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<1>
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. <br/>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.
<br/>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). <br/>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. <br/>Funding(s): XVIVO
Perfusion.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<2>
Accession Number
2035195580
Title
Short- and long-term outcomes of antegrade versus retrograde approaches in
patients undergoing percutaneous coronary intervention for chronic total
occlusion: A meta-analysis.
Source
International Journal of Cardiology. 418 (no pagination), 2025. Article
Number: 132590. Date of Publication: 01 Jan 2025.
Author
Goyal A.; Tariq M.D.; Shahnoor S.; Saeed H.; Khan A.M.; Sulaiman S.A.;
Jain H.; Khan R.; AlJaroudi W.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Tariq) Department of Internal Medicine, Foundation University Medical
College, Islamabad, Pakistan
(Shahnoor) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Saeed) Department of Internal Medicine, Rawalpindi Medical University,
Punjab, Rawalpindi, Pakistan
(Khan) Department of Internal Medicine, Ayub Medical College, Abbottabad,
Pakistan
(Sulaiman) School of Medicine, University of Jordan, Amman, Jordan
(Jain) Department of Internal Medicine, All India Institute of Medical
Sciences-, Jodhpur, India
(Khan) Department of Internal Medicine, Medical University of South
Carolina, Florence, SC, United States
(AlJaroudi) Department of Cardiology, WellStar MCG Health, Augusta, GA,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Chronic Total Occlusion (CTO) involves severe coronary artery
blockage that impairs blood flow and affects 15-20 % of patients
undergoing coronary angiography and over 40 % with diabetes or heart
failure. Percutaneous Coronary Intervention (PCI) is used to restore blood
flow in such cases. The retrograde approach, developed due to lower
success with the antegrade method in complex cases, improves outcomes but
increases complications. This meta-analysis compares the efficacy and
safety of both approaches to guide clinical practice. <br/>Method(s): A
comprehensive literature search was conducted on PubMed, Embase, Google
Scholar, and Scopus until June 5, 2024, to find studies comparing
antegrade and retrograde approaches in CTO-PCI patients. Pooled risk
ratios (RR) with 95 % confidence intervals (CI) were calculated using R
software (version 4.4.1), with significance set at p < 0.05.
Random-effects models were used for all analyses. <br/>Result(s): Our
analysis included 22 observational studies with 49,152 CTO-PCI patients:
35,844 in the antegrade arm and 13,308 in the retrograde arm. The
antegrade approach showed significantly lower risks of in-hospital
outcomes, including mortality [RR: 0.45; p < 0.001], myocardial infarction
[RR: 0.37; p < 0.001], major adverse cardiovascular events [RR: 0.34; p <
0.001], and cerebrovascular events [RR: 0.50; p = 0.011]. Long-term
outcomes, such as all-cause mortality [RR: 0.71; p = 0.157] and myocardial
infarction [RR: 0.76; p = 0.438], were comparable between both approaches.
<br/>Conclusion(s): The antegrade technique shows better outcomes and
procedural advantages over retrograde revascularization, though long-term
outcomes are similar. Further studies, especially randomized controlled
trials are needed to confirm these findings.<br/>Copyright &#xa9; 2024
Elsevier B.V.

<3>
Accession Number
2034982334
Title
Effects of oral pregabalin on postoperative sleep of patients after
video-assisted thoracoscopic surgery: a randomized double-blind controlled
trial.
Source
Minerva Anestesiologica. 90(10) (pp 872-881), 2024. Date of Publication:
October 2024.
Author
Liu H.; Wang Q.; Xu Z.; Zhang L.; Liu Y.; Zhao L.
Institution
(Liu, Wang, Xu, Zhang, Liu, Zhao) Key Laboratory of Anesthesiology, Xuzhou
Medical University, Xuzhou, China
(Liu, Wang, Xu, Zhang, Liu, Zhao) Department of Anesthesiology, Affiliated
Hospital of Xuzhou Medical University, Xuzhou, China
(Liu) Suining County People's Hospital, Xuzhou, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: The aim of this study was to explore the effect of oral
pregabalin at varying concentrations on postoperative sleep of patients
undergoing video-assisted thoracic surgery (VATS), and to identify the
optimal dosage. <br/>METHOD(S): A total of 120 VATS-treated patients
admitted from June 2023 to October 2023 were randomly assigned to be
orally administered with 75 mg pregabalin, 150 mg pregabalin and starch
capsules (control group) at a 1:1:1 ratio. One capsule of pregabalin (75
mg) and one capsule of placebo with the same shape and odor, two capsules
of pregabalin (150 mg), and two capsules of placebo with the same shape
and odor were administered orally to patients in the three groups on the
night of surgery, and in the morning and evening of postoperative days 2
and 3. The primary outcome was the incidence of postoperative sleep
disturbance (PSD) on postoperative day 1 (POD1). The secondary outcomes
included the St.Mary's Hospital Sleep Questionnaire (SMH), the Pittsburg
Sleep Quality Index (PSQI) and pain intensity measured with a Numerical
Rating Scale (NRS). Multivariate logistic regression analysis was
performed to identify risk factors for PSD in VATS-treated patients.
<br/>RESULT(S): The incidence of PSD on POD1 in the 75 mg pregabalin group
and 150 mg pregabalin group was significantly lower than that of the
control group (45.0% vs. 42.5% vs. 72.5%; P<0.0167 for two-by-two
comparisons of groups A and B with group C, respectively). The SMH scores
at night on POD1-3 were significantly higher in the 75 mg pregabalin group
and 150 mg pregabalin group than those of the control group (P<0.05).
Since there was definitive lower incidence of pain in the experimental
groups,the median NRS scores of the incisional pain on POD2-3 were
significantly lower in the 75 mg pregabalin group and 150 mg pregabalin
group (P<0.05). The incidence of dizziness in the 150 mg pregabalin group
was significantly higher than that of the 75 mg pregabalin group and
control group (55.0% vs. 25.0% vs. 32.5%; P<0.0167 for two-by-two
comparisons of groups A and C with group B, respectively). NRS score on
POD1, preoperative PSQI and Self-Rating Depression Scale scores were risk
factors for PSD in VATS-treated patients. <br/>CONCLUSION(S): Oral
administration of 75 mg or 150mg pregabalin for consecutive three days
after VATS effectively reduces the incidence of PSD and improves the
quality of sleep.<br/>Copyright &#xa9; 2024 EDIZIONI MINERVA MEDICA.

<4>
Accession Number
2035006270
Title
Moderate ischemic mitral regurgitation in ischemic heart disease: to
operate or not? A meta-analysis.
Source
Journal of Cardiovascular Surgery. 65(4) (pp 390-397), 2024. Date of
Publication: August 2024.
Author
Alsuayri R.A.; Alassiri A.K.; Awad A.K.; Faleh M.N.; Baqays R.T.;
Porqueddu M.
Institution
(Alsuayri) Batterjee Medical College for Sciences and Technology, Jeddah,
Saudi Arabia
(Alassiri) Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi
Arabia
(Awad) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Faleh) College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
(Baqays, Porqueddu) Department of Cardiac Surgery, King Fahd Armed Forces
Hospital, Jeddah, Saudi Arabia
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Deciding whether to perform coronary artery bypass grafting
(CABG) alone or in combination with mitral valve repair is a common
dilemma encountered by surgeons when treating patients with ischemic
mitral regurgitation, a common condition related to coronary artery
disease. Although ischemic mitral regurgitation after CABG has been linked
to unfavorable results, the benefits of including mitral valve repair are
still unknown. This discrepancy led us to undertake a systematic review
and meta-analysis to determine whether combining CABG with mitral valve
surgery leads to better clinical results than CABG alone. EVIDENCE
ACQUISITION: Studies comparing the results of CABG versus CABG with mitral
valve replacement were searched in the databases of PubMed and Google
Scholar. There were six randomized clinical trials included in this study.
EVIDENCE SYNTHESIS: We analyzed 852 patients' data. There were no
significant variations between patients who acquired CABG alone or
CABG+(MVR) in terms of their risk of death at one year, stroke, atrial
fibrillation, or hospitalization for heart failure. For recurrent/residual
mitral regurgitation; it revealed an RR=5.42, 95% CI, 0.77 to 37.98, and a
P value of =0.065. According to the analysis of study heterogeneity, no
apparent heterogeneity was identified in the outcomes of death after one
year, stroke, atrial fibrillation, or hospitalization for heart failure.
However, the outcome of recurrent or residual mitral regurgitation showed
significant variation (I²=66%). <br/>CONCLUSION(S): Patients
who underwent CABG alone versus CABG plus MVR did not differ significantly
from one another. However, the comparison of CABG alone with CABG plus MVR
underlines the need for customized treatment plans based on the unique
characteristics of each patient.<br/>Copyright &#xa9; 2024 EDIZIONI
MINERVA MEDICA.

<5>
Accession Number
2035125122
Title
2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative
Cardiovascular Management for Noncardiac Surgery: A Report of the American
College of Cardiology/American Heart Association Joint Committee on
Clinical Practice Guidelines.
Source
Journal of the American College of Cardiology. 84(19) (pp 1869-1969),
2024. Date of Publication: 05 Nov 2024.
Author
Thompson A.; Fleischmann K.E.; Smilowitz N.R.; de las Fuentes L.;
Mukherjee D.; Aggarwal N.R.; Ahmad F.S.; Allen R.B.; Altin S.E.; Auerbach
A.; Berger J.S.; Chow B.; Dakik H.A.; Eisenstein E.L.; Gerhard-Herman M.;
Ghadimi K.; Kachulis B.; Leclerc J.; Lee C.S.; Macaulay T.E.; Mates G.;
Merli G.J.; Parwani P.; Poole J.E.; Rich M.W.; Ruetzler K.; Stain S.C.;
Sweitzer B.; Talbot A.W.; Vallabhajosyula S.; Whittle J.; Williams K.A.
Publisher
Elsevier Inc.
Abstract
Aim: The "2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for
Perioperative Cardiovascular Management for Noncardiac Surgery" provides
recommendations to guide clinicians in the perioperative cardiovascular
evaluation and management of adult patients undergoing noncardiac surgery.
<br/>Method(s): A comprehensive literature search was conducted from
August 2022 to March 2023 to identify clinical studies, reviews, and other
evidence conducted on human subjects that were published in English from
MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for
Healthcare Research and Quality, and other selected databases relevant to
this guideline. Structure: Recommendations from the "2014 ACC/AHA
Guideline on Perioperative Cardiovascular Evaluation and Management of
Patients Undergoing Noncardiac Surgery" have been updated with new
evidence consolidated to guide clinicians; clinicians should be advised
this guideline supersedes the previously published 2014 guideline. In
addition, evidence-based management strategies, including pharmacological
therapies, perioperative monitoring, and devices, for cardiovascular
disease and associated medical conditions, have been
developed.<br/>Copyright &#xa9; 2024

<6>
Accession Number
2034806647
Title
Efficacy of perioperative pain management in paediatric cardiac surgery: A
protocol for a network meta-analysis.
Source
BMJ Open. 14(9) (no pagination), 2024. Article Number: e084547. Date of
Publication: 10 Sep 2024.
Author
Yan H.; Yan M.; Xiong Y.; Li Y.; Wang H.; Jia Y.; Yuan S.
Institution
(Yan, Yan, Li, Wang, Jia, Yuan) Department of Anesthesiology, Fuwai
Hospital, National Center of Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Xiong) Department of Gastroenterology, Beijing Hospital, National Center
of Gerontology, Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Congenital heart disease is a common birth defect, but
advancements in diagnosis and treatment have improved survival rates.
Enhanced recovery after surgery (ERAS) programmes have emerged in
paediatric cardiac surgery. Multimodal pain management, as a vital part of
ERAS programmes, has been found to be effective in reducing pain and
improving outcomes in cardiac surgery patients. Traditional methods of
pain control using high-dose opioids can lead to complications, so
nonopioid analgesics and regional anaesthesia techniques are being used to
reduce the consumption. However, there is a significant variability in
pain management practices in paediatric cardiac surgery. A network
meta-analysis (NMA) is needed to comprehensively compare the effects of
different analgesic interventions in this population. Methods and analysis
A comprehensive electronic literature database search will be performed
using electronic databases, mainly including PubMed, EMBASE, Web of
Science and Cochrane Central Register of Controlled Trials. All randomised
controlled trials associated with perioperative pain management for
paediatric cardiac surgery will be included. The primary outcome will be
visual analogue score or numeric rating scale of pain and total opioid
consumption (or equivalent) 24 hours after postoperative tracheal
extubation. The Revised Cochrane Risk of Bias Tool will be employed to
assess the quality of included articles. A random-effects pairwise
meta-analysis will be performed to report the head-to-head comparison.
Following the assessment of individual articles, an NMA will be conducted
using a Bayesian framework with random-effects' models. Ethics and
dissemination Ethics approval is not necessary because this study will be
based on publications. The results of this study will be published in a
peer-reviewed journal.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2024.

<7>
Accession Number
2034568109
Title
Pulsed Field Ablation to Treat Paroxysmal Atrial Fibrillation: Safety and
Effectiveness in the AdmIRE Pivotal Trial.
Source
Circulation. 150(15) (pp 1174-1186), 2024. Date of Publication: 08 Oct
2024.
Author
Reddy V.Y.; Calkins H.; Mansour M.; Wazni O.; Di Biase L.; Bahu M.; Newton
D.; Liu C.F.; Sauer W.H.; Goyal S.; Iyer V.; Nair D.; Athill C.; Hussein
A.; Whalen P.; Melby D.; Natale A.
Institution
(Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart
Hospital, New York, NY, United States
(Calkins) Johns Hopkins Medical Institutions, Baltimore, MD, United States
(Mansour) Massachusetts General Hospital, Boston, United States
(Wazni, Hussein) Cleveland Clinic Foundation, OH, United States
(Di Biase) Montefiore Health System, Albert Einstein College of Medicine,
New York, NY, United States
(Bahu) Phoenix Cardiovascular Research Group, AZ, United States
(Newton) Memorial Health University Medical Center, Savannah, GA, United
States
(Liu) New York Presbyterian-Weill Cornell Medicine, NY, United States
(Sauer) Brigham & Women's Hospital, Boston, MA, United States
(Goyal) Piedmont Heart Institute, Atlanta, GA, United States
(Iyer) Marin Health Medical Center, Larkspur, CA, United States
(Nair) St. Bernard's Medical Center, Arrhythmia Research Group, Jonesboro,
AR, United States
(Athill) San Diego Cardiac Center, CA, United States
(Whalen) Wake Forest Baptist Health, Winston-Salem, NC, United States
(Melby) Minneapolis Heart Institute, MN, United States
(Natale) Texas Cardiac Arrhythmia Research Foundation, Austin, United
States
(Natale) Department of Biomedicine and Prevention, Division of Cardiology,
University of Tor Vergata, Rome, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Evidence from clinical trials of early pulsed field ablation
(PFA) systems in treating atrial fibrillation has demonstrated their
promising potential to reduce complications associated with conventional
thermal modalities while maintaining efficacy. However, the lack of a
fully integrated mapping system, a staple technology of most modern
electrophysiology procedures, poses limitations in lesion creation and
workflow options. A novel variable-loop PFA catheter integrated with an
electroanatomic mapping system has been developed that allows for
real-time nonfluoroscopic procedural guidance and lesion indexing as well
as feedback of tissue-to-catheter proximity. AdmIRE (Assessment of Safety
and Effectiveness in Treatment Management of Atrial Fibrillation With the
Bosense-Webster Irreversible Electroporation Ablation System), a
multicenter, single-arm, Food and Drug Administration investigational
device exemption study, evaluated the long-term safety and effectiveness
of this integrated PFA system in a large United States-based
drug-refractory symptomatic paroxysmal atrial fibrillation patient
population. <br/>METHOD(S): Using the PFA catheter with a compatible
electroanatomic mapping system, patients with drug-refractory symptomatic
paroxysmal atrial fibrillation underwent pulmonary vein isolation. The
primary safety end point was primary adverse event within 7 days of
ablation. The primary effectiveness end point was a composite end point
that included 12-month freedom from documented atrial tachyarrhythmia (ie,
atrial fibrillation, atrial tachycardia, atrial flutter) episodes, failure
to achieve pulmonary vein isolation, use of a nonstudy catheter for
pulmonary vein isolation, repeat procedure (except for one redo during
blanking), taking a new or previously failed class I or III antiarrhythmic
drug at higher dose after blanking, or direct current cardioversion after
blanking. <br/>RESULT(S): At 30 centers, 277 patients with paroxysmal
atrial fibrillation (61.5+/-10.3 years of age; 64.3% male) in the pivotal
cohort underwent PFA. More than 25% of the procedures were performed
without fluoroscopy. Median (Q1, Q3) pulmonary vein isolation procedure,
fluoroscopy, and transpired PFA application times were 81.0 (61.0, 112.0),
7.1 (0.00, 14.3), and 31.0 (24.8, 40.9) minutes, respectively. The primary
adverse event rate was 2.9% (8 of 272), with the most common complication
being pericardial tamponade. The 12-month primary effectiveness end point
was 74.6%. The 1-year freedom from atrial fibrillation, atrial
tachycardia, or atrial flutter recurrence rate after blanking was 75.4%.
Substantial improvements in quality of life were observed as early as 3
months after the procedure, concurrent with a reduction in multiple health
care use measures. <br/>CONCLUSION(S): AdmIRE confirmed the safety and
effectiveness of the variable-loop PFA catheter, with short procedure and
PFA application times and low fluoroscopy exposure. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT05293639.<br/>Copyright &#xa9; 2024 The Authors. Circulation is
published on behalf of the American Heart Association, Inc., by Wolters
Kluwer Health, Inc.

<8>
Accession Number
2034429475
Title
Rapid Uptitration of Guideline-Directed Medical Therapies in Acute Heart
Failure With and Without Atrial Fibrillation.
Source
JACC: Heart Failure. 12(11) (pp 1845-1858), 2024. Date of Publication:
November 2024.
Author
Farmakis D.; Davison B.; Fountoulaki K.; Liori S.; Chioncel O.; Metra M.;
Celutkiene J.; Cohen-Solal A.; Damasceno A.; Diaz R.; Edwards C.; Gayat
E.; Novosadova M.; Bistola V.; Pang P.S.; Ponikowski P.; Saidu H.; Sliwa
K.; Takagi K.; Voors A.A.; Mebazaa A.; Cotter G.; Filippatos G.
Institution
(Farmakis, Fountoulaki, Liori, Bistola) Department of Cardiology, Athens
University Hospital Attikon, National and Kapodistrian University of
Athens Medical School, Athens, Greece
(Farmakis, Fountoulaki, Liori, Bistola) Physiology Lab, University of
Cyprus Medical School, Nicosia, Cyprus
(Davison, Cotter) Heart Initiative, Durham, NC, United States
(Davison, Edwards, Novosadova, Takagi, Cotter) Momentum Research Inc,
Durham, NC, United States
(Davison, Cotter) Universite Paris Cite, INSERM UMR-S 942 (MASCOT), Paris,
France
(Chioncel, Filippatos) Emergency Institute for Cardiovascular Diseases
"Prof. C.C. Iliescu," University of Medicine "Carol Davila,", Bucharest,
Romania
(Metra) Institute of Cardiology, ASST Spedali Civili, Department of
Medical and Surgical Specialties, Radiological Sciences and Public Health,
University of Brescia, Brescia, Italy
(Celutkiene) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,
Lithuania
(Cohen-Solal) Paris Cite University, INSERM U946, AP-HP, Lariboisiere
Hospital, Paris, France
(Damasceno) Faculty of Medicine, Eduardo Mondlane University, Maputo,
Mozambique
(Diaz) Estudios Clinicos Latinoamerica, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Gayat) Universite Paris Cite, INSERM UMR-S 942(MASCOT [Cardiovascular
MArkers in Stressed COndiTions]), Paris, France
(Pang) Department of Emergency Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Ponikowski) Department of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
(Saidu) Murtala Muhammed Specialist Hospital, Bayero University Kano,
Kano, Nigeria
(Sliwa) Cape Heart Institute, Department of Medicine and Cardiology,
Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
(Voors) Department of Cardiology, University of Groningen, University
Medical Centre Groningen, Groningen, Netherlands
(Mebazaa) Universite Paris Cite, INSERM UMR-S 942(MASCOT), Paris, France
(Mebazaa) Department of Anesthesiology and Critical Care and Burn Unit,
Saint-Louis and Lariboisiere Hospitals, University Hospital Federation
PROMICE (PRecision medicine for cOMprehensIve care of Critically ill
patieEnts), Departments Medico-Universitaires Parabol, Assistance Public -
Hopitaux de Paris, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Rapid uptitration of guideline-directed medical therapy (GDMT)
before and after discharge in hospitalized heart failure (HF) patients is
feasible, is safe, and improves outcomes; whether this is also true in
patients with coexistent atrial fibrillation/flutter (AF/AFL) is not
known. <br/>Objective(s): This study sought to investigate whether rapid
GDMT uptitration before and after discharge for HF is feasible, safe and
beneficial in patients with and without AF/AFL. <br/>Method(s): In this
secondary analysis of the STRONG-HF (Safety, Tolerability, and Efficacy of
Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure
Therapies) trial, GDMT uptitration and patient outcomes were analyzed by
AF/AFL status and type (permanent, persistent, paroxysmal).
<br/>Result(s): Among 1,078 patients enrolled in STRONG-HF, 496 (46%) had
a history of AF, including 238 assigned to high-intensity care (HIC) and
258 to usual care (UC), and 581 did not have a history of AF/AFL,
including 304 assigned to HIC and 277 to UC. By day 90, the average
percent optimal dose of neurohormonal inhibitors achieved in the HIC arm
was similar in patients with and without AF/AFL, reaching approximately
80% of the optimal dose (average absolute difference between AF/AFL and
non-AF/AFL groups: -0.81%; 95% CI: -3.51 to 1.89). All-cause death or HF
readmission by day 180 occurred less frequently in the HIC than the UC
arm, both in patients with and without AF (adjusted HR: 0.75 [95% CI:
0.48-1.19] in AF vs adjusted HR: 0.50 [95% CI: 0.31-0.79] in non-AF/AFL
patients; P for interaction = 0.2107). Adverse event rates were similar in
patients with and without AF/AFL. AF/AFL type did not affect either
uptitration or patient outcomes. <br/>Conclusion(s): Nearly half of acute
HF patients have AF/AFL history. Rapid GDMT uptitration before and early
after discharge is feasible, is safe, and may improve outcomes regardless
of AF presence or type. (Safety, Tolerability, and Efficacy of Rapid
Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies
[STRONG-HF]; NCT03412201)<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<9>
Accession Number
2031853272
Title
A Prospective, Randomized Trial of Bioresorbable Polymer Drug-Eluting
Stents versus Fully Bioresorbable Scaffolds in Patients Undergoing
Coronary Stenting.
Source
Journal of Clinical Medicine. 13(19) (no pagination), 2024. Article
Number: 5949. Date of Publication: October 2024.
Author
Wiebe J.; Byrne R.A.; Bradaric C.; Kuna C.; Kessler T.; Pfleiderer M.;
Kufner S.; Xhepa E.; Hoppmann P.; Joner M.; Schunkert H.; Laugwitz K.-L.;
Kastrati A.; Cassese S.
Institution
(Wiebe, Kuna, Kessler, Pfleiderer, Kufner, Xhepa, Joner, Schunkert,
Kastrati, Cassese) Klinik fur Herz- und Kreislauferkrankungen, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstrasse 36,
Munich 80636, Germany
(Wiebe, Kessler, Joner, Schunkert, Laugwitz, Kastrati) DZHK (German Centre
for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich
81377, Germany
(Byrne) Cardiovascular Research Institute, Mater Private Hospital, Dublin
D07 WKW8, Ireland
(Byrne) School of Pharmacy and Biomolecular Sciences, RCSI University of
Medicine and Health Sciences, Dublin D02 YN77, Ireland
(Bradaric, Hoppmann, Laugwitz) 1. med. Klinik, Klinikum Rechts der Isar,
Technische Universitat Munchen, Munich 81675, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The performance of an everolimus-eluting bioresorbable
scaffold (BRS) was inferior to an everolimus-eluting metallic drug-eluting
stent (DES) with permanent polymer, mainly due the mechanical features of
BRS technology. The performance of BRS as compared to metallic DES with
bioresorbable polymers remains unstudied. <br/>Method(s): This
prospective, randomized, multicenter, clinical trial enrolled patients who
underwent coronary stenting for de novo coronary lesions. Patients were
randomly assigned to bioresorbable polymer everolimus-eluting stents
(BP-EES) or everolimus-eluting BRS. The primary endpoint was percentage
diameter stenosis (in-device) at 6- to 8-month angiographic surveillance.
The main secondary endpoint was the device-oriented composite endpoint
(DOCE) of cardiac death/target vessel-myocardial infarction/target lesion
revascularization assessed after 12 months and 5 years. <br/>Result(s):
The trial was prematurely terminated after the enrollment of 117 of 230
patients (BP-EES, n = 60; BRS, n = 57) due to safety issues associated
with BRS technology. The primary endpoint of in-device diameter stenosis
at angiographic surveillance was 12.5 +/- 7.7% with BP-EES versus 19.3 +/-
16.5% with BRS (p = 0.01). The DOCE occurred in 5.0% in the BP-EES group
versus 12.3% of patients in the BRS group (hazard ratio [HR] 2.48, 95%
confidence interval [CI] 0.64-9.58, p = 0.19) after 12 months and in 11.7%
in the BP-EES group versus 26.4% of patients in the BRS group (HR 2.38,
95% CI 0.97-5.84, p = 0.06) after 5 years. <br/>Conclusion(s): BP-EES
showed superior mid-term angiographic performance compared with BRS.
Clinical event rates did not differ significantly between the groups up to
5 years of follow-up. These results should be interpreted with caution in
view of the premature discontinuation of the study.<br/>Copyright &#xa9;
2024 by the authors.

<10>
Accession Number
2031247035
Title
Recent advances in the treatment of refractory gastrointestinal
angiodysplasia.
Source
United European Gastroenterology Journal. 12(8) (pp 1128-1135), 2024. Date
of Publication: October 2024.
Author
Becq A.; Sidhu R.; Goltstein L.C.M.J.; Dray X.
Institution
(Becq) Gastroenterology Department, Paris-Est Creteil University, Henri
Mondor Hospital, AP HP, Creteil, France
(Sidhu) Division of Clinical Medicine, School of Medicine and Population
Health, University of Sheffield, Sheffield, United Kingdom
(Sidhu) Academic Unit of Gastroenterology and Hepatology, Sheffield
Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
(Goltstein) Department of Gastroenterology and Hepatology, Radboud
University Medical Center, Nijmegen, Netherlands
(Dray) Sorbonne University, Center for Digestive Endoscopy, Saint Antoine
Hospital, AP HP, Paris, France
Publisher
John Wiley and Sons Inc
Abstract
Gastrointestinal angiodysplasia (GIA) is a common, acquired, vascular
abnormality of the digestive tract, and a frequent cause of bleeding.
Refractory GIA criteria usually include recurrent bleeding, transfusions
and/or repeat endoscopy. Pharmacological and interventional treatments
have been the subject of recent high-quality publications. This review
provides an overview of the latest updates on non-endoscopic management of
refractory GIA. Aortic valve replacement has shown its efficacy in Heyde
syndrome and should be considered if indicated. Anti-angiogenic drugs,
such as Octreotide and Thalidomide, are efficient treatments of refractory
GIA-related bleeding. Somatostatin analogs should, based on efficacy and
tolerance profile, be considered first. In the future, a better
understanding of the physiopathology of GIA might help develop
new-targeted therapies.<br/>Copyright &#xa9; 2024 The Author(s). United
European Gastroenterology Journal published by Wiley Periodicals LLC on
behalf of United European Gastroenterology.

<11>
Accession Number
2025792786
Title
A comparative study of the effect of two different delivery techniques
(conventional versus microplegia) of del Nido cardioplegia on myocardium
in paeditric congenital heart disease.
Source
Perfusion (United Kingdom). 39(8) (pp 1587-1594), 2024. Date of
Publication: November 2024.
Author
Kulkarni S.R.; Bishnoi S.
Institution
(Kulkarni) King's College Hospital London, Dubai, United Arab Emirates
(Bishnoi) UN Mehta Institute of Cardiology and Research Centre, Ahmedabad,
India
Publisher
SAGE Publications Ltd
Abstract
Introduction: del Nido cardioplegia was developed for immature myocardium
to prevent myocardial damage by Ca⁺² in traditional blood
cardioplegia. But due to increased hemodilution and decreased colloid
oncotic pressure it may cause myocardial edema and increased cardiac
morbidity. Microplegia may have better cardioprotection in comparison to
del Nido as there is less hemodilution. <br/>Material(s) and Method(s): 60
patients from the age group of 1 to 14 years were divided into two groups
i.e. del Nido based microplegia group and conventional del Nido group for
studying two different cardioplegia technique. Data were collected and
compared for intraoperative Hb, CPK-MB and Trop-I levels changes and
requirement for defibrillation in intraoperative period. Demographic data,
CPB time and ACC time were also collected. <br/>Result(s): Marked
elevation in CPK-MB and Trop-I levels were seen in both groups.
Statistically significant difference was seen in CPK-MB levels after 6 h
of surgery where del Nido group has higher value in comparison to
microplegia group. No statistical difference was seen in Trop-I levels in
both groups. Strength of correlation (r) was also stronger for CPK-MB rise
in association with CPB time and ACC time, in del Nido group but not for
Trop-I. Significantly higher hemodilution was also seen in del Nido group
after delivering cardioplegia. None of the patients required
defibrillation in any group. <br/>Conclusion(s): Lesser hemodilution was
seen in microplegia group. Significant cardioprotection is associated with
use of microplegia solution in pediatric age group.<br/>Copyright &#xa9;
The Author(s) 2023.

<12>
Accession Number
2031055150
Title
Predictive significance of cardio ankle vascular index for the assessment
of cardiovascular risk in hypertensive patients: A systematic review.
Source
Journal of Clinical Hypertension. 26(9) (pp 1005-1014), 2024. Date of
Publication: September 2024.
Author
Saravanan C.R.; Chowdhury S.R.; Inban P.; Chandrasekaran S.H.; Pattani
H.H.; Santoshi K.; Bamba H.; Singh G.; Prajjwal P.; Ranjan R.; Marsool
M.D.M.; Amir O.
Institution
(Saravanan) Internal Medicine, Madras Medical College, Chennai, India
(Chowdhury) Cardiology, Lincoln County Hospital, Lincoln, United Kingdom
(Inban) Internal Medicine, St. Mary's General Hospital and Saint Clare's
Health, New York, NY, United States
(Chandrasekaran) Internal Medicine, Vijaya Hospitals, Chennai, India
(Pattani) Internal Medicine, Gujarat University, Ahmedabad, India
(Santoshi) Internal Medicine, MNR Medical College, Sangareddy, India
(Bamba, Singh) Internal Medicine, Government Medical College and Hospital,
Chandigarh, India
(Prajjwal) Internal Medicine, Bharati Vidyapeeth Medical College Pune,
Pune, India
(Ranjan) SCGMC Nanded, Nanded, India
(Marsool) Internal Medicine, Al-Kindy College of Medicine, University of
Baghdad, Baghdad, Iraq
(Amir) Internal Medicine, Al-Manhal Academy, Khartoum, Sudan
Publisher
John Wiley and Sons Inc
Abstract
Cardio-ankle vascular index (CAVI) is an innovative indicator of
large-artery stiffness, which is evaluated by the pulse wave velocity
(PWV) measurement. Mortality and morbidity due to cardiovascular diseases
among the general public with high-risk conditions such as hypertension
are usually associated with arterial stiffness. CAVI modelizes the hazard
of future cardiovascular events with standard risk factors. Additionally,
the "European Society of Hypertension and Cardiology" included the aortic
PWV assessment in managing hypertension in their updated guidelines in
2007. We conducted this systematic review to collect, summarize, and
evaluate the evidence from relevant reported studies. A literature search
of four databases was conducted comprehensively until February 2024.
Cardiovascular events are the primary outcome of interest in this study,
cardiovascular events that have been defined as major adverse cardiac
events include "heart failure", "stroke", "myocardial infarction",
"cardiovascular deaths", "stable angina pectoris", "coronary
revascularization", and "unstable angina pectoris". We included five
studies with a 11 698 sample size in this systematic review. All five
prospective studies investigated composite cardiovascular events as an
outcome. Three of them revealed a statistically significant prediction
ability of CAVI to assess Cardiovascular disease (CVD) risk. Further
analysis is required. Current evidence is insufficient to confirm the
predictive power of CAVI in the assessment of cardiovascular risk in
hypertensive patients. CAVI is modestly associated with incidents of CVD
risk. It is necessary to conduct further studies to assess CAVI concerning
CVD predictor measures in the masses and nations other than
Asia.<br/>Copyright &#xa9; 2024 The Author(s). The Journal of Clinical
Hypertension published by Wiley Periodicals LLC.

<13>
Accession Number
2031894954
Title
Preoperative visit-care for transcatheter aortic valve replacement: a
review.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
573. Date of Publication: December 2024.
Author
Tan J.; Wei G.; Ma F.; Yan H.; Wang X.; Hu Q.; Wei W.; Yang M.; Bai Y.
Institution
(Tan) Cardiology Department, People's Hospital of Yuxi City, Yuxi, China
(Wei, Yan, Wang, Bai) Cardiology Department, The First Affiliated Hospital
of Kunming Medical University, No. 295, Xichang Road, Kunming 650032,
China
(Ma, Yang) Department of Nursing, The First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Hu) Geriatric Intensive Care Unit Department, The First Affiliated
Hospital of Kunming Medical University, Kunming, China
(Wei) Digestive Surgery Department, The First Affiliated Hospital of
Kunming Medical University, Kunming, China
Publisher
BioMed Central Ltd
Abstract
Aim: The aim of this review is to evaluate and summarize the evidence for
preoperative visit-care of transcatheter aortic valve replacement (TAVR)
and to provide evidence-based support for clinical intervention.
<br/>Design(s): The review presents an evidence summary report, following
the standard of the Fudan University Center for Evidence-based Nursing.
<br/>Method(s): Literature related to preoperative visit-care for
transcatheter aortic valve replacement have been retrieved based on the
"6S" pyramid model of evidence. The types of literature included
systematic reviews, expert consensus, evidence summary, and guidelines.
Data sources: Up To Date, Cochrane Library, Joanna Briggs Institute,
National Institute for Health and Care Excellence, Medlive, American Heart
Association, Registered Nurses Association of Ontario, Scottish
Intercollegiate Guidelines Network, European Society of Cardiology,
American College of Cardiology, PubMed, CINAHL, Wanfang database, VIP
database, Chinese biomedical literature database, CNKI. The search period
is limited to the time when each database was established until February
2024. <br/>Result(s): A total of 18 articles were included in this review,
consisting of 1 systematic review, 1 evidence summary, 3 guidelines and 13
expert consensuses. This review summarized 30 pieces of the best evidence
for preoperative visit-care for transcatheter aortic valve replacement,
encompassing three evidence themes: multidisciplinary team collaboration,
preoperative assessment, and preoperative education. <br/>Conclusion(s):
The study has established an ideal foundation of evidence for preoperative
visit-care in TAVR. However, throughout the particular application
process, it was crucial to assess the feasibility and relevance of the
evidence in clinical practice by taking into account elements such as the
application setting, recommendations from experts with diverse expertise,
and the preferences of the patients.<br/>Copyright &#xa9; The Author(s)
2024.

<14>
Accession Number
2031438962
Title
Current Management and Therapy of Severe Aortic Stenosis and Future
Perspective.
Source
Journal of Atherosclerosis and Thrombosis. 31(10) (pp 1353-1364), 2024.
Date of Publication: 2024.
Author
Takeji Y.; Tada H.; Taniguchi T.; Sakata K.; Kitai T.; Shirai S.; Takamura
M.
Institution
(Takeji, Tada, Sakata, Takamura) Department of Cardiovascular Medicine,
Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
(Taniguchi) Department of Cardiovascular Medicine, Kobe City Medical
Center General Hospital, Kobe, Japan
(Kitai) Department of Heart Failure and Transplantation, National Cerebral
and Cardiovascular Center, Osaka, Japan
(Shirai) Division of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Intervention for severe aortic stenosis (AS) has dramatically progressed
since the introduction of transcatheter aortic valve replacement (TAVR).
Decades ago, controversies existed regarding comparing clinical outcomes
between TAVR and surgical aortic valve replacement (SAVR) in various risk
profiles. Recently, we discussed the durability of transcatheter heart
valves and their lifetime management after aortic valve replacement (AVR).
Regarding the management of AS, we discuss the appropriate timing of
intervention for severe aortic stenosis, especially in asymptomatic
patients. In spite of dramatic progression of intervention for AS, there
are no established medications available to prevent or slow the
progression of AS at present. Basic research and genome studies have
suggested several targets associated with the progression of aortic valve
calcification. Randomized controlled trials evaluating the efficacy of
medications to prevent AS progression are ongoing, which might lead to new
strategies for AS management. In this review, we summarize the current
management of AS and the drugs expected to prevent the progression of
AS.<br/>Copyright &#xa9; 2024 Japan Atherosclerosis Society.

<15>
Accession Number
2035203845
Title
Protective effect of intravenous amino acid on kidney function: A
systematic review and meta-analysis of randomized controlled trials.
Source
Journal of Critical Care. 85 (no pagination), 2025. Article Number:
154937. Date of Publication: February 2025.
Author
Jiang W.; Shi K.; Shao J.; Song L.; Shi Y.; Wang H.; Zhou L.; Li L.; Feng
Y.; Yu J.; Zheng R.
Institution
(Jiang, Shi, Shao, Song, Shi, Wang, Zhou, Li, Feng, Yu, Zheng) Department
of Critical Care Medicine, Northern Jiangsu People's Hospital Affiliated
to Yangzhou University, Yangzhou 225001, China
(Jiang, Shi, Shao, Song, Shi, Wang, Zhou, Li, Feng, Yu, Zheng) Department
of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou
225001, China
Publisher
W.B. Saunders
Abstract
Background: Acute kidney injury (AKI) is a common complication in
critically ill and cardiac surgery patients. Intravenous amino acids can
increase renal perfusion and replenish renal functional reserves. However,
the exact therapeutic efficacy of intravenous amino acids in reducing the
incidence of AKI remains uncertain. Therefore, this study aims to
comprehensively review the existing evidence to assess the potential of
intravenous amino acids in kidney protection. <br/>Method(s): EMBASE,
PubMed, MEDLINE, and the Cochrane Library were searched for randomized
controlled trials published on or before July 2, 2024, that examined the
relationship between Intravenous amino acids and renal function. We
extracted population characteristics and outcome variables related to
renal function from randomized controlled trials comparing intravenous
amino acid supplementation with no supplementation. We assessed this
evidence using the Risk of Bias 2 (RoB2) tool for randomized controlled
trials. Data were synthesized using a random-effects model.
<br/>Result(s): This review included 7 randomized controlled trials with a
total of 505 patients. The results showed that compared with the control
group, intravenous amino acid administration significantly reduced the
incidence of AKI (RR: 0.81, 95 % CI: 0.68-0.97, P = 0.02) and increased
urine output (MD: 308.87, 95 % CI: 168.68-449.06, P < 0.0001). However,
intravenous amino acids did not reduce mortality or the incidence of
kidney replacement therapy, with no statistical difference in 30-day
mortality (RR: 0.93, 95 % CI: 0.65-1.34, P = 0.71), 90-day mortality
(RR:1.00, 95 % CI: 0.77-1.29, P = 0.98), or need for kidney replacement
therapy (RR: 0.92, 95 % CI: 0.41-2.06, P = 0.83). Subgroup analysis
suggested that, regardless of sample size, intravenous amino acid
administration reduced the incidence of AKI and was particularly
significant in patients undergoing cardiac and major vascular surgery.
Furthermore, intraoperative intravenous amino acid therapy demonstrated a
significant reduction in the incidence of AKI compared to postoperative
administration. <br/>Conclusion(s): Intravenous amino acids protect renal
function in patients at high risk of AKI, particularly after cardiac
surgery. It reduces the incidence of AKI and increases urine output, but
has no significant effect on KRT and mortality.<br/>Copyright &#xa9; 2024

<16>
Accession Number
2034813307
Title
SIGNET: protocol for a multicentre, single-blind prospective, group
sequential, randomised controlled trial to evaluate the benefits of a
single dose of simvastatin given to potential organ donors declared dead
by neurological criteria on outcomes in organ recipients.
Source
BMJ Open. 14(9) (no pagination), 2024. Date of Publication: 18 Sep 2024.
Author
Evans A.; Mawson P.; Thomas H.; Keen K.; Watson C.J.E.; McAuley D.F.;
MacGowan G.A.; Sheerin N.S.; Fisher A.; Shaw J.; Yates H.; Fallow A.;
Kounali D.; Banks J.; Stevens M.; Paul R.; Hodge R.; Lawson E.; Harvey D.;
Dark J.
Institution
(Evans, Keen, Paul, Hodge) Clinical Trials Unit, NHS Blood and Transplant,
Cambridge, United Kingdom
(Mawson, MacGowan, Sheerin, Fisher, Shaw, Dark) Newcastle University,
Faculty of Medical Sciences, Newcastle upon Tyne, United Kingdom
(Thomas, Kounali, Banks) Clinical Trials Unit, NHS Blood and Transplant,
Bristol, United Kingdom
(Watson) Department of Surgery, University of Cambridge, The NIHR
Cambridge Biomedical Research Centre, Cambridge, United Kingdom
(McAuley) Centre for Experimental Medicine, Queen's University Belfast,
Belfast, United Kingdom
(MacGowan) Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Newcastle
Upon Tyne, United Kingdom
(Yates, Fallow) Patient and Public Involvement, Newcastle upon Tyne,
United Kingdom
(Stevens, Lawson) NHS Blood and Transplant Organ Donation, Cambridge,
United Kingdom
(Harvey) Adult Intensive Care, Nottingham University Hospitals NHS Trust,
Nottingham, United Kingdom
(Harvey) NHS Blood & Transplant Organ Donation, Bristol, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Successful organ transplantation in patients with end-stage
organ failure improves long-term survival, improves quality of life and
reduces costs to the NHS. Despite an increase in the number of deceased
organ donors over the last decade, there remains a considerable shortfall
of suitable organs available for transplantation. Over half of UK donors
are certified dead by neurological criteria following brain stem
compression, which leads to severe physiological stress in the donor,
combined with a hyperinflammatory state. Brain stem death-related
dysfunction is an important reason for poor organ function and hence
utilisation. For example, more than 30% of donation after brain stem death
cardiac transplant recipients need short-term mechanical cardiac support,
reflecting donor heart dysfunction. A small, randomised study previously
showed improved outcomes for cardiac transplant recipients if the donor
was given simvastatin. SIGNET takes inspiration from that study and
hypothesises a potential reduction in damage to the heart and other organs
during the period after diagnosis of death and prior to organ retrieval in
donors that receive simvastatin. Methods and analysis SIGNET is a
multicentre, single-blind, prospective, group sequential, randomised
controlled trial to evaluate the benefits of a single high dose of
simvastatin given to potential organ donors diagnosed dead by neurological
criteria on outcomes in all organ recipients. The trial will run across a
minimum of 89 UK sites with a recruitment target of 2600 donors over 4
years. Ethics and dissemination SIGNET received a favourable opinion from
the London, Queen Square Research Ethics Committee (Ref: 21/LO/0412) and
following approval of substantial amendment 1 in January 2023, the current
protocol is version 2 (7 December 2022). Substantial amendment 1 clarified
consent procedures and added additional sites and prescribers. Findings
from the study will be publicly available and disseminated locally and
internationally through manuscript publications in peer-reviewed journals
and conference presentations at national and international
platforms.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2024.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<17>
Accession Number
2034996587
Title
Preoperative and postoperative administration of vitamin C in cardiac
surgery patients - settings, dosages, duration, and clinical outcomes: a
narrative review.
Source
Annals of Medicine and Surgery. 86(6) (pp 3591-3607), 2024. Date of
Publication: 29 Apr 2024.
Author
Athanasiou A.; Charalambous M.; Anastasiou T.; Aggeli K.; Soteriades E.S.
Institution
(Athanasiou) Department of Cardiothoracic Surgery, Nicosia General
Hospital, Open University of Cyprus, Nicosia, Cyprus
(Charalambous) Department of Basic and Clinical Sciences, University of
Nicosia Medical School, Open University of Cyprus, Nicosia, Cyprus
(Anastasiou) Department of Medicine, University of Cyprus, Open University
of Cyprus, Nicosia, Cyprus
(Soteriades) Healthcare Management Program, School of Economics and
Management, Open University of Cyprus, Nicosia, Cyprus
(Soteriades) Department of Environmental Health, Environmental and
Occupational Medicine and Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
(Aggeli) Department of Cardiology, Hippocrates General Hospital, National
and Kapodistrian University of Athens, Athens, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Vitamin C or ascorbic acid is a water-soluble vitamin capable of directly
donating electrons to reactive oxygen species, attenuating electrical
remodeling, and cardiac dysfunction in patients undergoing cardiac surgery
(CS), considered one of the most effective defenses against free radicals
in the blood, thus being one of the first antioxidants consumed during
oxidative stress. The aim of this review is to assess the effects of
perioperative administration of vitamin C in CS patients. A comprehensive
literature search was conducted in order to identify prospective cohort
studies and/or randomized controlled trials reporting on the perioperative
effects of vitamin C among adult patients undergoing CS. Studies published
between January 1980 to December 2022 were included in our search,
resulting in a total of 31 articles that met all our inclusion criteria.
There seems to be a beneficial effect of vitamin C supplementation in
arrhythmias such as in postoperative atrial fibrillation, reduction of ICU
length of stay, and hospital length of stay, reduction in postoperative
ventilation time, in inotropic demand, and in postoperative fatigue.
Vitamin C can act as a scavenger of free radicals to decrease the
peroxidation of the lipids present in the cell membrane, and to protect
the myocardium postoperatively from ischemia/reperfusion injury, thus
attenuating oxidative stress and inflammation. It represents a readily
available and cost-effective strategy that could improve the outcome of
patients undergoing CS, by reducing the risk of serious cardiovascular
adverse events, both perioperatively and postoperatively. <br/>Copyright
&#xa9; 2024 The Author(s).

<18>
Accession Number
2034916772
Title
Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative
Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic
and Mitral Valve).
Source
Annals of Cardiac Anaesthesia. 27(4) (pp 324-329), 2024. Date of
Publication: 2024.
Author
Ram Kiran K.S.; Trivedi V.; Rajesh V.S.P.; Sharma M.; Haranal M.; Pandya
H.
Institution
(Ram Kiran, Trivedi, Rajesh, Sharma) Department of Cardiac Anesthesia,
U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil
Hospital (Medicity Campus), Asarwa, Gujarat, Ahmedabad, India
(Haranal) Department of Cardiovascular and Thoracic Surgery, UN Mehta
Hospital, Gujarat, Ahmedabad, India
(Pandya) Department of Reaseach, UN Mehta Hospital, Gujarat, Ahmedabad,
India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Aims and Objectives: The incidence of postoperative liver dysfunction is
high in patients undergoing double-valve replacement-mitral and aortic
valve replacement (DVR). This study aims to evaluate N-acetylcysteine's
free radical scavenging property (NAC) to prevent postoperative liver
dysfunction in these patients, thus affecting overall clinical outcomes.
<br/>Method(s): A single-center, prospective, randomized, double-blinded
interventional study of 60 patients divided into two groups of 30 each.
Group N received prophylactic intravenous NAC, and Group C received
volume-matched 5% dextrose. Data comprised demographics, liver function
tests (LFT), renal function tests (RFT), vasoactive-inotropic scores (VIS)
score, and C-reactive protein (CRP) at various time intervals.
Postoperative parameters such as ventilation duration, length of stay in
ICU (LOS-ICU), length of hospital stay (LOHS), atrial fibrillation (AF),
acute kidney injury (AKI) requiring hemodialysis, and mortality were
noted. Statistical analysis was performed with the Student's t-test and
Chi-square test (SPSS 22 software). <br/>Result(s): All postoperative LFT
parameters (total bilirubin, serum glutamic oxaloacetic transaminase
(SGOT), serum glutamic pyruvate transaminase (SGPT), and alkaline
phosphatase (ALP)) were significantly lower (P < 0.05) at 24, 48, and 72
hours in Group N compared to Group C. RFT and VIS scores were lower in
Group N; however, were not statistically significant except for Serum
Creatinine at 48 hours (P = 0.0478). Ventilation duration (P = 0.0465) and
LOS-ICU (P = 0.0431) were significantly lower in Group N. Other outcomes
like AF, LOHS, and mortality were lower in Group N but were not
statistically significant. <br/>Conclusion(s): Our study showed that
prophylactic administration of NAC in patients undergoing DVR is
associated with a reduction in the incidence of postoperative liver
dysfunction with a positive impact on postoperative outcomes. <br/>&#xa9;
2024 Copyright: 2024 Annals of Cardiac Anaesthesia.

<19>
Accession Number
2034916334
Title
The Effects of Postoperative Trimetazidine Treatment on
Ischemia-Reperfusion Injury after Isolated Surgical Myocardial
Revascularization.
Source
Journal of Cardiovascular Emergencies. 10(3) (pp 89-94), 2024. Date of
Publication: 01 Sep 2024.
Author
Kamen S.; Bistra D.-Y.; Todor G.; Asen I.; Gencho N.
Institution
(Kamen, Todor, Asen, Gencho) Department of Cardiovascular Surgery, "St.
George" University Hospital, Plovdiv, Bulgaria
(Bistra) Department of Cardiology, "St. George" University Hospital,
Plovdiv, Bulgaria
Publisher
Sciendo
Abstract
Background: Surgical revascularization is the gold standard in the
management of patients with multi-vessel coronary artery disease (CAD). It
is well known that increased oxidative stress during ischemia-reperfusion
and post-revascularization procedures leads to the release of free radical
in the circulation. This process can cause reversible or irreversible
myocardial damage. <br/>Aim(s): The aim of this study was to assess the
effect of trimetazidine on decreasing postoperative ischemia-reperfusion
myocardial damage. <br/>Material(s) and Method(s): This prospective
single-blind randomized controlled trial included 90 patients with
elective surgery, operated between March 2018 and October 2018. The
patients were divided into two equal groups, a study group and a control
group; those in the study group received trimetazidine 35 mg b.d.,
immediately after tracheal extubation, in addition to their regular
therapy. Pre- and postoperative levels of specific blood biomarkers such
as high-sensitivity troponin T (hs-TnT), creatine kinase-MB (CK-MB), and
malondialdehyde (MDA) were evaluated. Patients were followed for a period
of 6 months after surgery. <br/>Result(s): MDA levels were lower in
patients who received trimetazidine, leading to a reduction in oxidative
stress and improved cardiomyocyte protection by augmentation of the
antioxidant status. The quality-of-life assessment with the Minnesota
Living with Heart Failure Questionnaire yielded excellent results.
<br/>Conclusion(s): Improvement of myocardial cell metabolism and
decreasing the level of postoperative ischemia-reperfusion damage is
alleviated by postoperative regular trimetazidine therapy.<br/>Copyright
&#xa9; 2024 Sciendo. All rights reserved.

<20>
Accession Number
2035192992
Title
Concomitant Carotid and Coronary Artery Disease Management: A Review of
the Literature.
Source
Annals of Vascular Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Abou-Assi S.; Hanak C.R.; Khalifeh A.; Quatromoni J.G.; Caputo F.J.; Lyden
S.P.; Ambani R.N.
Institution
(Abou-Assi, Hanak, Khalifeh, Quatromoni, Caputo, Lyden, Ambani) Department
of Vascular Surgery, Cleveland Clinic Foundation, OH, United States
Publisher
Elsevier Inc.
Abstract
This review examines current evidence regarding management of patients
with both coronary and carotid artery disease. It highlights the elevated
stroke risk after surgery for this cohort and scrutinizes approaches to
minimize this risk. Various revascularization methods are outlined,
including carotid endarterectomy (CEA), carotid artery stenting (CAS), and
staged versus simultaneous surgical approaches. The importance of
judiciously screening coronary artery bypass grafting (CABG) candidates
for carotid stenosis is emphasized, suggesting risk factor-based targeted
screening is noninferior to indiscriminate screening. Efficacy comparisons
are made between revascularization strategies such as staged versus
synchronous CEA/CABG, CAS, and hybrid techniques. Controversies
surrounding necessity and optimal timing of carotid revascularization in
asymptomatic patients are addressed, indicating a need for rigorous
randomized controlled trials to establish definitive treatment
algorithms.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<21>
Accession Number
2035055705
Title
Exeporfinium chloride (XF-73) nasal gel significantly reduces
Staphylococcus aureus nasal carriage in cardiac surgery patients
throughout surgery and the early recovery period: Results from a
randomized placebo-controlled Phase 2 study.
Source
Infection Control and Hospital Epidemiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Mangino J.E.; Firstenberg M.S.; Rhys-Williams W.; Lees J.P.; Dane A.; Love
W.G.; Gonzalez Moreno J.; Martina Y.; Barker D.
Institution
(Mangino) Division of Infection Diseases, Department of Internal Medicine,
The Ohio State University, Columbus, OH, United States
(Firstenberg) Department of Surgery, Maui Memorial Medical Center, Maui,
HI, United States
(Rhys-Williams, Love, Barker) Destiny Pharma Plc, Brighton, United Kingdom
(Dane) Danestat Consulting Ltd., Macclesfield, United Kingdom
(Lees, Gonzalez Moreno, Martina) Formerly at Destiny Pharma Plc, Brighton,
United Kingdom
Publisher
Cambridge University Press
Abstract
Staphylococcus aureus nasal carriers were randomized (1:1) to XF-73 or
placebo nasal gel, administered 5x over 1/424hrs pre-cardiac surgery. S.
aureus burden rapidly decreased after 2 doses (-2.2log10 CFU/mL; placebo
-0.01log10 CFU/mL) and was maintained to 6 days post-surgery. Among XF-73
patients, 46.5% received post-operative anti-staphylococcal antibiotics
versus 70% in placebo (P = 0.045). <br/>Copyright &#xa9; Destiny Pharma
Limited, 2024. Published by Cambridge University Press on behalf of The
Society for Healthcare Epidemiology of America.

<22>
Accession Number
2034808092
Title
Antithrombotic Strategies After Transcatheter Aortic Valve Replacement in
Patients Without an Indication of Oral Anticoagulants A Network
Meta-Analysis of Randomized Controlled Trials.
Source
Cardiology in Review. (no pagination), 2024. Article Number: 0791. Date
of Publication: 2024.
Author
Abuelazm M.; Adhikari G.; Amin A.M.; Elhady M.M.; Awad A.K.; Mahmoud A.;
Gonnah A.R.; Abdelazeem B.
Institution
(Awad) Department of Medicine, Faculty of Medicine, Ain-Shams University,
Cairo, Egypt
(Abuelazm, Mahmoud) Department of Medicine, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Adhikari) Department of Medicine, Banner University Medical Center,
Tucson, AZ, United States
(Amin) Department of Medicine, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Elhady) Department of Medicine, Faculty of Medicine, Benha University,
Qalubiya, Egypt
(Awad) Department of Medicine, Faculty of Medicine, Galala University,
Suez, Egypt
(Gonnah) Department of Medicine, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Abdelazeem) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Single-antiplatelet therapy (SAPT) has been a standard of care
posttranscatheter aortic valve replacement with no clear evidence exist
using direct oral anticoagulants (DOACs), vitamin K antagonists (VKA), or
dual antiplatelet agents (DAPT); thus we aim to compare the safety and
efficacy of the various antithrombotic strategies after transcatheter
aortic valve replacement. We performed a network meta-analysis using a
frequentist framework, pooling dichotomous outcomes using risk ratio (RR),
and continuous data using mean difference, along with the corresponding
95% confidence interval (CI). Nine randomized controlled trials with 4193
patients were included, 567 patients were in the VKA group, 591 patients
in the SAPT group, 1571 patients in the DAPT group, and 1464 patients in
the DOACs group. Only DOAC showed a statistically significant higher risk
of all-cause mortality [RR of 1.88 (95% CI: 1.07-3.28)] with no
statistically significant difference between our arms in terms of
mortality. For minor bleeding, DAPT had a significant higher risk with RR
of 1.53 (95% CI: 1.04-2.25), while for major bleeding, DAPT and DOAC had a
significant higher risk with RR of 2.36 (95% CI: 1.27-4.40) and 4.74 (95%
CI: 2.05-10.92), respectively. There was no significant difference in
terms of stroke and life-threatening bleeding. Moreover, only DOAC showed
a significantly lower risk for valve thrombosis, when compared to other
strategies [RR: 0.24 (95% CI: 0.13-0.46)]. Overall, SAPT had lower major
bleeding events compared to other arms. There were no differences in the
outcomes of stroke, myocardial infarction, or life-threatening bleeding
outcomes. However, DOACs significantly reduced valve thrombosis compared
to VKAs.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All rights
reserved.

