) in the S-iFR and angiography group, respectively. The
mean lesion length was 42.3 +/- 12 mm and 39.8 +/- 12 (p = 0.297). The
implanted stent length was 32.7 +/- 17.2 mm in the S-iFR group and 43.1
+/- 14.9 mm in the angiography group (mean difference, -10.4 mm; 95%
confidence interval [CI], -16.9 to -4.0; p = 0.002). At one year, target
vessel failure (TVF) occurred in four patients: three (6.1%) in the S-iFR
group vs. one (1.9%) in the angiography group (p = 0.319). Conclusions.
Among patients with sequential or long diffuse coronary lesions, a
S-iFR-guided PCI strategy resulted in a reduction of the total stent
length compared to an angiography-guided PCI strategy. A nonsignificant
increase in TVF was observed in the S-iFR group. Copyright © 2024
by the authors.

<72>
Accession Number
2030904077
Title
The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with
Surgical Implications.
Source
Journal of Clinical Medicine. 13(15) (no pagination), 2024. Article
Number: 4285. Date of Publication: August 2024.
Author
Plutecki D.; Bonczar M.; Wilk J.; Necka S.; Joniec M.; Elsaftawy A.;
Matuszyk A.; Walocha J.; Koziej M.; Ostrowski P.
Institution
(Plutecki) Collegium Medicum, Jan Kochanowski University, Kielce 25-369,
Poland
(Bonczar, Wilk, Necka, Joniec, Matuszyk, Walocha, Koziej, Ostrowski)
Department of Anatomy, Jagiellonian University Medical College, Krakow
33-332, Poland
(Bonczar, Wilk, Necka, Walocha, Koziej, Ostrowski) Youthoria-Youth
Research Organization, Krakow 30-363, Poland
(Elsaftawy) Chiroplastica-Lower Silesian Centre of Hand and Aesthetic
Surgery, Wroclaw 54-117, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The thoracic duct (TD) and the cisterna chyli (CC) exhibit a
high degree of variability in their topographical and morphometric
properties. Material(s) and Method(s): PubMed, Scopus, Embase, Web of
Science, Cochrane Library, and Google Scholar were searched to identify
all studies that included information regarding the morphometric and
topographical characteristics of the TD and CC. Result(s): The most
frequent location of the TD termination was the left venous angle, with a
pooled prevalence of 45.29% (95% CI: 25.51-65.81%). Moreover, the TD
terminated most commonly as a single vessel (pooled prevalence = 78.41%;
95% CI: 70.91-85.09%). However, it divides into two or more terminating
branches in approximately a quarter of the cases. The pooled prevalence of
the CC was found to be 55.49% (95% CI: 26.79-82.53%). Conclusion(s):
Our meta-analysis reveals significant variability in the anatomy of the TD
and CC, particularly regarding TD termination patterns. Despite the
predominance of single-vessel terminations, almost a quarter of cases
exhibit branching, highlighting the complexity of the anatomy of the TD.
These findings demonstrate the importance of detailed anatomical knowledge
for surgeons to minimize the risk of accidental injury during head and
neck, as well as thoracic surgeries. Our study provides essential insights
that can enhance surgical safety and efficacy, ultimately improving
patient outcomes. Copyright © 2024 by the authors.

<73>
Accession Number
2030591294
Title
Current status of wearable cardioverter-defibrillator use in Japan.
Source
Journal of Arrhythmia. 40(4) (pp 998-1000), 2024. Date of Publication:
August 2024.
Author
Tonegawa-Kuji R.; Nishida T.; Sumita Y.; Miyamoto Y.; Kanaoka K.