<23>
Accession Number
2031895379
Title
Comparable bleeding and inflammation outcomes between heparin-coated and
uncoated minimal invasive extracorporeal circuits in isolated coronary
artery bypass surgery - A double-blinded randomized control trial.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Jenni H.; Kovacic B.; Mihalj M.; Huber M.; Rieben R.; Carrel T.; Siepe M.;
Kadner A.; Erdoes G.
Institution
(Jenni, Mihalj, Carrel, Siepe, Kadner) Department of Cardiac Surgery,
University of Bern, University Hospital Bern, Bern, Switzerland
(Kovacic, Rieben) Department of BioMedical Research, University of Bern,
Bern, Switzerland
(Mihalj) Department of Advanced Cardiopulmonary Therapies and
Transplantation, University of Texas Health Science Center, Houston, TX,
United States
(Huber, Erdoes) Department of Anesthesiology and Pain Medicine, University
of Bern, University Hospital Bern, Bern, Switzerland
Publisher
SAGE Publications Ltd
Abstract
Objective: Minimally invasive extracorporeal circulation has been shown to
be non-inferior or even superior to conventional cardiopulmonary bypass
circuits in isolated coronary artery bypass grafting, but there is little
evidence whether the addition of a heparin-coated circuit can further
reduce the inflammatory response and amount of bleeding in these patients.
<br/>Method(s): A single-center randomized control trial enrolled 49 adult
patients scheduled to undergo isolated coronary artery bypass grafting
with minimally invasive extracorporeal circulation (MiECC) between January
2015 and December 2018. Patients were randomized 1:1 to either the
heparin-coated circuit group, or the uncoated (control) circuit group. The
primary outcome was chest tube output 18 h after weaning from MiECC, and
secondary outcomes included inflammatory (TNF-alpha, IL-6, IL-8, IL-10)
and complement (C3a, C4d, C5a, sC5b-9) biomarkers, platelet count and
function (D2D, TAT, SDC1, PF4), number of transfused blood products, and
30-day survival. <br/>Result(s): Patients were randomized to undergo
myocardial revascularization using heparin-coated circuits (n = 25), and
to the uncoated MiECC circuit (n = 24), with comparable baseline
demographics. No significant difference was observed in chest tube output
and for all secondary outcomes. IL-6 and IL-8 were increased from baseline
at 18 h after weaning (effect size 0.29 and 0.05, respectively) and sC5b-9
was lower (effect size 0.11) in the heparin-coated than in the uncoated
MiECC, although not significantly different. <br/>Conclusion(s): Compared
with an uncoated MiECC circuit, heparin-coated MiECC circuit was not
associated with a reduction in postoperative bleeding, transfusion,
inflammation, complement activation, and platelet biomarkers, following
isolated coronary artery bypass grafting.<br/>Copyright &#xa9; The
Author(s) 2024.

<24>
Accession Number
645566380
Title
Effects of Wab-WPPEP on post-intensive care syndrome-family in family
caregivers of heart valve replacement patients: A randomized controlled
trial.
Source
Intensive & critical care nursing. 86 (pp 103817), 2024. Date of
Publication: 18 Oct 2024.
Author
Xiong J.; Wu T.-T.; Cai H.; He J.-Y.; Wang T.-Y.; Lin X.-X.; Li H.
Institution
(Xiong) Department of Nursing, Second Affiliated Hospital of Fujian
Medical University, Quanzhou, China; School of Nursing, Fujian Medical
University, Fuzhou, China
(Wu) Department of Nursing, First Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Cai, He, Wang) Cardiovascular Surgery Department, Fujian Provincial
Hospital, Fuzhou, China
(Lin) Cardiac Intensive Care Unit, Fujian Provincial Hospital, Fuzhou,
China
(Li) School of Nursing, Fujian Medical University, Fuzhou, China; Shengli
Clinical College of Fujian Medical University, Fuzhou, China
Abstract
OBJECTIVES: To evaluate the effects of a WeChat applet-based whole process
psychological empowerment program (Wab-WPPEP) on post-intensive care
syndrome-family in family caregivers of heart valve replacement patients.
DESIGN: Two-arm, parallel, randomized controlled clinical trial. SETTINGS:
A tertiary general hospital in Fuzhou, China. <br/>METHOD(S): Participants
were randomly assigned to two groups. The intervention group received
Wab-WPPEP, while the control group received routine care. The intervention
was implemented from ICU admission to one month post-discharge. The
primary outcome was anxiety, while secondary outcomes included depression,
post-traumatic stress disorder (PTSD), and quality of life. Outcomes were
assessed at baseline (T0), before ICU transfer (T1), pre-discharge (T2),
and one month post-discharge (T3) using standardized questionnaires.
Generalized estimating equations were used to analyze the
repeated-measures data. <br/>RESULT(S): The intervention group exhibited
greater improvements in anxiety (T1: beta = -1.92, 95 % CI: -2.35 to
-1.49, P < 0.001; T2: beta = -1.66, 95 % CI: -2.03 to -1.29, P < 0.001;
T3: beta = -3.98, 95 % CI: -4.34 to -3.62, P < 0.001), depression (T1:
beta = -1.32, 95 % CI: -1.79 to -0.85, P < 0.001; T2: beta = -1.70, 95 %
CI: -2.08 to -1.32, P < 0.001), and quality of life (T2: beta = 31.16, 95
% CI: 21.35 to 40.98, P < 0.001) compared to the routine-care group. PTSD
scores were also significantly lower in the intervention group (t =
-6.454, P < 0.001). <br/>CONCLUSION(S): Wab-WPPEP significantly reduced
anxiety and depression, improved quality of life, and alleviated PTSD
symptoms in family caregivers of heart valve replacement patients.
IMPLICATIONS FOR CLINICAL PRACTICE: Comprehensive psychological
interventions should be implemented throughout the ICU stay and recovery
period to improve family caregiver well-being.<br/>Copyright &#xa9; 2024
The Author(s). Published by Elsevier Ltd.. All rights reserved.

<25>
Accession Number
645565808
Title
Multiarterial Grafting in Redo CABG: Type of Arterial Conduit and Patient
Sex Determine Benefit.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 17 Oct 2024.
Author
Iacona G.M.; Bakhos J.J.; Houghtaling P.L.; Tipton A.E.; Ramsingh R.;
Smedira N.G.; Gillinov M.; McCurry K.R.; Soltesz E.G.; Roselli E.E.; Tong
M.Z.; Unai S.G.; Elgharably H.J.; Koprivanac M.J.; Svensson L.G.;
Blackstone E.H.; Bakaeen F.G.
Institution
(Iacona, Bakhos, Tipton, Ramsingh, Smedira, Gillinov, McCurry, Soltesz,
Roselli, Tong, Unai, Elgharably, Koprivanac, Svensson) Department of
Thoracic and Cardiovascular Surgery
(Houghtaling) Department of Quantitative Health Sciences, Cleveland
Clinic, Cleveland, OH, United States
(Blackstone) Department of Thoracic and Cardiovascular Surgery; Department
of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
(Bakaeen) Department of Thoracic and Cardiovascular Surgery.
Abstract
OBJECTIVE: To evaluate whether multiarterial grafting provides incremental
benefit above single arterial grafting in isolated redo CABG.
<br/>METHOD(S): From 1/1980 to 7/2020, 6559 adults underwent 6693 isolated
CABG reoperations. Patients undergoing multiarterial grafting were
propensity-score matched with those undergoing single arterial grafting,
with or without additional vein grafts, yielding 2005 well-matched pairs.
Endpoints were in-hospital postoperative complications, hospital
mortality, and long-term mortality. Median follow-up was 10 years with 25%
followed >17 years. Multivariable multiphase hazard modeling and
nonparametric random survival forests for survival were used to identify
patients for whom multiarterial grafting was most beneficial.
<br/>RESULT(S): Among propensity-matched patients, postoperative
complications for multiarterial versus single arterial grafting were any
reoperation, 50 (2.5%) versus 65 (3.2%); renal failure, 73 (3.6%) versus
55 (2.7%); stroke, 44 (2.2%) versus 38 (1.9%); and deep sternal infection,
36 (1.8%) versus 25 (1.2%). Hospital mortality was 1.7% (n=35) versus 2.8%
(n=56) (P=.03). Comparing multiarterial to single arterial grafting,
survival at 1 and 3 years was 95% versus 94% and 92% versus 88%, and at 5,
15, and 20 years, survival was 87%, 49%, and 31% versus 82%, 42%, and 25%.
Better survival after multiarterial grafting was confined to males with 2
patent internal thoracic artery grafts (P<.0001). <br/>CONCLUSION(S): Redo
CABG with multiarterial grafting can be performed with lower in-hospital
mortality and similar major morbidity to single arterial grafting. It is
associated with better long-term survival, particularly in males when 2
internal thoracic artery grafts are used.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.

<26>
Accession Number
645562072
Title
Trends in Transcatheter Versus Surgical Aortic Valve Replacement Outcomes
in Patients With Low-Surgical Risk: A Systematic Review and Meta-Analysis
of Randomized Trials.
Source
Journal of the American Heart Association. (pp e036179), 2024. Date of
Publication: 18 Oct 2024.
Author
Kazemian S.; Fallahtafti P.; Sharifi M.; Mohammadi N.S.H.; Soleimani H.;
Moghadam A.S.; Karimi E.; Sattar Y.; Jenab Y.; Mehrani M.; Hajizeinali A.;
Iskander M.; Sabet M.F.; Salehi N.; Al-Azizi K.; Hakim D.; Alam M.;
Hosseini K.
Institution
(Kazemian, Mohammadi, Soleimani, Jenab, Mehrani, Hosseini) Cardiac Primary
Prevention Research Center Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences Tehran Iran, Iran, Islamic Republic
of
(Kazemian, Fallahtafti, Sharifi, Mohammadi, Soleimani, Moghadam, Karimi,
Jenab, Mehrani, Hajizeinali, Hosseini) Tehran Heart Center Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences Tehran
Iran, Iran, Islamic Republic of
(Fallahtafti, Karimi) School of Medicine, Tehran University of Medical
Sciences Tehran Iran, Iran, Islamic Republic of
(Sattar) Department of Cardiology West Virginia University Morgantown WV
USA
(Iskander) Department of Medicine-Cardiology Medical College of Wisconsin
Milwaukee WI USA
(Sabet) Department of Internal Medicine McLaren/Flint/Michigan State
University Flint MI USA
(Salehi) Heart, Vascular and Thoracic Institute, Cleveland Clinic Akron
General Hospital Akron OH USA
(Al-Azizi) Department of Cardiology Baylor Scott and White The Heart
Hospital Plano TX USA
(Hakim) Cardiovascular Division Brigham & Women's Hospital/Harvard Medical
School Boston MA USA
(Alam) Texas Heart Institute, Baylor College of Medicine Houston TX USA
Abstract
BACKGROUND: Limited data exist on long-term outcomes after transcatheter
aortic valve replacement (TAVR) and surgical aortic valve replacement
(SAVR). This meta-analysis aims to elucidate outcome trends following TAVR
versus SAVR in patients with severe aortic stenosis and low-surgical risk.
METHODS AND RESULTS: A systematic search was conducted in PubMed, Embase,
Scopus, and the Cochrane Library databases from inception until May 2024,
to identify studies comparing TAVR versus SAVR in patients with
low-surgical risk (Society of Thoracic Surgeons predicted risk of
mortality score <4%). The primary outcome was all-cause mortality.
Secondary outcomes included cardiovascular mortality, stroke, disabling
stroke, rehospitalization, myocardial infarction, aortic valve
reintervention, permanent pacemaker implantation, and new-onset atrial
fibrillation. Binary random-effects models were used to compare the risk
of each outcome across various follow-up intervals and the risk of bias
was assessed using the Cochrane Collaboration's Risk of Bias-2 tool. The
meta-analysis included 6 randomized trials including 4682 patients. TAVR
was associated with a lower risk of all-cause mortality than SAVR in the
30-day (hazard ratio [HR: 0.45] [95% CI: 0.26-0.77], I2: 0%) and 30-day to
1-year (HR: 0.55 [95% CI: 0.37-0.81], I2: 16%) follow-ups. However, the
risk of all-cause mortality was similar during >1-year follow-ups. TAVR
was associated with a significantly lower risk of cardiovascular
mortality, disabling stroke, rehospitalization, new-onset atrial
fibrillation, and a higher risk of permanent pacemaker implantation
compared with SAVR during the 30-day follow-up. <br/>CONCLUSION(S): TAVR
was associated with a lower risk of all-cause mortality within the first
year of post-procedural follow-up compared with SAVR. However, the risk of
all-cause mortality was similar in >1-year follow-ups.

<27>
Accession Number
645561828
Title
Meta-analysis of improved mitral regurgitation after aortic valve
replacement.
Source
Perfusion. (pp 2676591241291338), 2024. Date of Publication: 19 Oct 2024.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Abstract
BACKGROUND: This meta-analysis aimed to compare survival outcomes among
patients experiencing improvement in untreated significant mitral
regurgitation (MR) following surgical aortic valve replacement (SAVR) or
transcatheter aortic valve replacement (TAVR) for severe aortic stenosis,
in contrast to those without improvement. <br/>METHOD(S): We conducted a
comprehensive search through February 2024. Pooled hazard ratios (HR) with
95% confidence intervals (CI) were computed. Kaplan-Meier curves depicting
all-cause mortality were reconstructed using individual patient data
derived from the included studies. <br/>RESULT(S): A systematic review
identified twelve non-randomized studies encompassing 4040 patients. The
pooled all-cause mortality of the meta-analysis demonstrated a significant
reduction in patients whose MR improved compared to those with persistent
MR after aortic valve replacement (AVR) (HR [95% CI] = 0.55 [0.47-0.64], p
< .01). The hazard ratio, derived from reconstructed time-to-event data,
indicated lower all-cause mortality in patients with improved MR after AVR
relative to the other cohort (HR [95% CI] = 0.50 [0.40-0.62], p < .01 in
all patients, 0.48 [0.34-0.68], p < .01 in patients undergoing SAVR, and
0.58 [0.42-0.80], p < .01 in those receiving TAVR). <br/>CONCLUSION(S): In
conclusion, this meta-analysis revealed that improved MR after AVR,
whether surgically or by transcatheter approach, correlates with superior
survival. The benefits of simultaneous or staged intervention on the
mitral valve in individuals undergoing AVR warrant validation in future
investigations.

<28>
Accession Number
645561105
Title
Frailty, age, and treatment effect of surgical coronary revascularization
in ischemic cardiomyopathy: a post hoc analysis of the STICHES trial.
Source
GeroScience. (no pagination), 2024. Date of Publication: 19 Oct 2024.
Author
Patel L.; Segar M.W.; Subramanian V.; Singh S.; Betts T.; Lokesh N.;
Keshvani N.; Patel K.; Pandey A.
Institution
(Patel, Subramanian, Singh, Betts, Lokesh, Keshvani, Pandey) Division of
Cardiology, Department of Medicine, University of Texas Southwestern
Medical Center, 5323 Harry Hines Blvd, Dallas, TX, United States
(Segar) Division of Cardiology, Texas Heart Institute, Houston, TX, United
States
(Patel) Division of Cardiology, Houston Methodist, Houston, TX, United
States
Abstract
Frailty is common among older patients with heart failure (HF). The
efficacy of coronary artery bypass grafting (CABG) on the risk of
mortality among frail patients with ischemic cardiomyopathy and HF is
uncertain, and whether frailty burden modifies the treatment benefits of
CABG among these patients is unknown. We performed a post hoc analysis of
the STICHES trial, a randomized trial of CABG with medical therapy vs
medical therapy alone among participants with ischemic cardiomyopathy with
ejection fraction<=35%. Baseline frailty was assessed through a Rockwood
Frailty Index (FI), and based on FI cut-offs from prior HF studies,
participants with FI>=0.311 were classified as more frail, and those with
FI<0.311 were classified as less frail. A multivariable Cox proportional
hazard model with multiplicative interaction terms was constructed to
evaluate whether frailty status modified the treatment effect of CABG on
mortality in the overall trial cohort and among those<60 vs>=60 years of
age. Of 1187 participants (12.4% female, 2.6% Black, median FI=0.33 [IQR
0.27-0.39]), 678 were characterized as more frail. Frailty burden did not
modify the efficacy of CABG on the risk of all-cause death in the overall
cohort (Pint CABGxfrailty=0.2). In age stratified analysis, Baseline
frailty status did not modify the treatment effect of CABG on the risk of
all-cause mortality among younger (<60 years, Pint CABGxfrailty=0.2) as
well as older participants (>=60 years, Pint CABGxfrailty=0.6). In this
post hoc analysis of the STICHES trial, baseline frailty status did not
modify the efficacy of CABG in the overall cohort as well as among younger
or older participants. Frailty alone should not be used as a criterion to
determine the utilization of CABG among patients with ischemic
cardiomyopathy.<br/>Copyright &#xa9; 2024. The Author(s), under exclusive
licence to American Aging Association.

<29>
Accession Number
645560042
Title
The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary
Management and Resectability of Locally Advanced Non-Small Cell Lung
Cancer.
Source
The Annals of thoracic surgery. (no pagination), 2024. Date of
Publication: 16 Oct 2024.
Author
Kim S.S.; Cooke D.T.; Kidane B.; Tapias L.F.; Lazar J.F.; Awori Hayanga
J.W.; Patel J.D.; Neal J.W.; Abazeed M.E.; Willers H.; Shrager J.B.
Institution
(Kim) Canning Thoracic Institute, Northwestern University Feinberg School
of Medicine, Northwestern Memorial Hospital, Chicago, IL, United States
(Cooke) Division of General Thoracic Surgery, University of California
Davis Health, Sacramento, CA, United States
(Kidane) Section of Thoracic Surgery, CancerCare Manitoba & University of
Manitoba, Winnipeg, Manitoba, CA
(Tapias) Division of Thoracic Surgery, Mayo Clinic, Rochester, MN, United
States
(Lazar) Ascension Saint Thomas Hospital, University of Tennessee Health
Science Center, Division of Thoracic Surgery, Nashville, TN, United States
(Awori Hayanga) Department of Cardiothoracic and Vascular Surgery, West
Virginia University Medicine, Morgantown, WV, United States
(Patel) Division of Hematology/Oncology, Department of Medicine,
Northwestern University, Chicago, IL, United States
(Neal) Division of Oncology, Department of Medicine, Stanford Cancer
Institute, Stanford, CA, United States
(Abazeed) Department of Radiation Oncology, Northwestern University,
Feinberg School of Medicine, Chicago, IL, United States
(Willers) Department of Radiation Oncology, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, United States
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Veterans Affairs Palo
Altos Health Care System, Stanford, CA, United States
Abstract
BACKGROUND: The contemporary management and resectability of locally
advanced lung cancer are undergoing significant changes as new data emerge
regarding immunotherapy and targeted treatments. The objective of this
document is to review the literature and present consensus among a group
of multidisciplinary experts to guide the determination of resectability
and management of locally advanced non-small cell lung cancer (NSCLC) in
the context of contemporary evidence. <br/>METHOD(S): The Society of
Thoracic Surgeon Workforce on Thoracic Surgery assembled a
multidisciplinary expert panel comprised of thoracic surgeons and medical
and radiation oncologists with established expertise in the management of
lung cancer. A focused literature review was performed, and expert
consensus statements were developed using a modified Delphi process to
address three major themes: (1) Assessing Resectability and
Multidisciplinary Management of Locally Advanced Lung Cancer, (2)
Neoadjuvant (including peri-operative) therapy, and (3) Adjuvant therapy.
<br/>RESULT(S): A consensus was reached on 19 recommendations. These
consensus statements reflect updated insights on resectability and
multidisciplinary management of locally advanced lung cancer based on the
latest literature and current clinical experience, mainly focusing on the
appropriateness of surgical therapy and emerging data regarding
neoadjuvant and adjuvant therapies. <br/>CONCLUSION(S): Despite the
complex decision-making process in managing locally advanced lung cancer,
this expert panel agreed on several key recommendations. This document
provides guidance for thoracic surgeons and other medical professionals in
the optimal management of locally advanced lung cancer based on the most
updated evidence and literature.<br/>Copyright &#xa9; 2024. Published by
Elsevier Inc.

<30>
Accession Number
645558772
Title
The prognostic utility of galectin-3 in patients undergoing cardiac
surgery: a scoping review.
Source
Biomarkers : biochemical indicators of exposure, response, and
susceptibility to chemicals. (pp 1-9), 2024. Date of Publication: 18 Oct
2024.
Author
Shah A.; Ding Y.; Walji D.; Rabinovich G.A.; Pelletier M.; El-Diasty M.
Institution
(Shah) School of Medicine, Queen's University, Kingston, ON, Canada
(Ding) Institute of Biomedical Engineering, Faculty of Applied Science and
Engineering, University of Toronto, Toronto, ON, Canada
(Walji, El-Diasty) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Rabinovich) Laboratorio de Glicomedicina, Instituto de Biologia y
Medicina Experimental, Consejo Nacional de Investigaciones Cientificas y
Tecnicas (CONICET) and Facultad de Ciencias Exactas y Naturales,
Universidad de Buenos Aires, Buenos Aires, Argentina
(Pelletier, El-Diasty) Cardiac Surgery Department, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
Abstract
OBJECTIVE: To review the utility of galectin-3 (Gal-3) as a biomarker for
postoperative adverse outcomes in patients undergoing cardiac surgery.
<br/>METHOD(S): This review was conducted in compliance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Electronic database search was conducted in October 2023.
Studies that measured pre- and/or postoperative plasma Gal-3 levels in
adult patients undergoing cardiac surgery were included. Primary outcomes
included postoperative morbidity and mortality. <br/>RESULT(S): Out of 391
studies screened, eight studies met the inclusion criteria. Two of the
three studies showed that preoperative plasma levels of Gal-3 were
associated with acute kidney injury (AKI) after cardiac surgery. Two of
the three studies reported a significant increase in preoperative Gal-3
levels in patients who developed postoperative atrial fibrillation (POAF).
The addition of Gal-3 to the EuroSCORE II model was found to statistically
improve the prediction of both AKI and POAF. Three of the five studies
suggested that Gal-3 levels can predict postoperative mortality. Finally,
one study suggested that lower preoperative Gal-3 levels was associated
with a higher likelihood of achieving left ventricular reverse remodeling
(LVRR) after surgery. <br/>CONCLUSION(S): Gal-3 may play a promising role
in predicting adverse outcomes in patients undergoing cardiac surgery. The
addition of Gal-3 to clinical risk prediction scores may improve their
discriminatory power in this group of patients. Future studies are
warranted to justify its incorporation into routine clinical practice.

<31>
Accession Number
645558712
Title
Three-Year Outcomes Following TAVR in Younger (<75 Years)
Low-Surgical-Risk Severe Aortic Stenosis Patients.
Source
Circulation. Cardiovascular interventions. (pp e014018), 2024. Date of
Publication: 18 Oct 2024.
Author
Modine T.; Tchetche D.; Van Mieghem N.M.; Deeb G.M.; Chetcuti S.J.;
Yakubov S.J.; Sorajja P.; Gada H.; Mumtaz M.; Ramlawi B.; Bajwa T.; Crouch
J.; Teirstein P.S.; Kleiman N.S.; Iskander A.; Bagur R.; Chu M.W.A.;
Berthoumieu P.; Sudre A.; Adrichem R.; Ito S.; Huang J.; Popma J.J.;
Forrest J.K.; Reardon M.J.
Institution
(Modine) Centre Hospitalier Universitaire de Bordeaux, L'Unite
Medico-Chirurgicale des Valvulopathies, Chirurgie Cardiaque, Universite de
Bordeaux, France
(Tchetche, Berthoumieu) Clinique Pasteur, Toulouse, France
(Van Mieghem, Adrichem) Department of Interventional Cardiology,
Thoraxcenter, Erasmus Medical Center Rotterdam, Netherlands
(Deeb) Department of Cardiac Surgery and Division of Interventional
Cardiology, Michigan Medicine Health Systems - University Hospital, Ann
Arbor, United States
(Chetcuti) Department of Internal Medicine and Division of Cardiovascular
Medicine, Michigan Medicine Health Systems - University Hospital, Ann
Arbor, United States
(Yakubov) Department of Cardiology, Ohio Health Riverside Methodist
Hospital
(Sorajja) Minneapolis Heart Institute Foundation, Abbott Northwestern
Hospital
(Gada, Mumtaz) Department of Interventional Cardiology and Cardiothoracic
Surgery, University of Pittsburgh Medical Center, Moffitt Heart/Pinnacle
Health, PA (H.G., Harrisburg, United States
(Ramlawi) Cardiothoracic Surgery, Lankenau Heart Institute, PA (B.R.),
Wynnewood, United States
(Bajwa, Crouch) Department of Interventional Cardiology and Cardiothoracic
Surgery, Aurora Health Care, Aurora St. Luke's Medical Center, Milwaukee,
United States
(Teirstein) Department of Interventional Cardiology, Scripps Clinic,
Scripps Prebys Cardiovascular Institute, La Jolla
(Kleiman, Reardon) Department of Interventional Cardiology and
Cardiothoracic Surgery, Methodist DeBakey Heart and Vascular Center,
Houston Methodist Hospital
(Iskander) Saint Joseph's Hospital Health Center, Syracuse, United States
(Bagur, Chu) London Health Sciences Centre - University Campus, ON, Canada
(Sudre) Centre Hospitalier Regional Universitaire de Lille, France
(Ito) Echocardiography Core Laboratory, Mayo Clinic, Rochester, United
Kingdom
(Huang, Popma) Medtronic, Mounds View
(Forrest) Department of Internal Medicine (Cardiology), Yale University
School of Medicine, CT (J.K.F.), New Haven, United States
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an
alternative to surgery in patients with severe aortic stenosis, but data
are limited on younger, low-risk patients. This analysis compares outcomes
in low-surgical-risk patients aged <75 years receiving TAVR versus
surgery. <br/>METHOD(S): The Evolut Low Risk Trial randomized 1414
low-risk patients to treatment with a supra-annular, self-expanding TAVR
or surgery. We compared rates of all-cause mortality or disabling stroke,
associated clinical outcomes, and bioprosthetic valve performance at 3
years between TAVR and surgery patients aged <75 years. <br/>RESULT(S): In
patients <75 years, 352 were randomized to TAVR and 351 to surgery. Mean
age was 69.1+/-4.0 years (minimum 51 and maximum 74); Society of Thoracic
Surgeons Predicted Risk of Mortality was 1.7+/-0.6%. At 3 years, all-cause
mortality or disabling stroke for TAVR was 5.7% and 8.0% for surgery
(P=0.241). Although there was no difference between TAVR and surgery in
all-cause mortality, the incidence of disabling stroke was lower with TAVR
(0.6%) than surgery (2.9%; P=0.019), while surgery was associated with a
lower incidence of pacemaker implantation (7.1%) compared with TAVR
(21.0%; P<0.001). Valve reintervention rates (TAVR 1.5%, surgery 1.5%,
P=0.962) were low in both groups. Valve performance was significantly
better with TAVR than surgery with lower mean aortic gradients (P<0.001)
and lower rates of severe prosthesis-patient mismatch (P<0.001). Rates of
valve thrombosis and endocarditis were similar between groups. There were
no significant differences in rates of residual >=moderate paravalvular
regurgitation. <br/>CONCLUSION(S): Low-risk patients <75 years treated
with supra-annular, self-expanding TAVR had comparable 3-year all-cause
mortality and lower disabling stroke compared with patients treated with
surgery. There was significantly better valve performance in patients
treated with TAVR. REGISTRATION: URL: https://clinicaltrials.gov; Unique
identifier: NCT02701283.

<32>
Accession Number
2028847647
Title
Effect of right internal mammary artery versus radial artery as a second
graft vessel in coronary artery bypass grafting on postoperative wound
infection in patients: A meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14592. Date of Publication: March 2024.
Author
Du H.; Gu X.; Zhang Z.; Dong Z.; Ran X.; Zhou L.
Institution
(Du, Gu, Zhang, Ran, Zhou) Department of Cardio Thoracic Surgery, No.988
Hospital of Joint Logistics Support Force, Jiaozuo, China
(Dong) Department of Cardio Surgery, WuHan Asia Cardiac Disease Hospital,
Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
Few studies have shown that radial artery (RA), which is used as a
secondary arterial graft, offers superior results compared with right
internal thoracic artery (RIMA) in coronary artery bypass grafting (CABG).
In a meta-analysis of observational studies starting in 2023, we looked at
the effect of re-operation on postoperative infection and haemorrhage in
CABG with RA vs. RIMA. The electronic database up to October 2023 was
examined in the course of the research. Analysis was carried out on the
clinical trials of postoperative wound infections and haemorrhage
re-surgery. Among 912 trials associated with CABG, we selected 8 trials to
be included in the final data analysis. The main results were secondary
wound infection and re-operation after surgery. The odds ratios (OR) and
confidence intervals (CIs) were computed on the basis of a randomized or
fixed-effect model of wound infection and re-operation. Seven trials
showed a significant reduction in the risk of wound infection in RA
treated as a secondary artery transplant compared with RIMA (OR, 1.60; 95%
CI, 1.03, 2.47 p = 0.04); Four trials showed that RIMA was not
significantly different from RA in the rate of re-operation for
postoperative bleeding (OR, 1.31; 95% CI, 0.60, 2.88 p = 0.50). In CABG,
RA is used as a secondary arterial conduit graft to lower the risk of
wound infection in CABG patients.<br/>Copyright &#xa9; 2024 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<33>
Accession Number
2035124864
Title
Ethanol infusion into the vein of Marshall reduced atrial tachyarrhythmia
recurrence during catheter ablation: A systematic review and
meta-analysis.
Source
Heart Rhythm O2. 5(10) (pp 728-738), 2024. Date of Publication: October
2024.
Author
Pranata R.; Kamarullah W.; Karwiky G.; Achmad C.; Iqbal M.
Institution
(Pranata, Kamarullah, Karwiky, Achmad, Iqbal) Department of Cardiology and
Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan
Sadikin General Hospital, Bandung, Indonesia
Publisher
Elsevier B.V.
Abstract
Background: Ethanol infusion into the vein of Marshall (EIVoM) may
increase mitral isthmus bidirectional block (MIBB) and cause local
autonomic denervation that may improve outcome. <br/>Objective(s): This
meta-analysis aimed to investigate whether the addition of EIVoM to atrial
fibrillation (AF) ablation led to a better outcome. <br/>Method(s):
Systematic literature search was performed using PubMed, Scopus,
ScienceDirect, and Europe PMC for studies that compared the addition of
EIVoM during AF ablation with radiofrequency ablation. The primary outcome
was atrial tachyarrhythmia (ATa) recurrence, defined as AF/atrial
flutter/atrial tachycardia after the blanking period. <br/>Result(s):
There were 2821 patients from 11 studies, and EIVoM was successful in 77%
(95% confidence interval [CI] 62%-92%). ATa recurrence was 27% (95% CI
20%-34%) in the EIVoM group and 42% (95% CI 33%-51%) in ablation-only
group. EIVoM reduced ATa recurrence (odds ratio [OR] 0.52; 95% CI
0.36-0.76; P < .001; I² = 76.92). The rate of MIBB was 85% (95%
CI 77%-94%) in the EIVoM group and 73% (95% CI 61%-85%) in the
ablation-only group, which was significantly higher (OR 3.87; 95% CI
1.46-10.28; P < .001; I² = 83.68). The mitral isthmus
reconnection rate (OR 0.44; 95% CI 0.15-1.29; P = .14; I² =
63.6) and repeat procedure rate (OR 0.76; 95% CI 0.53-1.08; P = .12;
I² = 48) were similar; however, a leave-one-out sensitivity
analysis showed P < .05 for both. The benefits of EIVoM were not affected
by age, left atrial diameter, and left ventricular ejection fraction (P >
.05). Age (P = .029) and left atrial diameter (P = .042) were inversely
associated with EIVoM benefits in terms of repeat ablation and mitral
isthmus reconnection (age; P = .003). <br/>Conclusion(s): The addition of
EIVoM to ablation increased MIBB and reduced ATa recurrence.<br/>Copyright
&#xa9; 2024 Heart Rhythm Society

<34>
Accession Number
2034928251
Title
Comparing the effect of sedation with dexmedetomidine and propofol on
sleep quality of patients after cardiac surgery: A randomized clinical
trial.
Source
Journal of Cardiovascular and Thoracic Research. 16(3) (pp 156-163), 2024.
Date of Publication: 2024.
Author
Azarfarin R.; Fard M.Z.; Ghadimi M.; Chaibakhsh Y.; Yousefi M.
Institution
(Azarfarin, Fard, Ghadimi, Chaibakhsh, Yousefi) Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Sleep quality is the main concern of patients after cardiac
surgery. We compared the effect of two routinely used sedatives on the
sleep quality of patients admitted to the intensive care unit (ICU) after
cardiovascular surgery. <br/>Method(s): It is a prospective, controlled,
randomized clinical trial. A total of 120 patients, after cardiac surgery
were enrolled. During extubating, patients were randomized into two
groups: 60 patients received an infusion of dexmedetomidine (precede; 0.5
mug/kg/h), and 60 patients received 50 mug/kg/min propofol for 6 hours.
Baseline characteristics were compared between the groups. The patients
completed the St. Mary's Hospital Sleep Questionnaire, and the scores were
compared between the groups. <br/>Result(s): The groups were not different
in terms of demographics, underlying diseases, smoking/ drug
abuse/alcohol, number of vessels involved, history of non-cardiac surgery,
and mean levels of serum parameters (P > 0.05). Most of the medications
used were similar between the groups (P > 0.05), except calcium channel
blockers (more frequently used in the propofol group [P = 0.027). The
details of surgery were not statistically significant different (P >
0.05); but, the mean volume of platelet received after the surgery was
higher in propofol group (P = 0.03). The propofol group had less problems
with last night's sleep (0 vs 0.1 +/- 0.66), felt more clear-headed (4.9
+/- 0.6 vs 4.68 +/- 0.58, were more satisfied with their last night's
sleep (52.1% vs 47.9%), but spent more time getting into sleep (0.38 +/-
1.67 vs 0 ) (P < 0.5). <br/>Conclusion(s): The sleep quality of patients
under the influence of propofol seemed to be better than dexmedetomidine
after cardiac surgery.<br/>Copyright &#xa9; 2024 The Author(s).

<35>
Accession Number
2034916769
Title
To Study the Efficacy of Ultrasound Guided Pecto-Intercostal Fascial Plane
Block in Patients Undergoing Midline Sternotomy in Open Cardiac Surgery: A
Randomized Prospective Comparative Study.
Source
Annals of Cardiac Anaesthesia. 27(4) (pp 301-308), 2024. Date of
Publication: 2024.
Author
Singh G.; Dhiraaj S.; Shamshery C.; Agarwal S.K.; Goyal P.; Ambasta S.
Institution
(Singh, Dhiraaj, Shamshery, Goyal, Ambasta) Department of Anaesthesiology,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh,
Lucknow, India
(Agarwal) Department of Cardio Thoracic and Vascular Surgery, Sanjay
Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh,
Lucknow, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
ABSTRACT: Background: The incidence of acute poststernotomy pain after
cardiac surgery is 80% 1. Pecto-intercostal fascial plane block (PIFB)
adjacent to the sternum anesthetizes the anterior cutaneous branches of
the intercostal nerves and may provide effective analgesia after
sternotomy. Methodology: A randomized controlled, double-blinded,
prospective comparative trial was conducted at a tertiary care center on
patients of midline sternotomy between 18 and 65 years and NYHA Class 2
and 3 for open cardiac surgery with the primary aim to evaluate analgesia
on deep breathing after 3 hours of PIFB block bilaterally. A total of 60
patients were enrolled and randomly divided into three groups. PIFB was
administered bilaterally before extubation, with 15 ml 0.125% bupivacaine
plain (Group B), and bupivacaine+ clonidine 0.25 mcg/kg (Group B+C). Group
C did not receive any intervention. All patients received acetaminophen 1
gram three times a day and injectable tramadol 1 mg/kg as a rescue
analgesic. <br/>Result(s): Baseline characteristics were similar among all
the groups. The Numeric Rating Scale (NRS) for pain was statistically
lower (P < 0.05) in Groups B and B+C compared to Group C at rest, deep
breathing, and coughing at 3, 6, and 12 hours after extubation. NRS on
deep breathing in Groups B, B+C, and C was (2.3, 1.5, 4.4) at 3 hours,
(2.3, 1.6, 4.3) at 6 hours, (2.8, 2.1, 3.9) at 12 hrs, and (4.3, 3.5,
3.6)} at 24 hours after extubation. The peak expiratory flow rate was the
highest in Group B. Rescue analgesia was not required in Group B.
<br/>Conclusion(s): PIFB reduces sternotomy pain compared to the control
group on deep breathing at 3 hours after block, with delayed requirement
of rescue analgesia and improved respiratory mechanics in terms of peak
expiratory flow rate at all time points. There is no benefit from adding
clonidine.<br/>Copyright &#xa9; 2024 Annals of Cardiac Anaesthesia.

<36>
Accession Number
2034733261
Title
Senescence and Inflamm-Aging Are Associated With Endothelial Dysfunction
in Men But Not Women With Atherosclerosis.
Source
JACC: Basic to Translational Science. 9(10) (pp 1163-1177), 2024. Date of
Publication: October 2024.
Author
Mury P.; Cagnone G.; Dagher O.; Wunnemann F.; Voghel G.; Beaudoin M.;
Lambert M.; Miquel G.; Noly P.-E.; Perrault L.P.; Carrier M.;
Thorin-Trescases N.; Joyal J.-S.; Lettre G.; Thorin E.
Institution
(Mury, Dagher, Wunnemann, Beaudoin, Lambert, Miquel, Noly, Perrault,
Carrier, Thorin-Trescases, Lettre, Thorin) Montreal Heart Institute
Research Center, University of Montreal, Montreal, QC, Canada
(Mury, Dagher, Lambert) Department of Pharmacology and Physiology, Faculty
of Medicine, University of Montreal, Montreal, QC, Canada
(Cagnone, Joyal) University Hospital Sainte Justine Research Center,
University of Montreal, Montreal, QC, Canada
(Dagher) Department of Cardiac Sciences, Libin Cardiovascular Institute,
Calgary, AB, Canada
(Voghel) Department of Family Medicine and Emergency Medicine, Faculty of
Medicine, University of Montreal, Montreal, QC, Canada
(Noly, Perrault, Carrier, Thorin) Department of Surgery, Faculty of
Medicine, University of Montreal, Montreal, QC, Canada
(Joyal) Department of Pediatrics, Faculty of Medicine, University of
Montreal, Montreal, QC, Canada
(Joyal) Department of Ophthalmology, Faculty of Medicine, University of
Montreal, Montreal, QC, Canada
(Lettre) Department of Medicine, Faculty of Medicine, University of
Montreal, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Coronary artery disease (CAD) is more prevalent in men than in women, with
endothelial dysfunction, prodromal to CAD, developing a decade earlier in
middle-aged men. We investigated the molecular basis of this dimorphism ex
vivo in arterial segments discarded during surgery of CAD patients. The
results reveal a lower endothelial relaxant sensitivity in men, and a
senescence-associated inflammaging transcriptomic signature in endothelial
cells. In women, cellular metabolism and endothelial maintenance pathways
are conserved. This suggests that senolytic therapies to reduce risk of
cardiovascular events in women with CAD may not be as effective as in
men.<br/>Copyright &#xa9; 2024 The Authors

<37>
Accession Number
2031853277
Title
Infective Endocarditis by Listeria Species-A Systematic Review.
Source
Journal of Clinical Medicine. 13(19) (no pagination), 2024. Article
Number: 5887. Date of Publication: October 2024.
Author
Kypraiou D.; Konstantaraki M.; Tsantes A.G.; Ioannou P.
Institution
(Kypraiou, Konstantaraki, Ioannou) School of Medicine, University of
Crete, Heraklion 71003, Greece
(Tsantes) Laboratory of Hematology and Blood Bank Unit, School of
Medicine, "Attikon" University Hospital, National and Kapodistrian
University of Athens, Athens 12462, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Infective endocarditis (IE) is a disease associated with significant
morbidity and mortality. It is more commonly caused by Gram-positive
cocci, but Gram-positive bacilli may seldom cause the disease. Listeria
monocytogenes is an aerobic Gram-positive coccobacillus and a foodborne
and opportunistic pathogen most commonly causing gastrointestinal
infections, even though bacteremia, sepsis, meningitis, and fetal
infections may also occur. Listeria IE has rarely been described, with
most reports being case reports or case series. Thus, the characteristics
of this disease remain largely unknown. This systematic review aimed to
present all published Listeria IE studies and describe their
characteristics. A search of PubMed, Scopus, and the Cochrane Library for
studies providing information on epidemiology, clinical findings,
treatment, and outcome of Listeria IE cases was performed. A total of 54
studies containing data from 62 patients were included. Among all
patients, 64.5% were male; the median age was 69 years. Among all
patients, 54.8% had a history of a prosthetic valve. The aortic valve was
the most commonly affected, followed by the mitral. Fever, heart failure,
and embolic phenomena were the most commonly encountered clinical
findings. The only isolated species was L. monocytogenes. Antimicrobial
resistance was relatively low for aminopenicillins and aminoglycosides,
the most commonly used antimicrobials for treating L. monocytogenes IE.
Surgery was performed in 27.4% of patients. Mortality was 37.1%. Patients
who survived were more likely to have had a prosthetic valve, to have
necessitated transesophageal echocardiography for the diagnosis, to have
mitral valve IE, and to have had surgical management; however, no factor
was identified in a multivariate logistic regression model as an
independent factor for overall mortality.<br/>Copyright &#xa9; 2024 by the
authors.

<38>
Accession Number
2030833126
Title
Combining Intravenous Thrombolysis and Dual Antiplatelet Treatment in
Patients With Minor Ischemic Stroke: A Propensity Matched Analysis of the
READAPT Study Cohort.
Source
Journal of the American Heart Association. 13(16) (no pagination), 2024.
Article Number: e036275. Date of Publication: 20 Aug 2024.
Author
Ornello R.; Foschi M.; De Santis F.; Romoli M.; Tassinari T.; Saia V.;
Cenciarelli S.; Bedetti C.; Padiglioni C.; Censori B.; Puglisi V.;
Vinciguerra L.; Guarino M.; Barone V.; Zedde M.; Grisendi I.; Diomedi M.;
Bagnato M.R.; Petruzzellis M.; Mezzapesa D.M.; Di Viesti P.; Inchingolo
V.; Cappellari M.; Zivelonghi C.; Candelaresi P.; Andreone V.; Rinaldi G.;
Bavaro A.; Cavallini A.; Moraru S.; Querzani P.; Terruso V.; Mannino M.;
Pezzini A.; Frisullo G.; Muscia F.; Paciaroni M.; Mosconi M.G.; Zini A.;
Leone R.; Palmieri C.; Cupini L.M.; Marcon M.; Tassi R.; Sanzaro E.; Paci
C.; Viticchi G.; Orsucci D.; Falcou A.; Beretta S.; Tarletti R.; Nencini
P.; Rota E.; Sepe F.N.; Ferrandi D.; Caputi L.; Volpi G.; La Spada S.;
Beccia M.; Rinaldi C.; Mastrangelo V.; Di Blasio F.; Invernizzi P.;
Pelliccioni G.; De Angelis M.V.; Bonanni L.; Ruzza G.; Caggia E.A.; Russo
M.; Tonon A.; Acciarri M.C.; Anticoli S.; Roberti C.; Manobianca G.;
Scaglione G.; Pistoia F.; Fortini A.; De Boni A.; Sanna A.; Chiti A.;
Barbarini L.; Caggiula M.; Masato M.; Del Sette M.; Passarelli F.;
Bongioanni M.R.; Toni D.; Ricci S.; De Matteis E.; Sacco S.
Institution
(Romoli) Stroke Unit Maurizio Bufalini Hospital, Cesena, Italy
(Tassinari, Saia) Department of Neurology, Santa Corona Hospital, Pietra
Ligure, Italy
(Cenciarelli, Bedetti, Padiglioni, Ricci) Department of Neurology Citta di
Castello Hospital, Citta di Castello, Italy
(Censori, Puglisi, Vinciguerra) Department of Neurology, ASST Cremona
Hospital, Cremona, Italy
(Guarino, Barone) IRCCS Istituto delle Scienze Neurologiche di Bologna,
Bologna, Italy
(Zedde, Grisendi) Department of Neurology, AUSL-IRCCS di Reggio Emilia
Reggio, Emilia, Italy
(Diomedi, Bagnato) Department of Systems Medicine Tor Vergata University
Hospital, Rome, Italy
(Petruzzellis, Mezzapesa) Stroke Unit, "F. Puca" AOU Consorziale
Policlinico, Bari, Italy
(Di Viesti, Inchingolo) Department of Neurology, Casa Sollievo della
Sofferenza, San Giovanni Rotondo, Italy
(Cappellari, Zivelonghi) Department of Neuroscience, Azienda Ospedaliera
Universitaria Integrata Verona, Verona, Italy
(Candelaresi, Andreone) Stroke Unit AORN Antonio Cardarelli, Naples, Italy
(Rinaldi, Bavaro) Department of Neurology Di Venere Hospital, Bari, Italy
(Cavallini, Moraru) Neurologia d'Urgenza-Stroke Unit IRCCS Mondino
Foundation, Pavia, Italy
(Querzani) Neurology Unit S.Maria delle Croci Hospital, Ravenna, Italy
(Terruso, Mannino) Department of Neurology, AOOR Villa Sofia-Cervello,
Palermo, Italy
(Pezzini) Department of Medicine and Surgery, University of Parma, Italy
(Frisullo) Neuroscienze, Organi di Senso e Torace Fondazione Policlinico
Universitario, Agostino Gemelli, Rome, Italy
(Muscia) Department of Neurology ASST-Ovest Milanese, Legnano, Italy
(Paciaroni, Mosconi) Department of Internal and Cardiovascular Medicine
Santa Maria della Misericordia Hospital, Perugia, Italy
(Zini) IRCCS Istituto delle Scienze Neurologiche di Bologna Maggiore
Hospital, Bologna, Italy
(Leone) Stroke Unit "M. R. Dimiccoli" Hospital, Barletta, Italy
(Palmieri) Medical Department E. Agnelli Hospital-Local Health Company
(ASL) TO3, Pinerolo, Italy
(Cupini) Stroke Unit S. Eugenio Hospital, Rome, Italy
(Marcon) Department of Neurology Cazzavillan Hospital, Arzignano, Italy
(Tassi) Emergency Department Azienda Ospedaliera Universitaria Senese,
Siena, Italy
(Sanzaro) Department of Neurology Umberto I Hospital, Siracusa, Italy
(Paci) Neurology Unit Ospedale "Madonna del Soccorso" San Benedetto del,
Tronto, Italy
(Viticchi) Experimental and Clinical Medicine Department Marche
Polytechnic University, Ancona, Italy
(Orsucci) Neurology Unit San Luca Hospital Lucca Castelnuovo, Garfagnana,
Italy
(Falcou) Stroke Unit Policlinico Umberto I Hospital, Rome, Italy
(Beretta) Department of Neurology Fondazione IRCCS San Gerardo dei
Tintori, Monza, Italy
(Tarletti) Stroke Unit Azienda Ospedaliero-Universitaria "Maggiore della
Carita", Novara, Italy
(Nencini) Stroke Unit Careggi University Hospital, Florence, Italy
(Rota) Department of Neurology San Giacomo Hospital, Novi Ligure, Italy
(Sepe, Ferrandi) Stroke Unit SS. Biagio e Arrigo, Alessandria, Italy
(Caputi) Department of Cardiocerebrovascular diseases ASST Ospedale
Maggiore di Crema Crema, Italy
(Volpi) Department of Neurology San Jacopo Hospital, Pistoia, Italy
(La Spada) Department of Neurology Antonio Perrino Hospital, Brindisi,
Italy
(Beccia) Department of Neurology Sant'Andrea Hospital, Rome, Italy
(Rinaldi, Mastrangelo) Neurology Unit "Infermi" Hospital, Rimini, Italy
(Di Blasio, De Angelis) Stroke Unit "S.Spirito" Hospital, Pescara, Italy
(Invernizzi) Departiment of Neurology, Istituto Ospedaliero Fondazione
Poliambulanza, Brescia, Italy
(Pelliccioni) Department of Neurology INRCA, Ancona, Italy
(De Angelis) Department of Neurology SS Annunziata Hospital, Chieti, Italy
(Bonanni) Dipartimento di Medicina e Scienze dell'Invecchiamento
Universita G. d'Annunzio di Chieti-Pescara, Pescara, Italy
(Ruzza) Department of Neurology Civil Hospital, Cittadella, Italy
(Caggia) Cardio-Neuro-Vascular Department, Neurology Unit Giovanni Paolo
II Hospital, Ragusa, Italy
(Russo) Department of Neurology St Misericordia Hospital, Rovigo, Italy
(Tonon) Department of Neurology Ospedale Civile Ss. Giovanni e Paolo
Venezia, Italy
(Acciarri) Department of Neurology A. Murri Fermo Hospital Fermo, Italy
(Anticoli) Stroke Unit Azienda Ospedaliera San Camillo, Rome, Italy
(Roberti) Department of Neurology San Filippo Neri Hospital, Rome, Italy
(Manobianca, Scaglione) Department of Neurology General Regional Hospital
"F. Miulli" Acquaviva delle Fonti, Italy
(Fortini) Internal Medicine San Giovanni di Dio Hospital, Florence, Italy
(De Boni) Department of Neuroscience San Bortolo Hospital, Vicenza, Italy
(Sanna) Stroke Unit AOU Sassari, Sassari, Italy
(Chiti) Neurology Unit Apuane Hospital, Massa, Italy
(Barbarini, Caggiula) Department of Neurology Vito Fazi Hospital, Lecce,
Italy
(Masato) Department of Neurology Mirano Hospital, Mirano, Italy
(Del Sette) Neuroscience IRCCS Ospedale Policlinico, San Martino Genoa,
Italy
(Passarelli) Department of Neurology Fatebenefratelli Hospital, Rome,
Italy
(Bongioanni) Department of Neurology SS Annunziata Hospital, Savigliano,
Italy
(Toni) Department of Human neurosciences, La Sapienza University, Rome,
Italy
(Ricci) Coordinatore Comitato Scientifico ISA-AII Citta' di Castello,
Italy
(De Matteis) Department of Brain Sciences Imperial College London, London,
United Kingdom
(Ornello, Foschi, De Santis, Pistoia, De Matteis, Sacco) Department of
Biotechnological and Applied Clinical Sciences, University of L'Aquila,
AQ, Via Vetoio 67100, Italy
Publisher
American Heart Association Inc.
Abstract
Background: The optimal treatment for acute minor ischemic stroke is still
undefined. and options include dual antiplatelet treatment (DAPT),
intravenous thrombolysis (IVT), or their combination. We aimed to
investigate benefits and risks of combining IVT and DAPT versus DAPT alone
in patients with MIS. <br/>Methods and Results: This is a prespecified
propensity score-matched analysis from a prospective multicentric
real-world study (READAPT [Real-Life Study on Short-Term Dual Antiplatelet
Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack]).
We included patients with MIS (National Institutes of Health Stroke Scale
score at admission <=5), without prestroke disability (modified Rankin
scale [mRS] score <=2). The primary outcomes were 90-day mRS score of 0 to
2 and ordinal mRS distribution. The secondary outcomes included 90-day
risk of stroke and other vascular events and 24-hour early neurological
improvement or deterioration (>=2-point National Institutes of Health
Stroke Scale score decrease or increase from the baseline, respectively).
From 1373 patients with MIS, 240 patients treated with IVT plus DAPT were
matched with 427 patients treated with DAPT alone. At 90 days, IVT plus
DAPT versus DAPT alone showed similar frequency of mRS 0 to 2 (risk
difference, 2.3% [95% CI -2.0% to 6.7%]; P=0.295; risk ratio, 1.03 [95% CI
0.98-1.08]; P=0.312) but more favorable ordinal mRS scores distribution
(odds ratio, 0.57 [95% CI 0.41-0.79]; P<0.001). Compared with patients
treated with DAPT alone, those combining IVT and DAPT had higher 24-hour
early neurological improvement (risk difference, 20.9% [95% CI
13.1%-28.6%]; risk ratio, 1.59 [95% CI 1.34-1.89]; both P<0.001) and lower
90-day risk of stroke and other vascular events (hazard ratio, 0.27 [95%
CI 0.08-0.90]; P=0.034). There were no differences in safety outcomes.
<br/>Conclusion(s): According to findings from this observational study,
patients with MIS may benefit in terms of better functional outcome and
lower risk of recurrent events from combining IVT and DAPT versus DAPT
alone without safety concerns.<br/>Copyright &#xa9; 2024 The Author(s).

<39>
Accession Number
2032045953
Title
Systematic review and meta-analysis of randomized and nonrandomized
studies on fractional flow reserve-guided revascularization.
Source
Revista Espanola de Cardiologia. 77(11) (pp 885-895), 2024. Date of
Publication: November 2024.
Author
Mangiacapra F.; Paolucci L.; Johnson N.P.; Viscusi M.M.; Ussia G.P.;
Grigioni F.; De Bruyne B.; Barbato E.
Institution
(Mangiacapra, Paolucci, Viscusi, Ussia, Grigioni) Research Unit of
Cardiovascular Science, Department of Medicine and Surgery, Universita
Campus Bio-Medico di Roma, Roma, Italy
(Mangiacapra, Paolucci, Viscusi, Ussia, Grigioni) Fondazione Policlinico
Universitario Campus Bio-Medico, Roma, Italy
(Johnson) Division of Cardiology, Department of Medicine, Weatherhead PET
Center, McGovern Medical School at UTHealth and Memorial Hermann Hospital,
Houston, TX, United States
(Viscusi, De Bruyne, Barbato) Cardiovascular Center, OLV Clinic, Aalst
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Roma, Italy
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Several studies have investigated the
effectiveness of fractional flow reserve (FFR) guidance in improving
clinical outcomes after myocardial revascularization, yielding conflicting
results. The aim of this study was to compare clinical outcomes in
patients with coronary artery disease following FFR-guided or
angiography-guided revascularization. <br/>Method(s): Both randomized
controlled trials (RCTs) and nonrandomized intervention studies were
included. Coprimary endpoints were all-cause death, myocardial infarction,
and major adverse cardiovascular events (MACE). The study is registered
with PROSPERO (CRD42022344765). <br/>Result(s): A total of 30 studies
enrolling 393 588 patients were included. FFR-guided revascularization was
associated with significantly lower rates of all-cause death (OR, 0.63;
95%CI, 0.53-0.73), myocardial infarction (OR, 0.70; 95%CI, 0.59-0.84), and
MACE (OR, 0.77; 95%CI, 0.70-0.85). When only RCTs were considered, no
significant difference between the 2 strategies was observed for any
endpoints. However, the use of FFR was associated with reduced rates of
revascularizations and treated lesions. Metaregression suggested that the
higher the rate of revascularized patients the lower the benefit of FFR
guidance on MACE reduction compared with angiography guidance (P = .012).
Similarly, higher rates of patients with acute coronary syndromes were
associated with a lower benefit of FFR-guided revascularization (P =
.039). <br/>Conclusion(s): FFR-guided revascularization was associated
with lower rates of all-cause death, myocardial infarction and MACE
compared with angiographic guidance, with RCTs and nonrandomized
intervention studies yielding conflicting data. The benefits of
FFR-guidance seem to be less evident in studies with high
revascularization rates and with a high prevalence of patients with acute
coronary syndrome.<br/>Copyright &#xa9; 2024 Sociedad Espanola de
Cardiologia

<40>
Accession Number
645396034
Title
Prophylactic non-invasive positive pressure ventilation reduces
complications and length of hospital stay after invasive thoracic
procedures: a systematic review.
Source
Journal of physiotherapy. 70(4) (pp 265-274), 2024. Date of Publication:
01 Oct 2024.
Author
da Conceicao Dos Santos E.; Monteiro R.L.; Fonseca Franco de Macedo J.R.;
Poncin W.; Lunardi A.C.
Institution
(da Conceicao Dos Santos) Master and Doctoral Programs in Physical
Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil; Department
of Biological and Health Sciences. Universidade Federal do Amapa, Macapa,
Brazil
(Monteiro) Department of Biological and Health Sciences. Universidade
Federal do Amapa, Macapa, Brazil
(Fonseca Franco de Macedo) Service de Pneumologie, Cliniques
Universitaires Saint-Luc, Brussels, Belgium
(Poncin) Service de Pneumologie, Cliniques Universitaires Saint-Luc,
Brussels, Belgium; Institut de Recherche Experimentale et Clinique (IREC),
Pole de Pneumologie, ORL et Dermatologie, Universite Catholique de
Louvain, Brussels, Belgium
(Lunardi) Master and Doctoral Programs in Physical Therapy, Universidade
Cidade de Sao Paulo, Sao Paulo, Brazil; Physical Therapy Department,
Universidade de Sao Paulo, Sao Paulo, Brazil
Abstract
QUESTION: In patients undergoing invasive thoracic procedures, what are
the effects of prophylactic non-invasive positive pressure ventilation
(NIV)? DESIGN: Systematic review with meta-analysis of randomised trials.
Methodological quality was assessed using the PEDro scale and the
certainty of evidence with the GRADE approach. PARTICIPANTS: Patients
undergoing invasive thoracic procedures. INTERVENTION: Continuous positive
airway pressure (CPAP) or bi-level positive airway pressure (BiPAP).
OUTCOME MEASURES: Length of hospital stay, postoperative pulmonary
complications, need for tracheal intubation, mortality, hypoxaemia,
pulmonary function and adverse events. Meta-analysis was performed for all
outcomes. Subgroup analyses estimated the effects of CPAP and BIPAP
independently. <br/>RESULT(S): Sixteen trials with 1,814 participants were
included. The average quality of the included studies was fair. Moderate
certainty evidence indicated that NIV reduces postoperative pulmonary
complications (RD -0.09, 95% CI -0.15 to -0.04) without increasing the
rate of adverse events (RD 0.01, 95% CI -0.02 to 0.04). Low certainty
evidence indicated that NIV reduces length of hospital stay (MD -1.4 days,
95% CI -2.2 to -0.5) compared with usual care. The effects on intubation
and mortality rates were very close to no effect, indicating that NIV is
safe. Subgroup analyses showed that the evidence for CPAP had more precise
estimates that that for BiPAP. <br/>CONCLUSION(S): NIV reduces
postoperative pulmonary complications and length of stay after invasive
chest procedures without increasing the risk of adverse events.
REGISTRATION: PROSPERO CRD42015019004.<br/>Copyright &#xa9; 2024
Australian Physiotherapy Association. Published by Elsevier B.V. All
rights reserved.

<41>
Accession Number
645393358
Title
Corrigendum to 'Trunk stabilising exercises promote sternal stability in
patients after median sternotomy for heart valve surgery: a randomised
trial' [J Physiother 2022;68:197-202.
Source
Journal of physiotherapy. 70(4) (pp 255), 2024. Date of Publication: 01
Oct 2024.
Author
Essam El-Sayed Felaya E.-S.; Abd Al-Salam E.H.; Abd El-Azeim A.S.
Institution
(Essam El-Sayed Felaya) Department of Physical Therapy for Internal
Medicine, Faculty of Physical Therapy, Cairo University, Giza, Egypt
(Abd Al-Salam) Department of Diagnostic Imaging, National Heart Institute,
Giza, Egypt
(Abd El-Azeim) Department of Basic Science, Faculty of Physical Therapy,
Cairo University, Giza, Egypt

<42>
Accession Number
2035135358
Title
TCT-130 Conduction Disturbances and Permanent Pacemaker Implantation After
Myval Transcatheter Heart Valve or Contemporary Standard Valves (Sapien
and Evolut) Implantation: Insights From the LANDMARK Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B338-B339), 2024. Date of Publication: 29 Oct 2024.
Author
Smits P.; Rampat R.; van Royen N.; Amat-Santos I.; Hudec M.; Bunc M.; Unic
D.; Hermanides R.; Ninios V.; Protasiewicz M.; Martin P.; Feres F.; de
Sousa Almeida M.; van Belle E.; Linke A.; Montorfano M.; Webster M.;
Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Kim W.-K.; Rothe
J.; Kristic I.; Chandra U.; Soliman O.; Baumbach A.; Tobe A.; Onuma Y.;
Serruys P.
Institution
(Smits) Maasstad Ziekenhuis, Rotterdam, the Netherlands, Netherlands
(Rampat) East Kent Hospitals University NHS Foundation Trust, Ashford,
United Kingdom
(van Royen) Radboud University Medical Center, Nijmegen, the Netherlands,
Netherlands
(Amat-Santos) Associate Professor, University of Valladolid, Spain,
Valladolid, Spain, Spain
(Hudec) SUSCCH, Banska Bystrica, Slovakia, Slovakia
(Bunc) University Medical Center Ljubljana, Ljubljana, Slovenia, Slovenia
(Unic) Dubrava University Hospital, Zagreb, Croatia, Croatia
(Hermanides) Isala, Zwolle, the Netherlands, Netherlands
(Ninios) Interbalkan European Medical Center, Thessaloniki, Greece, Greece
(Protasiewicz) Wroclaw Medical University, Wroclaw, Poland, Poland
(Martin) Hospital Universitario Gran Canaria Dr Negrin, Las Palmas de Gran
Canaria, Spain, Spain
(Feres) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Sao Paulo,
Brazil, Brazil
(de Sousa Almeida) Nova Medical School, Lisbon, Portugal, Portugal
(van Belle) Lille University, Lille, France, France
(Linke) University of Technology Dresden, Dresden, Germany, Germany
(Montorfano) San Raffaele Scientific Institute, Milan, Italy
(Webster) Auckland City Hospital, Auckland, New Zealand, New Zealand
(Toutouzas) Hippokration Hospital, Athens, Greece, Greece
(Teiger) CHU Henri Mondor, Creteil, France, France
(Bedogni) Policlinico San Donato, Milan, Italy
(Voskuil) UMC Utrecht, Zeist, the Netherlands, Netherlands
(Pan) Reina Sofia Hospital, Cordoba, Spain, Spain
(Kim) University of Giessen, Department of Cardiology, Koenigstein,
Germany, Germany
(Rothe) University Medical Center Freiburg, University Heart Center
Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Bad
Krozingen, Germany, Germany
(Kristic) University Hospital Split, Split, Croatia, Croatia
(Chandra) Meril Life Sciences, Nagpur, Maharashtra, India, India
(Soliman, Tobe, Serruys) University of Galway, Galway, Ireland, Ireland
(Baumbach) Department of Cardiology, Barts Heart Centre, Barts Health NHS
Trust, London, United Kingdom
(Onuma) National University of Ireland Galway, Galway, Ireland, Ireland
Publisher
Elsevier Inc.
Abstract
Background: LANDMARK was a multicenter randomized trial that demonstrated
noninferiority of the Myval balloon-expandable transcatheter heart valve
(THV) compared with the contemporary THVs (Sapien and Evolut series) at 30
days in patients with severe aortic stenosis. <br/>Method(s): From January
2021 to December 2023, 768 patients were randomized in a 1:1 ratio to
receive either the Myval or a contemporary THV. This substudy investigated
the conduction disturbances and rates of new permanent pacemaker
implantation (PPMI) after THV implantation in detail. An independent core
lab (CERC, Massy, France) analyzed electrocardiograms (ECGs).
<br/>Result(s): Electrocardiograms were analyzed in 757 patients at
baseline, 744 before-discharge, and 715 after 30 days. In both arms, mean
PR interval and QRS duration increased from baseline to predischarge (PR:
Myval DELTA+21 ms [P < 0.01], contemporary DELTA+15 ms [P < 0.01]; QRS:
Myval DELTA+15 ms [P < 0.01], contemporary DELTA+17 ms [P < 0.01]) and to
30 days (PR: Myval DELTA+7 ms [P < 0.01], contemporary DELTA+3 ms [P <
0.01], QRS: Myval DELTA+10 ms [P < 0.01], contemporary DELTA+9 ms [P =
0.07]). Before discharge, left bundle branch block (LBBB) was observed in
19% of the Myval and 24% of the contemporary group. At 30 days, the
frequency of LBBB decreased to 12% in both arms. The occurrence of new
PPMI at 30 days was 15% in the Myval and 17% in the contemporary arm. In
both arms, 90% of patients received PPMI before discharge, with no
differences in time between both arms. The leading cause of PPMI was
complete atrioventricular block (AVB) (Myval 79%, contemporary 69%),
followed by second-degree AVB (both arms 9%) and LBBB (Myval 7%,
contemporary 11%). Among clinical sites that included more than 20 cases
in the trial, the rate of PPI ranged from 0% to 33%, reflecting a wide
range in clinical practice. Analysis of predictors for PPMI is ongoing and
will be presented at TCT. <br/>Conclusion(s): In the randomized LANDMARK
trial, post-THV implantation significant increases of PR and QRS duration
were observed in both the Myval and the contemporary arms, which partially
resolved at 30 days. The rates of PPMI were similar between the 2 arms,
with complete AVB being the most frequent cause. A significant variation
in PPMI rates was observed among study sites. Categories: ENDOVASCULAR:
Diseases of the Aorta and Aortic Intervention.<br/>Copyright &#xa9; 2024

<43>
Accession Number
2035135271
Title
TCT-748 Early Economic Analysis of Integrated Robotic Assisted Augmented
Reality (AR) Visualization for Transcatheter Tricuspid Valve Repair (TTVR)
or Percutaneous Tricuspid Trans-Catheter 'Edge-to-Edge' Repair (T-TEER).
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B298), 2024. Date of Publication: 29 Oct 2024.
Author
Agarwal V.; Singh G.; O'Neill F.
Institution
(Agarwal) New York Presbyterian Columbia University, New York, New York,
United States
(Singh) University of California Davis Health System, Sacramento, CA,
United States
(O'Neill) Compass Medical, Belfast, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Tricuspid regurgitation represents a significant burden to the
health care system in the USAs and is associated with increased healthcare
utilization (hospitalizations, hospital days, and overall expenditure).
Transcatheter tricuspid valve repair (TTVR) and percutaneous tricuspid
transcatheter "edge-to-edge" repair (T-TEER) techniques have emerged as a
minimally invasive alternative to surgery for high-risk patients. However,
recent meta-analyses report a significant unmet need with regard to
mortality, morbidity, and health care resource use. Innovative advances in
technologies assisting physicians with anchoring, delivery, and durability
with the procedure are required to establish TTVR and T-TEER in a broad
patient population. This study aims to evaluate the economic impact of an
integrated robotic-assisted augmented reality (AR) visualization for TTVR
and T-TEER in the USAs. <br/>Method(s): An early cost-consequence model
was developed over a 30-day horizon from a U.S. perspective. Clinical
inputs were derived from published literature and expert opinion, and
costs were obtained from national databases. The model included procedural
cost, hospitalization, follow-up care, and adverse events. Hypothetical
cost-savings were informed with expert opinion to reduce adverse events
and resource use by 20%-30%. <br/>Result(s): At 30 days, robotic assisted
AR-TTVR and AR-T-TEER was projected to save $16,962 per patient. Savings
were primarily driven by a reduced length of stay and in costs associated
with reintervention following an unsuccessful TTVR or T-TEER. For a
provider performing 50 TTVR or T-TEER procedures the device could save
$1.68 million annually. <br/>Conclusion(s): Early modelling of robotic
assisted AR-TTVR is predicted to be highly cost-saving. Innovative
advances in technologies assisting physicians with anchoring, delivery,
and durability with the procedure is required to establish TTVR and T-TEER
in a broad patient population. The model emphasizes the significant unmet
need for the TTVR and T-TEER procedures and underlines the importance of
innovation to reduce provider burden in the USAs. The model can be used to
optimize clinical development and to inform longer-term economic analyses.
Categories: OTHER: Quality, Guidelines, Appropriateness Criteria,
Cost-Effectiveness, and Public Health Issues.<br/>Copyright &#xa9; 2024

<44>
Accession Number
2035135261
Title
TCT-622 Nationwide Outcomes of Transcatheter and Surgical Mitral Valve
Replacement.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B233), 2024. Date of Publication: 29 Oct 2024.
Author
Gupta R.; Umeh C.; Vaidya A.; Bhatia H.; Hotwani P.; Dhawan R.;
Eghreriniovo B.; Mohta T.; Mahdavian P.; Obi J.; Mohan J.; Zainea M.
Institution
(Gupta) University of California San Diego, Los Angeles, California, USA,
United States
(Umeh) Hemet Global Medical Center, California, Winchester, California,
USA, United States
(Vaidya) University of Southern California, Los Angeles, California, USA,
United States
(Bhatia) University of California San Diego, San Diego, California, USA,
United States
(Hotwani) Parkview Health, Fort Wayne, Indiana, USA, United States
(Dhawan, Eghreriniovo, Mohta, Mahdavian, Obi) Hemet Global Medical Center,
Hemet, California, USA, United States
(Mohan) McLaren Cardiovascular Institute, Mount Clemens, Michigan, USA,
United States
(Zainea) Mclaren Macomb, Shelby Township, Michigan, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: More than 41 million individuals suffer from either aortic or
mitral valve disease worldwide; therefore, it is imperative to review
treatment options. Transcatheter mitral valve replacement (TMVR) has shown
promising results as a viable alternative to surgical mitral valve
replacement (SMVR) for patients with a high surgical risk and those with
multiple co-morbidities. This study aimed to provide insights into the
comparative effectiveness and safety profiles of TMVR and SMVR in
real-world clinical settings. <br/>Method(s): We conducted a retrospective
analysis using data from the 2020 USA National Inpatient Sample (NIS),
focusing on patients who underwent TMVR and SMVR. This study's primary
endpoint of interest was the occurrence of procedural complications
following TMVR and SMVR, and the secondary endpoint was the length of
stay. <br/>Result(s): A total of 2,925 patients received a mitral valve
replacement, of which 259 (8.9%) got TMVR and 2,666 (91.1%) got SMVR.
Subset analysis showed that 50.8% were female. The mortality rate was 7.7%
during the hospital admission. The mean age was higher in those receiving
TMVR than SMVR (71.7 years vs 65.9 years; P < 0.001). The mean length of
stay was significantly lower in TMVR than in SMVR (7.3 days vs 15.3 days;
P < 0.001). In the multivariable analysis, TMVR, when compared with SMVR,
was used in older patients (OR: 1.05; 95% CI: 1.03-1.06; P < 0.001) and
was associated with lower all-cause mortality (OR: 0.31; 95% CI:
0.15-0.63; P = 0.001), lower length of hospital stay (OR: 0.86; 95% CI:
0.83-0.88; P < 0.001), lower acute myocardial infarction (OR: 0.22; 95%
CI: 0.07-0.71; P = 0.01), lower likelihood of the patients requiring
vasopressors (OR: 0.56; 95% CI: 0.33-0.95; P = 0.03) or placement of
cardiovascular implantable electronic devices (OR: 0.23; 95% CI:
0.08-0.67; P = 0.007). <br/>Conclusion(s): TMVR is associated with a
decreased length of stay and lower procedural complications than SMVR in
the national inpatient data set. This retrospective analysis demonstrates
the need for further randomized control trials on SMVR vs TMVR as the
incidence of mitral valve disease increases worldwide owing to the aging
population. Categories: STRUCTURAL: Valvular Disease:
Mitral.<br/>Copyright &#xa9; 2024

<45>
Accession Number
2035135191
Title
TCT-525 Mechanical Outcomes of Coronary Stenting Guided by Intravascular
Ultrasound Versus Optical Coherence Tomography: An Updated Meta-Analysis
of Randomized Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B179), 2024. Date of Publication: 29 Oct 2024.
Author
Pavan Lingamsetty S.S.; Kritya M.; Doma M.; Ubaid M.; Thyagaturu H.; Singh
S.; Martignoni F.; Megaly M.; Goldsweig A.
Institution
(Pavan Lingamsetty) Mamata Medical College, KHAMMAM, Andhra Pradesh,
India, India
(Kritya) IMH, Pune, India, India
(Doma) Alexandria Faculty of Medicine, Alexandria, Egypt, Egypt
(Ubaid) Montefiore Health System, New York, New York, United States,
United States
(Thyagaturu) West Virginia University, Morgantown, West Virginia, United
States
(Singh) Sinai Hospital of Baltimore, Baltimore, Maryland, United States
(Martignoni) TTUHSC, Lubbock, Texas, United States, United States
(Megaly) Ascension St John Medical Center-Tulsa, Tulsa, Oklahoma, United
States
(Goldsweig) University of Massachusetts-Baystate, Springfield,
Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Background: Intravascular imaging modalities, such as optical coherence
tomography (OCT) and intravascular ultrasound (IVUS), are employed to
guide percutaneous coronary intervention (PCI). This study aims to compare
the efficacy of IVUS-guided and OCT-guided PCI in terms of mechanical
outcomes. <br/>Method(s): PubMed, Embase, and Cochrane databases were
systematically searched until June 2024 for randomized controlled trials
(RCTs) comparing IVUS-guided PCI and OCT-guided PCI. The outcomes of
interest were minimum stent area (MSA), stent expansion index (defined as
MSA by reference lumen area), and diameter stenosis. A random-effects
model was used to assess mean differences (MDs) and standard mean
differences (SMDs) with 95% CIs. Statistical analyses were performed using
R version 4.3.2. <br/>Result(s): Six randomized controlled trials (RCTs)
were included that assessed 3,244 lesions, of which IVUS-guided PCI was
performed in 1,625 (50.1%) lesions. In the pooled analysis, the post-PCI
MSA was significantly higher in the IVUS-guided PCI group compared with
the OCT-guided PCI group (MD 0.65 mm²; 95% CI: 0.22-1.07
mm²; P < 0.01; Figure 1A) and post-PCI mean diameter stenosis
was significantly lower in IVUS-guided PCI group (MD: -1.08%; 95% CI:
-2.02% to -0.14%; P = 0.02; Figure 1B). The stent expansion index was
comparable among both groups (SMD: 0.22; 95% CI: -0.21 to 0.65; P = 0.31;
Figure 1C). [Formula presented] <br/>Conclusion(s): This meta-analysis
demonstrated that IVUS-guided PCI was associated with superior MSA and
reduced diameter stenosis compared with OCT-guided PCI, without any
difference in stent expansion index. Categories: IMAGING AND PHYSIOLOGY:
Imaging: Intravascular.<br/>Copyright &#xa9; 2024

<46>
Accession Number
2035135085
Title
TCT-144 Comparative Safety and Effectiveness of Transcatheter Aortic Valve
Replacement and Surgical Aortic Valve Replacement in Patients With a Small
Aortic Annulus: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B365-B366), 2024. Date of Publication: 29 Oct 2024.
Author
Madanat L.; Ayyad M.; Al-Abdouh A.; Mhanna M.; Alhuneafat L.; Obeidat L.;
Alqarqaz M.; Hanson I.; Abbas A.; Frisoli T.; Villablanca P.
Institution
(Madanat) William Beaumont University Hospital, Royal Oak, Michigan, USA,
United States
(Ayyad) Rutgers New Jersey Medical School, Newark, NJ, United States
(Al-Abdouh) University of Kentucky, Lexington, KY, United States
(Mhanna) The University of Iowa, Iowa City, IA, United States
(Alhuneafat) University of Minnesota, Minneapolis, MN, United States
(Obeidat, Frisoli, Villablanca) Henry Ford Hospital, Detroit, MI, United
States
(Alqarqaz) Henry Ford Hospital, West Bloomfield, MI, United States
(Hanson) Corewell Health William Beaumont University Hospital, Troy,
Michigan, USA, United States
(Abbas) Corewell Health William Beaumont University Hospital, Birmingham,
MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with a small aortic annulus (SAA) undergoing aortic
valve replacement are at increased risk of patient-prosthesis mismatch
(PPM), which adversely affects outcomes. Transcatheter aortic valve
replacement (TAVR) has shown promise in mitigating PPM compared with
surgical aortic valve replacement (SAVR). <br/>Method(s): We conducted a
systematic review and meta-analysis following PRISMA guidelines to compare
clinical outcomes, mortality, and PPM between SAA patients undergoing TAVR
and SAVR. <br/>Result(s): Nine studies were included with a total of 2,476
patients (1,259 patients in the TAVR group and 1,217 in the SAVR group).
TAVR demonstrated similar 30-day (OR: 0.65; 95% CI: 0.09-4.61; P = 0.22)
and 2-year mortality (OR: 0.82; 95% CI: 0.53-1.27: P = 0.24), myocardial
infarction (OR: 0.73; 95% CI: 0.1-5.18; P = 0.56), and stroke rates (OR:
1.1; 95% CI: 0.23-5.2; P = 0.86) compared with SAVR. However, TAVR showed
significant advantages in reducing severe PPM (OR: 0.53; 95% CI:
0.39-0.72; P < 0.0001) and major bleeding at both 30 days (OR: 0.44; 95%
CI: 0.31-0.64; P < 0.01) and 2 years (OR: 0.4; 95% CI: 0.21-0.77; P =
0.03) post procedure. Conversely, TAVR had worse outcomes in 30-day
permanent pacemaker implantation rates (OR: 2.76; 95% CI: 1.13-6.75; P
=0.04) (Figure 1). <br/>Conclusion(s): Our findings suggest that both TAVR
and SAVR are viable options for treating severe AS in patients with small
aortic annuli. TAVR offers advantages in reducing PPM and major bleeding,
whereas SAVR performs better in terms of pacemaker implantation rates.
Consideration of patient characteristics is crucial in selecting the
optimal treatment approach for severe AS. Categories: STRUCTURAL: Valvular
Disease: Aortic.<br/>Copyright &#xa9; 2024

<47>
Accession Number
2035135020
Title
TCT-33 Safety of Type A Aortic Dissection in Patients With Prior Cardiac
Surgery Versus Non-Prior Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B129), 2024. Date of Publication: 29 Oct 2024.
Author
Ullah I.; Ahmed M.; Ur Rahman H.A.; Irfan M.; Goyal A.; Khan A.W.; Cortese
B.
Institution
(Ullah) Khyber Teaching Hospital, Peshawar, Pakistan, Pakistan
(Ahmed) Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Karachi,
Pakistan, Pakistan
(Ur Rahman) Dow University of Health Sciences, Karachi, Pakistan, Pakistan
(Irfan) Wellstar Health System Spalding Hospital, Griffin, Georgia, USA,
United States
(Goyal) Seth Gordhandas Sunderdas Medical College and King Edward Memorial
Hospital, Mumbai, Maharashtra, India, India
(Khan) University of Missouri-Kansas City School of Medicine, Kansas City,
Missouri, USA, United States
(Cortese) University Hospitals, Cleveland, Ohio, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with prior cardiac surgery undergoing type A aortic
dissection are thought to have worse clinical outcomes compared to
patients without prior cardiac surgery. The aim of the study is to compare
the safety and efficacy of type A aortic dissection in patients with prior
cardiac surgery. <br/>Method(s): We systematically searched PubMed,
Scopus, and Google Scholar from database inception until November 2023. We
included 12 studies with a population of 8,132 in the nonprior group and
1,411 in the prior surgery group. Our primary outcome was mortality, and
the secondary outcomes were reoperation for bleeding and renal failure.
<br/>Result(s): Our pooled estimate shows a significantly lower rate of
mortality in nonprior cardiac surgery (risk ratio [RR]: 0.65; 95% CI:
0.57-0.74; P < 0.00001) (Figure). The pooled result for the outcome of
reoperation for bleeding was insignificant (RR: 0.78; 95% CI: 0.60-1.03; P
= 0.08). Similarly, renal failure was also insignificant (RR: 0.91; 95%
CI: 0.82-1.02; P = 0.12). Meta-regression showed there was no impact of
male sex and other baseline comorbidities, including diabetes mellitus,
hypertension, chronic kidney disease, chronic obstructive lung disease,
coronary artery disease, and connective tissue disorder. [Formula
presented] <br/>Conclusion(s): Patients with prior cardiac surgery have a
higher mortality rate compared to patients who have not undergone cardiac
surgery previously. Categories: ENDOVASCULAR: Diseases of the Aorta and
Aortic Intervention.<br/>Copyright &#xa9; 2024

<48>
Accession Number
2035135016
Title
TCT-890 Transcatheter Aortic Valve Replacement in Low-Risk Patients at
Four or More Years: A Meta-Analysis of Randomized Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B372), 2024. Date of Publication: 29 Oct 2024.
Author
Aalaei Andabili S.H.; Joseph E.; Resar J.; Rahman F.; Connolly J.
Institution
(Aalaei Andabili, Joseph, Connolly) Johns Hopkins Hospital, Baltimore, MD,
United States
(Resar) Johns Hopkins University School of Medicine, Baltimore, MD, United
States
(Rahman) John Hopkins University, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has comparable
outcomes to surgical aortic valve replacement (SAVR) in low-risk patients
at short-term follow-up. However, there is a paucity of data about outcome
of TAVR vs SAVR in low surgical risk patients at longer follow-ups
post-procedure. <br/>Method(s): A systematic review of all published
randomized controlled trials (RCTs) comparing TAVR and SAVR in patients at
low surgical risk was completed. A random-effects model meta-analysis was
performed to study major outcomes including all-cause mortality, stroke,
myocardial infarction, and aortic valve reintervention. <br/>Result(s):
From 1,333 manuscripts, 37 articles entered to full manuscript review
process and only 3 articles enrolled to the final analysis. A total of
2,644 patients (1,371 TAVR and 1,273 SAVR) patients with mean age of 74.3
+/- 5.8 were enrolled (Figure 1A). There was no significant difference in
all-cause and cardiovascular mortality, stroke, myocardial infarction, and
aortic valve reintervention between TAVR and SAVR groups at long-term
follow-up (Figure 1B). TAVR was associated with a higher rate of pacemaker
implantation, whereas patients in the SAVR group had more atrial
fibrillation. [Formula presented] <br/>Conclusion(s): At 4 or more years
of follow-up, TAVR is safe and has comparable outcomes to SAVR in patients
with low surgical risk. To our knowledge, this meta-analysis is the
longest follow-up of low-risk patients in RCTs. Further studies are
required to assess even longer-term durability of TAVR in low-risk
patients who likely have a longer survival. Categories: STRUCTURAL:
Valvular Disease: Aortic.<br/>Copyright &#xa9; 2024

<49>
Accession Number
2035134346
Title
TCT-972 Short-Term Outcomes of Transcatheter Tricuspid Valve Interventions
on Post-Procedural Length of Hospital Stay, Readmission for Heart Failure,
and Procedure Success If an Intracardiac Device Is Present: A Systematic
Review and Meta-Analysis in a New Era of Tricuspid Interventions.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B414), 2024. Date of Publication: 29 Oct 2024.
Author
Kumanayaka D.; Perez L.H.; Aiman W.; Ruman Y.A.; Chandra A.; Patel P.;
Patel A.; Suleiman A.
Institution
(Kumanayaka, Perez, Aiman, Ruman, Patel, Patel) New York Medical College
at Saint Michael's Medical Center, Newark, New Jersey, USA, United States
(Chandra) St Michael's Medical Center, Newark, New Jersey, USA, United
States
(Suleiman) Saint Michael's Medical Center, Newark, New Jersey, USA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter tricuspid valve repair/replacement (TVRR) has
become widely accepted as gauged by clinical outcomes. The Food and Drug
Administratoin approved 2 tricuspid devices to improve quality of life. We
aim to support evidence-based use of TVRR by summarizing the latest
evidence on the clinical effectiveness in terms of postprocedural length
of hospital stay, readmissions for heart failure, and procedure success if
an Intracardiac device is present. <br/>Method(s): We searched PubMed,
Embase, and Cochrane databases and performed a meta-analysis of the
included cohort studies using a fixed-effects model. Studies were excluded
if they did not present an outcome in each intervention group or did not
have enough information required for continuous data comparison. We
performed a meta-analysis of hazard ratio (HR) for 2 outcomes and odds
ratio (OR) for 1 outcome using the random-effects model to remove
inconsistency and compared the results with fixed-effects model. The
compared findings of both methods were similar. The variables used for
analysis were number of events in exposure group and total amount of
events. <br/>Result(s): Of 161 potentially relevant studies, 8
retrospective studies with a total of 1,717 patients were included in the
meta-analysis. Procedure (TVRR) success was associated with fewer
readmissions for heart failure in all 3 studies included in the analysis
of pooled HR (HR: 0.46, 95% CI: 0.33-0.63; P < 0.001). Procedure success
was also associated with shorter length of hospitalization post-procedure
in all 3 studies included in the analysis of pooled HR (HR: 0.48; 95% CI:
0.33-0.72; P < 0.001). There was no significant association between
procedure success and having an intracardiac device in all 3 studies
included in the analysis of pooled OR (OR: 0.79; 95% CI: 0.56-1.12; P =
0.18). <br/>Conclusion(s): Our meta-analysis showed that successful TVRR
for high-risk patients with severe TR is associated with significant
positive outcomes on postprocedural length of hospital stay and
readmissions for heart failure, regardless of presence of an intracardiac
device. With emerging improvements in device technology and procedural
performance, TVRR should be considered in severe and functional TR, to
improve clinical prognosis. Categories: STRUCTURAL: Valvular Disease:
Tricuspid.<br/>Copyright &#xa9; 2024

<50>
Accession Number
2035134303
Title
TCT-281 Interventional Strategies in Patients With Refractory Cardiogenic
Shock Secondary to Non-Acute Coronary Syndrome Compared to Refractory
Cardiogenic Shock Secondary to Acute Coronary Syndrome: A Systematic
Review and Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B58), 2024. Date of Publication: 29 Oct 2024.
Author
Javed N.; Khaja M.
Institution
(Javed, Khaja) BronxCare Health System, Bronx, New York, USA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Although acute coronary syndrome (ACS) is the primary cause of
cardiogenic shock (CS), a considerable number of CS cases in regular
clinical practice are attributed to other causes (non-ACS-related CS).
This is of clinical significance because some risk assessment tools have
shown to be less effective in patients with non-ACS-related CS.
Furthermore, more data should be available regarding managing refractory
cases in such a cohort. The systematic review aimed to determine the
outcomes of patients with non-ACS-related CS and compare these outcomes
with those of patients presenting with ACS CS. <br/>Method(s): This
systematic review (PROSPERO ID# CRD42024519863) from 1990 to 2024 aimed to
identify cases of refractory cardiogenic shock through clinical features
and subsequent confirmation of diagnosis with lab investigations. Patients
were divided into groups using non-ACS-related CS and ACS CS for
cardiovascular outcome assessment. <br/>Result(s): A total of 64 cases
were analyzed. The average age was 52.58 +/-16.70 years, with a majority
of male patients (67.2%). There were 41 cases with non-ACS-related CS,
with most hemodynamically unstable on presentation (82.8%). Extracorporeal
membrane oxygenation was less likely to be used with non-ACS-related CS
(OR: 0.02; 95% CI: 0.00-0.38; P = 0.009). Intra-aortic balloon pump was
more likely to be used for non-ACS-related CS (OR: 3.42; 95% CI:
1.56-5.06; P = 0.03) (Table). Survival analysis revealed percutaneous
coronary intervention and coronary artery bypass grafting to be
significant predictors of in-hospital survival in refractory ACS-CS and
Impella (Abiomed) implantation as predictors of in-hospital survival in
refractory non-ACS-related CS (P = 0.04). [Formula presented]
<br/>Conclusion(s): Refractory non-ACS-related CS usually presents in
advanced stages with greater instability. Although multiple measures have
been investigated, Impella could be favorable in improving mortality rates
for refractory non-ACS-related CS, whereas percutaneous intervention is
warranted for refractory ACS-CS. Further studies are needed to confirm our
findings. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and
Cardiac Arrest.<br/>Copyright &#xa9; 2024

<51>
Accession Number
2035134295
Title
TCT-931 Outcomes of Self-Expanding vs Balloon-Expandable Transcatheter
Aortic Valves in Patients With Small Aortic Annuli: A Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B393), 2024. Date of Publication: 29 Oct 2024.
Author
Elseidy S.; Vorla M.; Hamed M.; Rehan M.; Isaac J.; Mohamad T.; Castiello
T.; Mamas M.
Institution
(Elseidy) Ain Shams University Hospitals, Cairo, Egypt
(Vorla) Carle Foundation Hospital, Urbana, IL, United States
(Hamed) Florida Atlantic University, Boynton Beach, FL, United States
(Rehan) Karachi Medical and Dental College, Karachi, Pakistan
(Isaac) Menoufia University, Menoufia, Egypt
(Mohamad) Detroit Medical Center/Wayne State University, Dearborn, MI,
United States
(Castiello) Kings College London, London, United Kingdom
(Mamas) Royal Stoke Hospital, Stoke-on-Trent, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Despite the benefits of TAVR, there is a lack of head-to-head
comparison between different types of transcatheter aortic valves in
patients with small aortic annulus essential to guide clinical decisions
and improve patient outcomes in this high-risk group. <br/>Method(s): An
electronic search of Medline, Embase, and Cochrane databases was performed
until June 2024 for studies comparing self- vs balloon-expanding
transcatheter aortic valves in patients with severe aortic stenosis and
small aortic annulus. <br/>Result(s): The final analysis included 11
studies (2 RCTs and 9 observational studies) with 4,039 patients: 1,611 in
the SEV group and 2,428 in the BEV group. The mean age of the patients was
82 years, with women making up 80% of the study population. In patients
with a small aortic annulus, those in the SEV group had significantly
lower odds of patient-prosthesis mismatch (OR: 0.30; 95% CI: = 0.24-0.39;
P < 0.00001), better mean transvalvular gradients at both 30 days (MD:
-4.15; 95% CI: -4.93 to -3.98; P = 0.00001) and 1 year (MD: -7.20; 95% CI:
-8.42 to -5.97; P = 0.00001), a lower incidence of moderate to severe PVL
at 1 year (OR: 0.70; 95% CI: 0.49-1; P = 0.05), and a better iEOA at 30
days and 1 year compared with the BEV group. On the other hand, the BEV
group had lower odds of pacemaker implantation, major bleeding, and mild
PVL at 30 days. Subgroup analysis for RCTs validated these results.
[Formula presented] <br/>Conclusion(s): In patients with severe aortic
stenosis and small aortic annulus, Self-expanding valves are associated
with lower PPM, better mean transvalvular gradients, less long-term PVL,
and better iEOA at 30 days and 1 year. Categories: STRUCTURAL: Valvular
Disease: Aortic.<br/>Copyright &#xa9; 2024

<52>
Accession Number
2035134223
Title
TCT-139 Transcatheter Aortic Valve Replacement (TAVR) Versus Surgical
Aortic Valve Replacement (SAVR) in Low Surgical Risk Patients: A
Meta-Regression Analysis of Long-Term Studies.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B363), 2024. Date of Publication: 29 Oct 2024.
Author
Ahmad S.
Institution
(Ahmad) University of North Carolina at Chapel Hill, Durham, North
Carolina, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has become the
dominant modality for aortic stenosis (AS) patients at intermediate or
high surgical risk. However, for low surgical risk patients, there is a
paucity of data on long-term survival outcomes for TAVR vs surgical aortic
valve replacement (SAVR). <br/>Method(s): Databases were queried to
identify randomized controlled trials (RCTs) comparing TAVR to SAVR in
low-surgical-risk AS patients. RevMan 5.4.1 was used. P < 0.05 was
considered significant. Meta-regression analysis was done. <br/>Result(s):
Five RCTs (5,025 patients) met the inclusion criteria. All-cause
mortality, cardiovascular deaths, disabling stroke, and myocardial
infarction were comparable between TAVR and SAVR. Meta-regression analysis
between age and all-cause mortality was insignificant (P = 0.5),
indicating no effect of age on mortality post-intervention. [Formula
presented] [Formula presented] <br/>Conclusion(s): Even though previous
studies reporting early outcomes (<= 2 years) denoted favorable outcomes
for TAVR, our analysis using long-term follow-up studies shows no
significant differences in outcomes between the two. Categories:
ENDOVASCULAR: Diseases of the Aorta and Aortic Intervention.<br/>Copyright
&#xa9; 2024

<53>
Accession Number
2035134189
Title
TCT-758 Safety and Efficacy of Transcatheter Aortic Valve Replacement
(TAVR) With Self-Expanding Valves (SEV) Versus Surgical Aortic Valve
Replacement (SAVR): A Meta-Analysis and Trial Sequential Analysis (TSA) of
Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B305), 2024. Date of Publication: 29 Oct 2024.
Author
Ahmad S.
Institution
(Ahmad) University of North Carolina at Chapel Hill, Durham, North
Carolina, United States
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve replacement is a life-saving intervention for
patients with severe aortic stenosis (AS). Transcatheter aortic valve
replacement (TAVR) and surgical aortic valve replacement (SAVR) are the
most frequently used modalities. TAVR with balloon-expandable valves has
been shown to be non-inferior to SAVR. This meta-analysis seeks to explore
long-term safety and efficacy outcomes of self-expanding valves (SEV) vs
SAVR. <br/>Method(s): Databases were queried to identify randomized
controlled trials (RCTs) comparing SEV with SAVR in AS patients. All-cause
mortality or stroke, cardiovascular death, myocardial infarction, aortic
valve (AV) or heart failure (HF)-related hospitalization, and permanent
pacemaker placement were analyzed. RevMan 5.4.1 was used. ORs and 95% CIs
were estimated with a random-effects model. P < 0.05 was deemed
significant. Trial sequential analysis (TSA) was performed.
<br/>Result(s): Eight RCTs (8,082 patients) met the inclusion criteria.
TAVR with SEV was superior to SVAR in terms of risk of all-cause mortality
or stroke (OR: 0.81; 95 CI: 0.67- 0.98). The rates of cardiovascular
deaths, myocardial infarction, and AV- or HF-related hospitalizations did
not differ significantly between the 2 groups. Risk for permanent
pacemaker placement was significantly higher in the SEV group (OR: 3; 95%
CI: 2.47- 3.65). Cumulative Z-curve crossed the boundary for benefit on
TSA, indicating robustness of evidence. [Formula presented]
<br/>Conclusion(s): TAVR with SEV was associated with better all-cause
mortality or stroke outcomes, compared with SAVR. The rates of
procedure-related complications were similar between the two except for
the need for pacemaker implantation, which was higher in the SEV cohort.
Categories: ENDOVASCULAR: Diseases of the Aorta and Aortic
Intervention.<br/>Copyright &#xa9; 2024

<54>
Accession Number
2035134185
Title
TCT-60 Intracardiac or Transesophageal Echocardiography for Left Atrial
Appendage Occlusion: An Updated Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B183), 2024. Date of Publication: 29 Oct 2024.
Author
Dimitriadis K.; Beneki E.; Aznaouridis K.; Pyrpyris N.; Tsioufis P.;
Fragkoulis C.; Antonopoulos A.; Aggeli K.
Institution
(Dimitriadis, Beneki, Tsioufis) Hippokration Hospital, Athens, Greece,
Greece
(Aznaouridis) 1st Department of Cardiology, Athens Medical School,
Hippokration Hospital, Athens, Greece, Greece
(Pyrpyris) University of Athens, Athens, Greece, Greece
(Fragkoulis) Hippokration General Hospital, Athens, Greece, Greece
(Antonopoulos) First Cardiology Department, School of Medicine,
Hippokration General Hospital, National and Kapodistrian University of
Athens, Vas. Sofias 114, 11528, Athens, Greece, Greece
(Aggeli) 1st Cardiology Department, University of Athens, Hippokrateion
Hospital, Athens, Greece, Greece
Publisher
Elsevier Inc.
Abstract
Background: Intracardiac echocardiography (ICE) appears to be a potential
alternative for percutaneous left atrial appendage occlusion (LAAO) to
transesophageal echocardiography (TEE). However, there is still
uncertainty regarding the comparative effectiveness of the 2 modalities.
Thus, we performed a meta-analysis comparing ICE vs TEE for LAAO guidance.
<br/>Method(s): A systematic search in 3 different databases (PubMed, Web
of Science, Scopus) was performed. After selecting all appropriate trials
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines, a random effect meta-analysis was
performed. <br/>Result(s): A total of 18 studies (124,230 patients) were
included. Technical success was higher in ICE compared with TEE guidance
(OR: 0.74; 95% CI: 0.65-0.88) and fewer devices employed (SMD: -0.22; 95%
CI: -0.43 to -0.01). ICE use was related with more pericardial
effusion/tamponade and iatrogenic residual shunts (RR: 1.85; 95% CI:
1.38-2.49; and RR: 1.53; 95% CI: 1.12-2.09, respectively). More vascular
complications (RR: 1.56; 95% CI: 1.06-2.32) and major bleeding events (RR:
1.35; 95% CI: 1.20-1.85) were also noted in the ICE group. No difference
was found in any bleeding events (RR: 1.09; 95% CI: 0.86-1.37), peridevice
leak (RR: 0.96; 95% CI: 0.87-1.05), and peridevice leak larger than 5 mm
(RR: 0.99; 95% CI: 0.63-1.55). <br/>Conclusion(s): This metanalysis shows
ICE-guided imaging is an effective alternative to TEE in LAAO, with
enhanced technical success, possibly due to better structure
visualization. However, the increased rates of several adverse outcomes,
some related with the secondary vascular access as well, warrant caution
and further research in order to estimate their long-term effect in this
patient population. Categories: STRUCTURAL: Left Atrial Appendage
Exclusion.<br/>Copyright &#xa9; 2024

<55>
Accession Number
2035134135
Title
TCT-92 Early Transcatheter or Surgical Aortic Valve Replacement Versus
Conservative Management in Asymptomatic Patients With Severe Aortic
Stenosis: A Systematic Review and Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B244), 2024. Date of Publication: 29 Oct 2024.
Author
Yasmin F.; Shaikh A.; Asghar M.S.; Moeed A.; Najeeb H.; Waqar E.; Ram M.;
Nankani A.; Ochani R.; Aamir M.; Johnson D.
Institution
(Yasmin) Yale School of Medicine, New Haven, Connecticut, United States
(Shaikh) DeBakey Heart and Vascular Center, Houston Methodist Hospital,
Houston, Texas, United States
(Asghar) AdventHealth Sebring, Sebring, Florida, United States, United
States
(Moeed, Najeeb, Waqar, Ram, Nankani) Dow University of Health Sciences,
Karachi, Pakistan, Pakistan
(Ochani) SUNY Upstate Medical University, Syracuse, New York, United
States
(Aamir) Lehigh Valley Health Network, Allentown, Pennsylvania, United
States, United States
(Johnson) Thomas Jefferson University Hospital, Philadelphia,
Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: The guidelines for managing asymptomatic severe aortic
stenosis patients are still debatable, and it is not certain if either
conservative or early intervention proves to increase survival. Hence, we
pooled all the available literature to compare the outcomes of the 2
methods used. <br/>Method(s): We searched all the databases (MEDLINE,
Scopus, PubMed) for any relevant studies from their inception to November
2021. All the studies were screened according to inclusion criteria, and
the 10 studies were included in the final analysis. Only the studies that
reported at least 1 cardiovascular outcome during their follow-up were
included. Results were reported in the form of risk ratios (RRs), and a CI
of 95% was taken for the significance. <br/>Result(s): Of 4,873 patients,
1,796 patients were in the early intervention (surgical aortic valve
replacement [SAVR] and transcatheter aortic valve replacement [TAVR])
group, and 3,077 patients were in the conservative group. The average
follow-up time was 4.67 years. Early intervention as compared with
conservative management was associated with reduced risk of all-cause
mortality (RR: 0.34; 95% CI: 0.26-0.43; P < 0.00001), cardiac specific
(RR: 0.35; 95% CI: 0.25-0.48; P < 0.00001) and noncardiac mortality (RR:
0.40; 95% CI: 0.31-0.50; P < 0.00001), and heart failure hospitalization
(RR: 0.29; 95% CI: 0.11-0.80; P = 0.02). No significance was found with
30-day mortality (RR: 1.96; 95% CI: 0.21-18.61; P = 0.56) and myocardial
infarction (RR: 0.57; 95% CI: 0.32-1.04; P = 0.07). <br/>Conclusion(s):
This meta-analysis shows statistically significant reductions in risk for
all-cause mortality, cardiac specific mortality, noncardiac mortality,
sudden cardiac death, and heart failure hospitalizations in patients with
asymptomatic aortic stenosis who underwent early intervention as opposed
to conservative management. Categories: STRUCTURAL: Valvular Disease:
Aortic.<br/>Copyright &#xa9; 2024

<56>
Accession Number
2035134134
Title
TCT-653 Transcatheter or Surgical Aortic Valve Replacement Versus Clinical
Surveillance in Asymptomatic Severe Aortic Stenosis: A Systematic Review
and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B250), 2024. Date of Publication: 29 Oct 2024.
Author
Genereux P.
Institution
(Genereux) Gagnon Cardiovascular Institute, Morristown, New Jersey, USA,
United States
Publisher
Elsevier Inc.
Abstract
Background: For patients with severe aortic stenosis (AS) and no symptoms,
current American College of Cardiology/American Heart Association
guidelines recommend aortic valve replacement (AVR) for patients with
decreased ejection fraction (<50%), symptoms on low-level stress-test, or
the need for concomitant open-heart surgery. New randomized trials are
expected to be presented regarding the management of severe AS in patients
with no symptoms, especially including for the first time transcatheter
aortic valve replacement. We therefore conducted an updated systematic
review and a meta-analysis to evaluate the impact on outcomes of AVR in
asymptomatic patients with severe AS versus conservative clinical
surveillance (CS). <br/>Method(s): Published papers through May 2024 from
PubMed, Embase, and ClinicalTrials.gov were evaluated. Outcomes included
all-cause mortality, cardiovascular mortality, heart failure
hospitalizations, and stroke. Random effects modeling was used to estimate
pooled estimates with their respective 95% CIs. All analyses were carried
out using R version 4.0.5. Heterogeneity was assessed using Higgins I2
statistics. Subgroup analyses were performed for the following groups:
randomized controlled trials versus observational studies, studies where
patients underwent AVR within 90 days of initial diagnosis/randomization,
and studies where patients' asymptomatic status was confirmed with a
negative exercise stress test. Results and <br/>Conclusion(s): Results
will be available for first-time presentation and simultaneous publication
at TCT 2024, including the results of the most recent randomized
trials.<br/>Copyright &#xa9; 2024

<57>
Accession Number
2035134124
Title
TCT-685 Role of Intracoronary Adenosine on Prevention of No Reflow During
Primary PCI in STEMI Patients Guided by MVO in CMR.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B266), 2024. Date of Publication: 29 Oct 2024.
Author
Sadek Y.; Hatata A.
Institution
(Sadek) Helwan University, Cairo, Egypt, Egypt
(Hatata) Ainshams University, Cairo, Egypt, Egypt
Publisher
Elsevier Inc.
Abstract
Background: Microvascular obstruction (MVO) or no-reflow phenomenon is an
established complication of coronary reperfusion therapy for acute
myocardial infarction. It is increasingly recognized as a poor prognostic
indicator and marker of subsequent adverse left ventricular (LV)
remodeling. MVO or no-reflow phenomenon is an established complication of
coronary reperfusion therapy for acute myocardial infarction. It is
increasingly recognized as a poor prognostic indicator and marker of
subsequent adverse LV remodeling. <br/>Method(s): The sample size was 50
patients. Patients had been randomized into 2 groups. Patients in group A
were given adenosine routinely after establishing Thrombolysis In
Myocardial Infarction flow grade either spontaneously or by passing the
wire or noninflated balloon. Adenosine had been given through a catheter
to the distal coronary bed. Although group B had not been given adenosine,
magnetic resonance imaging was done within 48 hours of primary
percutaneous coronary intervention and repeated for follow-up after 3
months. In the magnetic resonance imaging protocol, the following were
assessed: MVO and the degree of hemorrhage within MVO tissue edema,
ejection fraction, degree of mitral regurgitation, segmental wall motion
abnormalities, extent of infarction whether transmural or subendocardial,
and degree of fibrosis. <br/>Result(s): The most important findings in our
study were an increase in TIMI flow grade and MBG in the adenosine group,
improvement in MVO without an increase in MV HG, improvement in LV volumes
and remodeling, increase in the LV mass and salvaged myocardium as
follows: cardiac magnetic resonance parameters including MSI, ejection
fraction changes LV volumes, MVO, and MV HG. <br/>Conclusion(s): Adenosine
improves no reflow when given as a prophylactic drug. It improves the
microcirculation, thus increasing the salvaged myocardium and improving
microvascular obstruction, and does not increase the percentage of
microvascular hemorrhage. Categories: IMAGING AND PHYSIOLOGY: Imaging:
Other.<br/>Copyright &#xa9; 2024

<58>
Accession Number
2035134090
Title
TCT-958 Incidence of Subclinical Bioprosthetic Mitral Valve Thrombosis:
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B408), 2024. Date of Publication: 29 Oct 2024.
Author
Zorman M.; Castle J.; Vibhishanan J.; Eastwick-Jones K.; Swan A.;
Coronelli M.; Dangas K.; Choksey A.; Johnson N.; Yan H.; Scott S.; Henry
M.; Cassar M.; Ferreira-Martins J.; Ordonez-Mena J.; Guerrero M.
Institution
(Zorman, Guerrero) Mayo Clinic, Rochester, Minnesota, USA, United States
(Castle, Vibhishanan, Swan, Choksey, Johnson, Yan, Scott, Cassar,
Ferreira-Martins) Oxford University Hospitals, Oxford, United Kingdom
(Eastwick-Jones, Coronelli, Henry, Ordonez-Mena) Oxford University,
Oxford, United Kingdom
(Dangas) University of Oxford, Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Subclinical leaflet thrombosis (SLT), visualized as
hypoattenuated leaflet thickening or restricted leaflet motion on cardiac
computed tomography, affects up to 30% of patients following bioprosthetic
aortic valve replacement. The incidence of SLT after bioprosthetic mitral
valve replacement and efficacy of anticoagulation for its prevention are
relatively understudied. <br/>Method(s): A literature search of Medline,
Embase, and Cochrane Library (January 2000-January 2024) identified 2,038
studies. After screening, 6 studies with structured computed tomography
follow-up of 222 patients with bioprosthetic mitral valves were included.
<br/>Result(s): Included studies reported 14 SLT events during the total
follow-up of 138 patient-years. The incidence of SLT was 30.95 (95% CI:
7.99-198.3; SLT events per 100 patient-years: I² = 75%). SLT
was 7.33-fold more common than clinically significant valve thrombosis
(incidence ratio [IR] clinically significant thrombosis/SLT: 7.33; 95% CI:
4.61-16.11; P = 0.001). The mean time to subclinical leaflet thrombosis
was 45 +/- 19 days. The incidence of SLT in patients on direct oral
anticoagulants (DOACs) and vitamin K antagonists (VKA) was comparable (IR
DOACs/VKAs: 2.35; 95% CI: 0.67-8.19; P = 0.181). No mortality, stroke,
transient ischemic attack, heart failure rehospitalization, or valve
reintervention events were reported in patients with SLT.
<br/>Conclusion(s): Based on available evidence, SLT is considerably more
common than clinically significant valve thrombosis. The impact of DOACs
and VKAs on the incidence of SLT is comparable. Further studies are needed
to better understand the relationship between SLT and clinical outcomes in
this patient group. Categories: STRUCTURAL: Valvular Disease:
Mitral.<br/>Copyright &#xa9; 2024

<59>
Accession Number
2035134077
Title
TCT-872 Transfemoral Transcatheter Aortic Valve Implantation Using the
Self-Expanding JenaValve Trilogy System in Patients With Aortic
Regurgitation: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B358), 2024. Date of Publication: 29 Oct 2024.
Author
Jain H.; Passey S.; Singh J.; Jain J.; Naveed H.; Goyal A.; Ahmed R.; Raza
S.
Institution
(Jain, Jain) All India Institute of Medical Sciences, Jodhpur, Rajasthan,
India, India
(Passey) University of Connecticut Health Center, Farmington, Connecticut,
USA, United States
(Singh) Government Medical College, Amritsar, Punjab, India, India
(Naveed) University of Houston/HCA Kingwood Hospital, Houston, Texas, USA,
United States
(Goyal) Seth Gordhandas Sunderdas Medical College and King Edward Memorial
Hospital, Mumbai, Mumbai, Maharashtra, India, India
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Raza) Department of Cardiology, University of Houston/HCA Kingwood
Hospital, Houston, Texas, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Aortic regurgitation (AR) leads to left ventricular
dysfunction and is associated with adverse outcomes. The JenaValve Trilogy
(JVT; JenaValve Technology) transcatheter heart valve (THV) is a
first-of-its-kind valve system designed to address the challenges of
transcatheter aortic valve implantation (TAVI) in AR. The current
literature on the efficacy of JVT is limited, prompting this
meta-analysis. <br/>Method(s): A systematic literature search of the major
bibliographic databases was conducted to identify studies evaluating the
clinical outcomes of JVT THV in patients with AR undergoing TAVI. The
incidence of outcomes (events/total) was pooled using the raw proportion
effect model in the restricted maximum likelihood estimator. Statistical
significance was set at P < 0.05. <br/>Result(s): Four studies including
357 patients with AR who underwent TAVI using the JVT system were
included. The mean age of the patients was 76.11 +/- 9.4 years with 42.8%
females. The pooled analysis demonstrated a technical success of 97% (95%
CI: 94-99; P < 0.001), 30-day mortality of 2% (95% CI: 1-4; P = 0.012),
30-day stroke of 2% (95% CI: 0-3; P = 0.001), and 30-day permanent
pacemaker implantation of 17% (95% CI: 6-27; P = 0.002) with JVT THV
(Figure). [Formula presented] <br/>Conclusion(s): JVT THV is a safe and
effective transfemoral percutaneous intervention for AR and is associated
with a high technical success rate of 97% and low 30-day adverse events.
Given its favorable performance, the JVT system may offer an alternative
for patients with AR who are not suitable for surgery. Further randomized
studies with long-term follow-up are crucial for investigating the
long-term benefits of the JVT system. Categories: STRUCTURAL: Valvular
Disease: Aortic.<br/>Copyright &#xa9; 2024

<60>
Accession Number
2035134059
Title
TCT-541 Gender Differences in Periprocedural Outcomes of Left Atrial
Appendage Occlusion: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B188), 2024. Date of Publication: 29 Oct 2024.
Author
Dimitriadis K.; Pyrpyris N.; Beneki E.; Aznaouridis K.; Kostakis P.;
Koulouriotis A.; Fragkoulis C.; Aggeli K.
Institution
(Dimitriadis, Beneki, Kostakis) Hippokration Hospital, Athens, Greece,
Greece
(Pyrpyris) University of Athens, Athens, Greece, Greece
(Aznaouridis) 1st Department of Cardiology, Athens Medical School,
Hippokration Hospital, Athens, Greece, Greece
(Koulouriotis, Fragkoulis) Hippokration General Hospital, Athens, Athens,
Greece, Greece
(Aggeli) 1st Cardiology Department, University of Athens, Hippokrateion
Hospital, Athens, Greece, Greece
Publisher
Elsevier Inc.
Abstract
Background: Gender differences are well established in cardiovascular
medicine, leading to different prognosis, management strategy and outcomes
between men and women. Left atrial appendage occlusion (LAAO) is a
well-established intervention for stroke prevention in patients with
atrial fibrillation with high thromboembolic risk and contraindication to
anticoagulation. Recently, several analyses from large studies directly
comparing periprocedural outcome between genders became available.
Therefore, the aim of this meta-analysis is to synthesize available
evidence comparing periprocedural outcomes on the two genders after LAAO.
<br/>Method(s): A systematic search in medical literature databases was
conducted, identifying studies specifically comparing LAAO in men and
women. After selecting all appropriate trials according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines, a random effect meta-analysis was performed. <br/>Result(s): A
total of 9 studies were included, with a population of 62,300 patients,
out of whom 36,023 were men and were 26,277 women. Device success was
similar between groups (RR: 1.00; 95% CI: 1.00-1.00). Regarding
periprocedural adverse events, these were significantly reduced in men
(RR: 0.64; 95% CI: 0.57-0.72), as were major adverse cardiovascular events
(RR: 0.51; 95% CI: 0.46-0.56), mortality (RR: 0.50; 95% CI: 0.34-0.72),
and major bleeding events (RR: 0.41; 95% CI: 0.24-0.72). No difference was
found in stroke events (RR: 0.69; 95% CI: 0.42-1.14). In a sensitivity
analysis, excluding the study mostly driving the results, men consistently
had significantly reduced adverse events (RR: 0.66; 95% CI: 0.51-0.85),
MACE (RR: 0.63; 95% CI: 0.51-0.77) and major bleeding events (RR: 0.29;
95% CI: 0.10-0.88), with no difference in mortality (RR: 0.72; 95% CI:
0.33-1.59) and stroke events (RR: 1.01; 95% CI: 0.29-3.74).
<br/>Conclusion(s): In studies directly comparing gender outcomes during
LAAO, women are at significantly higher risk of adverse events
peri-procedurally, with conflicting results regarding mortality. Such
gender differences, as well as long-term outcomes, should be considered
when deciding to suggest LAAO. Categories: OTHER: Women's Health
Issues.<br/>Copyright &#xa9; 2024