Institution
(Tonegawa-Kuji, Sumita, Kanaoka) Department of Medical and Health
Information Management, National Cerebral and Cardiovascular Center,
Suita, Japan
(Nishida, Kanaoka) Department of Cardiovascular Medicine, Nara Medical
University, Nara, Japan
(Miyamoto) Open Innovation Center, National Cerebral and Cardiovascular
Center, Suita, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: The current status of wearable cardiovascular defibrillators
(WCD) use in Japan is unclear. Method(s): Using a nationwide claims
database of Japan, we assessed characteristics of patients using WCD and
factors influencing subsequent implantable cardioverter-defibrillator
(ICD) implantation. Result(s): In 1049 cases, those with prior
cardiopulmonary arrest (CPA) or ventricular arrhythmia, cardiomyopathy, or
device-related issues were more likely to require permanent ICDs, whereas
females were less likely. Conclusion(s): Prior CPA or fatal
arrhythmia, underlying cardiomyopathy, or device-related issues were
associated with future permanent ICD implantation. These findings offer
insights into the current status of WCD use in Japan. Copyright ©
2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons
Australia, Ltd on behalf of Japanese Heart Rhythm Society.

<74>
Accession Number
2033992028
Title
Mechanical circulatory support devices in adults with congenital heart
disease.
Source
Current Opinion in Organ Transplantation. (no pagination), 2024. Article
Number: 1165. Date of Publication: 2024.
Author
Garba D.L.; Joseph S.; Cedars A.
Institution
(Garba, Cedars) Johns Hopkins Hospital, Baltimore, MD, United States
(Joseph) Thomas Jefferson Hospital, Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Mechanical circulatory support is used frequently as a
method of stabilizing patients with end stage heart failure who are unable
to safely await allograft availability. While this technology has been
fundamentally important in supporting patients with normal cardiac
anatomy, it is still used infrequently in adult patients with congenital
heart disease and end-stage heart failure. Here, we review the data on
mechanical circulatory support technology in this small but growing
population of patients with chronic heart disease prone to the development
of circulatory failure. Recent findings Mechanical circulatory support
(MCS) has been increasingly employed in adults with congenital heart
disease (ACHD) as a bridge to transplant. The new United Network for Organ
Sharing listing system favoring temporary MCS use with a higher listing
status offers another tool to stabilize ACHD patients and potentially
shorten wait times. Both temporary and Durable MCS could help improve
transplant candidacy and posttransplant outcomes in select groups of ACHD
patients. Summary Durable and temporary MCS have the potential to
significantly improve access to transplant and overall transplant outcomes
in ACHD patients. Copyright © 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<75>
Accession Number
2033992011
Title
Effect of In Vivo Administration of Fibrinogen Concentrate Versus
Cryoprecipitate on Ex Vivo Clot Degradation in Neonates Undergoing Cardiac
Surgery.
Source
Anesthesia and Analgesia. (no pagination), 2024. Article Number: 7123.
Date of Publication: 2024.
Author
Downey L.A.; Moiseiwitsch N.; Nellenbach K.; Xiang Y.; Brown A.C.;
Guzzetta N.A.
Institution
(Downey, Guzzetta) Department of Anesthesiology, Emory University School
of Medicine, Atlanta, GA, United States
(Downey, Guzzetta) Department of Anesthesiology, Children's Healthcare of
Atlanta, Atlanta, GA, United States
(Moiseiwitsch, Nellenbach, Brown) Department of Biomedical Engineering of
University of North Carolina-Chapel Hill, North Carolina State University,
Raleigh, NC, United States
(Moiseiwitsch, Nellenbach, Brown) Comparative Medicine Institute, North
Carolina State University, Raleigh, NC, United States
(Xiang) Department of Population and Public Health Sciences, Keck School
of Medicine of University of Southern California, Los Angeles, CA, United
States
(Brown) Department of Material Science and Engineering, North Carolina
State University, Raleigh, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Neonates undergoing cardiac surgery require fibrinogen
replacement to restore hemostasis after cardiopulmonary bypass (CPB).
Cryoprecipitate is often the first-line treatment, but recent studies
demonstrate that fibrinogen concentrate (RiaSTAP; CSL Behring) may be
acceptable in this population. This investigator-initiated, randomized
trial compares cryoprecipitate to fibrinogen concentrate in neonates
undergoing cardiac surgery (ClinicalTrials.gov NCT03932240). The primary
end point was the percent change in ex vivo clot degradation from baseline
at 24 hours after surgery between groups. Secondary outcomes included
intraoperative blood transfusions, coagulation factor levels, and adverse
events. METHOD(S): Neonates were randomized to receive
cryoprecipitate (control group) or fibrinogen concentrate (study group) as
part of a post-CPB transfusion algorithm. Blood samples were drawn at 4
time points: presurgery (T1), after treatment (T2), arrival to the
intensive care unit (ICU) (T3), and 24 hours postsurgery (T4). Using the
mixed-effect models, we analyzed the percent change in ex vivo clot
degradation from a patient's presurgery baseline at each time point.