<61>
Accession Number
2035134030
Title
TCT-162 Effectiveness and Safety of Self-Expanding Transcatheter Aortic
Valve Replacement Compared With Balloon-Expandable Bioprosthesis:
Meta-analysis and Systematic Review.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B396), 2024. Date of Publication: 29 Oct 2024.
Author
Akkawi M.; Elkholy M.; Abdulelah Z.; Rayyan A.; Al-Dqour M.; Damlakhy A.;
Alraies C.
Institution
(Akkawi) Detroit Medical Center, Dearborn, Michigan, USA, United States
(Elkholy) Detroit Medical Center, Wayne State University, Farmington
Hills, Michigan, USA, United States
(Abdulelah) Royal Papworth Hospital, Cambridge, United Kingdom
(Rayyan) University of Jordan, Amman, Jordan, Jordan
(Al-Dqour) East Tennessee State University, Johnston City, Tennessee, USA,
United States
(Damlakhy) Wayne State University, Detroit, Michigan, USA, United States
(Alraies) Detroit Medical Center Heart Hospital, Detroit, USA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has been proven
to be a safe alternative to surgical aortic valve replacement in patients
with symptomatic severe aortic stenosis who are at increased risk for
surgery. However, the literature comparing the cardiovascular outcomes
between self-expanding (SEV) and balloon-expanding (BEV) valves remains
limited. <br/>Method(s): Two independent researchers conducted a
comprehensive literature review on PubMed and Embase until June 2024. They
identified 8 randomized controlled trials that compared the clinical
outcomes between SEV and BEV TAVR. The analysis focused on cardiovascular
outcomes, including all-cause and cardiovascular (CV) mortality,
endocarditis, rehospitalization rates, stroke, permanent pacemaker
implantation (PPI), and total and paravalvular aortic regurgitation (PVR).
<br/>Result(s): A total of 4,032 (SEV = 2,006; BEV = 2,017) patients were
included with follow-up durations of 1 month to 5 years. Our pooled
analysis showed no statistically significant difference in 30-day, 1-year,
and long-term (>=3 years) all-cause or CV mortality rates between the
study groups. In addition, there was no significant difference in the
incidence of stroke, rehospitalization, endocarditis, or total aortic
valve regurgitation. However, the rates of PVR and PPI were higher in the
SEV group, with ORs 1.76 (1.13-2.74; P = 0.01) and 1.57 (1.23-2.00; P =
0.0002), respectively. [Formula presented] <br/>Conclusion(s): SEV had
similar outcomes to BEV in terms of all-cause mortality, cardiovascular
mortality, stroke, rehospitalization, and total aortic valve
regurgitation. However, it had a higher incidence of PVR and pacemaker
placement. Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright
&#xa9; 2024

<62>
Accession Number
2035133994
Title
TCT-874 Transcatheter Aortic Valve Replacement for Mixed Aortic Valve
Disease: An Updated Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B358-B359), 2024. Date of Publication: 29 Oct 2024.
Author
Kidess G.; Hamza M.; Basit J.; Alraies M.C.
Institution
(Kidess) Wayne State University School of Medicine, Grosse Pointe Park,
Michigan, USA, United States
(Hamza) Guthrie Medical Group, Cortland, New York, USA, United States
(Basit) Rawalpindi Medical University, Rawalpindi, Pakistan, Pakistan
(Alraies) Detroit Medical Center, Detroit, Michigan, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Mixed aortic valve disease (MAVD) is defined as aortic
stenosis (AS) occurring simultaneously with aortic regurgitation.
Transcatheter aortic valve replacement (TAVR) is associated with similar
mortality rates in MAVD compared with AS, whereas data on complications
are conflicting. The aim of this study is to synthesize evidence to
compare clinical outcomes of TAVR in MAVD compared to AS. <br/>Method(s):
A systematic literature review was conducted on PubMed and Embase for
studies on outcomes of TAVR in MAVD from inception until April 2024.
Primary outcomes were short- and long-term mortality. Secondary outcomes
were paravalvular regurgitation (PVR), vascular and bleeding
complications, pacemaker implantation, and cerebrovascular events. A
random-effects model was used to pool risk ratios (RRs) and 95% CIs for
clinical endpoints and was conducted using RStudio software (RStudio).
<br/>Result(s): Eleven observational studies including 133,558 patients
were included in the analysis (Figure). There were no significant
differences in primary endpoints (P > 0.05). MAVD was associated with
lower risk of cerebrovascular complications (RR: 0.65; 95% CI: 0.53-0.97)
and higher risk of PVR (RR: 1.29; 95% CI: 1.07-1.55). No significant
differences were noted in other secondary outcomes (P > 0.05). [Formula
presented] <br/>Conclusion(s): The similar mortality risk of TAVR in MAVD
compared to AS and higher risk of PVR in MAVD are in accordance with
recent studies. This meta-analysis is the first to show a significantly
lower risk of cerebrovascular events in MAVD patients, highlighting the
importance of future research to further delineate differences in outcomes
in this population. Categories: ENDOVASCULAR: Diseases of the Aorta and
Aortic Intervention.<br/>Copyright &#xa9; 2024

<63>
Accession Number
2035133973
Title
TCT-827 Rationale and Design of the Randomized Controlled PRO-TAVI Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B340), 2024. Date of Publication: 29 Oct 2024.
Author
Aarts H.; Hemelrijk K.; Broeze G.; Jan van Ginkel D.; Versteeg G.; Tijssen
J.; Grundeken M.J.; Claessen B.; Tonino P.; Schotborgh C.; Meuwissen M.;
Gert van Houwelingen K.; Wykrzykowska J.; Amoroso G.; Vossenberg T.;
Vriesendorp P.; van Royen N.; Berg J.T.; Delewi R.; Voskuil M.
Institution
(Aarts) University Medical Center Utrecht, Utrecht, Netherlands,
Netherlands
(Hemelrijk, Broeze, Grundeken, Claessen) Amsterdam University Medical
Center, Amsterdam, Netherlands, Netherlands
(Jan van Ginkel, Delewi) St. Antonius Hospital, Nieuwegein, Netherlands,
Netherlands
(Versteeg, van Royen) Radboud University Medical Center, Nijmegen,
Netherlands, Netherlands
(Tijssen) Amsterdam University Medical Center, Naarden, Netherlands,
Netherlands
(Tonino) Catharina Ziekenhuis, Eindhoven, Netherlands, Netherlands
(Schotborgh) HagaZiekenhuis, Den Haag, Netherlands, Netherlands
(Meuwissen) Breda Amphia Ziekenhuis, Breda, Netherlands, Netherlands
(Gert van Houwelingen) Thoraxcentrum Twente, MST Enschede, Enschede,
Netherlands, Netherlands
(Wykrzykowska) University Medical Center Groningen, Groningen,
Netherlands, Netherlands
(Amoroso) OLVG, Amsterdam, Netherlands, Netherlands
(Vossenberg) Medical Centre Leeuwarden, Leeuwarden, Netherlands,
Netherlands
(Vriesendorp) Maastricht University Medical Center+, Maastricht,
Netherlands, Netherlands
(Berg) St. Antonius Hospital, Bilthoven, Netherlands, Netherlands
(Voskuil) University Medical Center Utrecht, Zeist, Netherland,
Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Concomitant coronary artery disease (CAD) is highly prevalent
in patients undergoing transcatheter aortic valve implantation (TAVI). The
optimal treatment strategy for concomitant CAD is a topic of debate.
Concomitant CAD is not seldom characterized by multivessel disease and
calcified lesions with substantial risk of procedural complications. The
presence of severe aortic valve stenosis limits the ability to meet
physiological demands during percutaneous coronary intervention (PCI),
especially in case of life-threatening complications. The use of dual
antiplatelet therapy afterward also increases the risk of bleeding during
TAVI. Thus, an initial conservative strategy for concomitant CAD in
patients undergoing TAVI may be favorable. <br/>Method(s): The PRO-TAVI
(PeRcutaneous cOronary Intervention before TAVI) trial is an
investigator-initiated, multicenter, open-label, noninferiority,
randomized controlled trial comparing TAVI with PCI to TAVI without
routine preprocedural PCI. A total of 466 patients will be randomized in a
1:1 ratio to TAVI with or without preceding PCI. CAD is defined as at
least 1 stenosis of >=70% or at least 1 stenosis between 40% and 70%
combined with positive physiological measurement in a coronary artery with
a minimal diameter of 2.5 mm (Figure). The primary endpoint is a composite
of all-cause mortality, myocardial infarction, stroke, or type 2 to 4
bleeding at 12 months after randomization, in accordance with Valve
Academic Research Consortium 3. <br/>Result(s): Recruitment final exp.
12/2024. [Formula presented] <br/>Conclusion(s): The PRO-TAVI trial is an
investigator-initiated, randomized controlled trial investigating the
noninferiority of omitting routine PCI in patients with concomitant CAD.
Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9;
2024

<64>
Accession Number
2035133968
Title
TCT-816 Comparing FFR-Guided PCI and Conservative Management for
Nonculprit Lesions in STEMI Patients With Multivessel Disease: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B330), 2024. Date of Publication: 29 Oct 2024.
Author
Gonnah A.; Helmy A.; Elsnhory A.; Shazly O.; Mohamed S.; Labib A.; Saoudy
H.; Awad A.; Wilson K.; Roberts D.
Institution
(Gonnah) Hammersmith Hospital, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Awad, Shazly, Mohamed) Faculty of Medicine, Ain Shams University, Cairo,
Egypt, Egypt
(Helmy, Elsnhory) Faculty of Medicine, Al-Azhar University, Cairo, Egypt,
Egypt
(Labib) Department of Medicine, Northern Lincolnshire and Goole Hospitals
NHS Foundation Trust, Hull, United Kingdom
(Saoudy) Imperial College London NHS Trust, London, United Kingdom
(Awad) Faculty of Medicine, Galala University, Cairo, Egypt, Egypt
(Wilson) Inova Center for Personalized Heath, Fairfax, Virginia, USA,
United States
(Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: In patients with ST-segment elevation myocardial infarction
(STEMI) and multivessel coronary artery disease, the optimal management
strategy for nonculprit lesions is a subject of ongoing debate. There has
been an increased use of physiology guidance to assess the extent of
occlusion in nonculprit lesions and hence the need for stenting.
Fractional flow reserve (FFR) is commonly used as a technique. Our
analysis aims to compare FFR vs conservative management in the management
of nonculprit lesions in STEMI patients with multivessel disease.
<br/>Method(s): A comprehensive literature search was conducted on
databases from inception to May 25, 2024. We conducted a random-effects
meta-analysis using RevMan version 5.3.0 (Cochrane) with the Der-Simonian
and Laird method to combine the data. <br/>Result(s): The analysis of 5
randomized controlled trials including 3,759 patients revealed a
significantly lower incidence of major adverse cardiovascular events
(composite of all-cause mortality, nonfatal myocardial infarction, and the
need for revascularization [percutaneous coronary intervention (PCI) or
coronary artery bypass grafting]) in the FFR group compared to the
conservative management group (risk ratio [RR]: 0.65; 95% CI: 0.44-0.96; P
= 0.03). The revascularization rates were significantly lower in the FFR
group (RR: 0.53; 95% CI: 0.43-0.66; P < 0.00001). Additionally, unplanned
hospitalization leading to urgent revascularization and any-cause
hospitalization were significantly lower in the FFR group (RR: 0.72; 95%
CI: 0.56-0.94; P = 0.01 and RR = 0.62; 95% CI: 0.46-0.84; P = 0.002,
respectively). The FFR group had a higher risk of definite stent
thrombosis (RR: 2.26; 95% CI: 1.10-4.64; P = 0.03). No significant
differences were observed between the 2 groups in mortality,
hospitalization for heart failure, or myocardial infarction. Similarly,
bleeding rates, cerebrovascular accidents, and contrast-induced
nephropathy were comparable between both groups. <br/>Conclusion(s): Our
findings support FFR-guided PCI to manage nonculprit lesions in STEMI
patients with multivessel disease because it is safe and improves clinical
outcomes as well as reduces revascularization and hospitalization rates.
The risk of stent thrombosis remains a concern; however, this can be
reduced by optimizing medical treatment post-PCI. Categories: CORONARY:
Acute Myocardial Infarction.<br/>Copyright &#xa9; 2024

<65>
Accession Number
2035133891
Title
TCT-884 Transcatheter Aortic Valve Replacement Outcomes in Patients With
Cardiogenic Shock: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B370), 2024. Date of Publication: 29 Oct 2024.
Author
Madanat L.; Alhuneafat L.; Hanson I.; Abbas A.; Al-Abdouh A.; Ayyad M.;
Obeidat L.; Mhanna M.; Frisoli T.; Alqarqaz M.; Villablanca P.
Institution
(Madanat) William Beaumont University Hospital, Royal Oak, Michigan, USA,
United States
(Alhuneafat) University of Minnesota, Minneapolis, MN, United States
(Hanson) Corewell Health William Beaumont University Hospital, Troy,
Michigan, USA, United States
(Abbas) Corewell Health William Beaumont University Hospital, Birmingham,
MI, United States
(Al-Abdouh) University of Kentucky, Lexington, KY, United States
(Ayyad) Rutgers New Jersey Medical School, Newark, NJ, United States
(Obeidat, Frisoli, Villablanca) Henry Ford Hospital, Detroit, MI, United
States
(Mhanna) The University of Iowa, Iowa City, IA, United States
(Alqarqaz) Henry Ford Hospital, West Bloomfield, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: While transcatheter aortic valve replacement (TAVR) has
broadened treatment options for critically ill patients, outcomes among
those with concomitant cardiogenic shock (CS) are not well-explored.
<br/>Method(s): We conducted a comprehensive search of major databases for
studies comparing outcomes of TAVR in patients with and without CS since
inception up to October 31, 2023. Dichotomous outcomes were assessed using
the Mantel-Haenszel method (risk ratio, 95% CI), and continuous outcomes
were evaluated using mean difference and 95% CI with the inverse variance
method. <br/>Result(s): Five studies were included in the final analysis
with a total of 26,283 patients. Among the 7,267 (27.6%) patients with CS,
30-day mortality (OR: 3.41; 95% CI: 2.01-5.76; P < 0.01) and 30-day major
vascular complications (OR: 1.72; 95% CI: 1.54-1.92; P < 0.01) were higher
compared with those without CS. Conversely, 1-year mortality was not
significantly different (OR: 2.68; 95% CI: 0.53-13.46, P = 0.12). No
significant differences were observed in the likelihood of 30-day aortic
valve reintervention (OR: 3.20; 95% CI: 0.63-16.22, P = 0.09) or post-TAVR
aortic insufficiency (OR: 0.91; 95% CI: 0.33-2.51, P = 0.73) between both
groups. Furthermore, 30-day stroke, pacemaker implantation, and
in-hospital major bleeding were similar between both cohorts (Figure 1).
<br/>Conclusion(s): Among TAVR patients, short-term mortality is higher in
patients with CS. There was no significant difference in 1-year mortality,
need for AV reintervention, in-hospital bleeding or 30-day stroke and
pacemaker implantation in patients with CS shock compared with patients
not in CS. Categories: STRUCTURAL: Valvular Disease: Aortic<br/>Copyright
&#xa9; 2024

<66>
Accession Number
2035133864
Title
TCT-933 Win Ratio Analysis of the LANDMARK Trial: Myval Transcatheter
Heart Valve vs Contemporary Standard Valves (Sapien and Evolut) in
Patients With Severe Aortic Stenosis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B394), 2024. Date of Publication: 29 Oct 2024.
Author
Tobe A.; van Royen N.; Amat Santos I.J.; Hudec M.; Bunc M.; Ijsselmuiden
A.; Rosseel L.; Gamal A.; McInerney A.; Garg S.; Soliman O.; Onuma Y.;
Baumbach A.; Serruys P.
Institution
(Tobe, Soliman, Serruys) University of Galway, Galway, Ireland
(van Royen) Radboud University Medical Center, Nijmegen, Netherlands
(Amat Santos) University Clinical Hospital of Valladolid, Madrid, Spain
(Hudec) Banska Bystrica SUSCCH, Slovakia
(Bunc) University Medical Center Ljubljana, Ljubljana, Slovenia
(Ijsselmuiden) Maastricht University Medical Center/Zuyderland Hospital,
Maastricht, Netherlands
(Rosseel) Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
(Gamal) Blackpool Victoria Hospital, Preston, United Kingdom
(McInerney) Department of Cardiology, Saolta Group, Galway University
Hospital, Galway, Ireland
(Garg) University of Central Lancashire, Blackburn, United Kingdom
(Onuma) National University of Ireland Galway, Galway, Ireland
(Baumbach) Department of Cardiology, Barts Heart Centre, Barts Health NHS
Trust, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The LANDMARK trial reported the noninferiority of the Myval
transcatheter heart valve (THV) compared with the contemporary standard
THVs (Sapien and Evolut) regarding a 30-day composite endpoint in patients
with severe aortic stenosis. <br/>Method(s): The LANDMARK was a
multicenter, randomized, noninferiority trial comparing the Myval series
and the contemporary THV series. From January 2021 to December 2023, 768
patients were randomized 1:1 to Myval or contemporary THV group. This
substudy aimed to compare the 2 groups using a win ratio analysis. A
consensual ranking order of severity of the 7 items of the primary
composite endpoint was obtained among 10 cardiologists by means of the
Delphi method and became all-cause death, all stroke, VARC type 3 or 4
bleeding, major vascular complication, >= moderate prosthetic valve
regurgitation (PVR), acute kidney injury (AKI) stage 2-4, and new
permanent pacemaker implantation (PPI). <br/>Result(s): In the win ratio
analysis with 145,161 unmatched patient pairs, five events (death, stroke,
vascular complications, >= moderate PVR, and PPI) numerically favored the
Myval group, and 2 (bleeding and AKI) the contemporary group (Figure 1).
Overall, there were 34,290 wins in the Myval and 30,636 in the
contemporary group, such that the win ratio was not statistically
significant (34,290/30,636 = 1.12; 95% CI: 0.84-1.48; P = 0.43). [Formula
presented] <br/>Conclusion(s): The win ratio of the primary composite
endpoint was not statistically significant, and consistent with the
primary analysis of noninferiority of the Myval series to the contemporary
THV series at 30 days. Categories: STRUCTURAL: Valvular Disease:
Aortic.<br/>Copyright &#xa9; 2024

<67>
Accession Number
2035133815
Title
TCT-539 Pre-procedural Planning for Left Atrial Appendage Occlusion With
the Use of a Novel CT Scan Software.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B187), 2024. Date of Publication: 29 Oct 2024.
Author
Chan N.-Y.; Tam K.-C.; Chow D.
Institution
(Chan) Department of Medicine and Geriatrics, Princess Margaret Hospital,
Hong Kong
(Tam) Kiangwu Hospital, Macao
(Chow) St Paul's Hospital, Hong Kong
Publisher
Elsevier Inc.
Abstract
Background: Pre-procedural planning for left atrial appendage occlusion
(LAAO) is conventionally performed with the use of transesophageal
echocardiography (TEE). A novel CT scan software (TruPlan; Boston
Scientific) has become available recently but data on its accuracy are
lacking. <br/>Method(s): Twenty-one patients (10 women, mean age 73.6 +/-
7.5) with nonvalvular atrial fibrillation who underwent LAAO with Watchman
FLX (Boston Scientific) and pre-procedural CT were recruited.
Investigators were blinded of the procedural results and used TruPlan to
predict device sizes. The accuracy of prediction was compared with that
using TEE or another CT scan software (OsiriX; Pixmeo). <br/>Result(s):
The mean size of Watchman FLX implanted was 27.7 +/- 4.8 mm. TruPlan
approach accurately predicted the device size in 20 out of 21 patients
(95%), whereas the prediction accuracies with TEE and OsiriX were 71.4%
(15/21) and 43% (9/21), respectively. TruPlan achieved significantly
higher accuracy in predicting device size compared with other approaches
using TEE (P = 0.038) or OsiriX (P < 0.001). <br/>Conclusion(s): TruPlan,
a novel CT scan software, predicts with high accuracy the appropriate size
of Watchman FLX in LAAO procedures. The accuracy was shown to be
significantly higher than other approaches using TEE or OsiriX. Randomized
controlled studies are warranted to confirm the superiority of TruPlan
over conventional approaches in pre-procedural planning for LAAO
procedures. Categories: STRUCTURAL: Left Atrial Appendage
Exclusion.<br/>Copyright &#xa9; 2024

<68>
Accession Number
2035133687
Title
TCT-161 Comparing the Periprocedural Outcomes of Self-Expanding
Transcatheter Aortic Valve Replacement Versus Balloon-expandable
Bioprosthesis: Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B396), 2024. Date of Publication: 29 Oct 2024.
Author
Elkholy M.; Akkawi M.; Abdulelah Z.; Rayyan A.; Al-Dqour M.; Alraies C.
Institution
(Elkholy) Detroit Medical Center, Wayne State University, Farmington
Hills, Michigan, USA, United States
(Akkawi) Detroit Medical Center, Dearborn, Michigan, USA, United States
(Abdulelah) Royal Papworth Hospital, Cambridge, United Kingdom
(Rayyan) University of Jordan, Amman, Jordan, Jordan
(Al-Dqour) East Tennessee State University, Johnston City, Tennessee, USA,
United States
(Alraies) Detroit Medical Center Heart Hospital, Detroit, USA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is safe and
effective for symptomatic severe aortic stenosis who are at increased risk
for surgery. We compared the postprocedure outcomes between self-expanding
valves (SEVs) and balloon-expanding valves (BEV). <br/>Method(s): We
conducted a thorough literature review on PubMed and Embase up to June
2024 and found 8 randomized controlled trials that compared self-expanding
and balloon-expanding TAVR. The outcomes were the device's technical
success according to Valve Academic Research Consortium criteria and other
periprocedural outcomes. <br/>Result(s): Our analysis included 4,032
(2,006 SEVs and 2,017 BEVs) patients. SEVs and BEVs had similar device
success rates per Valve Academic Research Consortium criteria (OR: 1.01;
95% CI: 0.59-1.73; P = 0.96). They also had comparable results for
bioprosthetic valve dysfunction, valve dislocation/embolization, valve
thrombosis, major or life-threatening bleeding, coronary artery occlusion,
annulus rupture/aortic dissection, or acute kidney injury (Figure).
[Formula presented] <br/>Conclusion(s): Our analysis showed no significant
disparities between SEVs and BEVs in terms of device success,
bioprosthetic valve dysfunction, valve dislocation/embolization, valve
thrombosis, major or life-threatening bleeding, coronary artery occlusion,
or acute kidney injury. Categories: STRUCTURAL: Valvular Disease:
Aortic.<br/>Copyright &#xa9; 2024

<69>
Accession Number
2035133644
Title
TCT-336 The Effect of Transcatheter Aortic Valve Replacement on the Left
Atrial Mechanical Parameters: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B83-B84), 2024. Date of Publication: 29 Oct 2024.
Author
Jain H.; Passey S.; Singh J.; Jain J.; Naveed H.; Goyal A.; Jha J.; Alam
M.
Institution
(Jain, Jain) All India Institute of Medical Sciences, Jodhpur, Rajasthan,
India, India
(Passey, Jha) University of Connecticut Health Center, Farmington,
Connecticut, USA, United States
(Singh) Government Medical College, Amritsar, Punjab, India, India
(Naveed) University of Houston/HCA Kingwood Hospital, Houston, Texas, USA,
United States
(Goyal) Seth Gordhandas Sunderdas Medical College and King Edward Memorial
Hospital, Mumbai, Mumbai, Maharashtra, India, India
(Alam) Baylor College of Medicine, Houston, Texas, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an effective
percutaneous intervention for symptomatic aortic stenosis. TAVR can lead
to improvements in left ventricular mechanics; however, its effect on left
atrial (LA) parameters remains understudied. This meta-analysis aimed to
investigate the effect of TAVR on LA mechanical parameters, such as volume
index and strain (reservoir, conduit, and contractile), by comparing pre-
and post-TAVR values. <br/>Method(s): A comprehensive literature search
spanning major electronic databases was conducted to retrieve studies
comparing LA mechanical parameters pre- and post-TAVR. The mean
differences (MDs) with their corresponding 95% CIs were pooled using the
inverse variance random-effects model in Review Manager Version 5.4.1
software. Statistical significance was set at P < 0.05. <br/>Result(s):
Thirteen studies including 1,156 patients with aortic stenosis were
included. The mean age of the patients was 79.7 +/- 7 years. TAVR led to a
statistically significant improvement in the LA volume index (MD: 2.73;
95% CI: 1.41-4.05; P < 0.0001) and reductions in the LA reservoir strain
(MD: -3.80; 95% CI: -5.26 to -2.35; P < 0.00001), LA conduit strain (MD:
-2.07; 95% CI: -4.09 to -0.04; P = 0.05), and LA contractile strain (MD:
-1.96; 95% CI: -2.80 to -1.11; P < 0.00001) (Figure). [Formula presented]
<br/>Conclusion(s): TAVR leads to the favorable remodeling of the LA
chamber as noted by significant improvement in the LA volume index and
significant reductions in the LA strain parameters post-TAVR. Further
prospective studies are required to validate these results. Categories:
STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9; 2024

<70>
Accession Number
2035133529
Title
TCT-285 Comparative Efficacy of Hybrid vs Traditional Cardiac Surgery: A
Meta-Analysis of Survival Rates, Postoperative Complications, and Length
of Hospital Stay.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B59-B60), 2024. Date of Publication: 29 Oct 2024.
Author
Kumar H.; FNU T.
Institution
(Kumar, FNU) Dow University of Health Sciences, Karachi, Pakistan,
Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Cardiac and coronary artery surgery can be performed using
traditional methods or hybrid approaches. Hybrid cardiac surgery combines
minimally invasive techniques with conventional surgery, potentially
offering improved outcomes. <br/>Method(s): A systematic search was
conducted across databases from January 1, 2010, to June 1, 2023, to
identify relevant studies comparing hybrid and traditional cardiac
surgeries. The pooled standardized mean differences (SMD) with 95% CIs
were calculated for each outcome, employing a random effect model when
heterogeneity (I²) exceeded 50%. <br/>Result(s): Four studies
involving a total of 455 participants were included. The studies compared
hybrid cardiac surgery (230 patients) to traditional methods (225
patients). The hybrid surgery group demonstrated significantly higher
survival rates (SMD: 0.83; 95% CI: 0.30-1.35; P < 0.01) compared to the
traditional surgery group. Additionally, the hybrid surgery group
experienced fewer postoperative complications (SMD: -0.94; 95% CI: -1.45
to -0.42; P < 0.01). Patients undergoing hybrid surgery also had shorter
hospital stays (SMD: -1.75; 95% CI: -2.22 to -1.28; P < 0.01) compared
with those undergoing traditional surgery. [Formula presented]
<br/>Conclusion(s): Hybrid cardiac surgery is associated with improved
survival rates, fewer postoperative complications, and shorter hospital
stays compared with traditional cardiac surgery. These findings suggest
that hybrid approaches may enhance patient outcomes and should be
considered in appropriate cases. Further large-scale, randomized
controlled trials are needed to confirm these results. Categories:
CORONARY: Cardiac and Coronary Artery Surgery and Hybrid
Revascularization.<br/>Copyright &#xa9; 2024

<71>
Accession Number
2035133525
Title
TCT-761 Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk
Patients: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B306), 2024. Date of Publication: 29 Oct 2024.
Author
Upreti P.; Hanmandlu A.; Haider M.; Hamza M.; Chigurupati H.D.; Shaikh S.;
Bahar A.R.; Alraies C.
Institution
(Upreti) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, New York, USA, United States
(Hanmandlu) Wayne State University/Detroit Medical Center, Troy, Michigan,
USA, United States
(Haider) West Virginia University, Morgantown, West Virginia, USA, United
States
(Hamza) Guthrie Medical Group, Cortland, New York, USA, United States
(Chigurupati) New York Medical College at Saint Michael's Medical Center,
Newark, New Jersey, USA, United States
(Shaikh) SSM Health, St. Mary's Hospital-St. Louis, St. Louis, Missouri,
USA, United States
(Bahar) Wayne State University School of Medicine, Detroit, Michigan, USA,
United States
(Alraies) Detroit Medical Center Heart Hospital, Detroit, Michigan, USA,
United States
Publisher
Elsevier Inc.
Abstract
Background: In high-risk patients with severe symptomatic aortic stenosis
(AS), transcatheter aortic valve replacement (TAVR) has gained popularity.
There is insufficient evidence comparing the use of TAVR vs surgical
aortic valve replacement (SAVR) in severe AS. <br/>Method(s): We searched
PubMed and Embase, screened 2,363 articles, and identified 10 studies that
met eligibility criteria: randomized controlled trials (RCTs) comparing
TAVR with SAVR in low surgical risk AS candidates. We compared the
outcomes for 14 metrics between the 2 groups. A random-effects model
assessed heterogeneity between studies. <br/>Result(s): Our study had 10
RCTs with 4,510 TAVR and 4,422 SAVR patients, average age ~77 years, 58%
men, 15-month follow-up. We found that TAVR is associated with lower
cardiovascular mortality, atrial fibrillation, bleeding, and acute kidney
injury. TAVR is associated with a higher need for a permanent pacemaker,
paravalvular leaks, and vascular complications. There was no difference in
all-cause mortality, myocardial infarction, cardiovascular-related
hospitalization, stroke, aortic valve reintervention, valve thrombosis, or
endocarditis. [Formula presented] <br/>Conclusion(s): Although TAVR is
associated with lower cardiovascular mortality and bleeding, it has a
higher onset of paravalvular leak and need for PPM than SAVR.
Non-industry-funded RCTs using various transcatheter heart valve devices
for diverse population bases are needed to evaluate these outcomes
further. A multidisciplinary individualized heart-team approach should be
utilized for decision-making based on the available evidence. Categories:
STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9; 2024

<72>
Accession Number
2035133453
Title
TCT-271 Impella in Myocardial Infarction Complicated by Cardiogenic Shock:
An Updated Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B54), 2024. Date of Publication: 29 Oct 2024.
Author
Haider M.; Hamza M.; Upreti P.; Mir J.; Naveed H.; Basit J.; Naseer U.;
Pandya K.; Ahmed M.; Karamat M.; Sattar Y.; Harmouch K.M.; Alraies M.C.
Institution
(Haider, Sattar) West Virginia University, Morgantown, WV, United States
(Hamza) Guthrie Medical Group, Cortland, New York, United States
(Upreti) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, New York, United States
(Mir) University of Missouri, Columbia, Columbia, MO, United States
(Naveed) University of Houston/HCA Kingwood Hospital, Houston, TX, United
States
(Basit) Rawalpindi Medical University, Rawalpindi, Pakistan
(Naseer) University of South Dakota Sanford School of Medicine, Sioux
Falls, SD, United States
(Pandya) Cleveland Clinic, Cleveland, OH, United States
(Ahmed) Springfield Regional Medical Center, Springfield, OH, United
States
(Karamat) Ascension Saint Francis Hospital, Evanston, IL, United States
(Harmouch) Detroit Medical Center, Dearborn, MI, United States
(Alraies) Detroit Medical Center, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Despite recent technological advancements, myocardial
infarction complicated with cardiogenic shock is associated with high
mortality. Conflicting data have hindered the greater use of Impella
(Abiomed). We performed an updated meta-analysis. <br/>Method(s): We
searched PubMed and Embase, screened 787 articles, and identified 12
studies that met the eligibility criteria, comparing Impella to other
mechanical circulatory support systems in patients with myocardial
infarction complicated by cardiogenic shock. We evaluated various metrics
related to adverse events and clinical outcomes using the random effects
model to assess heterogeneity. <br/>Result(s): We did not find a
statistically significant difference between groups across all 23 included
metrics including in-house, 30-day, and 6-month mortality; cardiac,
noncardiac, and brain death; myocardial infarction; need for repeat
percutaneous coronary intervention; need for left ventricular assist
device; coronary bypass artery graft; stroke; limb ischemia; hemolysis;
major bleeding; thrombosis; and sepsis. Our subgroup analyses for
intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation, and
medical management revealed similar results for mortality (Table 1). IABP
was associated with better outcomes for bleeding, whereas extracorporeal
membrane oxygenation was associated with worse outcomes than Impella.
Impella was also associated with an increased risk of thrombosis than IABP
(Tables 2 to 4). [Formula presented] <br/>Conclusion(s): Our updated
meta-analysis did not relate Impella use to better outcomes. Heterogeneity
in the timing of device implantation calls for stricter reporting in
subsequent trials. Categories: CORONARY: Hemodynamic Support, Cardiogenic
Shock and Cardiac Arrest.<br/>Copyright &#xa9; 2024

<73>
Accession Number
2035133446
Title
TCT-231 Safety of Aspirin-Free Prasugrel Monotherapy After PCI: Pooled
Analysis of Three Months Outcomes in 508 Patients From ASET-I and
ASET-Japan Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B29-B30), 2024. Date of Publication: 29 Oct 2024.
Author
Miyashita K.; Muramatsu T.; Nakazawa G.; Ishibashi Y.; Onuma Y.; Lemos P.;
Serruys P.
Institution
(Miyashita, Serruys) University of Galway, Galway, Ireland
(Muramatsu) Fujita Health University Hospital, Toyoake, Japan
(Nakazawa) Kindai University Faculty of Medicine, Department of
Cardiology, Osaka-Sayama, Japan
(Ishibashi) St. Marianna University School of Medicine, Kawasaki, Japan
(Onuma) National University of Ireland Galway, Galway, Ireland
(Lemos) University of Sao Paulo Medical School, Sao Paulo, Sao Paulo,
Brazil
Publisher
Elsevier Inc.
Abstract
Background: Dual antiplatelet therapy (DAPT) with a P2Y<inf>12</inf>
inhibitor, in addition to aspirin, is the standard therapy after
percutaneous coronary intervention (PCI) to prevent device thrombosis and
ischemic cardiovascular events. Recent randomized controlled trials have
suggested that short-duration DAPT after PCI may provide an adequate
balance between ischemic and bleeding risks. This study aimed to assess
the safety and feasibility of prasugrel monotherapy immediately after
successful PCI in patients with chronic coronary syndrome (CCS) and
non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
<br/>Method(s): This is a pooled analysis of the 2 ASET (Acetyl-Salicylic
Elimination Trial) pilot studies conducted in Brazil and Japan, which uses
a similar trial protocol, except for the maintenance dose of prasugrel
according to the local regulatory approval (Brazil: 10 mg, Japan: 3.75
mg). These trials are multicenter, single-arm, open-label trials. In
ASET-I, 201 CCS patients were enrolled in Brazil, whereas in ASET-Japan,
206 CCS patients and 101 NSTE-ACS patients were enrolled. Patients with
anatomical SYNTAX (Synergy Between Percutaneous Coronary Intervention With
TAXUS and Coronary Artery Bypass Surgery) scores <23 were included. All
target lesions were treated with a platinum-chromium everolimus-eluting
stent. Prasugrel monotherapy was given to the patients after PCI. The
primary ischemic endpoint was the composite of cardiac death, spontaneous
target vessel myocardial infarction, or definite stent thrombosis, and the
primary bleeding endpoint was Bleeding Academic Research Consortium types
3 and 5 bleeding. <br/>Result(s): Three-month follow-up was completed in
508 patients (201 patients in Brazil and 307 patients in Japan). The mean
age was 65.3 +/- 10.7 years, and 73.6% were men. The mean anatomical
SYNTAX score was 7.7 +/- 4.6. At 3 months, 98.6% of patients (n = 500) was
on prasugrel monotherapy. The primary ischemic endpoints occurred in 1
patient (0.2%) who died 3 days after index procedure because of a
hemorrhagic stroke. The bleeding endpoint occurred in 3 patients (0.6%); 2
patients had a Bleeding Academic Research Consortium type 3a event related
to gastrointestinal bleeding, and the death caused by hemorrhagic stroke
was adjudicated as Bleeding Academic Research Consortium 5b. No stent
thrombosis event occurred. <br/>Conclusion(s): Prasugrel monotherapy
immediately after successful PCI was a feasible and safe strategy in
selected patients with CCS and NSTE-ACS. Categories: CORONARY:
Pharmacology/Pharmacotherapy.<br/>Copyright &#xa9; 2024

<74>
Accession Number
2035133441
Title
TCT-141 Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve
Replacement in Low-Risk Patients at Long-Term Follow-Up: Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B364), 2024. Date of Publication: 29 Oct 2024.
Author
Goel S.; Vinayak M.; Hooda A.; Krishnamoorthy P.; Sharma S.; Kini A.; Tang
G.
Institution
(Goel, Hooda) Mount Sinai Hospital, New York, New York, USA, United States
(Vinayak) Mount Sinai Hospital, Icahn School of Medicine, New York, New
York, USA, United States
(Krishnamoorthy) Division of Cardiology, Icahn School of Medicine at Mount
Sinai, New York, New York, USA, United States
(Sharma) The Mount Sinai Medical Center, Scarsdale, New York, USA, United
States
(Kini, Tang) Mount Sinai Heart Health System, New York, New York, USA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is increasingly
used in younger patients with severe, symptomatic aortic stenosis. The
long-term clinical and hemo-dynamic outcomes remain uncertain.
<br/>Method(s): We conducted an electronic database search of all
published data for randomized controlled trials (RCTs) that compared TAVR
vs surgical aortic valve replacement (SAVR) for low-surgical risk
patients. RCT with mean follow-up of more than 4 years were included in
the final analysis. Event rates were compared using a forest plot of ORs
using a fixed-effects model assuming interstudy heterogeneity.
<br/>Result(s): A total of 3 RCTs with 2,531 patients (1,332 in TAVR and
1,199 in SAVR group) were included in the final analysis. The mean
follow-up period was 5.03 years. Our meta-analysis showed that TAVR was
noninferior to SAVR in terms of clinical outcomes with similar all-cause
mortality, cardiac mortality, disabling stroke, aortic valve (AV)-related
hospitalization, and myocardial infarction. There was a higher incidence
of new prosthesis-patient mismatch with TAVR and SAVR was associated with
a higher incidence of new-onset atrial fibrillation. In terms of
hemodynamic outcomes, there were no differences between TAVR and SAVR for
AV reintervention, Endocarditis and bioprosthetic valve failure. There was
a higher incidence of clinical valve thrombosis and more than mild PVL
with TAVR. SAVR was associated with higher severe patient prosthesis
mismatch and severe structural valve deterioration [Formula presented]
<br/>Conclusion(s): TAVR compared with SAVR in low-risk patients at
long-term follow-up of more than 5 years has similar clinical outcomes but
with mixed hemodynamic outcomes. More long-term data from ongoing clinical
trials is needed to validate our findings. Categories: STRUCTURAL:
Valvular Disease: Aortic.<br/>Copyright &#xa9; 2024

<75>
Accession Number
2035133430
Title
TCT-849 Stroke in TAVR Patients Undergoing Procedures With Recapturable
Valves: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B349), 2024. Date of Publication: 29 Oct 2024.
Author
Haberman D.; Merdler I.; Chitturi K.; Lupu L.; Chaturvedi A.; Abusnina W.;
Cellamare M.; Zhang C.; Sawant V.; Vivien V.; Ben-Dor I.; Rogers T.;
Waksman R.
Institution
(Haberman, Chitturi, Lupu, Cellamare, Vivien) Medstar Washington Hospital
Center, Washington, DC, USA, United States
(Merdler) MedStar Washington Hospital Center, Washington DC, USA, United
States
(Chaturvedi) Georgetown University Medstar Washington Hospital Center,
Washington, DC, USA, United States
(Abusnina) Medstar Georgetown University Medical Center, Chevy Chase,
Maryland, USA, United States
(Zhang) Medstar Cardiovascular Research Network, Washington, DC, USA,
United States
(Sawant, Waksman) MedStar Washington Hospital Center, Washington, DC, USA,
United States
(Ben-Dor) Associate professor Georgetown University, Washington, DC, USA,
United States
(Rogers) MedStar Health, Washington, DC, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter heart valves (THVs) with recapturable and
repositionable capabilities are designed to optimize device deployment
during transcatheter aortic valve implantation (TAVI). However, procedural
safety concerns have arisen owing to the potential risks of aortic valve
tissue embolization and stroke associated with extended maneuvers during
valve implantation. This meta-analysis aimed to examine whether the use of
recapturable THVs are associated with higher stroke rates than the use of
nonrecapturable THVs during TAVI. <br/>Method(s): A systematic literature
search was conducted using PubMed, Embase, and the Cochrane Library to
identify prospective and retrospective studies comparing recapturable and
nonrecapturable THVs. The meta-analysis followed the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The
primary outcome was a stroke at 30 days. <br/>Result(s): A total of 13
studies published from 2013 to 2023 comparing recapturable THVs with
nonrecapturable THVs were included in the meta-analysis. The analysis
revealed no significant difference in 30-day mortality between the two
groups (OR: 1.04; 95% CI: 0.75-1.44). However, recapturable THVs were
associated with a higher risk of stroke at 30 days (OR: 1.46; 95% CI:
1.19-1.79). [Formula presented] <br/>Conclusion(s): Although recapturable
THVs offer several advantages, they may increase the risk of stroke.
Minimizing repositioning and recapturing of self-expanding valves with
recapturable capabilities is advised. Further research is needed to
examine methods to minimize the stroke rate of recapturable valves.
Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9;
2024

<76>
Accession Number
2035133371
Title
TCT-298 Coronary Artery Bypass Grafting Versus Coronary Artery Bypass
Grafting Plus Mitral Valve Surgery in Patients With Moderate Ischemic
Mitral Regurgitation: An Updated Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B68), 2024. Date of Publication: 29 Oct 2024.
Author
Ullah I.; Ahmed M.; Majeed K.; Maaz M.; Rizvi S.; Goyal A.; Irfan M.; Khan
A.W.; Cortese B.
Institution
(Ullah) Khyber Teaching Hospital, Peshawar, Pakistan, Pakistan
(Ahmed, Majeed, Maaz, Rizvi) Shaheed Mohtarma Benazir Bhutto Medical
College, Lyari, Karachi, Pakistan, Pakistan
(Goyal) Seth Gordhandas Sunderdas Medical College and King Edward Memorial
Hospital, Mumbai, Maharashtra, India, India
(Irfan) Wellstar Health System Spalding Hospital, Griffin, Georgia, USA,
United States
(Khan) University of Missouri-Kansas City School of Medicine, Kansas City,
Missouri, USA, United States
(Cortese) University Hospitals, Cleveland, Ohio, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting (CABG) and CABG plus mitral
valve surgery (MVS) have been leading options for the treatment of
moderate ischemic mitral regurgitation (IMR). The aim of this study is to
compare which among CABG and CABG + MVS in patients with moderate IMR is
superlative. <br/>Method(s): A detailed search of international databases,
including PubMed, Scopus, and Google Scholar, from inception until
November 2023 was done, and articles that compared on-pump CABG vs on-pump
CABG + MVS for moderate IMR, specifically patients with +2 and +3 grades
of mitral regurgitation, were selected. The primary outcome assessed was
all-cause mortality. <br/>Result(s): A total of 17 studies were included
with a patient population of 3,169, including 2,239 in the CABG group and
930 in the CABG + MVS group (Figure). All-cause mortality studies (risk
ratio [RR]: 0.89; 95% CI: 0.75-1.05; P = 0.16) was found to be
insignificant. From the secondary outcomes, 30-day mortality (RR: 0.42;
95% CI: 0.27-0.68; P = 0.0003) was significantly lower in the CABG + MVS
group. Moreover, left ventricular ejection fraction (mean difference [MD]:
-1.67; 95% CI: -3.19 to -0.14; P = 0.03) and change of mitral
regurgitation grade (MD: 1.16; 95% CI: 0.36-1.97; P = 0.004) significantly
favored the CABG + MVS group compared to the CABG arm. The outcome of CPB
(MD: -47.61; 95% CI: -61.91 to -33.32; P < 0.00001) and cross-clamp time
(MD: -38.35; 95% CI: -48.80 to -27.91; P < 0.00001) were significantly
shorter in the CABG arm. All other secondary outcomes were insignificant.
[Formula presented] <br/>Conclusion(s): No significant difference was
observed between the group of patients undergoing CABG and CABG + MVS
regarding all-cause mortality. Categories: STRUCTURAL: Valvular Disease:
Mitral.<br/>Copyright &#xa9; 2024

<77>
Accession Number
2035133328
Title
TCT-158 Comparative Efficacy and Safety of Self-Expanding Versus
Balloon-Expandable TAVR in Patients With Aortic Stenosis: A Systematic
Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B394-B395), 2024. Date of Publication: 29 Oct 2024.
Author
Adnan M.; Akhtar M.; Usman M.; Hamza M.; Bakhtiari M.I.; Zaheer W.; Saleem
A.; Naveed H.; Alam M.
Institution
(Adnan) Gujranwala Medical College, Lahore, Pakistan, Pakistan
(Akhtar) Quetta, Pakistan, Pakistan
(Usman) University of Health Sciences, Gujranwala, Pakistan, Pakistan
(Hamza) Guthrie Medical Group, Cortland, New York, USA, United States
(Bakhtiari, Saleem) Gujranwala Medical College, Gujranwala, Pakistan,
Pakistan
(Zaheer) Lahore, Pakistan, Pakistan
(Naveed) University of Houston/HCA Kingwood Hospital, Houston, Texas, USA,
United States
(Alam) Baylor College of Medicine, Houston, Texas, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with aortic stenosis have a high mortality risk. New
self-expanding valves (SEV) and balloon expandable valves (BEV) are used
in transcatheter aortic valve replacement (TAVR). We performed a
systematic review and meta-analysis to compare the clinical outcomes of
efficacy and safety of these 2 valves in patients of aortic stenosis.
<br/>Method(s): A systematic search of PubMed, Embase, and Cochrane was
conducted from inception to June 2024. Randomized controlled trials that
included adult human patients with aortic stenosis undergoing TAVR
comparing clinical outcomes of efficacy and safety between SEV and BEV
were eligible. Random effects meta-analysis using the inverse variance
method was employed. Quality appraisal was done using Cochrane Risk of
Bias 2 Tool. This review was registered with PROSPERO, CRD4202456362.
<br/>Result(s): We identified 8 RCTs and data from 2,779 patients was
analyzed. Random effects analysis showed that SEV when compared with BEV
significantly increased risk of all-cause mortality RR: 1.84 (95% CI:
1.11-3.04), cardiovascular mortality RR: 2.00 (95% CI: 1.05-3.83), and
permanent pacemaker implantation RR: 1.67 (95% CI: 1.22-2.28) at 30 days.
However, these outcomes were not statistically significant at 1 year.
Other assessed outcomes like stroke, acute kidney injury, and myocardial
infarction also did not have statically significant results [Formula
presented] <br/>Conclusion(s): BEV had improved mortality outcomes
compared to SEV in the short term. However, future clinical trials with
larger sample sizes are needed for comprehensive understanding.
Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9;
2024

<78>
Accession Number
2035133309
Title
TCT-77 Revascularization of Left Main Coronary Artery in Patients With
Chronic Kidney Disease: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B201), 2024. Date of Publication: 29 Oct 2024.
Author
Gialamas I.; Kalogeras K.; Zakynthinos G.E.; Lysandrou A.; Gounaridi M.I.;
Siasos G.
Institution
(Gialamas) 3rd Department of Cardiology, Athens, Greece
(Kalogeras, Zakynthinos, Lysandrou, Siasos) 3rd Cardiology Department,
University of Athens Medical School, Sotiria Chest Diseases Hospital,
Athens, Greece
(Gounaridi) Sotiria Hospital, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: Left main coronary artery disease (LMCAD) is a critical
condition requiring invasive treatment, traditionally managed by coronary
artery bypass grafting (CABG) or more recently by percutaneous coronary
intervention (PCI). Chronic kidney disease (CKD) is a common comorbidity
in those patients, affecting the outcome and treatment options. This
systematic review and meta-analysis compare the outcomes of PCI and CABG
in patients with both LMCAD and CKD. <br/>Method(s): A systematic
literature search in PubMed, Embase, and CENTRAL was conducted. Studies
that compared PCI and CABG in the setting of LMCAD and CKD were included.
The extracted primary endpoints were all-cause death and major adverse
cardiac and cerebrovascular events (MACCE). Secondary endpoints included
30-day all-cause death, myocardial infarction (MI), revascularization,
stroke, and cardiovascular death. Statistical analysis was conducted in R.
<br/>Result(s): The article retrieval resulted in 6,059 articles, of which
7 studies with 3,475 patients were included. Pooled analysis of the
primary outcomes revealed a higher incidence of all-cause death (HR: 1.38;
95% CI: 1.09-1.76; I²: 4%) and MACCE (HR: 1.50; 95% CI:
1.26-1.78; I²: 0%) in patients treated with PCI compared to
CABG. Additionally, patients treated with PCI had a higher incidence of
myocardial infarction (MI) (HR: 1.76; 95% CI: 1.15-2.71; I²:
8%) and revascularization rates (HR: 3.66; 95% CI: 1.84-7.30;
I²: 57%). No difference was found in 30-day all-cause death
(OR: 0.92; 95% CI: 0.35-2.41; I²: 57%) and stroke rates (HR:
0.70; 95% CI: 0.40-1.22; I²: 0%). <br/>Conclusion(s): This
systematic review and meta-analysis showed that despite the modern
improvements in novel stenting techniques and technologies, PCI seems to
be inferior to CABG, in patients suffering from both LMCAD and CKD. There
is a critical need for more well-designed randomized controlled trials to
better guide revascularization strategies in this high-risk population.
Categories: CORONARY: Complex and Higher Risk Procedures for Indicated
Patients (CHIP).<br/>Copyright &#xa9; 2024

<79>
Accession Number
2035133276
Title
TCT-956 Validation of the VARC-HBR Criteria in TAVI Patients on Oral
Anticoagulation.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B407), 2024. Date of Publication: 29 Oct 2024.
Author
Overduin D.; Jan van Ginkel D.; Bor W.; Peper J.; Berg J.T.
Institution
(Overduin, Jan van Ginkel, Peper) St. Antonius Hospital, Nieuwegein,
Netherlands, Netherlands
(Bor) St. Antonius Hospital, Utrecht, Netherlands, Netherlands
(Berg) St. Antonius Hospital, Bilthoven, Netherlands, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Bleeding remains frequent after transcatheter aortic valve
implantation (TAVI). Recently, the Valve Academic Research Consortium high
bleeding risk criteria were introduced to identify patients at (very) high
risk of bleeding. These criteria await validation. <br/>Method(s): Data
were obtained from the POPular PAUSE TAVI trial, a randomized clinical
trial comparing interruption vs continuation of oral anticoagulation
during TAVI. Major and minor bleeding risk criteria were identified at
baseline, and bleeding events were captured up to 30 days after TAVI.
Patients were classified into 3 groups: with <=1 minor criterion (moderate
risk), with 1 major or 2 minor criteria (high risk), and with >=2 major or
>=3 minor criteria (very high risk). <br/>Result(s): A total of 856
patients were included: 370 (43.2%) moderate risk, 330 (38.6%) high risk,
and 156 (18.2%) very high risk. Bleeding risk criteria occurring in more
than 1% of patients are shown in Figure A. The incidence of Bleeding
Academic Research Consortium 3 to 5 major bleeding was 5.1% for moderate
risk, 9.1% for high risk, and 16.0% for very high risk (P < 0.001; Figure
B). Receiver operating characteristic analysis showed an area under the
curve of 0.63 (95% CI: 0.56-0.69), indicating moderate discriminative
performance of the 3-class risk score (Figure C). [Formula presented]
<br/>Conclusion(s): The presence of additional Valve Academic Research
Consortium high bleeding risk criteria, defined by the 3 risk classes,
aligned with a gradual increase in Bleeding Academic Research Consortium 3
to 5 bleeding in patients requiring oral anticoagulation within the first
30 days after TAVI. However, the discriminative performance is moderate.
Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9;
2024

<80>
Accession Number
2035133246
Title
TCT-433 Five-Year Clinical Results of Patients Treated With Angiolite
Drug-Eluting Stents: Real Life Registry (Epic02-Rango Study).
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B128), 2024. Date of Publication: 29 Oct 2024.
Author
Perez de Prado A.; Ocaranza-Sanchez R.; Trillo R.; Lozano F.; Bermudez
E.P.; Torres A.; Laso F.S.; Gonzalez L.F.; Sabate M.; Rodrigues A.; Burgos
J.M.; Rumoroso J.
Institution
(Perez de Prado) Hospital Universitario de Leon, Leon, Spain, Spain
(Ocaranza-Sanchez) Lucus Augusti Universitary Hospital, Lugo, Spain, Spain
(Trillo) Hospital Clinico de Santiago, Santiago De C., Spain, Spain
(Lozano) University General Hospital of Ciudad Real. Spain, Ciudad Real,
Spain, Spain
(Bermudez) Hospital CUV Arrixaca. Murcia, Murcia, Spain, Spain
(Torres, Torres) Hospital Araba, Vitoria Gasteiz, Spain, Spain
(Laso) Hospital Universitario Marques de Valdecilla, Santander, Spain,
Spain
(Gonzalez) Hospital Universitario de Cruces, Barakaldo (Bizkai), Spain,
Spain
(Sabate) Hospital Clinic of Barcelona, Barcelona, Spain, Spain
(Rodrigues) Centro Hospitalar de Gaia, Gaia, Portugal, Portugal
(Burgos) Hospital Universitario de Toledo, Toledo, Spain, Spain
(Rumoroso) Hospital Galdakao-Usansolo, Galdakao, Spain, Spain
Publisher
Elsevier Inc.
Abstract
Background: A real-world registry of Angiolite, a fluoropolymer based
sirolimus-eluting stent (iVascular, Barcelona, Spain) fulfills a
comprehensive research program. After positive initial results (FIH study:
ANCHOR, NCT02776267; RCT: Angiolite vs Xience, NCT03049657), we analyze
the long-term results in a nonselected population. <br/>Method(s): All
consecutive patients who underwent PCI with the use of, at least, one
Angiolite stent and gave informed consent were prospectively included in
17 centers for 1 year. The exclusion criteria were absolute
contraindication for DAPT, cardiogenic shock, or high probability of
follow-up loss. The primary objective was TLF as a composite of cardiac
death, target vessel related MI or clinically-driven TLR at 1, 2, and 5
years. Secondary endpoints were the individual components of the primary
objective, MACE (all-cause death, any MI, or any revascularization), and
stent thrombosis. <br/>Result(s): We report the 5-year results of 646
patients with a higher risk profile than included in the aforementioned
RCT. The patients were older (66 +/- 12 vs 62 +/- 10 years; P = 0.002),
with more previous MI (18.4% vs 7.3%), previous PCI/CABG (20.3% vs 10.9%),
and multivessel disease (48.1% vs 22.7%); all P < 0.05. Also, clinical
presentation was STEMI in 23.1% in the registry vs 10.9% in the RCT (P =
0.004). Five-year all-cause death, cardiac death, and MI rates were 11.5%,
5%, and 4%. Definite or probable device thrombosis rate was 0.9%; no cases
of stent thrombosis were detected beyond 1 year. There was at least 1
re-PCI in 7.0% of patients, which 2.3% was a TLR, 3.3% TVR, and 3.7%
non-TVR. Thus, TLF, TVF, and MACE rates were 4.6%, 5.6%, and 17.8%,
respectively. Two subgroups were predefined: small vessels (<=2.5 mm; n =
116) and diabetes mellitus (n = 199). The 5-year results in small vessels
group were close to those in the whole group (TLF 6%, TVF 7.8%, and MACE
19%). As expected, diabetics showed worse clinical prognosis albeit good
stent performance results:TLF 10.1%, TVF 12.6%, and MACE 42%.
<br/>Conclusion(s): In summary, the 5-years results of Epic02-Rango
registry of Angiolite stent in a real-world population corroborate its
excellent efficacy and safety profile. No signals of late events appeared.
Categories: CORONARY: Stents: Drug-Eluting and Bare Metal.<br/>Copyright
&#xa9; 2024