Intraoperative blood product transfusions, coagulation factor levels,
perioperative laboratory values, and adverse events were collected.
 RESULT(S): Thirty-six neonates were enrolled (intent to treat [ITT]).
Thirteen patients in the control group and seventeen patients in the study
group completed the study per protocol (PP). After normalizing to the
patient's own baseline (T1), no significant differences were observed in
clot degradation at T2 or T3. At T4, patients in the study group had
greater degradation when compared to those in the control group (826.5%,
95% confidence interval [CI], 291.1-1361.9 vs -545.9%, 95% CI, -1081.3 to
-10.4; P <.001). Study group patients received significantly less median
post-CPB transfusions than control group patients (ITT, 27.2 mL/kg
[19.0-36.9] vs 41.6 [29.2-52.4]; P =.043; PP 26.7 mL/kg [18.8-32.2] vs
41.2 mL/kg [29.0-51.4]; P <.001). No differences were observed in bleeding
or thrombotic events. CONCLUSION(S): Neonates who received fibrinogen
concentrate, as compared to cryoprecipitate, have similar perioperative ex
vivo clot degradation with faster degradation at 24 hours postsurgery,
less post-CPB blood transfusions, and no increased bleeding or thrombotic
complications. Our findings suggest that fibrinogen concentrate adequately
restores hemostasis and reduces transfusions in neonates after CPB without
increased bleeding or thrombosis risk. Copyright © 2024
International Anesthesia Research Society.

<76>
Accession Number
2033992005
Title
Changes in the Term Neonatal Electroencephalogram with General Anesthesia:
A Systematic Review with Narrative Synthesis.
Source
Anesthesiology. (no pagination), 2024. Article Number: 5088. Date of
Publication: 2024.
Author
Corlette S.J.; Walker S.M.; Cornelissen L.; Brasher C.; Bower J.; Davidson
A.J.
Institution
(Corlette, Brasher, Davidson) Department of Anaesthesia and Pain
Management, Royal Children's Hospital, Melbourne, VIC, Australia
(Corlette, Davidson) Department of Paediatrics, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Corlette) Murdoch Children's Research Institute, Melbourne, VIC,
Australia
(Walker) Paediatric Pain Research Group, University College London,
Developmental Neurosciences, Institute of Child Health, Great Ormond
Street, London, United Kingdom
(Cornelissen) Department of Anesthesiology,Critical Care and Pain
Medicine, Boston Children's Hospital, Boston, MA, United States
(Cornelissen) Harvard Medical School, Boston, MA, United States
(Brasher) Department of Critical Care, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Bower) Faculty of Fine Arts and Music, University of Melbourne,
Melbourne, VIC, Australia
(Davidson) Murdoch Children's Research Institute, Melbourne Children's
Trial Centre, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Although effects of general anesthesia on neuronal activity in
the human neonatal brain are incompletely understood,
electroencephalography provides some insight and may identify
age-dependent differences. Method(s): A systematic search (MEDLINE,
Embase, PubMed, and Cochrane Library to November 2023) retrieved English
language publications reporting electroencephalography during general
anesthesia for cardiac or noncardiac surgery in term neonates (37 to 44
weeks postmenstrual age). Data were extracted, and risk of bias (ROBINS-I
Cochrane tool) and quality of evidence (Grading of Recommendations
Assessment, Development, and Evaluation [GRADE] checklist) were assessed.
 Result(s): From 1,155 abstracts, 9 publications (157 neonates; 55.7%
male) fulfilled eligibility criteria. Data were limited, and study quality
was very low. The occurrence of discontinuity, a characteristic pattern of
alternating higher and lower amplitude electroencephalography segments,
was reported with general anesthesia (94 of 119 neonates, 6 publications)
and with hypothermia (23 of 23 neonates, 2 publications). Decreased power
in the delta (0.5 to 4 Hz) frequency range was also reported with
increasing anesthetic dose (39 neonates; 3 publications).
 Conclusion(s): Although evidence gaps were identified, both
increasing sevoflurane concentration and decreasing temperature are
associated with increasing discontinuity. Copyright © 2024 The
Author(s).

<77>
Accession Number
644989236
Title
A Randomized Comparison of the Treatment Sequence of Percutaneous Coronary
Intervention and Transcatheter Aortic Valve Implantation: Rationale and
Design of the TAVI PCI Trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 07
Aug 2024.
Author
Stahli B.E.; Linke A.; Westermann D.; Van Mieghem N.M.; Leistner D.M.;
Massberg S.; Alber H.; Mugge A.; Musumeci G.; Kesterke R.; Schneider S.;
Kastrati A.; Ford I.; Ruschitzka F.; Kasel M.A.
Institution
(Stahli) Department of Cardiology, University Heart Center, University
Hospital Zurich, Zurich, Switzerland
(Linke) Department of Internal Medicine and Cardiology, Herzzentrum
Dresden, University Clinic, Technische Universitat Dresden, Dresden,
Germany
(Westermann) Department of Cardiology and Angiology, Faculty of Medicine,
University Heart Center Freiburg-Bad Krozingen, University of Freiburg,
Freiburg, Germany
(Van Mieghem) Department of Cardiology, Cardiovascular Institute,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Leistner) Department of Medicine, Cardiology, Goethe University Hospital,
DZHK Partner Site Rhein-Main, Frankfurt
(Massberg) Medizinische Klinik und Poliklinik I, LMU University Hospital,
LMU Munich, DZHK (German Centre for Cardiovascular Research), Partner Site
Munich Heart Alliance, Munich, Germany
(Alber) Department of Internal Medicine and Cardiology, Landeskrankenhaus,
Klagenfurt, Austria
(Mugge) University Hospital St Josef-Hospital, Cardiology and Rhythmology,
Ruhr University Bochum, Bochum, Germany
(Musumeci) SC Cardiologia, AO Ordine Mauriziano, Torino, Italy
(Kesterke, Ruschitzka, Kasel) Department of Cardiology, University Heart
Center, University Hospital Zurich, Zurich, Switzerland
(Schneider) Institut fur Herzinfarktforschung (IHF), Ludwigshafen, Germany
(Kastrati) Deutsches Herzzentrum Munchen, Technische Universitat, DZHK
(German Centre for Cardiovascular Research), partner site Munich Heart
Alliance, Munich, Germany
(Ford) Robertson Centre for Biostatistics, University of Glasgow, Glasgow,
United Kingdom
Abstract
BACKGROUND: About half of patients with severe aortic stenosis present
with concomitant coronary artery disease. The optimal timing of
percutaneous coronary intervention (PCI) and transcatheter aortic valve
implantation (TAVI) in patients with severe aortic stenosis and
concomitant coronary artery disease remains unknown. STUDY DESIGN: The
TAVI PCI trial is a prospective, international, multicenter, randomized,
two-arm, open-label study planning to enroll a total of 986 patients. It
is designed to investigate whether the strategy "angiography-guided
complete revascularization after (within 1-45 days) TAVI" is non-inferior
to the strategy "angiography-guided complete revascularization before
(within 1-45 days) TAVI" using the Edwards SAPIEN 3 or 3 Ultra
Transcatheter Heart ValveTM in patients with severe aortic stenosis and
concomitant coronary artery disease. Patients are randomized in a 1:1
ratio to one of the two treatment strategies. The primary end point is a
composite of all-cause death, non-fatal myocardial infarction,
ischemia-driven revascularization, rehospitalization (valve- or
procedure-related including heart failure), or life-threatening/disabling
or major bleeding at 1 year. CONCLUSION(S): The TAVI PCI trial tests
the hypothesis that the strategy "PCI after TAVI" is non-inferior to the
strategy "PCI before TAVI" in patients with severe aortic stenosis and
concomitant coronary artery disease. Copyright © 2024. Published
by Elsevier Inc.

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