<81>
Accession Number
2035133143
Title
TCT-762 Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve
Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B306-B307), 2024. Date of Publication: 29 Oct 2024.
Author
Alam Kayani A.M.; Garcia A.; Lemus-Zamora R.E.; Rashid M.A.; Abela O.
Institution
(Alam Kayani, Rashid, Abela) AdventHealth Tampa, Tampa, Florida, USA,
United States
(Garcia, Lemus-Zamora) Indiana University School of Medicine,
Indianapolis, Indiana, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has emerged as
an effective alternative to surgical aortic valve replacement (SAVR) in
the management of aortic stenosis (AS), especially in patients who are at
high or prohibitive surgical risk. However, there is limited evidence
regarding the long-term efficacy of TAVR in low and intermediate surgical
risk patients. <br/>Method(s): PubMed, Web of Science, Google Scholar, and
Cochrane databases were searched from inception until June 23, 2024.
Outcomes measured included all-cause mortality, stroke, and permanent
pacemaker implantation (Figure). The outcomes were reported using HRs with
a random effects model using 95% CIs. <br/>Result(s): Seven randomized
controlled trials with 7,901 patients (mean age = 79 years, 42% females)
at low and intermediate surgical risk were selected. The mean Society of
Thoracic Surgeons Predicted Risk of Mortality score was 3.1%, and the
average follow-up time was 4 years. There was no significant difference
between TAVR and SAVR in the risk for all-cause mortality (HR: 0.96; 95%
CI: 0.80-1.15; P = 0.65; I²: 55%) and stroke (HR: 0.95; 95% CI:
0.80-1.12; P = 0.55; I²: 8%). However, TAVR was associated with
a significantly increased risk for permanent pacemaker implantation (HR:
2.13; 95% CI: 1.47-3.10; P < 0.0001; I²: 88%). [Formula
presented] <br/>Conclusion(s): There was no difference in long-term risk
for all-cause mortality and stroke between TAVR and SAVR in patients at
low and intermediate surgical risk. However, TAVR was associated with an
increased risk for permanent pacemaker implantation. Categories:
STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9; 2024

<82>
Accession Number
2035133136
Title
TCT-290 Survival After PCI or CABG in Patients With NSTEMI and Left Main
Disease: A Report From the Registry.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B62), 2024. Date of Publication: 29 Oct 2024.
Author
Omerovic E.
Institution
(Omerovic) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden, Sweden
Publisher
Elsevier Inc.
Abstract
Background: The long-term outcome of percutaneous coronary intervention
(PCI) vs coronary artery bypass graft (CABG) for patients with
non-ST-segment elevation myocardial infarction (NSTEMI) and left main
disease (LM) remains controversial. <br/>Method(s): We used data from the
national SWEDEHEART registry on all revascularized patients with NSTEMI in
Sweden between January 2005 and June 2022. The primary endpoint was
all-cause mortality. We aimed to emulate the target RCT by applying these
eligibility criteria: NSTE-ACS with LM, no cardiogenic shock or cardiac
arrest before admission, and no previous stroke, renal failure, cancer, or
dementia. We used multilevel logistic regression with follow-up time as a
log-transformed offset variable and hospital as a random effect. We
applied double-robust adjustment using the instrumental variable method
with 2-step residual inclusion and inverse probability weighting
propensity score to adjust for known and unknown confounders. The
treatment-preference instrument was the quintile of preference for
percutaneous coronary intervention (PCI) at the treating hospital. We
calculated the number of days and months that revascularization could
prolong life using the restricted mean survival time method.
<br/>Result(s): A total of 9,168 patients (76.4% men and 23.6% women) were
included; 22.9% had diabetes, and 13.6% had a previous MI. The mean age
was 71.1 +/- 9.7 years (60.4% were >70 years of age), and 22.9% had
postinfarction heart failure. The primary designated therapy was PCI in
3,795 (41.2%) and CABG in 5,373 (58.6%). The median follow-up time was 5.9
years (range: 1 day to 17.1 years). There were 3,446 (37.6%) deaths. The
risk of death (adjusted OR: 2.29; 95% CI: 1.96-2.67; P < 0.001) was higher
after PCI. For patients with a life expectancy of at least 15 years after
revascularization, the average lifetime was 2.9 years (95% CI: 2.6-3.3
years) longer after CABG (P < 0.001) (Figure 2). However, for patients
with a life expectancy <=5 years, the average lifetime was 5.6 (95% CI:
18.0-32.4; P < 0.001) longer after CABG. <br/>Conclusion(s): CABG is
associated with lower mortality than PCI in NSTEMI patients with LM. The
survival benefit of CABG decreases for those with shorter life expectancy.
Categories: CORONARY: Acute Coronary Syndromes.<br/>Copyright &#xa9; 2024

<83>
Accession Number
2035133037
Title
TCT-907 High-Flow Nasal Oxygenation in Sedation for Transcatheter Aortic
Valve Replacement Procedures: Results of the Randomized Controlled
HIGH-OXY-TAVR Study.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B382), 2024. Date of Publication: 29 Oct 2024.
Author
Manzano A.; Gimenez M.; Regueiro A.; Carretero M.J.; Pozo M.; Vega F.;
Perdomo J.M.; Brugaletta S.; Italiano S.; Trilla M.; Rovira I.; Sabate M.;
Arguis M.J.; Ibanez C.
Institution
(Manzano, Italiano) Hospital Clinic, Barcelona, Spain, Spain
(Gimenez, Carretero) Hospital Clinic, Barcelona, Spain, Spain
(Regueiro, Pozo, Rovira, Arguis, Ibanez) Hospital Clinic Barcelona,
Barcelona, Spain, Spain
(Vega) Hospital Clinic Barcelona, Barcelona, Spain, Spain
(Perdomo) Hospital Clinic of Barcelona, Barcelona, Spain, Spain
(Brugaletta) Hospital Clinic, University of Barcelona, Barcelona, Spain,
Spain
(Trilla) Hospital Clinic de Barcelona, Barcelona, Spain, Spain
(Sabate) Hospital Clinic of Barcelona, Barcelona, Spain, Spain
Publisher
Elsevier Inc.
Abstract
Background: Conscious sedation is the current standard of care during
transcatheter aortic valve replacement (TAVR). However, sedation could
produce hypoxia and hypercapnia that can aggravate hemodynamic
disturbances during the procedure. Data on high flow nasal oxygenation
(HFNO) efficacy in hypoxia prevention in TAVR are conflicting. We aimed to
determine the benefit of HFNO during TAVR and potential impact on tissue
injury prevention. <br/>Method(s): The HIGH-OXY-TAVR unicentric study
randomized 1:1 the use of HFNO vs conventional oxygenation during deep
sedation for transfemoral TAVR. HFNO was administered by the Optiflow
Nasal High Flow delivery system (Fisher and Paykel) at a flow rate of 60
L/min and FiO2 0.6 (intervention group [IG]). The control group (CG)
received 6 L/min oxygen via dry nasal specs. The primary endpoint was the
number of desaturation episodes (SpO<inf>2</inf> <93% for >10 s).
Secondary outcomes included changes in arterial partial pressure of oxygen
(pO<inf>2</inf>) at 45 min. Serological biomarkers were collected before
the procedure and at 8 h after TAVR. <br/>Result(s): Of a total of 132
randomized patients, 7 were excluded due to crossover to general
anesthesia to allow vascular surgical repair, resulting in a final cohort
of 125 patients (IG: n = 64; CG: n = 61). The number of desaturation
episodes was significantly lower in the IG (median 0 [0-5] vs 1 [0-12] in
the CG; P < 0.005). Any episode of desaturation occurred less often in the
IG (n = 13 [20.3%] vs n = 31 [50.8%]; RR: 0.39; 95% CI: 0.23-0.68; P <
0.005; number needed to treat of 3.3 patients). At 45 min, pO<inf>2</inf>
was significantly higher in the IG (mean 180 +/- 74 vs 126 +/- 56 mm Hg; P
< 0.05). At 8 h, mean glomerular filtration rate was higher in the IG
(mean 66.7 +/- 20 vs 57.6 +/- 23 mL/min per 1.73 m²; P < 0.05).
The rest of the serologic biomarkers related to tissue injury were also
numerically higher in the CG. <br/>Conclusion(s): The HIGH-OXY-TAVR study
demonstrated that HFNO provides a superior oxygenation profile compared
with standard oxygen therapy during TAVR. The potential benefit on
end-organ function will need to be confirmed in larger studies.
Categories: STRUCTURAL: Valvular Disease: Aortic.<br/>Copyright &#xa9;
2024

<84>
Accession Number
2035131847
Title
TCT-150 Impact of Naples Prognostic Score on Clinical Outcomes After
Transcatheter Aortic Valve Replacement in Patients With Severe Aortic
Stenosis: A Systematic Review and Meta-Analysis With Reconstructed
Time-to-Event Data.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B368), 2024. Date of Publication: 29 Oct 2024.
Author
Turkmani M.; Amin A.M.; Al Barznji S.; Elbenawi H.; Salam D.
Institution
(Turkmani) Michigan State University/McLaren Healthcare, Rochester Hills,
Michigan, USA, United States
(Amin) Mansoura University, Mansoura, Egypt, Egypt
(Al Barznji) Michigan State University/McLaren Healthcare, Pontiac,
Michigan, USA, United States
(Elbenawi) Mayo Clinic, Rochester, Minnesota, USA, United States
(Salam) Cleveland Clinic, Rochester, Michigan, USA, United States
Publisher
Elsevier Inc.
Abstract
Background: Preoperative inflammatory and nutritional status impact
outcomes in transcatheter aortic valve replacement (TAVR) patients. The
Naples Prognostic Score (NPS) assesses these factors. We aim to study
NPS's impact on clinical outcomes post-TAVR in severe AS patients.
<br/>Method(s): We comprehensively searched PubMed, Web of Science,
Scopus, Embase, and CENTRAL through June 2024. We conducted a pairwise and
prognostic systematic review and meta-analysis with reconstructed
time-to-event data using RV.4.3.1. <br/>Result(s): With 3 studies
included, our cohort had 1,113 patients. Pairwise meta-analysis showed
high NPS (3-4) significantly increased overall mortality (risk ratio [RR]:
2.06; 95% CI: 1.77-2.40; P < 0.01) and acute kidney injury (RR: 1.67;95%
CI: 1.07-2.62; P = 0.02) compared with low NPS (0-2). No significant
differences in in-hospital mortality, pacemaker implantation, and major
bleeding were found between high and low NPS. Adjusted prognostic
meta-analysis indicated high NPS (3-4) was associated with a 617% higher
overall mortality risk compared to low NPS (0-2) (HR: 7.17; 95% CI:
5.29-9.71; P < 0.01) (Figure). Reconstructed Kaplan-Meier analysis showed
a 407% increased overall mortality risk for high NPS (3-4) (HR: 5.07; 95%
CI: 4.03-6.39; P < 0.00001) over 72 months. [Formula presented]
<br/>Conclusion(s): Preoperative inflammatory and nutritional status
significantly impact TAVR outcomes. The NPS is a key indicator of
malnutrition and inflammation in severe AS patients undergoing TAVR.
Including NPS in preoperative evaluations helps stratify patients,
ensuring accurate identification of those who will benefit most from TAVR.
However, further research is needed to validate NPS's effectiveness in
predicting post-TAVR outcomes. Categories: STRUCTURAL: Valvular Disease:
Aortic.<br/>Copyright &#xa9; 2024

<85>
Accession Number
2035174190
Title
Left atrial appendage occlusion devices vs direct oral anticoagulants for
atrial fibrillation: An updated systematic review and meta-analysis.
Source
Current Problems in Cardiology. 50(1) (no pagination), 2025. Article
Number: 102880. Date of Publication: January 2025.
Author
Fernandes J.M.; Pinheiro R.P.S.; Serpa F.; de Andrade N.M.; Pereira V.;
Sbardelotto A.E.E.; Gomes W.F.
Institution
(Fernandes) Faculdade Israelita de Ciencias da Saude Albert Einstein, Rua
Comendador Elias Jafet, 755- Sao Paulo, Sao Paulo 05653-000, Brazil
(Pinheiro, Sbardelotto) Universidade Federal do Rio de Janeiro, Rua
Professor Rodolpho Paulo Rocco, 255- Rio de Janeiro, Rio de Janeiro
21941-617, Brazil
(Serpa) Department of Internal Medicine, University of Texas Southwestern
Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, United States
(de Andrade) Escola Bahiana de Medicina e Saude Publica- Bahia, Av. Dom
Joao VI, 275, Bahia, Salvador 40290-000, Brazil
(Pereira) Facultad Ciencias Biomedicas, Universidad Austral, Av. Juan
Domingo Peron, 1500- Pilar, Buenos Aires B1629, Argentina
(Gomes) INC Hospital, Department of Interventional Cardiology,
Universidade Federal do Parana, Faculdades Pequeno Principe, Hospital
Santa Casa de Misericordia de Curitiba, Rua Jeremias Maciel Perretto, 300,
Parana, Curitiba 81210-310, Brazil
Publisher
Elsevier Inc.
Abstract
Background: Direct Oral Anticoagulants (DOACs) are the first line
anticoagulation for patients with non-valvular atrial fibrillation (NVAF).
Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a new
therapy and its safety and effectiveness compared with DOACs are still
controversial. <br/>Method(s): A systematic review of randomized
controlled trials and observational studies was conducted, focusing on
patients with NVAF. Outcomes analyzed included: (1) all-cause mortality;
(2) cardiovascular (CV) mortality; (3) thromboembolic events; (4) stroke
or transient ischemic attack (TIA); (5) bleeding events; and a (6)
composite of death, hemorrhagic, and thromboembolic events. We performed a
subgroup analysis of major bleeding according to different definitions:
(1) Bleeding Academic Research Consortium (BARC); (2) International
Society on Thrombosis and Haemostasis (ISTH); and (3) other definitions.
<br/>Result(s): Ten studies involving 18,507 patients were included, with
42.35 % undergoing LAAO. In pooled analysis, LAAO was associated with
lower rates of all-cause mortality (HR 0.63; 95 % CI 0.50-0.80),
cardiovascular mortality (HR 0.56; 95 % CI 0.45-0.70), and of the
composite outcome (HR 0.73; 95 % CI 0.58-0.92). A trend towards lower
stroke/TIA events was observed but not statistically significant. Overall
bleeding events did not significantly differ between groups; using the
ISTH definition, LAAO showed significantly lower incidence of bleeding
events (HR 0.63; 95 % CI 0.43-0.91). No difference was found in
thromboembolic events. <br/>Conclusion(s): LAAO was associated with a
significantly lower all-cause mortality and cardiovascular mortality, as
well as the composite of death, hemorrhagic or thromboembolic events, as
compared with DOACs.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<86>
Accession Number
2034998725
Title
Comparing outcomes of balloon-expandable vs. self-expandable valves in
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Annals of Medicine and Surgery. 86(7) (pp 4060-4074), 2024. Date of
Publication: 26 Jan 2024.
Author
Khan Q.A.; Farrukh A.M.; Belay N.F.; Li D.; Afzal M.; Nadella A.; Semakieh
B.; Baqi A.; Robles Rodriguez A.M.; Biougnach M.
Institution
(Khan) Khyber Teaching Hospital, MTI KTH, Peshawar, Pakistan
(Farrukh) University of Galway, School of Medicine, Galway, Ireland
(Belay) Michigan State University, East Lansing, MI, United States
(Li) Idaho College of Osteopathic Medicine, Meridian, ID, United States
(Afzal) St. George's University, School of Medicine True Blue, Grenada
(Nadella) Nanjing Medical University, Nanjing, China
(Semakieh) Arkansas College of Osteopathic Medicine, AR, United States
(Baqi) Mercy Saint Vincent Medical Center, Toledo, OH, United States
(Robles Rodriguez) Universidad Central Del Caribe, PR, Puerto Rico
(Biougnach) Lycee Paul Valery High School, Meknes, Morocco
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Aortic stenosis (AS) is a common heart condition categorized
into congenital and acquired forms. Transcatheter aortic valve replacement
(TAVR) is an innovative method for AS management, and two valve types,
self-expanding valves (SEV) and balloon-expandable valves (BEV), are used
in TAVR. The objective of this study is to compare the clinical outcomes
associated with balloon-expandable and self-expandable valves in
transcatheter aortic valve replacement. <br/>Method(s): The researchers
conducted a comprehensive meta-analysis following PRISMA guidelines and
AMSTAR-2 tool. The methodology involved a systematic literature search,
strict eligibility criteria, unbiased study selection, meticulous data
extraction, quality assessment, and rigorous statistical analysis.
<br/>Result(s): Our analysis included twenty-six papers and 26 553
patients. BEV exhibited significant advantages over SEV in overall
mortality across 21 studies, particularly in perioperative and 30-day
assessments. However, no substantial disparities emerged between the two
valve types in stroke incidence. BEV demonstrated notable benefits in
reducing hospitalization rates across 6 studies and significantly fewer
instances of permanent pacemaker implantations across 19 studies,
particularly evident in the perioperative setting. Other secondary
outcomes like bleeding, acute kidney injury, and myocardial infarction
showcased non-significant differences between BEV and SEV.
<br/>Conclusion(s): The analysis indicates that BEV may offer benefits in
specific aspects of TAVR outcomes, but further research is needed to fully
understand the factors influencing patient outcomes and mortality in TAVR
procedures. <br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<87>
Accession Number
2035126538
Title
State of the Art Review: Aortic Valve Repair in Infants and Children.
Source
Annals of Thoracic Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Chiu P.; Higgins H.A.; Baird C.W.
Institution
(Chiu, Higgins, Baird) Department of Cardiac Surgery, Boston Children's
Hospital, Boston, Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Background: Congenital aortic and truncal valve disease is challenging in
infants and children given the lack of available prostheses in very small
sizes and the limited durability of homograft aortic valve replacement.
<br/>Method(s): A comprehensive literature search was performed using the
PubMed database. Studies were included either if the report included
patients less than 1 year of age or if the technique was tailored to
accommodate for somatic growth. <br/>Result(s): Techniques for aortic and
truncal valve repair addressing each aspect of the aortic valve
complex-the aorta, aortic annulus, commissures, and cusps-were reviewed.
The incidence of reoperation after aortic or truncal valve repair is
significant at 10 years and ranges from 30% to 70% depending on the
underlying diagnosis and the repair technique used. A significant
challenge in interpreting the published literature relates to the lack of
anatomic data available in the publications, thus limiting both the
ability to make direct comparisons among operative techniques and the
ability to draw conclusions regarding these techniques as applied to
varied causes. <br/>Conclusion(s): A comprehensive understanding of the
aortic valve complex is necessary to achieve adequate results in pediatric
aortic valve repair given the high variability in these
valves.<br/>Copyright &#xa9; 2024 The Society of Thoracic Surgeons

<88>
Accession Number
2031895367
Title
Bifurcated Endografts for the Treatment of Aortoiliac Disease a Systematic
Review and Individual Patient Data (IPD) Meta-Analysis.
Source
Journal of Endovascular Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Manaki V.; Bontinis V.; Bontinis A.; Giannopoulos A.; Kontes I.; Ktenidis
K.
Institution
(Manaki, Bontinis, Bontinis, Giannopoulos, Kontes, Ktenidis) Department of
Vascular Surgery, AHEPA University General Hospital, Aristotle University
of Thessaloniki, Thessaloniki, Greece
Publisher
SAGE Publications Inc.
Abstract
Background: This review aimed to assess the efficacy and safety of
bifurcated endografts in the treatment of aortoiliac disease (AOID).
<br/>Method(s): A systematic search on PubMed, Scopus, and Web of Science
was performed. The primary endpoint was primary patency, whereas secondary
endpoints included reintervention, technical, clinical success, and
overall postoperative complications. <br/>Result(s): Ten studies with a
total of 365 patients were included in this review. Most included studies
used the AFX unibody endograft, one study the Excluder endograft, and one
the Powerlink endograft. The majority of included patients displayed
TransAtlantic InterSociety Consensus (TASC) D aortoiliac lesions (56.1%
205/365). The pooled primary patency estimates at 12, 24, and 36 months
were 93.93% (95% confidence interval [CI]: 87.7-100), 91.46% (95% CI:
84.6-98.8), and 90.25% (95% CI: 82.6-98.6), respectively. The mean primary
patency time was 85.74 months (95% CI: 71.99-86.88). The pooled freedom
from reintervention estimates at 12, 24, and 36 months were 91.94% (95%
CI: 81.4-100), 91.03% (95% CI: 79.8-100), and 91.03% (95% CI: 79.8-100),
respectively. The pooled estimates of major complications (rupture, graft
thrombosis, amputation) were 11.12% (95% CI, 0.05%-3.03%), 3.76%
(0.32%-9.45%), and 0.38% (0%-2.59%), whereas the pooled estimates for
minor complications (hematoma, groin infection, dissection) and overall
mortality were 5.27% (95% CI, 1.11%-11.38%), 6.93% (95% CI, 2.94%-12.16%),
2.19% (95% CI, 0.06%-6.14%), and1.57% (95% CI, 0.13-3.97), respectively.
Technical and clinical success estimates were 99.92% (95% CI: 98.86%-100%)
and 99.47% (95% CI: 94.92%-100%), respectively. <br/>Conclusion(s): The
application of bifurcated endografts may present a safe and viable option
in the treatment of AOID, with preliminary results indicating promising
primary patency outcomes. However, the definitive assessment of their
efficacy and safety will be better determined through long-term follow-up
studies and high-quality randomized controlled trials, which are essential
to substantiate these initial findings. Clinical Impact: Bifurcated
endograft application may be a safe and viable alternative for high-risk
patients with complex AOID TASC C and D lesions with encouraging primary
patency outcomes potentially comparable to those of open surgery.
Non-negligible postoperative complication rates were also noted.
High-quality randomized controlled trials and studies comparing CERAB,
kissing stenting, and the use bifurcated endografts for the treatment of
AOID is necessary to draw more definite conclusions.<br/>Copyright &#xa9;
The Author(s) 2024.

<89>
Accession Number
2031814118
Title
Semaglutide effects on safety and cardiovascular outcomes in patients with
overweight or obesity: a systematic review and meta-analysis.
Source
International Journal of Obesity. (no pagination), 2024. Date of
Publication: 2024.
Author
Cleto A.S.; Schirlo J.M.; Beltrame M.; Gomes V.H.O.; Acras I.H.; Neiverth
G.S.; Silva B.B.; Juliatto B.M.S.; Machozeki J.; Martins C.M.
Institution
(Cleto, Schirlo, Beltrame, Gomes, Acras, Neiverth, Silva, Juliatto,
Machozeki, Martins) State University of Ponta Grossa, Department of
Medicine, Parana, Brazil
Publisher
Springer Nature
Abstract
Background: Semaglutide is a GLP-1 receptor agonist that provides a
reduction in glycated hemoglobin and weight. The objective was to evaluate
whether the use of semaglutide, in individuals with overweight or obesity,
reduces cardiovascular outcomes and adverse effects (AE). <br/>Method(s):
The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane
Library were surveyed. <br/>Result(s): Initially, 3333 articles were
found, of which 19 articles were included. An additional search included
19 studies, totaling 38 articles. Relative risk (RR) values were
significant for hospitalization due to heart failure (HF) 0.24 95% CI
0.12-0.57 (n = 2; 1045 participants; I2 = 0.18), death due to
cardiovascular causes 0.83 95% CI 0.71-0.98 (n = 3; 24 084 participants;
I2 = 0.21), death from any cause 0.79 95% CI 0.70-0.89 (n = 3; 24 084
participants; I2 = 0.07), coronary revascularization 0.76 95% CI 0.69-0.85
(n = 2;20 951 participants; I2 = 0.41), and non-fatal myocardial
infarction 0.76 95%CI 0.66-0.88 (n = 3; 24 084 participants; I2 = 0.21),
with a difference between the subgroups (p = 0.05), favoring the
subcutaneous administration route. The RR of stroke was 0.65 95% CI
0.44-0.97 for patients with diabetes (n = 2; 6480 participants; I2 =
0.66). There was no difference between the frequency of constipation and
routes of administration, as well as between doses of oral semaglutide.
The RR of adverse effects was only not significant for discontinuation of
treatment for oral semaglutide. <br/>Conclusion(s): The use of semaglutide
reduced 76% in hospitalization due to HF, 17% deaths due to cardiovascular
causes, 21% deaths due to any cause, 24% non-fatal myocardial infarction,
24% coronary revascularization and 35% stroke (in patients with diabetes).
The use of semaglutide was associated with a higher relative risk and
frequency of most adverse effects evaluated.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Nature Limited 2024.

<90>
Accession Number
645549871
Title
Educational programmes for improving medication adherence among older
adults with coronary artery disease: A systematic review and
meta-analysis.
Source
International journal of nursing studies. 161 (pp 104924), 2024. Date of
Publication: 09 Oct 2024.
Author
Xu M.; Lo S.H.S.; Miu E.Y.N.; Choi K.C.
Institution
(Xu, Lo, Miu, Choi) Nethersole School of Nursing, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
Abstract
BACKGROUND: Coronary artery disease is the leading cause of death
worldwide. Adhering to coronary artery disease medications is the priority
of its treatment. Medication adherence is suboptimal among older adults
with coronary artery disease. Educational programmes are used and
recommended in improving medication adherence among older adults with
coronary artery disease. The evidence about the effects of educational
programmes on medication adherence among older adults with coronary artery
disease is, however, limited. AIM: To evaluate the effects of educational
programmes designed for improving medication adherence among older adults
with coronary artery disease. <br/>METHOD(S): 12 English databases and
five Chinese databases were searched from database inception to January
2024. Randomised controlled trials examining the effects of educational
programmes for improving medication adherence among older adults (aged 60
years old or above) with coronary artery disease (including myocardial
infarction, stable or unstable angina, undergoing percutaneous coronary
intervention, or undergoing coronary artery bypass grafting) were
included. The quality of the included studies was assessed by the Cochrane
Risk of Bias Tool v2. Meta-analysis was conducted using random-effect
models with Review Manager 5.3. Narrative synthesis was conducted if the
results of the included studies were not appropriate or possible for
meta-analysis. The Grading of Recommendations, Assessment, Development,
and Evaluation approach was used to assess the certainty of evidence.
<br/>RESULT(S): 5607 records were retrieved, and 5600 records were
excluded. Six randomised controlled trials were included. The results
showed that educational programmes could significantly improve medication
adherence at two to six months post-intervention (standardised mean
difference (SMD): 1.13, 95 % confidence interval (CI): 0.33 to 1.94, P =
0.006, Moderate certainty of evidence), but there was no significant
evidence to support their effect on medication adherence within one-month
post-intervention (SMD: 2.18, 95 % CI: -1.22, 5.58, P = 0.21, Low
certainty of evidence). Narrative synthesis found that the educational
programmes potentially improved medication adherence over six months
post-intervention, understanding of coronary artery disease and related
medications, and medication management capacity. <br/>CONCLUSION(S):
Educational programmes could significantly improve medication adherence
among older adults with coronary artery disease at two to six months
post-intervention, and potentially improve medication adherence over six
months post-intervention. The effect on medication adherence within
one-month post-intervention was inconclusive. Designing the educational
programmes with theoretical frameworks and refined components helps
address their complex health needs. More rigorous evaluation of the
effects of educational programmes on medication adherence of the older
adults with coronary artery disease is warranted. REGISTRATION: PROSPERO
(Registration Number: CRD42024472344; Registration name: Educational
programmes for improving medication adherence among older adults with
coronary artery disease: A systematic review).<br/>Copyright &#xa9; 2024
The Authors. Published by Elsevier Ltd.. All rights reserved.

<91>
Accession Number
2026621880
Title
Redosing of long acting cardioplegic solutions in adult cardiac surgery: A
comparative study.
Source
Perfusion (United Kingdom). 39(8) (pp 1685-1691), 2024. Date of
Publication: November 2024.
Author
Gunaydin S.; McCusker K.; Nicotra W.
Institution
(Gunaydin) Department of Cardiac Surgery, University of Health Sciences,
Ankara, Turkey
(McCusker) Department of Clinical Perfusion, Lawrence Technological
University, Southfield, MI, United States
(Nicotra) Department of Cardiac Surgery, St Clair Hospital, Pittsburgh,
PA, United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Despite promising results regarding using long-acting
cardioplegia in the adult population, little data exists specifically for
operations requiring prolonged aortic cross-clamp needing additional
doses. In this pilot study, we evaluated the outcomes of patients
undergoing surgery with prolonged cross-clamp time based on four different
redosing compositions. <br/>Method(s): During the period from January 2019
until June 2022, 288 patients undergoing cardiac surgery with an expected
cross-clamp time over 60 min were prospectively randomized regarding the
type of the cardioplegia used: Group 1 (N = 150)- single-dose del Nido
antegrade cardioplegia and Group 2 (N = 138)- single-dose
Histidine-Tryptophane-Ketoglutarate (HTK) antegrade cardioplegia. In
patients with ischemic time over 60 min, needing a redosing were further
analyzed separately in four subgroups: (A) Cold whole blood (CWB) (4:1) (N
= 95); (A1: DN-CWB; A2: HTK-CWB) and (B) St Thomas Solution (N = 92) (B1:
DN-St Thomas; B2: HTK-St Thomas. Control groups were C1 (DN redosed by DN)
and C2 (HTK by HTK). <br/>Result(s): Troponin levels in A1 and B1 groups
were significantly lower than in DN-control. Respiratory support time and
incidence of atrial fibrillation were significantly lower in Group A1
versus DN-control. <br/>Conclusion(s): Long-acting cardioplegic techniques
are becoming widely utilized in the adult population, with minimal data on
redosing methods/compositions for prolonged cases. Due to the small
patient population, further investigation is needed to delineate optimal
redosing methods, but this report brings to attention the initial success
of multiple strategies.<br/>Copyright &#xa9; The Author(s) 2023.

<92>
Accession Number
2026399759
Title
Cardiac surgery-Associated acute kidney injury - A narrative review.
Source
Perfusion (United Kingdom). 39(8) (pp 1516-1530), 2024. Date of
Publication: November 2024.
Author
Rasmussen S.B.; Boyko Y.; Ranucci M.; de Somer F.; Ravn H.B.
Institution
(Rasmussen, Boyko, Ravn) Department of Anaesthesiology and Intensive Care,
Odense University Hospital, Odense, Denmark
(Rasmussen, Ravn) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
(Ranucci) Department of Cardiovascular Anaesthesiology and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(de Somer) Heart Centre, University Hospital Ghent, Gent, Belgium
Publisher
SAGE Publications Ltd
Abstract
Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) is a serious
complication seen in approximately 20-30% of cardiac surgery patients. The
underlying pathophysiology is complex, often involving both patient- and
procedure related risk factors. In contrast to AKI occurring after other
types of major surgery, the use of cardiopulmonary bypass comprises both
additional advantages and challenges, including non-pulsatile flow,
targeted blood flow and pressure as well as the ability to manipulate
central venous pressure (congestion). With an increasing focus on the
impact of CSA-AKI on both short and long-term mortality, early
identification and management of high-risk patients for CSA-AKI has
evolved. The present narrative review gives an up-to-date summary on
definition, diagnosis, underlying pathophysiology, monitoring and
implications of CSA-AKI, including potential preventive interventions. The
review will provide the reader with an in-depth understanding of how to
identify, support and provide a more personalized and tailored
perioperative management to avoid development of CSA-AKI.<br/>Copyright
&#xa9; The Author(s) 2023.

<93>
Accession Number
2025820180
Title
Individualized heparin monitoring and management reduces protamine
requirements in cardiac surgery on minimal invasive extracorporeal
circulation; A prospective randomized study.
Source
Perfusion (United Kingdom). 39(8) (pp 1595-1604), 2024. Date of
Publication: November 2024.
Author
Gkiouliava A.; Argiriadou H.; Antonitsis P.; Goulas A.; Papapostolou E.;
Sarridou D.; Karapanagiotidis G.T.; Anastasiadis K.
Institution
(Gkiouliava, Argiriadou, Papapostolou, Sarridou) Department of
Anesthesiology and Intensive Care, AHEPA University Hospital, Aristotle
University of Thessaloniki School of Medicine, Thessaloniki, Greece
(Antonitsis, Karapanagiotidis, Anastasiadis) Cardiothoracic Department,
AHEPA University Hospital, Aristotle University of Thessaloniki School of
Medicine, Thessaloniki, Greece
(Goulas) First Laboratory of Pharmacology, Aristotle University of
Thessaloniki School of Medicine, Thessaloniki, Greece
Publisher
SAGE Publications Ltd
Abstract
Introduction: Individualized heparin and protamine management is
increasingly used as a strategy to reduce coagulation activation and
bleeding complications. While it is associated with increased heparin
requirements during Cardiopulmonary Bypass (CPB), the impact on protamine
administration remains controversial. We aim to investigate the effect of
heparin level-guided monitoring on protamine dosing during cardiac surgery
where low-anticoagulation protocols are implemented. <br/>Method(s): This
is a prospective, randomized, controlled trial. A total of 132 patients
undergoing elective full-spectrum cardiac surgery with Minimal Invasive
Extracorporeal Circulation (MiECC) were recruited. All patients were
managed by the same anaesthetic, surgical and perfusion team. Patients
were randomly allocated in two groups; the individualized
heparin-protamine titration (IHPT) group and the conventional
heparinization and reversal group by using ACT (cACT) with a 0.75:1,
protamine: heparin ratio. Titration was accomplished with the Hepcon HMS
Plus (Medtronic, Minneapolis, MN) system. The primary outcome of the study
was the total protamine dose used. Secondary outcomes comprised of the
total heparin dose, the percentage of patients achieving target ACT, 24-h
transfusion requirements, postoperative bleeding, duration of mechanical
ventilation, major morbidity and length of hospital stay. Patients in each
group were divided in two subgroups according to the target ACT; those
operated for coronary artery bypass grafting (CABG) using a target ACT
>300 s and the rest (non-CABG) patients operated with a target ACT >400 s,
respectively. <br/>Result(s): Protamine requirements were significantly
reduced when IHPT was implemented; CABG (118 +/- 24 mg vs 163 +/- 61 mg; p
< 0.001) and non-CABG cases (151 +/- 46 mg vs 197 +/- 45 mg; p < 0.001).
Moreover, heparin requirements were significantly higher in the non-CABG
subgroup managed with IHPT (34,539 +/- 7658 IU vs 29,893 +/- 9037 IU; p =
0.02). In overall, no significant differences were detected with respect
to postoperative bleeding, transfusion of RBC or other blood products.
<br/>Conclusion(s): Individualized heparin monitoring and management
reduces protamine requirements in cardiac surgery with MiECC implementing
reduced anticoagulation strategy. Trial registration: clinicaltrials.gov;
NCT04215588.<br/>Copyright &#xa9; The Author(s) 2023.

<94>
Accession Number
2025620465
Title
Does heparin rebound lead to postoperative blood loss in patients
undergoing cardiac surgery with cardiopulmonary bypass?.
Source
Perfusion (United Kingdom). 39(8) (pp 1491-1515), 2024. Date of
Publication: November 2024.
Author
Rijpkema M.; Vlot E.A.; Stehouwer M.C.; Bruins P.
Institution
(Rijpkema, Vlot, Bruins) Department of Anaesthesiology, Intensive Care and
Pain Management, St Antonius Hospital, Nieuwegein, Netherlands
(Stehouwer) Department of extracorporeal circulation, St Antonius
Hospital, Nieuwegein, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Background: Heparin rebound is a common observed phenomenon after cardiac
surgery with CPB and is associated with increased postoperative blood
loss. However, the administration of extra protamine may lead to increased
blood loss as well. Therefore, we want to investigate the relation between
heparin rebound and postoperative blood loss and the necessity to provide
extra protamine to reverse heparin rebound. <br/>Method(s): We searched
PubMed, Cochrane, EMBASE, Google Scholar and Web of Science to review the
question: "Does heparin rebound lead to postoperative blood loss in
patients undergoing cardiac surgery with cardiopulmonary bypass."
Combination of search words were framed within four major categories:
heparin rebound, blood loss, cardiac surgery and cardiopulmonary bypass.
All studies that met our question were included. Quality assessment was
performed using the Cochrane risk of bias (RoB2) tool for randomized
controlled trials and the risk of bias in non-randomized studies of
intervention (ROBINS-I) for non-randomised trials. <br/>Result(s): 4
randomized and 17 non-randomized studies were included. The mean incidence
of heparin rebound was 40%. The postoperative heparin levels, due to
heparin rebound, were often below or equal to 0.2 IU/mL. We could not
demonstrate an association between heparin rebound and postoperative blood
loss or transfusion requirements. However the quality of evidence was poor
due to a broad variety of definitions of heparin rebound, measured by
various coagulation tests and studies with small sample sizes.
<br/>Conclusion(s): The influence of heparin rebound on postoperative
bleeding seems to be negligible, but might get significant in conjunction
with incomplete heparin reversal or other coagulopathies. For that reason,
it might be useful to get a picture of the entire coagulation spectrum
after cardiac surgery, as can be done by the use of a viscoelastic test in
conjunction with an aggregometry test.<br/>Copyright &#xa9; The Author(s)
2023.

<95>
Accession Number
2030646628
Title
Cardiac Rehabilitation in Saudi Arabia: Current Status and Future
Directions.
Source
Current Cardiology Reports. 26(10) (pp 1077-1083), 2024. Date of
Publication: October 2024.
Author
Osailan A.M.
Institution
(Osailan) Department of Health and Rehabilitation Sciences, College of
Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj,
Saudi Arabia
Publisher
Springer
Abstract
Purpose of Review: Cardiovascular diseases (CVDs) are the leading cause of
mortality in Saudi Arabia. Cardiac rehabilitation (CR) is one of the
well-known interventions to control and minimize the burden of CVDs.
Despite recommendations, CR utilization remains suboptimal in Saudi Arabia
due to many reasons, including limited awareness, logistical barriers,
shortage of specialized facilities and trained professionals, and
perceptions about CVDs illness. This review is to evaluate the current
status, effectiveness, accessibility, and challenges of CR utilization in
Saudi Arabia, and to explore potential future directions for improving
these services. The review addresses key questions regarding the incidence
of CVDs, the characteristics of existing CR programs, barriers to CR
access, and stakeholder perspectives. Recent Findings: Recent studies
demonstrate that the effectiveness of CR, particularly exercise training,
in improving outcomes for post-coronary artery bypass grafting (CABG)
patients is well-documented, though data on its impact on other cardiac
conditions is limited. There are significant barriers to CR utilization in
Saudi Arabia, including limited awareness, logistical challenges, a
shortage of specialized facilities and trained professionals, and cultural
perceptions about CVD. Stakeholder perspectives highlight the necessity
for culturally sensitive and inclusive approaches, particularly in
addressing gender-specific needs and enhancing patient-provider
communication. The Saudi Vision 2030 presents opportunities to expand and
enhance CR services in alignment with international standards.
<br/>Summary: This review found that while CR is a crucial intervention
for managing CVDs, its utilization in Saudi Arabia is suboptimal due to
various barriers. To improve CR access and effectiveness, future
strategies should focus on increasing public and professional awareness,
developing infrastructure, training healthcare professionals, and
fostering public-private partnerships. These measures are essential to
making CR more accessible and tailored to the diverse needs of the Saudi
population, ultimately enhancing the quality of cardiovascular care and
patient outcomes in the region.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<96>
Accession Number
2030618295
Title
Efficacy and safety of pulsed-field versus conventional thermal ablation
for atrial fibrillation: A systematic review and meta-analysis.
Source
Journal of Arrhythmia. 40(5) (pp 1059-1074), 2024. Date of Publication:
October 2024.
Author
Amin A.M.; Nazir A.; Abuelazm M.T.; Ibrahim A.A.; Elbenawi H.; Aboutaleb
A.; Ellabban M.; Arnaout M.; Turkmani M.; Abdelazeem B.; Volgman A.S.
Institution
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nazir) Faculty of Medicine, King Edward Medical University, Lahore,
Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Ibrahim) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Aboutaleb) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Ellabban) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Arnaout) Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab
Republic
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Department of Internal Medicine, McLaren Health Care-Oakland,
Pontiac, MI, United States
(Abdelazeem) Department of Cardiology, West Virginia University, West, VA,
United States
(Volgman) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Pulsed-field ablation (PFA) has emerged as an innovative
alternative to radiofrequency (RF) and cryoablation because it selectively
targets myocardial tissue. Thus, we aim to estimate the efficacy and
safety of PFA versus thermal ablation for atrial fibrillation (AF)
ablation. <br/>Method(s): A systematic review and meta-analysis were
retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September
2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR)
and continuous data using mean difference (MD) with a 95% confidence
interval (CI). PROSPERO ID: CRD42023480321. <br/>Result(s): We included 17
studies with a total of 2255 patients. PFA was significantly associated
with a decreased incidence of AF recurrence (RR: 0.66 with 95% CI [0.51,
0.87], p =.003). However, there was no significant difference between PFA
and thermal ablation in arrhythmia recurrence (RR: 0.92 with 95% CI [0.74,
1.46], p =.42). PFA was significantly associated with decreased total
procedure time (MD: -15.15 with 95% CI [-20.23, -10.07], p <.00001),
decreased heart rate change (MD: -7.39 with 95% CI [-12.16, -2.62], p
=.002), decreased phrenic nerve palsy (RR: 0.38 with 95% CI [0.15, 0.98],
p =.05), and reduced esophageal lesions (RR: 0.09 with 95% CI [0.01,
0.69], p =.02). On the contrary, PFA was significantly associated with
increased pericardial tamponade (RR: 6.14 with 95% CI [1.43, 26.33], p
=.01). <br/>Conclusion(s): PFA was significantly associated with decreased
AF recurrence, total procedure time, heart rate change, phrenic nerve
palsy, esophageal lesion, and increased incidence of pericardial tamponade
compared with thermal ablation.<br/>Copyright &#xa9; 2024 The Author(s).
Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on
behalf of Japanese Heart Rhythm Society.

<97>
Accession Number
2030267343
Title
Perioperative transfusion study (PETS): Does a liberal transfusion
protocol improve outcome in high-risk cardiovascular patients undergoing
non-cardiac surgery? A randomised controlled pilot study.
Source
Transfusion Medicine. 34(5) (pp 398-404), 2024. Date of Publication:
October 2024.
Author
Ali S.; Roubos S.; Hoeks S.E.; Verbrugge S.J.C.; Koopman-van Gemert
A.W.M.M.; Stolker R.J.; van Lier F.
Institution
(Ali, Roubos, Hoeks, Stolker, van Lier) Department of Anaesthesiology,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Verbrugge) Department of Anaesthesiology, Franciscus Gasthuis &
Vlietland, Rotterdam, Netherlands
(Koopman-van Gemert) Department of Anaesthesiology, Albert Schweitzer
Hospital, Dordrecht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Small studies have shown that patients with advanced coronary
artery disease might benefit from a more liberal blood transfusion
strategy. The goal of this pilot study was to test the feasibility of a
blood transfusion intervention in a group of vascular surgery patients who
have elevated cardiac troponins in rest. <br/>Method(s): We conducted a
single-centre, randomised controlled pilot study. Patients with a
preoperative elevated high-sensitive troponin T undergoing non-cardiac
vascular surgery were randomised between a liberal transfusion regime
(haemoglobin >10.4 g/dL) and a restrictive transfusion regime (haemoglobin
8.0-9.6 g/dL) during the first 3 days after surgery. The primary outcome
was defined as a composite endpoint of all-cause mortality, myocardial
infarction or unscheduled coronary revascularization. <br/>Result(s): In
total 499 patients were screened; 92 were included and 50 patients were
randomised. Postoperative haemoglobin was different between the
intervention and control group; 10.6 versus 9.8, 10.4 versus 9.4, 10.9
versus 9.4 g/dL on day one, two and three respectively (p < 0.05). The
primary outcome occurred in four patients (16%) in the liberal transfusion
group and in two patients (8%) in control group. <br/>Conclusion(s): This
pilot study shows that the studied transfusion protocol was able to create
a clinically significant difference in perioperative haemoglobin levels.
Randomisation was possible in 10% of the screened patients. A large
definitive trial should be possible to provide evidence whether a liberal
transfusion strategy could decrease the incidence of postoperative
myocardial infarction in high risk surgical patients.<br/>Copyright &#xa9;
2024 The Author(s). Transfusion Medicine published by John Wiley & Sons
Ltd on behalf of British Blood Transfusion Society.

<98>
Accession Number
2034348291
Title
The Association Between Renal Desaturation Measured Using Near-Infrared
Spectroscopy and Postoperative Acute Kidney Injury: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2606-2612),
2024. Date of Publication: November 2024.
Author
Wang B.; Shi H.; Yao Y.; Liu S.; Shi C.
Institution
(Wang, Shi) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Shi) Department of Anesthesiology, Shijingshan Hospital, Beijing, China
(Yao) Department of Anesthesiology, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Fuwai Hospital, Peking
Union Medical College, Beijing, China
(Liu) Department of Cardiac Surgery, Peking University International
Hospital, Beijing, China
Publisher
W.B. Saunders
Abstract
Objectives: The objective of this systematic review was to clarify the
status of near-infrared spectroscopy (NIRS) in monitoring perioperative
renal regional tissue oxygen saturation (rSO<inf>2</inf>) and determine
whether there is evidence supporting its use in predicting postoperative
acute kidney injury (AKI). <br/>Design(s): A systematic search of
electronic databases was conducted to identify all clinical studies that
utilized NIRS to monitor renal rSO<inf>2</inf> during the perioperative
period to observe postoperative AKI. <br/>Setting(s): Studies published
online as of May 31, 2024, were included in the review.
<br/>Participant(s): Studies involving human participants undergoing
surgery with a predefined outcome of AKI were included.
<br/>Intervention(s): Regional tissue oxygen saturation was measured using
NIRS. <br/>Measurements and Main Results: A total of 144 records were
identified in the primary search after removing duplicates. After
screening, 18 studies were included in the analysis, consisting of 3
case-control studies and 15 prospective cohort studies. Thirteen reports
focused on pediatric surgery, whereas five reports focused on adult
surgery. Sixteen studies involved cardiovascular surgery with
cardiopulmonary bypass, and two studies focused on liver surgery. All
studies received a quality score of 7 or above. Significant heterogeneity
and mostly short follow up periods were noted. <br/>Conclusion(s): Renal
desaturation may indicate AKI in patients; however, further studies are
required to substantiate this relationship. Additional clinical trials are
necessary to evaluate normal values and establish the exact threshold of
renal rSO<inf>2</inf> that signifies a meaningful decline in renal
function.<br/>Copyright &#xa9; 2024

<99>
Accession Number
2034254619
Title
Comparison Between Histidine-Tryptophan-Ketoglutarate Cardioplegia and
Cold Blood Cardioplegia for Myocardial Protection in Tetralogy of Fallot
Patients Undergoing Surgical Repair: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2643-2650),
2024. Date of Publication: November 2024.
Author
Abdel Twab S.M.; Kamal F.; Fouad A.
Institution
(Abdel Twab, Kamal, Fouad) Department of Anaesthesiology, Intensive Care,
and Pain Management, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
Publisher
W.B. Saunders
Abstract
Objectives: This study was conducted to compare the efficacy of
histidine-tryptophan-ketoglutarate (HTK) cardioplegia and cold blood
cardioplegia (CBC), especially for postoperative right ventricular (RV)
function after tetralogy of Fallot repair. <br/>Design(s): Randomized,
double-blinded, parallel-group, controlled clinical trial.
<br/>Setting(s): Ain Shams University Hospitals. <br/>Participant(s): A
total of 100 children (1 to 5 years old) scheduled for tetralogy of Fallot
repair. <br/>Intervention(s): Patients were allocated (double-blinded 1:1
allocation ratio) to either the HTK group that received HTK cardioplegia
(30 mL/kg via antegrade route) or the CBC group that received cold blood
cardioplegia with blood-to-Ringer solution (4:1) in a volume of 20 mL/kg.
<br/>Measurements and Main Results: The HTK group showed a statistically
significant reduction of the vasoactive inotropic score on admission to
the pediatric intensive care unit (13.0 +/- 4.1) in comparison to the CBC
group (15.5 +/- 5.4), with a p value of 0.011. However, after 24 hours,
the vasoactive-inotropic score was comparable. Lactate level during the
first 24 hours was 6.2 +/- 0.7 mmol/L in the HTK group and 6.9 +/- 0.4
mmol/L in the CBC group (p < 0.0001). Serial troponin measurements were
lower in the HTK group (1.49 +/- 0.45) compared to the CBC group (1.69 +/-
0.18) at the first 72 hours postoperatively (p = 0.005). Postoperative
echocardiographic assessment of RV function by means of tricuspid annular
plane systolic excursion and myocardial performance index were better in
the HTK group than in the CBC grpup (p < 0.05). <br/>Conclusion(s): HTK
cardioplegia may offer better cardiac protection to pediatric patients
undergoing tetralogy of Fallot repair than our institutional standard CBC
with better recovery for the hypertrophic RV.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<100>
Accession Number
2034253555
Title
Postoperative Hydration in Children Using Intermittent Boluses of Balanced
Salt Solution: Results of a Randomized Control Trial.
Source
Journal of Pediatric Surgery. 59(11) (no pagination), 2024. Article
Number: 161660. Date of Publication: November 2024.
Author
Johnston W.R.; Mak Croughan A.L.; Hwang R.; Collins S.; Washington A.;
Neary K.; Mattei P.
Institution
(Johnston, Mak Croughan, Hwang, Collins, Washington, Neary, Mattei)
General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia,
Philadelphia, PA, United States
(Johnston) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
Publisher
W.B. Saunders
Abstract
Background: Postoperative maintenance fluids are traditionally provided
via hypotonic dextrose containing fluids administered intravenously by
continuous infusion. We hypothesized that scheduled weight-based boluses
of balanced salt solution would be more physiologic, reduce fluid volumes,
and improve patient comfort. <br/>Method(s): As part of an IRB-approved
randomized controlled trial (Boluses of Ringer's in Surgical Kids, BRiSK),
we randomized patients aged 1-21 years undergoing elective abdominal or
thoracic surgery to post-operatively receive weight-based
D<inf>5</inf>0.45NS+20mEq/L KCl at a continuous rate or intermittent
boluses of Lactated Ringer's solution until oral liquid toleration.
Patients with nephropathy, diabetes, or receiving parenteral nutrition
were excluded. We analyzed electrolytes, urine output, fluid volume, and
adverse events. <br/>Result(s): We enrolled and randomized 60 patients: 29
to continuous fluids and 31 to bolus fluids. One patient from the bolus
group dropped out. No patients crossed over due to difficulties with
application of the bolus protocol. There were no baseline differences
between groups with a mean age of 12.6 +/- 1.4yr and weight of 50.9 +/-
7.2 kg. There were no serious adverse events or electrolyte disturbances
in either group. Patients in the bolus group received significantly less
total fluid than those in the continuous group (0.43 mL/kg/h vs 1.1
mL/kg/h, p < 0.001) with no difference in urine output [1.4 +/- 0.2
mL/kg/h vs 1.6 +/- 0.3 mL/kg/h, p = 0.211]. There were two episodes of
mild hypoglycemia in the bolus group compared to seven episodes of mild
hyperglycemia in the continuous group. <br/>Conclusion(s): Administration
of post-operative intravenous fluids as boluses of balanced salt solution
is feasible, safe, and results in significantly less fluid administered
compared to a traditional continuous protocol. <br/>Level of Evidence:
II.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<101>
[Use Link to view the full text]
Accession Number
2034227539
Title
Extracorporeal Cardiopulmonary Resuscitation Use Among Children With
Cardiac Disease in the ICU: A Meta-Analysis and Meta-Regression of Data
Through March 2024.
Source
Pediatric Critical Care Medicine. 25(10) (pp e410-e417), 2024. Date of
Publication: 01 Oct 2024.
Author
Sperotto F.; Daverio M.; Amigoni A.; Gregori D.; Dorste A.; Kobayashi
R.L.; Thiagarajan R.R.; Maschietto N.; Alexander P.M.
Institution
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Cardiology, Boston Children's Hospital, Boston, MA, United States
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Pediatrics, Harvard Medical School, Boston, MA, United States
(Daverio, Amigoni) Pediatric Intensive Care Unit, Department of Women's
and Children's Health, University of Padova, Padova, Italy
(Gregori) Laboratories of Epidemiological Methods and Biostatistics,
Department of Environmental Medicine and Public Health, University of
Padova, Padova, Italy
(Dorste) Boston Children's Hospital Library, Boston Children's Hospital,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: Epidemiologic data on extracorporeal cardiopulmonary
resuscitation (ECPR) use in children with cardiac disease after
in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate
trends in ECPR use over time in critically ill children with cardiac
disease. DATA SOURCES: We performed a secondary analysis of a recent
systematic review (PROSPERO CRD42020156247) to investigate trends in ECPR
use in children with cardiac disease. PubMed, Web of Science, Embase, and
Cumulative Index to Nursing and Allied Health Literature were screened
(inception to September 2021). For completeness of this secondary
analysis, PubMed was also rescreened (September 2021 to March 2024). STUDY
SELECTION: Observational studies including epidemiologic data on ECPR use
in children with cardiac disease admitted to an ICU. DATA EXTRACTION: Data
were extracted by two independent investigators. The risk of bias was
assessed using the National Heart Lung and Blood Institutes Quality
Assessment Tools. Random-effects meta-analysis was used to compute a
pooled proportion of subjects undergoing ECPR; meta-regression was used to
assess trends in ECPR use over time. DATA SYNTHESIS: Of the 2664 studies
identified, 9 (17,669 patients) included data on ECPR use in children with
cardiac disease. Eight were cohort studies, 1 was a case-control, 8 were
retrospective, 1 was prospective, 6 were single-center, and 3 were
multicenter. Seven studies were included in the meta-analysis; all were
judged of good quality. By meta-analysis, we found that a pooled
proportion of 21% (95% CI, 15-29%) of pediatric patients with cardiac
disease experiencing IHCA were supported with ECPR. By meta-regression
adjusted for category of patients (surgical vs. general cardiac), we found
that the use of ECPR in critically ill children with cardiac disease
significantly increased over time (p = 0.026). <br/>CONCLUSION(S): About
one-fifth of critically ill pediatric cardiac patients experiencing IHCA
were supported with ECPR, and its use significantly increased over time.
This may partially explain the increased trends in survival demonstrated
for this population.<br/>Copyright &#xa9; 2024 by the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies.

<102>
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. 38(11) (pp 2783-2791),
2024. Date of Publication: November 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
Abstract
Objective: Cardiac surgery can be complicated by the development of a
systemic inflammatory response syndrome related to cardiopulmonary bypass.
This potentially contributes to the occurrence of postoperative morbidity
and mortality. Corticosteroids can be used to reduce such inflammation,
but the overall balance between potential harm and benefit is unknown and
may be age-dependent. The present meta-analysis aims to evaluate the
effects of prophylactic corticosteroids in pediatric and non-elderly adult
cardiac surgery patients. <br/>Design(s): Systematic review and
meta-analysis of randomized trials. <br/>Setting(s): Cardiac surgery with
cardiopulmonary bypass. <br/>Participant(s): Patients younger than 65
years old (pediatric and non-elderly adults). <br/>Intervention(s):
Perioperative use of corticosteroids versus placebo or standard care.
<br/>Measurements and Main Results: Two independent investigators searched
PubMed, EMBASE and the Cochrane Library from inception to January 20,
2024. The primary outcome was mortality at the longest follow-up
available. Secondary outcomes included acute kidney injury, atrial
fibrillation, myocardial injury, cerebrovascular events, and infections.
Our search strategy identified a total of 17 randomized trials involving
6,598 patients. Mortality was significantly reduced in the corticosteroid
group (78/3321 [2.3%] vs. 116/3277 [3.5%]; risk ratio = 0.69; 95%
confidence interval, 0.52 to 0.92; P = 0.01; I2 = 0%; NNT = 91). Moreover,
the highest postoperative vasoactive inotropic score (VIS) was
significantly lower in corticosteroid group (MD: -2.07, 95% CI -3.69 to
-0.45, P = 0.01, I2 = 0%). No significant differences in secondary
outcomes between the two treatment groups were recorded.
<br/>Conclusion(s): This meta-analysis of randomized trials highlights the
potential benefits of corticosteroids on survival in cardiac surgery for
patients younger than 65 years old.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<103>
Accession Number
2034056811
Title
A Phase 3, Randomized, Active-controlled, Single-blind Clinical Trial to
Evaluate the Efficacy of Fibrin Sealant Grifols in Achieving Hemostasis in
Pediatric Surgery.
Source
Journal of Pediatric Surgery. 59(11) (no pagination), 2024. Article
Number: 161639. Date of Publication: November 2024.
Author
Balanescu L.; Gajdobranski D.; Sretenovic A.; Kalinova K.; Vajda P.; Hanna
K.; Querolt M.; Camprubi S.; Mondou E.
Institution
(Balanescu) Spitalul Clinic de Urgenta pentru Copi 'Grigore Alexandrescu',
Bucuresti, Romania
(Gajdobranski) Institute for Health Protection of Children and Youth,
Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
(Sretenovic) University Children's Hospital, Belgrade, Serbia
(Kalinova) UMHAT, General and Operative Surgery Clinic, Department of
Pediatric Surgery, Stara Zagora, Bulgaria
(Vajda) University of Pecs Clinical Centre, Pecs, Hungary
(Hanna, Mondou) Grifols Therapeutics LLC, Research Triangle Park, NC,
United States
(Querolt, Camprubi) Instituto Grifols, S.A., Sant Cugat, Spain
Publisher
W.B. Saunders
Abstract
Background: In this study, two fibrin sealant products, Fibrin Sealant
Grifols (FS Grifols 80 mg/mL fibrinogen; 500 IU/mL thrombin) and Evicel
(fibrinogen 55-85 mg/mL; thrombin 800-1200 IU/mL) were studied for
efficacy in achieving hemostasis at a targeted bleeding site (TBS) on
parenchymous or soft tissue in pediatric surgeries. <br/>Method(s): This
phase 3, single-blind, active comparator, non-inferiority trial compared
the number of patients achieving hemostasis at a TBS at four
(T<inf>4</inf> - primary endpoint), seven (T<inf>7</inf>) and 10
(T<inf>10</inf>) minutes after application, Safety and tolerability were
assessed by recording adverse events during and after procedures. Eligible
patients were <18 years old undergoing elective, open, non-cardiac
thoracic, abdominal or pelvic surgeries. Preterm (<37 weeks gestation) and
newborn (0-27 days) infants were eligible. <br/>Result(s): At
T<inf>4</inf>, 98.7% of FS Grifols group (n = 91) and 95.4% of the Evicel
group (n = 87) achieved hemostasis. All patients with residual bleeding at
T<inf>4</inf> were undergoing soft tissue surgery. All patients achieved
hemostasis by T<inf>7</inf>. At T<inf>10</inf>, all patients achieved
hemostasis except one (FS Grifols (no observation recorded)). There were
no incidents of persistent bleeding. For FS Grifols, 26.5% of patients had
treatment-emergent adverse events (TEAEs) and 18.4% for Evicel. One TEAE
(moderate procedural pain - FS Grifols group) was considered possibly
related to study treatment. Three patients died for reasons unrelated to
the study medications. <br/>Conclusion(s): FS Grifols was safe and
effective at achieving hemostasis in pediatric patients having
parenchymous or soft tissue surgeries. The efficacy of FS Grifols was
non-inferior to Evicel. <br/>Level of Evidence: I.<br/>Copyright &#xa9;
2024 The Authors

<104>
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. 38(11) (pp 2668-2674),
2024. Date of Publication: November 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. <br/>Design(s):
Randomized controlled trial. <br/>Setting(s): Cairo University Hospital
and National Heart Institute, Egypt. <br/>Participant(s): Patients aged 18
to 70 years who underwent a cardiac surgical procedure through a midline
sternotomy. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<105>
Accession Number
2032856250
Title
The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in
Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and
Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(11) (pp 2792-2800),
2024. Date of Publication: November 2024.
Author
Wang W.; Yang W.; Liu A.; Liu J.; Yuan C.
Institution
(Wang, Yuan) Department of Anesthesiology, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Yang) Department of Anesthesiology, Deyang People's Hospital, Sichuan,
Deyang, China
(Liu) Department of Anesthesiology, Heze Municipal Hospital, Shandong,
Heze, China
(Liu) Department of Emergency Surgery, Jining No. 1 People's Hospital,
Shandong, Jining, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the analgesic effect of erector spinae plane block
in adults undergoing median sternotomy cardiac surgery. Design and
setting: The Cochrane, Embase, and PubMed databases from inception to
January 2024 were searched. The study has been registered in the
International Prospective Register of Systematic Reviews (CRD42023470375).
<br/>Participant(s): Eight randomized controlled trials involving 543
patients, comparing with no block or sham block, were included, whether it
was a single injection or continuous. <br/>Measurements and Main Results:
The primary outcomes were pain scores and opioid consumption. Erector
spinae plane block reduced pain scores immediately after extubation (mean
difference [MD], -1.19; 95% confidence interval [CI], -1.67 to -0.71; p
for heterogeneity = 0.10), at 6 hours after extubation (MD, -1.96; 95% CI,
-2.85 to -1.08; p for heterogeneity < 0.0001), and at 12 hours after
extubation (MD, -0.98; 95% CI, -1.55 to -0.40; p for heterogeneity <
0.00001). The decrease in pain scores reached the minimal clinically
important difference within 6 hours. Opioid consumption 24 hours after
surgery decreased by 35.72 mg of oral morphine equivalents (95% CI, -50.88
to -20.57; p for heterogeneity < 0.0001). Sensitivity analysis confirmed
the stability of results. The quality of primary outcomes was rated as
very low to moderate. <br/>Conclusion(s): Erector spinae plane block
decreased pain scores within 12 hours after extubation, reached the
minimal clinically important difference within 6 hours, and decreased
opioid consumption 24 hours after surgery, based on data of very low to
moderate quality. However, high-quality randomized controlled trials are
necessary to validate these findings.<br/>Copyright &#xa9; 2024 Elsevier
Inc.

<106>
Accession Number
2032820479
Title
Zero-contrast left atrial appendage closure, a feasible alternative for
patients with a high risk of contrast-induced nephropathy: Systematic
literature review and meta-analysis.
Source
Heart Rhythm. 21(11) (pp 2136-2147), 2024. Date of Publication: November
2024.
Author
Rodriguez J.F.; Pachon-Londono M.J.; Areiza L.A.; Rodriguez W.G.
Institution
(Rodriguez, Pachon-Londono) Universidad del Rosario, Bogota, Colombia
(Areiza) Hospital Universitario Mayor, Mederi, Bogota, Colombia
(Rodriguez) Colsubsidio Calle 63, Bogota, Colombia
Publisher
Elsevier B.V.
Abstract
Background: Left atrial appendage closure (LAAC) is an alternative to
reduce thrombotic risk in patients with nonvalvular atrial fibrillation.
This procedure conventionally requires the use of a contrast agent. A
significant proportion of patients who undergo this procedure have chronic
kidney disease, with a high risk of contrast-induced nephropathy.
<br/>Objective(s): We aimed to systematically review existing literature
regarding the feasibility and safety of a zero-contrast LAAC technique.
<br/>Method(s): We searched the MEDLINE/PubMed, Embase, and Cochrane
Central Register of Controlled Trials databases for studies comparing a
zero-contrast LAAC technique with conventional LAAC up to April 2024. From
each study, we extracted baseline characteristics, feasibility, and safety
outcomes. A random model meta-analysis was used to compare outcomes
between groups. <br/>Result(s): Five studies reporting data from 367
patients were included. A 100% successful implantation rate was reported
in all the zero-contrast groups. The mean number of recaptures reached no
significant difference between the groups (mean difference, -0.15; CI,
-0.67 to 0.37; I² = 0%; P = .58). The zero-contrast group had a
significantly shorter fluoroscopy time (mean difference, -4.03; CI, -7.72
to -0.34; I² = 67%; P = .03). Complications related to the
procedure, peridevice leak, and device-associated thrombus rates were not
significantly different between the groups. <br/>Conclusion(s):
Zero-contrast LAAC is a feasible alternative. The success and complication
rates are consistent with those of conventional LAAC. Aside from the
inherent benefit of zero-contrast exposure, this technique allows a
reduction in fluoroscopy time.<br/>Copyright &#xa9; 2024 Heart Rhythm
Society

<107>
Accession Number
2032488750
Title
Infective Endocarditis and Antithrombotic Therapy.
Source
Cardiology (Switzerland). 149(5) (pp 513-522), 2024. Date of Publication:
01 Oct 2024.
Author
Morelli C.; Rocca B.; Gigante B.
Institution
(Morelli, Rocca) NeuroFarBa Department, University of Florence, Florence,
Italy
(Rocca) Department of Safety and Bioethics, Catholic University School of
Medicine, Rome, Italy
(Gigante) Division of Cardiovascular Medicine, Department of Medicine,
Karolinska Institutet, Stockholm, Sweden
Publisher
S. Karger AG
Abstract
Background: Incidence of infective endocarditis (IE) is progressively
raising because of the increasing number of cardiovascular invasive
procedures, support treatment and devices, awareness in the medical
community, and improved diagnostic modalities. IE pathophysiology is a
unique model of immunothrombosis, and the clinical course is often
complicated by either embolic or hemorrhagic events. Managing
antithrombotic treatment is challenging and the level of supporting
evidence scant. The aim of this review was to discuss and present the
embolic and bleeding complication associated with IE and review the
available evidence on antithrombotic treatment in patients with IE with
and without a previous indication to antithrombotic drugs. <br/>Summary:
Embolic events occur in 20-40% of patients with IE and are associated with
high morbidity and mortality. Acute ischemic stroke is the most common
neurological complication. A beneficial effect of antithrombotic therapy
in preventing ischemic stroke for patients with IE has never been formally
tested in adequately powered randomized clinical trials. Atrial
fibrillation is a common complication associated with severe infections,
requiring anticoagulation. Furthermore, patients with IE have a high risk
of unprovoked and anticoagulation treatment-related bleeding. In
particular, intracerebral bleeding is the most severe complication in
about 5% of patients with IE. Single antiplatelet therapy with low-dose
aspirin after hospitalization for IE has been shown to reduce causes
mortality within 90 days without an increase of hemorrhagic strokes. In
the absence of bleeding complications, recent guidelines recommend to
maintain low-dose aspirin. No data are available on the management of
patients with IE while on dual antiplatelet therapy. Key Messages: Several
gaps in knowledge remain about antithrombotic management in patients with
IE and most of the evidence relies on observational studies.
Individualized strategies based on clinical evaluation, comorbidities,
patient engagement, and shared decisions strategies are
encouraged.<br/>Copyright &#xa9; 2024 The Author(s)

<108>
Accession Number
2031832491
Title
Impact of an enhanced recovery after surgery program integrating
cardiopulmonary rehabilitation on post-operative prognosis of patients
treated with CABG: protocol of the ERAS-CaRe randomized controlled trial.
Source
BMC Pulmonary Medicine. 24(1) (no pagination), 2024. Article Number: 512.
Date of Publication: December 2024.
Author
Yang Q.; Wang L.; Zhang X.; Lu P.; Pan D.; Li S.; Ling Y.; Zhi X.; Xia L.;
Zhu Y.; Chen Y.; Liu C.; Jin W.; Reinhardt J.D.; Wang X.; Zheng Y.
Institution
(Yang, Zhang, Pan, Li, Zhi, Xia, Zhu, Chen, Zheng) Department of
Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical
University, No.300 Guangzhou Road, Nanjing 210029, China
(Wang) Department of Rehabilitation Medicine, Qingdao Hospital, University
of Health and Rehabilitation Sciences (Qingdao Municipal Hospital),
Qingdao, China
(Lu, Liu, Jin, Wang) Department of Thoracic & amp; Cardiovascular Surgery,
the First Affiliated Hospital of Nanjing Medical University, Nanjing,
China
(Ling, Reinhardt) Institute for Disaster Management and Reconstruction,
Sichuan University, No. 122 Huanghezhong Road First Section, Sichuan,
Chengdu 610207, China
(Ling) Department of Management Science and Engineering, Stanford
University, Stanford, CA, United States
(Reinhardt) Swiss Paraplegic Research, Nottwil, Switzerland
(Reinhardt) Department of Health Sciences and Medicine, University of
Lucerne, Lucerne, Switzerland
(Reinhardt) Rehabilitation Research Center, The First Affiliated Hospital
of Nanjing Medical University, Jiangsu, Nanjing, China
Publisher
BioMed Central Ltd
Abstract
Background: Coronary artery bypass grafting is associated with a high
occurrence of postoperative cardiopulmonary complications. Preliminary
evidence suggested that enhanced recovery after surgery can effectively
reduce the occurrence of postoperative cardiopulmonary complications.
However, enhanced recovery after surgery with systematic integration of
cardiopulmonary rehabilitation (ERAS-CaRe) into for Coronary artery bypass
grafting has not been evaluated so far. We thus design the ERAS-CaRe
randomized-controlled trial to evaluate possible superiority of embedding
cardiopulmonary rehabilitation in ERAS over ERAS alone as well as to
investigate effects of differential timing of cardiopulmonary
rehabilitation within enhanced recovery after surgery (pre-, post-,
perio-operative) on post-operative cardiopulmonary complications following
Coronary artery bypass grafting surgery. <br/>Method(s): ERAS-CaRe is a
pragmatic, randomized-controlled, parallel four-arm, clinical trial. Three
hundred sixty patients scheduled for Coronary artery bypass grafting in
two Chinese hospitals will be grouped randomly into (i) Standard enhanced
recovery after surgery or (ii) pre-operative ERAS-CaRe or (iii)
post-operative ERAS-CaRe or (iv) perio-operative ERAS-CaRe. Primary
outcome is the occurrence of cardiopulmonary complications at 10 days
after Coronary artery bypass grafting. Secondary outcomes include the
occurrence of other individual complications including cardiac, pulmonary,
stroke, acute kidney injury, gastrointestinal event, ICU delirium rate,
reintubation rate, early drainage tube removal rate, unplanned
revascularization rate, all-cause mortality, ICU readmission rate, plasma
concentration of myocardial infarction-related key biomarkers etc.
<br/>Discussion(s): The trial is designed to evaluate the hypothesis that
a cardiopulmonary rehabilitation based enhanced recovery after surgery
program reduces the occurrence of cardiopulmonary complications following
Coronary artery bypass grafting and to determine optimal timing of
cardiopulmonary rehabilitation within enhanced recovery after surgery. The
project will contribute to increasing the currently limited knowledge base
in the field as well as devising clinical recommendations. Trial
registration: The trial was registered at the Chinese Clinical Trials
Registry on 25 August 2023 (ChiCTR2300075125; date recorded: 25/8/2023,
https://www.chictr.org.cn/).<br/>Copyright &#xa9; The Author(s) 2024.

<109>
Accession Number
2031824273
Title
Comparative analysis of MitraClip/TriClip and PASCAL in transcatheter
tricuspid valve repair for tricuspid regurgitation: a systematic review
and meta-analysis.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
557. Date of Publication: December 2024.
Author
Balata M.; Gbreel M.I.; Hassan M.; Becher M.U.
Institution
(Balata) University of Erlangen-Nuremberg, Erlangen, Germany
(Balata, Becher) University of Bonn, Bonn, Germany
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Hassan) Theodor Bilharz Research Institute, Giza, Egypt
(Becher) Department of Cardiology, City hospital Solingen, Solingen,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: The edge-to-edge transcatheter tricuspid valve repair (TTVR)
has emerged as a promising technique for the treatment of tricuspid
regurgitation (TR). Despite its potential, comparative data on the
performance of the novel edge-to-edge devices-MitraClip, PASCAL, and
TriClip-remain controversial. In this study, we aim to evaluate the safety
and efficacy of these devices in treating TR. <br/>Method(s): Five
databases were systematically searched up to May 2023, with an updated
search conducted in May 2024. Only original studies were included in the
analysis and were critically evaluated using an adapted version of the
Newcastle-Ottawa Scale (NOS) for observational cohort studies and the
Cochrane Risk of Bias (ROB) tool for randomized controlled trials.
<br/>Result(s): The database search yielded 2239 studies, out of which 21
studies were included in the final analysis. These studies encompassed a
total of 2178 patients who underwent TTVR using either the MitraClip,
TriClip, or PASCAL devices. The risk of bias across these studies ranged
from moderate to high. No significant differences were found among the
three devices in terms of effective regurgitant orifice area (EROA) and
tricuspid regurgitant volume. However, TriClip demonstrated statistically
superior efficacy in reducing vena contracta compared to both MitraClip
and PASCAL (P < 0.01) [TriClip: (MD = -7.4; 95% CI: -9.24, -5.56),
MitraClip: (MD = -4.04; 95% CI: -5.03, -3.05), and PASCAL: (MD = -6.56;
95% CI: -7.76, -5.35)]. The procedural success rates and incidence of
single leaflet device attachment (SLDA) were similar across all devices.
Furthermore, there were no significant differences in mortality, stroke
rates, or major bleeding events among the three devices.
<br/>Conclusion(s): The TriClip outperforms the MitraClip and PASCAL in
reducing vena contracta width, indicating greater effectiveness for severe
tricuspid regurgitation. All devices show similar safety profiles and
procedural success rates. Further research is needed to confirm these
results.<br/>Copyright &#xa9; The Author(s) 2024.

<110>
Accession Number
2031795447
Title
The role of chronic total occlusions in non-infarct-related arteries in
acute coronary syndrome patients: a systematic review.
Source
Future Cardiology. 20(10) (pp 581-590), 2024. Date of Publication: 2024.
Author
Sliman H.; Sliman R.K.A.; Knaapen P.; Nap A.; Henriques J.; Verouden N.;
Claessen B.E.P.M.
Institution
(Sliman) Department of Cardiology, Carmel Medical Center, Heart Center,
Haifa, Israel
(Sliman) Department of Pediatrics, Clalit Health Care Organization, Carmel
Medical Center, Haifa, Israel
(Knaapen, Nap, Henriques, Verouden, Claessen) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences,
Amsterdam 1105 AZ, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Aim: This systematic review evaluated the impact of a chronic total
occlusion (CTO) in a non-infarct-related artery (non-IRA) on clinical
outcomes in acute coronary syndrome (ACS) patients and assessed the
benefits of staged revascularization. <br/>Method(s): We performed a
comprehensive systematic review to provide further insight into the impact
of a CTO in a non-IRA on clinical outcomes after ACS. Moreover, we review
the currently available evidence on the clinical significance of staged
revascularization for a CTO in a non-IRA patients with ACS and propose
whether prophylactic CTO percutaneous coronary intervention (PCI) could
improve outcomes in patients who subsequently develop an ACS.
<br/>Result(s): Our search identified 999 studies, from which 30 were
selected and ten were included in the analysis. The results showed a trend
of higher all-cause mortality and major adverse cardiac event rates in the
culprit-only-PCI group compared with the multivessel (MV)-PC I group in ST
elevation myocardial infarction patients, with varying statistical
significance across different outcomes. <br/>Conclusion(s): This review
highlights the significant impact of non-IRA CTOs in ACS. Successful CTO
revascularization may provide benefits, particularly in ST elevation
myocardial infarction, but the optimal management approach remains
uncertain. The presence of a non-IRA CTO, especially in cardiogenic shock,
predicts worse outcomes. Further research is warranted to determine the
effective strategies to improve survival.<br/>Copyright &#xa9; 2024
Informa UK Limited, trading as Taylor & Francis Group.

<111>
Accession Number
2031085146
Title
Prognostic value of the stress-hyperglycaemia ratio in patients with
moderate-to-severe coronary artery calcification: Insights from a large
cohort study.
Source
Diabetes, Obesity and Metabolism. 26(11) (pp 4933-4944), 2024. Date of
Publication: November 2024.
Author
Lin Z.; Song Y.; Yuan S.; He J.; Dou K.
Institution
(Lin, Song, Yuan, He, Dou) Department of Cardiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Lin, Song, Yuan, He, Dou) Cardiometabolic Medicine Center, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Lin, Song, Yuan, He, Dou) State Key Laboratory of Cardiovascular Disease,
Beijing, China
(Dou) National Clinical Research Center for Cardiovascular Diseases,
Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Aim: To evaluate the relationship between the stress-hyperglycaemia ratio
(SHR) and the clinical prognosis of patients with moderate-to-severe
coronary artery calcification (MSCAC). <br/>Method(s): We consecutively
enrolled 3841 patients with angiography-detected MSCAC. The individuals
were categorized into three groups based on SHR tertiles: T1 (SHR <=
0.77), T2 (0.77 < SHR <= 0.89) and T3 (SHR > 0.89). The SHR value was
calculated using the formula SHR = [admission glucose (mmol/L)]/[1.59 x
HbA1c (%) - 2.59]. The primary outcomes were major adverse cardiovascular
and cerebrovascular events (MACCEs), including all-cause death, non-fatal
myocardial infarction and non-fatal stroke. <br/>Result(s): During a
median follow-up of 3.11 years, 241 MACCEs were recorded. Kaplan-Meier
survival analysis showed that the SHR T3 group had the highest incidence
of MACCEs (P <.001). Moreover, findings from the restricted cubic spline
analysis showed a significant and positive association between the SHR and
MACCEs. This correlation remained consistent even after considering other
variables that could potentially impact the results
(P<inf>non-linear</inf> =.794). When comparing SHR T1 with SHR T3, it was
found that SHR T3 was significantly associated with an increased risk of
the primary outcome (adjusted hazard ratio = 1.50; 95% confidence
interval: 1.10-2.03). <br/>Conclusion(s): Patients with MSCAC showed a
positive correlation between the SHR and MACCE rate over a 3-year
follow-up period. The study showed that an SHR value of 0.83 is the key
threshold, indicating a poor prognosis. Future large-scale multicentre
investigations should be conducted to determine the predictive value of
the SHR in patients with MSCAC.<br/>Copyright &#xa9; 2024 John Wiley &
Sons Ltd.

<112>
Accession Number
2030960273
Title
Convergent ablation for persistent atrial fibrillation: A UK multicentre
perspective.
Source
Journal of Cardiovascular Electrophysiology. 35(10) (pp 2039-2052), 2024.
Date of Publication: October 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.<br/>Copyright &#xa9; 2024
The Author(s). Journal of Cardiovascular Electrophysiology published by
Wiley Periodicals LLC.

<113>
Accession Number
2030846741
Title
Editorial to "Long-term outcomes of ventricular tachycardia ablation in
repaired tetralogy of Fallot: systematic review and meta-analysis".
Source
Journal of Arrhythmia. 40(5) (pp 1169-1170), 2024. Date of Publication:
October 2024.
Author
Nabeshima T.; Sumitomo N.
Institution
(Nabeshima, Sumitomo) Department of Pediatric Cardiology, Saitama Medical
University International Medical Center, Saitama, Hidaka, Japan
Publisher
John Wiley and Sons Inc

<114>
Accession Number
2028577184
Title
Evaluation of Vasodilatory Effect of Nitroglycerin in Cardioplegia
Solution on Patients Undergoing Coronary Artery Bypass Graft Surgery.
Source
ARYA Atherosclerosis. 19(3) (pp 25-32), 2023. Date of Publication: May
2023.
Author
Hosseini A.; Shahzamani M.; Amiri F.
Institution
(Hosseini, Shahzamani) Department of Surgery, Chamran Cardiovascular and
Medical Research Hospital, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Amiri) Department of Surgery, School of Medicine, Isfahan University of
Medical Sciences, Isfahan, Iran, Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
INTRODUCTION: This study aimed to evaluate the vasodilatory effect of
nitroglycerin (NTG) in cardioplegia solution on changes in troponin I and
creatine phosphokinase-MB (CPK-MB) levels during coronary artery bypass
graft (CABG) surgery. <br/>METHOD(S): A randomized controlled double-blind
clinical trial was performed on 44 patients who were candidates for CABG
surgery. These patients were divided into two groups. In the first group
(NTG group), 3 mg/kg NTG was added to the cardioplegia solution, while 10
cc placebo (distilled water) was added to the cardioplegia solution in the
second group (control group). Troponin I and CPK-MB levels were then
assessed before and after the surgery. <br/>RESULT(S): In this study,
72.7% and 27.3% of patients in the NTG group and 68.2% and 31.8% of
patients in the control group were male and female, respectively. In
addition, 9.1% within the age range of 40-50 years, 27.3% within the age
range of 50-60 years, and 63.6% within the age range of more than 60 years
were present in the NTG group. Moreover, 18.2% within the age range of
40-50 years, 36.4% within the age range of 50-60 years, and 45.5% within
the age range of more than 60 years were present in the control group.
Although the mean cardiopulmonary bypass (CPB) and cross-clamp time was
insignificantly higher in the NTG group compared to the control group. In
addition, troponin I and CPK-MB levels after surgery in the NTG group with
the mean of 2090.68 +/- 1856.07 and 97.27 +/- 38.17 were significantly
lower than those of the control group with the mean of 2697.02 +/- 5586.56
and 137.95 +/- 227.99, respectively (P-value <0.05). <br/>CONCLUSION(S):
According to the results of this study, although troponin I and CPK-MB
levels increased significantly after CABG surgery, this increase was
significantly lower in the intervention group compared to the control
group following the administration of NTG.<br/>Copyright &#xa9; 2023,
Isfahan University of Medical Sciences(IUMS). All rights reserved.

<115>
Accession Number
2034993605
Title
Renal vein thrombosis in a patient secondary to high-grade rhabdoid renal
cell carcinoma: A case report and review of literature.
Source
Annals of Medicine and Surgery. 86(4) (pp 2194-2199), 2024. Date of
Publication: 06 Mar 2024.
Author
Kc M.; Bhattarai H.B.; Subedi P.; Kashyap A.; Wadhwa M.; Kaur D.; Koirala
S.; Gautam S.
Institution
(Kc, Wadhwa, Kaur) North Alabama Medical Center, Florence, AL, United
States
(Bhattarai) Dubai London Hospital, Dubai, United Arab Emirates
(Subedi) Nepalese Army Institute of Health Sciences, Tribhuvan University,
Sanobharyang, Nepal
(Kashyap) Tribhuvan University, Institute of Medicine, Maharajgunj Medical
Campus, Maharajgunj, Nepal
(Koirala) Gandaki Medical College Teaching Hospital and Research Center,
Pokhara, Nepal
(Gautam) Advent Health, Orlando, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Renal cell carcinoma, a common kidney tumour which is often
incidentally discovered on imaging, can manifest with atypical symptoms.
Renal cell carcinoma with rhabdoid features is a rare occurrence and even
rarer in case of adults. Renal cell carcinoma has the tendency to form
thrombus that can migrate to renal vein, inferior vena cava and even right
atrium. Case presentation: The authors report a case of an 81-year-old
male with rhabdoid renal cell carcinoma presenting with persistent cough
for 6-7 months. with tumour thrombus extending into the renal vein and
hepatic inferior vena cava. The patient was found feeble for the surgery
and hence was treated on anticancer drugs pembrolizumab and axitinib.
<br/>Conclusion(s): Renal cell carcinoma has the tendency to form tumour
thrombus in renal vein and inferior vena cava. Prognosis without surgical
intervention in these conditions is very poor.<br/>Copyright &#xa9; 2024
The Author(s). Published by Wolters Kluwer Health, Inc.

<116>
Accession Number
2034916771
Title
Bilateral Ultrasound-Guided Erector Spinae Plane Block for Management of
Acute Postoperative Surgical Pain after Pediatric Cardiac Surgeries
Through a Midline Sternotomy.
Source
Annals of Cardiac Anaesthesia. 27(4) (pp 316-323), 2024. Date of
Publication: 2024.
Author
Mogahed M.M.; Abd El-Ghaffar M.S.; Elkahwagy M.S.
Institution
(Mogahed) Department of Anesthesiology, Faculty of Medicine, Tanta
University, Egypt
(Abd El-Ghaffar) Department of Surgical ICU and Pain Medicine, Faculty of
Medicine, Tanta University, Egypt
(Elkahwagy) Department of Cardiothoracic Surgery, Faculty of Medicine,
Tanta University, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Ultrasound (US) guided erector spinae plane block (ESPB) is a
safe and effective technique in providing perioperative pain management in
pediatrics with a high success rate. The Aim of this Study: Was to compare
the efficacy of bilateral ultrasound-guided erector spinae plane block for
management of acute postoperative surgical pain after pediatric cardiac
surgeries through a midline sternotomy. <br/>Method(s): One hundred
patients aged 4-12 years were randomly assigned into two groups, both
groups received general anesthesia followed by bilateral sham erector
spinae plane block at the level of T 6 transverse process using 0.4 ml/kg
normal saline on each side in the control group (group C) or bilateral
ultrasound-guided erector spinae plane block at the level of T 6
transverse process using 0.4 ml/kg ropivacaine 0.2% with a maximum dose of
2 mg/kg mixed with adrenaline 2 mcg/ml in erector spinae plane block group
(group E). The postoperative pain scores were evaluated immediately
post-extubation, at 1 hour, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, and 24
hours after extubation, total consumption of intraoperative fentanyl and
time to first rescue analgesic administration were also recorded.
<br/>Result(s): There was a statistically high significant delay in the
group E (314.72 +/- 45.94) compared with the group C (36.7 +/- 7.22) as
regards to the mean (SD) of the time of the rescue analgesia (P < 0.001)
(with 95% CI), moreover; the number of rescue analgesic was significantly
higher in the group C compared with the group E (P < 0.001) (with 95% CI)
and the mean (SD) of total intraoperative and postoperative levels
fentanyl requirements in the group C were significantly higher compared
with the group E (6.47 +/- 0.98 and 5.09 +/- 0.83) (with 95% CI) in group
C versus (4.69 +/- 0.71 and 2.31 +/- 0.66) (with 95% CI) in group E
respectively (P < 0.001) (with 95% CI). <br/>Conclusion(s):
Ultrasound-guided bilateral ESPB with ropivacaine and adrenaline delays
the postoperative need of analgesia and reduces postoperative fentanyl
consumption at 24 h in pediatric patients undergoing cardiac surgery
through midline sternotomy.<br/>Copyright &#xa9; 2024 Annals of Cardiac
Anaesthesia.

<117>
Accession Number
2034072285
Title
Effect of Preoperative Clopidogrel on Outcomes of Isolated Coronary Artery
Bypass Graft: An STS National Database Analysis.
Source
Annals of Thoracic Surgery. 118(5) (pp 1054-1062), 2024. Date of
Publication: November 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,
MN, United States
(Todd) Division of Clinical Trials and Biostatistics, Department of
Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2024 The
Society of Thoracic Surgeons

<118>
Accession Number
2030907121
Title
Bariatric surgery and drugs: Review of the literature and Adverse Drug
Reactions analysis in French National Pharmacovigilance Database.
Source
Therapies. 79(5) (pp 577-587), 2024. Date of Publication: 01 Sep 2024.
Author
Nicol C.; Jacquot J.; Chebane L.; Combret S.; Pecquet P.-E.; Massy N.;
Bagheri H.
Institution
(Nicol, Jacquot, Chebane, Bagheri) Service de pharmacologie medicale,
centre de pharmacovigilance de Toulouse, CIC1436, faculte de medecine, CHU
de Toulouse, Toulouse 31000, France
(Combret) Centre regional de pharmacovigilance de Bourgogne, CHU de Dijon,
Dijon 21000, France
(Pecquet) Service de pharmacologie clinique, centre de pharmacovigilance
d'Amiens, CHU d'Amiens, Amiens 80000, France
(Massy) Centre regional de pharmacovigilance de Rouen, CHU de Rouen, Rouen
76000, France
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Bariatric surgery is the only treatment for severe obesity
(BMI > 35 kg/m²) currently recognized as effective both in
achieving tangible and lasting weight loss, and in improving
obesity-related comorbidities such as type 2 diabetes, hypertension, and
cardiovascular complications. Bariatric surgery, like any other surgery of
the digestive tract, can have an impact on nutrient absorption, as well as
on drug absorption. The literature on drug management in bariatric surgery
patients concerned mainly of case reports and retrospective studies
involving a small number of patients. No official guidelines are
available. <br/>Method(s): We conducted a literature search on the
consequences of bariatric surgery in terms of drug bioavailability and/or
effect. The Medline (PubMed) database was searched using the following
keywords: "bariatric surgery", "bioavailability", "gastric bypass", and
"obesity". We completed this review with an analysis of reports of adverse
drug reactions (ADRs) in post-bariatric surgery patients for obesity
registered in the National pharmacovigilance database (PVDB). We selected
all cases with the mention of "bariatric surgery and/or gastrectomy" as
"medical history". After reading the cases, we excluded those in which the
patient had undergone surgery for an indication other than obesity, where
the route of administration was other than oral, and cases in which ADRs
resulted from voluntary overdose, attempted suicide, allergy, switch to
Levothyrox new formulation, meningioma under progestative drugs,
inefficacy related to generic substitution and medication error.
<br/>Result(s): The literature search identified mainly "case report"
about the impact of bariatric surgery on so-called "narrow therapeutic
window" drugs. We identified 66 informative cases out of a total of 565
cases selected (11%) in the PVDB. Nevertheless, the information does not
allow a clear relationship between the occurrence of the ADR and the
influence of bariatric surgery. <br/>Conclusion(s): There is a lack of
official information and/or recommendations on medication use in subjects
who have undergone bariatric surgery. Apart from under-reporting, ADRs
reports remain largely uninformative. Health professional and patients
would be awareness for improving, quantitatively and qualitatively the
reporting of ADRs in this population.<br/>Copyright &#xa9; 2024 Societe
francaise de pharmacologie et de therapeutique

<119>
Accession Number
2027802660
Title
Does addition of plane blocks to multimodal analgesic strategy really
improve postoperative pain control after endoscopic aortic valve
replacement?.
Source
Regional Anesthesia and Pain Medicine. 49(10) (pp 775-776), 2024. Date of
Publication: 08 Oct 2024.
Author
Xue F.-S.; He N.; Cheng Y.
Institution
(Xue, He, Cheng) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing, China
Publisher
BMJ Publishing Group

<120>
Accession Number
634167015
Title
A prospective randomized trial comparing biatrial and isolated left atrial
ablation in patients with long-standing persistent atrial fibrillation
undergoing CABG.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 445), 2020. Date of
Publication: November 2020.
Author
Kalybekova A.; Chernyavskyi A.; Lukinov V.
Institution
(Kalybekova, Chernyavskyi, Lukinov) Meshalkin National Medical Research
Center, Novosibirsk, Russian Federation
Publisher
Oxford University Press
Abstract
Purpose: To compare the efficacy and safety of left atrial ablation (LAA)
with those of biatrial ablation (BA) in patients with long-standing
persistent atrial fibrillation (AF) in common with CABG.
<br/>Background(s): AF is the most common heart rhythm disorder, while CAD
is the most common cardiovascular disease. Chronic coronary syndrome and
atrial fibrillation coexist in many patients. Long-standing persistent
atrial fibrillation (AF) is frequent pathology in patients undergoing
CABG. Surgical ablation in such patients is currently an effective
treatment of AF. Pulmonary vein isolation (PVI) may reduce AF recurrences
in 70% of patients with paroxysmal form of AF. However, the efficacy of
ablation in patients with long-standing persistent AF is rather low.
Clinical studies have shown that the right atrium can also be involved in
the AF initiation and maintenance. Areas localized in both atrias are
characterized by rapid electrical activity, which is critical in the AF
persistence. Therefore, we have hypothesized that in long-standing
persistent AF BA could be more effective than isolated LAA.
<br/>Method(s): Between 2016 and 2019, 116 patients with long-standing
persistent AF and CAD who underwent open-heart surgery were included in
this single blind prospective randomized study and divided into two
groups: 58 patients in group 1 underwent isolated LAA + CABG, and group II
(58 patients) - BA + CABG. All the patients had Reveal LINQ ICM System
(Medtronic, USA) implanted during the index procedure. The mean age was 65
[61; 67.75] years versus 62 [58; 66] years (p=0.050) and 83% versus 84%
(p>0.999) were men in BA and LAA groups, respectively. The follow-up time
was 22+/-3 months for two groups. The primary endpoint was freedom from AF
during 24-month follow-up based on 24-hour Holter monitoring ECG
registration and Reveal device data. <br/>Result(s): This study has
demonstrated that in CAD patients with longstanding persistent AF, PVI in
combination with multiple linear lesions in the right atrium while GABG
produce a significantly higher success rate than PVI alone. After 24
months, AF recurred in 38% of patients in the BA group and in 64% - in the
LAA group (p=0.010). Univariate logistic regression analysis showed
indicators as long axis of left atria in mm (OR 3.45, 95%; CI 1.77 to
7.64, p=0.001) in LAA group and (OR 2.02, 95%; CI 1.03 to 4.26, p=0.049)
in-group BA increases the risk of AF. Chronic kidney disease (OR 2.95, 95%
CI 1.05 to 9.22, p=0,048), and mitral regurgitation (OR 1.18, 95% CI 1.01
to 1.41, p=0.047) have been found the independent predictors of AF
recurrence in the LAA group. Arrhythmia on the third day after procedure
increases the risk of AF (OR 3.79, 95% CI 1.45 to 10. 58, p=0.008) in the
LAA group in a long-term follow-up. <br/>Conclusion(s): The study has
demonstrated that BA is more effective for treatment of long-standing
persistent AF in CAD patients undergoing CABG.

<121>
Accession Number
634166325
Title
Complete versus culprit-only percutaneous coronary intervention in
patients with non-ST-segment elevation acute coronary syndrome: A
meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 2552), 2020. Date of
Publication: November 2020.
Author
Sakurai R.
Institution
(Sakurai) International University of Health and Welfare, School of
Medicine, Chiba, Japan
Publisher
Oxford University Press
Abstract
Background: The clinical benefit of complete or culprit-only percutaneous
coronary intervention (PCI) in patients with non-ST-segment elevation
acute coronary syndrome (NSTE-ACS) still remains controversial.
<br/>Purpose(s): The purpose of this study was to investigate the clinical
outcomes of complete or culprit-only PCI in patients with unstable angina
and/or non-ST-segment elevation myocardial infarction. <br/>Method(s):
PubMed, the Cochrane Library, and Web of Science were queried to conduct a
meta-analysis. The same terms or relevant studies were also queried on the
website of the U.S. National Institute of Health and relevant reviews. The
primary endpoint was the incidence of major adverse cardiac events (MACE:
the composite of all-cause mortality, myocardial infarction, or coronary
revascularisation) during follow-up period, and the secondary endpoints
were the incidences of each component of MACE. When multiple follow-up
results were reported in the same study, the latest results were
abstracted. Pooled estimates were calculated using a random-effects model.
<br/>Result(s): Nine studies (60345 patients) were included in this
meta-analysis. The risk of all-cause mortality (odds ratio (OR): 0.79, 95%
confidence interval (CI): 0.64-0.98, p=0.03) or coronary revascularisation
(OR: 0.71, 95% CI: 0.50-1.00, p=0.05) were lower in the complete PCI group
than in the culprit-only PCI group, whereas the risk of MACE (OR: 0.98,
95% CI: 0.65-1.49, p=0.94) or myocardial infarction (OR: 0.77, 95% CI:
0.54-1.08, p=0.13) was similar between the 2 groups. <br/>Conclusion(s):
In this meta-analysis, complete PCI is associated with a lower risk of
all-cause mortality or coronary revascularisation, and a similar risk of
MACE or myocardial infarction compared with culprit-only PCI in patients
with NSTE-ACS.

<122>
Accession Number
634166219
Title
Thirty-day incidence of stroke after transcatheter aortic valve
implantation: A meta-and network meta-analysis comparing self-expandable
versus balloon-expandable valve prostheses.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 2593), 2020. Date of
Publication: November 2020.
Author
Seppelt P.C.; Mas-Peiro S.; De Rosa R.; Murray I.; Fichtlscherer S.;
Zeiher A.M.; Vasa-Nicotera M.
Institution
(Seppelt, Mas-Peiro, De Rosa, Murray, Fichtlscherer, Zeiher,
Vasa-Nicotera) University Hospital Frankfurt, Goethe University,
Department of Cardiology, Frankfurt am Main, Germany
Publisher
Oxford University Press
Abstract
Introduction: Stroke is a major and feared complication after
transcatheter aortic valve implantation (TAVI). So far it is unknown,
weather the valve deployment system itself has an impact on the incidence
of periinterventional stroke. We sought to identify the incidence of
30-day stroke after transfemoral TAVI with self-expandable (SE) and
balloon-expandable (BE) valves and performed a meta- and network
meta-analysis to analyze differences related to the valve deployment
system. <br/>Method(s): Overall 2706 articles were searched comparing
directly the performance of SE and BE TAVI valves, from which 7 were
included for analysis (one randomized controlled trial, 6 propensity score
matching studies) with a total number of 2488 patients. Meta-analysis used
random effects model and reported risk ratios (RRs). To compare different
type of valves a random-effects network meta-analysis based on a
frequentist framework for indirect and mixed comparisons was applied and
reported odds rations (ORs). Using P-Score the relative ranking
probability of each valve was estimated and the hierarchy of competing
valves was obtained. <br/>Result(s): Thirty-day incidence of stroke was
1.9% in SE (22 out of 1139, Medtronic CoreValve, Medtronic Evolut R and
Pro, Boston Scientific ACURATE neo and St. Jude Medical Portico) and 3.1%
in BE TAVI valves (42 out of 1349, Edwards Sapien 3 and XT) resulting in a
RR of 0.65, (95% confidence interval (CI) 0.51 to 0.82). In accordance
with the estimated P-Score CoreValve was the best effective for a
reduction of 30-day stroke (72,5%) whereas the worst were Sapien 3 and XT
(19.%). Combined direct and indirect evidence showed no superiority of
CoreValve compared with Sapien valves (OR 0.469, 95% CI 0.13-1.64)
concerning 30-day stroke incidence. <br/>Conclusion(s): Our meta-analysis
indicates a higher thirty-day incidence of stroke after TAVI with BE
valves compared to SE valves. Furthermore, we could not find evidence for
superiority of a specific valve system. Randomized controlled trials with
head to head comparison of SE and BE valves are needed to address this
open question.

<123>
Accession Number
634166129
Title
Anticoagulation and outcomes after surgical aortic valve replacement with
a biological prosthesis.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 2689), 2020. Date of
Publication: November 2020.
Author
Angleitner P.; Zinggl M.; Werner P.; Coti I.; Mach M.; Kocher A.; Laufer
G.; Andreas M.
Institution
(Angleitner, Zinggl, Werner, Coti, Mach, Kocher, Laufer, Andreas) Medical
University of Vienna, Vienna, Austria
Publisher
Oxford University Press
Abstract
Background: No strong recommendation exists regarding the use of
short-term anticoagulation after surgical aortic valve replacement (SAVR)
with a biological prosthesis. <br/>Purpose(s): Our aim was to analyze
outcomes of patients receiving warfarin versus low-molecular weight
heparin (LMWH) after isolated SAVR. <br/>Method(s): We retrospectively
analyzed all adult patients who underwent surgery between 2009 and 2017 at
our department (n=598). Exclusion criteria included pre-operative
anticoagulation, atrial fibrillation, dialysis, previous aortic valve
replacement, or active endocarditis. Patients who were discharged alive
were stratified according to the type of anticoagulation (warfarin, n=332,
55.5%; LMWH, n=266, 44.5%). Long-term survival during the follow-up period
was analyzed (median follow-up, 5.6 years). <br/>Result(s): Patients who
received warfarin had significantly lower logistic EuroSCORE and were
younger (Table 1). Warfarin was more frequently utilized between 2009 and
2014, whereas LMWH was more commonly used between 2015 and 2017.
Kaplan-Meier curves in Figure 1 show that patients who received warfarin
had significantly superior long-term survival (log-rank test: p=0.002).
Multivariable Cox proportional hazards regression analysis confirmed that
the use of warfarin was associated with significantly lower risk of
long-term mortality when compared with LMWH (hazard ratio [HR] 0.50, 95%
confidence interval [CI] 0.34-0.74, p=0.001). Covariables in this model
included logistic EuroSCORE, era, and duration of cardiopulmonary bypass.
<br/>Conclusion(s): The present analysis suggests that the use of warfarin
is associated with significantly superior survival after SAVR with a
biological prosthesis. Our findings require validation in a prospective
randomized controlled trial. (Table Presented).

<124>
Accession Number
634166074
Title
Computed tomography derived predictors of permanent pacemaker implantation
after transcatheter aortic valve implantation: A meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 2582), 2020. Date of
Publication: November 2020.
Author
Maier O.; Zeus T.; Jung C.; Westenfeld R.; Polzin A.; Kelm M.; Veulemans
V.
Institution
(Maier, Zeus, Jung, Westenfeld, Polzin, Kelm, Veulemans) University
Hospital Duesseldorf, Duesseldorf, Germany
Publisher
Oxford University Press
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
wellestablished alternative to surgery for the treatment of patients with
severe symptomatic aortic stenosis at high and intermediate surgical risk.
Unfortunately, the occurrence of electrical conduction disturbances
remains one of the most frequent complications of the procedure. While the
impact of electrocardiographic and procedural predictors on PPI is well
examined, there is still a lack of knowledge regarding anatomical
predictors screened by multislice computed tomography (MSCT).
<br/>Purpose(s): We performed a meta-analysis to summarize available
studies that reported the incidence of PPI after TAVI with new-generation
devices and provided raw data for preprocedural MSCT. <br/>Method(s): The
authors conducted a literature search in PubMed database until December
31, 2019 to identify studies that investigated preprocedural MSCT data and
rate of PPI following TAVI with new-generation devices. Twelve
observational studies (n=3133) met inclusion criteria for final analysis.
<br/>Result(s): PPI was performed in 509 patients (16.2%) after TAVI,
mostly due to high degree atrioventricular (AV) block (80.8%). The rate of
PPI varied widely from 7.9% to 35.8% in individual studies. Regarding
secondary endpoints' analysis of relative risk (RR) and mean difference
(MD) electrocardiographic PPI-predictors after TAVI appeared to be
pre-existing atrial fibrillation (AF) (RR 1.21; 95% CI 1.05-1.40;
p=0.008), right bundle branch block (RBBB) (RR 4.22; 95% CI 3.30-5.41;
p<0.0001) and AV block grade I (RR 1.63; 95% CI 1.16-2.29; p=0.005).
Patients requiring PPI had larger annulus perimeter (MD 1.66 mm; 95% CI
0.67-2.66 mm; p=0.001) and shorter membranous septum length (MD -0.86 mm;
95% CI -1.74-0.02 mm; p=0.05) assessed by preprocedural MSCT. Concerning
calcium load of device landing zone, pacemaker dependent patients showed
increased calcification of the non-coronary cusp (MD 39.76 mm3; 95% CI
18.60- 60.93 mm3; p=0.0002), the left-coronary cusp (LCC) (MD 47.60 mm3;
95% CI 19.40-75.81 mm3; p=0.0009) and the total left ventricular outflow
tract (LVOT) (MD 19.17 mm3; 95% CI 6.68-31.66 mm3; p=0.003). Lower
implantation depth (MD 0.83 mm from NCC; 95% CI 0.20-1.47 mm; p=0.01) and
oversizing by annulus diameter/area (MD 1.76%; 95% CI 0.68-2.84%; p=0.001)
were procedural predictors of PPI following TAVI. <br/>Conclusion(s): This
structured meta-analysis proved PPI rate in 16.2% of patients following
TAVI. Beside well-known electrocardiographic (AF, RBBB, AV block grade I)
and procedural predictors (implantation depth, oversizing) this
meta-analysis showed for the first time that MSCT derived anatomical
values (annulus perimeter, membranous septum length) and distribution of
device landing zone's calcification (NCC, LCC, LVOT) are associated with
increased risk of PPI following TAVI.

<125>
Accession Number
634166033
Title
Adenosine diphosphate receptor inhibitor monotherapy with ticagrelor or
clopidogrel following percutaneous coronary intervention: A systematic
review and meta-analysis of randomized controlled trials.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 2578), 2020. Date of
Publication: November 2020.
Author
Haghbayan H.; Durocher D.P.; Coomes E.A.; Lavi S.
Institution
(Haghbayan, Durocher, Lavi) London Health Sciences Centre, Division of
Cardiology, Department of Medicine, London, Canada
(Coomes) University of Toronto, Division of Infectious Diseases,
Department of Medicine, Toronto, Canada
Publisher
Oxford University Press
Abstract
Background and purpose: In patients undergoing percutaneous coronary
intervention (PCI) with implantation of coronary stents, the risk of stent
thrombosis is mitigated with antiplatelet therapy. While current clinical
practice is to treat patients with dual antiplatelet therapy (DAPT)
combining aspirin with an adenosine diphosphate receptor inhibitor
(ADPri), prolonged therapy is associated with heightened bleeding risk.
Limiting DAPT to a shorter period after PCI, followed by ADPri
monotherapy, may be an attractive strategy for optimizing the balance
between thrombotic and bleeding risks. While several randomized controlled
trials (RCTs) have been published examining this strategy, the optimal
duration of abbreviated DAPT run-in and the ideal choice of ADPri remain
uncertain. <br/>Method(s): We undertook a systematic review and
meta-analysis of RCTs assessing abbreviated DAPT followed by ADPri
monotherapy post coronary stenting. Our primary outcomes were defined as
clinically important bleeding, major adverse cardiovascular events (MACE),
and all-cause mortality. We searched Ovid MEDLINE and EMBASE from their
inceptions to November 2019 with study selection and data extraction
performed in duplicate. We pooled data at one year using random effects
models; relative risks (RRs) with 95% confidence intervals (95% CIs) were
generated using the inverse variance method. Pre-specified sub-group
analyses were undertaken according to duration of DAPT and the primary
ADPri employed. <br/>Result(s): Four trials (n=29084) were eligible for
inclusion. Mean age was 65 years and 51.5% of patients were recruited in
the context of acute coronary syndrome. Following meta-analysis, the
occurrence of clinically significant bleeding events was significantly
lower in patients receiving ADPri monotherapy (4 studies; n=29084;
RR=0.60; 95% CI, 0.43-0.83; I2=73%; Figure-A), with no significant
difference in the rates of all-cause mortality (4 studies; n=29084;
RR=0.87; 95% CI, 0.71-1.06; I2=0%; Figure- B) or MACE (4 studies; n=29084;
RR=0.90; 95% CI, 0.79-1.03; I2=1%; Figure-C). In subgroup analysis, trends
toward lower rates of both all-cause mortality (2 studies; n=23082
participants; RR=0.81; 95% CI, 0.65-1.01; I2=0%; Figure-B) and MACE (2
studies; n=23082 participants; RR=0.90; 95% CI, 0.79-1.03; I2=25%;
Figure-C) were seen in the studies employing ticagrelor as opposed to
clopidogrel; however, neither analysis reached statistical significance
(p-values=0.06 and 0.19, respectively). There was no differential
treatment effect based on the duration of abbreviated DAPT prior to ADPri
monotherapy in sub-group analysis. <br/>Conclusion(s): Following PCI in
patients with coronary disease, an abbreviated course of DAPT followed by
ADPri monotherapy significantly reduces rates of bleeding with no
difference in rates of MACE or all-cause mortality. Future studies are
required to conclusively determine whether the use of ticagrelor in this
setting may also reduce rates of all-cause mortality. (Figure Presnted).

<126>
Accession Number
634164351
Title
Identifying high thrombotic risk in atrial fibrillation patients
undergoing percutaneous coronary intervention: Is there a benefit of
triple therapy?.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 1451), 2020. Date of
Publication: November 2020.
Author
Bor W.L.; Zwart B.; De Veer A.J.W.M.; Mahmoodi B.K.; Kelder J.C.; Cannon
C.P.; Ten Berg J.M.
Institution
(Bor, De Veer, Mahmoodi, Kelder, Ten Berg) St Antonius Hospital,
Nieuwegein, Netherlands
(Zwart) Catharina Hospital, Eindhoven, Netherlands
(Cannon) Brigham and Women'S Hospital, Harvard Medical School, Boston,
United States
Publisher
Oxford University Press
Abstract
Introduction: Patients requiring concomittant use of oral anticoagulants
for atrial fibrillation and dual antiplatelet therapy after percutaneous
coronary intervention (PCI) are at increased risk of bleeding and
mortality. Omittance of aspirin (dual antithrombotic therapy, DAT) reduces
bleeding as compared to triple antithrombotic therapy (TAT), but might not
ascertain antithrombotic efficacy, especially in high-risk patients.
<br/>Purpose(s): To identify a subgroup of patients at high thrombotic
risk that might benefit most from TAT over DAT. <br/>Method(s): The study
was performed in a combined cohort of two randomised controlled trials
(WOEST, RE-DUAL PCI) comparing TAT versus DAT after PCI. A Cox
proportional hazards model predictive for the composite thrombotic
endpoint of cardiovascular death, myocardial infarction (MI), stent
thrombosis, and ischaemic stroke was built by stepwise selection of
plausible predictor variables. Area under the receiver operating curve
(AUC) was obtained, and clinical outcomes (thrombotic endpoint, bleeding
[BARC 2,3+5], and all-cause mortality) were compared between the highest
quintile of predicted thrombotic risk (high risk) and the remainder of
patients (low-intermediate risk). Within the different risk groups, effect
of TAT versus DAT was compared. <br/>Result(s): A total of 3288 patients
in the combined WOEST and RE-DUAL cohorts were included in this analysis.
Approximately half underwent PCI for acute coronary syndrome. In 250
patients (7.6%) the composite thrombotic endpoint occurred during the
first year. The final Cox proportional hazards model predicting thrombotic
events contained: left ventricular ejection fraction, 3-vessel disease, MI
at index PCI, peripheral artery disease, prior stroke, left circumflex
coronary artery stenting, a history of MI, PCI to a bypass graft, and
platelet count. The discriminatory capacity of the ischaemic model was
fair (AUC 0.68, 95% confidence interval 0.64-0.71). Incidence of
thrombotic events and mortality was higher in the high-risk as compared to
low-intermediate risk patients (15.8% vs 5.6%, and 8.4% vs 3.2%,
respectively, both p<0.001), whereas bleeding was comparable (20.5% vs
19.6%, p=0.60). No statistically significant effect of TAT over DAT was
seen with regards to the thrombotic endpoint in both high and
lowintermediate risk patients (13.9% vs 17.0%, p=0.36, and 6.5% vs 5.0%,
p=0.11, respectively). Bleeding was significantly reduced with DAT versus
TAT in both high and low-intermediate risk patients (minus 12.8% and 8.1%,
both p<0.02). For low-intermediate risk patients a statistically
significant increase in mortality was found with TAT versus DAT (4.2% vs
2.5%, p=0.02), whereas this was not found in high-risk patients (7.2% vs
9.1%, p=0.47). <br/>Conclusion(s): No significant antithrombotic advantage
of TAT over DAT was found in high-risk patients. However, TAT increased
bleeding risk in all patients, and increased mortality in low-intermediate
risk patients.

<127>
Accession Number
634163962
Title
Efficacy of fractional flow reserve-guided percutaneous coronary
intervention for patients with angina pectoris: A network meta-analysis.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 1469), 2020. Date of
Publication: November 2020.
Author
Shinohara H.; Kodera S.; Kiyosue A.; Ando J.; Morita H.; Komuro I.
Institution
(Shinohara, Kodera, Kiyosue, Ando, Morita, Komuro) University of Tokyo
Hospital, Tokyo, Japan
Publisher
Oxford University Press
Abstract
Background: Evaluation of hemodynamic parameters, such as fractional flow
reserve (FFR), is recommended before percutaneous coronary intervention
(PCI) for patients with angina pectoris (AP). However, the advantage of
FFR-guided PCI has not been fully established. A network metaanalysis
(NMA) synthesizes the results of studies on multiple competing
interventions. Moreover, no NMA has evaluated randomized controlled trials
for AP to compare FFR-guided PCI and other treatments. To clarify whether
FFR-guided PCI improves the prognosis in patients with AP, we performed
this study. <br/>Method(s): Multiple databases were searched for studies
published from 2000 to 2018. The search terms were based on Medical
Subject Headings and keywords including "angioplasty", "coronary artery
bypass", "percutaneous coronary intervention", "coronary disease", and
"randomized controlled trial". And an NMA was performed to compare
outcomes of FFRguided PCI, non-FFR-guided PCI, coronary artery bypass
grafting (CABG), and medical treatment (MT) for AP based on estimated odds
ratios (ORs). The primary endpoint was all-cause mortality. The secondary
endpoints were the occurrence of MI. Treatments were ranked by the surface
under the cumulative ranking curve. <br/>Result(s): The study included
18,093 patients from 15 randomized controlled trials. No evidence of
inconsistency was observed among the studies. The NMA showed that the
all-cause mortality of FFR-guided PCI was not significantly different from
that of the other treatment groups (CABG: OR, 1.1; 95% confidence interval
[CI], 0.67-1.7; non-FFR-guided PCI: OR, 0.85; 95% CI, 0.53-1.4; and MT:
OR, 0.83; 95% CI, 0.52-1.3). The NMA for myocardial infarction, which
included 13,548 patients from 11 randomized controlled trials, showed that
FFR-guided PCI tended to reduce the occurrence of myocardial infarction
compared with MT (OR, 0.60; 95% CI, 0.36- 1.0). According to the surface
under the cumulative ranking curve, CABG was the best treatment, followed
by FFR-guided PCI, non-FFR-guided PCI, and MT. <br/>Conclusion(s):
FFR-guided PCI for AP showed no significant prognostic improvement
compared with non-FFR-guided PCI, CABG, and MT. CABG was the best
treatment for AP, followed by FFR-guided PCI, non-FFRguided PCI, and MT.

<128>
Accession Number
634163920
Title
Prasugrel versus ticagrelor in patients with acute coronary syndrome
undergoing percutaneous coronary intervention; a meta-analysis of
randomized controlled trials.
Source
European Heart Journal. Conference: European Society of Cardiology
Congress, ESC 2020. Virtual. 41(SUPPL 2) (pp 1465), 2020. Date of
Publication: November 2020.
Author
Rodriguez Z.; Valdecanas A.; Palileo N.
Institution
(Rodriguez, Valdecanas, Palileo) St. Luke's Medical Center Quezon City,
Quezon City, Philippines
Publisher
Oxford University Press
Abstract
Background: Dual antiplatelet therapy (DAPT) with ASA and a P2Y12
inhibitor is the cornerstone of anti-thrombotic therapy for patients
undergoing PCI. The 2014 European Society of Cardiology (ESC)/European
Association for Cardio-Thoracic Surgery (EACTS) guidelines on myocardial
revascularization recommend DAPT with prasugrel or ticagrelor over
clopidogrel, however, a comparison between the efficacy in reducing all
cause mortality and major bleeding of prasugrel versus ticagrelor is
sparse. <br/>Objective(s): To perform a meta-analysis of randomized
controlled trials (RCT) in the determination of the efficacy and safety of
prasugrel as compared to ticagrelor among ACS patients undergoing PCI.
<br/>Method(s): Extensive search of PubMed, Cochrane Library, Ovid,
EMBASE, Google scholar, Medline and Herdin was done up to November 2019.
Studies were limited to RCTs comparing ticagrelor vs. prasugrel among
acute coronary syndrome (ACS) patients undergoing PCI. Outcome measures
include all-cause mortality and major bleeding. Statistical analysis was
done using Review manager V5.3. <br/>Result(s): Thirteen RCTs with 6086
patients were included in this study. Pooled analysis using random effects
model showed no difference in reduction of all-cause mortality between
prasugrel versus ticagrelor (92 vs 107, RR of 0.77, 95% CI of 0.58-1.02,
p-value of 0.07, I2 of 0%). Likewise, major bleeding (using BARC and TIMI
as defined by the Bleeding Academic Research Consortium scale and
Thrombolysis in Myocardial Infarction definitio) was similar between
prasugrel and ticagrelor (91 vs 111, RR of 0.83, 95% CI of 0.63-1.09,
p-value of 0.18, I2 of 0%). <br/>Conclusion(s): There were no significant
differences in the reduction of all cause mortality and major bleeding
among ACS patients undergoing PCI receiving prasugrel versus ticagrelor.
Our study may support the equal recommendation of both P2Y12 inhibitors as
in the above guidelines.

<129>
Accession Number
632378488
Title
Prevention of nosocomial infection using oral chlorhexidine among patients
undergoing cardiac surgery: A meta-analysis.
Source
American Journal of Respiratory and Critical Care Medicine. Conference:
American Thoracic Society International Conference, ATS 2020.
Philadelphia, PA United States. 201(1) (no pagination), 2020. Date of
Publication: 2020.
Author
Ogbac M.E.; Tamayo J.V.
Institution
(Ogbac) Section of Pulmonology, Perpetual Help Medical Center-Las Pinas,
Las Pinas, Philippines
(Tamayo) Perpetual Help Medical Center-Las Pinas, Las Pinas, Philippines
Publisher
American Thoracic Society
Abstract
Rationale:Infections namely pneumonia, urinary tract infection, and wound
infection can complicate post-operative outcomes of cardiac surgeries such
as percutaneous coronary intervention and coronary artery bypass grafts.
These preventable complications have caused significant delay in the
improvement and even death in certain patients undergoing these
procedures. Oral chlorhexidine has been proven to prevent nosocomial
infections particularly ventilatorassociated pneumonia (VAP). Certain
studies have also proved its effect on the prevention of infection among
nonintubated patients. In this meta-analysis, we studied the different
randomized controlled trials (RCT) comparing the effect of oral
chlorhexidine in the prevention of nosocomial infections among patients
undergoing cardiac surgeries. <br/>Method(s):Several published RCT about
the effect of oral chlorhexidine and occurrence of nosocomial infection
among patients undergoing cardiac surgeries were identified using PUBMED,
MEDLINE, COCHRANE, and EMBASE. The studies included were published from
1996 to 2019. The primary outcome was the incidence of nosocomial
infection. Subset analysis was also made comparing the different
nosocomial infections. <br/>Result(s): Based on this meta-analysis, it was
found that oral chlorhexidine has significantly reduced the number of
nosocomial infections after cardiac surgeries. Among these infections,
hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP),
urinary tract infection, and wound infection have lower incidence in
patients treated with oral chlorhexidine although only the HAP and VAP
were statistically significant. The incidence of positive culture growth
was also statistically in favor with oral chlorhexidine.
<br/>Conclusion(s): Nosocomial infections are deleterious complications of
post cardiac procedures that can be easily prevented. With this study, it
has shown that the use of oral chlorhexidine as part of the routine
regimens during cardiac surgeries can significantly prevent if not lower
incidence of infection.

<130>
Accession Number
2035053358
Title
Comparative analysis of survival rate and quality of life in axial-flow
pump left ventricular assist devices (LVADs).
Source
Heart and Lung. 69 (pp 127-137), 2025. Date of Publication: 01 Jan 2025.
Author
Savar A.K.; Wang H.; Chen N.; Cheng Y.
Institution
(Savar, Wang, Chen, Cheng) Shanghai Interventional Medical Device
Engineering Technology Research Center, University of Shanghai for Science
and Technology, Shanghai, China
(Savar) University of Shanghai for Science and Technology, 516 Jungong
Road, Phone: +8617821130410
Publisher
Elsevier Inc.
Abstract
Background: The rising heart failure rates globally show the pressing
demand for treatment progress, especially in Left Ventricular Assist
Devices (LVADs). Axial-flow pump LVADs are gaining notice for their small
size, few moving parts, and potential for miniaturization, providing a
vital option for heart transplants during donor shortages.
<br/>Objective(s): Despite several studies on LVADs, there is a notable
lack of research specifically comparing axial-flow pumps with similar
technology. This gap hinders the identification of the most optimal
technology to guide development efforts and meet patient needs. This study
aims to comprehensively compare the most commonly used axial-flow pumps
and provide a detailed analysis focusing on survival rates and quality of
life parameters. <br/>Method(s): As a developer of axial-flow pumps
(LVADs), our group conducted a systematic review of the current axial-flow
pump LVADs. We analyzed studies comparing these devices, focusing on key
metrics such as survival rates and quality of life. <br/>Result(s): The
HeartMate 2 and Jarvik 2000 show superior survival rates (up to 86.9 % at
6 months, 96.3 % at 3 years) and (6-month survival 67 %-91 %)
respectively, compared to the other axial flow pumps LVAD. The results
underscore the importance of choosing the optimal device and informing the
direction of future developments. <br/>Conclusion(s): In this paper, we
aim to inform future studies to enhance their effectiveness and advance
the overall performance of these devices, ultimately benefiting patients
and developers. This review furnishes evidence-based recommendations for
the most appropriate axial-flow pumps based on survival rates and quality
of life parameters.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<131>
Accession Number
2035075362
Title
Role of KIM-1 in early diagnosis of contrast-induced nephropathy following
invasive cardiac procedure: A systematic review.
Source
Clinical Epidemiology and Global Health. 30 (no pagination), 2024. Article
Number: 101765. Date of Publication: 01 Nov 2024.
Author
Shuaib M.; Masoom M.; Khan M.A.
Institution
(Shuaib, Masoom, Khan) Department of Translational and Clinical Research,
School of Chemical and Life Sciences (SCLS), Jamia Hamdard, New Delhi
110062, India
Publisher
Elsevier B.V.
Abstract
This systematic review aims to provide a comprehensive analysis of the
diagnostic efficacy of KIM-1 in CI-AKI. We evaluated its potential as a
robust biomarker for the early identification and prediction of AKI
progression. Methodology: To assess KIM-1 as a biomarker for CI-AKI,
relevant databases were searched. Inclusion criteria comprised studies
measuring KIM-1 levels in patients undergoing cardiac procedures with
contrast media and data were extracted. Methodological quality and bias
were evaluated using Quadas-2 tool. <br/>Conclusion(s): KIM-1 shows
promise as a biomarker for renal injury. Its upregulation, correlation
with injury severity, and involvement in tissue repair support its
clinical relevance. Prospero registration number:
CRD42023431419.<br/>Copyright &#xa9; 2024 The Authors

<132>
Accession Number
2034994165
Title
Health-related quality of life outcomes in children after congenital heart
disease surgery in low-middle-income countries: a systematic review and
meta-analysis.
Source
Annals of Medicine and Surgery. 86(8) (pp 4695-4704), 2024. Date of
Publication: 27 Jun 2024.
Author
Luitel P.; Yadav R.; Neupane N.; Paudel S.; Adhikari N.; Punukollu R.
Institution
(Luitel, Yadav, Neupane, Paudel, Adhikari) Maharajgunj Medical Campus,
Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal
(Punukollu) Division of Transplant Surgery, Mayo Clinic, Phoenix, AZ,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Improved treatments for children with congenital heart
disease (CHD) have led to a growing interest in long-term functional
outcomes such as health-related quality of life (HRQOL). Studies on HRQOL
in children with CHD have yielded contradictory results. In this study, we
aimed to perform a systematic review and meta-analysis to analyze the
effect of surgery on HRQOL outcomes in children with CHD in low-income and
middle-income countries. <br/>Method(s): A comprehensive search for
articles was performed using the Medline (PubMed), Scopus, and Embase
databases from their inception to September 5, 2023. Studies reporting QOL
outcomes in children <18 years and published in English were included.
<br/>Result(s): Of the 1239 records screened, 10 studies, including 1721
participants, were included in the study. The overall QOL was
significantly better in the control group than in the children who
underwent surgery for CHD (P=0.04, standard mean difference of -0.62, 95%
CI: -1.2 to -0.04), and the overall QOL was significantly better in the
children with CHD after surgery than before surgery (P=0.05, standard mean
difference of -0.56, 95% CI: -1.11 to -0.01). <br/>Conclusion(s): The QOL
of children from low-income and middle-income countries who undergo
surgery for CHD is significantly poorer than that of controls in all
dimensions except the emotional domain. Meanwhile, surgery has the
greatest impact on improving the physical domain in children with CHD
after surgery. Strategies to improve HRQOL in this subgroup of patients
should be further investigated.<br/>Copyright &#xa9; 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.

<133>
Accession Number
2034994125
Title
Efficacy and outcomes of antiplatelet therapy versus oral anticoagulants
in patients undergoing transcatheter aortic valve replacement: a
systematic review and meta-analysis.
Source
Annals of Medicine and Surgery. 86(5) (pp 2911-2925), 2024. Date of
Publication: 15 Mar 2024.
Author
Goyal A.; Abbasi F.Q.; Tariq M.D.; Kanagala S.G.; Changez M.I.K.; Safi D.;
Basit J.; Sulaiman S.A.; Marsool M.D.M.; Daoud M.; Sohail A.H.
Institution
(Goyal, Safi) Department of Internal Medicine, Seth GS Medical College and
KEM Hospital, Mumbai, India
(Abbasi) Federal Medical College, Islamabad, Pakistan
(Tariq) Foundation University Medical College, Islamabad, Pakistan
(Changez) Department of Surgery, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Basit) Department of Internal Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Kanagala) Department of Internal Medicine, Metropolitan Hospital Center,
New York, NY, United States
(Sulaiman) Department of Internal Medicine, School of Medicine, University
of Jordan, Amman, Jordan
(Marsool) Department of Internal Medicine, Al-Kindy College of Medicine,
University of Baghdad, Baghdad, Iraq
(Daoud) Department of Internal Medicine, Bogomolets National Medical
University, Kyiv, Ukraine
(Sohail) Department of Surgery, University of New Mexico Health Sciences,
Albuquerque, NM, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Recent guidelines suggest that antiplatelet therapy (APT) is
the standard of care in the absence of long-term oral anticoagulation
(OAC) indications in patients post-transcatheter aortic valve replacement
(TAVR). The superiority of one method over the other remains
controversial. <br/>Material(s) and Method(s): Several databases,
including MEDLINE, Google Scholar, and EMBASE, were electronically
searched. The primary endpoint was the all-cause mortality (ACM) rate.
Secondary endpoints included cardiovascular death, myocardial infarction
(MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism,
and valve thrombosis in post-TAVR patients receiving APT and oral
anticoagulants (OACs). Forest plots were generated using Review Manager
version 5.4, with a p value less than 0.05 indicating statistical
significance. Subgroup analysis was performed to explore potential sources
of heterogeneity. <br/>Result(s): Twelve studies were selected. No
significant differences were observed in APT and OAC group for ACM [risk
ratio (RR): 0.67; 95% CI:0.45-1.01; P=0.05], cardiovascular death
[RR:0.91; 95% CI:0.73-1.14; P=0.42], MI [RR:1.69; 95% CI:0.43-6.72;
P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58-1.06; P=0.12], ischaemic stroke
[RR:0.83; 95% CI:0.50-1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI:
0.23-5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51-1.21; P=0.28],
minor bleeding [RR:1.09; 95% CI: 0.80-1.47; P=0.58], life-threatening
bleeding [RR:0.85; 95% CI:0.55-1.30; P=0.45], any bleeding [RR:0.98; 95%
CI:0.83-1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44-1.70;
P=0.68]. The risk of valve thrombosis was higher in patients receiving APT
than in those receiving OAC [RR:2.61; 95% CI:1.56-4.36; P =0.0002].
<br/>Conclusion(s): Although the risk of valve thrombosis increased in
patients receiving APT, the risk of other endpoints was comparable between
the two groups.<br/>Copyright &#xa9; 2024 The Author(s). Published by
Wolters Kluwer Health, Inc.

<134>
Accession Number
2034913392
Title
High-exchange ULTrafiltration to enhance recovery after paediatric cardiac
surgery (ULTRA): study protocol for a Canadian double-blinded randomised
controlled trial.
Source
BMJ Open. 14(8) (no pagination), 2024. Article Number: e080597. Date of
Publication: 28 Aug 2024.
Author
Bierer J.; Stanzel R.; Henderson M.; Krmpotic K.; Andreou P.; Marshall
J.S.; Sapp J.; Horne D.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Dalhousie University,
Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Krmpotic) Department of Critical Care, Dalhousie University, Halifax, NS,
Canada
(Andreou) Department of Community Health and Epidemiology, Dalhousie
University, Halifax, NS, Canada
(Marshall) Department of Microbiology & Immunology, Dalhousie University,
Halifax, NS, Canada
(Sapp) Division of Cardiology, Dalhousie University, Halifax, NS, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Surgical repair is the standard of care for most infants and
children with congenital heart disease. Cardiopulmonary bypass (CPB) is
required to facilitate these operations but elicits a systemic
inflammatory response, leading to postoperative organ dysfunction,
morbidity and prolonged recovery after the surgery. Subzero-balance
ultrafiltration (SBUF) has been shown to extract proinflammatory cytokines
continuously throughout the CPB exposure. We hypothesize that a
high-exchange SBUF (H-SBUF) will have a clinically relevant
anti-inflammatory effect compared with a low-exchange SBUF (L-SBUF).
Methods and analysis The ULTrafiltration to enhance Recovery After
paediatric cardiac surgery (ULTRA) trial is a randomised, double-blind,
parallel-group randomised trial conducted in a single paediatric cardiac
surgery centre. Ninety-six patients less than 15 kg undergoing cardiac
surgery with CPB will be randomly assigned to H-SBUF during CPB or L-SBUF
during CPB in a 1:1 ratio with stratification by The Society of Thoracic
Surgeons-European Association for Cardio-Thoracic Surgery (STAT) score 1
and STAT score 2-5. The primary outcome is peak postoperative
vasoactive-ventilation-renal score. Time series and peak values of
vasoactive-ventilation renal score, vasoactive-inotrope score, ventilation
index and oxygenation index will be collected. Secondary clinical outcomes
include acute kidney injury, ventilator-free days, inotrope-free days, low
cardiac output syndrome, mechanical circulatory support, intensive care
unit length of stay and operative mortality. Secondary biomarker data
include cytokine, chemokine and complement factor concentrations at
baseline before CPB, at the end of CPB exposure and 24 hours following
CPB. Analyses will be conducted on an intention-to-treat principle. Ethics
and dissemination The study has ethics approval (#1024932 dated August 31,
2021) and enrolment commenced in September 2021. The primary manuscript
and any subsequent analyses will be submitted for peer-reviewed
publication.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2024.

<135>
Accession Number
2034906769
Title
Short- and long-term outcomes in isolated vs. hybrid thoracoscopic
ablation in patients with atrial fibrillation: a systematic review and
reconstructed individual patient data meta-analysis.
Source
Europace. 26(10) (no pagination), 2024. Article Number: euae232. Date of
Publication: 01 Oct 2024.
Author
Aerts L.; Kawczynski M.J.; Bidar E.; Luermans J.G.L.; Chaldoupi S.-M.;
Meir M.L.; Kowalewski M.; Maessen J.G.; Heuts S.; Maesen B.
Institution
(Aerts, Kawczynski, Bidar, Maessen, Heuts, Maesen) Department of
Cardiothoracic Surgery, Maastricht University Medical Centre, Postbus
5800, Maastricht 6202 AZ, Netherlands
(Aerts, Kawczynski, Bidar, Luermans, Chaldoupi, Kowalewski, Maessen,
Heuts, Maesen) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, PO Box 616, Maastricht 6200 MD, Netherlands
(Luermans, Chaldoupi) Department of Cardiology, Maastricht University
Medical Centre, Postbus 5800, Maastricht 6202 AZ, Netherlands
(Meir) Department of Cardiac Surgery, University Hospital Brussels,
Brussels, Belgium
(Kowalewski) Clinical Department of Cardiac Surgery and Transplantology,
National Medical Institute, The Ministry of Interior and Administration,
Centre of Postgraduate Medical Education, Warsaw, Poland
Publisher
Oxford University Press
Abstract
Aims Both isolated thoracoscopic and hybrid thoracoscopic atrial
fibrillation (AF) ablation techniques have demonstrated favourable
outcomes in the management of patients with (long-standing) persistent AF,
as compared with catheter ablation. However, it is currently unknown
whether there is a difference in short- and long-term outcomes when
comparing these two minimally invasive surgical AF ablation procedures.
Therefore, a systematic review and meta-analysis were performed to
investigate these two techniques, with a specific emphasis on long-term
freedom from atrial tachyarrhythmias (ATAs). Methods A systematic search
through PubMed, EMBASE, and the Cochrane Library databases was performed.
All studies reporting and results on short-term outcomes were included in
the meta-analysis. A pooled analysis of long-term freedom from ATA was
performed based on Kaplan-Meier (KM) curve-derived individual patient
data. Reconstructed individual time-to-event data were analysed in a
multivariable Cox frailty model with adjustments for age, sex, type of AF,
duration of AF history, and study variable (frailty term in the frailty
Cox model). In total, 53 studies were included in the meta-analysis,
encompassing 4950 patients. There were no differences in major short-term
outcomes (mortality or stroke) between isolated thoracoscopic and hybrid
thoracoscopic ablation. A total of 18 studies reported KM curves for
long-term freedom from ATA, comprising 2038 patients. Adjusted analysis
revealed that hybrid ablation was significantly associated with greater
freedom from ATA [adjusted hazard ratio (aHR) = 0.59, 95% confidence
interval (CI): 0.43-0.83, P < 0.001] compared with isolated thoracoscopic
ablation. Additionally, older age (aHR = 1.07, 95% CI: 1.03-1.12, P =
0.002) and a higher percentage of male patients (aHR = 1.02, 95% CI:
1.01-1.03, P < 0.001) were significantly associated with lower long-term
freedom from ATA recurrence. Conclusion Hybrid thoracoscopic AF ablation
is associated with a greater long-term freedom from ATA when compared with
isolated thoracoscopic ablation, without differences in
complications.<br/>Copyright &#xa9; The Author(s) 2024.

<136>
Accession Number
2034928230
Title
The effect of mannitol on postoperative renal function in patients
undergoing coronary artery bypass surgery: A double-blinded randomized
controlled trial.
Source
Journal of Cardiovascular and Thoracic Research. 16(3) (pp 146-151), 2024.
Date of Publication: 2024.
Author
Maslakpak M.H.; Bilejani E.; Negargar S.; Khalili A.; Alinejad V.; Faravan
A.
Institution
(Maslakpak) Maternal and Childhood Obesity Research Center, Nursing and
Midwifery School, Urmia University of Medical, Urmia, Iran, Islamic
Republic of
(Bilejani, Negargar) Department of Anesthesia, Faculty of Medicine, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Khalili) Cardiovascular Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Alinejad) Department of Biostatistics, Urmia University of Medical
Sciences, Urmia, Iran, Islamic Republic of
(Faravan) Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Mannitol, an osmotic diuretic solution, is commonly utilized
in priming cardiopulmonary bypass (CPB) and can impact kidney function.
This study was conducted to investigate the impact of mannitol use during
CPB on kidney function in patients undergoing coronary artery bypass
surgery. <br/>Method(s): This randomized, double-blind clinical trial
studied 90 patients undergoing coronary artery bypass surgery. In the
control group (n = 45), the prime solution included Ringer's lactate, and
in the intervention group (n = 45), the prime solution had 200 ml of
mannitol 20% and Ringer's lactate. A P-value < 0.05 was considered
significant. The primary endpoint of this study is renal function.
<br/>Result(s): Demographic characteristics and risk factors were not
significantly different between the two groups (P > 0.05). Additionally,
there was no statistically significant difference between two groups in
terms of CPB time, aortic cross-clamp time, length of time connected to
mechanical ventilation, 30-day mortality, ICU, and hospital stay time (P >
0.05). Furthermore, no statistically significant difference was observed
between the two groups in serum creatinine levels (P = 0.53) or BUN levels
(P = 0.13). The study also found no statistically significant difference
in the diuresis rate between the two groups (P = 0.10).
<br/>Conclusion(s): The present study has shown that adding mannitol to
the prime has no effect on kidney function, length of time connected to
mechanical ventilation, length of stay in the ICU, or 30-day mortality.
Therefore, it suggests that mannitol cannot be used as a preventative
strategy for acute kidney injury after cardiac surgery.<br/>Copyright
&#xa9; 2024 The Author(s).

<137>
Accession Number
2034810360
Title
Digital wound monitoring with artificial intelligence to prioritise
surgical wounds in cardiac surgery patients for priority or standard
review: Protocol for a randomised feasibility trial (WISDOM).
Source
BMJ Open. 14(9) (no pagination), 2024. Article Number: e086486. Date of
Publication: 17 Sep 2024.
Author
Tanner J.; Rochon M.; Harris R.; Beckhelling J.; Jurkiewicz J.; Mason L.;
Bouttell J.; Bolton S.; Dummer J.; Wilson K.; Dhoonmoon L.; Cariaga K.
Institution
(Tanner) School of Health Sciences, University of Nottingham, Nottingham,
United Kingdom
(Rochon, Cariaga) Infection Prevention and Control, Guy's and St Thomas'
NHS Foundation Trust, London, United Kingdom
(Harris) NIHR Research Support Service, Nottingham, United Kingdom
(Beckhelling) University Hospitals of Derby and Burton NHS Foundation
Trust, Derby, United Kingdom
(Jurkiewicz, Mason) Isla Health, London, United Kingdom
(Bouttell, Bolton) Centre for Healthcare Equipment and Technology
Adoption, Nottingham, United Kingdom
(Dummer) Health Innovation East Midlands, Nottingham, United Kingdom
(Wilson) Liverpool Heart and Chest Hospital NHS Foundation Trust,
Liverpool, United Kingdom
(Dhoonmoon) Central and North West London NHS Foundation Trust, London,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Digital surgical wound monitoring for patients at home is
becoming an increasingly common method of wound follow-up. This regular
monitoring improves patient outcomes by detecting wound complications
early and enabling treatment to start before complications worsen.
However, reviewing the digital data creates a new and additional workload
for staff. The aim of this study is to assess a surgical wound monitoring
platform that uses artificial intelligence to assist clinicians to review
patients' wound images by prioritising concerning images for urgent
review. This will manage staff time more effectively. Methods and analysis
This is a feasibility study for a new artificial intelligence module with
120 cardiac surgery patients at two centres serving a range of patient
ethnicities and urban, rural and coastal locations. Each patient will be
randomly allocated using a 1:1 ratio with mixed block sizes to receive the
platform with the new detection and prioritising module (for up to 30 days
after surgery) plus standard postoperative wound care or standard
postoperative wound care only. Assessment is through surveys, interviews,
phone calls and platform review at 30 days and through medical notes
review and patient phone calls at 60 days. Outcomes will assess safety,
acceptability, feasibility and health economic endpoints. The decision to
proceed to a definitive trial will be based on prespecified progression
criteria. Ethics and dissemination Permission to conduct the study was
granted by the North of Scotland Research Ethics Committee 1 (24/NS0005)
and the MHRA (CI/2024/0004/GB). The results of this Wound Imaging Software
Digital platfOrM (WISDOM) study will be reported in peer-reviewed
open-Access journals and shared with participants and stakeholders. Trial
registration numbers ISRCTN16900119 and NCT06475703.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024.

<138>
Accession Number
2031765064
Title
Effects and mechanisms of supramaximal high-intensity interval training on
extrapulmonary manifestations in people with and without chronic
obstructive pulmonary disease (COPD-HIIT): study protocol for a
multi-centre, randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 664. Date of
Publication: December 2024.
Author
Jakobsson J.; Burtin C.; Hedlund M.; Boraxbekk C.-J.; Westman J.; Karalija
N.; Stal P.; Sandstrom T.; Ruttens D.; Gosker H.R.; De Brandt J.; Nyberg
A.
Institution
(Jakobsson, Hedlund, Westman, De Brandt, Nyberg) Section of Physiotherapy,
Department of Community Medicine and Rehabilitation, Umea University, Umea
901 87, Sweden
(Burtin) REVAL - Rehabilitation Research Center, BIOMED - Biomedical
Research Institute, Hasselt University, Diepenbeek 3590, Belgium
(Boraxbekk, Karalija) Umea Centre for Functional Brain Imaging (UFBI),
Umea University, Umea 901 87, Sweden
(Boraxbekk) Diagnostic Radiology, Department of Radiation Sciences, Umea
University, Umea 901 87, Sweden
(Boraxbekk) Institute of Sports Medicine Copenhagen (ISMC) and Department
of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen 2400,
Denmark
(Boraxbekk) Institute for Clinical Medicine, Faculty of Medical and Health
Sciences, University of Copenhagen, Copenhagen 2200, Denmark
(Ruttens) Department of Respiratory Medicine, Ziekenhuis Oost-Limburg,
Genk 3600, Belgium
(Ruttens) Faculty of Medicine and Life Sciences, Hasselt University,
Diepenbeek 3590, Belgium
(Karalija, Stal) Department of Medical and Translational Biology, Umea
University, Umea 901 87, Sweden
(Sandstrom) Department of Public Health and Clinical Medicine, Umea
University, Umea 901 87, Sweden
(Gosker) Department of Respiratory Medicine, NUTRIM School of Nutrition
and Translational Research in Metabolism, Maastricht University Medical
Center+, Maastricht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Beyond being a pulmonary disease, chronic obstructive
pulmonary disease (COPD) presents with extrapulmonary manifestations
including reduced cognitive, cardiovascular, and muscle function. While
exercise training is the cornerstone in the non-pharmacological treatment
of COPD, there is a need for new exercise training methods due to
suboptimal adaptations when following traditional exercise guidelines,
often applying moderate-intensity continuous training (MICT). In people
with COPD, short-duration high-intensity interval training (HIIT) holds
the potential to induce a more optimal stimulus for training adaptations
while circumventing the ventilatory burden often associated with MICT in
people with COPD. We aim to determine the effects of supramaximal HIIT and
MICT on extrapulmonary manifestations in people with COPD compared to
matched healthy controls. <br/>Method(s): COPD-HIIT is a prospective,
multi-centre, randomized, controlled trial with blinded assessors and data
analysts, employing a parallel-group designed trial. In phase 1, we will
investigate the effects and mechanisms of a 12-week intervention of
supramaximal HIIT compared to MICT in people with COPD (n = 92) and
matched healthy controls (n = 70). Participants will perform watt-based
cycling two to three times weekly. In phase 2, we will determine how
exercise training and inflammation impact the trajectories of
neurodegeneration, in people with COPD, over 24 months. In addition to the
92 participants with COPD performing HIIT or MICT, a usual care group (n =
46) is included in phase 2. In both phases, the primary outcomes are a
change from baseline in cognitive function, cardiorespiratory fitness, and
muscle power. Key secondary outcomes include change from baseline exercise
tolerance, brain structure, and function measured by MRI,
neuroinflammation measured by PET/CT, systemic inflammation, and
intramuscular adaptations. Feasibility of the interventions will be
comprehensively investigated. <br/>Discussion(s): The COPD-HIIT trial will
determine the effects of supramaximal HIIT compared to MICT in people with
COPD and healthy controls. We will provide evidence for a novel exercise
modality that might overcome the barriers associated with MICT in people
with COPD. We will also shed light on the impact of exercise at different
intensities to reduce neurodegeneration. The goal of the COPD-HIIT trial
is to improve the treatment of extrapulmonary manifestations of the
disease. Trial registration: Clinicaltrials.gov: NCT06068322.
Prospectively registered on 2023-09-28.<br/>Copyright &#xa9; The Author(s)
2024.

<139>
[Use Link to view the full text]
Accession Number
2034525858
Title
Advances in understanding and managing pediatric heart failure and
transplant.
Source
Current Opinion in Pediatrics. 36(5) (pp 489-495), 2024. Date of
Publication: 01 Oct 2024.
Author
Xu W.; Richmond M.
Institution
(Xu, Richmond) Pediatric Advanced Cardiac Care and Transplantation,
Division of Pediatric Cardiology, Columbia University, Vagelos College of
Physicians and Surgeons, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis article highlights the most recent advances in a
review of the current literature in the field of pediatric heart failure
and transplantation.Recent findingsDiagnostically, the identification of
new genetic factors has contributed to a deeper understanding of
cardiomyopathy in children. Novel medications like sacubitril/valsartan
and Sodium-Glucose cotransporter-2 (SGLT2) inhibitors, which are now
standard in the adult population are being studied in pediatric population
and offer new promise of pediatric heart failure treatment. Ventricular
assist devices are more commonly used in cardiomyopathy patients and
single ventricle patients as a bridge to transplant. Recent pediatric
heart transplant society (PHTS) data demonstrated that waitlist survival
improved significantly over the past decades (i) and new treatments such
as daratumumab and eculizumab have been used in high-risk populations and
demonstrate promising results. TEAMMATE trial is the first multicenter
randomized clinical trial (RCT) in pediatric heart transplant (HT) to
evaluate the safety and efficacy of everolimus (EVL) and low-dose
tacrolimus (TAC) compared to standard-dose TAC and mycophenolate mofetil
(MMF). It will provide valuable information about the safety and efficacy
of EVL, TAC, and MMF (ii).Donor cell-free DNA has been used more in
pediatric transplant recipients and has significantly decreased invasive
EMB (iii).SummaryThis past 5 years have witness dramatic progress in the
field of pediatric heart failure and transplantation including more use of
mechanical support in heart failure patients with various underlying
etiology, especially use of mechanical support in single ventricle
patients and the use of sacubitril/valsartan and SGLT2 inhibitors in the
pediatric population. The problem of the highly sensitized transplant
recipient remains, although novel therapeutics have been added to our
toolbox of options to maintain healthy allograft function. Ongoing
research aims to further enhance our understanding and management of
pediatric heart failure, emphasizing the need for continued innovation in
this complex field. <br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<140>
Accession Number
2031863097
Title
Omega-3 Supplementation in Coronary Artery Bypass Graft Patients: Impact
on ICU Stay and Hospital Stay-A Systematic Review and Meta-Analysis.
Source
Nutrients. 16(19) (no pagination), 2024. Article Number: 3298. Date of
Publication: October 2024.
Author
Ouagueni A.; Shi Z.; Shraim M.; Al-Zoubi R.M.; Zarour A.; Al-Ansari A.;
Bawadi H.
Institution
(Ouagueni, Shi, Bawadi) Department of Human Nutrition, College of Health
Science, QU-Health, Qatar University, Doha 2713, Qatar
(Shraim) Department of Public Health, College of Health Science,
QU-Health, Qatar University, Doha 2713, Qatar
(Al-Zoubi, Al-Ansari) Surgical Research Section, Department of Surgery,
Hamad Medical Corporation, Doha 576214, Qatar
(Al-Zoubi) Department of Chemistry, Jordan University of Science and
Technology, P.O. Box 3030, Irbid 22110, Jordan
(Al-Zoubi) Department of Biomedical Sciences, College of Health Science,
Qatar University, Doha 2713, Qatar
(Zarour) Acute Care Surgery Division, Department of Surgery, Hamad Medical
Corporation, Doha 576214, Qatar
(Al-Ansari) Department of Surgery, Division of Urology/Andrology, Hamad
Medical Corporation, Doha 576214, Qatar
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Coronary artery bypass graft (CABG) is associated
with inflammation and complications, potentially leading to prolonged ICU
and hospital stays. Omega-3 PUFA has anti-inflammatory properties, thought
to potentially reduce complications in CABG patients. This study aims to
systematically review and meta-analyze the impact of perioperative omega-3
PUFA supplementation on total ICU and total hospital stays in CABG
patients; Methods: Randomized controlled trials examining the effects of
omega-3 PUFA supplementation (IV/oral) on ICU and hospital stays in CABG
patients were included. Studies were searched for in PubMed, EMBASE,
PsychINFO, CINAHL, and the Cochrane Central Register of Controlled Trial
databases, along with hand searching of reference lists. The quality and
risk of bias of the included studies were evaluated by two independent
reviewers using the revised Cochrane risk-of-bias tool. Meta-analysis was
performed using fixed or random effects models according to the level of
heterogeneity by mean difference with their 95% confidence intervals;
Results: Twelve studies were included in the qualitative analysis and
seven in the meta-analysis. Omega-3 PUFA was associated with a significant
reduction in days of hospital stay (-0.58 (95% CI -1.13, -0.04)). Subgroup
analysis showed that only oral omega-3 PUFA supplementation resulted in a
statistically significant reduction in length of hospitalization after
subgroup analysis with MD -0.6 (95% CI -1.17, -0.04); <br/>Conclusion(s):
This study suggests that perioperative omega-3 PUFA supplementation may
reduce the length of hospitalization in CABG patients, especially when
administered orally. However, the findings should be interpreted
cautiously due to the high level of heterogeneity.<br/>Copyright &#xa9;
2024 by the authors.

<141>
[Use Link to view the full text]
Accession Number
645327422
Title
International Variation in Health Status Benefits in Patients Undergoing
Initial Invasive Versus Conservative Management for Chronic Coronary
Disease: Insights From the ISCHEMIA Trial.
Source
Circulation. Cardiovascular quality and outcomes. 17(10) (pp e010534),
2024. Date of Publication: 01 Oct 2024.
Author
Ikemura N.; Spertus J.A.; Nguyen D.; Fu Z.; Jones P.G.; Reynolds H.R.;
Bangalore S.; Bhargava B.; Senior R.; Elghamaz A.; Goodman S.G.; Lopes
R.D.; Pracon R.; Lopez-Sendon J.; Maggioni A.P.; Kohsaka S.; Roth G.A.;
White H.D.; Mavromatis K.; Boden W.E.; Rodriguez F.; Hochman J.S.; Maron
D.J.
Institution
(Ikemura, Spertus, Nguyen, Fu, Jones) University of Missouri-Kansas City's
Healthcare Institute for Innovations in Quality and Saint Luke's Mid
America Heart Institute, J.A.S
(Ikemura, Kohsaka) Department of Cardiology, Keio University School of
Medicine, Japan (N.I., Tokyo, Japan
(Reynolds, Bangalore, Hochman) Cardiovascular Clinical Research Center,
Leon H. Charney Division of Cardiology, New York University Grossman
School of Medicine (H.R.R., S.B.
(Bhargava) All India Institute of Medical Sciences, India
(Senior, Rodriguez, Maron) Department of Medicine, Stanford University
School of Medicine
(Elghamaz) United Kingdom (R.S., Northwick Park Hospital, London, United
Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Lopes) Duke Clinical Research Institute, Durham, United Kingdom
(Pracon) National Institute of Cardiology, Poland (R.P.), Warsaw, United
States
(Lopez-Sendon) IdiPaz Research Institute and Hospital Universitario La
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri Research
Center, Heart Care Foundation, Florence, United States
(Roth) Division of Cardiology, University of Washington
(White) Health New Zealand Te Whatu Ora, Green Lane Cardiovascular
Services and University of Auckland
(Mavromatis) Atlanta VA Medical Center
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, United Kingdom
Abstract
BACKGROUND: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) demonstrated greater
health status benefits with an initial invasive strategy, as compared with
a conservative one, for patients with chronic coronary disease and
moderate or severe ischemia. Whether these benefits vary globally is
important to understand to support global adoption of the results.
<br/>METHOD(S): We analyzed participants' disease-specific health status
using the validated 7-item Seattle Angina Questionnaire (SAQ: >5-point
differences are clinically important) at baseline and over 1-year
follow-up across 37 countries in 6 international regions. The average
effect of initial invasive versus conservative strategies on 1-year SAQ
scores was estimated using Bayesian proportional odds regression and
compared across regions. <br/>RESULT(S): Considerable regional variation
in baseline health status was observed among 4617 participants (mean
age=64.4+/-9.5 years, 24% women), with the mean SAQ summary scores of
67.4+/-19.5 in Eastern Europe participants (17% of the total), 71.4+/-15.4
in Asia-Pacific (18%), 74.9+/-16.7 in Central and South America (10%),
75.5+/-19.5 in Western Europe (26%), and 78.6+/-19.2 in North America
(28%). One-year improvements in SAQ scores were greater in regions with
lower baseline scores with initial invasive management (17.7+/-20.9 in
Eastern Europe and 11.4+/-19.3 in North America), but similar in the
conservative arm. Adjusting for baseline SAQ scores, similar health status
benefits of an initial invasive strategy on 1-year SAQ scores were
observed (ranging from 2.38 points [95% CI, 0.04-4.50] in North America to
4.66 points [95% CI, 2.46-6.94] in Eastern Europe), with an 88.3%
probability that the difference in benefit across regions was <5 points.
<br/>CONCLUSION(S): In patients with chronic coronary disease and moderate
or severe ischemia, initial invasive management was associated with a
consistent health status benefit across regions, with modest regional
variability, supporting the international generalizability of health
status benefits from invasive management of chronic coronary disease.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01471522.

<142>
Accession Number
645162141
Title
Enhancing Guidewire Efficacy for Transradial Access: The EAGER Randomized
Controlled Trial.
Source
Circulation. Cardiovascular interventions. 17(10) (pp e014529), 2024. Date
of Publication: 01 Oct 2024.
Author
Bland A.C.; Meere W.; Mikhail P.; Chuah E.; Redwood E.; Ferreira D.;
Howden N.; Perkovic A.; Saunders S.L.; Kelty A.; Kull T.; Hill A.; Spina
R.; Sarathy K.; May A.; Parkinson M.; Ishak M.; Collins N.; Boyle A.;
William M.; Jeyaprakash P.; Ford T.J.
Institution
(Bland, Meere, Mikhail, Chuah, Redwood, Howden, Perkovic, Saunders, Kelty,
Kull, Hill, Spina, Sarathy, May, Parkinson, Ishak, William, Jeyaprakash,
Ford) Cardiology Department, Gosford Hospital, Central Coast Local Health
District, Australia (A.C.B., W.M., P.M., E.C., E.R., N.H., A.P., S.L.S.,
A.K., T.K., A.H., R.S., K.S., A.M., M.P., M.I., M.W., P.J., T.J.F.)
(Bland, Saunders, Collins, Boyle, William, Ford) School of Medicine and
Public Health, The University of Newcastle, Australia (A.C.B., S.L.S.,
N.C., A.B., M.W., T.J.F.)
(Ferreira, Collins, Boyle) Cardiology Department, John Hunter Hospital,
Hunter New England Local Health District, Newcastle, N.C, United Kingdom
Abstract
BACKGROUND: The 1.5 mm Baby J hydrophilic narrow J-tipped wire is a
development of the standard 0.035" 3-mm J-tipped peripheral guidewire,
designed to improve efficiency of transradial coronary procedures by
safely navigating small caliber radial arteries to the aorta. There is
currently a lack of evidence comparing the procedural success and safety
of different peripheral guidewires used in transradial cardiac procedures.
We compared the efficacy and safety of a narrow J-tipped hydrophilic
0.035" wire (intervention, Radifocus Baby J guidewire; TERUMO Co, Tokyo,
Japan) versus a standard fixed-core 0.035" J wire (control).
<br/>METHOD(S): Investigator-initiated, blinded, Australian, multicenter
randomized trial in patients undergoing clinically indicated coronary
angiography or percutaneous coronary intervention. Patients were
randomized 1:1 to use either the control guidewire or the intervention
guidewire. The primary end point (technical success) was defined as
gaining aortic root access with the randomized guidewire. <br/>RESULT(S):
In all, 330 patients were randomized between October 2022 and June 2023
(median age was 69 years, 36% were female, and body mass index was 29
kg/m2). The primary end point was achieved more frequently in the
intervention group (96% versus 84%; absolute risk reduction 12% [95% CI,
5.7-18.3]; P<0.001). Women assigned to the control wire experienced a
higher failure rate compared with men (31% versus 8% in men; P<0.001).
Fluoroscopy time was significantly lower in the Baby J group (median, 344
versus 491 seconds; P=0.024). The main mechanisms of failure using the
control wire were radial artery spasm (15/26; 57%) and subclavian
tortuosity (5/26; 19.2%). There were no differences in overall procedure
times, major adverse cardiovascular events, or vascular complications
between guidewires. <br/>CONCLUSION(S): A narrow 1.5 mm J-tipped
hydrophilic guidewire resulted in greater technical success and reduced
fluoroscopy time compared with the standard 3-mm J-tipped nonhydrophilic
guidewire. The guidewire is safe and demonstrated key incremental benefits
for the transradial approach, particularly in women. REGISTRATION: URL:
https://www.anzctr.org.au/; Unique identifier: ACTRN12622001557729.

<143>
Accession Number
2035135393
Title
TCT-186 Periprocedural Continuation Versus Interruption of Oral
Anticoagulation During Transcatheter Aortic-Valve Implantation: Impact on
Health-Related Quality of Life.
Source
Journal of the American College of Cardiology. Conference: Thirty-Sixth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Walter
E. Washington Convention Center, Washington United States. 84(18
Supplement) (pp B10), 2024. Date of Publication: 29 Oct 2024.
Author
Jan van Ginkel D.; Bor W.; Peper J.; Overduin D.; Berg J.T.
Institution
(Jan van Ginkel, Peper, Overduin) St. Antonius Hospital, Nieuwegein,
Netherlands
(Bor) St. Antonius Hospital, Utrecht, Netherlands
(Berg) St. Antonius Hospital, Bilthoven, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: One-third of patients undergoing transcatheter aortic valve
implantation (TAVI) has an indication for oral anticoagulation (OAC)
because of concomitant disease. Interruption of OAC during TAVI may
decrease the risk of bleeding, whereas continuation may decrease the risk
of thromboembolism. The impact of both strategies on health-related
quality of life is unknown. <br/>Method(s): In this international,
open-label, randomized, clinical trial, patients on OAC undergoing TAVI
were randomized 1:1 to periprocedural continuation vs interruption of OAC.
Health-related quality of life was assessed using the Kansas City
Cardiomyopathy Questionnaire (KCCQ) and Short Form-12 questionnaire before
and at 30 and 90 days after TAVI. <br/>Result(s): A total of 858 patients
were included: 431 were assigned to continuation and 427 to interruption
of OAC; 796 patients (92.8%) filled out at least 1 follow-up
questionnaire. At baseline, the median overall KCCQ summary score was 54.7
(Q1-Q3: 35.2-73.2). The median KCCQ summary score was 72.9 (Q1-Q3:
54.7-87.0) in the continuation group and 72.4 (Q1-Q3: 55.1-86.9) in the
interruption group at 30 days (P = 0.88) and 75.3 (Q1-Q3: 54.4-87.0) vs
76.8 (Q1-Q3: 58.1-86.9) at 90 days (P = 0.22) (Figure). Accordingly, Short
Form-12 physical and mental component summary scores showed no differences
between both groups at 30 and 90 days after TAVI. [Formula presented]
<br/>Conclusion(s): In patients undergoing TAVI with a concomitant
indication for OAC, periprocedural continuation was similar to
interruption of OAC with respect to health-related quality of life early
after TAVI. Categories: STRUCTURAL: Valvular Disease:
Aortic.<br/>Copyright &#xa9; 2024

<144>
Accession Number
645519434
Title
A novel Australian medical device (Organ Angel) for oxygenated hypothermic
perfusion of donor hearts in a porcine model for up to 6 hours.
Source
Transplantation. Conference: 30th International Congress of the
Transplantation Society, TTS 2024. Istanbul Turkey. 108(9 Supplement) (pp
214), 2024. Date of Publication: September 2024.
Author
Besanko J.; Coates T.; Edwards J.; Beltrame J.; Worthington M.; Ou R.
Institution
(Besanko, Coates) Centre for Clinical and Experimental
Transplantation(CCET), Royal Adelaide Hospital, Adelaide, Australia
(Besanko, Edwards, Worthington, Ou) D'Arcy Sutherland Cardiothoracic,
Royal Adelaide Hospital, Adelaide, Australia
(Coates, Beltrame) Department of Medicine, University of Adelaide,
Adelaide, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Evidence from randomised human and experimental trials indicate that the
results of heart transplantation improve with the use of perfusion of
donor hearts. In these studies, we evaluated the efficacy of a novel
mechanical perfusion device in preserving procaine hearts for six hours ex
vivo. The device utilises hypothermic perfusion with celsior solution at a
low flow rate of 40ml/min. This device is small, portable, weight 16kgs,
operates on batteries, fits in a standard economy domestic airline seat
and facilitates the flow of oxygenated hypothermic fluid. 12 Porcine
hearts were explanted using standard techniques and randomised to either
be preserved via cold storage (n=6) or mechanical perfusion (n=6).
Following preservation, the hearts were reanimated on a bench bypass
circuit and assessed for two hours. Cardiac performance was assessed in
the working model after a stabilization period in non-working status
(langendorff model). The mechanical perfusion device demonstrated superior
preservation compared to cold storage in terms of cardiac performance
(Cardiac output) on the bench bypass circuit electron microscopy, and
biochemical normality. These findings suggest that the mechanical
perfusion device provides an alternative to cold storage preservations and
has the potential to improve the preservation of hearts for
transplantation.

<145>
Accession Number
645518324
Title
A pilot randomised controlled trial of advanced recovery room care post
living donor kidney transplantation.
Source
Transplantation. Conference: 30th International Congress of the
Transplantation Society, TTS 2024. Istanbul Turkey. 108(9 Supplement) (pp
100-101), 2024. Date of Publication: September 2024.
Author
Venkataraman K.; Ludbrook G.; Coates T.; Collins M.
Institution
(Venkataraman, Coates, Collins) Central and Northern Adelaide Renal and
Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia
(Venkataraman, Ludbrook, Coates, Collins) Faculty of Health and Medical
Sciences, University of Adelaide, Adelaide, Australia
(Ludbrook) Department of Anaesthesia, Royal Adelaide Hospital, Adelaide,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Significant variation exists between hospitals in the
management of kidney transplant recipients in the immediate postoperative
period. Post-operative care settings described in the literature include
intensive care units, high dependency units and renal wards. No
comparative data exists to inform practices. Advanced Recovery Room Care
(ARRC) is a model of post-operative care that provides a high dependency
unit level of care, under the supervision of an anaesthetist and trained
critical care nurses. ARRC was designed, among other things, to detect and
address post operative hypotension. Post operative hypotension has been
linked to post-operative adverse cardiovascular events and may adversely
affect graft function. ARRC has been shown, in non-transplant settings, to
increased days at home within 30 days post operatively and reduce medical
emergency responses post operatively, chiefly by reducing hypotension. We
sought to investigate the safety, feasibility and efficacy of ARRC in the
post-operative management of kidney transplantation. Methodology: We
conducted a single-centre pilot open-label randomised controlled trial
(ACTRN12622001093774), randomising live donor kidney transplant recipients
1:1 to either post operative care in the ARRC or to standard of care
management on the renal ward. The intervention involved closer
haemodynamic monitoring, more frequent medical officer review and the
ability to assess and address post operative hypotension with fluids and
vasopressors. The primary outcomes were 1) safety (adverse events in the
first 28 days post transplantation), 2) recruitment feasibility and 3)
episodes of hypotension between groups, defined as a systolic blood
pressure of less than 100 mmHg or a mean arterial pressure under 70mmHg.
<br/>Result(s): An interim analysis was performed after 11 months of
recruitment (Jan 2024), after approximately 75% of the recruitment target
was met. 27 living donor transplants have been performed during the study
to date; 18 recipients were eligible for enrolment into the trial. A total
of 14 participants underwent randomisation (Figure 1). There were no major
adverse events in either arm. 4 out of 7 participants (57%) were
hypotensive post operatively in the control arm compared to 1 out of 7
participants (14%) in the intervention. The trial is ongoing. (Figure
Presented).

<146>
Accession Number
645533010
Title
Upper- vs Lower-Extremity Secondary Access During Transcatheter Aortic
Valve Implantation: A Randomized Clinical Trial.
Source
JAMA network open. 7(10) (pp e2438578), 2024. Date of Publication: 01 Oct
2024.
Author
Versteeg G.A.A.; Rooijakkers M.J.P.; Hemelrijk K.I.; Vlaar P.J.; Overduin
D.C.; van Wely M.H.; Aarts H.M.; van Ginkel D.-J.; van Nunen L.X.; van
Geuns R.J.; van Garsse L.A.F.M.; Geuzebroek G.S.C.; Verkroost M.W.A.;
Cetinyurek-Yavuz A.; Heijmen R.H.; Ten Berg J.M.; Tonino P.A.L.; Delewi
R.; van Royen N.
Institution
(Versteeg, Rooijakkers, van Wely, van Nunen, van Geuns, van Royen)
Department of Cardiology, Radboud University Medical Center, Nijmegen,
Netherlands
(Hemelrijk, Aarts, Delewi) Department of Cardiology, Amsterdam,
Netherlands
(Vlaar, Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Overduin, van Ginkel, Ten Berg) Department of Cardiology, St Antonius
Hospital, Nieuwegein, Netherlands
(van Garsse, Geuzebroek, Verkroost, Heijmen) Department of Cardiothoracic
Surgery, Radboud University Medical Center, Nijmegen, Netherlands
(Cetinyurek-Yavuz) Department of IQ Health, Section of Biostatistics,
Radboud University Medical Center, Nijmegen, Netherlands
(Ten Berg) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
Abstract
Importance: An upper-extremity approach for secondary access during
transfemoral transcatheter aortic valve implantation (TAVI) may reduce
clinically relevant secondary access site-related bleeding.
<br/>Objective(s): To investigate the safety and efficacy of an
upper-extremity approach compared with a lower-extremity approach in
patients undergoing TAVI. <br/>Design, Setting, and Participant(s): The
TAVI XS trial was a randomized clinical trial performed between November
28, 2022, and November 15, 2023, with a 30-day follow-up, in 4 TAVI
centers in the Netherlands. Eligibility was determined first, and only
those patients with severe aortic stenosis and no contraindication for
upper- or lower-extremity secondary access were informed about the study
and asked to participate. <br/>Intervention(s): Participants were
randomized 1:1 between the upper-extremity approach (radial artery
diagnostic access and upper-arm vein for temporary pacing lead placement)
and lower-extremity approach (femoral artery diagnostic access and femoral
vein for temporary pacing lead placement) for secondary access during
TAVI. <br/>Main Outcomes and Measures: Primary end point was clinically
relevant bleeding (Bleeding Academic Research Consortium type 2, 3, or 5)
of the randomized secondary access. Secondary end points included any
clinically relevant bleeding, time to mobilization, duration of
hospitalization, secondary access failure, and procedural time.
<br/>Result(s): Of a total of 324 eligible patients, 238 patients
undergoing transfemoral TAVI (mean [SD] age, 79.4 [6.5] years; 150 male
[63.0%]; median European System for Cardiac Operative Risk Evaluation II
score, 2.2% [IQR, 1.5%-3.5%]) were included. The primary end point
occurred in 5 of 119 patients (4.2%) in the upper-extremity group and 16
of 119 (13.4%) in the lower-extremity group (odds ratio [OR], 0.28 [95%
CI, 0.10-0.80]; P=.01). Incidence of any clinically relevant bleeding was
decreased in the upper-extremity group (25 of 119 [21.0%] vs 41 of 119
[34.5%] patients; OR, 0.51 [95% CI, 0.28-0.91]; P=.02). There was no
difference in time to mobilization or duration of hospitalization.
Secondary access failure (14 of 119 [11.8%] vs 1 of 119 [0.8%] patients;
OR, 15.73 [95% CI, 2.03-121.69]; P=.001) and procedural time (60.0 [IQR,
39.0-88.0; 95% CI, 53.0-70.0] vs 48.0 [IQR, 34.0-64.0; 95% CI, 40.0-55.0]
minutes; P=.002) were higher in the upper-extremity cohort. Conclusion and
Relevance: In this randomized clinical trial of patients undergoing
transfemoral TAVI, the upper-extremity approach for secondary access was
associated with less clinically relevant access site-related bleeding
compared with the conventional lower-extremity approach and should be
considered to reduce periprocedural bleeding complications. Trial
Registration: ClinicalTrials.gov Identifier: NCT05672823.

<147>
Accession Number
2034810020
Title
Effect of mannitol on postoperative delirium in patients undergoing
coronary artery bypass graft: a randomised controlled trial.
Source
Open Heart. 11(2) (no pagination), 2024. Article Number: e002743. Date of
Publication: 22 Aug 2024.
Author
Hemmati Maslakpak M.; Negargar S.; Farbod A.; Khalili A.; Bilehjani E.;
Alinejad V.; Faravan A.
Institution
(Hemmati Maslakpak) Maternal and Childhood Obesity Research Center,
Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia,
Iran, Islamic Republic of
(Negargar, Bilehjani) Department of Anesthesia, Faculty of Medicine,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Farbod, Khalili) Cardiovascular Research Center, Madani Heart Center,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Alinejad) Department of Biostatistics, Urmia University of Medical
Sciences, Urmia, Iran, Islamic Republic of
(Faravan) Student Research Committee, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
Publisher
BMJ Publishing Group
Abstract
Objective Postoperative delirium (POD), especially after cardiac surgery
with cardiopulmonary bypass (CPB), is a relatively common and severe
complication increasing side effects, length of hospital stay, mortality
and healthcare resource costs. This study aimed to determine the impact of
using mannitol serum in the prime of CPB for preventing the occurrence of
delirium in patients undergoing coronary artery bypass surgery. Methods
This study is a single-centre, double-blinded, randomised, controlled
trial that was conducted from December 2022 to May 2023. Patients in the
age range of 18-70 who underwent elective coronary artery bypass surgery
were included in the study. In the control group (n=45), the prime
solution included Ringer's lactate serum. In the intervention group
(n=45), the prime solution consisted of 200 mL mannitol serum and Ringer's
lactate serum. The primary outcome of the study was the incidence of POD.
Secondary outcomes included the duration of mechanical ventilation, length
of stay in the intensive care unit (ICU) and 30-day in-hospital mortality.
Results There were no statistically significant differences in demographic
characteristics and risk factors between the control and intervention
groups (p<0.05). However, the incidence of POD was significantly lower in
the intervention group compared with the control group (22.25% vs 42.2%,
p=0.035). There were no significant differences between the two groups
regarding CPB time, aortic cross-clamp time, duration of mechanical
ventilation and length of stay in ICU (p<0.05). Additionally, mortality
rates and rates of return to the operating room did not differ
significantly between the two groups (p<0.05). Conclusions This study
concluded that adding mannitol to the prime of CPB pump can help reduce
the incidence of delirium after cardiac surgery.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024.

<148>
Accession Number
2034797011
Title
Anti-inflammatory effect of colchicine on organ damage during the
perioperative period of cardiac surgery: A study protocol for a
multicentre, randomised, double-blind, placebo-controlled clinical trial.
Source
BMJ Open. 14(9) (no pagination), 2024. Article Number: e084368. Date of
Publication: 12 Sep 2024.
Author
Li X.; Luo Y.; Cai X.; Lv Z.; Kong Y.; Guo Q.; Zhu J.; Pan T.; Wang D.
Institution
(Li, Luo, Guo, Pan, Wang) Department of Cardiac Surgery, Nanjing Drum
Tower Hospital, Chinese Academy of Medical Sciences, Peking Union Medical
College, Graduate School of Peking Union Medical College, Beijing, China
(Cai, Kong) Department of Cardiac Surgery, Nanjing Drum Tower Hospital,
Clinical College, Nanjing University of Chinese Medicine, Nanjing, China
(Lv, Wang) Department of Cardiac Surgery, Nanjing Drum Tower Hospital, The
Affiliated Hospital, Nanjing University Medical School, Nanjing
University, Nanjing, China
(Zhu, Wang) Department of Cardiac Surgery, Nanjing Drum Tower Hospital,
Clinical College, Nanjing Medical University, Nanjing, China
Publisher
BMJ Publishing Group
Abstract
Introduction The systemic inflammatory response syndrome during the
perioperative period of cardiac surgery can lead to serious postoperative
complications and significantly increase the hospital mortality rate.
Colchicine, a widely used traditional anti-inflammatory drug, has good
clinical value in cardiovascular anti-inflammatory therapy. Our
preliminary single-centre study had confirmed the protective value of
colchicine in patients undergoing cardiac surgery with cardiopulmonary
bypass. For this multicentre investigation, we aim to further validate the
anti-inflammatory and organ-protective effects of low-dose colchicine
during the perioperative period in a low-risk population. Methods and
analysis This study is a multicentre, randomised, double-blind,
placebo-controlled clinical trial. A total of 768 patients undergoing
elective cardiac surgery will be enrolled from eight heart centres in
China. The participants will be randomly assigned to two groups: the
colchicine group will receive low-dose colchicine (0.5 mg once-a-day
dosing regimen (QD) orally for 3 days before the surgery and 0.5 mg dosing
frequency of every other day (QOD) continuously for 10 days after the
surgery), whereas the placebo group will be given starch tablets for the
same time and dosage. Primary endpoints are the occurrence of
postoperative inflammatory diseases, including postoperative atrial
fibrillation, acute respiratory distress syndrome, preoperative myocardial
injury and post-pericardiotomy syndrome. Secondary endpoints included
laboratory tests on postoperative days 1, 3, 5, 7 and 10, intensive care
unit data, APACHE II score, Murray lung injury score, medication-related
gastrointestinal reactions, 30-day and 90-day all-cause mortality,
surgical data, chest radiograph on postoperative days 1, 2 and 3, and
chest CT within 14 days after surgery. Ethics and dissemination This
research has received approval from the Medical Ethics Committee of
Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical College
(approval number 2023-366-01). The study findings will be made available
by publishing them in an open access journal.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024.

<149>
Accession Number
2031845473
Title
Ischemic stroke incidence in intermediate or high-risk patients undergoing
transcatheter aortic valve replacement versus surgical aortic valve
replacement: a comparative systematic review and meta-analysis.
Source
Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 60(1) (no
pagination), 2024. Article Number: 125. Date of Publication: December
2024.
Author
Rehman S.; Ghani M.; Riaz A.; Raza S.S.M.; Zahid M.; Malik M.H.Z.; Amir
A.; Lokesh E.; Ashrita K.; Kachhadia M.P.; Karmani V.K.
Institution
(Rehman) Department of Neurology, Jinnah Sindh Medical University, Sindh,
Karachi, Pakistan
(Ghani) Department of Internal Medicine, Allama Iqbal Medical College,
Punjab, Lahore, Pakistan
(Riaz) Ziauddin University, Sindh, Karachi, Pakistan
(Raza) Department of Internal Medicine, Karachi Medical and Dental
College, Sindh, Karachi, Pakistan
(Zahid) Department of Internal Medicine, Ziauddin University, Sindh,
Karachi, Pakistan
(Malik) Department of Internal Medicine, Jinnah Medical and Dental
College, Sindh, Karachi, Pakistan
(Amir) Department of Internal Medicine, Dow University of Health, Sindh,
Karachi, Pakistan
(Lokesh, Ashrita) Department of Internal Medicine, Osmania Medical
College, Gujarat, Hyderabad, India
(Kachhadia) Department of Internal Medicine, Pandit Deendayal Upadhyay
Medical College Rajkot, Gujarat, Rajkot, India
(Karmani) Department of Internal Medicine, Jinnah Sindh Medical
University, Sindh, Karachi, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and purpose: This comparative systematic review and
meta-analysis investigated the incidence of ischemic stroke in
intermediate-to-high-risk patients undergoing transcatheter aortic valve
replacement versus surgical aortic valve replacement. <br/>Method(s): We
conducted a systematic review and meta-analysis following the PRISMA
guidelines, searching PubMed, Google Scholar, Embase, Web of Science, and
Cochrane CENTRAL databases from their inception to December 2023. The
evaluated outcomes were primarily incidence of stroke and transient
ischemic attack (TIA), along with other secondary safety end-points at 30
days and 1 year post-procedure. Odds ratios (ORs) with 95% confidence
intervals (CIs) were utilized for each study, employing a random-effects
model for data synthesis irrespective of heterogeneity. Statistical
heterogeneity was assessed using I² statistics. All statistical
analyses were conducted using Review Manager. <br/>Result(s): We screened
8028 articles and included 8 studies consisting of 5 randomized controlled
trials and 3 observational studies. The studies examining 30-day and
1-year stroke incidence found no significant difference between TAVR and
SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p = 0.30, OR 0.92, 95% CI
0.64 to 1.33, p = 0.67, respectively). Both TAVR and SAVR also had a
comparable risk of having a transient ischemic attack within 30 days (OR
0.93, 95% CI 0.24 to 3.63, p = 0.92, I² 52%) and 1 year (OR
1.15, 95% CI 0.72 to 1.82, p = 0.56, I² 0%) following the
procedure. Regarding safety endpoints, TAVR had lower rates of all-cause
mortality and acute kidney injury at 1 year post-procedure, but a higher
incidence of major vascular complications at both 30 days and 1 year
compared with SAVR. <br/>Conclusion(s): The results suggest that TAVR and
SAVR have comparable outcomes for both TIA and stroke incidence at 30 days
and 1 year post-procedure, but display varying safety profiles in
intermediate-to-high surgical risk patients.<br/>Copyright &#xa9; The
Author(s) 2024.

<150>
[Use Link to view the full text]
Accession Number
2034969058
Title
Projection of visual material on postoperative delirium in patients
undergoing cardiac surgery: A double blind randomized clinical trial.
Source
Medicine (United States). 103(40) (pp e39470), 2024. Date of Publication:
04 Oct 2024.
Author
Mendez-Martinez C.; Casado-Verdejo I.; Fernandez-Fernandez J.A.;
Sanchez-Valdeon L.; Bello-Corral L.; Mendez-Martinez S.; Sandoval-Diez A.;
Gomez-Salgado J.; Garcia-Suarez M.; Fernandez-Garcia D.
Institution
(Mendez-Martinez, Casado-Verdejo, Fernandez-Fernandez, Sanchez-Valdeon,
Bello-Corral, Garcia-Suarez, Fernandez-Garcia) Health Research Nursing
Group (GREIS), University of Leon, Leon, Spain
(Mendez-Martinez, Mendez-Martinez, Sandoval-Diez, Garcia-Suarez)
University Hospital of Leon, Leon, Spain
(Casado-Verdejo, Fernandez-Fernandez, Sanchez-Valdeon, Bello-Corral,
Fernandez-Garcia) Department of Nursing and Physiotherapy, University of
Leon, Leon, Spain
(Gomez-Salgado) Department of Sociology, Social Work and Public Health,
Faculty of Labour Sciences, University of Huelva, Huelva, Spain
(Gomez-Salgado) Safety and Health Postgraduate Program, Universidad
Espiritu Santo, Guayaquil, Ecuador
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative delirium is a neurobehavioral disorder that can
appear after surgery. It is characterized by an altered level of
consciousness and impaired cognitive function. The aim of this study was
to evaluate the impact of visual projection of images of relatives or
loved ones in patients undergoing cardiac surgery in the immediate
postoperative period, and its influence on the incidence and development
of postoperative delirium. <br/>Method(s): A randomized, double-blind
clinical trial was designed in the immediate postoperative period of adult
patients undergoing cardiac surgery. Consolidated Statement of Reporting
Trials guidelines were followed. A control group (CG) and an intervention
group (IG) were established. In the IG, the patients underwent a visual
projection, while the usual unit treatment was carried out with the CG.
Sociodemographic, anthropometric, anesthetic, and surgical variables were
also recorded. The postoperative delirium assessment scale used was the
confusion assessment method for diagnosing delirium in intensive care unit
patients. <br/>Result(s): Information was collected from 104 patients
undergoing cardiac surgery. Most of the patients included in the study
were men (66.35%) and the most performed surgical intervention was aortic
valve replacement (34.62%). In the CG, positive patients in postoperative
delirium increased from 19.23% to 25%, while in the IG they decreased from
5.77% to 1.92%. The logistic regression analysis presents a prediction
model where the variables that influence the model are gender and group
membership, meaning that being female and belonging to the IG
significantly reduce the presence of delirium. <br/>Conclusion(s): The
projection of visual material reduced the incidence of postoperative
delirium in patients undergoing cardiac surgery, although it cannot be
established that it is effective as a treatment once the pathology is
already established.<br/>Copyright &#xa9; 2024 the Author(s). Published by
Wolters Kluwer Health, Inc.

<151>
Accession Number
2035120994
Title
Late follow-up for a randomized trial of surgical treatment of tricuspid
valve regurgitation in patients undergoing left ventricular assist device
implantation.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Mendiola Pla M.; Russell S.D.; Milano C.A.; Chiang Y.; Kang L.; Poehlein
E.; Green C.L.; Benedetti F.; Billard H.; Bryner B.S.; Schroder J.N.;
Daneshmand M.A.; Nicoara A.; DeVore A.D.; Patel C.B.; Bishawi M.
Institution
(Mendiola Pla, Milano, Kang, Benedetti, Billard, Schroder) Division of
Cardiothoracic Surgery, Duke University Medical Center, Durham, NC, United
States
(Russell, DeVore, Patel) Division of Cardiology, Duke University Medical
Center, Durham, NC, United States
(Chiang) Division of Cardiovascular and Thoracic Surgery, Aurora St Luke's
Medical Center, Milwaukee, Wis, United States
(Poehlein, Green) Department of Biostatistics and Bioinformatics, Duke
University School of Medicine, Durham, NC, United States
(Bryner) Division of Cardiothoracic Surgery, Northwestern University
Feinberg School of Medicine, Chicago, Ill, United States
(Daneshmand, Bishawi) Division of Cardiothoracic Surgery, Emory
University, Atlanta, GA, United States
(Nicoara) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: We previously reported that concurrent tricuspid valve surgery
(TVS) was not associated with a lower incidence of early right heart
failure (RHF) in patients undergoing durable left ventricular assist
device (LVAD) implantation. This follow-up analysis aimed to further
define the clinical impact of concurrent TVS after 2 months of follow-up.
<br/>Method(s): Patients with moderate or severe tricuspid regurgitation
(TR) on preoperative echocardiography (n = 71) were randomized to LVAD
implantation either alone (no TVS group; n = 34) or with concurrent TVS
(TVS group; n = 37). Randomization was stratified by preoperative right
ventricular dysfunction. The patients were followed for at least 12 months
after surgery. The incidence of RHF was determined by an adjudication
committee using Interagency Registry for Mechanically Assisted Circulatory
Support criteria. Functional studies and repeat echocardiography were
performed at 12 months. <br/>Result(s): Demographics were similar in the 2
study arms. At 12 months, the rate of moderate or severe RHF was 50.0% in
the no TVS arm versus 51.4% in the TVS arm. No patients developed RHF
between 6 and 12 months following the procedure. Death from RHF was 5.4%
in the TVS arm versus 8.8% in the no TVS arm. At 12 months, there was no
significant difference in TR severity between the 2 arms, owing to
improvement in TR severity in the no TVS arm. Cardiopulmonary exercise
testing at 12+ months revealed no significant between-group difference in
peak oxygen consumption. <br/>Conclusion(s): In patients with significant
preimplantation TR, the severity of TR improved over time in the no TVS
arm with LVAD implantation alone. By 12 months, there was no significant
difference in TR severity between the 2 arms. This may account for the
lack of difference in late clinical or functional
parameters.<br/>Copyright &#xa9; 2024 The American Association for
Thoracic Surgery

<152>
Accession Number
2034916712
Title
International incidence of melanoma in heart transplant recipients: a
meta-analysis.
Source
Melanoma Research. (no pagination), 2024. Date of Publication: 2024.
Author
Campillo P.; Kesler A.; Ramirez C.A.; Ramirez C.J.; Daher J.C.; Grimm M.;
Sabina M.; Bizanti A.
Institution
(Campillo, Kesler, Ramirez, Ramirez, Daher, Grimm, Sabina, Bizanti)
Department of Internal Medicine, Lakeland Regional Health Medical Center,
Lakeland, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
The incidence of heart transplants in the USA has increased by 85.8% since
2011, resulting in a growing population of recipients requiring long-term
immunosuppressive therapy. While essential for preventing organ rejection,
this therapy significantly increases melanoma risk. This meta-analysis
investigates the incidence and risk factors of melanoma in heart
transplant recipients. A systematic review and meta-analysis were
conducted following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines, including observational studies reporting
melanoma incidence in heart transplant recipients. Relative risk (RR) was
synthesized from standardized incidence ratios, hazard ratios, incidence
rate ratios, and standardized mortality ratios. The meta-analysis
incorporated 10 studies, including 22 415 heart transplant recipients. The
pooled RR was 2.21 (95% confidence interval: 1.32-3.71; P = 0.003),
indicating a significantly elevated melanoma risk. This study highlights
the critical need for preventive dermatological strategies in heart
transplant recipients and calls for further research into the impact of
different immunosuppressive regimens on melanoma risk. Despite
limitations, these findings offer valuable insights for optimizing
long-term patient care. Melanoma Res XXX: XXXX-XXXX Copyright &#xa9; 2024
The Author(s). Published by Wolters Kluwer Health, Inc.

<153>
Accession Number
2034916689
Title
Benefits and Harms of Coronary Revascularization in Non-Dialysis-Dependent
CKD and Ischemic Heart Disease: A Systematic Review and Meta-Analysis.
Source
Clinical Journal of the American Society of Nephrology. (no pagination),
2024. Date of Publication: 2024.
Author
Patel D.M.; Wilson L.M.; Wilson R.F.; Yang X.; Gharibani T.; Robinson K.A.
Institution
(Patel) Division of Nephrology, Department of Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Wilson, Wilson, Yang, Gharibani, Robinson) Department of Health Policy
and Management, Johns Hopkins Bloomberg School of Public Health,
Baltimore, MD, United States
(Robinson) Department of Medicine, Johns Hopkins University, Baltimore,
MD, United States
(Robinson) Department of Epidemiology, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiovascular disease is the leading cause of death in people
with chronic kidney disease (CKD). Coronary revascularization can improve
cardiac function and prognosis in people with ischemic heart disease;
however, in people with CKD, there is concern that potential harms could
outweigh benefits of revascularization. Evidence on the balance of these
risks and benefits, specifically in people with non-dialysis-dependent
CKD, is lacking. <br/>Method(s): We conducted a systematic review of
randomized controlled trials (RCTs) to assess the risks and benefits of
revascularization, compared to medical management, among adults or
children with ischemic heart disease and CKD not requiring kidney
replacement therapy (dialysis or transplantation). We searched PubMed,
Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL)
through December 12^th, 2023. Two people independently screened
titles and abstracts followed by full-text review, serially extracted data
using standardized forms, independently assessed risk of bias, and graded
the certainty of evidence (COE). <br/>Result(s): Evaluating data from nine
RCTs, we found that people with CKD and ischemic heart disease treated
with revascularization may experience lower all-cause mortality compared
to people receiving medical management (RR 0.80, 95% CI 0.64-0.98; COE,
low). Revascularization may reduce incidence of myocardial infarction (RR
0.81, 95% CI 0.64-1.04; COE, low) and heart failure (RR 0.80, 95% CI
0.52-1.23; COE, low). The effect on cardiovascular mortality is uncertain
(HR 0.67, 95% CI 0.37-1.20; COE, very low). Evidence was insufficient for
patient-reported outcomes and adverse kidney events. Data were limited by
heterogeneity of patient populations and the limited number of trials.
<br/>Conclusion(s): In people with non-dialysis-dependent CKD,
revascularization may be associated with lower all-cause mortality
compared to medical management and may also lower the risk of
cardiovascular events. Additional data surrounding kidney and
patient-reported outcomes are needed to comprehensively engage in shared
decision making and determine optimal treatment strategies for people with
CKD and ischemic heart disease.<br/>Copyright &#xa9; 2024 by the American
Society of Nephrology.

<154>
Accession Number
645537608
Title
The effect of an open-heart surgery patient care protocol on
post-sternotomy pain, anxiety and quality of care: A randomized controlled
trial.
Source
Nursing in critical care. (no pagination), 2024. Date of Publication: 16
Oct 2024.
Author
Dagcan Sahin N.; Gurol Arslan G.
Institution
(Dagcan Sahin) Faculty of Health Sciences, Kutahya Health Sciences
University, Kutahya, Turkey
(Gurol Arslan) Fundamentals of Nursing Department, Nursing Faculty, Dokuz
Eylul University, Izmir, Turkey
Abstract
BACKGROUND: Open-heart surgery patients face many problems because of
post-sternotomy pain. Care protocols can eliminate pain and pain-related
problems by providing holistic care. AIM: The aim of this study was to
examine the effect of an open-heart surgery patient care protocol
developed in the study on post-sternotomy pain, anxiety and quality of
care. STUDY DESIGN: The study was carried out as a double-blind randomized
controlled trial. The sample size was calculated. Considering some
attrition, the sample size was increased by 10% for each group, and a
total of 68 participants, including 34 in each group, were included in the
sample. Data were collected using a 'Patient Information Form', a
'Post-Sternotomy Pain Follow-up Form', the 'Numeric Rating Scale', the
'State Anxiety Inventory' and the 'Strategic and Clinical Quality
Indicators in Postoperative Pain Management Questionnaire'. The patients
in the experimental group were given care in accordance with the protocol,
which was developed in the study, on postoperative days 0, 1 and 2.
<br/>RESULT(S): The statistical evaluation showed a significant difference
between the mean scores of the experimental (F=7.28; p<.001) and control
groups (F=2.42; p<.05) on the pain assessment scale. It was determined
that the number of analgesics used in the experimental group was
statistically significantly lower than in the control group. Intra-group
comparisons showed that there was a difference between the mean pre-test
and post-test state anxiety scale scores of the groups (p<.001). The
experimental group had higher mean scores on the Strategic and Clinical
Quality Indicators in Postoperative Pain Management Questionnaire than
that of the control group (p<.001). <br/>CONCLUSION(S): The protocol
developed in the study was found to be effective in reducing pain, the use
of NSAIDs and opioids, and anxiety levels and increasing the level of
quality of care. RELEVANCE TO CLINICAL PRACTICE: The protocol was original
and feasible in that it included independent nursing interventions to
improve the quality of care by reducing pain and anxiety. Particularly,
the use of protocols in intensive care units was nurses' strongest
resource in patient care management. Thus, the protocol, which was
prepared for intensive care patients who most frequently experience pain
and anxiety, was promising for nurses in improving the quality of care by
reducing pain and anxiety. However, it is necessary to conduct further
studies involving longitudinal follow-up in samples and institutions with
similar conditions.<br/>Copyright &#xa9; 2024 The Author(s). Nursing in
Critical Care published by John Wiley & Sons Ltd on behalf of British
Association of Critical Care Nurses.

<155>
Accession Number
645532596
Title
Coronary Revascularization Guided With Fractional Flow Reserve or
Instantaneous Wave-Free Ratio: A 5-Year Follow-Up of the DEFINE FLAIR
Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2024. Date of Publication: 16 Oct 2024.
Author
Escaned J.; Travieso A.; Dehbi H.-M.; Nijjer S.S.; Sen S.; Petraco R.;
Patel M.; Serruys P.W.; Davies J.
Institution
(Escaned, Travieso) Hospital Clinico San Carlos IDISSC, Complutense
University of Madrid and CIBERCV, Madrid, Spain
(Escaned, Travieso) Comprehensive Clinical Trials Unit at UCL, University
College London, London, United Kingdom
(Dehbi) Imperial College Healthcare NHS Trust, Hammersmith Hospital,
London, United Kingdom
(Nijjer, Sen, Petraco, Davies) Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Patel) Department of Cardiology, University of Galway, Galway, Ireland
(Serruys) College of Medicine Nursing and Health Sciences, University of
Galway, Galway, Ireland
Abstract
Importance: The differences between the use of fractional flow reserve
(FFR) or instantaneous wave-free ratio (iFR) in the long term are unknown.
<br/>Objective(s): To compare long-term outcomes of iFR- and FFR-based
strategies to guide revascularization. <br/>Design, Setting, and
Participant(s): The DEFINE-FLAIR multicenter study randomized patients
with coronary artery disease to use either iFR or FFR as a pressure index
to guide revascularization. Patients from 5 continents with coronary
artery disease and angiographically intermediate severity stenoses who
underwent hemodynamic interrogation with pressure wires were included.
These data were analyzed from March, 13, 2014, through April, 27, 2021.
MAIN OUTCOME MEASURES: Five-year major adverse cardiac events (MACE) (a
composite of all-cause death, nonfatal myocardial infarction, and
unplanned revascularization), as well as the individual components of the
combined end point. <br/>Result(s): At 5 years of follow-up, no
significant differences were found between the iFR (mean age [SD], 65.5
[10.8] years; 962 male [77.5%]) and FFR (mean age [SD], 65.2 [10.6] years;
929 male [74.3%]) groups in terms of MACE (21.1% vs 18.4%, respectively;
hazard ratio [HR], 1.18; 95% CI, 0.99-1.42; P=.06). While all-cause death
was higher among patients randomized to iFR, it was not driven by
myocardial infarction (6.3% vs 6.2% in the FFR study arm; HR, 1.01; 95%
CI, 0.74-1.38; P=.94) or unplanned revascularization (11.9% vs 12.2% in
the FFR group; HR, 0.98; 95% CI, 0.78-1.23; P=.87). Furthermore, patients
in whom revascularization was deferred on the basis of iFR or FFR had
similar MACE in both study arms (17.9% in the iFR group vs 17.5% in the
FFR group; HR, 1.03; 95% CI, 0.79-1.35; P=.80) with similar rates of the
components of MACE, including all-cause death. On the contrary, in
patients who underwent revascularization after physiologic interrogation,
the incidence of MACE was higher in the iFR group (24.6%) compared with
the FFR group (19.2%) (HR, 1.36; 95% CI, 1.07-1.72; P=.01). Conclusions
and relevance: At 5-year follow up, an iFR based-strategy was not
statistically different than an FFR strategy to guide revascularization in
terms of MACE, nonfatal myocardial infarction, and unplanned
revascularization. Trial Registration: ClinicalTrials.gov Identifier:
NCT02053038.

<156>
Accession Number
2034893017
Title
The outcome of surgery for congenital heart disease in India: A systematic
review and metanalysis.
Source
Annals of Pediatric Cardiology. 17(3) (pp 164-179), 2024. Date of
Publication: 2024.
Author
Kadiyani L.; Kalaivani M.; Iyer K.S.; Ramakrishnan S.
Institution
(Kadiyani, Ramakrishnan) Department of Cardiology, All India Institute of
Medical Sciences, New Delhi, India
(Kalaivani) Department of Biostatistics, All India Institute of Medical
Sciences, New Delhi, India, India
(Iyer) Department of Pediatric and Congenital Heart Surgery, Fortis
Escorts Heart Institute, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The mortality risks of children undergoing various cardiac
surgeries for congenital heart disease (CHD) in India are not well
defined. We conducted a systematic review and meta-analysis to estimate
the inhospital mortality of various common CHD surgeries reported in India
and compared it to representative data from established Western databases.
<br/>Methods and Results: We searched four bibliographic databases for
studies published in India over the last 25 years. In total, 135 studies
met the inclusion criteria and included 30,587 patients aged from 1 day to
65 years. The pooled mortality rate of 43 Indian studies reporting
multiple CHD surgical outcomes is 5.63% (95% confidence interval [CI]:
4.26-7.16; I 2 = 93.9%), whereas the Western data showed a pooled
mortality rate of 2.65% (P value for comparison <0.0001). The pooled
mortality risk for ventricular septal defect closure and tetralogy of
Fallot repair in Indian studies was 2.87% (95% CI: 0.76-5.91; I 2 = 62.4%)
and 4.61% (95% CI: 2.0-8.02; I 2 = 87.4%), respectively. The estimated
mortality risk was higher than the Western databases for all subcategories
studied except for surgeries in the grown-ups with CHD population and
coarctation repair. <br/>Conclusion(s): The estimated mortality risks are
higher among Indian patients undergoing cardiac surgery for CHD as
compared to Western data. We need prospective multicentric data to
document whether the observed excess mortality exists after adjusting for
various high-risk features and comorbidities in Indian patients. We need
systemic measures to improve the outcomes of CHD surgeries in
India.<br/>Copyright &#xa9; 2024 Annals of Pediatric Cardiology.

<157>
Accession Number
2031803951
Title
A multicentric, randomized, controlled clinical trial to study the impact
of bedside model-informed precision dosing of vancomycin in critically ill
children-BENEFICIAL trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 669. Date of
Publication: December 2024.
Author
De Cock P.A.; Colman R.; Amza A.; De Paepe P.; De Pla H.; Vanlanduyt L.;
Van der Linden D.; De Buyser S.; Kokur H.; Clauwaert C.; Snauwaert E.; Le
Roux M.; Brichard B.; Goyet M.D.V.D.; Haenecour A.; Peetermans L.; Willems
L.; Mondelaers V.; Panahandeh M.; Benamour M.; Vanderdonck M.; Guillaume
L.; Nevraumont A.; Tossens B.; Deltombe M.; Chatzis O.; Ceuterick I.;
Vanlaer E.; Elst L.V.; Cosaert K.; Segers H.; Labarque V.; Uyttebroeck A.;
van Damme K.; Verbeeck S.; Debuf M.J.; Vanbuggenhout L.; Rayyan M.;
Thewissen L.; Eerdekens A.; Dereymaker A.; Elst Z.V.; Slegers L.; Colomina
M.S.; Viterbo V.G.; Vicinanza A.; Rooze S.; Berette-Piccoli X.; Francois
T.; Sijmons M.; d'Haese J.; De Potter L.; Krechting F.; De Bisschop B.;
Lefevere J.; Sonnaert M.; Camfermann F.; Mertens S.; Clottens N.; Bauters
T.; De Wilde B.; Verrijckt A.; de Jaeger A.; Willems J.; Beel E.; Schepens
T.; Pauline N.; De Meulemeester J.; Garabedian L.; Keymeulen A.; De Coen
K.; Goossens L.; Zecic A.; Smets K.; Boland L.; van Damme A.; Laurent H.;
Piersigilli F.; Danhaive O.; Derriks F.; Renard M.; Van Der Werff Ten
Bosch J.; Mauel R.; Bordon V.; Dhont E.; Vanhaesebrouck S.; Godart V.;
Smits A.; Vens D.V.; Biarent D.; Debouver P.; Clarysse A.; Cools F.;
Schelstraete P.
Institution
(De Cock) Department of Hospital Pharmacy, Ghent University Hospital,
Ghent, Belgium
(De Cock) Department of Basic and Applied Medical Sciences, Faculty of
Medicine and Health Sciences, Ghent University, Ghent, Belgium
(De Cock) Department of Pediatric Intensive Care, Ghent University
Hospital, Ghent, Belgium
(Colman) Biostatistics Unit, Faculty of Medicine and Health Sciences,
Ghent University, Ghent, Belgium
(Amza, De Paepe) Department of Emergency Medicine, Ghent University
Medicine, Ghent University Hospital, Ghent, Belgium
(De Pla, Vanlanduyt) Health, Innovation and Research Institute, Ghent
University Hospital, Ghent, Belgium
(Van der Linden) Department of Pediatrics, Pediatric Infectious Diseases,
Specialized Pediatric Service, Cliniques Universitaires Saint-Luc,
Brussels, Belgium
Publisher
BioMed Central Ltd
Abstract
Background : Vancomycin is a commonly prescribed antibiotic to treat
serious Gram-positive infections in children. The efficacy of vancomycin
is known to be directly related to the pharmacokinetic/pharmacodynamic
(PK/PD) index of the area under the concentration-time curve (AUC) divided
by the minimal inhibitory concentration (MIC) of the pathogen. In most
countries, steady-state plasma concentrations are used as a surrogate
parameter for this target AUC/MIC, but this practice has some drawbacks.
Hence, AUC-based dosing using model-informed precision dosing (MIPD) tools
has been proposed for increasing the target attainment rate and reducing
vancomycin-related nephrotoxicity. Solid scientific evidence for these
claimed benefits is lacking in children. This randomized controlled trial
aims to investigate the large-scale utility of MIPD dosing of vancomycin
in critically ill children. <br/>Method(s): Participants from 14 neonatal
intensive care, pediatric intensive care, and pediatric hemo-oncology ward
units from 7 hospitals are randomly allocated to the intervention or
standard-of-care comparator group. In the intervention group, a MIPD
dosing calculator is used for AUC-based dosing, in combination with extra
sampling for therapeutic drug monitoring in the first hours of treatment,
as compared to standard-of-care. An AUC24h between 400 and 600 is
targeted, assuming an MIC of 1 mg/L. Patients in the comparator group
receive standard-of-care dosing and monitoring according to institutional
guidelines. The primary endpoint is the proportion of patients reaching
the target AUC24h/MIC of 400-600 between 24 and 48 h after the start of
vancomycin treatment. Secondary endpoints are the proportion of patients
with (worsening) acute kidney injury during vancomycin treatment, the
proportion of patients reaching target AUC24h/MIC of 400-600 between 48
and 72 h after the start of vancomycin treatment, time to clinical cure,
ward unit length-of-stay, hospital length-of-stay, and 30-day all-cause
mortality. <br/>Discussion(s): This trial will clarify the propagated
benefits and provide new insights into how to optimally monitor vancomycin
treatment in critically ill children. Trial registration: Eudract number:
2019-004538-40. Registered on 2020-09-08 ClinicalTrials.gov NCT046666948.
Registered on 2020-11-28<br/>Copyright &#xa9; The Author(s) 2024.

<158>
Accession Number
2031756359
Title
Enhancing cardiac postoperative care: a smartwatch-integrated remote
telemonitoring platform for health screening with ECG analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1443998. Date of Publication: 2024.
Author
Monteiro R.; Rabello G.C.M.; Moreno C.R.; Moitinho M.S.; Pires F.A.;
Samesina N.; Cesar L.A.M.; Tarasoutchi F.; Fernandes F.; Martins P.C.C.O.;
Mariano B.M.; Soeiro A.D.M.; Palhares A.; Pastore C.A.; Jatene F.B.
Institution
(Monteiro, Rabello, Moreno, Moitinho, Martins, Mariano, Jatene) Department
of Cardiovascular Surgery-InovaInCor, Instituto do Coracao, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Brazil
(Pires, Palhares) Biomedical Informatics Laboratory, Instituto do Coracao,
Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao
Paulo, Sao Paulo, Brazil
(Samesina, Pastore) Electrocardiography Unit, Instituto do Coracao,
Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao
Paulo, Sao Paulo, Brazil
(Cesar) Chronic Coronary Disease Unit, Instituto do Coracao, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Brazil
(Tarasoutchi) Valvular Heart Disease Clinical Unit, Instituto do Coracao,
Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao
Paulo, Sao Paulo, Brazil
(Fernandes) Cardiomyopathy-Aortic Diseases Clinical Unit, Instituto do
Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Fernandes, Soeiro) InCor Emergency Unit, Instituto do Coracao, Hospital
das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo,
Sao Paulo, Brazil
Publisher
Frontiers Media SA
Abstract
Aims: The integration of smartwatches into postoperative cardiac care
transforms patient monitoring, systematically tracking vital signs and
delivering real-time data to a centralized platform. This study focuses on
developing a platform for seamless integration, assessing reliability, and
evaluating the impact on post-cardiac surgery. The goal is to establish a
robust foundation for understanding the efficacy and dependability of
smartwatch-based telemonitoring, enhancing care for this population.
<br/>Methods and Results: A total of 108 cardiac surgery patients were
divided into telemonitoring (TLM) and control (CTL) groups. The TLM group
utilized smartwatches for continuous monitoring of vital parameters
(SpO<inf>2</inf>, HR, BP, ECG) over 30 +/- 3 days. Statistical analyses
(Pearson, Intraclass Correlation, Bland-Altman, Tost Test) were employed
to compare smartwatch measurements with traditional methods. Significant
correlations and concordance were observed, particularly in HR and BP
measurements. Challenges were noted in SpO<inf>2</inf> measurement. The
ECG algorithm exhibited substantial agreement with cardiologists (Kappa:
0.794; p > 0.001), highlighting its reliability. The telemonitoring
platform played a crucial role in early detection of clinical changes,
including prompt Emergency Department (ED) visits, contributing
significantly to preventing outcomes that could lead to mortality, such as
asymptomatic Atrioventricular block. Positive patient responses affirmed
technological efficacy, especially in identifying cardiac arrhythmias like
atrial fibrillation. <br/>Conclusion(s): The integration of smartwatches
into remote telemonitoring for postoperative cardiac care demonstrates
substantial potential, improving monitoring and early complication
detection, thereby enhancing patient outcomes. The FAPO-X Study (Assisted
Digital Telemonitoring with Wearables in Patients After Cardiovascular
Surgery; NCT05966857) underscores the promising role of telemonitoring in
postoperative cardiac care.<br/>Copyright 2024 Monteiro, Rabello, Moreno,
Moitinho, Pires, Samesina, Cesar, Tarasoutchi, Fernandes, Martins,
Mariano, Soeiro, Palhares, Pastore and Jatene.

<159>
Accession Number
2031867753
Title
Erector spinae plane block versus intravenous opioid for analgesia in
pediatric cardiac surgery: A systematic review and meta-analysis.
Source
Paediatric Anaesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Lombardi R.A.; Pereira E.M.; Amaral S.; Medeiros H.J.S.; Alrayashi W.
Institution
(Lombardi) Department of Anesthesiology, University of Nebraska Medical
Center, Omaha, NE, United States
(Pereira) Division of Medicine, Federal University of Minas Gerais, Minas
Gerais, Belo Horizonte, Brazil
(Amaral) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Medeiros) Department of Anesthesiology, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Alrayashi) Department of Anesthesiology, Critical Care, and Pain
Medicine, Boston Children's Hospital and Harvard Medical School, Boston,
MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The erector spinae plane block (ESPB) has recently emerged
as a regional anesthesia technique for perioperative pain management in
pediatric cardiac surgery. However, evidence comparing its effectiveness
with intravenous (IV) opioid-based analgesia is limited. We aimed to
evaluate and compare the analgesic efficacy of ESPB versus IV opioids in
this setting. <br/>Method(s): We systematically reviewed and meta-analyzed
studies comparing ESPB with IV opioid analgesia in pediatric cardiac
surgeries with midline sternotomy. Primary outcomes were intraoperative
fentanyl consumption and intensive care unit (ICU) length of stay (LOS).
Secondary outcomes included postoperative opioid consumption, time to
first rescue analgesia, pain scores, postoperative vomiting and other
complications, extubation time, and hospital LOS. Statistical analyses
were performed using RStudio version 4.2.3. <br/>Result(s): Five studies
with 384 patients were included, with 178 receiving ESPB. ESPB
significantly reduced intraoperative fentanyl use (MD -1.90
mug.kg^-1; 95% CI -3.15 to -0.66 mug.kg^-1; p =.003;
I² = 58%) and ICU LOS (MD -3.50 h; 95% CI -4.32 to -2.69 h; p
<.0001; I² = 0%). No significant differences were found in the
remaining outcomes. <br/>Conclusion(s): Our findings suggest the ESPB
might be an important adjunct to enhancing analgesia for midline
sternotomies in pediatric cardiac surgery, potentially reducing
intraoperative opioid requirements and ICU LOS. PROSPERO Registration: CRD
42024526961.<br/>Copyright &#xa9; 2024 The Author(s). Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<160>
Accession Number
2035092046
Title
Association Between Surgical Approach < Surgical Outcome in Lung Cancer
Patients Undergoing Segmentectomy.
Source
Journal of Thoracic Oncology. Conference: The 2024 World Conference on
Lung Cancer. San Diego United States. 19(10 Supplement) (pp S522), 2024.
Date of Publication: October 2024.
Author
Shiono S.; Suzuki J.; Watanabe H.; Endo M.
Institution
(Shiono, Suzuki, Watanabe) Yamagata University, Yamagata, Japan
(Endo) Yamagata Prefectural Central Hospital, Yamagata, Japan
Publisher
Elsevier Inc.
Abstract
Introduction: Although segmentectomy tends to have a better overall
survival for early stage lung cancers based on the results of randomized
clinical trials, local recurrence rate following segmentectomy is higher
than that following lobectomy. To perform a safe segmentectomy and reduce
the local recurrence rate, an understanding of the 3-dimensional anatomy
is essential. Segmentectomy performed through a thoracotomy (8-12 cm in
length), the so-called hybrid approach, provides direct vision
intraoperatively and is safe. Video-assisted thoracic surgery (VATS)
provides a 2-dimensional view without direct vision. The purpose of this
study was to compare short-term surgical outcomes and survival among
patients who underwent segmentectomy for lung cancer using a hybrid
approach compared to VATS. <br/>Method(s): This was a retrospective study
using a prospectively collected database from two institutions. Patients
with clinical T1N0M0-stage IA with the following characteristics underwent
segmentectomy: patient request, poor performance status, and impaired
respiratory function and/or severe co-morbidities. In one institution the
hybrid approach was performed via an 8-cm thoracotomy, while VATS without
direct vision was performed at the other institution. From June 2016 to
December 2021, a total of 250 patients underwent segmentectomy for lung
cancer. We evaluated 250 patients who underwent segmentectomy using the
hybrid approach or VATS and compared the perioperative surgical outcomes
and overall survival. Additionally, propensity score matching was
performed to balance patient characteristics between the groups.
<br/>Result(s): Ninety-seven hybrid approaches and 153 VATSs were
performed. The background of patients was similar in the groups, but the
proportion of complex segmentectomies was higher in VATS (52.6% vs. 73.9%;
P<0.001). The intraoperative and acute postoperative surgical outcomes in
the hybrid approach and VATS, respectively, were as follows: median
operative time, 146 and 167 min (P=0.006); median blood loss, 4 and 49 g
(P<0.001); number of dissected lymph nodes, 4 and 2 (P=0.046); incidence
of grade >=2 postoperative complications, 18.6% and 13.2% (P=0.252);
median duration of chest tube drainage, 2 and 1 d (P=0.008); median
postoperative hospital stay, 4 and 4 d (P=0.832); and readmission within
30 d after discharge, 5.2% and 1.3% (P=0.113). There was 1 death within 30
d after surgery using VATS. The 5-year overall survival with the hybrid
approach and VATS was 91.7% and 92.6%, respectively (P=0.408). After
propensity score matching, the hybrid approach had a shorter operative
time and less blood loss than VATS. The 5-year overall survival was 92.2%
and 90.6%, for the hybrid approach and VATS, respectively (P=0.792).
<br/>Conclusion(s): The hybrid approach was associated with shorter
operative times, less blood loss, and more dissected lymph nodes than
VATS. There were no significant differences in perioperative surgical
outcomes. Although the number of complex segmentectomies was higher in
VATS than in the hybrid approach, the hybrid approach had superior
intraoperative outcomes and similar survival compared to VATS. Keywords:
Lung cancer, Segmentectomy, VATS<br/>Copyright &#xa9; 2024

<161>
Accession Number
2035084796
Title
The Treatment Outcome of SBRT and Sublobar Resection for Vulnerable
Elderly Patients with Stage IA Non-Small Cell Lung Cancer.
Source
Journal of Thoracic Oncology. Conference: The 2024 World Conference on
Lung Cancer. San Diego United States. 19(10 Supplement) (pp S538), 2024.
Date of Publication: October 2024.
Author
Asami M.; Katsumata S.; Yasui K.; Yamaguchi D.; Matsushima K.; Masuda T.;
Hayasaka K.; Kojima H.; Konno H.; Isaka M.; Harada H.; Ohde Y.
Institution
(Asami, Katsumata, Yasui, Yamaguchi, Matsushima, Masuda, Hayasaka, Kojima,
Konno, Isaka, Harada, Ohde) Shizuoka Cancer Center, Shizuoka, Japan
Publisher
Elsevier Inc.
Abstract
Introduction: In Japan, about 60% of patients who underwent resection for
lung cancer were aged 70 years or older and 14% of patients were
octogenarian. Lobectomy has long been the standard radical treatment for
lung cancer. However, sublobar resection has become one of the standard
treatments based on the results of recent two randomized controlled
trials. In practice, we often face cases where we cannot perform standard
resection for vulnerable elderly patients. Sublobar resection or
stereotactic body radiotherapy (SBRT) are considered for these patients.
There are no randomized controlled trials comparing sublobar resection and
SBRT, so that the treatment for these patients remains controversial,
especially for those with solid-predominant tumors. We aimed to compare
the survival and incidence of complications of SBRT with those of sublobar
resection for vulnerable elderly patients with clinical stage IA non-small
cell lung cancer (NSCLC). <br/>Method(s): Using the radiology database and
the thoracic surgical database of the Shizuoka Cancer Center, patients >=
75 years of age with performance status (PS) 0-2 who underwent SBRT or
sublobar resection with curative intent for solid-predominant clinical
stage IA NSCLC with <=3cm in size from January 2010 to December 2017 were
included in this study. All surgical patients were judged as ineligible
for lobectomy with mediastinal lymph node dissection by surgeon in charge
for reasons such as poor pulmonary function, comorbidities, and advanced
age. Patients underwent sublobar resection without mediastinal lymph node
dissection. A total of 119 patients were investigated in this study. To
reduce selection bias, a propensity score matching method was used. The
propensity score model was estimated using a logistic regression model
that adjusted for preoperatively detectable patient characteristics,
including age, sex, PS, smoking status, preoperative lung function (using
vital capacity), comorbidities, solid tumor size on thin-slice CT (TSCT)
and tumor appearance (pure-solid/part-solid) on TSCT. We compared the SBRT
group to the surgery group on complications within 90 days after treatment
and survival outcome. <br/>Result(s): Of the 119 patients included, 86
underwent SBRT and 33 underwent sublobar resection. The median follow-up
periods for surgery and SBRT were 5.1 and 4.2 years, respectively. The
SBRT group included significantly older patients (median: 82 vs 79) and
larger tumors (median: 18 vs 16 mm) than the surgery group. After
matching, we analyzed 24 patients in each group. The incidence of >=Grade
2 complications was not significantly different between the two groups
(12.5% and 29.1%, p=0.286). Overall survival rate at 3 years was 77.1% in
the SBRT group compared with 75% in the surgery group (p=0.343).
Recurrence-free survival rate at 3 years was 69.4% in the SBRT group and
66.7% in the surgery group (p=0.336). There were no significant
differences in survival between the two groups. <br/>Conclusion(s): Our
results suggest that SBRT might be relatively safer compared to surgery
and post-treatment survival outcomes of SBRT may be comparable to those of
surgery for vulnerable elderly patients. SBRT may be an effective
treatment option for these patients. Randomized controlled trials are
required to confirm these results. Keywords: SBRT, sublobar resection,
NSCLC<br/>Copyright &#xa9; 2024

<162>
Accession Number
2035084594
Title
A Clinical Conundrum: Lung Cancer in the Breast.
Source
Journal of Thoracic Oncology. Conference: The 2024 World Conference on
Lung Cancer. San Diego United States. 19(10 Supplement) (pp S519-S520),
2024. Date of Publication: October 2024.
Author
Nakata J.A.; Whittall I.; Russo M.; Friedberg J.; Su S.
Institution
(Nakata, Friedberg, Su) Fox Chase Cancer Center, Philadelphia, PA, United
States
(Whittall) Thomas Jefferson University School of Medicine, Philadelphia,
PA, United States
(Russo) Temple University, Philadelphia, PA, United States
(Friedberg, Su) Temple University Health Systems, Philadelphia, PA, United
States
Publisher
Elsevier Inc.
Abstract
Introduction: Most patients with lung cancer present with advanced
disease. Rarely, lung cancer can metastasize to the breast and be
confounded with primary breast carcinoma. To date, only case reports or
small series have been published on this topic. Our study provides the
largest comprehensive review of the current literature to highlight common
key clinical and histopathologic features in this unique patient
population. <br/>Method(s): A search using the PubMed database for studies
published from 1962 to 2024 was performed using the following keywords:
"lung cancer", "non-small cell lung cancer", "lung adenocarcinoma", "lung
squamous cell", "small cell lung cancer", "lung neuroendocrine",
"metastasis to breast", "metastasize to breast", "breast", "metastasize".
A secondary search using the references of relevant studies was performed
for additional articles. The inclusion criteria consisted of studies of
lung cancer with breast metastasis. Articles were excluded for any of the
following criteria: 1) lung cancer with breast metastasis was not
described, 2) abstracts without full texts were available, 3) insufficient
clinical data reported, 4) non-original cases, 5) study was not published
in a peer-reviewed journal, or 6) study was written in a non-English
language. <br/>Result(s): Our literature search produced 3268 unique
articles. 359 full manuscripts were reviewed based on inclusion and
exclusion criteria. 84 manuscripts were included comprising 146 total
patients. A summary of patient demographics, clinical disease
characteristics, tumor immunohistochemistry and biomarker profile, disease
management, and clinical outcomes is described in Table 1. Adenocarcinoma
was the predominant cancer type in the breast. 57/114 (50%) of patients
had metachronous metastatic breast disease with an average identification
time of 24 months from diagnosis of lung primary. The most common site of
additional metastatic disease was bone in 32/75 patients (42.7%).
Biomarker analysis was consistent with lung adenocarcinoma in most
patients; however, markers typically associated with non-lung sites,
namely breast and gastrointestinal origin, were positive in a minority of
patients. 26/103 (25.2%) were initially managed as primary breast cancer
with 24/26 patients undergoing breast resection. Excisional thoracic
surgery was performed in 11/49 (22.4%) of patients, which included
lobectomy, pneumonectomy, segmentectomy, and decortication. The overall
mortality was 58.9%, with an average follow-up of 14.9 months.
<br/>Conclusion(s): Patients with lung cancer that have breast metastasis
may be at high risk for misdiagnosis and inappropriate treatments
including unnecessary surgery. Our study demonstrates that careful
clinical consideration and thorough histopathologic evaluation is critical
for accurate management and optimal prognosis for metastatic lung cancer.
[Formula presented] Keywords: Lung cancer, Breast,
Metastasis<br/>Copyright &#xa9; 2024

<163>
Accession Number
2031857529
Title
Adoption of the Robotic Platform across Thoracic Surgeries.
Source
Journal of Clinical Medicine. 13(19) (no pagination), 2024. Article
Number: 5764. Date of Publication: October 2024.
Author
Tung K.H.; Yendamuri S.; Seastedt K.P.
Institution
(Tung) Department of Surgery, University at Buffalo, Buffalo, NY 14203,
United States
(Tung, Yendamuri, Seastedt) Department of Thoracic Surgery, Roswell Park
Comprehensive Cancer Center, Buffalo, NY 14203, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
With the paradigm shift in minimally invasive surgery from the
video-assisted thoracoscopic platform to the robotic platform, thoracic
surgeons are applying the new technology through various commonly
practiced thoracic surgeries, striving to improve patient outcomes and
reduce morbidity and mortality. This review will discuss the updates in
lung resections, lung transplantation, mediastinal surgeries with a focus
on thymic resection, rib resection, tracheal resection,
tracheobronchoplasty, diaphragm plication, esophagectomy, and
paraesophageal hernia repair. The transition from open surgery to
video-assisted thoracoscopic surgery (VATS) to now robotic video-assisted
thoracic surgery (RVATS) allows complex surgeries to be completed through
smaller and smaller incisions with better visualization through
high-definition images and finer mobilization, accomplishing what might be
unresectable before, permitting shorter hospital stay, minimizing healing
time, and encompassing broader surgical candidacy. Moreover, better
patient outcomes are not only achieved through what the lead surgeon could
carry out during surgeries but also through the training of the next
generation via accessible live video feedback and recordings. Though
larger volume randomized controlled studies are pending to compare the
outcomes of VATS to RVATS surgeries, published studies show
non-inferiority data from RVATS performances. With progressive
enhancement, such as overcoming the lack of haptic feedback, and future
incorporation of artificial intelligence (AI), the robotic platform will
likely be a cost-effective route once surgeons overcome the initial
learning curve.<br/>Copyright &#xa9; 2024 by the authors.

<164>
Accession Number
645512544
Title
Best treatment option for secondary mitral regurgitation surgery: a
network meta-analysis of randomized and non-randomized controlled studies.
Source
Scientific reports. 14(1) (pp 24037), 2024. Date of Publication: 14 Oct
2024.
Author
Nappi F.; Salsano A.; Dimagli A.; Santini F.; Gambardella I.; Ellouze O.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
(Salsano, Santini) Division of Cardiac Surgery DISC Department, Ospedale
Policlinico San Martino, Genoa, Italy
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Gambardella) Department of Cardiothoracic Surgery, Weill Cornell
Medicine-New York. Presbyterian Medical Center, 505 E 70th St, New York,
NY, USA
(Ellouze) Department of Anesthesia, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
Abstract
The objective of this study is to ascertain whether subvalvular papillary
muscle repair in conjunction with restrictive mitral valve annuloplasty
represents the most efficacious treatment for patients presenting with
secondary ischemic mitral regurgitation, as compared to restrictive mitral
valve annuloplasty alone and to mitral valve replacement. A network
meta-analysis was conducted to investigate outcomes of randomized
controlled trials, propensity-matched studies, and observational studies,
comparing various treatments for secondary ischemic mitral regurgitation.
The average follow-up duration for late mortality was 4.4 years. Coronary
artery bypass grafting (CABG) without mitral valve surgery had a late
mortality incidence of 3.7%. Restrictive mitral annuloplasty demonstrated
a rate of 6.5%, while restrictive mitral annuloplasty+CABG resulted in a
rate of 4.1%. Subvalvular papillary muscle repair plus restrictive mitral
annuloplasty +/- CABG and mitral valve replacement+CABG had rates of 4.4%
and 5.1%. SUCRA analysis showed that CABG was the most effective treatment
for reducing late mortality (70.0%). This was followed by subvalvular
papillary muscle repair plus restrictive mitral annuloplasty with or
without CABG (62.4%). The top strategy for decreasing early death,
reoperation, and readmission to the hospital for heart failure is
subvalvular papillary muscle repair plus restrictive mitral annuloplasty
with or without CABG, based on SUCRA probabilities (84.6%, 85.54%, and
86.3%, respectively). Subvalvular papillary muscle repair plus restrictive
mitral annuloplasty +/- CABG has potential to reduce the risks associated
with early mortality, reoperation, and re-hospitalization for heart
failure. However, further research is required to substantiate these
findings.<br/>Copyright &#xa9; 2024. The Author(s).

<165>
Accession Number
645506548
Title
The Effect of Teleprehabilitation on Adverse Events After Elective Cardiac
Surgery: A Randomized Controlled Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2024.
Date of Publication: 08 Oct 2024.
Author
Scheenstra B.; van Susante L.; Bongers B.C.; Lenssen T.; Knols H.; van
Kuijk S.; Nieman M.; Maessen J.; Van't Hof A.; Sardari Nia P.
Institution
(Scheenstra, Maessen, Sardari Nia) Department of Cardiothoracic Surgery,
Heart and Vascular Center, Maastricht University Medical Center,
Maastricht, The Netherlands; Department of Cardiothoracic Surgery,
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, The Netherlands
(van Susante) Department of Cardiothoracic Surgery, Heart and Vascular
Center, Maastricht University Medical Center, Maastricht, Netherlands
(Bongers) Department of Nutrition and Movement Sciences, Institute of
Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht
University, Maastricht, The Netherlands; Department of Surgery, Institute
of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht
University, Maastricht, The Netherlands
(Lenssen) Department of Physical therapy, Maastricht University Medical
Center, Maastricht, Netherlands
(Knols) Department of Psychiatry and Psychology, Maastricht University
Medical Center, Maastricht, Netherlands
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Center, Maastricht, Netherlands
(Nieman) Department of Pulmonology, Maastricht University Medical Center,
Maastricht, Netherlands
(Van't Hof) Department of Cardiology, Heart and Vascular Center,
Maastricht University Medical Center, Maastricht, The Netherlands;
Department of Cardiology, Zuyderland Medical Center, Heerlen, The
Netherlands
Abstract
BACKGROUND: Patients scheduled for cardiac surgery and procedures often
present with modifiable risk factors for adverse perioperative outcomes.
Prehabilitation has shown potential to enhance mental and physical fitness
however, its effect on clinical cardiovascular endpoints in this
population has not been studied. <br/>OBJECTIVE(S): The current trial was
designed to evaluate the effect of a personalized multimodal
teleprehabilitation on the incidence of composite endpoint on major
adverse cardiovascular events (MACE) in patients scheduled for elective
cardiac surgery. <br/>METHOD(S): In a multicentre randomized controlled
trial, 394 patients awaiting elective cardiac surgery and procedures were
enrolled. Of these, 197 patients were randomized to an online multimodal
personalized teleprehabilitation program through shared-decision making by
a multidisciplinary team, and 197 were assigned to a control group. The
primary outcome was MACE, (i.e., cardiovascular death, myocardial
infarction, stroke, hospitalization for heart failure or other
life-threatening cardiac events, and earlier or repeated intervention), as
measured from the randomization until 1-year postoperatively. All events
were adjudicated by a blinded event committee. Secondary outcomes included
length of hospital stay, postoperative complications, quality of life,
adherence to the program, and effect on the incidence of modifiable risk
factors. Sensitivity analyses of the primary outcome were conducted
adjusting for baseline characteristics to evaluate the consistency of
treatment effects. <br/>RESULT(S): From randomization until one year
postoperatively, the primary endpoint occurred in 33 patients (16.8%) in
the teleprehabilitation group and 50 patients (25.5%) in the control group
(difference 8.8%; 95% confidence interval (CI) 0.7 to 16.8; P=0.032). This
difference was primarily driven by a reduction in hospitalizations and the
sensitivity analyses showed that treatment effect was mainly in the
patients undergoing a cardiac surgery rather than transcatheter procedures
with adjusted odds ratio of 0.54 (95% CI, 0.30-0.96; P = 0.035).
Teleprehabilitation also reduced the incidence of active smokers, elevated
pulmonary risk scores, and elevated depression scores. There was no
significant difference in postoperative length of hospital stay,
occurrence of postoperative complications, physical fitness, incidence of
obesity, or malnutrition. <br/>CONCLUSION(S): Multimodal personalized
teleprehabilitation resulted in a clinically relevant and statistically
significant reduction of the primary endpoint in patients undergoing
cardiac surgery. CLINICALTRIALS: gov (NCT04393636).<br/>Copyright &#xa9;
2024. Published by Elsevier Inc.